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Posts for category: Oral Health

By George H Johnson, Jr., DDS, FAGD
April 05, 2021
Category: Oral Health
Tags: oral health  
AnEatingDisorderMayShowItselfinTheMouth

Although dental care is our primary focus, we dentists are also on the lookout for other health problems that may manifest in the mouth. That's why we're sometimes the first to suspect a patient may have an eating disorder.

Eating disorders are abnormal dietary patterns that can arise from mental or emotional issues, the most common being anorexia nervosa and bulimia nervosa. Each has different behaviors: Anorexics abnormally restrict their food intake (“self-starvation”), while bulimics typically eat heavily and then induce vomiting (“binge and purge”).

Although bulimics are more likely to binge and purge, anorexics may also induce vomiting. That practice in particular can leave a clue for dentists. While vomiting, powerful stomach acid enters the mouth, which can then soften and erode tooth enamel.

It's the pattern of erosion a dentist may notice more than the erosion itself that may indicate an eating disorder. A person while vomiting normally places their tongue against the back of the lower teeth, which somewhat shields them from acid. The more exposed upper teeth will thus tend to show more erosion than the bottom teeth.

A dentist may also notice other signs of an eating disorder. Enlarged salivary glands or a reddened throat and tongue could indicate the use of fingers or objects to induce vomiting. Lack of oral hygiene can be a sign of anorexia, while signs of over-aggressive brushing or flossing may hint of bulimia.

For the sake of the person's overall well-being, the eating disorder should be addressed through professional counseling and therapy. An excellent starting point is the website nationaleatingdisorders.org, sponsored by the National Eating Disorders Association.

The therapy process can be lengthy, so patients should also take steps to protect their teeth in the interim. One important measure is to rinse out the mouth following purging with a little baking soda mixed with water. This will help neutralize oral acid and reduces the risk of erosion. Proper brushing and flossing and regular dental visits can also help prevent dental disease.

An eating disorder can be traumatic for both patients and their families, and can take time to overcome. Even so, patients can reduce its effect on their dental health.

If you would like more information on eating disorders and dental care, 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.”

By George H Johnson, Jr., DDS, FAGD
March 16, 2021
Category: Oral Health
Tags: osteoporosis  
CertainDrugsforOsteoporosisCouldImpactYourDentalCare

Osteoporosis is a serious bone weakening disease in older adults that can turn a minor fall into a major bone fracture. But the condition could also impact dental treatment—triggered ironically by the drugs used to treat osteoporosis rather than the disease itself.

From the Latin for “porous bone,” osteoporosis causes bone to gradually lose mineral structure. Over time the naturally-occurring spaces between mineralized portions of the bone enlarge, leaving it weaker as a result.

Although there's no definitive cure for osteoporosis, a number of drugs developed over the last couple of decades can inhibit its progress. Most fall into two major categories, bisphosphonates and RANKL inhibitors.

These drugs work by inhibiting the normal growth cycle of bone. Living bone constantly changes as cells called osteoblasts produce new bone. A different type, osteoclasts, clear away older bone to make room for these newer cells. The drugs selectively destroy osteoclasts so that the older bone, which would have been removed by them, remains for a longer period of time.

Retaining older cells longer initially slows the disease process. But there is a downside: in time, this older bone kept in place continues to weaken and lose vitality. In rare instances it may eventually become detached from its blood supply and die, resulting in what is known as osteonecrosis.

Osteonecrosis mostly affects two particular bones in the body: the femur (the long bone in the upper leg) and the jawbone. In regard to the latter, even the stress of chewing could cause osteonecrosis in someone being treated for osteoporosis. It can also occur after tooth extractions or similar invasive procedures.

If you're taking a bisphosphonate or RANKL inhibitor, you'll want to inform your dentist so that the necessary precautions can be taken before undergoing dental work more invasive than routine cleanings or getting a filling or crown.  If you need major dental work, your dentist or you will also need to speak with your physician about stopping the drug for a few months before and after a dental procedure to minimize the risk of osteonecrosis.

Fortunately, the risk for dental problems while undergoing treatment for osteoporosis is fairly low. Still, you'll want to be as prepared as possible so that the management of your osteoporosis doesn't harm your dental health.

If you would like more information on osteoporosis and 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 “Osteoporosis Drugs & Dental Treatment.”

By George H Johnson, Jr., DDS, FAGD
March 06, 2021
Category: Oral Health
DontEatMotorizedCornontheCobandOtherDentalSafetyTips

We're all tempted occasionally to use our teeth in ways that might risk damage. Hopefully, though, you've never considered anything close to what singer, songwriter and now social media persona Jason Derulo recently tried in a TikTok video—attempting to eat corn on the cob spinning on a power drill. The end result seemed to be a couple of broken front teeth, although many of his followers suspected an elaborate prank.

Prank or not, subjecting your teeth to “motorized corn”—or a host of other less extreme actions or habits—is not a good thing, especially if you have veneers, crowns or other dental work. Although teeth can withstand a lot, they're not invincible.

Here, then, are four things you should do to help ensure your teeth stay healthy, functional and intact.

Clean your teeth daily. Strong teeth are healthy teeth, so you want to do all you can to prevent tooth decay or gum disease. Besides semi-annual dental cleanings, the most important thing you can do is to brush and floss your teeth daily. These hygiene tasks help remove dental plaque, a thin biofilm that is the biggest culprit in dental disease that could weaken teeth and make them more susceptible to injury.

