Posts for: October, 2013
Nothing ruins a thirst-quenching cold beverage or a dish of your favorite ice cream like a sudden pang of tooth sensitivity. If you're experiencing this problem — and especially if there are other triggers, like biting down — we encourage you to make an appointment. It could be something harmless and temporary, but it's always prudent to check. At the very least, you'll feel better once the underlying problem is identified and treated if necessary.
Here are some common sources of tooth sensitivity:
- Enamel erosion — typically caused by acidic beverages/food, regurgitation of stomach acids (due to gastroesophageal reflux disease [GERD] or the eating disorder bulimia), or improper brushing
- Tooth decay — a sugary diet and poor dental hygiene may be contributing factors
- Tooth fracture or chipping due to tooth grinding (bruxism) or other trauma
- Gum recession due to age, improper tooth brushing, or gum disease
- Filling that needs repair or replacement
- Residual effects of recent dental work
Some things you can try at home to minimize sensitivity include:
- Ease up on the toothbrush; a light touch is all that's needed to dislodge daily plaque build-up
- Try using fluoride-containing toothpaste like an ointment over the affected area (fluoride decreases fluid exchange from the oral environment to the nerve inside the tooth)
- Take a non-steroidal anti-inflammatory such as ibuprofen (use judiciously and according to the package insert guidelines)
Discomfort related to recent dental work should resolve on its own; give it several weeks. If you're feeling discomfort for another reason, even if the sensitivity subsides, the underlying cause may still require attention.
If you would like more information about tooth sensitivity, 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 “Sensitive Teeth.”
One of the top concerns in healthcare is the interactions and side effects of medications. Drugs taken for separate conditions can interact with each other or have an effect on some other aspect of health. It's important then that all your health providers know the various medications you are taking, along with other lifestyle habits. That includes your dental team.
Calcium channel blockers (CCBs) are one type of medication that can have an effect on your oral health. CCBs are used primarily to control hypertension (high blood pressure), and to treat other cardiovascular conditions like angina or abnormal heart rhythm. They work by dilating blood vessels, which makes it easier for the heart to pump.
CCBs are now recognized as a contributing factor in the development of a condition known as gingival hyperplasia in which the gum tissues “overgrow,” extending in some cases abnormally over the teeth. This abnormal growth can be painful and uncomfortable, and can make oral hygiene more difficult to perform. The overgrowth of tissue can also be socially embarrassing.
There's also a secondary factor that can increase the risk for tissue overgrowth in patients taking a CCB — poor oral hygiene. In the absence of a good hygiene routine, a layer of bacterial plaque known as biofilm can build up on tooth surfaces and lead to various forms of gum disease, including hyperplasia. The overgrown tissue contributes in turn to this disease process by inhibiting effective oral hygiene.
If you've already developed gingival hyperplasia or some other form of gum disease, it's important for you to receive periodontal treatment for the disease as soon as possible. Once we have the condition under control, it's then a matter of regular dental checkups and cleanings to reduce the risk of disease, including gingival hyperplasia. We can also help you develop effective hygiene practices that inhibit this condition while you are taking a CCB.
If you would like more information on the effects of medication on oral 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 “Blood Pressure Medications.”
Although traditional porcelain laminate veneers are much less invasive than other cosmetic dental applications, they still often require the removal of some of the surface tooth enamel, a process known as tooth reduction. Now, an alternative veneer treatment known as “no-prep” veneers eliminates this initial step of tooth reduction for some patients.
Although most reductions take very little of the tooth enamel, they do permanently alter the tooth. No-prep veneers are growing in popularity because the tooth is not permanently altered, allowing for two benefits: if desired, the veneer application can be reversed and the tooth returned to its original state; and there's more flexibility for patients to “test-drive” their new look with prototype veneers worn while the permanent veneers are manufactured, with changes made easily during this tryout period.
Dentists have long regarded at least a minimum of tooth reduction as absolutely necessary for the proper adhesion of veneers, and to avoid a bulky or over-contoured smile. And, while advances in no-prep veneers have largely addressed these concerns, it is true this option isn't for every patient considering a veneer application.
