Posts for category: Oral Health
The change from primary teeth to permanent is an announcement to the world that a boy or girl is "growing up." "Growing up," though, is still not "grown"—the new teeth are still in a period of development that can affect how we treat them if they're injured or diseased.
While a new tooth erupts with all its anatomical layers, the middle dentin is somewhat thinner than it will be after it matures. The pulp, the tooth's innermost layer, produces new dentin and gradually increases the dentin layer during this early development period. While the pulp continues to produce dentin over a tooth's lifetime, most of it occurs in these early years.
To prevent or stop any infection, we would normally perform a root canal treatment in which we remove the pulp tissue and fill the empty pulp chamber and root canals. This poses no real issue in an older tooth with mature dentin. Removing the pulp from an immature tooth, though, could interrupt dentin development and interfere with the tooth's root growth. Besides a higher risk of discoloration, the tooth could become more brittle and prone to fracture.
That's why we place a high priority on preserving a younger tooth's pulp. Rather than a root canal treatment, we may treat it instead with one of a number of modified techniques that interact less with the pulp. Which of these we use will depend on the extent of the pulp's involvement with the injury or disease.
If it's unexposed, we may use a procedure called indirect pulp therapy, where we remove most of the tooth's damaged dentin but leave some of the harder portion intact next to the pulp to avoid exposure. If, though, some but not all of the pulp is damaged, we may perform a pulpotomy: here we remove the damaged pulp tissue while leaving the healthier portion intact. We may then apply a stimulant substance to encourage more dentin production to seal the exposure.
These and other techniques can help repair an injured young tooth while preserving most or all of its vital pulp. Although we can't always use them, when we can they could give the tooth its best chance for a full life.
If you would like more information on caring for your child's 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 “Saving New Permanent Teeth after Injury.”
Drugs play an indispensable role in treating disease. For example, life without antibiotics would be much more precarious—common infections we think nothing of now would suddenly become life-threatening.
But even the most beneficial drug can have disruptive side effects. Antibiotics in particular can cause a rare but still disturbing one: a growth on the tongue that at first glance looks like dark hair. In fact, it's often called "black hairy tongue."
It isn't hair—it's an overgrowth of naturally occurring structures on the tongue called filiform papillae. These tiny bumps on the tongue's upper surface help grip food while you're chewing. They're normally about a millimeter in length and tend to be scraped down in the normal course of eating. As they're constantly growing, they replenish quickly.
We're not sure how it occurs, but it seems with a small portion of the population the normal growth patterns of the papillae become unbalanced after taking antibiotics, particularly those in the tetracycline family. Smoking and poor oral hygiene also seem to contribute to this growth imbalance. As a result, the papillae can grow as long as 18 millimeters with thin shafts resembling hair. It's also common for food debris and bacteria to adhere to this mass and discolor it in shades of yellow, green, brown or black.
While it's appearance can be bizarre or even frightening, it's not health-threatening. It's mostly remedied by removing the original cause, such as changing to a different antibiotic or quitting smoking, and gently cleaning the tongue everyday by brushing it or using a tongue scraper you can obtain from a pharmacy.
One word of caution: don't stop any medication you suspect of a side effect without first discussing it with your prescribing doctor. While effects like black hairy tongue are unpleasant, they're not harmful—and you don't want to interfere with treatments for problems that truly are.
Wearing braces will probably never make your list of Most Pleasurable Life Experiences: you'll have to avoid certain foods and habits, endure some occasional discomfort, and perhaps feel some embarrassment about your appearance. The good news, though, is that at worst, these are mostly no more than inconveniences and additionally they're well worth the straighter, more attractive smile you'll achieve.
But there's one downside to braces that can lead to something more serious. The braces hardware makes brushing and flossing more difficult—and that could increase your risk of dental disease.
The principal goal of oral hygiene is to remove dental plaque, a thin film of accumulated bacteria and food particles that can cause tooth decay or periodontal (gum) disease. Without effective brushing and flossing, plaque can build up quickly and make the chances of having either of these two diseases more likely.
Not only does the braces hardware hinder your toothbrush's or floss's access to the parts of the teeth it covers, but it can also create "hiding places" for plaque build-up. Several studies have found that braces wearers on average have up to two to three times the plaque build-up of non-braces wearers.
There are ways, though, to make hygiene easier while wearing braces, particularly with flossing. Floss threaders or interproximal brushes can both be used to access between teeth while wearing braces. Another option is a water flosser or irrigator that sprays pressurized water between teeth (and beneath brackets and wires) to remove plaque. And braces wearers can get a prevention boost with topical fluoride applications or antibacterial mouth rinses to reduce disease-causing bacteria.
