Posts for tag: oral health
Eaten in a fast food restaurant lately? If so, maybe you’ve noticed some changes in the big, colorful signs behind the counters. Many have begun promoting a few “healthier” selections (like salads and grilled items) and giving a more extensive listing of nutritional information. But there’s one thing you might not have noticed on those displays: a listing for soda among the beverage choices in the kiddie meal packages. That’s because they are no longer there.
Recently, Burger King quietly removed sugary fountain drinks from the in-store and online menu boards that show what you get with kids’ meals. They were following the lead of McDonalds and Wendy’s, both of which made similar moves in prior months. You can still get a soda with your kiddie burger if you specifically ask for one, but we’re hoping you won’t; here’s why.
For one thing, youth obesity has nearly tripled in the past three decades. As the U.S. Centers for Disease Control and Prevention (CDC) has noted, it’s now an epidemic affecting more than one in six children and adolescents. Many of the extra calories kids get are blamed on sugary drinks: According to a study by the Harvard School of Public Health, children’s daily calorie intake from these beverages rose by 60 percent in recent years. Obesity makes kids more likely to get many diseases, and can lead to problems in psychological and social adjustment.
But that’s not all. As dentists, we’re concerned about the potential for soda to cause tooth decay, which is still the number one chronic disease in children around the world. The association between sugary drinks and cavities is clear. So is the fact that tooth decay causes pain, countless hours of missed school and work, and expense that’s largely unnecessary, because it’s a disease that is almost 100 percent preventable.
While the new signage at fast food restaurants won’t make soda disappear, it does tend to make it less of an automatic choice. Anything that discourages children from routinely consuming soda is bound to help — and let’s point out that the same thing goes for other sweet and acidic beverages including so-called “sports” and “energy” drinks. It’s best to try and eliminate these from your child’s diet; but if you do allow them, at least limit them to mealtimes, and give your mouth a break from sweets between meals. That gives the saliva enough time to do its work as a natural buffer and acid-neutralizer.
What else can you do to help keep your child’s oral hygiene in tip-top shape? Be sure they brush their teeth twice and floss once every day, and bring them in for regular checkups and cleanings. But if you do suspect tooth decay, don’t delay treatment: Left alone, decay bacteria can infect the inner pulp of the tooth, resulting in severe pain, inflammation, and possibly the need for root canal treatment.
If you would like more information about children’s oral health, please contact us or schedule an appointment. You can learn more by reading the Dear Doctor magazine articles “How to Help Your Child Develop the Best Habits for Oral Health” and “Top 10 Oral Health Tips For Children.”
A focus on dental care in senior citizens is just as important as it is for children. Indeed, oral health in your later years can be a major factor in your quality of life.
For one, aging effects on other parts of the body can make dental care more challenging. Some hygiene tasks once performed easily become harder — arthritis, for example, or loss of muscle strength may make it difficult to hold a toothbrush or floss. In such cases, you may need to find new ways to make the task easier: a power toothbrush with a larger handle; pre-loaded floss holders or a water flosser; or adaptations to a manual brush to make it easier to hold, like attaching a tennis ball or bike handle.
Other age-related conditions — and their treatments — can negatively impact oral health. Less saliva production, which is a consequence of aging or certain drugs, increases the risk of tooth decay or periodontal (gum) disease. Older adults often develop gastric reflux problems that can introduce tooth enamel-eroding stomach acid into the mouth. And medications called bisphosphonates, often prescribed to treat osteoporosis, may interfere in rare cases with bone healing after tooth extraction or similar procedures.
Prior dental work can also prove challenging to treating dental disease. It becomes more difficult to preserve teeth threatened with decay if there are significant restorations or appliances to work around. Pain perception can also diminish with age, so that dental disease may not be noticed until later stages when significant damage has already occurred.
Oral care requires more attention as we grow older, or as we care for older family members. Your best defense against disease is to continue regular six-month visits with us. In addition to normal cleanings and checkups, we’ll also screen for oral cancer (a more prevalent occurrence in older adults), review your prescriptions or other supplements and medications for any possible side effects to oral health, check the fit of any dentures or other restorations and evaluate the effectiveness of your hygiene.
While other age-related conditions may capture the majority of your attention, you shouldn’t allow that to neglect your dental care. With your continued efforts, along with our support and your family’s, you can continue to enjoy good oral health throughout your lifetime.
Nearly half of all Americans have some form of periodontal (gum) disease. Without proper daily hygiene and treatment, this aggressive disease can ultimately cause tooth loss. It also appears the effects of gum disease reach beyond the mouth, as researchers have found relationships between it and other systemic diseases.
Inflammation, the body’s response to infection, is at the center of these relationships. In the case of gum disease, periodontal tissues become inflamed as the body attempts to isolate and fight the infection. If the inflammation becomes chronic, however, it will begin to damage gum tissues.
Inflammation is also a major feature of diabetes, a condition in which the pancreas doesn’t produce enough insulin. Without enough of this hormone that transforms sugar into usable energy for the body, the sugar accumulates in the blood stream; as a result, the patient becomes more susceptible to an exaggerated inflammatory response when the body encounters an infection. This is especially true for periodontal infections: the resulting inflammation can be greater and harder to control in diabetic patients. What’s more, uncontrolled gum disease may worsen their blood sugar levels.
Although not as prominent as with diabetes, cardiovascular disease also seems to share a connection with gum disease. This collection of chronic conditions like high blood pressure or restricted blood vessel flow raises the risk of heart attack or stroke. Like gum disease, inflammation is a major component in the progression of cardiovascular disease — in fact, both diseases leave similar chemical “markers” in the blood that indicate their early development.
Ongoing research has also produced some promising treatment findings for both gum disease and inflammatory diseases, which also include osteoporosis, respiratory disease and rheumatoid arthritis. We’re now finding in many cases that treating one side of the disease connection can have positive effects on the other side. For example, diabetics who receive professional treatment for gum disease may see better blood sugar control.
With this in mind, the best approach is to practice effective, daily oral hygiene to reduce the risk of gum disease, coupled with regular office cleanings and checkups. Not only will this help you maintain optimum oral health, it may also contribute to better management of other conditions you may have.
If you would like more information on the relationship between periodontal (gum) disease and other diseases, 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 “Good Oral Health Leads to Better Health Overall.”
While most dental problems are caused by disease or trauma, sometimes the root problem is psychological. Such is the case with bulimia nervosa, an eating disorder that could contribute to dental erosion.
Dental erosion is the loss of mineral structure from tooth enamel caused by elevated levels of acid in the mouth, which can increase the risk for decay and eventual tooth loss. While elevated acid levels are usually related to inadequate oral hygiene or over-consumption of acidic foods and beverages, the practice of self-induced vomiting after food binging by bulimic patients may also cause it. Some of the strong stomach acid brought up by vomiting may remain in the mouth afterward, which can be particularly damaging to tooth enamel.
It’s often possible to detect bulimia-related erosion during dental exams. The bottom teeth are often shielded by the tongue during vomiting, so erosion may be more pronounced on the unshielded upper front teeth. The salivary glands may become enlarged, giving a puffy appearance to the sides of the face below the ears. The back of the mouth can also appear red and swollen from the use of fingers or objects to induce vomiting.
Self-induced vomiting may not be the only cause for dental erosion for bulimics. Because the disorder causes an unhealthy focus on body image, bulimics may become obsessed with oral hygiene and go overboard with brushing and flossing. Aggressive brushing (especially just after throwing up when the tooth enamel may be softened) can also damage enamel and gum tissue.
Treatment must involve both a short — and long-term approach. Besides immediate treatment for dental erosion, a bulimic patient can minimize the effect of acid after vomiting by not brushing immediately but rinsing instead with water, mixed possibly with a little baking soda to help neutralize the acid. In the long-term, though, the eating disorder itself must be addressed. Your family doctor is an excellent starting point; you can also gain a great deal of information, both about eating disorders and treatment referrals, from the National Eating Disorders Association at their website, www.nationaleatingdisorders.org.
The effects of bulimia are devastating to mental and physical well-being, and no less to dental health. The sooner the disorder can be treated the better the person’s chance of restoring health to their mind, body — and mouth.
If you would like more information on the effect of eating disorders on oral health, 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 “Bulimia, Anorexia & Oral Health.”
Periodontal (gum) disease is mainly caused by bacterial plaque built up on tooth surfaces due to ineffective oral hygiene. For most cases, treatment that includes plaque and calculus (tartar or calcified plaque) removal and renewed daily hygiene is highly effective in stopping the disease and restoring health to affected gum tissues.
However, you might have additional health factors that may make it more difficult to bring the disease under control. If your case is extreme, even the most in-depth treatment may only buy time before some or all of your teeth are eventually lost.
Genetics. Because of your genetic makeup, you could have a low resistance to gum disease and are more susceptible to it than other people. Additionally, if you have thin gum tissues, also an inherited trait, you could be more prone to receding gums as a result of gum disease.
Certain bacteria. Our mouths are home to millions of bacteria derived from hundreds of strains, of which only a few are responsible for gum disease. It’s possible your body’s immune system may find it difficult to control a particular disease-causing strain, regardless of your diligence in oral care.
Stress. Chronic stress, brought on by difficult life situations or experiences, can have a harmful effect on your body’s immune system and cause you to be more susceptible to gum disease. Studies have shown that as stress levels increase the breakdown of gum tissues (along with their detachment from teeth) may also increase.
Disease advancement. Gum disease can be an aggressive infection that can gain a foothold well before diagnosis. It’s possible, then, that by the time we begin intervention the disease has already caused a great deal of damage. While we may be able to repair much of it, it’s possible some teeth may not be salvageable.
While you can’t change genetic makeup or bacterial sensitivity, you can slow the disease progression and extend the life of your teeth with consistent daily hygiene, regular cleanings and checkups, and watching for bleeding, swollen gums and other signs of disease. Although these additional risk factors may make it difficult to save your teeth in the long-run, you may be able to gain enough time to prepare emotionally and financially for dental implants or a similar restoration.
If you would like more information on the treatment of gum disease, 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 “Periodontal (Gum) Treatment & Expectations.”
We have learned that an important part of oral health is education — but more importantly, making it fun to learn so that you retain (and apply) what you learn! For this reason, we have put together the following self-test so that you can quickly access your knowledge on the subject of mouthguards.
- The first sport to use (and require) protective mouthguards was:
- ice hockey
- Research conducted by the American Dental Association (ADA) found that individuals are ___ times more likely to damage their teeth when not wearing a mouthguard while engaged in contact sports or rigorous physical exercise.
- As a rule of thumb, females do not require mouthguards because they are not as physically active as their male counterparts.
- The American Academy of General Dentistry (AAGD) reports that mouthguards prevent more than ______ injuries to the mouth and/or teeth each year.
