Posts for: October, 2013
It used to be that the only option for straightening a teenager's teeth involved lots of shiny hardware. Besides the esthetic downside, traditional orthodontic devices (braces) can interfere with the enjoyment of certain favorite foods, irritate the inside of the mouth, trap food particles (potentially another esthetic embarrassment and sustenance for cavity-causing bacteria), and complicate dental hygiene routines.
These aren't causes for concern with clear orthodontic aligners, however, which consist of a series of transparent plastic, removable trays that fit over the teeth and gradually move them into better positioning. About every two weeks, the teen proceeds to the next aligner in the progression (or set of aligners if treatment involves both the upper and lower teeth) until the improved alignment goal is reached. The trays are meant to be worn 22 hours a day, but they can be removed for eating, brushing and flossing, and, on a limited basis, special occasions.
Thanks to relatively recent developments in the design of clear aligner systems, teens who previously were not considered good candidates for this modality may now have this option available to them. This includes:
- Teens whose second molars (the last to come in except for wisdom teeth) haven't fully emerged. Aligners now come with “eruption tabs” that serve as place-holders for teeth that are still growing into position.
- Teens with severely rotated teeth requiring complicated movement. Tooth-colored attachments called “buttons” can be temporarily bonded onto teeth to provide additional leverage, and elastics (rubber bands) can also be used to promote movement.
Compliance is always a concern with any orthodontic treatment — whether it be gum chewing with traditional braces or wearing clear aligners for the requisite period of time each day. Aligners now come with built-in colored “compliance indicators” that fade with use over time. This makes it possible for orthodontists, dentists, parents and teens alike to monitor both compliance and treatment progress.
If you would like more information about clear orthodontic aligners 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 “Clear Aligners for Teens.”
You hardly notice the moist environment of your mouth — unless it becomes uncomfortably dry. Some instances of dry mouth are quite normal — when you first wake in the morning after reduced saliva flow during sleep, when you're stressed, or when you're dehydrated and need fluids. But some are not normal — millions of people, in fact, suffer from a chronic inadequacy of saliva production and flow.
Chronic dry mouth (or xerostomia) can have a greater effect on your oral health than discomfort. Saliva performs a number of tasks for the body: its enzymes help break down food before digestion; its antimicrobial properties help reduce harmful bacteria and its buffering ability helps neutralize acid, both of which reduce the risk of tooth decay.
There are a number of causes for chronic dry mouth. One of the most common arises as a side effect of over 500 medications, both prescription and over-the-counter. The major contributors to dry mouth fall into three main types: antihistamines, used to treat allergies; diuretics, prescribed to cardiac patients to drain excess fluid; and antidepressants. Diseases like Diabetes, Parkinson's disease, or AIDS can also cause dry mouth. Some treatments can too — persons undergoing head or neck radiation or chemotherapy may experience dry mouth.
If you've noticed dry mouth over several days, it's a good idea to visit us for an exam. Our first step is to try to determine the extent and cause of the condition. Depending on what we find, we can then recommend a treatment path that includes some changes in habit and prescribed medications. For example, if lack of hydration is contributing to dry mouth, we would recommend drinking an adequate amount of water, as well as cutting back on caffeinated or acidic beverages. We might also prescribe medication to stimulate saliva flow. Consuming foods that contain xylitol, a natural sugar substitute, may also do the same.
It's also important that you maintain a good oral hygiene regimen and regular dental checkups and cleanings. Good oral hygiene and the proper treatment for chronic dry mouth will greatly reduce your risk of tooth decay and other diseases.
If you would like more information on the causes and treatment of dry mouth, 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 “Dry Mouth.”
Tooth sensitivity is an all too common problem among dental patients. If eating certain foods or simply touching a tooth causes you pain, you should know why this may be happening and what can be done about it.
Tooth sensitivity occurs in most cases because the portion of the tooth known as the dentin has been exposed. The dentin contains nerve fibers that inform and alert the brain about the current environment of the tooth (temperature or pressure changes). The enamel protects the tooth from environmental extremes.
Receding gums are the most common cause for dentin exposure — the enamel only protects the crown of the tooth and is not present on the root of the tooth. Acids in certain foods can then begin to erode the dentin around the roots and expose nerves. Sweet items (mainly sugar) and temperature shifts irritate the nerve endings, causing pain.
While receding gums (most commonly caused by brushing too hard and too often) may be the most common cause for sensitivity, it isn't the only one — tooth decay may also lead to it. Untreated, decay works its way into the tooth pulp and irritates the nerves. Treating the decay and filling the tooth may also cause sensitivity unless the dentist places a lining designed to minimize it temporarily while the area heals.
