Posts for category: Oral Health
We've all had them — tiny sores that pop up seemingly out of nowhere under the tongue or the inside of the cheek. They're named aphthous ulcers, but are more commonly known as canker sores. For some people, they can be a recurring irritation.
Round with a yellow-gray center surrounded by reddened skin, aphthous ulcers seem to coincide with periods of anxiety or stress, or as a result of some minor trauma. Many people will feel a tingling or painful sensation a few hours or days before the ulcers appear. Once they appear they usually persist for a week to ten days before finally drying and healing. In the meantime they can be painful, especially while eating or drinking.
One form known as recurrent aphthous stomatitis (RAS) affects about a quarter of the population with outbreaks of multiple ulcers that occur regularly. RAS ulcers are usually one centimeter or more in size — the larger the sore the more painful they tend to be.
There are ways to ease the discomfort of an ulcer outbreak and help hasten their healing. A number of over-the-counter products can be used in minor cases to numb the area temporarily and cover it to facilitate healing. We can also apply steroids or inject other medications for more severe cases. You may also find curbing your eating of certain foods like tomato sauce, citrus or spicy dishes can help.
For the most part aphthous ulcers aren't dangerous. In some situations, though, you should seek dental or medical evaluation: a sore that doesn't heal within two weeks; increases in severity, frequency or duration of ulcers; or when you don't seem to ever be without an ulcer in your mouth. We may need to perform tests, including tissue biopsy, to make sure there aren't any underlying systemic conditions causing the ulcers.
More than likely, though, you'll only need relief from the aggravation caused by aphthous ulcers. Among the many remedies, there's one right for you.
If you would like more information on aphthous ulcers or other mouth sores, 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 “Mouth Sores.”
Losing teeth to tooth decay or periodontal (gum) disease is never easy. But with implant-supported bridgework, you can regain lost function and appearance with a restoration that could last for many years.
Don’t think, though, that dental disease woes are a thing of the past with your new implants. Although your restoration itself can’t be infected, the supporting gums and underlying bone can, often through bacterial plaque accumulating around the implants. The bone that supports the implants could deteriorate, dramatically increasing your chances of losing your restoration.
It’s essential, then, that you keep the area between the bridge and gums clean of plaque through daily hygiene. This definitely includes flossing around the implants.
Flossing with an implant-supported bridge will be different than with natural teeth: instead of flossing between teeth you’ll need to thread the floss between the bridge and gums. Although this is a bit more difficult, it can be done with the help of a floss threader, a device with a loop on one end and a long, thin plastic point on the other—similar to a sewing needle.
To use it, thread about 18” of floss through the loop and then pass the threader’s thin end first through the space between the bridge and gums toward the tongue until the floss threader pulls through. You can then take hold of one end of the floss and then pull the threader completely out from beneath the bridge. Then, you wrap the ends around your fingers as you would normally and thoroughly floss the implant surfaces you’re accessing. You then release one end of the floss, pull out the remainder, rethread it in the threader and repeat the process in the next space between implants.
You also have other hygiene tool options: prefabricated floss with stiffened ends that thread through the bridge-gum space that you can use very easily; or you can purchase an interproximal brush that resembles a pipe cleaner with thin plastic bristles to access the space and brush around the implants.
Some patients also find an oral irrigator, a handheld device that sprays a pressurized stream of water to loosen and flush away plaque, to be an effective way of keeping this important area clean. But that said, oral irrigators generally aren’t as effective removing dental plaque as are floss or interproximal brushes.
Whatever flossing method you choose, the important thing is to choose one and practice it every day. By keeping bacterial plaque from building up around your implants, you’ll help ensure you won’t lose your restoration to disease, so it can continue to serve you for many years to come.
We often don't realize how important something is until it's gone. Like saliva: you're usually not aware that it's cleaning the mouth, neutralizing mouth acid or helping with digestion. But that could change if your saliva flow drops below normal: your health may soon suffer with your mouth taking the brunt.
In particular, reduced saliva flow increases your risk for tooth decay and periodontal (gum) disease. Both diseases are linked to oral bacteria. While many of the myriad strains in the mouth are beneficial, a few bacteria can infect and inflame gum tissues. Bacteria also produce acid, which can soften and erode enamel and make the teeth more susceptible to decay.
Saliva inhibits bacteria in a number of ways. It first clears the mouth of leftover food so not as much stays behind to form bacterial plaque, a thin film of food particles that builds up on teeth. You still need to brush and floss daily to remove plaque, but it's less effective without saliva's cleansing action. Saliva also contains antibodies that destroy disease-causing bacteria and other organisms, which keeps their populations in the mouth low.
