Dental Health (640)
I have been approached by a number of patients lately who I now refer to as “Silent Sufferers”.
They present with multiple broken teeth, inflamed and sensitive gums, and mobile teeth as well. They may have bad breath associated with this as well. They are self conscious of their appearance. This causes them to refrain from smiling and laughing.
Furthermore, they have trouble eating. Their diet is affected as they keep to soft foods. These people suffer for many years. They are embarrassed by their predicament and do not discuss this with their friends and families.
There is more research emerging that poor teeth can lead to various system illnesses such as cardiovascular disease. These are problems that should not be neglected.
They avoid the dentist either to fear of the dentist or humiliation.
I encourage you to consult with your local oral surgeon or dentist. There are multiple treatment strategies today that can have your bad teeth removed, and sometimes even replaced in the same day with dental implants. This can be done comfortably with IV sedation in the office.
If this sounds like you or a loved one, I encourage you to consult your dentist or oral surgeon and learn of the different options that may be available to you.
Here was a recent correspondence that I received from a patient:
“My question was how to go about booking a consultation, and if you had some type of partial financing as I am self employed. I have saved up a down payment but am worried about the severity of my dental issues. Basicly I have multiple broken teeth and receding gums, which I am now to the point of only being able to eat soft food. It is also effecting my income as I deal with the public. If there is any way possible to help my health please let me know as I can be reached most hours of the day. Thanks for your time.”
Regular dental visits are important because they help keep your teeth and gums healthy. You should have a regular dental visit at least every six months.
There are two parts to a regular dental visit. One part is the check-up. The other is the cleaning.
Your dental professional will check for cavities and to see if there is plaque or tartar on your teeth. Plaque is a clear, sticky layer of bacteria. If it is not removed, it can harden and become tartar. You cannot remove tartar with brushing and flossing. If plaque and tartar build up on your teeth, they can cause oral diseases.
Plaque and Tarter Build Up
Next, your gums will be checked. This will be done with a special tool to measure the spaces between your teeth and gums. With healthy gums, the spaces are shallow. When people have gum disease, the spaces may become deeper.
The check-up should also include your tongue, throat, face, head, and neck. This is to look for any signs of trouble, swelling, or cancer.
Brushing and flossing help clean the plaque from your teeth, but you can’t remove tartar at home. During the cleaning, your dental professional will use special tools to remove tartar. This is called scaling.
After your teeth are scaled, they may be polished. In most cases, a gritty paste is used for this. It helps to remove any surface stains on your teeth.
The final step is flossing. Your dental professional will use floss to make sure the areas between your teeth are clean.
What You Should Do Between Visits
Be sure to take care of your teeth and gums between regular dental visits. Plaque is always forming on your teeth, but you can get rid of it by brushing and flossing regularly. Here are some tips for good oral care at home.
• Brush your teeth at least twice a day. Be sure to use a toothpaste that contains fluoride.
• Floss at least once a day.
• Use a mouth rinse to help get rid of plaque bacteria. This will also help to freshen breath.
For more information on regular dental visits, talk to your dental team.
Underneath your tooth’s outer enamel and within the dentin is an area of soft tissue called the pulp tissue. While a tooth’s pulp tissue does contain nerve fibers, it is also composed of arteries, veins, lymph vessels and connective tissues. Each tooth’s nerve enters the tooth at the very tip of its roots. From there, the nerve runs through the center of the root in small canals, which join up with the tooth’s pulp chamber. Your canals are very small, thin divisions that branch off from the top chamber down to the tip of the root. A tooth has at least one but no more than four roots.
When the pulp becomes infected due to a deep cavity or fracture that allows bacteria to seep in or injury due to trauma, it can die. Damaged or dead pulp causes increased blood flow and cellular activity and pressure cannot be relieved from the inside of the tooth. Root Canal therapy is necessary because the tooth will not heal by itself. Pain usually worsens until one is forced to seek emergency dental attention.
A Root Canal is a procedure done to save the damaged or dead pulp in the canal of the tooth by cleaning out the diseased pulp and reshaping the canal. The canal is filled with a rubber like substance called gutta percha or another material to prevent recontamination of the tooth. The tooth is then permanently sealed, with the possibility of a crown made of porcelain or metal alloy. This enables patients to keep the original tooth.
