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By Gerald D. Gray, DDS
July 16, 2019
Category: Oral Health
Tags: oral health  
SeeYourDentistifYouHaveoneoftheseTop3OralProblems

For years people tuned in to enjoy one of David Letterman's "Top 10 lists," a frequent gag performed on his show Late Night. Each countdown list poked fun at off-the-wall topics like "Top 10 New York City Science Projects" or "Top 10 Questions People Ask when Shopping for an Umbrella."

Recently, the American Dental Association presented their own kind of list—"America's Top 3 Oral Health Problems"—based on surveys of around 15,000 people across the U.S. But unlike the popular Late Night lists, this one is no laughing matter.

Coming in at #3, 29% of the respondents indicated they had experienced tooth pain at some time in their life. Tooth pain is the body's way of alerting to trouble in the mouth, anything from a decayed tooth to a gum abscess. The best thing to do if you have any persistent oral pain is to see your dentist as soon as possible for a thorough examination. And you should do this even if the pain goes away.

The second most prominent oral problem among people is difficulty biting or chewing, about 31% of those in the surveys. As with tooth pain, the reasons can vary greatly, including cracked, loose or deeply decayed teeth, dentures or jaw joint disorders (TMD). Because dental disease is usually the ultimate culprit, the best way to avoid this is to practice daily brushing and flossing and regular dental visits. And, as with tooth pain, you should see your dentist if you're having symptoms.

At 33% of respondents, the number one oral problem in America is chronic dry mouth. It's a constant inadequate flow of saliva often caused by medications or certain systemic conditions. Because saliva helps protect the mouth against infection, a restricted flow increases your risk of disease. If you notice your mouth is dry all the time, you should talk to your dentist about ways to boost your saliva. If you're taking medications, ask your doctor if they could be causing your symptoms and if you could change to something else.

While any of these Top 3 oral problems can be a stepping stone to more serious dental problems, it doesn't necessarily have to lead to that. You can improve your dental health through daily oral hygiene and regular dental treatment. And it might help you stay off this unpleasant list.

If you would like more information on treating dental 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 “Top 3 Oral Health Problems.”

CharlizeTheronBackinActionAfterDentalSurgery

When they’re introducing a new movie, actors often take a moment to pay tribute to the people who helped make it happen — like, you know, their dentists. At least that’s what Charlize Theron did at the premiere of her new spy thriller, Atomic Blonde.

"I just want to take a quick moment to thank my dentists," she told a Los Angeles audience as they waited for the film to roll. "I don’t even know if they’re here, but I just want to say thank you."

Why did the starring actress/producer give a shout-out to her dental team? It seems she trained and fought so hard in the action sequences that she actually cracked two teeth!

“I had severe tooth pain, which I never had in my entire life,” Theron told an interviewer from Variety. At first, she thought it was a cavity — but later, she found out it was more serious: One tooth needed a root canal, and the other had to be extracted and replaced with a dental implant — but first, a bone grafting procedure was needed. “I had to put a donor bone in [the jaw] to heal,” she noted, “and then I had another surgery to put a metal screw in there.”

Although it might sound like the kind of treatment only an action hero would need, bone grafting is now a routine part of many dental implant procedures. The reason is that without a sufficient volume of good-quality bone, implant placement is difficult or impossible. That’s because the screw-like implant must be firmly joined with the jawbone, so it can support the replacement tooth.

Fortunately, dentists have a way to help your body build new bone: A relatively small amount of bone material can be placed in the missing tooth’s socket in a procedure called bone grafting. This may come from your own body or, more likely, it may be processed bone material from a laboratory. The donor material can be from a human, animal or synthetic source, but because of stringent processing techniques, the material is safe for human use. Once it is put in place your body takes over, using the grafted material as a scaffold on which to build new bone cells. If jawbone volume is insufficient for implants, it can often be restored to a viable point in a few months.

Better yet, when grafting material is placed in the tooth socket immediately after extraction, it can keep most of the bone loss from occurring in the first place, enabling an implant to be placed as soon as possible — even before the end of a movie’s shooting schedule.

Will Atomic Blonde prove to be an action-movie classic? Only time will tell. But one thing’s for sure: When Charlize Theron walks down the red carpet, she won’t have to worry about a gap in her smile.

If you have questions about bone grafting or dental implants, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Dental Implant Surgery” and “Immediate Dental Implant.”

GettingaNewToothinaDayWillDependonYourBoneHealth

If you know anyone with a dental implant, you may know it can be a long process in getting one. Several weeks or months can pass between removing the old tooth and placing the implant, and then several more weeks before affixing the permanent crown.

But with recent advances in implant technology, some patients don't have to wait as long for a new implant and crown. In fact, one procedure commonly known as "tooth in one day," allows patients to walk in with a problem tooth and out the same day with a new "one."

Not every implant patient, however, can undergo this accelerated procedure. If you're considering implants, the state of your bone health will determine whether or not you can.

Implants need a certain amount of available bone for proper placement. But bone loss, a common consequence of missing teeth or dental disease, can reduce bone volume to less than what's needed to place an implant. The patient may first need to undergo grafting to regenerate the bone or choose another restorative option.