- Which of the following sports or activities does the ADA recommend that participants wear protective mouthguards:
- all of the above
- The US Centers for Disease Control (CDC) reports that more than ______ sports-related injuries end-up in the emergency room each year with injury or damage to the teeth and mouth.
- Over-the-counter mouthguards are just as effective as professionally made mouthguards.
- In addition to the trauma of having a tooth (or teeth) knocked out, individuals who have suffered from this type of injury may end up spending ______ per tooth over a lifetime for teeth that are not properly preserved and replanted according to the National Youth Sports Foundation for Safety.
- $10,000 to $20,000
- $15,000 to $25,000
- $25,000 to $35,000
- Less than $10,000
Answers: 1) b, 2) d, 3) b, 4) a, 5) d, 6) c, 7) b, 8) a
You can learn more about the importance of mouthguards when you continue reading the Dear Doctor magazine article “Athletic Mouthguards.” And if you have already experienced a dental injury, it may not be too late. However, we need to evaluate the damage so that we can establish a plan for restoring optimal oral health. Contact us today to learn more about protecting your mouth and teeth or to schedule an appointment.
One of our primary goals in dentistry is to deliver effective treatment to patients with the least amount of discomfort. This is especially true after a procedure — controlling pain and inflammation will actually help reduce recovery time.
There are many strong pain relievers available, including prescription opiates like morphine or codeine. It has been shown, however, that healing and comfort are enhanced with non-steroidal anti-inflammatory drugs (NSAID) because they not only minimize pain, but they also reduce inflammation after a procedure. One common NSAID is Ibuprofen, which works by blocking prostaglandins, a substance released by inflamed, damaged tissues. NSAIDs are very popular with dentists and other health professionals because they act primarily on the inflammation site and don’t impair consciousness like opiates. They’re also usually less expensive than pain medication requiring a prescription.
While relatively safe, NSAIDs do have side effects that could cause serious problems for some patients. The most common caution regards NSAID’s tendency to thin blood and reduce the natural clotting mechanism, especially if taken habitually over a period of time. They can damage the kidneys and the stomach lining (causing ulcers or dangerous bleeding), and they’ve also been linked to early miscarriages and heart attacks.
For these reasons, NSAIDs are not recommended for pregnant women, patients with a history of stomach or intestinal bleeding, or patients being treated for heart disease. In the latter case, NSAIDs may interfere with the effectiveness of low-dose aspirin therapy (another type of NSAID) to prevent future heart attacks or strokes.
Health officials recommend all patients limit their dosage of a NSAID to no more than 2400 milligrams a day for short term pain relief, unless otherwise advised by a doctor. For the most part, a single 400 mg dosage is usually sufficient for pain control during a post-procedure recovery.
Your dentist will typically obtain your medical history before you undergo a dental procedure, including the medications you’re taking. Depending on your current health status and the type of procedure you’re undergoing, your dentist will recommend a pain control regimen to follow after the procedure is over.
Following those recommendations, and alerting your healthcare provider if you encounter any side effects from pain medication, will help assure your recovery period after dental work is short, safe and uneventful.
If you would like more information on the use of NSAIDs to control discomfort after a dental procedure, 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 “Treating Pain With Ibuprofen.”
Ah, the baby teeth: those cute little pearl buttons that start to appear in a child’s mouth at around 6 to 9 months of age. Like pacifiers and bedtime stories, they’ll be gone before you know it — the last usually disappear by age 10-13. So if the dentist tells you that your young child needs a root canal, you might wonder why — isn’t that tooth going to be lost anyway?
The answer is yes, it is — but while it’s here, it has some important roles to play in your child’s development. For one thing, baby teeth perform the same functions in kids as they do in adults: Namely, they enable us to chew, bite, and speak properly. The primary teeth also have a valuable social purpose: they allow us to smile properly. If a baby tooth is lost prematurely at age 6, the child may suffer detrimental effects for five years or more — and that’s a long time for someone so young!
Even more important, baby teeth have a critical function in the developing mouth and jaw: Each one holds a space open for the permanent tooth that will eventually replace it — and it doesn’t “let go” until the new tooth is ready to come in. If a primary (baby) tooth is lost too soon, other teeth adjacent to the opening may drift into the empty space. This often means that the permanent teeth may erupt (emerge above the gum line) in the wrong place — or sometimes, not at all.
The condition that occurs when teeth aren’t in their proper positions is called malocclusion (“mal” – bad; “occlusion” – bite). It can cause problems with eating and speaking, and often results in a less-than-perfect-looking smile. It’s the primary reason why kids get orthodontic treatment — which can be expensive and time-consuming. So it makes sense to try and save baby teeth whenever possible.
Procedures like a root canal — or the similar but less-invasive pulpotomy — are often effective at preserving a baby tooth that would otherwise be lost. But if it isn’t possible to save the tooth, an appliance called a space maintainer may help. This is a small metal appliance that is attached to one tooth; its purpose is to keep a space open where the permanent tooth can come in.
If your child is facing the premature loss of a primary tooth, we will be sure to discuss all the options with you. It may turn out that preserving the tooth is the most cost-effective alternative in the long run. If you have questions about your child’s baby teeth, please contact us or schedule an appointment for a consultation.
Tongue and other piercings are a current fad or trend, but can often lead to unforeseen problems.
Piercing the tongue and installing a metal ornament called a tongue bolt commonly leads to chipped teeth, sensitivity, and pain. More frequently, it can cause problems with the gums, such as recession, inflammation, infection, bone loss, and even nerve damage.
In one case reported by the American Medical Association, a teenager suffered 20 to 30 daily electrical shocks in many areas of her face after having her tongue pierced and installing a tongue bolt. A neurologist found that the bolt irritated the nerves to her tongue, causing the symptoms. After the bolt was removed, the shocks and symptoms ceased and her tongue healed.
Having the bolts placed may be painful. The tongue is rich in nerves and blood vessels and a lot of bleeding can occur, which can be difficult to stop. Think about how painful it is when you bite your tongue or lip accidentally. And tongue and lip bolts are not generally placed by health professionals or under sterile conditions.
If you are considering getting an oral piercing, make an appointment with us to discuss all the possible ramifications before you make the decision to go ahead. If you already have an oral piercing, be sure to come in for frequent checkups.
Contact us today to schedule an appointment to discuss your questions about oral piercings. You can also learn more by reading the Dear Doctor magazine article on “Body Piercings and Teeth: The dangers of tongue and lip piercing.”
Although sometimes controversial, body piercing has exploded in popularity, especially among young people. Aside from the social debate about such practices, there are health risks to consider. Oral piercings, in particular — especially of the tongue — could have an adverse effect on your dental health.
The trouble begins with the piercing procedure itself. The tongue is composed of a number of muscle groups that given its wide range of function require a lot of energy. To supply this energy the tongue has a large network of blood vessels; during a piercing it's not uncommon for profuse bleeding to occur. The tongue also contains a lot of nerve fibers — a piercing may result not only in severe pain, but in possible nerve damage too.
The tongue bolt, the most common tongue piercing, can cause a lot of damage in the mouth during wear, such as tooth chipping and increased sensitivity. It can also interfere with oral hygiene and contribute to the growth of tooth decay and gum disease. And, as with any cut or abrasion to soft tissue, piercings increase the risk of infection.
There are also issues if and when you decide to give up the tongue bolt — fortunately, though, not to the same degree as during wear. Cuts to the tongue tend to heal quickly, so the piercing hole may fill in spontaneously. In some circumstances, however, a surgical procedure (similar to one performed on large ear piercings) may be required to repair the piercing hole.
For the long-term sake of your oral health, we would advise against having your tongue or lips pierced. And, if you already have a piercing, please consider giving it up — in the long run you'll be doing your teeth, gums and other tissues in your mouth a favor.
If you would like more information on oral piercing and its effects, 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 “How to Help Your Child Develop the Best Habits for Oral Health.”
Fluoride has been proven to strengthen tooth enamel against decay. That’s why it’s not only added to toothpaste and other dental products, but also to drinking water — in nearly three-quarters of U.S. water systems.
While research has eased most serious health questions about fluoride, there remains one moderate concern. Too much fluoride over time, especially in infants and young children, could lead to “enamel fluorosis,” an excess of fluoride in the tooth structure that can cause spotting or streaking in the enamel. While often barely noticeable, some cases of fluorosis can produce dark staining and a pitted appearance. Although not a symptom of disease, fluorosis can create a long-term cosmetic concern for the person.
To minimize its occurrence, children under the age of 9 shouldn’t regularly ingest fluoride above of the recommended level of 0.70 ppm (parts per million). In practical terms, you as a parent should monitor two primary sources of fluoride intake: toothpaste and drinking water.
Young children tend to swallow toothpaste rather than spit it out after brushing, which could result in too much fluoride ingestion if the amount is too great. The American Academy of Pediatric Dentistry therefore recommends a small “smear” of toothpaste for children under two, and a pea-sized amount for children up to age six. Brushing should also be limited to no more than two times a day.
Your child or infant could also take in too much fluoride through fluoridated drinking water, especially if you’re using it to mix infant formula. You should first find out the fluoride levels in your local water system by contacting the utility or the health department. If your system is part of the U.S. Centers for Disease Control and Prevention’s (CDC) “My Water’s Fluoride” program, you may be able to access that information on line at http://apps.nccd.cdc.gov/MWF/Index.asp.
If the risk for developing fluorosis in your area is high, you can minimize your infant’s intake with a few recommendations: breastfeed rather than use formula; use “ready-to-feed” formula that doesn’t need mixing and contains lower fluoride levels; and use bottled water specifically labeled “de-ionized,” “purified,” “de-mineralized,” or “distilled.”
Fluoride can be a wonderful adjunct to dental care in reducing risk for tooth decay. Keeping an eye on how much fluoride your child takes in can also minimize the chance of future appearance problems.
If you would like more information on the possible effects of fluoride on young children, 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 “Tooth Development and Infant Formula.”
Contrary to what you might think, a knocked out tooth doesn’t inevitably mean tooth loss. Time is of the essence — the shorter the interval between injury and replanting the tooth, the better the tooth’s long-term survival. The longer the interval, on the other hand, the less likely the tooth can survive beyond a few years. That phenomenon is due to the mouth’s natural mechanism for holding teeth in place.
The tooth root maintains its attachment with the jaw bone through an intermediary tissue known as the periodontal ligament. Tiny fibers from one side of the ligament securely attach to the tooth root, while similar fibers attach to the bone on the opposite side of the ligament. This maintains stability between the teeth and bone while still allowing incremental tooth movement in response to mouth changes like tooth wear.
While the ligament fibers will attempt to reattach to a replanted tooth’s root, the longer the tooth is out of the socket the less likely the fibers will fully reattach. An “ankylosis” may instead form, in which the root attaches directly to the jaw bone without the periodontal ligament. In this situation the body no longer “recognizes” the tooth and begins to treat it like a foreign substance. In all but the rarest cases, the tooth root will begin to resorb (dissolve); at some point (which varies from patient to patient) the attachment becomes too weak for the tooth to remain in place and is lost.