First, you will be given a local anesthetic to numb the area. A rubber damn is then placed around the tooth to isolate it. Next, an opening is drilled into the tooth or through the crown into the pulp chamber. The canals are cleaned of all diseased pulp, shaped, disinfected and then filled with gutta percha. You will leave the dentists office with a temporary filling and follow up with your general dentist for your permanent restoration.
Did you know that a properly trained physical therapist can be an asset to you in the treatment of your TMJ issues? A physical therapist who has taken the appropriate course work is able to treat dental clients for everything from commonly heard of TMJ problems to generalized tooth pain, facial pain, alignment issues, as well as related headaches and neck/cervical spine issues.
While not everyone is familiar with TMJ (or more appropriately TMD, temporomandibular joint dysfunction) as a term, many have issues with this joint, the joint where the jaw bone (mandible) meets the head (temporal bones).
Are you a person who clenches their teeth when stressed? Perhaps you grind them while you’re asleep? Does your mouth click or pop when you open and/or close it? Has your jaw ever locked open or closed on you? Is it painful to open your mouth to eat or get dental work done? If your answer to any of these questions is “yes” then you likely have problems with your TMJ and its surrounding soft tissue and bony structure which can be address by a specialized physical therapist in conjunction with your dentist.
If a physical therapist has pursued specialized study of the skull (or cranium), he/she has the background knowledge on the anatomy and mechanics of the jaw and how these hinged joints function in relationship to the head. With this knowledge he/she will be able to assess both the bony structure of the skull and the soft tissue that links the jaw to the head and determine where the underlying issues are with respect to alignment or abnormal muscle pull.
Through this assessment, a therapist is then able to apply specific manual or hands-on treatment skills, to correct alignment and soft tissue imbalances. Once balance has been restored to these structures, many of the above symptoms including pain and popping can be resolved.
So what do you do if you think you fall into this category of people with TMJ Dysfunction? First, go to your dentist and have them do a complete exam. If it’s decided you have TMJ issues, ask them to refer you for physical therapy. Many patients have benefited from the hands-on treatment of these regions.
Why live with pain and limitation from your jaw when you don’t have to?
A new patient to a dental practice may not know why there is so much paperwork to fill out. Patients often breeze through the health history questionnaire, perhaps not even answering all of the line items.
They figure it has nothing to do with teeth, so it can’t be important. But the fact is, every single question is critical.
There are chemicals used in dentistry, and we routinely prescribe a variety of medications. We need to know your health history to ensure optimal care and safety.
It is absolutely important for your dentist to know your complete health history including any diseases or syndromes, surgeries, allergies, and medications.
Even if they seem to you to be completely unrelated to your oral health, it’s always better to err on the side of safety.
For instance, consider Hibiclens, a popular cleanser applied during surgical procedures. Some people have
a negative reaction to Hibiclens.
The active ingredient in Hibiclens is chlorhexidine gluconate, the same active ingredient used in a popular oral rinse sometimes used or prescribed by dentists.
If you had a bad reaction to Hibiclens, you could potentially be allergic to chlorhexidine gluconate and your dentist needs to know that.
While this particular example may or may not apply directly to you, the point is that as a healthcare provider, your dentist needs to know as much as possible about your health history.
We can only treat you properly if we have all of the information. We can only have the information if you tell us. So tell us.
Teeth, Gums in Your 40’s – Once you enter your 40’s, you may notice significant wear on your teeth, restorations (fillings) which may have failed already, movement or migration of your gum line, possible bone loss, spaces between your teeth, crowding, and your mouth seeming to collapse, muscle soreness, yellow staining, and sensitivity.
Here you may consider restorative intervention, periodontal treatment, occlusal (bite) rehabilitation, and muscle deprogramming as your choice of treatment. More aggressive care is necessary to complement the dental therapies recommended for balanced dental oral health.
Teeth, Gums in Your 50’s – Age 50 and up tend to be more pronounced stages of your 40s. Numerous treatments are recommended here combining prevention and intervention oral and dental treatments.
Here some perceived notions of what is health, play a misleading role in making you think oral health and a young smile is not an achievable goal. Custom treatments involving periodontal treatment, custom teeth whitening and conditioning, replacing old corroded crowns, bridges, and implants are options you may need to consider.
Teeth, Gums in Your 60’s – Age 60 may have brought on loss of dentition in addition to all the nuances already mentioned in your 40s and 50s. Implants, bridges, and other restorative prosthetics will allow you to be able to regain chewing capabilities you may have lost to various degrees.
