It may begin as an itching or burning feeling on your skin, followed by numbness or sensitivity to touch. But then you develop a painful red rash that forms crusty lesions. Fever and fatigue may follow.
These are the common symptoms for a form of chicken pox called shingles, a contagious disease from the human herpes group of viruses. While anyone can contract the shingles virus, it most often lies dormant in a person’s nervous system for decades after an earlier bout of chicken pox. It then breaks out (sometimes repeatedly), usually in patients over fifty.
A shingles outbreak can be miserable. It could also affect your dental care, especially if you have a rash on your face and neck. Here are 3 things you should do if you have shingles in regard to your dental care and overall health.
Tell your dentist you have shingles. A shingles outbreak is highly contagious in its early stages and can spread from direct contact with blisters or through airborne secretions from the infected person’s respiratory system. Even a simple teeth cleaning (especially with an ultrasonic device) at this stage could spread the virus to staff and other patients. So inform your dentist if your appointment coincides with an outbreak—it may be necessary to re-schedule your visit.
Start antiviral treatment as soon as possible. If you’re diagnosed with shingles, more than likely your doctor or dentist will recommend immediate antiviral treatment (typically acyclovir or famciclovir) within 3 days of symptom onset. This can help speed up healing, alleviate pain and possibly prevent more serious complications.
Get the shingles vaccine. Of course, you don’t have to wait for shingles to occur—there is an effective vaccine that could help prevent an outbreak. If you’ve had chicken pox (over 90% of American adults have) or you’re over sixty with or without previous chicken pox, the U.S. Centers for Disease Control recommends you get vaccinated.
When is the best time to floss your teeth: Morning? Bedtime? How about: whenever and wherever the moment feels right?
For Cam Newton, award-winning NFL quarterback for the Carolina Panthers, the answer is clearly the latter. During the third quarter of the 2016 season-opener between his team and the Denver Broncos, TV cameras focused on Newton as he sat on the bench. The 2015 MVP was clearly seen stretching a string of dental floss between his index fingers and taking care of some dental hygiene business… and thereby creating a minor storm on the internet.
Inappropriate? We don't think so. As dentists, we're always happy when someone comes along to remind people how important it is to floss. And when that person has a million-dollar smile like Cam Newton's — so much the better.
Of course, there has been a lot of discussion lately about flossing. News outlets have gleefully reported that there's a lack of hard evidence at present to show that flossing is effective. But we would like to point out that, as the saying goes, “Absence of evidence is not evidence of absence.” There are a number of reasons why health care organizations like the American Dental Association (ADA) still firmly recommend daily flossing. Here are a few:
- It's well established that when plaque is allowed to build up on teeth, tooth decay and gum disease are bound to follow.
- A tooth brush does a good job of cleaning most tooth surfaces, but it can't reach into spaces between teeth.
- Cleaning between teeth (interdental cleaning) has been shown to remove plaque and food debris from these hard-to-reach spaces.
- Dental floss isn't the only method for interdental cleaning… but it is recognized by dentists as the best way, and is an excellent method for doing this at home — or anywhere else!
Whether you use dental floss or another type of interdental cleaner is up to you. But the ADA stands by its recommendations for maintaining good oral health: Brush twice a day for two minutes with fluoride toothpaste; visit your dentist regularly for professional cleanings and checkups; and clean between teeth once a day with an interdental cleaner like floss. It doesn't matter if you do it in your own home, or on the sidelines of an NFL game… as long as you do it!
Enamel — that tough, outermost tooth layer — protects your teeth from all sorts of hazards, from bacterial attack to temperature extremes. But although the hardest substance in the human body, enamel has a mortal enemy — acid. High acid levels can cause the minerals in enamel to dissolve, a process called de-mineralization. And although saliva can neutralize these levels in approximately 45-60 minutes and restore some of the enamel’s lost minerals, a constant acidic environment can overwhelm this natural mechanism.
That’s why you should be careful with the amount and frequency of acidic foods and drinks like citrus fruits or coffee. You should be especially concerned about your intake of sodas, energy drinks or sports drinks. The latter in particular are designed to replace fluids and nutrients during intense exercise or sports events, but are often consumed as a regular beverage. And all these drinks mentioned are often sipped on throughout the day, resulting in a constant wash of acid in your mouth that can interrupt the protective response of saliva.
