Medication and Heart Disease
Certain kinds of medications can have an adverse effect on your teeth.
Long ago, children exposed to tetracycline developed tooth problems, including discoloration, later in life. The medication fell out of use, however, and is not an issue today.
The best precaution is to ask your family physician if any medications he or she has prescribed can have a detrimental effect on your teeth or other oral structures.
A condition called dry mouth is commonly associated with certain medications, including antihistamines, diuretics, decongestants and pain killers. People with medical conditions, such as an eating disorder or diabetes, are often plagued by dry mouth. Other causes are related to aging (including rheumatoid arthritis), and compromised immune systems. Garlic and tobacco use are other known culprits.
Dry mouth occurs when saliva production drops. Saliva is one of your body’s natural defenses against plaque because it acts to rinse your mouth of cavity-causing bacteria and other harmful materials.
Some of the less alarming results of dry mouth include bad breath. But dry mouth can lead to more serious problems, including burning tongue syndrome, a painful condition caused by lack of moisture on the tongue.
If dry mouth isn’t readily apparent, you may experience other conditions that dry mouth can cause, including an overly sensitive tongue, chronic thirst or even difficulty in speaking.
Heart Disease
Poor dental hygiene can cause a host of problems outside your mouth—including your heart.
Medical research has uncovered a definitive link between heart disease and certain kinds of oral infections such as periodontal disease. Some have even suggested that gum disease may be as dangerous as or more dangerous than other factors such as tobacco use.
A condition called chronic periodontitis, or persistent gum disease, has been linked to cardiovascular problems by medical researchers.
In short, infections and harmful bacteria in your mouth can spread through the bloodstream to your liver, which produces harmful proteins that can lead to systemic cardiac problems. That’s why it’s critical to practice good oral hygiene to keep infections at bay—this includes a daily regimen of brushing, flossing and rinsing.
Antibiotic Prophylaxis
In some cases, patients with compromised immune systems or who fear an infection from a dental procedure may take antibiotics before visiting the dentist.
It is possible for bacteria from your mouth to enter your bloodstream during a dental procedure in which tissues are cut or bleeding occurs. A healthy immune system will normally fight such bacteria before they result in an infection.
However, certain cardiovascular conditions in patients with weakened hearts could be at risk for an infection or heart muscle inflammation (bacterial endocarditis) resulting from a dental procedure.
Patients with heart conditions (including weakened heart valves) are strongly advised to inform our office before undergoing any dental procedure. The proper antibiotic will prevent any unnecessary complications.
Fluoride
For decades, fluoride has been held in high regard by the dental community as an important mineral that strengthens tooth enamel, which thereby helps to prevent decay of tooth structures.
Water fluoridation is endorsed by nearly every major health and safety-related organization in the world. Communities make it a common practice to “fluoridate” their drinking supplies in order for the general population to benefit from this inexpensive and effective preventative treatment. According to the American Dental Association, more than 144 million U.S. residents in more than 10,000 communities drink fluoridated water, most from public water supplies with sodium fluoride added artificially.
Bottled water, home water treatment systems, and fluoride exposure
Can the consistent use of bottled water result in individuals missing the benefits of optimally fluoridated water? Can home water treatment systems (e.g., water filters) affect optimally fluoridated water supplies? The answer is yes to both. Read how you can avoid some of the pitfalls that may be preventing you from getting the maximum value of fluoride, in this article from the American Dental Association.
ADA statement on FDA toothpaste warning labels
The American Dental Association`s Council on Scientific Affairs believes that one part of the warning now required on fluoride toothpastes by the Food and Drug Administration (FDA) could unnecessarily frighten parents and children, and that the label greatly overstates any demonstrated or potential danger posed by fluoride toothpastes. The label language, “If you accidentally swallow more than used for brushing, seek professional help or contact a poison control center immediately,” is now required on all fluoride toothpastes. But the ADA, in a letter sent to the FDA last year, pointed out that a child could not absorb enough fluoride from toothpaste to cause a serious problem and that the excellent safety record on fluoride toothpaste argues against any unnecessary regulation.
Enamel fluorosis
According to the American Academy of Pediatric Dentistry, a child may face a condition called enamel fluorosis if he or she receives too much fluoride during the years of tooth development. Too much fluoride can result in defects in tooth enamel.
