There's ample evidence tobacco smoking increases your risk for tooth decay and periodontal (gum) disease. But the same may be true for electronic cigarettes (E-cigs): Although millions have turned to “vaping” believing it's a safer alternative to smoking, there are growing signs it might also be harmful to oral health.
An E-cig is a device with a chamber that holds a liquid solution. An attached heater turns the liquid into a vapor the user inhales, containing nicotine, flavorings and other substances. Because it doesn't contain tar and other toxic substances found in tobacco, many see vaping as a safer way to get a nicotine hit.
But a number of recent research studies seem to show vaping isn't without harmful oral effects. A study from Ohio State University produced evidence that E-cig vapor interferes with the mouth's bacterial environment, or oral microbiome, by disrupting the balance between harmful and beneficial bacteria in favor of the former. Such a disruption can increase the risk for gum disease.
Other studies from the University of Rochester, New York and Universit? Laval in Quebec, Canada also found evidence for vaping's negative effects on oral cells. The Rochester study found astringent flavorings and other substances in vaping solutions can damage cells. The Quebec study found a staggering increase in the normal oral cell death rate from 2% to 53% in three days after exposure to E-cig vapor.
Nicotine, E-cig's common link with tobacco, is itself problematic for oral health. This addictive chemical constricts blood vessels and reduces blood flow to the mouth's tissues. This not only impedes the delivery of nutrients to individual cells, but also reduces available antibodies necessary to fight bacterial infections. Regardless of how nicotine enters the body—whether through smoking or vaping—it can increase the risk of gum disease.
These are the first studies of their kind, with many more needed to fully understand the effects of vaping on the mouth. But the preliminary evidence they do show should cause anyone using or considering E-cigs as an alternative to smoking to think twice. Your oral health may be hanging in the balance.
Nothing beats the form and function of a real tooth—but dental implants come pretty close. That's why they're tops among both dentists and patients for replacing missing teeth.
Much of an implant's functionality and durability can be credited to its material construction, from the titanium metal post imbedded in the jawbone to the lifelike porcelain crown attached at its other end. But an implant's “nuts and bolts” isn't the only reason why this premier dental restoration is so popular: A good portion of their success comes from the adjunct support provided by digital technology.
Without this varied array of computer-based applications used in planning, designing and installing them, implants couldn't produce the level of satisfactory outcomes they currently do. Here then are a few of the high-tech tools dentists use to make sure your implants result in a winning smile.
CBCT scanning. Implant placement requires a high degree of precision often complicated by various anatomical structures like nerves, blood vessels and sinuses within the gums and jaws. Cone Beam Computer Tomography (CBCT) scanners rotate around a patient's head, taking hundreds of digital x-ray images that are then assembled into a 3-D model image. Dentists can view this model from various angles to identify obstacles and better pinpoint the best implant locations.
Digital impressions. Dentists can also create a 3-D digital impression model of the inside of a patient's mouth that can give them views of their current teeth and gums from any angle. This aids in determining the size and type of implant so that it blends seamlessly with remaining teeth. A digital impression can also provide both the dentist and patient a preview appearance of their future smile after treatment.
3-D printed surgical guides. To accurately drill the implant site during surgery, dentists often create a custom-made device called a surgical guide that fits into the patient's mouth during the procedure. Using results from scanning and digital impressions, highly accurate guides can be created with a 3-D printer. This further ensures that the implant will be in the exact best location for the most attractive and functional outcome.
Implantology is as much art as it is science in achieving a beautiful smile. These and other digital tools help make that desirable end a reality.
If you would like more information on dental implants, please contact us or schedule an appointment for a consultation.
Your tooth enamel’s main nemesis is oral acid: normally produced by bacteria, foods or beverages, acid can dissolve enamel’s mineral content and cause erosion and decay. But acid might be a bigger problem for you if you also have gastroesophageal reflux disease or GERD.
GERD is a digestive condition in which stomach acid backs up into the digestive tract. Normally, a ring of muscle at the end of the esophagus prevents stomach acid from coming up into it. But if it weakens, this powerful acid can splash up into the esophagus and irritate its more delicate lining and result in a burning sensation known as heartburn or acid indigestion.
The problem for teeth, though, is that GERD could cause stomach acid to potentially come up into the mouth. Because of its high acidic pH (2.0 or less), stomach acid can cause major erosion in tooth enamel, leaving them pitted, yellow and sensitive. If not caught and treated early, some of your teeth could be damaged to the point that they have a questionable prognosis.
There are some things you can do to minimize GERD’s effect on your dental health. First and foremost, see a doctor about managing your symptoms, which might include medication. Be sure you also inform your dentist that you have GERD and what medications you’re taking.
