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Posts for category: Oral Health

By Dr. Mark C. Pothitakis
January 12, 2022
Category: Oral Health
Tags: gum disease  
TheFirstStepToBeatingGumDiseaseIsUnderstandingHowItStarts

If you're over thirty, you have a fifty-fifty chance of contracting gum disease and your odds worsen as you get older. But your fate isn't sealed, especially if you know what to do to prevent this harmful disease.

But before we discuss your prevention strategy, let's look first at oral bacteria, the basic cause for gum disease. Although most bacterial strains in your mouth are benign or even beneficial, a few can infect your gums. And, the more of them there are in your mouth, the higher your risk for infection.

These bacteria multiply with the help of a sticky biofilm called dental plaque, providing them a ready source of food and shelter. Plaque and its hardened form tartar accumulate daily on dental surfaces, particularly if you don't practice daily brushing and flossing.

Once a gum infection begins, the body unleashes an inflammatory response to isolate the infected tissues from healthy ones. As a result, the gums can become swollen and reddened, and may easily bleed. If you see signs like these, you should seek treatment as soon as possible to stop the infection's advance.

And, advance it will, spreading ever deeper into the gums until it threatens the supporting bone. At this point, with the gums becoming detached from the teeth and the bone compromised, the affected teeth could be in imminent danger of loss.

These basic disease processes underscore the importance of one thing—the daily removal of bacterial plaque through brushing and flossing. The bacteria that cause disease don't thrive well in an environment devoid of plaque.

But even if you're diligent about your hygiene, you may still miss some plaque; this can then calcify into tartar, which is likely impossible to remove with brushing and flossing. That's why you need dental cleanings at least every six months to remove stubborn tartar and any lingering plaque.

Regular dental visits also increase your chances of early gum disease detection. The earlier we're able to diagnose and start treating an infection, the better the outcome.

Gum disease can begin and advance quickly, sometimes without you noticing. But daily brushing and flossing, regular dental cleanings and prompt attention at the first sign of trouble can help you stay ahead of this harmful disease.

If you would like more information on preventing gum disease, 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 “How Gum Disease Gets Started.”

By Dr. Mark C. Pothitakis
January 07, 2022
Category: Oral Health
AMinorProcedureCouldHelpanInfantWithThisNursingProblem

Newborns come into the world eager and ready to partake of their mother's milk. But an anatomical quirk with some infants could make breastfeeding more difficult for them.

The structure in question is a frenum, a tiny band of tissue connecting softer parts of the mouth with firmer parts, like the upper lip to the gums, and the tongue to the floor of the mouth. If they're abnormally short, thick or tight, however, the baby might find it difficult to obtain a good seal around the mother's nipple.

Without that seal, the baby has a difficult time drawing milk out of the breast and as a result, they may attempt to compensate by chewing on the nipple. The sad outcome is often continuing hunger and frustration for the baby, and pain for the mother.

To alleviate this problem, a physician can clip the frenum to loosen it. Known as a frenotomy, (or a frenectomy or frenuplasty, depending on the exact actions taken), it's a minor procedure a doctor can perform in their office.

It begins with the doctor deadening the area with a numbing gel or injected anesthesia. After a few minutes to allow the anesthesia to take effect, they clip the frenum with surgical scissors or with a laser (there's usually little to no bleeding with the latter).

Once the frenum has been clipped, the baby should be able to nurse right away. However, they may have a learning curve to using the now freed-up parts of their mouth to obtain a solid seal while nursing.

Abnormal frenums that interfere with nursing are usually treated as soon as possible. But even if it isn't impeding breastfeeding, an abnormal frenum could eventually interfere with other functions like speech development, or it could foster the development of a gap between the front teeth. It may be necessary, then, to revisit the frenum at an older age and treat it at that time.

Although technically a surgical procedure, frenotomies are minor and safe to perform on newborns. Their outcome, though, can be transformative, allowing a newborn to gain the full nourishment and emotional bonding they need while breastfeeding.

If you would like more information on tongue or lip ties, 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 “Tongue Ties, Lip Ties and Breastfeeding.”

3ThingsYouCanDotoKeepHolidaySweetsFromInterferingWithYourDentalHealth

In his iconic poem, "A Visit from St. Nicholas," Clement Moore wrote of children sleeping "while visions of sugar plums danced in their heads." Indeed, sweet treats are still interwoven into the holidays—and a prime reason why we tend to put on pounds during the season. It may also be why your next dental visit might come with some unpleasant news.

The starring actors in much of traditional holiday snacking and feasting are naturally-occurring or added sugars. Carbohydrates like refined sugar in particular can dramatically affect your dental health if you over-consume them, because they can feed the bacteria that causes both tooth decay and gum disease.

There are ways, though, to reduce their impact on your teeth and gums. You can, of course, go "cold turkey" and cut refined sugar out completely, as well as curtail other carbohydrates like refined flours and fruit. It's effective, but not much fun—and what are the holidays without fun?

More in line with "moderation in all things," there are other ways to minimize the impact of carbohydrates on your teeth and gums during the holiday season. Here are a few of them.

Limit refined sugar. While you and your family may not be up for banning sugar during the holidays, you can reduce it significantly. For instance, prepare more savory items rather than the sweeter kinds. If you must go for sweet, opt for naturally occurring sugars in fruit or dairy rather than refined table sugar or high fructose corn syrup.

