Healthy Mouth, Happy Heart!

Cardiovascular disease claims the lives of about 2,400 people every day.  New medical guidelines published in the American Journal of Cardiology encourage medical and dental professionals to cooperatively diagnose and manage patients who are at risk for heart disease and stroke. According to the American Academy of Periodontology, healthy gums can ward off heart disease and prevent you from becoming a statistic.

Most people have experienced gingivitis, which is the mildest form of gum disease. If gingivitis is left untreated, it can progress and involve the deeper tissues surrounding the teeth.  Gum disease leads to inflammation and bleeding, which allows oral bacteria to access the bloodstream. Research has suggested that some of these bacteria can cause blood clots in the arteries, which may contribute to blockages that lead to stroke.

Research conducted at several major universities, including the State University of New York at Buffalo, has concluded that inflammation is a common factor underlying both cardiovascular and periodontal disease. What does this mean for people living with heart disease or those at risk? Ultimately, controlling both conditions simultaneously leads to improved overall health for patients.  Don’t be surprised if your dentist refers you to a cardiologist, or if your physician sends you to the dentist’s office for an evaluation.

Are you at risk for developing heart disease? There are a number of steps you can take to positively impact your health:

• If you take Statin – type medications for high cholesterol, take them consistently.
• Keep up with your medical and dental checkups.
• Eat a healthy diet. It’s good for your gums and your heart.
• Tell your dentist if you are being treated by a physician.
• Brush and floss regularly, and have regular dental cleanings.
• If your dentist tells you that you have periodontal disease, follow through with the recommended treatment… it could save your life!

Most people realize that their dental checkups are important, but people who have or are at high risk for periodontal conditionsshould be seen for more frequent exams and cleanings? Sometimes this additional service is covered by insurance and sometimes it isn’t – regardless, rest assured that your dentist is making recommendations that are in your best interests.  We look forward to seeing you at your next visit and would be happy to help answer any questions you may have about managing your risks for cardiovascular or periodontal disease, and improving your overall health.

How Cavities Start

Sweets are the biggest culprit in causing cavities

Finding a cavity during a routine trip to the dentist is a familiar- if unpleasant – experience for many people; but most don’t realize that tooth decay is actually a disease process caused by bacteria, which can transmitted between people. Properly referred to as dental caries, this common oral disease affects children and adults of all ages… and is mostly preventable if you understand how the disease begins and spreads.

A cavity is actually a hole in the tooth. The hole is the end result of an infection by bacteria that produce acids which dissolve tooth structure. The dentist fills these holes as they are discovered but unfortunately, placing a filling the tooth without reducing the number of harmful bacteria in the mouth doesn’t usually cure the disease, and new cavities are likely to develop. Over 500 varieties of oral bacteria are found in the mouth, including the acid-producing Streptococcus mutans which is largely responsible for cavities. When they are not thoroughly and regularly removed by careful brushing and flossing, bacteria reproduce and thrive in a sticky substance that allows them to adhere to and destroy tooth surfaces. The key to controlling the caries disease process is to eliminate or control the cause – that sticky bacterial colony known as dental plaque.

Sugary or starchy foods that are left over in the mouth after eating provide a source of food for Streptococcus mutans, which creates acid as a waste product. Acids in the mouth break down and dissolve the minerals, primarily calcium in the teeth. As you probably are aware, brushing and flossing removes both the leftover food particles and the plaque, and is therefore a first line of defense against tooth decay. However, sometimes even people who have good oral hygiene develop cavities.

What is the explanation?

Bacteria are too small to be seen and can easily work their way underneath tiny cracks and openings that typically develop over time around old fillings, crowns and bridge work. Furthermore, when the molars are being formed, often deep and narrow grooves develop in the chewing surfaces. These grooves are wide enough to allow acids and microscopic bacteria to enter but too narrow to be cleaned with your tooth brush. That’s why even people who take excellent care of their teeth and have had great checkups for years still need periodic dental x-rays and professional examinations.

Because the risk of getting a cavity is directly related to both bacteria and the acid level in your mouth there are several steps you can take to prevent the caries process from starting:

• Don’t allow sweet drinks or foods to linger in the mouth over long periods of time. The longer teeth are exposed to these substances the more time bacteria will have to feed on it and produce acids that will bathe and destroy the teeth.

