Geriatric Dental Problems
G U A R A N T E E D S M I L E
What Causes Tooth Sensitivity?
Tooth sensitivity occurs when the underlying layer of your teeth – the dentin – becomes exposed as a result of receding gum tissue (the protective blanket that covers the tooth roots). The roots, which are not covered by hard enamel, contain thousands of tiny tubules leading to the tooth’s never center (the pulp). These dentinal tubules (or channels) allow the stimuli – for example, the hot, cold, or sweet food – to reach the nerve in your tooth, which results in the pain you feel.
There are many factors that may lead to the development of tooth sensitivity, including.
Brushing too hard. Over time, brushing too hard or using a hard-bristled toothbrush can wear down enamel and cause the dentin to be exposed. It can also cause recession of the gums (the gum tissue pulls away from the teeth)
Recession of the gums. As gums move away from a tooth due to conditions such as periodontal disease, the root surface becomes exposed.
Gum disease (gingivitis). Inflamed and sore gum tissue may cause sensitivity due to the loss of supporting ligaments, which exposes the root surface that leads directly to the nerve of the tooth.
Cracked teeth. Chipped or broken teeth may fill with bacteria from plaque and enter the pulp causing Inflammation.
Teeth grinding. grinding or clenching your teeth may wear down the enamel and expose underlying dentin.
Tooth whitening products or toothpaste with baking soda and peroxide. These products are major contributors to teeth sensitivity.
Your age. Tooth sensitivity is highest between the ages of 25 and 30.
Plaque build-up. The presence of plaque on the root surfaces can cause sensitivity.
Mouthwash use. Long-term use of some mouthwashes. Some over-the-counter mouthwashes contain acids that can worsen tooth sensitivity if you have exposed dentin (the middle layer of the tooth). The acids further damage the dentin layer of the tooth. If you have dentin sensitivity, ask your dentist about the use of a neutral fluoride solution.
Acidic foods. Regular consumption of foods with a high acid content, such as citrus fruits, tomatoes, pickles and tea, can cause enamel erosion.
Recent routine dental procedures. Sensitivity can occur following teeth cleaning, root planing, crown placement, and tooth restoration. Sensitivity caused by dental procedures is temporary, usually disappearing in 4 to 6 weeks.
What Can I Do to Reduce Tooth Sensitivity?
Maintain good oral hygiene. Continue to follow proper brushing and flossing techniques to thoroughly clean all parts of your teeth and mouth.
Use a soft bristled toothbrush. This will result in less toothbrush abrasion to the tooth surface and less irritation to your gums. Brush gently and carefully around the gum line so you do not remove more gum tissue.
Use desensitizing toothpaste. There are several brands of toothpaste available for sensitive teeth. With regular use you should notice a decrease in sensitivity. You may need to try several different brands to find the product that works best for you. Another tip. spread a thin layer of the toothpaste on the exposed tooth roots with your finger or a Q-tip before you go to bed. Do not use a tartar control toothpaste; rather, use a fluoridated toothpaste.
Watch what you eat. Frequent consumption of highly acid foods can gradually dissolve tooth enamel and lead to dentin exposure. They may also aggravate the sensitivity and start the pain reaction.
Use fluoridated dental products. Daily use of a fluoridated mouth rinse can decrease sensitivity. Ask your dentist about available products for home use.
Avoid teeth grinding. If you grind or clench your teeth, use a mouth guard at night.
See your dentist at regular intervals. Get professional tooth cleaning, oral hygiene instructions, and fluoride treatments every 6 months.
If you still have discomfort, talk to your dentist. There may be some dental procedures that may help reduce sensitivity, including the use of:
White fillings (bonding) to cover exposed root surfaces
Fluoride varnishes applied to the exposed root surface
Dentin sealers applied to the exposed root surface
Cavities occur as a result of tooth decay. Tooth decay is the destruction of tooth structure. Tooth decay can affect both the enamel (the outer coating of the tooth) and the dentin layer of the tooth.
