Posts for: November, 2020
Heartburn is a big problem: Each year we Americans spend around $10 billion on antacid products, twice as much as for over-the-counter pain relievers. It's an even bigger problem because many indigestion sufferers actually have acid reflux or GERD (gastroesophageal reflux disease), a chronic disease that can cause physical harm—including to teeth.
That's why we've joined with other healthcare providers for GERD Awareness Week, November 17-23, to call attention to the causes and consequences of this disease. In addition to the harm it poses to the esophagus (the “tube” leading from the mouth to the stomach through which food passes), GERD could also damage your teeth to the point of losing them.
GERD is usually caused by the weakening of the lower esophageal sphincter, a ringed muscle located at the junction between the esophagus and the stomach. It acts as a “one-way valve” allowing food into the stomach, but not back into the esophagus. If it weakens, powerful stomach acid can come back into the esophagus and possibly even the mouth. The latter scenario poses a danger to teeth's protective layer of enamel.
Although tough and durable, enamel softens after prolonged contact with acid. Oral acid isn't all that unusual—acid levels typically rise right after eating, causing a temporary softening of enamel. Our saliva, however, goes to work to bring down those acid levels and stabilize enamel.
But if stomach acid enters the mouth because of GERD, the increased acidity can overwhelm saliva's ability to neutralize it. This can lead to enamel erosion, tooth decay and ultimately tooth loss. The enamel damage can be so pronounced that dentists are often the first to suspect GERD.
If you're diagnosed with GERD, here's what you can do to protect your teeth.
- Manage your GERD symptoms through medication, avoidance of spicy/acidic foods, alcohol, caffeine or tobacco products, and maintaining an optimum weight;
- Stimulate saliva by drinking more water, using saliva boosters, or (with your doctor's consent) changing from medications that may be restricting saliva flow;
- Speak with your dentist about strengthening your enamel with special toothpastes or mouthrinses containing extra fluoride or amorphous calcium phosphate (ACP).
You should also brush and floss daily to lower your risk of dental disease, but with one caveat: Don't brush your teeth during or immediately after a reflux episode, as you might remove microscopic bits of softened enamel. Instead, rinse your mouth with water mixed with a half-teaspoon of baking soda (an acid neutralizer) and wait about an hour to brush. The extra time also gives saliva time to further neutralize any remaining acid.
GERD can be unpleasant at best and highly destructive at worst. Don't let it ruin your teeth or your smile.
If you would like more information about GERD and dental health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “GERD and Oral Health” and “Dry Mouth.”
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.”
Singer and actor Demi Lovato has a new claim to fame: formidable martial artist. When she is not in the recording studio, on stage or in front of the camera, Lovato can often be found keeping in shape at Jay Glazer's Hollywood (California) gym. Glazer, who is best known as a sports journalist, also runs conditioning programs for professional athletes and celebrities based on mixed martial arts. On March 6, Glazer got more than he bargained for when 5'3" Lovato stepped into the ring and knocked out his front tooth.
Glazer reportedly used super glue to put his tooth back together. Not a good idea! While it may not be convenient to drop everything and get to the dental office, it takes an expert to safely treat a damaged tooth. If you glue a broken tooth, you risk having to undergo major work to correct your temporary fix—it's no easy task to "unglue" a tooth, and the chemicals in the glue may damage living tooth tissue as well as the surrounding gum and bone.
Would you know what to do in a dental emergency? Here are some guidelines:
- If you chip a tooth, save the missing piece if possible. We may be able to reattach it.
- If your tooth is cracked, rinse your mouth with warm water, but don't wiggle the tooth around or bite down on it. If it's bleeding, hold clean gauze to the area and call our office.
- If your tooth is knocked loose or is pushed deeper into the socket, don't force the tooth back into position on your own. Immediate attention is very important.
- If your tooth is knocked out, there's a chance it can be reattached. Pick up the tooth while being careful not to touch the root. Then rinse it off and have either someone place into its socket, or place it against the inside of your cheek or in a glass of milk. Please call the office immediately or go to a hospital.
What's the best thing to do in an emergency? Call us right away, and DON'T super glue your tooth! You can prevent worse problems by letting a professional handle any dental issues. And if you've been living with a chipped, broken or missing tooth, call us to schedule an appointment for a consultation—there are several perfectly safe ways to restore your smile. Meanwhile, if you practice martial arts to keep in shape, think twice before getting into the ring with Demi Lovato!