• Avoid sour candy and limit food and drink like soda, tea, and citrus fruits which increase the acidity of the mouth and harm the enamel.

• Stay away from anything sweet that sticks to the teeth. Foods like fruit rollups or taffy are obvious problems, but even “healthy” foods like raisins can stick and become be a source of food for decay causing bacteria!

• Brush twice and floss at least once daily to remove plaque.

• If you can’t brush after eating or drinking, rinse with water.

• Maintain regular dental checkups with periodic x-rays to check under fillings and between teeth where the dentist can’t see.

• Consider placing sealants (a semi-permanent plastic coating) on molars when they first erupt around age 6; this will keep harmful bacteria from invading deep inaccessible grooves.

• Make sure everyone in the family has had a checkup and is controlling their cavity risk factors when a new baby is on the way. Oral bacteria are transmitted between family members!

• Fluoride helps to remineralize teeth that have been “softened” with acids. Use fluoride toothpaste and ask your dental professional whether you are at high risk for cavities. Fluoride or another type of mouth rinse may also be recommended in either an over the counter or prescription strength.

• A one ounce piece of cheese eaten at the end of a meal helps neutralize acids.

• Xylitol, a sugar alcohol found in many products or sold as a sweeter chemically interacts with bacteria, preventing them from reproducing and reducing the acidity of the mouth. Ask your dental professional how you can incorporate Xylitol products into your diet.

• Specialized laser instruments are available to detect early cavities that are still too small to see. If detected early, in many cases these can be repaired (remineralized) without drilling and filling simply by adding minerals back into the dissolving tooth structure.

Managing dental caries is about more than just filling cavities. Though you may not have been aware of it, your dentist assesses your risk factors for tooth decay, including dietary and oral hygiene habits, family history and sometimes even body chemistry and saliva flow. A variety of techniques can be implemented at home and in the dental office to lower your risk for developing cavities and the dentist can make specific recommendations based on his assessment. Do you have a positive experience with any of the decay prevention techniques discussed in the article? We would like to hear from you!

Dry Mouth: Beyond Thirst

Is your mouth constantly dry and uncomfortable? Do you drink glasses and glasses of water in an attempt to hydrate your tongue, cheeks, and gums—but nothing seems to cure your ailments? Well, first things first: maybe you’re not thirsty! While dehydration is most obvious cause of dry mouth, there are other factors that commonly contribute—and they’re probably incorporated into your daily routine.

In its simplest regard, dry mouth is a result of inadequate saliva production. Saliva is produced to assist people in speaking, eating, and swallowing. Without enough saliva, any normal activities involving your mouth will continue to dehydrate your mouth. Throughout a day, you habitually and often unknowingly utilize your mouth, and in turn constantly deplete your saliva at practically all times. When your body isn’t producing saliva, the dryness builds up more and more, causing further symptoms detrimental to your oral health.

The most common symptoms associated with diagnosed dry mouth are frequent thirst, dry/sticky tongue, sores, dry lips, cracked corners of the mouth, dry or burning mouth and throat, rawness of the tongue, hoarse voice, and even bad breath.

So dry mouth and it’s correlated symptoms are caused by a reduction in saliva—but if drinking a lot of water isn’t helping you produce more saliva, what inhibits your body from this natural function?

Various pharmaceuticals are the largest cause. Recent studies have found that many drugs, over the counter or prescription, have mouth drying and saliva inhibiting side effects. The ADA and other health organizations are trying to bring awareness to consequences and risks of over 500 drugs and their contribution to dry mouth. Many people ingest dry-mouth-causing drugs on a daily basis (nearly half of Americans) because it’s a common side effect of pain relievers, anti-depressants, blood pressure medications, asthma and allergy relief, and diuretics.

This poses problem because the people who take these drugs are usually especially dependent on their medications. Prescriptions and other meds greatly assist the daily functions of millions of Americans. But at the same time, they cause other problems that may have bigger consequences than users realize.

And other than discomfort, dry mouth can contribute to actual oral health problems. When your mouth is dry, it’s more susceptible to getting sores, which can become quickly infected without protection from saliva. Also, saliva helps prevent teeth decay by cleaning and coating your teeth, so dry mouth often contributes to decaying, chipping, and overall unhealthy teeth.

