Tuesday, August 15, 2017

Are you afraid of the dentist?

Fighting Dental Fear

Fear that affects one’s ability to seek or receive dental treatment has real consequences. Ignoring gingivitis, gum disease characterized by bleeding, puffy gums, can cause it to progress to periodontitis, advanced gum disease characterized by bone loss in the jaw and loose teeth. Cavities left untreated only get bigger. A sore in the mouth that does not heal may be a sign of oral cancer and ignoring it can be deadly. Neglecting the teeth during pregnancy can result in low birth weight.

Avoiding dental treatment also has financial consequences. A small cavity that could have been treated with fluoride or a filling may end up needing more extensive treatment like a root canal, crown, or other expensive restoration. These treatments also require multiple visits leading to more time off from work. A restored tooth is more likely to need future treatment versus a natural tooth.

Dental fear that prevents a person from getting treatment is recognized as a debilitating phobia called odontophobia. Fear of the dentist or of dental treatment may be related to a person’s tolerance for pain and is often an issue for people who have suffered from abuse. Estimates on the number of people affected by true dental phobia varies widely from 9% to over 30%, however, most people can testify to the fact that going to the dentist for treatment is no walk in the park. 
Dental Fear. (image:ym)

There are a variety of things that may cause dental fear. Some patients may be ashamed that they have waited so long to see the dentist. Aside from being afraid that something is seriously wrong, they fear “the lecture” they may get for not taking care of their teeth. 

Pain is a also common fear. While dentistry has come a long way, it still involves the administration of anesthetic with needles or other methods that can be scary for some people. 

Bad childhood experiences with dental treatment are a cause of fear, too.  People with dental fear have also cited feelings of loss of control during treatment and a general discomfort with the sights, sounds and even smells of a dental office. Some people feel uncomfortable with treatment because they have a strong gag reflex or report feeling like they may choke during dental procedures. 

Whatever the reason, dental fear is real and can be troubling for people. Still, dental treatment and regular dental check ups are absolutely necessary for health.

There are a number of ways to try to cope with dental fear:

Ask questions and discuss your fears with the dentist or dental hygienist. It’s not necessary to reveal your innermost secrets but being upfront about your dental fear will help guide them with your treatment. For example, if you fear the sight of needles, the tray can be covered or they can adjust their approach to keep the needle out of the line of your sight.

Find a dentist and dental hygienist you like and whose staff make you feel comfortable and welcome. 

A dental office’s environment is important. An environment suited to your personality can help you deal with the anxiety you feel when visiting the dentist. Perhaps you favor a soothing environment with soft music or prefer an office with lots of stimuli, like televisions mounted on the ceiling for patient viewing.

Set the mood with music.  Listening to music on headphones during treatment can be very helpful for people who are sensitive to noise.

Wearing sunglasses or goggles while receiving treatment can help with harsh lights.

It is important to set your appointment when you are least likely to be stressed. If rushing to an appointment after a day at work stresses you out, consider making early morning or weekend appointments instead. Dental office staff should be willing to work with you and help keep you on track for your appointments.

Resist the urge to cancel. It is important to keep your appointments since delaying treatment or not going for regular dental hygiene visits is only likely to worsen your dental issue.

Stress reducing methods like guided relaxation techniques and biofeedback, or other professional help like counseling or hypnosis, may help reduce anxiety in the dental setting as well. 

Do you have dental fear? Answer TRUE or FALSE to the questions below:

I hate going to the dentist
I had a bad childhood experience at the dental office
I don’t trust what my dental hygienist tells me
I don’t trust what my dentist tells me
I hate having my teeth cleaned
I frequently cancel appointments for no reason

If you answered TRUE to most of these questions you may have dental anxiety. Think about the reasons you don’t like to or want to go to the dentist and ways you can cope with them. If you are avoiding treatment because of your fear talk to your doctor or dentist to get the help you need.

One of the best ways to deal with dental issues is to not have them in the first place! It is worth the small effort it takes to brush and floss every day.


Sources: http://jada.ada.org/article/S0002-8177(16)30966-7/fulltext; Milgrom, P., Weinstein, P., Heaton, L.J. Treating Fearful Dental Patients: A Patient Management Handbook. 3rd ed. Dental Behavioral Resources.ComSeattle, WA2009; http://www.dentalfearcentral.org/; https://www.health.harvard.edu/blog/dental-fear-our-readers-suggest-coping-techniques-20100825327; 1. Moore R, Birn H. [Phenomenon of dental fear] Tandlaegebladet. 1990;94:34–41. [PubMed]

This blog is not intended to treat or diagnose any illness or condition. Please see your medical or dental professional for treatment and care.



