Posts for category: Oral Health
Shingles is a painful viral infection that could potentially recur in sufferers for years. It causes painful skin rashes, general nerve pain, fever and fatigue. In extreme cases, it can cause blindness if the eyes become infected. And because it’s highly contagious, it could affect your dental treatment.
Formally known as herpes zoster, shingles is a recurrent form of chicken pox. If you contracted chicken pox in childhood, the shingles virus could lay dormant for several years. In fact, most people who contract shingles are over 50.
Because it acutely affects the nerves around the skin, the disease’s most common symptom is a belted or striped rash pattern that often appears on one side of the body and frequently on the head, neck or face. While the severity of symptoms may vary among patients, shingles can be a significant health threat to certain people, especially pregnant women, cancer patients or individuals with compromised immune systems.
In its early stages, the shingles virus can easily pass from person to person, either by direct contact with the rash or by airborne secretions that others can inhale. Because it’s highly contagious, even a routine teeth cleaning could potentially spread the virus to dental staff or other patients. Because of the significant health threat it potentially poses to some people, your dental provider may decline to treat you if you’re showing symptoms of the disease.
To stay ahead of this, let your dentist know you’re experiencing a shingles episode if you have an upcoming dental appointment, in which case you may need to reschedule. In the meantime, you should seek medical attention from your physician who may prescribe antiviral medication. Starting it within 3 days of a shingles outbreak can significantly reduce your pain and discomfort as well as its contagiousness.
And if you’re over sixty or at risk for shingles, consider getting the shingles vaccine. This readily available vaccine has proven effective in preventing the disease and could help you avoid the pain and disruption this viral infection can bring to your life.
Chronic stress can cause any number of physical problems like back pain, insomnia or stomach ulcers. In the mouth, it can also be the cause of teeth grinding or clenching habits that may lead to pain and tooth damage.
Besides toothaches and jaw pain, stress-related teeth grinding may also be causing your teeth to wear at a faster than normal rate. While the teeth can withstand normal forces generated from biting and chewing, a grinding habit could be subjecting the teeth to forces beyond their normal range. Over time, this could produce excessive tooth wear and contribute to future tooth loss.
Here, then, are some of the treatment options we may use to stop the effects of stress-related dental habits and provide you with relief from pain and dysfunction.
Drug Therapy. Chronic teeth grinding can cause pain and muscle spasms. We can reduce pain with a mild anti-inflammatory pain reliever (like ibuprofen), and spasms with a prescribed muscle relaxant drug. If you have sleep issues, you might also benefit from occasional sleep aid medication.
A Night or Occlusal Guard. Also known as a bite guard, this appliance made of wear-resistant acrylic plastic is custom-fitted to the contours of your bite. The guard is worn over your upper teeth while you sleep or when the habit manifests; the lower teeth then glide over the hard, smooth surface of the guard without biting down. This helps rest the jaw muscles and reduce pain.
Orthodontic Treatment. Your clenching habit may be triggered or intensified because of a problem with your bite, known as a malocclusion. We can correct or limit this problem by either moving the teeth into a more proper position or, if the malocclusion is mild, even out the bite by reshaping the teeth in a procedure known as occlusal (bite) equilibration.
Psychological Treatment. While the preceding treatments can help alleviate or correct dental or oral structural problems, they may not address the underlying cause for a grinding habit — your psychological response to stress. If you’re not coping with stress in a healthy way, you may benefit from treatments in behavioral medicine, which include biofeedback or psychological counseling.
If you would like more information on dental issues related to stress, 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 “Stress & Tooth Habits.”
If you have chronic jaw pain, you know how difficult eating, speaking or even smiling can be. Many sufferers will do anything to gain relief, even surgery. But before you go down that road, consider the traditional conservative approach to temporomandibular disorders (TMD) management first—it could provide the most relief with the least risk of side effects.
The temporomandibular joints connect the lower jaw to the skull on either side of the head. These ball and socket joints also contain a cushioning disk to facilitate movement. This disk is believed to be the primary focus for jaw pain problems known collectively as TMD.
Doctors now believe injury, stress, metabolic issues, jaw anatomy defects or similar factors trigger the chain reaction of muscle spasms, pain and soreness that can erupt during a TMD episode. A TMD patient may experience pain within the jaw muscles or joints themselves, clicking sensations, or an inability to open the jaw to its full range.
