When things get unpleasant in your mouth, it’s most often related to some underlying cause. In fact, the discomfort you’re feeling is often a call to action to have it checked and treated.
The American Dental Association recently surveyed approximately 15,000 U.S. adults about their oral problems. If you have any of the top 3 problems found in this survey, it could be a “warning bell” sounding in your mouth right now.
Here, then, are the top 3 dental problems in America, what they mean and what you should do about them.
#3: Tooth Pain. About a third of respondents (more among those younger or from lower-income households) indicated pain as a problem. As a warning sign of something wrong, tooth pain could be telling you that you have a decayed tooth, a gum abscess or something similar. The best thing to do is get a checkup as soon as possible. It’s unlikely that whatever is causing the pain will go away on its own and procrastination could make ultimate treatment more complex and difficult.
#2: Difficulty Biting. A slightly higher number of people named difficulty chewing and biting as their main oral problem. As with tooth pain, chewing difficulty causes could be many: cracked, loose or decayed teeth, ill-fitted dentures, or a jaw joint disorder (TMD). Again, if it hurts to chew or bite, see a dentist. Besides the underlying problem, chewing difficulties could also affect the quality of your nutrition.
#1: Dry Mouth. Chronic dry mouth garnered the highest response in the survey, especially among older adults. This is more serious than the occasional “cotton mouth” feeling we all experience—with chronic dry mouth the salivary glands aren’t producing enough saliva to neutralize mouth acid or fight disease, thus increasing your risk for tooth decay or periodontal (gum) disease. It’s most likely caused by medications or systemic conditions, so talk with your dentist or physician about boosting saliva flow.
When we refer to periodontal (gum) disease, we’re actually talking about a family of progressive, infectious diseases that attack the gums and other tissues attached to the teeth. Caused primarily by bacterial plaque left on tooth surfaces from inefficient oral hygiene, gum disease can ultimately lead to tooth loss.
There’s only one way to stop the infection and restore health to diseased tissues — remove all of the offending plaque and calculus (hardened plaque deposits) possible from tooth and gum surfaces, including below the gum line at the roots. The basic tools for this task are specialized hand instruments called scalers or ultrasonic equipment that vibrates plaque loose. A series of cleaning sessions using these tools could stop the infection and promote healing if followed with a consistent, efficient daily hygiene habit.
There are times, however, when the infection has progressed so deeply below the gum line or into the tissues that it requires other procedures to remove the plaque and infected tissue. One such situation is the formation of an abscess within the gum tissues, a pus-filled sac that has developed in response to infection. After administering local anesthesia, the abscess must be treated to remove the cause and allow the infectious fluid to drain. The area is then thoroughly flushed with saline or an antibacterial solution.
The gum tissues are not completely attached to the tooth surface for a small distance creating a space. These spaces are called periodontal pockets when they are inflamed and continue to deepen as the disease progresses. These inflamed and sometimes pus-filled pockets form when tissues damaged by the infection detach from the teeth. If the pockets are located near the gum line, it may be possible to clean out the infectious material using scaling techniques. If, however, they’re located four or more millimeters below the gum line a technique known as root planing may be needed, where plaque and calculus are shaved or “planed” from the root surface. As the disease progresses and the pockets deepen, it may also be necessary for surgical intervention to gain access to the tooth roots.
To stop gum disease and promote soft tissue healing, we should use any or all treatment tools at our disposal to reach even the most difficult places for removing plaque and calculus. The end result — a saved tooth — is well worth the effort.
If you would like more information on treating periodontal 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 “Treating Difficult Areas of Periodontal Disease.”
Chipped a tooth? Don't beat yourself up—this type of dental injury is quite common. In fact, you probably have a favorite celebrity who has chipped one or more of their teeth. The list is fairly long.
Some chipped a tooth away from the limelight, such as Tom Cruise (a hockey puck to the face as a teen), Jim Carrey (roughhousing on the playground) and Paul McCartney (a sudden stop with a moped). Others, though, chipped a tooth while “on the job.” Taylor Swift, Hillary Duff and Jennifer Lopez have all chipped a tooth on stage with a microphone. And chipped teeth seem to be an occupational hazard among professional athletes like former NFL star, Jerry Rice.
Since smiles are an indispensable asset to high-profile celebrities, you can be sure these stars have had those chipped teeth restored. The good news is the same procedures they've undergone are readily available for anyone. The two most common restorations for chipped teeth are dental bonding and veneers.
The least invasive way to fix a chipped tooth is bonding with a material known as composite resin. With this technique, resin is first mixed to match the tooth color and then applied to the chipped area or applied in layers of color to get just the right look. After a bit of shaping, curing and adjustment, we're done—you can walk out with a restored tooth in one visit.
