Monthly Archives: April 2011

Nutrition and Oral Health: You Really Are What You Eat!

It’s true! Do you have gingivitis, periodontal disease, mouth sores or frequent cavities? Most people know that good nutrition is an important part of an overall healthy lifestyle, but did you also know that what you eat actually has a direct impact on the health of your teeth and gums?

Here is something to smile about: a well balanced diet that is high in fiber can improve your oral health, and may reduce the risk of other diseases as well. Poor nutrition impacts the entire immune system, making it less efficient at fighting disease – including oral disease. As a result, people whose diet is lacking in key nutrients are more susceptible to a variety of systemic disorders including diabetes and cardiovascular disease. As a matter of fact, a study that appeared in the Journal of Periodontology reported that periodontal (gum and bone) disease progresses faster and is more severe in patients whose diet is deficient in certain nutrients. The key nutrients for a healthy mouth include:

Calcium: Teeth and the bones that support them are strengthened by the calcium they contain; and when there is not enough in your diet, the risk of developing gum disease and tooth decay is greater. Researchers have studied the relationship between calcium intake and gum disease, and have found that the participants with the healthiest teeth and gums consumed more than 800 mg of calcium daily, whereas those who consumed fewer than 500 mg were 54% more likely to develop gum disease. The best sources of calcium are dairy products, such as milk, cheese, and yogurt, however, beans, oysters and certain green, leafy vegetables are also rich in calcium. Calcium is also commercially added (fortified) to some juices and breakfast cereals. Supplements are available in various dosages for the lactose-intolerant and those who are calcium deficient in their diet.

Iron: Iron deficiency can cause tongue inflammation and mouth sores. Iron is found in many foods, particularly liver and red meat, but other iron-rich foods include bran cereals, some nuts, and spices.

Vitamin B3 (niacin): A lack of vitamin B3 can cause bad breath and canker sores in the mouth. To boost your B3 levels, eat chicken and fish.

Vitamins B12 and B2 (riboflavin) and folic Acid: When you do not consume enough of the vitamins B12 and B2 in your diet, you can develop mouth sores and a condition called pernicious anemia in which the body does not have enough red blood cells or hemoglobin. Pernicious anemia is often diagnosed in the dental office because patients with the condition will have a swollen red, shiny tongue. All three of these nutrients are essential for healthy gums .Red meat, chicken, liver, pork, fish, and dairy products like milk, yogurt, and cheese, are good sources of vitamin B12. Vitamin B2 is found in foods like pasta, bagels, spinach, and almonds. Spinach and broccoli are good sources of folic acid.

Vitamin C. Too little vitamin C may lead to bleeding gums and loose teeth. Not only does this vitamin support a healthy immune system for fighting disease, vitamin C is necessary to help the body produce collagen, a substance that gives support and structure to the gums and other body tissues. Sweet potatoes, raw red peppers, strawberries and citrus fruit like oranges are great sources of vitamin C.

Vitamin D. Vitamin D is necessary for the body absorb calcium. A diet low in vitamin D may cause a burning sensation in the mouth, with a metallic or bitter taste and dry mouth. Drink milk, and eat egg yolks and fish to increase your vitamin D intake.

Fiber: Foods with fiber stimulate saliva flow, which is the body’s natural defense against cavities. About 20 minutes after you eat something containing sugars or starches, saliva begins to neutralize the acids that destroy tooth enamel. As an added benefit, the fruits and vegetables that are fiber-rich are also good sources of other important nutrients!

Bacteria feed on leftover foods in the mouth and they produce acid which causes tooth decay. Carbohydrates like breads and pasta, or sticky foods that contain sugar – even natural sugar can be as harmful as a candy bar because they cling to the teeth and are not easily washed away by saliva. Soda that is high in sugar presents an obvious cavity risk, but all soda contains acids and phosphorous that erodes the tooth enamel. Even the fruits and vegetables that are so important nutritionally contain sugars that are damaging if left in contact with the teeth. You have heard it before: good homecare, including brushing and flossing are essential to a healthy mouth, and don’t forget about regular checkups and cleaning!

How sure are you that your diet is well balanced? Could you be at risk? Older adults or people with health issues that make eating certain foods difficult are at particular risk for oral health problems, but vegetarians who avoid meat and animal products may also be at higher risk for gum disease if they lack the nutrients these foods provide. Ensure that you’re getting the nutrients, vitamins and minerals your body needs… speak to your physician and dentist, and check out the U.S. Department of Agriculture’s website.


Senior Oral Health: Smiles For A Lifetime

Like the rest of the body, our mouth and likewise our oral health needs change as we get older; and just a few generations ago, oral disease and eventual tooth loss were expected parts of the aging process. Thanks to advancements in medicine over the past fifty years, adults expect to live longer healthier lives… and when seniors and the people who care for them are aware of their unique oral health needs, it is not unrealistic to expect to keep teeth in great shape for a lifetime of smiles!

