Posts for category: Oral Health
The mouth isn’t an island unto itself — problems there may be indicative of deeper physical or emotional issues. Â The condition of a family member’s teeth and gums, for example, could be signs of bulimia, an eating disorder.
Characterized by food binging and purging through self-induced vomiting, bulimia can also have a severe effect on the teeth. Regular inducement of vomiting introduces stomach acid into the mouth that can attack and soften the mineral content of tooth enamel. As a result, 90% of bulimics develop enamel erosion.
The erosion pattern often differs from that produced by other high acid causes like the over-consumption of sodas. Because the tongue instinctively covers the back of the bottom teeth during vomiting, they’re often shielded from much of the acid wash. Bulimics are much more apt to exhibit heavier erosion on the upper front teeth, particularly on the tongue side and biting edges.
Bulimia and similar disorders produce other signs as well, like soft tissue ulceration or swollen salivary glands that exhibit puffiness of the face. The roof of the mouth, throat and back of the tongue may appear roughened from the use of fingers or objects to induce gagging.
Unlike sufferers of anorexia nervosa who tend to be negligent about their hygiene (which itself increases their risk of dental disease), bulimics have a heightened sensitivity to their appearance. This concern may prompt them to aggressively brush right after purging, which can cause more of the softened enamel to be removed.
Treating the dental consequences of bulimia requires a two-pronged approach. In the short term, we want to lessen the impact of stomach acid by discouraging the person from brushing immediately after purging — better to rinse with water and a little baking soda to buffer the acid and wait about an hour before brushing. We may also suggest a sodium fluoride mouth rinse to help strengthen and re-mineralize the enamel.
In the long-term, though, the disorder itself must be addressed through professional help. One good source is the National Eating Disorders website (nationaleatingdisorders.org). Besides information, the association also provides a toll-free helpline for referrals to professionals.
As with any eating disorder, bulimia can be trying for patients and their families. Addressing the issue gently but forthrightly will begin their journey toward the renewal of health, including their teeth and gums.
If you would like more information on the effect of eating disorders on dental 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 “Bulimia, Anorexia & Oral Health.”
On the big screen, Australian-born actress Margot Robbie may be best known for playing devil-may-care anti-heroes—like Suicide Squad member Harley Quinn and notorious figure skater Tonya Harding. But recently, a discussion of her role in Peter Rabbit proved that in real life, she’s making healthier choices. When asked whether it was hard to voice a character with a speech impediment, she revealed that she wears retainers in her mouth at night, which gives her a noticeable lisp.
“I actually have two retainers,” she explained, “one for my bottom teeth which is for grinding my teeth, and one for my top teeth which is just so my teeth don't move.”
Clearly Robbie is serious about protecting her dazzling smile. And she has good reasons for wearing both of those retainers. So first, let’s talk about retainers for teeth grinding.
Also called bruxism, teeth grinding affects around 10 percent of adults at one time or another, and is often associated with stress. If you wake up with headaches, sore teeth or irritated gums, or your sleeping partner complains of grinding noises at night, you may be suffering from nighttime teeth grinding without even being aware of it.
A type of retainer called an occlusal guard is frequently recommended to alleviate the symptoms of bruxism. Typically made of plastic, this appliance fits comfortably over your teeth and prevents them from being damaged when they rub against each other. In combination with stress reduction techniques and other conservative treatments, it’s often the best way to manage teeth grinding.
Orthodontic retainers are also well-established treatment devices. While appliances like braces or aligners cause teeth to move into better positions, retainers are designed to keep teeth from moving—helping them to stay in those positions. After active orthodontic treatment, a period of retention is needed to allow the bite to stabilize. Otherwise, the teeth can drift right back to their old locations, undoing the time and effort of orthodontic treatment.
So Robbie has the right idea there too. However, for those who don’t relish the idea of wearing a plastic appliance, it’s often possible to bond a wire retainer to the back surfaces of the teeth, where it’s invisible. No matter which kind you choose, wearing a retainer can help keep your smile looking great for many years to come.
