Osteoporosis is a serious bone weakening disease in older adults that can turn a minor fall into a major bone fracture. But the condition could also impact dental treatment—triggered ironically by the drugs used to treat osteoporosis rather than the disease itself.
From the Latin for “porous bone,” osteoporosis causes bone to gradually lose mineral structure. Over time the naturally-occurring spaces between mineralized portions of the bone enlarge, leaving it weaker as a result.
Although there's no definitive cure for osteoporosis, a number of drugs developed over the last couple of decades can inhibit its progress. Most fall into two major categories, bisphosphonates and RANKL inhibitors.
These drugs work by inhibiting the normal growth cycle of bone. Living bone constantly changes as cells called osteoblasts produce new bone. A different type, osteoclasts, clear away older bone to make room for these newer cells. The drugs selectively destroy osteoclasts so that the older bone, which would have been removed by them, remains for a longer period of time.
Retaining older cells longer initially slows the disease process. But there is a downside: in time, this older bone kept in place continues to weaken and lose vitality. In rare instances it may eventually become detached from its blood supply and die, resulting in what is known as osteonecrosis.
Osteonecrosis mostly affects two particular bones in the body: the femur (the long bone in the upper leg) and the jawbone. In regard to the latter, even the stress of chewing could cause osteonecrosis in someone being treated for osteoporosis. It can also occur after tooth extractions or similar invasive procedures.
If you're taking a bisphosphonate or RANKL inhibitor, you'll want to inform your dentist so that the necessary precautions can be taken before undergoing dental work more invasive than routine cleanings or getting a filling or crown. If you need major dental work, your dentist or you will also need to speak with your physician about stopping the drug for a few months before and after a dental procedure to minimize the risk of osteonecrosis.
Fortunately, the risk for dental problems while undergoing treatment for osteoporosis is fairly low. Still, you'll want to be as prepared as possible so that the management of your osteoporosis doesn't harm your dental health.
If you would like more information on osteoporosis and dental health, 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 “Osteoporosis Drugs & Dental Treatment.”
Learning you're pregnant can change your life in a heartbeat—or now two. Suddenly, what was important to you just seconds before the news takes a back seat to the reality of a new life growing within you.
But although many of your priorities will change, there's one in particular that shouldn't—taking care of your dental health. In fact, because of the hormonal changes that will begin to occur in your body, your risk of dental disease may increase during pregnancy.
Because of these hormonal variations, you may find you have increased cravings for certain foods. If that includes eating more carbohydrates (especially sugar), bacteria can begin to multiply in your mouth and make you more susceptible to tooth decay and periodontal (gum) disease.
The hormones in themselves can also increase your risk of gum disease in particular. There's even a name for a very common form of gum infection—pregnancy gingivitis—which affects around two-fifths of pregnant women. If not treated, it could aggressively spread deeper within the gums and endanger both your teeth and supporting jaw bone.
The key to minimizing both tooth decay and gum disease is to keep your mouth clean of dental plaque, a thin bacterial biofilm most responsible for these diseases. You can do this by keeping up daily brushing and flossing and maintaining regular dental cleanings and checkups. Professional dental care is especially important during pregnancy.
You may, though, have some reservations about some aspects of dental care, especially if they involve undergoing local anesthesia. But many medical organizations including the American Congress of Obstetricians and Gynecologists and the American Dental Association recommend dental treatment during pregnancy. Even procedures involving local anesthesia won't increase the risk of harm to you or your baby.
That said, though, elective dental work such as cosmetic enhancements, might be better postponed until after the baby is born. It's best to discuss with your dentist which treatments are essential and should be performed without delay, and which are not. In general, though, there's nothing to fear for you or your baby continuing your regular dental care—in fact, it's more important than ever.
If you would like more information on dental care during pregnancy, 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 “Dental Care During Pregnancy.”
Life has changed dramatically over the centuries. But although our ancient forebears wouldn't recognize much of our modern world, they would be well acquainted with one particular oral habit that still persists. There's some evidence from archeological dental examinations that our ancestors also clenched or ground their teeth.
This habit of involuntarily gnashing, clenching or grinding the teeth together is most prevalent among children, although not considered a major problem at these younger ages. But it can continue into adulthood, as it does for one in ten people, and lead to an array of problems from worn teeth to jaw joint pain.
As to why adult teeth grinding occurs, researchers have proposed a number of possibilities. Some believe it may be related to the arousal response that occurs when a person passes through various stages of sleep. It also appears that certain psychoactive drugs can trigger it. But at the top of the cause list, teeth grinding is believed to be a physical outlet for stress.
Because of the possibility of multiple causes, there is no one method for treatment—instead, it's better to tailor treatments to the individual. Universally, though, patients who use drugs, alcohol or tobacco, all of which are considered contributing factors, may reduce grinding episodes by restricting their use of these substances.
