Posts for category: Oral Health
Around 20 million people—mostly women after menopause—take medication to slow the progress of osteoporosis, a debilitating disease that weakens bones. But although effective, some osteoporosis drugs could pose dental issues related to the jawbones.
Osteoporosis causes the natural spaces that lie between the mineral content of bone to grow larger over time. This makes the bone weaker and unable to withstand forces it once could, which significantly increases the risk of fracture. A number of drugs have been developed over time that stop or slow this disease process.
Two of the most prominent osteoporosis drugs are alendronate, known also by its trade name Fosamax, and denosumab or Prolia. While originating from different drug families, alendronate and denosumab work in a similar way by destroying specialized bone cells called osteoclasts that break down worn out bone and help dissolve it. By reducing the number of these cells, more of the older bone that would have been phased out lasts longer.
In actuality this only offers a short-term benefit in controlling osteoporosis. The older bone isn’t renewed but only preserved, and will eventually become fragile and more prone to fracture. After several years the tide turns negatively for the bone’s overall health. It’s also possible, although rare, that the bone simply dies in a condition called osteonecrosis.
The jawbones are especially susceptible to osteonecrosis. Forces generated by chewing normally help stimulate jawbone growth, but the medications in question can inhibit that stimulus. As a result the jawbone can diminish and weaken, making eventual tooth loss a real possibility.
Osteonecrosis is most often triggered by trauma or invasive dental procedures like tooth extractions or oral surgery. For this reason if you’re taking either alendronate and denosumab and are about to undergo a dental procedure other than routine cleaning, filling or crown-work, you should speak to your physician about suspending your medication temporarily. Dentists often recommend a suspension of three to nine months before the procedure and three months afterward.
Some research indicates this won’t worsen your osteoporosis symptoms, especially if you substitute another treatment or fortify your skeletal system with calcium and vitamin D supplements. But taking this temporary measure could help protect your teeth in the long run.
If you would like more information on the effect of osteoporosis treatment on dental 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 “Osteoporosis Drugs & Dental Treatment.”
Chronic jaw pain and limited jaw mobility are two common symptoms of a group of conditions known as temporomandibular joint disorders (TMJD or TMD). Several effective treatments have developed over the years, despite the fact that the underlying causes for TMD remain an elusive quarry for medical researchers.
But we may now have a promising new lead in understanding TMD: a possible link between it and other systemic inflammatory diseases. In recent study researchers interviewed over 1,500 people with TMD about various aspects of their lives. Nearly two-thirds reported at least three or more other inflammatory health conditions like fibromyalgia, chronic headaches or rheumatoid arthritis.
These statistics suggest a relationship between TMD and these other conditions. Further exploration of these possible links could result not only in a greater understanding of TMD but better treatment strategies for it and the other related conditions.
In the meantime, though, what can you do if you're currently dealing with TMD?
As of now the approaches with the best results continue to be conservative, non-invasive techniques we've used for several years. Thermal therapies like hot or cold compresses to the jaw area, for example, are quite effective in providing pain relief, and muscle relaxant drugs have proven beneficial for improving jaw mobility.
More radical approaches like jaw surgery have also come into prominence. But there's a caveat here: a significant number of people find their conditions don't improve or may even worsen. In the study previously mentioned, only 38% of respondents who had undergone jaw surgery saw any range of improvement (from slight to significant); by contrast, 28% indicated no change in symptoms and 46% said they were worse off.
It's important, then, that you thoroughly discuss your condition with your dentist, verifying first that you have TMD.Â Together you can develop a treatment plan to relieve pain and restore jaw function. If your dentist or surgeon suggests surgery, consider seeking a second opinion before choosing this more radical approach.
Hopefully, further research into the causes and relationships of TMD with other health conditions will yield still better treatments. In the meantime, you may still find relief and improve your quality of life with the proven techniques available now.
If you would like more information on treatments for chronic jaw pain, 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 “Chronic Jaw Pain and Associated Conditions.”
In the quest for the ideal diet, people often stress over one particular food group: carbohydrates. And for good reason—some carbohydrates have been linked to chronic inflammation, a contributing factor in many diseases. One such condition in particular, periodontal (gum) disease, could permanently damage your dental health.
But before you throw all the carbs out of your diet, let’s take a closer look at them. Not all carbs are the same or contribute to inflammation to the same degree.
Carbohydrates are organic compounds existing in living tissues. In foods, the most prevalent of these are sugars and starches that break down during digestion into the simple sugar glucose, which the cells in an organism use for energy.
But not all carb-based foods digest at the same rate, measured along a scale called the glycemic index. High glycemic foods like sugar, baked goods or potatoes digest quickly and can rapidly increase the glucose levels in the blood (blood sugar). This sudden glucose spike then triggers an insulin surge from the pancreas to restore the level to normal. This process in turn can cause inflammation.
On the other end of the glycemic index are complex or unrefined carbohydrates that digest much more slowly, and don’t quickly elevate blood sugar like simple carbs. In fact, nutritional studies consistently show carbohydrates in most vegetables, greens, beans or whole grains may actually decrease inflammation.
