Fermented and distilled beverages have been a part of human culture for millennia. They help us celebrate the joys of life and the companionship of family and friends. But alcohol also has a darker side, if over-consumed: a cause for many social ills, a vehicle for addiction and a contributor to “unwell” being. The latter is particularly true when it comes to oral health.
April is National Alcohol Awareness Month, a time when advocates, public officials and healthcare providers call attention to the negative effects that alcohol can have on society at large and on individuals in particular. In regard to oral health, here are a few ways alcohol might cause problems for your mouth, teeth and gums.
Bad breath. Although not a serious health problem (though it can be a sign of one), halitosis or bad breath can damage your self-confidence and interfere with your social relationships. For many, bad breath is a chronic problem, and too much alcohol consumption can make it worse. Limiting alcohol may be a necessary part of your breath management strategy.
Dry mouth. Having a case of “cottonmouth” may involve more than an unpleasant sensation—if your mouth is constantly dry, you're more likely to experience tooth decay or gum disease. Chronic dry mouth is a sign you're not producing enough saliva, which you need to neutralize acid and fight oral bacteria. Heavy alcohol consumption can make your dry mouth worse.
Dental work. Drinking alcohol soon after an invasive dental procedure can complicate your recovery. Alcohol has an anticoagulant effect on blood, making it harder to slow or stop post-operative bleeding that may occur with incisions or sutures. It's best to avoid alcohol (as well as tobacco) for at least 72 hours after any invasive dental procedure.
Oral cancer. Oral cancer is an especially deadly disease with only a 57% five-year survival rate. Moderate to heavy alcohol drinkers have anywhere from 3 to 9 times the risk of contracting cancer than non-drinkers—and generally the higher the alcohol content, the higher the risk. As with other factors like tobacco, the less alcohol you drink, the lower your risk for oral cancer.
Given its risks to both health and well-being, many people refrain from alcohol altogether. If you do choose to drink, the American Cancer Society and other health organizations recommend no more than two drinks per day for men and one per day for women. Being responsible with alcohol will enhance both the overall quality of your life and your oral health.
If you would like more information about the effect of alcohol and other substances on oral health, please contact us schedule a consultation. To learn more, read the Dear Doctor magazine article “Diet and Prevention of Oral Cancer.”
Although dental care is our primary focus, we dentists are also on the lookout for other health problems that may manifest in the mouth. That's why we're sometimes the first to suspect a patient may have an eating disorder.
Eating disorders are abnormal dietary patterns that can arise from mental or emotional issues, the most common being anorexia nervosa and bulimia nervosa. Each has different behaviors: Anorexics abnormally restrict their food intake (“self-starvation”), while bulimics typically eat heavily and then induce vomiting (“binge and purge”).
Although bulimics are more likely to binge and purge, anorexics may also induce vomiting. That practice in particular can leave a clue for dentists. While vomiting, powerful stomach acid enters the mouth, which can then soften and erode tooth enamel.
It's the pattern of erosion a dentist may notice more than the erosion itself that may indicate an eating disorder. A person while vomiting normally places their tongue against the back of the lower teeth, which somewhat shields them from acid. The more exposed upper teeth will thus tend to show more erosion than the bottom teeth.
A dentist may also notice other signs of an eating disorder. Enlarged salivary glands or a reddened throat and tongue could indicate the use of fingers or objects to induce vomiting. Lack of oral hygiene can be a sign of anorexia, while signs of over-aggressive brushing or flossing may hint of bulimia.
For the sake of the person's overall well-being, the eating disorder should be addressed through professional counseling and therapy. An excellent starting point is the website nationaleatingdisorders.org, sponsored by the National Eating Disorders Association.
The therapy process can be lengthy, so patients should also take steps to protect their teeth in the interim. One important measure is to rinse out the mouth following purging with a little baking soda mixed with water. This will help neutralize oral acid and reduces the risk of erosion. Proper brushing and flossing and regular dental visits can also help prevent dental disease.
An eating disorder can be traumatic for both patients and their families, and can take time to overcome. Even so, patients can reduce its effect on their dental health.
If you would like more information on eating disorders and dental care, 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 “Bulimia, Anorexia & Oral Health.”
The NBA's reigning MVP Giannis Antetokounmpo may seem unstoppable, but he proved no match for a troubled tooth. Antetokounmpo, the self-proclaimed “Greek Freak,” missed one of the final three 2020 regular season games for a dental issue that resulted in last-minute oral surgery. According to a Milwaukee Bucks spokesperson, the star underwent “a root-canal like procedure.”
Root canal therapy, often simply called “a root canal,” may be needed when there is an infection inside the tooth. When dental pulp becomes inflamed or infected, excruciating pain can result. Pulp is the soft tissue that fills the inside of the tooth. It is made up of nerves, blood vessels and connective tissue. During root canal treatment, the pulp is removed, the space inside the tooth is disinfected, it is filled with a special material, and then the hole is sealed up.
A root canal is nothing to fear. It relieves pain by getting rid of infection and is so effective that over 15 million of them are performed in the U.S. each year. This routine procedure generally requires only local anesthetic, and your mouth should be back to normal within a day or two after treatment. Antetokounmpo can attest to that, as he returned to play the next day.
