My Blog

Posts for: June, 2019

By Daniel Brengman DDS, PA
June 27, 2019
Category: Oral Health
Tags: oral health   gluten  
GlutenSensitivitycanLeadtoDentalProblems

There’s been a growing awareness about the effects of gluten, a protein found in grains like wheat, rye and sometimes oats, on certain people. An estimated 1 in 133 Americans have Celiac Disease (CD), a gluten-related disorder that causes the body’s immune system to work against itself. And if you have CD, you could eventually face dental problems like enamel pitting and erosion.

When a person with CD consumes gluten, their immune system mistakenly identifies the protein as malicious and attacks it. The attack occurs in the membranes that line the digestive system, which in the process destroys cilia, tiny hair-like structures that aid in food absorption. This disrupts the body’s normal absorption of nutrients, which can lead to a number of systemic conditions including intestinal cancer.

Because of the lack of nutrients, your teeth’s enamel may develop defects. You may begin to see dull spots or pitting, or chalky grooves in its normally shiny surface: this is a sign you’ve lost surface enamel crystals (decalcification). You may also be more susceptible to outbreaks of aphthous ulcers (canker sores).

Because symptoms can be misdiagnosed or go unnoticed, it may be years before you know you have CD. You can, however, get a definitive diagnosis through a blood test for gluten antibodies, which is then confirmed with a biopsy of a tissue specimen from the intestine.

While there’s ongoing research for CD-related medication, there’s currently only one recognized treatment for it — remove gluten from your diet. This is much harder than it sounds, and requires knowing what you can and can’t eat, along with strict monitoring of food package labeling. Thankfully, the world is becoming better educated in this respect as more food manufacturers are clearly labeling products containing gluten and restaurants are providing gluten-free menu options.

Once you have dietary controls in place, your dental issues can be treated as any other person, with one exception: none of the products used in treatment like polishing paste or fluoride gels should contain gluten, and must be verified before using.

CD is a serious condition that could even become life-threatening. Knowing you or someone in your family has it will help you protect both your overall health and your teeth.

If you would like more information on the gluten’s effect 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 “Gluten & Dental Problems.”


By Daniel Brengman DDS, PA
June 17, 2019
Category: Oral Health
Tags: oral health  
DoThisforYourDentalHealthBeforeDuringandAfterCancerTreatment

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.

If you would like more information on caring for your teeth while undergoing intensive medical treatment, please contact us or schedule an appointment for a consultation.


By Daniel Brengman DDS, PA
June 07, 2019
Category: Dental Procedures
J-LosUnluckyBreakChippingaToothonStage

Whether she’s singing, dancing or acting, Jennifer Lopez is a performer who is known for giving it all she’s got. But during one show, Lopez recently admitted, she gave a bit more then she had planned.

“I chipped my tooth on stage,” she told interviewers from Entertainment Tonight, “and had to finish the show….I went back thinking ‘Can I finish the show like this?’”

With that unlucky break, J-Lo joins a growing list of superstar singers—including Taylor Swift and Michael Buble—who have something in common: All have chipped their teeth on microphones while giving a performance.

But it’s not just celebs who have accidental dental trouble. Chips are among the most common dental injuries—and the front teeth, due to their position, are particularly susceptible. Unfortunately, they are also the most visible. But there are also a number of good ways to repair chipped, cracked or broken teeth short of replacing them.

For minor to moderate chips, cosmetic bonding might be recommended. In this method, special high-tech resins, in shades that match your natural teeth, are applied to the tooth’s surface. Layers of resin, cured with a special light, will often restore the tooth to good appearance. Best of all, the whole process can often be done in just one visit to the dental office, and the results can last for several years.

For a more permanent repair—or if the damage is more extensive—dental veneers may be another option. Veneers are wafer-thin shells that cover the entire front surface of one or more teeth. Strong, durable and natural-looking, they can be used to repair moderate chips, cracks or irregularities. They can also help you get a “red-carpet” smile: brilliant white teeth with perfectly even spacing. That’s why veneers are so popular among Hollywood celebs—even those who haven’t chipped their teeth!

Fortunately, even if the tooth is extensively damaged, it’s usually possible to restore it with a crown (cap), a bridge—or a dental implant, today’s gold standard for whole-tooth replacement. But in many cases, a less complex type of restoration will do the trick.

Which tooth restoration method did J-Lo choose? She didn’t say—but luckily for her adoring fans, after the microphone mishap she went right back up on stage and finished the show.

If you have a chipped tooth but you need to make the show go on, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”