Posts for: June, 2015
If you’re taking medication to regulate your blood pressure, you may be familiar with some of the general side effects, like nausea, drowsiness or dizziness. But some blood pressure drugs might also cause complications with your oral health.
This is true of one class of drugs in particular used for blood pressure regulation. Calcium channel blockers (CCBs) are used to regulate blood pressure by dilating (relaxing) blood vessels, making it easier for the heart to pump blood. They’re often prescribed to patients who can’t tolerate beta blockers, another common blood pressure drug.
Besides other general side effects, CCBs can also cause gingival hyperplasia (gum overgrowth) and mouth dryness. The former condition occurs when the gum tissues grow and extend beyond their normal size over the teeth. Besides pain and discomfort, hyperplasia creates an abnormal appearance which can be embarrassing. Research findings also indicate that hyperplasia development from CCB use is also linked to poor hygiene habits, which give rise to periodontal (gum) disease.
Mouth dryness is defined as less than normal saliva flow. Besides discomfort, the condition may increase your risk of dental disease: saliva is a key part in keeping bacterial levels low and maintaining the mineral content of enamel. Inadequate saliva flow can’t maintain this balance, which increases the bacterial population in the mouth and the risk of infection leading to gum disease or tooth decay.
To avoid both of these side effects, it’s important first to let us know if you’re taking blood pressure medication and what kind. You may also need more frequent dental visits, especially if you’re displaying symptoms of dental disease. Studies have found that frequent dental visits to remove bacterial plaque and calculus (hardened plaque deposits) may significantly reduce gum overgrowth in patients taking a CCB. You should also maintain a recommended daily regimen of oral hygiene (brushing and flossing).
Because of possible effects on your dental health from a number of drugs, it’s always important to let us know the medications you’re regularly taking. As with CCBs, we can incorporate that knowledge into your dental treatment to assure your safety and optimal oral health.
If you would like more information on managing your oral care while on medication, 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 “Blood Pressure Medications.”
Orthodontics can produce an amazing smile transformation. With today’s advanced appliances and techniques even the most difficult malocclusions (bad bites) can be overcome. All of this innovation, however, depends on one basic anatomical fact: though firmly set in the mouth, our teeth can still move.
Teeth are actually held in place by the periodontal ligament, a strong, elastic tissue that attaches to them through tiny collagen fibers on one side of the ligament and to the jawbone with similar fibers on the other side. When pressure is placed against a tooth, the bone on the opposite side of the force begins to dissolve (resorb), allowing the tooth to move. As it moves, new bone is built up behind the tooth, to stabilize it. Orthodontists take advantage of this natural mechanism through orthodontic hardware like braces that applies pressure in the desired direction of movement, while the ligament and bone do the rest.
There is, though, a downside to this process. The teeth, bone and gum tissues can contain a kind of “memory” for the former natural position of the teeth. Over time, the lower front teeth tend to take a gradual migratory movement back towards their original position. Also, as we age the lower front teeth may crowd each other as there is a genetic influence for teeth to move to the midline of the face, causing a pressure that allows the skinny lower front teeth to slip behind each other. As a result of both of these tendencies, corrected teeth may retreat from their new positions.
To stop these tendencies, we use an appliance known as a retainer after braces or other hardware is removed. As the name implies, this appliance “retains” the teeth in their new position. For structural “memory,” the retainer will keep the teeth in their new position until the impulse to return to the old one has faded, about eighteen months. Retainers can also slow or stop the natural genetic influence of movement, but it may mean wearing a retainer for an indefinite period, especially individuals who’ve undergone orthodontic treatment later in life.
The length of time you’ll need to wear a retainer after braces — and what type, whether a removable appliance or one permanently attached — will depend on a number of factors including the type of malocclusion, your individual mouth structure and age. We’ll recommend the best option that ensures the best chance of keeping your teeth in their new position.
If you would like more information on retainers after orthodontic treatment, 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 “Why Orthodontic Retainers?”
The traditional way to restore a tooth with an artificial crown takes several weeks and multiple office visits: from tooth preparation and impression molding to crown production by a dental laboratory, followed by adjustments and cementing. Now, there’s an alternative that reduces this process to a fraction of the time, and all from your dentist’s office.
Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM) is a digital system that enables dentists to create dental restorations with laboratory-grade materials in minutes rather than weeks. As it continues to innovate, you’ll see more and more dentists investing in the new technology for their patients.
A crown restoration with CAD/CAM begins like any other with decay removal and preparation of the tooth. It diverges, though, from the traditional in how an impression of your teeth and gums is obtained: instead of rubber-like molding materials to create a physical impression, we lightly dust the mouth interior with a reflective powder. Using a scanning wand, the reflective powder allows us to capture multiple, detailed images of your mouth that the CAD/CAM computer transforms into an accurate three-dimensional model.
We use the model to first assess if the tooth has been effectively prepared for a restoration. If so, the design feature of the system will provide us with thousands of tooth forms to choose from to match with your natural teeth. You’ll be able to view the proposed size and shape of the new crown via computer simulation before signing off on the design.
Next is the actual manufacture of the crown that takes place right in the dentist’s office. A pre-formed block of ceramic material is inserted in the milling equipment where, following the pre-determined computer design, the milling heads carve the ceramic block. After milling, we fine-tune the crown surface and apply stains or glazes fired to create a life-like color and texture that matches your natural teeth. We can then adjust the crown in your mouth and permanently affix it to the tooth.
While much of the CAD/CAM system is automated, ultimate success still depends on the dentist’s expertise and artistry. CAD/CAM enhances those skills with greater precision and in much less time than traditional crowns. It’s certainly a growing option for many people to restore the form and function of decayed teeth.
If you would like more information on computer-aided dental restorations, 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 “Creating In-Office Dental Restorations with Computers.”
Mouth injuries in children and teens are more common than you might think: about one out of three boys and one out of four girls will have experienced an injury before they graduate from high school. Besides contact sports, other types of accidents like car crashes or falls are high on the cause list.
Although most dental injuries aren’t considered true emergencies, there are a few where prompt action may mean the difference between ultimately saving or losing a tooth. One such situation is a knocked out tooth.
In the event of a knocked out (or avulsed) tooth, your primary goal is to place the tooth back into the empty socket as quickly as possible. Teeth that have been out of the mouth for less than five minutes have the best chance of reattachment and survival. The first step is to quickly locate the missing tooth.
Once you’ve found it, use only cold, clean water run or poured over the tooth to carefully clean off dirt or debris (no soaps or cleansers). You should also avoid touching the tooth root or scrubbing any part of it. After cleaning it of debris, gently place the tooth back in its socket, then immediately contact us or visit an emergency room. While you’re en route to our office the patient should carefully hold the tooth in place. If the tooth can’t be immediately placed into the socket (the patient is unconscious, for example), then you should place the tooth in a clean container and keep it moist with cold milk, a sterile saline solution or even the patient’s saliva.
Taking these steps increases the chances of a successful re-implantation, although the injury may ultimately affect the tooth’s lifespan. Replanted teeth can suffer from root resorption (where the root tissue dissolves) or a process known as ankylosis in which the tooth fuses directly to the jawbone with no healthy periodontal ligament in between. Either of these conditions can lead to tooth loss.
Still, it’s worthwhile to try to save the tooth, even if for a few more years. Those extra years can help you prepare for a future restoration.
If you would like more information on responding to dental injuries, 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 “Accidental Tooth Loss.”