Posts for tag: oral health
The change from primary teeth to permanent is an announcement to the world that a boy or girl is "growing up." "Growing up," though, is still not "grown"—the new teeth are still in a period of development that can affect how we treat them if they're injured or diseased.
While a new tooth erupts with all its anatomical layers, the middle dentin is somewhat thinner than it will be after it matures. The pulp, the tooth's innermost layer, produces new dentin and gradually increases the dentin layer during this early development period. While the pulp continues to produce dentin over a tooth's lifetime, most of it occurs in these early years.
To prevent or stop any infection, we would normally perform a root canal treatment in which we remove the pulp tissue and fill the empty pulp chamber and root canals. This poses no real issue in an older tooth with mature dentin. Removing the pulp from an immature tooth, though, could interrupt dentin development and interfere with the tooth's root growth. Besides a higher risk of discoloration, the tooth could become more brittle and prone to fracture.
That's why we place a high priority on preserving a younger tooth's pulp. Rather than a root canal treatment, we may treat it instead with one of a number of modified techniques that interact less with the pulp. Which of these we use will depend on the extent of the pulp's involvement with the injury or disease.
If it's unexposed, we may use a procedure called indirect pulp therapy, where we remove most of the tooth's damaged dentin but leave some of the harder portion intact next to the pulp to avoid exposure. If, though, some but not all of the pulp is damaged, we may perform a pulpotomy: here we remove the damaged pulp tissue while leaving the healthier portion intact. We may then apply a stimulant substance to encourage more dentin production to seal the exposure.
These and other techniques can help repair an injured young tooth while preserving most or all of its vital pulp. Although we can't always use them, when we can they could give the tooth its best chance for a full life.
If you would like more information on caring for your child's teeth, 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 “Saving New Permanent Teeth after Injury.”
Dairy foods have played a role in human diets for thousands of years. More than one kid—whether millennia ago on the Mesopotamian plains or today in an American suburb—has been told to drink their milk to grow strong. This is because milk and other dairy products contain vitamins and minerals that are essential for a healthy body, including healthy teeth and gums. In honor of National Dairy Month in June, here are four ways dairy boosts your oral health:
Dental-friendly vitamins, minerals and proteins. Dairy products are an excellent source of many vitamins and minerals that are important for good dental health. They are packed with calcium and phosphorus, two minerals that work together to strengthen tooth enamel. In addition to the vitamins they contain naturally, milk and yogurt are fortified with vitamin D, which aids in calcium and phosphorus absorption; cheese contains a small amount of vitamin D naturally. What's more, dairy proteins have been shown to prevent or reduce the erosion of tooth enamel and strengthen the connective tissues that hold teeth in place.
Lactose: a more tooth-friendly sugar. Sugars like sucrose or high fructose corn syrup, which are routinely added to processed foods, are a primary trigger for tooth decay. This is because certain oral bacteria consume sugar, producing acid as a by-product. The acid weakens tooth enamel, eventually resulting in cavities. Dairy products—at least those without added sugar—are naturally low in sugar, and the sugar they contain, lactose, results in less acid production than other common sugars.
The decay-busting power of cheese. We know that high acidity in the mouth is a major factor in decay development. But cheese is low in acidity, and a quick bite of it right after eating a sugary snack could help raise the mouth's pH out of the danger zone. Cheeses are also rich in calcium, which could help preserve that important mineral's balance in tooth enamel.
Dairy for gum health. A study published in the Journal of Periodontology found that people who regularly consumed dairy products had a lower incidence of gum disease than those who did not. And since gum health is related to the overall health, it's important to do all we can to prevent and manage gum disease.
For those who cannot or choose not to consume dairy products, there are other foods that supply calcium naturally, such as beans, nuts and leafy greens—and many other foods are fortified with calcium, vitamin D and other nutrients. It may be wise to take a multivitamin or calcium with vitamin D as a supplement as well.
If you would like more information about nutrition and oral health, please contact us or schedule an appointment for a consultation. To learn more, read the Dear Doctor magazine articles “Nutrition & Oral Health” and “How to Help Your Child Develop the Best Habits for Oral Health.”
Drugs play an indispensable role in treating disease. For example, life without antibiotics would be much more precarious—common infections we think nothing of now would suddenly become life-threatening.
But even the most beneficial drug can have disruptive side effects. Antibiotics in particular can cause a rare but still disturbing one: a growth on the tongue that at first glance looks like dark hair. In fact, it's often called "black hairy tongue."
It isn't hair—it's an overgrowth of naturally occurring structures on the tongue called filiform papillae. These tiny bumps on the tongue's upper surface help grip food while you're chewing. They're normally about a millimeter in length and tend to be scraped down in the normal course of eating. As they're constantly growing, they replenish quickly.