For example, patients with large or forward-positioned teeth are not good candidates for no-prep veneers. Patients who choose a veneer treatment over orthodontic treatment for certain conditions will likely need some tooth preparation to achieve an acceptable aesthetic result. For patients generally, no-prep veneers have a limited application range on the bottom jaw due to space limitations.
Simply put, traditional veneers are a more versatile option for most patients. On the other hand, no-prep veneers can be a good choice for patients with genetically small or misshapen teeth, teeth reduced by erosion or grinding, or those with narrow or diminished smiles.
If you're considering this option, our first step is to conduct a complete examination of your teeth and mouth. We'll carefully evaluate every aspect of your mouth structure and overall dental condition. If you fit the criteria, you may be able to avoid tooth reduction and still gain the smile you desire.
If you would like more information on no-prep veneers, 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 “Porcelain Veneers Without the Drill.”
Your otherwise beautiful smile has one noticeable flaw — one or more of your teeth are deeply discolored or stained. More than likely this staining is deep within the teeth, what we refer to as intrinsic staining. There are a number of reasons this can occur — from fillings or use of antibiotics, for example — and our first approach should be to attempt a whitening technique.
However, if that doesn't produce the desired result, porcelain laminate veneers are another option you might consider. Veneers are made of dental porcelain, a bio-compatible material that can be shaped and colored to closely match neighboring teeth. After a minimal amount of tooth reduction (removal of some of the enamel from the tooth surface) to prepare for the laminate, the veneers are then permanently bonded to the tooth surface and cover the discolored natural tooth. Besides changing the appearance of discolored or stained teeth, veneers can also be used to correct other imperfections such as chipped or misshapen teeth.
Patients, however, have a common question: how long will the veneers last? With proper care, veneers can last anywhere from seven years to more than twenty years. It's possible, though, to damage them — for example, you can break them if you bite down on something that goes beyond the porcelain's tolerance range, such as cracking nut shells with your teeth (not a good idea even for natural teeth!). You should also keep in mind that veneers are composed of inert, non-living material and are attached and surrounded by living gum tissue that can change over time. This process may eventually alter your appearance to the point that the veneer may need to be removed and reapplied to improve the look of your smile.
If a veneer is damaged, all is not necessarily lost. It may be possible to re-bond a loosened veneer or repair a chipped area. The worst case is replacement of the veneer altogether. Chances are, though, this will only happen after the veneer has already served you — and your smile — for many years.
If you would like more information on porcelain laminate veneers, 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 “Porcelain Veneers.”
Chewing tobacco has a certain cachet among its users, especially young boys and men, who believe using it makes them appear macho or “cool.” They also believe this “smokeless” variety (as it's often marketed by tobacco companies) is safer than cigarettes or cigars.
Unfortunately, nothing could be further from the truth. In reality, chewing tobacco is harmful to your health — and especially your oral health. Regular use of these products can lead to severe dental and mouth conditions resulting in disease, disfigurement, or even death.
Like the smoked variety, chewing tobacco infuses its users with nicotine, a chemical stimulant naturally produced by the tobacco plant. The body responds to the stimulant's effect and begins to crave it, leading to addiction.
The problem, though, is the other ingredients in chewing tobacco: more than thirty other substances known to cause various kinds of cancer, including oral. Oral cancer alone is extremely dangerous: many patients suffer partial or complete loss of oral tissue and facial structures, including the tongue, lower jaw or even the face. Some even lose their lives — statistics show that only half of those with oral cancer survive more than five years after diagnosis.
Although cancer may be the most harmful effect of chewing tobacco, it isn't the only one. Researchers have found tobacco users have higher rates of tooth decay and gum disease than non-users. Tobacco also causes cosmetic and hygiene problems, including tooth staining and chronic bad breath.
If you're a tobacco user in any form, and especially chewing or spit tobacco, as your dentist we would advise you to consider quitting the habit. Giving up tobacco will not only improve your oral health and appearance, it may even save your life.
If you would like more information on the dangers of chewing tobacco, 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 “Chewing Tobacco.”