- Dry Mouth
- TMJ - Temporomandibular Joint and Muscle Disorders
- Bad Breath - Halitosis
- Gum Disease
- Impacted Tooth
Recommending Methods to Cope
Reduced saliva flow that results in a dry mouth is a common problem among older adults. It is caused by certain medical disorders and is often a side effect of medications such as antihistamines, decongestants, pain killers and diuretics.
Some of the common problems associated with dry mouth include a constant sore throat, burning sensation, problems speaking, difficulty swallowing, hoarseness or dry nasal passages. Left untreated, dry mouth can damage your teeth. Without adequate saliva to lubricate your mouth, wash away food, and neutralize the acids produced by plaque, extensive decay can occur.
Your dentist can recommend various methods to restore moisture. Sugar-free candy or gum stimulates saliva flow, and moisture can be replaced by using artificial saliva and oral rinses.
Dry mouth is a potential side effect of numerous medications (prescribed and over-the-counter). Among them are antihistamines, decongestants, painkillers, high blood pressure medications, muscle relaxants, drugs for urinary incontinence, Parkinson’s disease medications, antidepressants and many others. Drying irritates the soft tissues in the mouth, which can make them inflamed and more susceptible to infection. Without the cleansing effects of saliva, tooth decay and other oral health problems become more common. Patients using oral inhalers for asthma often develop oral candidiasis, an oral fungal infection, and are encouraged to rinse their mouths with water after using the inhaler.
Keeping You Informed
If you use a bisphosphonate medication to prevent or treat osteoporosis (a thinning of the bones) or as part of cancer treatment therapy, you should advise your dentist. In fact, any time your health history or medications change, you should make sure the dental office has the most recent information in your patient file. Here's why:
Some bisphosphonate medications (such as Fosamax, Actonel, Boniva) are taken orally (swallowed) to help prevent or treat osteoporosis and Paget's disease of the bone. Others, such as Aredia, Bonefos, Didronel or Zometa, are administered intravenously (injected into a vein) as part of cancer therapy to reduce bone pain and hypercalcemia of malignancy (abnormally high calcium levels in the blood), associated with metastatic breast cancer, prostate cancer and multiple myeloma.
In rare instances, some individuals receiving intravenous bisphosphonates for cancer treatment have developed osteonecrosis (pronounced OSS-tee-oh-ne-KRO-sis) of the jaw, a rare but serious condition that involves severe loss, or destruction, of the jawbone.
Symptoms include, but are not limited to:
- Pain, swelling, or infection of the gums or jaw
- Gums that are not healing
- Loose teeth
- Numbness or a feeling of heaviness in the jaw
- Exposed bone
If you receive intravenous bisphosphonates (or received them in the past year) and experience any of these or other dental symptoms, tell your oncologist and your dentist immediately.
More rarely, osteonecrosis of the jawbone has occurred in patients taking oral bisphosphonates.
Most cases of osteonecrosis of the jaw associated with bisphosphonates have been diagnosed after dental procedures such as tooth extraction; however, the condition can also occur spontaneously. Also, invasive dental procedures, such as extractions or other surgery that affects the bone can worsen this condition. Patients currently receiving intravenous bisphosphonates should avoid invasive dental procedures if possible. The risk of osteonecrosis of the jaw in patients using oral bisphosphonates following dental surgery appears to be low.
Am I at Risk?
Because osteonecrosis of the jaw is rare, researchers cannot yet predict who, among users, will develop it. To diagnose osteonecrosis of the jaw, doctors may use x-rays or test for infection (taking microbial cultures). Treatments for osteonecrosis of the jaw may include antibiotics, oral rinses and removable mouth appliances. Minor dental work may be necessary to remove injured tissue and reduce sharp edges of damaged bone. Surgery is typically avoided because it may make the condition worse. The consensus is that good oral hygiene along with regular dental care is the best way to lower your risk of developing osteonecrosis.
Cancer Treatment and Oral Health
Dental care is an important element of overall cancer treatment. As soon as possible after the cancer diagnosis, the patient's treatment team should involve the dentist. Individuals who will undergo cancer treatment should:
- Schedule a dental exam and cleaning before cancer treatment begins and periodically during the course of treatment.
- Tell the dentist that he or she will be treated for cancer.
- Discuss dental procedures, such as extractions or insertion of dental implants, with the oncologist before starting the cancer treatment.
- Have the dentist check and adjust removable dentures as needed.
- Tell the dentist and physician about any bleeding of the gums, or pain, or unusual feeling in the teeth or gums, or any dental infections.