Tooth decay occurs when foods containing carbohydrates (sugars and starches) such as breads, cereals, milk, soda, fruits, cakes, or candy are left on the teeth. Bacteria that live in the mouth digest these foods, turning them into acids. The bacteria, acid, food debris, and saliva combine to form plaque, which clings to the teeth. The acids in plaque dissolve the enamel surface of the teeth, creating holes in the teeth called cavities, or caries.
Who Gets Cavities?
Many people think cavities only affect children, but changes that occur with aging make cavities an adult problem too. Recession of the gums (a pulling away of gum tissue from the teeth), often associated with an increased incidence of gingivitis (gum disease), can expose tooth roots to plaque. Also, sugary food cravings in pregnant women can make them more vulnerable to developing cavities.
Decay around the edges of fillings is also common in older adults. Because many older adults lacked the benefits of fluoride and modern preventive dental care when they were growing up, they often have a number of dental fillings. Over the years, these fillings may weaken and can fracture, allowing bacteria to accumulate in the tiny crevices causing tooth decay.
How Do I Know if I Have a Cavity?
Your dentist can discover cavities during your regular dental check-up. The tooth surface feels soft when probed by your dentist with a dental instrument. X-rays can also show cavities before they become visible to the eye.
In advanced stages of tooth decay, you might experience a toothache, especially after consuming sweet, hot, or cold foods or drinks. Other signs of tooth decay are visible pits or holes in the teeth.
How Are Cavities Treated?
Cavities are treated in a number of different ways depending on the extent of tooth decay. If decay is not extensive, the decayed portion of the tooth is removed by drilling and replaced with a filling made of silver alloy, gold, porcelain, or a composite resin. Restorative materials used in fillings are considered safe. Concerns have been raised over the safety of mercury-based, silver amalgams in particular, but the ADA, FDA, and other public health agencies continue to support the safety of this restorative material. Allergies to silver amalgam are rare as are allergies to other restorative materials.
If the decay is extensive and there is limited tooth structure remaining, crowns will be used. If a crown is needed, the decayed or weakened area of the tooth is removed and repaired and a crown is fitted over the remainder of the tooth. Crowns are made from gold, porcelain, or porcelain fused to metal.
If the decay causes the nerve or pulp of the tooth to die, a root canal will be performed. During the procedure, the center of the tooth (including the nerve, blood vessel, and tissue) is removed along with the decayed portions of the tooth. The roots are then filled with a sealing material. If necessary, a crown can be placed over the filled tooth.
Several new treatments are under development. One experimental technique uses fluorescent light to detect the development of cavities long before they can be detected by traditional means, such as x-rays or dental examination. In many cases, if cavities can be detected early, the decay process can be stopped or reversed.
A dental sealant is an acrylic-like material that helps shield out decay-causing bacteria from the chewing surfaces of back teeth. We base our diagnosis and recommendation for dental sealants on the patient’s susceptibility to tooth decay and how the teeth were shaped when they originally formed below the gum. Though there is no specific age at which sealants are indicated, often we will recommend that the best time to apply them is when the six-year molars (the first permanent back teeth) appear.
|Even a single toothbrush bristle cannot reach all the way into the depressions and grooves to extract food particles, bacteria and plaque.||The sealant material flows to the depth of the groove, sealing out decay-causing bacteria.|
How Do Sealants Help Prevent Decay?
Sealant material forms a protective barrier by bonding to tooth surfaces and covering natural depressions and grooves (called pits and fissures) in the teeth. More than 75 percent of dental decay begins in the pit and fissure areas of the back teeth. Combined with proper home care and regular dental visits, sealants are extremely effective in preventing tooth decay.
Are Sealants Suitable For All Teeth?
Sealants are applied only to pit and fissure areas of specific teeth. Unfortunately they cannot be applied to the surfaces in between teeth, where daily flossing is recommended to prevent decay. Though sealants are most often applied to children’s teeth, many adults are now seeking the preventive benefits of pit and fissure sealants as well.
