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Posts for category: Oral Health

By Daniel Brengman DDS, PA
July 01, 2020
Category: Oral Health
Tags: jaw pain   tmj disorders  
FollowThese4TipsforMoreComfortableEatingWithChronicJawPain

Eating is like breathing: We often do it without much thought. But if you suffer from chronic jaw pain, every bite can get your attention—and not in a good way. What's worse, in an effort to avoid the pain associated with a temporomandibular joint disorder (TMD) you might make less than nutritious food choices.

But there are ways to eat healthy without aggravating the symptoms of TMD—not just your choices of food, but also how you prepare and actually eat the food. Here are 4 tips that can help you manage eating with TMD.

Choose moist foods in sauces or gravy. A lot of chewing action is intended to mix saliva with tough or dry foods to make them easier to digest. But this extra jaw action can irritate the jaw joints and muscles and increase your discomfort. To help reduce your jaws' work load, choose foods with a high moisture content, or cook them in a sauce or gravy.

Peel foods with skin. Fresh fruits and vegetables are an excellent source of vitamins and minerals, but their tough outer skin or peel is often hard to chew. Although these parts may also contain nutrients, removing them allows you to gain most of the nutritional benefit of the food while making it easier to chew it.

Cut foods into bite-size pieces. A lot of discomfort with TMD occurs with having to open the jaws wide to accommodate large pieces of food. To minimize the amount of jaw opening, take time to cut all your food portions down into smaller pieces. Doing so can help you avoid unnecessary discomfort.

Practice deliberate eating. All of us can benefit from slower, more methodical eating, but it's especially helpful for someone with TMD. By chewing deliberately and slowly and doing your best to limit jaw opening, you can enhance your comfort level.

Eating often becomes an arduous task for someone with TMD that increases pain and stress. But practicing these tips can make your dining experience easier—and more enjoyable.

If you would like more information on managing TMD in everyday life, 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 “What to Eat When TMJ Pain Flares Up.”

By Daniel Brengman DDS, PA
June 11, 2020
Category: Oral Health
Tags: tooth erosion  
LimitAcidicBeveragestoProtectYourChildsToothEnamelfromErosion

Tooth enamel erosion is a serious issue for many children that can result in permanent impairment of oral health. The problem isn’t just bacterial acid that causes tooth decay — it’s also the high acid content of sodas, energy and sports drinks widely popular among children and teenagers today.

Enamel is made of the strongest substance in the human body, which enables it to shield the inner layers of the teeth from disease and other environmental factors. Its chief nemesis, though, is acid: when enamel interacts with high concentrations of acid for a prolonged time, its mineral content will begin to soften and dissolve, a process known as de-mineralization. Saliva is the enamel’s main protection against acid with the ability to neutralize (or buffer) acid and restore some of the enamel’s mineral content, usually within thirty minutes to an hour after we eat.

The high acid content of many popular beverages, however, can overwhelm saliva’s buffering ability, especially if a person is sipping for an extended time on an acidic drink. This kind of exposure is different from acid produced by bacteria that causes tooth decay: bacterial acid tends to concentrate in specific areas of the teeth, while the constant wash from acidic beverages will have a more generalized eroding effect on teeth.

This level of enamel loss is irreversible, which can leave a tooth in peril of decay and ultimate loss — and increase long-term dental care and costs. The best strategy is to have your child stop or significantly curtail drinking highly acidic beverages. Rather than drink sports beverages for hydration, substitute water, nature’s hydrator. Milk can also be a viable beverage substitute.

If you do allow some acidic beverages, try to limit them to mealtimes and discourage extended sipping. Look for drinks with added calcium as this can reduce the beverage’s erosive potential. The goal is to reduce the amount and duration beverage acid is in contact with tooth enamel.

Making these changes will help greatly to protect your child’s tooth enamel, and give saliva a chance to do its job protecting it. Your efforts will also increase your child’s chances of better dental health in the future.

If you would like more information on dental erosion, please contact us today to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Erosion.”

By Daniel Brengman DDS, PA
May 22, 2020
Category: Oral Health
Tags: gum disease  
WithoutPromptInterventionGumDiseaseCouldDamageToothRoots

Periodontal (gum) disease often involves more than gum inflammation. The real danger is what this bacterial infection may be doing to tissues beneath the gum line—including tooth roots and supporting bone.

Gum disease can do extensive damage to the forked areas where the roots separate from the main tooth body. If one of these areas, known as a furcation, becomes infected, the associated bone may begin to diminish. And you may not even know it's happening.

Fortunately, we may be able to detect a furcation involvement using x-rays and tactile (touch) probing. The findings from our examination will not only verify a furcation involvement exists, but also how extensive it is according to a formal classification system that dentists use for planning further treatment.

A Class I involvement under this system signifies the beginning of bone loss, usually a slight groove in the bone. Class II signifies two or more millimeters of bone loss. Class III, also called a “through and through,” represents bone loss that extends from one side of the root to the other.

The class of involvement will guide how we treat it. Obviously, the lower the class, the less extensive that treatment will be. That's why regular dental checkups or appointments at the first sign of gum problems are a must.

