My Blog
By Aaron S. Berger, DMD
May 13, 2021
Category: Oral Health
Tags: oral health  
GumDiseaseCouldImpactMoreThanYourOralHealth

Preventing periodontal (gum) disease not only preserves your teeth and gums, it might also benefit the rest of your health. There's growing evidence that gum disease has links to other systemic diseases.

Gum disease usually starts with dental plaque, a thin film of bacteria and food particles, which triggers a bacterial gum infection. Left untreated, the infection advances and steadily breaks down the gums' attachment to teeth.

This can create large ulcerated areas that are too weak to prevent the passing of bacteria and toxins into the bloodstream and other parts of the body. There's growing evidence from epidemiology (the study of the spread and control of disease) that this bloodstream transfer, as well as the inflammation that accompanies gum disease, could affect other body-wide conditions or diseases.

Diabetes. This chronic condition occurs when the body can't adequately produce insulin, a hormone that regulates sugar (glucose) in the blood, or can't respond to it. Diabetes can inhibit healing, cause blindness or lead to death. Both diabetes and gum disease are inflammatory in nature, and there's some evidence inflammation arising from either condition may worsen the other.

Heart disease. Heart attack, congestive heart failure, stroke and other cardiovascular diseases are a leading cause of death. Like diabetes and gum disease, these heart-related conditions are also characterized by inflammation. There are also specific types of bacteria that arise from gum disease that can travel through the body and increase the risk of heart disease.

Arthritis. An autoimmune disease, rheumatoid arthritis causes debilitating pain, particularly involving the joints, and leads to decreased mobility. Interestingly, many newly diagnosed arthritis patients are also found to have some form of periodontal disease—the two diseases, in fact, follow a similar development track. Although this may hint of a connection, we need more research to determine if there are indeed links between the two diseases.

Regardless of any direct relationships between gum disease and other conditions, preventing and treating it can improve both your oral and general health. You can lower your risk of gum disease by practicing daily brushing and flossing and undergoing regular dental cleanings to remove plaque. And at the first sign of gum problems, see your dentist as soon as possible for early intervention—the earlier the better.

If you would like more information on oral health 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 “Good Oral Health Leads to Better Health Overall.”

WhatsThatonYourTeethNickJonasHowtoAvoidaSimilarSmileOops

Think no one is looking at your smile when you’re out in public? Nick Jonas’ recent experience might convince you otherwise. While the Jonas Brothers were performing during the 2020 Grammys, fans watching on television picked up on some dark matter between his teeth.

To say Twitter lit up is an understatement. For many, it was that thing you couldn’t unsee: Forget the performance, what was that between his teeth? Jonas later fessed up by tweeting, “…At least you all know I eat my greens.”

We’re sure Nick and his brothers take care of their teeth, as most any high-profile entertainer would. You can probably attribute his dental faux pas to trying to squeeze in some nourishment during a rushed performance schedule.

Still, the Grammy incident (Spinachgate?) shows that people do notice when your teeth aren’t as clean as they should be. To avoid that embarrassment, here are some handy tips for keeping your teeth looking their best while you’re on the go.

Start with a clean mouth. You’re more apt to collect food debris during the day if you have built-up plaque on your teeth. This sticky bacterial biofilm attracts new food particles like a magnet. Remove plaque by thoroughly brushing and flossing before you head out the door.

Rinse after eating. Although your saliva helps clear leftover food from your mouth, it may not adequately flush away all the debris. You can assist this process by swishing and rinsing with clean water after a meal.

Keep a little floss handy. Even after rinsing, stubborn bits of food can remain lodged between teeth. So just in case, keep a small bit of emergency floss (or a floss pick) in your purse or wallet to remove any debris you see or feel between your teeth.

Watch what you eat. Some foods—like popcorn, sticky snacks or fibrous vegetables—are notorious for sticking in teeth. Try to avoid eating these foods right before a public appearance where your smile may be critical.

And here’s an added bonus: Not only will these tips help keep your smile attractive on the go, they’ll also help keep it healthy. Rinsing with water, for example, helps lower your mouth’s acid level after eating, a prime factor in tooth decay. And flossing, both as a regular practice and for occasional stuck food, decreases plaque and subsequently your risk of tooth decay and gum disease.

Remember, a healthy mouth is the starting place for a beautiful smile. Keep it that way with dedicated hygiene habits at home or on the go.

If you would like more information on tips for better oral hygiene, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Daily Oral Hygiene.”

By Aaron S. Berger, DMD
April 23, 2021
Category: Oral Health
Tags: sensitive teeth  
TreatingToothSensitivityDependsonItsCause

A scoop of ice cream is one of life's little pleasures. But for one in three Americans, it could be something altogether different—an excruciating pain when cold ice cream meets teeth. This short but painful experience that can happen when dental nerves encounter hot or cold temperatures is called tooth sensitivity.

A look at tooth anatomy will help explain why. Teeth are mainly composed of outer enamel, a layer of nerves and blood vessels within the tooth called the pulp, and dentin, a porous layer in between. The pulp nerves pick up temperature and pressure sensations from outside the teeth through a network of tiny passageways (tubules) in the dentin. Enamel muffles these sensations before traveling the tubules, which prevents overstimulation of the nerves.

This careful balance can be disrupted, however, if the enamel becomes eroded by acid from foods or beverages, or as a byproduct of bacteria. This exposes the underlying dentin to the full brunt of outward sensations, which can then impact the nerves and cause them to overreact.

