What Are Supernumerary Teeth?

supernumerary teethIt is normal to have 20 primary teeth and 32 permanent teeth. Hyperdontia is a condition characterized by the presence of extra, or supernumerary, teeth. The extra teeth can be located in any part of the mouth and can develop from separate tooth buds or from the splitting of permanent tooth buds.

Supernumerary teeth can occur in both primary (deciduous) and permanent teeth, but they are much more common among permanent teeth. There can be either one or several supernumerary teeth present. Most cases involve a single tooth. The most common supernumerary teeth are permanent anterior incisors in the upper arch, followed by upper and lower fourth molars.

About 1 to 4 percent of people have at least one extra tooth. Supernumerary teeth are equally common among males and females in deciduous teeth, but among permanent teeth they are twice as common in males as in females.

Supernumerary teeth are divided into several groups. Conical teeth are peg-shaped and are usually located in the front of the mouth. Tuberculate teeth have two or more tubercles, or cusps. They are very rare and usually occur in pairs. Supplemental teeth occur as duplicates in the series of normal teeth. They are generally located in the lateral incisor, premolar, and molar regions. Odontoma teeth can be completely disorganized or can resemble the normal teeth structure.

The cause of hyperdontia is not clear, but dentists have several theories. Some believe the extra teeth are caused by abnormal division of a tooth, while others believe they are caused by hyperactive dental lamina. Supernumerary teeth may also be caused by genetics.

Extra teeth can cause many problems. They can displace adjacent teeth, prevent normal teeth from erupting through the gums, or lead to crowding in the mouth. All of these problems require that the supernumerary teeth be removed.

Cysts can form if a person has extra teeth. Supernumerary teeth can also cause resorption of the adjacent teeth’s roots in some parts of the mouth. In those cases, the extra teeth need to be removed immediately.

Supernumerary teeth are not always problematic. If they do not cause any of these issues, they can be left alone.

Oral Health Can Affect Athletic Performance

sports oral healthA paper just published by dental experts supports the notion that oral health can impact athletic performance.

A group of British and North American dental experts published a Consensus Statement in the British Journal of Sports Medicine. They say that simple and inexpensive measures, such as better brushing and flossing, could improve athletes’ performance.

Cyclist Sir Dave Brailsford introduced the theory of marginal gains, which holds that small gains in areas that are not normally associated with athletic performance can lead to significant improvements in sports. According to the Consensus Statement, improving oral health could have the same marginal gains as expensive physical therapies.

The link between oral health and athletic performance was first studied at the 1968 Olympic Games. At the 2012 Summer Olympics in London, 30 percent of all medical visits were for dental issues. Eighteen percent of athletes said oral health negatively affected their performance, and 46.5 percent had not seen a dentist in the past year, despite a requirement that athletes have a dental exam within 12 months of the competition.

Many athletes have been found to have tooth decay, eroded enamel, gum disease, infections around wisdom teeth, and impacted molars. Athletes with oral health problems can experience pain, problems eating and sleeping, systemic inflammation, lack of confidence, and other problems that could affect their performance.

Athletes from wealthy and poor countries are affected at equal rates. The oral health of athletes is similar to that of non-athletes living in poor communities without access to adequate dental care.

The authors of the Consensus Statement point to several reasons for their findings. Athletes tend to consume high-carbohydrate diets and sports drinks that can erode tooth enamel. They can also experience dry mouth while competing. Eating disorders can be a factor in some sports where weight is important. Athletes may also not be aware of the importance of oral health and its link to performance in sports.

The authors recommend that athletes pay more attention to brushing with fluoride toothpastes and mouth rinses and flossing. They also advise athletes to choose water or hypotonic drinks instead of sports drinks.

The Right Way to Floss

floss teethFlossing is an important part of oral health care, but it is one that many people skip. Flossing is more important than brushing to protect the teeth and gums.

Flossing removes plaque, a bacterial film that forms between teeth and along the gum line. Plaque can only be removed by flossing or by getting a deep cleaning at the dentist’s office. Flossing every day can help you prevent gum disease and tooth loss.

Here are some tips on how to floss from the American Dental Association.

• Cut an 18-inch long piece of floss. Wrap most of it around the middle finger on one hand and the rest around the middle finger on the other hand.

• Hold the string tightly between your thumb and forefinger and guide it between your teeth with a rubbing motion. When you reach the gum line, form a C and follow the shape of the tooth. Hold the floss firmly against the tooth and move it up and down. Repeat with the rest of your teeth, using a fresh section of floss each time.