The first-line treatment for furcation involvements is much the same as for gum disease in general: We manually remove bacterial plaque, the main source of infection, from the root surfaces using hand instruments and ultrasonic equipment. This is often followed by localized antibiotics to further disinfect the area and stymie the further growth of the furcation involvement.

We also want to foster the regrowth of lost tissue, if at all possible. Classes II and III involvements may present a challenge in this regard, ultimately requiring grafting surgery to stimulate tissue regeneration.

The best approach by far is to prevent gum disease, the ultimate cause for a furcation involvement. You can reduce your chances of gum disease by brushing and flossing daily to remove disease-causing plaque. Regular dental cleanings and checkups, at least every six months, help round out this prevention strategy.

A furcation involvement could ultimately endanger a tooth's survival. We can stop that from happening—but we'll have to act promptly to achieve the best results.

If you would like more information on treating gum disease, 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 “What are Furcations?

By Daniel Brengman DDS, PA
May 12, 2020
Category: Oral Health
Tags: oral health   nutrition  
UseSweetenerSubstitutesWiselytoReduceSugarinYourDiet

Although a variety of foods provide energy-producing carbohydrates, sugar is among the most popular. It’s believed we universally crave sugar because of the quick energy boost after eating it, or that it also causes a release in our brains of serotonin endorphins, chemicals which relax us and make us feel good.

But there is a downside to refined sugars like table sugar or high-fructose corn syrup: too much in our diets contributes to conditions like cardiovascular disease, diabetes, and dental disease. On the latter, sugar is a primary food source for oral bacteria; the more sugar available in the mouth the higher the levels of bacteria that lead to tooth decay and gum disease.

Moderating your intake of refined sugars and other carbohydrates can be hard to do, given that many processed foods contain various forms of refined sugar. A diet rich in fresh fruits and vegetables helps control sugar intake as well as contribute to overall health. Many people also turn to a variety of sugar substitutes: one study found roughly 85% of Americans use some form of it in place of sugar. They’re also being added to many processed foods: unless you’re checking ingredients labels, you may be consuming them unknowingly.

Sugar substitutes are generally either artificial, manufactured products like saccharin or aspartame or extractions from natural substances like stevia or sorbitol. The good news concerning your teeth and gums is that all the major sugar substitutes don’t encourage bacterial growth. Still, while they’re generally safe for consumption, each has varying properties and may have side-effects for certain people. For example, people with phenylketonuria, a rare genetic condition, can’t process aspartame properly and should avoid it.

One alcohol-based sweetener in particular is of interest in oral care. A number of studies indicate xylitol may actually inhibit bacterial growth and thus reduce the risk of tooth decay. You can find xylitol in a variety of gum and mint products.

When considering what sugar substitutes to use, be sure you’re up to date on their potential health effects for certain individuals, as well as check the ingredients labels of processed foods for added sweeteners. As your dentist, we’ll also be glad to advise you on strategies to reduce sugar in your diet and promote better dental health.

If you would like more information on your best options for sweeteners, 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 “Artificial Sweeteners.”

WithOutdoorSportsHopefullyPoisedtoBeginBePreparedforOralInjuries

National Physical Fitness & Sports Month in May, sponsored by the President's Council on Sports, Fitness & Nutrition, is a fitting time to encourage us to play sports. Many of us already feel the Spring itch to get out there and get involved. Unfortunately, an increase in sports or exercise activities also means an increase in potential physical injury risks, including to the face and mouth.

Although COVID-19 protective measures are delaying group sports, there's hope that many leagues will be able to salvage at least part of their season. If so, you should know what to do to keep yourself or a family member safe from oral and dental injuries.

First and foremost, wear a sports mouthguard, a plastic device worn in the mouth to reduce hard impacts from other players or sports equipment. A custom-fitted guard made by a dentist offers the best level of protection and the most comfortable fit.

But even though wearing a mouthguard significantly lowers the chances of mouth injuries, they can still occur. It's a good idea, then, to know what to do in the event of an oral injury.

Soft tissues. If the lips, cheeks, gums or tongue are cut or bruised, first carefully clean the wound of dirt or debris (be sure to check debris for any tooth pieces). If the wound bleeds, place some clean cotton gauze against it until it stops. If the wound is deep, the person may need stitches and possible antibiotic treatments or a tetanus shot. When in doubt, visit the ER.

Jaws. A hard blow could move the lower jaw out of its socket, or even fracture either jaw. Either type of injury, often accompanied by pain, swelling or deformity, requires medical attention. Treating a dislocation is usually a relatively simple procedure performed by a doctor, but fractures often involve a more extensive, long-term treatment.

Teeth. If a tooth is injured, try to collect and clean off any tooth pieces you can find, and call us immediately. If a tooth is knocked out, pick it up by the crown end, clean it off, and place it back into the empty socket. Have the person gently but firmly clench down on it and call the office or go to the ER as quickly as possible. Prompt attention is also needed for teeth moved out of alignment by a hard blow.

Playing sports has obvious physical, mental and social benefits. Don't let an oral injury rob you or a family member of those benefits. Take precautions and know what to do during a dental emergency.

If you would like more information about, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “An Introduction to Sports Injuries & Dentistry” and “Dental Injuries: Field-Side Pocket Guide.”