Osteoporosis—Your Teeth Tell a Tale

Osteoporosis affects more than 10 million Americans. While it can strike anyone at any age, it is especially common among women aged 50 and older. If you have been diagnosed with osteoporosis, it means that your bones are weaker and more prone to fracture. In addition to those individuals already diagnosed with osteoporosis, as many as 34 million Americans have low bone density, the first step on the road to osteoporosis.

Many people are not diagnosed with osteoporosis until they suffer a fracture—or come to our office. Even though we often associate it with hip fractures, osteoporosis can affect all bones of the body, including the jaw and the teeth. And because you probably visit our office more often than you do your general physician, we may be the first to spot low bone density or osteoporosis.

Some early signs of low bone density include

• loose or missing teeth
• bone loss in the jaw or around the teeth
• loose or ill-fitting dentures
• gum disease

Even if you have not experienced any of those conditions, low bone density may show up on a routine dental x-ray, an effective tool to distinguish people with osteoporosis from those with normal bone density. By comparing dental x-rays from one year to the next, we often can identify decreases in bone density.

You can help prevent low bone density by

• including Vitamin D and calcium (either from food or supplements) in your diet
• performing weight-bearing exercises
• avoiding smoking and excess alcohol consumption

Remember that dairy products are not the only sources of calcium in food. Broccoli, almonds, beans, salmon and leafy dark greens also contain good amounts of calcium.

There are many reasons to visit our office frequently for checkups and cleanings. Knowing that we are in a position to spot low bone density before anyone else can be one more reason to see us on a regular basis. And if you experience loose teeth or dentures, be sure to call us for an appointment, so that we can not only treat your problem but also identify its cause.

Share the Cup, Share the Germs

Let’s brush off one myth right away: Medically speaking, there’s no reason to toss your toothbrush and replace it after you’ve been ill to prevent reinfecting yourself with the same “bug.” Antibodies against whatever common viral or bacterial illness you’ve just experienced—such as a cold or strep throat—have built up in your body. That means that any germs remaining on your toothbrush won’t make you sick again.

However—and it’s a big however—if you live with other people, you still need to worry about infecting them. If you have a family member who has just been ill, you’re probably concerned that you and others might catch what he or she just had.

What rules should you apply to your home’s arsenal of oral health supplies? Some suggestions to help keep everyone healthier, no matter what point in the wellness/illness cycle you’re currently experiencing:

• After brushing, rinse your toothbrush thoroughly with hot water. Be sure to let it dry thoroughly—viruses, bacteria and fungi like dampness. Consider having two toothbrushes per person, so a dry one is always ready.
• Store toothbrushes belonging to different people as far away from each other as possible.
• Keep toothbrushes as distant from the toilet as you can. Always flush with the lid closed to prevent droplets from escaping and possibly landing on toothbrushes.
• Never share a common rinsing cup, whether made of glass, plastic or china. Instead, use the more sanitary choice: disposable paper cups. That’s what we do in our office.
• Wash your hands prior to and after brushing to keep germs on your skin from finding their way into your mouth.
• Replace your toothbrush every three months to ensure that the bristles aren’t too worn to clean your teeth effectively.
• While you or another family member is sick, don’t share the same tube of toothpaste.

At your next visit, ask us for more tips about keeping your home oral health supplies as clean and germ-free as possible.

Does Dental Work Make Your Blood Pressure Rise?

Hypertension (high blood pressure)—sometimes called the silent killer because of its lack of obvious symptoms—increases the risk of heart attack, stroke and kidney failure, among other problems. If you have your hypertension under control, congratulations. Not only are you managing your overall health, but we can safely clean your teeth and treat your oral health issues. The same applies if you have normal blood pressure and an in-office reading confirms that.

But if you know you have uncontrolled hypertension or you don’t know what your usual blood pressure is and it turns out to be very high, we may not be able to provide dental services to you until your blood pressure improves. Your safety in the dental chair is our priority; if you have very high blood pressure, we’re less able to ensure that safety.

The American Dental Association offers guidelines for blood pressure and dental treatment. A top number (systolic pressure) of less than 120 and a bottom number (diastolic pressure) of less than 80 is considered normal. A reading somewhere between 120/80 to 139/89 may reflect stress or pain (perhaps from the oral discomfort we’ll be treating) but should have no impact on your dental treatment. With a reading between 140/90 to 159/99, we will still perform the necessary dental work but will recommend that you consult a physician.

When your blood pressure is in the 160/100 to 179/109 range, however, you need to consult a physician soon, and we may decide not to perform any invasive procedures that day. With very high blood pressure—a systolic reading of 180 or higher and/or a diastolic reading of 110 or higher—we probably will not work on your teeth even in a dental emergency, although we will provide antibiotics or pain medication if necessary.

Should you or a loved one have hypertension, please consult your physician for treatment options as soon as possible. And be sure to keep your twice-yearly dental appointments. We can provide cleanings that not only benefit your teeth but help keep gingivitis at bay.

