Forty years have passed since the first reported case of Acquired Immune Deficiency Syndrome (AIDS), and it and the human immunodeficiency virus (HIV) that causes it are still with us. About 1.2 million Americans are currently infected with HIV, with 50,000 new cases diagnosed each year.
The emergence of antiretroviral drugs, though, has made it possible for many with HIV to live normal lives. Even so, the virus can still have a profound effect on health, including the teeth and gums. Because of its effect on the immune system, HIV+ patients are at greater risk for a number of oral conditions, like a fungal infection called candidiasis ("thrush").
Another common problem is chronic dry mouth (xerostomia), caused by a lack of saliva production. Not only does this create an unpleasant mouth feel, but the absence of saliva also increases the risk for tooth decay and periodontal (gum) disease.
The latter can be a serious malady among HIV patients, particularly a severe form of gum disease known as Necrotizing Ulcerative Periodontitis (NUP). With NUP, the gums develop ulcerations and an unpleasant odor arising from dead gum tissue.
Besides plaque removal (a regular part of gum disease treatment), NUP may also require antibiotics, antibacterial mouthrinses and pain management. NUP may also be a sign that the immune system has taken a turn for the worse, which could indicate a transition to the AIDS disease. Dentists often refer patients with NUP to a primary care provider for further diagnosis and treatment.
Besides daily brushing and flossing, regular dental cleanings are a necessary part of a HIV+ patient's health maintenance. These visits are also important for monitoring dental health, which, as previously noted, could provide early signs that the infection may be entering a new disease stage.
It's also important for HIV+ patients to see their dentist at the first sign of inflamed, red or bleeding gums, mouth lesions or loose teeth. Early treatment, especially of emerging gum disease, can prevent more serious problems from developing later.
Living with HIV-AIDS isn't easy. But proper health management, including for the teeth and gums, can help make life as normal as possible.
If you would like more information on dental care and HIV-AIDS, 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 “HIV-AIDS & Oral Health.”
Picture yourself with a beautiful smile…what do you see? Besides straight and uniform teeth framed by the gums, you should also see one other thing indicative of a great smile—your teeth an attractive shade of translucent white.
But as you age your teeth can begin to dull as the enamel loses its translucency and the underlying dentin thickens and yellows. You no longer have the bright smile you once had in younger days.
But if the discoloration is mainly on the outer enamel, teeth whitening could be your answer for regaining your youthful smile. This is a procedure in which we apply a solution containing a bleaching agent (usually hydrogen peroxide) to your teeth. Aided by heat or light to activate it, the solution can temporarily whiten the enamel.
Teeth whitening isn't an exclusive treatment provided by a dentist—there are a number of retail products that enable you to bleach your teeth at home. But there are distinct advantages to having your teeth professionally whitened.
For one, we can control the level of brightness by adjusting the strength of the bleaching solution. This allows you to achieve the kind of look you want—from a more natural and subtler shade to a more dazzling color often called “Hollywood White.”
Any external teeth whitening application will fade with time, regardless of whether they're professional or DIY. But a dental office whitening may last longer due to our stronger solutions and curing techniques. And, by caring for your whitening (by avoiding tobacco and food items that stain teeth) and obtaining occasional touch-ups in our office, the shine could last for a few years.
Again, this particular whitening technique only works with outer staining and yellowing. If your discoloration originates from inside the teeth, you'll need a more invasive method. And your teeth should be reasonably healthy before undergoing whitening.
All in all, though, teeth whitening is an easy and affordable way to brighten your smile. It could help you take years off your appearance.
If you would like more information on teeth whitening, 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 “Teeth Whitening: Brighter, Lighter, Whiter….”
Although dental care is our primary focus, we dentists are also on the lookout for other health problems that may manifest in the mouth. That's why we're sometimes the first to suspect a patient may have an eating disorder.
Eating disorders are abnormal dietary patterns that can arise from mental or emotional issues, the most common being anorexia nervosa and bulimia nervosa. Each has different behaviors: Anorexics abnormally restrict their food intake (“self-starvation”), while bulimics typically eat heavily and then induce vomiting (“binge and purge”).
Although bulimics are more likely to binge and purge, anorexics may also induce vomiting. That practice in particular can leave a clue for dentists. While vomiting, powerful stomach acid enters the mouth, which can then soften and erode tooth enamel.
It's the pattern of erosion a dentist may notice more than the erosion itself that may indicate an eating disorder. A person while vomiting normally places their tongue against the back of the lower teeth, which somewhat shields them from acid. The more exposed upper teeth will thus tend to show more erosion than the bottom teeth.
A dentist may also notice other signs of an eating disorder. Enlarged salivary glands or a reddened throat and tongue could indicate the use of fingers or objects to induce vomiting. Lack of oral hygiene can be a sign of anorexia, while signs of over-aggressive brushing or flossing may hint of bulimia.
