Posts for category: Oral Health
Your risk for periodontal (gum) disease increases if you’re not brushing or flossing effectively. You can also have a higher risk if you’ve inherited thinner gum tissues from your parents. But there’s one other risk factor for gum disease that’s just as significant: if you have a smoking habit.
According to research from the U.S. Centers for Disease Control (CDC), a little more than sixty percent of smokers develop gum disease in their lifetime at double the risk of non-smokers. And it’s not just cigarettes—any form of tobacco use (including smokeless) or even e-cigarettes increases the risk for gum disease.
Smoking alters the oral environment to make it friendlier for disease-causing bacteria. Some chemicals released in tobacco can damage gum tissues, which can cause them to gradually detach from the teeth. This can lead to tooth loss, which smokers are three times more likely to experience than non-smokers.
Smoking may also hide the early signs of gum disease like red, swollen or bleeding gums. But because the nicotine in tobacco restricts the blood supply to gum tissue, the gums of a smoker with gum disease may look healthy. But it’s a camouflage, which could delay prompt treatment that could prevent further damage.
Finally because tobacco can inhibit the body’s production of antibodies to fight infection, smoking may slow the healing process after gum disease treatment. This also means tobacco users have a higher risk of a repeat infection, something known as refractory periodontitis. This can create a cycle of treatment and re-infection that can significantly increase dental care costs.
It doesn’t have to be this way. You can substantially lower your risk of gum disease and its complications by quitting any kind of tobacco habit. As it leaves your system, your body will respond much quicker to heal itself. And quitting will definitely increase your chances of preventing gum disease in the first place.
Quitting, though, can be difficult, so it’s best not to go it alone. Talk with your doctor about ways to kick the habit; you may also benefit from the encouragement of family and friends, as well as support groups of others trying to quit too. To learn more about quitting tobacco visit www.smokefree.gov or call 1-800-QUIT-NOW.
If you would like more information on how smoking can affect your 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 “Smoking and Gum Disease.”
Around 20 million people—mostly women after menopause—take medication to slow the progress of osteoporosis, a debilitating disease that weakens bones. But although effective, some osteoporosis drugs could pose dental issues related to the jawbones.
Osteoporosis causes the natural spaces that lie between the mineral content of bone to grow larger over time. This makes the bone weaker and unable to withstand forces it once could, which significantly increases the risk of fracture. A number of drugs have been developed over time that stop or slow this disease process.
Two of the most prominent osteoporosis drugs are alendronate, known also by its trade name Fosamax, and denosumab or Prolia. While originating from different drug families, alendronate and denosumab work in a similar way by destroying specialized bone cells called osteoclasts that break down worn out bone and help dissolve it. By reducing the number of these cells, more of the older bone that would have been phased out lasts longer.
In actuality this only offers a short-term benefit in controlling osteoporosis. The older bone isn’t renewed but only preserved, and will eventually become fragile and more prone to fracture. After several years the tide turns negatively for the bone’s overall health. It’s also possible, although rare, that the bone simply dies in a condition called osteonecrosis.
The jawbones are especially susceptible to osteonecrosis. Forces generated by chewing normally help stimulate jawbone growth, but the medications in question can inhibit that stimulus. As a result the jawbone can diminish and weaken, making eventual tooth loss a real possibility.
Osteonecrosis is most often triggered by trauma or invasive dental procedures like tooth extractions or oral surgery. For this reason if you’re taking either alendronate and denosumab and are about to undergo a dental procedure other than routine cleaning, filling or crown-work, you should speak to your physician about suspending your medication temporarily. Dentists often recommend a suspension of three to nine months before the procedure and three months afterward.
Some research indicates this won’t worsen your osteoporosis symptoms, especially if you substitute another treatment or fortify your skeletal system with calcium and vitamin D supplements. But taking this temporary measure could help protect your teeth in the long run.
If you would like more information on the effect of osteoporosis treatment on dental 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 “Osteoporosis Drugs & Dental Treatment.”
Chronic pain can turn your life upside down. While there are a number of disorders that fit in this category, two of them—fibromyalgia and temporomandibular disorders (TMD)—can disrupt your quality of life to the extreme. And it may be the two conditions have more in common than similar symptoms—according to one study, three-fourths of patients diagnosed with fibromyalgia show symptoms of TMD.
To understand why this is, let’s take a closer look at these two conditions.
Fibromyalgia presents as widespread pain, aching or stiffness in the muscles and joints. Patients may also have general fatigue, sleep problems, mood swings or memory failures. TMD is a group of conditions that often result in pain and impairment of the temporomandibular joints that join the jaw with the skull. TMD can make normal activities like chewing, speaking or even yawning painful and difficult to do.
Researchers are now focusing on what may, if anything, connect these two conditions. Fibromyalgia is now believed to be an impairment of the central nervous system within the brain rather than a problem with individual nerves. One theory holds that the body has imbalances in its neurotransmitters, which interfere with the brain’s pain processing.
Researchers have also found fibromyalgia patients with TMD have an increased sensitivity overall than those without the conditions. In the end, it may be influenced by genetics as more women than men are prone to have either of the conditions.
Treating these conditions is a matter of management. Although invasive techniques like jaw surgery for TMD are possible, the results (which are permanent) have been inconclusive in their effectiveness for relieving pain. We usually recommend patients try more conservative means first to lessen pain and difficulties, including soft foods, physical therapy, stretching exercises and muscle relaxant medication. Since stress is a major factor in both conditions, learning and practicing relaxation techniques may also be beneficial.
In similar ways, these techniques plus medication or cognitive-behavioral therapy that may influence neurotransmission can also help relieve symptoms of fibromyalgia. Be sure then that you consult with both your physician and dentist caring for both these diseases for the right approach for you to help relieve the effects of these two debilitating conditions.
If you would like more information on managing TMD or fibromyalgia, 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 “Fibromyalgia and Temporomandibular Disorders.”
During pregnancy, your body isn’t the only part of your life that changes. Instead of “me,” you’re now thinking about “us”—you and the new person growing inside you. Because of this change in focus you may be re-examining your current habits to see if any could adversely affect your baby.
If you’re concerned your regular dental visits might be one of these, don’t be. Both the American Congress of Obstetricians and Gynecologists (ACOG) and the American Dental Association (ADA) recommend continuing regular dental exams and cleanings even during pregnancy.
In fact, professional dental care is often more important during pregnancy. Because of hormonal changes, you may develop food cravings for more carbohydrates like sugar. Unfortunately, eating more sugar could increase your risk for dental diseases like tooth decay and periodontal (gum) disease.
These same hormonal changes can also make you more prone to gum disease. There’s even a specific form of it known as pregnancy gingivitis that often occurs in expectant mothers. You may also experience “pregnancy tumors,” large, reddened areas of swelling on the gums.
To decrease your risk of pregnancy-related dental disease, you should certainly keep up your regular dental visits—and more if you begin to notice signs like swollen or bleeding gums. And although it’s usually best to postpone elective procedures like cosmetic dental work, you should be able to safely undergo any essential treatment for disease even if it requires local anesthesia. But do discuss any proposed dental work with both your dentist and obstetrician to be sure.
There are also things you can do for yourself during pregnancy that support your dental health. Be sure you’re practicing good oral hygiene habits like daily brushing and flossing. And by all means eat a well-balanced diet and restrict your sugar intake if at all possible. Taking care of these things will help you avoid dental problems and help make this memorable time in your life as joyous as possible.
If you would like more information on caring for your teeth during pregnancy, 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 Care During Pregnancy.”
The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.
In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?
The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.
Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.
So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”
Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.
If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”