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Posts for category: Oral Health

AsAntetokounmpoKnowsEvenanNBAStarCanBeSidelinedbyaToothache

The NBA's reigning MVP Giannis Antetokounmpo may seem unstoppable, but he proved no match for a troubled tooth. Antetokounmpo, the self-proclaimed “Greek Freak,” missed one of the final three 2020 regular season games for a dental issue that resulted in last-minute oral surgery. According to a Milwaukee Bucks spokesperson, the star underwent “a root-canal like procedure.”

Root canal therapy, often simply called “a root canal,” may be needed when there is an infection inside the tooth. When dental pulp becomes inflamed or infected, excruciating pain can result. Pulp is the soft tissue that fills the inside of the tooth. It is made up of nerves, blood vessels and connective tissue. During root canal treatment, the pulp is removed, the space inside the tooth is disinfected, it is filled with a special material, and then the hole is sealed up.

A root canal is nothing to fear. It relieves pain by getting rid of infection and is so effective that over 15 million of them are performed in the U.S. each year. This routine procedure generally requires only local anesthetic, and your mouth should be back to normal within a day or two after treatment. Antetokounmpo can attest to that, as he returned to play the next day.

However, delaying root canal treatment when you need it can have serious consequences. If left untreated, an infection inside the tooth continues to spread, and it may move into the gums and jaw and cause other problems in the body. So, how do you know if you may need a root canal? Here are some signs:

Lingering sensitivity to hot or cold temperatures. One sign of nerve damage inside your tooth is pain that is still there 30 seconds after eating or drinking something hot or cold.

Intense pain when biting down. You may feel pain deep within your tooth, or in your jaw, face or other teeth. The pain may be hard to pinpoint—and even if it improves at times, it usually comes back.

A chipped, cracked or discolored tooth. A chip or crack can allow bacteria to enter the tooth, and the tooth may darken if the tissue inside is damaged.

A pimple on the gum. A bump or pimple on the gum that doesn't go away or keeps coming back may signify that a nearby tooth is infected.

Tender, swollen gums. Swollen gums may indicate an infection inside the tooth or the need for periodontal treatment.

And sometimes there is no pain, but an infection may be discovered during a dental exam.

Tooth pain should never be ignored, so don't put off a dental visit when you have a toothache. In fact, if a bad toothache goes away, it could mean that the nerves inside the tooth have died, but the infection may still be raging. Also, be sure to keep up with your regular dental checkups. We may spot a small problem that can be addressed before it becomes a bigger problem that would require more extensive treatment.

Remember, for dental issues both large and small, we're on your team! If you would like more information about tooth pain, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Tooth Pain? Don't Wait!” and “Root Canal Treatment: What You Need to Know.”

By Eli B. Mayes, DDS
March 22, 2021
Category: Oral Health
Tags: osteoporosis  
CertainDrugsforOsteoporosisCouldImpactYourDentalCare

Osteoporosis is a serious bone weakening disease in older adults that can turn a minor fall into a major bone fracture. But the condition could also impact dental treatment—triggered ironically by the drugs used to treat osteoporosis rather than the disease itself.

From the Latin for “porous bone,” osteoporosis causes bone to gradually lose mineral structure. Over time the naturally-occurring spaces between mineralized portions of the bone enlarge, leaving it weaker as a result.

Although there's no definitive cure for osteoporosis, a number of drugs developed over the last couple of decades can inhibit its progress. Most fall into two major categories, bisphosphonates and RANKL inhibitors.

These drugs work by inhibiting the normal growth cycle of bone. Living bone constantly changes as cells called osteoblasts produce new bone. A different type, osteoclasts, clear away older bone to make room for these newer cells. The drugs selectively destroy osteoclasts so that the older bone, which would have been removed by them, remains for a longer period of time.

Retaining older cells longer initially slows the disease process. But there is a downside: in time, this older bone kept in place continues to weaken and lose vitality. In rare instances it may eventually become detached from its blood supply and die, resulting in what is known as osteonecrosis.

Osteonecrosis mostly affects two particular bones in the body: the femur (the long bone in the upper leg) and the jawbone. In regard to the latter, even the stress of chewing could cause osteonecrosis in someone being treated for osteoporosis. It can also occur after tooth extractions or similar invasive procedures.

If you're taking a bisphosphonate or RANKL inhibitor, you'll want to inform your dentist so that the necessary precautions can be taken before undergoing dental work more invasive than routine cleanings or getting a filling or crown.  If you need major dental work, your dentist or you will also need to speak with your physician about stopping the drug for a few months before and after a dental procedure to minimize the risk of osteonecrosis.

Fortunately, the risk for dental problems while undergoing treatment for osteoporosis is fairly low. Still, you'll want to be as prepared as possible so that the management of your osteoporosis doesn't harm your dental health.

If you would like more information on osteoporosis and dental health, 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 “Osteoporosis Drugs & Dental Treatment.”

ThisMinorDentalProcedureCouldMakeBreastfeedingEasierforanInfant

Breastfeeding is nature's way of providing complete nourishment to a newborn in their first years of life. It can also have a positive impact on their emerging immune system, as well as provide emotional support and stability. But although nursing comes naturally to an infant, there are circumstances that can make it more difficult.

One example is an abnormality that occurs in one in ten babies known as a tongue tie. A tongue tie involves a small band of tissue called a frenum, which connects the underside of the tongue with the floor of the mouth. The frenum, as well as another connecting the inside of the upper lip with the gums, is a normal part of oral anatomy that helps control movement.