We're not sure how it occurs, but it seems with a small portion of the population the normal growth patterns of the papillae become unbalanced after taking antibiotics, particularly those in the tetracycline family. Smoking and poor oral hygiene also seem to contribute to this growth imbalance. As a result, the papillae can grow as long as 18 millimeters with thin shafts resembling hair. It's also common for food debris and bacteria to adhere to this mass and discolor it in shades of yellow, green, brown or black.
While it's appearance can be bizarre or even frightening, it's not health-threatening. It's mostly remedied by removing the original cause, such as changing to a different antibiotic or quitting smoking, and gently cleaning the tongue everyday by brushing it or using a tongue scraper you can obtain from a pharmacy.
One word of caution: don't stop any medication you suspect of a side effect without first discussing it with your prescribing doctor. While effects like black hairy tongue are unpleasant, they're not harmful—and you don't want to interfere with treatments for problems that truly are.
More than 20 million people in the United States use electronic cigarettes or e-cigs as an alternative to tobacco smoking. While many users believe "vaping" is a healthier alternative to regular cigarettes, recent research into the health effects of e-cigs could put a damper on that belief. There's particular concern among dentists that this popular habit could harm users' dental health.
E-cigs are made with a chamber that holds the liquid vaping solution and a heating mechanism to heat the liquid and vaporize it. Users inhale the vapor, which contains nicotine and flavorings, as they would a traditional cigarette.
The nicotine alone can be problematic for dental health as we'll see in a moment. But the vapor also contains aerosols that some research indicates could damage the inner skin linings of the mouth in a similar fashion to the smoke of traditional cigarettes. One study by researchers with the Université Laval in Quebec, Canada found evidence that e-cig vapor increased the death rate of mouth cells, and led to greater cell irregularities over time.
According to other studies, there's evidence that e-cig vapor may disrupt the balance of the oral microbiome, the communities of both beneficial and harmful bacteria that normally live in the mouth. The imbalance in favor of more harmful bacteria could increase the risk for dental disease, particularly periodontal (gum) disease.
Finally, nicotine from e-cigs seemed to create similar conditions in the mouth as it does with tobacco. Nicotine in any form can constrict blood vessels and reduce the body's ability to fight infection and to heal. Research indicates both forms of nicotine increase the risk for dental disease and make treatment more difficult.
These findings only identify conditions created by e-cigs that could be problematic for future dental health. Although we don't fully understand the long-term health effects of this new habit, based on the evidence so far the mouth may not fare so well. It's looking like e-cigs may be no safer for your teeth and gums than the cigarettes they replace.
In the last half century, fluoride has become an effective weapon against tooth decay. The naturally occurring mineral helps strengthen enamel, the teeth's hard, protective cover.
Although it's safe for consumption overall, too much during early tooth development can lead to fluorosis, a brownish, mottled staining in enamel. To avoid it, a child's daily consumption of fluoride should optimally be kept at around 0.05-0.07 milligrams per kilogram of body weight, or an amount equal to one-tenth of a grain of salt per two pounds of weight.
The two main therapeutic fluoride sources have limits to help maintain this balance: utilities that fluoridate drinking water are required to add no more than 4 parts fluoride per million (ppm) of water; toothpaste manufacturers likewise only add a small amount of fluoride compared to clinical gels and pastes dentists apply to teeth for added decay protection.
But drinking water and toothpaste aren't the only sources of fluoride your child may encounter. Even if you have a non-fluoridated water supply, you should still keep a close watch on the following items that could contain fluoride, and discuss with us if you should take any action in regard to them.
Infant formula. The powdered form especially if mixed with fluoridated water can result in fluoride concentrations 100 to 200 times higher than breast or cow's milk. If there's a concern, use fluoride-free distilled or bottled spring water to mix formula.
Beverages. Many manufacturers use fluoridated water preparing a number of packaged beverages including sodas (two-thirds of those manufactured exceed .6 ppm), soft drinks and reconstituted fruit juices. You may need to limit your family's consumption of these kinds of beverages.
Certain foods. Processed foods like cereals, soups or containing fish or mechanically separated chicken can have high fluoride concentrations, especially if fluoridated water was used in their processing. When combined with other fluoride sources, their consumption could put children at higher risk for fluorosis.
Toothpaste. Although mentioned previously as a moderate fluoride source, you should still pay attention to how much your child uses. It doesn't take much: in fact, a full brush of toothpaste is too much, even for an adult. For an infant, you only need a smear on the end of the brush; as they grow older you can increase it but to no more than a pea-sized amount.
If you would like more information on fluoride and how it strengthens teeth, 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 “Fluoride & Fluoridation in Dentistry.”