Smoking and Its Effects on Oral Health

dentistSmoking can lead to lung cancer and many other medical conditions, but it can also cause a host of oral health problems. If left untreated, those issues can lead to gum disease, tooth loss, tooth decay, cancer, and other problems.

Smoking can cause many problems in the mouth, such as bad breath, tooth discoloration, inflammation of the salivary glands on the roof of the mouth, buildup of plaque and tartar, loss of bone in the jaw, increased risk of leukoplakia (white patches in the mouth), gum disease that can lead to tooth loss, delayed healing after oral treatment procedures, failure of dental implant procedures, and oral cancer.

Smoking cigarettes, cigars, and pipes and chewing tobacco can affect the attachment of bone and soft tissue to the teeth, which can lead to gum disease. This makes smokers susceptible to infections, such as periodontal disease. It can also reduce blood flow to the gums, which can slow healing.

Research has found that smoking cigars and pipes is just as dangerous as smoking cigarettes for tooth loss, bone loss, periodontal disease, bad breath, stained teeth, and oral cancer. Smokeless tobacco carries the same risks, in addition to the threat of gum recession, which can expose the roots of teeth and make them prone to sensitivity and decay. Sugars in smokeless tobacco also increase the risk of tooth decay.

If you smoke, quitting can greatly reduce your risk of developing these problems. Reducing the amount you smoke can also lower your risk.

Your doctor or dentist can help you quit smoking with medication and nicotine gum or patches. You can also attend a smoking cessation class or support group that is offered by your local hospital, employer, or insurance company. Other treatments, such as herbal remedies, hypnosis, and acupuncture, are helpful for some people.

Dental Treatments for Sleep Apnea

mandibular oral applianceSleep apnea is a potentially life-threatening condition that affects over 18 million Americans. Many do not know they have it and are not receiving treatment.

Sleep apnea occurs when tissue in the back of the throat collapses and causes the airway to become blocked. This reduces the amount of oxygen traveling to the organs, including the heart and brain. When the blood-oxygen level gets low enough, the person wakes up briefly. In some people, this happens hundreds of times per night.

Sleep apnea can cause fatigue, memory loss, depression, impaired concentration, stroke, heart attack, congestive heart failure, and hypertension. People with sleep apnea tend to be older, obese, and have thick necks, but the condition can affect anyone.

A sleep specialist can diagnose sleep apnea. One common treatment is Continuous Positive Air Pressure (CPAP), which provides a steady stream of air through a tube connected to a mask to keep the airway open. An oral and maxillofacial surgeon can eliminate tissue in the soft palate, uvula, and tongue to keep the airway from collapsing. Other, more complex surgeries can reposition the mouth and facial bones. Oral appliances, weight loss, avoiding tobacco and alcohol, and changing sleeping position are other common treatments.

tongue retaining oral applianceOral appliances are a good treatment option for people with mild to moderate obstructive sleep apnea who do not want to use CPAP, do not respond well to it, or are not good candidates for the treatment. Oral appliances can be used alone or in combination with weight loss, surgery, or CPAP.

Oral appliances maintain an open, unobstructed airway in the throat when worn while a person is sleeping. They reposition the lower jaw, tongue, soft palate, and uvula; stabilize the lower jaw and tongue; and increase the tongue’s muscle tone. Custom-made oral appliances work better than ones sold over-the-counter.

Oral appliances fall into two main categories. Tongue retaining appliances use a suction bulb to hold the tongue in a forward position, which prevents the back of the tongue from collapsing during sleep and blocking the airway. Mandibular repositioning devices reposition the lower jaw and keep it protruding during sleep. This indirectly pulls the tongue forward, which stimulates muscle activity, keeps the tongue rigid, and opens the airway. It also keeps the lower jaw and other structures stable to prevent the mouth from opening.

A dentist with training in oral appliance therapy can help you choose the right type of appliance. It can take weeks or months for the examination, evaluation to choose the best type of appliance, fitting, adaptation, and function of the appliance. It is important to receive ongoing care and follow-ups.

Most people find that oral appliances are comfortable and get used to them in a couple of weeks. They are small and convenient, and treatment is non-invasive and reversible.

What Is a Diastema?

diastema before afterA diastema is a gap between teeth. The most common type is a midline diastema, or gap between the two upper front teeth.

Diastemas are extremely common. It is estimated that up to 97 percent of children have diastemas. They are a natural part of development that are often corrected naturally. However, if a child still has a diastema after adult teeth have erupted, it will be permanent and will require professional treatment to be closed.

A diastema can form for several reasons. It is often caused by a discrepancy between the sizes of the jaws and teeth, such as teeth that are too small in proportion to the jaw. A diastema can also be caused by missing or undersized teeth or habits such as excessive thumb sucking in children.