- Update a medical history record with the dentist to include the cancer diagnosis and treatments.
- Provide the dentist and oncologist with each other's name and telephone number for consultation.
- Maintain excellent oral hygiene to reduce the risk of infection
What is TMJ and How Is It Treated?
Arguably the most complex set of joints in the human body, the Temporomandibular joints, or TMJ, connect the lower jaw (mandible) to the skull (temporal bone) in front of the ear. The TMJ is comprised of muscles, blood vessels, nerves, and bones which control the opening and closure of the mouth. The joints allow movement up and down, side to side, and forward and back—all the mobility necessary for biting, chewing and swallowing food, for speaking and for making facial expressions.
Temporomandibular Joint (TMJ) and Muscle Disorders
Due to the complexity of the muscular systems associated with the jaw area, the Temporomandibular Joints can often become misaligned or irritated. This can lead to pain in the surrounding soft tissues as well as clicking, popping, or deviations in the movements of the TMJ joints. Others symptoms include: biting or chewing difficulty or discomfort, earache, headache, jaw pain or tenderness of the jaw, reduced ability to open or close the mouth.
Causes of TMJ disorder vary among patients but are often related to injury, oral misalignment and clenching or grinding of the teeth. Conditions that routinely affect other joints in the body, such as arthritis, also affect the temporomandibular joint.
TMJ Treatment and Therapy
Because the cause of TMJ disorders varies widely from patient to patient, it is best to let your dentist develop a treatment plan that’s right for you. Our experienced team at Bennett Family Dentistry can diagnose and recommend a treatment to alleviate pain and improve or restore normal TMJ function, typically using non-invasive TMJ therapy procedures.
If you are suffering from the symptoms of TMJ disorder, please contact us to set up a consultation with one of our TMJ treatment specialists.
Bad Breath - Halitosis
Where It Comes From and How to Combat It
Bad breath is an embarrassing condition that everyone experiences from time to time. However, for some people, bad breath (halitosis) is a chronic condition that they may not even be aware of. We can help identify the cause of bad breath and, if it’s due to an oral condition, develop a treatment plan to eliminate it.
Causes of Bad Breath
Bad breath is caused by odor-producing bacteria that grow and populate within the mouth. It can result from poor dental health habits and be an indicator of other health problems. Common causes of bad breath include:
- Inconsistent Brushing/Flossing Habits
- Dry Mouth (Xerostomia)
- Foods with a strong odor (such as Garlic or Onions)
- Tobacco Products
- Periodontal (Gum) Disease
- Sinus or Respiratory Infections
- Improperly Fitted Dental Appliances
What Health Problems Are Associated With Bad Breath?
Persistent bad breath or a bad taste in your mouth may be warning signs of gum (periodontal) disease. Gum disease is caused by the buildup of plaque on teeth. The bacteria cause toxins to form in the mouth, which irritates the gums. If gum disease continues untreated, it can damage the gums and jawbone.
Bad breath may also be the sign of medical disorders, such as a local infection in the respiratory tract, chronic sinusitis, postnasal drip, chronic bronchitis, diabetes, gastrointestinal disturbance, liver or kidney ailment. If your dentist determines that your mouth is healthy, you may be referred to your family doctor or a specialist to determine the cause of bad breath.
What Can I Do to Prevent Bad Breath?
Practice good oral hygiene.
Brush twice a day with fluoride toothpaste to remove food debris and plaque. Brush your teeth after you eat (keep a toothbrush at work or school to brush after lunch). Don't forget to brush your tongue, too. Replace your toothbrush every 2 to 3 months. Use floss or an interdental cleaner to remove food particles and plaque between your teeth once a day. Dentures should be removed at night and cleaned thoroughly before being placed in your mouth the next morning.
See your dentist regularly - at least twice a year.
He or she will conduct an oral examination and professional teeth cleaning and will be able to detect and treat periodontal disease, dry mouth, or other problems that may be the cause of bad mouth odor.
Stop smoking/chewing tobacco-based products.
Ask your dentist for tips on kicking the habit.
Drink lots of water.
This will keep your mouth moist. Chewing gum (preferably sugarless) or sucking on candy (preferably sugarless) also stimulates the production of saliva, which helps wash away food particles and bacteria.
Keep a log of the foods you eat.
If you think the foods that you eat may be causing your bad breath, record what you eat. Bring the log to your dentist to review. Similarly, make a list of the medications you take. Some medications may play a role in creating mouth odors.
Your oral health is our top priority.
We understand the conditions that cause bad breath and the embarrassment that it can cause for our patients. Please contact us for more information or to schedule a consultation with one of our team members.
