Frequently in dentistry we get questions about over the counter whitening toothpastes. It is a frustrating topic for those of us in dentistry because over the counter toothpaste doesn’t whiten, it only brightens. Whitening is done by products formulated from peroxides. No over the counter product will effectively bleach better than a product obtained from your dental office. Only a dental office can sell a product with a strong enough peroxide to actually whiten. A new product is getting a lot of buzz on social media for its whitening claims. This toothpaste receives mixed reviews from users though. Many complained of canker sores which can easily be attributed to the sodium laurel sulfate in the ingredient list. It also relies on alumina to produce the clean, reduced plaque feeling they advertise. Alumina is an abrasive. Many people complained that after a few weeks of use they had terrible sensitivity issues which can be the result of an overly abrasive toothpaste. Finally, this product promotes that it is free of dangerous peroxides. Peroxide is only dangerous when consumed in high concentrations, not from merely wearing whitening trays. It is important to remember that fantastic claims from over the counter products cannot always be trusted.
The manual toothbrush that we are familiar with today is the latest incarnation of a personal hygiene tool that has been in use for centuries. The original toothbrush was a sharpened twig made of sweet smelling wood. Then in 15th century China a bone handle brush embedded with hog bristles was invented that ultimately replaced the twig. Now the electronic brush is the highest on the evolutionary ladder of toothbrush evolution. The ADA states that a manual toothbrush is perfectly fine for those who have a good flossing and brushing technique, which unfortunately most patients do not have. The electric toothbrush action can be anywhere from 6,000 to 30,000 strokes per minute which can vastly improve the quality of brushing while leaving the gum and tooth structure safe. Most models also have a timer that helps to train the user to brush for the adequate amount of time. Electric toothbrushes are beneficial to any age patient, but particularly children and the elderly. Children are inconsistent with brushing, and the electric brush helps even out the quality of their homecare. For elderly patients who for a variety of health reasons have lost the ability to brush well the electric brush can make up the difference. Overall the electric toothbrush is a better choice than a manual toothbrush.
Approximately 90 million Americans snore. That means not only the person snoring, but their spouse and children may suffer from lack of quality sleep. Unfortunately disturbed sleep is not the only consequence of snoring. According to a UCLA School of Dentistry study this struggle for breath contributes to high blood pressure and stroke risk. In sleep, the muscles and soft tissue of the mouth and throat relax and decrease the airway. This will increase the velocity of air flowing through and results in vibrations which produce the noise of snoring. If this is a problem for you ask our dentists about a Silent Nite appliance. This custom fit appliance positions the lower jaw forward by using select connectors attached to the upper and lower transparent forms. The appliance has a soft inner layer that rests comfortably against the teeth and gums with a hard outer shell that resists breaking so that the appliance is comfortable yet durable. It requires two appointments for this appliance, the first to take impressions and then a second to deliver the appliance and check the fit. Silent Nite does not interfere with breathing through the mouth, and it allows slight movement of the jaw to minimize stiffness. Wearing the appliance overnight may produce a slight feeling of jaw misalignment due to the build up of lymphatic fluid in the joint, but that quickly disappears with normal function. Many insurance companies do not provide coverage for the appliance, but it is a small price to pay for the benefit of a good night sleep.
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.