“No man is an island….” So wrote the poet John Donne four centuries ago. And while he meant the unity of humanity, the metaphor could equally apply to the interdependence of the various parts of the human body, including the mouth. According to recent scientific research, your mouth isn’t an “island” either.
Much of this research has focused on periodontal (gum) disease, an infection most often caused by bacterial plaque that triggers inflammation in the gum tissues. Although an important part of the body’s defenses, if the inflammation becomes chronic it can damage the gums and weaken their attachment to the teeth. Supporting bone may also deteriorate leading eventually to tooth loss.
Avoiding that outcome is good reason alone for treating and controlling gum disease. But there’s another reason—the possible effect the infection may have on the rest of the body, especially if you have one or more systemic health issues. It may be possible for bacteria to enter the bloodstream through the diseased gum tissues to affect other parts of the body or possibly make other inflammatory conditions worse.
One such condition is diabetes, a disease which affects nearly one person in ten. Normally the hormone insulin helps turn dietary sugars into energy for the body’s cells. But with diabetes either the body doesn’t produce enough insulin or the available insulin can’t metabolize sugar effectively. The disease can cause or complicate many other serious health situations.
There appears to be some links between diabetes and gum disease, including that they both fuel chronic inflammation. This may explain why diabetics with uncontrolled gum disease also often have poor blood sugar levels. Conversely, diabetics often have an exaggerated inflammatory response to gum disease bacteria compared to someone without diabetes.
The good news, though, is that bringing systemic diseases like diabetes under control may have a positive effect on the treatment of gum disease. It may also mean that properly treating gum disease could also help you manage not only diabetes, but also other conditions like cardiovascular disease, osteoporosis, or rheumatoid arthritis. Taking care of your teeth and gums may not only bring greater health to your mouth, but to the rest of your body as well.
If you would like more information on treating dental diseases like gum disease, 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 “Good Oral Health Leads to Better Health Overall.”
Over the last century dentistry has acquired the knowledge, techniques and treatments to prevent or minimize tooth decay. With this enhanced knowledge we’ve amassed a wealth of data about what increases dental disease development and what prevents it.
This has produced a balanced approach to identifying and treating disease-causing factors and incorporating factors that inhibit tooth decay. Known as Caries Management By Risk Assessment (CAMBRA), this approach first identifies each patient’s individual set of risk factors for dental disease and then develops a customized prevention and treatment plan to minimize their risk.
Rather than simply reacting to occurrences of tooth decay — “drill and fill” — CAMBRA anticipates and targets your susceptibility to decay. The primary factors can be represented by the acronym BAD: Bad bacteria, particular strains that produce acid, which at high levels erode enamel and expose the teeth to infection; Absence of saliva, or “dry mouth,” an insufficient flow of saliva that can’t effectively neutralize acid and restore mineral content to enamel; and Dietary habits too heavy in sugar or acid, which can result in bacterial growth and enamel erosion.
With an accurate picture of your particular risk level we can then apply countering factors from the other side of the balance — those that protect teeth from decay. In this case, we use the acronym SAFE: stimulating Saliva flow when needed or applying Sealants on chewing surfaces most susceptible to decay; Antimicrobials that reduce unhealthy bacteria levels and give healthy bacteria an opportunity to thrive; incorporating Fluoride, a chemical known to strengthen enamel, through hygiene products or direct application to the teeth; and an Effective diet, low in sugar and acid and high in fresh fruits, vegetables and whole grains.
There are a number of preventive and treatment measures that fall into each of the four preventive factors. Using the CAMBRA approach we can develop a treatment and prevention plan that incorporates measures that uniquely fit your dental health situation. With such a plan we can greatly reduce your risk of disease development and impact and better ensure a long and healthy life for your teeth and gums.
If you would like more information on managing dental disease prevention, 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 “Tooth Decay: How to Assess Your Risk.”
The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.
In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?
The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.
Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.
So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”
Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.
If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”
A toothache means you have tooth decay, right? Not necessarily — your pain could be signaling a number of potential causes. Determining where, how much and how often it hurts will help us find out the cause and apply the appropriate treatment.
A single symptom, for example, can mean many things. A twinge of tooth pain as you consume hot or cold foods might indicate localized tooth decay easily repaired by a filling. But it could also mean the tooth's root surface has been exposed as a result of periodontal (gum) disease — aggressive plaque removal and maybe even gum surgery might be necessary. Or it could be a sign of inner pulp decay: in this case you'll likely need a root canal treatment to save the tooth.
Pulp decay can also announce itself with a very sharp and constant pain radiating from one or more teeth. You shouldn't hesitate to see us for an examination — even if the pain goes away. Pain cessation most likely means the nerves in the pulp have died. The infection, however, still exists, so you'll still probably need a root canal treatment.
If you notice severe, continuous pain and pressure around a tooth, particularly about the gums, you may have a localized, inflamed area of infection called an abscess. An abscess can be the result of gum disease, but it might also stem from a foreign body like a popcorn husk, getting stuck below the gums. We'll need to conduct a complete dental examination to determine the cause and how to treat it.
Finally, a sharp pain when you bite down could mean many things such as a loose filling or a fractured (cracked) tooth. The latter especially requires immediate attention to save the tooth.
These are just a few of the possible causes behind mouth or facial pain. Although all of them are serious, a few are true dental emergencies and can't wait if we're going to save a tooth. The sooner you see us, the sooner we can help relieve the pain, minimize any damage and avert disaster.
If you would like more information on treating tooth 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 “Tooth Pain? Don't Wait!”
Although primary (“baby”) teeth have a lifespan of only a few years, they’re still important to a child’s current and future dental health. In the present, they help a child eat, speak and smile properly. They also help create a healthy future as placeholders for developing permanent teeth yet to come in.
If, however, a child loses a primary tooth prematurely due to decay, the corresponding permanent tooth could come in misaligned. That’s why we do what we can to help a decayed primary tooth reach its full lifespan. And there are different ways to do this depending on the type of tooth.
With front teeth, which don’t encounter the same chewing forces as those in the back, we may use a tooth-colored filling. This approach is also preferable for appearance’s sake since front teeth are highly visible when a child speaks or smiles.
Primary molars, on the other hand, need a more robust solution. A filling may not be able to withstand the level of long-term chewing forces that these back teeth normally encounter. And because they’re less visible than front teeth, there’s less concern about aesthetics.
That’s why many pediatric dentists prefer stainless steel crowns for molars. Just like their permanent teeth counterparts, a primary crown fits over and completely covers a tooth. They’re typically pre-formed, coming in different shapes and sizes that can then be customized for the tooth in question. After preparing and removing any decayed material from the tooth, we can usually install the crown in one visit with local anesthesia and a sedative (if the child needs it for anxiety).
While a steel crown isn’t the most attractive restoration, it typically handles the higher chewing forces in the back of the mouth better and longer than a filling. That’s especially critical for primary molars, which are some of the last teeth to fall out (as late as ages 10-12). And besides preserving it as a permanent tooth placeholder, a crown also helps the tooth function effectively in the present.
Regardless of what method we use, though, preserving primary teeth is a primary goal of pediatric dentistry. And with a stainless steel crown, we can keep those important back molars functioning for as long as they’re intended.
If you would like more information on caring for primary 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 “Stainless Steel Crowns for Kids.”
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