Posts for category: Oral Health
Your teeth naturally wear as you age, but you may be making it worse if you grind your teeth.
Teeth grinding is a behavior that causes the teeth to gnash, grind or clench against each other generating forces greater than those produced from normal biting. These forces often result in tooth wear that cause not only functional problems but result in a more aged appearance. Grinding occurs while a person is awake, but most often episodes occur while asleep at night.
Teeth grinding is quite common in children, but not usually of great concern since most grow out of it. There's even a school of thought that teeth grinding might even help readjust an uneven bite.
Among adults, though, other factors seem to contribute to teeth grinding. Many researchers believe nighttime grinding occurs as a person passes through different sleep phases including deep REM (Rapid Eye Movement) sleep. It may also have a connection with chronic snoring.
Certain medications seem to contribute to teeth grinding, particularly psychoactive drugs like amphetamines. Nicotine falls in this category, which could be why tobacco users report twice the incidence of the habit compared to non-users. Teeth grinding is also connected to another fact of modern life: stress. People who grind their teeth tend to have higher levels of anxiety, hostility or depression.
Because there are multiple triggers, there are many treatment approaches. Whatever course we take, our aim is to eliminate or minimize those factors that contribute to your habit. For example, we can create a custom mouth guard for night wear to prevent the teeth from making solid contact and thus reduce the biting pressure.
Perhaps the most important thing is to control or reduce stress. This is particularly helpful at night to prepare you for restful sleep by changing some of your behaviors. We also encourage investigating other stress therapies like biofeedback, meditation or group therapy.
Whatever the means, bringing teeth grinding under control not only reduces problems now, but could also help prevent abnormal teeth wearing and future health issues down the road.
If you would like more information on causes and treatments for teeth grinding, 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 “Stress & Tooth Habits.”
Dental caries (tooth decay) is a leading cause of tooth loss. But with prompt diagnosis and care we can often stop it before it causes too much damage.
The traditional treatment approach is simple: remove all diseased tooth structure and then restore the tooth with a filling. But this otherwise effective treatment has one drawback: you may lose significant healthy structure to accommodate a suitable filling or to make vulnerable areas easier to clean from bacterial plaque.
That's why a new treatment approach called minimally invasive dentistry (MID) is becoming more common. The goal of MID is to remove as little of a tooth's natural enamel and dentin as possible. This leaves the treated tooth stronger and healthier, and could reduce long-term dental costs too.
Here's how MID could change your future dental care.
Better risk assessment. MID includes a treatment protocol called caries management by risk assessment (CAMBRA). With CAMBRA, we evaluate your individual tooth decay risk, including oral bacteria levels, the quality of saliva flow to neutralize mouth acid, and sugar consumption. We then use our findings to customize a treatment plan that targets your areas of highest risk.
New detection methods. The real key to fighting tooth decay is to find it before it can destroy tooth structure with the help of new diagnostic technology. Besides advances in x-ray imaging that provide better views with less radiation exposure, we're also using powerful dental microscopes, lasers and infrared photography to show us more about your teeth than we can see with the naked eye.
"Less is More" treatments. In contrast to the dental drill, many dentists are now using air abrasion rather than a dental drill to remove decayed tooth material. Air abrasion emits tiny material particles within a pressurized air stream that leaves more healthy tooth structure intact than with drilling. We're also using new filling materials like composite resin that not only resemble natural tooth color, but require less structural removal than other types of fillings.
Using MID, we can treat tooth decay while preserving more of your natural teeth. This promises better long-term outcomes for future dental health.
If you would like more information on new treatments for 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: When Less Care is More.”
One of the health issues pregnant women should be concerned about is a higher risk of periodontal (gum) disease. But you don’t have to be pregnant to have an increased risk — you also may be more susceptible to dental disease if you’re taking certain birth control pills.
Gum disease is a bacterial infection caused by plaque, food debris that builds up on tooth and gum surfaces due to poor oral hygiene. If left untreated gum disease can eventually lead to the breakdown of connective gum tissue and cause tooth loss.
Pregnant women are at greater risk because of an increased level of female hormones (estrogen) in their blood stream. This causes a change in the blood vessels that supply the gums, making them more susceptible to the effects of bacteria. A number of birth control options also increase estrogen levels, causing much of the same effect. To heighten the effect, you may also have a predisposition toward gum disease by your genetics or a high stress level.