Symptoms and Treatment
For many people, gingivitis can be a painful and unsightly problem. Gingivitis in and of itself is a nondestructive gum disease and can be reversed if treated properly. But if not treated, it can worsen and become periodontitis, which is a more destructive form of gum disease in which periodontal fibers or bone may be lost. There are typically two types of gingivitis, plaque induced and non-plaque-induced gingivitis. When plaque builds up, bacteria also build up. This causes the gums to become inflamed and easily irritated by brushing. When plaque is not removed it turns into a hard deposit called tartar. Both tartar and plaque produce toxins that infect the gum.
Symptoms of Gingivitis
- Tender to the touch gums
- Swollen gums
- Discolored gums (eg. red or purple)
- Mouth sores
- Gums bleed during and after tooth brushing
Gingivitis is not typically painful; many people have it without even knowing it. One of the early signs is a pinkish toothbrush – a sign of bleeding gums with slight pressure. Healthy gums should be pink and firm. Gums that are puffy, dusty red-colored and bleed easily should be seen by your dentist. The sooner you see your doctor the better chance you have of reversing damage and preventing further problems.
Causes of Gingivitis
Gingivitis most always begins with plaque. Plaque is formed by the interaction of sugars and starches with the bacteria that is already in your mouth. Brushing your teeth removes this plaque, but plaque forms quickly so you need to brush often. If plaque stays on your teeth for three or more days, it starts to turn to tartar. The tartar and plaque buildup irritates the gums and causes infection.
Treatment for Gingivitis
Treatment focuses on the reduction of oral bacteria in an effort to remove plaque. Teeth need to be cleaned thoroughly by a dentist or hygienist twice a year for removal of tartar and plaque. It is important to brush, floss and use an antibacterial mouth rinse in between visits to maintain the overall health of the gums.
Are You at Risk?
There are two common forms of gum disease: gingivitis and periodontitis. Gingivitis is a less destructive type of periodontal disease that can be reversed if treated properly, but periodontitis is more advanced. When the space between the teeth and the gums collect debris and become infected. toxins produced by the bacteria in the plaque break down the bone and connective tissue that holds the teeth in place. If left untreated, periodontitis can lead to the loss of teeth.
The disease occurs when microorganisms grow on the surface of the teeth. The body can sometimes have an overaggressive immune reaction to these organisms, which leads to the loss of bone or teeth. Some forms of periodontitis can be irreversible. Gum disease is the leading cause of tooth loss in adults.
Symptoms of Gum Disease
- Breath odor or bad taste in the mouth
- Bright shiny gums
- Formation of deep pockets between teeth and gums
- Loose or shifting teeth
- Change in the way teeth fit together when you bite
(Note: Early symptoms are the same as gingivitis)
Gum disease is the leading cause of tooth loss in adults. Nonsurgical treatments such as scaling, root planning, and antibiotics can be effective. Surgery may be necessary in some case to open up the pockets cause the inflammation to remove the buildup of plaque and tartar. Since tartar and plaque contain bacteria, tooth infection might occur. Oral hygiene is an important means of prevention for any oral disease. Contact a doctor if any signs of gum disease occur.
- Poor oral health habits
- Older age
- Decreased immunity
- Poor nutrition
- Hormonal changes
- Substance abuse
Research suggests that the bacteria associated with periodontitis can travel through your bloodstream, affecting other parts of your body. Bacteria may travel to arteries in your heart and trigger a cycle of inflammation and arterial narrowing that contributes to heart attacks.
What Is an Impacted Tooth?
An impacted tooth, like an embedded tooth, is a tooth that stays below the surface of the gum instead of breaking through the gum and into the mouth. However, where an impacted tooth and an embedded tooth differ is why they do not break through into the mouth.
While an embedded tooth is prevented from erupting because it is covered by bone, an impacted tooth cannot erupt because it is wedged against another tooth or teeth. If a tooth becomes impacted or embedded and causes a person problems, it may need to be removed by a dentist. The most common teeth impacted are the wisdom teeth (the third set of molars).
Symptoms of an Impacted Tooth
- Bad breath
- Occasional difficulty in opening the mouth
- Pain associated with the gum or jaw bone
- Prolonged jaw ache
- Gap where a tooth did not emerge
If the tooth is not causing any problems, treatment is not necessary. Pain relievers may help if the tooth is causing discomfort. Extraction (removal) is the usual treatment for an impacted tooth. Difficult cases may require an oral surgeon. In some cases, the tooth becomes infected and antibiotics are needed.