Acid Reflux | Alhambra Dentist

Teeth are so hard you would think they would be indestructible and that they would not be adversely affected by anything. Due to the strength of enamel and bone, they should remain the same from the day the teeth come into the mouth to the day they are no longer needed. Unfortunately, this is far from true. While we would like to think of teeth as being strong and unchanging, most people know that teeth can be damaged by tooth decay-causing bacteria. We know, too, that teeth can be damaged by mechanical means – attrition caused by tooth grinding and clenching and abrasion caused by improper tooth brushing. However, few people know that there is a third factor that can destroy teeth – chemical erosion.

Chemical erosion is caused by excess acid coming in contact with a tooth for extended periods of time. The acid attack can be self-inflicted (bulimia) or more commonly from a problem with acid reflux. In acid (gastric) reflux, the acidic and partly digested contents of the stomach are returned back into the throat and oral cavity. Normally, the lower esophageal sphincter muscle (LES), connecting the esophagus with the stomach, closes once food passes into the stomach. This closure prevents the stomach contents from flowing back up into the esophagus. Acid reflux occurs when this sphincter does not work properly and allows acidic fluid to return to the esophagus and higher – the mouth.

This condition sometimes can actually be noted by a dentist long before it is acknowledged by a patient or physician. The dentist will see a characteristic smooth and circular erosion of the cusp tips of the lower first molars. The cusp tips (bumps on a tooth) lose their peak, flatten, and become concave. Soon the enamel cover is broached and the underlying dentin is exposed. Because dentin is “softer” than enamel, the erosion can progress more quickly. This acid erosion has a very different appearance from tooth loss due to a mechanical etiology. Attrition and abrasion have a very sharp, edged, and well-delineated look. Chemical erosion has a softer and more rounded presentation and is localized first to lower first molars (lower first molars are the first permanent molars to erupt into the mouth) so that the permanent teeth have the longest potential exposure. When the acid refluxes (returns) to the mouth, it pools mostly around the lower first molars. This is the site of the most erosive features.

A significant portion of the population experiences acid reflux at least once a month. About 25% of those who are affected are unaware of their problem. Infants and young children can be affected, and there may be a genetic component to this disease. Early diagnosis from erosion of the permanent lower first molars can be made as early as 7 or 8 years of age. A hiatal hernia may weaken the LES and cause reflux. Diet and lifestyle contribute to acid reflux. Chocolate, peppermint, citrus, tomatoes, fried or fatty foods, coffee (especially acidic coffee), alcoholic beverages, garlic, and onions are foods to avoid. Weight gain (also weight gain associated with pregnancy) and smoking (by relaxing the LES) may be contributing factors.

As is true with most medical and dental problems, the earlier the diagnosis is made, the easier it is to treat. Variable factors include the nature and severity of the problem, as well as frequency and type of fluid that refluxes from the stomach. Under supervision of your physician, change in diet, eating habits, and/or medication (over-the-counter or prescription) can be effective. It is recommended that you first consult your physician or a specialist (gastroenterologist) if you suspect you have gastric reflux or other gastro-intestinal ailments.

Dentally, once the enamel is broached and the dentin becomes visible, it is recommended that the affected areas be protected by covering them with an enamel replacement – a tooth-colored bonding material. This material not only protects the dentin and enamel, it may be more resistant to the acid than is naturally occurring dentin. Many times, drilling preparation is not needed. See your dentist regularly so that problems like these can be detected and treated in time.

If you would like more information about acid reflux, call Dr. Chao in Alhambra, CA at (626) 308-9104 or visit www.alhambradental.com.

Dr. Chao proudly serves Alhambra and all surrounding areas.

Gum Disease: Rubber Tipping Better Than Antibiotics | Alhambra Dentist

A recent study showed that massaging the gums with a rubber tip (found at the other end of some toothbrushes) is actually more effective in reducing germ count than a regimen of antibiotics!