Ideally, a knocked out tooth should be replanted within 5 minutes of the injury (for step-by-step instructions, refer to The Field-Side Guide to Dental Injuries available on-line at www.deardoctor.com/dental-injuries). Even if you pass the 5-minute window, however, it’s still advisable to attempt replanting. With a subsequent root canal treatment (to remove dead tissue from the inner tooth pulp and seal it from infection), it’s possible the tooth can survive for at least a few years, plenty of time to plan for a dental implant or similar tooth replacement.
If you would like more information on treatment for a knocked out tooth, 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 “Knocked Out Tooth.”
While it doesn’t garner the star power of blood, saliva is still an important bodily fluid. A true multi-tasker, saliva contributes in many ways to the function and health of the body, from stronger teeth to more efficient digestion.
Here are six ways saliva helps your mouth and body function properly and stay healthy.
The mouth’s natural cleanser. Bacteria are responsible for much of the dental disease that plagues us, particularly tooth decay and gum disease. Saliva clears the mouth of food remnants, bacteria’s primary feeding source, after we eat. This leaves a cleaner mouth and fewer bacteria to cause infection.
The immune system’s partner. Saliva contains an antibody called Immunoglobulin A (IgA) that attacks disease-causing microorganisms. Along with secreting other antibacterial agents like lactoferrin and lyzozyme that curb the growth and development of bacteria, saliva serves as the body’s first line of defense against pathogens entering through the mouth.
Acid neutralizer. The optimal oral environment is a neutral pH of 7. Many of our foods and beverages, though, are highly acidic, which can raise the mouth’s acid level. The acidic environment causes the minerals in tooth enamel to soften and dissolve (a process called de-mineralization). Saliva restores the balance by neutralizing any remaining acid after we eat (a process that takes about 30 to 60 minutes).
Mineral replacer. Even under normal conditions, enamel will de-mineralize to some extent whenever the mouth becomes acidic. Saliva restores some of the enamel’s lost minerals like calcium and phosphate while it’s neutralizing acid. If fluoride is also present in saliva from fluoridated drinking water or toothpaste, it too is absorbed by the enamel making it stronger and more resistant to acid attacks.
Digestion enhancer. Saliva lubricates the mouth while we eat, making it easier for us to chew (and taste) our food. Saliva also releases the enzyme amylase as we chew to break down starches before the food enters our stomach. The end result is more efficient and comfortable digestion.
The wave of the future in diagnostics. Like blood and urine, saliva contains genetic and disease markers that could tell a physician if a patient has a certain condition. Since collecting a saliva sample is much easier than with these other bodily fluids, diagnosing disease with saliva will become more prevalent as more calibrated devices reach the market.
If you would like more information on the role of saliva in the body, 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 “Saliva.”
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.
The main strategy in fighting dental disease is to try to prevent it in the first place. The success of this strategy depends largely on effective oral hygiene with three essential elements: daily brushing, daily flossing, and semi-annual checkups with professional cleaning.
Many people have little trouble incorporating brushing into their daily routine; flossing, though, is a different matter for some. They may feel it’s too time-consuming or too hard to perform. Patients with orthodontic appliances especially may encounter difficulty navigating the floss around the appliance hardware.
Flossing, though, is extremely important for removing bacterial plaque, the primary aim of oral hygiene. This thin film of food remnant that builds up and sticks to the teeth is the breeding ground for bacteria that cause both tooth decay and periodontal (gum) disease. It’s important that as much plaque as possible is removed from the teeth and gum surfaces every day. While brushing removes plaque from the open surfaces of the teeth, flossing removes plaque clinging between teeth and around the gums that can’t be accessed with a toothbrush.
If traditional flossing is too difficult, there’s a viable alternative using an oral irrigator. Also known as a water flosser, an oral irrigator directs a stream of pressurized, pulsating water inside the mouth to blast away plaque in these hard to reach places. The hand applicator comes with a variety of tips that can be used for a number of dental situations, such as cleaning around braces or implants. In home use since the early 1960s, the latest versions of oral irrigators have proven to be very effective, especially for orthodontic patients — research shows an oral irrigator used in conjunction with brushing can remove up to five times more plaque than just brushing alone.
That being said, traditional flossing is also effective at plaque removal when performed properly. Sometimes, resistance to flossing can be remedied with a little training during dental checkups. We can work with you on techniques to improve your flossing activity, as well as train you to use an oral irrigator.
Whichever method you choose, it’s important for you to incorporate flossing (or irrigation) into your daily routine. Removing plaque, especially in those hard to reach places, is essential for reducing your risk of developing destructive dental disease.
If you would like more information on flossing or oral irrigation, 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 “Cleaning Between Your Teeth.”
Your children’s health is a major concern for you, even before they’re born. That concern should include their dental health and, yes, even before they’re born — a baby’s primary teeth are already forming just a few weeks into pregnancy.
Here, then, are some important tips for keeping your child’s dental health, before and after birth, on track.
Eat healthy during pregnancy. Your baby’s teeth actually begin to mineralize around the third or fourth month of your pregnancy. You can aid this process by eating a diet rich in calcium, phosphorous and protein.
Fight tooth decay by limiting sugar. Sugar is a major contributor to tooth decay, especially in primary teeth. To reduce this risk, limit sugary snacks as much as possible, and avoid bottles filled with sugar-filled liquids (including breast milk) during your baby’s sleeping hours.
Begin good hygiene early. When teeth first appear in the mouth you should begin to wipe around the teeth and gums with a water-soaked gauze pad right after feeding. As teeth develop, begin to gently brush them with a soft-bristled brush with just a smear of fluoridated toothpaste. Teach your child beginning around age 2 to brush for themselves with a pea-sized amount of paste on the brush. By age 6, they should be able to brush on their own and ready to learn flossing.
Schedule regular dental visits and cleanings. Dental checkups should begin around their first birthday and continue semi-annually. Your dentist is a key resource in monitoring tooth development, preventing disease and developing future treatment strategies.
Make your home “tooth-friendly.” Your home environment can be a danger to your child’s mouth. Check for hard or sharp surfaces your child could fall on and eliminate the danger — it’s estimated half of dental injuries to children under seven occur near home furniture. Check your drinking water as well — does your system add fluoride, a proven cavity fighter, or do you need to find other sources?
Taking a few precautions and establishing good life-long dental habits will help ensure your child’s teeth and gums remain healthy right into adulthood.
If you would like more information on oral health for children, 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 “Top 10 Oral Health Tips for Children.”
If you’ve come in to our office lately, chances are you’ve been asked to fill out a form or answer a question about what medications — both prescription and non-prescription — you are currently using. Of course, if you’re taking a blood-pressure drug or a pill to help control your cholesterol, you wouldn’t hesitate to put it on the list. But how about those vitamins and herbal supplements you take — do you really have to list those too?
The answer is a definite yes — and some of the reasons why may surprise you. Did you know that many “natural” dietary supplements can have potentially serious interactions with other drugs you may be prescribed? For example, herbal preparations made from the plant called St. John’s Wort are often used by people seeking relief from depression or anxiety. However, the active chemical compounds in this herb can interfere with some anesthetic drugs, and may make it harder for you to recover from the effects of anesthesia. Ginkgo biloba and some other commonly used herbs have a similar effect.
Even some vitamins have the potential to cause negative interactions. Large doses of Vitamin E, for example, can increase the risk of internal bleeding in people who are taking blood thinners or non-steroidal anti-inflammatory medications (NSAIDS), such as aspirin and ibuprofen. These medications are commonly prescribed for pain relief after minor dental procedures.
Does that mean you have to stop taking vitamins and herbal supplements if you may need a dental or medical procedure? Not necessarily. Vitamins are indeed vital to your health, and a deficiency in one or more of these important substances can result in serious diseases — like scurvy, which formerly plagued sailors lacking access to fresh fruits and vegetables. If you’ve been told you have a vitamin deficiency, taking vitamin pills is a must.
But the best way to get the proper amount of vitamins is through a healthy, well-balanced diet rich in fruits, vegetables, and whole grains. Not only does consuming these foods give you the most “natural” source of vitamins — it also provides you with other essential micronutrients and fiber, and it is low in fat and cholesterol.
No nutritional supplement is a substitute for a healthy diet — and that’s something we’d like everyone to remember. We’d also like to remind you to tell us about ALL the medications and supplements you’re taking, especially if you’re going to have a procedure. Giving us complete information will help ensure that you’ll remain as healthy and safe as possible.
If you have questions about dietary supplements, nutrition and your teeth, please call our office to arrange a consultation. You can learn more in the Dear Doctor magazine article “Vitamins & Dietary Supplements: What Every Consumer Should Know.”
It’s a recognized goal of modern dentistry to help you keep your natural teeth clean and disease-free, so you’ll be able to enjoy them for your whole life. But dentists can’t accomplish that goal by ourselves — we need your help! Maintaining good oral hygiene is the best way to ensure that your smile stays as healthy as it should be. Here are a few simple tips that can make a big difference in your dental health.
- Use the right brush, and change it as needed. What’s the right brush? Generally speaking, it’s one with soft bristles that’s small enough to fit your mouth comfortably. However, if you have trouble using a manual brush effectively (because of arthritis, for example), consider getting a good-quality electric brush. Change your brush when its bristles begin to stiffen or wear out. Ask us about proper brushing technique if you have any questions — and, of course, make sure to use a toothpaste with fluoride.
- Floss — every day. Because no matter how hard you try, you simply can’t reach all the areas in between your teeth with a brush alone — and that’s where many cavities get started. Plus, when it comes to preventing periodontal (gum) disease, flossing may be even more important than brushing, since it can actually remove plaque (a bacterial film) from under the gums. So no more excuses — OK?
- Stay away from sugary drinks and between-meal snacks. That includes sodas, cookies, and so-called “energy” drinks, which often pack a damaging one-two punch of sugar and caffeine. If you eat sugary treats at all, do so only after a meal. This will give your mouth plenty of “free time” to neutralize the acids that result when sugar is processed by oral bacteria. It’s these acids that are the primary cause of tooth decay.
- Avoid bad oral-health habits. Some you already know: smoking (or using tobacco products of any kind); excessive consumption of alcohol; chewing on pencils, fingernails, or anything else that doesn’t belong in your mouth. But some you may not know: A clenching or grinding habit at night can cause serious tooth damage without you even realizing it. Getting an oral piercing increases your chance of chipping a tooth, and can lead to other problems. And playing sports without a mouthguard is risky business.
- See your dentist regularly. You can do plenty on your own to keep up your oral health — but it’s also important to see us regularly. When you come in for an office visit, we will check you for early signs of problems, and take care of any that we find… before they get bigger and harder to treat. We’ll also make sure you leave with a sparkling smile that has been thoroughly and professionally cleaned.