Inflammation is also a primary factor in gum disease, caused by a bacterial infection in the gums. Chronic inflammation damages the gums’ attachment with the teeth and can contribute to eventual tooth loss. And if your body already has an overactive inflammatory response due to your diet, you could be even more susceptible to gum disease.
A change in your diet in relation to carbs could help reduce this risk. Eat less sugar, white flour, rice and potatoes and more complex carbs like fresh vegetables and fruits. For even more protection include foods rich in Omega-3 fatty acids (like certain fish and nuts) and less Omega 6 foods (fried food or pastries, or chips, for example). And don’t forget your antioxidants, vitamins and minerals.
Eating fewer simple carbs and more complex carbs will help reduce inflammation in the body. And that’s a good thing for your gums.
If you would like more information on how diet affects dental 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 “Carbohydrates Linked to Gum Disease.”
As if the preteen years didn’t give kids and their parents enough to think about, new oral health concerns loom on the horizon. Along with major changes to the body, brain and emotions, additional risk factors for tooth decay and gum disease appear during adolescence — the period of development starting around age 10 and extending through the teen years that marks the transition from childhood to adulthood.
Even with declining rates of tooth decay across the nation, the cavity rate remains high during adolescence. According to the American Academy of Pediatrics, 1 in every 5 adolescents has untreated tooth decay. What’s more, the onset of puberty — usually beginning around age 10-11 in girls and 11-12 in boys — brings changes in hormone levels that can affect gum health.
We all have millions of microorganisms in our mouth, representing hundreds of different species of mostly helpful, but some harmful, bacteria. Research has shown that total oral bacteria increases between ages 11 and 14, and new types of bacteria are introduced, including some that are not friendly to teeth and gums. Some unfamiliar microbes trigger an exaggerated inflammatory response to dental plaque, so gum bleeding and sensitivity are experienced by many children in this age group. In fact, “puberty gingivitis,” which peaks around age 11-13, is the most common type of gum disease found during childhood.
A combination of hormones, lifestyle changes and poor oral hygiene habits raises the risk of oral health problems among adolescents. A more independent social life may be accompanied by a change in eating habits and easier access to snacks and beverages that are sugary, acidic (like sports drinks and soda) or full of refined carbohydrates — none of which are tooth-healthy choices. And as children move toward greater independence, parents are less likely to micromanage their children’s personal care, including their oral hygiene routines. Good oral hygiene can keep dental plaque at bay, lowering the chance of having gingivitis and cavities. But let’s face it: Adolescents have a lot to think about, and keeping up with their oral health may not be top of mind.
To help your preteen stay on top of their oral health, keep healthy snacks at home for your children and their friends and make sure you are well stocked with supplies such as new toothbrushes, floss and toothpaste. In addition, most preteens (and teens) can benefit from gentle reminders about oral hygiene routines.
For optimal oral health through all stages of life, make sure your preteen keeps up with professional teeth cleanings and exams, and talk with us about whether fluoride treatments or sealants may be appropriate for your child.
For more on your child’s oral health, read “How to Help Your Child Develop the Best Habits for Oral Health” and “Dentistry & Oral Health For Children” in Dear Doctor magazine.
If you’ve just received a dental implant restoration, congratulations! This proven smile-changer is not only life-like, it’s also durable: more than 95% of implants survive at least 10 years. But beware: periodontal (gum) disease could derail that longevity.
Gum disease is triggered by dental plaque, a thin film of bacteria and food particles that builds up on teeth. Left untreated the infection weakens gum attachment to teeth and causes supporting bone loss, eventually leading to possible tooth loss. Something similar holds true for an implant: although the implant itself can’t be affected by disease, the gums and bone that support it can. And just as a tooth can be lost, so can an implant.
Gum disease affecting an implant is called peri-implantitis (“peri”–around; implant “itis”–inflammation). Usually beginning with the surface tissues, the infection can advance (quite rapidly) below the gum line to eventually weaken the bone in which the implant has become integrated (a process known as osseointegration). As the bone deteriorates, the implant loses the secure hold created through osseointegration and may eventually give way.
As in other cases of gum disease, the sooner we detect peri-implantitis the better our chances of preserving the implant. That’s why at the first signs of a gum infection—swollen, reddened or bleeding gums—you should contact us at once for an appointment.
If you indeed have peri-implantitis, we’ll manually identify and remove all plaque and calculus (tartar) fueling the infection, which might also require surgical access to deeper plaque deposits. We may also need to decontaminate microscopic ridges found on the implant surface. These are typically added by the implant manufacturer to boost osseointegration, but in the face of a gum infection they can become havens for disease-causing bacteria to grow and hide.
Of course, the best way to treat peri-implantitis is to attempt to prevent it through daily brushing and flossing, and at least twice a year (or more, if we recommend it) dental visits for thorough cleanings and checkups. Keeping its supporting tissues disease-free will boost your implant’s chances for a long and useful life.
If you would like more information on caring for your dental implants, 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 “Gum Disease can Cause Dental Implant Failure.”