If you were asked to identify the number one mouth problem affecting dental health, what would you name? Toothaches? Poor hygiene? Jaw joint issues?
Believe it or not, the top issue among 15,000 respondents in a recent American Dental Association (ADA) survey was dry mouth. A full one-third of the respondents had experienced chronic lack of normal saliva flow; difficulty biting and tooth pain, took second and third place, respectively.
We’ve all experienced the discomfort of temporary dry mouth when we first wake up in the morning or after eating certain foods. But chronic dry mouth is much more serious with long-term effects on a person’s teeth and gum health. This is because among its other important properties, saliva helps neutralize enamel-softening mouth acid and restores minerals to enamel after acid contact. Without sufficient saliva flow you’re much more susceptible to dental disease.
While there are several causes for dry mouth, perhaps the most common is as a side effect to at least five hundred known medications. Because older people tend to take more medications than other age groups, dry mouth is an acute problem among people over 60 (a major factor for why dry mouth took the survey’s top health problem spot).
You can help ease dry mouth from medications by first asking your doctor about switching to alternative medications that don’t affect saliva production. If not, be sure to drink more water during the day and especially when you take your oral medication (a few sips before and after).
You can help your dry mouth symptoms from any cause by drinking more water, limiting your consumption of alcohol or caffeine, and avoiding tobacco products. You can also use substances that stimulate saliva flow—a common one is xylitol, an alcohol-based sugar that’s used as a sweetener in certain gums and candies. Not only does xylitol boost saliva flow it also inhibits the growth of bacteria and thus decreases your risk of disease.
And speaking of reducing bacteria and their effects, don’t neglect daily brushing and flossing. These habits, along with regular dental cleanings and checkups, will benefit you just as much as your efforts to reduce dry mouth in avoiding dental disease.
Fans of the primetime TV show The Middle were delighted to see that high school senior Sue, played by Eden Sher, finally got her braces off at the start of Season 6. But since this popular sitcom wouldn’t be complete without some slapstick comedy, this happy event is not without its trials and tribulations: The episode ends with Sue’s whole family diving into a dumpster in search of the teen’s lost retainer. Sue finds it in the garbage and immediately pops it in her mouth. But wait — it doesn’t fit, it’s not even hers!
If you think this scenario is far-fetched, guess again. OK, maybe the part about Sue not washing the retainer upon reclaiming it was just a gag (literally and figuratively), but lost retainers are all too common. Unfortunately, they’re also expensive to replace — so they need to be handled with care. What’s the best way to do that? Retainers should be brushed daily with a soft toothbrush and liquid soap (dish soap works well), and then placed immediately back in your mouth or into the case that came with the retainer. When you are eating a meal at a restaurant, do not wrap your retainer in a napkin and leave it on the table — this is a great way to lose it! Instead, take the case with you, and keep the retainer in it while you’re eating. When you get home, brush your teeth and then put the retainer back in your mouth.
If you do lose your retainer though, let us know right away. Retention is the last step of your orthodontic treatment, and it’s extremely important. You’ve worked hard to get a beautiful smile, and no one wants to see that effort wasted. Yet if you neglect to wear your retainer as instructed, your teeth are likely to shift out of position. Why does this happen?
As you’ve seen firsthand, teeth aren’t rigidly fixed in the jaw — they can be moved in response to light and continuous force. That’s what orthodontic appliances do: apply the right amount of force in a carefully controlled manner. But there are other forces at work on your teeth that can move them in less predictable ways. For example, normal biting and chewing can, over time, cause your teeth to shift position. To get teeth to stay where they’ve been moved orthodontically, new bone needs to form around them and anchor them where they are. That will happen over time, but only if they are held in place with a retainer. That’s why it is so important to wear yours as directed — and notify us immediately if it gets lost.
And if ever you do have to dig your retainer out of a dumpster… be sure to wash it before putting in in your mouth!
If you would like more information on retainers, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “The Importance of Orthodontic Retainers” and “Why Orthodontic Retainers?”
Waiting is part of life for a teenager: waiting to get a driver’s license, to graduate high school or to leave home and stretch their wings. A teenager with lost teeth may also need to wait until they’re older to obtain dental implants.
The reason arises from the differences in how implants and natural teeth attach to the jaw. Although natural teeth may seem rigidly set in the bone, they’re actually held in place by an elastic tissue between them and the bone known as the periodontal ligament. Tiny filaments that attach to the teeth on one side and the bone on the other hold the teeth in place, but also allow the teeth to move gradually in response to mouth changes.
A titanium implant post doesn’t have this relationship with the periodontal ligament — it’s attached directly to the jaw bone. Over time the bone, which has a special affinity with titanium, grows and adheres to it to form a durable bond without an attachment to the periodontal ligament. Because of this the implant can’t move like a natural tooth.