A diastema can be caused by an incorrect swallowing reflex. In most people, the tongue presses against the roof of the mouth when swallowing. Some people press their tongues against their front teeth when swallowing, which can cause a space to develop.

Periodontal disease can lead to loss of bone that supports the teeth. This can cause teeth to become loose and shift.

A midline diastema can also be caused by a large labial frenum, the tissue that connects the lip to the gums. If the frenum is too large, too wide, or too tight, it can cause a gap to form between the top two front teeth.

For a person who is genetically predisposed to a diastema, there is no way to prevent it.

A diastema usually does not cause any dental problems. People who choose to have their gaps closed generally do so for cosmetic reasons. Several treatment options are available.

In most cases, a diastema needs to be treated with a full set of braces followed by retainer therapy because moving one tooth can cause others to shift. If the gap is small, a less invasive treatment such as Invisalign can be used.

If a patient has a midline diastema and no other dental problems, veneers or dental bonding can be used to cover the gap. If a tooth is missing, a dental bridge or implant may be needed.

If the diastema is caused by a large labial frenum, it may be necessary to undergo a frenectomy, a dental surgery that removes or loosens the tissue, prior to beginning orthodontic treatment.

If your child has a diastema between his or her baby teeth, it is likely that it will close on its own. The American Dental Association recommends that children be examined by an orthodontist by the age of 7 to identify any potential problems. It is also important to take care of baby teeth because decay can cause them to fall out too early, which can cause adult teeth to shift and lead to a permanent diastema.

Could a Dental Problem Be Causing Your Headaches?

headacheAccording to the American Academy of Craniofacial Pain, about one in eight Americans suffers from chronic headaches that interfere with daily life. An estimated 80 percent of headaches are caused by muscle tension. A misaligned bite is a common cause of muscle tension that leads to headaches. Muscle tension headaches caused by dental stress can cause pain on one or both sides of the head or around the entire head.

Tension headaches are caused when muscles are strained and contracted for long periods of time. When you swallow, your upper and lower teeth come together to brace your jaw against your skull. If your bite is unstable because of poorly aligned teeth or a missing tooth, your muscles work harder to bring your teeth together, which can lead to muscle strain and pain.

An unstable bite can cause muscles in the neck to lengthen or shorten, which throws the head off balance and causes other muscles to strain to continue to support the head. The muscles become painful, which causes you to feel tense. That in turn makes the muscle spasms worse, which contributes to more pain.

The pain that you experience from muscle tension in your jaw can be referred to other parts of your head. If you have pain behind your eyes, sore or tired jaw muscles when you wake up, teeth grinding, clicking or popping jaw joints, or a head or scalp that are painful to the touch, these are signs that your headaches could have a dental origin.

If you think your headaches might be caused by a misaligned bite, contact your dentist. He or she will examine your teeth, muscles, and jaw joints to figure out if that is the cause of your headaches and recommend treatment to correct your bite and ease the strain on your muscles.

Headaches could have other non-dental causes. Seek immediate medical attention if your headache leads to weakness in an arm or leg, loss of vision, disorientation, or loss of consciousness.

Preparing to Get Your Teeth Whitened

teeth whiteningIf you are planning to get your teeth whitened, it is important to prepare in advance in order to achieve the best possible results.

Before you get your teeth whitened, you should have a dentist check to make sure that you are in overall good oral health. If you have cavities or if the roots of your teeth are exposed due to gum disease, the chemicals used in the whitening process could aggravate those conditions. If you have any dental problems, you should have them treated before you whiten your teeth.

Your dentist will be able to determine the location and cause of the stains on your teeth. Extrinsic stains are on the surface of the teeth. They can be caused by food, drinks, and smoking. Extrinsic stains can be removed by teeth whitening. Intrinsic stains are located underneath the tooth enamel and cannot be removed through a whitening procedure. Teeth whitening also does not work on veneers, dental caps, or crowns.

You should have your teeth cleaned by a hygienist before your whitening procedure in order to remove any tartar and other debris that you cannot remove on your own. It is also important to brush and floss well every day to prevent problems prior to your whitening procedure.

If you experience sensitivity, begin brushing with a desensitizing toothpaste two weeks prior to your whitening treatment. This can prevent sensitivity during and after the procedure. If you are prone to extreme sensitivity, you can take a pain killer prior to the whitening procedure, but only after checking with your doctor.

Set aside enough time for the procedure, as well as prep or recovery time. Ask your dentist’s office how long it will take.