CDC web site provides information on community water fluoridation
People seeking information on whether their water system is fluoridated can now find out by visiting a new Web site at the Centers for Disease Control and Prevention (CDC). The new feature, “My Water`s Fluoride,” allows consumers in participating states to check out basic information about their water system, including the number of people served by the system and the target fluoridation level. Optimal levels recommended by the U.S. Public Health Service and CDC for drinking water range from 0.7 parts per million (ppm) for warmer climates, to 1.2 ppm for cooler climates accounting for the tendency to drink more water in warmer climates. States that are currently participating include Arizona, Colorado, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Maine, Massachusetts, Michigan, Minnesota, Nebraska, New Hampshire, Nevada, North Dakota, Oklahoma, Pennsylvania and Wisconsin.
Flossing
What is flossing?
Flossing is a method for removing bacteria and other debris that cannot be reached by a toothbrush. It generally entails a very thin piece of synthetic cord you insert and move up and down between the sides of two adjoining teeth.
Why is flossing important?
Many dentists believe that flossing is the single most important weapon against plaque. In any event, daily flossing is an excellent and proven method for complementing your brushing routine and helping to prevent cavities, periodontal disease, and other dental problems later in life. It also increases blood circulation in your gums. Floss removes plaque and debris that stick to your teeth and gums.
How often to floss
Floss at least once every day. Like brushing, flossing should take about three minutes and can easily be done while doing another activity, such as watching television. Do not attempt to floss your teeth while operating a motor vehicle or other machinery.
Flossing techniques
There are two common methods for flossing, the “spool method” and the “loop method”.
The spool method is the most popular for those who do not have problems with stiff joints or fingers. The spool method works like this: Break off about 18 inches of floss and wind most of it around your middle finger. Wind the rest of the floss similarly around the middle finger of your other hand. This finger takes up the floss as it becomes soiled or frayed. Move the floss between your teeth with your index fingers and thumbs. Maneuver the floss up and down several times forming a “C” shape around the tooth. While doing this, make sure you go below the gum line, where bacteria are known to collect heavily.
The loop method is often effective for children or adults with dexterity problems like arthritis. The loop method works like this: Break off about 18 inches of floss and form it into a circle. Tie it securely with two or three knots. Place all of your fingers, except the thumb, within the loop. Use your index fingers to guide the floss through your lower teeth, and use your thumbs to guide the floss through the upper teeth, going below the gum line and forming a “C” on the side of the tooth.
With either method of flossing, never “snap” the floss because this can cut your gums. Make sure that you gently scrape the side of each tooth with the floss.
Your gums may be tender or even bleed for the first few days after flossing – a condition that generally heals within a few days.
Denture Care
Dentures today are made from very advanced materials designed to give you a natural appearance.
However, keep in mind that just like your teeth, dentures should be cared for with the same diligence. This means daily brushing and regular visits to your dentist.
Regular visits to your dentist are critical. Your dentist also can make minor adjustments that ensure that your dentures continue fitting naturally and comfortably.
Just like natural teeth, dentures need to be cleansed of plaque, food particles and other debris. Keeping your dentures in top shape will also help keep the soft tissues of your mouth healthy; an unclean or malformed denture can cause infections and irritation.
Cleaning Techniques
Remember to rinse and brush your dentures after every meal, and soak them in denture solution overnight. This also allows your gums to breathe while you sleep.
Here are some simple techniques for keeping your dentures clean:
- People can brush their dentures in a variety of ways. Some people use soap and water or a slightly abrasive toothpaste. Popular denture pastes and creams also can be used.
- Avoid using highly abrasive chemicals or pastes, or vigorously brushing with hard bristled toothbrushes. These can scratch or even crack dentures.
- Hold your dentures gently to avoid loosening a tooth.
- Clean your dentures with cool or tepid water over a water-filled sink. Hot water may warp a denture. A small washcloth placed in the bottom of the bowl will ensure that your denture isn’t damaged if it falls.
- Soak your dentures overnight in any commercially available product like Efferdent or Polident, and remember to rinse your dentures before placing them back in your mouth.
- Remember to use a separate toothbrush to clean your own natural teeth, as well as all of your gum tissues. In lieu of a toothbrush, a soft washcloth may be used to wipe your gums.
