Acquired Immune Deficiency Syndrome (AIDS) jolted our collective consciousness in the 1980s. The deadly disease caused by the human immunodeficiency virus (HIV) had no known cure and, at the time, no effective treatment.
HIV is a retrovirus, a virus with a genetic makeup and reproduction system differing from other kinds. After taking up permanent residency in the body, HIV begins “hijacking” the replication process of cells in the body's immune system and replacing it with a copy of its own. This destroys the cells' ability to protect the body from hostile organisms. As the virus affects more and more cells, the patient's condition ultimately develops into AIDS.
An estimated 35 million people worldwide (1.2 million in the U.S.) are currently infected with the virus. Thanks to new antiretroviral drugs, though, HIV can be kept from accelerating into AIDS. While their condition remains serious, many HIV positive patients can now live long and relatively normal lives. Even so, having the virus requires them to pay close attention to their health, including their mouth.
Even while stalled from becoming AIDS, HIV can still cause oral problems for 30 to 80% of patients. The fungal infection candidiasis (also known as thrush) is the most common of these problems, which appears as lesions, cracking skin or creamy white patches on the tongue or palate that easily bleed. Patients also have higher risks for dry mouth, oral cancer and periodontal (gum) disease.
HIV positive patients must practice diligent daily oral care and see their dentist for checkups regularly. Prevention, early diagnosis and treatment can keep gum disease and other damaging conditions under control. Monitoring oral health is also important because certain mouth conditions could be an early sign the infection is entering a new advanced stage in the body that requires additional attention.
Keeping vigilant in all aspects of health is a way of life for someone with HIV. Such vigilance, though, can help them maintain a healthy mouth and even prolong their life.
One of the most popular subjects in books, magazines and social media is food — the things we should or should not eat (or at least not too much). While losing weight is a popular focus, it's only one part of the whole — a balanced diet that supplies the nutrients we need to be healthy.
What you eat can also make a difference in your oral health. Here are 4 changes you should make to your dietary habits to cut down on the risk of dental disease.
Adopt a nutritionally sound diet plan. When we say diet, we're not talking about the latest weight-loss sensation — we mean a planned way of eating for life. For most people, that's a balanced diet of fresh fruits and vegetables, protein and dairy. Your teeth and gums have the best chance of remaining strong and healthy with a nutrient-rich diet.
Manage your sugar intake. Sugar and similar carbohydrates are a rich food source for bacteria that cause dental disease. It's important then that you keep your sugar consumption within limits: don't eat more than six teaspoons of processed sugar a day (or three for a child); avoid sugary snacks between meals; and try to satisfy your sweet tooth with the natural sugars found in fresh fruits and vegetables.
Cut back on acidic beverages. Sodas, juices, sports and energy drinks are all the rage. They're also high in acid, which at chronic levels can soften and erode tooth enamel. So, try to drink them only at meal times and avoid sipping on them over long periods. And, if you're hydrating yourself after moderate work or exercise, try nature's perfect hydrator — water.
Avoid eating before bedtime. A good portion of the acid in our mouths after we eat can be neutralized by saliva. As we sleep, though, our saliva flow slows down and doesn't have the same buffering power as it does during the day. So, try not to eat as least an hour before you turn in for the night, especially foods with added sugar.
If you would like more information on nutrition 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 article “Nutrition & Oral Health.”
Tooth decay and periodontal (gum) disease pose the most common dangers to dental health. But there are some rare conditions that can also place teeth at risk to be on the lookout for during regular dental checkups.
One such condition is root resorption in an adult tooth, in which the root itself or its surface breaks down and is absorbed by the body. Resorption occurs naturally in a primary (“baby”) tooth so it can loosen and give way for an incoming permanent tooth. Â Resorption still occurs in a limited form with young permanent teeth but should eventually stop.
Sometimes, though, it doesn’t, either from the inside of the tooth out (internal resorption) or more often from the outside in, usually around the neck-like (or “cervical”) portion of the tooth. This more common occurrence, External Cervical Resorption (ECR), can first appear as pink spots on the enamel and then progress into cavity-like areas. If not found and treated promptly, damage can occur quickly and lead to tooth loss.