If you would like to learn more about maintaining good oral hygiene, please contact us or schedule an appointment for a consultation. For more information, see the Dear Doctor magazine articles on “How to Help Your Child Develop the Best Habits for Oral Health” and “Oral Hygiene Behavior.”
You may have heard the expression: “If you just ignore your teeth, they will go away.” That may be true — but by practicing good oral hygiene, more and more people are now able to keep their natural teeth in good condition for their entire life. So we prefer to put a more positive spin on that old saw: “Take care of your teeth and they will take care of you — always.” What’s the best way to do that? Here are our top five tips:
- Brush and floss every day. You knew this was going to be number one, right? Simply put, tooth decay and gum disease are your teeth’s number one enemies. Effective brushing and flossing can help control both of these diseases. Using a soft-bristle brush with fluoride toothpaste and getting the floss into the spaces between teeth (and a little under the gum line) are the keys to successful at-home tooth cleaning and plaque removal.
- Don’t smoke, or use any form of tobacco. Statistically speaking, smokers are about twice as likely to lose their teeth as non-smokers. And “smokeless” tobacco causes tooth discoloration, gum irritation, an increased risk for cavities, and a higher incidence of oral cancers. Of course, smoking also shortens your life expectancy — so do yourself a favor, and quit (or better yet, don’t start).
- Eat smart for better oral (and general) health. This means avoiding sugary between-meal snacks, staying away from sodas (and so-called “energy” or “sports” drinks), and limiting sweet, sticky candies and other smile-spoiling treats. It also means enjoying a balanced diet that’s rich in foods like whole grains, fruits and vegetables. This type of diet incorporates what’s best for your whole body — including your teeth.
- Wear a mouthguard when playing sports. An active lifestyle has many well-recognized health benefits. But if you enjoy playing basketball, bicycling, skiing or surfing — or any other sport where the possibility of a blow to the face exists — then you should consider a custom-fitted mouthguard an essential part of your gear. Research shows that athletes wearing mouthguards are 60 times less likely to suffer tooth damage in an accident than those who aren’t protected — so why take chances with your teeth?
- See your dentist regularly. When it comes to keeping your smile sparkling and your mouth healthy, we’re your plaque-fighting partners. We’ll check you for early signs of gum disease or tooth decay — plus many other potential issues — and treat any problems we find before they become serious. We’ll also help you develop healthy habits that will give you the best chance of keeping your teeth in good shape for your whole life.
If you would like to learn more about keeping your teeth healthy for life, please contact us or schedule an appointment for a consultation. For more information, see the Dear Doctor magazine articles “Tooth Decay — The World’s Oldest & Most Widespread Disease” and “Dentistry & Oral Health For Children.”
Your dental care would be much more limited without our ability to see “below the surface” with x-ray imaging. But since x-rays passing through the body are a form of radiation, could your exposure from them be hazardous to your health?
It depends on exposure dosages and, of course, the amount you have been exposed to over your lifetime. But, decades of research have demonstrated that exposure to dental x-rays during your regular office visits are only a fraction of the radiation you normally encounter from the natural environment every year.
X-rays have the ability to pass through body tissues, but at different rates for soft tissue like skin and muscle and hard tissue like bone. This effect creates shadows on exposed film; the differentiation is in such detail that a trained technician can interpret not only internal structures, but defects such as fractured bone or, in the case of dentistry, signs of tooth decay and bone loss from gum disease.
But like other energy sources in our environment, x-rays do emit radiation that in high doses can be dangerous to living tissue. The amount of exposure is measured in millisieverts (mSv), a unit that allows for comparison of doses from different sources of radiation. Scientists have calculated that we’re normally exposed to between 2 and 4.5 mSv every year.
By contrast, a single digital periapical image taken of a tooth is equal to 1 microsievert (μSv), or one thousandth of an mSv; a full mouth series (between 18 and 20 images) creates an exposure of 85 μSv, or 85/1000 of one mSv. In addition, advances in technology have further reduced the radiation exposure from x-ray imaging. For example, digital imaging has reduced exposure during full mouth x-rays from seven to ten days of equal exposure from normal background radiation to half a day, and with no loss in image quality.
In effect, dental x-rays pose little to no risk for patients. Still, understanding that x-ray imaging does expose patients to radiation, dentists follow certain protocols and safety precautions. For example, dentists will place a lead apron around their patients’ chest area during an x-ray exposure.
As your dentist, we’re happy to address any concerns you may have about x-ray radiation exposure. But rest assured, the x-ray devices used in your dental care, so necessary in the fight against tooth decay and other diseases, are safe and reliable.
If you would like more information on the use of x-ray technology and safety, 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 “X-Ray Frequency and Safety.”
Did you know that you probably do at least one thing during the course of an average day that puts your healthy smile at risk? These are some of the more common offenders:
Coffee, Soda, and Sports Drink Consumption
If you really can’t give them up, try to consume these beverages with restraint. Their high acidity and/or sugar content can erode protective tooth enamel, making your pearly whites more prone to staining and decay. Even natural fruit juices should be consumed in moderation as they tend to be high in sugar and sometimes acidity (e.g. orange juice). Your best bet? Water, of course. It won’t damage your teeth and thanks to fluoridation may even help remineralize and fortify your enamel.
Brushing Immediately After Eating
If you were told to brush after every meal, forget it. Acids in foods and beverages can soften your enamel, and brushing may actually accelerate erosion. Wait at least an hour to brush, which is the time it generally takes for your oral pH to normalize and your tooth enamel to reharden. However, it is advisable after eating to floss and rinse out your mouth with plain water or a mineralized dental wash to help wash away food particles.
Jaw Clenching, Tooth Grinding, Pencil Chewing
These and similar “parafunctional” behaviors — outside the uses for which teeth are designed — can cause undue tooth wear and exert stresses that can cause chips and fractures. They can affect other parts of the oral system, too, potentially resulting in jaw joint pain and muscle spasms, headaches and other head and neck ailments.
It’s hard to cut out all high-sugar/high-acid foods and beverages, so where complete elimination isn’t possible, focus on moderation and try to consume them only during mealtime. Jaw clenching and other parafunctional behaviors are often subconscious and may be harder to control; in such cases an unobtrusive device like a clear occlusal (bite) guard can alleviate the problem.
If you would like more information about tooth damage and prevention please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Tooth Decay” and “Stress & Tooth Habits.”
Your mouth’s biting and chewing function is an intricate interplay of your teeth, jaws, lips, cheeks and tongue. Most of the time everything works in orderly fashion, but occasionally the soft tissues of the tongue or cheeks get in the way and are accidentally bitten. The resultant wound creates a traumatic fibroma, an overgrowth of tissue that develops to cover the affected area.
A fibroma consists of fibrous tissue made up of the protein collagen; this traumatized tissue functions much like a callous on a tender spot of skin by binding together the new tissues forming as the wound heals. But because the fibroma is raised on the surface of the cheek more than normal tissue, the chances are high it will be bitten again and reinjured, even multiple times. If this occurs the fibroma becomes tougher and more pronounced.
As it becomes raised and hardened in this way, it becomes more noticeable. More than likely, though, it poses no danger other than as an inconvenience. If it becomes too much of a nuisance, or you have concerns that it’s more than a benign growth, it can be removed with a simple fifteen-minute procedure. An oral surgeon, periodontist or dentist with surgical training will first anesthetize the area with a local anesthetic; the fibroma is then completely excised (removed) and the wound opening sutured with two or three small sutures. Any post-procedure discomfort should be mild and easily managed by pain medication like aspirin or ibuprofen.
Although it’s highly unlikely the fibroma is cancerous, the excised tissue should then be sent for biopsy. Viewing the tissue microscopically is the only definitive way to determine the true nature of the tissue and confirm any diagnosis that the tissue is benign. This is no cause for alarm as it’s a standard healthcare procedure to biopsy this particular kind of excised tissue.
“Bumps and lumps” are common occurrences in the mouth. It’s a good idea to point them out to us during your regular checkups or at any time if you have a concern. In either case, this bothersome problem can be easily treated.
If you would like more information on traumatic fibromas, 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 “Common Lumps and Bumps in the Mouth.”
Your toothbrush serves the invaluable purpose of minimizing bacterial buildup (plaque) that can irritate gums and lead to periodontal disease, infection of the bone and tissues supporting your teeth. Brushing also helps dislodge food particles that certain oral bacteria would otherwise feed on, producing acids in the process that can eat through protective tooth enamel and the vulnerable dentin below. Given its importance to your oral health, you can maximize your toothbrush’s effectiveness by using and storing it properly, and replacing it (or the brush head if you have a powered model) regularly.
Using and Storing Your Brush
All that’s needed to dislodge plaque from oral surfaces is a relaxed grip and a gentle jiggling motion. Too much pressure can wear away tooth enamel, cause gum tissue to recede, and shorten the life of your brush head.
When you’re done using your brush:
- Thoroughly rinse it to remove any remaining tooth paste, food particles, etc.
- If you’re super-vigilant, you also can disinfect your brush by soaking it in mouthwash, brush-sanitizing rinse, or a half water/half hydrogen peroxide solution, or dipping it in boiling water for 5 to 10 seconds.
- Air dry in an upright position and do not routinely cover your toothbrush or store it in a closed container. A dark, moist environment is more conducive to the growth of microorganisms.
Replacing and Recycling Your Toothbrush
Even with the best of care, toothbrush bristles become frayed and worn and their cleaning effectiveness diminishes after 3 or 4 months, according to the American Dental Association, though it could be sooner depending on factors unique to each patient. Besides checking the bristles regularly, a good way of keeping track is to write the date you start using your toothbrush in permanent pen on a big-enough spot on the handle (or doing it on masking tape applied to the base of a power brush).
Once your brush has passed its useful life for oral hygiene, you can still get plenty of mileage out of it. You’ll find plenty of ideas on the internet for cleaning grout between tiles and grime-filled spots around taps and toilet lid hinges; removing mud from boot treads; scrubbing off corrosion from around car battery terminals and more!
If you would like more information about oral hygiene, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Toothbrush Lifespan” and “Manual vs Powered Toothbrushes.”
As life spans have increased over the last century so has the importance of maintaining good oral health. Teeth are such a critical component in good nutrition and disease protection, it’s important we do all we can to preserve them for a lifetime.
Through advances in dentistry and oral hygiene, two of teeth’s greatest enemies, dental caries (tooth decay) and periodontal (gum) disease, are not only quite treatable but even preventable. The fact remains, though, that like the rest of our body, our teeth are still subject to aging. The irreplaceable outer layer known as enamel is especially susceptible to wear over time.
