Posts for: October, 2013
One of the top concerns in healthcare is the interactions and side effects of medications. Drugs taken for separate conditions can interact with each other or have an effect on some other aspect of health. It's important then that all your health providers know the various medications you are taking, along with other lifestyle habits. That includes your dental team.
Calcium channel blockers (CCBs) are one type of medication that can have an effect on your oral health. CCBs are used primarily to control hypertension (high blood pressure), and to treat other cardiovascular conditions like angina or abnormal heart rhythm. They work by dilating blood vessels, which makes it easier for the heart to pump.
CCBs are now recognized as a contributing factor in the development of a condition known as gingival hyperplasia in which the gum tissues “overgrow,” extending in some cases abnormally over the teeth. This abnormal growth can be painful and uncomfortable, and can make oral hygiene more difficult to perform. The overgrowth of tissue can also be socially embarrassing.
There's also a secondary factor that can increase the risk for tissue overgrowth in patients taking a CCB — poor oral hygiene. In the absence of a good hygiene routine, a layer of bacterial plaque known as biofilm can build up on tooth surfaces and lead to various forms of gum disease, including hyperplasia. The overgrown tissue contributes in turn to this disease process by inhibiting effective oral hygiene.
If you've already developed gingival hyperplasia or some other form of gum disease, it's important for you to receive periodontal treatment for the disease as soon as possible. Once we have the condition under control, it's then a matter of regular dental checkups and cleanings to reduce the risk of disease, including gingival hyperplasia. We can also help you develop effective hygiene practices that inhibit this condition while you are taking a CCB.
If you would like more information on the effects of medication 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 “Blood Pressure Medications.”
One of your teeth's best defenses against tooth decay is its hard, outer layer made of a mineral-rich substance known as enamel. This great protector, however, has an enemy — acid — from the foods and drinks we consume as well as the acid byproducts from bacterial plaque. A high acidic level in the mouth could lead to the complete erosion of enamel, leaving teeth more susceptible to decay.
When the acid level in the mouth rises, calcium and other minerals in enamel become soft and begin to slough off, a process called de-mineralization. But the body can reverse this process with the help of saliva, which can neutralize acid. Saliva also contains calcium that can bind to the tooth surface and help replace what was lost during de-mineralization — a process known as re-mineralization. Saliva can normally accomplish this in thirty minutes to an hour after eating.
Unfortunately, saliva's neutralizing power can be overwhelmed when there is too much acid present. This occurs when we ingest substances like sodas or sports drinks that are high in citric acid. Many of these same beverages also have a high buffering capacity that slows the neutralizing effect of saliva. Ironically, we can also interrupt re-mineralization if we brush our teeth too quickly after eating or drinking something acidic. The enamel has been softened by the acid and when we brush before re-mineralization we can actually brush away some of the enamel.
There are some steps you can take to help this natural process for maintaining a healthy pH balance in the mouth. First, limit your intake of acidic foods and beverages. Drink water for rehydration, or at least acidic beverages enriched with calcium. If you do drink an acidic beverage use a straw to reduce acid contact with teeth, try not to swish it around in your mouth, and try to drink it during mealtime. Finally, wait 30 to 60 minutes before brushing your teeth after eating or drinking something acidic.
Tooth enamel is a key component in maintaining healthy teeth. Protecting this prime defense against decay will pay you dividends for many years to come.
If you would like more information on enamel erosion, 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 “Dental Erosion.”
You've probably heard that thumb sucking can be harmful to your child's mouth, but do you know why?
Keep in mind that thumb sucking is completely normal in children up to a certain age. In fact, 95% of babies suck their thumb! This is because it provides them with a sense of security and a way to test and learn about their new world. The American Academy of Pediatric Dentistry recommends that parents and caregivers encourage children to cease this habit by age three.