Tuesday, August 1, 2017

Gum Disease and Cancer in Women

If you could reduce your risk of getting cancer by brushing and flossing, would you do it? 

There are two types of gum disease: Gingivitis and Periodontal Disease. Both of these mean that the gums are infected with germs and there is inflammation in the mouth.

Gingivitis is the “reversible” type of gum disease. It is characterized by bleeding, puffy gums and it’s the type commonly discussed on toothpaste commercials. Gingivitis can be reversed with regular brushing and flossing in addition to eating a healthy diet.

Periodontal Disease is an advanced form of gum disease and is what happens over time if you ignore gingivitis. In people with Periodontal Disease, germs in the mouth have increased in amount and changed in type. In an effort to get rid of the germs, the body’s immune system responds by destroying the tiny connective tissues that keep the teeth attached to the gums and by destroying bone levels in the jaw. Periodontal disease is “irreversible” yet it can be controlled with proper treatment. 

People are often unclear about whether they have gum disease yet over 50% of adults have some form of it.

If you have Periodontal Disease, your dentist or dental hygienist may have discussed with you the “pockets” in your gums and recommended “deep” cleanings. You may have been told that you have “receding” gums or you may feel like your teeth have “shifted.”  These simple terms are used to help people understand their gum health, however, Periodontal Disease is a complex and serious condition. It is important to manage periodontal disease before further destruction to the mouth, like tooth loss, occurs.

Avoiding Periodontal Disease may also help to guard against common cancers in women. 

A recent long-term study that followed over 65,000 women revealed that there is an association between certain cancers and Periodontal Disease. The association to esophageal cancer was strongest but it was also evident in cancers of the lung, gallbladder, breast, and skin. Overall, women with Periodontal Disease were 14% more likely to get cancer than women without Periodon
Gum disease, cancer & women yml
tal Disease; 20% more likely for women who are current or former smokers.



Sources: Reuters.com & Medscape; original source article:  bit.ly/2w2vmvi Cancer Epidemiology, Biomarkers and Prevention, published online August 1, 2017

This blog is not intended to treat or diagnose any condition or illness. Please consult your medical or dental professional for treatment.



Saturday, July 8, 2017

What's New on the New Nutrition Labels

The New Nutrition Labels

What's new and what it means for your teeth

The nutrition label on packaged goods is changing to make it easier for people to understand the nutritional value of what they are eating and to be in line with current scientific knowledge.

This change, mandated by the U.S. Food and Drug Administration (FDA,) reflects current research on what people actually eat or drink.

Food Serving Sizes Get a Reality Check, source: FDA.gov
For example, because people usually drink a can of sugar-sweetened soda in one sitting, the serving size of soda is being increased from 8 ounces to 12 ounces, the size of the can of soda. Twenty ounce bottles of sugar-sweetened beverages likewise will be considered only one serving. Other serving sizes will decrease. The serving size of yogurt, for instance, will decrease from 8 ounces to 6 ounces because data revealed that 6 ounces is the amount that someone typically eats in one serving. Any package that contains what might be considered one serving and could be eaten in one sitting must list the total amounts per package or have two labels, one per serving and one per package. (No more doing the math!)

Also changing are the nutrients that are listed. Some, like Vitamin A and C are being eliminated, while others, like Vitamin D and Potassium are now required. How fat is being listed is also changing. In addition to total fat, the type of fat is included.

Completely new to the label is a listing of added sugars. 

Obesity is a huge health problem. In the U.S. over 72 million adults and over 12 million children are obese. Not one State is within the national obesity rate health goal of less than 15%

Sugar is a major culprit. 

Added sugars should be no more than 10 percent of total calories. Any more than that prevents people from staying within daily calories limits and getting the valuable nutrients they need. There is no recommended amount of sugar in the diet and certainly no recommended amount of added sugar. Although sugar fuels our cells, our bodies make all that is needed by converting the food we eat into sugar. Additional sugar is simply not necessary in the diet.

Science has long known that the teeth are negatively affected by sugar as well. For good oral health the recommendation remains to eat whole fruits rather than juices and to strictly limit sugar sweetened beverages in the diet. Sugar along with plaque bacteria can cause cavities and sugar causes inflammation in the entire body, including the mouth.

Old label vs. New Label, source: FDA.gov
This change is a great way for everyone to monitor and cut down on sugar in their diets, should they care to do so. But changing the label in and of itself will do nothing unless people take personal responsibility for their own health and also learn how and what they should be eating.

Companies with packaged food and beverage sales over $10 million have until July of 2018 to start using the new labels and rules and smaller companies have an additional year. Be on the look-out for the new labels!

