Posts for category: Oral Health
Most childhood sicknesses are highly treatable and quickly fade from memory afterward. But there's one viral infection that can reappear years later, albeit in a different form and this time it might not be as forgettable. It could even impact your dental care.
Varicella, more commonly known as chicken pox, is a viral infection that mainly affects children. Fortunately, the itchy blisters and other symptoms associated with it usually clear up on their own. But the virus itself, varicella zoster virus (VZV), can remain behind and become dormant.
Fast-forward a few decades, and the child once with chicken pox is now an adult, usually over 50. In 20-30% of former chicken pox patients, the virus reactivates as a new infection known commonly as shingles.
Shingles often begins with an itching, burning or numbing sensation on the skin that develops into a severe rash. Because of its effect on surface nerves, the rash often takes on a striped or belt-like pattern on the skin. A shingles outbreak can also cause fever, fatigue and pain, the latter of which in rare cases can be quite severe.
Shingles in its early stages is also highly contagious, transmitted easily through either physical contact with the skin lesions or through airborne secretions. This is especially troubling for certain groups: pregnant women, patients undergoing cancer or other serious disease treatment, or those with compromised immune systems. For them, shingles can pose a significant risk for complications.
Because of its easy transmission, and the danger it can pose to certain groups, dentists typically postpone treatment—even routine dental cleanings—for patients experiencing a shingles outbreak, especially a facial rash. Once their outbreak subsides, those procedures can be rescheduled.
If you develop what you think is shingles, you should seek medical attention as soon as possible. Certain prescribed antiviral medications can ease the symptoms and hasten recovery, but they're most effective if started within three days of the onset of the disease. There's also an effective vaccination for shingles recommended for people over 60 to help avoid the disease altogether.
One other thing! If you do develop shingles and have an upcoming dental appointment, let your dentist know. Better to reschedule your visit after you've recuperated than to put others' health at risk.
If you would like more information on shingles and dental care, 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 “Shingles, Herpes Zoster.”
Some things in life are almost guaranteed to make you go, "Uh, oh"—your car won't start, your a/c goes out, or, worse yet, you get an unexpected letter from the IRS.
Here's another: One of your teeth is loose. And, if you don't act quickly, that loose tooth may soon become a lost tooth.
But first, we need to find out why it's loose. It's usually due to one of two types of injury related to your bite. One type is called primary occlusal trauma. This results from your teeth encountering higher than normal biting forces. This often happens if you habitually gnash or grind your teeth together outside of normal functions like eating or speaking.
The other type is secondary occlusal trauma. In this case, the supporting gum tissues and bone have been weakened or lost by disease, with the gum tissues possibly becoming detached. Without this support, even normal biting forces could loosen a tooth.
Our treatment approach for a loose tooth may differ depending on which of these is the cause. For primary occlusal trauma, we want to reduce the biting forces that have contributed to loosening the tooth. One way to do this is to create a mouthguard that when worn prevents teeth from making solid contact during grinding episodes.
For secondary trauma, we want to first focus on treating any gum disease responsible for weakening the gum tissues. Once we have it under control, the gums and bone tissues can heal and possibly regain and strengthen their attachment with the tooth.
At the same time, we may also need to stabilize a loose tooth to prevent its loss. This usually involves splinting, whereby we use neighboring healthy teeth to support the loose tooth. One way to do this is to attach a metal strip across the backs of the loose tooth and its more stable neighbors, or by way of a channel cut through the top biting surfaces of the teeth.
If a loose tooth regains its attachment with the gums and bone, it may stabilize and any splinting can be removed. If not, splinting may become a permanent solution. Either way, prompt treatment can help us save your loose tooth.
If you would like more information on treating loose teeth, 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 “Loose Teeth: Biting Forces Can Loosen Teeth.”
There's still much about the underlying nature of chronic jaw joint dysfunction we have yet to unravel. Treating these conditions known as temporomandibular joint disorders (TMDs) may therefore require some experimentation to find what works for each individual patient.
Most TMD therapies are relatively conservative: eating softer foods, taking anti-inflammatory pain relievers or undergoing physical therapy. There have been some surgical techniques tried to relieve jaw pain and dysfunction, but these have so far had mixed results.
Recently, the use of the drug Botox has been promoted for relieving jaw pain, albeit temporarily. Botox contains tiny amounts of botulinum toxin type A, a poisonous substance derived from the bacterium Clostridium botulinum, which can cause muscle paralysis. It's mainly used to cosmetically smooth out small wrinkles around facial features.
Because of these properties, some physicians have proposed Botox for TMD treatment to paralyze the muscles around the jaw to reduce pain and discomfort. While the treatment sounds intriguing, there are a number of reasons to be wary of it if you have TMD.