• Be sure to floss all of your teeth, especially the ones in the back. If you have trouble reaching your back teeth, ask your dentist about plastic, disposable, Y-shaped flossers; small, rounded brushes; pointed, rubber tips; or wooden or plastic picks.

• You should floss at least once a day. Find a time that is convenient for you and make it a habit. It is better to floss in the evening than the morning. Saliva production is lower while you are sleeping, which makes it harder for food particles to be washed away. Keep your floss with your toothbrush and toothpaste or take some with you to use when you are away from home.

• Use wide ribbon or tape floss. Wide floss covers a greater portion of the tooth than fine floss and cleans better. It is also easier to use and less likely to cut the gums. Waxed and unwaxed floss can both remove food particles and plaque effectively, but waxed floss is easier to use. You can use flavored wax floss to make your mouth feel extra fresh and clean.

• If you have recessed gums, varied size gaps between your teeth, or braces, try a threader or loop. If the floss shreds, you could have a cavity or a problem with dental work and should see your dentist.

If your gums hurt or bleed when you floss, that is all the more reason to continue. Painful or bleeding gums could be a sign of gum disease. If you brush and floss every day, the pain and bleeding should stop within two weeks. If not, visit your dentist.

It is important to practice good oral hygiene during pregnancy. If you are pregnant, you are at risk for gum disease, enamel wear, and other dental conditions.

Begin flossing your child’s teeth when there are two touching each other. Help your child until the age of 11.

Common Dental Problems for People over 50

dental healthAs you age, you become susceptible to new health problems that were less of a concern when you were younger. People over 50 are at higher risk of developing several common dental conditions.

If you are over 50, you can get cavities on surfaces of teeth that did not have them before, around old fillings, or at the roots of teeth. The roots become softer and more exposed as you age. You can reduce your risk of developing cavities by drinking fluorinated water or using a toothpaste and mouth rinse that contain fluoride.

Saliva protects the teeth from decay, but many older adults develop dry mouth. This is often a side effect of medications, which many older adults take. Dry mouth can cause a sticky feeling in your mouth; trouble swallowing; dryness in your throat; dry, cracked lips; a metallic taste in your mouth; persistent bad breath; or increased thirst. If you have dry mouth, you can stimulate saliva production by drinking more water or chewing sugar-free candy or gum. Your dentist may also prescribe a saliva substitute or recommend an over-the-counter product.

Gingivitis is an early form of gum disease that can cause the gums to become swollen or red or to bleed easily. If left untreated, gingivitis can lead to periodontitis, which can cause the gums to pull away from the teeth and form pockets that can become infected. Periodontitis can eventually lead to loss of bone and teeth. Visit your dentist regularly for checkups and cleanings.

The risk of developing oral cancer increases as people age. It is often caused by heavy smoking and alcohol use. The Human Papilloma Virus can also cause oral cancer. The best way to survive oral cancer is to get screened by your dentist and catch it early.

Teeth can become crowded in people over 50, which can cause food to get stuck and lead to decay. Misaligned teeth can also lead to erosion of teeth and damage to supporting tissue and bone. Crowding and periodontal disease can lead to tooth loss. If you believe your teeth have shifted, see an orthodontist. You may need a retainer, spacer, or braces, or you may simply need to get your teeth cleaned more often.

Respiratory Conditions and Oral Health

dentist patientMany medications used to treat respiratory conditions can affect oral health. If you have a respiratory illness, it is crucial that you tell your dentist about all the prescription and over-the-counter drugs you take, the dosages, how often you take them, and when they were prescribed.

Cromolyn, a medication used to treat asthma, can cause nausea, cough, a bad taste in the mouth, and irritation in the mouth or throat.

Strong anti-inflammatory medicines called corticosteroids that are used to treat asthma can cause dry mouth. They can also contribute to fungal, or yeast, infections in your mouth and slow down your healing process.

If you use an inhaler that contains steroids, use a spacer, a plastic tube that attaches to the inhaler and holds the dose while you inhale. After you use your inhaler, rinse your mouth with water to reduce your risk of getting a yeast infection.

When you visit the dentist, you should take your inhaler with you. Tell your dentist how often you have asthma attacks, what triggers them, how serious your asthma is, when you had your last asthma attack, and any visits to the hospital that were related to your asthma.

The adrenal glands normally produce hormones that help the body respond to stress. Steroids used to treat asthma may make the body less able to respond to stress, which can cause problems during dental visits in rare circumstances. Tell your dentist if you have been taking steroids for more than two weeks.

