Posts for category: Oral Health
Modern life can be demanding. The body helps us rise to the occasion through responses we collectively call stress.
But while stress can be a good thing, it can also overwhelm us and manifest in some harmful way: bouts of back pain, stomach ulcers or even acne. It could also trigger tooth grinding, often occurring as we sleep. And like other stress relievers, tooth grinding can be detrimental to your health long term.
Teeth-on-teeth contact occurs normally when we eat or speak, or simply as our jaws contact each other with glancing touches hundreds if not thousands of times a day. Such normal contact is beneficial because it stimulates healthy bone growth in the jaw. But if the forces created exceed the normal range as with tooth grinding (up to ten times), it can cause a bevy of problems to the teeth and jaws.
While excessive jaw motion during teeth grinding can cause inflammation and painful spasms in the muscles, the greater danger is to the teeth, which could even fracture from the high amount of force. The more common occurrence, though, is an increased rate of enamel erosion, which causes the tooth to lose vital structure and eventually appear shorter in appearance.
Fortunately, there are ways to reduce teeth grinding or its severity. The first order of business is to treat its effects by reducing its symptoms and ongoing damage. We can recommend some behavior modification techniques to alter the frequency of the habit or a night guard to protect the teeth from the intensity of the habit if you’re unable to change the behavior.
A custom-fitted night or occlusal guard, a retainer-like dental appliance made of smooth acrylic plastic is designed so that the lower teeth glide over the guard surface when grinding and can’t make solid contact with the upper teeth. This reduces the generated force and helps protect the teeth.
In the long term, though, you should address the root cause — how you’re handling daily stress. Treatment by a psychotherapist or counselor, for example, could help you develop ways to channel stress in more productive ways.
However your treatment strategy develops, it’s important to address stress and teeth grinding as soon as possible. Controlling it will have long-term benefits for your teeth and smile.
If you would like more information on dealing with stress that causes tooth grinding, 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 “Stress & Tooth Habits.”
When your favorite baseball team wins, it's hard not to get excited — especially if you're right there in the stadium. It's even better when a player tosses the ball to fans. But sometimes, in the heat of the moment, things can go awry.
That's what happened during a recent game at New York's Yankee Stadium. After catching the ball that ended the game in an 8-2 Dodgers win, Los Angeles outfielder Yasiel Puig tossed it into a cheering crowd of supporters. “I saw it coming at me and I remember thinking, 'I don't have a glove to catch this ball,'” Dodgers fan Alyssa Gerharter told the New York Daily News. “I felt it hit me and I could feel immediately with my tongue there's a hole. And I looked down at my hand and saw there's a tooth in my hand.”
Ouch. Just like that, one fan's dream became… a not-so-good dream. But fortunately for the 25-year-old software engineer, things went uphill from there. Ushers quickly escorted her into a first-aid room at the stadium. She was then rushed to a nearby hospital, where the upper front tooth was re-inserted into her jaw. After a follow-up appointment at her dentist's office the next day, Gerharter said she remains hopeful the re-inserted tooth will fuse with the bone, and won't require replacement.
We hope so too. And in fact, she has as good a chance of a successful outcome as anyone, because she did everything right. If you're not sure what to do about a knocked-out tooth, here are the basics:
- locate the tooth, handle it carefully (don't touch the root surface), and if possible gently clean it with water
- try to open the person's mouth and find the place where the tooth came from
- carefully re-insert the tooth in its socket if possible, making sure it is facing the right way
- hold the tooth in place with a soft cloth as you rush to the dental office or the nearest urgent care facility
- if it can't be replaced in its socket, place the tooth in a special preservative solution or milk, or have the person hold it between the cheek and gum (making sure they won't swallow it) — and then seek immediate care at the dental office
- follow up at the dental office as recommended
In general, the quicker you perform these steps, the more likely it is that the tooth can be preserved. How quick is quick? The best outcomes are expected when re-implantation occurs in no more than five minutes. So if you're in this situation, don't wait: get (or give) appropriate first aid right away — it just might save a tooth!
If you would like more information about what to do in a dental emergency, contact us or schedule an appointment for a consultation. You can learn more the Dear Doctor articles “Knocked Out Tooth,” and “The Field-Side Guide to Dental Injuries.”
Vaping, the use of an electronic cigarette or E-cigarette, has exploded in popularity over the last few years. But although touted by proponents as a cleaner and healthier alternative to smoking, vaping has also gained recent notoriety with the rise of lung injuries and even deaths linked to the practice.
But long before these headlines of late, dentists were sounding the alarm about vaping in regard to oral health. There are a number of elements associated with vaping that can make it as hazardous to your teeth and gums as traditional smoking.
Nicotine. While vaping and smoking are different in many ways, they do share one commonality: They both deliver nicotine through the lungs into the bloodstream. Nicotine in turn can constrict blood vessels, including those in the mouth. This restricts the delivery of nutrients and disease-fighting agents to the teeth and gums, increasing the risk of tooth decay and gum disease.
