Drugs play an indispensable role in treating disease. For example, life without antibiotics would be much more precarious—common infections we think nothing of now would suddenly become life-threatening.
But even the most beneficial drug can have disruptive side effects. Antibiotics in particular can cause a rare but still disturbing one: a growth on the tongue that at first glance looks like dark hair. In fact, it's often called "black hairy tongue."
It isn't hair—it's an overgrowth of naturally occurring structures on the tongue called filiform papillae. These tiny bumps on the tongue's upper surface help grip food while you're chewing. They're normally about a millimeter in length and tend to be scraped down in the normal course of eating. As they're constantly growing, they replenish quickly.
We're not sure how it occurs, but it seems with a small portion of the population the normal growth patterns of the papillae become unbalanced after taking antibiotics, particularly those in the tetracycline family. Smoking and poor oral hygiene also seem to contribute to this growth imbalance. As a result, the papillae can grow as long as 18 millimeters with thin shafts resembling hair. It's also common for food debris and bacteria to adhere to this mass and discolor it in shades of yellow, green, brown or black.
While it's appearance can be bizarre or even frightening, it's not health-threatening. It's mostly remedied by removing the original cause, such as changing to a different antibiotic or quitting smoking, and gently cleaning the tongue everyday by brushing it or using a tongue scraper you can obtain from a pharmacy.
One word of caution: don't stop any medication you suspect of a side effect without first discussing it with your prescribing doctor. While effects like black hairy tongue are unpleasant, they're not harmful—and you don't want to interfere with treatments for problems that truly are.
A toothache means a tooth has a problem, right? Most of the time, yes: the pain comes from a decayed or fractured tooth, or possibly a gum infection causing tooth sensitivity.
Sometimes, though, the pain doesn't originate with your teeth and gums. They're fine and healthy—it's something outside of your tooth causing the pain. We call this referred pain—one part of your body is sending or referring pain to another part, in this instance around your mouth.
There are various conditions that can create referred pain in the mouth, and various ways to treat them. That's why you should first find out the cause, which will indicate what treatment course to take.
Here are a few common non-dental causes for tooth pain.
Trigeminal Neuralgia. The trigeminal nerves situated on either side of the face have three large branches that extend throughout the face; the branch to the jaw allows you to feel sensation as you chew. When one of the nerve branches becomes inflamed, usually from a blood vessel or muscle spasm pressing on it, it can refer the pain to the jaw and seem like a toothache.
Temporomandibular Joint Disorder (TMD). These two joints that connect the lower jaw to the skull can sometimes become dysfunctional for a variety of reasons. This can set up a cycle of spasms and pain that can radiate throughout the jaw and its associated muscles. The pain can mimic a toothache, when it actually originates in the jaw joints.
Teeth Grinding. This is an unconscious habit, often occurring at night, in which people clench or grind their teeth together. Although quite common in children who tend to grow out of it, teeth grinding can continue into adulthood. The abnormally high biting forces from this habit can cause chipped, broken or loosened teeth. But it can also cause jaw pain, headaches and tenderness in the mouth that might feel like a toothache.
These and other conditions unrelated to dental disease can seem like a tooth problem, when they're actually something else. By understanding exactly why you're feeling pain, we can then focus on the true problem to bring relief to your life.
Not long ago the dental bridge was the alternative treatment of choice to partial dentures for restoring lost teeth. Over the last few decades, however, dental implants have nudged bridgework out of this premier spot.
That doesn’t mean, though, that bridgework has gone the way of the horse and buggy. In fact, it may still be a solid restorative alternative to partial dentures for certain people.
A traditional bridge consists of a series of porcelain crowns affixed to each other like pickets in a fence. The end crowns are fitted onto the teeth on either side of the empty tooth space; known as abutment teeth, they support the bridge. The crowns in the middle, known as pontics (from the French for “bridge”), replace the teeth that have been lost.
Bridges have been an effective and cosmetically pleasing method for tooth replacement for nearly a century. To achieve those results, though, a good portion of the abutment teeth’s structure must be removed to accommodate the crowns. This permanently alters these teeth, so they’ll require a restoration from that point on.
Dental implants, on the other hand, can be installed in the missing space without impacting any neighboring teeth. What’s more, implants provide greater support to the underlying bone than can be achieved with bridgework.
But not everyone is a viable candidate for implants, and ironically the reason most often has to do with the bone. If a patient has suffered significant bone volume loss, either because of disease or the long-term absence of the natural teeth, there may not be enough bone to properly support an implant. Unless we can adequately restore this lost bone volume through grafting, we’ll need to consider another type of restoration.
