Posts for: February, 2021
In recent years, dental implants have helped traditional bridgework take a giant leap forward. A few strategically placed implants can provide the highest support and stability we can currently achieve for this well-known dental restoration.
Implants derive this stability from the bone in which they're imbedded. Once surgically installed, the bone around a metal implant begins to grow and adhere to its titanium surface. Over time, this creates a strong anchor that firmly holds the implant in place.
But the implants' stability can be threatened if the gums around them become diseased. Gum disease, a bacterial infection caused mainly by dental plaque, can advance silently below the gum surface until it ultimately infects the bone. This can cause significant bone loss around an implant, which can weaken it to the point of failure.
To avoid this scenario, it's important to prevent gum disease by flossing daily to remove accumulated dental plaque between the implant-supported bridge and the gums, particularly around the implants. This kind of flossing around bridgework is more difficult than flossing between teeth, but it can be done with the help of a device called a floss threader.
A floss threader is a small plastic hand tool with a loop on one end and a stiffened edge on the other (similar to a sewing needle). You begin by threading about 18" of dental floss through the loop, and then work the other end of the threader between the bridge and gums to the other side.
With the floss threaded between the bridge and gums, you can now remove it from the threader, grasp each end, and floss around the sides of each implant you can reach. You'll then need to repeat the process by removing the floss, rethreading it in the threader and inserting it into the next section between implants, continuing to floss until you've accessed each side of each implant.
You can also use pre-packaged floss thread sections with a stiffened end to facilitate threading. But whichever product you use, it's important to perform this task each day to prevent a gum infection that could rob you of your implant-supported bridge.
If you would like more information on oral hygiene practices with dental work, 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 “Oral Hygiene for Fixed Bridgework.”
Chronic jaw pain can be an unnerving experience that drains the joy out of life. And because of the difficulty in controlling it patients desperate for relief may tread into less-tested treatment waters.
Temporomandibular disorders (TMDs) are a group of conditions affecting the joints connecting the lower jaw to the skull and their associated muscles and tendons. The exact causes are difficult to pinpoint, but stress, hormones or teeth grinding habits all seem to be critical factors for TMD.
The most common way to treat TMD is with therapies used for other joint-related problems, like exercise, thermal (hot and cold) applications, physical therapy or medication. Patients can also make diet changes to ease jaw function or, if appropriate, wear a night guard to reduce teeth grinding.
These conservative, non-invasive therapies seem to provide the widest relief for the most people. But this approach may have limited success with some patients, causing them to consider a more radical treatment path like jaw surgery. Unfortunately, surgical results haven't been as impressive as the traditional approach.
In recent years, another treatment candidate has emerged outside of traditional physical therapy, but also not as invasive as surgery: Botox injections. Botox is a drug containing botulinum toxin type A, which can cause muscle paralysis. Mostly used in tiny doses to cosmetically soften wrinkles, Botox injections have been proposed to paralyze certain jaw muscles to ease TMD symptoms.
Although this sounds like a plausible approach, Botox injections have some issues that should give prospective patients pause. First, Botox can only relieve symptoms temporarily, requiring repeated injections with increasingly stronger doses. Injection sites can become painful, bruised or swollen, and patients can suffer headaches. At worst, muscles that are repeatedly paralyzed may atrophy, causing among other things facial deformity.
The most troubling issue, though, is a lack of strong evidence (outside of a few anecdotal accounts) that Botox injections can effectively relieve TMD symptoms. As such, the federal Food and Drug Administration (FDA) has yet to approve its use for TMD treatment.
The treatment route most promising for managing TMD remains traditional physical and drug therapies, coupled with diet and lifestyle changes. It can be a long process of trial and error, but your chances for true jaw pain relief are most likely down this well-attested road.
If you would like more information on treating jaw disorders, 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 “Botox Treatment for TMJ Pain.”
A full night's sleep isn't a luxury—we all need it for a healthy mind and body. But 50-70 million people in the U.S. aren't getting enough sleep because of a chronic sleep disorder like obstructive sleep apnea (OSA).
OSA happens when a sleeper's airway becomes blocked (most commonly by the tongue), cutting off oxygen to the brain. The body rouses from sleep to overcome the blockage. This awakening could last only a few seconds, after which the person immediately goes back to sleep. But it can occur hundreds of times a night and interrupt deeper sleep needed for a good night's rest.
Sleep disorders like OSA are a significant medical problem that could contribute to serious health issues like high blood pressure or cardiovascular disease. If you're experiencing fatigue, irritability or your family's complaints of you snoring, you should see a physician for diagnosis and treatment options.
You should also consider another health professional who could be helpful in dealing with OSA—and may even be able to provide a treatment option: your dentist. Here's how.
A dentist could discover your OSA. Because of twice-a-year dental visits, dentists often see patients more frequently than other healthcare providers. A properly trained dentist could pick up on signs and symptoms of sleep disorder, including patients falling asleep and even snoring while in the dentist's chair.
Dentists are familiar with the mouth. Few healthcare providers focus on the oral cavity like dentists. Besides the teeth and gums, dentists also have extensive knowledge of the tonsils, uvula and tongue that often play a role in sleep disorders. As such, a dentist may notice abnormalities during routine exams that might contribute to airway obstruction during sleep.
Dentists provide a treatment option. Many OSA patients use a CPAP mask to maintain an open airway during sleep. But CPAP therapy can be uncomfortable for some. For mild to moderate cases of OSA, dentists can create an oral appliance based on the patient's mouth dimensions that prevents the tongue from sinking back into the throat.
If you believe you may have OSA or a similar sleep disorder, by all means speak with your doctor. But also mention it to your dentist—your dental provider might hold the key to a better night's sleep.
If you would like more information on how we could help with your sleep apnea symptoms, 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 “Sleep Disorders & Dentistry.”