When Food Drives a Wedge Between You and Your Teeth

You enjoyed that popcorn you ate at the movies last week. But the enjoyment is gone now that a husk is stuck firmly and painfully between your tooth and gum. Some foods, such as popcorn, are notorious for getting stuck in the teeth. When the particles cannot be easily removed, food impaction―the forceful wedging of food or other foreign material between the gum tissues and teeth—may occur.

Teeth or implants with large spaces between them are susceptible to food wedging. Receding gums, whether from aging or gum disease, can also cause gaps between the teeth and gums where food may become trapped. Faulty implants or crowns can be guilty as well.

Food that remains wedged over a period of time can become impacted, leading to pain, inflammation and difficulty chewing. Left untreated, food impaction can have very serious consequences. Inflamed tissue is less resistant to bacteria and can allow more debris to become entrapped. Over time, an infection can develop and cause further destruction of gum tissue and bone. The ultimate result could be tooth loss.

You need to see us right away for a thorough evaluation if you suspect impacted food, particularly if inflammation has already set in. In addition to a clinical examination, we will probably take an x-ray to confirm the diagnosis of food impaction, after which we will design a treatment plan.

Treatment usually involves irrigation of the area, often with a warm saline or antiseptic solution. Should all food particles and inflammatory matter not be removed during irrigation, we will continue debris and plaque removal using periodontal instruments, a procedure much like having your teeth cleaned. If the impaction has been caused by a weakened implant or crown, we may need to replace the restoration. We may prescribe antibiotics to treat any infection.

By maintaining meticulous dental hygiene, you can keep your teeth and gums healthy. And healthy teeth and gums resist food impaction.

Sinus Infection: A Pain in the Teeth

Do you have an aching face and pain in your teeth, especially the upper rear teeth? Naturally, you might think you need dental treatment right away. But those symptoms could also signal a sinus infection.

Sinus inflammation can cause pain in your upper back teeth because they are located close to the sinuses. When an infection causes the sinuses to fill with fluid, the pressure can lead to a toothache in your upper back teeth.

If you have these symptoms, make an appointment to see us. We can examine your teeth and perform some tests to see if the pain has a dental origin. Typically, we will take an x-ray, ask if you have a history of sinusitis and inquire about other symptoms, such as nasal congestion, headache, tenderness over the sinuses and fever. These could indicate that your tooth pain is sinus-related.

We may also perform a percussion test by tapping on individual teeth to see whether that causes pain.

Generalized pain in multiple teeth is usually another indicator of sinus infection. If we rule out a dental cause for your tooth and facial pain, we will likely recommend that you see your physician for a sinus evaluation.

If your physician determines that you have sinusitis, he or she will often prescribe a decongestant to reduce the swollen nasal tissues. If your sinusitis has a bacterial component, you may need an antibiotic as well.

A toothache isn’t the only dental problem that may arise. Congested sinuses can cause you to breathe through your mouth, and people who breathe through their mouths develop plaque and tartar buildup more quickly because of dry mouth. Bad breath can also result from the infection. And sinus infections may make it difficult to practice good oral hygiene because of the discomfort involved.

It is important to treat a sinus infection before it actually causes a dental problem. The next time you have pain in your teeth, call our office. You’ll breathe easier.

Finding Oral Clues for Acid Reflux

When you settle into our dental chair, you may not feel as though you are visiting Sherlock Holmes and Dr. Watson. But much of our work involves playing dental detective. Sometimes we may find the first clues that identify a systemic disease or disorder. When we see enamel worn away on molars or on the back of other teeth, and we can rule out tooth-grinding as a cause, the most likely suspect is gastroesophageal reflux disease (GERD).

How can a person have a condition as typically uncomfortable as GERD and not know it? After all, GERD is also known as acid reflux disease. People with GERD suffer from a malfunction of the esophageal sphincter, a kind of valve situated between the esophagus and stomach that normally prevents stomach acid from backing up into the esophagus. If the valve doesn’t close, the acid comes up. All that regurgitated acid usually spells heartburn.

But not everyone with GERD experiences heartburn. Other symptoms—which aren’t exclusive to GERD, and thus can throw clinicians off the GERD trail—can include dry mouth, chest pain, sore throat or the sensation of a lump in the throat. Although heartburn may eventually develop, we may be the first to see visible evidence of GERD: enamel loss.

Hydrochloric acid—the primary ingredient of what “comes up” during a reflux episode—is strong enough to destroy tooth enamel. Since enamel doesn’t regenerate, once it’s gone, it’s gone for good (and decay can more easily flourish). But if we catch GERD early enough and treat it aggressively, we can keep enamel destruction to a minimum.

What’s more, early treatment may help to avoid the other possible consequences of untreated long-term GERD. These range from inflammation and swallowing difficulties all the way to esophageal cancer.

Please be sure to keep your regularly scheduled oral health appointments. They not only give you clean teeth but provide a chance for us to view your mouth as a window into your overall health.

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