Tuesday, November 26, 2013

Keep Your Mouth Shut

It's funny I've heard the saying "close your mouth or you'll catch flies".  I never really thought that  keeping your mouth closed would have medical implications. Perhaps if you were a member of the mob.  Now that I am a dentist I realize that mouth breathers usually have permanent gingivitis.While this is not as bad as it sounds it still gives the person  red and bleeding gums.  This is the extent to which I was taught mouth breathing affected people.
   It now seems that mouth breathing has other and more serious considerations. There is a strong correlation between  breathing rate and a number of diseases Asthma being one.  It also has effects on posture- the head and neck are extended creating muscle stress. The abdomen and diaphragm are impacted.  Which causes a loss of muscle strength.  There is Long Face syndrome which is pretty much what the name implies... a long face which was thought to be genetic but the culprit is mouth breathing. It also turns out that nasal (through the nose) breathing supplies more oxygen to the blood than mouth breathing. This is a brief overview a more indepth analysis of breathing is found by reading Patrick McKeown and the seminal works of Konstantin Buteyko.

Friday, September 27, 2013

The End of Root Canals!?

The news is filled with advances of all sorts.  Smart phones have more computing power than the computers used to put men on the moon.  Cars are smarter than the mainframes used at MIT in the fifties. Face, hand, arm transplants used to be science fiction, now while not routine, are not uncommon.
    Dentistry has also come a huge way in a short period of time.  Digital x rays, scanning teeth instead of impressions with purple gooey stuff that not only makes you gag, but tastes disgusting. Just around the corner is three D printing of fillings.
  What is on the horizon is the end of the Root canal.  Looked at it objectively, a root canal is really no ones idea of a great treatment. Cleaning out the nerve knowing that you will never be able to get it all out.  Doing a procedure that I can't see what I'm doing, with a ton of anomalies and deviations. Then having a dead tooth that can't tell you if anything is wrong.  Don't misunderstand, it is a great procedure in that you get to save teeth that would need to be extracted.  Hopefully I can look back and put root canal in the category of "it was the best we could do at the time".  Research in stem cells has been going on in dentistry.  Instead of removing the nerve and putting in a filler researchers are trying to use stem cells to regenerate the nerve.  This is a whole new world where instead of doing something that is almost as good, you get to have a tooth that is as good as new.

Thursday, September 26, 2013

Stop Cavities Chew Gum

People want to know-What can I do to prevent cavities?  Well, there is the brushing and flossing of teeth.  That's kind of obvious though.  There is eating candy. I know this sounds counter intuitive, Even crazy.   If the candy has Xylitol as a sweetener though, then eat away. Xylitol prevents decay and slows down the progress sometimes even reversing a cavity that is already present.  First off what is Xylitol? It is a sweetener derived from  fibers of many fruits and vegetables, and can be extracted from various berries, oats, and mushrooms, as well as fibrous material such as corn husks and sugar cane bagasse, and birch. It has 33% less calories than sugar and is the only sweetener that reduces decay, remineralizes tooth, and helps prevent ear aches. If an expecting mother eats it regularly the child has a lower rate of cavities. It has no deleterious effect on the developing baby.  It is best as a hard candy but can be chewed in a gum.  It has been studied extensively and shows no side effects in clinical doses.  Children are more than happy to eat it. It has no problems with long term use.  It is pretty much a win- win, which is a rare thing in dentistry.

Sources: Wikipedia, Dentaltown

Monday, July 15, 2013

White Spots on Your Teeth

There are a number of reasons that there are white spots on your teeth.  It can range from an issue called fluorosis, which means that a person has had too much fluoride and it has affected the tooth structure.  What people forget is that many mouth washes have fluoride, major metropolitan areas have fluoride in the water,toothpastes, bottled water and on top of that some dentists do fluoride treatments after a cleaning.  These things make it easy to get white spots on the teeth when you are a kid and the teeth are growing.  There are other types of white spots- after wearing braces with wires, around the brackets, which were glued to the teeth  people will get white spots. These spots are due to poor oral hygiene around the brackets. Poor oral hygiene will also cause white lines at the gum line of the teeth.
    These are the common causes of white spots that can be reversed easily and with minimal invasiveness.  What it requires is scrubbing the teeth, cleaning them with a gel and then using a calcium paste to force calcium back into the tooth, repeat if needed. It's Simple and  effective.  If this method doesn't work then you can move onto more invasive techniques like composite(bonding), veneers(porcelain facings) or decide that the spots aren't so bad after all.
    There is one last type of white spot that hasn't been covered. Sometimes when a person gets a cavity the tooth can turn a dull white.  This gives the patient and dentist no option but to treat the decay.

Monday, July 8, 2013

News Flash-Your nose ....it's on your face!!

Alrighty, I am going to start this blog up...again.  Let me tell you doing this blogging thing is not as easy as it looks. Today's topic is the New York Times article "Rethinking the Twice-Yearly Dentist Visit".
    I am amazed at the confusion caused by the routine things in dentistry.  The article (paraphrased) says that a cookie cutter approach to treating patients might not be the best way to care for a patient. The reaction to this article ranges from "wow, I knew the dentist was ripping me off" to "Isn't science great and what will they discover next".
    First off, the origin of the twice a year cleaning is murky.  It either come from  "Amos and Andy in the middle of the last century" or a toothpaste jingle ,where you need to use this toothpaste and see your dentist twice a year.  It doesn't really matter where it comes from. What matters is that a one size fits all is a terrible way to treat a patient. I don't know when it happened, the patient devolved from being an individual  with needs, quirks,and desires to being a  widget that is plugged into a one size fits all regimen. Then out comes amazing new information! The patient is a person!
   The time between cleanings should be based on the patients needs and desires.  I have some patients that I see once every three years.  Why should I see them more often?  They don't need to have a cleaning and are not prone to getting cavities.  I am sure they have better things to do than going to the dentist.  I have other patients I see every three months.  Why? Because they need to.
    So, is the dentist ripping you off?  No,  how often you get a cleaning should be decided between you and you're dentist.  Wow, mind blowing. What will they think of next?