The normal wearing down of teeth occurs because of occlusal (bite) activity. As our upper and lower teeth interact with each other through constant biting and chewing activities, some of the enamel surface naturally wears away as we age. Our biggest concern shouldn’t be the wear itself but the rate of wear — whether it’s exceeded the normal range.
Habits that increase the frequency and rate of biting forces are the most common reason for excessive enamel erosion. Such habits include excessive tooth-to-tooth contact as when we clench or grind our teeth and tooth-to-foreign object, the chronic habit of holding hard objects (nails, pencils, pins, etc.) tightly between the teeth. Many of these habits are a response to psychological stress that can even carry over into our sleep.
The key is to minimize these effects on the normal process of wear, and to protect teeth for as long as possible. How to accomplish that goal depends on your individual circumstance: treatments could include such things as orthodontics to correct bite problems that contribute to abnormal wear, considering restoring worn teeth with new crowns or fillings, or reducing grinding or clenching with nocturnal mouth guards or some form of stress-relief therapy.
In cases where abnormal wear has passed the point where it doesn’t make sense to repair your natural teeth, all is not lost — restorations such as dental implants can help restore lost function and inhibit further erosion. Advances over the last thirty years in restoration techniques can, in effect, extend a new lease on life for your teeth. What’s more, we can also restore form — to bring back that smile from your younger years.
If you would like more information on tooth erosion and aging, 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 “How and Why Teeth Wear.”
Do you clench your jaw or grind your teeth? Bite your nails? Chew on pencils or toothpicks? Or, heaven forbid, unscrew hard-to-open bottle caps using your precious pearly whites?
Over time, habits such as these — referred to in dentistry as “parafunctional” (para – outside; functional – normal) or beyond the range of what nature intended — can inflict excessive wear and tear on your teeth. Besides the impact damaged teeth can have on your smile, so called “tooth to tooth” and “tooth to foreign object” behaviors can cause physical problems, such as jaw joint and muscle pain, headaches, earaches, and even neck and back pain.
Use of Excessive Force
Parafunctional behaviors exert an abnormal amount of force on your teeth — up to 10 times the amount used for biting and chewing. Tooth grinding or “bruxism” (from the Greek word brykein – “gnash the teeth”) is particularly detrimental and is commonly seen in individuals who are experiencing a stressful time in their life. Some medications can also trigger it. Since bruxism often occurs while people sleep, it's possible to be unaware of it unless a partner comments (it can be noisy!) or a dental professional points out the tell-tale signs of wear.
To counter the adverse effects of nocturnal tooth grinding our office can create a customized night or occlusal (bite) guard. Typically fashioned from a hard, clear “processed acrylic” (wear-resistant plastic), this type of guard is amazingly inconspicuous. It is made to fit over the biting surfaces of the upper teeth only and is thinner than a dime. When it is worn, the lower teeth easily glide over the upper teeth rather than chomping into and gnashing with them, which minimizes the likelihood of erosion, chipping and uneven or excessive wear of the biting surface of the teeth. The guard is so unobtrusive, that some people even wear it as they go about their daily activities.
Remember: In addition to proper dental hygiene, you can help keep your teeth healthy by using them wisely!
If you would like more information about parafunctional habits like bruxism and ways to protect your teeth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Stress & Tooth Habits” and “How And Why Teeth Wear.”
You hardly notice the moist environment of your mouth — unless it becomes uncomfortably dry. Some instances of dry mouth are quite normal — when you first wake in the morning after reduced saliva flow during sleep, when you're stressed, or when you're dehydrated and need fluids. But some are not normal — millions of people, in fact, suffer from a chronic inadequacy of saliva production and flow.
Chronic dry mouth (or xerostomia) can have a greater effect on your oral health than discomfort. Saliva performs a number of tasks for the body: its enzymes help break down food before digestion; its antimicrobial properties help reduce harmful bacteria and its buffering ability helps neutralize acid, both of which reduce the risk of tooth decay.
There are a number of causes for chronic dry mouth. One of the most common arises as a side effect of over 500 medications, both prescription and over-the-counter. The major contributors to dry mouth fall into three main types: antihistamines, used to treat allergies; diuretics, prescribed to cardiac patients to drain excess fluid; and antidepressants. Diseases like Diabetes, Parkinson's disease, or AIDS can also cause dry mouth. Some treatments can too — persons undergoing head or neck radiation or chemotherapy may experience dry mouth.
If you've noticed dry mouth over several days, it's a good idea to visit us for an exam. Our first step is to try to determine the extent and cause of the condition. Depending on what we find, we can then recommend a treatment path that includes some changes in habit and prescribed medications. For example, if lack of hydration is contributing to dry mouth, we would recommend drinking an adequate amount of water, as well as cutting back on caffeinated or acidic beverages. We might also prescribe medication to stimulate saliva flow. Consuming foods that contain xylitol, a natural sugar substitute, may also do the same.
It's also important that you maintain a good oral hygiene regimen and regular dental checkups and cleanings. Good oral hygiene and the proper treatment for chronic dry mouth will greatly reduce your risk of tooth decay and other diseases.
If you would like more information on the causes and treatment of dry mouth, 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 “Dry Mouth.”
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.”
Every pregnant woman knows that her body will go through a series of profound changes as it's making a new life. Along with the alterations in overall size and changes in eating and sleeping patterns, pregnancy also affects the teeth and gums. Here are some answers to common questions women may have about oral health during pregnancy.
1) What's the most important thing I can do for my baby's oral health?
Maintain your own dental and general health! Eat a healthy and balanced diet — it provides the nutrients, vitamins and minerals needed for proper development of your baby's teeth and bones. While food cravings and aversions are common, try to at least limit your intake of sugary snacks to mealtimes. Don't neglect the good habits of brushing, flossing, and seeing your dentist regularly. This will help minimize the possibility of tooth decay or gum disease.
2) Does pregnancy make me more susceptible to gum disease?
Yes. “Pregnancy gingivitis” (“gingival” – gum tissue; “it is” – inflammation of) may develop from the second to the eighth month. This is mostly due to elevated hormone levels. In the presence of gum disease, pregnancy hormones may stimulate the production of prostaglandins, which cause inflammation of gum tissues. Occasionally, benign growths called “pregnancy tumors” may also appear on the gums during the second trimester. If they don't resolve themselves, these may be surgically removed after the baby is born.
3) With all my other concerns right now, why is the health of my teeth and gums so important?
Several studies have shown a link between periodontal (gum) disease, pre-term delivery and low birth weight — conditions which put some newborns at greater risk for health complications. There's also a correlation between more severe periodontal disease and an increased rate of pre-eclampsia, a potentially serious condition. But treating periodontal disease decreases the level of inflammation-causing prostaglandins. That's one reason why you should come into our office for an evaluation as soon as you know you're expecting.
4) Is it safe to get dental treatments while I'm pregnant?
Dental examinations and routine treatment during pregnancy is generally safe for both mom and baby. If you need non-urgent dental care, it may be most comfortable in the first five months of pregnancy. Situations requiring urgent care are managed as they arise, to treat pain and infection and to reduce stress to the developing fetus. Under the watchful eye of your dentist, it's possible to have anesthesia, X-rays and dental medications (if needed) without undue risk. So don't let worries about dental treatments keep you from coming in for a check-up!
If you would like more information about pregnancy and oral health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Pregnancy and Oral Health,” and “Expectant Mothers.”
Do you snore? You can admit it. Most everyone does, from time to time. But if snoring becomes a frequent and disturbing feature of your nighttime routine, it may be more than just an annoyance. Did you know that excessive snoring — when accompanied by irritability and depression, daytime sleepiness and confusion, and/or several other physical and mood problems — is one of the common symptoms of a sleep-related breathing disorder (SRBD)?
SRBDs are potentially serious conditions, with consequences that can range from poor workplace performance to possible cardiovascular and brain damage. One of the most significant of these maladies is called Obstructive Sleep Apnea, or OSA, a condition in which the tongue and surrounding soft tissues fall back into the throat and obstruct air flow. This reduces oxygen levels in the blood, causing the body to wake suddenly — and in severe cases, it can happen up to 50 times an hour, without a person consciously realizing it.
Needless to say, that doesn't make for a good night's sleep. But even if it turns out your snoring problem isn't severe OSA, it can still prevent you (and your partner) from feeling refreshed in the morning. Did you know that we may be able to recommend an oral appliance that has been proven to alleviate problem snoring in many cases? This custom-made device, worn while you're sleeping, helps maintain an open airway in the throat and reduce breathing problems.
If you have this condition, it's critical that you get professional advice. Dentists who have received special training in sleep problems can evaluate you, provide medical referrals when needed, and help determine the type of appliance that may work best for you. Since sleep disorders can be problematic, a thorough evaluation and follow-up monitoring is essential.
Several treatments for SRBDs are available. But oral appliance therapy, when it's recommended, offers some distinct advantages. The small appliances are comfortable, easy to wear, and very portable — unlike more complex medical devices such as CPAP machines. They're a non-invasive and reversible treatment that should be considered before undertaking a more intensive treatment, like surgery. Could an oral appliance benefit you? Why not ask us if we can help you get a good night's sleep.
If you would like more information about oral appliance therapy for sleep problems, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Sleep Disorders and Dentistry” and “Sleep Apnea FAQs.”
You've probably brushed your teeth every day since early childhood when your parents handed you your first toothbrush. But do you really know if you're doing it effectively and removing disease causing bacterial plaque or biofilm? Let's take a look at the basics of tooth brushing.
What is the goal of brushing and flossing your teeth? While it is true that brushing your teeth freshens your breath and removes stains from the surfaces of your teeth, the principal goal of tooth brushing is to remove dental bacterial plaque. This biofilm grows in the nooks and crannies of your teeth, and especially at the gum line — regardless of what you eat or drink. If left on your teeth, this bacterial film can cause gingivitis (inflammation of your gums). It can progress to periodontal disease, affecting the supporting bone of your teeth and even result in tooth loss. This means that flossing should also be an important part of your daily dental hygiene routine to remove plaque from the protected areas between your teeth.
Can you actually brush too much? More is not always better and can be damaging. We advise you to use a soft brush and to brush gently. It does not take force to remove plaque, and using a toothbrush too vigorously can damage your gums and cause them to recede (shrink away from your teeth), causing sensitivity and tooth wear. It takes between 12 and 24 hours for plaque to form on your teeth, so you don't need to brush more than twice a day and floss once a day.
How do you know when you've done a good job? A good test is that your teeth should feel like you've just had a professional cleaning. Your tongue is a great evaluator — just feel for smoothness at the gum line.
Is a powered toothbrush better than a manual one? An evidence-based study comparing all the research available found little difference between power and manual toothbrushes. The conclusion was that some powered toothbrushes with a rotation-oscillation action achieve a modest reduction in plaque and gingivitis compared to manual toothbrushes. But as we say, “it's not the brush, it's the hand that holds it.”