That’s where bridgework could be a viable option for patients in this or similar situations. With continuing advances in materials and new applications, the traditional bridge still remains an effective and important means to restore a smile marred by missing teeth.
If you would like more information on dental restoration options, 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 “Crowns & Bridgework.”
Is a chipped tooth big news? It is if you’re Justin Bieber. When the pop singer recently posted a picture from the dental office to his instagram account, it got over 2.6 million “likes.” The snapshot shows him reclining in the chair, making peace signs with his hands as he opens wide; meanwhile, his dentist is busy working on his smile. The caption reads: “I chipped my tooth.”
Bieber may have a few more social media followers than the average person, but his dental problem is not unique. Sports injuries, mishaps at home, playground accidents and auto collisions are among the more common causes of dental trauma.
Some dental problems need to be treated as soon as possible, while others can wait a few days. Do you know which is which? Here are some basic guidelines:
A tooth that’s knocked out needs attention right away. First, try and locate the missing tooth and gently clean it with water — but avoid holding the tooth’s roots. Next, grasp the crown of the tooth and place it back in the socket facing the correct way. If that isn’t possible, place it between the cheek and gum, in a plastic bag with the patient’s saliva or a special tooth preservative, or in a glass of cold milk. Then rush to the dental office or emergency room right away. For the best chance of saving the tooth, it should be treated within five minutes.
If a tooth is loosened or displaced (pushed sideways, deeper into or out of its socket), it’s best to seek dental treatment within 6 hours. A complete examination will be needed to find out exactly what’s wrong and how best to treat it. Loosened or displaced teeth may be splinted to give them stability while they heal. In some situations, a root canal may be necessary to save the tooth.
Broken or fractured (cracked) teeth should receive treatment within 12 hours. If the injury extends into the tooth’s inner pulp tissue, root canal treatment will be needed. Depending on the severity of the injury, the tooth may need a crown (cap) to restore its function and appearance. If pieces of the tooth have been recovered, bring them with you to the office.
Chipped teeth are among the most common dental injuries, and can generally be restored successfully. Minor chips or rough edges can be polished off with a dental instrument. Teeth with slightly larger chips can often be restored via cosmetic bonding with tooth-colored resins. When more of the tooth structure is missing, the best solution may be porcelain veneers or crowns. These procedures can generally be accomplished at a scheduled office visit. However, if the tooth is painful, sensitive to heat or cold or producing other symptoms, don’t wait for an appointment — seek help right away.
Justin Bieber earned lots of “likes” by sharing a picture from the dental office. But maybe the take-home from his post is this: If you have a dental injury, be sure to get treatment when it’s needed. The ability to restore a damaged smile is one of the best things about modern dentistry.
If you have questions about dental injury, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Repairing Chipped Teeth” and “Porcelain Crowns & Veneers.”
Although preventable, the occurrences of tooth decay are all too common. Yet decay doesn’t appear out of the blue: certain mouth conditions set the disease in motion.
Here are a few signs of such conditions to watch for — they could be telling you you’re at higher risk for tooth decay.
Visible plaque. Plaque is a thin film of bacteria and food accumulating on tooth surfaces and a prime haven for causing periodontal disease. If you actually see it — a crusty, yellowish film — that means there’s a large, unhealthy amount of it. It’s essential to remove it daily through diligent brushing and flossing and more thorough office cleanings at least twice a year.
Poor saliva flow. One of this bodily fluid’s functions is to neutralize mouth acid, usually thirty minutes to an hour after we eat. If saliva flow is inadequate, though, acid levels may remain high and endanger the enamel. “Dry mouth” can occur from a number of causes, including some medications and chemotherapy treatments. It’s important to alleviate the cause if possible by changing medications or stimulating saliva flow through other means.
Tooth shape and appliances. Largely determined by heredity, your teeth contain unique, tiny grooves known as pits and fissures that could harbor plaque. Certain appliances like retainers, braces or night guards can inhibit saliva flow and cause your teeth to retain more plaque. It’s important then to adjust your hygiene efforts to offset these anatomical or treatment factors.
Acid-producing conditions. Diseases like gastro-esophageal reflux disease (GERD) or eating disorders can introduce stomach acid into the mouth that is highly erosive to tooth enamel. It’s imperative for you or a family member to control these conditions through medication, dietary changes, or — in the case of eating disorders — behavioral therapy.
Eating habits. Sugar and other carbohydrates are a ready food source for bacteria. Likewise, acidic foods and beverages (like coffee, tea, and sports or energy drinks) can cause high acid levels for too long. Cut back on eating and drinking these foods and beverages, especially as snacks, to reduce acid levels that could lead to decay.
If you would like more information on strategies to prevent tooth decay, 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 “Tooth Decay: How to Assess Your Risk.”
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