If you’re not on any sort of daily medication and dry mouth persists, there are a few other causes. Smoking and chewing tobacco have huge health risks, dry mouth among them. Also, neck or back injuries can cause nerve damage that inhibits the body from sending saliva production messages to the brain. Any medical condition that resulted in the surgical removal of salivary glands would also cause dry mouth.

If you have dry mouth, here are some dos and don’ts to help you cope:

DO: Maintain a daily oral health routine. Brush your teeth and tongue with toothpaste that has fluoride. And as always, remember to floss.

DON’T: Eat spicy, sugary, or dry foods. They’ll only add to the dryness.

DO: Chew sugar free gum or suck on sugar free candies and lozenges. This can help stimulate saliva production.

DON’T: Smoke or drink excessive alcoholic or caffeinated beverages.

DO: Try out mouth guards with gel to produce artificial saliva.

Most of all, DO tell your doctor or dentist. They can help you figure out the cause of your dry mouth case, suggest treatment, and possibly change your daily prescription to something with less harmful or annoying side effects. At best, DON’T let your dry mouth persist.

Grinding and Clenching

Unexplained soreness of the jaw or neck muscles and persistent headaches could be an indication that you are suffering from bruxism, or grinding and clenching of the teeth.  The problem is treatable and more common that you may realize, even though most people are completely unaware that they do it.

Frequently, people who clench and grind their teeth do so during sleep, and learn about it from their sleep partner.    Sometimes bruxism is discovered when clients ask their dentist about pain or an odd sensation that their teeth are loose. However, the habit can create a long list of symptoms from mild to significant and can be quite destructive to the teeth themselves as well as to supporting structures, causing the gum recession and bone loss which can eventually cause teeth to be lost. Among people who chronically grind, fractured teeth and damage to the nerves which can require root canal therapy are common.  Unfortunately, this treatable behavior can exist for a long time before it is diagnosed, because many of the symptoms can be easily overlooked or ignored, and may be thought to have another cause.  Consider bringing to your dentist’s attention any of the following symptoms:

• Earache
• Headaches or Migraines
• Loose teeth
• Changes in the way your teeth fit together
• Sensitive teeth
• Tinnitus
• Gum recession
• Neck pain
• Insomnia
• Soreness of the jaw or neck

Bruxism is thought to run in families but it is also be a common response to stress, anxiety and depression. Other causes of the habit include bite problems, eating disorders, excessive alcohol use, and medical conditions such as Parkinson’s disease and obsessive compulsive disorder.  Ideally, treating bruxism involves managing or eliminating the cause but obviously, this is not always possible andtreatment for the behavior and its symptoms often focuses on interruption of the grinding, relieving stress on the jaw joint and and preventing damage to the teeth .

Careful examination of the teeth may reveal fine cracks, wear facets in the tooth anatomy, and otherwise unexplained changes in the bone around the teeth. These findings, along with a thorough medical history will help your dentist diagnose bruxism and suggest a treatment plan.  Most frequently, a hard plastic occlusal splint is custom made to fit the teeth. Worn while sleeping, this “nightguard ”  protects the teeth by covering their surface and enabling them to  glide easily.  The night guard is form-fitting, covers all of the upper teeth and  prevents them from shifting over time which ultimately prevents gradual changes in how teeth  fit together.  A different type of  FDA approved appliance called an NTI(Nociceptive Trigeminal Inhibition system)  fits only over the upper front teeth and prevents the back teeth from touching at all.  Other treatment options including biofeedback, hypnosis, dietary supplements and (rarely) Botox injections are less well known and have had mixed or questionableresults.

People who have been grinding their teeth for a long time may have significantly damaged their teeth;  in severe cases they can even be worn down to the gum line. The damage may have left teeth  sensitive and susceptible to cavities, and may have even caused changes in the shape of your face or the way you feel about your smile. The first step in addressing these issues is always to treat the  bruxism  so that no further damage occurs; and the good news is that there are several cosmetic options that can improve the function of your teeth as well as their appearance.      Your cosmetic dentist may suggest crowns, veneers or bonding as part of your complete treatment  plan.

