Posts for category: Oral Health
In the early Eighties, dentists began noticing symptoms among a few patients that indicated something far more serious. They were, in fact, among the first healthcare providers to recognize what we now know as HIV-AIDS.
Today, about 1.2 million Americans have contracted the Human Immunodeficiency Virus (HIV). It’s a retrovirus, somewhat different than other viruses: it can invade immune system cells and hijack their replication mechanism to reproduce itself. Untreated it eventually destroys these cells to give rise to the more serious, life-threatening disease Acquired Immunodeficiency Syndrome (AIDS).
Thanks to antiretroviral drugs, most HIV positive patients live somewhat normal lives and avoid the more serious Acquired Immunodeficiency Syndrome (AIDS). But while antiretroviral therapy effectively inhibits the action of the virus, it isn’t a cure — the virus is a permanent resident of the body and can still affect health, especially in the mouth.
In this regard, one of the more common conditions associated with HIV is Candidiasis, a fungal infection also known as thrush, which causes cracking of the mouth corners and lesions or white patches on the surface of the tongue or roof of the mouth. HIV patients may also experience limited saliva flow that causes dry mouth (xerostomia) with effects that range from bad breath to a higher risk of tooth decay.
The most serious effect, though, of HIV on oral health is the body’s lower resistance to fight periodontal (gum) disease. HIV patients are especially susceptible to a severe form known as Necrotizing Ulcerative Periodontitis (NUP), a sign as well of immune system deterioration and the beginning of AIDS. This painful condition causes gum ulcerations, extensive bleeding, and the rapid deterioration of gum attachment to teeth.
If you or a family member is HIV positive, you’ll need to pay close attention to oral health. Besides diligent brushing and flossing, you or they should also regularly visit the dentist. These visits not only provide diagnosis and treatment of dental problems, they’re also an important monitoring point for gauging the extent of the HIV infection.
Taking care of dental problems will also ease some of the discomfort associated with HIV. Thanks to proper oral care, you or someone you love can experience a higher quality of life.
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!
Saliva is a true workhorse among bodily fluids — it breaks down food for digestion, keeps harmful bacteria in check and neutralizes acid that is destructive to tooth surfaces. So when saliva flow is chronically diminished, it’s more serious than the uncomfortable feeling of “dry mouth” — it can have a detrimental effect on your overall health.
It’s normal to experience temporary mouth dryness: in the morning (because saliva flow slows during sleep), when we’re under stress, or after smoking or consuming certain foods and beverages like onions or coffee. But chronic dry mouth (“xerostomia”) is different — the mouth remains dry for extended periods, leading to problems like tooth decay caused by inadequate acid neutralization.
Medications are one of the most common causes for xerostomia. According to the Surgeon General, there are over 500 medications — both prescription and over-the-counter — that can cause it, including antihistamines, diuretics and antidepressants. Radiation or chemotherapy used for cancer treatment may also cause dry mouth, sometimes permanently. There are also systemic conditions that affect saliva flow like diabetes, Parkinson’s disease, cystic fibrosis, and many autoimmune diseases.
Treating chronic dry mouth will of course depend on the underlying cause. If drug-related the first approach should be to find a substitute medication that won’t as readily cause reduced saliva flow. If that’s not possible, then it’s helpful to drink more water when taking the medication (a few sips before and a full glass afterward). You can also cut back on caffeinated, acidic or sugary foods and drinks as well as alcohol, and refrain from tobacco use.
A saliva stimulant might also help. Besides prescription medication, there are other products like xylitol, a natural alcohol sugar found in chewing gum, toothpaste or rinses, that help increase saliva flow — and xylitol also inhibits the growth of decay-causing bacteria.
The most important thing for chronic dry mouth is maintaining consistent daily hygiene through brushing and flossing and regular dental cleanings and checkups. Helping to increase your saliva flow and making every effort to prevent dental disease will help keep this condition from harming your teeth and gums.
If you would like more information on the causes and treatment of dry mouth, 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 “Dry Mouth.”
