Perhaps you haven’t thought of it quite this way, but saliva is one of the true wonders of the human body. This unassuming fluid performs a variety of tasks to aid digestion and help protect your mouth from disease. And you hardly notice it — except when it’s not there.
That’s the case for millions of people in America who have a chronic condition called xerostomia or “dry mouth.” This happens when the salivary glands don’t secrete enough saliva, normally two to four pints daily.
Of course, we can experience mouth dryness when we first wake up (saliva flow ebbs while we sleep), feel stressed, use tobacco, or consume alcohol and certain foods like onions or spices. It becomes a problem, though, when periods of low saliva become chronic. Without its preventive capabilities, you’ll be at much higher risk for dental diseases like tooth decay or periodontal (gum) disease.
Chronic dry mouth can occur for various reasons: systemic diseases like cancer or autoimmune deficiencies can cause it, as well as radiation or chemotherapy treatments. One of the most common causes, though, is medication, both over-the-counter and prescription. The surgeon general identifies over 500 known drugs that may inhibit saliva production, including some antihistamines, diuretics and antidepressants. It’s often why older people who take more medications than younger people suffer more as a population from dry mouth.
Because of its long-term health effects, it’s important to try to boost saliva flow. If your mouth is consistently dry, try to drink more fluids during the day. If you suspect your medication, see if your physician can prescribe a different drug. It also helps to drink a little water before and after taking oral medication.
We may also recommend medication or other substances that stimulate saliva or temporarily substitute for it. Xylitol, a natural alcohol sugar that also inhibits bacterial growth, can help relieve dryness. You’ll often find it in gums or mints.
Chronic dry mouth is more than a minor irritation — it can lead to more serious conditions. In addition to these tips, be sure to also keep up your regular dental visits and maintain a daily schedule of oral hygiene to prevent dental disease.
If you would like more information on overcoming dry mouth, 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 “Dry Mouth: Learn about the Causes and Treatment of this Common Problem.”
In her decades-long career, renowned actress Kathy Bates has won Golden Globes, Emmys, and many other honors. Bates began acting in her twenties, but didn't achieve national recognition until she won the best actress Oscar for Misery — when she was 42 years old! “I was told early on that because of my physique and my look, I'd probably blossom more in my middle age,” she recently told Dear Doctor magazine. “[That] has certainly been true.” So if there's one lesson we can take from her success, it might be that persistence pays off.
When it comes to her smile, Kathy also recognizes the value of persistence. Now 67, the veteran actress had orthodontic treatment in her 50's to straighten her teeth. Yet she is still conscientious about wearing her retainer. “I wear a retainer every night,” she said. “I got lazy about it once, and then it was very difficult to put the retainer back in. So I was aware that the teeth really do move.”
Indeed they do. In fact, the ability to move teeth is what makes orthodontic treatment work. By applying consistent and gentle forces, the teeth can be shifted into better positions in the smile. That's called the active stage of orthodontic treatment. Once that stage is over, another begins: the retention stage. The purpose of retention is to keep that straightened smile looking as good as it did when the braces came off. And that's where the retainer comes in.
There are several different kinds of retainers, but all have the same purpose: To hold the teeth in their new positions and keep them from shifting back to where they were. We sometimes say teeth have a “memory” — not literally, but in the sense that if left alone, teeth tend to migrate back to their former locations. And if you've worn orthodontic appliances, like braces or aligners, that means right back where you started before treatment.
By holding the teeth in place, retainers help stabilize them in their new positions. They allow new bone and ligaments to re-form and mature around them, and give the gums time to remodel themselves. This process can take months to years to be complete. But you may not need to wear a retainer all the time: Often, removable retainers are worn 24 hours a day at first; later they are worn only at night. We will let you know what's best in your individual situation.
So take a tip from Kathy Bates, star of the hit TV series American Horror Story, and wear your retainer as instructed. That's the best way to keep your straight new smile from changing back to the way it was — and to keep a bad dream from coming true.
If you would like more information about orthodontic retainers, please contact us or schedule an appointment for a consultation. You can learn more about this topic in the Dear Doctor magazine articles “Why Orthodontic Retainers?” and “The Importance of Orthodontic Retainers.” The interview with Kathy Bates appears in the latest issue of Dear Doctor.
Over the last century and a half millions of people have had a tooth cavity filled with “silver” amalgam. Perhaps you’re one of them. The use of this effective and durable filling has declined in recent years, but only because of the development of more attractive tooth-colored materials.
At the same time there’s another issue that’s been brewing in recent years about this otherwise dependable metal alloy: the inclusion of mercury in amalgam, about half of its starting mixture. Various studies have shown mercury exposure can have a cumulative toxic effect on humans. As a result, you may already be heeding warnings to limit certain seafood in your diet.
So, should you be equally concerned about amalgam fillings — even going so far as to have any existing ones removed?