There’s one other source for high mouth acidity that comes not from outside the body but from within. GERD — Gastro Esophageal Reflux Disease — is a condition in which digestive acid refluxes (flows back) into the esophagus. While chronic acid reflux can damage the lining of the esophagus and lead to ulcers or even cancer, it may also pose a danger to teeth if the acid regularly rises into the mouth. Individuals encountering this will know it by the awful, acrid taste of vomit in their mouth.
To reduce the chances of high mouth acid due to food intake, limit the consumption of acidic foods and beverages to meal times and sports drink consumption to strenuous exercise or sporting events. Better yet, consider the greatest hydrator of all, water — with a neutral pH of 7.
If you’re experiencing chronic heartburn or other GERD symptoms, make an appointment to see your primary care doctor or a gastroenterologist as soon as possible. Many treatments are effective and will not only improve your general health but may also help preserve your tooth enamel.
If you would like more information on the effect of acid in the mouth and how to reduce it, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Dentistry & Oral Health for Children” and “GERD — Gastro Esophageal Reflux Disease.”
For decades, traditional braces were the only orthodontic choice for moving misaligned teeth. Although they’re quite effective, they can cause discomfort and, for teens especially, embarrassment due to their noticeable metallic appearance.
In recent years, though, technology has produced an alternative to braces that’s proven effective for many types of patients. Besides being less cumbersome and disruptive to everyday life than braces, clear aligners have another advantage that appeals to teens — they’re much less visible.
Introduced in the late 1990s, clear aligners are a system of individual trays made of nearly invisible polyurethane plastic worn over the upper teeth. The trays are computer-generated based on the patient’s individual mouth structure captured in photographs and x-rays. Each tray in the sequence is incrementally smaller in size; the patient begins wearing the first aligner in the series for about two weeks, 20 to 22 hours a day. They then switch to the next tray in the series for about the same amount of time, and continue in this fashion until they’ve worn each aligner in the series.
Besides their improvement in appearance, aligners also have another advantage: unlike traditional braces, aligners can be removed from the mouth for eating or on a limited basis for rare important social occasions. Brushing and flossing are also much easier with aligners, which don’t pose the same access problems as traditional braces.
Clear aligners were once only effective with select types of orthodontic patients, which didn’t always include teens. Over the last decade, however, significant changes to design and additional implements have widened their application to more patients, especially teens. For example, we can now add tiny “power ridges” to the aligner design that give greater precision over desired tooth movement to create a more controlled and efficient force on the teeth. More recent aligners are also being produced with a thinner, more comfortable material.
A thorough orthodontic exam will tell whether your teen is a good candidate for clear aligners. If so, they’ll benefit from a more comfortable and less embarrassing experience while gaining a new smile for life.
If you would like more information on clear aligners, 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 “Clear Aligners for Teens.”
As we age we become more susceptible to dental diseases. A common but often initially unnoticed problem for seniors is root decay.
We’re all familiar with tooth decay in the crown, the visible tooth above the gum line. Bacteria feeding on leftover sugar in the mouth produce acid, which at high levels erodes the teeth’s protective enamel. This forms cavities and, if untreated, deeper infection within the tooth that could reach the bone via the root canals.
But decay can also directly attack a tooth’s roots below the gum line. Roots are made of dentin and covered by a very thin layer of mineralized tooth structure called cementum. Cementum, which is much softer than enamel, is often lost because of its thinness, thus exposing the root’s dentin. This can make the area more susceptible to decay than the enamel-covered crown. Normally, though, the roots also have the gums covering them as added protection against bacterial infection.
But gum recession (shrinkage), a common experience for people in their later years, can expose the root surfaces. As a result, the roots become much more susceptible to decay. And an ensuing infection could spread more quickly into the interior of the tooth than decay originating in the crown.
That’s why it’s important to remove the decayed material and fill the root cavity to prevent the infection’s spread. While similar to a crown filling, the treatment can be more difficult if the root cavity extends below the gum line. In this case, we may need to perform a surgical procedure to access the cavity.
There are other things we can do to help prevent root cavities or limit their damage. We can apply fluoride varnish to strengthen the teeth and provide extra protection against cavities, or prescribe a fluoride rinse for use at home. We can also keep an eye out and treat periodontal (gum) disease, the main cause for gum recession.
The most important thing, though, is what you do: brush and floss thoroughly each day to remove bacterial plaque and limit sugary or acidic foods in your diet. Preventing decay and treating cavities as soon as possible will help ensure you’ll keep your teeth healthy and functional all through your senior years.
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