Posts for category: Oral Health
Your teeth can take decades of daily biting and chewing and not miss a beat. But they do have a nemesis, dental disease, which can easily get the upper hand. As a result, millions of people lose teeth each year to tooth decay and periodontal (gum) disease.
But while both the living tissue that makes up teeth and gums are susceptible to bacterial attack, the non-living materials in a life-like dental implant are impervious to disease. That being the case, you would think your implants wouldn't need as much hygiene as your other teeth.
But they still do. True, implants in themselves aren't affected by infection, but the bone and other tissues that support them can become diseased. This often happens with advanced cases of gum disease.
There is, in fact, a particular form of gum infection associated with implants called peri-implantitis ("peri"—around; "it is"—inflammation), which occurs in the gums around an implant. Once it starts, peri-implantitis can advance at a rapid pace.
This is because implants don't have the gum attachment of real teeth, which can fight and slow the advance of a gum infection. Because an implant doesn't have this attachment, any infection around it continues virtually unimpeded. If the bone supporting an implant becomes infected, it can weaken to the point that the implant fails.
But this dire scenario can be avoided with continuing hygiene and maintenance of the gum tissues surrounding the implant. You should brush and floss every day around implants to remove dental plaque, the bacterial film most responsible for dental disease, just as you do with natural teeth.
It's also important to keep up regular dental visits for cleanings to remove lingering plaque and tartar (hardened plaque). Your dentist may also notice and clean away any residual cement from the restoration, which can also cause gum inflammation.
And, you should promptly see your dentist if you notice any telltale signs of a gum infection, such as swelling, redness or bleeding, especially around implants. The quicker we diagnose and treat a case of gum disease, particularly peri-implantitis, the less likely it will endanger your implant.
In a little over a century, antibiotics have changed the face of healthcare. We no longer fear cholera, strep throat or even a small cut as our forebears did a hundred years ago. Antibiotics are also an essential weapon against infection in dental situations.
But evidence is mounting that we're overusing these miracle drugs. Besides continued growth in antibiotic prescriptions, sometimes to preempt a possible infection rather than treat an existing one, food producers are increasingly adding them to animal feed and other products as a preventive measure.
The problem with expanding our uses of antibiotics is the ability of targeted microorganisms to develop defenses against our most common drugs. Some may even mutate into a kind of "super bug" like Methicillin-resistant Staphylococcus aureus (MRSA), which no longer responds to a particular antibiotic.
As older antibiotics become less effective, we must develop newer drugs to overcome the strengthened defenses of targeted microorganisms. But this takes time—meanwhile, as antibiotic options dwindle, more than 2 million people each year encounter an antibiotic-resistant infection that results in around 20,000 deaths according to the Centers for Disease Control (CDC).
But there are hopeful signs that the world is now rising to meet the threat of antibiotic resistance. For example, support is growing within the U.S., Canada and the EU to ban the use of antibiotics in animal feed except for treating actual infections.
Many healthcare organizations are also exploring ways to reduce unnecessary antibiotic prescriptions. One way is to make better use of testing, especially to identify the precise bacteria causing an infection so that it can be targeted with a specific antibiotic that will best respond to it.
We're also seeing modifications in the use of antibiotics as a preventive measure. For example, people with certain conditions like congenital heart problems or joint prosthetics have routinely received antibiotics before dental procedures to preempt infection. In recent years that list of conditions has been trimmed substantially.
The move toward a more conservative use of antibiotics will have an impact on healthcare, including dentistry. But whatever the changes, dentists and other health professionals will continue to place their patient's health at the forefront.
If you would like more information on the use of antibiotics in dentistry, 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 “Antibiotics: Use and Abuse.”
There's still much about the underlying nature of chronic jaw joint dysfunction we have yet to unravel. Treating these conditions known as temporomandibular joint disorders (TMDs) may therefore require some experimentation to find what works for each individual patient.
Most TMD therapies are relatively conservative: eating softer foods, taking anti-inflammatory pain relievers or undergoing physical therapy. There have been some surgical techniques tried to relieve jaw pain and dysfunction, but these have so far had mixed results.
Recently, the use of the drug Botox has been promoted for relieving jaw pain, albeit temporarily. Botox contains tiny amounts of botulinum toxin type A, a poisonous substance derived from the bacterium Clostridium botulinum, which can cause muscle paralysis. It's mainly used to cosmetically smooth out small wrinkles around facial features.
Because of these properties, some physicians have proposed Botox for TMD treatment to paralyze the muscles around the jaw to reduce pain and discomfort. While the treatment sounds intriguing, there are a number of reasons to be wary of it if you have TMD.
