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Posts for category: Oral Health

By Jennifer Robb, D.M.D.
September 20, 2021
Category: Oral Health
Tags: oral hygiene   gum disease  
PlaqueRemovalistheTopPriorityforPreventingorTreatingGumDisease

Tooth loss is often the unfortunate conclusion to a case of untreated periodontal (gum) disease—incentive enough to try either to prevent it or aggressively treat an infection should it occur. In either case, the objective is the same: to remove all plaque from dental surfaces.

Dental plaque (and its hardened form, tartar) is a thin buildup of bacteria and food particles on tooth surfaces. It's a ready food source for sustaining the bacteria that cause gum disease. Removing it can prevent an infection or “starve” one that has already begun.

Your first line of prevention is brushing and flossing your teeth daily to remove any accumulated plaque. Next in line are dental cleanings at least twice a year: This removes plaque and tartar that may have survived your daily hygiene.

Plaque removal is also necessary to stop an infection should it occur. Think of it as a more intense dental cleaning: We use many of the same tools and techniques, including scalers (or curettes) or ultrasonic devices to loosen plaque that is then flushed away. But we must often go deeper, to find and remove plaque deposits below the gums and around tooth roots.

This can be challenging, especially if the infection has already caused damage to these areas. For example, the junctures where tooth roots separate from the main body of the tooth, called furcations, are especially vulnerable to disease.

The results of infection around furcations (known as furcation involvements or furcation invasions) can weaken the tooth's stability. These involvements can begin as a slight groove and ultimately progress to an actual hole that passes from one end to the other (“through and through”).

To stop or attempt to reverse this damage, we must access the roots, sometimes surgically. Once we reach the area, we must remove any plaque deposits and try to stimulate regrowth of gum tissue and attachments around the tooth, as well as new bone to fill in the damage caused by the furcation involvement.

Extensive and aggressive treatment when a furcation involvement occurs—and the earlier, the better—can help save an affected tooth. But the best strategy is preventing gum disease altogether with dedicated oral hygiene and regular dental visits.

If you would like more information on preventing and treating gum disease, 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 “What are Furcations?

By Jennifer Robb, D.M.D.
September 10, 2021
Category: Oral Health
HowaToothCausedHannahBronfmansMysteryAilments

Hannah Bronfman, well-known DJ and founder of the health and beauty website HBFIT.com, took a tumble while biking a few years ago. After the initial pain and bruising subsided, all seemed well—until she started experiencing headaches, fatigue and unexplained weight gain. Her doctors finally located the source—a serious infection emanating from a tooth injured during the accident.

It's easy to think of the human body as a loose confederation of organs and tissues that by and large keep their problems to themselves. But we'd do better to consider the body as an organic whole—and that a seemingly isolated condition may actually disrupt other aspects of our health.

That can be the case with oral infections triggered by tooth decay or gum disease, or from trauma as in Bronfman's case. These infections, which can inflict severe damage on teeth and gums, may also contribute to health issues beyond the mouth. They can even worsen serious, life-threatening conditions like heart disease.

The bacteria that cause both tooth decay and gum disease could be the mechanism for these extended problems. It's possible for bacteria active during an oral infection to migrate to other parts of the body through the bloodstream. If that happens, they can spread infection elsewhere, as it appears happened with Bronfman.

But perhaps the more common way for a dental disease to impact general health is through chronic inflammation. Initially, this defensive response by the body is a good thing—it serves to isolate diseased or injured tissues from healthier tissues. But if it becomes chronic, inflammation can cause its own share of damage.

The inflammation associated with gum disease can lead to weakened gum tissues that lose their attachment to teeth. But clinical research over the last few years also points to another possibility—that periodontal inflammation could worsen the inflammation associated with diseases like heart disease, diabetes or arthritis.

Because of this potential harm not only to your teeth and gums but also to the rest of your body, you shouldn't take an oral injury or infection lightly. If you've had an accident involving your mouth, see your dentist as soon as possible for a complete examination. You should also make an appointment if you notice signs of infection like swollen or bleeding gums.

Prompt dental treatment can help you minimize potential damage to your teeth and gums. It could also protect the rest of your health.

If you would like more information about the effects of dental problems on the rest of the body, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “The Link Between Heart and Gum Diseases.”

By Jennifer Robb, D.M.D.
August 31, 2021
Category: Oral Health
Tags: dental injury  
HowYouCanReducetheImpactofanOralInjuryonYourStudentAthlete

August is the traditional "kickoff" month for football season with student athletes representing the vast majority of players. And, while a new season promises to be exciting for both players and fans, there are risks for potential injury to jaws, teeth and gums.

If your household includes a football player (or other contact sport participant), you'll want to do everything you can to reduce their chances for injury or long-term damage. That involves two aspects: prevention and immediate first aid after a potential injury.

In terms of prevention, your student athlete should wear a mouthguard to protect their teeth and gums from blows to the face or mouth. Constructed of soft, pliable plastic, these oral devices cushion an impact from a hard contact that might otherwise seriously injure them. A mouthguard should be worn for any physical activity associated with the sport—including practices.

There are various styles of mouthguards, but most fall within two categories: a retail version known as "boil and bite;" and a custom mouthguard created by a dentist. Regarding the first kind, as the name implies, a boil and bite is first softened with hot water right out of the packaging. The wearer then places it in their mouth while it's still soft and bites down to create an individual fit.