Many children stop sucking thumbs by themselves between the ages of two and four. However, if you are having issues getting your child to stop after this point, you should inform us at your next appointment. Thumb sucking can actually block your child's front teeth from fully erupting and can also push the teeth forward. The number of hours per day and how much pressure your child applies will affect how far out of position the teeth end up. Excessive thumb sucking can also cause your child's jaw to develop incorrectly. This is why it is so important to stop sucking habits before permanent teeth start to erupt.
There are many creative ways that you can help your child cut back and eventually stop sucking his or her thumb. You might try to implement some behavioral management techniques, such as offering rewards after your child goes a length of time without thumb sucking. If your child is old enough to understand consequences, you can simply try explaining what will happen if he or she keeps up with this habit. If you continue to have trouble, speak with us at your next appointment and we can discuss other options, such as a mouth appliance that blocks this habit.
If you would like more information about thumb sucking, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “How Thumb Sucking Affects the Bite.”
Rock star Steven Tyler fell and broke his two front teeth while on tour with his band Aerosmith not long ago. But Tyler was back on stage the very next day, thanks to modern dental implant technology.
Dental implants are the most optimal tooth replacement system in use today. The reason we say “system” is because replacing teeth with implants involves two, or sometimes three, components: the implant itself, which replaces the root-part of the tooth; the dental crown that sits on top of it to replace the part of the tooth that's visible in the mouth; and a connecting piece placed in between the implant and crown, known as an abutment.
The implant itself, made of titanium, is placed directly into the jawbone with a minor surgical procedure. Titanium has the unique ability to fuse to bone, creating a very strong connection. An implant provides virtually the same function as a natural tooth root, including stabilizing the bone underneath and preventing its loss — something that naturally occurs when a tooth is lost.
This fusion process takes a period of weeks, which is why the implant needs time to heal before a permanent crown is attached. One reason for early implant failure is “loading” them with biting forces too soon. But in experienced hands, implants are extremely successful. Documented research and clinical studies indicate success rates of over 95% — which is higher than any other tooth replacement option. Once integrated and functional, implants can last a lifetime. That's why, though they are a bit more expensive initially than other tooth-replacement options, they are more cost-effective in the long term.
Of course, another advantage of implants is that they look and feel completely natural. Just ask Steven Tyler!
If you would like more information about dental implants, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Dental Implants.” Dear Doctor also has more on “The Hidden Consequences of Losing Teeth.”
It can happen in an instant — your child takes a hard hit to the mouth while playing football, basketball or some other contact sport. Suddenly, he or she faces the severest of dental injuries: a knocked out tooth.
There's both good and bad news about this situation. First, the good news: the knocked out tooth can be reinserted into its socket and take root again. The bad news, though, is that the tooth has only the slimmest of chances for long-term survival — and those chances diminish drastically if the reinsertion doesn't take place within the first five minutes of the injury.
Outside of the five-minute window, it's almost inevitable that the tooth root won't reattach properly with the tiny fibers of the periodontal ligament, the sling-like tissue that normally holds the tooth in place to the jawbone. Instead, the root may fuse directly with the bone rather than via the ligament, forming what is called ankylosis. This will ultimately cause the root to melt away, a process known as resorption, and result in loss of the tooth.
Of course, the resorption process will vary with each individual — for some, tooth loss may occur in just a few years, while for others the process could linger for decades. The best estimate would be four to seven years, but only if the tooth receives a root canal treatment to remove any dead tissue from the tooth pulp and seal it from possible infection. Over time the tooth may darken significantly and require whitening treatment. Because the tooth may be fused directly to the jawbone it can't grow normally as its neighbor teeth will and thus may appear uneven in the smile line. From a cosmetic point of view, it may be best at that time to remove the tooth and replace it with an implant or other cosmetic solution.
In many ways the longevity of the tooth post-injury really depends on time — the time it takes to reinsert the knocked out tooth into its socket. The quicker you take action, the better the chances the tooth will survive.
If you would like more information on treating 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: How Long Will a Tooth Last After Replantation?”