Over time, even daily care of your dentures may require them to be cleaned by the dentist. A powerful ultrasonic cleaner may be used to remove hard accumulations of tartar and other substances.
Prevention Tips for Children
Infants
Infants should be seen by our office after the first six months of age, and at least by the child’s first birthday. By this time, the baby’s first teeth, or primary teeth, are beginning to erupt and it is a critical time to spot any problems before they become big concerns.
Conditions like gum irritation and thumb-sucking could create problems later on. Babies who suck their thumbs may be setting the stage for malformed teeth and bite relationships.
Another problem that can be spotted early is a condition called “baby bottle tooth decay,” which is caused by sugary substances in breast milk and some juices, which combine with saliva to form pools inside the baby’s mouth.
If left untreated, this can lead to premature decay of your baby’s future primary teeth, which can later hamper the proper formation of permanent teeth.
One of the best ways to avoid baby bottle tooth decay is to not allow your baby to nurse on a bottle while going to sleep. Avoid dipping pacifiers in sweet substances such as honey, because this only encourages early decay in the baby’s mouth. Encouraging your young child to drink from a cup as early as possible will also help stave off the problems associated with baby bottle tooth decay.
Teething, Pacifiers and Thumb-Sucking
Teething is a sign that your child’s gums are sore. This is perfectly normal. You can help relieve this by allowing the baby to suck on a teething ring, or gently rubbing your baby’s gums with the back of a small spoon, a piece of wet gauze, or even your finger.
For babies under the age of 4, teething rings and pacifiers can be safely used to facilitate the child’s oral needs for relieving gum pain and for suckling. After the age of 4, pacifiers are generally discouraged because they may interfere with the development of your child’s teeth.
Moreover, thumb-sucking should be strongly discouraged because it can lead to malformed teeth that become crooked and crowded.
Primary and Permanent Teeth
Every child grows 20 primary teeth, usually by the age of 3. These teeth are gradually replaced by the age of 12 or so with a full set of 28 permanent teeth, and later on, four molars called “wisdom teeth.”
It is essential that a child’s primary teeth are healthy, because their development sets the stage for permanent teeth. If primary teeth become diseased or do not grow in properly, chances are greater that their permanent replacements will suffer the same fate. For example, poorly formed primary teeth that don’t erupt properly could crowd out spaces reserved for other teeth. Space maintainers can sometimes be used to correct this condition, if it is spotted early enough.
Brushing
Babies’ gums and teeth can be gently cleaned with special infant toothbrushes that fit over your finger. Water is suitable in lieu of toothpaste (because the baby may swallow the toothpaste). Parents are advised to avoid fluoride toothpastes on children under the age of 2.
Primary teeth can be cleansed with child-sized, soft-bristled toothbrushes. Remember to use small portions of toothpaste (a pea-sized portion is suitable), and teach your child to spit out, not swallow, the toothpaste when finished.
Fluoride
Fluoride is generally present in most public drinking water systems. If you are unsure about your community’s water and its fluoride content, or learn that it has an unacceptable level of fluoride in it, there are fluoride supplements your dentist can prescribe. Your child may not be getting enough fluoride just by using fluoride toothpaste.
Toothaches
Toothaches can be common in young children. Sometimes, toothaches are caused by erupting teeth, but they also could indicate a serious problem.
You can safely relieve a small child’s toothache without the aid of medication by rinsing the mouth with a solution of warm water and table salt. If the pain doesn’t subside, acetaminophen may be used. If such medications don’t help, contact your dentist immediately.
Injuries
You can help your child prevent oral injuries by closely supervising him during play and not allowing the child to put foreign objects in the mouth.
For younger children involved in physical activities and sports, mouth guards are strongly encouraged, and can prevent a whole host of injuries to the teeth, gums, lips and other oral structures.
Mouth guards are generally small plastic appliances that safely fit around your child’s teeth. Many mouth guards are soft and pliable when opened, and mold to the child’s teeth when first inserted.
If the tooth has been knocked out, try to place the tooth back in its socket while waiting to see our office. Remember to hold the dislocated tooth by the crown—not the root. If you cannot relocate the tooth, place it in a container of cold milk, saline or the victim’s own saliva. Place the tooth in the solution.
