Healthy Hints By Heather

Our very own Heather Metzler peroidically expounds on various subjects of interest to everyone interested in maximizing their smile while maintaining excellent health. Below she offers our collective wisdom on just how to attain that worthy goal.

How Did I Get That Cavity?

What is tooth Decay? Tooth decay, also known as a cavity, is the destruction of tooth enamel. It occurs when foods containing carbohydrates are frequently left on the teeth. Carbohydrates are sugars and starches that are in most foods including, milk, fruits, breads, candy and soda pop, to mention a few. Bacteria that live in the mouth thrive on these foods, producing acids that attack tooth enamel. The stickiness of the plaque keeps these acids in contact with your teeth. Over a period of time, these acids destroy tooth enamel, resulting in tooth decay or cavity.

How can tooth decay be prevented? Prevention is simple and the key to long-term health. The plaque that is the home for the bacteria needs to be removed from the tooth surface. Brush, brush, brush, brush a minimum of three times daily. Then floss between the teeth daily, this will remove bacteria from the areas the toothbrush cannot reach. Keep snacking limited, and brush after enjoying snacks. Nutritious and balanced meals are essential for controlling not only tooth decay, but also overall health. Visit your dentist regularly (twice a year) for professional dental cleanings and oral examinations. The examination will include detection of tooth decay, periodontal disease (gum disease), oral cancer screening, and evaluation of present restorations (fillings). Decay can occur around the margins or edges of fillings and crowns.

Who gets cavities? We are all at risk because of the bacteria in our mouths. Children and senior citizens are more susceptible to decay, then others due to a number of factors. People who eat diets high in starch and sugar, especially sticky candy and soda pop, are at a much greater risk. Taking a number of different medications and or having a dry mouth also increase the caries rate. Root decay is decay on the root of the tooth. This happens after a person has had periodontal (gum) disease and the gums have receded, leaving part of the root exposed. Since there is no enamel covering your roots, these exposed areas decay more readily. Most people over the age of 60 have most root exposure. Recurrent cavities are cavities around existing fillings. Decay can form here due to these areas not being as smooth as a natural tooth surface. Also over time the bond between the filling and the tooth may weaken and allow saliva and bacteria to leak between the filling and tooth. This type of leak will always cause a cavity after some time.

Bad Breath: Cause, Effect & Solution

Everyone has been the cause a time or two, and everyone has smelled the effect of bad breath a time or two. So what causes this malodor that is reeks havoc in daily conversions? Bad breath is also known as halitosis, which by definition means an unpleasant odor exhaled when breathing. So what’s the cause? Bad breath is not always a simple poor hygiene issue. It can be a smelly warning that your health is failing.

One common cause is food and plaque formation. The breakdown of food particles around your teeth that lead to plaque and bacteria growth will cause a foul odor. The solution is simple here, brush, brush and brush and floss.

Eating foods containing volatile oils is another source, for example onions, garlic, some vegetables, and alcohol. When digested this foods release pungent oils that enter the bloodstream are carried through the lungs and exhaled when breathing. The solution is to warn your surrounding companions that you ate these types of food and your breath may smell.

Another common cause is a dental problem such as a gum infection and/or dental cavities. Both of these are caused by bacteria that their by-products (waste) result in an odor. The solution is good oral hygiene and regular dental exams to detect decay (cavities) as soon as possible. The diagnosis of gingivitis and periodontal disease is crucial in preventing or stabilizing bone loss around the teeth.

Dry mouth can cause “morning breath,” this occurs naturally during sleeping. Saliva helps cleanse and moisten the mouth, without adequate saliva dead cells accumulate on the tongue, cheeks and gums. The solution is to brush and floss upon waking. Some medications and smoking will also cause dry mouth. Increasing water intake will help keep the mouth moist.

Sinus infections due to nasal discharge can cause mouth odor. Strep throat, tonsillitis, mononucleosis, bronchitis and other upper respiratory infections are all sources of bad breath, until the infection clears.

Tobacco products are of course a smelly source that is very pungent and offensive. Tobacco users are also more likely to have periodontal disease, an additional source of bad breath.

Disease is a very serious cause that can be life threatening. Chronic lung infections and abscesses are very foul-smelling. Kidney failure can cause a urine-like smell. Liver failure may cause an odor described as “fishy.” Uncontrolled diabetes often has a fruity breath odor. Chronic reflux of stomach acids can also produce bad breath. This is a few diseases that are known to produce bad breath, although these are not exclusive.

How Hormonal Changes May Impact the Mouth

Most women have never considered the thought that hormonal changes that women experience through their lives do influence their gums and oral health. As men and women have differences in their biological framework, women have different oral health needs based on their physiology. This is based on the research done by Dr. Peter Trainor, president of the Ontario Dental Association. Being a woman is extraordinary, fun, and fulfilling, but it’s not always easy. A woman’s body goes through so many changes that good oral hygiene is especially important. These changes are mostly contributed to fluctuating hormone levels throughout different stages in a womanÍs life such as puberty, pregnancy, and menopause. The use of oral contraceptives will contribute to these changes as well.