We don’t fully understand the exact nature and causes for ECR, but we have identified risk factors for its development. Excessive orthodontic force on the teeth or any other trauma can cause damage to the periodontal ligament (which holds teeth in place with the jaw bone). Teeth grinding habits and some dental procedures like internal tooth whitening can also be risk factors.That being said, though, the vast majority of people who experience these issues don’t develop ECR.
Although the causes aren’t fully understood, we can still treat it: the key to success is early detection. You probably won’t notice early signs of ECR, but we can often detect spots from routine x-rays. We can then remove the tissue cells within the lesions causing the damage and restore the area with a tooth-colored filling material. If ECR has extended near the tooth’s interior pulp layer, then a root canal treatment may be needed.
Needless to say, the more extensive ECR occurs in the roots, the less likely the tooth can be saved and may need to be extracted. It’s important, therefore, to maintain regular dental checkups (at least twice a year) to increase your chances of catching a developing problem early.
If you would like more information on root resorption in adult 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 article “Root Resorption: An Unusual Phenomenon.”
Sleep — you'll spend a third of your life in its blissful embrace. But it isn't a luxury: you need it as much as nutrition and exercise. An occasional bad night's sleep leaves you irritable and drowsy; a bad night's sleep every night could endanger your health.
One of the most common causes for chronic poor sleep is obstructive sleep apnea. This occurs when the airway becomes blocked and you stop breathing temporarily. The blockage may be due to an oversized tongue, tonsils or uvula, an abnormal jaw or chin structure, or nasal polyps and congestion. When your brain notices you're not breathing, it rouses you just enough to relieve the blockage. These incidents can occur and end in seconds several times a night without you being aware of it.
This interrupts your normal sleep patterns, including the critical rapid eye movement (REM) of deep sleep that occurs at different times during the night. The results of not getting enough REM sleep are quite unhealthy: besides irritability and reduced concentration, poor REM sleep is linked to depression, headaches, decreased sex drive, acid reflux, high blood pressure or the onset of diabetes. Your night time experience — as well as your sleep partner's — won't be pleasant either as you may experience night time sweating and snoring.
Fortunately, sleep apnea can be treated. Our first considered treatment is a custom-fitted night guard you wear while you sleep that holds the tongue back from the airway. If your apnea is more severe, you may need to consider continuous positive airway pressure (CPAP) therapy, which uses a machine to pump pressurized air through a mask you wear while sleeping to force the airway open. You might also benefit from surgery to remove excess soft tissue obstructing the airway.
If you or your family has noticed any of these symptoms mentioned, make an appointment to see us — we're trained to look for oral signs in the mouth that may indicate sleep apnea. The sooner we can implement a treatment strategy, the sooner you'll begin experiencing a good night's sleep and better health.
If you would like more information on sleep apnea and what to do about it, 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 “Sleep Disorders & Dentistry.”
Root canal treatment can be an effective life preserver for a heavily decayed tooth. The question a lot of people ask, though, is how long might the tooth survive after treatment.
That’s an important concern since the treated tooth was in dire straits beforehand as decay had infected its inner most layer, the pulp. The infection, which had caused the living bundles of nerves, blood vessels and connective tissue within to become inflamed and diseased, was poised to invade even deeper through the root canals. During the root canal treatment, the infected pulp tissue is removed and the empty chamber and root canals are filled with a special filling to seal the tooth from further infection.
The protection, though, isn’t an absolute certainty: how long a treated tooth survives depends on a number of factors. For one, the earlier a diseased tooth can be initially diagnosed — especially if the infection hasn’t spread into the jawbone — the better the procedural outcome. Likewise, the chances of longevity are also better if the initial root canal treatment was thorough in identifying and filling all the root canals as well as capping the tooth with a life-like crown in a timely manner after treatment.
The type and location of the tooth can also affect its long-term health. Front teeth, with their single roots and canals are easier to access and treat. Back teeth, by contrast, can have two or more roots and a more intricate canal network. These kinds of complications could require the use of special microscopic equipment and the expertise of an endodontist, a specialist in root canals.
Even if a re-infection occurs, the tooth isn’t necessarily lost. A repeat root canal treatment that addresses these and other issues, could give the tooth a “third” chance. In any case, if a tooth is worth saving attempting a root canal treatment is generally preferable to losing the tooth and replacing it with a prosthetic tooth — it’s well worth the try.
If you would like more information on root canal treatments, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Root Canal Treatment: How Long Will it Last.”
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