Posts for category: Oral Health
By the time you reach adulthood, roughly 100 trillion microscopic organisms will have taken up residence in and on your body, outnumbering your own cells 10 to 1. Most are bacteria, a domain of the animal kingdom considered synonymous with disease. But only a few of the thousands of bacterial species cause us harm; the rest are either benign or actually beneficial to our health, including in our mouths.
Dentistry pioneered much of our knowledge about bacteria, developing processes used to identify, classify and understand those species inhabiting our mouths. Science as a whole is catching up with the Human Microbiome Project (HMP) begun in 2007. Through HMP, researchers have catalogued and begun to study more than 10,000 bacterial species.
We’re finding that our bodies develop a symbiotic relationship with many of these creatures invisible to the naked eye. During our infancy the bacteria we ingest from birth and breast feeding begin to interact with our body’s immune system, “teaching” it to refrain from attacking friendly organisms that contribute to health and searching and destroying enemy species that cause disease.
We’re also learning that an imbalance with our individual population of bacteria has links with disease. Our digestive system is a prime example: bacteria related to obesity can overpopulate our digestive tract, while malnutrition can create an environment that produces too many bacteria that inhibit digestion of vitamins and other nutrients.
The same microbial imbalance can occur in the mouth. For example, our typical Western diet encourages the growth of bacteria most associated with tooth decay (Streptococcus mutans). We’re also finding that tobacco smoking creates a mouth environment more conducive to the bacteria that cause gum disease. Just by quitting smoking you can alter that environment to encourage growth of health-promoting bacteria and inhibit growth of malevolent species.
The desired outcome of this knowledge is to develop treatments that target disease-causing bacteria without harming those beneficial to us (as often occurs with traditional antibiotics). In dentistry, such possibilities could help stop the spread of tooth decay, gum disease or similar bacterial infections, while fostering a healthier oral environment that prevents disease and protects health.
Does the word “vitamin” make you think of a capsule that comes from a bottle… one that you’re supposed to take every day to improve your health? If so, it shows the effectiveness of the marketing strategy used by the vitamin and dietary supplement industry — a business that’s valued at $25 billion annually. The other definition, of course, is a substance that your body requires (in small amounts) to control normal metabolic functions and sustain life. It’s often assumed that taking vitamins in pill form can help you be healthier. But is that assertion really backed up by evidence?
It’s true that if your body is severely lacking in any of the 13 vitamins, you could be at risk for developing a disease related to vitamin deficiency: scurvy or pellagra, for example. Moreover, several vitamins (notably vitamins C and E, and beta carotene, a precursor to vitamin A) are also antioxidants; these are molecules that can protect our cells (and our genetic material) from damage caused by toxins in the environment and metabolic processes within our bodies.
Fruits and vegetables are rich in vitamins A and C, and vitamin E is found in vegetable oils. That’s one of the reasons why nutritionists and health-care providers stress the importance of a well-balanced diet, including plenty of plant-based foods. Many studies have shown that people who eat lots of vegetables and fruits have lower incidences of heart disease, cancer, and other chronic health problems.
You can also buy substances marketed as antioxidants and nutritional supplements in pill form. But contrary to what you might expect, in that form they don’t seem to have the same protective effect on the body. Scientists still aren’t sure why this is so, but it may have to do with the presence of many other biologically active compounds in vegetables and fruits. In fact, there is solid evidence that taking too many vitamins or supplements can be dangerous to your health.
We’re certainly not saying it’s of no use to take vitamins or nutritional supplements — especially if a deficiency is known to exist. If an individual isn’t getting enough vitamin D because they avoid exposure to sunlight, for example, then it makes sense to take a supplemental dose. But we need to remember that a supplement in pill form isn’t a substitute for a balanced diet — and taking unneeded supplements, or excessive doses, can lead to problems. Like it or not, there are few shortcuts on the road to good health. For more information about vitamins and supplements, see the Dear Doctor magazine article “Vitamins & Dietary Supplements: What Every Consumer Should Know.”
Periodontal (gum) disease is an infectious disease that progressively weakens the attachment of supporting tissues to the teeth, including gums, ligaments and bone. If not stopped, the loss of attachment will eventually lead to bone and tooth loss.
A thin layer of plaque that builds up on teeth (mainly due to poor oral hygiene habits) is the main breeding ground for the bacteria that cause gum disease. Our main treatment goal is to remove as much of this plaque as possible from tooth and gum surfaces. Much of the plaque can be removed using special hand or ultrasonic instruments that deep clean dental surfaces, including the roots. But while effective, these manual techniques may not address the full extent of infection, especially if the disease is well advanced.
If severe bone loss has already occurred, deep pockets of infection may have developed. As bone loss progresses, teeth with multiple roots may also develop an anatomical problem known as furcation invasions where the roots of the tooth branch off. If there continues to be signs of disease, like gum inflammation, bleeding or pus formation, it’s these hard to reach areas that may still be a problem even after extensive treatment. If so, we may need to take a different approach with antimicrobial or antibiotic products.