TMD therapy has traditionally followed an orthopedic path—treating jaw joints like any other joint. In recent years, though, a more aggressive treatment model has emerged that promotes more invasive techniques like orthodontics, dental work or jaw surgery to relieve discomfort. But the track record for this model, especially concerning jaw surgery, remains hazy at best and offers no guarantee of relief. These techniques are also irreversible and have even made symptoms worse in some patients.
It’s usually prudent, then, to try conservative treatments first. This can include pain and muscle relaxant medication, jaw exercises, stretching and massage, and dietary changes to reduce chewing force. Patients with teeth grinding habits may also benefit from a bite guard worn at night to reduce the biting force during sleep and help the joints relax.
By finding the right mix of treatments, you may be able to find significant relief from TMD symptoms with the conservative approach. If not, you might then discuss more invasive options with your dentist. But even if your dentist recommends such a procedure, you would be wise to seek a second opinion.
TMD can definitely interfere with your quality of life and peace of mind. But there are ways to reduce its effects and make for a happier life.
If you would like more information on managing chronic jaw pain, 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 “Seeking Relief from TMD.”
Daily fatigue or complaints of your snoring from family have led you to see your doctor about the problem. After an exam and a test session in a sleep lab, your problem now has a name — obstructive sleep apnea.
This common sleep-related breathing disorder (SRBD) occurs when the soft tissues in the back of the throat over-relax during sleep. The relaxed tissues obstruct air flow to the trachea (windpipe) and cause “apnea,” where you cease to breathe. The lack of oxygen causes you to wake, even for a micro-second, to begin breathing again. This may occur multiple times throughout the night, diminishing the quality of your sleep and leading not only to drowsiness and daily fatigue but also contribute to cardiovascular disease or other systemic conditions.
The most effective treatment for sleep apnea is the use of a Continuous Positive Airway Pressure (CPAP) machine while you sleep. The machine delivers pressurized air to a face mask you wear while you sleep; the additional pressure keeps the airway open. However, a CPAP machine does have a few disadvantages, including discomfort while attached to the machine, nasal congestion and dryness, or claustrophobia. These effects can be so pronounced for some patients, they’re unable to adjust themselves to the machine.
If you have mild to moderate sleep apnea, there may be an alternative — a custom-fitted oral appliance we manufacture for you to wear in your mouth while you sleep. The appliance pulls the lower jaw forward resulting in a wider opening of the airway. In addition to being less cumbersome than a CPAP mask, an oral appliance is easier to wear, compact in size for easy travel and doesn’t require electricity.
While an oral appliance is an effective alternative to a CPAP machine for many patients, it does have a few disadvantages including problems with saliva flow (too much or too little), muscle or teeth soreness and minor tooth or jaw movement. Still, an oral appliance might be the right solution to relieve your sleep apnea over the long-term.
If you would like more information on treatments for sleep apnea, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Sleep Disorders & Dentistry” and “Sleep Apnea FAQs.”
As a cancer patient, you know how important radiation and chemotherapy are to overcoming the disease. But these treatments often come at a price to other aspects of your health, including your teeth and gums if the treatment target includes the head or neck regions.
Radiation and chemotherapy are effective because they target and destroy cancer cells. Unfortunately, they may also kill non-cancerous, healthy cells; in the mouth, for example, they can damage the cells in the salivary glands and disrupt their ability to produce adequate saliva flow, leading to xerostomia (dry mouth).
This could seriously affect your teeth’s protective enamel shell. As we eat or drink, our mouth’s pH level can become too acidic. Acid is your enamel’s primary enemy because it causes the minerals in the enamel to soften and dissolve (de-mineralization). Saliva neutralizes acid and replaces much of the enamel’s minerals.
Without adequate saliva flow, the enamel will tend to erode over time. You can further aggravate the situation if you routinely consume acidic foods and drinks, like sipping energy drinks or soda during the day. Once the enamel is gone it can’t be replaced naturally, and the teeth will be in serious danger of tooth decay and eventual loss of function and appearance.
To avoid these consequences you should take steps during cancer treatment to reduce your risk for xerostomia or other unhealthy mouth conditions: limit your consumption of acidic foods and beverages; use mouth rinses to counteract acidity and inhibit bacterial growth; and promote saliva flow through medication.
It may be, though, that enamel erosion and subsequent tooth damage is unavoidable. In this case, you may need to consider restorative options with artificial crowns or other cosmetic enhancements — not only to improve your appearance but also to protect your natural teeth from further damage.
Before considering the latter, you should undergo a complete dental examination to assess your condition and make sure you have adequate bone and gum support, and any dental disease under control. From here, we can go about restoring the attractive smile that may have faded during your battle with cancer.