First, rinse the mouth of any blood or other debris and place a cold cloth or compress on the cheek near the injury. This will keep down swelling.
For a fractured tooth, it is best to rinse with warm water and again, apply a cold pack or compress. Ibuprofen may be used to help keep down swelling.
If the tooth fracture is minor, the tooth can be sanded or if necessary, restored by the dentist if the pulp is not severely damaged.
If a child’s primary tooth has been loosened by an injury or an emerging permanent tooth, try getting the child to gently bite down on an apple or piece of caramel; in some cases, the tooth will easily separate from the gum.
Irritation caused by retainers or braces can sometimes be relieved by placing a tiny piece of cotton or gauze on the tip of the wire or other protruding object. If an injury occurs from a piece of the retainer or braces lodging into a soft tissue, contact our office immediately and avoid dislodging it yourself.
Sealants
Sealants fill in the little ridges on the chewing part of your teeth to protect and seal the tooth from food and plaque. The application is easy to apply and typically last for several years.
Seniors and Oral Health
More and more people are avoiding the need for dentures as they grow older, going against the notion that false teeth are a normal part of growing older.
In fact, there’s usually no reason for you NOT to keep your teeth your entire life, providing you maintain a healthy balanced diet and practice good oral hygiene.
Another desirable side effect of good oral hygiene: avoiding more serious problems such as hypertension, cardiovascular disease, diabetes, and even stroke. Indeed, medical research is beginning to show that a healthy mouth equates to a healthy body and a longer life.
Dexterity and Arthritis
People who suffer from arthritis or other problems of dexterity may find it difficult and painful to practice good oral hygiene.
Thankfully, industry has responded with ergonomically designed devices such as toothbrushes and floss holders that make it easier to grasp and control.
You can also use items around the house to help you. Inserting the handle of your toothbrush into a small rubber ball, or extending the handle by attaching a small piece of plastic or Popsicle stick may also do the trick.
Floss can also be tied into a tiny loop on either side, making it easier to grasp and control the floss with your fingers.
Tooth Care
Plaque is an insidious substance—a colorless, sticky film—that blankets your teeth and creates an environment in which bacteria erode tooth enamel, cause gum irritation, infection in inner structures such as pulp and the roots, and in extreme cases, tooth loss.
Some of the biggest culprits causing plaque are foods rich in sugar and carbohydrates, including soda beverages, some juices, candy and many kinds of pasta, breads and cereals.
Plaque also can attack fillings and other restorations in your mouth, which can lead to more costly treatment down the road.
Plaque is the main cause of tooth decay. It can also cause your gums to become irritated, inflamed, and bleed. Over time, the plaque underneath your gums may cause periodontal disease, which can lead to bone loss and eventual tooth loss.
Inside your teeth, decay can gradually destroy the inner layer, or dentin. It can also destroy the pulp, which contains blood vessels, nerves and other tissues, as well as the root.
Periodontal disease is advanced gum disease. This serious condition occurs when the structures that support your teeth—the gums and bone—break down from the infection. Pain, hypersensitivity and bleeding are some of the signs of periodontal disease.
Simple Preventative Measures
The two best defenses against tooth decay and gum disease are a healthy, well-balanced diet and good oral hygiene, including daily brushing with fluoride toothpaste, flossing and rinsing. Most public drinking water contains fluoride, but if you are unsure of your water supply, then use a good quality mouth rinse containing fluoride.
A good way to help your oral health between brushing is chewing sugarless gum; this stimulates your body’s production of saliva, a powerful chemical that actually neutralizes plaque formation and rinses decay-causing food particles and debris from your mouth.
In some cases, our office can prescribe anti-cavity rinses or apply special anti-cavity varnishes or sealants to help fight decay.
The Food and Drug Administration classifies mouth rinses into two categories – therapeutic and cosmetic.
In general, therapeutic rinses with fluoride have been shown to actually fight cavities, plaque and gingivitis.
On the other hand, cosmetic rinses merely treat breath odor, reduce bacteria and/or remove food particles in the mouth. They do nothing to treat or prevent gingivitis.
People who have difficulty brushing (because of physical difficulties such as arthritis) can benefit from a good therapeutic mouth rinse.
