No Numbing Gel for Babies

Teething is a normal part of development.  Baby teeth start to erupt between 5-7 months of age and continue to come in until the child is about three years old.  Babies may seem fussy, cry, and chew on their hands.  A cold cloth or teething ring for baby to chew on or massaging the gums with a clean finger are the best ways to treat discomfort.  (Fever during teething is coincidental and use of products with acetaminophen should be used according to directions to avoid overdose in an infant.)  While parents may be distressed that their child is in pain, numbing gels are never recommended to treat teething pain.  Over the counter products can do more harm than good and can cause a rare but potentially fatal condition called methemoglobinemia in which the oxygen level of the blood drops.  Parents should also never use left over adult prescriptions to treat teething pain in babies. 

For more information about the products in question and to read the FDA's warning, please go to:
http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm385817.htm 

Now a word about the use of numbing gels for adults.  Pain in the mouth that is so severe you find yourself applying numbing gel is not normal.  Cavities or infections in the mouth do not get better, they only get worse.  At best numbing gel will only temporarily alleviate pain and then you may find yourself in a more painful or potentially dangerous situation.  If your teeth or a tooth hurts, see a dentist! 

This information is not intended to diagnose or treat any disease or condition.  Please visit your medical or dental professional for treatment.

Bad Breath and Sniffing out Lung Cancer

I have patients who are diligent about brushing and use mouthwash yet complain of bad breath.  There are several causes of bad breath but I usually address flossing habits first.  Flossing gets in between the teeth where the toothbrush can't reach.  Plaque, which is made of germs, live and grow all over the mouth.  Not flossing is like taking a shower and washing your face but not washing your hair or your ears - you're not doing the whole job.  Plaque stinks and unfortunately there is no other way to effectively get the plaque out from between the teeth.  Even new electronic devices, which are like mini water-picks, still recommend flossing in their instructions.  There simply is no substitute.  When investigating reasons for bad breath, other things to look at are medications, tooth alignment, mouth breathing and other health considerations.  Some medications can cause dry mouth, a common side effect of certain meds, which can lead to bad breath.  Supplements like fish oil or garlic, foods like onions or other odiferous foods can also cause it.  Tooth alignment can cause the mouth not to fully close, leading to drying of the mouth tissues and again, bad breath.  Mouth breathing at night or snoring, sometimes a sign of a serious health issue like sleep apnea, can also cause this problem as can life style habits, like smoking and drinking.  Bad breath certainly can be troublesome so it is best to discuss the issue frankly with your medical or dental professional especially since chronic bad breath may indicate underlying health problems.  It was also reported recently that the breath in general may even reveal other important information about a person's health.  At a conference of the American Society for Clinical Oncology new research revealed some amazing results.  Researchers reported that they have developed a machine using nanotechnology that can "smell" the breath of patients with lung cancer and other lung ailments.  Simply by breathing into a tube subtle changes in the body chemistry of the person are detected.  While this technology is still being tested the initial results seem promising.  (Please see the original article at http://www.livescience.com/46108-breath-test-lung-cancer.html ) Perhaps someday your doctor, dentist, or dental hygienist will be able to administer a simple breath test that can save your life or the life of your loved one.  That sure smells sweet.
This information is not intended to treat or diagnose any dental or medical problem or illness.  Please visit your medical or dental health professional if you need medical or dental treatment!

