Posts for tag: oral health
You may think your blood pressure is only important to your general health — but it can also affect your dental care. That’s why it’s increasingly common for dental providers to include blood pressure monitoring for patients during routine visits.
High blood pressure is a risk factor for several major health conditions including heart attack, stroke and diabetes, and is one of the most common diagnoses in the United States. Even so, many people don’t know their blood pressure is abnormally high. It may be discovered during an annual health visit, or not at all. Since many people visit their dentist twice a year for cleanings, taking a blood pressure reading during these visits increases the chance of detecting a high pressure.
In one study published in the Journal of the American Dental Association, the researchers looked at dental patients who had not seen a doctor in the previous twelve months and who underwent blood pressure screening during a regular dental visit. Seventeen percent of those studied learned they were at increased risk for cardiovascular disease.
High blood pressure can also have a direct effect on how we treat your teeth and gums. For example, we may have to adapt and become more diligent about preventing dental disease if you’re taking a blood pressure drug that could trigger reduced saliva flow (dry mouth), a factor in tooth decay. Certain local anesthetics may also contain substances like epinephrine that constrict blood vessels, which can increase blood pressure. To avoid this if you’re hypertensive, we may need to adjust the dosage of anesthetic drugs to lessen this effect.
Monitoring blood pressure in the dental office is a good example of how all healthcare services can interact with each other. At the very least, a blood pressure check at your next cleaning could alert you to a potentially dangerous condition you didn’t even know you had.
If you would like more information on the relationship of blood pressure and other medical issues to dental health, 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 “Monitoring Blood Pressure.”
If you’ve noticed redness or small skin cracks at the corners of your mouth, you may have a common infection known as perleche or angular cheilitis. Depending on its cause, there are ways to treat the redness and skin cracking to lessen your discomfort.
The term perleche comes from the French word “lecher,” meaning to lick. This is derived from the tendency of perleche patients to constantly lick the area to ease irritation; unfortunately, this also helps perpetuate the inflammation. Once the skin is broken the area is commonly infected by yeast called candida albicans.
Initially, perleche may arise from a variety of sources, most of them locally from either inside or around the mouth, although it can be triggered by a general body infection or disease like diabetes or cancer, or vitamin or iron deficiencies. Inside the mouth reduced saliva flow, tissue inflammation under a rarely cleaned denture (denture stomatitis), pressure on the mouth corners caused by a collapsed bite due to missing teeth and similar conditions can elevate the risks for infection. Around the mouth wrinkling or “marionette lines,” deep lines that extend from the mouth to the chin due to aging or environmental exposure, can contribute to crack formation. Drooling during sleep or as a result of orthodontic treatment is also a contributing cause.
The main focus of treatment for perleche is to bring any infection under control. This can be accomplished with a course of oral or topical antifungal (yeast-attacking) medication. If the infection has spread into the mouth or throat we might then prescribe a troche, a small lozenge designed to dissolve, which you would rinse with and then swallow to affect other portions of the mouth. Steroid or zinc oxide ointments applied directly to the skin can control inflammation and serve as a barrier agent with antifungal properties to promote healing.
If the cause is more related to dental problems (ill-fitting dentures or missing teeth), then it’s important to have these addressed and treated. You may also consult a dermatologist for treatments to lessen wrinkling around the mouth that might also contribute to chronic cases of perleche.
If you would like more information on cracked mouth corners, 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 “Cracked Corners of the Mouth.”
Although cancer treatment has advanced steadily in recent decades, the most used therapies continue to be radiation and chemotherapy to eradicate cancerous cells. And while they often work, both can cause "collateral damage" in healthy tissues near the targeted cells.
This can create a number of indirect consequences for a patient's health, including in the mouth. The salivary glands, for example, can be damaged by radiation treatments aimed at the head or neck. The effect on these glands can interrupt the normal flow of saliva and cause xerostomia or "dry mouth."
Lack of adequate saliva causes more than an unpleasant, sticky mouth feeling. One of saliva's main functions is to neutralize acid that builds up naturally after eating. Without it, high acid levels can cause enamel and root surface erosion and lead to tooth decay.
Cancer treatment can also contribute to gastro-esophageal reflux disease (GERD). This disease causes stomach acid to bypass the natural tissue barriers of the esophagus and enter the mouth. As with dry mouth, the increased acid level from GERD can be just as devastating to enamel—and the damage will be permanent.
To minimize these effects on your dental health, it's important to take proactive steps before, during and after cancer treatment. If at all possible, have any needed dental work performed before you begin radiation or chemotherapy—it's better to start it with teeth and gums as healthy as possible.
