Currently about 91 Americans die everyday due to opioid addiction. Opioids are a category of drugs that include hydrocodone, oxycodone, heroin, methadone, and fentanyl. They depress the central nervous system reducing pain sensation, providing a sedative effect, and producing euphoria. These drugs are extremely addictive over time, and it is important to recognize this in the dental office where they are a tool for treatment. It is important to be aware of symptoms of addiction in patients. Systemic signs of opioid abuse include constricted pupils, depressed respiration, anorexia, and constipation. These are symptoms that can be readily visible to anyone in regular contact with an addict. In the dental office there are also symptoms in the mouth that can be diagnosed such as xerostomia, bruxism, and extremely poor oral hygiene. Early diagnosis can increase success in overcoming addiction. Withdrawal from opioids can be difficult, and proper treatment can sometimes require drug therapy.
When a patient presents with occlusal or incisal wear on their teeth the inevitable question is do you clench or grind your teeth? Grinding involves sliding your teeth across each other, while clenching is holding top and bottom teeth tightly together. Both conditions are called bruxism, and they present with the same symptoms. Symptoms included are as follows: headache/earache, sore jaw, jaw clicking, frequent toothaches, sensitive teeth, facial pain, worn/cracked teeth or fillings, tongue marks, or trouble sleeping. The causes of bruxism can be stress, disorders, or malocclusion. Treatment can involve a night guard, medication for pain or muscle spasms, and exercises to manipulate the muscles. It may involve multiple treatment to get the condition under control.
Temporomandibular Disorder or TMD is a condition that affects many dental patients. New evidence suggests that it may be associated with undiagnosed hypothyroidism. Hypothyroidism symptoms included muscle weakness, stiffness, and aches. This can affect the muscles of the head and neck, affecting their ability to properly support the joint. In fact the forward head posture of some TMD patients may also put pressure on the thyroid gland. There is also a higher occurrence of the thyroid conditions of Hashimoto’s Disease and Wilson’s disease with severe TMD patients. When the subject of joint pain comes up it might be a good time to discuss the symptoms of hypothyroidism. They include the following: muscle weakness, dry skin, constipation, puffy face, hoarseness, impaired memory, carpal tunnel syndrome, fatigue, weight gain, thinning hair, slowed heart rate, joint pain/stiffness, brittle fingernails, cold sensitivity, heavy/irregular menstrual periods, depression, elevated cholesterol, muscle aches/tenderness/stiffness, and infertility. It can be very beneficial to the patient to review these conditions and symptoms to see if a trip to their medical doctor is in order in cases of TMD.
A recently completed study by the University of Rochester Medical Center has provided evidence that e-cigarettes are just as harmful to the teeth and gums as regular cigarettes. When the vapors from the e-cigarettes burn it promotes the release of inflammatory proteins. This produces cellular stress and damage. Cellular damage is the root of many oral diseases, like cancer for instance. The extent of the damage directly relates to the frequency of use. The American Lung Association has now called on the FDA to step in and regulate these products.
The newest research by the CDC reveals that low income children with sealants has increased by 70% preventing nearly 1 million cavities. This proves that sealants play a pivotal role in keeping children’s oral health in tact. Sealants are placed on the permanent molars of children. It is a liquid plastic that flows into the grooves on the occlusal or biting surface. The plastic is then hardened with a light. This creates a barrier that prevents food and bacteria from depositing deep in the groove where toothbrushes cannot adequately brush. While they are extremely effective, dental sealants are not permanent and can wear off. It is essential that you ask your dentist to examine these for replacement at every cleaning appointment. Insurance coverage will vary for this procedure so as a patient it is in your best interest to know what your benefits specify.
Approximately 800,00 Americans die annually from cardiovascular disease. How does this relate to dentistry? The bacteria that cause gum disease and inflammation are the suspected culprit. There is now a greater link between patients with periodontal disease developing heart disease than those with high cholesterol. While the mechanism is not fully know the proposed scenario is that the bacteria from the infected gums enter the bloodstream through normal chewing or tooth brushing. It is them believed that these oral bacteria can adhere to the fatty plaque in the bloodstream. This can cause blockages to develop in the bloodstream to develop. These same bacteria can possibly trigger an inflammation response where blood vessels swell and slow blood flow contributing to clot formation. It is important that as a patient you monitor your gums for the signs of gum disease to protect your heart health. Swollen, red gums that bleed when brushed or flossed are not healthy. Gum tissue that is not firmly attached to teeth is not healthy. Pus between teeth or persistent bad breath is not healthy. If you have any of these symptoms see your dentist immediately for a treatment plan to improve your dental health and reduce your risk for cardiovascular disease.
Oral probiotics are a completely natural way to improve the health of your mouth by repopulating it with good bacteria. The good bacteria introduced combats inflammation, the first step in both gingivitis and periodontitis. They also help reduce the production of sulfur gases produced by bacteria that colonize the back of the tongue and promote fresher breath. Additionally, oral probiotics help neutralize the mouth’s pH which helps produces a healthy saliva flow. There is even new research to suggest that some oral probiotics may even attack and kill Streptococcus mutans the bacteria responsible for cavities. While there is no recommended dose, research reveals that 1 to 10 billion live cultures per day which can be obtained in one serving of a probiotic rich food per day.
Pregnancy controls all aspects of a woman’s life, even her dental visit. It is important to follow a few guidelines when you go. First, be sure to let the dentist and hygienist know how far along your pregnancy is, and if you are experiencing a high risk pregnancy. Secondly you should disclose if you are taking any prescription or over the counter medications. Third, it is important to reveal an changes in your oral health. This would include color of your tissue, pain in your gums, bleeding of gums, or swelling of tissue. Finally, let him know if you have any painful or loose teeth. While you want to obtain your doctor’s approval before getting radiographs it is sometimes necessary to diagnose decay or infection. If either of these conditions is left untreated it can be more risky to your pregnancy than dental treatment or radiographs.
It is January and as usual we are inundated with messages about how to lose weight and get healthy. All of the yummy holiday foods are now gone from the grocery store and have been replaced with the low fat, sugar free, and unprocessed foods. We all know that these choices are good for our body but did you realize these choices also help your teeth. A steady “diet” of sugary foods and drinks can also damage your teeth. Plaque, the sticky film that we remove from our teeth with brushing, flossing, and rinsing contains bacteria. This bacteria produces acid as a by-product of eating the sugar that we ingest. This acid attacks the enamel surface of the tooth, and can remain on the surface of the teeth for 20 minutes after eating. Over time the worn enamel decays and becomes a cavity. Sipping a sugary drink or sucking on mints or candies can keep the acid production levels high all through the day making your teeth vulnerable to cavities. This year be mindful of your choices for your body and your teeth.
A well balanced diet helps prevent heart disease, diabetes, and tooth decay. Just like the body, the teeth and gums require vitamins, protein, calcium, and phosphorous to be healthy. A healthy diet includes an abundance of unprocessed foods like whole grains, vegetables, and fruits. Protein should be lean and come from a variety of sources like fish, chicken, eggs, beans, cheese, and yogurt. Choices should be low in fat, sugar, and salt. It is also important to portions in moderation. Even healthy foods like apples, carrots, and milk contain natural sugars that can lead to acid production. Some good guidelines are to avoid processed food and sugars, limit snacking between meals, rinse with water after snacks, and if you eat sugary foods and drinks eat them with meals.