Posts for category: Oral Health
One of the unfortunate aspects of aging is tooth wear. Depending on your diet, years of biting and chewing can cause enamel along the biting surfaces to erode. Your body also can't replace enamel — so when it comes to teeth it's not a question of if, but how much your teeth will wear during your lifetime.
To make matters worse, certain conditions cause tooth wear to accelerate. Teeth softened by acids or tooth decay, for example, erode faster than healthier teeth. So will grinding habits: often fueled by stress, these include chewing on hard items like nails, pencils or bobby pins.
You may also grind your teeth, usually while you sleep. Normal biting and chewing produces pressure of about 13 to 23 pounds per square inch: grinding your teeth at night can well exceed this, even up into the hundreds of pounds.
There are some things we can do to alleviate these issues. For clenching and grinding habits, one primary step is to address stress through counseling or biofeedback therapy. For nighttime teeth grinding we can create a bite guard to wear while you sleep that will prevent your teeth from generating abnormal forces.
Finally, it's important that you take care of your teeth through daily oral hygiene, regular office cleanings and checkups, and a nutritious diet for maintaining strong bones and teeth. Keeping your teeth free from diseases that could compromise your enamel as well as other aspects of your mouth will help them stay as strong as possible.
If you would like more information on slowing the rate of tooth wear as you age, 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.”
Many people have questions about the proper use of antibiotics — especially today, as the overuse of these medications has become a concern. It isn’t necessary for most people to take antibiotics before having a dental procedure. But for a few — notably, those with particular heart conditions and, in some cases, joint replacements — pre-medication is advisable. The question may be even more confusing now, because the standard recommendations have recently changed — so let’s try and sort things out.
First, why would anyone need antibiotics before dental treatment? Essentially, it’s because of the chance that an open wound could allow bacteria from the mouth to enter the bloodstream. For people in good health, the body is capable of quickly containing and neutralizing the bacterial exposure. But people with some types of heart disease, heart transplants, and/or total joint replacements have a greater likelihood of developing a bacterial infection, which can be dangerous — or even life-threatening. The same may be true of people whose immune systems are compromised.
At one time, people with a broad range of heart problems and artificial joints were advised to pre-medicate; today, new research indicates that fewer people need to take this step. Antibiotics are currently recommended before dental procedures if you have:
- An artificial heart valve, or a heart valve repaired with artificial material
- A history of endocarditis
- A heart transplant with abnormal heart valve function
- Cyanotic congenital heart disease (a birth defect where blood oxygen levels are lower than normal) that hasn’t been fully repaired — including children with surgical shunts and conduits
- A congenital heart defect that has been completely repaired with artificial material or with a device — but only for the first six months after the repair procedure
- Repaired congenital heart disease with residual defects, such as leakage or abnormal flow
In addition, not everyone who has an artificial joint needs antibiotic premedication. Instead, your health care providers will rely on your individual medical history to determine whether this step is required in your situation. However, having a compromised immune system (due to diabetes, cancer, arthritis, chemotherapy and other factors) is still an indication that antibiotics may be needed.
The question of whether or not to pre-medicate is an important one — so it’s vital that you share all relevant medical information with your doctors and dentists, and make sure everyone is in the loop. That way, the best decisions can be made regarding your treatment.
Your mouth is teeming with bacteria—millions of them. But don't be alarmed: Most are benign or even beneficial. There are, however, some bacteria that cause tooth decay or periodontal (gum) disease, which can damage your oral health.
These disease-causing bacteria feed and multiply within a thin biofilm of leftover food particles on tooth surfaces called dental plaque. To reduce these bacterial populations—and thus your disease risk—you'll need to keep plaque from building up through daily brushing and flossing.
Now, there's brushing and flossing—and then there's effective brushing and flossing. While both tasks are fairly simple to perform, there are some things you can do to maximize plaque removal.
Regarding the first task, you should brush once or twice a day unless your dentist advises otherwise. And "Easy does it" is the rule: Hard, aggressive scrubbing can damage your gums. A gentle, circular motion using a good quality toothbrush will get the job done. Just be sure to brush all tooth surfaces, including the nooks and crannies along the biting surfaces. On average, a complete brushing session should take about two minutes.
You should also floss at least once a day. To begin with, take about 18" of thread and wrap each end around an index or middle finger. Pulling taut and using your thumbs to help maneuver the thread, ease the floss between teeth. You then wrap it around each tooth side to form a "C" shape and gently slide the floss up and down. Continue on around until you've flossed between each tooth on both jaws.
