What is an ABSCESS all about anyway?

AnnC

Ann Clark RDH

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The Secrets About Halitosis

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Wendy Parker, RDH

The Secrets About Halitosis

Before we even start trading secrets, what is Halitosis?  Halitosis is the fancy word for “Bad Breath.”  We’ve all had it at one point or another.  Whether that is morning breath, when we’ve forgotten to brush, or when we’ve eaten something with a strong taste.  Whether temporary or permanent, bad breath comes to everyone.  So let’s talk about the secrets of where it comes from, why we get it, and most importantly, how to get rid of it!

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Bad breath can come from several sources.  Here’s a list of some of the most common ones:

  • Tooth decay or / and gum disease such as gingivitis
  • Dentures and bridges
  • Mouth sores
  • Dry mouth
  • Post-nasal drip and congestion of the nasal passages
  • Food stuck between the teeth
  • Coating of the tongue caused by a build up of bacteria
  • Infection of the throat and tonsils
  • Sinusitis
  • Nasal polyps
  • Bronchitis or pneumonia
  • Acid reflux and GERD
  • Chronic constipation
  • Digestive problems and stomach ulcers
  • High-protein diet that includes fish, cheeses, and meats
  • Foods that are strong smelling or spicy such as onions and garlic, exotic spices (ie. curry)
  • Supplements, such as Fish Oil Capsules
  • Low Carb Diets – causing “Ketone breath” as a result of the low carb consumption causing the body to burn fat as it’s energy source which then causes an end product of the body making ketones, which causes a fruity acetone-like odor when exhaled
  • Certain medications
  • Smoking
One of the most common reasons people have halitosis is due to a condition called “Black Hairy Tongue” or a coated tongue.  It sounds scary and unusual, but it’s something that can be cured quickly.
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The bacteria build up on tiny rounded projections called papillae which are on the surface of the tongue, also known as tastebuds. These papillae grown longer catch all the food and bacteria in the mouth.  Without brushing your tongue or removing the bacteria, it can embed in the tongue and causing a coating.  Black hairy tongue is caused by bacteria or fungi in the mouth, which make the tongue to appear black and hairy.

Certain lifestyle habits and conditions can make people more likely to develop black hairy tongue. They include:

  • poor oral hygiene
  • smoking tobacco
  • drinking a lot of coffee or tea
  • using antibiotics (which may disrupt the normal balance of bacteria in the mouth)
  • being dehydrated
  • taking medications that contain the chemical Bismuth (such as Pepto-Bismol for upset stomach)
  • not producing enough saliva
  • regularly using mouthwash that contains peroxide, witch hazel, or menthol
  • getting radiation therapy to the head and neck

Black hairy tongue is more common in men, people who use intravenous drugs, and those who are HIV-positive.

Now that we learned about Halitosis and Black Hairy Tongue, here are tips and tricks to getting rid of it:

Gently brush your teeth twice a day with a soft toothbrush, but more importantly, don’t forget your tongue!!! Start at the back of your tongue and scrape forward, being sure not to scrub the tongue and embed the bacteria even further.   You can use a tongue scraper to make sure you’re thoroughly cleaning the area. Be sure to come in for your regular check up and cleanings so that your friendly hygienist can help you too!  Soon, the coating will go away and so will the bad breath.

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If you find that you have consistent bad breath you can try our other tips:

  • If you smoke, quit.
  • Add more roughage to your diet. Soft foods won’t clean off the tongue effectively.
  • Drink plenty of water throughout the day to help keep your mouth clean.

Natural home remedies include:

  • Fenugreek should be consumed in the form of a tea made with one teaspoon of fenugreek seeds in one liter of water. Simmer till the water is infused and strain before drinking. When consumed regularly, fenugreek seeds are an excellent home remedy for halitosis.
  • Making a tea or infusion with fresh parsley or cloves is also a good way to treat bad breath. Simply boil water with freshly chopped parsley and drop in a few cloves to the mix. Cool the mixture and strain before using it as a natural mouthwash after eating. There have been numerous studies supporting claims about the efficacy of cloves and clove oil in dental care.
  • include fresh vegetables, fruits and grains into your daily diet.
  • increase your intake of Vitamin C from foods
  • include guava in your diet

An individual should consult their physician for a diagnosis if they have

  • persistent dry mouth
  • sores in the mouth
  • pain with chewing or swallowing
  • white spots on the tonsils
  • Fever
  • any other symptoms of concern

Call your doctor or dentist if the problem doesn’t get better on its own. Your doctor may prescribe antibiotics or an antifungal drug to get rid of the bacteria or yeast. Topical medications, such as tretinoin (Retin-A), are also sometimes prescribed. As a last resort, if the problem doesn’t improve, the papillae can be surgically clipped off with a laser or electrosurgery.

