Posts for: February, 2014
Periodontal (gum) diseases like gingivitis (inflammation of the gum tissues) can exist in a chronic form for some time, while gradually worsening. But given the right conditions, gingivitis could elevate quickly into an acute, painful condition known as Acute Necrotizing Ulcerative Gingivitis (ANUG). While it can be effectively treated, it’s important to diagnose ANUG early and begin treatment as soon as possible.
ANUG is also known as “trench mouth” as it was commonly recognized among soldiers in the trenches during World War I. Its name describes it as “necrotizing” and “ulcerative,” because when left untreated it kills (“necrotizes”) soft gum tissue, particularly the triangular tissue between teeth known as papillae, and causes severe and painful sores. A person with ANUG may also exhibit very bad breath and taste, with an odor peculiar to the disease. It’s believed that acute stress, poor nutrition and a lack of sleep can trigger the condition in individuals with pre-existing gingivitis.
As with other forms of gum disease, the first priority of treatment is to alleviate the symptoms. Besides initial cleaning (also known as scaling), we would also prescribe antibiotics (particularly Metronidazole, which is effective against the specific bacteria responsible for ANUG), an antibacterial mouthrinse like chlorhexidine, and a mild saline rinse. We would also control pain and inflammation with non-steroidal anti-inflammatory drugs like aspirin or ibuprofen.
As the symptoms come under control, it’s then necessary to treat the underlying gingivitis by continuing the thorough cleaning of the affected surfaces, including the roots, of as much plaque and tartar as possible. Good oral hygiene with semi-annual professional cleanings must become regular habits to inhibit future reoccurrences of the disease. Quitting smoking, eating a healthy diet and managing stress are also advisable.
Without treatment, ANUG symptoms will persist; you could eventually lose the affected papillae, and experience other detrimental effects to other periodontal tissue and bone structures. If you suspect you may have gingivitis or this acute form, you should visit us as soon as possible for a full evaluation and treatment. The earlier we diagnose and treat gum disease, the better your long-term outlook.
If you would like more information on painful gums, 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 “Painful Gums in Teens and Adults.”
Your dental care would be much more limited without our ability to see “below the surface” with x-ray imaging. But since x-rays passing through the body are a form of radiation, could your exposure from them be hazardous to your health?
It depends on exposure dosages and, of course, the amount you have been exposed to over your lifetime. But, decades of research have demonstrated that exposure to dental x-rays during your regular office visits are only a fraction of the radiation you normally encounter from the natural environment every year.
X-rays have the ability to pass through body tissues, but at different rates for soft tissue like skin and muscle and hard tissue like bone. This effect creates shadows on exposed film; the differentiation is in such detail that a trained technician can interpret not only internal structures, but defects such as fractured bone or, in the case of dentistry, signs of tooth decay and bone loss from gum disease.
But like other energy sources in our environment, x-rays do emit radiation that in high doses can be dangerous to living tissue. The amount of exposure is measured in millisieverts (mSv), a unit that allows for comparison of doses from different sources of radiation. Scientists have calculated that we’re normally exposed to between 2 and 4.5 mSv every year.
By contrast, a single digital periapical image taken of a tooth is equal to 1 microsievert (μSv), or one thousandth of an mSv; a full mouth series (between 18 and 20 images) creates an exposure of 85 μSv, or 85/1000 of one mSv. In addition, advances in technology have further reduced the radiation exposure from x-ray imaging. For example, digital imaging has reduced exposure during full mouth x-rays from seven to ten days of equal exposure from normal background radiation to half a day, and with no loss in image quality.
In effect, dental x-rays pose little to no risk for patients. Still, understanding that x-ray imaging does expose patients to radiation, dentists follow certain protocols and safety precautions. For example, dentists will place a lead apron around their patients’ chest area during an x-ray exposure.
As your dentist, we’re happy to address any concerns you may have about x-ray radiation exposure. But rest assured, the x-ray devices used in your dental care, so necessary in the fight against tooth decay and other diseases, are safe and reliable.