Chronic obstructive pulmonary disease (COPD) does not affect the mouth and teeth, but people with the condition sometimes have colds or upper respiratory infections and may take steroids for long periods of time. This can contribute to yeast infections and the body’s decreased ability to handle stress.

If you have COPD, the way you sit in the dentist’s chair may affect your breathing. Your dentist can help you find a comfortable position. He or she can supply oxygen if you need it during the visit. If you use oxygen at home, be sure your portable tank is full and take it to the dentist’s office for your appointment.

Tuberculosis can cause large lymph nodes in the neck and can rarely cause painful sores in the mouth. A saliva or “sputum” culture can determine whether or not your tuberculosis is active. If you have active tuberculosis, you should not go to the dentist because you could spread it to other people. If you need emergency dental care, go to the hospital. If your tuberculosis is inactive, you can go to the dentist.

A sinus infection can cause pain in the upper teeth that can be mistaken for a dental problem. If you have sinusitis, you may have pain in more than one tooth on the same side of your mouth.

Medications used to treat a sinus infection, such as antihistamines, can cause dry mouth, which can increase your risk of developing tooth decay and a yeast infection. Breathing through your mouth can also cause your mouth to become dry.

If you have a sinus infection, tell your dentist what medications you are taking. If you have chronic sinusitis and have been taking antibiotics for several weeks, bacteria can become resistant to them. If you need an antibiotic, your dentist may need to prescribe a different dose or type.

Screening Can Detect Oral Cancer Early

oral cancer screeningOral cancer can manifest itself in the form of growths or sores on the lips, tongue, cheeks, floor of the mouth, hard and soft palate, sinuses, and pharynx. If not diagnosed and treated early, oral cancer can be fatal.

Oral cancer can cause swelling, thickening, lumps, bumps, rough spots, crusts, eroded areas, or velvety white, red, or speckled patches in the mouth. It can also cause bleeding in the mouth or numbness, pain, or tenderness in the face, mouth, or neck. Oral cancer can cause sores on the face, neck, or mouth that bleed easily and do not heal within two weeks, a soreness or feeling that something is stuck in the back of the throat, or difficulty chewing, swallowing, talking, or moving the jaw or tongue. Oral cancer can also cause hoarseness, chronic sore throat, change in the voice, ear pain, a change in the way the teeth or dentures fit together, or dramatic weight loss.

According to the American Cancer Society, men are twice as likely to develop oral cancer as women. Men over 50 have the greatest risk. Other risk factors include smoking, using smokeless tobacco, excessive drinking of alcohol, excessive sun exposure, and family history of cancer. Over a quarter of oral cancers are found in people who did not smoke or drink excessively.

Many dentists believe that oral cancers can be detected through screenings. The American Dental Association and the American Cancer Society recommend oral cancer screening.

Your dentist can check for signs of oral cancer during a routine exam. If your dentist notices lesions in your mouth, he or she can perform additional tests to determine whether they are or may become cancerous.

One procedure involves coating lesions with a blue dye. If an area appears darker than the rest of the mouth, it is more likely to be or become cancerous.

Another procedure involves rinsing the mouth with a fluorescent rinse and then looking at the mouth with a special light. Abnormal tissue looks different when seen under the light.

Exfoliative cytology involves scraping cells from the mouth or lip with a piece of cotton, brush, or small wooden stick. The cells are viewed under a microscope to see if they are abnormal.

A brush biopsy involves using a brush to collect cells from all the layers of a lesion. The cells are studied under a microscope to see if they are abnormal.

Some tests can detect oral cancer early and improve survival rates. It is important to see your dentist for regular exams and oral cancer screenings.

Study Finds Correlation between Dentists and Obesity Rates

dentist patientResearchers at the Yale School of Public Health conducted a study that identified a correlation between higher prevalence of dentists and lower adult obesity rates. The researchers found that for every additional dentist per 10,000 people in a county, the adult obesity rate declined by 1 percent. The results of the study were published in the September 1 issue of the Journal of the American Dental Association.

The researchers decided to look at dentist prevalence because it had never been studied in relation to obesity rates. The information was made publicly available as part of the Robert Wood Johnson County Health Rankings and Roadmaps program.

The researchers controlled for other factors that have been correlated with obesity rates, such as education and income levels, the number of recreational facilities and fast food restaurants, and obesity rates in surrounding counties.

After controlling for all of these factors, the researchers found that greater numbers of dentists correlated with lower obesity rates. The effect was even more apparent in counties with higher concentrations of primary care physicians. The prevalence of dentists also correlated with significantly lower obesity rates in counties where over 25 percent of children live in poverty.