It's also possible to reduce the incidence of teeth grinding through better stress management. People can learn and use individual relaxation techniques like meditation, mindfulness or biofeedback. For sleep-related teeth grinding it may also be helpful to forgo use of electronic devices before bedtime for a better night's sleep.
Dental treatments like an occlusal guard worn mainly during sleep can minimize the effects of nocturnal teeth grinding. This custom-made appliance prevents teeth from coming fully into contact with each other, thus lowering the intensity of the biting forces generated and preventing cumulative damage to teeth and dental work.
If you have symptoms like sore teeth and jaws, reports from your family hearing you grind your teeth, or catching yourself during the day clenching your teeth, make an appointment for a full examination. From there, we'll help you find the right combination of solutions to keep this old habit from complicating your oral health.
If you would like more information on teeth grinding, 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 “Teeth Grinding.”
We're all tempted occasionally to use our teeth in ways that might risk damage. Hopefully, though, you've never considered anything close to what singer, songwriter and now social media persona Jason Derulo recently tried in a TikTok video—attempting to eat corn on the cob spinning on a power drill. The end result seemed to be a couple of broken front teeth, although many of his followers suspected an elaborate prank.
Prank or not, subjecting your teeth to “motorized corn”—or a host of other less extreme actions or habits—is not a good thing, especially if you have veneers, crowns or other dental work. Although teeth can withstand a lot, they're not invincible.
Here, then, are four things you should do to help ensure your teeth stay healthy, functional and intact.
Clean your teeth daily. Strong teeth are healthy teeth, so you want to do all you can to prevent tooth decay or gum disease. Besides semi-annual dental cleanings, the most important thing you can do is to brush and floss your teeth daily. These hygiene tasks help remove dental plaque, a thin biofilm that is the biggest culprit in dental disease that could weaken teeth and make them more susceptible to injury.
Avoid biting on hard objects. Teeth's primary purpose is to break down food for digestion, not to break open nuts or perform similar tasks. You should also avoid habitual chewing on hard objects like pencils, nails or ice to relieve stress. And, you may need to be careful eating apples or other foods with hard surfaces if you have veneers or composite bonding on your teeth.
Wear a sports mouthguard. If you or a family member are regularly involved with sports like basketball, baseball/softball or football (even informally), you can protect your teeth from facial blows by wearing an athletic mouthguard. Although you can obtain a retail variety in most stores selling sporting goods, a custom-made guard by a dentist offers the best protection and comfort.
Visit your dentist regularly. As mentioned before, semi-annual dental cleanings help remove hidden plaque and tartar and further minimize your risk of disease. Regular dental visits also give us a chance to examine your mouth for any signs of decay or gum disease, and to check on your dental health overall. Optimizing your dental health plays a key part in preventing dental damage.
You should expect an unpleasant outcome involving your teeth with power tools. But a lot less could still damage them: To fully protect your dental health, be sure you practice daily oral care, avoid tooth contact with hard objects and wear a mouthguard for high-risk physical activities.
If you would like more information on caring for your cosmetic dental work, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Porcelain Veneers” and “An Introduction to Sports Injuries & Dentistry.”
Tooth decay can be a big problem for children's primary (baby) teeth. It doesn't take long for a tooth to become infected and the infection spread to their neighbors.
But since it will eventually give way to a permanent tooth, why not just pull a diseased primary tooth? Although that sounds sensible, there are important reasons for helping a troubled primary tooth survive to its natural end.
Current usefulness. They may not be around for long, but primary teeth serve children well while they have them. They enable a child to eat solid foods to further their physical development. They also figure prominently in speech development, which could be stunted by lost teeth.
The smile factor. Young children are also honing their social skills, and smiling is an important part of learning to fit in with family and friends. A tooth that's missing for some time, especially in the “smile zone,” could affect their smile and have an adverse effect on their social development.
Future teeth health. A primary tooth reserves the space intended for the future permanent tooth, helping to ensure the incoming tooth erupts in the right position. If it's not there, however, other teeth can drift into the space, crowding the incoming tooth out of its proper alignment.
That last reason could have the most long-term effect, causing the development of a poor bite that could require extensive orthodontic treatment. To avoid this and any other physical or social consequences accompanying its premature loss, it's worth the effort to try to protect and save a primary tooth.
Preventively, we can apply sealants on biting surfaces more prone to plaque buildup (the main cause of decay) and topical fluoride to strengthen enamel. When decay does occur, we may be able to remove it and fill the tooth, cap a tooth with a steel crown, or even use a modified root canal procedure in the case of advanced tooth decay.
The best way, however, to protect your child's primary teeth is to brush and floss them every day. Removing harmful plaque vastly reduces the risk of tooth decay. Coupled with professional dental care, your child can avoid tooth decay and get the most out of their primary teeth.
If you would like more information on children's 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 “Importance of Baby Teeth.”
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