Posts for: September, 2013
Dry mouth is a condition that many of us have experienced at some point in life. However, for some people it is a problem that can wreak havoc on their lives. This is why we have put together this list of questions we are most frequently asked about dry mouth.
What is dry mouth?
The medical term for dry mouth is “xerostomia” (“xero” – dry; “stomia” – mouth) and it affects millions of people in the US alone. It is caused by an insufficient flow of saliva, the liquid produced by the salivary glands. These glands are located in the inside cheeks of the mouth by the back top molars and in the floor (under the tongue) of the mouth. When functioning properly, they produce two to four pints of liquid every 24 hours.
Can drugs contribute to dry mouth?
Yes, both prescription and over-the-counter (OTC) drugs can cause dry mouth. This is one reason we so often find it in senior citizens, as they are typically on more medications than younger, healthier people.
What about diseases...can they cause dry mouth?
Certain systemic (general body) and autoimmune (“auto” – self; “immune” – resistance system) diseases, in which the body reacts against its own tissue, can cause dry mouth. Other diseases that can be the culprit include: diabetes, Parkinson's disease, cystic fibrosis, and AIDS (Acquired Immune Deficiency Syndrome). Radiation and chemotherapy used to treat head and neck cancers can inflame, damage or destroy the salivary glands—thus causing dry mouth.
Are there any remedies for dry mouth?
Yes! If medication is the primary cause of your dry mouth, there may be other, similar drugs that can be substituted that do not produce the same side effect. If you feel this describes your situation, discuss your concerns with the prescribing physician. Another option is taking an OTC or prescription saliva stimulant to temporarily relieve the dryness. Or, you can suck on a candy made with xylitol, a natural sugar substitute, four to five times a day. Xylitol has been shown to help stimulate the production of saliva with the added benefit of reducing the odds of getting cavities.
The “wear and tear” nature of gingival (gum) tissue enables it to readily handle the chewing and biting actions of eating and still perform its most important function: protecting the roots of your teeth from decay and environmental exposure. But while they're resilient, they're not invincible: it's quite possible for them to lose their attachment to a tooth and begin to recede, leaving the root surfaces exposed.
Gum recession can occur for a number of reasons: poor oral hygiene; over brushing and flossing; malocclusion (a poor bite); personal habits, like biting down on hard foreign objects; or poorly fitted dentures or other appliances. From a genetic point of view, people with thinner gingival tissues are more prone to gum recession than those with thicker tissues. Whatever the cause, the result is the same — the exposed tooth becomes more sensitive to environmental factors (such as heat, cold, abrasion or erosion). More importantly, it now has a higher susceptibility to decay and disease, leading to its possible demise.
But there may be a solution. Although the original tissue may be lost, periodontal plastic surgery can restore a protective layer of tissue to the tooth, and at the same time give you back the smile you once had.
From the Greek word “plastik” for sculpting or modeling clay, plastic surgery procedures restore both form and function to a bodily structure. While the term “plastic surgery” can apply to other procedures in medicine such as rhinoplasty or face lifts, the periodontal procedure particularly involves grafting similar tissue to an area of recession, and then “shaping” it into a natural, life-like form.
To graft means to remove tissue from a donor site and attach it to a recipient site. In the case of periodontal tissue, the recipient patient can also be the donor with the tissue coming from some other area of the same mouth (the graft can also come from another human or an animal). Using advanced techniques and a touch of artistry, the surgeon positions and sutures the graft in place.
The result: not only a new protective covering for your tooth, but a more pleasing appearance when you smile.
If you would like more information on periodontal plastic surgery, 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 “Periodontal Plastic Surgery.”
If you're looking to improve the appearance of your smile, tooth whitening treatments — whether done at home or in our office — are a popular option. Here are the answers to some questions that many people ask before they begin the process.
Q: Are commonly used tooth-whitening methods safe?
A: Yes — provided they are used as directed. A large body of research has shown that using the correct concentration of peroxide — the bleach that whitens teeth — for the proper amount of time is not known to cause any major health problems. However, there have been cases where poor-quality bleaching solutions and/or excessive usage have caused deterioration of tooth enamel and extreme gum sensitivity. Always follow our office's recommendation.
Q: Does this mean I have to have in-office treatments to whiten my teeth?
A: No. But you should come in for a thorough dental examination, with x-rays, before you begin whitening treatments. Why? Because if there is trouble with the underlying tooth structure, then whitening the tooth is like painting over rusty metal: It hides the symptom, but doesn't fix the problem. Abscesses and root-canal problems are just two of the underlying causes of tooth discoloration that should be treated before teeth are whitened.
Q: What are some different methods for whitening teeth, and how long do they take?
A: The fastest is in-office whitening treatments, using a strong bleaching solution and appropriate gum protection. Next comes the cost-effective method of at-home bleaching with custom-made flexible plastic trays (sometimes called nightguard vital bleaching.) If you're not in a hurry, over-the-counter (OTC) products can do the same thing — given enough time. One study comparing different whitening treatments found that a six-shade improvement in whitening was accomplished by three in-office treatments. A week was needed for custom-tray bleach applications, or 16 daily applications of OTC products, to achieve comparable results.
Q: Can any tooth be made bright white?
A: No. Every tooth has a maximum level of whiteness, beyond which it can't get any lighter. Furthermore, fillings, crowns and other dental restorations can't be lightened with bleach — another reason to talk to our office; we can help you achieve the best possible look for your particular smile.
Q: How long will my white teeth last?
A: It depends. No whitening method is permanent, but the typical result lasts for up to two years. To preserve that bright smile, you can take some positive steps: Avoid tobacco and beverages that stain, like red wine, tea and coffee; keep up with regular cleanings in our office; and, practice good oral hygiene at home. You can also have a touch-up treatment once or twice a year.
If you need more information about tooth whitening, or you're ready to start the process, 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 “Important Teeth Whitening Questions Answered.”
There are a number of materials and techniques available in cosmetic dentistry that help us improve our patients' smiles. Porcelain veneers stand out as one of the most popular and least interventional of these options.
As the name implies, a veneer is a thin layer of dental restorative material that covers the original tooth surface. Veneers don't require an extensive amount of tooth preparation or removal of sound tooth structure, as with a crown or bridge.
Veneers are made of dental porcelain, a material compatible with living tissue and with a very life-like appearance. The dentist as artist can fashion the porcelain to precisely imitate an individual's natural teeth, including the natural color and hue of surrounding teeth.
Are porcelain veneers an option for you? Only a smile analysis in our office can determine that. Your teeth must be in a somewhat normal position. The teeth in question must have a sufficient amount of remaining tooth structure to support veneers. And you must have symmetrical gum contours that will allow for proper framing of the teeth, which will enhance the final cosmetic result.
If your current dental health meets these criteria, then porcelain veneers could help correct spaces between teeth that aren't too wide, improve poor color, or address poor shape, contours or minor bite problems. Veneers, however, do have their limitations. They aren't effective if you have poor tooth position, if the root positions are widely out of line, or if you have a poor profile. Some form of orthodontics may be needed initially for these situations.
That being said, porcelain veneers are an excellent long-term option in the right situation. Depending on your individual circumstance and how you care for your teeth, a veneer application can last for several years, or if they come loose or become chipped they can be repaired in most cases. The material is strong enough to withstand normal pressures exerted during chewing or biting, as long as you avoid activities like opening nutshells with your teeth or chewing on very hard candy.
Overall, porcelain veneers can give your smile a whole new look with little impact on your remaining tooth structure.
If you would like more information on porcelain veneers, 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 “Smile Design Enhanced With Porcelain Veneers.”