Posts for: September, 2014
Picture this: You’re feeling some mild irritation in your mouth, which seems to be coming from the area near your tongue. You go to the mirror, open wide… and notice a series of red patches on the tongue’s surface, which are surrounded by whitish borders. Should you drop what you’re doing and rush to get medical help right away?
Sure, a visit to the dentist might be a good idea to rule out more serious problems — but first, sit down and relax for a moment. Chances are what you’re experiencing is an essentially harmless condition called “benign migratory glossitis,” which is also known by its common name — geographic tongue. While it may look unusual, geographic tongue isn’t a serious condition: It’s not cancerous or contagious, and it doesn’t generally lead to more severe health problems. However, it can make your tongue feel a bit more sensitive, and may occasionally lead to mild sensations of burning, stinging or numbness.
The appearance of reddish patches on the tongue results from the temporary loss of structures called papillae: tiny bumps which normally cover the tongue’s surface. These patches may appear or disappear over the course of days — or even hours — and sometimes appear to change their shape or location.
What causes geographic tongue? Several factors seem to be responsible for setting off the problem, but as of yet the actual cause of the disease is unknown. Among these triggers are emotional stress and psychological upsets, hormonal disturbances, and deficiencies in zinc or vitamin B. The condition, which affects between one and three percent of the population, is seen more frequently in non-smokers, in women, and in those with a family history of the problem. It is also associated with people who suffer from psoriasis, a common skin condition, and those who have a fissured (deeply grooved) tongue.
Unfortunately, there is no “cure” for geographic tongue — but the good news is that treatment is usually unnecessary. If you’re experiencing this condition, it may help if you avoid foods with high levels of acidity (like tomatoes and citrus fruits), as well as hot and spicy foods. Alcohol and other astringent substances (like some mouthwashes) may also aggravate it.
While geographic tongue isn’t a serious condition, it can cause worry and discomfort. That’s why it’s a good idea for you to come into the office and have it checked, just to make sure. A thorough examination can put your mind at ease, and rule out other conditions that may be more of a concern. We may be also able to help you manage this condition by prescribing anesthetic mouth rinses, antihistamines, or other treatments.
If you would like more information about geographic tongue, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Geographic Tongue.”
Tooth preservation is the ultimate aim of a root canal treatment. But how long should you expect a treated tooth to last? The answer will depend on a few different variables.
A root canal treatment is necessary when a tooth’s pulp — the inner tissue made of nerves, blood vessels and connective tissues — becomes infected with disease. As the pulp dies, the infection spreads into the adjacent bone; this can eventually lead to loss of the tooth.
To stop this process, we enter the tooth and remove all of the pulp, disinfect the pulp chamber and the root canals, and then fill the chamber and canals. Depending on the type of tooth and level of decay, we seal the tooth with a filling or install a crown to prevent re-infection. it’s then quite possible for a treated tooth to survive for years, decades, or even a lifetime.
There are a number of factors, though, that may affect its actual longevity. A primary one depends on how early in the disease you receive the root canal treatment. Tooth survival rates are much better if the infection hasn’t spread into the bone. The earlier you’re treated, the better the possible outcome.
Tooth survival also depends on how well and thorough the root canal is performed. It’s imperative to remove diseased tissue and disinfect the interior spaces, followed by filling and sealing. In a related matter, not all teeth are equal in form or function. Front teeth, used primarily for cutting and incurring less chewing force, typically have a single root and are much easier to treat than back teeth. Back teeth, by contrast, have multiple roots and so more root canals to access and treat. A front tooth may not require a crown, but a back tooth invariably will.
These factors, as well as aging (older teeth tend to be more brittle and more susceptible to fracture), all play a role in determining the treated tooth’s survival. But in spite of any negative factors, a root canal treatment is usually the best option for a diseased or damaged tooth. Although there are a number of good options for replacing a lost tooth, you're usually better in the long run if we can preserve your natural tooth for as long as possible.
If you would like more information on root canal treatments, 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 “Root Canal Treatment: How Long Will it Last?”
You have a beautiful smile, but you hesitate to show it because of your stained teeth. Fortunately, whitening techniques could take away that embarrassment.
There are two basic types of tooth staining or discoloration: extrinsic, in which the stain is on the surface of the teeth and mostly caused by substances like coffee, wine or tobacco; and intrinsic, which occurs deep within the tooth, caused by such factors as aging, previous dental treatments and fillings, the use of antibiotics (tetracycline, predominantly), or over-exposure to fluoride.
Whitening or bleaching is an effective and relatively affordable solution for many instances of both intrinsic and extrinsic staining. Bleaching solutions are available in over-the-counter (OTC) home kits or as a professional application in the dental office.