How Are Sealants Applied?
In this painless procedure, a solution is applied to the chewing surface of the tooth to condition the enamel and help it bond more effectively to the sealant material. The tooth is thoroughly washed and dried. Then the sealant material is applied and allowed to harden, sometimes using ultraviolet light. The procedure takes only a few minutes.
How Long Do Sealants Last?
Depending on your chewing pattern, the sealant effect can last many years. Even though sealant material is durable, at subsequent dental appointments we make sure the sealant material is intact. Occasionally, we might need to replace or add a new layer of sealant material to keep the protective barrier strong and effective.
Now That Your Teeth Have Been Sealed.
Chewing on ice cubes, hard candy or very sticky foods should be avoided as much as possible. Here are some tasty, healthful snack alternatives that combined with sealants, fluoride and good home care, can help to reduce your susceptibility to tooth decay:
reduced fat peanut butter
sugar-free, non-fat fruit yogurt
dry, unsweetened cereal
Sealants Versus Fluoride.
Sealants and fluoride are materials designed to preserve and prolong the life of your teeth by preventing dental decay. Sealants are applied topically to certain areas of individual teeth and are a visible sign that the tooth is being protected. Fluoride, on the other hand, may be used effectively from the pre-natal stages through the adolescent period, when children are most prone to cavities. Once absorbed and retained in tooth enamel, fluoride stays on the teeth permanently, though invisibly. Unlike sealants, fluoride is supplied in a variety of forms, including commercially prepared mouth rinses, foams, gels, drinking water and many toothpastes.
Applying sealants and fluoride can be important steps in preventing tooth decay. Here are some other steps you should take to protect your teeth:
Brush and floss regularly.
Follow a balanced diet.
Visit us at least twice a year for routine checkups.
Gingivitis and Periodontal Disease
Gingivitis, also generally called gum disease or periodontal disease, describes the events that begin with bacterial growth in your mouth and may end – if not properly treated – with tooth loss due to destruction of the tissue that surrounds your teeth.
What’s the Difference Between Gingivitis and Periodontics?
Gingivitis usually precedes periodontics. However, it is important to know that not all gingivitis progresses to periodontics.
In the early stage of gingivitis, bacteria in plaque build up, causing the gum’s to become inflamed (red and swollen) and often easily bleed during tooth brushing. Although the gums may be irritated, the teeth are still firmly planted in their sockets. No irreversible bone or other tissue damage has occurred at this stage.
When gingivitis is left untreated, it can advance to periodontists. In a person with periodontists, the inner layer of the gum and bone pull away from the teeth and form pockets. These small spaces between teeth and gum’s collect debris and can become infected. The body’s immune system fights the bacteria as the plaque spreads and grows below the gum line.
Toxins or poisons – produced by the bacteria in plaque as well as the body’s “good” enzymes involved in fighting infections – start to break down the bone and connective tissue that hold teeth in place. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. When this happens, teeth are no longer anchored in place, they become looser, and tooth loss occurs. Gum disease, in fact, is the leading cause of tooth loss in adults.
What Causes Periodontal Disease?
Plaque is the primary cause of periodontal disease. However, other factors can contribute to gum disease. These include:
Hormonal changes such as those occurring during pregnancy, puberty, menopause, and monthly menstruation-make gums more sensitive, which makes it easier for gingivitis to develop.
Illnesses may affect the condition of your gum’s. This includes diseases such as cancer or HIV that interfere with the immune system. Because diabetes affects the body’s ability to use blood sugar, patients with this disease are at higher risk of developing infections, including periodontal disease.
Medications can affect oral health because some lessen the flow of saliva, which has a protective effect on teeth and gums. Some drugs, such as the anticoagulant medication Dilantin and the anti-angina drug Procardia and Adalat, can cause abnormal growth of gum tissue.