Avoid biting on hard objects. Teeth's primary purpose is to break down food for digestion, not to break open nuts or perform similar tasks. You should also avoid habitual chewing on hard objects like pencils, nails or ice to relieve stress. And, you may need to be careful eating apples or other foods with hard surfaces if you have veneers or composite bonding on your teeth.

Wear a sports mouthguard. If you or a family member are regularly involved with sports like basketball, baseball/softball or football (even informally), you can protect your teeth from facial blows by wearing an athletic mouthguard. Although you can obtain a retail variety in most stores selling sporting goods, a custom-made guard by a dentist offers the best protection and comfort.

Visit your dentist regularly. As mentioned before, semi-annual dental cleanings help remove hidden plaque and tartar and further minimize your risk of disease. Regular dental visits also give us a chance to examine your mouth for any signs of decay or gum disease, and to check on your dental health overall. Optimizing your dental health plays a key part in preventing dental damage.

You should expect an unpleasant outcome involving your teeth with power tools. But a lot less could still damage them: To fully protect your dental health, be sure you practice daily oral care, avoid tooth contact with hard objects and wear a mouthguard for high-risk physical activities.

If you would like more information on caring for your cosmetic dental work, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Porcelain Veneers” and “An Introduction to Sports Injuries & Dentistry.”

By George H Johnson, Jr., DDS, FAGD
February 24, 2021
Category: Oral Health
Tags: oral hygiene  
FlossinganImplant-SupportedBridgecanPreventaDamagingGumInfection

In recent years, dental implants have helped traditional bridgework take a giant leap forward. A few strategically placed implants can provide the highest support and stability we can currently achieve for this well-known dental restoration.

Implants derive this stability from the bone in which they're imbedded. Once surgically installed, the bone around a metal implant begins to grow and adhere to its titanium surface. Over time, this creates a strong anchor that firmly holds the implant in place.

But the implants' stability can be threatened if the gums around them become diseased. Gum disease, a bacterial infection caused mainly by dental plaque, can advance silently below the gum surface until it ultimately infects the bone. This can cause significant bone loss around an implant, which can weaken it to the point of failure.

To avoid this scenario, it's important to prevent gum disease by flossing daily to remove accumulated dental plaque between the implant-supported bridge and the gums, particularly around the implants. This kind of flossing around bridgework is more difficult than flossing between teeth, but it can be done with the help of a device called a floss threader.

A floss threader is a small plastic hand tool with a loop on one end and a stiffened edge on the other (similar to a sewing needle). You begin by threading about 18" of dental floss through the loop, and then work the other end of the threader between the bridge and gums to the other side.

With the floss threaded between the bridge and gums, you can now remove it from the threader, grasp each end, and floss around the sides of each implant you can reach. You'll then need to repeat the process by removing the floss, rethreading it in the threader and inserting it into the next section between implants, continuing to floss until you've accessed each side of each implant.

You can also use pre-packaged floss thread sections with a stiffened end to facilitate threading. But whichever product you use, it's important to perform this task each day to prevent a gum infection that could rob you of your implant-supported bridge.

If you would like more information on oral hygiene practices with dental work, 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 “Oral Hygiene for Fixed Bridgework.”

By George H Johnson, Jr., DDS, FAGD
February 14, 2021
Category: Oral Health
Tags: oral health   pregnancy  
DontAvoidDentalCareWhileYourePregnant

Learning you're pregnant can change your life in a heartbeat—or now two. Suddenly, what was important to you just seconds before the news takes a back seat to the reality of a new life growing within you.

But although many of your priorities will change, there's one in particular that shouldn't—taking care of your dental health. In fact, because of the hormonal changes that will begin to occur in your body, your risk of dental disease may increase during pregnancy.

Because of these hormonal variations, you may find you have increased cravings for certain foods. If that includes eating more carbohydrates (especially sugar), bacteria can begin to multiply in your mouth and make you more susceptible to tooth decay and periodontal (gum) disease.

The hormones in themselves can also increase your risk of gum disease in particular. There's even a name for a very common form of gum infection—pregnancy gingivitis—which affects around two-fifths of pregnant women. If not treated, it could aggressively spread deeper within the gums and endanger both your teeth and supporting jaw bone.

The key to minimizing both tooth decay and gum disease is to keep your mouth clean of dental plaque, a thin bacterial biofilm most responsible for these diseases. You can do this by keeping up daily brushing and flossing and maintaining regular dental cleanings and checkups. Professional dental care is especially important during pregnancy.

You may, though, have some reservations about some aspects of dental care, especially if they involve undergoing local anesthesia. But many medical organizations including the American Congress of Obstetricians and Gynecologists and the American Dental Association recommend dental treatment during pregnancy. Even procedures involving local anesthesia won't increase the risk of harm to you or your baby.

That said, though, elective dental work such as cosmetic enhancements, might be better postponed until after the baby is born. It's best to discuss with your dentist which treatments are essential and should be performed without delay, and which are not. In general, though, there's nothing to fear for you or your baby continuing your regular dental care—in fact, it's more important than ever.

If you would like more information on dental care during pregnancy, 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 “Dental Care During Pregnancy.”