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Weapons of Mouth Destruction – Part 2

Weapons of Mouth Destruction – Part 2

These WMDs are unquestionably real. In this post, I will continue discussing the various threats to your oral health so that you can be on guard against them.
Please see part 1 for weapons 1-3.

 

#4 Tobacco
This one is a no-brainer when it comes to your overall health, but many people don’t recognize the damaging effects of tobacco on the oral cavity. The most significant risk of tobacco is oral cancer. Squamous cell carcinoma is the most dangerous form, accounting for the vast majority of oral-cancer related deaths. It is rare for an individual who has no history of tobacco use to get this type of cancer. Since it is mostly preventable, dental professionals such as myself owe it to their patients to discuss the risk of using tobacco and encourage quitting. It is also critical to perform an oral cancer screening, where all the soft tissues in the mouth are closely examined for lumps, patches, ulcers or other irregularities as part of routine check-ups. Smoking tobacco is the worst offender, but chewing tobacco carries risks as well. It is easy to recognize when a person regularly uses chewing tobacco due to the obvious changes in the tissue where the tobacco routinely sits. There is no safe form of tobacco. Period.
The other major threat of tobacco is gum disease, or what dentists call periodontal disease. When a person uses tobacco regularly (especially smoking), the immune system is compromised and cannot respond adequately to bacterial infection. Since periodontal disease is caused by bacteria, it progresses more rapidly in smokers. It starts with the breakdown of the gum attachment around the tooth, and if not treated, advances to bone loss. Eventually this can cause loosening of the teeth, and ultimately their loss. The effects of tobacco are dose-dependent, so the more you use, the higher your risk of losing your teeth. The solution is simple, but not easy – quit using tobacco! Fortunately, there are many options for patients today who desire help with quitting. Ask us at Inspire Dental for help if you are ready to quit.

 

#5 Acid
In WMDs part 1, I discussed the mechanism by which sugar causes tooth decay and the role of acid in this process. Strong acids have the ability to literally dissolve, or ‘erode’ the teeth. The enamel will start to be negatively affected at a pH of 5.5 or less. Acids from dietary sources can be damaging on their own if they are present in the mouth frequently. People who suck on lemons or other acidic foods will have a characteristic pattern of enamel erosion in the area where the acid contacts the teeth. Stomach acid is extremely strong with a pH as low as 1.5, and if an individual suffers from acid reflux (heartburn or GERD) or vomits very frequently, the surface of the teeth will have a characteristic eroded appearance. Sodas and sports drinks are bigtime offenders as well, with pH levels ranging from 2.5 to 4. Seriously!?!? The amount of contact time is critical, so sipping on an acidic beverage vs. chugging it is much more dangerous over the long-term. I can’t help but cringe when I see young people drinking these energy drinks that are loaded with sugar, caffeine and acid. Erosion is irreversible – once enamel is gone, it is GONE! Without enamel the teeth are at much higher risk of decay or further erosion or abrasion, as the dentin (the next layer inward) is softer and much less resistant to damage. The solution? Avoidance is the best defense. These super-acidic-sugar-loaded drinks are always a losing proposition. If you insist, have the drink with a meal instead of sipping throughout the day. The same goes for fruit juice. Keep contact time to a minimum and don’t brush your teeth immediately after an acid challenge since you can more easily wear away the enamel. If you have acid reflux or vomit frequently, seek treatment from your primary care doctor.

 

#6 Dry mouth
Saliva is a beautiful, wonderful thing. It helps us swallow food and keeps of our soft tissues from sticking to each other. It contains enzymes that start the digestive process, ions to buffer the pH, hormones and antibacterial agents. This SPIT is amazing! Many of us don’t realize just how great it is until we suddenly have less of it. Many medications cause saliva output to decrease, leaving the mouth feeling dry. Medical treatments such as chemotherapy and radiation can make the production come to a screeching halt. Without all the protective and comforting effects of saliva, people experience pain and burning in their mouths, have much higher risk of tooth decay, even bad breath – all negative for oral health and quality of life in general. The treatment of dry mouth is tricky and complex because often the medication or procedure causing the problem cannot be avoided. This typically means that we must do our best to counteract the negative effects. There are several products marketed to people with dry mouth. These include specialized mouthwash products, toothpastes, and saliva substitutes which can be quite helpful. For very extreme cases, medications can be prescribed to increase saliva production. This doesn’t come without a few side effects of its own, however, which must be weighed against the benefits to the individual. Sometimes higher concentrations of fluoride are used in toothpaste or gel form to aid in preventing tooth decay. While the benefit to the teeth is obvious, it presents concerns to overall health since it’s not a good idea to ingest much fluoride. Ask me for more information about this if you are interested…
I hope this information has made you more aware of the various threats to your oral health. I firmly believe that knowledge is the first step to prevention and informed patients are empowered to take charge of their health and well-being. Along with the amazing team at Inspire Dental, I am here to educate you and support you in achieving the best health possible!