Come to our office for a demonstration. Any brush, whether electric or hand-powered, requires professional demonstration and training so that you know how to remove plaque correctly. Bring your toothbrush with you on your next visit to our office, so we can see your brushing technique and make sure you are doing it correctly for the most efficient plaque removal. And don't be embarrassed — nobody really knows how to brush effectively until they're shown!
Contact us today to schedule an appointment or to discuss your questions about tooth brushing and oral hygiene. You can also learn more by reading the Dear Doctor magazine article “Manual vs Powered Toothbrushes.”
What do burnt eggshells, crushed bones, brick dust and ox-hoof ashes have in common? Are they things you discovered in your kid's pocket? Ingredients in a witches brew? Funky organic compost materials?
It may be hard to believe — but they're all substances that were once used to make toothpaste, from ancient Egyptian concoctions through 18th century British blends. But don't worry: You won't find any broken crockery or ashes inside a modern tube! Today's toothpastes are scientifically formulated to be effective in removing plaque, which helps prevent tooth decay and gum disease (not to mention bad breath.) So what makes them work so well?
One class of ingredients found in all toothpastes is abrasives — also called cleaning and polishing agents. These slightly grainy substances make the mechanical action of brushing more effective. But unlike crushed bones, or the harsh, gritty particles of yore, today's abrasives are designed to remove stains and bacterial films without damaging tooth structure.
Next come detergents, which account for the foam you see when you brush vigorously. Detergents (sometimes called “surfactants”) help to break up and wash away materials that would otherwise be difficult to dissolve. An ingredient called sodium lauryl sulfate, which is also found in many shampoos, is probably the most common detergent used in toothpastes.
Fluoride, first included in toothpaste in 1914, is another common ingredient. In fact, all toothpastes that carry the seal of the American Dental Association contain it, typically in the form of sodium fluoride, stannous fluoride or sodium monofluorophosphate. It has been proven to make tooth enamel stronger and more resistant to decay.
In addition to these primary components, toothpastes generally contain flavorings to make them more palatable, and binders and preservatives to hold them together and keep them from drying out. Special-purpose toothpastes — like those designed to whiten teeth, prevent tartar, or help reduce sensitivity — have added ingredients.
But regardless of what's in your toothpaste, there's one thing you should remember: It's not the paste (or the brush) that keeps your teeth and gums healthy — it's the hand that holds it! Brushing once or twice a day, using a soft brush with the proper technique (and your favorite toothpaste!) is probably the most important thing you can do at home to enhance your overall oral health.
If you have questions about toothpastes or oral hygiene, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine article “Toothpaste — What's In It?”
Protecting your children is one of your most important roles as a parent or caregiver. Dental sealants are one way you can protect your children's teeth from the ravages of tooth decay, drilling and fillings — and they can be applied simply, comfortably and quickly right here in our office.
What is a dental sealant?
A dental sealant is a thin, plastic film that is painted onto the tiny grooves on the chewing surfaces of the back teeth (usually the premolars and molars) to prevent caries (cavities) and tooth decay. And by allowing us to use sealants to seal these little nooks and crannies where your child's toothbrush can't reach, you will dramatically reduce their chances for developing tooth decay. This one, simple and quick office visit could save you both money and time with fewer dental visits and healthier, cavity-free teeth.
So will sealants guarantee no (or no more) cavities?
No, just like life, there are few guarantees. Your child's oral hygiene, regular dental visits, fluoride, sugar consumption and genetics are the other important factors that will determine to what degree your child experiences tooth decay. However, research shows that pit and fissure (chewing surface) decay accounts for approximately 43% of all decayed surfaces in children aged 6 to 7, even though the chewing surfaces (of the back or posterior teeth) constitute only 14% of the tooth surfaces at risk. This demonstrates the vulnerability of the chewing surfaces of the posterior teeth to decay. By placing a protective seal over the areas of teeth at risk, you can effectively and proactively protect your children's teeth.
How long do sealants last?
Research has shown that some sealants can last up to 10 years. However, if you opt for sealants for your children's teeth, we will closely monitor them with each office visit to ensure that they are still doing their job. As needed, we can apply more sealant.
If you wake yourself by snoring or have been told by others that you snore, you should share this fact with us during your next visit. Why? Many people are shocked to learn that their dentist is a vital resource for treating snoring and Obstructive Sleep Apnea (OSA), a condition that occurs when the upper airway (back of your throat) is blocked or obstructed causing significant airflow disruption or even no airflow whatsoever for 10 seconds or more.
Self Test For Sleep Apnea
While your responses to the following questions are not a diagnosis for OSA, they can be warning signs that you may have OSA or another condition that is impacting your sleep.
- Are you a loud habitual snorer?
- Has anyone ever witnessed you holding your breath, gasping for air or even choking while asleep?
- Do you regularly feel un-refreshed or tired even after waking from eight or more hours of sleep?
- Do you find yourself easily falling asleep throughout your day at work or at home?
- Do you suffer from poor concentration or judgment, memory loss, irritability and/or depression from lack of sleep?
- Are you 15 pounds over the normal weight range for your height and/or does you neck measure more than 17 inches around if you are male and 16 inches if you are female?
If you answered, “yes” to any of the above questions, you should share your responses to all of these questions with both your physician and us so that you can receive a thorough examination to address your sleep concerns. And if you are diagnosed with OSA, we can help with specific oral treatment options that may work best for you.
Research has revealed that over 12 million Americans suffer from Obstructive Sleep Apnea (OSA), a condition that occurs when the upper airway (tissues at the back of the mouth and throat) collapse causing significant airflow disruption or even no airflow whatsoever for 10 seconds or more. It can leave you feeling tired, depressed, irritable, as well as cause memory loss and poor concentration. But, did you know that we can help treat your sleep apnea?
The primary method dentists who are trained in sleep medicine use to treat OSA is through the use of an oral appliance. Similar in look to an orthodontic retainer or sports mouthguard, oral appliances are designed to maintain an opened, unobstructed, upper airway during sleep. And while there are many different oral appliances available in the marketplace, less than 20 have been approved through the FDA (Food and Drug Administration) for treating sleep apnea. The key to success is to avoid those over-the-counter (OTC), generic mouthguards and instead use a professionally made and custom-fitted oral appliance, made from a precise models of your teeth and mouth. They are best at keeping your airway open and preventing the muscles and soft tissues from sagging down when relaxed during sleep. Other advantages of custom-fit oral appliances are that they can reposition your lower jaw, tongue, soft palate and uvula (the tissue in the back of the throat that dangles like a punching bag); stabilize your lower jaw and tongue; and increase the muscle tone of your tongue.
But Is Treatment Really That Important?
Absolutely! If undiagnosed and/or left untreated, sleep apnea can be life threatening. It can cause heart attacks, strokes, impotence, irregular heartbeat, high blood pressure, and heart disease — many of which can kill you.
Want To Learn More?
To learn more about sleep apnea, read the Dear Doctor article, “Snoring & Sleep Apnea.” Or if you are ready for a thorough examination and to discuss your snoring, contact us today to schedule an appointment.
The CDC (Centers for Disease Control and Prevention) calls fluoridation of drinking water one of the ten most important public health measures of the 20th century, along with such measures as vaccination and motor-vehicle safety.
A fluoride concentration of about one milligram per liter (1 mg/L), or 1 part per million (1ppm), in the water supply is associated with substantially fewer cavities. This concentration of fluoride (equivalent to a grain of salt in a gallon of water) has been found to have no negative health effects.
The connection between fluoride and oral health was confirmed in the first half of the 20th century, and by 1955 the first clinically proven fluoride toothpaste was launched. Fluoride-containing toothpastes are common today, along with other fluoride-containing products.
Protective Effects of Fluoride
Ongoing studies have shown that fluoride has both a systemic (through the body) effect and a local effect at the tooth surfaces. Tooth decay takes place as part of a kind of active war between de-mineralization and re-mineralization, in which acids produced by bacteria in plaque (a biofilm in your mouth) soften and dissolve the minerals (de-mineralization) in the tooth's surface. At the same time, the saliva bathing the tooth acts to re-harden the tooth's surface by adding minerals back (re-mineralization). If fluoride is present in the biofilm and in the saliva, it protects against de-mineralization.
The fluoride you drink in your water is deposited in your bones. Bone is an active living substance that is constantly broken down and rebuilt as a normal body process. As this happens the fluoride is released into the blood, from which it can enter the saliva and act on the tooth surface. The fluoride in toothpastes and products like rinses is delivered directly to the tooth surface. Fluorides can also be eaten in foods with high fluoride content such as teas, dry infant cereals and processed chicken, fish and seafood products.
Problems with Over-use
Eating or swallowing too much fluoride can contribute to a discoloration of teeth called dental fluorosis, which varies in appearance from small white striations to stained pitting and severe brown mottling of the enamel. To avoid this effect, monitor children's tooth brushing to make sure they use only a small amount of fluoride toothpaste and do not swallow it.
Adding fluoride to water has been controversial because some people believe that it may cause other harmful effects. However, most health experts believe that fluoridated water carries no significant health risks and significantly contributes to public health by preventing tooth decay.
The term TMD means “Temporomandibular Disorder.” But if you suffer from this disorder, it means pain. The pain can be mild or severe, acute or chronic, and it can appear to be centered in different locations, making it difficult to diagnose.
People who clench or grind their teeth because of stress often experience the pain of TMD. They might not even know they are engaging in these habits, because they do them subconsciously, for example when driving in traffic or engaging in vigorous exercise. Another cause of TMD might be an injury such as a blow to the jaw.
You can feel your temporomandibular joints working if you place your fingers in front of your ears and move your lower jaw up and down. On each side the joint is composed of an almond shaped structure at the end of the lower jaw, called the condyle, which fits neatly into a depression in the temporal bone (the bone on the side of your skull near your ear). A small disc between the two bones allows the lower jaw to move forward and sideways. The joints are stabilized by ligaments and moved by muscles.
TMD pain is the result of a process that begins when a stimulus such as psychological stress or an injury to the joint causes spasms (involuntary muscle contractions) in the muscles that move the joint. Blood vessels in the muscle begin to accumulate waste products, causing chemical changes and lactic acid buildup in the muscle. Nerves in the muscle then signal the brain to stop the movement of the jaw by registering pain.
TMD pain can appear to originate from various locations in your jaw, head, or neck. This is why it's important to make an appointment with our office for a professional assessment and diagnosis.
Treatment aims to relieve the symptoms of pain and discomfort and to prevent them from recurring in the future. Treatment can include heat, mild painkillers, muscle relaxants, soft diet, and simple jaw exercises, as well as education regarding the causes of TMD. To prevent further pain you may be provided with a “bite guard,” or referred to relaxation training with a licensed therapist. A bite guard is designed to prevent the lower teeth from biting hard into the upper teeth. It is commonly worn at night, but can also be worn during the day if clenching and grinding are apparent.
