Posts for category: Oral Health
Narcotics have long played an important role in easing severe pain caused by disease, trauma or treatment. Healthcare professionals, including dentists, continue to prescribe them as a matter of course.
But narcotics are also addictive and can be dangerous if abused. Although addictions often arise from using illegal drugs like heroin, they can begin with prescriptive narcotics like morphine or oxycodone that were initially used by patients for legitimate reasons.
As a result, many healthcare providers are looking for alternatives to narcotics and new protocols for pain management. This has led to an emerging approach among dentists to use non-addictive non-steroidal anti-inflammatory drugs (NSAIDs) as their first choice for pain management, reserving narcotics for more acute situations.
Routinely used by the public to reduce mild to moderate pain, NSAIDs like acetaminophen, ibuprofen or aspirin have also been found to be effective for managing pain after many dental procedures or minor surgeries. NSAIDs also have fewer side effects than narcotics, and most can be obtained without a prescription.
Dentists have also found that alternating ibuprofen and acetaminophen can greatly increase the pain relief effect. As such, they can be used for many more after-care situations for which narcotics would have been previously prescribed. Using combined usage, dentists can further limit the use of narcotics to only the most severe pain situations.
Research from the early 2010s backs up this new approach. A study published in the Journal of the American Dental Association (JADA) concluded that patients receiving this combined ibuprofen/acetaminophen usage fared better than those only receiving either one individually. The method could also match the relief power of narcotics in after care for a wide range of procedures.
The NSAID approach is growing in popularity, but it hasn't yet displaced the first-line use of narcotics by dental professionals. The hesitancy to adopt the newer approach is fueled as much by patients, who worry it won't be as adequate as narcotics to manage their pain after dental work, as with dentists.
But as more patients experience effective results after dental work with NSAIDs alone, the new approach should gain even more momentum. And in the end, it promises to be a safer way to manage pain.
If you would like more information on dental pain management, 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 “Are Opioids (Narcotics) the Best Way to Manage Dental Pain?”
What makes a beautiful smile? Beautiful teeth, for sure. But there's also another component that can make or break your smile, regardless of your teeth's condition: your gums. Although their primary function is to protect and stabilize the teeth, your gums also enhance them aesthetically by providing an attractive frame.
But just as a painting displayed in an oversized frame can lose some of its appeal, so can your smile if the size of your gums appears out of proportion with your teeth. Normally, a smile that displays more than four millimeters of gum tissue is considered “gummy.”
There are some things we can do to improve your gum to teeth ratios. What we do will depend on which of the following is the actual cause for your gummy smile.
Excess gum tissue. We'll start with the obvious: you have excess gum tissue that obscures some of the visible tooth crown. We can often correct this with a surgical procedure called “crown lengthening,” which removes some of the excess tissue and then reshapes the gums and bone to expose more teeth length.
Teeth that appear too short. The problem may not be your gums — it could be your teeth appear too short. This can happen if the teeth didn't erupt fully, or if they've worn down due to aging or a grinding habit. One option here is to “lengthen” the tooth cosmetically with veneers, crowns or other bonding techniques.
Higher lip movement. Rather than your teeth and gums being out of size proportion, your upper lip may be rising too high when you smile, a condition known as hypermobility. One temporary fix is through Botox injections that paralyze the lip muscles and prevent their movement from overextending. We could also use periodontal surgery to perform a lip stabilization procedure that permanently corrects the upper lip movement.
Overextended jaw. Your gums may seem more prominent if your upper jaw extends too far down and forward. In this case, orthognathic (jaw straightening) surgery might be used to reposition the jaw relative to its connection with the skull. Setting the jaw up and back in this way would reduce the prominence of the gums when you smile.
As you can see, treatments range from cosmetic techniques to moderate surgical procedures. A full dental exam will help determine which if any of these measures could reduce gumminess and improve your smile.
If you would like more information on correcting gummy smiles, 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 “Gummy Smiles.”
The top cause for adult tooth loss isn't decay or trauma—it's periodontal (gum) disease. The disease may begin with the gums, but it can ultimately damage underlying bone enough to weaken its support of teeth, causing them to loosen and fall out.
But that's not the end of the havoc gum disease can wreak. The consequences of an uncontrolled infection can ripple beyond the mouth and worsen other health problems like diabetes, heart disease or arthritis.
The common link between gum disease and these other conditions is the inflammatory response, a natural mechanism to fight infection caused by disease or trauma. This mechanism changes blood vessels to increase blood flow to hasten the travel of protective white blood cells to the injury or disease location.
But if this mechanism that supports healing becomes chronic, it can actually do harm. The chronic inflammation that occurs with gum disease can damage mouth structures, just as inflammation from diabetes or arthritis can damage other parts of the body. And any form of chronic inflammation, even that found in gum disease, can worsen other inflammatory diseases.