If you have questions about teeth grinding or orthodontic retainers, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Teeth Grinding” and “The Importance of Orthodontic Retainers.”
Considering all the intensive conditioning, practice and training they do, most people would expect elite athletes to be… well… healthy. And that’s generally true — except when it comes to their oral health. A major study of Olympic contenders in the 2012 London games showed that the oral health of athletes is far worse than that of the general population.
Or to put it more succinctly: “They have bodies of Adonis and a garbage mouth.”
That comment, from Dr. Paul Piccininni, a practicing dentist and member of the International Olympic Committee’s medical commission, sums up the study’s findings. In terms of the numbers, the report estimates that about one in five athletes fared worse in competition because of poor oral health, and almost half had not seen a dentist in the past year. It also found that 55 percent had cavities, 45 percent suffered from dental erosion (excessive tooth wear), and about 15 percent had moderate to severe periodontal (gum) disease.
Yet, according to Professor Ian Needleman of University College, London, lead author of the study, “Oral health could be an easy win for athletes, as the oral conditions that can affect performance are all easily preventable.”
Many of the factors that had a negative impact on the athletes are the same ones that can degrade your own oral health. A follow-up paper recently published in the British Journal of Sports Medicine identified several of these issues. One is a poor diet: The consumption of excessive carbohydrates and acidic foods and beverages (including sports drinks) can cause tooth decay and erosion of the protective enamel. Another is dehydration: Not drinking enough water can reduce the flow of healthy saliva, which can add to the damage caused by carbohydrates and acids. The effects of eating disorders (which are more commonly seen in certain sports, such as gymnastics) can also dramatically worsen an individual’s oral health.
Sound familiar? Maybe it’s because this brings up some issues that dentists have been talking about all along. While we don’t mean to nag, this study does point out that even world-class competitors have room for improvement with their oral hygiene. How about you? Whether you’re a triathlete in training, a weekend warrior or an armchair aficionado, good oral health can have a major effect on your well-being.
If you have additional questions about oral health, please contact us or schedule an appointment for a consultation. For more information, see the Dear Doctor magazine article “Good Oral Health Leads to Better Health Overall.”
Like most people, you’ve no doubt experienced occasional dry mouth as when you’re thirsty or just waking from sleep. These are normal occurrences that usually don’t last long.
But xerostomia or chronic dry mouth is another matter. Not only is this continual lack of adequate saliva uncomfortable, it could increase your risk for tooth decay or periodontal (gum) disease.
What’s more, chronic dry mouth can have a number of causes. Here are 3 common causes and what you can do about them.
Inadequate fluid intake. While this may seem obvious, it’s still common—you’re simply not consuming enough water. This deprives the salivary glands of adequate fluid to produce the necessary amount of saliva. If you’re regularly thirsty, you’ll need to increase the amount of water you drink during the day.
Medications. More than 500 drugs, both over-the-counter and prescription, can cause dry mouth as a side effect. This is one reason why older adults, who on average take more medications, have increased problems with dry mouth. There are some things you can do: first, talk with your healthcare provider about alternative drugs for your condition that are less likely to cause dry mouth; drink more water right before taking your medication and right afterward; and increase your daily intake of water.
Diseases and treatments. Some systemic diseases like diabetes or Parkinson’s disease can lead to xerostomia. Autoimmune conditions are especially problematic because the body may turn on its own tissues, the salivary glands being a common target. Radiation or chemotherapy treatments can also damage the glands and lead to decreased saliva production. If you have such a condition, talk with your healthcare provider about ways to protect your salivary glands.
You can also ease dry mouth symptoms with saliva boosters like xylitol gum or medications that stimulate saliva production. Limit your intake of caffeinated drinks and sugary or acidic foods. And be sure you stay diligent with your oral hygiene habits and regular dental visits to further reduce your risks of dental disease.
If you would like more information on the causes and treatments of dry mouth, 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 “Dry Mouth: Learn about the Causes and Treatment of this Common Problem.”
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.”