If these simpler treatments do not solve the problem, we may recommend more complex procedures such as bite adjustment or, as a last resort, surgical treatment may be needed.
Nearly everyone who has ever played a sport, or had a child participate in one, has had that panic-filled moment when they witness an injury. And when you consider that there are more than 22,000 dental injuries each year in children younger than 18 years of age, you see there is fact to backup this concern. This is just one reason why we strongly encourage all of our patients who are involved in activities such as football, soccer, hockey, wrestling, lacrosse, skateboarding, field hockey and more to wear one of our custom-fitted professional mouthguards. It is especially true for basketball and baseball, which are responsible for the largest number of dental injuries.
The following are some key issues to help you understand the importance and advantages mouthguards offer.
Is there a way to determine who is at the highest risk for sports injuries?
Yes there are several. Age, gender, dental anatomy, and the type of sports being played are the four categories used to measure the risks for dental injuries. Young male teens still top the list of most likely to be injured; however, the gap is closing with more females getting involved in sports. Learn which sports or exercise activities made the American Dental AssociationÃ¢Â€Â™s list of recommendations for using a custom mouthguard, when you continue reading “Athletic Mouthguards.”
What's the difference between a “boil and bite” mouthguard and a professionally made mouthguard?
We are often asked this very important question. While some over-the-counter (OTC) mouthguards provide what is advertised as a “custom-fit” to your teeth, it is nowhere near the fit — and thus protection — you receive from our mouthguards that are crafted from precise molds of your teeth. Additionally, because all aspects of our mouthguards are tailored to each specific mouth, they provide much more protection and comfort. This important fact can enhance performance as the athlete can literally breathe easier while wearing one of our mouthguards.
What can I do if I witness a dental injury?
The first important fact to know is that you do not have to be a dental or healthcare professional to assist. However, before jumping in to help out, consult Dear Doctor's Field-Side Guide to Dental Injuries. This pocket-sized, quick-reference guide details what you should do at the scene of a dental injury based on the type of injury. But best of all, it is available to you free of charge from Dear Doctor.
Want to know more?
Tooth decay is not trivial. It's a worldwide epidemic, one of the most common of all diseases — second only to the common cold. It affects more than one fourth of U.S. children of ages 2 to 5 and half of those 12 to 15. Among adults, tooth decay affects more than ninety percent of those over age 40.
Prevention of cavities starts with a healthy diet and effective brushing and flossing, but it is much more complex than that. Three strategies for reducing dental caries (tooth decay) include:
Protect with Fluoride and Sealants
This works best when fluoride is applied to the crystalline coating of your child's teeth just after they push through the gums (erupt). The fluoride becomes incorporated into the tooth's surface and acts as a barrier to decay. Studies have shown that low doses of fluoride are safe and effective.
Dental sealants are used as a companion to fluoride because they seal tiny pits and fissures in the tooth's structure, creating an even stronger barrier.
Modify Oral Bacteria
Every mouth contains bacteria, no matter how well you clean your teeth. Not all bacteria cause tooth decay. The problem bacteria are those that produce acid as a byproduct of their life processes. We can identify acid-producing bacteria in your mouth, you can reduce their concentrations using antibacterial mouthrinses such as chlorhexidine, and pH neutralizing agents (substances that reduce the amount of acid).
Reduce Sugars in Your Diet
Bacteria in your mouth ferment sugars and other carbohydrates, producing acids that eat into the mineralized outside structure of your teeth, the enamel. So eating fewer sugars — particularly added sugars such as those in juices, sodas, candy and other sweets — will help prevent decay. Your total sugar intake should be less than fifty grams, or about ten teaspoons, per day. If you begin to read labels showing sugar content of common foods, you may be surprised at the amount you consume without knowing it.
If you must snack between meals, non-sugary snacks like raw vegetables and fresh fruits create a better environment for your teeth.
Xylitol, an “alcohol sugar” used in some chewing gums and dental products, has been shown to reduce decay-producing bacteria.
Try these easy strategies to keep your teeth healthy and functional throughout your lifetime.
The medical term for dry mouth is xerostomia (“xero” – dry; “stomia” – mouth), something that many of us have experienced at some point in life. However, for some people it can be a chronic condition that is ideal for promoting tooth decay. It can also be a warning sign of a more serious health condition.
Dry mouth occurs when there is an insufficient flow of saliva, the fluid secreted by the salivary glands. Your major salivary glands are located in two places: inside the checks by the back top molars and in the floor of the mouth, with about six hundred tiny glands scattered throughout your mouth. And many people are surprised to learn that when they are functioning normally, saliva glands secret between two and four pints of saliva per day! While this may sound like a lot (and it is), saliva is key for buffering or neutralizing acids in the mouth. Without this powerful protection, tooth decay can increase quickly. This is especially true for older individuals who have exposed tooth root surfaces.
It is also important to note that there are times when mouth dryness is perfectly normal. For example, when you wake, you will probably have a slightly dry mouth because saliva flow slows at night. Another example is if you are dehydrated when it is simply a warning sign that you need to drink more fluids (especially water). Other causes for temporary dry mouth include stress as well as what you consume: coffee, alcohol, onions, and certain spices.
You can also have a dry mouth due to a side effect from an over-the-counter (OTC) or prescription medication. If it turns out that this is the cause in your case, you need to talk to the prescribing physician to see if there is something else you can take to avoid this side effect. If there are no substitutes, one tip you can try is to take several sips of water before taking the medication followed by a full glass of water, or chew gum containing xylitol, which moistens your mouth and decreases the risk of tooth decay.
Another cause of dry mouth is radiation treatment for cancer in the head and neck region. Yes, these treatments are crucial for fighting cancer; however, they can inflame, damage or destroy salivary glands. You can also have dry mouth from certain systemic (general body) or autoimmune (“auto” – self; “immune” – resistance system) diseases, diabetes, Parkinson's disease, cystic fibrosis and AIDS (Acquired Immune Deficiency Syndrome).
Some of the most important lessons parents and caregivers can give their children involve teaching and demonstrating good oral health habits. The following tips from the Centers for Disease Control and Prevention (CDC) are some ideas for helping you keep your children's teeth healthy.
- Start cleaning teeth early.
As soon as a child's first tooth erupts (appears), you should clean it daily by using a clean, damp cloth. Once several teeth are in, you should switch to a small, soft-bristled toothbrush. As for using toothpaste containing fluoride, you typically should start using it to brush your child's teeth at around 2 years old. However, there are some situations in which we recommend using toothpaste earlier than age 2. It just depends on your childÃ¢Â€Â™s mouth and development.
- Use the right amount of fluoride toothpaste.
Many people are aware that using toothpaste containing fluoride is an important tool for fighting tooth decay. But, many are shocked to discover how much should be used and what could happen if too much is used and swallowed. Because children under the age of 6 may tend to swallow all or some portion of toothpaste, you should only use (and teach them to use) a small amountÃ¢Â€Â”about the size of a pea. Otherwise, they could be at risk for getting white spots on their permanent teeth years later from having swallowed too much fluoride. This is also a key reason for teaching children how to rinse and spit properly after brushing their teeth.
- Supervise brushing.
Because children's abilities and maturity can vary greatly from child to child, you should brush your children's teeth until they have demonstrated the ability to handle the task alone. However, even when you give them the power to self-brush, you need to monitor them closely to ensure they are doing a thorough job, using the correct amount of toothpaste, and not brushing in a way that could damage teeth or gums. Brushing for too long and too hard are bad habits that can be detrimental to teeth and gums.
- Talk to your child's doctor and with our office.
Did you know that your first appointment should be at age one? The age one dental visit can be critical in establishing great communication and trust, and preventing early childhood decay. And having a positive rapport with your dentist and physician is important at any age; however, it is vital for parents and caregivers to develop great communication with their healthcare professionals on behalf of their children from the start of life. Not only does it model good habits for them to observe, but it also helps you stay abreast of the oral and general health needs.
Want to learn more?
If you suffer from snoring or think you may have Obstructive Sleep Apnea (OSA), did you know that your dentist could play an important role in treating your condition? For most people this is surprising; however, we can provide both education and some treatment options. And as needed, we will work with your other healthcare professionals to get an accurate diagnosis so that you can improve both your sleep and your health.
Oral Appliance Therapy: These devices may look like orthodontic retainers or sports mouthguards, but they are designed to maintain an open, unobstructed, upper airway (tissues at the back of your throat) during sleep. There are many different oral appliances available but less than 20 have been approved through the FDA (Food and Drug Administration) for treating sleep apnea. Depending on your specific condition, we may use it alone or in combination with other means of treating your OSA. HereÃ¢Â€Â™s how they work. They reposition the lower jaw, tongue, soft palate and uvula (the tissue in the back of the throat that dangles like a punching bag); stabilize the lower jaw and tongue; and increase the muscle tone of the tongue — unblocking the airway.
Continuous Positive Airway Pressure (CPAP): CPAP bedside machines generate pressurized air delivered through a tube connected to a mask covering the nose and sometimes mouth. Pressurized air opens the airway (windpipe) in the same manner as blowing into a balloon; when air is blown in, the balloon opens and gets wider. This treatment option is generally not used for snoring, but rather for the more serious condition, OSA.
Surgery: Specially trained oral and maxillofacial surgeons may include more complex jaw advancement surgeries. Additionally, an Ear, Nose & Throat (ENT) specialist (otolaryngologist) may consider surgery to remove excess tissues in the throat. It also may be necessary to remove the tonsils and adenoids (especially in children), the uvula, or even parts of the soft palate.
The first step towards getting a great night's sleep if you are a snorer that has never been diagnosed or treated for your condition is to obtain a thorough examination by a physician specifically trained in diagnosing and treating sleep disorders. And depending on the seriousness of your condition, he or she may strongly encourage you to participate in a sleep study. The results from this “study” can provide your dentist and other healthcare professionals with precise data about your snoring, breathing and sleeping habits. This information is key to treating OSA, if you are in fact diagnosed with this condition. Learn more when you read, “Snoring & Sleep Apnea.” Or if you are ready for a thorough examination and to discuss your snoring, contact us today to schedule an appointment.
Do you constantly feel like you are running on empty? Do you snore, feel like napping every day, or even drink multiple cups of coffee just for the caffeine boost? You may have a sleep related breathing disorder (SRBD) or Sleep Apnea (“a” – without; “pnea” – breath) in which your airways become obstructed causing chronic loud snoring. The good news is that we can help both diagnose and treat this disorder, which means you will be able to finally get the rest that you (and your sleeping partner) so desperately need.
The reason that sleep apnea is so disruptive to daily living is that it causes awakening for a few seconds up to 50 times per night, significantly decreasing the amount of deep sleep that is necessary for full rejuvenation. Airway blockage during sleep commonly results from obesity, an enlarged tongue or tonsils, and other factors that can cause your airway to close off when you lie down, all increasing the likelihood that you will suffer from sleep apnea. These conditions are dangerous and impair the brain and heart from receiving adequate oxygen, increasing your risk for both stroke and heart attack.