You can lessen this link between gum disease and other conditions—as well as improve your oral health—by preventing or seeking prompt treatment for any periodontal infection in the following ways:
- Practice daily brushing and flossing to clear away bacterial dental plaque, the main cause of gum disease;
- See your dentist regularly for more thorough dental cleanings and checkups;
- See your dentist promptly if you notice red, swollen or bleeding gums, common signs of a gum infection;
- Stop smoking to lower your risk for both gum disease and tooth decay;
- Adopt a healthy diet, which can help you lose weight (a factor in diabetes and other inflammatory diseases) and strengthen your immune system;
- Manage other inflammatory conditions to lessen their effect on your gum disease risk.
Taking these steps can help you avoid the inflammation caused by gum disease that might also affect the rest your body. Seeking prompt treatment at the first sign of an infection will also minimize the damage to your teeth and gums and the effect it could have on the rest of your health.
If you would like more information on prevention and treatment of gum disease, 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 “Gum Disease & Systemic Health.”
Tooth decay is a destructive disease that could rob you of your teeth. But it doesn't appear out of nowhere—a number of factors can make it more likely you'll get cavities.
But the good news is you can be proactive about many of these factors and greatly reduce your risk of tooth decay. Here are a few questions to ask yourself to point you in the right direction for preventing this destructive disease.
Do you brush and floss every day? A daily habit of brushing and flossing removes buildup of dental plaque, a bacterial film on teeth that's the top cause for tooth decay and periodontal (gum) disease. Hit or miss hygiene, though, can greatly increase your risk for developing a cavity.
Do you use fluoride? This naturally occurring chemical has been proven to strengthen tooth enamel against decay. Many locations add fluoride to drinking water—if your area doesn't or you want to boost your fluoride intake, use toothpastes, mouthrinses or other hygiene products containing fluoride.
Do you smoke? The nicotine in tobacco constricts blood vessels in the mouth so that they provide less nutrients and antibodies to the teeth and gums. Your mouth can't fight off infection as well as it could, increasing your risk of dental diseases like tooth decay.
Do you have dry mouth? This isn't the occasional bout of “cotton mouth,” but a chronic condition in which the mouth doesn't produce enough saliva. Saliva neutralizes mouth acid, so less of it increases your risk for decay. Chronic dry mouth can be caused by medications or other underlying conditions.
Do you snack a lot between meals? Sugary snacks, sodas or energy drinks can increase oral bacteria and acidity that foster tooth decay. If you're snacking frequently between meals, your saliva's acid neutralizing efforts may be overwhelmed. Coordinate snacking with mealtimes to boost acid buffering.
You can address many of these questions simply by adopting a daily habit of brushing and flossing, regular dental cleanings and checkups, and eating a healthy, “tooth-friendly” diet. By reducing the risk factors for decay, you can avoid cavities and preserve your teeth.
If you would like more information on preventing tooth decay, 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 “Tooth Decay: How to Assess Your Risk.”
Howie Mandel, one of America’s premier television personalities, rarely takes it easy. Whether performing a standup comedy gig or shooting episodes of America’s Got Talent or Deal or No Deal, Mandel gives it all he’s got. And that intense drive isn’t reserved only for his career pursuits–he also brings his A-game to boosting his dental health.
Mandel is up front about his various dental issues, including multiple root canal treatments and the crowns on his two damaged front teeth. But he’s most jazzed about keeping his teeth clean (yep, he brushes and flosses daily) and visiting his dentist regularly for cleanings and checkups.
To say Howie Mandel is keen on taking care of his teeth and gums is an understatement. And you can be, too: Just five minutes a day could keep your smile healthy and attractive for a lifetime.
You’ll be using that time—less than one percent of your 1,440 daily minutes—brushing and flossing to remove dental plaque buildup. This sticky, bacterial film is the main cause of tooth decay and gum disease. Daily hygiene drastically reduces your risk for these tooth-damaging diseases.
But just because these tasks don’t take long, that’s not saying it’s a quick once-over for your teeth: You want to be as thorough as possible. Any leftover plaque can interact with saliva and become a calcified form known as calculus (tartar). Calculus triggers infection just as much as softer plaque—and you can’t dislodge it with brushing and flossing.
When you brush, then, be sure to go over all tooth areas, including biting surfaces and the gum line. A thorough brushing should take about two minutes. And don’t forget to floss! Your toothbrush can’t adequately reach areas between teeth, but flossing can. If you find regular flossing too difficult, try using a floss threader. If that is still problematic, an oral irrigator is a device that loosens and flushes away plaque with a pressurized water stream.
To fully close the gate against plaque, see us at least every six months. Even with the most diligent efforts, you might still miss some plaque and calculus. We can remove those lingering deposits, as well as let you know how well you’re succeeding with your daily hygiene habit.
Few people could keep up with Howie Mandel and his whirlwind career schedule, but you can certainly emulate his commitment to everyday dental care—and your teeth and gums will be the healthier for it.
If you would like more information about daily dental care, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Daily Oral Hygiene: Easy Habits for Maintaining Oral Health” and “10 Tips for Daily Oral Care at Home.”