A shingles outbreak can be painful and embarrassing. It could also interfere with many areas of your life—including your dental care.
Known medically as herpes zoster, shingles is a viral form of chicken pox. The virus can lie dormant for many years or decades in people that had chicken pox as a child, breaking out later in life (sometimes repeatedly). It's estimated about a quarter of people who had chicken pox as a child, about 90% of adults, will experience a shingles outbreak.
In the beginning, a person with shingles may notice an itching or burning skin irritation, as well as numbness or sensitivity to touch. In time, a red, crusty rash can develop, usually forming a belted or striped pattern on the torso, head or facial areas. The patterning is caused by the virus's disruption of nerves that serve those parts of the body.
Shingles could impact your dental care because it can be contagious early in an outbreak. As such, it can be transmitted to other people via contact with the rash or through airborne respiratory particles. Dental staff members or other patients who are pregnant, undergoing cancer treatment or with other conditions that compromise their immune systems can develop serious health problems if they contract the virus.
If you have an upcoming appointment, it's best then to let your dentist know you've been diagnosed with shingles. If your treatment involves physical contact that could spread the virus, they may wish to reschedule you until the outbreak clears up.
There are ways to hasten the healing process with antiviral treatments like acyclovir or famciclovir. For best results, these treatments should begin within 3 days of a shingles outbreak. There is also a shingles vaccine that can help you avoid an outbreak altogether. The U.S. Centers for Disease Control (CDC) recommend it for adults over 60.
Having shingles can be painful and stressful, and pose a major interruption of your daily life and routine. With proper management, though, it can be contained so you can get on with your life—and your dental care.
If you would like more information on managing shingles and dental care, 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 “Shingles, Herpes Zoster.”
While periodontal (gum) disease could ruin your dental health, it doesn’t have to. Dentists and periodontists (specialists in gums and other supporting tooth structures) have effective methods for stopping it, especially if the infection is diagnosed and treated in its earliest stages. With effective treatment, those swollen, reddened and bleeding gums can return to a healthy shade of pink.
But even if we stop the infection, you’re not out of danger. If you’ve had at least one bout with gum disease, you’re at higher risk for another infection. We will need to maintain ongoing vigilance to prevent another infection.
If you’ve recently undergone treatment for gum disease, here are 3 things you should do to keep your now healthy gums continually healthy.
Practice daily oral hygiene. Gum disease arises most often from dental plaque, a thin biofilm of disease-causing bacteria that builds up on tooth surfaces. It’s important for everyone to remove this buildup with daily brushing and flossing, but it’s even more so if you’ve already experienced gum disease. Practicing effective oral hygiene every day will reduce the presence of bacteria that could ignite a new infection.
See the dentist more frequently. The general rule for routine dental cleanings and checkups is twice a year. But you may need more frequent visits, post-gum disease. Depending on the severity of your disease, we may recommend you make return visits at two- to three-month intervals of time. These visits may also include heightened screenings to ensure another infection hasn’t taken hold, as well as procedures to make it easier to clean certain tooth areas prone to plaque buildup.
Manage other health conditions. Gum disease’s severity is often caused by the inflammatory response your body initiates to fight the infection, which then becomes chronic. This is similar to other conditions like diabetes, heart disease or rheumatoid arthritis: There’s evidence inflammation elsewhere in the body could worsen a gum infection, and vice-versa. Managing other health conditions through medical care, medication and lifestyle changes could minimize the occurrence and severity of a future gum infection.
If you would like more information on remaining infection-free after gum disease, 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 “Periodontal Cleanings.”
Your tooth enamel’s main nemesis is oral acid: normally produced by bacteria, foods or beverages, acid can dissolve enamel’s mineral content and cause erosion and decay. But acid might be a bigger problem for you if you also have gastroesophageal reflux disease or GERD.
GERD is a digestive condition in which stomach acid backs up into the digestive tract. Normally, a ring of muscle at the end of the esophagus prevents stomach acid from coming up into it. But if it weakens, this powerful acid can splash up into the esophagus and irritate its more delicate lining and result in a burning sensation known as heartburn or acid indigestion.
The problem for teeth, though, is that GERD could cause stomach acid to potentially come up into the mouth. Because of its high acidic pH (2.0 or less), stomach acid can cause major erosion in tooth enamel, leaving them pitted, yellow and sensitive. If not caught and treated early, some of your teeth could be damaged to the point that they have a questionable prognosis.
There are some things you can do to minimize GERD’s effect on your dental health. First and foremost, see a doctor about managing your symptoms, which might include medication. Be sure you also inform your dentist that you have GERD and what medications you’re taking.