During treatment, try to continue regular dental visits to monitor your oral health and receive any needed preventive or therapeutic treatments. Depending on your condition and the advice of your dentist, you may need to increase your visit frequency during this time. Your dentist can help with boosting your saliva production and strengthening your tooth enamel. But you should also practice daily brushing and flossing, drink plenty of water and seek treatment for any resulting GERD symptoms.
Even with the best efforts, though, your teeth and gums may still incur damage while treating your cancer. Fortunately, there are a wide array of materials and procedures that can effectively restore them to health. So, once your treatments are completed consult with a dentist on your options for improving the health and appearance of your teeth and gums.
The mouth isn’t an island unto itself — problems there may be indicative of deeper physical or emotional issues. Â The condition of a family member’s teeth and gums, for example, could be signs of bulimia, an eating disorder.
Characterized by food binging and purging through self-induced vomiting, bulimia can also have a severe effect on the teeth. Regular inducement of vomiting introduces stomach acid into the mouth that can attack and soften the mineral content of tooth enamel. As a result, 90% of bulimics develop enamel erosion.
The erosion pattern often differs from that produced by other high acid causes like the over-consumption of sodas. Because the tongue instinctively covers the back of the bottom teeth during vomiting, they’re often shielded from much of the acid wash. Bulimics are much more apt to exhibit heavier erosion on the upper front teeth, particularly on the tongue side and biting edges.
Bulimia and similar disorders produce other signs as well, like soft tissue ulceration or swollen salivary glands that exhibit puffiness of the face. The roof of the mouth, throat and back of the tongue may appear roughened from the use of fingers or objects to induce gagging.
Unlike sufferers of anorexia nervosa who tend to be negligent about their hygiene (which itself increases their risk of dental disease), bulimics have a heightened sensitivity to their appearance. This concern may prompt them to aggressively brush right after purging, which can cause more of the softened enamel to be removed.
Treating the dental consequences of bulimia requires a two-pronged approach. In the short term, we want to lessen the impact of stomach acid by discouraging the person from brushing immediately after purging — better to rinse with water and a little baking soda to buffer the acid and wait about an hour before brushing. We may also suggest a sodium fluoride mouth rinse to help strengthen and re-mineralize the enamel.
In the long-term, though, the disorder itself must be addressed through professional help. One good source is the National Eating Disorders website (nationaleatingdisorders.org). Besides information, the association also provides a toll-free helpline for referrals to professionals.
As with any eating disorder, bulimia can be trying for patients and their families. Addressing the issue gently but forthrightly will begin their journey toward the renewal of health, including their teeth and gums.
If you would like more information on the effect of eating disorders on dental health, 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.”
If you're the principal caregiver for an older person, you may have already faced age-related health challenges with them. Good preventive care, however, can ease the impact of health problems. This is especially true for their teeth and gums: with your support you're loved one can have fewer dental problems and enjoy better health overall.
Here are a number of things you should focus on to protect an older person's dental health.
Hygiene difficulties. With increased risk of arthritis and similar joint problems, older people may find brushing and flossing more difficult. You can help by modifying their toothbrush handles with a tennis ball or bicycle grip for an easier hold, or switch them to an electric toothbrush. A water flosser, a device that uses a pressurized water spray to remove plaque, may also be easier for them to use than thread flossing.
Dry mouth. Xerostomia, chronic dry mouth, is more prevalent among older populations. Dry mouth can cause more than discomfort—with less acid-neutralizing saliva available in the mouth, the risk for dental diseases like tooth decay or periodontal (gum) disease can soar. To improve their saliva flow, talk with their doctors about alternative medications that cause less dry mouth; and encourage your loved one to drink more water and use products that help boost saliva flow.
Dentures. If your older person wears dentures, be sure these appliances are being cleaned and maintained daily to maximize their function and reduce disease-causing bacteria. You should also have their dentures fit-tested regularly—chronic jawbone loss, something dentures can't prevent, can loosen denture fit over time. Their dentures may need to be relined or eventually replaced to ensure continuing proper fit and function.
Osteoporosis. This common disease in older people weakens bone structure. It's often treated with bisphosphonates, a class of drugs that while slowing the effects of osteoporosis can cause complications after certain dental procedures. It's a good idea, then, for an older person to undergo any needed dental work before they go on osteoporosis medication.
Keep alert also for any signs of dental disease like unusual spots on the teeth or swollen or bleeding gums. Visiting the dentist for these and regular dental cleanings, checkups and oral cancer screenings could prevent many teeth and gum problems.
If you would like more information on senior 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 “Aging & Dental Health.”