Eat sweet treats with meals. Constant snacking often comes with the holiday season. And, why not—all those abundant goodies are just begging to be eaten. But noshing all the time never allows your mouth's saliva, which neutralizes the enamel-eroding acid produced by the bacteria fueled by sugar, a chance to finish its buffering. Instead, try as much as possible to limit treats to mealtimes.

Use different sweeteners. There are a number of alternative sweeteners to regular sugar, both natural and artificial. Some work better in baked goods, while others are more suitable for candies or beverages. Xylitol in particular, a sugar alcohol, actually discourages oral bacterial growth. You can also use natural sweetening agents like stevia or erythritol to help reduce refined sugar in your treats.

Even if you normally limit carbohydrates, it's understandable if their consumption rises during the holidays. That's why it's important you don't neglect daily brushing and flossing to help control bacterial plaque, the main driver for dental disease. Both effective oral hygiene and reining in the sweets will help your teeth and gums sail through the holidays into the new year.

If you would like more information about protecting your oral health during the holidays, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “The Bitter Truth About Sugar.”

By Dr. Mark C. Pothitakis
December 23, 2021
Category: Oral Health
Tags: tooth decay  
TheresMoreWeCanDoAboutToothDecayBesidesDrillandFill

Until recently, the standard treatment for tooth decay remained essentially the same for nearly a century: Remove any decayed structure, then prepare and fill the cavity. But that singular protocol has begun to change recently.

Although "drilling and filling" saves teeth, it doesn't fully address the causes of decay. In response, dentists have broadened their approach to the disease—the focus now is on an individual patient's particular set of risk factors for decay and how to reduce those.

At the heart of this new approach is a better understanding of oral bacteria, the true cause of decay. Bacteria produce acid, which can erode tooth enamel and create a gateway into the tooth for decay to advance. We therefore want to lower those risk factors that may lead to bacterial growth and elevated acidity.

One of our major objectives in this newer approach is to reduce plaque, a thin film of food particles used by bacteria for food and habitation. Removing plaque, principally through better oral hygiene, in turn reduces decay-causing bacteria.

Plaque isn't the only mechanism for bacterial growth and acidity. Appliances like dentures or retainers accumulate bacteria if not regularly cleaned. Reduced saliva flow, often due to certain medications or smoking, limits this fluid's ability to buffer acid and acid reflux or acidic beverages like sodas, sports or energy drinks can disrupt the mouth's normal pH and increase the risk for enamel erosion.

Our aim, then, is to develop a long-term strategy based on the patient's individual set of oral disease risk factors. To determine those, we'll need to examine their medical history (including family), current health status and lifestyle habits. From there, we can create a specific plan targeting the identified risk factors for decay.

Some of the elements of such a strategy might include:

  • Daily brushing and flossing, along with regular dental cleanings;
  • Fluoride dental products or treatments to strengthen enamel;
  • Changes in diet and excess snacking, and ceasing from any tobacco use;
  • Cleaning and maintaining appliances, as well as monitoring past dental work.

Improving the mouth environment by limiting the presence of oral bacteria and acid can reduce the occurrence of tooth decay and the extent of treatment that might be needed. It's a more nuanced approach that can improve dental health.

If you would like more information on tooth decay prevention and treatment, 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 “Tooth Decay: How to Assess Your Risk.”

By Dr. Mark C. Pothitakis
December 18, 2021
Category: Oral Health
Tags: sleep apnea  
YourDentistMayBeAbleToProvideYouWithaSleepApneaSolution

Morning tiredness, brain fog and snoring are just some of the indicators of a medical condition known as sleep apnea. And, it's worse than waking up on the wrong side of the bed—over time, sleep apnea could increase your risk for heart disease or other life-threatening conditions.

Sleep apnea occurs when air flow becomes restricted during sleep, usually by the tongue blocking the airway. As oxygen levels begin to fall, the brain signals the body to wake up to "fix" the air flow problem.

As this arousal may only last a second or two, you may not remember it when you awaken in the morning. But it can happen numerous times a night, depriving you of the deep sleep your body needs for rest and repair.

Fortunately, there are ways to treat sleep apnea. In extreme instances, you may need surgery to correct anatomical defects causing the condition. For most cases, though, the most common treatment is continuous positive airway pressure (CPAP) therapy, which consists of a portable pump delivering pressurized air through a face mask that keeps the throat open while you sleep.

Used by millions of patients, CPAP can be quite effective. Some patients, though, feel uncomfortable using a CPAP machine for various reasons. If you're one of those unhappy CPAP campers or you would like to consider a possible alternative, your dentist might have the answer: oral appliance therapy (OAT).

An OAT device is worn in the mouth during sleep to prevent the tongue from falling back against the back of the throat and blocking the airway. There are various forms of OAT appliances, but they're all custom-made by a dentist to fit an individual patient's mouth. They work best for mild to moderate sleep apnea in which the tongue is the primary culprit in airway blockage.

If you suspect you may have sleep apnea, you should undergo a complete examination by a doctor or dentist to confirm it. If you've been diagnosed with mild to moderate sleep apnea, talk to your dentist about an OAT device. You may find OAT can provide you the relief you need for a better night's sleep.

If you would like more information on oral treatments for sleep apnea, 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 “If You Snore, You Must Read More!