Hopefully this let you in on some of our secrets to a happy healthy mouth!  Happy brushing and breathing everyone!

Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Sources: 

http://www.webmd.com/oral-health/guide/black-hairy-tongue

http://www.home-remedies-for-you.com/remedy/Halitosis.html

http://www.emedicinehealth.com/bad_breath_halitosis/page4_em.htm

Oral Health: A Window to your Overall Health

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Andra Mahoney, BS RDH

Oral Health: A Window to your Overall Health

Many people are realizing that there is a direct connection between oral health and total body health.  It is finally being generally accepted that oral health and general health are to be interpreted as one entity, not separate as has been the view in the past.  Dentists has been saying this for years, and finally science is proving them right! You cannot be healthy without good oral health.

“The mouth can act as a portal of entry for infection, ” says Salomon Amar, DMD, PhD, Professor and Director at the Center for Anti-Inflammatory Therapeutics at Boston University School of Dental Medicine.  “Ongoing inflammation in your mouth can allow bacteria to enter the bloodstream, which may lead to more inflammation in other parts of your body, such as the heart.”

What conditions may be linked to oral health?

Your oral health might affect, be affected by, or contribute to various diseases and conditions, including:

Endocarditis. Endocarditis is an infection of the inner lining of your heart (endocardium). Endocarditis typically occurs when bacteria or other germs from another part of your body, such as your mouth, spread through your bloodstream and attach to damaged areas in your heart.

Cardiovascular disease. Some research suggests that heart disease, clogged arteries, and stroke might be linked to the inflammation and infections that oral bacteria can cause.

In 2005, the NIH funded a study on this topic. They randomly selected 1,056 participants with no prior heart attacks or strokes.  All were evaluated for levels of periodontal bacteria.  After removing the effects of the other risk factors of age, gender, and smoking, Moise Desvarieux, MD, PhD, Associate Professor of Epidemiology at the Mailman School and lead author of the study stated, “It was found that there was an independent relationship between gum disease and heart disease.” One theory about why this may occur is that small amounts of bacteria enter your bloodstream while you’re chewing. “Bad” bacteria from an infected mouth may lodge itself inside blood vessels, ultimately causing dangerous blockages. Strengthening his theory is the fact that when scientists have looked at atherosclerotic blood vessels, they have sometimes found fragments of periodontal bacteria. Meanwhile, a study published in the New England Journal of Medicine in 2007, established that aggressive treatment of gum disease reduces the incidence of atherosclerosis within six months.

It has been found that up to 91% of patients with heart disease have periodontitis. “The theory is that inflammation in the mouth causes inflammation in the blood vessels,” says Sally Cram, DDS, PC, Consumer Adviser for the American Dental Association. “This can increase the risk for heart attack in a number of ways. Inflamed blood vessels allow less blood to travel between the heart and the rest of the body, raising blood pressure. There’s also a greater risk that fatty plaque will break off the wall of a blood vessel and travel to the heart or the brain, causing a heart attack or stroke.”

Pregnancy and birth. Periodontitis has been linked to premature birth and low birth weight.

Scientists believe that gum disease or inflammation in the mouth possibly triggers an increase in a chemical compound called prostaglandin, which induces early labor. While this theory has not yet been confirmed, a 2001 study found that pregnant women who develop gum disease between weeks 21 and 24 of their pregnancy are four to seven times more likely to give birth before week 37. There is evidence that poor gum health in the extreme can lead to low birth weight as well.

Babies born too early or at a low birth weight often have significant health problems, including lung conditions, heart conditions, and learning disorders. While many factors can contribute to premature or low birth weight deliveries, infection and inflammation in general seem to interfere with a fetus’ development in the womb.

Though men have periodontitis more often than women do, hormonal changes during pregnancy can increase a woman’s risk. For the best chance of a healthy pregnancy, Pamela McClain, DDS, President of the American Academy of Periodontology, recommends a comprehensive periodontal exam, “If you’re pregnant or before you become pregnant, identify whether or not you’re at risk.”

Diabetes. Diabetes reduces the body’s resistance to infection which puts the gums at risk.

Gum disease appears to be more frequent and severe among people who have diabetes. Research shows that people who have gum disease have a harder time controlling their blood sugar levels.  Researchers at Columbia University’s Mailman School of Public Health followed 9,296 non-diabetic participants, measuring their level of periodontic bacteria over the course of 20 years. “We found that people who had higher levels of periodontal disease had a two-fold risk of developing type 2 diabetes over that time period compared to people with low levels or no gum disease,” explains Ryan Demmer, PhD, Associate Researcher at the Department of Epidemiology at the Mailman School and the lead author. There are a few theories about why this might be the case.  One proposes that when infections in your mouth get bad enough, it can lead to low-grade inflammation throughout your body, which in turn wreaks havoc on your sugar-processing abilities. “There are all kinds of inflammatory molecules,” says Dr. Demmer, “and it’s believed that maybe some attach to insulin receptors and prevent the body’s cells from using the insulin to get glucose into the cell.”

