Posts for category: Oral Health
Drugs play an indispensable role in treating disease. For example, life without antibiotics would be much more precarious—common infections we think nothing of now would suddenly become life-threatening.
But even the most beneficial drug can have disruptive side effects. Antibiotics in particular can cause a rare but still disturbing one: a growth on the tongue that at first glance looks like dark hair. In fact, it's often called "black hairy tongue."
It isn't hair—it's an overgrowth of naturally occurring structures on the tongue called filiform papillae. These tiny bumps on the tongue's upper surface help grip food while you're chewing. They're normally about a millimeter in length and tend to be scraped down in the normal course of eating. As they're constantly growing, they replenish quickly.
We're not sure how it occurs, but it seems with a small portion of the population the normal growth patterns of the papillae become unbalanced after taking antibiotics, particularly those in the tetracycline family. Smoking and poor oral hygiene also seem to contribute to this growth imbalance. As a result, the papillae can grow as long as 18 millimeters with thin shafts resembling hair. It's also common for food debris and bacteria to adhere to this mass and discolor it in shades of yellow, green, brown or black.
While it's appearance can be bizarre or even frightening, it's not health-threatening. It's mostly remedied by removing the original cause, such as changing to a different antibiotic or quitting smoking, and gently cleaning the tongue everyday by brushing it or using a tongue scraper you can obtain from a pharmacy.
One word of caution: don't stop any medication you suspect of a side effect without first discussing it with your prescribing doctor. While effects like black hairy tongue are unpleasant, they're not harmful—and you don't want to interfere with treatments for problems that truly are.
More than 20 million people in the United States use electronic cigarettes or e-cigs as an alternative to tobacco smoking. While many users believe "vaping" is a healthier alternative to regular cigarettes, recent research into the health effects of e-cigs could put a damper on that belief. There's particular concern among dentists that this popular habit could harm users' dental health.
E-cigs are made with a chamber that holds the liquid vaping solution and a heating mechanism to heat the liquid and vaporize it. Users inhale the vapor, which contains nicotine and flavorings, as they would a traditional cigarette.
The nicotine alone can be problematic for dental health as we'll see in a moment. But the vapor also contains aerosols that some research indicates could damage the inner skin linings of the mouth in a similar fashion to the smoke of traditional cigarettes. One study by researchers with the Université Laval in Quebec, Canada found evidence that e-cig vapor increased the death rate of mouth cells, and led to greater cell irregularities over time.
According to other studies, there's evidence that e-cig vapor may disrupt the balance of the oral microbiome, the communities of both beneficial and harmful bacteria that normally live in the mouth. The imbalance in favor of more harmful bacteria could increase the risk for dental disease, particularly periodontal (gum) disease.
Finally, nicotine from e-cigs seemed to create similar conditions in the mouth as it does with tobacco. Nicotine in any form can constrict blood vessels and reduce the body's ability to fight infection and to heal. Research indicates both forms of nicotine increase the risk for dental disease and make treatment more difficult.
These findings only identify conditions created by e-cigs that could be problematic for future dental health. Although we don't fully understand the long-term health effects of this new habit, based on the evidence so far the mouth may not fare so well. It's looking like e-cigs may be no safer for your teeth and gums than the cigarettes they replace.
If your dentist found tooth decay on your last visit, you might have been surprised. But tooth decay doesn't occur suddenly—it's a process that takes time to unfold.
It begins with bacteria—too many, that is. Bacteria naturally live in the mouth, but when their populations grow (often because of an abundance of leftover sugar to feed on) they produce high amounts of acid, a byproduct of their digestion. Too much acid contact over time softens and eventually erodes tooth enamel, making decay easier to advance into the tooth.
So, one important strategy for preventing tooth decay is to keep your mouth's bacterial population under control. To do that, here are 4 common-sense tactics you should perform between dental visits.
Practice daily hygiene. Bacteria thrive in dental plaque, a thin film of food particles that builds up on teeth. By both brushing and flossing you can reduce plaque buildup and in turn reduce disease-causing bacteria. In addition, brushing with a fluoride toothpaste can also help strengthen tooth enamel against acid attacks.
Cut back on sugar. Reducing how much sugar you eat—and how often –deprives bacteria of a prime food source. Constant snacking throughout the day on sweets worsens the problem because it prevents saliva, the body's natural acid neutralizer, from reducing high acid levels produced while eating. Constant snacking doesn't allow saliva to complete this process, which normally takes about thirty minutes to an hour. To avoid this scenario, limit any sweets you eat to mealtimes only.