Caution: Even rinses that are indicated to treat plaque or cavities are only moderately effective. In fact, regular rinsing with water and use of good quality fluoride toothpaste are just as or more effective.
Sealants
Sealants are liquid coatings that harden on the chewing surfaces of teeth and are showing a great deal of effectiveness in preventing cavities—even on teeth where decay has begun.
The pits and grooves of your teeth are prime areas for opportunistic decay. Even regular brushing sometimes misses these intricate structures on the chewing surfaces of your teeth.
The sealants are applied to the chewing surfaces and are designed to prevent the intrusion of bacteria and other debris into the deep crevices on the tops of teeth.
Sealants actually were developed about 50 years ago, but didn’t become commonly used until the 1970s. Today, sealants are becoming widely popular and effective; young children are great candidates for preventative measures like sealants (especially on molars) because in many cases, decay has not set in. Even on teeth where decay is present, sealants have been shown to fight additional damage.
Application
Sealants are applied by first cleaning the tooth surface. The procedure is followed by “etching” the tooth with a chemical substance, which allows the sealant to better adhere. After the sealant is applied, a warm light source is directed to the site to promote faster drying. Sealants usually need re-application every five to 10 years.
X-Rays
When X-rays pass through your mouth during a dental exam, more X-rays are absorbed by the denser parts (such as teeth and bone) than by soft tissues (such as cheeks and gums) before striking the film. This creates an image on the radiograph. Teeth appear lighter because fewer X-rays penetrate to reach the film. Cavities and gum disease appear darker because of more X-ray penetration. The interpretation of these X-rays allows the dentist to safely and accurately detect hidden abnormalities.
How often dental X-rays (radiographs) should be taken depends on the patient`s individual health needs. It is important to recognize that just as each patient is different from the next, so should the scheduling of X-ray exams be individualized for each patient. Your medical and dental history will be reviewed and your mouth examined before a decision is made to take X-rays of your teeth.
The schedule for needing radiographs at recall visits varies according to your age, risk for disease and signs and symptoms. Recent films may be needed to detect new cavities, or to determine the status of gum disease or for evaluation of growth and development. Children may need X-rays more often than adults. This is because their teeth and jaws are still developing and because their teeth are more likely to be affected by tooth decay than those of adults.
Toothaches
Simple toothaches can often be relieved by rinsing the mouth to clear it of debris and other matter. Sometimes, a toothache can be caused or aggravated by a piece of debris lodged between the tooth and another tooth. Avoid placing an aspirin between your tooth and gum to relieve pain, because the dissolving aspirin can actually harm your gum tissue.
Broken, Fractured, or Displaced Tooth
A broken, fractured or displaced tooth is usually not a cause for alarm, as long as decisive, quick action is taken.
If the tooth has been knocked out, try to place the tooth back in its socket while waiting to see your dentist.
First, rinse the mouth of any blood or other debris and place a cold cloth or compress on the cheek near the injury. This will keep down swelling.
If you cannot locate the tooth back in its socket, hold the dislocated tooth by the crown – not the root. Next, place it in a container of warm milk, saline or the victim’s own saliva and keep it in the solution until you arrive at the emergency room or dentist’s office.
For a fractured tooth, it is best to rinse with warm water and again, apply a cold pack or compress. Ibuprofen may be used to help keep down swelling.
If the tooth fracture is minor, the tooth can be sanded or if necessary, restored by the dentist if the pulp is not severely damaged.
If a child’s primary tooth has been loosened by an injury or an emerging permanent tooth, try getting the child to gently bite down on an apple or piece of caramel; in some cases, the tooth will easily separate from the gum.
Diabetes
People living with diabetes are vulnerable to a host of systemic problems in their entire body. Unfortunately, the mouth and teeth are not immune from such problems, and many diabetics with oral problems go undiagnosed until conditions become advanced.
Infections and other problems such as receding gums and gum disease, or periodontal disease, are common afflictions among diabetics for many reasons; for instance, diabetics often are plagued by diminished saliva production, which can hamper the proper cleansing of cavity-causing debris and bacteria from the mouth. In addition, blood sugar levels that are out of balance could lead to problems that promote cavities and gum disease.
As with any condition, good oral hygiene, including regular brushing, flossing and rinsing, as well as the proper diabetic diet, will go a long way in preventing