DENTAL PLAQUE AND ORAL HEALTH OVER THE LONG TERM

Accumulation of dental plaque can cause gingivitis and periodontal disease with loss of bone tissue. Long term exposure to plaque can also lead to tooth demineralization and destruction due to decay. I recently read a research article that investigated the continuity and change in plaque levels across the long term and the association of plaque with oral health. The study involved collecting plaque data on individuals at 5, 9,15,18,26 and 32 years of age. Much of what you would expect was found. For instance, those with high plaque levels lost more teeth (nearly five times more teeth) due to dental decay as compared to those with low plaque scores.

Interestingly, it has been shown that the body’s response to plaque may differ according to a person’s sex, race, and medical status. For example, children with type 1 diabetes mellitus have worse oral hygiene than do children who do not have diabetes, despite similar oral hygiene practices. People who are socially advantaged, have high self esteem or are female are more likely to brush frequently than those who are not. Flossing behaviors follow a pattern similar to that of tooth brushing behaviors, as do more general hygiene practices. Recent research has shown a link between general hygiene behaviors – such as hand washing – and oral hygiene practices.

Of no surprise, these particular studies found that smoking and poor oral hygiene have a synergistic effect on periodontal disease.

Most of what was found is what I would have expected. When considering the role of plaque in the cause of dental disease (decay and periodontal disease) time is the most important factor. Oral health is really about long-term self-care. Frequent professional dental prophylaxis reduces the severity and progression of gingivitis, periodontal disease and decay, however effective plaque control by good home care is a critical factor in long term dental health.

Posted in General Health and Dental Care | Tagged , , , , | Leave a comment

High-tech, Small Change and Big Result

At the Studio we have many types of technology available to help us assist in the best dental care possible. One of the new pieces of technology which we incorporated last year was a diode laser. The laser enables us to esthetically contour gum tissue, help control bleeding around cavity preparations and assist in biopsy procedures, to name a few of it’s applications. These procedures are done painlessly and heal quickly.

Recently, a young woman came to our dental practice that had previously had a veneer placed on one of her front teeth. She was pleased with the result, although she was slightly disappointed that her front teeth were not the same length and the gum tissue heights were different as well. When she smiled it bothered her. In fact, she told me that she would occasionally try to push the gum tissue up with her finger nail, hoping it would recede to the height of the adjacent tooth.

In a painless fashion I was able to shorten the porcelain veneer and then utilize the diode laser to contour the gum tissue. These procedures took less than ten minutes to complete and she was elated with the results. She had no idea that such a small change could have such a huge effect on the cosmetic outcome. She had just assumed it would take replacement of the porcelain veneer and an extensive surgical procedure to correct the gum tissue discrepancy.

The introduction of the diode laser is one more way we have incorporated high technology to improve our clinical outcomes.

Posted in Uncategorized | Leave a comment

7 Self Examination Tips To Detect Signs Of Oral Cancer

We came across this article posted recently by Dr. Todd Welch in Oral Pathology and thought we’d share it. Here are seven simple self-examine steps you can take to help identify oral cancers in their earliest stages.

1. Tongue and floor of the mouth
•Look in a mirror and stick out your tongue.
•Examine the upper surface of the tongue for any unusual lumps or obvious changes in color. Dark blotches, for example, on the upper surface of the tongue should be examined.
•Pull the tongue forward and examine the sides for lumps, bumps, masses and, again, obvious changes in skin color or texture. If you discover any obvious swelling, see a dentist. Oral cancers are often painless, making them difficult to diagnosis based on pain. But you can see oral cancer, in many instances, early enough to solve the problem as an out patient. How cool is that?!
•Examine the underside of your tongue by placing the tip of your tongue on the roof of your mouth. Same procedure. See any unusual bumps, lumps, swelling or changes in skin color.
•Your tongue should have a uniform texture and uniform color. Glide you finger along the underside of your tongue to feel for unseen bumps. Any deviation should be examined by your family dentist first to see if a visit to an oncologist is step #2.
2. Examine the roof of your mouth
The roof of the mouth is easy to examine with your eyes and with your fingers. Tilt your head back as you stand in front of a mirror. Position yourself so you get a good view of the entire upper mouth. Perform a visual exam for discoloration. Then gently slide your finger over the roof of your mouth feeling for any kind of protrusion. (Pizza blisters don’t count.) If you feel anything out of the ordinary, report to your dentist stat!