Before taking such a drastic step, let’s look at the facts. To begin with, not all forms of mercury are equally toxic. The form causing the most concern is called methylmercury, a compound formed when mercury released in the environment combines with organic molecules. This is the form certain large fish like salmon and tuna ingest, which we then ingest when we eat them. Methylmercury can accumulate in the body’s tissues where at high levels it can damage various organ systems.
Dental amalgam, on the other hand, uses elemental mercury. Dentists take it in liquid form and mix it with a powder of other metals like silver, tin and copper to create a pliable paste. After it’s placed in a prepared cavity, the amalgam hardens into a compound in which the mercury interlaces with the other metals and becomes “trapped.”
Although over time the filling may emit trace amounts of mercury vapor, it’s well below harmful levels. You’re more likely to encounter “un-trapped” mercury in your diet than from a dental filling. And scores of studies over amalgam’s 150-year history have produced no demonstrable ill effects due to mercury.
Although it now competes with more attractive materials, amalgam still fills (no pun intended) a necessary role. Dentists frequently use amalgam in less visible back teeth, which encounter higher chewing pressures than front teeth. So, if you already have an amalgam filling or we recommend one to you, relax — you’re really in no danger of mercury poisoning.
Major league baseball player Aaron Judge made news in July by breaking Joe DiMaggio's record for most home runs scored by a New York Yankees rookie. Then he made news again, this time for breaking something else. Following their game-winning home run against the Tampa Bay Rays in the 11th inning, the Yanks met for a spontaneous victory celebration at home plate. It was all fun and games… until an errant helmet accidentally slammed into Judge's mouth, breaking off half his left front tooth. Ouch!
Even if you're not playing big-league baseball, accidents sometimes happen. So what's the best dental treatment if you chip or break a tooth? It all depends on how much is broken off.
When a tooth has a small chip in it, dental bonding may be sufficient. Layering on tooth-colored bonding material results in a natural look, and it can be completed in one dental visit. However, bonding material in time will discolor, and it is not as strong as real tooth structure, so eventually it may need re-treatment.
Dental veneers or crowns may be used to restore more seriously damaged teeth. Veneers, thin porcelain shells that cover the front surface of teeth, can be used to restore minor to moderate chips. A crown (“cap”) is used when the damage is greater and more structural support is required. A crown replaces the visible part of the tooth above the gum line.
When the soft pulp tissue inside the tooth is damaged, root canal treatment will be needed to save the tooth. Despite the outdated rumors some people have heard, root canal procedures don't cause pain — they actually relieve it. During the procedure, exposed or infected pulp is removed and the inside of the tooth is sealed. Then a lifelike crown is placed so the tooth looks as good as new.
If the tooth cannot be saved — for example, it breaks off below the gum line — a dental implant may be your best option. Dental implants are small titanium posts that are surgically inserted and then capped with an artificial crown. Implant-supported teeth can last a lifetime and are usually indistinguishable from natural teeth.
So what happened with Judge's tooth? Thanks to a Friday morning visit to the dentist, he was smiling again with a temporary crown — and smiling over the fact that his tooth garnered more attention than the Yankees' dramatic 11th inning win.
If you have questions about cosmetically-pleasing tooth restorations, please contact our office or schedule a consultation. (If you have a dental injury, call us immediately!) You can learn more in the Dear Doctor magazine articles “Dental Implants” and “A Step-by-Step Guide to Root Canal Treatment.”
A blow to the face can result in a variety of injuries to your jaws and the temporomandibular joints (TMJs) that join the lower jaw to the skull. Only a thorough examination can determine the type and extent of the injury, and how to treat it.
The pain you feel in your jaw may indicate a direct injury, usually near the joint. This could mean the joint head (condyle) has dislocated, or moved out of the joint space. It could also mean you’ve fractured your lower jaw, most commonly just below the head of the joint.
Jaw pain can also indicate structures near the jaw and joint have been damaged and the jaw is indirectly affected. In some cases a damaged tooth may be radiating pain signals through the jaw (along similar nerve paths). More likely, trauma to soft tissue near the jaw joint has swelled with inflammation, putting pressure on the joint and temporarily stopping the condyle from seating fully in the joint space.
Any of these injuries can also cause painful muscle spasms, a defensive reaction from the body that causes muscles on either side of the jaw to limit movement preventing further damage (a natural splint, if you will). Thus, the pain may be compounded by a diminished range of motion when you try to chew or speak.
It’s important, therefore, to determine the exact cause of pain and limited movement before commencing treatment. Spasms and inflammation are usually treated with muscle relaxant drugs and anti-inflammatory pain relievers. In the case of a dislocation, gentle manipulation can ease the condyle back into the joint space. A fracture would require more extensive treatment, including repositioning broken bone and immobilizing the jaw from movement to allow healing. In the most severe cases, surgical treatment may be necessary to internally immobilize the joint.
If you sustain an injury that results in jaw swelling and pain, you should see us without delay. The sooner we can diagnose and begin the proper treatment for your injury, the less likely you’ll encounter long-term problems and the sooner you’ll be pain and swelling free.
If you would like more information on the causes and treatment of jaw pain, 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 “Jaw Pain.”
This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.