A boil and bite guard can achieve a reasonable fit and provide adequate protection for a wearer. But to gain a precise fit that provides better comfort and protection, a custom-made mouthguard by a dentist is worth the extra cost. We create a custom mouthguard using an impression mold of the individual wearer's mouth. The resulting guard is thinner and more compact than the typical boil and bite.

An athletic mouthguard can drastically reduce the risk of serious injury during sports play, but, as with any element of risk, it can't reduce that risk to zero. It's important then to know what to do if a rare dental injury does occur.

The key is to act quickly, especially if a tooth has been knocked out of its socket. Putting it back into the socket as soon as possible could help save the tooth long-term. To know what steps to take for this and other kinds of dental injuries, it's good to have a reference guide handy. Here's a printable dental injury pocket guide that gives you detailed instructions for dental first aid.

Sports participation can have a lasting, positive impact on your child. But the specter of injury can also have an impact, definitely not positive and with long-term consequences. With regard to their dental health, you can make that possibility much less likely.

If you would like more information about protecting your student athlete's teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Athletic Mouthguards.”

By Jennifer Robb, D.M.D.
August 11, 2021
Category: Oral Health
Tags: oral health  
CrackedMouthCornersHowtoResolveThisIrritatingProblem

In addition to the usual tooth and gum problems, dentists also see patients with soft tissue infections in and around the mouth. One of the more common of these is the irritation or "cracking" of the corners of the mouth.

Formally known as angular cheilitis (or perleche, a French word, meaning "to lick"), cracked mouth corners are localized irritations made worse by saliva accumulation or an accompanying yeast infection. They're prominent among children and young adults who drool during sleep or while wearing orthodontic braces.

Older adults can also develop cracked mouth corners because of deep wrinkle lines around the mouth ("marionette lines") or tissue irritation from wearing dentures. Teeth loss, especially in the back of the jaws, can weaken facial support leading to collapse of the bite, which can contribute to angular cheilitis.

The condition can cause anything from minor discomfort at the mouth corners to a yeast infection that spreads throughout the mouth and throat. Whatever the symptoms, treatment usually begins with antifungal medication in the form of a mouthrinse or a topical ointment. The dentist may also prescribe a steroid ointment like zinc oxide paste to control inflammation and serve as a barrier against infection.

If the infection has spread beyond the mouth corners, patients may also need to use an antibacterial mouthrinse (usually chlorhexidine) to clear up the infection and help prevent a relapse. Besides cleaning their appliances with chlorhexidine, denture wearers with angular cheilitis should also take their dentures out at night to reduce the chances of a reoccurrence.

Along the same vein, patients who contend with frequent cracked mouth corners and who have missing teeth should have those teeth replaced by some form of restoration. If that involves dentures, it's important to maintain a good fit with them to reduce the chances of tissue irritation. And patients with deep wrinkle lines around their mouth may be able to lessen them through dermatological treatment.

Even though cracked mouth corners rarely pose a major health problem, the discomfort they cause can be a drag on your daily life and activities. Remember that you don't have to suffer—a visit to your dentist could start you on your journey toward relief from this irritating problem.

If you would like more information on angular cheilitis and similar mouth conditions, 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 “Cracked Corners of the Mouth.”

By Jennifer Robb, D.M.D.
July 12, 2021
Category: Oral Health
Tags: tooth decay  
WhatYouCanDoToHelpYourChildAvoidToothDecay

So, when should you begin taking measures to prevent tooth decay in your child's teeth? When their teeth first begin to show? When all of their primary (baby) teeth are in? Or, wait until their permanent teeth begin erupting?

Actually, tooth decay can be a problem as early as two months of age, before a child's first tooth even comes in. In essence, then, dental disease prevention should be on your radar soon after your child is born. Here's what you can do to prevent the damage of tooth decay to their teeth now and its impact on their dental health in the future.

Start oral hygiene during nursing. Brushing and flossing are lifetime habits that reduce the risk of dental disease. When your children are young, you'll have to perform these tasks for them, ultimately training them to perform them on their own. But even earlier, before their first tooth, you'll want to clean their gums after feedings with a wet cloth to reduce disease-causing bacteria.

Initiate dental visits by age 1. It's appropriate on or before their first birthday, when most children already have a few primary teeth, to begin regular dental visits for cleanings and checkups. Seeing the dentist every six months at an early age will help your child stay well ahead of tooth decay. And starting visits early increases the likelihood it will become a regular part of their lives into adulthood.

Protect against decay. You and your dentist are partners in protecting your child from dental disease. Besides daily oral hygiene, you can also help by providing a dental-friendly diet, and especially restricting sugary snacks and avoiding sweetened liquids in bedtime bottles (including breast milk or formula). In addition to routine care, your dentist can also provide other measures to fight decay, like sealants or topical fluoride.

It's also important for you to set an example for your child to follow. Children soak up what's important to their parents—in this case, watching you take care of your teeth and seeing the dentist as a friend and ally against dental disease. That's your end goal: preventing dental disease now, and instilling the value of dental care that will last your child a lifetime.

If you would like more information on helping your child avoid tooth decay, 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 “Taking the Stress Out of Dentistry for Kids.”