If you are using an at-home whitening kit, you should also get a check-up and cleaning first and follow good oral hygiene practices. If your dentist is preparing your at-home kit, he or she may need to make a mold of your teeth, provide the necessary materials, and schedule a follow-up appointment.

Call your dentist if you experience extreme or prolonged sensitivity or pain after you get your teeth whitened. Be sure to continue brushing and flossing to maintain your white smile.

What Causes Swollen and Bleeding Gums?

flossingTaking care of your gums is an important part of oral health. Bleeding or swollen gums can be caused by several factors and can be a sign of gum disease.

Over 75 percent of Americans over 35 have some form of gum disease. Most have the less severe gingivitis, while 5 to 15 percent have more advanced periodontitis. Gingivitis is generally not painful and can be reversed if it is detected early and good oral hygiene habits are followed. If it is left untreated, gingivitis can progress to periodontitis and lead to tooth loss.

Brushing too hard is one common cause of bleeding gums. Use a manual or electric toothbrush with soft nylon bristles that have blunted ends. Use gentle, circular motions to avoid damaging your gums.

Floss your teeth at least once a day. Use gentle up and down motions following the natural curve of your teeth.

Canker sores, or mouth ulcers, can make gums painful and swollen. While their cause is not known, canker sores may be caused by bacteria or viruses and may come back over time. They are not contagious.

Chemotherapy to treat cancer can cause stomatitis, which causes painful sores and ulcers in the mouth. This can lead to painful, swollen, and bleeding gums.

Smoking is another common cause of bleeding, sensitive, or painful gums. People who smoke are much more likely to develop gum problems than those who don’t.

Women may experience redness, swelling, and sensitivity in their gums due to hormonal changes from puberty, menstruation, pregnancy, menopause, and hormonal birth control.

Consult your dentist if you notice changes in the way your teeth fit together when biting or in the way your dentures fit. You should also schedule an appointment if you have deep pockets between your teeth and gums, if your gums bleed during and after tooth brushing, if you have loose or shifting teeth, if you have persistent bad breath or an unpleasant taste in the mouth, if your gums are receding, or if your gums are red, swollen, or tender.

There are several steps you can take to prevent sore, swollen, or bleeding gums. Brush your teeth twice a day and floss once daily. Eat a well-balanced diet and drink plenty of water. If you smoke, quit. If your gums are sensitive, you should avoid extremely hot or cold foods or drinks. You can also reduce stress to lower the levels of cortisol, the stress hormone that causes inflammation throughout the body, including in the gums.

What Is Zoom Whitening?

Zoom whiteningZoom whitening is a procedure that uses a hydrogen peroxide gel activated with a UV light to remove stains from teeth. While individual results cannot be predicted, in many patients Zoom treatments can significantly lighten the color of teeth.

The procedure is done in up to three 15-minute sessions. The old layer of gel is removed after each session, and a new layer is applied. Some people have to stop after only one or two sessions because their teeth become sensitive. It is possible to see significant results after just one or two sessions.

The results are visible immediately after the procedure, but there may be a rebound effect that causes the teeth to lose some of their whiteness. This occurs because the procedure removes moisture from the teeth. As they regain moisture, the teeth may appear less white. If you have white spots on your teeth, they may appear whiter immediately after the procedure, but they should blend in more after a few days.

If you are planning to have any cosmetic work done, it is best to wait about a week before choosing a shade until you see the final results of the teeth whitening procedure. If you have had restorative work, such as a crown, veneer, or filling, Zoom whitening will not change its color.

For the first 48 hours after the Zoom procedure, the pores in the enamel of your teeth will be open. This will make your teeth susceptible to staining. Your dentist will give you a list of things you should not eat or drink during this time in order to prevent your teeth from becoming stained. If you do eat or drink something you shouldn’t, you should brush your teeth or rinse your mouth with water as soon as possible.

If you experience sensitivity after the procedure, you can take an anti-inflammatory, such as ibuprofen, and brush with a toothpaste for sensitive teeth.

Some doctors recommend that pregnant women not have any elective cosmetic procedures. If you are considering Zoom whitening and you are pregnant, discuss it with your doctor.

Scaling and Root Planing Can Treat Gum Disease

dentistScaling and root planing are treatments used to remove plaque and calculus from the teeth that allow bacteria to grow and contribute to gum disease. Scaling and root planing are the most common and conservative means of treating periodontal disease.

Scaling is the removing of calculus, or tartar, and plaque that are attached to the teeth, especially below the gum line and along the root. Planing smoothes the surface of the root. This prevents plaque from being able to attach to rough surfaces.

