Posts for category: Oral Health
After your son or daughter's dental exam, you expect to hear about cavities, poor bites or other dental problems. But your dentist might suggest a different kind of problem you didn't expect—an eating disorder.
It's not a fluke occurrence—a dental exam is a common way bulimia nervosa or anorexia nervosa come to light. That's because the teeth are often damaged by the behaviors of a patient with an eating disorder.
Most of this damage occurs because of purging, the practice of induced vomiting after eating. During vomiting stomach acid can enter the mouth and "wash" against the back of the teeth. After repeated episodes, the acid dissolves the mineral content of tooth enamel and causes it to erode. There's also a tell-tale pattern with eating disorders: because the tongue partially shields the back of the lower teeth while purging, the lower teeth may show less enamel erosion than the upper.
Hygiene practices, both negligent and too aggressive, can accelerate erosion. Anorexics often neglect basic grooming and hygiene like brushing and flossing, which increases the likelihood of dental disease. Bulimia patients, on the other hand, can be fastidious about their hygiene. They're more likely to brush immediately after purging, which can cause tiny bits of the enamel immediately softened by the acid wash to slough off.
In dealing with a family member's eating disorder, you should consider both a short and long-term approach to protect their dental health. In the sort-term the goal is to treat the current damage and minimize the extent of any future harm. In that regard, encourage them to rinse with water (mixed optionally with baking soda to help neutralize acid) after purging, and wait an hour before brushing. This will give saliva in the mouth a chance to fully neutralize any remaining acid. Your dentist may also recommend a sodium fluoride mouth rinse to help strengthen their tooth enamel.
For the long-term, your goal should be to help your loved one overcome this potentially life-threatening condition through counseling and therapy. To find out more about treatment resources near you, visit the National Eating Disorders Association website at nationaleatingdisorders.org. Taking steps to treat an eating disorder could save not only your loved one's dental health, but also their life.
If you would like more information on eating disorders and 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 “Bulimia, Anorexia & Oral Health.”
People who’ve lost all their teeth have benefitted from a solution that’s been around for generations: removable dentures. These appliances have helped millions of people chew and eat food, speak, and smile confidently.
But for all their benefits (including affordability) there’s still some things you need to do to get the most out of them like cleaning them daily or having us check them regularly for damage and wear. And, there’s one thing you shouldn’t do: wear them around the clock. Not removing them when you sleep at night can harm your oral health and reduce your dentures’ longevity.
Dentures are fitted to rest on the gums and the bony ridges that once held your natural teeth. This exerts pressure on the underlying bone that can cause it to gradually dissolve (resorb). This loss in bone volume eventually loosens your denture’s fit. If you’re wearing them all the time, the process progresses faster than if you took them out each night.
The under surfaces of dentures are also a prime breeding ground for bacteria and fungi. Besides unpleasant odors and irritation, these microorganisms are also the primary cause for dental disease. Research has found that people who sleep in their dentures have higher occurrences of plaque, a thin film of bacteria and food remnants that cause periodontal (gum) disease. They’re also more prone to higher levels of yeast and the protein interleukin-6 in the blood, which can trigger inflammation elsewhere in the body.
To avoid these and other unpleasant outcomes, you should develop a few important habits: remove and rinse your dentures after eating; brush them at least once a day with dish or anti-bacterial soap or a denture cleanser (not toothpaste, which can be too abrasive); and take them out when you sleep and place them in water or an alkaline peroxide-based solution.
Be sure you also brush your gums and tongue with an extra soft toothbrush (not your denture brush) or wipe them with a clean, damp washcloth. This will help reduce the level of bacteria in the mouth.
Taking these steps, especially removing dentures while you sleep, will greatly enhance your well-being. Your dentures will last longer and your mouth will be healthier.
Although cancer treatment has advanced steadily in recent decades, the most used therapies continue to be radiation and chemotherapy to eradicate cancerous cells. And while they often work, both can cause "collateral damage" in healthy tissues near the targeted cells.
This can create a number of indirect consequences for a patient's health, including in the mouth. The salivary glands, for example, can be damaged by radiation treatments aimed at the head or neck. The effect on these glands can interrupt the normal flow of saliva and cause xerostomia or "dry mouth."
Lack of adequate saliva causes more than an unpleasant, sticky mouth feeling. One of saliva's main functions is to neutralize acid that builds up naturally after eating. Without it, high acid levels can cause enamel and root surface erosion and lead to tooth decay.
