Posts for: September, 2013
Metal braces are often considered a rite of passage for teenagers whose teeth need straightening. While some teens have no problem with this, others are more self-conscious and would like a less noticeable and less restrictive form of orthodontic treatment (“ortho” – to straighten; “odont” – teeth). After all, traditional braces can sometimes require diet modification, regular tightenings can cause discomfort, and the hardware itself can irritate the inside of the mouth. All of these things can limit a teen's ability to function normally during an already difficult stage of life.
That's why many teens today are opting for removable clear aligners, which have been popular with adults for years. In this system of orthodontic treatment, transparent, flexible, plastic “trays” are custom-made to move an individual's teeth into better alignment in a step-by-step fashion. Each tray moves the teeth a little bit further, according to a precise plan developed with specialized computer software by an orthodontist, or a general dentist who has received special training. It's not available from every dentist, but we are happy to be able to offer it here.
It used to be that clear aligners were not recommended for teens for two main reasons. For one thing, because they are removable rather than attached to the teeth, it was assumed a teenager would not be as conscientious as an adult about wearing them nearly 24 hours a day, which is necessary to achieve the desired results. Now, however, clear aligners for teens have colored “compliance indicators” that fade over time. With this new tool, dentists and parents — and teens themselves — can monitor compliance and progress.
The other main problem in prescribing clear aligners for teens had been that their second molars are still growing into position. This problem, too, has been solved. Clear aligners now have “eruption tabs” that serve as space-holders for teeth that have yet to grow in.
Finally, in recent years, improvements have been made to the whole clear aligner system that allow it to be used for more serious malocclusions (bad bites). So it's actually a viable option for more orthodontic patients in general — teens as well as adults.
If you would like to learn more about clear aligners for your teenager, please contact us or schedule an appointment for a consultation. You can also find out more in the Dear Doctor magazine article “Clear Aligners For Teenagers.”
The weapons in the war against cancer are stronger and more effective than ever. But as in real war, those weapons can inflict harm on innocent bystanders — in the case of cancer treatment, other cells in your body. Your mouth in particular may develop side effects from these treatments.
The basic purpose of common cancer treatments like chemotherapy and radiation is to destroy and inhibit future growth of cancer cells. They're very effective to that end, but they can also destroy healthy cells caught in the “crossfire” with malignant cells or have an adverse effect on the body's immune system and its response to infection. Chemotherapy in particular negatively affects blood cells developing within bone marrow, which leads to lower resistance to infection.
These can have secondary effects on the mouth. Patients undergoing cancer treatment can develop painful ulcers and sores within the mouth cavity, and reduced immunity makes them more susceptible to tooth decay or gum disease (especially if risk factors were present before cancer treatment). Certain treatments may also cause dry mouth in some patients.
If you are being treated for cancer, or about to begin treatment, we can help mitigate these effects on your oral health. The first step is to perform a complete dental examination to identify any issues that may affect or be affected by the cancer treatment. We would then treat those conditions (if possible before cancer treatment begins).
We would also monitor your oral health during the treatment period and treat any complications that arise. Such treatments might include applications of high-potency fluoride to strengthen teeth against decay, anti-bacterial rinses to reduce the risk of bacterial growth, and medications to stimulate saliva if you should encounter dry mouth.
Fighting cancer will be your main priority. You should, however, remain aware of how cancer treatment may affect other aspects of your health. As your dentist, we will partner with you in seeing that your teeth and gums remain as healthy as possible during this process.
If you would like more information on caring for oral health during cancer treatment, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Oral Health During Cancer Treatment.”
A consistently dry mouth is not only uncomfortable and unpleasant but also probably more serious than you think. Dry mouth, medically known as xerostomia (“xero” – dry; “stomia” – mouth) affects millions of people, but few understand why it happens or why it is important.
What Causes Dry Mouth?