To begin with, the claims for Botox's success in relieving jaw pain have been mainly anecdotal. On the other hand, findings from randomized, double-blind trials have yet to show any solid evidence that Botox can produce these pain-relieving effects.
But even if it lived up to the claims of TMD pain relief, the effect would eventually fade in a few weeks or months, requiring the patient to repeat the injections. It's possible with multiple Botox injections that the body will develop antibodies to fight the botulinum toxin, causing the treatment to be less effective with subsequent injections.
Of even greater concern are the potential side effects of Botox TMD treatment, ranging from headaches and soreness at the injection site to more serious muscle atrophy and possible facial deformity from repeated injections. There's also evidence for decreased bone density in the jaw, which could have far-reaching consequences for someone with TMD.
The best approach still seems to lie in the more conservative therapies that treat TMD similar to other joint disorders. Finding the right combination of therapies that most benefit you will help you better manage your symptoms.
If you would like more information on treatments for TMD, 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 “Botox Treatment for TMJ Pain.”
The big day finally arrives when your braces come off. And there it is—your new, beautiful, straight smile! But on closer inspection you notice something else: tiny white spots on your teeth.
Those pale, chalky spots are called white spot lesions (WSLs). They occur when acid has contacted the tooth enamel for too long, dissolving essential minerals like calcium in those particular areas. The occurrences of WSLs during and after braces highlights a major challenge during orthodontic treatment—keeping your teeth clean.
Braces' wires and brackets tend to get in the way of brushing and flossing, making it easier to miss plaque—the bacterial film that produces acid—on tooth areas around the hardware. Those missed areas could in time lead to WSLs.
The main objective with WSLs is prevent them from occurring during braces wear as much as possible. To do this, you'll need to increase your time and effort brushing and flossing, especially around orthodontic hardware. You can make it easier, though, by using a few tools that often work better than regular toothbrushes and floss like interproximal toothbrushes, power brushes, floss threaders or water flossers.
You can also help lower your mouth's acidity by avoiding or limiting acidic foods and beverages, including juices, sodas, sports and energy drinks. And, by all means, keep up your regular dental cleaning schedule with your general dentist.
Should WSLs develop while you're wearing braces, don't panic. It's possible they'll diminish on their own, or at least not worsen. We can also foster re-mineralization of the enamel with applied fluoride, short bursts of laser light or a procedure called microabrasion that restores damaged areas below the enamel surface.
For more resistant WSLs, we can also inject a liquid tooth-colored resin into them that when hardened by a curing light can make those areas look translucent like normal enamel. We can also use other cosmetic solutions like bonding or veneers to improve your teeth's appearance.
Like other dental problems, dealing with a WSL is usually more successful if caught and treated early. So, check your teeth often while wearing braces, and if you notice anything unusual don't hesitate to call your dentist.
If you would like more information on oral care while wearing braces, 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 “White Spots on Teeth During Orthodontic Treatment.”
Dinnertime is a great opportunity to enjoy not only your meal, but also the company of friends and family. But a temporomandibular joint disorder (TMD) can drain the pleasure from these dining experiences if the mere act of chewing is a painful ordeal.
Besides curbing pleasure while dining, eating difficulties caused by TMD can also affect your health: You may find yourself limiting your choices to only those that cause the least amount of discomfort. But those restricted choices may deprive you of a balanced diet essential to overall well-being.
But there are ways to reduce your discomfort and enjoy a greater abundance of healthy foods, as well as your dining experience. Here are 3 tips to make eating easier if you have TMD.
Prepare your food. Easing TMD discomfort starts while you're preparing your food to cook. First off, remove the tougher peel or skin from apples, potatoes or similar fruits and vegetables. And, be sure to chop foods into small enough pieces to reduce how much your jaws must open to comfortably chew your food.
Choose “wetter” cooking methods. One of the best ways to soften foods is to moisten them, either during the cooking process or by adding it in some form to the dish. Use braising techniques when you cook as much as possible. And try to incorporate sauces or gravies, especially with leaner meats, for added moisture.
Modify your eating habits. Food prep is only one aspect of a more comfortable dining experience with TMD—you can also benefit from modifying how you eat. Concentrate on taking smaller bites of food and slow down your chewing motion. You should also limit how much you open your jaw while chewing to keep it within your comfort range as much as possible.
With a little experimentation, you can find the right balance between a wide variety of foods and more comfortable eating. If you have TMD, using these tips could help mealtime become a delightful—and more nutritious—experience.
If you would like more information on managing TMD, 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 to Eat When TMJ Pain Flares Up.”