Posts for: November, 2020
Heartburn is a big problem: Each year we Americans spend around $10 billion on antacid products, twice as much as for over-the-counter pain relievers. It's an even bigger problem because many indigestion sufferers actually have acid reflux or GERD (gastroesophageal reflux disease), a chronic disease that can cause physical harm—including to teeth.
That's why we've joined with other healthcare providers for GERD Awareness Week, November 17-23, to call attention to the causes and consequences of this disease. In addition to the harm it poses to the esophagus (the “tube” leading from the mouth to the stomach through which food passes), GERD could also damage your teeth to the point of losing them.
GERD is usually caused by the weakening of the lower esophageal sphincter, a ringed muscle located at the junction between the esophagus and the stomach. It acts as a “one-way valve” allowing food into the stomach, but not back into the esophagus. If it weakens, powerful stomach acid can come back into the esophagus and possibly even the mouth. The latter scenario poses a danger to teeth's protective layer of enamel.
Although tough and durable, enamel softens after prolonged contact with acid. Oral acid isn't all that unusual—acid levels typically rise right after eating, causing a temporary softening of enamel. Our saliva, however, goes to work to bring down those acid levels and stabilize enamel.
But if stomach acid enters the mouth because of GERD, the increased acidity can overwhelm saliva's ability to neutralize it. This can lead to enamel erosion, tooth decay and ultimately tooth loss. The enamel damage can be so pronounced that dentists are often the first to suspect GERD.
If you're diagnosed with GERD, here's what you can do to protect your teeth.
- Manage your GERD symptoms through medication, avoidance of spicy/acidic foods, alcohol, caffeine or tobacco products, and maintaining an optimum weight;
- Stimulate saliva by drinking more water, using saliva boosters, or (with your doctor's consent) changing from medications that may be restricting saliva flow;
- Speak with your dentist about strengthening your enamel with special toothpastes or mouthrinses containing extra fluoride or amorphous calcium phosphate (ACP).
You should also brush and floss daily to lower your risk of dental disease, but with one caveat: Don't brush your teeth during or immediately after a reflux episode, as you might remove microscopic bits of softened enamel. Instead, rinse your mouth with water mixed with a half-teaspoon of baking soda (an acid neutralizer) and wait about an hour to brush. The extra time also gives saliva time to further neutralize any remaining acid.
GERD can be unpleasant at best and highly destructive at worst. Don't let it ruin your teeth or your smile.
If you would like more information about GERD and dental health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “GERD and Oral Health” and “Dry Mouth.”
As the old Fifties song goes, “Little things mean a lot.” They can also be the most irritating, like a hangnail, a papercut—or a certain kind of oral sore. Although rarely concerning to health, this particular kind of “bump” in the mouth can be unnerving.
Although known as a traumatic fibroma, it's not as dire as it sounds: It's simply a small wound created when your inside cheek gets in the “line of fire” between your teeth while biting or chewing. It's an experience most of us have had, and though it's a minor occurrence, it can make us wince with pain.
But the pain usually lasts only a few seconds—until the next time, which is a distinct possibility. The body creates a protective callous over the wound made of fibers (hence the name fibroma) of a protein called collagen. This creates a rise in the skin surface that increases the chances the area will again get in the way of the teeth and be bitten. Each bite leads to another layer of collagen, a more prominent rise and even greater probability of another bite.
Rather than let this irritating situation repeat itself, you can undergo a minor surgical procedure to remove the fibroma. Usually performed be an oral surgeon or periodontist, the area is numbed first with a local anesthetic and the fibroma removed with a scalpel; the resulting wound is then closed with a few stitches or a laser, in which case no stitches are necessary. As a result, the cheek surface flattens out and becomes less likely to get in between the teeth.
The dentist may also preserve some of the removed tissue and submit it for a biopsy to check for any cancer cells or other abnormalities. You shouldn't be concerned about this: Examining excised tissue is a routine step performed for a variety of surgical procedures. It's used to verify the tissue in question is benign, which in this case is the vast majority of the time.
After the procedure, you might experience some minor discomfort for a few days, usually manageable with a mild pain reliever like aspirin or ibuprofen. The procedure itself only takes about fifteen minutes, but it can provide you lasting relief from that bedeviling little sore in your mouth.
If you would like more information on treating mouth sores, 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 “Common Lumps and Bumps in the Mouth.”
Getting a new implant tooth in only one day sounds too good to be true. But it's true—up to a point. Whether or not you can undergo an immediate crown replacement (attaching a crown to an implant right after surgery) will depend mostly on the underlying bone.
Traditionally, an implant crown isn't attached until several weeks after surgery to allow bone cells to grow and adhere to an implant's titanium surface (osseointegration). The gums are sutured back in place to protect the metal implant until it develops a durable hold within the bone. But this also leaves you with a noticeable missing tooth gap during the integration period.
A “tooth in a day” procedure gives you a full smile right after implant surgery. There is one catch, though—this first crown will be temporary and it won't be able to receive biting pressure.
Until the bone and implant fully integrate, attaching a full-sized permanent crown can damage the implant. To avoid this, the initial crown is slightly shorter than the future permanent crown. This prevents it from contacting solidly with teeth on the other jaw while biting or chewing, which can generate enough force to potentially damage the implant.
If you undergo an immediate-load crown on your implant, you'll have to return later for the full-length permanent crown. In the meantime, though, you'll avoid the embarrassment of a missing tooth in your smile.
With that said, the target bone must be healthy and intact for you to undergo a “tooth in a day” procedure. That isn't always the case with missing teeth—over time, bone volume can gradually diminish. The subsequent loss can complicate implant placement, which must be exact to achieve the most natural outcome. If extensive bone loss exists, you may need grafting to build up enough bone to adequately support an implant.
Even if an implant can be placed, the bone may still be too weak to allow for immediate crown placement. In that case, the traditional procedure may be the best course to allow the bone and implant to fully bond.
To determine if you're a candidate for a “tooth in a day” implant procedure, you'll first need to have a thorough dental exam that includes an assessment of bone health. If it's sound, you may be able to have a full smile right after implant surgery.
If you would like more information on dental implant restorations, 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 “Same-Day Tooth Replacement With Dental Implants.”