Posts for category: Oral Health
It seems with each new election cycle another U.S. state legalizes marijuana use. It remains a flashpoint issue that intersects politics, law and morality, but there's another aspect that should also be considered—the health ramifications of using marijuana.
From an oral health perspective, it doesn't look good. According to one study published in the Journal of Periodontology a few years ago, there may be a troubling connection between marijuana use and periodontal (gum) disease.
Gum disease is a common bacterial infection triggered by dental plaque, a thin biofilm on tooth surfaces. As the infection advances, the gum tissues become more inflamed and lose their attachment to teeth. This often results in widening gaps or "pockets" between the teeth and gums filled with infection. The deeper a periodontal pocket, the greater the concern for a tooth's health and survivability.
According to the study, researchers with Columbia University's College of Dental Medicine reviewed data collected from nearly 2,000 adults, a quarter of which used marijuana at least once a month. They found the marijuana users had about 30 individual pocket sites on average around their teeth with a depth of at least 4 millimeters. Non-users, by contrast, only averaged about 22 sites.
The users also had higher incidences of even deeper pockets in contrast to non-users. The former group averaged nearly 25 sites greater than 6 millimeters in depth; non-users, just over 19. Across the data, marijuana users appeared to fare worse with the effects of gum disease than those who didn't use.
As concerning as these findings appear, we can't say that marijuana use singlehandedly causes gum disease. The condition has several contributing risk factors: diet, genetics, and, most important of all, how well a person manages daily plaque removal, the main driver for gum disease, through brushing and flossing.
Still, the data so far seems to indicate using marijuana can make gum disease worse. Further studies will be needed to fully test this hypothesis. In the meantime, anyone using marijuana should consider the possible consequences to their oral health.
October 20th is World Osteoporosis Day, putting the spotlight on this degenerative bone condition and the impact it has on millions of people. Not only does it significantly increase the risk of potentially life-threatening fractures, but it can also indirectly affect dental health.
This connection arises from the use of certain treatment drugs that ultimately could lead to complications following some forms of dental work. These particular drugs, mainly bisphosphonates like Fosamax™ and RANKL inhibitors like Prolia™, destroy bone cells called osteoclasts, whose function is to clear away worn out regular bone cells (osteoblasts). With fewer osteoclasts targeting them, more older osteoblast cells survive longer.
In the short-term, a longer life for these older cells helps bones afflicted by osteoporosis to retain volume and density, and are thus less likely to fracture. Long-term, however, the surviving osteoblasts are less elastic and more brittle than newly formed cells.
In the end, these longer living cells could eventually weaken the bone. In rare situations, this can result in parts of the bone actually dying—a condition known as osteonecrosis. The bones of the body with the highest occurrences of osteonecrosis are the femur (the upper leg bone) and, of specific concern to dental care, the jawbone.
The effect of these medications on the jawbone actually has a name—drug-induced osteonecrosis of the jaw (DIONJ). Fortunately, there's only a 1% risk of it occurring if you're taking these drugs to manage osteoporosis. It's also not a concern for routine procedures like cleanings, fillings or crown placements. But DIONJ could lead to complications with more invasive dental work like tooth extraction, implant placement or periodontal surgery.
It's important, then, that your dentist knows if you're being treated for osteoporosis and the specific drugs you're taking. Depending on the medication, they may suggest, in coordination with your physician, that you take a "drug holiday"—go off of the drug for a set period of time—before a scheduled dental procedure to ease the risk and effects of osteonecrosis.
Because infection after dental work is one possible consequence of osteonecrosis, it's important that you practice thorough oral hygiene every day. Your dentist may also prescribe an antiseptic mouth rinse to include with your hygiene, as well as antibiotics.
You may also want to talk to your doctor about alternative treatments for osteoporosis that pose a lower risk for osteonecrosis. These can range from traditional Vitamin D and calcium supplements to emerging treatments that utilize hormones.
Osteoporosis can complicate dental work, but it doesn't have to prevent you from getting the procedures you need. Working with both your dentist and your physician, you can have the procedures you need to maintain your dental health.
If you would like more information about osteoporosis and dental care, please contact us or schedule a consultation.
"Trick or treat!" Chances are, you'll hear that cry from costumed children at your door this October 31st. Fortunately, you're unlikely to be in any danger of mischief should you fail to reward your trick or treaters. But there may be an unpleasant "trick" awaiting them—or, more specifically, their teeth: tooth decay.
The underlying factor for this occurrence is the candy they've eagerly collected on their spooky foray, over $2 billion worth nationwide for this one holiday alone. That's because all that candy your kids will fill up on post-Halloween is loaded with refined sugar.
But something else loves all that sweetness as much as your kids—decay-causing bacteria living in their mouths. Oral bacteria thrive—and multiply—on sugar—which means more acid, a by-product of their digestive process, which can erode tooth enamel, which then opens the door to tooth decay.
Now, we don't want to rain on anyone's parade, much less on a child's traditional night of fun in late October. The key, like many other of life's pleasures, is moderation. Here, then, are a few tips from the American Dental Association for having a more "dental-friendly" Halloween.
Provide alternative treats. Candy may be ubiquitous to Halloween, but it isn't the only thing you have to put in their sacks. Be sure you also include items like sealed, one-serving packages of pretzels, or peanut butter or cheese sandwich crackers.
Choose candy wisely. Considering dental health, the best candies are those that don't linger in the mouth long. Stay away, then, from sticky or chewy candies, which do just that. Also, try to avoid hard candies that might damage the teeth if bitten down on.