Dry mouth, a phenomenon associated with some medications, history of radiation therapy, or diminished salivary gland function may have altered the composition and flow of your saliva, which in turn may affect your oral microflora, the strength of your teeth, and the susceptibility to caries.
Diabetes, radiation and other cancer treatments have shown to have an impact on your oral health and appropriate preparation for undergoing oncologic treatment is recommended for keeping your teeth healthy. While many systemic conditions present with manifestations in the oral cavity, many of the same conditions also cause imbalances that can affect your mouth.
I trust the title caught your attention. Many in the medical and dental community rely on a superficial explanation and understanding of the dental anatomical relation to obstructive sleep apnea (OSA). This can result in a distorted picture of how the body functions as a whole.
We need a better understanding of how our body’s second-to-second management of our survival leads to and helps perpetuate chronic illness and the effects of aging.
The most immediate need of the body is survival. And, the most immediate threat to survival is loss of air supply. Any survival threat signals the autonomic nervous system (ANS) to activate our fight or flight reaction, often referred to as our “adrenal” or “stress” response.
Since 2007, in numerous Your Health Magazine articles, I have described how an unstable jaw-tongue-throat anatomical relationship that facilitates OSA during sleep does not disappear while one is awake.
The dental profession can integrate knowledge of posture and position of the same tongue in denture construction assurance of ease of swallowing and speaking with the difficulty of breathing associated with OSA. Same tongue, same influences day or night. The type and degree of influence and reaction will obviously vary when awake from when asleep.
I have shown how this inter-relationship is the origin of all disease, with diet, nutrition and exercise, while important, playing supporting roles because they have a much less “immediate” impact upon the stress response. Thus they hold much less immediate influence and leverage. This jaw-tongue-throat relationship has a huge impact on health and well-being.
Studying and understanding it, how it impacts, and is impacted by the whole body, mind and spirit referred to as Oral Systemic Balance® can lead to the knowledge to improve its stability and function. I believe that this can influence all the chronic conditions that appear to progress and increase in number, intensity and frequency as we age, because it addresses the origin.
Our current symptom management approach of “relieve,” “repair,” and “replace” (RRR) as conveniently as possible, ignores root causes, the symptoms of which can be multiple steps down a series of reactions.
While our current RRR approach will always be needed, the frequency of need for it is likely to be greatly diminished as origin focused health management is better understood, appreciated and implemented. It is our only means of reversing the landslide of exponential cost increases associated with our current concept of the human body and medical care.
Orthodontists are dentists who receive an extra 2-3 years of specialized education and training beyond dental school to learn the proper way to diagnose, and treat by straightening mal-alignment of teeth, muscles and jaws to improve function and esthetics. To aid the process of choosing an orthodontic specialist, here are some very important questions to ask to assure you are seeing the best smile designer expert.
1. Are you an orthodontist? What type of orthodontic training did you receive beyond dental school? How much training? What type (weekend or manufacturer’s courses, or 2-3 years of orthodontic education beyond dental school)? Are you a member of the American Association of Orthodontists?
2. What services do you offer? Do you treat all orthodontic cases or just minor cases? What about complex cases involving compromised teeth and bone? Do you treat adults, children or both? Do you treat periodontal cases? Implant cases? Jaw surgery cases? TMD cases?
3. Are you utilizing state-of-the-art, self-ligating bracket systems, clear, metal, nickle-free and lingual braces, clear aligners and functional appliances for early treatment, space management and growth guidance?
4. Has your clinical staff had any orthodontic training? Is your administrative staff familiar with insurances and flexible spending/health savings accounts?
5. Do you further your education by attending continuing education courses? Have you received additional training in state-of-the-art adjunctive procedures such as TADS, temporary anchorage devices, and gingival laser procedures?
6. Will you communicate with referring doctors and update them of my progress? Do you work with my doctors helping them set the stage for implants, crowns and bridges?
The answers to these questions will assist in making the right decision regarding your orthodontist. You must ultimately feel comfortable with who will design your resulting smile.
Dental procedures can be performed quicker, more effectively and more comfortably thanks to the growing popularity of laser dentistry. Laser (Light Amplification by Stimulated Emission of Radiation) technology has been used in various types of medical procedures for years. It is a natural progression for dental offices to follow as dental laser technology continues to improve and patients begin to demand more services from this exciting field. Eventually, dental lasers could make it possible for dentists to access any part of any tooth, thereby totally replacing the need for the traditional dental drill. This may help to relieve the fear and anxiety many people experience when they go to the dentist.