You can get a rough idea how well you did after each hygiene session by rubbing your tongue against your teeth—they should feel slick and smooth. If you feel any grittiness, some plaque still remains. Your dentist can give you a more precise evaluation of your cleaning effectiveness at your regular dental visits. This is also when they'll clean your teeth of any missed plaque and tartar.
While professional dental cleanings are important, what you do every day to remove plaque is the real game changer for optimum oral health. Becoming a brushing and flossing "ninja" is the best way to keep your healthy smile.
If you would like more information on daily oral care, 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 “Daily Oral Hygiene: Easy Habits for Maintaining Oral Health.”
In the early Eighties, dentists began noticing symptoms among a few patients that indicated something far more serious. They were, in fact, among the first healthcare providers to recognize what we now know as HIV-AIDS.
Today, about 1.2 million Americans have contracted the Human Immunodeficiency Virus (HIV). It’s a retrovirus, somewhat different than other viruses: it can invade immune system cells and hijack their replication mechanism to reproduce itself. Untreated it eventually destroys these cells to give rise to the more serious, life-threatening disease Acquired Immunodeficiency Syndrome (AIDS).
Thanks to antiretroviral drugs, most HIV positive patients live somewhat normal lives and avoid the more serious Acquired Immunodeficiency Syndrome (AIDS). But while antiretroviral therapy effectively inhibits the action of the virus, it isn’t a cure — the virus is a permanent resident of the body and can still affect health, especially in the mouth.
In this regard, one of the more common conditions associated with HIV is Candidiasis, a fungal infection also known as thrush, which causes cracking of the mouth corners and lesions or white patches on the surface of the tongue or roof of the mouth. HIV patients may also experience limited saliva flow that causes dry mouth (xerostomia) with effects that range from bad breath to a higher risk of tooth decay.
The most serious effect, though, of HIV on oral health is the body’s lower resistance to fight periodontal (gum) disease. HIV patients are especially susceptible to a severe form known as Necrotizing Ulcerative Periodontitis (NUP), a sign as well of immune system deterioration and the beginning of AIDS. This painful condition causes gum ulcerations, extensive bleeding, and the rapid deterioration of gum attachment to teeth.
If you or a family member is HIV positive, you’ll need to pay close attention to oral health. Besides diligent brushing and flossing, you or they should also regularly visit the dentist. These visits not only provide diagnosis and treatment of dental problems, they’re also an important monitoring point for gauging the extent of the HIV infection.
Taking care of dental problems will also ease some of the discomfort associated with HIV. Thanks to proper oral care, you or someone you love can experience a higher quality of life.
If you’ve noticed some of your teeth seem to be “longer” than you remembered, it’s not because they’ve grown. Rather, your gums have shrunk back or receded to expose more of the underlying tooth.
It’s not just unattractive — gum recession could lead to severe consequences like bone or tooth loss. But before we begin treatment we need to find out why it happened. Knowing the true cause will help us put together the right treatment plan for your situation.
Here are 4 of the most common causes for gum recession and what we can do about them.
The kind of gum tissues you have. There are two kinds of risk factors: those you can control and those you can’t. Because you inherited the trait from your parents, your gum tissue thickness falls into the latter category. Although there are degrees within each, gum tissues are generally classified as either thick or thin. If you have thin tissues, you’re more susceptible to gum recession — which means we’ll need to be extra vigilant about caring for your gum health.
Tooth position. Normally a tooth erupts during childhood in the center of its bony housing. But it can erupt outside of it, often resulting in little to no gum tissue growth around it. The best solution is to move the tooth to a better position within the bony housing through orthodontics. This in turn could stimulate gum growth.
Over-aggressive brushing. Ironically, gum recession could be the result of brushing, one of the essential hygiene tasks for dental health. Consistently brushing too hard can inflame and tear the tissues to the point they begin to recede. Brushing doesn’t require a lot of force to remove plaque: use gentle, circular motions and let the detergents and mild abrasives in your toothpaste do the rest.
Periodontal (gum) disease. This, by far, is the greatest cause for gum recession: an infection caused by built-up bacterial plaque. The weakened tissues begin to detach from the teeth and recede. Gum disease can be treated with aggressive plaque removal and supporting techniques; but it’s also highly preventable. Practicing daily brushing and flossing and regularly visiting your dentist for thorough cleanings and checkups are the best practices for keeping your gums as healthy as possible.
If you would like more information on gum recession, 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 “Gum Recession.”