Scaling and root planing are done with electric or air-powered ultrasonic scalers and hand instruments. The ultrasonic instruments have a relatively dull metal tip that vibrates at a very high frequency to remove plaque and calculus from the teeth and a water irrigation system that cools the tip and flushes out debris from around the tooth. Hand instruments have cutting edges that are used to chip away plaque and calculus. A variety of instruments can be used for different teeth and tooth surfaces.

Ultrasonic instruments are used first to remove large amounts of plaque and calculus from the roots and crowns of the teeth. Hand instruments are then used to remove any remaining plaque or calculus and make the tooth’s surface smooth. Your dentist may insert antibiotic fibers into the pockets between your teeth and gums to promote healing and prevent infection.

If you have gingivitis, the early stage of gum disease, you may be able to have the scaling and root planing procedure completed in one visit. If you have more progressive gum disease, or periodontitis, your dentist will probably do one quadrant of your mouth at a time.

Some people experience discomfort during scaling and root planing. A local anesthetic may be used to numb the area. If your medical doctor has told you to take antibiotics before dental procedures, be sure to discuss that with your dentist.

You may have some soreness or sensitivity to heat and cold for a few days after the procedure. You can treat that with over-the-counter pain relievers. You may experience some minor bleeding for up to a week. Your dentist may give you an antiseptic mouth rinse to use. You should continue brushing and flossing as usual. If you develop a fever, heavy bleeding, pain, or swelling, call your dentist.

The procedure carries some risks. Scaling and root planing eliminate pockets that can trap bacteria. This can cause the gums to recede, which may expose parts of the roots and make the teeth sensitive to heat and cold. The procedure can potentially introduce harmful bacteria in to the bloodstream. The gum tissue can also become infected. You should discuss these risks and the potential benefits with your dentist.

GERD Can Cause Tooth Decay

dentistGastroesophageal reflux disease (GERD) can contribute to tooth decay when acid from the stomach wears away at enamel. The enamel on the sides of the teeth near the tongue and palate are generally affected more than the outer surfaces of the teeth.

GERD occurs when a problem with the esophagus and the lower esophageal sphincter allows stomach acid to travel back up to the mouth. This acid can damage enamel and lead to tooth decay if the problem persists over a period of time. If left untreated, GERD can also lead to ulcers or esophageal cancer.

Diet can contribute to GERD. Eating spicy foods and drinking excessive amounts of coffee and wine are common causes.

Common symptoms of GERD include heartburn, a burning sensation in the chest, nausea after eating, coughing, wheezing, difficulty swallowing, sore throat, hiccups, hoarseness, and a change in voice. In some cases, GERD may not have these obvious symptoms. Silent GERD can be just as destructive to teeth. One symptom is an unexplained sour taste in the mouth.

If your dentist believes your tooth decay may be caused by GERD, you should visit your doctor for diagnosis and treatment. You can take over-the-counter or prescription medications to treat the symptoms of GERD. You can also change your diet and avoid drugs such as aspirin, ibuprofen, and naproxen and take acetaminophen instead.

Patients with GERD often experience dry mouth, which can increase the amount of bacteria and plaque in the mouth and further contribute to tooth decay. Medications used to treat GERD can also dry out the mouth. If you have GERD, you can combat dry mouth by sucking on breath mints, candies, or lozenges, but you should avoid ones that contain sugar because that can contribute to tooth decay.

Baking Soda Can Improve Oral Health

baking sodaBaking soda has many uses in cooking and cleaning, but it can also improve oral health by neutralizing the acids that contribute to many problems in the mouth.

Baking soda can remove stains caused by food, beverages, nicotine, and alcohol and whiten teeth. It is included in many toothpastes and tooth whitening products. You can also dampen your toothbrush, dip it into a small dish of baking soda, shake off any excess, and brush your teeth to remove stains.

Gum disease, or gingivitis, is caused when plaque accumulates on the teeth. If left untreated, it can lead to sore, swollen, bleeding, or infected gums, as well as a host of more serious health problems. Brushing with baking soda or a toothpaste that contains it can help you prevent gum disease.

Halitosis, or bad breath, can be caused by acid from foods that stick to the teeth, tongue, and mouth. Baking soda can rebalance the levels of acid in the mouth and prevent bad breath. You can create a mouth rinse by dissolving half a teaspoon of baking soda in a glass of water.

Ulcers and sores in the mouth are painful, and they can be made worse because they come into contact with food, drinks, and other irritants, which can make them take a long time to heal. Baking soda can soothe ulcers and sores in the mouth and speed up the healing process. You can make a soothing mouth rinse by dissolving one or two teaspoons of baking soda in a glass of water.

Brushing and rinsing with baking soda is an effective way to prevent many oral health problems. It is included in many toothpastes, or you can make a toothpaste or rinse with the baking soda found in a box in your own kitchen.