One in ten Americans has diabetes, a serious condition that may increase the development and severity of other health problems—including gum disease. Because of this latter connection, dental providers join other health professionals during November's National Diabetes Month to call attention to this chronic disease and its effect on health and well-being.
There's another health condition with a diabetes connection that isn't as well known: obstructive sleep apnea (OSA). It's also of keen interest to dental providers, as dentists are often involved in the discovery and treatment of this common sleep disorder.
OSA is the temporary blockage of the airway during sleep by the tongue or other anatomical structures. The subsequent drop in oxygen awakens the body to remove the obstruction. People with OSA may not realize they have the condition, but their bed partner can often attest to their snoring, snorting and gasping for breath during the night. Such episodes can occur several times per night, depriving the person of sufficient sleep.
Chronic OSA can contribute to the development of other health problems, among them Type 2 diabetes. It can do this first by interfering with the metabolization of glucose (blood sugar). It may also increase the body's resistance to insulin, the primary hormone regulating glucose.
Fortunately, properly managing OSA can lower your risk for diabetes, and that's where dentists may be able to help. For one thing, we dentists are often the first to notice early signs of OSA—sometimes even before our patients do.
According to the American Sleep Apnea Association, as many as 80% of the estimated 22 million Americans with OSA may not know they have it. But dentists often identify OSA indicators while examining patients: signs like an enlarged tongue or tonsils, or patients falling asleep in the exam chair. While we can't formally diagnose OSA, we often refer symptomatic patients to a sleep specialist.
Dentists also offer an alternative to the most common OSA therapy, which is continuous positive airway pressure (CPAP). This therapy employs a motorized pump that delivers pressurized air into the throat via face mask to keep the airway open during sleep. Although effective, some people find a CPAP machine noisy and uncomfortable to use.
Alternatively, dentists can provide an oral device that can often help patients with mild to moderate OSA that's worn in the mouth during sleep. Most of the various types of these appliances either reposition the lower jaw with a hinge mechanism to keep the throat open or pull the tongue away from the airway through a suction effect.
Diabetes is one part of a chain reaction that can bring unexpected challenges to your health, including to your teeth and gums. You can slow or even stop its development with proper diet, exercise and good, restful sleep. Dealing with OSA is often part of that equation—and we may be able to help.
If you would like more information about the prevention and treatment of diabetes, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Oral Appliances for Sleep Apnea.”
As the old Fifties song goes, “Little things mean a lot.” They can also be the most irritating, like a hangnail, a papercut—or a certain kind of oral sore. Although rarely concerning to health, this particular kind of “bump” in the mouth can be unnerving.
Although known as a traumatic fibroma, it's not as dire as it sounds: It's simply a small wound created when your inside cheek gets in the “line of fire” between your teeth while biting or chewing. It's an experience most of us have had, and though it's a minor occurrence, it can make us wince with pain.
But the pain usually lasts only a few seconds—until the next time, which is a distinct possibility. The body creates a protective callous over the wound made of fibers (hence the name fibroma) of a protein called collagen. This creates a rise in the skin surface that increases the chances the area will again get in the way of the teeth and be bitten. Each bite leads to another layer of collagen, a more prominent rise and even greater probability of another bite.
Rather than let this irritating situation repeat itself, you can undergo a minor surgical procedure to remove the fibroma. Usually performed be an oral surgeon or periodontist, the area is numbed first with a local anesthetic and the fibroma removed with a scalpel; the resulting wound is then closed with a few stitches or a laser, in which case no stitches are necessary. As a result, the cheek surface flattens out and becomes less likely to get in between the teeth.
The dentist may also preserve some of the removed tissue and submit it for a biopsy to check for any cancer cells or other abnormalities. You shouldn't be concerned about this: Examining excised tissue is a routine step performed for a variety of surgical procedures. It's used to verify the tissue in question is benign, which in this case is the vast majority of the time.
After the procedure, you might experience some minor discomfort for a few days, usually manageable with a mild pain reliever like aspirin or ibuprofen. The procedure itself only takes about fifteen minutes, but it can provide you lasting relief from that bedeviling little sore in your mouth.
If you would like more information on treating mouth sores, 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 “Common Lumps and Bumps in the Mouth.”
Before implants, people often turned to a removable appliance to replace multiple missing teeth. Known as a removable partial denture (RPD), this appliance could restore both appearance and function at an affordable price.
But although implants may have diminished their use, RPDs haven't gone extinct. They're still a viable option for patients who can't afford implants or fixed bridgework, or who can't obtain implants due to the state of their dental health.
Although replacing only a few teeth rather than an entire arch, RPDs are similar in basic concept to full dentures. The prosthetic (artificial) teeth are anchored in a resin or plastic that's colored to resemble the gums, precisely placed to fit into the missing gaps. This assembly is further supported by a frame made of vitallium, a lightweight but strong metal alloy. The appliance fits upon the arch with the missing teeth, supported by vitallium clasps that grip adjacent natural teeth.
Each RPD must be custom designed for each patient to fit perfectly without excessive movement during chewing. Too much movement could warp the fit, reduce the RPD's durability or damage other teeth. To achieve this secure fit, dentists must take into account the number and location of missing teeth to be replaced, and then apply a specific construction pattern to balance the appliance.