One of saliva's most important functions, though, is buffering acid. The mouth's ideal pH level is neutral, but many foods we eat can cause it to become more acidic.Â Even a slight acidic rise after eating can soften the minerals in enamel. But saliva goes to work immediately and usually restores normal pH within a half hour to an hour. It also aids in re-mineralizing the enamel.
For these reasons, it's important for you to find out the cause of chronic dry mouth and treat it. If it's a side effect of your medication, talk to your doctor about an alternative, or drink more water before and after you take your dose. Certain products can also stimulate saliva flow, like chewing gum with xylitol, an alcohol-based sweetener that has dental health-protecting properties too.
Although you often don't notice this unsung bodily fluid swishing in your mouth, it's important that you take care of it. Keeping your saliva flowing will help ensure better oral health.
If you would like more information on the importance of saliva to 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 “Saliva: How it is used to Diagnose Disease.”
Implant-supported fixed bridges are growing in popularity because they offer superior support to traditional bridges or dentures. They can also improve bone health thanks to the affinity between bone cells and the implants' titanium posts.
Even so, you'll still need to stay alert to the threat of periodontal (gum) disease. This bacterial infection usually triggered by dental plaque could ultimately infect the underlying bone and cause it to deteriorate. As a result the implants could loosen and cause you to lose your bridgework.
To avoid this you'll need to be as diligent with removing plaque from around your implants as you would with natural teeth. The best means for doing this is to floss around each implant post between the bridgework and the natural gums.
This type of flossing is quite different than with natural teeth where you work the floss in between each tooth. With your bridgework you'll need to thread the floss between it and the gums with the help of a floss threader, a small handheld device with a loop on one end and a stiff flat edge on the other.
To use it you'll first pull off about 18" of dental floss and thread it through the loop. You'll then gently work the sharper end between the gums and bridge from the cheek side toward the tongue. Once through to the tongue side, you'll hold one end of the floss and pull the floss threader away with the other until the floss is now underneath the bridge.
You'll then loop each end of the floss around your fingers on each hand and work the floss up and down the sides of the nearest tooth or implant. You'll then release one hand from the floss and pull the floss out from beneath the bridge. Rethread it in the threader and move to the next section of the bridge and clean those implants.
You can also use other methods like specialized floss with stiffened ends for threading, an oral irrigator (or "water flosser") that emits a pressurized spray of water to loosen plaque, or an interproximal brush that can reach into narrow spaces. If you choose an interproximal brush, however, be sure it's not made with metal wire, which can scratch the implant and create microscopic crevices for plaque.
Use the method you and your dentist think best to keep your implants plaque-free. Doing so will help reduce your risk of a gum infection that could endanger your implant-supported bridgework.
If you would like more information on implant-supported bridges, 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 “Oral Hygiene for Fixed Bridgework.”
There’s been a growing awareness about the effects of gluten, a protein found in grains like wheat, rye and sometimes oats, on certain people. An estimated 1 in 133 Americans have Celiac Disease (CD), a gluten-related disorder that causes the body’s immune system to work against itself. And if you have CD, you could eventually face dental problems like enamel pitting and erosion.
When a person with CD consumes gluten, their immune system mistakenly identifies the protein as malicious and attacks it. The attack occurs in the membranes that line the digestive system, which in the process destroys cilia, tiny hair-like structures that aid in food absorption. This disrupts the body’s normal absorption of nutrients, which can lead to a number of systemic conditions including intestinal cancer.
Because of the lack of nutrients, your teeth’s enamel may develop defects. You may begin to see dull spots or pitting, or chalky grooves in its normally shiny surface: this is a sign you’ve lost surface enamel crystals (decalcification). You may also be more susceptible to outbreaks of aphthous ulcers (canker sores).
Because symptoms can be misdiagnosed or go unnoticed, it may be years before you know you have CD. You can, however, get a definitive diagnosis through a blood test for gluten antibodies, which is then confirmed with a biopsy of a tissue specimen from the intestine.
While there’s ongoing research for CD-related medication, there’s currently only one recognized treatment for it — remove gluten from your diet. This is much harder than it sounds, and requires knowing what you can and can’t eat, along with strict monitoring of food package labeling. Thankfully, the world is becoming better educated in this respect as more food manufacturers are clearly labeling products containing gluten and restaurants are providing gluten-free menu options.
Once you have dietary controls in place, your dental issues can be treated as any other person, with one exception: none of the products used in treatment like polishing paste or fluoride gels should contain gluten, and must be verified before using.
CD is a serious condition that could even become life-threatening. Knowing you or someone in your family has it will help you protect both your overall health and your teeth.
If you would like more information on the gluten’s effect 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 “Gluten & Dental Problems.”