Normal or not?

Changes in the skin, bones, circulation and immune system that affect the body also affect the mouth; and even the teeth undergo normal changes with age. Do you know what to expect?

A decline in the function of the immune system is a natural part of aging, but it is significant because it makes the body less capable of fighting infection. Everyone has both good and harmful bacteria in their mouth but as a result of the aging immune system, there is a gradual shift toward a greater number of the harmful bacteria which are responsible for gum disease, tooth decay and fungal infections such as yeast or thrush.

  • The Enamel: the outer shell of the tooth is the hardest substance in the body, and it is not replenished over time. Normal wear and tear over the life span causes it to be gradually worn away, which can expose the softer dentin underneath, making teeth more vulnerable to decay. Professional fluoride treatments may be recommended to strengthen the enamel. White fillings protect exposed dentin and cosmetically enhance your appearance… a stronger and more youthful smile is possible!
  • The Dentin: is the yellower, softer layer that underlies the enamel and covers the nerve of the tooth. Dentin is continually produced over the life of the tooth, and over time the tooth will naturally become darker and less sensitive to temperature. Older adults can and do have their teeth whitened with outstanding results. Usually, a cosmetic whitening procedure performed in the dental office is preferable to an over the counter product when the teeth have darkened significantly.
  • The Pulp: is the core of the tooth where the nerve and blood supply are found. The pulp shrinks as we age, making teeth less sensitive overall. Cavities may be much deeper and larger before they are felt. Many people mistakenly believe that dental checkups are less important as we get older but in reality, they are more important than ever!
  • The Bone: that supports the teeth should not change just because we get older. However, a person’s oral hygiene over their life span will directly impact the health of the bone over time. Periodontal (bone and gum) examinations are an important part of a routine dental checkup appointment for everyone. People who have had gum disease should have their bone level monitored more frequently, especially if they have difficulty fighting infections.
  • The Gums: lose collagen and connective tissue with age. Just like the skin of the rest of the body, the gums become thinner, more fragile, more susceptible to injury and infection, and may take longer to heal.

Common problems

Normal physiological changes may leave older adults vulnerable to oral complications… declining eyesight, failing memory and even arthritis may make self-care more challenging and those professional checkups much more critical. Chronic conditions such as diabetes, osteoporosis, and circulatory problems are often associated with aging and these can these have a major impact the health of the mouth as well. Regular checkups can alert your dentist to the possibility of underlying medical conditions that you may not be aware of; and just in case you still need to be convinced, here are some surprising facts about oral health problems commonly experienced by seniors:

  • Among those over 75 years of age, about 50% of have cavities on the roots of their teeth (root caries) and may not be aware of it. Untreated decay can progress into the pulp of the tooth causing pain and serious blood infections, such as septicemia.
  • About 25% of seniors ages 65 to 74 have severe periodontal disease. Research has linked this condition with other serious health problems such as diabetes, heart disease, stroke, respiratory illness and pneumonia in institutionalized patients.
  • Oral cancer is diagnosed most frequently in people over age 65. Each year 30,000 new cases of oral and throat cancers are diagnosed and about 8,000 individuals die from these diseases. Early cancers are treatable, but since they are usually painless they often remain undetected until they have reached the later stages. Do you know about your risk factors for oral cancer? There are many… including tobacco and alcohol use, but some oral cancers develop in people with no known risk factors at all. When was the last time you were examined by a dental professional?
  • Dry mouth is a major side effect of over 400 medications, many of which are taken by older adults. Blood pressure medications, cholesterol-lowering drugs, medicines for Alzheimer’s disease and antidepressants are just a few examples. Don’t underestimate the importance of this treatable condition… it contributes to tooth decay, gum disease, denture discomfort and it makes eating and speaking difficult or painful.

No matter what your age, a healthy mouth is important for general health and quality of life… and many older adults are choosing to cosmetically enhance their teeth for a real self esteem boost! Your personal oral health needs might include preventive checkups, fixing or replacing teeth or a brighter and younger looking smile. Whatever the case may be, your dental team has the expertise and the products that will allow you to look your best and love your smile for a lifetime! What types of services would you be most interested in learning more about?


Why is my mouth so dry… and what does it mean?

A chronically dry mouth is also known as “xerostomia” (pronounced zero-sto-me-a). Not a disease itself, xerostomia is a symptom of something that has limited the body’s ability to produce saliva… and it is more than just a nuisance, it’s a serious condition that can create havoc in the mouth and affect your overall health and quality of life. The problem is much more common than you might think…are you one of the millions of people who need some relief?

