Posts for: December, 2017
Eating disorders cause more than psychological harm. The binge-purge cycle of bulimia or the self-starvation patterns of anorexia can also injure the physical body, especially the mouth.
For example, nine in ten people with bulimia will experience tooth enamel erosion from stomach acid entering the mouth from induced vomiting. Although purging is less frequent with anorexic patients, one in five will also develop erosion.
An eating disorder isn't the only reason for enamel erosion: you can have high acid levels from over-consuming sodas, energy drinks or certain foods, or not properly brushing and flossing every day. But erosion related to an eating disorder does produce a distinct pattern in the teeth. When a person vomits, the tongue moves forward and presses against the bottom teeth, which somewhat shields them from acid contact. This can create less erosion in the lower front teeth than in others.
Eating disorders can cause other oral effects. Stomach acid contact can eventually burn and damage the mouth's soft tissues. The salivary glands may become enlarged and cause puffiness along the sides of the face. The use of fingers or other objects to induce gagging can injure and redden the back of the throat, the tongue and other soft tissues.
It's important to stop or at least slow the damage as soon as possible. To do so requires both a short– and long-term strategy. In the short-term, we want to neutralize mouth acid as soon as possible after it enters the mouth, especially after purging. Rather than brushing, it's better to rinse out the mouth with water or with a little added baking soda to neutralize the acid. This will at least help reduce the potential damage to enamel.
In the long-term, though, we need to address the disorder itself for the sake of both the person's overall well-being and their oral health. You can speak with us or your family physician about options for counseling and therapy to overcome an eating disorder. You may also find it helpful to visit the website for the National Eating Disorders Association (nationaleatingdisorders.org) for information and a referral network.
If you would like more information on how eating disorders can affect 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 “Bulimia, Anorexia & Oral Health.”
Although periodontal (gum) disease usually affects your gums first, your teeth may eventually suffer. That’s because the disease can damage both attaching gum tissues and supporting bone.
One advanced sign of this is when one or more teeth become loose. A loose tooth is an alarm bell that you’re about to lose it.
Fortunately, we can often treat loose diseased teeth with a two-phase approach. First and foremost, we need to bring the gum infection under control by removing plaque and calculus (tartar) — the “fuel” for the infection — from all tooth and gum surfaces. Depending on how extensive it is, we have options: we can use specially designed hand instruments to remove plaque and calculus, ultrasonic equipment that loosens and flushes plaque and calculus away, or, if necessary, conventional or laser surgery.
Depending on the extent of the infection, in some cases we may need to use regenerative surgical techniques like gum and bone grafting to replace lost tissue. Healing takes time, though, which leads to the second phase of treatment — securing the loose tooth during gum healing.
The most common way is through a bite adjustment, where teeth are altered to equilibrate chewing forces evenly. This results in all the teeth being hit at the same time allowing the loose teeth to heal and tighten up.
Another option is splinting teeth together. Although there are different methods, the basic idea is to join the loose teeth with stable teeth like pickets in a fence. One way is to bond splinting material across the back surfaces of the involved teeth. Another way is to cut in a small channel across the teeth and insert and bond a rigid strip of metal to splint the teeth in place.
The splint is usually a temporary measure while the gums heal. In some situations, though, we may need to perform a permanent splint by crowning the affected teeth and then splinting the crowns together. If you have a grinding habit we may also prescribe a night guard to limit the damage done while you sleep.
Before deciding on which technique is best for you, we would first need to evaluate the health of the affected teeth to see whether the effort would be worth it. It could be the tooth’s supporting bone structure has become so deteriorated that it might be better to extract the tooth and consider an implant or other replacement. First, though, we would attempt if at all practical to save the tooth — and the sooner we begin treating it, the better your chances for such an outcome.
If you would like more information on loose teeth and gum disease, 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 “Treatment for Loose Teeth.”