Posts for category: Oral Health
Narcotics have long played an important role in easing severe pain caused by disease, trauma or treatment. Healthcare professionals, including dentists, continue to prescribe them as a matter of course.
But narcotics are also addictive and can be dangerous if abused. Although addictions often arise from using illegal drugs like heroin, they can begin with prescriptive narcotics like morphine or oxycodone that were initially used by patients for legitimate reasons.
As a result, many healthcare providers are looking for alternatives to narcotics and new protocols for pain management. This has led to an emerging approach among dentists to use non-addictive non-steroidal anti-inflammatory drugs (NSAIDs) as their first choice for pain management, reserving narcotics for more acute situations.
Routinely used by the public to reduce mild to moderate pain, NSAIDs like acetaminophen, ibuprofen or aspirin have also been found to be effective for managing pain after many dental procedures or minor surgeries. NSAIDs also have fewer side effects than narcotics, and most can be obtained without a prescription.
Dentists have also found that alternating ibuprofen and acetaminophen can greatly increase the pain relief effect. As such, they can be used for many more after-care situations for which narcotics would have been previously prescribed. Using combined usage, dentists can further limit the use of narcotics to only the most severe pain situations.
Research from the early 2010s backs up this new approach. A study published in the Journal of the American Dental Association (JADA) concluded that patients receiving this combined ibuprofen/acetaminophen usage fared better than those only receiving either one individually. The method could also match the relief power of narcotics in after care for a wide range of procedures.
The NSAID approach is growing in popularity, but it hasn't yet displaced the first-line use of narcotics by dental professionals. The hesitancy to adopt the newer approach is fueled as much by patients, who worry it won't be as adequate as narcotics to manage their pain after dental work, as with dentists.
But as more patients experience effective results after dental work with NSAIDs alone, the new approach should gain even more momentum. And in the end, it promises to be a safer way to manage pain.
If you would like more information on dental pain management, 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 “Are Opioids (Narcotics) the Best Way to Manage Dental Pain?”
During this time of year, many of us dust off traditional family recipes and make our favorite holiday treats. There is, however, a small price to pay for all that nostalgic goodness in the shape of a few extra pounds to deal with in the new year. We may also be increasing the risk for something even more unpleasant: tooth decay.
The main cause, of course, is a certain carbohydrate integral to many holiday goodies: sugar. We humans love it, but so do oral bacteria that readily devour any sugar lingering in our mouth after eating. This fuels bacterial reproduction, which in turn increases the production of acid that softens tooth enamel.
There are a number of strategies you can follow to reduce this effect. You can remove sugar completely from your holiday preparations—and risk family and friends “voting you off the island.” Or, you can try these tips for easing the impact of holiday sugar on your dental health.
Look for ways to reduce sugar. Just because you're not throwing the sugar bowl out the window doesn't mean you have to go all out using it. Instead, try to modify older recipes (or look for newer versions) to decrease the amount of sugar in candies and baked goods. You may also consider alternative sweeteners like sucralose that tolerate high baking temperatures.
Balance savory with sweet. Not all holiday treats need to be sweet—you can add items that take advantage of more savory seasonings. For example, try offering up popcorn with a sprinkling of cinnamon or other holiday spice, or a creative assortment of cheeses (which in turn promote saliva flow to neutralize acid).
Combine treats with mealtimes. Continuous snacking may be part of the holiday tradition, but it can also raise the risk for tooth decay. Acidity increases when we eat, but saliva normally neutralizes it within thirty minutes to an hour. However, saliva can get overwhelmed during continuous snacking, resulting in longer periods of high acidity that damages tooth enamel. Instead, try to combine snack times with mealtimes.
Don't neglect your oral hygiene. Even though things can get hectic during the holidays, make a point of keeping up daily brushing and flossing. Regular hygiene keeps dental plaque, a thin film of harmful bacteria and food particles (including sugar), from building up on your teeth. Reducing plaque lowers your overall decay risk. Attention to oral health through your day-to-day dental hygiene routine along with regular professional cleanings and checkups is the best thing you can do to avoid dental disease.
The holidays should be a joyous time for you and your family. They can also be a healthy time for your teeth and gums, if you minimize the role of sugar in your holiday treats.
If you would like more information about boosting your dental health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Nutrition & Oral Health” and “The Bitter Truth About Sugar.”
Knowing what to do—and what not to do—when your child is sick can greatly affect their health and well-being. That's especially true with dental problems.
Here then are some Dos and Don'ts for 3 common problems children experience with their teeth and gums.
Teething. An infant's first teeth breaking through the gums is a normal but often unpleasant experience. Fortunately, teething episodes only last a few days. And, there's usually no need to see the dentist unless they have a fever or diarrhea while teething. In the meantime:
- Do: provide them chilled (not frozen) cloth or plastic items to bite and gnaw, and massage their gums to relieve painful pressure. You can also give them an age-appropriate dose of a mild pain reliever.