3. Check your cheeks
Visually inspect your cheeks. Extend them (be gentle) to look for red, white or dark-colored patches.  Next, place your forefinger on the interior check and your thumb on the outer cheek. Gently squeeze as you rotate you fingers across the entire cheek. This is the best way to detect lumps, bumps or swelling – through the sense of touch. Cheek cancer can often be felt before there are any visible symptoms.

4. Head and Neck
Stand with your head straight up in front of a mirror.  Usually, your face is uniform, i.e., has the same shape on both sides. However, a lump, bump or other protrusion on one side of the face is a definite signal to see your doctor. It may be nothing, it may be something. In either case, it’s worth checking out and a visit to your family doctor is the best place to start when you first detect unevenness within your facial structure.

5. Lips
The lips are highly sensitive to sunlight and lip cancer is one possible (and unfortunate) result. Open your mouth and examine both the outer and inner lip for changes in color or texture.  Gently extend you lips to get the best view of the interior lip area. (You may have to do a little twisting to get the view you want. If so, use a hand mirror to get a good look at the interior lip surface.) Discoloration and protrusions are sometimes early signs of lip cancer.  However, you accidently bite your lip, the lips are constantly moving as you talk, you moisten your lips with your tongue and so on, so expect to see changes. Even the seasons change the exterior portion of the lip so dried lips in the middle of winter aren’t a sign of cancer, though you may want to get some chap stick to keep lips moist.

6. Neck Area
This is where the esophagus and larynx are located, but we can’t see that far down our own throats, even if we stand on our heads. (Please don’t try this at home.)  However, using a feather-light touch, gently slide you fingers along the sides and front of your neck feeling for any lumps that you discover on one side of your neck but not the other. Use your finger tips to gently glide over the skin of your neck feeling for anything out of the ordinary.  Next, apply a small amount of pressure as you slide your fingers over the skin. This time note any tenderness, soreness of swelling. So, first a gentle exam, and then add a little pressure to identify any soreness or swelling.

7. A Persistent Cough
You can feel it and hear it – a cough that just doesn’t go away. Often, you chalk it up to a cold, but you don’t have any symptoms of a cold. Just that cough.  Smokers (28% of Americans still smoke despite all the solid evidence that smoking is bad for just about every part of your body) may experience “smoker’s” cough that comes and goes. This often occurs when the upper portion of the lungs become irritated. It also occurs when the airway to the lungs becomes irritated and inflamed. Most smokers just live with it, though for many, not as long.  Quitting, even for a couple of days, will sometimes clear up a case of smoker’s cough, but if you still have a scratchy sore throat even though you’ve given up smoking until your throat feels better, make an appointment to see your doctor.

There are some other things you can do to ensure early detection of mouth cancers. Ask your dentist to perform an examine each time you’re in for a cleaning. Some dental professionals perform this examine routinely. All will be happy to give your mouth and throat a good look if you ask. Make examining your mouth part of your oral hygiene regimen each day. Takes less than a minute, you get a better feeling for what’s going on in there (and therefore can more easily identify changes), and you may hit the jackpot and discover a form of oral cancer before it even has the chance to do any damage. Today’s treatments, using computer-assisted and robotic surgery, deliver better outcomes for those who do find a lump, bump or notice a dark spot on the cheek that wasn’t there six months ago.

Take the time to check for oral cancers. It may give you more time, even though it only takes a minute.

Posted in Uncategorized | Leave a comment

Our First Video Production!