This is extremely important for implant placement because the jaws in particular won’t fully develop in most people until their late teens or early twenties: the upper jaw in particular will tend to grow out and down. Natural teeth accommodate to these changes, but the implant can’t — it will appear to retreat into the jaw. The gum tissues surrounding the implant also won’t conform to the continuing growth and may appear receded.
The best approach is to choose a temporary replacement option until the jaws and other facial bone structures have finished growing. One example is a bonded bridge in which we use a bonding agent to attach a bridge of artificial teeth to teeth on either side of a missing tooth — bonding won’t permanently alter them as with a traditional bridge. Once the jaws have finished growing, we can remove the bonded bridge and install the more permanent implant.
Ask any teenager: waiting can be hard. But with dental implants, waiting until the right time will help ensure the attractive result is a permanent one.
If you would like more information on dental restorations and teenagers, 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 “Teenagers & Dental Implants.”
October brings fall leaves, pumpkins — and National Dental Hygiene Month. As you change your summer clothes for a fall wardrobe, it may also be time to change your toothbrush for a new one. The American Dental Association (ADA) recommends replacing your toothbrush every three to four months. If that sounds like a lot, just think: This small but very important tool gets a lot of use!
If you brush your teeth twice a day for two minutes each time as recommended by the ADA, that’s two hours of brushing action in one month. Three to four months of twice-daily brushing makes for six to eight hours of brushing time, or a couple hundred uses. This is all an average toothbrush can take before it stops doing its job effectively.
Toothbrush bristles are manufactured to have the right amount of give, tapering, and end-rounding for optimal cleaning. When new, a toothbrush can work its way around corners and between teeth to remove dental plaque. Old bristles, however, lose the flexibility needed to reach into nooks and crannies for a thorough cleaning. Worn bristles may curl, fray or break — and can scratch your gums or tooth enamel. A toothbrush with stiff, curled bristles does not leave your mouth feeling as clean. This may lead to brushing too often or too hard, which is bad for your gums.
A good rule of thumb is to replace your toothbrush every season — unless you see signs that you need a new one sooner. For example, if you wear braces, you may have to replace your toothbrush more frequently since brushing around braces puts more wear and tear on the brush.
For healthy teeth and gums, make sure your primary oral hygiene tool is in tip-top shape. Taking care of the little things now can avoid inconvenient and expensive dental problems later. Don’t forget to schedule regular professional dental cleanings, and be sure to ask if you have any questions about your dental hygiene routine at home. To learn more about the importance of good oral hygiene, read “Daily Oral Hygiene: Easy Habits for Maintaining Oral Health” and “Dental Hygiene Visit: A True Value in Dental Healthcare” in Dear Doctor magazine.
If you’ve lost some teeth you may eventually want to replace them with dental implants. Implants by far are the restoration of choice due to their life-likeness and durability. But those advantages don’t come cheaply — implants can be expensive especially for multiple teeth.
If you’re forced to wait financially for implants, you still have other intermediary options like a removable partial denture (RPD). The conventional RPD has a rigid acrylic base colored to resemble gum tissue supported by a metal frame with attached prosthetic (false) teeth at the missing teeth locations. They’re held secure in the mouth through metal clasps that fit over the remaining teeth.
But these conventional RPDs can sometimes be uncomfortable to wear and don’t always cover the bottom of the gum completely. If this is a concern, you might consider an alternative: flexible RPDs. The base of this RPD is made of a form of flexible nylon rather than acrylic plastic. They’re much more lightweight but still fit securely in the mouth with thin plastic extensions rather than metal clasps. The base can also be more easily formed to cover areas where gum tissue may have receded.
While flexible RPDs hold up better to wear and tear than their conventional counterparts, they must still be maintained like any other appliance. They can accumulate plaque (bacterial biofilm) responsible for tooth decay and periodontal (gum) disease, so daily thorough cleaning is a must. And if there fit becomes loose they can be more difficult to reline or repair than other types of dentures.
They also share a common weakness with other dentures — they can’t prevent and may even stimulate bone loss. As bone ages, old cells dissolve and new ones form to take their place. As we eat and chew our teeth transmit the forces generated through the teeth to the bone to stimulate it to grow. RPDs and other dentures can’t transmit this stimulus, so the bone replaces much slower to the point that the bone volume can diminish.
That’s why it’s best to consider any RPD as a temporary solution until you can obtain an implant for a more permanent and bone-friendly option. In the meantime, though, an RPD can provide you with a great solution for both form and function for missing teeth.
If you would like more information on RPD choices, 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 “Flexible Partial Dentures: An Aesthetic Way to Replace Teeth Temporarily.”
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