Posts for category: Oral Health
Periodontal disease may start in the gums’ superficial layers, but it’s not likely to stay there. As the disease moves deeper it can wreak havoc on tooth roots and bone as well as gum tissue attachments. Teeth with multiple roots are in particular peril because of the “forks” called furcations that form where the roots separate from each other. Infected furcations can be very difficult to treat.
We primarily treat gum disease by removing its main source, a thin film of bacteria and food particles called dental plaque that builds up on teeth. To remove it we most often use special hand tools or ultrasonic equipment to vibrate it loose. As the plaque and tartar diminish, the infection begins to wane.
But we can’t be completely successful in stopping the disease if any lingering plaque deposits remain. This especially includes furcations where the infection can cause significant damage to the roots. Although cleaning furcations of plaque can be difficult, it’s not impossible with the aforementioned tools and antimicrobial substances to disinfect the area.
The real problem, though, is access—effectively getting to the furcations to treat them. We may need to perform a surgical procedure called flap surgery where we create a hinged flap in the gum tissue to move it aside and access the root area beneath. Afterward we replace the flap and suture the tissue back in place.
In some cases, the infection may have already caused significant damage to the tissue and underlying bone. We may therefore need to graft gum or bone tissues to these damaged areas to stimulate re-growth. We may also need to surgically reshape the gum attachments around a tooth to make it easier in the future to access and clean the area.
These additional treatments around furcations can be very involved and labor-intensive. That’s why the best outcomes occur if we’re able to start treatment in the early stages of an infection. So, if you notice red, swollen or bleeding gums contact your dentist as soon as possible. Treating gum disease as early as possible will help ensure your tooth roots won’t suffer extensive damage.
If you would like more information on treating 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 “What are Furcations? Branching Tooth Roots can be Periodontal Nightmares.”
Every May, the National Fibromyalgia & Chronic Pain Association asks people around the world to spread awareness of fibromyalgia and other chronic pain conditions. Anyone with fibromyalgia and its associated joint and muscle pain knows all too well how chronic pain can disrupt everyday life. And as we see frequently in the dental office, people contending with the jaw pain and dysfunction associated with a temporomandibular joint disorder (TMD) can equally relate.
But here’s the kicker—if you’ve been diagnosed with either TMD or fibromyalgia, there’s a good chance you’re also dealing with both conditions. For example, in one recent survey of over a thousand TMD patients, two-thirds reported also having fibromyalgia or similar kinds of health issues. Researchers are looking intently at possible connections between TMD and fibromyalgia since understanding any potential link between the two might open the door to new ways of treatment.
Fibromyalgia patients experience frequent muscle spasms and fatigue throughout their bodies, coupled with other problems like sleeplessness and memory difficulties. Most researchers today believe it’s caused by a malfunction within the central nervous system (CNS) to process pain. Those working with TMD research are also considering whether the same type of malfunction contributes to jaw joint pain and dysfunction.
TMD is an umbrella term for various disorders involving the jaw joints and associated muscles. When you come to the dental office, it is important that we know about any TMD pain you may be experiencing because this can affect your dental visits. For example, people with TMD may have trouble holding their mouth open for an extended period of time, so we can adjust dental exams and treatments accordingly. Also, we will want to look for underlying dental conditions that may have contributed to your TMD.
If you’re experiencing both TMD and fibromyalgia symptoms, be sure you let us as well as your rheumatologist know the various symptoms you’re experiencing with each condition, the treatments you’re undergoing and the medications you’re taking.
For TMD in particular, here are a few things you can do to reduce its impact on your daily life:
- Avoid foods that require heavy chewing or jaw widening;
- Use thermal therapies like warm compresses or ice packs to ease jaw stiffness and pain;
- Practice relaxation techniques to reduce stress in your life;
- Ask about muscle relaxants or other medications that might help.
You may find that some of these practices, particularly stress reduction, are also helpful in managing fibromyalgia. And if there is a deeper connection between TMD and fibromyalgia, unraveling the mystery could hopefully lead to even greater relief for both.
If you would like more information about managing your symptoms, please contact us or schedule an appointment for a consultation. To learn more, read the Dear Doctor magazine articles “Chronic Jaw Pain and Associated Conditions” and “Fibromyalgia and Temporomandibular Disorders.”
Most dental problems arise from tooth decay and periodontal (gum) disease. But they aren't the only source of danger to your teeth—gastroesophageal reflux disease (GERD) could be just as damaging to your tooth enamel as dental disease.
GERD usually occurs when a ring of muscles at the top of the stomach weaken, allowing stomach acid to enter the esophagus. This resulting acid reflux can make life unpleasant and pose potential health dangers—over time it can damage the lining of the esophagus and cause ulcers and pre-cancerous cells. It can also erode tooth enamel if acid enters the mouth and raises its level of acidity.