Bacteria that cause gum disease are like vampires. They must live in the dark. Oral bacteria are “anaerobic,” meaning that they cannot live in the presence of oxygen. They thrive in dark spaces between the gum and the roots of the teeth called gum “pockets”. Brushing and flossing are effective in part because oxygen is introduced into these pockets.

Vigorous massaging of the gums with the rubber tip introduces fresh air into these dead spaces. In comparing the percentage of bacteria between those who massage their gums with the rubber tip and those who took antibiotics, the rubber tipping group actually had slightly more reduction in bacterial count. Both groups brushed and floss their teeth during the experiment.

The additional benefit of massaging your gums with the rubber tip is that plaque and cellular fluids are flushed out and circulation in the gums is improved.

This is not to say that you should only massage your gums, and not brush and floss your teeth. In fact, you should only massage your gums after you have thoroughly brushed and flossed your teeth. As a precaution, if you have moderate to severe gum disease, it may not be a good idea to massage your gums before you talk to your dentist.

Here is how you can massage your gums: Grasp the handle firmly in your hand and place the rubber tip between the spaces between two teeth. Point the rubber tip toward the center of the teeth. Gently press the rubber tip upward if you are massaging the upper arch, and downward if dealing with the lower arch. If you encounter bleeding from the gums, you are either massaging too hard, or you have a gum condition that should be checked by your dentist. Continue to massage every space between the teeth for 10 to 15 seconds. Do not massage the spaces between the front teeth. Slight temporary soreness is to be expected. This soreness will likely disappear over two weeks. If soreness persists, then you should consult your dentist. Do not massage your gums if there is heavy plaque formation. Under certain circumstances, your dentist may ask you to massage your gums vigorously. In other circumstances, your dentist may instruct you not to use the rubber tip at all.

And if you are still unsure of how to use the rubber tip properly, ask your hygienist or dentist for a demonstration.

If you would like more information about rubbertipped toothbrushes, call Dr. Chao in Alhambra, CA at (626) 308-9104 or visit www.askyourdentistaboutpinhole.com.

Dr. Chao proudly serves Alhambra and all surrounding areas.

2019-08-16T23:16:01+00:00May 17th, 2019|General Dentistry, Periodontal|

Which Cause More Cavities – Mother’s Milk or Cow Milk? | Alhambra Dentist

A recent study comparing cola, sucrose drinks, honey, human milk, and cow milk indicates that cola, sucrose and honey cause more cavities than human or cow milk. But human milk caused significantly more cavities than cow milk, according to a study conducted at the University of Rochester Medical Center, published in the October issue of Pediatrics.

The authors do not advocate substituting cow milk for human milk. This study does warn parents to stop allowing babies to drink sugary liquids from bottles, to sweeten water with honey, or to let babies fall asleep on the nipple. Furthermore, nursing mothers are alerted to the need to observe good hygiene practices after feeding, especially once infant’s first teeth have erupted.

The interaction of bacteria with sugar produces acid that chemically dissolves enamel, the hard, mineralized outer layer of the tooth. The longer sugar is allowed to remain in the mouth, the more severe the chemical damage. Limiting the time of exposure of infant’s teeth to sugary products or milk by cleaning and rinsing the infant’s mouth after feeding helps to minimize progression of dental decay.

A common question often asked is, “Why save baby teeth?” First of all, untreated cavities cause food trapping and discomfort in eating. When cavities get deep, infection and necrosis (tissue death) of the dental nerve results. This kind of infection is similar to gangrene. Often the infant or the child does not complain until pain and other symptoms rise to an intolerable level. When active infection is present in and around the tooth, the infant may have to undergo the trauma of a surgical extraction with a local anesthetic (novacaine). IV sedation or general anesthesia may be necessary with infants or young children.

Prematurely lost posterior baby teeth may need to be replaced with a spacer, so that the remaining teeth do not collapse into the space left by the extracted tooth. If collapsing of the space is allowed to take place, orthodontic treatment may be necessary when the child gets older. Therefore, it is essential that parents practice good dental hygiene in feeding infants and teach them good hygiene habits as they grow up.