Cancer treatment can also contribute to gastro-esophageal reflux disease (GERD). This disease causes stomach acid to bypass the natural tissue barriers of the esophagus and enter the mouth. As with dry mouth, the increased acid level from GERD can be just as devastating to enamel—and the damage will be permanent.
To minimize these effects on your dental health, it's important to take proactive steps before, during and after cancer treatment. If at all possible, have any needed dental work performed before you begin radiation or chemotherapy—it's better to start it with teeth and gums as healthy as possible.
During treatment, try to continue regular dental visits to monitor your oral health and receive any needed preventive or therapeutic treatments. Depending on your condition and the advice of your dentist, you may need to increase your visit frequency during this time. Your dentist can help with boosting your saliva production and strengthening your tooth enamel. But you should also practice daily brushing and flossing, drink plenty of water and seek treatment for any resulting GERD symptoms.
Even with the best efforts, though, your teeth and gums may still incur damage while treating your cancer. Fortunately, there are a wide array of materials and procedures that can effectively restore them to health. So, once your treatments are completed consult with a dentist on your options for improving the health and appearance of your teeth and gums.
Although not high on the glamour scale, saliva is nonetheless an important ingredient in a healthy life. This "multi-tasker" fluid helps break down your food for better digestion and supplies antibodies to thwart threatening microorganisms coming in through the mouth.
But perhaps its most important role is to neutralize mouth acid that can erode tooth enamel. Without this buffering action, you're at much greater risk for tooth decay and possible tooth loss.
That's why chronic dry mouth is much more than just an unpleasant feeling. If you're not producing enough saliva, your risk for developing tooth decay (and periodontal disease too) skyrocket.
Here are 3 things you can do to avoid dry mouth and promote healthier saliva flow.
Watch what goes in your mouth. Some foods, beverages and other substances can interfere with saliva production. Caffeine in coffee, sodas and other beverages can cause your body to lose water needed to produce adequate saliva. So can alcohol, which can also further irritate dry tissues. And any type of tobacco use can decrease saliva production and heighten the dry mouth effect, another good reason to kick the habit.
Drink more water. Water is the main ingredient in saliva, so keeping yourself hydrated throughout the day helps ensure a ready supply. Drinking water also helps dilute acid concentrations and washes away leftover food particles that could become a food source for oral bacteria, the main source for mouth acid.
Ask questions about your medications. Many medications can trigger chronic dry mouth including drugs to treat cancer, high blood pressure, depression or allergies. If you have chronic dry mouth, talk with your physician about the medications you're taking and ask if there are any alternatives that have less of an effect. If not, drink more water, especially while taking oral medication.
You can also reduce dry mouth symptoms by using a humidifier while you sleep or using products that boost saliva production. And be sure you're brushing and flossing daily to further reduce your risk of dental disease. Managing dry mouth won't just make your mouth feel better—it will help your teeth and gums stay healthier too.
For a healthy pregnancy, it helps to have healthy teeth and gums. In fact, the American College of Obstetricians and Gynecologists (ACOG) encourages its members to advise expectant moms to see their dentist. But maintaining oral health can be more challenging when you’re expecting. For one thing, hormonal changes make you more susceptible to periodontal (gum) disease, which has been linked to “systemic” (general body) health problems including preterm labor and low birth weight.
Periodontal (gum) disease results from the buildup of bacterial plaque on tooth surfaces in the absence of good oral hygiene. It typically starts as gingivitis — inflammation and redness around the gum margins and bleeding when brushing and flossing. If the infection progresses, it can attack the structures supporting the teeth (gums, ligaments, and bone) and may eventually result in tooth loss. And if the infection enters the bloodstream, it can pose health risks elsewhere in the body. Studies suggest that oral bacteria and their byproducts are able to cross the placenta and trigger an inflammatory response in the mother, which may in turn induce early labor.
TLC for Your Oral Environment
Brushing twice daily with fluoride toothpaste and flossing or using another interdental cleaner at least once daily is your first-line defense again bacteria buildup. Professional cleanings are also important to remove hardened plaque (calculus) that brushing and flossing may miss. And regular checkups can catch problems early to avoid or minimize adverse effects. Periodontal disease and tooth decay aren’t always painful or the pain may subside, so you won’t always know there’s a problem.
Dental emergencies such as cavities, root canals and tooth fractures should be treated promptly to address pain and infection, thereby reducing stress to the developing fetus. Of course, if you know you need a cavity filled or a root canal prior to becoming pregnant, that’s the optimal time to get treated!
If you would like more information about dental care during pregnancy, please contact us or schedule an appointment for a consultation. You can also learn more about the subject by reading the Dear Doctor magazine article “Pregnancy and Oral Health.”