For Brighter Smiles

There is nothing like being with friends to make me feel like a million bucks.  Friday night it was at a formal, lavish affair to celebrate our town's anniversary and honor community members who make it a great place to live.  It was a little daunting to walk by myself into this throng of people dressed to the nines, laughing, talking and drinking.  Making my way through the crowd I saw my friends across the room and social anxiety faded to relief!  These are the friends I have made since moving to town twenty years ago.  (Where has the time gone!?)  Some of them I have known for more than a decade and others met more recently but all are cherished.  One who knows my kids well and whom we affectionately called "Crossing Guard Lady" for years.  We now paint sets together for our community theater show and I so appreciate her common sense and no nonsense advice.  Another who simply cracks me up with her wit and uncommon humor.  She's that person who makes you feel like you're in 4th grade again.  And several more friends each of whom evoke such wonderful memories and have a special spot in my heart.  It makes me feel so blessed.  On Saturday, it was by contrast a very informal affair - girls night out at a friend's home.  Just pull up a chair and grab a glass of wine or a beer.  We know each other so well that when we see each other it's almost as if the conversation picks up where it left off.  These are the women I have known since I was a teen and who know where the bodies are buried!  (What happens in the Poconos stays in the Poconos.)  We've gotten in trouble together, had a blast together, and celebrated the specials times in each other's lives together.  We joke and laugh so hard it's hard to breathe.  We talk about our lives, jobs, families, various gynecological and medical procedures, and everything else we can think of to talk about.  We can say anything to each other and we do.  I find that so amazing.  I can't imagine my life without these people in it.  So driving home today, I was smiling.  I was ear to ear grinning just thinking about this weekend, the many past weekends and days, and more I hope to come.  Nothing makes my smile brighter than my friends.

Drugs and Dry Mouth (The Top Five Prescription Drugs)

Dry mouth (also called xerostomia,) can be very uncomfortable.  Your entire mouth including the lips, tongue and throat can become very dry if saliva production decreases.  Having dry mouth can making eating uncomfortable or painful and can cause bad breath.  It can lead to higher levels of plaque, tooth decay, and dentures that are ill-fitting.  It may even cause an outbreak of thrush, a yeast infection that can occur in the mouth.  Unfortunately, dry mouth is a common side effect of many medications.  While saliva levels can return to normal if a medication is discontinued, this is not an option for many people.  If a medication needs to be taken for a long period of time or permanently, dry mouth must be managed to maintain the health of the mouth and teeth.  The mouth, after all, is meant to be a wet place!  Dry mouth symptoms can be managed by sipping water frequently, chewing sugarless gum or sucking on sugarless candies, using lip balms and with products like Biotene.  Biotene is sold in drug stores without a prescription as a rinse, spray or gel.  It acts by lubricating the mouth and holding in moisture.  (For more information see http://m.biotene.com/) There are also store brands available.  Since saliva production decreases during sleep, using this kind of product before going to bed may be very helpful.  It is also very important to continue to brush and floss regularly if you have dry mouth.  Below lists the five most commonly prescribed drugs. ( http://www.drugs.com/stats/top100/sales ) 

Three of them - Abilify, Nexium, and Advair Diskus - can cause dry mouth.

1-      Abilify (aripiprazole) – treats depression. 

2-      Nexium (esomeprazole) – treats GERD (gastroesophageal reflux disease) and reduces stomach acid.

3-      Humira (adalimumab) – treats rheumatoid arthritis, osteoarthritis, psoriasis; also may be used to treat Crohn’s disease and ulcerative colitis.

4-      Crestor (rosuvastatin) – lowers “bad” cholesterol

5-      Advair Diskus (fluticasone & salmeterol) – for treatment of asthma and COPD.  

Dry mouth can interfere with your quality of life and the health of your mouth so speak with your doctor, dentist, dental hygienist or other health professional about ways to manage it.

This information is not intended to treat or diagnose any dental or medical problem or illness.  Please visit your medical or dental health professional if you need medical or dental treatment!

Sweet Dreams Are Made of Teeth (apologies to Annie Lennox)

Have you ever dreamed about your teeth?  Dreams about your teeth or dreams that your teeth are falling out are surprisingly common.  You might not be surprised that I see teeth in my dreams, however, I had dreams about teeth long before becoming a dental hygienist.