There are RPDs that are meant to be used short-term, as with a teenager whose jaw isn't yet mature for dental implants. But the metal-framed RPDs we've described are designed for long-term use. There is, however, one primary downside: RPDs have a propensity to collect dental plaque, a thin biofilm most responsible for dental disease that could further deteriorate your dental health.
To avoid this, you'll need to keep both the RPD and the rest of your teeth and gums as clean as possible with daily brushing and flossing, and appliance care. And like dentures, it's best to remove the RPD when you go to bed at night to discourage the growth of harmful bacteria.
To see if an RPD to replace your missing teeth is an option for you, visit us for a complete dental exam. From there, we can advise you further as to whether an RPD could affordably restore your missing teeth and your smile.
If you would like more information on RPDs, 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 “Removable Partial Dentures.”
Mike Tyson made a splash when he faced off against sharks during the Discovery Channel's Shark Week 2020. But there's bigger news for fans of the former undisputed world heavyweight champion: After a 15-year absence, he will enter the ring again for two exhibition matches in the Fall. However, it's not just Tyson's boxing action that made news during his 20-year career. His teeth have also gotten their fair share of press.
Tyson used to be known for two distinctive gold-capped teeth in the front left side of his mouth. He made headlines when he lost one of the shiny caps—not from a blow by a fellow pugilist but from being headbutted by his pet tiger as Tyson leaned in for a kiss. Tyson's teeth again garnered attention when he had his recognizable gold caps replaced with tooth-colored restorations. But the world champion may be best known, dentally at least, for his trademark tooth gap, or “diastema” in dentist-speak. Several years ago, he had the gap closed in a dental makeover, but he soon regretted the move. After all, the gap was a signature look for him, so he had it put back in.
That's one thing about cosmetic dentistry: With today's advanced technology and techniques, you can choose a dental makeover to suit your individual taste and personality.
An obvious example is teeth whitening. This common cosmetic treatment is not a one-size-fits-all option. You can choose whether you want eye-catching Hollywood white or a more natural shade.
If your teeth have chips or other small imperfections, bonding may be the solution for you. In dental bonding, tooth-colored material is placed on your tooth in layers and then hardened with a special light. The material is matched to your other teeth so the repaired tooth fits right in. This procedure can usually be done in just one office visit.
For moderate flaws or severe discoloration, porcelain veneers can dramatically improve your appearance. These thin, tooth-colored shells cover the front surface of the tooth—the side that shows when you smile. Veneers are custom-crafted for the ideal individualized look.
Dental crowns can restore single teeth or replace missing teeth as part of a dental bridge. Again, they are manufactured to your specifications. With restorations like crowns and veneers, the smallest detail can be replicated to fit in with your natural teeth—even down to the ridges on the tooth's surface.
And if, like Mike Tyson, you have a gap between your teeth that makes your smile unique, there's no reason to give that up if you opt for a smile makeover. Whether you would like a small cosmetic enhancement or are looking for a more dramatic transformation, we can work with you to devise a treatment plan that is right for you.
If you would like more information about smile-enhancing dental treatments, please contact us or schedule a consultation. You can learn more in the Dear Doctor magazine article “Cosmetic Dentistry: A Time for Change.”
What a difference a hundred years can make—especially the last one hundred. In the early 20th Century, trains were the prime mode of cross-country transportation, electrical power was not universally available, and only the well-to-do could afford automobiles and telephones. We live in a far different world, transformed by digital media, air travel and instantaneous global communication.
Dental care has also made exponential leaps. Dentists in the early 21st Century have more effective and powerful treatments for disease, as well as life-like and durable restorations for missing teeth and less-than-perfect smiles. As far as dentistry goes, you couldn't live in a better time.
But if you thought the last century was amazing for dental care, you won't believe what may soon be coming your way this century. Here are a few of the incredible possibilities poised to become reality in the near future.
Regenerating teeth. As of now, the permanent teeth you have is all you're going to have—but that may soon change. Researchers are closing in on the ability to grow new dentin—and if that becomes practical, other parts of teeth may be next. Utilizing a person's stem cells, the building blocks of specialized human tissue, may yield the greatest prize of all, a completely regenerated tooth.
Targeting bacteria. Tooth decay and other dental diseases are most often caused by bacteria—but not every strain. The true culprits are a select few like Streptococcus mutans, which causes tooth decay. Based on growing knowledge of the human genome, we may one day be able to develop therapies that block transmission of specific bacteria from caregivers to infants, or inhibit these bacteria's ability to produce acid that erodes tooth enamel.
Employing “nano” tools. Nanotechnology tools and devices are no bigger than 100 nanometers (a nanometer is a one billionth of a meter), and perform tasks on the cellular level. Many researchers believe we may soon develop a device of this size that can seek out and destroy tiny clusters of cancer cells within the human body before they spread. This could be a game-changer for treating deadly oral cancer.
The current state of dental care would have amazed our great-grandparents. But we may soon be just as amazed at what 21st Century brings us.
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