Types of Dental Lasers
The Food and Drug Administration (FDA) has approved of a variety of hard and soft tissue lasers for use in the dental treatment of adults and children. Because dental lasers have unique absorption characteristics, they are used to perform specific dental procedures.
• Hard Tissue Lasers: Hard tissue lasers have a wavelength that is highly absorbable by hydroxyapatite (calcium phosphate salt found in bone and teeth) and water, making them more effective for gently cutting through natural tooth structure.
The primary use of hard tissue lasers (Erbium Lasers) is to cut into bone and teeth with extreme precision. Hard tissue lasers are often used in the “prepping” or “shaping” of teeth for composite bonding, the removal of tooth decay and the repair of certain worn down dental fillings.
• Soft Tissue Lasers: Soft tissue lasers represent wavelengths that are highly absorbable by water and hemoglobin (oxygenating protein in red blood cells), making them more effective for soft tissue management. Commonly used soft tissue lasers include CO2 (carbon dioxide) and diode lasers, which may be used as a part of periodontal treatment and have the ability to kill bacteria and activate the re-growth of tissues. The diode laser and the carbon-dioxide laser minimize damage to surrounding tissue and removes tissue faster and with greater accuracy.
Soft tissue lasers penetrate soft tissue while sealing blood vessels and nerve endings. This is the primary reason why many people experience virtually no postoperative pain following the use of a laser. Also, soft tissue lasers allow tissues to heal faster. It is for this reason that a growing number of cosmetic dental practices are incorporating the use of soft tissue lasers for gingival sculpting procedures.
• Diagnostic Lasers: The iTeroTM system is a technology that uses a laser-based wand that scans a patient’s prepared tooth and takes an extremely accurate optic impression for crown and bridge cases. The iTero scan replaces the gagging, gooky impression materials that most patients find very distasteful. Lasers provide energy and specific proteins that help move messages between cells to match the body’s natural ability to use light spectrums to heal damaged cells. Some dental laser technology has been developed that can be used to generate both hard and soft tissue laser energy, depending upon the patient’s needs.
Obstructive sleep apnea (OSA) is a common condition which can shorten your lifespan on average by seven years.
The condition arises when you fall asleep and your tongue and throat muscles relax, causing your airway to become so restricted that you actually stop breathing during your sleep.
Then, after your brain is deprived of oxygen for awhile, it stimulates you to wake up, gasp for breath, and then resume breathing normally until it happens again.
Most people are unaware of the condition because they don’t reach full consciousness each time they gasp for breath, so they don’t remember waking up every few minutes. The only symptom most people with OSA experience is daytime sleepiness.
There are severe medical consequences, however, for patients with untreated OSA.
Hardening of the arteries leading to heart attacks or stroke, high blood pressure, and falling asleep at the wheel are the most deadly. So treatment of OSA is very important.
The first line of defense is a machine known as the CPAP (continuous positive airway pressure).
It is essentially an air compressor attached to a hose and a mask which fits over your face when you sleep (think Top Gun fighter pilot).
While very effective in the lab, the actual effectiveness in real life is less than 50% because most patients can’t tolerate the bulky equipment or toss it off during their sleep.
Fortunately, the dental community can offer an effective alternative to CPAP. Oral appliances have been used for many years to reduce snoring, and the same appliances can often treat OSA as well.
In fact, oral appliances have been approved by the FDA as a first line of defense in mild to moderate OSA cases.
Most oral appliances are composed of upper and lower retainers which are either hooked together or have attachments which prevent the lower jaw from falling back.
This holds the tongue off the back of the throat and keeps the airway open. Common appliances that hold the jaw forward are the Silencer, the OASYS, Herbst, TAP, and SomnoMed MAS.
Sometimes moving the jaw forward is ineffective, so other appliances such as the Full Breath Solution or the Tongue Retaining Device can be used to keep the tongue off the back of the throat without moving the jaw forward.
Finally, oral appliances can be used to prevent sleep apnea as well.
There is increasing evidence that narrow dental arches which push the tongue back or require extractions to complete orthodontic treatment can increase the likelihood of developing sleep apnea later in life.
So interceptive orthodontics at an early age (typically between the ages of 6-11) utilizing palate expanders or similar appliances can actually help prevent future cases of sleep apnea from developing in the first place.