-Kari

Weapons of Mouth Destruction – Part 1

Weapons of Mouth Destruction – Part 1

Everyone knows that sugar is bad for your teeth. But there are so many other threats to your oral health that you may be less aware of. In this 2-part post, I will highlight the key players when it comes to mouth destruction so you can be on guard!
#1: Sugar
Yes, we must talk about this first because it really is important to understand the mechanism of tooth decay. For a tooth to get decay, several factors must all be present at the same time. The first is bacteria. Thanks to our parents, we all were inoculated with oral bacteria at a pretty young age. It is impossible to avoid this (good luck never sharing a utensil, food or beverage with your kid, let alone not kissing their sweet face!). So we just have to deal with the consequences. There are many different species of bacteria in our mouths, and some of us have higher concentrations of the more aggressive strains than others. These bacteria are fueled by simple carbohydrates, forming a sticky substance called plaque and producing acid as a byproduct of their metabolism. This is the real offender. Over time, if the sticky plaque remains on your teeth, the acid will start to dissolve the enamel of your tooth. If not halted early, this process progresses past the enamel, deeper into your tooth. The worst case scenario is that the destruction makes its way into the nerve of your tooth, carrying the bacteria with it. Once the nerve is infected, a raging toothache can ensue. Not fun. This destruction can also cause teeth to break since their structural integrity is undermined by decay. The solution to the sugar problem is multi-fold. Avoiding simple sugar in general minimizes the amount of damage that is possible (don’t we all wish that were easy?). Keep in mind that the majority of common foods and beverages in our modern American diets are laden with sugar. Reading nutrition labels is necessary to really know what you are eating/drinking. Having good hygiene also mitigates risk from sugar because removing the plaque from the surface of the tooth halts the process. Brushing is the primary means of achieving this, but since the bristles of a brush can only reach so far, it is also necessary to clean in between your teeth with something else. Dental floss, water flossers (like the Waterpik®) or smaller brushes designed to get in between your teeth will do the job. Yes, it’s a hassle to go to all this trouble, but it is worth the effort! You can also work to lessen the number of bacteria in your mouth. Antiseptic rinses aim to do this. Keep in mind that there are a lot of mouthwashes on the market, but only a few are truly antiseptic. You also must rinse with them for the prescribed amount of time at full strength to really do the job. Even so, there are places in the mouth that bacteria lurk that a mouthwash will never reach. Ask us friendly folks at Inspire Dental for more details!
#2: Parafunction
This is a fancy word us dentists use to describe the activities the teeth and muscles of the mouth are engaged in that are not part of necessary function. At the most basic level, the function of the oral cavity is to start the digestive process by chewing food and breaking down carbohydrates with enzymes. Speech and breathing are other vital functions that the oral cavity plays a role in. Clenching or grinding your teeth are actions that are not accomplishing anything productive, so they are considered “parafunctional” activities. These habits can be very destructive to the TMJs, the muscles of the face, the teeth themselves, and even the gums and bone around the teeth. The really pesky thing about parafunction lies in the fact that it is quite often out of our control. Many of us do this while we are asleep. Some of us clench or grind our teeth when under stress (anyone who commutes up or down I-25 can relate!). The solution to this problem is complex. I wish it were simpler. One method for minimizing the wear and tear on the teeth and supporting structures is to use a mouth guard. (I’m not referring to the sports kind here – although those are also a great idea.) We often call them ‘night guards’ because they are typically worn while sleeping. They are made of acrylic and custom fitted to your teeth. A night guard serves as a layer of protection between the teeth so when you are grinding in your sleep, you’ll wear down the acrylic and not your enamel. It also takes the stress off of your muscles and joints so you’ll likely feel better when you wake up. I have also been reading lately about a strong connection between nighttime clenching/grinding and airway problems such as sleep apnea. It appears that when we are struggling to breathe, one response is to clench or grind our teeth. This means that a person who treats their sleep apnea may also be treating their parafunction issue. Now that’s really exciting for so many reasons!
#3 Abrasion
Now I’m speaking to you overachievers. You know who you are! You assume that if a soft-bristled toothbrush does a good job, a hard-bristled one will work even better! You want to get in, get done, and get out when it comes to brushing, so you quickly and aggressively scrub your teeth. Or, perhaps you enjoy brushing a lot, you take your time, and do it 5 or 6 times a day. I can think of much better hobbies than this, and I’m a DENTIST for goodness sake! It’s super important to do a good job removing plaque from your teeth and gums, and this cannot be accomplished well in less than 2 minutes for most people. We also need to brush and floss with regular frequency for optimal results. But, you CAN overdo it, and the effects on your teeth are detrimental. I see patients all the time who are brushing with a medium or hard-bristled toothbrush, are pushing too hard, or using a less-than-ideal motion when brushing. The damage is very recognizable. You’ll experience gum recession and what we call “toothbrush abrasion” where areas of your teeth along the gumline are worn or notched out. This can often go hand in hand with parafunction (see #2). My recommendation is to use a soft-bristled toothbrush and a gentle circular motion. Save the hard bristles for cleaning grout! We are happy to demo the best technique for you at Inspire Dental. It truly is amazing how many of us adults never really learned the proper way to brush our teeth. Let’s fix that! The other thing to be aware of if you are prone to this sort of destruction is the type of toothpaste you use. Avoid baking soda or whitening toothpaste if you have gum recession or sensitivity. These products are more abrasive and will remove stains well, but can also do damage when used incorrectly.

That’s all for now….stay tuned for part 2 of “Weapons of Mouth Destruction.”

-Kari