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Posts for category: Oral Health

By Robert S. Mather, DDS
June 27, 2019
Category: Oral Health
Tags: oral health  
ThisRareTongueConditionOftenLooksWorsethanitActuallyis

There are a few mouth conditions so rare most of us have never heard of them. Geographic tongue would fall into this category, affecting only one to three percent of the population. Even so, these irregular reddish patches resembling land masses on a map (hence the name) might be alarming at first glance—but they pose no danger and usually cause very little discomfort.

Geographic tongue is also known as benign migratory glossitis. As its clinical name implies, the unusual red patchy areas (often surrounded by a grayish white border) aren't cancerous nor contagious. The patches also appear to change shape and move around ("migrate") the tongue.

The reddish appearance comes from the temporary disappearance of tiny bumps on the tongue surface called papillae, which can leave the tongue smooth to the touch in affected areas. The lost papillae may reappear again a few hours or days later, and may occasionally disappear again. While it's not painful, you can experience a stinging or burning sensation emitting from these patchy areas.

We're not sure how and why geographic tongue erupts, but it's believed high emotional or psychological stress, hormonal imbalance or certain vitamin deficiencies might be factors in its cause. There may also be a link between it and psoriasis, a condition that can cause dry, itchy patches on the skin.

If you're one of the rare individuals who has episodes of geographic tongue, the good news is it's harmless, only mildly uncomfortable and usually temporary. The bad news, though, is that there's no known cure for the condition—but it can be managed to ease discomfort during outbreaks.

It's been found that highly acidic and spicy foods, as well as astringents like alcohol or some mouthrinses, can increase the level of discomfort. By avoiding these or similar foods or substances, you can reduce the irritation. Your dentist may also be able to help by prescribing anesthetic mouthrinses, antihistamines or steroid ointments.

For the most part, you'll simply have to wait it out. Other than the mild, physical discomfort, the worst part is often simply the appearance of the tongue. But by watching your diet and other habits, and with a little help from us, you can cope with these irritations when it occurs.

If you would like more information on geographic tongue and similar oral issues, 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 “Geographic Tongue: No Cause for Alarm.”

BeontheAlertforWhiteSpotsonTeethWhileWearingBraces

While wearing braces is the path to a healthier and more attractive smile, it can be a difficult journey. One of your biggest challenges will be keeping your teeth clean to avoid a higher risk of tooth decay.

Tooth decay starts with dental plaque, a thin film of bacteria and food particles that accumulates on teeth. Daily brushing and flossing clear this accumulation. But the hardware of braces makes it difficult to access all tooth surfaces, and can even become a haven for plaque.

One sign in particular of tooth decay while wearing braces is the appearance of chalk-like spots on the teeth known as white spot lesions (WSLs). WSLs occur because the minerals in the enamel beneath them have begun to break down in response to decay. The spots can eventually cause both structural and cosmetic problems for a tooth.

The best approach to WSLs is to prevent them from developing in the first place. You'll need to be extra vigilant with daily oral hygiene while wearing braces to reduce plaque buildup. To help with the increased difficulty you might consider using a special toothbrush designed to maneuver more closely around orthodontic hardware. You may also find using a water flosser to be a lot easier than flossing thread.

Preventing tooth decay and WSLs also includes what you eat or drink to reduce the effects of enamel de-mineralization. The bacteria that cause decay thrive on sugar, so limit your intake of sweetened foods and beverages. And to avoid excessive demineralization cut back on acidic foods as well.

If despite your best preventive efforts WSLs still form, we can take steps to minimize any damage. For one, we can give your enamel a boost with fluoride applications or other remineralization substances. We can also inject a tooth-colored resin beneath the surface of a WSL that will make it less noticeable.

With any of these and other treatments, though, the sooner we can treat the WSL the better the outcome. Practicing good hygiene and dietary habits, as well as keeping an eye out for any WSL formations, will do the most to protect your new and improved smile.