In response to your many questions on the correct way to maximize the use of custom TEETH WHITENING TRAYS we have produced our very first educational video clip. It can be found on our website (www.gattidds.com) under Educational Library – Cosmetic Dentistry – Teeth Whitening. It is located about halfway down that page. You may go directly there by clicking the following link:  http://www.gattidds.com/education-library/cosmetic-dentistry/teeth-whitening/  As we do more of these I am sure the quality of the production will increase, however I assure you that the content of this one is correct and “on target.”

For most people, using well fitted (and this is the key) custom whitening trays is the most cost effective way to keep their smile as white and bright as possible over the course of time. Typically, after the initial two to three weeks of whitening, it only takes a 20 to 30 minute touch up every four to six months to maintain a bright new smile. In fact, if you will just remember to bring your trays with you to your hygiene visit, we will put the bleach in them after we clean your teeth and by the time you get home, you’ll be done.

If there are other instructional videos that you will find helpful, please let us know.

Posted in Cosmetic dentist, Cosmetic Dentistry, Dentistry, General Health and Dental Care | Tagged , , | Leave a comment

Do I Have Bad Breath?

I have had several clients tell me recently they are concerned about bad breath and wonder what they can do to be more self-confident about the freshness of their breath. Bad breath odor is a common problem caused by bacteria that grow in the mouth and on the tongue, especially deep down in the fissures of the tongue. When these bacteria feed, they release gaseous waste products known as Volatile Sulfuric Compounds (VSCs) and they cause a foul-smelling odor often associated with that “rotten egg” smell commonly known as bad breath. Keeping the oral tissues clean and healthy and practicing good oral hygiene habits of removing plaque and food debris on a regular daily basis is important. However, there is another step that helps immensely with preventing bad breath and this is known as tongue scraping.

There are many tongue scrapers available on the market today. They can be found over the counter at many local drug and discount stores. Here at the Studio we recommend and dispense a very simple and inexpensive scraper. The scraper is placed as far back on the tongue as is comfortable and is then pulled forward. There is no need to place the scraper so far back in the mouth that the gag reflex is activated. The scraping motion is repeated as many times as is necessary until the dark discolored material is removed. It is amazing how much debris can be scraped from the tongue and how much difference this makes in having confidence that your breath is fresh rather than offensive!

Marsha Jones, RDH

Posted in Dentistry, General Health and Dental Care, oral health, Uncategorized | Tagged , , , , , | Leave a comment

Toothaches

A toothache is rarely just a toothache – it is usually something more severe which requires attention. Listed below are some of the more frequent reasons, symptoms and treatment for toothaches that I see every day. Please realize this is not a complete list and symptoms can often times be confusing. As a general rule, if the symptoms persist for more than a day or two or increase in severity – see a dentist.

Dentin exposure: This often occurs when there is gum tissue recession and the root structure is exposed. Typically these areas do not hurt unless exposed to mechanical stimulation (e.g. running a tooth brush across the tooth at the gumline), sweets or cold. The pain is relieved as soon as the stimulus is eliminated. Treatment can be as simple as using tooth sensitivity toothpaste or going to a high fluoride prescription toothpaste or an in office application of fluoride varnish.

Trauma: This can be as simple as biting down on something hard when you do not anticipate it occurring (e.g. hitting an un-popped kernel of corn). It can also occur from a blow to the face or even from night time grinding. If this is a single event, the pain will often take several hours to actually occur. The tooth will become sensitive to cold, biting force or just pushing on it with your tongue. Treatment can vary from just allowing time (as little as a day) to requiring a root canal (in the case of severe trauma) to having a night guard fabricated to eliminate forceful night time grinding.

Cracked tooth syndrome: This is related to the above and often occurs when a tooth has a filling and is in a weakened state. A person with a cracked tooth will often report that the pain only occurs while eating rather hard items, only in a specific spot and that the pain typically is intense, but is relieved as soon as the biting pressure is off the tooth. The treatment of choice is typically a crown, however, if the crack has caused damage to the tooth pulp (nerve, lymph system, and blood supply), a root canal may be indicated as well.

