Posts for: October, 2013
Dry mouth is a condition that many of us have experienced at some point in life. However, for some people it is a problem that can wreak havoc on their lives. This is why we have put together this list of questions we are most frequently asked about dry mouth.
What is dry mouth?
The medical term for dry mouth is “xerostomia” (“xero” – dry; “stomia” – mouth) and it affects millions of people in the US alone. It is caused by an insufficient flow of saliva, the liquid produced by the salivary glands. These glands are located in the inside cheeks of the mouth by the back top molars and in the floor (under the tongue) of the mouth. When functioning properly, they produce two to four pints of liquid every 24 hours.
Can drugs contribute to dry mouth?
Yes, both prescription and over-the-counter (OTC) drugs can cause dry mouth. This is one reason we so often find it in senior citizens, as they are typically on more medications than younger, healthier people.
What about diseases...can they cause dry mouth?
Certain systemic (general body) and autoimmune (“auto” – self; “immune” – resistance system) diseases, in which the body reacts against its own tissue, can cause dry mouth. Other diseases that can be the culprit include: diabetes, Parkinson's disease, cystic fibrosis, and AIDS (Acquired Immune Deficiency Syndrome). Radiation and chemotherapy used to treat head and neck cancers can inflame, damage or destroy the salivary glands—thus causing dry mouth.
Are there any remedies for dry mouth?
Yes! If medication is the primary cause of your dry mouth, there may be other, similar drugs that can be substituted that do not produce the same side effect. If you feel this describes your situation, discuss your concerns with the prescribing physician. Another option is taking an OTC or prescription saliva stimulant to temporarily relieve the dryness. Or, you can suck on a candy made with xylitol, a natural sugar substitute, four to five times a day. Xylitol has been shown to help stimulate the production of saliva with the added benefit of reducing the odds of getting cavities.
Metal braces for correcting teeth alignment have long been a fixture of adolescence. But although they're effective, they tend to put a crimp on a teenager's life with changes in diet and irritation and discomfort from the devices and regular adjustments. For many teens, though, these are minor compared to the change in their appearance that comes with traditional braces, and the embarrassment they may feel.
In recent years, there's been a growing use of another orthodontic device that reduces many of these inconveniences, especially regarding appearance. Known as the clear aligner, this transparent, “almost invisible” device can be taken out for eating, cleaning or important social events.
Clear aligners are a sequential set of clear trays made of polyurethane plastic that are generated for an individual patient using information derived from x-rays, photographs or models. Each tray in the sequence is slightly different from the previous one to account for the tooth movement achieved wearing the previous tray. The patient will wear a tray for about two weeks and then, if all looks well, move to the next tray. This process continues until the teeth arrive at the proper alignment, a period of about six to twenty-four months depending on the patient's initial condition and their progress.
Up until recently, aligners were a viable option for a limited category of patients, mainly adults. Recent advances have changed that. Aligners now include tiny “power ridges” that enable them to move teeth in more than one plane, something previous versions were unable to do. “Eruption tabs” can also be incorporated into aligner sets to hold the space for permanent teeth that haven't erupted yet — a must for many younger patients. We can also temporarily bond attachments to the teeth known as buttons (made with a composite that blends in with the natural tooth color) that give more leverage and stability to the aligner.
With these changes, clear aligners are now an effective choice for a wider group of patients, including many teens. Aligners are comfortable to wear, easy to care for, and for teens acutely conscious of their appearance, less obtrusive than traditional metal braces.
If you would like more information on clear aligners, 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 “Clear Aligners for Teens.”
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.”
If your gums appear reddish, puffy and bleed easily — especially at the margins where they meet your teeth — instead of their normal pink, you have gingivitis (“gingiva” – gums; “itis” – inflammation). Gingivitis is one of the first signs of periodontal disease (“peri” – around; “odont” – tooth) that affects the tissues that attach to the teeth, the gums, periodontal ligament and bone. Other common symptoms of periodontal disease include bad breath and taste.
If periodontal (gum) disease is allowed to progress, one possible consequence is gum recession exposing the root surfaces of the teeth. This can cause sensitivity to temperature and touch. Another sign is that the gum tissues may start to separate from your teeth, causing pocket formation; this is detectable by your dentist or hygienist. As pocket formation progresses the bone supporting the teeth is destroyed leading to loose teeth and/or gum abscesses. Unchecked or untreated it leads to tooth loss.
Inflammation, a primary response to infection is actually your immune (resistance) system's way of mounting a defense against dental plaque, the film of bacteria that concentrates between your teeth and gums every day. If the bacteria are not removed, the inflammation and infection become chronic, which literally means, “frustrated healing.” Smoking is a risk factor for periodontal disease. Smokers collect plaque more quickly and have drier mouths, therefore, cutting down or quitting smoking can reduce the severity of gum disease. Stress has also been shown to affect the immune (resistance) system, so stress reduction practices can help here as well as in other parts of your life. Gum disease can also affect your general health especially if you have diabetes, cardiovascular or other systemic (general) diseases of an inflammatory nature.
Periodontal disease is easily preventable. The best way to stop the process is to remove each day's buildup of plaque by properly brushing and flossing your teeth. Effective daily dental hygiene has been demonstrated to be effective in stopping gingivitis. It sounds simple, but although most people think they're doing a good job, they may not be. Effective brushing and flossing requires demonstration and training. Come and see us for an evaluation of how well you're doing. Regular checkups and cleanings with our office are necessary to help prevent gingivitis and periodontal disease. In addition if you already have periodontal disease you may need a deep cleaning known as root planing or debridement to remove deposits of calcified plaque called calculus or tartar, along with bacterial toxins that have become ingrained into the root surfaces of your teeth.
Gum disease is often known as a silent disease because it doesn't hurt, so see our office for a periodontal exam today.
Contact us today to schedule an appointment or to discuss your questions about gingivitis and periodontal disease. You can also learn more by reading the Dear Doctor magazine article “Understanding Gum (Periodontal) Disease.”