Your tooth enamel is often under assault from oral acid produced by bacteria and certain foods. Unless neutralized, acid can erode your enamel, and lead to destructive tooth decay.
But there's another type of acid that may be even more destructive—the acid produced in your stomach. Although important for food digestion, stomach acid outside of its normal environment can be destructive. That includes your teeth, if stomach acid finds its way into your mouth. And that can happen if you have gastroesophageal reflux disease (GERD).
GERD, a chronic condition affecting 1 in 5 adults, is caused by the weakening of the lower esophageal sphincter, a ring of muscle at the intersection of the esophagus and the stomach that prevents stomach acid from traveling back into the digestive tract and damaging the esophageal liner.
It's also possible for stomach acid to travel as far up as the mouth. With a pH of 2.0 or less, stomach acid can lower the mouth's normal pH level of 7.0 well below the 5.5 pH threshold for enamel softening and erosion. This can cause your teeth, primarily the inside surfaces of the upper teeth, to become thin, pitted or yellowed. Your teeth's sensitivity may also increase.
If you have GERD, you can take precautions to avoid tooth damage and the extensive dental work that may follow.
- Boost acid buffering by rinsing with water (or a cup of water mixed with a ½ teaspoon of baking soda) or chewing on an antacid tablet.
- Wait about an hour to brush your teeth following a reflux episode so that your saliva has time to neutralize acid and re-mineralize enamel.
- If you have chronic dry mouth, stimulate saliva production by drinking more water, chewing xylitol gum or using a saliva supplement.
You can also seek to minimize GERD by avoiding tobacco and limiting your consumption of alcohol, caffeine or spicy and acidic foods. Your doctor may also prescribe medication to control your GERD symptoms.
Preventing tooth decay or gum disease from the normal occurrences of oral acid is a daily hygiene battle. Don't let GERD-related acid add to the burden.
If you would like more information on protecting your teeth from acid reflux, 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 “GERD and Oral Health.”
“Orthodontic treatment” and “braces” almost seem like synonymous terms. But while braces certainly are orthodontic, it isn't the only tool in an orthodontist's toolkit.
A good example is a device is known as a Herbst appliance. It's used in situations where the upper jaw is outpacing the growth and development of the lower jaw during childhood. If not corrected, this could cause the top teeth to protrude abnormally beyond the lower teeth.
The Herbst appliance gently and gradually coaxes the lower jaw to grow in a more forward direction, thus “catching up” with the upper jaw. The top part of the device consists of two metal tubes hinged to small elastic bands, which are cemented to the cheek side of the upper back teeth (molars), one on either side of the jaw.
Two smaller tubes are attached in like fashion to the lower teeth, and then inserted into the larger tubes. As the lower jaw moves, the smaller tubes move within the larger to create pressure that gently pushes the jaw forward. Over time, this can sync the growth progress of both the upper and lower jaws, and reduce the chances of a poor bite.
For best results, a Herbst appliance is usually placed to coincide with a child's most rapid period of jaw growth, usually between 11 and 14. They could be placed as early as 8 or 9, however, in situations where the front teeth are already protruding well beyond the lips. In any event, the goal is to positively influence the growth of the lower jaw to alleviate or at least minimize the need for future orthodontic treatment.
As a fixed device, there's no need for a child or parent to tend to it as with other methods, like orthodontic headwear worn in conjunction with braces. A Herbst appliance can, however, alter the normal sensations associated with eating, swallowing and speaking, which may take a little adjustment time for the child. Wearers will also need to be extra vigilant with daily brushing and flossing because of a higher risk of tooth decay.
These, though, are minor inconveniences compared with the benefit of improved bite development. As such, a Herbst appliance could be a positive investment in your child's dental future.
If you would like more information on interceptive orthodontics, 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 “The Herbst Appliance.”
If it seems like your teeth are getting longer as you get older, it's unlikely they're magically growing. More likely, your gums are shrinking or receding from your teeth. Besides the negative effect on your appearance, gum recession exposes you and vulnerable tooth areas to harmful bacteria and painful sensitivity.
Although common among older adults, gum recession isn't necessarily a part of aging: It's primarily caused by periodontal (gum) disease, in which infected gum tissues can weaken and detach from the teeth. This, along with bone loss, leads to recession.
But gum disease isn't the only cause—ironically, brushing your teeth to prevent dental disease can also contribute to recession. By brushing too aggressively or too often (more than twice a day), you could eventually damage the gums and cause them to recede. Tobacco use and oral piercings can also lead to weakened or damaged gums susceptible to recession.