One way to lessen the effect of higher acid in the mouth is to stimulate saliva production, which helps neutralize acid. You can do this by drinking plenty of water, taking a saliva booster or chewing xylitol-sweetened gum. You can also rinse with plain water or water mixed with baking soda (1/2 teaspoon to a cup of water), or chew an antacid tablet to help balance your mouth’s pH level.
And don’t forget to look out for your enamel. Be sure you’re practicing daily brushing and flossing and using fluoride hygiene products to strengthen it. Your dentist can also apply topical solutions or prescribe special rinses with higher concentrations of fluoride.
GERD can be an unpleasant experience that escalates into major problems. Don’t let it compromise your dental health.
Kathy Bates has been a familiar face to filmgoers since her Oscar-winning performance as Annie Wilkes in Misery. She's best known for playing true-to-life characters like Wilkes or Barbara Jewell in last year's Richard Jewell (for which she earned her fourth Oscar nomination). To keep it real, she typically eschews cosmetic enhancements—with one possible exception: her smile.
Although happy with her teeth in general, Bates noticed they seemed to be “moving around” as she got older. This kind of misalignment is a common consequence of the aging process, a result of the stresses placed on teeth from a lifetime of chewing and biting.
Fortunately, there was an orthodontic solution for Bates, and one compatible with her film career. Instead of traditional braces, Bates chose clear aligners, a newer method for moving teeth first introduced in the late 1990s.
Clear aligners are clear, plastic trays patients wear over their teeth. A custom sequence of these trays is developed for each patient based on their individual bite dimensions and treatment goals. Each tray in the sequence, worn in succession for about two weeks, places pressure on the teeth to move in the prescribed direction.
While clear aligners work according to the same teeth-moving principle as braces, there are differences that make them more appealing to many people. Unlike traditional braces, which are highly noticeable, clear aligners are nearly invisible to others apart from close scrutiny. Patients can also take them out, which is helpful with eating, brushing and flossing (a challenge for wearers of braces) and rare social occasions.
That latter advantage, though, could pose a problem for immature patients. Clear aligner patients must have a suitable level of self-responsibility to avoid the temptation of taking the trays out too often. Families of those who haven't reached this level of maturity may find braces a better option.
Clear aligners also don't address quite the range of bite problems that braces can correct. Some complex bite issues are thus better served by the traditional approach. But that gap is narrowing: Recent advances in clear aligner technology have considerably increased their treatability range.
With that said, clear aligners can be an ideal choice for adults who have a treatable bite problem and who want to avoid the appearance created by braces. And though they tend to be a little more expensive than braces, many busy adults find the benefits of clear aligners to be worth it.
The best way to find out if clear aligners could be a viable option for you is to visit us for an exam and consultation. Like film star Kathy Bates, you may find that this way of straightening your smile is right for you.
If you would like more information about tooth straightening, please contact us or schedule a consultation.
Periodontal (gum) disease often involves more than gum inflammation. The real danger is what this bacterial infection may be doing to tissues beneath the gum line—including tooth roots and supporting bone.
Gum disease can do extensive damage to the forked areas where the roots separate from the main tooth body. If one of these areas, known as a furcation, becomes infected, the associated bone may begin to diminish. And you may not even know it's happening.
Fortunately, we may be able to detect a furcation involvement using x-rays and tactile (touch) probing. The findings from our examination will not only verify a furcation involvement exists, but also how extensive it is according to a formal classification system that dentists use for planning further treatment.
A Class I involvement under this system signifies the beginning of bone loss, usually a slight groove in the bone. Class II signifies two or more millimeters of bone loss. Class III, also called a “through and through,” represents bone loss that extends from one side of the root to the other.
The class of involvement will guide how we treat it. Obviously, the lower the class, the less extensive that treatment will be. That's why regular dental checkups or appointments at the first sign of gum problems are a must.
The first-line treatment for furcation involvements is much the same as for gum disease in general: We manually remove bacterial plaque, the main source of infection, from the root surfaces using hand instruments and ultrasonic equipment. This is often followed by localized antibiotics to further disinfect the area and stymie the further growth of the furcation involvement.
We also want to foster the regrowth of lost tissue, if at all possible. Classes II and III involvements may present a challenge in this regard, ultimately requiring grafting surgery to stimulate tissue regeneration.
The best approach by far is to prevent gum disease, the ultimate cause for a furcation involvement. You can reduce your chances of gum disease by brushing and flossing daily to remove disease-causing plaque. Regular dental cleanings and checkups, at least every six months, help round out this prevention strategy.
A furcation involvement could ultimately endanger a tooth's survival. We can stop that from happening—but we'll have to act promptly to achieve the best results.
If you would like more information on treating 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 “What are Furcations?”
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