Posts for category: Oral Health
Over the last century dentistry has acquired the knowledge, techniques and treatments to prevent or minimize tooth decay. With this enhanced knowledge we’ve amassed a wealth of data about what increases dental disease development and what prevents it.
This has produced a balanced approach to identifying and treating disease-causing factors and incorporating factors that inhibit tooth decay. Known as Caries Management By Risk Assessment (CAMBRA), this approach first identifies each patient’s individual set of risk factors for dental disease and then develops a customized prevention and treatment plan to minimize their risk.
Rather than simply reacting to occurrences of tooth decay — “drill and fill” — CAMBRA anticipates and targets your susceptibility to decay. The primary factors can be represented by the acronym BAD: Bad bacteria, particular strains that produce acid, which at high levels erode enamel and expose the teeth to infection; Absence of saliva, or “dry mouth,” an insufficient flow of saliva that can’t effectively neutralize acid and restore mineral content to enamel; and Dietary habits too heavy in sugar or acid, which can result in bacterial growth and enamel erosion.
With an accurate picture of your particular risk level we can then apply countering factors from the other side of the balance — those that protect teeth from decay. In this case, we use the acronym SAFE: stimulating Saliva flow when needed or applying Sealants on chewing surfaces most susceptible to decay; Antimicrobials that reduce unhealthy bacteria levels and give healthy bacteria an opportunity to thrive; incorporating Fluoride, a chemical known to strengthen enamel, through hygiene products or direct application to the teeth; and an Effective diet, low in sugar and acid and high in fresh fruits, vegetables and whole grains.
There are a number of preventive and treatment measures that fall into each of the four preventive factors. Using the CAMBRA approach we can develop a treatment and prevention plan that incorporates measures that uniquely fit your dental health situation. With such a plan we can greatly reduce your risk of disease development and impact and better ensure a long and healthy life for your teeth and gums.
If you would like more information on managing dental disease prevention, 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 “Tooth Decay: How to Assess Your Risk.”
Ever since childhood, when her career as a model and actress took off, Brooke Shields has enjoyed worldwide recognition — through advertisements for designer jeans, appearances on The Muppet Show, and starring roles in big-screen films. But not long ago, that familiar face was spotted in an unusual place: wearing a nasal anesthesia mask at the dentist's office. In fact, Shields posted the photo to her own Instagram account, with the caption “More dental surgery! I grind my teeth!” And judging by the number of comments the post received, she's far from alone.
In fact, researchers estimate that around one in ten adults have dental issues that stem from teeth grinding, which is also called bruxism. (Many children also grind their teeth, but it rarely causes serious problems, and is often outgrown.) About half of the people who are teeth grinders report problems like persistent headaches, jaw tenderness and sore teeth. Bruxism may also result in excessive tooth wear, and may damage dental work like crowns and bridges; in severe cases, loosened or fractured teeth have been reported.
Researchers have been studying teeth grinding for many years; their findings seem to indicate that it has no single cause. However, there are a number of factors that play a significant role in this condition. One is the anatomy of the jaw itself, and the effect of worn or misaligned teeth on the bite. Another factor relates to changes in brain activity that occur during the sleep cycle. In fact, nocturnal (nighttime) bruxism is now classified as a sleep-related movement disorder. Still other factors, such as the use of tobacco, alcohol and drugs, and a high level of stress or anxiety, can make an individual more likely to experience bruxism.
What can be done for people whose teeth grinding is causing problems? Since this condition may have many causes, a number of different treatments are available. Successful management of bruxism often begins by striving to eliminate the factors that may cause problems — for example, making lifestyle changes to improve your health, creating a soothing nighttime environment, and trying stress-reduction techniques; these may include anything from warm baths and soft music at bedtime, to meditation and mindfulness exercises.
Several dental treatments are also available, including a custom-made occlusal guard (night guard) that can keep your teeth from being damaged by grinding. In some cases, a bite adjustment may also be recommended: In this procedure, a small amount of enamel is removed from a tooth to change the way it contacts the opposite tooth, thereby lessening the biting force on it. More invasive techniques (such as surgery) are rarely needed.
A little tooth grinding once in a while can be a normal response to stress; in fact, becoming aware of the condition is often the first step to controlling it. But if you begin to notice issues that could stem from bruxism — or if the loud grinding sounds cause problems for your sleeping partner — it may be time to contact us or schedule an appointment. You can read more about bruxism in the Dear Doctor magazine article “Stress and Tooth Habits.”
If you have periodontal (gum) disease, it's important for you to know its effects aren't limited to your mouth. A number of studies demonstrate gum disease can affect the rest of your body — and what may be going on elsewhere could likewise stimulate gum disease.
Here are 3 diseases or conditions that seem to share a link with gum disease.
Diabetes. This chronic disease results from the body's inability to interact properly with insulin, the hormone necessary for turning glucose (sugar) into energy, or producing enough of it. There's clear evidence that having diabetes increases your risk of gum disease and vice-versa. If you have diabetes, it's important that you keep it under control for your gum's sake as much as for your overall health.