Unexplained symptoms may not be as mysterious as you think… why not talk to your dentist about bruxism and what treatment options may be right for you?  You deserve a beautiful, pain-free smile!

Dental Anxiety? There is Hope and Help!

How do you feel about making a dental appointment? That may sound like an odd question but for between ten and thirty percent of Americans, anxiety about dental treatment and embarrassment about the anxiety – are major obstacles to overcome.  Although nobody really enjoys dental treatment, if anxiety or phobia is contributing to chronic, untreated dental problems then you should know that your dentist understands why this happens. There is hope and treatment that can help make scheduling and showing up for that dental appointment less traumatic.

A history of one or more unpleasant experiences or perhaps even something unexplained may contribute to their fears, which might range from a mild nervous feeling to excessive fear, complete with a range of physical symptoms that can include nausea, tremors and dizziness.  Unfortunately, too many people in this situation manage their anxiety by avoiding the dental office – and treatment that they know they need – altogether. The result of long term dental neglect can be serious, painful and expensive… but also unnecessary.  There are many solutions available for to treat dental anxiety so that it does not interfere with your good health.

Often dental anxiety is directly related to fear of not having control over what happens to you, which can be  triggered simply by being placed in a physically vulnerable position such as lying flat on your back with someone’s hands in around your face.   A simple and very effective way to manage this kind of anxiety is to simply discuss your feelings with your dentist, who will reassure you that you are in charge of your appointment. Sometimes, just knowing that the dentist or hygienist will not proceed with treatment if you are uncomfortable can alleviate anxiety and make treatment tolerable.

Many patients have learned to successfully manage mild to moderate anxiety by using their favorite music on an I-pod or CD player as a distraction; others have sought relief through learning mediation and relaxation techniques, and research suggests that hypnosis may be a promising treatment.

When dental anxiety or dental phobia is severe, there are several medical options that your dentist may offer. Nitrous Oxide, or “laughing gas” is a colorless and odorless gas, commonly available at the dentist’s office.  The relaxing, sedative effects begin working almost instantly as they are breathed in, and leave the body within a few minutes after removing the nose mask. Patients remain completely conscious and in-control throughout the procedure but without anxiety and no long lasting effects.

Alternatively, some patients benefit from “conscious sedation” in which sedative medications are prescribed by the dentist or a physician; this method is frequently used in pediatric (children’s) dental offices but is also used to help anxious adults. Usually such medications are taken at the dental office before treatment begins, and in some cases they may be delivered intravenously. Conscious sedation makes patients feel comfortable and sleepy without falling asleep; but unlike being “knocked out” with general anesthesia, they continue to breathe on their own and can interact with the dental team. Patients may also opt for an oral anti-anxiety medicine that they can take at home, which has a less profound physical effect.  Both situations require that someone accompany the patient to their appointment and drive them home afterward, because they may still be feeling the effect of the drug.

Technology has its’ place in helping manage dental anxiety as well, and can be a good solution for patients who would prefer not to take medications.   Many people are actually more anxious about needles and injections than they are about dental treatment, and for those patients a painless injection system may be the answer to their concerns. Another wonderful advancement, lasers have been used in dentistry for surgery, fillings and other procedures since about 1994. When a laser is used, often bleeding, swelling and pain are dramatically reduced and depending on the procedure to be performed, little or no anesthetic may be necessary. Lasers have the additional benefit that they do not emit the high pitched whine of the dental drill – a sound that invokes anxiety and sets many patients’  “teeth on edge” so to speak.  Speaking of unpleasant, sounds, researchers in London have recently developed an entirely silent dental drill. The device, which plugs into an MP3 player, actually cancels out that whining sound and as a result, patients feel more comfortable and less fearful.

Ultimately one of the easiest and most painless things that you can do to alleviate anxiety is to prevent dental problems altogether- as always, the keys are good homecare techniques, professional advice and regular checkups that allow the dentist to identify problems when they are small and easily treated…

So how do you feel about scheduling that overdue appointment? Talk to us, and let us help find a solution that will make it easier.  Have you have had an experience with one or more anxiety-reducing technique or product? We would like to hear about it.  What has worked for you, and what might you like to try in the future?