My Blog

Posts for: March, 2015

By Phil Hart, DDS
March 26, 2015
Category: Oral Health
Tags: oral health  
ChronicBitingHabitsCanLeadtoLooseTeeth

Periodontal (gum) disease is the most likely cause of a loose, permanent tooth. This progressive infection causes damage to the gums and bone tissues that hold teeth in place, leading to looseness and ultimately tooth loss.

Gum disease, however, isn’t the only cause: although not as common, excessive biting forces over time may also lead to loose teeth. The excessive force stretches the periodontal ligaments that hold teeth in place, causing the teeth to become loose.

This condition is called occlusal trauma. In its primary form, the patient habitually grinds or clenches their teeth, or bites or chews on hard objects like pencils or nails. Generating 20-30 times the normal biting force, these habits can cause considerable damage. It can also be a factor when gum disease is present — supporting bone becomes so weakened by the disease, even normal biting forces can cause mobility.

If you recognize the early signs of grinding or clenching, particularly jaw soreness in the morning (since many instances of teeth grinding occur while we sleep), it’s important to seek treatment before teeth become loose. The symptoms are usually treated directly with muscle relaxants, an occlusal guard worn to soften the force when teeth bite down, or stress management, a major trigger for teeth grinding. The sooner you address the habit, the more likely you’ll avoid its consequences.

If, however, you’re already noticing a loose tooth, treatment must then focus on preserving the tooth. Initially, the tooth may need to be splinted, physically joined to adjacent teeth to hold it in place while damaged tissues heal. In some cases, minute amounts of enamel may need to be removed from the tooth’s biting surfaces to help the tooth better absorb biting forces. Other treatments, including orthodontics and gum disease treatment, may also be included in your treatment plan.

If you notice a loose tooth, it’s critical you contact us as soon as possible for an evaluation — if you delay you increase the chances of eventually losing it. The earlier you address it, the better your chances of preserving your tooth.

If you would like more information on loose teeth, 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 “Loose Teeth.”


TVAnchorNancyODellDiscussesPregnancyandOralHealth

We've all heard of morning sickness, but did you know that it's also not unusual for pregnant women to experience oral discomfort? This is what Entertainment Tonight co-host Nancy O'Dell discovered when she was expecting her daughter, Ashby. In an exclusive interview with Dear Doctor magazine, Nancy described how her gums became extra-sensitive during pregnancy, leading her dentist to diagnose her with “pregnancy gingivitis” (“gingival” – gum tissue; “itis” – inflammation).

“While my dental health has always been relatively normal, pregnancy did cause me some concern about my teeth and gums,” Nancy said. “With my dentist's advice and treatment, the few problems I had were minimized,” she said.

It's especially important to maintain good oral hygiene during pregnancy with routine brushing and flossing, and regular professional cleanings. This will reduce the accumulation of the dental bacterial plaque that leads to gum disease. Both mother and child are particularly vulnerable to these bacteria during this sensitive time. Scientific studies have established a link between preterm delivery and the presence of periodontal (gum) disease in pregnant women. Also, the elevated hormone levels of pregnancy cause the tiny blood vessels of the gum tissues to become dilated (widened) and therefore more susceptible to the effects of plaque bacteria and their toxins. Gingivitis is especially common during the second to eighth months of pregnancy.

Excess bacterial plaque can occasionally lead to another pregnancy-related condition in the second trimester: an overgrowth of gum tissue called a “pregnancy tumor.” In this case, “tumor” means nothing more than a swelling or growth. Pregnancy tumors, usually found between the teeth, are completely benign but they do bleed easily and are characterized by a red, raw-looking mulberry-like surface. They can be surgically removed if they do not resolve themselves after the baby is born.

If you are experiencing any pregnancy-related oral health issues, please contact us today to schedule an appointment for a consultation. If you would like to read Dear Doctor's entire interview with Nancy O'Dell, please see “Nancy O'Dell.” Dear Doctor also has more on “Pregnancy and Oral Health: Everything You Always Wanted To Know But Never Knew To Ask.”