If your supporting bone is sound, your dentist might then proceed with the implant. But you will still have to wait a while for your new crown. The implant needs to integrate with the bone to improve its hold. This integration process can take anywhere from a minimum of six weeks to more commonly twelve weeks. After the attachment is mature, the dentist may need to undo the gum covering before taking impressions for the formation of the new crown.

But it is possible to have a tooth or teeth in a day. For a single tooth, your dentist may be able to immediately attach a crown right after implant surgery if the implant is very stable. Even so, this crown will need to be temporary, slightly shorter than a permanent crown so that it won't make contact with other teeth and put too much pressure on the new implant. After further healing from bone integration, impressions will be taken so that you'll receive your permanent crown shortly.

Immediate crown placement can allow you to have the cosmetic and limited functional benefit of a new tooth right from the start. If multiple implants are placed in one arch in a day, it's possible to have immediate teeth if enough implants are attached together with a temporary restoration.

This is different from a single implant replacing a single tooth and does create confusion for patients when they read about teeth in a day.┬áRegardless, no final tooth crown can be placed at the time of an implant—only a temporary restoration.

If you would like more information on your options for dental implants, 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 “Same-Day Tooth Replacement with Dental Implants.”

By Gerald D. Gray, DDS
June 16, 2019
Category: Oral Health
Tags: oral health  
ThisRareTongueConditionOftenLooksWorsethanitActuallyis

There are a few mouth conditions so rare most of us have never heard of them. Geographic tongue would fall into this category, affecting only one to three percent of the population. Even so, these irregular reddish patches resembling land masses on a map (hence the name) might be alarming at first glance—but they pose no danger and usually cause very little discomfort.

Geographic tongue is also known as benign migratory glossitis. As its clinical name implies, the unusual red patchy areas (often surrounded by a grayish white border) aren't cancerous nor contagious. The patches also appear to change shape and move around ("migrate") the tongue.

The reddish appearance comes from the temporary disappearance of tiny bumps on the tongue surface called papillae, which can leave the tongue smooth to the touch in affected areas. The lost papillae may reappear again a few hours or days later, and may occasionally disappear again. While it's not painful, you can experience a stinging or burning sensation emitting from these patchy areas.

We're not sure how and why geographic tongue erupts, but it's believed high emotional or psychological stress, hormonal imbalance or certain vitamin deficiencies might be factors in its cause. There may also be a link between it and psoriasis, a condition that can cause dry, itchy patches on the skin.

If you're one of the rare individuals who has episodes of geographic tongue, the good news is it's harmless, only mildly uncomfortable and usually temporary. The bad news, though, is that there's no known cure for the condition—but it can be managed to ease discomfort during outbreaks.

It's been found that highly acidic and spicy foods, as well as astringents like alcohol or some mouthrinses, can increase the level of discomfort. By avoiding these or similar foods or substances, you can reduce the irritation. Your dentist may also be able to help by prescribing anesthetic mouthrinses, antihistamines or steroid ointments.

For the most part, you'll simply have to wait it out. Other than the mild, physical discomfort, the worst part is often simply the appearance of the tongue. But by watching your diet and other habits, and with a little help from us, you can cope with these irritations when it occurs.

If you would like more information on geographic tongue and similar oral issues, 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 “Geographic Tongue: No Cause for Alarm.”

ToothTypeandConditioncanAffectRootCanalTherapyEffectiveness

Root canal therapy is the unsung "hero" of dentistry. Although often falsely maligned as an unpleasant experience, millions of decayed teeth have been saved thanks to this routine treatment.

But although root canal therapy can save your tooth, we can't guarantee it won't be affected by another infection. There are other factors to consider how long a treated tooth will remain healthy.

Root canal therapy stops and limits the damage from tooth decay that has infected the inner pulp and root canals. A dentist or endodontist (a root canal specialist) drills into the tooth to gain access to the pulp. They remove the diseased pulp tissue and then fill the empty pulp chamber and root canals with a specialized filling called gutta percha. The tooth is then sealed and later crowned to protect it against future fracture or infection.

The probability of that occurring may depend on when a dentist performs the root canal in the disease progression—and the earlier the better. If decay has already infected the underlying bone, the tooth's long-term prognosis even with root canal therapy could be dim. That's why you should see a dentist as soon as possible for any tooth pain, even if it goes away.

The type of tooth could impact long-term health. Teeth with single roots are usually easier to treat. But those with multiple roots and an intricate root canal network can be more difficult to treat, and require specialized equipment and techniques.

Age can also impact root canal therapy longevity. The older a root canal-treated tooth is, the more brittle and susceptible to fracture it can become, which can pose complications. That's why we typically place crowns on treated teeth to protect them from both future infection and undue stress created while biting and chewing.

To help mitigate these possible factors, you should see your dentist regularly for checkups and at the first sign of pain or other abnormalities for the earliest treatment possible. And for more complex tooth issues, your dentist may refer you to an endodontist to perform your root canal. With early intervention and attentive care, your root canaled tooth could enjoy many years of life.

If you would like more information on root canal 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 “Root Canal Treatment: How Long Will It Last?





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