Are you reading nutrition labels to help make healthy food choices?

sources: www.cdc.gov; www.fda.gov

This blog is not intended to diagnose or treat any condition or illness. Please see your doctor or dentist for treatment and any health concerns.

Friday, June 23, 2017

Flying or Diving this Summer? Avoid Tooth Squeeze!

Ever have tooth pain during a flight? You may be experiencing barodontalgia, also known as “tooth squeeze”. Tooth squeeze is not itself a dental disease but may indicate a dental problem. When air pressure changes, a cavity, poorly done filling or crown, or even sensitivity, can trigger pain. Pilots and flight crew are vulnerable to this condition but it can happen to anyone. 

Barodontalgia generally occurs on ascent and descent but can also happen during any flight over 5,000 feet in altitude and in pressurized as well as smaller, non-pressurized planes. The pain may persist or go away quickly and the type of pain can help identify the problem. A dull, throbbing pain may indicate a cavity while a sharp, deep pain may indicate the need for a root canal. Pain in the upper, back teeth may even indicate a sinus issue.
Plane - yml 2014

Divers also can experience tooth squeeze. Even dental recession can make a person susceptible. The change in pressure can cause a build-up of air in the tubules of the tooth and in severe cases even crack a tooth. Anyone planning to dive should wait a week after having dental treatment with anesthesia and anyone planning to take a flight in a small non-pressurized plane, should wait at least twenty-four hours before doing so.

If you are experiencing any kind of dental pain, you should see a dental professional right away. Don't ignore it regardless of whether it is persistent or comes and goes. The last thing you want to do while on vacation is end up in a dental chair!

Have a safe and healthy summer.

Source: Open Journal of Dentistry and Oral Medicine 3(2): 35-38, 2015 http://www.hrpub.org DOI: 10.13189/ojdom.2015.030201 Barodontalgia: Etiology, Features and Prevention Prajna V. Kini1 , Vinod Rakesh Jathanna2,* , Ramya V. Jathanna3 , Karthik Shetty2

This blog is not intended to treat or diagnose any disease or condition. If you are experiencing a dental or medical issue seek treatment from a dental or medical professional right away.

Monday, February 20, 2017

Happy President's Day: George Washington's Teeth


Contrary to what you heard in grammar school, George Washington did not have wooden teeth. He did have dentures made out of a variety of materials including lead, gold, and brass, with teeth carved from ivory, hippo, and cow teeth. There were also some human teeth set into his dentures - other's and possibly some of his own. Some think that staining from red wine and foods in the tiny fractures of the fake teeth may have resulted in the wooden look of Washington's teeth. This rumor may also have come from the fact that his last dentist was a Dr. Greenwood. Washington gave Greenwood his very last real tooth, the only one he still had when he became president, as a gift when it, too, failed. Dr. Greenwood then wore this tooth displayed in a small glass case in a chain around his neck.

Sketch of Washington's dentures & dollar bill, ym
So what caused Washington’s devastating tooth loss?  Historical documents suggest he was particular about caring for his teeth to the point of obsession, and owned toothbrushes, tooth powders, tongue scrapers and other implements to clean his mouth. Still, he started losing his teeth in his twenties. By his own account, his tooth loss was caused by a bad habit of his youth - cracking walnuts with his teeth! The scar on his cheek is from an abscess that required draining, and in portraits of the president when he was older, there are obvious signs that the loss of his teeth had changed the look of his face.

Washington often complained that his dentures hurt and were ill-fitting and he was constantly in contact with dentists. A letter to his dentist that was intercepted by the British may have even changed the course of a battle. Because Washington directed his dentist to send him dental materials in New York, the British decided to not send troop reinforcements South.

Some historians speculate that Washington had a genetic disorder that affected his teeth.  He was tall compared to his family members and other men of that time. He also had other physical signs that indicate the possibility of a genetic defect. (Washington had no biological children of his own and was thought to be infertile - the children that he and Martha raised were from her previous marriage.) 

Washington suffered from many illnesses throughout his life including small pox, malaria and tuberculosis. He may even have suffered from metal poisoning from the medications he took or from materials, like lead, that made up his dentures. Indeed, the bloodletting that was used to treat his very last illness, epiglottitis (swelling of the cartilage that covers the windpipe when swallowing,) is suspected to be what actually caused his death at the age of 68 in December of 1799.

For more information about Washington, his teeth, and other fascinating facts about his life visit: www.mountvernon.org, www.smithsonianmag.com, and www.si.edu

This blog is for entertainment purposes only and not intended to treat or diagnose any medical or dental condition. Please see your dentist or doctor if you are having health problems.