Posts for category: Oral Health
Losing teeth will certainly disrupt your otherwise beautiful smile. It could also potentially affect your food choices and whether or not you receive proper nutrition.
But something else just as consequential could be happening beneath the surface of your gums—you could be losing bone. Significant bone loss in the jaw could adversely affect remaining teeth and facial structure, as well as limit your future restoration choices.
To understand why this occurs we must first consider what bone is: living, cellular tissue. Like the body's other cells, bone has a life cycle: cells form, live and eventually dissolve (or resorb), and are then replaced by new cells. Stimulation from forces generated during chewing traveling up through the tooth roots to the jawbone keep this cycle going at a healthy pace.
But when a tooth is missing, so is this stimulation. This could slow the replacement rate and cause bone volume to gradually decrease. The jawbone width could decrease by as much as 25% the first year alone and several millimeters in height after just a few years.
Although dentures (a popular and affordable choice) can restore lost function and appearance, they can't duplicate this needed stimulation. They even accelerate bone loss by irritating and creating compressive forces on the bony ridges and the gums they rest upon.
One restoration, however, can actually help stop bone loss and may even reverse it: dental implants. This happens because an implant's metal titanium post imbedded in the jawbone attracts bone cells to grow and adhere to its surface. This could actually increase bone density at the site.
To gain this advantage, it's best to obtain implants as soon as possible after tooth loss. If you allow bone loss to occur by waiting too long, there may not be enough to properly support an implant. Even then it might be possible to build up the diminished bone through grafting. But if that's not possible, we'll have to consider a different restoration.
To determine the condition of your bone after losing teeth, visit us for a complete examination. Afterward, we'll be able to discuss with you the best way to address both your overall dental health and your smile.
If you would like more information on treating missing teeth, 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 “The Hidden Consequences of Losing Teeth.”
You might not be aware how much force your jaws generate while you eat or chew. But you can become aware in a hurry when part of your inside cheek or lip gets in the way.
What may be even worse than the initial painful bite are the high odds you’ll bite the same spot again—and again. That’s because of a feature in the skin’s healing process.
As a surface wound heals, it often forms a cover of fibrous tissue consisting of the protein collagen. This traumatic fibroma, as it’s called, is similar to a protective callous that develops on other areas of damaged skin. In the process, though, it can become “taller” than the surrounding skin surface, which increases the chances of another bite.
This second bite often results in more fibrous tissue formation that rises even higher from the skin surface, which then becomes more likely to be bit again. After repeated cycles, the initial wound can become a noticeable, protruding lump.
These kinds of sores are typically not cancerous, especially if they’ve appeared to form slowly over time. But they can be a nuisance and the occasion of sharp pain with every subsequent bite. There is, though, an effective way to deal with it—simply have it removed.
While it involves a surgical procedure—an oral surgeon, periodontist or dentist with surgical training usually performs it—it’s fairly minor. After numbing the area with a local anesthetic, the dentist will then completely excise the lesion and close the resulting gap in the skin with two or three small sutures (it could also be removed with a laser). The wound should heal within a few days leaving you with a flat, flush skin surface.
The tissue removed is usually then biopsied. Although it’s highly unlikely it was more than an annoying sore, it’s still common procedure to examine excised tissues for cancer cells. If there appears to be an abnormality, your dentist will then see you to take the next step in your treatment.
More than likely, though, what you experienced was a fibroma. And with it now a thing of the past, you can chew with confidence knowing it won’t be there to get in the way.
If you would like more information on dealing with common mouth sores, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Common Lumps and Bumps in the Mouth.”
Fans of the legendary rock band Steely Dan received some sad news a few months ago: Co-founder Walter Becker died unexpectedly at the age of 67. The cause of his death was an aggressive form of esophageal cancer. This disease, which is related to oral cancer, may not get as much attention as some others. Yet Becker's name is the latest addition to the list of well-known people whose lives it has cut short—including actor Humphrey Bogart, writer Christopher Hitchens, and TV personality Richard Dawson.
As its name implies, esophageal cancer affects the esophagus: the long, hollow tube that joins the throat to the stomach. Solid and liquid foods taken into the mouth pass through this tube on their way through the digestive system. Worldwide, it is the sixth most common cause of cancer deaths.
Like oral cancer, esophageal cancer generally does not produce obvious symptoms in its early stages. As a result, by the time these diseases are discovered, both types of cancer are most often in their later stages, and often prove difficult to treat successfully. Another similarity is that dentists can play an important role in oral and esophageal cancer detection.