It has also been noted that inflammation that starts in the mouth seems to weaken the body’s ability to control blood sugar. People with diabetes have trouble processing sugar because of a lack of insulin, the hormone that converts sugar into energy.  “Periodontal disease further complicates diabetes because the inflammation impairs the body’s ability to utilize insulin,” says Dr McClain. Diabetes and periodontitis have a two-way relationship. High blood sugar provides ideal conditions for infection to grow, including gum infections. Diabetes can also slow the healing process and lower resistance to infections, including oral infections.  Fortunately you can use the gum disease-diabetes relationship to your favor: managing one can help bring the other under control.

HIV/AIDS. Oral problems, such as painful mucosal lesions, are common in people who have HIV/AIDS.  Studies suggest that oral bacteria and the inflammation associated with periodontitis, a severe form of gum disease, might play a role in some diseases. Certain diseases, such HIV/AIDS, can lower the body’s resistance to infection, making oral health problems more severe.

Osteoporosis. Osteoporosis, which causes bones to become weak and brittle, might be linked with periodontal bone loss and tooth loss.  Osteoporosis and periodontitis have an important thing in common, bone loss. Researchers are testing the theory that inflammation triggered by periodontitis could weaken bone in other parts of the body.

Alzheimer’s disease. Tooth loss before age 35 might be a risk factor for Alzheimer’s disease.
Dementia: The bacteria from gingivitis may enter the brain through either nerve channels in the head or through the bloodstream, that might even lead to the development of Alzheimer’s disease.

Pneumonia. A 2008 study of elderly participants found that the number who developed pneumonia was 3.9 times higher in patients with periodontal infection than in those free from it. “The lungs are very close to the mouth,” says Marsha Rubin, DDS, practicing Diplomat of Special-care Dentistry at New York-Presbyterian/Weill Cornell. “Even in a healthy mouth there is lot of bacteria, but bacteria in a not-healthy mouth can get aspirated into the lungs, causing pneumonia or aggravating COPD, chronic obstructive pulmonary disorder.” Several intervention studies cited by the CDC show that an improvement in oral health can lead to a reduction in respiratory infection.  Periodontal disease may make pneumonia and chronic obstructive pulmonary disorder worse, possibly by increasing the amount of bacteria in the lungs.

Pancreatic Cancer. A study published in 2007 in the Journal of the National Cancer Institute surveyed 51,529 American men about their health every two years between 1986 and 2002. Of the 216 participants who developed pancreatic cancer, 67 of them also had periodontal disease. Independent of the participants’ smoking status, the study found that having a history of periodontal disease was associated with an increased risk of pancreatic cancer. This, according to the study, could be because of systemic inflammation or increased levels of carcinogenic compounds produced in the infected mouth. Interestingly, another viable theory about why gum disease may cause type 2 diabetes points to damage to the pancreas as well. “With the pancreatic cancer study, we thought it was very interesting that you have this localized infection that has an impact on a systemic organ that is very intimately tied to the pathophysiology of diabetes,” says Dr. Desvarieux.

Cancer.  Your dentist and hygienist should screen for oral cancer and other cancers of the head and neck, including skin cancer, cancer of the jaw bone, and thyroid cancer, during routine checkups. He or she feels for lumps or irregular tissue changes in your neck, head, cheeks and oral cavity, and thoroughly examines the soft tissues in your mouth, specifically looking for any sores or discolored tissues. Survival rates greatly increase the earlier oral cancer is discovered and treated. During your next dental visit, ask your dentist to do an oral cancer screening. See your dentist immediately if you observe:

Any sore that persists longer than two weeks

A swelling, growth, or lump anywhere in around the mouth or neck

White or red patches in the mouth or on the lips

Repeated bleeding from the mouth or throat

Difficulty swallowing or persistent hoarseness

Scientists aren’t sure of the exact cause of oral cancer. However, the carcinogens in tobacco products, alcohol and certain foods, HPV infections, as well as excessive exposure to the sun, have been found to increase the risk of developing oral cancer. Risk factors for oral cancer may also be genetically inherited. You can help prevent oral cancer by:

Not smoking or using spit tobacco

Limiting your alcohol intake

Eating plenty of fruits and vegetables

Also, periodic self-examinations can increase your chances of detecting oral cancer, so be sure to examine your face, cheeks, jaw and neck regularly for any changes or lumps.