Flavorings. One of the big appeals of vaping, especially with young people, is the availability of various flavorings. But while they may have cool names like “cotton candy” or “cherry crush,” the additives themselves and the compounds they create in the mouth can irritate and inflame oral membranes. They may also diminish enamel hardness, which dramatically increases tooth decay risk.
Mouth dryness. The vapor produced by an E-cigarette is an aerosol: Many of the solid particles for the various ingredients in the vaping solution are suspended within the vapor. The combination of all these chemicals and compounds can lead to mouth dryness. Not only can this cause an unpleasant feeling, it creates an environment favorable to bacteria that contribute to dental disease.
For the good of both your general and oral health, it's best to avoid vaping. The risks it may pose to your teeth and gums far outweigh any proposed benefits over smoking. The best course if you're a smoker wanting a healthier lifestyle, including for your mouth, is to undergo a medically-supervised tobacco cessation program to quit the habit. That's a far better way than vaping to protect your general and oral health.
If you would like more information on the oral hazards of E-cigarettes, 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 “Vaping and Oral Health.”
Around 20 million people—mostly women after menopause—take medication to slow the progress of osteoporosis, a debilitating disease that weakens bones. But although effective, some osteoporosis drugs could pose dental issues related to the jawbones.
Osteoporosis causes the natural spaces that lie between the mineral content of bone to grow larger over time. This makes the bone weaker and unable to withstand forces it once could, which significantly increases the risk of fracture. A number of drugs have been developed over time that stop or slow this disease process.
Two of the most prominent osteoporosis drugs are alendronate, known also by its trade name Fosamax, and denosumab or Prolia. While originating from different drug families, alendronate and denosumab work in a similar way by destroying specialized bone cells called osteoclasts that break down worn out bone and help dissolve it. By reducing the number of these cells, more of the older bone that would have been phased out lasts longer.
In actuality this only offers a short-term benefit in controlling osteoporosis. The older bone isn’t renewed but only preserved, and will eventually become fragile and more prone to fracture. After several years the tide turns negatively for the bone’s overall health. It’s also possible, although rare, that the bone simply dies in a condition called osteonecrosis.
The jawbones are especially susceptible to osteonecrosis. Forces generated by chewing normally help stimulate jawbone growth, but the medications in question can inhibit that stimulus. As a result the jawbone can diminish and weaken, making eventual tooth loss a real possibility.
Osteonecrosis is most often triggered by trauma or invasive dental procedures like tooth extractions or oral surgery. For this reason if you’re taking either alendronate and denosumab and are about to undergo a dental procedure other than routine cleaning, filling or crown-work, you should speak to your physician about suspending your medication temporarily. Dentists often recommend a suspension of three to nine months before the procedure and three months afterward.
Some research indicates this won’t worsen your osteoporosis symptoms, especially if you substitute another treatment or fortify your skeletal system with calcium and vitamin D supplements. But taking this temporary measure could help protect your teeth in the long run.
If you would like more information on the effect of osteoporosis treatment on dental 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 “Osteoporosis Drugs & Dental Treatment.”
Since the late 19th Century, dentists have used established protocols to successfully prevent and treat tooth decay. But there've been changes to this approach the last few years to improve its effectiveness, changes we now refer to as Minimally Invasive Dentistry or MID.
The older approach for treating dental caries (tooth decay) follows the protocols established by Dr. G.V. Black, considered the father of modern dentistry. Black advocated removing not only decayed structure but also some of the healthier but vulnerable portions of a tooth, to avoid further decay and make the tooth easier to clean. This resulted in larger fillings, although they've become smaller as dental techniques have advanced.
MID, on the other hand, aims to remove as little tooth structure as possible while still effectively treating and preventing future decay. To achieve that goal we begin first with a complete assessment of a patient's individual decay risk, known as Caries Management By Risk Assessment (CAMBRA).
With CAMBRA, we're looking at other factors besides individual tooth health: a patient's hygiene, lifestyle and dietary habits; the types and amount of bacteria present; and the quality of saliva flow, needed to neutralize mouth acid. With these the results we develop a customized prevention and treatment strategy.
MID also focuses on detecting dental caries as early as possible. Besides traditional x-rays, we're beginning to use other methods like dental microscopes, laser fluorescence, infrared photography or optical scanning. Early detection leads to early intervention, and with techniques that are much less invasive than the traditional approach.
The new approach also changes how we repair decayed teeth. We're increasingly using air abrasion, a technology that uses fine particles in a pressurized air stream to remove softer decayed tooth material and less healthy structure than the traditional dental drill. We're also using composite resin and other advanced materials for filings: these tooth-colored materials are stronger than previous versions and are quickly taking the place of metal amalgam, requiring less structural removal to accommodate them.
MID's core principles are early disease detection, proactive prevention and treatment with less structural removal. With this enhanced approach to effective dentistry, we're keeping your teeth healthy with minimal discomfort, lower costs and less long-term impact.