Anyone who has endured constant thirst knows how uncomfortable and annoying it is; but over time people sometimes adjust their thinking and “get used to it”, perhaps not even realizing how the condition has significantly limited their ability to taste, affected their eating habits, nutrition and speech. Saliva has a natural cleansing and protective effect, so without it the teeth are more susceptible to cavities. Without saliva, denture wearers may find they have more sores and increased difficulty tolerating their prosthesis.

Depending on the cause, a dry mouth can sometimes be cured entirely. Often, however, it can be treated to control the effects. In any event, xerostomia is a red flag that should not be ignored… not an inconvenience you should simply learn to live with. Some of the most common causes include:

  • Medications: Several hundred different pharmaceuticals ranging from heart and blood pressure medications, analgesics (pain medication), antidepressants, diuretics and cold medicines like antihistamines can reduce saliva flow, making this by far the most common cause of xerostomia. Chances are you have –or someone you know has- taken one of these types of drugs. Seniors are at especially high risk for dry mouth because they frequently take several medications. Unfortunately, the benefit of the medication is usually so important that the drug can’t be eliminated, but it doesn’t hurt to discuss managing the side effects with your physician.
  • Cancer treatment: The radiation and chemotherapy used to treat cancer can change the texture (thickness, or viscosity), flow and composition of saliva. Many times the resulting xerostomia resolves once the cancer treatment is complete. The exception is that radiation treatment to the head and neck can permanently damage the salivary glands.
  • Nerve Damage: Damage to the nerves that supply sensation to the mouth can occur as a result of surgery or injury. Salivary glands may themselves be healthy; but they cannot function normally unless the nerves can stimulate them to produce saliva.

When xerostomia can’t be completely eliminated, there are several treatments available to help alleviate discomfort and protect your mouth. Most people find some relief by sipping water or regularly or sucking on ice chips or hard candy… but beware of candy that is acidic (like lemon drops) or that contains sugar. This combination contributes to the breakdown of tooth enamel and is a recipe for disaster in the person with a dry mouth… the risk of getting cavities is even greater when there is no saliva to buffer the effects of the acid and sugar! Try using a lozenge that contains Xylitol, a sugar substitute with an anti-bacterial effect.

Over the counter toothpastes, mouth rinses, sprays and gels that contain glycerin and protective enzymes are available for purchase in the oral hygiene section of the drug store or the market; and several saliva substitutes are available by prescription… ask your dentist, physician or pharmacist for more information about these products! At home, make sure you are keeping your mouth meticulously clean: floss and brush daily and reduce sugar in your diet, but avoid mouthwash with alcohol in it because it is very drying. Be sure to ask for a fluoride treatment when you schedule your cleaning appointments for extra cavity protection. Your dental professional can let you know if an antibacterial rinse or a prescription fluoride product for use at home may be right for you as well.

Dry mouth is a common and manageable symptom but unfortunately, many people never talk about it. Sometimes it seems trivial when compared to the other conditions that they are living with which may be causing it. If someone you care for is at risk for xerostomia because they take medications or have a medical condition – ask them if they are suffering… you might be surprised, and you might be able to suggest something to help!

Are you one of the many people who live with a chronically dry mouth? Have you tried – or would you consider trying one of the prescription or over the counter remedies to help relieve your xerostomia?


Tooth-fully Speaking

Tooth-fairy tales are favorites among young children, but myths and misconceptions about dentistry are abundant in adult circles as well. How well can you decipher fact from fiction? These common misconceptions often begin with a grain of truth, but they quickly depart…creating unreasonable anxiety and potentially serious consequences, so it’s always a good idea to check your facts with a professional.

Myth: Too much sugar causes tooth decay.

The fact is that limiting sugar intake is a good idea, but the amount of sugar that you eat or drink is not nearly as important as the amount of time that the sugar has contact with the teeth. Oral bacteria consume sugar and produce acids that dissolve the tooth enamel, so slowly-dissolving candies and sweet drinks like soda or juice that are sipped over long periods of time are particularly problematic because they increase the amount of time teeth are exposed to the acid. Your best bet is to consume carbohydrates (like cookies and bread), or sweet drinks and foods all at once. Then rinse with water or better yet, brush your teeth. A small piece of cheese after a meal has also been shown to neutralize harmful acids in the mouth.

Myth:  Losing baby teeth to tooth decay is okay.

It is a common myth that losing baby teeth due to tooth decay is not important, because baby teeth fall out anyway. Sometimes a dentist will delay fixing a small cavity in a baby tooth, especially if a child is close to the age when the tooth will be lost anyway. This practice spares the child unnecessary pain and anxiety. However, the fact is that untreated cavities in baby teeth can result in damage to the developing crowns of the permanent teeth, and if baby teeth are lost too soon, the permanent teeth may not erupt correctly and a child may require braces to correct his bite. Your best bet is to prevent problems altogether, or at the very least identify them early. Ensure regular checkups for your child beginning as soon as his teeth erupt.