A correlation does not prove that having more dentists necessarily caused lower obesity rates. The correlation could have several explanations. It could mean that people who visit the dentist are more health conscious and tend to eat healthier foods than those who do not go to the dentist. It could also mean that dentists are doing a good job of educating their patients so they can make healthy food choices.

The findings could inspire further research that can look at individual patients and dentists, longitudinal studies of communities, and intervention studies in which dentists educate their patients about how to eat healthy and prevent obesity.

The researchers believe that dentists could play a role in reducing obesity rates across the country. According to the Centers for Disease Control and Prevention, obesity affects 34.9 percent of American adults and costs $147 billion for health care expenses annually.

What Your Mouth Says about Your Overall Health

oral healthYour dentist can diagnose a lot more than just cavities and gum disease from looking at your mouth. Oral health problems can contribute to a host of other medical problems, and many medical conditions can affect oral health.

Almost 50 percent of American adults have some form of periodontal, or gum, disease, which often goes untreated. Gum disease can lead to problems with the teeth and other medical conditions. Changes in the appearance of the gums can also allow a dentist to diagnose other health issues.

Gingivitis and more serious gum disease, periodontitis, are associated with tooth loss, heart disease, diabetes, and other medical problems. Researchers believe the inflammation associated with gum disease can contribute to cardiac problems.

People with diabetes are at increased risk of developing abscesses, infections that occur at the root of a tooth or on the gums between teeth. A person who is having trouble managing blood sugar is prone to abscesses, and the inflammation that abscesses cause can make it more difficult for the person to control his or her blood sugar. Healthy people can also develop abscesses. If you get one, you should see your dentist.

Stress and anxiety can raise levels of the hormone cortisol, which can cause inflammation throughout the body, including the gums. This inflammation can cause gum disease which, if untreated, can lead to tooth and bone loss.

About 5 percent of pregnant women get pregnancy tumors, small red growths that can appear on the gums or between the teeth. While pregnancy tumors are not dangerous, they can lead to increased sensitivity. Women with pregnancy tumors may need extra dental care.

Anemia, or iron deficiency, can cause the gums to lose their normal red color. People with anemia can have gums that are pale pink, or even white.

Autoimmune diseases, including lupus and Crohn’s disease, can lead to sore red spots in the mouth, and lichen planus, another autoimmune disease, can cause sores on the skin and white spots in the mouth. These tender and painful spots can cause ulcers in the mouth, but they usually respond well to treatment.

Antidepressants such as Prozac, Paxil, and Zoloft (SSRIs) and some antihistamines used to treat allergies can decrease the flow of saliva, which can lead to dry mouth and cavities. A dentist can recommend sprays, saliva substitutes, or other treatments for this problem.

Be sure to visit your dentist for regular exams. Your dentist may be able to diagnose medical problems you don’t even know you have or may be able to help you avoid developing them in the first place.

Stress Can Affect Oral Health

stressStress can affect people in many ways, both mental and physical. Many people do not realize that stress can even affect their oral health.

Canker sores are small ulcers with a white or grayish base and red border that can be found inside the mouth. Experts are not sure of their cause but believe they may be due to problems with the immune system, bacteria, or viruses. Stress, fatigue, and allergies can increase the likelihood of getting canker sores. They are not contagious. If you get a canker sore, avoid spicy and acidic foods and treat it with over-the-counter topical anesthetics. Canker sores generally disappear within 10 days.

Cold sores, or fever blisters, are caused by the herpes simplex virus. They are fluid-filled blisters that are generally found on or around the lips, but they may also appear under the nose or around the chin. Cold sores are contagious. They can be triggered by emotional upset, a fever, sunburn, or a skin abrasion. If you get a cold sore, begin treating it immediately with over-the-counter medication or a prescription antiviral medication. Fever blisters often heal on their own in about a week.

Being stressed out can make you grind your teeth. Many people who grind their teeth are not aware that they do it. If you already have a tendency to grind your teeth, or bruxism, stress can make it worse. Teeth grinding can cause problems with the temporomandibular joint (TMJ) that is located where the skull and lower jaw meet in front of the ear. If you grind your teeth, your dentist may recommend a night guard or other appliance to treat the problem.

Stress can affect your mood and lead to depression. This can make you less likely to follow good eating habits and to take care of your teeth and gums, which can contribute to cavities or gum disease. If you are becoming depressed, talk to your doctor and find strategies to help you reduce your level of stress.

Stress can have many effects on the body, including oral health problems. If you believe that stress is affecting your oral health, consult your dentist about treatments and discuss ways to reduce stress with your doctor.

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.