Cardiovascular disease. Like diabetes, this group of heart and blood vessel diseases has a related characteristic with gum disease: inflammation. This natural function of the immune system limits tissue damage caused by disease or injury. But in both CVD and gum disease, inflammation can become chronic and itself cause damage. Further, some types of bacteria associated with gum disease can contribute to a higher risk of CVD. Minimizing gum disease occurrence with good oral hygiene could positively impact your risk of CVD.
Pregnancy. While certainly not a disease, pregnancy does trigger hormonal changes in the mother that in turn could elevate her risk of gum disease, particularly pregnancy gingivitis. Not only does this pose problems for the mother's teeth and gums, some studies connect gum disease to the increased possibility of early, pre-term birth. A sharper focus on dental care during pregnancy not only benefits the mother but may also be important for the health of the baby.
These aren't the only conditions that can be affected by gum disease: others like osteoporosis, respiratory disease or rheumatoid arthritis also share links with the disease. If you have any systemic condition like these, it pays to be extra vigilant in preventing and treating gum disease.
If you would like more information on periodontal (gum) disease, 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 “Good Oral Health Leads to Better Health Overall.”
When is the best time to floss your teeth: Morning? Bedtime? How about: whenever and wherever the moment feels right?
For Cam Newton, award-winning NFL quarterback for the Carolina Panthers, the answer is clearly the latter. During the third quarter of the 2016 season-opener between his team and the Denver Broncos, TV cameras focused on Newton as he sat on the bench. The 2015 MVP was clearly seen stretching a string of dental floss between his index fingers and taking care of some dental hygiene business… and thereby creating a minor storm on the internet.
Inappropriate? We don't think so. As dentists, we're always happy when someone comes along to remind people how important it is to floss. And when that person has a million-dollar smile like Cam Newton's — so much the better.
Of course, there has been a lot of discussion lately about flossing. News outlets have gleefully reported that there's a lack of hard evidence at present to show that flossing is effective. But we would like to point out that, as the saying goes, “Absence of evidence is not evidence of absence.” There are a number of reasons why health care organizations like the American Dental Association (ADA) still firmly recommend daily flossing. Here are a few:
- It's well established that when plaque is allowed to build up on teeth, tooth decay and gum disease are bound to follow.
- A tooth brush does a good job of cleaning most tooth surfaces, but it can't reach into spaces between teeth.
- Cleaning between teeth (interdental cleaning) has been shown to remove plaque and food debris from these hard-to-reach spaces.
- Dental floss isn't the only method for interdental cleaning… but it is recognized by dentists as the best way, and is an excellent method for doing this at home — or anywhere else!
Whether you use dental floss or another type of interdental cleaner is up to you. But the ADA stands by its recommendations for maintaining good oral health: Brush twice a day for two minutes with fluoride toothpaste; visit your dentist regularly for professional cleanings and checkups; and clean between teeth once a day with an interdental cleaner like floss. It doesn't matter if you do it in your own home, or on the sidelines of an NFL game… as long as you do it!
If you have periodontal (gum) disease, you probably already know you’re in danger of eventual tooth and bone loss if the infection isn’t brought under control. But if you also have diabetes, the effects from gum disease could extend well beyond your mouth.
Gum disease is a bacterial infection caused by plaque, a film of food remnant that builds up on tooth surfaces mainly due to poor oral hygiene. As the infection grows, your body’s immune system responds by flooding your gum tissues with antibodies to fight it, resulting in inflammation. As the inflammation persists, though, it damages the gum and underlying bone tissue, which in turn leads to gum and bone loss from the teeth.
Diabetes also causes an inflammatory response within the body. The disease develops either as a result of the body’s decreased ability to produce insulin to balance the glucose (sugar) levels in the bloodstream (Type 1) or the body develops a resistance to insulin’s effects (Type 2). As a result diabetics experience abnormally high blood glucose levels, a condition called hyperglycemia. This triggers chronic inflammation that can lead to inhibited wound healing, increased risk of heart, kidney or eye disease, coma or death.
Gum disease can worsen diabetic inflammation, and vice versa. The effects of the oral infection add to the body’s already overloaded response to diabetes. In turn, the immune system is already compromised due to diabetes, which can then increase the severity of the gum disease.
Research and experience, though, have found that pursuing treatment and disease management for either condition has a positive effect on managing the other. Treating gum disease through plaque removal, antibiotic therapy, surgery (if needed) and renewed oral hygiene will diminish the oral infection and reduce the body’s immune response. Caring for diabetes through medication, diet, exercise and lifestyle changes like quitting smoking will in turn contribute to a quicker healing process for infected gum tissues.
Treating gum disease when you have diabetes calls for a coordinated approach on both fronts. By caring for both conditions you’ll have a more positive effect on your overall health.