Sinus infections: I often see patients that are complaining of pain in the upper molar and premolar region that is not due to the teeth, but due to inflamed sinuses exerting pressure on the teeth. The symptoms are generally pain involving an area rather than a single tooth. The pain increases when bending over or jumping. Usually, taking a sinus decongestant will resolve the symptoms.

Decay: Deep tooth decay can cause mild to severe tooth pain. This results from the pulp of the tooth (nerve, lymph system and blood supply) becoming inflamed or necrotic. The treatment may involve the gamut from doing a filling to requiring a root canal and a crown. As a temporary solution Ibuprofen can often be utilized (swallowed, not placed on the tooth). However, antibiotic therapy may be indicated as well.

Posted in Dentistry, General Health and Dental Care, oral health | Tagged , , , , , , , , , , , | Leave a comment

New Government Recommendation On Water Fluoridation

On Friday, 1/7/2011, I heard an NPR story about the U.S. Government proposal to change the recommendation for the amount of fluoride to be added to municipal water supplies. They are recommending decreasing the amount of fluoride from 1 ppm to .7 ppm due to recent evidence of the increase of fluorosis (white spots or lines) seen in the teeth of adolescents. Minor fluorosis is apparently evident in 40% of children.

It will be interesting to see how this plays out in the media in the upcoming weeks and months. I suspect the entire debate on water fluoridation will again be entertained.

On a side note, not all of the white spots you see on your teeth or your children’s teeth are fluorosis. Many of the white spots we observe are in post orthodontic cases or areas of inadequate plaque removal. These spots, although white, are actually areas of demineralization of tooth structure and are in fact more prone to decay. In essence, they are the opposite of fluorosis and are an indication for the increased use of topical fluoride.

Posted in Dentistry, oral health, Teeth Safety | Tagged , , , , , | Leave a comment

Probably everyone has seen pictures of “baby bottle syndrome”.  You know what I am referring to, Mom puts baby to bed with a bottle of fruit juice and baby gets terrible decay due to the constant contact of sugar with the teeth.  Well, one of the things you may not be familiar with is the harmful effect of sport drinks, energy drinks, sweet tea, etc.  Even if you are drinking the sugar free drinks, be aware of the harmful effects they have on your teeth.

    

I am not trying to use a scare tactic here; I just don’t think most people realize how harmful these drinks can be.  With excellent oral hygiene it is not as much of an issue, but that is not always the case.  So, like in a lot of things, moderation is the key.

Posted in General Health and Dental Care, oral health, Teeth Safety, Uncategorized | Tagged , , , , , , | Leave a comment

We have new technology – a soft tissue laser!

We have recently added a soft tissue diode laser to our practice.  With the addition of the laser we are now often able to painlessly contour gum tissue in order to access deep areas of decay, esthetically contour gum tissue and eliminate bleeding around areas to be restored.

The laser also allows us to remove fibromas and other oral lesions without bleeding or sutures, making recovery quicker and painless.

This is yet one more piece of technology we have been able to implement to make your dental experience faster, easier and most importantly, better.

Posted in Uncategorized | Leave a comment

Connection Between Systemic Health And Dental Health

Lately there has been much written about the connection between systemic health and dental health. In fact, Missouri is starting a campaign, “Your Mouth Is Talking: Are You Listening?” Knowing that, I felt it necessary to bring it up before you hear it across the river.

Almost every day some article comes across my desk about the connection between periodontal disease and cardiac disease, stroke, low birth weight babies and diabetes, to name just a few. This week I have read no less than four articles on the connection between periodontal disease and diabetes. It is not clear why, but periodontal disease occurs more often and is more severe in people with diabetes. This is especially true for those whose glucose levels are not well controlled. There is evidence that suggests that treating periodontal disease might help improve blood sugar control.

Bottom line, maintaining good oral health at home is critical to achieving a healthy mouth and a healthy body. Brush your teeth and clean between your teeth with dental floss or an interdental cleaner once a day and you will be doing a great deal to benefit your overall health.

Posted in oral health | Tagged , | Comments Off