This can be a problem because acid can soften and dissolve the mineral content of tooth enamel. This is the primary cause of tooth decay as acid produced by oral bacteria attack enamel. The more bacteria present, often thriving in dental plaque, the higher the potential levels of acid that can damage enamel. Stomach acid, which is strong enough to break down food, can cause similar harm to enamel if it causes higher than normal acidity in the mouth.
There are some things you can do to protect your teeth if you have GERD, namely manage your GERD symptoms with lifestyle changes and medication. You may need to avoid alcohol, caffeine or heavily acidic or spicy foods, all known to aggravate GERD symptoms. Quitting smoking and avoiding late night meals might also ease indigestion. And your doctor may recommend over-the-counter or prescription drugs to help control your acid reflux.
You can also boost your teeth's enamel health by practicing daily brushing and flossing—but not right after a reflux episode. The enamel could be softened, so brushing can potentially remove tiny particles of mineral content. Instead, rinse with water mixed with or without a little baking soda to help neutralize acid and wait about an hour—this will give saliva, the mouth's natural acid neutralizer, time to restore the mouth's normal pH level.
And be sure you're using a fluoride toothpaste. Fluoride strengthens enamel—in fact, your dentist may recommend topical fluoride applications to boost the effect.
These and other tips can help minimize the effects of GERD on your dental health. With an ounce of prevention, you can keep it from permanently damaging your teeth.
If you would like more information on managing your dental health with GERD, 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 “GERD and Oral Health.”
Today's dental restorations are truly amazing. Not only are they life-like and functional, they can endure for many years a hostile environment of bacteria, acid and heavy biting forces.
Even so, you'll still need to take care of your restorations to help them last. Here's how to extend the life of 3 common forms of dental work.
Fillings. We use fillings, both metal amalgam and tooth-colored materials, to repair holes or cavities in teeth caused by tooth decay. Although strong, dental fillings can break if you subject them to abnormally high biting force (like chewing ice). There's also a chance that if a slight separation occurs between the filling and tooth, bacteria can take up residence and reignite the decay process. To prevent this, practice a daily regimen of oral hygiene to clean away bacterial plaque—and reduce sugar in your diet, a prime food source for bacteria.
Veneers. Usually made of thin porcelain, veneers are bonded to the front of teeth to mask chips, stains, gaps or other blemishes. But although they're strong, veneers aren't immune to damage. Habits like biting nails, the aforementioned ice chewing or unconsciously grinding your teeth could cause a chipped veneer. And if periodontal (gum) disease causes your gums to recede, the exposed part of the tooth may look noticeably darker than the veneer. To protect your veneers and their appearance, avoid habits like ice chewing, and seek treatment for teeth grinding and dental disease.
Bridgework. Bridges are used to replace one or more missing teeth. Traditional bridges use the natural teeth on either side of the gap to support the bridge; for a single missing tooth, implants are a preferable option because they don't require permanently altering the neighboring teeth to support it. With either option, though, you should brush and floss around the restoration to reduce the risk of dental disease. Infections like gum disease or tooth decay could eventually weaken the bridge's supporting teeth or gum disease can damage an implant's gum and bone support.
With any dental restoration, be sure to practice daily oral hygiene, eat a nutritious, low-sugar diet, and see your dentist regularly for cleanings and checkups. Taking care of your dental work will help it take care of you for a long time to come.
Although not high on the glamour scale, saliva is nonetheless an important ingredient in a healthy life. This "multi-tasker" fluid helps break down your food for better digestion and supplies antibodies to thwart threatening microorganisms coming in through the mouth.
But perhaps its most important role is to neutralize mouth acid that can erode tooth enamel. Without this buffering action, you're at much greater risk for tooth decay and possible tooth loss.
That's why chronic dry mouth is much more than just an unpleasant feeling. If you're not producing enough saliva, your risk for developing tooth decay (and periodontal disease too) skyrocket.
Here are 3 things you can do to avoid dry mouth and promote healthier saliva flow.
Watch what goes in your mouth. Some foods, beverages and other substances can interfere with saliva production. Caffeine in coffee, sodas and other beverages can cause your body to lose water needed to produce adequate saliva. So can alcohol, which can also further irritate dry tissues. And any type of tobacco use can decrease saliva production and heighten the dry mouth effect, another good reason to kick the habit.
Drink more water. Water is the main ingredient in saliva, so keeping yourself hydrated throughout the day helps ensure a ready supply. Drinking water also helps dilute acid concentrations and washes away leftover food particles that could become a food source for oral bacteria, the main source for mouth acid.
Ask questions about your medications. Many medications can trigger chronic dry mouth including drugs to treat cancer, high blood pressure, depression or allergies. If you have chronic dry mouth, talk with your physician about the medications you're taking and ask if there are any alternatives that have less of an effect. If not, drink more water, especially while taking oral medication.
You can also reduce dry mouth symptoms by using a humidifier while you sleep or using products that boost saliva production. And be sure you're brushing and flossing daily to further reduce your risk of dental disease. Managing dry mouth won't just make your mouth feel better—it will help your teeth and gums stay healthier too.