So what do dreams about teeth mean?  Dream analysis has been around for a long time.  From Joseph’s prophetic dreams in the bible to the surreal dream paintings of Salvador Dali̒, dreams tantalize and fascinate people. Freud proposed that a person’s dreams hold deeper meaning that can be interpreted only by analyzing its details using (his) psychoanalytic methods.  In Freud’s “The Interpretation of Dreams” he illustrates this method using his own dreams.  He describes a dream about a patient he treated who was also his good friend.  Her treatment was not as successful as he would have hoped.  In the dream Freud attempts to give his friend an oral exam, which she resists and he imagines she must have false teeth!  After exploring all the details of his dream, Freud concludes his dream uncovers a desire to gain back the respect of a person who is very important to him.  Freud believed that all dreams are the “(disguised) fulfilment of a (suppressed, repressed) wish.”(1) 

Modern pop culture puts dream analysis squarely in the realm of entertainment like horoscopes or psychic readings.  Websites abound that make suggestions as to why we dream about particular subjects.  Although studies have been conducted to explore what happens to the brain while dreaming, there is little scientific basis to dream analysis.  It is very subjective.  It would be difficult to pinpoint what any dream means to any given person without understanding that person’s perspective, history and environment.  The physiology and anatomy of the brain, like any other organ, may not vary much from person to person but the experiences of each individual can vary greatly and will influence the brain's performance and reactions.   The structure and function of the heart is the same in all, but the heart of an athlete will be much more prepared to run a marathon than the heart of a person who smokes two packs a day.  So it is difficult to say what causes teeth dreams or what the meaning of teeth dreams would be to different individuals.  Still, dreaming about the teeth is a very common occurrence.  (Perhaps not so surprising if we consider that (almost) everyone has them!)  Analysis of teeth dreams offer a variety of interpretations including issues of self-esteem, concern about money, death, fear of death or loss of a loved one, and even lying and deception.

In the dental profession, it is generally accepted that the health of the teeth and self-esteem are linked.  There are thousands of advertisements and sites from cosmetic dentists to implant dentists and orthodontists touting various procedures as a way to improve the way we look and feel about ourselves.  A recent study in the U.K. revealed that tooth loss might affect the way people feel about themselves both socially and psychologically.  Some of the people in the study reported staying home because of the condition of their teeth and compared tooth loss to the loss of a limb.(2)  An Italian study confirmed that having misaligned teeth could affect the “psychosocial well-being” of adolescents.(3)

If the condition of the teeth is a contributing factor to how attractive a person feels, then teeth are an important element of self-esteem.  But this depends on individuals and the importance they place on their teeth, as well as cultural and other factors.  Dentists and dental hygienists know that some patients value their dental health much more highly than others.  So the reasons that people dream about their teeth must be as varied as people themselves!  And how could a dream about the teeth falling out or rotting be the fulfillment of any kind of wish as Freud proposed? Teeth dreams, generally, are pretty disturbing.  Perhaps the horror of the dream forces the person to realize that he or she wishes to do, wants to do, or should be doing something different.  Or maybe it’s just guilt over eating that last piece of chocolate cake!

I welcome your comments and thoughts!

(1) The Interpretation of Dreams, Sigmund Freud (1913) Third Edition, translated by A.A. Brill.  New York: The Macmillan Company, 1913.  New York: Bartleby.com, 2010

(2) Rousseau, N., Steele, J., May, C. and Exley, C. (2014), ‘Your whole life is lived through your teeth’: biographical disruption and experiences of tooth loss and replacement. Sociology of Health & Illness, 36: 462–476. doi: 10.1111/1467-9566.12080
(3) Perillo L, Esposito M, Caprioglio A, Attanasio S, Santini AC, Carotenuto M.Orthodontic treatment need for adolescents in the Campania region: the malocclusion impact on self-concept. Patient Prefer Adherence. 2014 Mar 19;8:353-9. doi: 10.2147/PPA.S58971. eCollection 2014. PubMed PMID: 24672229; PubMed Central PMCID: PMC3964173

This information is not intended to treat or diagnose any dental or medical condition.  If you have a medical or dental concern, please seek treatment from a medical or dental professional.