Alleviating pain from sensitivity begins with how you brush your teeth. Remember: the goal of brushing is to remove plaque, which does not require vigorous action. Brush gently with a soft-bristled brush and not too often. We might even recommend not brushing a very sensitive tooth for a few days to give the tooth a rest. You should also brush with a toothpaste containing fluoride, which will help strengthen the tooth surface against the effects of acids and sweets.
During an office visit, we can also apply a fluoride varnish or use certain filling materials that will serve as a barrier for the sensitive area. For cases where decay has irreversibly damaged the tooth pulp, a root canal may be the best treatment.
Tooth sensitivity isn't necessarily something you have to live with. There are treatments that can relieve or lessen the pain.
If you would like more information on tooth sensitivity and what can be done 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 “Sensitive Teeth.”
If you wince while eating certain foods and beverages, you're not alone — one in three Americans suffer from the pain of tooth sensitivity. Fortunately, there are ways to treat it and reduce the pain.
Dentinal hypersensitivity occurs when dentin loses its protective cover. Dentin, a living tissue within a tooth, is composed of tiny tubules that act as conduits for transmitting sensations from the surface of the tooth to the nerves in the inner pulp. These tubules are protected by cementum, a hard, outer layer that covers the tooth root. But when the root becomes exposed, the cementum is easily stripped from the root. The tubules become more sensitive to sensations of temperature or pressure.
Receding gums are the main culprit for root exposure. This condition can result from periodontal disease, which arises mainly from poor oral hygiene. At the other end of the spectrum, over-aggressive brushing can lead to receding gums. Brushing may also contribute to another source of dentinal hypersensitivity: enamel erosion. The minerals in enamel begin to soften and erode as the acidic level of the mouth rises. Saliva neutralizes the acid and can restore a neutral balance in about thirty minutes to an hour after eating. If you brush before this process completes, you could brush away some of the softened enamel.
To properly treat tooth sensitivity, our first step is to find the cause. If it stems from improper or premature brushing, we can counsel you on proper technique. If periodontal disease is a factor, we would first treat the disease and then work with you on a proper oral hygiene regimen to reduce bacterial plaque, the main cause of the infection.
There are treatments as well to reduce nerve sensitivity and thereby ease the pain. Toothpastes and other mouth products with fluoride help reduce sensitivity, as well as products containing potassium nitrate or potassium citrate. We can also apply a varnish containing a concentrated dose of fluoride directly to tooth surfaces. Another approach is to block the tubules using bonding agents or sealants; this will reduce their capacity to receive and transmit sensations.
If you would like more information on the causes and treatment of tooth sensitivity, 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 “Treatment of Tooth Sensitivity.”
Like a shadowy figure hovering at the edge of the movie frame, cancer may be scariest when you can't see it clearly. That's why, instead of looking away, many people have chosen to take a proactive attitude toward the disease. They're learning about the benefits of prevention, early detection and treatment — and so can you. How much do you know about oral cancer? Here are five fast facts.
Oral cancer isn't just an older person's disease.
In the past, people over 40 years of age were the main population group in which oral cancer was found. But in recent years, a growing number of young people have also been diagnosed with the disease. The sexually transmitted Human Papilloma Virus (HPV16) is thought to be responsible for the increase in oral cancer among younger people.
Oral cancer can de deadly.
While it accounts for just 2-3% of all cancers, its survival rate is far lower than lots of cancers you've heard more about. Why? Because its symptoms can be hard to tell from more benign mouth sores, and isn't caught in the early stage often enough. When discovered in its later stages, the 5-year survival rate for this disease is just 58%.
There are several risk factors for oral cancer.
Moderate to heavy drinkers and users of tobacco products — whether smoked or smokeless — are at far greater risk than non-users. Chronic exposure to the sun, besides leading to skin cancer, is also clearly associated with cancers of the lip. And, because of HPV, the same risk factors for other sexually transmitted diseases apply to oral cancer as well. Genetic predisposition also plays a role, as it does in many other diseases.
Lifestyle choices can decrease the odds of getting oral cancer.
Obviously, giving up tobacco, moderating alcohol consumption and avoiding risky sexual behavior will mitigate these risk factors. But you can also lessen your chances of getting the disease by eating a healthy diet. Studies have shown that a high intake of fruits and vegetables is protective against oral cancer — and other cancers as well.
Early detection boosts the survival rate for oral cancer above 80%.
Yet the earliest symptoms of oral cancer are hard for many people to distinguish from common maladies like cold sores. What's the best way to detect it? Do something you should be doing anyway — get regular dental checkups! We're trained to find the signs of a potential problem via a quick, painless screening that can be done at your routine checkup. We can also schedule biopsies or other diagnostic tests if they're needed.
If you have concerns about oral cancer, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Oral Cancer” and “Diet and Prevention of Oral Cancer.”