Posts for: January, 2014
In modern times, metals have played an important role in tooth preservation and restoration. From the dental amalgam used for a century and a half to fill cavities to the titanium alloy of dental implants, your dental care would not be as comprehensive as it is today without them. But could these metals, so important in providing oral health, cause an allergic reaction in some people?
An allergy is an exaggerated response of the body’s immune system to any substance (living or non-living) it identifies as a threat. The response could be as minor as a rash or as life-threatening as a systemic shut-down of the body’s internal organs. An allergy can develop with anything, including metals, at any time.
A low percentage of the population has an allergy to one or more metals: some surveys indicate 17% of women and 3% of men are allergic to nickel, while even fewer are allergic to cobalt and chromium. Dermatitis patients seem to have a higher reaction rate, some allergic even to metals in jewelry or clothing that contact the skin.
Dental amalgam, an alloy made of various metals including mercury, has been used effectively since the mid-19th Century to fill cavities; even with today’s tooth-colored resin materials, amalgam is still used for many back teeth fillings. Over its history there have been only rare reports of allergic reactions, mainly localized rashes or moderate inflammation.
The most recent metal to come under scrutiny is titanium used in dental implants. Not only is it highly biocompatible with the human body, but titanium’s bone-loving (osteophilic) quality encourages bone growth around the implant’s titanium post inserted into the jawbone, strengthening it over time. But does titanium pose an allergic threat for some people? One study reviewed the cases of 1,500 implant patients for any evidence of a titanium allergy. The study found a very low occurrence (0.6%) of reactions.
The conclusion, then, is that the use of metals, especially for dental implants, carries only a minimal risk for allergic reactions and none are life-threatening. The vast majority of dental patients can benefit from the use of these metals to improve their oral health without adverse reaction.
If you would like more information on metal allergies with dental materials, 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 “Metal Allergies to Dental Implants.”
Your mouth’s biting and chewing function is an intricate interplay of your teeth, jaws, lips, cheeks and tongue. Most of the time everything works in orderly fashion, but occasionally the soft tissues of the tongue or cheeks get in the way and are accidentally bitten. The resultant wound creates a traumatic fibroma, an overgrowth of tissue that develops to cover the affected area.
A fibroma consists of fibrous tissue made up of the protein collagen; this traumatized tissue functions much like a callous on a tender spot of skin by binding together the new tissues forming as the wound heals. But because the fibroma is raised on the surface of the cheek more than normal tissue, the chances are high it will be bitten again and reinjured, even multiple times. If this occurs the fibroma becomes tougher and more pronounced.
As it becomes raised and hardened in this way, it becomes more noticeable. More than likely, though, it poses no danger other than as an inconvenience. If it becomes too much of a nuisance, or you have concerns that it’s more than a benign growth, it can be removed with a simple fifteen-minute procedure. An oral surgeon, periodontist or dentist with surgical training will first anesthetize the area with a local anesthetic; the fibroma is then completely excised (removed) and the wound opening sutured with two or three small sutures. Any post-procedure discomfort should be mild and easily managed by pain medication like aspirin or ibuprofen.
Although it’s highly unlikely the fibroma is cancerous, the excised tissue should then be sent for biopsy. Viewing the tissue microscopically is the only definitive way to determine the true nature of the tissue and confirm any diagnosis that the tissue is benign. This is no cause for alarm as it’s a standard healthcare procedure to biopsy this particular kind of excised tissue.
“Bumps and lumps” are common occurrences in the mouth. It’s a good idea to point them out to us during your regular checkups or at any time if you have a concern. In either case, this bothersome problem can be easily treated.
If you would like more information on traumatic fibromas, 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.”
Electric-powered toothbrushes have been in use for decades, and continue to enjoy wide popularity. But since their inception in the 1950s, there’s been a continuous debate not only about the best choice among powered toothbrushes, but whether powered toothbrushes are as effective in removing plaque as manual toothbrushes.
These debates are fueled by a large body of research over many years on powered toothbrushes. For instance, an independent research firm known as the Cochrane Collaboration has evaluated over 300 hundred studies of powered toothbrushes (over a thirty-year span) using international standards to analyze the data.
Surprisingly, they found only one type of powered toothbrush (using a rotation-oscillation action) that statistically outperformed manual toothbrushes in the reduction of plaque and gingivitis. Although from a statistical point of view the difference was significant, in practical terms it was only a modest increase in efficiency.
In all actuality, the most important aspect about toothbrushes in effective oral hygiene isn’t the brush, but how it’s used — or as we might say, “it’s not the brush so much as the hand that holds it.” The fact remains, after first flossing, a manual toothbrush can be quite effective in removing plaque if you brush once or twice a day with a soft-bristle brush using a gentle brushing motion.
Although a powered toothbrush does much of the work for you, it still requires training to be effective, just as with a manual toothbrush. We would encourage you, then, to bring your toothbrush, powered or manual, on your next cleaning visit: we would be happy to demonstrate proper technique and give you some useful tips on making your brushing experience more effective.
Remember too: brushing your teeth and flossing isn’t the whole of your oral hygiene. Although a critical part, brushing and flossing should also be accompanied with semi-annual professional cleanings to ensure the removal of as much disease-causing plaque as possible.
If you would like more information on types of toothbrushes, 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 “Manual vs. Powered Toothbrushes.”
Singer Olivia Newton-John's daughter Chloe is now a lovely, grown woman, but Olivia recently recounted to Dear Doctor magazine a rather creative method she found to sooth Chloe's teething troubles many years ago.
“When Chloe was a baby and teething I remember using a frozen bagel for her sore gums,” Olivia said. “She loved it!”
Cold is often very soothing to a teething child's gums. In fact, the American Academy of Pediatric Dentistry (AAPD) recommends using a clean, chilled, rubber teething ring, or cold wet washcloth. Chilled pacifiers can also be helpful. Be sure not to freeze teething rings or pacifiers as ice can actually burn sensitive mouth tissues.
Older teethers can sometimes find relieve from cold foods such as popsicles (or bagels!) but make sure your child eats these sugar-containing foods only at mealtimes so as not to promote tooth decay.
If your baby has not yet begun the teething (or tooth-eruption) process, you can expect it to begin usually between six and nine months. It may, however, start as early as three months or as late as twelve months.
Teething symptoms vary among children, as does the length of time it takes for a tooth to make its appearance. But many parents notice the following signs:
- Biting and gnawing
- Gum swelling
- Chin (facial) rash
- Disrupted sleeping patterns
- Ear rubbing
- Decreased appetite
These symptoms are usually most bothersome during the week that the tooth is breaking (erupting) through the gums, starting about four days before and lasting about three days after the tooth appears.
Occasionally, teething discomfort can be considerable. If that is the case with your baby, you can give her or him acetaminophen or ibuprofen in the appropriate dose (check with your pharmacist if you're not sure what that is). The medicine should be swallowed — not massaged into the gums, as this can also burn. Numbing agents should not be used for children under 2, except under the advice and supervision of a healthcare professional.
If you would like to learn more about teething or any other child-related oral health issue, please contact us or schedule an appointment for a consultation. If you would like to read Dear Doctor's entire interview with Olivia Newton-John, please see “Olivia Newton-John.” Dear Doctor also has more on “Teething Troubles.”