If you would like more information on preventing dental disease while wearing braces, 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 “White Spots on Teeth During Orthodontic Treatment.”

PreservingthePulpisPriorityOnewithaNewlyEruptedPermanentTooth

The change from primary teeth to permanent is an announcement to the world that a boy or girl is "growing up." "Growing up," though, is still not "grown"—the new teeth are still in a period of development that can affect how we treat them if they're injured or diseased.

While a new tooth erupts with all its anatomical layers, the middle dentin is somewhat thinner than it will be after it matures. The pulp, the tooth's innermost layer, produces new dentin and gradually increases the dentin layer during this early development period. While the pulp continues to produce dentin over a tooth's lifetime, most of it occurs in these early years.

To prevent or stop any infection, we would normally perform a root canal treatment in which we remove the pulp tissue and fill the empty pulp chamber and root canals. This poses no real issue in an older tooth with mature dentin. Removing the pulp from an immature tooth, though, could interrupt dentin development and interfere with the tooth's root growth. Besides a higher risk of discoloration, the tooth could become more brittle and prone to fracture.

That's why we place a high priority on preserving a younger tooth's pulp. Rather than a root canal treatment, we may treat it instead with one of a number of modified techniques that interact less with the pulp. Which of these we use will depend on the extent of the pulp's involvement with the injury or disease.

If it's unexposed, we may use a procedure called indirect pulp therapy, where we remove most of the tooth's damaged dentin but leave some of the harder portion intact next to the pulp to avoid exposure. If, though, some but not all of the pulp is damaged, we may perform a pulpotomy: here we remove the damaged pulp tissue while leaving the healthier portion intact. We may then apply a stimulant substance to encourage more dentin production to seal the exposure.

These and other techniques can help repair an injured young tooth while preserving most or all of its vital pulp. Although we can't always use them, when we can they could give the tooth its best chance for a full life.

If you would like more information on caring for your child's 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 “Saving New Permanent Teeth after Injury.”

DentalInjuryIsJustaTemporarySetbackforBasketballStarKevinLove

The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.

In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?

The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.

Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.

So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”

Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.

If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”

NationalChildrensDentalHealthMonthHighlightsImportanceofBabyTeeth

We all know that a child's baby teeth don't last forever. So if those little teeth develop problems, like severe decay, chips or cracks, it doesn't much matter—right? Wrong! National Children's Dental Health Month, observed in February, is the perfect occasion to remember why baby teeth need the same meticulous care as adult teeth:

  • Baby teeth perform the exact same jobs adult teeth do, only in little mouths. Without healthy teeth, a child can't eat comfortably, speak properly or smile with confidence. Given that the last baby tooth doesn't fall out until around age 12, children need to rely on these "temporary" teeth for a long time!
  • While there often are no symptoms of early tooth decay, badly decayed baby teeth can become painful—and the problem may get worse quickly. Untreated tooth decay can lead to suffering and expense that could have been avoided with relatively simply dental treatment.
  • Baby teeth help guide adult teeth into the right position. Each baby tooth helps hold the right amount of space open for the next tooth that will grow in. When a baby tooth is lost before the permanent replacement is ready to grow in, orthodontic problems can result.

As you can see, good dental health has a big impact on a child's quality of life and health—in both the present and the future. That's why it's important to treat childhood dental disease and injuries promptly and properly. Regular dental exams are the best way to keep on top of your child's dental health. If a cavity is discovered at a routine exam, prompt treatment can keep the decay from spreading to the root canals.

If your child plays sports, ask us about a custom-made mouthguard. This small device can protect your child's teeth from serious injury.  And if a baby tooth does get knocked out, let us know. It may be best to fit your child with a very small dental device called a space maintainer, which will hold that empty space open until the permanent tooth beneath it grows in.

If you would like more information about children's dental health, please contact us or schedule an appointment a consultation. You can also learn more by reading the Dear Doctor magazine article “Importance of Baby Teeth.”