Bad habits such as smoking make it harder for gum tissue to repair itself.
Poor oral hygiene habits such as not brushing and flossing on a daily basis, make it easier for gingivitis to develop.
Family history of dental disease can be a contributing factor for the development of gingivitis.
What Are the Symptoms of Periodontal Disease?
Periodontal disease may progress painlessly, producing few obvious signs, even in the late stages of the disease. Although the symptoms of periodontal disease often are subtle, the condition is not entirely without warning signs. Certain symptoms may point to some form of the disease. They include:
Gum’s that bleed during and after tooth brushing
Red, swollen, or tender gum’s
Persistent bad breath or bad taste in the mouth
Formation of deep pockets between teeth and gum’s
Loose or shifting teeth
Changes in the way teeth fit together upon biting down, or in the fit of partial dentures.
Even if you don’t notice any symptoms, you may still have some degree of gum disease. In some people, gum disease may affect only certain teeth, such as the molars. Only a dentist or a periodontist can recognize and determine the progression of gum disease
How Does My Dentist Diagnose Periodontal Disease?
During a periodontal exam, your dentist or periodontist typically checks for these things:
Gum bleeding, swelling, firmness, and pockets (the space between the gum and tooth; the larger and deeper the pocket, the more severe the disease)
Teeth movement and sensitivity and proper teeth alignment
Your jawbone to help detect the breakdown of bone surrounding your teeth
How Is Periodontal Disease Treated?
The goals of periodontal treatment are to promote reattachment of healthy gums to teeth; reduce swelling, the depth of pockets, and the risk of infection; and to stop disease progression. Treatment options depend on the stage of disease, how you may have responded to earlier treatments, and your overall health. Options range from nonsurgical therapies that control bacterial growth to surgery to restore supportive tissues. A full description of the various treatment options is provided in Gum Disease Treatments.
How Can Gingivitis Be Prevented?
Gingivitis can be reversed in nearly all cases when proper plaque control is practiced. Proper plaque control consists of professional cleanings at least twice a year and daily brushing and flossing. Brushing eliminates plaque from the surfaces of the teeth that can be reached; flossing removes food particles and plaque from in between the teeth and under the gum line.
Other health and lifestyle changes that will decrease the risk, severity, and speed of gum disease development include:
Stop smoking. Tobacco use is a significant risk factor for development of periodontitis. Smokers are seven times more likely to get periodontitis than nonsmokers, and smoking can lower the chances of success of some treatments.
Reduce stress. Stress may make it difficult for your body’s immune system to fight off infection.
Maintain a well-balanced diet. Proper nutrition helps your immune system fight infection. Eating foods with antioxidant properties, for example, those containing vitamin E or vitamin C (vitamin E-containing foods include vegetable oils, nuts, green leafy vegetables; vitamin C-containing foods include citrus fruits, broccoli, potatoes) can help your body repair damaged tissue.
Avoid clenching and grinding your teeth. These actions may put excess force on the supporting tissues of the teeth and could increase the rate at which these tissues are destroyed.
Despite following good oral hygiene practices and making other healthy lifestyle choices, the American Academy of Periodontology says that up to 30% of the Americans may be genetically susceptible to gum disease. And those who are genetically predisposed may be up to six times more likely to develop some form of gum disease. If anyone in your family has gum disease, it may mean that you are at greater risk as well. If you are more susceptible to gum disease, your dentist or periodontist may recommend more frequent check-ups, cleanings, and treatments to better manage the condition.
Is Periodontal Disease Linked to Other Health Problems?
According to the CDC, researchers have uncovered potential links between periodontal disease and other serious health conditions. In people with healthy immune systems, the bacteria in the mouth that makes its way into the bloodstream is usually harmless. But under certain circumstances, the CDC says these microorganisms are associated with health problems such as stroke and heart disease. Diabetes is not only a risk factor for periodontal disease, but periodontal disease may make diabetes worse.
What Is Dental Implant Treatment?
