Posts for tag: oral health
There's no doubt about it — dentures have changed your life. Now you can eat and speak normally, and smile again with confidence. But if you're going to continue to benefit from your dentures, you'll need to take care of them. One of the best things you can do is not sleep with them in.
There are a couple of important reasons why you should take your dentures out when you go to bed. First, dentures tend to compress the bony ridges of the gums that support them. This contributes to the loss of the underlying bone, an occurrence common with missing teeth. Wearing dentures around the clock can accelerate this bone loss, which eventually loosens your denture fit.
Constant denture wearing also contributes to mouth conditions conducive to dental disease. You're more likely to develop tongue and denture plaque (a thin film of bacteria and food particles) that can cause gum inflammation or yeast development. The presence of the latter could also trigger a chronic response from your immune system that might make you more susceptible to other diseases.
Good oral hygiene is just as important with dentures as with natural teeth. Besides removing them at night, you should also take them out and rinse them after eating and brush them at least once a day with a soft tooth brush. And be sure to use regular dish or hand soap (especially antibacterial) or denture cleanser — toothpaste is too abrasive for denture surfaces.
It's also a good habit to store your dentures in water or, better, an alkaline peroxide solution. This will help deter plaque and yeast development. And don't forget the rest of your mouth: brush your tongue and gums with a very soft toothbrush (different from your denture brush) or clean them off with a damp cloth.
Taking care of your dentures will ensure two things. You'll lower your risk for disease — and you'll also help extend your dentures' life and fit.
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.
Gastroesophageal reflux disease (GERD) is a digestive disorder that can lead to a number of serious health problems. One of them, tooth erosion, could ruin your dental health.
Your stomach uses strong acids to break down food during digestion. A ring of muscle just above the stomach called the esophageal sphincter works as a one-way valve to allow food contents into the stomach but prevent acid from traveling back up through the esophagus.
GERD occurs when the esophageal sphincter weakens and starts allowing acid into the esophagus and potentially the mouth. The acid wash can eventually damage the esophageal lining, causing pain, heartburn, ulcers or even pre-cancerous cells.
Acid coming up in the mouth can cause the mouth’s normally neutral pH to slide into the acidic range. Eventually, these high acid levels soften and erode tooth enamel, increasing the risk of decay and tooth loss.
Accelerated erosion is often a sign of GERD—in fact, dentists may sound the first warning that a patient has a gastrointestinal problem. Unfortunately, a lot of damage could have already occurred, so it’s important to take steps to protect your teeth.
If you’ve been diagnosed with GERD, be sure to maintain good oral hygiene practices like brushing or flossing, especially using fluoride toothpaste to strengthen enamel. But try not to brush right after you eat or during a GERD episode: your teeth can be in a softened condition and you may actually brush away tiny particles of mineral. Instead, wait about an hour after eating or after symptoms die down.
In the meantime, try to stimulate saliva production for better acid neutralization by chewing xylitol gum or using a saliva booster. You can also lower mouth acid by rinsing with a cup of water with a half teaspoon of baking soda dissolved in or chewing on an antacid tablet.
You can also minimize GERD symptoms with medication, as well as avoiding alcohol, caffeine or spicy and acidic foods. Try eating smaller meals, finishing at least three hours before bedtime, and avoid lying down immediately after eating. Quitting smoking and losing weight may also minimize GERD symptoms.
GERD definitely has the potential to harm your teeth. But keeping the condition under control will minimize that threat and benefit your health overall.
If you would like more information on the effects of GERD 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 “GERD and Oral Health.”
If you’ve noticed redness or small skin cracks at the corners of your mouth, you may have a common infection known as perleche or angular cheilitis. Depending on its cause, there are ways to treat the redness and skin cracking to lessen your discomfort.
The term perleche comes from the French word “lecher,” meaning to lick. This is derived from the tendency of perleche patients to constantly lick the area to ease irritation; unfortunately, this also helps perpetuate the inflammation. Once the skin is broken the area is commonly infected by yeast called candida albicans.
Initially, perleche may arise from a variety of sources, most of them locally from either inside or around the mouth, although it can be triggered by a general body infection or disease like diabetes or cancer, or vitamin or iron deficiencies. Inside the mouth reduced saliva flow, tissue inflammation under a rarely cleaned denture (denture stomatitis), pressure on the mouth corners caused by a collapsed bite due to missing teeth and similar conditions can elevate the risks for infection. Around the mouth wrinkling or “marionette lines,” deep lines that extend from the mouth to the chin due to aging or environmental exposure, can contribute to crack formation. Drooling during sleep or as a result of orthodontic treatment is also a contributing cause.
The main focus of treatment for perleche is to bring any infection under control. This can be accomplished with a course of oral or topical antifungal (yeast-attacking) medication. If the infection has spread into the mouth or throat we might then prescribe a troche, a small lozenge designed to dissolve, which you would rinse with and then swallow to affect other portions of the mouth. Steroid or zinc oxide ointments applied directly to the skin can control inflammation and serve as a barrier agent with antifungal properties to promote healing.
If the cause is more related to dental problems (ill-fitting dentures or missing teeth), then it’s important to have these addressed and treated. You may also consult a dermatologist for treatments to lessen wrinkling around the mouth that might also contribute to chronic cases of perleche.
If you would like more information on cracked mouth corners, 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 “Cracked Corners of the Mouth.”
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.”