Many people see dentists more often than any other health care professionals—at recommended twice-yearly checkups, for example. During routine examinations, we check the mouth, tongue, neck and throat for possible signs of oral cancer. These may include lumps, swellings, discolorations, and other abnormalities—which, fortunately, are most often harmless. Other symptoms, including persistent coughing or hoarseness, difficulty swallowing, and unexplained weight loss, are common to both oral and esophageal cancer. Chest pain, worsening heartburn or indigestion and gastroesophageal reflux disease (GERD) can also alert us to the possibility of esophageal cancer.
Cancer may be a scary subject—but early detection and treatment can offer many people the best possible outcome. If you have questions about oral or esophageal cancer, call our office or schedule a consultation. You can learn more in the Dear Doctor magazine article “Oral Cancer.”
Periodontal (gum) disease causes more than simple gum swelling—this bacterial infection can harm and destroy your teeth’s supporting structures, including the bone. Its aggressiveness sometimes requires equally aggressive treatment.
Gum disease usually begins with dental plaque, a thin film of bacteria and food particles on tooth and gum surfaces. Without proper oral hygiene plaque builds up with large populations of bacteria that can trigger an infection.
The growth of this disease is often “silent,” meaning it may initially show no symptoms. If it does, it will normally be reddened, swollen and/or bleeding gums, and sometimes pain. A loose tooth is often a late sign the disease has severely damaged the gum ligaments and supporting bone, making tooth loss a distinct possibility.
If you’re diagnosed with gum disease, there is one primary treatment strategy—remove all detected plaque and calculus (tartar) from tooth and gum surfaces. This can take several sessions because as the gums begin responding to treatment and are less inflamed, more plaque and calculus may be discovered.
Plaque removal can involve various techniques depending on the depth of the infection within the gums. For surfaces above or just below the gum line, we often use a technique called scaling: manually removing plaque and calculus with specialized instruments called scalers. If the infection has progressed well below the gum line we may also use root planing, a technique for “shaving” plaque from root surfaces.
Once infection reaches these deeper levels it’s often difficult to access. Getting to it may require a surgical procedure known as flap surgery. We make incisions in the gums to form what looks like the flap of an envelope. By retracting this “flap” we can then access the root area of the tooth. After thoroughly cleansing the area of infection, we can do regenerative procedures to regain lost attachment. Then we suture the flap of gum tissue back into place.
Whatever its stage of development, it’s important to begin treatment of gum disease as soon as it’s detected. The earlier we can arrest its spread, the less likely we’ll need to employ these more invasive procedures. If you see any signs of gum disease as mentioned before, contact us as soon as possible for a full examination.
If you would like more information on preventing and treating 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 “Treating Difficult Areas of Periodontal Disease.”
“No man is an island….” So wrote the poet John Donne four centuries ago. And while he meant the unity of humanity, the metaphor could equally apply to the interdependence of the various parts of the human body, including the mouth. According to recent scientific research, your mouth isn’t an “island” either.
Much of this research has focused on periodontal (gum) disease, an infection most often caused by bacterial plaque that triggers inflammation in the gum tissues. Although an important part of the body’s defenses, if the inflammation becomes chronic it can damage the gums and weaken their attachment to the teeth. Supporting bone may also deteriorate leading eventually to tooth loss.
Avoiding that outcome is good reason alone for treating and controlling gum disease. But there’s another reason—the possible effect the infection may have on the rest of the body, especially if you have one or more systemic health issues. It may be possible for bacteria to enter the bloodstream through the diseased gum tissues to affect other parts of the body or possibly make other inflammatory conditions worse.
One such condition is diabetes, a disease which affects nearly one person in ten. Normally the hormone insulin helps turn dietary sugars into energy for the body’s cells. But with diabetes either the body doesn’t produce enough insulin or the available insulin can’t metabolize sugar effectively. The disease can cause or complicate many other serious health situations.
There appears to be some links between diabetes and gum disease, including that they both fuel chronic inflammation. This may explain why diabetics with uncontrolled gum disease also often have poor blood sugar levels. Conversely, diabetics often have an exaggerated inflammatory response to gum disease bacteria compared to someone without diabetes.
The good news, though, is that bringing systemic diseases like diabetes under control may have a positive effect on the treatment of gum disease. It may also mean that properly treating gum disease could also help you manage not only diabetes, but also other conditions like cardiovascular disease, osteoporosis, or rheumatoid arthritis. Taking care of your teeth and gums may not only bring greater health to your mouth, but to the rest of your body as well.
If you would like more information on treating dental diseases like 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 “Good Oral Health Leads to Better Health Overall.”