Increases in the hormones progesterone and estrogen may result in increased blood circulation to the gums. Levels of these hormones typically increase at puberty, menstruation cycle, pregnancy, and women taking hormonal contraceptives (birth control pill). Increased circulation to the gums may make the gums more sensitive to irritants in the mouth, such as plaque. Plaque is the soft and sticky substance that accumulates on the teeth from food debris and bacteria. The bacteria in the plaque cause the infection in the gums, although when there is an increase in hormone levels this intensifies the problem. The heightened sensitivity that may occur when hormone levels are high only intensifies a preexisting problem of poor plaque control and/or diet. The gums may be red, swollen, bleeding, and or tender.

Pregnancy gingivitis is most common in the first trimester. This is due to the body adjusting to changing and increased hormone levels. Since oral contraceptives contain estrogen and progesterone, they cause the body to imitate pregnancy. The most obvious oral changes for many women may occur during menopause. Some women report experiencing discomfort, pain and occasional burning in their mouth and gums. Experiencing altered taste perceptions with salty, peppery, and/or sour foods is also common during this time of a woman's life.

The Shocking News About Flouride

Aging In Teeth and Associated Issues

Various theories have been discussed as in an attempt to understand the deterioration of structure and function of teeth as we age but the truth is there is no need to look any further then the simple process of wear and tear. Tooth wear is a common finding in the elderly. Different types of tooth wear are:

Attrition — This is a form of frictional wear induced during movements by repeated contact with opposing teeth. Attrition occurs by teeth wearing one another and is greatly influenced by the consistency of ones diet. Attrition is one of the major sources of tooth loss. Some attrition would be expected in elderly patients. Wear that is slight and not causing symptoms requires no active treatment. However, the elderly patient should be examined at recall appointments to determine whether any significant change has taken place.

Abrasion — This describes the condition in which tooth substance is lost by frictional effects such as damage caused by tooth brushing. It is important to know that once abrasion is diagnosed that it is not allowed to persist for too long, otherwise structural weakening of the teeth may take place.

Erosion — This term describes the loss of enamel by the action of ingested or regurgitated acids. The main source of ingested acid is from citrus fruits, vinegars and medications. Once diagnosed this may involve modification of the diet. Those patients who suffer form acid regurgitation, particularly at night will possibly have to require tooth protection for their teeth. Desensitizing toothpaste can be used to reduce pain.

The elderly have a tendency to believe that they are poor candidates for restorative work in the dental office. Many believe that ill health, disability and poor oral health is just the inevitable of aging. Therefore they do not seek out a dentist and seek restoration for their teeth.

The needs of an elderly patient are no different from the needs of any other age group. They need maintenance, function and aesthetics. And they need to have an understanding of the nature of dental caries (decay) and periodontal disease. It is important to know that restorative procedures will do nothing to prevent either dental decay or periodontal disease. The only function of restorations (fillings) is to replace diseased or missing tooth structure and in some cases to protect the remaining dental hard tissues from fracturing.

The following are some important needs with which the staff at Dr. Jeffery Hartman’s office wants to motivate our elderly:

1. Oral Hygiene — Plaque in mature patients can present a problem. Loss of manual dexterity and reduction of the ability to concentrate inevitability reduce the efficiency of controlling plaque buildup challenges. The exposure of root surfaces increases the difficulty of plaque removal. A further difficulty is the sensitivity of the root surfaces when brushing exposed dentine which may discourage brushing altogether. All of these factors combine to make the prevention of dental disease difficult for the majority of elderly patients.

2. Good Home Care — The use of disclosing solutions can help the patient know what they can do and what they should be trying to achieve. It may be that the patient’s dexterity will not support flossing or the use of wood points but the use of small brushes with handles may be possible.

3. Tooth Fracture — It is important for elderly patients to know that the elderly often suffer from fracture of the teeth without a history of trauma. These may range from chipping the edge of a front tooth to the loss of a single cusp of a back molar or to complete loss of the crown of a tooth. The factors that can be responsible are:

a. Age changes the dental tissues.
b. The effect of previous restorations and old fillings.
c. Biting and/or occlusal factors.

4. Missing Teeth — Loss of teeth at any age can be demoralizing or a welcome relief from pain. When teeth are missing the remaining ones can change positions and drift into the surrounding space. What follows are choices of procedures which may prove successful at replacing missing teeth. Cost is usually the factor that determines the patient’s choice.

a. Removable Partial Denture — A removable partial denture helps you to properly chew your food, something that is difficult when teeth are missing. A removable partial denture can help improve your speech and prevent your face from sagging by giving support to your lips and cheeks. The patient needs to know that there may be some occlusal changes and that adjustments are usually necessary over time. Once the adjustments are made, your dentist may recommend that you remove it before going to bed and replace it in the morning.

b. Complete Immediate Dentures — Periodontal health implies at least 6 mm. of healthy bone around the roots, minimal pockets and a positive attitude by the patient to good oral hygiene. If one of these is compromised and the patient has lost some or all of their natural teeth complete dentures can replace missing teeth and their smile. The denture(s) can be made to closely resemble your natural teeth. Growing accustomed to the dentures can be a challenge for some. New dentures feel awkward and possibly uncomfortable for the first few weeks. Salivary flow temporarily increases. Minor irritations or soreness is not unusual. These problems often diminish as your mouth becomes accustomed to new dentures. Your dentist can make adjustments over time.