Posts for: December, 2015
Saliva is a true workhorse among bodily fluids — it breaks down food for digestion, keeps harmful bacteria in check and neutralizes acid that is destructive to tooth surfaces. So when saliva flow is chronically diminished, it’s more serious than the uncomfortable feeling of “dry mouth” — it can have a detrimental effect on your overall health.
It’s normal to experience temporary mouth dryness: in the morning (because saliva flow slows during sleep), when we’re under stress, or after smoking or consuming certain foods and beverages like onions or coffee. But chronic dry mouth (“xerostomia”) is different — the mouth remains dry for extended periods, leading to problems like tooth decay caused by inadequate acid neutralization.
Medications are one of the most common causes for xerostomia. According to the Surgeon General, there are over 500 medications — both prescription and over-the-counter — that can cause it, including antihistamines, diuretics and antidepressants. Radiation or chemotherapy used for cancer treatment may also cause dry mouth, sometimes permanently. There are also systemic conditions that affect saliva flow like diabetes, Parkinson’s disease, cystic fibrosis, and many autoimmune diseases.
Treating chronic dry mouth will of course depend on the underlying cause. If drug-related the first approach should be to find a substitute medication that won’t as readily cause reduced saliva flow. If that’s not possible, then it’s helpful to drink more water when taking the medication (a few sips before and a full glass afterward). You can also cut back on caffeinated, acidic or sugary foods and drinks as well as alcohol, and refrain from tobacco use.
A saliva stimulant might also help. Besides prescription medication, there are other products like xylitol, a natural alcohol sugar found in chewing gum, toothpaste or rinses, that help increase saliva flow — and xylitol also inhibits the growth of decay-causing bacteria.
The most important thing for chronic dry mouth is maintaining consistent daily hygiene through brushing and flossing and regular dental cleanings and checkups. Helping to increase your saliva flow and making every effort to prevent dental disease will help keep this condition from harming your teeth and gums.
If you would like more information on the causes and treatment of dry mouth, 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 “Dry Mouth.”
A few days before the Oscars, Vanity Fair magazine asked Academy Awards host Neil Patrick Harris to name his most treasured possession. Was it his Tony award statuette for best leading actor in a musical? His star on the Hollywood Walk of Fame? The stethoscope he wore while playing teenaged doctor Doogie Howser on TV? No, as it turns out, the 41-year-old actor’s most treasured possession is… his wisdom teeth. Yes, you read that correctly. “Oddly, I still have my four wisdom teeth,” Harris said. “I refuse to let them go or I’ll lose my wise parts.”
How odd is it for a 41-year-old to have wisdom teeth? Actually, not that odd at all. While it is true that wisdom teeth are often removed, there’s no one-size-fits-all approach to this. It all depends on whether they are causing problems now, or are likely to cause problems in the future.
The trouble wisdom teeth cause is related to the fact that they are the last molars to come in, and that molars are large in size. By the time wisdom teeth appear between the ages of 17 and 21, there often is not enough room for them in the jaw. Sometimes it’s because you may have inherited a jaw size that’s too small for your tooth size; and generally speaking, the size of the human jaw has evolved to become smaller over time.
If room is lacking, the adjacent molar (that came in earlier) can interfere with the path of eruption — causing the wisdom tooth to come in at an odd angle. The wisdom tooth can hit up against that other tooth, possibly causing pain or damaging the adjacent tooth. This is known as “impaction.” Sometimes the wisdom tooth breaks only partway through the gum tissue, leaving a space beneath the gum line that’s almost impossible to clean, causing infection. A serious oral infection can jeopardize the survival of teeth, and even spread to other parts of the body.
If a wisdom tooth is impacted, will you know it? Not necessarily. A tooth can be impacted without causing pain. But we can see the position of your wisdom teeth on a dental x-ray and help you make an informed decision as to whether they should stay or go. If removal is the best course of action, rest assured that this procedure is completely routine and that your comfort and safety is our highest priority. If there is no great risk to keeping them, as Neil Patrick Harris has done, we can simply continue to monitor their condition at your regular dental checkups. It will be particularly important to make sure you are reaching those teeth with your brush and floss, and that you keep to your schedule of regular professional cleanings at the dental office. All healthy teeth are indeed worth treasuring.
If you would like more information about wisdom teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”
Many people with diabetes are hesitant about getting dental implants because they’re under the impression their chances of failure are greater than for non-diabetics. But if you’re one of the 26 million Americans with diabetes, that isn’t necessarily so — with a little extra precaution before, during and after implant surgery.
Diabetes is a group of diseases that affect how the body processes glucose. This simple sugar is used by the body to provide energy to cells, but can also cause damage if its volume level in the bloodstream is too high. The body normally regulates this through the hormone insulin produced by the pancreas.
The pancreas in people with Type 1 diabetes doesn’t produce insulin and so they must receive an outside source of the hormone through daily injections with careful daily monitoring of glucose levels. Those with Type 2 diabetes, the most common form of the disease, don’t produce a sufficient amount of insulin or the body no longer responds to the insulin produced. For either type, abnormal glucose levels — either too high or too low — can have adverse affects on the body, including blindness, nerve damage, gangrene, coma or death.
Diabetes can also slow wound healing, increase the risk of infection, and alter the body’s inflammatory response, all of which are major concerns when placing implants. Because implant placement involves minor surgery in which a wound results, there’s been wide concern that a slower healing process could increase the risk of implant failure.
Recent studies, though, are encouraging especially for patients who have their diabetes under control through medication, diet and exercise. Patients with poor glucose control are at higher risk, because it can take longer for the bone to heal around an implant after placement. For such individuals special considerations to guard against infection may be needed during implant surgery.
In fact, the implant success rate for most diabetics is about the same as for non-diabetic patients, 95%. With proper disease management and a little extra wound care, you can be among the many that experience a favorable outcome and a more attractive smile with dental implants.