This hyper-sensitivity can also occur around the tooth roots, but for a different reason. Because the gums primarily protect this area rather than enamel, the roots can become hyper-sensitive if they lose gum coverage, a condition known as gum recession caused mainly by gum disease or over-aggressive hygiene.

Besides using dental products that block nerve sensation, reducing sensitivity largely depends on addressing the underlying cause. If gum disease, the focus is on removing plaque, a bacterial film on dental surfaces that causes and sustains the disease. Stopping an infection allows the gums to heal and hopefully regain their original teeth coverage. More advanced cases, though, may require grafting surgery to foster gum regeneration.

If the cause is enamel erosion or other results of decay or trauma, we can utilize a number of treatments depending on the extent of tooth damage including cavity filling, root canal therapy or crowning. As a last resort, we may need to remove a tooth that's beyond reasonable repair.

If you've begun to experience sensitive teeth, it's important that you see us as soon as possible. The earlier we can diagnose the cause, the less invasive we can be with treatments to ease or even stop this most unpleasant experience.

If you would like more information on tooth sensitivity, 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 “Treatment of Tooth Sensitivity.”

By Aaron S. Berger, DMD
April 13, 2021
Category: Oral Health
Tags: oral health  
ANewDentalPainManagementApproachReducestheNeedforNarcotics

Narcotics have long played an important role in easing severe pain caused by disease, trauma or treatment. Healthcare professionals, including dentists, continue to prescribe them as a matter of course.

But narcotics are also addictive and can be dangerous if abused. Although addictions often arise from using illegal drugs like heroin, they can begin with prescriptive narcotics like morphine or oxycodone that were initially used by patients for legitimate reasons.

As a result, many healthcare providers are looking for alternatives to narcotics and new protocols for pain management. This has led to an emerging approach among dentists to use non-addictive non-steroidal anti-inflammatory drugs (NSAIDs) as their first choice for pain management, reserving narcotics for more acute situations.

Routinely used by the public to reduce mild to moderate pain, NSAIDs like acetaminophen, ibuprofen or aspirin have also been found to be effective for managing pain after many dental procedures or minor surgeries. NSAIDs also have fewer side effects than narcotics, and most can be obtained without a prescription.

Dentists have also found that alternating ibuprofen and acetaminophen can greatly increase the pain relief effect. As such, they can be used for many more after-care situations for which narcotics would have been previously prescribed. Using combined usage, dentists can further limit the use of narcotics to only the most severe pain situations.

Research from the early 2010s backs up this new approach. A study published in the Journal of the American Dental Association (JADA) concluded that patients receiving this combined ibuprofen/acetaminophen usage fared better than those only receiving either one individually. The method could also match the relief power of narcotics in after care for a wide range of procedures.

The NSAID approach is growing in popularity, but it hasn't yet displaced the first-line use of narcotics by dental professionals. The hesitancy to adopt the newer approach is fueled as much by patients, who worry it won't be as adequate as narcotics to manage their pain after dental work, as with dentists.

But as more patients experience effective results after dental work with NSAIDs alone, the new approach should gain even more momentum. And in the end, it promises to be a safer way to manage pain.

If you would like more information on dental pain management, 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 “Are Opioids (Narcotics) the Best Way to Manage Dental Pain?

By Aaron S. Berger, DMD
April 03, 2021
Category: Oral Health
Tags: oral health  
AcidRefluxCouldBeDamagingYourTeeth

Your tooth enamel is often under assault from oral acid produced by bacteria and certain foods. Unless neutralized, acid can erode your enamel, and lead to destructive tooth decay.

But there's another type of acid that may be even more destructive—the acid produced in your stomach. Although important for food digestion, stomach acid outside of its normal environment can be destructive. That includes your teeth, if stomach acid finds its way into your mouth. And that can happen if you have gastroesophageal reflux disease (GERD).

GERD, a chronic condition affecting 1 in 5 adults, is caused by the weakening of the lower esophageal sphincter, a ring of muscle at the intersection of the esophagus and the stomach that prevents stomach acid from traveling back into the digestive tract and damaging the esophageal liner.

It's also possible for stomach acid to travel as far up as the mouth. With a pH of 2.0 or less, stomach acid can lower the mouth's normal pH level of 7.0 well below the 5.5 pH threshold for enamel softening and erosion. This can cause your teeth, primarily the inside surfaces of the upper teeth, to become thin, pitted or yellowed. Your teeth's sensitivity may also increase.

If you have GERD, you can take precautions to avoid tooth damage and the extensive dental work that may follow.

  • Boost acid buffering by rinsing with water (or a cup of water mixed with a ½ teaspoon of baking soda) or chewing on an antacid tablet.
  • Wait about an hour to brush your teeth following a reflux episode so that your saliva has time to neutralize acid and re-mineralize enamel.
  • If you have chronic dry mouth, stimulate saliva production by drinking more water, chewing xylitol gum or using a saliva supplement.

You can also seek to minimize GERD by avoiding tobacco and limiting your consumption of alcohol, caffeine or spicy and acidic foods. Your doctor may also prescribe medication to control your GERD symptoms.

Preventing tooth decay or gum disease from the normal occurrences of oral acid is a daily hygiene battle. Don't let GERD-related acid add to the burden.

If you would like more information on protecting your teeth from acid reflux, 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 “GERD and Oral Health.”





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