Posts for: February, 2017
Although periodontal (gum) disease is the most common cause of bone loss in the mouth, women at or past menopause face another condition that could cause complications with their oral bone health — osteoporosis.
While normal bone goes through a balanced cycle of resorption (the dissolving of bone tissue) and re-growth, osteoporosis, a hormone-induced disease, tips the scale toward resorption. This reduces bone density, which weakens the bone and makes them more susceptible to fracture.
Some studies have shown a link between osteoporosis and existing gum disease; however, the greater concern at present from an oral health standpoint regards the side effects of a certain class of drugs called bisphosphonates used in the treatment of osteoporosis. Bisphosphonates slow excessive bone resorption, which helps restore normal balance to the bone growth cycle.
Some long-term users of bisphosphonates, however, may develop a complication in their jaw bone known as osteonecrosis in which isolated areas of the bone lose vitality and die. This can complicate certain types of oral surgery, particularly to install dental implants (which rely on stable bone for a successful outcome). While research is still ongoing, it does appear individuals at the highest risk of osteonecrosis are those with underlying cancers who receive high-dose intravenous bisphosphonate treatment every month for an extended period of time.
It’s important then that you let us know before any dental procedure if you’ve been diagnosed with osteoporosis and what treatment you’re receiving for it. If you’ve been taking a bisphosphonate for an extended period of time, we may recommend that you stop that treatment for three months (if possible) before undergoing oral surgery. While your risk of complications from osteonecrosis is relatively small, adding this extra precaution will further reduce that risk and help ensure a successful outcome for your scheduled dental procedure.
If you would like more information on osteoporosis and 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 articles “Osteoporosis & Dental Implants” and “Good Oral Health Leads to Better Health Overall.”
Are bleeding gums something you should be concerned about? Dear Doctor magazine recently posed that question to Dr. Travis Stork, an emergency room physician and host of the syndicated TV show The Doctors. He answered with two questions of his own: “If you started bleeding from your eyeball, would you seek medical attention?” Needless to say, most everyone would. “So,” he asked, “why is it that when we bleed all the time when we floss that we think it’s no big deal?” As it turns out, that’s an excellent question — and one that’s often misunderstood.
First of all, let’s clarify what we mean by “bleeding all the time.” As many as 90 percent of people occasionally experience bleeding gums when they clean their teeth — particularly if they don’t do it often, or are just starting a flossing routine. But if your gums bleed regularly when you brush or floss, it almost certainly means there’s a problem. Many think bleeding gums is a sign they are brushing too hard; this is possible, but unlikely. It’s much more probable that irritated and bleeding gums are a sign of periodontal (gum) disease.
How common is this malady? According to the U.S. Centers for Disease Control, nearly half of allÂ Americans over age 30 have mild, moderate or severe gum disease — and that number increases to 70.1 percent for those over 65! Periodontal disease can occur when a bacteria-rich biofilm in the mouth (also called plaque) is allowed to build up on tooth and gum surfaces. Plaque causes the gums to become inflamed, as the immune system responds to the bacteria. Eventually, this can cause gum tissue to pull away from the teeth, forming bacteria-filled “pockets” under the gum surface. If left untreated, it can lead to more serious infection, and even tooth loss.
What should you do if your gums bleed regularly when brushing or flossing? The first step is to come in for a thorough examination. In combination with a regular oral exam (and possibly x-rays or other diagnostic tests), a simple (and painless) instrument called a periodontal probe can be used to determine how far any periodontal disease may have progressed. Armed with this information, we can determine the most effective way to fight the battle against gum disease.
Above all, don’t wait too long to come in for an exam! As Dr. Stork notes, bleeding gums are “a sign that things aren’t quite right.” Â If you would like more information about bleeding gums, please contact us or schedule an appointment. You can read more in the Dear Doctor magazine article “Bleeding Gums.” You can read the entire interview with Dr. Travis Stork in Dear Doctor magazine.
While out with friends one evening, you take a bite of ice cream. Suddenly, pain shoots through your teeth. It only lasts a second, but it's enough to ruin your good time.
This could be tooth sensitivity, a painful reaction to hot or cold foods. It often occurs when the enamel in prolonged contact with acid has eroded. Acid is a waste product of bacteria found in plaque, a thin film of food particles that builds up on tooth surfaces due to inadequate brushing and flossing. Enamel normally mutes temperature or pressure sensation to the underlying dentin layer and nerves. Loss of enamel exposes the dentin and nerves to the full brunt of these sensations.
Sensitivity can also happen if your gums have shrunk back (receded) and exposed dentin below the enamel. Although over-aggressive brushing can often cause it, gum recession also happens because of periodontal (gum) disease, a bacterial infection also arising from plaque.
The best way to avoid tooth sensitivity is to prevent enamel erosion or gum recession in the first place. Removing accumulated plaque through daily brushing and flossing is perhaps the most essential part of prevention, along with a nutritious diet low in sugar and regular dental cleanings and checkups.
It's also important to treat any dental disease that does occur despite your best hygiene efforts. Gum disease requires aggressive plaque removal, especially around the roots. While receded gum tissues often rebound after treatment, you may need gum grafting surgery to restore lost tissues if the gums have receded more deeply. For enamel erosion and any resulting decay you may need a filling, root canal treatment or a crown, depending on the depth and volume of structural damage.
While you're being treated you can also gain some relief from ongoing sensitivity by using a toothpaste with potassium nitrate or similar products designed to desensitize the dentin. Fluoride, a known enamel strengthener, has also been shown to reduce sensitivity. We can apply topical fluoride directly to tooth surfaces in the form of gels or varnishes.
Don't suffer through bouts of tooth sensitivity any more than you must. Visit us for a full exam and begin treatment to relieve you of the pain and stress.
If you would like more information on the causes and treatment of 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 “Treatment of Tooth Sensitivity.”