Think of dental implants as metal anchors, usually made of titanium, that are surgically placed into the jawbone to hold permanent replacement teeth or dentures. Through a process called “osteointegration”, the jawbone actually attaches itself to the implant over time, providing tremendous stability.
Implant treatment is usually performed by a general dentist, oral surgeon, periodontist or a team of these doctors. To devise the best treatment plan for you, we first complete a medical and dental history and a thorough oral examination, including x-rays. The procedure and follow-ups are often performed in the dental office using local anesthetic. Depending upon your individual situation, other types of anesthesia may be used to ensure your comfort.
During surgery, each implant is placed within the jawbone to serve as an anchor for the post that will eventually support the replacement teeth. Generally from three to six months or more is then allowed for the bone tissue to grow around the implants and hold them securely in place.
Immediately after surgery we will give you specific post surgical instructions to assure the best possible healing. In addition, we may prescribe pain medication and in some cases, antibiotics to aid in the healing process and help alleviate any discomfort. At this time, you may be fitted with temporary dentures or natural-looking teeth to help you function as normally as possible. You also will need to limit your diet to soft foods and follow important oral hygiene instructions. Follow-up care is important during this time.
Once the jawbone has firmly healed around the implant, a small post is attached to each implant. The post protrudes through the gum line and serve as an anchor for the replacement teeth. This short procedure usually requires only local anesthesia. After your gums have healed, the replacement teeth or dentures are securely attached to the posts.
Because dental implants are patterned after the structure of your natural teeth, they provide a highly stable support system for the replacement teeth or dentures. Other benefits include:What Are the Benefits of Dental Implants?
Improved biting pressure. Healthy teeth are able to absorb over 500 pounds of biting pressure per square inch. If you’ve worn dentures for a long time, that pressure may be diminished significantly to one tenth that of natural teeth. Dental implants can often restore the amount of pressure that can be withstood to nearly the same level of healthy natural teeth.
Comfort and fit. Because your replacement teeth are anchored securely to the implants in your jawbone, they can’t slip and slide like unsecured dentures can. When dentures aren’t secure enough, they often cause sores in the mouth and an annoying clicking sound. Dental implants eliminate these problems.
Longevity and reliability. With proper oral hygiene and care, scientifically tested and approved dental implant systems have been shown to last as long as 20 years or more with few complications.
Increased self confidence. Because dental implants function remarkably like natural teeth, most people who get them experience a renewed sense of self confidence once they realize they can again chew, talk, laugh and smile with confidence.
What Risks Are Involved?
Dental implant surgery has proved to be successful for hundreds of thousands of people over the years. Negative effects such as bleeding, infection, injury to the nerves or sinus cavity, or incomplete healing of the bone around the implant resulting in implant failure are rare. During the healing process however, discomfort, swelling and inflammation of the gums, normal responses to oral surgery, may be present in varying degrees. If you have questions about your individual situation or want to discuss what is considered normal in the healing process, we will be happy to address your concerns.
How Do I Know If I’m a Good Candidate for Dental Implants?
If you face the loss of one or several teeth or if you’re dissatisfied with dentures or other options available to you, you may find that dental implants are right for you. Age is not typically a major factor: successful dental implants have been performed on young people as well as the elderly.
During your initial consultation, we’ll help you decide. In general, we look for the following characteristics:
general good health
sufficient underlying bone to support the implants
good attitude to ensure that you follow through with vital oral hygiene habits
What Type of Care Is Required for Dental Implants?
The care you give to your dental implant makes a tremendous difference in the overall satisfaction your experience, as well as the longevity of the implant itself. With proper oral hygiene habits brushing, flossing, and regular dental check-ups your implant will serve you well.
Are NOT Expensive,
but NEGLECT is.
Do not neglect your dental problems or diseases.
Early treatment will restore normal function of your teeth and your sweet smile too. Delay in treatment might result in permanent loss of teeth, infections, under-nutrition, etc.
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