Wait to brush after eating. Although this sounds counterintuitive, your tooth enamel is in a softened state until saliva completes the acid neutralizing process previously described. If you brush immediately after eating you could brush away tiny particles of softened enamel. Instead, rinse your mouth out with water and wait an hour for saliva to do its work before brushing.
Boost your saliva. Inadequate saliva flow could inhibit the fluid's ability to adequately neutralize acid or provide other restorative benefits to tooth enamel. You can improve flow with supplements or medications, or by drinking more water during the day. Products with xylitol, a natural sugar alternative, could give you a double benefit: chewing gums and mints containing it could stimulate more saliva flow and the xylitol itself can inhibit bacterial growth.
You may think your blood pressure is only important to your general health — but it can also affect your dental care. That’s why it’s increasingly common for dental providers to include blood pressure monitoring for patients during routine visits.
High blood pressure is a risk factor for several major health conditions including heart attack, stroke and diabetes, and is one of the most common diagnoses in the United States. Even so, many people don’t know their blood pressure is abnormally high. It may be discovered during an annual health visit, or not at all. Since many people visit their dentist twice a year for cleanings, taking a blood pressure reading during these visits increases the chance of detecting a high pressure.
In one study published in the Journal of the American Dental Association, the researchers looked at dental patients who had not seen a doctor in the previous twelve months and who underwent blood pressure screening during a regular dental visit. Seventeen percent of those studied learned they were at increased risk for cardiovascular disease.
High blood pressure can also have a direct effect on how we treat your teeth and gums. For example, we may have to adapt and become more diligent about preventing dental disease if you’re taking a blood pressure drug that could trigger reduced saliva flow (dry mouth), a factor in tooth decay. Certain local anesthetics may also contain substances like epinephrine that constrict blood vessels, which can increase blood pressure. To avoid this if you’re hypertensive, we may need to adjust the dosage of anesthetic drugs to lessen this effect.
Monitoring blood pressure in the dental office is a good example of how all healthcare services can interact with each other. At the very least, a blood pressure check at your next cleaning could alert you to a potentially dangerous condition you didn’t even know you had.
If you would like more information on the relationship of blood pressure and other medical issues to 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 “Monitoring Blood Pressure.”
In the battle against tooth decay, fluoride is an important weapon. Since the discovery of its dental health benefits a century ago, fluoride has been credited with saving countless teeth.
But over its history in dental care, this natural-occurring chemical has also had its share of controversy with concerns raised from time to time on potential health dangers. These run the gamut from “conspiracy theory” speculations to credible research like a 2006 National Research Council study that suggested a possible increased risk of bone fracture or cancer from over-consumption of fluoride.
Even so, there is actually little evidence or even record of incidence for such dire consequences. The only definitive health effect from fluoride found after decades of copious research is a condition called fluorosis, a permanent staining effect on the teeth. Fluorosis poses a cosmetic problem but does not harm the health of the teeth.
Moderation in fluoride use seems to be the key to gaining its health benefits while avoiding fluorosis. One influential fluoride researcher, Dr. Steven Levy, estimates 0.05-0.07 milligrams of fluoride per one kilogram of body weight (about a tenth the weight of a grain of salt for every two pounds) is sufficient to gain the optimum dental benefit from fluoride.
The real question then is whether your family’s current consumption of fluoride is within this range. That will depend on a number of factors, including whether your local water utility adds fluoride to your drinking water supply and how much. You may also be ingesting fluoride through processed foods, juices and even some bottled waters. And you can encounter fluoride in dental care including toothpastes and clinical treatments.
One way to moderate your family’s fluoride intake is to be sure all your family members are using the correct amount of fluoride toothpaste for their age while brushing. Infants need only a slight smear on the end of the brush, while older children can brush adequately with just a pea-sized amount. For other tips and advice, talk to your dentist about your family’s fluoride intake and how you might adjust it.
Even with the possibility of fluorosis, fluoride still provides an incredible benefit in preventing tooth decay. By understanding fluoride and keeping your intake within normal ranges you can maximize its benefit for healthier teeth and minimize the fluorosis risk.
If you would like more information on the role of fluoride in 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 “Fluoride & Fluoridation in Dentistry.”