For the sake of the person's overall well-being, the eating disorder should be addressed through professional counseling and therapy. An excellent starting point is the website nationaleatingdisorders.org, sponsored by the National Eating Disorders Association.
The therapy process can be lengthy, so patients should also take steps to protect their teeth in the interim. One important measure is to rinse out the mouth following purging with a little baking soda mixed with water. This will help neutralize oral acid and reduces the risk of erosion. Proper brushing and flossing and regular dental visits can also help prevent dental disease.
An eating disorder can be traumatic for both patients and their families, and can take time to overcome. Even so, patients can reduce its effect on their dental health.
If you would like more information on eating disorders 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 “Bulimia, Anorexia & Oral Health.”
Best known for her roles in E.T. and Ever After, and more recently as a suburban mom/zombie on Netflix's Santa Clarita Diet, Drew Barrymore is now bringing her trademark quirky optimism to a new talk show, The Drew Barrymore Show on CBS. Her characteristic self-deprecating humor was also on display recently on Instagram, as she showed viewers how she keeps her teeth clean and looking great.
In typical Drew fashion, she invited viewers into her bathroom to witness her morning brushing ritual (complete with slurps and sloshes). She also let everyone in on a little insider Drew 411: She has extremely sensitive teeth, so although she would love to sport a Hollywood smile, this condition makes teeth whitening difficult.
Barrymore's sensitivity problem isn't unique. For some, bleaching agents can irritate the gums and tooth roots. It's usually a mild reaction that subsides in a day or two. But take heart if you count yourself among the tooth-sensitive: Professional whitening in the dental office may provide the solution you are looking for.
In the dental office, we take your specific needs into account when we treat you. We have more control over our bleaching solutions than those you may find in the store, allowing us to adjust the strength to match your dental needs and your smile expectations and we can monitor you during treatment to keep your teeth safe. Furthermore, professional whitening lasts longer, so you won't have to repeat it as often.
After treatment, you can minimize discomfort from sensitive teeth by avoiding hot or cold foods and beverages. You may also find it helpful to use a toothpaste or other hygiene product designed to reduce tooth sensitivity.
The best thing you can do is to schedule an appointment with us to fully explore your problems with sensitivity and how we may help. First and foremost, you should undergo an exam to ensure any sensitivity you're experiencing isn't related to a more serious issue like tooth decay or gum recession.
Having a bright smile isn't just advantageous to celebrities like Drew Barrymore—it can make a difference in your personal and professional relationships, as well as your own self-confidence. We can help you achieve that brighter smile while helping you avoid sensitivity afterward.
If you would like more information about teeth whitening, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Important Teeth Whitening Questions Answered.”
By the time a person passes the half-century mark, they've done quite a bit of living: their share of ups and downs, successes and failures, and joys and sorrows. But while aging can take its toll on their physical and cognitive health, older adults still have much to offer from their life experience. It often falls to other family members to keep them in the best health possible—including their oral health.
Helping an older adult maintain healthy teeth and gums is crucial to their overall well-being. So in recognition of Older Americans Month in May, here are 4 tips for helping an older family member keep a healthy mouth.
Support their daily hygiene. Age-related physical and cognitive impairment can make the simple tasks of brushing and flossing much more difficult. You can help by providing an older family member with tools that make it easier for them to clean their teeth, like larger handled toothbrushes or water flossers. In some cases, you may have to perform their hygiene tasks for them, but it's worth the effort to reduce their risk of dental disease.
Watch for "dry mouth." If an older person complains of their mouth being constantly dry, take it seriously. Chronic dry mouth is a sign of not enough saliva, which could make them more prone to dental disease. The likely culprits, especially for older adults, are prescription medications, so speak with their doctor about alternatives. You can also encourage them to use saliva boosters or to drink more water.
Ask for oral cancer screens. Ninety percent of oral cancer occurs in people over the age of 40, with the risk increasing with age. Be sure, then, to ask for an oral cancer screen during their dental visits, presuming it's not already being done. Screenings usually involve visual and tactile examinations of the inside of the mouth and the sides of the neck, looking for unusual lesions, swelling or discolorations. The sooner oral cancer is found, the better the chances of a successful treatment outcome.
Have dental work checked. An older person may have acquired various forms of dental work like bridges, implants or removable dentures. Because these play an important role in their oral health, you should have their dental work checked routinely. This is particularly true for dentures, which can lose their fit and comfort over time. Dental work in need of repair makes dental function more difficult and can increase their risk of disease.
Given the depth of responsibility in caring for an older adult, it's easy to let some things slip by the wayside. Their oral health shouldn't be one of them—giving it the priority it deserves will pay dividends in their health overall.
If you would like more information about oral care for an older adult, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Aging & Dental Health” and “Dry Mouth.”
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