You can lower your risk of gum recession by abstaining from unhealthy habits and proper oral hygiene to prevent gum disease. For the latter, your primary defense is gentle but thorough brushing and flossing every day to remove harmful dental plaque. You should also see your dentist at least twice a year for professional dental cleanings and checkups.
If, however, you do experience gum recession, there are a number of ways to restore your gums or at least minimize the recession. To start with, we must treat any gum disease present by thoroughly removing all plaque and tartar (calcified plaque), which fuels the infection. This reduces inflammation and allows the gums to heal.
With mild recession, the gums may rejuvenate enough tissue to recover the teeth during healing. If not, we may be able to treat exposed areas with a tooth-colored material that protects the surface, relieves discomfort and improves appearance.
If the recession is more advanced, we may still be able to stimulate gum regeneration by attaching a tissue graft with a micro-surgical procedure. These types of periodontal surgeries, however, can require a high degree of technical and artistic skill for best results.
In any event, the sooner we detect gum disease or recession, the quicker we can act to minimize the damage. Doing so will ensure your gums are healthy enough to protect your teeth and preserve your smile.
If you would like more information on gum recession, 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 “Gum Recession.”
Learning you're pregnant can change your life in a heartbeat—or now two. Suddenly, what was important to you just seconds before the news takes a back seat to the reality of a new life growing within you.
But although many of your priorities will change, there's one in particular that shouldn't—taking care of your dental health. In fact, because of the hormonal changes that will begin to occur in your body, your risk of dental disease may increase during pregnancy.
Because of these hormonal variations, you may find you have increased cravings for certain foods. If that includes eating more carbohydrates (especially sugar), bacteria can begin to multiply in your mouth and make you more susceptible to tooth decay and periodontal (gum) disease.
The hormones in themselves can also increase your risk of gum disease in particular. There's even a name for a very common form of gum infection—pregnancy gingivitis—which affects around two-fifths of pregnant women. If not treated, it could aggressively spread deeper within the gums and endanger both your teeth and supporting jaw bone.
The key to minimizing both tooth decay and gum disease is to keep your mouth clean of dental plaque, a thin bacterial biofilm most responsible for these diseases. You can do this by keeping up daily brushing and flossing and maintaining regular dental cleanings and checkups. Professional dental care is especially important during pregnancy.
You may, though, have some reservations about some aspects of dental care, especially if they involve undergoing local anesthesia. But many medical organizations including the American Congress of Obstetricians and Gynecologists and the American Dental Association recommend dental treatment during pregnancy. Even procedures involving local anesthesia won't increase the risk of harm to you or your baby.
That said, though, elective dental work such as cosmetic enhancements, might be better postponed until after the baby is born. It's best to discuss with your dentist which treatments are essential and should be performed without delay, and which are not. In general, though, there's nothing to fear for you or your baby continuing your regular dental care—in fact, it's more important than ever.
If you would like more information on dental care during pregnancy, 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 “Dental Care During Pregnancy.”
If you think periodontal (gum) disease is something that only happens to the other guy (or gal), you might want to reconsider. Roughly half of adults over age 30—and nearly three-quarters over 65—have had some form of gum disease.
Gum disease isn't some minor inconvenience: If not treated early, a gum infection could lead to bone and tooth loss. Because it's inflammatory in nature, it may also impact the rest of your health, making you more susceptible to diabetes, heart disease or stroke.
Gum disease mainly begins with dental plaque, a thin film of food particles on tooth surfaces. Plaque's most notable feature, though, is as a haven for oral bacteria that can infect the gums. These bacteria use plaque as a food source, which in turn fuels their multiplication. So, the greater the plaque buildup, the higher your risk for a gum infection.
The best way to lower that risk is to reduce the population of bacteria that cause gum disease. You can do this by keeping plaque from building up by brushing and flossing every day. It's important for this to be a daily habit—missing a few days of brushing and flossing is enough for an infection to occur.
You can further reduce your disease risk by having us clean your teeth regularly. Even if you're highly proficient with daily hygiene, it's still possible to miss some plaque deposits, which can calcify over time and turn into a hardened form called tartar (or calculus). Tartar is nearly impossible to remove with brushing and flossing, but can be with special dental tools and techniques.
Even with the most diligent care, there's still a minimal risk for gum disease, especially as you get older. So, always be on the lookout for red, swollen or bleeding gums. If you see anything abnormal like this, see us as soon as possible. The sooner we diagnose and begin treating a gum infection, the better your chances it won't ultimately harm your dental health.
If you would like more information on the prevention and treatment of 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.”
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