Acquired Immune Deficiency Syndrome (AIDS) jolted our collective consciousness in the 1980s. The deadly disease caused by the human immunodeficiency virus (HIV) had no known cure and, at the time, no effective treatment.
HIV is a retrovirus, a virus with a genetic makeup and reproduction system differing from other kinds. After taking up permanent residency in the body, HIV begins “hijacking” the replication process of cells in the body's immune system and replacing it with a copy of its own. This destroys the cells' ability to protect the body from hostile organisms. As the virus affects more and more cells, the patient's condition ultimately develops into AIDS.
An estimated 35 million people worldwide (1.2 million in the U.S.) are currently infected with the virus. Thanks to new antiretroviral drugs, though, HIV can be kept from accelerating into AIDS. While their condition remains serious, many HIV positive patients can now live long and relatively normal lives. Even so, having the virus requires them to pay close attention to their health, including their mouth.
Even while stalled from becoming AIDS, HIV can still cause oral problems for 30 to 80% of patients. The fungal infection candidiasis (also known as thrush) is the most common of these problems, which appears as lesions, cracking skin or creamy white patches on the tongue or palate that easily bleed. Patients also have higher risks for dry mouth, oral cancer and periodontal (gum) disease.
HIV positive patients must practice diligent daily oral care and see their dentist for checkups regularly. Prevention, early diagnosis and treatment can keep gum disease and other damaging conditions under control. Monitoring oral health is also important because certain mouth conditions could be an early sign the infection is entering a new advanced stage in the body that requires additional attention.
Keeping vigilant in all aspects of health is a way of life for someone with HIV. Such vigilance, though, can help them maintain a healthy mouth and even prolong their life.
Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.
“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…
For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.
When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.
A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.
But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.
Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!
If you have questions about repairing chipped teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”
Watching your kids dress up in cute, spooky costumes and go out trick-or-treating can be a real thrill. But thinking about the dental damage caused by eating all those sweets might just give you the chills. So is it best to act like a witch and take away all the candy from those adorable little ghosts and goblins?
Relax! According to experts like the American Dental Association, it’s OK to let kids enjoy some sweet treats on special occasions like Halloween—especially if they have been taking good care of their oral hygiene all year long, by brushing twice each day and flossing once every day. But to help keep cavities away from those young smiles, there are some things parents (and everyone else) should understand.
Cavities—small holes in the tooth’s outer surface that result from the decay process—get started when bacteria in the mouth feed on sugar and produce acids. The acids eat away at the hard enamel coating of teeth. If left untreated, decay will eventually reach the soft inner core of the tooth, causing even more serious damage.
There are several ways to stop the process of tooth decay. One is to take away the sugar that decay bacteria feed on. Because this ingredient is common in so many foods, it’s hard to completely eliminate sugar from the diet. Instead, it may be more practical to limit the consumption of sweets. For example, if kids are only allowed to eat sugary treats around mealtimes, it gives the mouth plenty of “downtime,” in which healthful saliva can neutralize the bacterial acids. It also helps to avoid sweets that stick to teeth (like taffy or gummy bears) and those that stay in the mouth for a long time (like hard candy).
Another way to help stop tooth decay is by maintaining top-notch oral hygiene. Decay bacteria thrive in the sticky film called plaque that clings stubbornly to the surfaces of teeth. Plaque can be removed by—you guessed it—effective brushing and flossing techniques. While it’s a good start, brushing alone won’t remove plaque from the spaces between teeth and under the gums: That’s why flossing is an essential part of the daily oral hygiene routine. Helping your kids develop good oral hygiene habits is among the best things you can do to fight cavities.
And speaking of habits, there are a few others that can help—or hurt—your oral health. For example, drinking plenty of water keeps the body hydrated and benefits oral health; but regularly drinking soda and other sweetened or acidic beverages greatly increases the risk of tooth decay. And seeing your dentist on a regular basis for professional cleanings and routine checkups is one of the most beneficial habits of all. Working together, we can help keep tooth decay from turning into a scary situation for kids—and adults too.
