Posts for category: Oral Health
If you've ever been alarmed to find oddly-shaped red patches on your tongue, you can relax for the most part. Most likely, you're part of a small fraction of the population with a condition known as geographic tongue.
The name comes from the irregular shape of the patches that seem to resemble land formations on a map. Its medical name is benign migratory glossitis, which actually describes a lot about the condition. The patches are actually areas of inflammation on the tongue (“glossus” – tongue; “itis” – swelling) that appear to move around or migrate. They're actually made up of areas where the tiny bumps (papillae) you normally feel have disappeared: the patches feel flat and smooth compared to the rest of the tongue.
We're not sure why geographic tongue occurs. It often runs in families and seems to occur mostly in middle-aged adults, particularly women and non-smokers. It's believed to have a number of triggers like emotional stress, hormonal disturbances or vitamin or mineral deficiencies. There may also be a link between it and the skin condition psoriasis. Under a microscope the red patchiness of both appears to be very similar in pattern; the two conditions often appear together.
The bad news is we can't cure geographic tongue. But the good news is the condition is benign, meaning it's not cancerous; it's also not contagious. It poses no real health threat, although outbreaks can be uncomfortable causing your tongue to feel a little sensitive to the touch with a burning or stinging sensation. Some people may also experience numbness.
Although we can't make geographic tongue go away permanently, you should come by for an examination to confirm that is the correct diagnosis. Once we know for sure that you do have migratory glossitis, we can effectively manage discomfort when it flares up. You should limit your intake of foods with high acidity like tomatoes or citrus fruits, as well as astringents like alcohol or certain mouthrinses. We can also prescribe anesthetic mouthrinses, antihistamines or steroid ointments if the discomfort becomes more bothersome.
It may look strange, but geographic tongue is harmless. With the right care it can be nothing more than a minor annoyance.
If you would like more information on benign migratory glossitis, 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 “Geographic Tongue.”
A loose primary (“baby”) tooth is often a cause for celebration. A loose permanent tooth, however, is a cause for concern. A permanent tooth shouldn't even wiggle.
If you have a loose tooth, it's likely you have a deeper dental problem. Here are the top underlying causes for loose teeth.
Gum disease. Teeth are held in place by an elastic tissue called the periodontal ligament. But advanced periodontal (gum) disease, a bacterial infection usually caused by film buildup on teeth called dental plaque, can damage the ligament and cause it to detach. If it's not treated, it could lead to tooth loss.
Bite-related trauma. A normal bite helps balance out the forces generated when we chew so they don't damage the teeth. But if a misaligned tooth protrudes higher from the jaw, the opposing tooth will likely create more downward pressure on it while chewing. This can stress the tooth's supporting ligament to the point of looseness.
Self-inflicted trauma. While they may be trendy, tongue jewelry can cause dental damage. A wearer who clicks the “barbell” of a tongue stud against their teeth could be creating conditions conducive for gum damage and bone loss, which can cause tooth looseness. Similarly, taking orthodontics into your own hands could also damage your teeth, especially if you have undiagnosed gum disease.
Genetics. Although you can't prevent it, the type of resistance or susceptibility you inherited from your parents (as well as your dental anatomy) can cause you dental problems. Thinner gum tissues, especially around the roots, can make you more susceptible to gum disease or dental trauma, which in turn could contribute to tooth looseness.
There are things you can do to lessen your chance of loose teeth. Brush and floss every day to remove disease-causing bacterial plaque and see a dentist regularly for cleanings to reduce your risk of gum disease. If you have any misaligned teeth, consult with an orthodontist about possible treatment. And avoid oral jewelry and DIY orthodontics.
If you do notice a loose tooth, see us as soon as possible. We'll need to diagnose the underlying cause and create a treatment plan for it. We may also need to splint the tooth to its neighbors to stabilize it and reduce your risk of losing it permanently.
If you would like more information on tooth mobility, 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 “When Permanent Teeth Become Loose.”
If your child has a toothache, there’s good news — and not so good news. The good news is the pain rarely indicates an emergency. On the downside, though, it may definitely be something that needs our attention.
Here, then, are 4 things you should do as a parent when your child tells you their tooth hurts.
Try to find out exactly where the pain is and how long it has hurt. Ask your child which tooth or part of the mouth hurts. You should also find out, as best you can, when the pain started and if it’s constant or intermittent. Anything you learn will be useful information if you bring them to the office for an examination. And, any tooth pain that keeps your child up at night or lasts more than a day should be examined.