One way to lessen the effect of higher acid in the mouth is to stimulate saliva production, which helps neutralize acid. You can do this by drinking plenty of water, taking a saliva booster or chewing xylitol-sweetened gum. You can also rinse with plain water or water mixed with baking soda (1/2 teaspoon to a cup of water), or chew an antacid tablet to help balance your mouth’s pH level.
And don’t forget to look out for your enamel. Be sure you’re practicing daily brushing and flossing and using fluoride hygiene products to strengthen it. Your dentist can also apply topical solutions or prescribe special rinses with higher concentrations of fluoride.
GERD can be an unpleasant experience that escalates into major problems. Don’t let it compromise your dental health.
The monarchs of the world experience the same health issues as their subjects—but they often tend to be hush-hush about it. Recently, though, the normally reticent Queen Elizabeth II let some young dental patients in on a lesser known fact about Her Majesty's teeth.
While touring a new dental hospital, the queen told some children being fitted for braces that she too “had wires” once upon a time. She also said, “I think it's worth it in the end.”
The queen isn't the only member of the House of Windsor to need help with a poor bite. Both Princes William and Harry have worn braces, as have other members of the royal family. A propensity for overbites, underbites and other malocclusions (poor bites) can indeed pass down through families, whether of noble or common lineage.
Fortunately, there are many ways to correct congenital malocclusions, depending on their type and severity. Here are 3 of them.
Braces and clear aligners. Braces are the tried and true way to straighten misaligned teeth, while the clear aligner method—removable plastic mouth trays—is the relative “new kid on the block.” Braces are indeed effective for a wide range of malocclusions, but their wires and brackets make it difficult to brush and floss, and they're not particularly attractive. Clear aligners solve both of these issues, though they may not handle more complex malocclusions as well as braces.
Palatal expanders. When the upper jaw develops too narrowly, a malocclusion may result from teeth crowding into too small a space. But before the upper jaw bones fuse together in late childhood, orthodontists can fit a device called a palatal expander inside the upper teeth, which exerts gentle outward pressure on the teeth. This encourages more bone growth in the center to widen the jaw and help prevent a difficult malocclusion from forming.
Specialized braces for impacted teeth. An impacted tooth, which remains partially or completely hidden in the gums, can impede dental health, function and appearance. But we may be able to coax some impacted teeth like the front canines into full eruption. This requires a special orthodontic technique in which a bracket is surgically attached to the impacted tooth's crown. A chain connected to the bracket is then looped over other orthodontic hardware to gradually pull the tooth down where it should be.
Although some techniques like palatal expanders are best undertaken in early dental development, people of any age and reasonably good health can have a problem bite corrected with other methods. If you are among those who benefit from orthodontics, you'll have something in common with the Sovereign of the British Isles: a healthy, attractive and straighter smile.
If all goes normally, we have most of our permanent teeth as we enter puberty. Except, though, when it doesn't—sometimes incoming permanent teeth don't fully erupt, often because there's not enough room for them on the jaw. This can leave all or part of a tooth still up inside the gum and bones.
This condition is known as impaction, and it can cause problems with a person's bite and their smile. This is especially true of the upper canines, those pointed teeth located just under the eyes. Without them present, a person's smile can look oddly different. Moreover, it can worsen their bite and increase the risk of trauma and disease for nearby teeth.
Fortunately, there may be a way to coax impacted canines into erupting into their proper position on the jaw. It will involve, though, some minor surgery and orthodontic intervention to accomplish that feat.
First, though, a patient with missing canines should undergo a thorough orthodontic evaluation. This exam will reveal not only what may be going on with the missing teeth, but how the whole bite has been affected. Knowing the big picture will help direct the next treatment steps.
After pinpointing the impacted teeth's exact position (usually through x-rays or cone beam CT scanning), we then decide whether it's feasible to attempt to expose the teeth. Sometimes, a tooth's position is so out of place that it may be best to remove it and consider a dental implant or other restorative measures.
If it is in a workable position, then the impacted teeth would be exposed surgically (usually by an oral surgeon or periodontist). The surgeon would then bond a small bracket to the exposed tooth and then attach a small chain.
After suturing the incised gum tissues back in place, the chain extending outward from the gums would then be looped over orthodontic hardware attached to other teeth. This will place downward pressure on the upper canine tooth, and over several months prod it to fully erupt.
This may sound like an elaborate procedure, but it's fairly routine and predictable. As a result, a patient can finally get the full benefit of all their teeth, enhance their dental health and transform their smile.
If you would like more information on dealing with impacted teeth, 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 “Exposing Impacted Canines.”
This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.