If you have questions about cavity prevention or oral hygiene, please contact our office or schedule a consultation. You can learn more in the Dear Doctor magazine articles “How to Help Your Child Develop the Best Habits for Oral Health” and “Tooth Decay—How to Assess Your Risk.”
Because the mouth is one of the most sensitive areas of the body, we go to great lengths to eliminate pain and discomfort associated with dental work. Anesthesia, both local and general, can achieve this during the actual procedure—but what about afterward while you’re recuperating?
While a few procedures may require prescription opioids or steroids to manage discomfort after a procedure, most patients need only a mild over-the-counter (OTC) pain reliever. There are several brands available from a group of medicines called non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs like aspirin or ibuprofen work by blocking the release of prostaglandins into the body, which cause inflammation in tissues that have been damaged or injured.
Unlike their stronger counterparts, NSAIDs have fewer side-effects, cost less and aren’t addictive. And unlike opioids NSAIDs don’t impair consciousness, meaning patients can usually resume normal activities more quickly.
But although they’re less dangerous than opioids or steroids, NSAIDs can cause problems if taken at too strong a dose for too long. Its major side effect is interference with the blood’s clotting mechanism, known as “thinning the blood.” If a NSAID is used over a period of weeks, this effect could trigger excessive external and internal bleeding, as well as damage the stomach lining leading to ulcers. Ibuprofen in particular can damage the kidneys over a period of time.
To minimize this risk, adults should take no more than 2400 milligrams of a NSAID daily (less for children) and only for a short period of time unless directed otherwise by a physician. For most patients, a single, 400 milligram dose of ibuprofen can safely and effectively relieve moderate to severe discomfort for about 5 hours.
Some patients should avoid taking a NSAID: pregnant women, those with a history of stomach or intestinal bleeding, or heart disease (especially if following a daily low dose aspirin regimen). If you have any of these conditions or similar concerns, be sure you discuss this with your dentist before your procedure for an alternative method for pain management.
If you would like more information on managing discomfort after dental procedures, 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 “Treating Pain with Ibuprofen.”
Imagine not having your upper teeth for talking and eating, not to mention your appearance, and you’ll have some idea of what Beauty the bald eagle experienced after losing the top of her beak to a hunter’s bullet in northern Idaho. She couldn’t groom or feed herself and could barely drink water, relying instead on the conservation group that had taken her under their wing for assistance. But the magnificent raptor was eventually made whole and able once again to eat, drink and preen unaided. It took a visionary mechanical engineer and a very skillful dentist who designed and attached the first-of-its-kind bald eagle “dental” prosthetic — dubbed the “bionic beak.”
Prosthetic Teeth for Humans
Fortunately, the field of human prosthetic dentistry (or prosthodontics) is much more advanced than it is for our avian friends. We have several options for replacing missing teeth (as well as parts of missing teeth) that restore aesthetic appearance and functionality while potentially preventing other problems such as the drifting out of alignment or loss of remaining teeth.
Bridges. As the name suggests, these custom-made devices span the area that is missing a tooth/teeth. Fixed (not removable) bridges are made up of an artificial tooth/teeth fused between two crowns that fit over your existing teeth or dental implants (see below) on either side of the gap. There are removable bridges, but they are considered temporary fixes.
Dentures. These are custom-made removable replacements for missing teeth. Partial dentures offer a removable alternative to fixed bridges and are used when some teeth are missing in an upper or lower arch (jaw). Full dentures are used when all teeth are missing in an arch. Replacement teeth are embedded in an acrylic base that fits over your gums and mimics their color.
Dental Implants. These are the closest thing to having your own tooth/teeth back. An implant is a small titanium post that is placed in the jawbone beneath the gum to serve the same purpose as a tooth root. Once the bone joins to the implant (a process called osseo-integration), a lifelike crown is attached to it.
We would be glad to discuss which option would be right for you.
If you have questions about tooth replacement, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Dental Implant Surgery,” and “Crowns & Bridgework.” Beauty the eagle’s story of rehabilitation can be found here: //blog.theanimalrescuesite.com.
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