- Don't: rub any medication on their gums, which can irritate them and other soft tissues. Never use alcohol or aspirin to alleviate teething discomfort. And avoid using anything with benzocaine, a numbing agent which can be hazardous to young children.
Toothache. Whether a momentary sensitivity to hot or cold or a sharp, throbbing pain, a child's toothache often signals tooth decay, a bacterial disease which could eventually lead to tooth loss.
- Do: make a dental appointment at your child's first complaint of a toothache. Ease the pain with a warm-water rinse, a cold compress to the outside of the jaw, or a mild pain reliever.
- Don't: rub medication on the teeth or gums (for similar reasons as with teething). Don't apply ice or heat directly to the affected tooth or gums, which can burn them.
Bleeding gums. Gum bleeding from normal brushing or flossing, along with red or swollen gums, may indicate periodontal (gum) disease. Although rare in children, it can still happen—and it can put an affected tooth in danger.
- Do: see your dentist if bleeding continues for a few days. Continue to brush gently with a soft-bristled toothbrush around the gums to remove plaque, a thin-biofilm most responsible for gum infection.
- Don't: brush aggressively or more than twice a day, which could unnecessarily irritate and damage the gums. And don't stop brushing—it's important to remove plaque buildup daily to lessen the gum infection.
As the old Fifties song goes, “Little things mean a lot.” They can also be the most irritating, like a hangnail, a papercut—or a certain kind of oral sore. Although rarely concerning to health, this particular kind of “bump” in the mouth can be unnerving.
Although known as a traumatic fibroma, it's not as dire as it sounds: It's simply a small wound created when your inside cheek gets in the “line of fire” between your teeth while biting or chewing. It's an experience most of us have had, and though it's a minor occurrence, it can make us wince with pain.
But the pain usually lasts only a few seconds—until the next time, which is a distinct possibility. The body creates a protective callous over the wound made of fibers (hence the name fibroma) of a protein called collagen. This creates a rise in the skin surface that increases the chances the area will again get in the way of the teeth and be bitten. Each bite leads to another layer of collagen, a more prominent rise and even greater probability of another bite.
Rather than let this irritating situation repeat itself, you can undergo a minor surgical procedure to remove the fibroma. Usually performed be an oral surgeon or periodontist, the area is numbed first with a local anesthetic and the fibroma removed with a scalpel; the resulting wound is then closed with a few stitches or a laser, in which case no stitches are necessary. As a result, the cheek surface flattens out and becomes less likely to get in between the teeth.
The dentist may also preserve some of the removed tissue and submit it for a biopsy to check for any cancer cells or other abnormalities. You shouldn't be concerned about this: Examining excised tissue is a routine step performed for a variety of surgical procedures. It's used to verify the tissue in question is benign, which in this case is the vast majority of the time.
After the procedure, you might experience some minor discomfort for a few days, usually manageable with a mild pain reliever like aspirin or ibuprofen. The procedure itself only takes about fifteen minutes, but it can provide you lasting relief from that bedeviling little sore in your mouth.
If you would like more information on treating mouth sores, 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 “Common Lumps and Bumps in the Mouth.”
After years battling disease, your troubled tooth reached its useful life's end. It's been extracted, and we've replaced it with a life-like dental implant. So now, as far as the implant goes, disease is no longer an issue…right?
Sorry, no—though not to the same degree as a natural tooth, an implant could be endangered by gum disease. Although the implant's materials can't be infected, the supporting gums and bone can.
In fact, there's a particular type of gum disease associated with implants known as peri-implantitis (“peri” around an implant; “itis” inflammation) that first affects the gums surrounding an implant. Although peri-implantitis can arise from an excess of dental cement used to affix the crown to the implant, it most commonly starts like other forms of gum disease with dental plaque.
Dental plaque, and its hardened form calculus (tartar), is a thin, bacterial biofilm that builds up on teeth surfaces. It can quickly accumulate if you don't remove it every day with proper brushing and flossing. The bacteria living in plaque can infect the outer gum tissues and trigger inflammation.
Gum disease around natural teeth can spread quickly, but even more so with implants. That's because the natural attachment of the gums helps supply antibodies that impede infection. Implants, relying solely on their connection with the bone, don't have those gum attachments. As a result, peri-implantitis can move rapidly into the supporting bone, weakening the implant to the point of failure.
The good news, though, is that peri-implantitis can be treated successfully through aggressive plaque removal and antibiotics. But the key to success is to catch it early before it progresses too far—which is why you should see your dentist at the first sign of gum swelling, redness or bleeding.
You can also prevent peri-implantitis by practicing daily brushing and flossing, including around your dental implant. You should also see your dentist twice a year (or more, if they advise) for cleanings and checkups.
Dental implants overall have a greater than 95% success rate, better than any other tooth restoration system. But they still need daily care and regular cleanings to ensure your implants are on the positive side of those statistics.