Other conditions. Other conditions that might be linked to oral health include Sjogren’s syndrome, an immune system disorder that causes dry mouth, and eating disorders.

Because of these potential links, be sure to tell your dentist if you’re taking any medications or have had any changes in your overall health, especially if you’ve had any recent illnesses or you have a chronic condition, such as diabetes.

How can I protect my oral health?

To protect your oral health, practice good oral hygiene every day. For example:

Brush your teeth at least twice a day.

Floss daily.

Eat a healthy diet and limit between-meal snacks.

Replace your toothbrush every three to four months or sooner if bristles are frayed.

Schedule regular dental checkups.

Also, contact your dentist as soon as an oral health problem arises. It is important to let your dentist know your full family medical history. If you have periodontal disease, make sure you see your dentist frequently and get it treated promptly, before it progresses to the point where you begin losing teeth or it starts to affect your overall health.  Remember, taking care of your oral health is an investment in your overall health.

One thing is clear: the body and mouth are not separate. Your body can affect your mouth and likewise, your mouth can affect your body.  Taking good care of your teeth and gums can really help you live well longer.

Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Sources:

http://www.nidcr.nih.gov/DataStatistics/SurgeonGeneral/sgr/part1.htm

http://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/dental/art-20047475

https://www.deltadentalins.com/oral_health/connection-oral-health.pdf

http://www.colgate.com/en/us/oc/oral-health/conditions/gum-disease/article/sw-281474979066921

http://www.everydayhealth.com/dental-health/101.aspx

http://www.webmd.com/oral-health/features/oral-health-the-mouth-body-connection

http://www.webmd.com/oral-health/features/oral-health-affects-wellness

Tooth Sensitivity

KatieM

Katie Moynihan RDH

Tooth Sensitivity

Sensitive teeth is one of the most common concerns among dental patients. Tooth sensitivity occurs due to enamel loss or gum recession which exposes the underlying dentin structure of the tooth. The dentin layer of your tooth is found underneath the enamel and contains several tiny tubes which run from the nerve to the outside of the tooth. When exposed, these tubes are highly sensitive to temperature changes, sweets, or mechanical forces. Not to mention very painful!

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Tooth sensitivity can be caused by several factors. Aggressive brushing can wear away your enamel at the gumline leading to gum recession and exposed tooth root. Another cause of sensitivity can be from continuous grinding of the teeth to the point that the enamel is completely worn down to the dentin layer. Cracked teeth or worn fillings can create passageways to the nerve of the tooth. Periodontal disease, or severe gum disease, can contribute to sensitivity because the gums around the teeth break down and lead to gum loss and bone loss.

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There are several ways to help reduce tooth sensitivity either at home or at the dental office. The type of treatment will depend of what is causing the sensitivity.

At home treatments include:

  • using a soft or extra-soft toothbrush while brushing gently in order to avoid toothbrush abrasion at the gumline (take a good look at your toothbrush…if the bristles are pointing in multiple directions, you’re brushing too hard!)
  • using a toothpaste that contains potassium nitrate, which penetrates the exposed dentin and soothes the nerve endings
  • using a fluoride toothpaste to help strengthen the tooth and exposed dentin
  • using MI Paste (available at your dental office) to block dentin tubule openings
  • limit acidic foods and drinks because they can remove small amounts of enamel over time

In office treatments include:

  • application of a fluoride varnish – helps seal the tubules and rebuild exposed dentin
  • application of a fluoride foam – provides a high dose of fluoride to help strengthen teeth
  • bonding agents can be placed at the gumline if necessary to seal exposed dentin and reduce sensitivity
  • restorative treatment if needed to correct the tooth that is causing the sensitivity
  • periodontal treatment if needed to keep gums healthy around the teeth

A mix of potassium nitrate and fluoride is your best solution for desensitization. Some products which include these active ingredients include Sensodyne, Pronamel, Colgate Sensitive Pro Relief, and Colgate Prevident 5000 Sensitive. These products must be used on a regular basis for at least 30 days before any therapeutic benefit will take place. Whitening and tartar control toothpastes contain abrasive ingredients that can damage tooth enamel and may be too harsh for those with sensitive teeth. The application of a fluoride varnish is always available in-office at your request. If you suffer from tooth sensitivity, feel free to ask us which desensitizing agents will work best for you!

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Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Sources:

http://www.ada.org/~/media/ADA/Publications/Files/patient_33.ashx

https://us.sensodyne.com/faq.aspx

http://www.colgate.com/en/us/oc/oral-health/conditions/tooth-sensitivity/article/treatment-options-for-tooth-sensitivity

http://www.mouthhealthy.org/en/az-topics/s/sensitive-teeth