To begin with, the claims for Botox's success in relieving jaw pain have been mainly anecdotal. On the other hand, findings from randomized, double-blind trials have yet to show any solid evidence that Botox can produce these pain-relieving effects.
But even if it lived up to the claims of TMD pain relief, the effect would eventually fade in a few weeks or months, requiring the patient to repeat the injections. It's possible with multiple Botox injections that the body will develop antibodies to fight the botulinum toxin, causing the treatment to be less effective with subsequent injections.
Of even greater concern are the potential side effects of Botox TMD treatment, ranging from headaches and soreness at the injection site to more serious muscle atrophy and possible facial deformity from repeated injections. There's also evidence for decreased bone density in the jaw, which could have far-reaching consequences for someone with TMD.
The best approach still seems to lie in the more conservative therapies that treat TMD similar to other joint disorders. Finding the right combination of therapies that most benefit you will help you better manage your symptoms.
If you would like more information on treatments for TMD, 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 “Botox Treatment for TMJ Pain.”
Half of adults over age 30, and an astounding 70% over 65, have had some form of periodontal (gum) disease. Unchecked, a bacterial gum infection can spread into the supporting bone and destroy attachments between the teeth and gums. Because of its rapidity and aggressiveness, gum disease is the number one cause of tooth loss among adults.
But there may be even more harm caused by gum disease beyond losing teeth: There's growing evidence gum disease may worsen other diseases like diabetes, heart disease or rheumatoid arthritis. Patients with gum disease are also more likely to suffer from one or more of these systemic conditions.
The link between gum disease and these other diseases appears to be inflammation. When tissue becomes injured or diseased, swelling (inflammation) occurs to isolate these tissues from the rest of the body. Under normal circumstances, this is a critical defense mechanism to protect the body overall.
But this response is a temporary measure—if it becomes chronic, it can actually damage the tissues it's trying to protect. This often happens with gum disease as inflammation can't overcome the gum infection, and both sides settle into a kind of trench warfare. The same story plays out with other diseases with an inflammatory response. And if the body is waging war with a gum infection, it can worsen these other conditions.
It's important then to take care of your gums and the rest of the body to minimize chronic inflammation. You can help prevent a gum infection by brushing and flossing every day and getting your teeth cleaned professionally at least every six months. You should also see your dentist if you notice swollen, reddened or bleeding gums, often the first signs of gum disease.
It can also benefit your gums if you're addressing other inflammatory issues in your body. Besides regular medical care, you can reduce your risk for other systemic diseases by eating a healthy diet, keeping your weight at an optimum level and avoiding smoking.
The individual parts of your body aren't isolated islands: Diseases that affect one can eventually affect all. By preventing or treating gum disease as early as possible, you'll also help reduce the effects of other systemic diseases.
If you think there's not much difference between toothbrushes, a quick look on a retail oral care aisle might change your mind. About the only thing toothbrushes really have in common are a handle and bristled head.
Choosing the right toothbrush, therefore, might seem overwhelming. But choose you must: Your toothbrush is an essential tool in the fight against tooth decay and periodontal (gum) disease. Without it, your odds for developing dental disease skyrocket.
Along with flossing, brushing is the best way to remove daily plaque buildup, that bacterial film most responsible for dental disease. Brushing also minimizes the buildup of tartar, the hardened form of plaque that's just as harmful as softer plaque. And, brushing stimulates your gum tissues to help prevent or lessen inflammation.
But back to all those brushes—with so many options to weigh, how do you come up with your best choice? Actually, there are some basic tips that can help you narrow things down.
Bristle stiffness. Considering other cleaning chores, you might think you'll need a stiff brush. The opposite—a soft-bristled brush—is usually true. Your toothpaste's mild abrasives and the mechanical action of brushing perform most of the plaque removal. And stiffer brushes could irritate and damage your gums or tooth enamel, leading to bigger problems.
Size and shape. Through a little trial and error (and advice from your dentist), you may find a brush with an angled or tapered neck helps you get into difficult places, especially around the back teeth. If you have problems with grip, you may also opt for a brush with a large diameter handle. Bottom line: Choose a brush you feel comfortable handling.
ADA Seal of Acceptance. Common on dental product packaging, this seal indicates that after rigorous testing the item meets the high standards of the American Dental Association, and that it does what the packaging says it does. Even so, some quality brushes don't have this seal, so ask your dentist their opinion on a particular brand.
There's one more critical component—how well you use your toothbrush. For that, ask your dentist or hygienist for tips on better brushing. Combining the right brush and technique goes a long way toward avoiding dental disease.
If you would like more information on choosing the right toothbrush for you, 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 “Sizing Up Toothbrushes.”