The study of sleep and its disorders is relatively new. One successful way to treat sleep apnea is with a “CPAP” machine which uses a Continuous Positive Airway Pressure mask overnight to keep air passages open while sleeping. Another more comfortable, less noisy, and unobtrusive method is to use Oral Appliance Therapy, which features an appliance like a retainer that can be custom fitted to your mouth made by a dentist trained in sleep medicine.
And yes, dentists are increasingly being recruited to help study and treat sleep disorders. There are actually several ways in which we can help. Because we see our patients on a regular basis, we are uniquely qualified to diagnose early signs of SRBDs. For example, if you start to snore almost immediately after falling asleep in the dental chair, we will be able to discuss this important warning sign with you. We can also examine the back of your mouth to see if you possess any of the traits that point to SRBDs, including large tonsils and/or an elongated uvula — the tissue in the back of your throat that looks like a little punching bag.
So, if you want to stop snoring and start sleeping well or you think you may have a SRBD, call our office to schedule a basic oral exam and consultation. If you would like to learn more about the link between dentistry and the treatment of sleep disorders, read the Dear Doctor magazine article “Sleep Disorders & Dentistry.”
Nearly everyone has snored at some point in life. However, if your sleeping partner routinely tells you that you suffer from this problem, you really should take action to confirm or deny your suspicions. You may be like one of the 50 to 70 million people in the US alone that suffer from Obstructive Sleep Apnea (OSA), a medical condition in which the upper airway (the back of your throat) collapses during sleep thus limiting your intake of oxygen. And this condition is serious. If left untreated, OSA can lead to a stroke, impotence, an irregular heartbeat, heart attacks, high blood pressure, and other forms of heart disease.
The first and most important step you should take if you snore is to obtain a thorough examination by both your primary-care physician and our office. We have completed specialized training in sleep medicine so that we can not only diagnose but also thoroughly treat your sleep disorders.
If you are diagnosed with this problem, relax. We have many ways we can treat your condition. One of the most common methods is to provide you with oral appliance therapy. This first line of treatment involves our making a customized oral appliance (mouthpiece) that will hold your lower jaw forward. By doing this, we can move your tongue away from the back of your throat so that your airway is less likely to get blocked while you sleep. (It is this blockage that causes the infamous snoring sound.)
Another option we may consider using to treat your sleep apnea if it is moderate to advanced is a Continuous Positive Airway Pressure (CPAP) machine. These machines require you to sleep with a mask over your nose and/or mouth and produce continuous pressure in your windpipe so that your tongue is forced forward away from your airway. Not only can these machines potentially eliminate your snoring, but they can also give you the restful night's sleep that you have been missing.
The last and most permanent solution for treating certain non-responsive cases of sleep apnea is surgery. This option is typically reserved for the most advanced cases to eliminate or reduce an obstruction to the airway.
Contact us today to discuss your questions about sleep apnea or to schedule an appointment. You can also learn more about sleep apnea when you continue reading the Dear Doctor magazine article “Sleep Disorders & Dentistry.”
Ensuring that your children have good oral health is (or should be) the goal of every parent or caregiver. But how confident are you about this topic? The following true/false quiz will help you evaluate your expertise while learning more about keeping your child's teeth healthy.
- All children older than 6 months should receive a fluoride supplement every day.
- Parents should start cleaning their child's teeth as soon as the first tooth appears.
- Parents should start brushing their child's teeth with toothpaste that contains fluoride at age 3.
- Children younger than 6 years should use enough toothpaste with fluoride to cover the toothbrush.
- Parents should brush their child's teeth twice a day until the child can handle the toothbrush alone.
- Young children should always use fluoride mouthrinses after brushing.
- False. Check with your child's physician or dentist about your children's specific fluoride needs. If your drinking water does not have enough fluoride to help prevent cavities, parents of a child older than 6 months should discuss the need for a fluoride supplement with a physician or our office.
- True. Start cleaning as soon as the first tooth appears by wiping the tooth every day with a clean, damp cloth. Once more teeth erupt, switch to a small, soft-bristled toothbrush.
- False. Parents should start using toothpaste with fluoride to brush their childrenÃ¢Â€Â™s teeth at age 2. Only use toothpaste with fluoride earlier than age 2 if the child's doctor or our office recommends it.
- False. Young children should use only a pea-sized amount of fluoride toothpaste. Fluoride is important for fighting cavities, but if children younger than 6 years swallow too much fluoride, their permanent teeth may develop white spots. Using no more than a pea-sized amount of toothpaste with fluoride can help prevent this from happening.
- True. Because children usually do not have the skill to brush their teeth well until around age 4 or 5, parents should brush their young children's teeth thoroughly twice a day. You should continue doing this until the child can demonstrate a proper brushing technique.
- False. Fluoride mouthrinses have a higher concentration of fluoride than toothpaste containing fluoride. Children younger than 6 years of age should not use fluoride mouthrinses unless your child's doctor or our office recommends it. Young children tend to swallow rather than spit it out, and swallowing too much fluoride before age 6 may cause the permanent teeth to have white spots.
If you feel you missed too many of the above questions, read the Dear Doctor article, “Oral Hygiene Behavior.”
It is not uncommon to have one or more teeth that are particularly sensitive to heat, cold, or pressure. If you have such a tooth, you probably want to know what caused it and what you can do about it. Here are some frequently asked questions, and their answers.
What causes teeth to become sensitive?
The most common cause of sensitivity is exposure of the tooth's dentin, a layer of the tooth's structure that is just below the outer protective layer (the enamel).
The dentin is sensitive but the enamel layer is not. Why?
The enamel is composed of minerals that are hard and protective. It is not living tissue and has no nerve supply. The dentin layer underneath is bone-like living tissue that does contain nerve fibers. It is protected by enamel above the gum line and by gum tissue in the area of the tooth's root, below the gum line. If the tooth's protective covering is reduced, the nerve fibers in that section of the dentin are exposed to changes in temperature and pressure, which they conduct to the inner pulp layer (nerve) of the tooth. The sensations that reach the tooth's interior pulp layer cause pain.
What causes exposure of the dentin layer in teeth?
Often the dentin is exposed by receding gums, causing areas of the tooth that are normally below the gum surface to be uncovered.
What makes gums recede?
One cause of receding gums is excessive, rough brushing techniques. This is particularly common in individuals who have a family history of thin gum tissues. Removing the film of bacteria called plaque requires only gentle action with a soft brush. This is one reason that we stress the value of learning proper and effective brushing techniques. Gum recession becomes worse after the uncovered dentin of the tooth's root is exposed to erosion from sweet and acidic foods and beverages, such as fruit juices.
Doesn't tooth sensitivity indicate decay?
Decay can also cause tooth sensitivity. As decay destroys a tooth's structure, it eventually invades the inner pulp of the tooth, causing greater and greater pain.
How can you prevent or reduce tooth sensitivity?
As we mentioned above, learn proper brushing techniques; we would be happy to demonstrate them. Use a toothpaste that contains fluoride, which increases the strength of the tooth's protective coating. In more serious cases, we can apply a fluoride varnish or a filling material as a barrier to cover sensitive areas. If you experience long-term tooth sensitivity, make an appointment for an assessment and diagnosis so that we can determine the cause and proper treatment.
Test yourself on your knowledge of this dental procedure.
- A root canal is
- A canal shaped structure in the root of your tooth
- A blood vessel carrying blood from your gum to your tooth
- An instrument used by your dentist in performing dental surgery
- Which of these are symptoms of root canal infection?
- Sharp, acute and intense pain, which is difficult to pinpoint
- Sharp pain when biting down on your tooth or on food
- Lingering pain after eating hot or cold foods
- Dull ache and pressure
- Tenderness (accompanied by swelling) in the nearby gums
- All the above
- If you don't feel any pain you do not have a root canal infection.
- Root canal treatment is a very painful experience.
- Root canal treatment is called endodontic therapy. What does this word mean?
- Bringing the end of your problems
- Inside your tooth
- Fighting gum disease
- You need root canal treatment if
- The inside or pulp of your tooth becomes inflamed or infected
- Your tooth needs to be gently moved in order to correct your bite
- Acid erosion is damaging your tooth
- During root canal treatment the canals in your teeth are cleaned out and sealed off.
- Who is qualified to perform root canal treatment?
- General dentists
- Both of the above
- a. A root canal is a canal shaped space within the root of a tooth that holds the tooth's pulp — which contains the tooth's nerves and blood vessels.
- f. — all of the above
- False. It is possible to have an infection that has stopped hurting but is still present and causing damage.
- False. Root canal treatment doesn't cause pain, it relieves it.
- b. The word comes from roots meaning “inside” and “tooth.”
- True. A small opening is made in the chewing surface of your tooth to gain access to the pulp. Dead and dying tissue is removed and the pulp is cleaned and disinfected. The canals are shaped and then sealed with filling materials to prevent future infection.
- c. All general dentists have received training in endodontic treatment and can perform most endodontic procedures. They often refer people needing complicated root canal treatment to endodontists, who have had specialized training in endodontic diagnosis and treatment.
Periodontal or gum disease is an often silent disease that can cause significant damage to the health of your teeth and body. The reason it is so often classified as a silent disease is because it is chronic or longstanding and often without any symptoms or pain that most people associate with a disease until it may be too late.
If you think you may have gum disease, here is what to look for:
- Bleeding gums — probably one of the most common and overlooked early warning signs that most people ignore is thinking that the bleeding is being caused by brushing their teeth too hard. The truth is that you would have to brush extremely hard to cause healthy gum tissues to bleed.
- Bad breath — something everyone has experienced; however, it can also be a warning sign of periodontal disease. This is especially true for people who hate or refuse to floss their teeth, thereby trapping literally billions of bacteria where they love to collect in the protected areas between the teeth.
- Redness, swelling, and/or receding gums — all signs of gum disease often accompanied by sensitivity of the gum tissues around the teeth.
- Chronic inflammation — long-standing gum inflammation is a sign that your gum tissues are not healing properly. Periodontal disease exhibits periods with bursts of activity followed by periods where the body tries to recover.
- Loose and/or moving teeth — that seem to be drifting into a new position, are visible signs that you are highly likely to have periodontal disease.
- Abscess formation — late stage gum disease is characterized by painful, swollen, red pockets of pus, which denotes an acute localized periodontal infection.
If you have any of these signs, you need to make an appointment for a thorough evaluation. Otherwise, you could end up losing your teeth to the second most common disease known to man after tooth decay. To learn more about gum disease, continue reading, “Warning Signs of Periodontal (Gum) Disease.” Or, contact us today to schedule an appointment.