Bonding works well with slight to moderate chips, but it could be less durable when there is more extensive damage. For that, you may want to consider porcelain veneers. Veneers are thin wafers of dental porcelain that are bonded to the front of teeth to mask blemishes like stains, slight gaps or, yes, chips. Veneers can be so lifelike that you won't be able to tell the veneered tooth from your other teeth. They are fashioned to match the color and shape of an individual's teeth. Because of the time and design detail involved, veneers are more expensive than bonding, yet still within an affordable range for many.
Teeth require some alteration before applying traditional veneers because otherwise the teeth can appear bulky when the veneer is bonded to the existing tooth. To compensate, we remove a little of the tooth enamel. Because this loss is permanent, you'll need to wear veneers or have some other form of restoration for the tooth from then on. For many people, though, that's a small price to pay for a smile without chips.
Your first step to repairing a chipped tooth is to come in for an examination. From there, we'll recommend the best option for your situation. And regardless of which, bonding or veneers, we can change your smile for the better.
If you would like more information about restoring injured teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Teeth Whitening” and “Porcelain Veneers: Strength and Beauty as Never Before.”
If you’re taking medication to regulate your blood pressure, you may be familiar with some of the general side effects, like nausea, drowsiness or dizziness. But some blood pressure drugs might also cause complications with your oral health.
This is true of one class of drugs in particular used for blood pressure regulation. Calcium channel blockers (CCBs) are used to regulate blood pressure by dilating (relaxing) blood vessels, making it easier for the heart to pump blood. They’re often prescribed to patients who can’t tolerate beta blockers, another common blood pressure drug.
Besides other general side effects, CCBs can also cause gingival hyperplasia (gum overgrowth) and mouth dryness. The former condition occurs when the gum tissues grow and extend beyond their normal size over the teeth. Besides pain and discomfort, hyperplasia creates an abnormal appearance which can be embarrassing. Research findings also indicate that hyperplasia development from CCB use is also linked to poor hygiene habits, which give rise to periodontal (gum) disease.
Mouth dryness is defined as less than normal saliva flow. Besides discomfort, the condition may increase your risk of dental disease: saliva is a key part in keeping bacterial levels low and maintaining the mineral content of enamel. Inadequate saliva flow can’t maintain this balance, which increases the bacterial population in the mouth and the risk of infection leading to gum disease or tooth decay.
To avoid both of these side effects, it’s important first to let us know if you’re taking blood pressure medication and what kind. You may also need more frequent dental visits, especially if you’re displaying symptoms of dental disease. Studies have found that frequent dental visits to remove bacterial plaque and calculus (hardened plaque deposits) may significantly reduce gum overgrowth in patients taking a CCB. You should also maintain a recommended daily regimen of oral hygiene (brushing and flossing).
Because of possible effects on your dental health from a number of drugs, it’s always important to let us know the medications you’re regularly taking. As with CCBs, we can incorporate that knowledge into your dental treatment to assure your safety and optimal oral health.
If you would like more information on managing your oral care while on medication, 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 “Blood Pressure Medications.”
Dental implants are popular with both patients and dentists for their durability and likeness to natural teeth. That natural look, though, can be difficult to attain, especially in what’s known as the “smile zone” — the area of the mouth where teeth are most visible when you smile.
Our biggest concern is the upper front teeth, where the gums are most visible, especially if you smile widely. It takes considerable skill, experience and artistry to position implants in this area so that they appear to naturally emerge from the gums and blend well with other teeth.
To obtain that natural look, we must first assess whether or not there’s enough bone present, which tends to dissolve (resorb) when a tooth is missing, to sufficiently anchor the implant in the right position. There also needs to be sufficient bone around adjacent teeth to support the tiny triangles of gum tissue between teeth called papillae. Without the papillae an unattractive black hole may result between the implant and an adjacent tooth or implant.
Another factor we must consider is the type of gum tissue you have. Everyone generally inherits one of two types of tissue from their parents: thin or thick. The type you have can influence the way the implant appears to emerge from the gums. If you have thick gums, they’re easier to work with and can cover more of the implant. Thinner tissues aren’t quite as easy and are less forgiving if an implant isn’t placed as precisely as possible.
In recent years, improvements in implant design have sought to provide greater stability around bone and gum tissues to offset some of the issues we’ve mentioned. A variation on the design of the top of the implant (where the crown is attached) changes the direction of growth for gum tissues from a horizontal orientation to a vertical one, which can help with the final appearance.
The first step, if you’re considering dental implants for a tooth in the smile zone, is to visit us for a complete examination to see if any of these factors may have an impact on your situation. We can then advise you on the best course of action to achieve the most attractive smile possible.
If you would like more information on dental implants, 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 “Implant Aesthetics.”
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