Don't keep it all. Before they dig in, have your child sort through their sack and choose a set number of pieces to keep and enjoy. Then, find a creative way to share the rest with others. This limits the number of sugary treats consumed after Halloween, while also encouraging sharing.
Restrict snacking. Continuous snacking on Halloween candy can be a problem—the constant presence of sugar in the mouth encourages bacterial growth. Instead, limit your child's snacking on Halloween treats to select times, preferably after meals when saliva (an acid neutralizer) is more active.
Brush and floss. Even with non-sugary foods and snacks, dental plaque can still build up on teeth. This thin biofilm provides a haven for bacteria that increases your child's chances for tooth decay. Be sure, then, that your kids brush and floss every day, especially around holidays.
Halloween can be the source for fond, childhood memories. Follow these tips to make sure tooth decay doesn't ultimately put a damper on your family's fun.
If you would like more information about protecting your children's teeth from tooth decay, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “The Bitter Truth About Sugar.”
Even masterpiece paintings need an appropriate frame. Likewise, our gums help bring out our teeth's beauty.
But gums are more than enhancements for our smile appearance—they're also critical to good oral health. In recognition of National Gum Care Month, there are a couple of reasons why you should look after your gums just like you do your teeth.
For one, the gums are primarily responsible for holding teeth in place. With healthy gums, the teeth won't budge even under chewing stress (although this attachment does allow for micro-movements). Diseased gums, however, are another story: Advancing gum disease weakens gum attachment, causing teeth to loosen and eventually give way.
The gums also protect the root end of teeth from pathogens and oral acid, just as enamel protects the crown. Gum disease can also foul up this protective mechanism as infected gums have a tendency to shrink away from the teeth (also known as gum recession). This exposes the roots to an increased risk for disease.
So, taking care of your gums is an essential part of taking care of your teeth. And, the basic care for them is the same as for your pearly whites: daily brushing and flossing and regular dental cleanings. These habits remove the buildup of dental plaque, a thin film of food and bacteria that cause gum disease.
It's also important to keep a watchful eye for any signs of gum abnormalities. Be on the alert for unusual gum redness, swelling and bleeding. Because these may be indicators of an infection already underway, you should see us for an examination as soon as possible.
If we find gum disease, we can begin immediate treatment in the form of comprehensive plaque removal. If the disease has advanced to the root, we may need to access this area surgically to remove any infection. So, the sooner we're able to diagnose and treat an infection, the less likely that scenario will occur.
Ironically, something meant to protect your gums could also damage them. You can do this with excessive and overly aggressive brushing. Putting too much "elbow grease" into brushing, as well as doing it more than a couple of times a day, could eventually cause the gums to recede. Instead, apply only the same degree of pressure to brushing as you would while writing with a pencil.
As we like to tell our patients, take care of your mouth, and your mouth will take care of you. Something similar could be said about your gums: Take care of these essential soft tissues, and they'll continue to support and protect your teeth.
Buffalo Bills wide receiver Stefon Diggs wrapped up the NFL regular season in January, setting single-season records in both catches and receiving yards. The Bills handily beat the Miami Dolphins, earning themselves the second seed in the AFC playoffs, and Diggs certainly did his part, making 7 catches for 76 yards. But what set the internet ablaze was not Diggs' accomplishments on the field but rather what the camera caught him doing on the sidelines—flossing his teeth!
The Twitterverse erupted with Bills fans poking fun at Diggs. But Diggs is not ashamed of his good oral hygiene habits, and CBS play-by-play announcer Kevin Harlan expressed his support with “Dental hygiene is something to take note of, kids! There's never a bad place to floss” and “When you lead the NFL in catches and yards, you can floss anytime you want.”
We like to think so. There's an old joke among dentists:
Q. Which teeth do you need to floss?
A. Only the ones you want to keep.
Although this sounds humorous, it is borne out in research. Of note, a 2017 study showed that people who floss have a lower risk of tooth loss over periods of 5 years and 10 years, and a 2020 study found that older adults who flossed lost an average of 1 tooth in 5 years, while those who don't lost around 4 teeth in the same time period.
We in the dental profession stress the importance of flossing as a daily habit—and Stefon Diggs would likely agree—yet fewer than 1 in 3 Americans floss every day. The 2016 National Health and Nutrition Examination Survey (NHANES), conducted by the CDC's National Center for Health Statistics, revealed that only 30% of Americans floss every day, while 37% floss less than every day and 32% never floss.
The biggest enemy on the football field may be the opposing team, but the biggest enemy to your oral health is plaque, a sticky film of bacteria and food debris that builds up on tooth surfaces. Plaque can cause tooth decay and gum disease, the number one cause of tooth loss among adults. Flossing is necessary to remove plaque from between teeth and around the gums where a toothbrush can't reach. If not removed, plaque hardens into tartar, which can only be removed by the specialized tools used in the dental office. Regular professional dental cleanings are also needed to get at those hard-to-reach spots you may have missed.
If Diggs can find time to floss during a major NFL game, the rest of us can certainly find a couple minutes a day to do it. While we might not recommend Diggs' technique of flossing from one side of the mouth to the other, we commend his enthusiasm and commitment to keeping his teeth and gums healthy. Along with good dental hygiene at home—or on the sidelines if you are Stefon Diggs—regular professional dental cleanings and checkups play a key role in maintaining a healthy smile for life.