Posts for category: Oral Health
Chronic pain can turn your life upside down. While there are a number of disorders that fit in this category, two of them—fibromyalgia and temporomandibular disorders (TMD)—can disrupt your quality of life to the extreme. And it may be the two conditions have more in common than similar symptoms—according to one study, three-fourths of patients diagnosed with fibromyalgia show symptoms of TMD.
To understand why this is, let’s take a closer look at these two conditions.
Fibromyalgia presents as widespread pain, aching or stiffness in the muscles and joints. Patients may also have general fatigue, sleep problems, mood swings or memory failures. TMD is a group of conditions that often result in pain and impairment of the temporomandibular joints that join the jaw with the skull. TMD can make normal activities like chewing, speaking or even yawning painful and difficult to do.
Researchers are now focusing on what may, if anything, connect these two conditions. Fibromyalgia is now believed to be an impairment of the central nervous system within the brain rather than a problem with individual nerves. One theory holds that the body has imbalances in its neurotransmitters, which interfere with the brain’s pain processing.
Researchers have also found fibromyalgia patients with TMD have an increased sensitivity overall than those without the conditions. In the end, it may be influenced by genetics as more women than men are prone to have either of the conditions.
Treating these conditions is a matter of management. Although invasive techniques like jaw surgery for TMD are possible, the results (which are permanent) have been inconclusive in their effectiveness for relieving pain. We usually recommend patients try more conservative means first to lessen pain and difficulties, including soft foods, physical therapy, stretching exercises and muscle relaxant medication. Since stress is a major factor in both conditions, learning and practicing relaxation techniques may also be beneficial.
In similar ways, these techniques plus medication or cognitive-behavioral therapy that may influence neurotransmission can also help relieve symptoms of fibromyalgia. Be sure then that you consult with both your physician and dentist caring for both these diseases for the right approach for you to help relieve the effects of these two debilitating conditions.
If you would like more information on managing TMD or fibromyalgia, 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 “Fibromyalgia and Temporomandibular Disorders.”
Along with daily brushing and flossing, limiting your child’s sugar consumption is an important way to prevent tooth decay. We all know the usual suspects: candy, sugar-added snacks and sodas. But there’s one category you may not at first think fits the profile—juices. But even natural juices with no added sugar can raise your child’s risk of tooth decay if they’re drinking too much.
Tooth decay is caused by certain strains of bacteria in the mouth, which produce acid. Sugar in any form (sucrose, fructose, maltose, etc.) is a primary food source for these bacteria. When there’s a ready food source, bacteria consume it and produce abnormally high levels of acid. This can cause the mineral content of tooth enamel to dissolve faster than saliva, which neutralizes acid, can reverse the tide.
Juices without added sugar still contain the natural sugar of the fruit from which they originate. The American Academy of Pediatrics conducted a study of the effect of these natural juice sugars on dental health. Their conclusion: it can have an effect, so the amount of juice consumed daily by a child should be restricted according to age.
They’ve since published guidelines to that effect:
- Under age 1 (or any child with abnormal weight gain): no juice at all;
- Ages 1-3: no more than 4 ounces a day;
- Ages 4-6: no more than 6 ounces a day;
- Ages 7-18: no more than 8 ounces (1 cup) a day.
Again, these are guidelines—you should also discuss the right limits for your individual child with your dentist or pediatrician. And if you’re wondering what kind of beverages pose less risk of tooth decay, you can look to low or non-fat milk. And, of course, don’t forget water—besides containing no sugar, nature’s hydrator has a neutral pH, so it won’t increase acidity in the mouth.
Tooth decay is one of the biggest health problems many kids face. But with good teeth-friendly habits, including restricting sugar intake in any of its many forms (including juices) you can go a long way in reducing their risk of this destructive disease.
Over the last century effectively treating a decayed tooth has often required removing any decayed structure with drilling and then filling the remaining cavity. While this approach does save teeth that might otherwise be lost, it can also result in a fair amount of healthy structure removed in the process.
But continuing advances in dentistry are now making possible a new approach to tooth decay treatment that preserves as much of the healthy portions of tooth as possible. This new way is often referred to as minimally invasive dentistry (MID).
The primary goal of MID treatment is to intercept and treat decay as early as possible to minimize tooth damage. It begins with helping patients identify their own individual risk factors for decay such as the presence of disease-causing bacteria, the adequacy of their saliva flow, or their lifestyle and dietary habits. We then recommend changes or preventive measures to reduce those risks.
The next step in MID is using various diagnostic technologies to find decay as early as possible. X-rays continue to play a major role, but dentists are also using dental microscopy to magnify the earliest forms of decay. Many also utilize laser fluorescence, infrared photography and optical scanning to further “see” decay difficult to detect with the naked eye.
In regard to treatments, MID adopts the adage “less is more.” If caught early enough, we can encourage the re-mineralization of enamel that acid has eroded with CPP-ACP, a substance acquired from milk, or strengthen teeth with topical fluoride applications. Instead of the dental drill, many dentists now turn to air abrasion for decay removal, equipment that emits a fine stream of abrasive particles that harms less healthy structure than a drill.
And if lasers continue to develop at their current pace, we’ll be able to use this technology to perform much more precise decay treatment than possible with manual instruments. As a result, we’ll be able to treat decayed teeth with less invasive means to preserve as much healthy structure as possible.
As these and other developments continue, MID promises a bright future for preventing and treating tooth decay. As a result, there’ll be less tooth structure loss and more attractive and healthy smiles.
If you would like more information on the latest techniques for treating tooth decay, 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 “Minimally Invasive Dentistry.”
Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.
“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…
For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.
When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.
A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.
But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.
Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!
If you have questions about repairing chipped teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”
While tooth decay seems to get most of the “media attention,” there’s another oral infection just as common and destructive: periodontal (gum) disease. In fact, nearly half of adults over 30 have some form of it.
And like tooth decay, it begins with bacteria: while most are benign or even beneficial, a few strains of these micro-organisms can cause gum disease. They thrive and multiply in a thin, sticky film of food particles on tooth surfaces called plaque. Though not always apparent early on, you may notice symptoms like swollen, reddened or bleeding gums.
The real threat, though, is that untreated gum disease will advance deeper below the gum line, infecting the connective gum tissues, tooth roots and supporting bone. If it’s not stopped, affected teeth can lose support from these structures and become loose or out of position. Ultimately, you could lose them.
We can stop this disease by removing accumulated plaque and calculus (calcified plaque, also known as tartar) from the teeth, which continues to feed the infection. To reach plaque deposits deep below the gum line, we may need to surgically access them through the gums. Even without surgery, it may still take several cleaning sessions to remove all of the plaque and calculus found.
These treatments are effective for stopping gum disease and allowing the gums to heal. But there’s a better way: preventing gum disease before it begins through daily oral hygiene. In most cases, plaque builds up due to a lack of brushing and flossing. It takes only a few days without practicing these important hygiene tasks for early gingivitis to set in.
You should also visit the dentist at least twice a year for professional cleanings and checkups. A dental cleaning removes plaque and calculus from difficult to reach places. Your dentist also uses the visit to evaluate how well you’re doing with your hygiene efforts, and offer advice on how you can improve.
Like tooth decay, gum disease can rob you of your dental health. But it can be stopped—both you and your dentist can keep this infection from ruining your smile.