If you would like more information on the use of x-ray technology and safety, 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 “X-Ray Frequency and Safety.”
The Tooth Fairy has been easing the process of losing baby teeth for hundreds of years — at least 500 years according to one authority on the subject. Her name is Brady Reiter, and while she looks only age 11 in earth years, she is actually a 500-year-old Tooth Fairy; at least she plays one on DVD.
Brady is the star of Tooth Fairy 2, a new DVD comedy also starring Larry the Cable Guy as a novice Tooth Fairy doing penance for questioning the existence of the magical sprite who leaves payment under pillows for lost teeth.
In a charming interview with Dear Doctor magazine, Brady says it wasn't very difficult to play an ancient tooth fairy trapped in a child's body.
“I'm kind of more mature than an average 11-year-old because I have older brothers and sisters,” Brady told Dear Doctor. “It was kind of just connecting with my inner 500-year-old. It was very fun to play a character like that!”
Brady also enjoyed working with Larry, who dons a pink tutu and fluffy wings for his role.
“In hair and makeup every morning, he'd be making all these jokes,” she said. “He just cracked us up 100 percent of the time!”
But as much fun as Brady had on the set, her character, Nyx, is all business. And that's how Brady, who recently lost her last baby tooth, has always believed it should be.
“My whole life I thought the Tooth Fairy is just like Nyx,” Brady said. “They know what to do, they come in, they're professionals, you don't see them and they never make a mistake and forget your tooth. Just like Santa Claus, tooth fairies are very professional.”
Brady also told Dear Doctor that she is very excited to be helping the National Children's Oral Health Foundation fight childhood tooth decay as spokesfairy for America's ToothFairy Kids Club. The club offers kids personalized letters from the Tooth Fairy along with lots of encouraging oral health tips and fun activities.
If you would like to enroll your child in the club — it's free! — please visit www.AmericasToothFairyKids.org. And to make sure your child's teeth and your own are decay-free and as healthy as possible, please contact us to schedule your next appointment.
A substantial amount of research has recently pointed up the connection between oral health and systemic (whole-body) health. But recently, one study went a step further: It seems to show that having certain dental-health issues in middle age — for example, tooth loss and gum disease — could signal a deterioration in cognitive function.
Study author Gary Slade, a professor at the University of North Carolina at Chapel Hill, summed it up: “We were interested to see if people with poor dental health had relatively poorer cognitive function, which is a technical term for how well people do with memory and with managing words and numbers,” he said in an interview with U.S. News and World Report. “What we found was that for every extra tooth that a person had lost or had removed, cognitive function went down a bit. The same was true [for] patients with severe gum disease.”
Does this mean that losing teeth is a little like losing brain cells? Not really, because it isn’t clear which condition occurred first… or even if one caused the other. For example, it could be that a poor diet is responsible for both poor dental health and a decline in cognitive ability; on the other hand, there could be a genetic link between both conditions. Or, it could simply mean that people with cognitive difficulties don’t take good care of their teeth.
Still, the association is intriguing — especially because it echoes some previous studies, which indicate that systemic inflammation could be a major cause of both problems. What’s the oral-systemic connection? No one is exactly sure yet, but research suggests a relationship between periodontal disease and other diseases such as heart disease, stroke and diabetes. The common link may be bacteria: The same microorganisms that cause problems in the mouth might be able to spread through the body, producing a low-grade inflammation — one that’s waiting for the right conditions to burst into fire.
So, should you rush out and grab everything off the drugstore’s oral health products shelf? Well, we wouldn’t necessarily go that far… but here’s a more sensible suggestion: Take good care of your teeth and gums. Both tooth decay and periodontal disease can cause a number of problems with your health — yet both can be treated effectively… and they’re largely preventable!
If you haven’t visited our office in a while, why not come in for an exam? When you do, ask us what’s the best way to keep your smile looking great and feeling clean and healthy. Our goal is to help you maintain proper oral hygiene — for life. If you would like more information about oral health and systemic diseases, call our office for a consultation. You can learn more in the Dear Doctor magazine article “The Link Between Heart & Gum Diseases.”