If you would like more information about diabetes, call Dr. Chao in Alhambra, CA at (626) 308-9104 or visit www.alhambradental.com.

Dr. Chao proudly serves Alhambra and all surrounding areas.

Frequent Recreational Use of Cannabis Is Associated with Gum Disease | Alhambra Dentist

Recreational use of cannabis is permissible in some states, including California. Anecdotal and observational reports have pointed to Cannabis use being involved with receding gums and gum disease. An analysis of the data from the National Health and Nutritional Examination (NHANES) indicated the following:

Periodontal (gum) disease, one of the most common chronic conditions in the United States, is a major cause of tooth loss among adults. Although periodontitis has a genetic component, factors such as increased age, gender, chronic conditions such as diabetes, exposure to tobacco, and oral hygiene may also increase the risk or severity of the disease. Researchers examined data from the 2011-2012 cycle of the National Health and Nutritional Examination survey to evaluate whether cannabis use (i.e., marijuana or hashish) may also be a risk factor for periodontitis prevalence and severity.

NHANES is designed to be representative of the noninstitutionalized civilian population of the United States aged 30 years or older and includes both a demographic and behavioral questionnaire, as well as a full-mouth periodontal examination conducted at 6 sites per tooth.

This analysis was restricted to the 1,938 adults who received a complete periodontal examination and answered questions on substance use. Those who reported they used marijuana or hashish once or more every month for the last 12 months were categorized as frequent cannabis users, while those who reported using marijuana or hashish less than once per month were categorized as non-frequent cannabis users. Frequent cannabis users had significantly greater clinical attachment loss than non-frequent, and significantly higher mean number of sites with pocket depths of 4 mm or more and attachment loss of 3 mm or more.

Confounding factors for age, gender, race/ethnicity, family income, diabetes, alcohol and smoking, and treatment for gum disease within the past year were accounted for in the study. The odds of severe periodontitis were 1.4 higher for frequent cannabis users than those who never or rarely used cannabis.

This analysis demonstrates the effect of cannabis as a potential risk factor for periodontal disease. Check with your dentist about the possible effect of cannabis use on your dental health. (Portions of this article was excerpted from ADA News.)

If you would like more information about gum disease, call Dr. Chao in Alhambra, CA at (626) 308-9104 or visit www.alhambradental.com.

Dr. Chao proudly serves Alhambra and all surrounding areas.

2019-08-16T23:18:19+00:00May 9th, 2019|Periodontal|

Saliva Can Predict Diabetes

Certain proteins (biomarkers) in the saliva of children have been identified to be possible predictors of Type II diabetes in a study published online in Public Library of Science, June 2014. Based on this study, it is anticipated that salivary testing can in the future displace other more invasive methods, such as blood tests. It is speculated that in the future, saliva collected during a dental visit can be used to help diagnose medical conditions in conjunction with your physician.

The present study was conducted by researchers from the Forsyth Institute in Cambridge, MA. They evaluated metabolic differences in 774 11-year-old children who were underweight, of normal healthy weight, overweight or obese.

In this study four salivary biomarkers, including insulin and C-reactive protein, changed with increasing obesity. Other biomarkers can be identified in future studies that can be used to diagnose or prognosticate (predict) risk of disease, regardless of body weight.

The advantage of salivary testing is that it is non-invasive and can be easily used to screen large numbers of people, especially children. This sort of non-invasive testing is important in developing disease prevention programs focused on children.

Called Salivary Diagnostics, this kind of testing “could provide a more acceptable alternative, which could create a new paradigm for research in preventive health,” said Dr. Max Goodson, author and senior member of the staff at Department of Applied Oral Sciences at The Forsyth Institute. More and more, your dentist will be corroborating with your physician, working together to bring you better dental health, as well as system health.

Seeing your dentist regularly has become even more important than ever.

If you would like more information about diabetes, call Dr. Chao in Alhambra, CA at (626) 308-9104 or visit www.alhambradental.com.

Dr. Chao proudly serves Alhambra and all surrounding areas.