The American Diabetes Association has declared November National Diabetes Month. If you or a loved one has diabetes, you may already know that diabetes puts you at greater risk for gum disease. Let's look at four must-know facts about diabetes and gum disease.
#1. Gum disease is an acknowledged complication of diabetes.
High levels of blood sugar can interfere with your mouth's ability to fight infection, making you more susceptible to gum disease. People with poorly controlled diabetes may have more severe gum disease and may ultimately lose more teeth due to gum disease—in fact, one in five people who have lost all their teeth have diabetes.
#2. Gum disease makes diabetes harder to control.
Diabetes and gum disease are a two-way street when it comes to adverse health effects. Not only does diabetes increase the risk of gum disease, but gum disease can make diabetes harder to manage. Infections such as gum disease can cause blood sugar levels to rise. This is because chronic inflammation can throw the body's immune system into overdrive, which affects blood sugar levels. Since higher blood sugar weakens the body's ability to fight infection, untreated gum disease may raise the risk of complications from diabetes.
#3. You can do a lot to take charge of your health.
If you have diabetes and gum disease, you may feel as if you've been hit with a double whammy. While it's true that having both conditions means you are tasked with managing two chronic diseases, there is a lot you can do to take care of your health. Do your best to control blood sugar by taking prescribed medications, following a balanced diet, and exercising. In addition, pay special attention to your oral healthcare routine at home: Brushing your teeth twice a day and flossing once a day can go a long way in preserving good oral health.
#4. Preventing and managing gum disease should be a team effort.
We can work together to prevent, treat, and control periodontal disease. Come in for regular professional dental cleanings and checkups so we can monitor the health of your teeth and gums and provide specialized treatment such as deep cleanings when necessary. Diligent dental care can improve your oral health and help control your diabetes.
Remember, we're on your team. Let us know if there have been changes in your diabetes, your medication, or your oral health. If you have questions about diabetes and your oral health, please contact us or schedule an appointment for a consultation. To learn more, read the Dear Doctor magazine article “Good Oral Health Leads to Better Health Overall.”
If you have chronic jaw pain, you know how difficult eating, speaking or even smiling can be. Many sufferers will do anything to gain relief, even surgery. But before you go down that road, consider the traditional conservative approach to temporomandibular disorders (TMD) management first—it could provide the most relief with the least risk of side effects.
The temporomandibular joints connect the lower jaw to the skull on either side of the head. These ball and socket joints also contain a cushioning disk to facilitate movement. This disk is believed to be the primary focus for jaw pain problems known collectively as TMD.
Doctors now believe injury, stress, metabolic issues, jaw anatomy defects or similar factors trigger the chain reaction of muscle spasms, pain and soreness that can erupt during a TMD episode. A TMD patient may experience pain within the jaw muscles or joints themselves, clicking sensations, or an inability to open the jaw to its full range.
TMD therapy has traditionally followed an orthopedic path—treating jaw joints like any other joint. In recent years, though, a more aggressive treatment model has emerged that promotes more invasive techniques like orthodontics, dental work or jaw surgery to relieve discomfort. But the track record for this model, especially concerning jaw surgery, remains hazy at best and offers no guarantee of relief. These techniques are also irreversible and have even made symptoms worse in some patients.
It’s usually prudent, then, to try conservative treatments first. This can include pain and muscle relaxant medication, jaw exercises, stretching and massage, and dietary changes to reduce chewing force. Patients with teeth grinding habits may also benefit from a bite guard worn at night to reduce the biting force during sleep and help the joints relax.
By finding the right mix of treatments, you may be able to find significant relief from TMD symptoms with the conservative approach. If not, you might then discuss more invasive options with your dentist. But even if your dentist recommends such a procedure, you would be wise to seek a second opinion.
TMD can definitely interfere with your quality of life and peace of mind. But there are ways to reduce its effects and make for a happier life.
If you would like more information on managing chronic jaw pain, 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 “Seeking Relief from TMD.”