The most effective antimicrobial substance for reducing bacteria in biofilm is a chlorhexidine mouthrinse. The typical 0.12% solution is only available by prescription — if taken for a prolonged time it can result in tooth staining, affected taste or mouth irritation. To assure the solution reaches below the gum line, it will need to be applied by us in the office, followed up flushing irrigation of the affected area.
Another alternative is topically applied antibiotics that can stop or even reverse the progression of gum disease. There’s evidence that topical applications can penetrate into these deeper areas of infection. A common antibiotic used in this way is tetracycline, which has been shown to stop inflammation and infection.
These treatments don’t eliminate the need for mechanical cleaning, and the prolonged use of antibacterial products can have a detrimental effect on “good” bacteria (needed, for example, to complete the digestive process). It will depend on the extent of the gum disease to determine how successful conservative treatment may be. It’s also important that you contribute to your own dental health with a renewed daily oral hygiene habit.
If you would like more information on treatments for 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 “Treating Difficult Areas of Periodontal Disease.”
If you’re in the habit of making New Year’s resolutions, perhaps you’ve made familiar promises like losing weight, running a 5k race or joining a gym. How about this one: “I resolve this year to take better care of my teeth.” Better yet, you needn’t wait for the next January 1st — you can begin better oral hygiene habits today.
Although maybe not as glamorous as other self-improvement habits, oral hygiene still promises huge benefits not only for your teeth and gums, but also for your general health and possibly your wallet. Daily brushing and flossing reduces your risk of tooth decay and periodontal (gum) disease, which can in turn reduce your long-term dental care costs. Besides, clean teeth just look better!
If brushing your teeth hasn’t been a regular habit for you, here are a few tips to get you on the right track:
Pick the right brush. For most people, a soft bristled, multi-tufted toothbrush is the best choice. If you’re not sure what kind of brush to use, ask us for recommendations.
Look for the basics in toothpaste. Store shelves are filled with toothpastes promising everything from teeth whitening to tartar control. Just be sure of two things: that the product contains fluoride (proven to reduce the risk of tooth decay) and it has the American Dental Association’s Seal of Approval. If you have sensitive teeth, ask us about toothpaste options that address this or other special situations.
Easy does it with the technique. Over-vigorous brushing can harm your teeth’s enamel and cause gum recession. Hold the brush handle between your fingertips with no more pressure than you would hold a pencil. Position the brush-head at the gum line at about a 45-degree angle and gently clean all your tooth surfaces. If you’re trying this approach for the first time, the task should take about two minutes.
Visit your dentist twice a year to keep on track. Think of your dental healthcare team as your “personal trainers” in oral hygiene. Besides monitoring your overall dental health and removing hard to reach plaque through semi-annual cleanings, they’ll also coach you on your new lifetime habit of better oral hygiene.
If you would like more information on oral hygiene, 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.”
They work hard, and put in lots of time on the field and at home. They learn the rules of the game — as well as the unwritten rules of sportsmanship and teamwork. They receive the proper training, and wear appropriate protective equipment. But sometimes, in spite of everything, kids who participate in sports can be subject to injury. Fortunately, in today's dentistry there are a variety of treatments, as well as preventive measures, which can help.
When faced with serious dental injury, time is of the essence in saving teeth. So, don't delay — come in to see us immediately! If treated promptly, it's possible for teeth which have been dislodged — or even knocked out of the mouth — to be put back in position and stabilized. Afterwards, follow-up treatment will ensure that the tooth has the best chance of recovery.
The treatment of kids' dental injuries is sometimes different than that of adults. For example, in adults, a root canal would generally be necessary, followed by a tooth restoration (crown). But some kids may not need this treatment, since their teeth are still developing. Also, replacing a missing primary (baby) tooth may not be recommended, since it may hinder development of the permanent teeth. Based on his or her individual circumstances, we can develop an appropriate treatment plan for your child.
Luckily, the most common dental injuries aren't nearly as serious — they typically involve chipped or cracked teeth. Most can be repaired by reattaching the broken piece, or using a tooth-colored restoration. If a large part of the structure of a permanent tooth is missing, a crown or “cap” may be placed on the visible part, above the gum line. Smaller chips, even in primary teeth, can be successfully repaired by cosmetic bonding with composite resin materials.
Finally, if your child is involved in athletic activities — or if you are — consider obtaining a custom-made mouthguard. Numerous studies have shown that this protective gear can help prevent many dental injuries. Unlike the off-the-shelf types found in some sporting-goods stores, the ones we provide are individually fabricated from an exact model of the teeth. They're strong, fit comfortably, and offer superior protection at a reasonable cost.
If you have questions about the treatment of sports-related dental injuries, or about mouthguards, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Trauma & Nerve Damage to Teeth” and “Mouthguards.”