There are some things you can do, however, to help lower your risk if you’re taking birth control medication. First and foremost, practice a consistent, daily habit of brushing and flossing. If you’re unsure if your technique is effective, we can provide guidance and training to make sure you’re performing these tasks properly. You should also visit us at least twice a year for office cleanings and checkups: no matter how effective you are with brushing and flossing, plaque can still accumulate in hard to reach places and form hardened deposits known as calculus.
You should also be on the lookout for signs of disease like gum redness, swelling or bleeding. If you see any of these signs, contact us as soon as possible for a thorough examination. As with many other issues involving health, the sooner we begin treatment for gum disease the better your chances of stopping it before it does too much harm.
If you would like more information on the relationship between gum disease and pregnancy or birth control, 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 “Pregnancy & Birth Control.”
It’s estimated that between 10 and 40 million adults in the U.S. suffer from chronic jaw pain and disability. Healthcare providers refer to it as temporomandibular joint disorder (TMJD), a group of conditions characterized by pain and limited function with the jaw joints, as well as related muscles and tissues.
People with TMJD often experience popping, clicking or grating sounds when they move their lower jaw. The more serious symptoms, however, are severe pain and limited movement of the jaw. The causes of TMJD haven’t been fully substantiated, but it’s believed to be influenced by a person’s genetic background, their gender (most patients are women of childbearing age), their environment and behavioral habits. This uncertainty about the underlying causes has made it difficult to improve treatment strategies for the disorder.
One promising area of research, though, is suspected connections between TMJD and other health problems. In one survey of over 1,500 TMJD patients, nearly two-thirds indicated they had three or more other chronic conditions. Among the most frequently named were fibromyalgia, chronic fatigue syndrome, rheumatoid arthritis, and sleep disturbances.
We’re not quite sure how or why TMJD might be linked to these other conditions, but further study is underway. Researchers hope any knowledge uncovered could lead to advances in our ability to diagnose, treat and prevent TMJD.
Until then, the more traditional treatment approach remains the best course of action: medication to relax muscles and relieve pain; thermal therapies using hot and cold compresses during flare-ups; and physical therapy. Switching to softer foods temporarily may also give jaw muscles a rest from over-activity. Although jaw surgery is an option, we should consider it a last resort after other therapies have proven altogether ineffective in relieving pain and restoring function.
If you suspect you have TMJD, please visit a medical doctor first. Other conditions could mimic the symptoms of the disorder and would need to be ruled out first. If the diagnosis is TMJD, you’re not alone. You can receive information, support and updates on the latest research by visiting the TMJ Association at www.tmj.org.
If you would like more information on chronic jaw 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 “Chronic Jaw Pain and Associated Conditions.”
If you’ve had a total joint replacement or similar procedure, you will want your surgeon to decide if you need to take an antibiotic before you undergo dental work. This is a precaution to prevent a serious infection known as bacteremia.
Bacteremia occurs when bacteria become too prevalent in the bloodstream and cause infection in other parts of the body, especially in joints and bone with prosthetic (replacement) substances. It’s believed that during invasive dental procedures bacteria in the mouth can enter the bloodstream through incisions and other soft tissue disruptions.
Joint infections are a serious matter and can require extensive therapy to bring it under control. Out of this concern, the use of antibiotics as a prophylactic (preventive measure) against bacteremia once included a wide range of patients for a variety of conditions and procedures. But after an in-depth study in 2007, the American Dental Association concluded that the risks for many of these patient groups for infection triggered by a dental procedure was extremely low and didn’t warrant the use of antibiotic premedication therapy.
As a result, recommendations for antibiotic therapy changed in 2009, eliminating many groups previously recommended for premedication. But because of the seriousness of joint infection, The American Academy of Orthopedic Surgeons still recommends the therapy for joint replacement patients about to undergo any invasive procedure, including dental work. It’s especially needed for patients who also have some form of inflammatory arthritis, a weakened immune system, insulin-dependent diabetes, hemophilia, malnourishment or a previous infection in an artificial joint.
The guidelines for antibiotic premedication can be complex. It’s best, then, to speak with both your orthopedic surgeon and us about whether you should undergo antibiotic therapy before you undergo a dental procedure. The ultimate goal is to reduce the risks of any disease and to keep both your mouth and your body safe from infection.
If you would like more information on the use of antibiotics in 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 “Premedication for Dental Treatment.”