TeensMayNeedaTemporaryReplacementforMissingTeeth

Tooth replacement at any age is a challenge, but especially for teenagers. Dental implants in particular may not be possible yet for teens or young adults whose jaws are still developing. Because it’s imbedded directly into bone, the implant will not move with the jaw as jaw growth occurs, making it look potentially unattractive.

The best solution could be a temporary replacement until their jaw reaches maturity. One such option is a removable partial denture (RPD), an artificial tooth set in an acrylic base that resembles gum tissue. Although we associate dentures with older adults, an RPD works well for teens as a temporary measure. Perhaps the best version for a younger person utilizes metal clips that fit over adjacent teeth and hold the RPD in place. Although quite resilient, the wearer needs to be careful when biting into something hard (like an apple or similar firm fruit) or the artificial tooth may break off.

Another option, a bonded bridge, is a fixed solution similar to a traditional bridge. Whereas a traditional bridge is supported by crowns affixed to the teeth on either side of the empty socket (and requiring extensive alteration of the teeth to accommodate them), a bonded bridge attaches to the supporting teeth with wing-like projections of dental material that attaches to the backs of the adjacent teeth, hidden from view. Although not as secure as a traditional bridge, they can conceivably endure until the teen’s jaw structure is ready for an implant or other permanent solution.

Choosing between an RPD and a bonded bridge will depend on a number of factors, including the teen’s individual bite, clenching or biting habits and the health and strength of supporting bone and gums. Regardless of the type of solution chosen, it’s important to maintain good oral hygiene, especially around a bridge. If bacterial plaque is allowed to build up on tooth surfaces, it could result in an infection that can damage both gums and bone, and reduce the chances of a successful implant in the future.

All these and other considerations should be discussed after a thorough examination. From there, we can advise you on the best course of action to restore both appearance and function until it’s time for a permanent restoration.

If you would like more information on temporary tooth replacements for teens, please contact us or schedule an appointment for a consultation.


WhileUsuallyBenignLichenPlanusLesionsShouldStillbeExamined

If you’ve noticed a small sore in your mouth, it’s possible you have a non-contagious disease known as lichen planus. Although usually benign, it’s still a good idea to have it examined and monitored.

The condition is so named because its lesions are similar in appearance to lichen, the algae and fungi organism often found on rocks and trees. It’s believed to be a type of autoimmune disease, in which the body treats some of its own cells as foreign and reacts adversely to them. Certain medications and substances may also cause a lichenoid reaction. Besides the inner cheeks, gums or tongue, lichen planus may also appear on other skin or mucous surfaces on the wrists, legs or fingernails.

When it appears inside the mouth it usually resembles a lacy pattern of white lines or ulceration. Gum tissues may become red and inflamed, with some soreness after brushing or eating. Although there’s no known cure for lichen planus, it rarely causes serious problems — in fact, you may not even be aware you have the condition unless pointed out during a dental exam. It may, in time, fade away.

If the lesions do become bothersome (painful, itchy or overly-sensitive), there are some ways to ease discomfort: brushing with a soft toothbrush (to minimize irritation), flossing, and avoiding acidic or spicy foods and beverages which have been known to cause flare-ups. Managing stress is also helpful, and a topical steroid may be prescribed for more severe outbreaks.

Perhaps the greatest concern with lichen planus, though, is it may resemble more serious conditions, particularly oral cancer. The only way to be certain that it is a benign condition is to perform a biopsy on some of the affected tissue. If you notice a problem, be sure to visit us for a complete examination. And regardless of whether you have the condition or not, regular oral cancer screenings, as well as limits on alcohol consumption and stopping use of tobacco, will also reduce your risk of oral cancer.

Odds are if you have a case of lichen planus it isn’t causing you any problems. If it does cause you discomfort, though, you can take steps to ease your symptoms.

If you would like more information on lichen planus and similar oral conditions, please contact us or schedule an appointment for a consultation.