Besides taking a little extra time with brushing and flossing, you can also boost your mouth's health with good nutrition choices, less sugar consumption and keeping up regular dental visits. And, you should also see your dentist promptly if you notice any signs of tooth or gum problems—the sooner you have it checked and treated, the less damage any dental disease is likely to cause.
It's not easy keeping your teeth and gums plaque-free while wearing braces. But with a little extra time and effort, a few helpful tools and your dentist's support, you can maintain a healthy mouth during orthodontic treatment.
If you would like more information on best hygiene practices while wearing braces, 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 “Caring for Teeth during Orthodontic Treatment.”
Proponents of legalized marijuana have won phenomenal gains over the last decade. Despite the federal government's continuing criminalization of the drug, several states including California, Colorado and Massachusetts, have voted to legalize its recreational use.
Most people are aware of the social and political controversies the marijuana legalization movement stirs. But there's another side to this roiling issue: the health effects of marijuana, particularly for your teeth and gums. What may be lost beneath the more exciting headlines about ballot initiatives is the growing evidence that habitual marijuana use may increase the risk and severity of periodontal (gum) disease.
Gum disease is a bacterial infection caused by dental plaque, a thin film of bacteria and food particles that accumulates on teeth. The spreading infection triggers inflammation, a normal bodily response to disease that's ordinarily beneficial. But if the inflammation becomes chronic it weakens the gums' attachment to the teeth. This can create voids or periodontal pockets of infection around the teeth. The disease can eventually damage the underlying bone, which could accelerate tooth loss.
Poor oral hygiene is the biggest factor for an increased risk of gum disease; thinner gum tissue (an inherited condition or related to poor tooth position) is another factor, as well as lifestyle habits like tobacco use or excessive alcohol consumption. Add marijuana to the list: there's now some evidence that its use increases the risk for more severe periodontal pockets if the disease occurs.
In a recent study, researchers with the Columbia University College of Dental Medicine reviewed statistics on the care for nearly 2,000 adult patients; a quarter of those in the study were frequent marijuana users. The marijuana users proportionately had deeper periodontal pocket occurrences than the rest of the patients in the study that didn't use the drug.
The study doesn't say that marijuana causes periodontal (gum) disease. But it does suggest that marijuana use might increase its severity. As with other substances and practices in our society, marijuana use comes with a caveat: it may be legal where you live, but it may not necessarily be good for your health.
If you would like more information on the effects of marijuana use on your oral 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 “As More States Legalize Marijuana, Link to Gum Disease is a Concern.”
Now that we’re into the New Year, it’s a good time to look over your list of resolutions. Did you remember to include dental health on your list? Here’s one simple resolution that can help keep your smile bright and healthy through the New Year and beyond: Floss every day!
Your oral hygiene routine at home is your first line of defense against tooth decay and gum disease. While brushing your teeth twice a day effectively removes much of the food debris and dental plaque from your teeth, brushing alone is not sufficient to remove all the plaque that forms on your teeth and around your gums. For optimal oral health, flossing once a day is also necessary.
Which teeth do you need to floss? Any dentist will tell you, “Only the ones you want to keep!” And yet according to a national survey of over 9,000 U.S. adults age 30 and older, nearly 70% don’t floss every day, and nearly one third admit that they don’t floss their teeth at all. Unfortunately, if you don’t floss, you’ll miss cleaning about a third of your tooth surfaces. When plaque is not removed, this sticky film of bacteria releases acids that cause cavities and gum disease. With dental floss, however, you can clean between the teeth and around the gums where a toothbrush can’t reach.
Flossing is an essential component of good oral hygiene. Still, daily flossing seems to be a harder habit to get into than brushing. Some people tense up their cheek muscles while flossing, making it harder to comfortably reach the back teeth, so remember to relax as you floss. If unwaxed floss doesn’t glide easily between teeth, try waxed floss. If you have trouble using traditional dental floss, you can try threader floss, which has a rigid tip, interdental brushes, floss picks, or a water flosser, which cleans by way of pressurized water.
It’s not too late to add one more resolution to your list, and flossing is a habit that will go a long way toward keeping you in the best oral health. And along with good dental hygiene at home, regular professional dental cleanings and checkups are key to a healthy smile. If you would like more information about maintaining excellent dental health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Daily Oral Hygiene” and “Flossing—A New Technique.”