Look for signs of recent injury. Your child may have suffered a blow to the mouth that has damaged the teeth and gums. Besides asking if they remember getting hurt in the mouth, be sure to look for chipped teeth, cracks or other signs of trauma. Even if there aren’t any outward signs of injury, the tooth’s interior pulp may have been damaged and should be checked out.
Look for signs of dental disease. Take a close look at the tooth your child’s complaining about: do you see brown spots or obvious cavities? You should also look for swollen gums or sores on the inside of the mouth. If there’s been no apparent injury, these could be signs of infection related to tooth decay.
Try to relieve pain symptoms. If you don’t see anything unusual, there may be a piece of candy or other hard food debris between the teeth causing the pain — gently floss around the tooth to dislodge it. If the pain persists give appropriate doses of ibuprofen or acetaminophen (not aspirin). If there’s swelling, you can also apply an icepack on the outside of the jaw. In any case, you should definitely schedule a visit with us for an examination.
If you would like more information on dental care for your child, 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 “A Child’s Toothache.”
While sports like football, basketball and soccer have exploded in popularity over the last few decades, many Americans still have a soft spot for the granddaddy of them all: baseball. While technology has changed many aspects of the game, many of its endearing traditions live on.
Unfortunately, one baseball tradition isn’t so endearing and definitely hazardous to health—tobacco, primarily the smokeless variety. Players and coaches alike, even down to the high school level, have promoted or at least tolerated its use.
But there are signs this particular baseball tradition is losing steam. Not long ago, the San Francisco Giants became the first major league baseball team to prohibit tobacco in its home stadium—on the field as well as in the stands. The move was largely in response to a law passed by the City of San Francisco, but it does illustrate a growing trend to discourage tobacco use in baseball.
While smoking, chewing or dipping tobacco can certainly impact a person’s overall health, it can be especially damaging to the teeth, gums and mouth. Our top oral health concern with tobacco is cancer: Research has shown some correlation between tobacco use (especially smokeless) and a higher risk of oral cancer.
You need look no further than the highest ranks of baseball itself to notice a link between tobacco and oral cancer. Although from different eras, Babe Ruth and Tony Gwynn, both avid tobacco users, died from oral cancer. Other players like pitcher Curt Schilling have been diagnosed and treated for oral cancer.
Cancer isn’t the only threat tobacco poses to oral health. The nicotine in tobacco can constrict blood vessels in the mouth; this in turn reduces the normal flow of nutrients and disease-fighting immune cells to the teeth and gums. As a result, tobacco users are much more susceptible to contracting tooth decay and gum disease than non-users, and heal more slowly after treatment.
That’s why it’s important, especially in youth baseball, to discourage tobacco use on the field. While most of baseball’s traditions are worthy of preservation, the chapter on tobacco needs to close.
Osteoporosis is a major health condition affecting millions of people, mostly women over 50. The disease weakens bone strength to the point that a minor fall or even coughing can result in broken bones. And, in an effort to treat it, some patients might find themselves at higher risk of complications during invasive dental procedures.
Over the years a number of drugs have been used to slow the disease’s progression and help the bone resist fracturing. Two of the most common kinds are bisphosphonates (Fosamax) and RANKL inhibitors (Prolia). They work by eliminating certain bone cells called osteoclasts, which normally break down and eliminate older bone cells to make way for newer cells created by osteoblasts.
By reducing the osteoclast cells, older bone cells live longer, which can reduce the weakening of the bone short-term. But these older cells, which normally wouldn’t survive as long, tend to become brittle and fragile after a few years of taking these drugs.
This may even cause the bone itself to begin dying, a relatively rare condition called osteonecrosis. Besides the femur in the leg, the bone most susceptible to osteonecrosis is the jawbone. This could create complications during oral procedures like jaw surgery or tooth extractions.
For this reason, doctors recommend reevaluating the need for these types of medications after 3-5 years. Dentists further recommend, in conjunction with the physician treating osteoporosis, that a patient take a “drug holiday” from either of these two medications for several months before and after any planned oral surgery or invasive dental procedure.
If you have osteoporosis, you may also want to consider alternatives to bisphosphonates and RANKL inhibitors. New drugs like raloxifene (which may also decrease the risk of breast cancer) and teriparatide work differently than the two more common drugs and may avoid their side effects. Taking supplements of Vitamin D and calcium may also improve bone health. If your physician still recommends bisphosphonates, you might discuss newer versions of the drugs that pose less risk of osteonecrosis.
Managing osteoporosis is often a balancing act between alleviating symptoms of the disease and protecting other aspects of your health. Finding that balance may help you avoid future problems, especially to your dental health.
If you would like more information on osteoporosis and 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 “Osteoporosis Drugs & Dental Treatment.”