But if the frenum is too short, thick or taut, it could restrict the movement of the tongue or lip. This can interfere with the baby acquiring a good seal on the breast nipple that allows them to draw out milk. Instead, the baby may try to chew on the nipple rather than suck on it, leading to an unpleasant experience for both baby and mother.

But this problem can be solved with a minor surgical procedure called a frenotomy (also frenectomy or frenuplasty). It can be a performed in a dentist's office with just a mild numbing agent applied topically to the mouth area (or injected, in rare cases of a thicker frenum) to deaden it. After a few minutes, the baby's tongue is extended to expose the frenum, which is then snipped with scissors or by laser.

There's very little post-op care required (and virtually none if performed with a laser). But there may be a need for a child to “re-learn” how to breastfeed since the abnormal frenum may have caused them to use their oral muscles in a different way to compensate. A lactation expert may be helpful in rehabilitating the baby's muscles to nurse properly.

A restrictive frenum isn't necessarily a dire situation for an infant—they can continue to feed with a bottle filled with formula or pumped breastmilk. But employing this minor procedure can enable them to gain the other benefits associated with breastfeeding.

If you would like more information on tongue ties and other oral abnormalities in children, 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 “Tongue Ties, Lip Ties and Breastfeeding.”

WhatsThatonYourTeethNickJonasHowtoAvoidaSimilarSmileOops

Think no one is looking at your smile when you’re out in public? Nick Jonas’ recent experience might convince you otherwise. While the Jonas Brothers were performing during the 2020 Grammys, fans watching on television picked up on some dark matter between his teeth.

To say Twitter lit up is an understatement. For many, it was that thing you couldn’t unsee: Forget the performance, what was that between his teeth? Jonas later fessed up by tweeting, “…At least you all know I eat my greens.”

We’re sure Nick and his brothers take care of their teeth, as most any high-profile entertainer would. You can probably attribute his dental faux pas to trying to squeeze in some nourishment during a rushed performance schedule.

Still, the Grammy incident (Spinachgate?) shows that people do notice when your teeth aren’t as clean as they should be. To avoid that embarrassment, here are some handy tips for keeping your teeth looking their best while you’re on the go.

Start with a clean mouth. You’re more apt to collect food debris during the day if you have built-up plaque on your teeth. This sticky bacterial biofilm attracts new food particles like a magnet. Remove plaque by thoroughly brushing and flossing before you head out the door.

Rinse after eating. Although your saliva helps clear leftover food from your mouth, it may not adequately flush away all the debris. You can assist this process by swishing and rinsing with clean water after a meal.

Keep a little floss handy. Even after rinsing, stubborn bits of food can remain lodged between teeth. So just in case, keep a small bit of emergency floss (or a floss pick) in your purse or wallet to remove any debris you see or feel between your teeth.

Watch what you eat. Some foods—like popcorn, sticky snacks or fibrous vegetables—are notorious for sticking in teeth. Try to avoid eating these foods right before a public appearance where your smile may be critical.

And here’s an added bonus: Not only will these tips help keep your smile attractive on the go, they’ll also help keep it healthy. Rinsing with water, for example, helps lower your mouth’s acid level after eating, a prime factor in tooth decay. And flossing, both as a regular practice and for occasional stuck food, decreases plaque and subsequently your risk of tooth decay and gum disease.

Remember, a healthy mouth is the starting place for a beautiful smile. Keep it that way with dedicated hygiene habits at home or on the go.

If you would like more information on tips for better oral hygiene, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Daily Oral Hygiene.”

FlossinganImplant-SupportedBridgecanPreventaDamagingGumInfection

In recent years, dental implants have helped traditional bridgework take a giant leap forward. A few strategically placed implants can provide the highest support and stability we can currently achieve for this well-known dental restoration.

Implants derive this stability from the bone in which they're imbedded. Once surgically installed, the bone around a metal implant begins to grow and adhere to its titanium surface. Over time, this creates a strong anchor that firmly holds the implant in place.

But the implants' stability can be threatened if the gums around them become diseased. Gum disease, a bacterial infection caused mainly by dental plaque, can advance silently below the gum surface until it ultimately infects the bone. This can cause significant bone loss around an implant, which can weaken it to the point of failure.

To avoid this scenario, it's important to prevent gum disease by flossing daily to remove accumulated dental plaque between the implant-supported bridge and the gums, particularly around the implants. This kind of flossing around bridgework is more difficult than flossing between teeth, but it can be done with the help of a device called a floss threader.

A floss threader is a small plastic hand tool with a loop on one end and a stiffened edge on the other (similar to a sewing needle). You begin by threading about 18" of dental floss through the loop, and then work the other end of the threader between the bridge and gums to the other side.

With the floss threaded between the bridge and gums, you can now remove it from the threader, grasp each end, and floss around the sides of each implant you can reach. You'll then need to repeat the process by removing the floss, rethreading it in the threader and inserting it into the next section between implants, continuing to floss until you've accessed each side of each implant.

You can also use pre-packaged floss thread sections with a stiffened end to facilitate threading. But whichever product you use, it's important to perform this task each day to prevent a gum infection that could rob you of your implant-supported bridge.

If you would like more information on oral hygiene practices with dental work, 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 “Oral Hygiene for Fixed Bridgework.”