Most bleaching solutions use carbamide peroxide, a chemical compound that is effective in removing most stains. OTC home applications contain carbamide peroxide (or an equivalent) in concentrations of about 10% as opposed to 15-35% found in professional solutions. Though less costly than a professional application, OTC products take longer (usually up to three weeks) to achieve desired results. With its stronger solution, a professional application in our office can achieve the same level of brightness in only one or two visits. We may also use special lighting to accelerate the chemical process, as well as rubber dams or gels to protect gums and soft tissues from solution irritation during the procedure.
Although effective, whitening isn't a permanent solution — over time the effect will fade, usually six months to a year depending on how you care for your teeth. Matching tooth color can also be difficult in some cases, especially if you have a mix of natural teeth and artificial crowns or bridges. And, whitening may not be adequate for some types of staining.
Regardless of which application you wish to use — OTC or professional — it's a good idea to visit us first for a professional consultation. We can recommend whether whitening is a good choice for your particular type and level of staining, or if some other option like porcelain veneers might be the better choice. Regardless, there are solutions to the problem of staining, and a way to gain a brighter smile.
If you would like more information on bleaching, 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 “Teeth Whitening.”
While dental implants are the preferable choice for teeth replacement, your life circumstances may cause you to postpone it or some other permanent restoration. In the meantime, you need a temporary solution for your tooth loss.
Removable partial dentures (RPDs) have met this need for many years. RPDs are traditionally made of rigid, acrylic plastic resin and fasten to existing teeth with metal clasps. While effective as temporary tooth replacements, RPDs do have their drawbacks: they can be uncomfortable, develop a loose fit and are prone to wear and staining.
Recently, though, new RPDs made of a flexible type of nylon are addressing some of these drawbacks. Because the nylon material is thermoplastic (able to change shape under high heat), it can be injected into a cast mold of a patient’s mouth to create the denture base, to which life-like replacement teeth are then attached. And rather than a metal clasp, these RPDs have thin, finger-like nylon extensions that fit snugly around existing teeth at the gum line.
The new RPDs are lightweight, resistant to fracture and offer a more comfortable, snugger fit than the older RPD. And because the nylon material can be made to closely resemble gum tissue, the base can be designed to cover receding gum tissue, which may further improve the appearance of a patient’s smile.
On the downside, these new RPDs are difficult to reline or repair if they’re damaged or the fit becomes loose. And like all RPDs, they must be regularly removed and cleaned thoroughly to prevent any accumulating bacterial biofilm that could increase the risk of gum disease or tooth decay (the attachment extensions are especially susceptible to this accumulation). They should also be removed at night, since the reduction in saliva flow while you sleep can worsen bacterial buildup.
Still, the new flexible RPD is a good choice to bridge the time gap between lost teeth and a permanent restoration. They can restore lost function and improve your smile during the transition to implants or a fixed bridge.
By the time you reach adulthood, roughly 100 trillion microscopic organisms will have taken up residence in and on your body, outnumbering your own cells 10 to 1. Most are bacteria, a domain of the animal kingdom considered synonymous with disease. But only a few of the thousands of bacterial species cause us harm; the rest are either benign or actually beneficial to our health, including in our mouths.
Dentistry pioneered much of our knowledge about bacteria, developing processes used to identify, classify and understand those species inhabiting our mouths. Science as a whole is catching up with the Human Microbiome Project (HMP) begun in 2007. Through HMP, researchers have catalogued and begun to study more than 10,000 bacterial species.
We’re finding that our bodies develop a symbiotic relationship with many of these creatures invisible to the naked eye. During our infancy the bacteria we ingest from birth and breast feeding begin to interact with our body’s immune system, “teaching” it to refrain from attacking friendly organisms that contribute to health and searching and destroying enemy species that cause disease.
We’re also learning that an imbalance with our individual population of bacteria has links with disease. Our digestive system is a prime example: bacteria related to obesity can overpopulate our digestive tract, while malnutrition can create an environment that produces too many bacteria that inhibit digestion of vitamins and other nutrients.
The same microbial imbalance can occur in the mouth. For example, our typical Western diet encourages the growth of bacteria most associated with tooth decay (Streptococcus mutans). We’re also finding that tobacco smoking creates a mouth environment more conducive to the bacteria that cause gum disease. Just by quitting smoking you can alter that environment to encourage growth of health-promoting bacteria and inhibit growth of malevolent species.
The desired outcome of this knowledge is to develop treatments that target disease-causing bacteria without harming those beneficial to us (as often occurs with traditional antibiotics). In dentistry, such possibilities could help stop the spread of tooth decay, gum disease or similar bacterial infections, while fostering a healthier oral environment that prevents disease and protects health.