Posts for category: Oral Health
Sure, it’s big news when celebs tweet selfies from the dental office… if you’re still living in the 20th century. But in Hollywood today, it’s harder to say who hasn’t posted snaps of themselves in the dentist’s chair than who has. Yet the pictures recently uploaded to Twitter by Mark Salling, the actor and singer who regularly appears as Noah “Puck” Puckerman on the popular TV series Glee, made us sit up and take notice.
“Getting my chipped tooth fixed. Also, apparently, I’m a big grinder,” read the caption. The photo showed a set of upper front teeth with visible chips on the biting surface. What’s so special about this seemingly mundane tweet? It’s a great way of bringing attention to a relatively common, but often overlooked problem: teeth clenching and grinding, also called bruxism.
Although bruxism is a habit that affects scores of people, many don’t even realize they have it. That’s because the condition may only become active at night. When the teeth are unconsciously ground together, the forces they produce can wear down the enamel, cause chipping or damage to teeth or dental work (such as veneers or fillings), or even loosen a tooth! While it’s common in children under 11 years old, in adults it can be a cause for concern.
Sometimes, mouth pain, soreness and visible damage alert individuals to their grinding habits; other times, a dental professional will notice the evidence of bruxism during an exam or cleaning: tooth sensitivity and telltale wear and tear on the chewing surfaces. Either way, it’s time to act.
Bruxism is most often caused by stress, which can negatively impact the body in many ways. It may also result from bite problems, the overuse of stimulating substances (caffeine, alcohol, tobacco, and illegal drugs), and as a side effect of certain medications. Sometimes, simply becoming aware of the habit can help a person get it under control. Common methods of stress reduction include exercise, meditation, a warm bath or a quiet period before bedtime; these can be tried while we monitor the situation to see if the problem is going away.
If stress reduction alone doesn’t do the trick, several other methods can be effective. When bruxism is caused by a minor bite problem, we can sometimes do a minor “bite adjustment” in the office. This involves removing a tiny bit of enamel from an individual tooth that is out of position, bringing it in line with the others. If it’s a more serious malocclusion, orthodontic appliances or other procedures may be recommended.
When grinding is severe enough to damage teeth or dental work, we may also recommend a custom-made night guard (occlusal guard), which you put in your mouth at bedtime. Comfortable and secure, this appliance prevents your teeth from being damaged by contacting each other, and protects your jaw joints from stresses due to excessive grinding forces.
Whether or not you have to smile for a living, teeth grinding can be a big problem. If you would like more information about this condition, call our office to schedule a consultation for a consultation.
The American marketplace usually offers us plenty of buying choices — sometimes it seems too many. A case in point: the toothpaste aisle at your local supermarket.
It can be a bit overwhelming with all the razzle-dazzle packaging and exciting claims of “Whiter Teeth!” or “Fresher Breath!” But toothpaste really isn't that complicated, if you keep in mind its primary goal: to help you with your toothbrush remove disease-causing plaque from teeth surfaces.
And the vast majority can, thanks to ingredients you'll find in just about every brand. All toothpastes, for example, contain some form of abrasive material that boosts the mechanical action of brushing to remove plaque. This isn't new: the ancient Egyptians used ox-hoof ashes, burnt eggshells and pumice as abrasives. Today you'll find hydrated silica (originating from sand), hydrated alumina or calcium carbonate as abrasives on the ingredient list.
You also need some form of detergent to help loosen and break down substances that won't dissolve in water. Toothpaste detergent is much milder than that which you use on your dishes. The most common is sodium lauryl sulfate, a foaming agent found in shampoo and other beauty products. It's been used safely for half a century in toothpaste, although it can irritate the inner linings of some people's mouths. If this is a problem for you, you should look for toothpaste with a different detergent.
There is also a myriad of other ingredients, including binders, humectants (which help the toothpaste retain moisture) and flavorings. You may also find bleaching agents that help brighten your teeth, although they may not be strong enough to remove deep staining, something we would need to help you with.
And let's not forget one other frequent ingredient: fluoride. This natural chemical strengthens enamel and helps fight tooth decay as part of a disease prevention strategy. It's perhaps the most valuable ingredient you'll find in toothpaste, so make sure it's in your chosen brand.
If you want to simplify your decision, choose toothpaste with the seal of acceptance from the American Dental Association. The seal indicates the claims of the toothpaste manufacturer have been independently verified. You can trust those brands to help keep your teeth clean and free from disease. In the end, that's really what you want from your toothpaste.
If you would like more information on the right toothpaste 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 “Toothpaste: What's in it?”
You might see your teeth and gums as separate parts of your mouth. But we dentists see them as a unified biological system, each of them contributing to your mouth's various functions: eating, speaking and, of course, smiling.