It is normal to awaken with a dry mouth because saliva flow decreases at night. But if your mouth is persistently dry throughout the day, it may be a result of habits such as smoking, alcohol or too much coffee drinking or even dehydration. It is also a common side effect of some medications. Xerostomia is not a disease in itself, but it could be a symptom of salivary gland or other systemic (general body) disease.
Why is Saliva Important?
A persistently dry mouth can be a problem. Not only does it feel unpleasant and lead to bad breath, it can also significantly increase your risk for tooth decay. Saliva lubricates your mouth for chewing, eating, digestion and even speaking. Saliva also has important antibacterial activities. Most importantly normal healthy salivary flow neutralizes and buffers acids in the mouth to protect the teeth from the acids produced by bacteria on the teeth that cause decay, and by acids in sodas, sports drinks and juices that can erode tooth enamel.
Not only does saliva neutralize acids but with its high mineral content it can actually reverse de-mineralization — the process by which acids attack enamel and remove calcium from the enamel surface. Healthy saliva actually re-mineralizes the outer layers of tooth enamel, but the process can take 30-60 minutes. That's why it's important not to snack on sugars or drink sodas between meals — one an hour and your mouth is acidic all the time.
Individuals without enough saliva are especially at risk for root decay and fungal infections, and they are also more likely to lose tooth substance through abrasion and erosion.
What Can We Do for a Dry Mouth?
If your mouth is usually dry, make an appointment with us to assess the causes of the problem. However it may be more serious with medical implications. The solution may be as simple as drinking more water and using good daily oral hygiene, or it may necessitate prescription medication to promote more saliva flow.
Contact us today to schedule an appointment to discuss your dry mouth and what we can do to help. For more information read the article in Dear Doctor magazine “Tooth Decay – How To Assess Your Risk.”
Because its symptoms can be easy to overlook, gum disease is sometimes called a “silent” malady. But don't underestimate this problem! Untreated periodontal disease can progress into a serious condition, possibly leading to tooth loss and even systemic (whole-body) health issues. With proper preventive measures and appropriate treatment, however, the disease can be controlled.
The root cause of periodontal disease — actually, a group of related diseases, all of which affect the tissues surrounding the teeth — is the buildup of bacterial plaque (also referred to as biofilm) around the gums. While hundreds of types of bacteria live in the mouth, only a comparatively few are thought to be harmful. But when oral hygiene (namely, brushing and flossing) is inadequate, the environment in the mouth becomes favorable to those harmful types.
The disease often begins with inflammation of the gums called gingivitis. It symptoms include bad breath, bleeding gums, and soreness, redness, or tenderness of the gum tissue. However, in some people these early warning signs are ignored, or masked by the effects of harmful habits like smoking.
Gum disease is chronic; that means, if left alone, it will worsen over time. Periodontitis, as it progresses, causes damage to the ligament that helps hold the tooth in place, as well as bone loss. This may become increasingly severe, and ultimately result in the loss of the tooth. Severe periodontitis is also associated with whole-body (systemic) inflammation, which has been linked to an increased incidence of cardiovascular diseases, like stroke and heart attack.
But there's no reason to allow gum disease to progress to this stage! Prevention — that is, regular daily brushing and flossing as well as regular dental cleanings — is a primary means of keeping this problem at bay. Plus, every time you have a regular dental checkup, your gums are examined for early signs of trouble. Of course, if you notice the symptoms of gum disease, you should come in for a check-up as soon as you can.
There are a number of effective treatments for gum disease. One of the most conservative, routine ways are those regular dental cleanings we referred to earlier, usually called scaling and root planning. Using hand-held and ultrasonic instruments, the buildup of plaque (tartar) is carefully removed, sometimes under local anesthesia. A follow-up evaluation may show that this treatment, carried out on a regular schedule, is all that's needed. Or, it may be time for a more comprehensive therapy.
If you have concerns about gum disease, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Understanding Gum (Periodontal) Disease” and “Warning Signs of Periodontal (Gum) Disease.”