However, delaying root canal treatment when you need it can have serious consequences. If left untreated, an infection inside the tooth continues to spread, and it may move into the gums and jaw and cause other problems in the body. So, how do you know if you may need a root canal? Here are some signs:
Lingering sensitivity to hot or cold temperatures. One sign of nerve damage inside your tooth is pain that is still there 30 seconds after eating or drinking something hot or cold.
Intense pain when biting down. You may feel pain deep within your tooth, or in your jaw, face or other teeth. The pain may be hard to pinpoint—and even if it improves at times, it usually comes back.
A chipped, cracked or discolored tooth. A chip or crack can allow bacteria to enter the tooth, and the tooth may darken if the tissue inside is damaged.
A pimple on the gum. A bump or pimple on the gum that doesn't go away or keeps coming back may signify that a nearby tooth is infected.
Tender, swollen gums. Swollen gums may indicate an infection inside the tooth or the need for periodontal treatment.
And sometimes there is no pain, but an infection may be discovered during a dental exam.
Tooth pain should never be ignored, so don't put off a dental visit when you have a toothache. In fact, if a bad toothache goes away, it could mean that the nerves inside the tooth have died, but the infection may still be raging. Also, be sure to keep up with your regular dental checkups. We may spot a small problem that can be addressed before it becomes a bigger problem that would require more extensive treatment.
Remember, for dental issues both large and small, we're on your team! If you would like more information about tooth pain, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Tooth Pain? Don't Wait!” and “Root Canal Treatment: What You Need to Know.”
If you live an average lifespan, you'll spend more than 200,000 hours in blissful slumber. It's not a waste, though: You absolutely need this much sleep to maintain optimum physical and mental health. That's why the National Sleep Foundation recognizes each March as Sleep Awareness Month to highlight the obstacles to a good night's sleep. One such obstacle is obstructive sleep apnea (OSA)—and if you have it, we may be able to help you reduce the harm it may be causing you.
OSA is the blockage of the airway during sleep, usually when the tongue relaxes against the back of the throat. As the oxygen level falls, the brain arouses the sleeper to restore airflow. This only takes a few seconds before the person slips back into sleep, but it can occur several times an hour.
As this scenario repeats itself night after night, the person becomes deprived of the deeper stages of sleep they need to stay healthy. The long-term effect can even be life-threatening: Besides chronic fatigue and “brain fog,” there's also an increased risk of high blood pressure, disease or other serious health conditions.
But there are ways to reduce chronic OSA, the most common being a therapy known as continuous positive airway pressure (CPAP). A CPAP machine, prescribed by a medical doctor, consists of a small pump that streams pressurized air into the mouth through a hose and facemask; the increased air pressure in the mouth helps keep the airway open. It's a proven method, but not always a favorite with some patients who find it uncomfortable and restrictive to wear every night.
If you're in that camp regarding CPAP therapy, an alternative may be possible: oral appliance therapy (OAT), which dentists can provide. Worn in the mouth during sleep, this custom-fitted mouthguard-like appliance repositions the tongue so that it doesn't block the airway. There is a variety of mechanisms, but most involve a hinge that positions the lower jaw forward, which in turn pulls the tongue away from the back of the throat.
These less invasive OAT devices may be an alternative to CPAP therapy for people who have mild to moderate OSA and find CPAP machines difficult to use. If you've been diagnosed with OSA and CPAP therapy hasn't been a good fit for you, speak with us about an OAT device. It could help you overcome this common disorder and get the deep sleep you need for a healthy mind and body.
If you would like more information about a dental approach to obstructive sleep apnea, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Sleep Disorders & Dentistry.”
In any given year, 4 million tweens and teens are in the process of having their teeth straightened with braces or clear aligners. It's so common we tend to consider orthodontic treatment for young people as a rite of passage into adulthood.
But it doesn't necessarily have to be that way—it might be possible to stop or at least minimize a poor bite before it fully develops. That's the goal of interceptive orthodontics—treatments that head off or “intercept” a bite problem early.
The goal isn't necessarily to reposition misaligned teeth, but to correct a problem that can lead to misalignment. Here are some examples.
A narrow jaw. A narrowly developing jaw can crowd incoming teeth out of their normal positions. For the upper jaw, though, we can take advantage of a temporary separation in the bones in the roof of the mouth (palate) with a device called a palatal expander. Placed against the palate, the expander exerts outward pressure on the teeth and jaw to widen this separation. The body fills in the gap with bone to gradually widen the jaw.
Abnormal jaw alignment. It's possible for a jaw to develop abnormally during childhood so that it extends too far beyond the other. Using a hinged device called a Herbst appliance, it's possible to interrupt this abnormal growth pattern and influence the bones and muscles of the jaw to grow in a different way.
Missing primary teeth. An important role for a primary (baby) tooth is to hold a place for the future permanent tooth. But if the primary tooth is lost too soon, other teeth can drift into the space and crowd out the intended permanent tooth. To prevent this, we can insert a space maintainer: This simple looped metal device prevents teeth from drifting and preserves the space for the permanent tooth.
Although these and other interceptive treatments are effective, some like the palatal expander do their best work within a limited age frame. To take advantage of interceptive orthodontics in a timely manner, parents should seek a bite evaluation for their child from an orthodontist around age 6. The earlier we detect a growing bite problem, the greater your chances for successful intervention.
If you would like more information on treating emerging bite problems early, 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 “Interceptive Orthodontics.”
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