The teeth-gum-mouth relationship is also a factor when things aren't going well. Tooth decay, for example, doesn't suddenly appear — conditions have to be present in the mouth to cause it. The same can be said for periodontal (gum) disease or bite problems.
So the best approach in dental care is to consider the whole — to first learn all we can about your mouth. We need to understand not only your current problems but also your health history and the unique features of your mouth. With this deeper understanding we can formulate a long-term plan that addresses all your individual needs.
We specifically want to identify your individual oral health risks, from your genetic makeup to any past problems with dental disease or the bite. We then want to assess your current state of health: do you have any presence of dental disease? Is any past dental work failing or in need of updating? Are there any biomechanical issues with the bite or bone loss that need to be addressed?
With this more complete picture, we can then prioritize your care and treatment. Some things like gum disease require immediate attention. Other areas such as bite problems or cosmetic issues may require planning and time to fully address. Our aim, though, is to eventually bring you to as high a level of health as your individual situation will permit.
Once we've achieved an acceptable level of health, our aim is to then maintain that level. This includes monitoring for changes in your oral health and intervening when necessary.
As you can see, establishing a care strategy is only the beginning — and care will always be ongoing. In fact, we'll need to modify your care as new issues arise or you experience the effects of aging. Our end goal, however, always remains the same — to help you achieve and keep the most healthy and attractive mouth possible.
If you would like more information on getting the most from your 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 “Successful Dental Treatment: Getting the Best Possible Results.”
One of the unfortunate aspects of aging is tooth wear. Depending on your diet, years of biting and chewing can cause enamel along the biting surfaces to erode. Your body also can't replace enamel — so when it comes to teeth it's not a question of if, but how much your teeth will wear during your lifetime.
To make matters worse, certain conditions cause tooth wear to accelerate. Teeth softened by acids or tooth decay, for example, erode faster than healthier teeth. So will grinding habits: often fueled by stress, these include chewing on hard items like nails, pencils or bobby pins.
You may also grind your teeth, usually while you sleep. Normal biting and chewing produces pressure of about 13 to 23 pounds per square inch: grinding your teeth at night can well exceed this, even up into the hundreds of pounds.
There are some things we can do to alleviate these issues. For clenching and grinding habits, one primary step is to address stress through counseling or biofeedback therapy. For nighttime teeth grinding we can create a bite guard to wear while you sleep that will prevent your teeth from generating abnormal forces.
Finally, it's important that you take care of your teeth through daily oral hygiene, regular office cleanings and checkups, and a nutritious diet for maintaining strong bones and teeth. Keeping your teeth free from diseases that could compromise your enamel as well as other aspects of your mouth will help them stay as strong as possible.
If you would like more information on slowing the rate of tooth wear as you age, 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 “How and Why Teeth Wear.”
The mouth isn’t an island unto itself — problems there may be indicative of deeper physical or emotional issues. Â The condition of a family member’s teeth and gums, for example, could be signs of bulimia, an eating disorder.
Characterized by food binging and purging through self-induced vomiting, bulimia can also have a severe effect on the teeth. Regular inducement of vomiting introduces stomach acid into the mouth that can attack and soften the mineral content of tooth enamel. As a result, 90% of bulimics develop enamel erosion.
The erosion pattern often differs from that produced by other high acid causes like the over-consumption of sodas. Because the tongue instinctively covers the back of the bottom teeth during vomiting, they’re often shielded from much of the acid wash. Bulimics are much more apt to exhibit heavier erosion on the upper front teeth, particularly on the tongue side and biting edges.
Bulimia and similar disorders produce other signs as well, like soft tissue ulceration or swollen salivary glands that exhibit puffiness of the face. The roof of the mouth, throat and back of the tongue may appear roughened from the use of fingers or objects to induce gagging.
Unlike sufferers of anorexia nervosa who tend to be negligent about their hygiene (which itself increases their risk of dental disease), bulimics have a heightened sensitivity to their appearance. This concern may prompt them to aggressively brush right after purging, which can cause more of the softened enamel to be removed.
Treating the dental consequences of bulimia requires a two-pronged approach. In the short term, we want to lessen the impact of stomach acid by discouraging the person from brushing immediately after purging — better to rinse with water and a little baking soda to buffer the acid and wait about an hour before brushing. We may also suggest a sodium fluoride mouth rinse to help strengthen and re-mineralize the enamel.
In the long-term, though, the disorder itself must be addressed through professional help. One good source is the National Eating Disorders website (nationaleatingdisorders.org). Besides information, the association also provides a toll-free helpline for referrals to professionals.
As with any eating disorder, bulimia can be trying for patients and their families. Addressing the issue gently but forthrightly will begin their journey toward the renewal of health, including their teeth and gums.
If you would like more information on the effect of eating disorders 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 “Bulimia, Anorexia & Oral Health.”