Myth: Dental decay is only a young person’s problem.

Generally adults are more conscientious about their homecare; but the fact is anyone can be at risk for getting a cavity. Receding gums are common in older adults, and the condition can result in cavities developing on the exposed roots of teeth.  Frequently prescribed medications like antidepressants, diuretics, blood pressure medications, and antihistamines cause a dry mouth which increases the risk of tooth decay. . . Just like children, adults should know their risk factors: limit sugar intake, use fluoride toothpaste, and visit the dentist for regular checkups.

Myth: Brushing my teeth with a medium or hard brush will do a better job.

Always use a soft toothbrush to avoid damage to the gums and teeth.   The fact is that a correct technique is far more effective than aggressive brushing… remember that the material you are trying to remove is soft. Once it hardens, you cannot remove it with a tooth brush anyway.  Your tooth enamel is resilient, and you can safely brush it after every meal as long as you are gentle. People who use an electric or ultrasonic brush should use extra caution, because these can be destructive when used improperly. Get individual instructions from your dental professional!

Myth: I shouldn’t brush (or floss) my teeth if my gums bleed.
Bleeding is never a good sign, and the fact is that it is most often the result of plaque (bacteria) which is not properly removed by regular brushing and flossing.  Instead of avoiding the area, which makes the problem worse, your best bet is make an extra effort to brush and floss gently twice a day and visit your dental professional to be evaluated.  Persistently bleeding Gums that bleed persistently even when oral hygiene is adequate may signal an underlying medical problem and you should seek medical advice.

Myth: Teeth whitening will damage my enamel.

Whitening can improve almost everyone’s smile, but the fact is that there is a right and wrong way to use them and they are not appropriate for everyone. However, when used according to manufacturer’s directions, they are safe and effective and can be used with confidence.

Myth: A dental checkup is necessary every six months.


Twice a year is a common interval and is effective for many people. However, the fact is that frequency of your checkups depends on many factors including your ability to take care of your teeth and gums, whether you have had periodontal disease, and your history of cavities. The dentist and hygienist will make an individual recommendation for you based on your particular needs.

Myth: Bad breath is only caused by not brushing your teeth properly.


The fact is that most breath odor is caused by poor oral hygiene; however, smoking, certain foods and sometimes an underlying disease such as diabetes can make your breath smell bad. If you are brushing and flossing consistently and breath odor is a persistent problem, see the dentist for an evaluation. You may also wish to consult your family doctor to rule out a medical condition.

 

Myth: Bad teeth run in my family.

The fact is that genetics do play a role in how susceptible you may be to oral disease; and there are certain rare inherited disorders that cause abnormally brittle or deficient tooth enamel. However, in the vast majority of cases poor oral hygiene and dental plaque are the real cause of cavities and gum disease. It is true that problems “run in families”… After all, children learn to care for their teeth from their parents- and not all parents place a high priority on dental care. Ultimately whether or not your teeth are healthy depends mostly upon your behavior, not your genetics.

 

 

Myth: Dentures will be easier than caring for my teeth

While dentures are an important option for people who have lost their teeth, they are not without their own set of challenges.  Over time, the bone that supported your natural teeth will begin to dissolve away, making it difficult to maintain a good denture fit.  Even the best fitting dentures will take time to get used to and will never be quite as good as the teeth Mother Nature made. Dentures may help resolve pain and other issues when the natural teeth are badly diseased or decayed; but the fact is that dentures also predispose a person to mouth sores, and an upper denture may affect the way your food feels and tastes in your mouth because it covers the palate.  Dentures- and the mouth that they are worn in require regular maintenance, just like natural teeth and they are really best reserved for a last resort.

Myth: It’s easier to extract a tooth than to save it.

The truth is that an ounce of prevention really is worth a pound of cure! Bone dissolves around the place where a tooth has been lost; this changes the shape of the jaw and can affect the way the remaining teeth fit together.   Replacement of a lost tooth may require placement of a bridge, which will most likely need to be remade at least once. Implants are an excellent replacement option, but a surgical procedure is necessary.  An extraction may seem like a simple, inexpensive solution for a tooth that is causing a problem but the fact is that almost always, it is less expensive and less complicated in the long run to prevent tooth loss.

Myth: The Tooth Fairy collects children’s lost baby teeth and leaves a gift in exchange.

Fact… of course!

Don’t rely on “word-of-mouth” when it comes to your oral health. There are many trustworthy sources for checking up on oral health facts, including the American Dental Association, your dental professional team and of course, the six year old with the quarter under his pillow!