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.”
Brushing and flossing are two of the best things you can do to fight dental disease and maintain healthy teeth and gums.
Or is it flossing and brushing? What we mean is, should you floss first or brush first?
There's virtually no debate among dental professionals about whether or not to perform both hygiene tasks. While brushing removes disease-causing plaque from the broad surfaces of teeth, flossing gets to deposits of this disease-causing, bacterial film lodged between the teeth that brushing can't reach. You don't want to neglect one task over the other if you want to fully minimize your risk of tooth decay or gum disease (and don't forget semi-annual dental cleanings too).
But where there is some debate—good-natured, of course—among dentists is over whether it's better hygiene-wise to brush before flossing or vice-versa. For those on Team Brush, you should pick up your toothbrush first for the best results.
By brushing before you floss, you'll remove most of the plaque that has accumulated since your last cleaning session. If you floss first, the flossing thread has to plow through a lot of the plaque that otherwise might be removed by brushing. For many, this can lead to an unpleasant sticky mess. By removing most of the plaque first via brushing, you can focus your flossing on the small amount left between teeth.
Team Floss, on the other hand, believes giving flossing first crack at loosening the plaque between teeth will make it easier for the detergent in the toothpaste to remove it out of the way during brushing. It may also better expose these in-between areas of teeth to the fluoride in your toothpaste while brushing. And because flossing is generally considered a bit more toilsome to do than brushing, tackling it first could increase the likelihood you'll actually floss and not neglect it after brushing.
So, which task should you perform first? Actually, it's up to you: Weighing both sides, it usually comes down to which way is the most comfortable for you and will give you the greatest impetus for flossing. Because no matter which “team” you're on, the important thing is this: Don't forget to floss.
If you would like more information on personal 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 “Daily Oral Hygiene.”
Millions of people have obstructive sleep apnea—and some don’t even realize it. That’s because even though these airway-blocking episodes can occur several times a night, they may only last a few seconds. The brain rouses the body just long enough to open the airway but not long enough to awaken the person to consciousness.
Even though a person with sleep apnea might not remember what happened to them, they can still experience the effects of sleep disturbance: drowsiness, irritability or an inability to focus. Over time, the accumulation of “bad sleep” could increase their risk for heart disease or other life-threatening conditions.
But there are effective ways to alleviate or lessen obstructive sleep apnea. The main “go-to” treatment is a method called continuous positive airway pressure (CPAP). CPAP utilizes an electric pump that supplies a constant flow of pressurized air through a mask worn by the patient while sleeping. The increased air pressure around the throat helps keep the airway open.
But although it’s effective, CPAP is unpopular with many people who have tried it. Many find the hose and other equipment cumbersome, or the mask too uncomfortable or restrictive to wear. As a result, quite a number simply avoid using it.
If you’ve had a similar experience with CPAP or would rather explore other options, we may have an alternative: an oral appliance you wear while you sleep. It can help prevent or lessen symptoms in cases of mild to moderate airway obstruction caused by the tongue or other forms of tissue.
Sleep apnea appliances come in two basic forms. One uses metal hinges to help move the lower jaw and tongue forward. The other form has a compartment that fits around the tongue and applies suction to help keep the tongue moved forward.
These appliances may not be suitable for patients with severe sleep apnea or whose cause is something other than a physical obstruction like abnormal neurological signaling patterns. But where they are appropriate, they can be an effective alternative to CPAP and the key to a better night’s sleep.
If you would like more information on this dental solution for sleep apnea, 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 “Oral Appliances for Sleep Apnea.”
Ed Helms is best known for his role as the self-absorbed, Ivy League sales rep, Andy Bernard, on television's The Office. But to millions of fans he's also Stu, a member of a bachelor trip to Las Vegas in the 2009 movie The Hangover. In it, Stu and his friends wake up from a wild night on the Strip to find some things missing: the groom-to-be, their memories and, for Stu, a front tooth.
In reality, the missing tooth gag wasn't a Hollywood makeup or CGI (computer-generated imagery) trick—it was Ed Helm's actual missing tooth. According to Helms, the front tooth in question never developed and he had obtained a dental implant to replace it. He had the implant crown removed for the Hangover movie and then replaced after filming.
Helms' dental situation isn't that unusual. Although most of the 170 million-plus teeth missing from Americans' mouths are due to disease or trauma, a few happened because the teeth never formed. While most of these congenitally missing teeth are in the back of the mouth, a few, as in Helms' case, involve front teeth in the “smile zone,” which can profoundly affect appearance.
Fortunately, people missing undeveloped teeth have several good options to restore their smiles and dental function. The kind of tooth missing could help determine which option to use. For example, a bridge supported by the teeth on either side of the gap might work well if the teeth on either side are in need of crowns.
If the missing tooth happens to be one or both of the lateral incisors (on either side of the centermost teeth), it could be possible to move the canine teeth (the pointy ones, also called eye teeth) to fill the gap. This technique, known as canine substitution, may also require further modification—either by softening the canines' pointed tips, crowning them or applying veneers—to help the repositioned teeth look more natural.
The optimal solution, though, is to replace a missing tooth with a dental implant which then has a lifelike crown attached to it, as Ed Helms did to get his winning smile. Implant-supported replacement teeth are closest to natural teeth in terms of both appearance and function. Implants, though, shouldn't be placed until the jaw has fully developed, usually in early adulthood. A younger person may need a temporary restoration like a bonded bridge or a partial denture until they're ready for an implant.
Whatever the method, there's an effective way to restore missing teeth. Seeing us for an initial exam is the first step toward your own winning smile.
As we get older, we become more susceptible to chronic health conditions like diabetes, heart disease or arthritis. We can also begin to see more problems with our teeth and gums.
Whether it's ourselves or an older loved one, oral health deserves a heightened focus as we age on prevention and prompt treatment. Here's what you can do to protect you or a family member's teeth and gums during the aging process.
Make accommodations for oral hygiene. Keeping your mouth clean of disease-causing plaque is important at any age. But it may become harder for someone getting older: Manual dexterity can falter due to conditions like arthritis or Parkinson's Disease. Older adults with decreased physical ability may benefit from larger gripped toothbrushes or those modified with a bicycle handle. Electric power brushes are another option, as are water irrigators that can do as effective a job of flossing as threaded floss.
Watch out for “dry mouth.” Older adults often develop chronic dry mouth due to saliva-reducing medications they might be taking. It's not just an unpleasant feeling: Inadequate saliva deprives the mouth of acid neutralization. As a result, someone with chronic dry mouth has a higher risk for tooth decay. You can reduce dry mouth by talking with your doctor about prescriptions for you or a family member, drinking more water or using saliva boosting products.
Maintain regular dental visits. Regular trips to the dentist are especially important for older adults. Besides professional cleanings, dentists also check for problems that increase with aging, such as oral cancer. An older adult wearing dentures or other oral appliances also needs to have them checked periodically for any adverse changes to fit or wear.
Monitor self-care. As long as they're able, older adults should be encouraged to care daily for their own teeth. But they should also be monitored in these areas, especially if they begin to show signs of decreased mental or physical abilities. So, evaluate how they're doing with brushing and flossing, and look for signs of tooth decay or gum disease.
Aging brings its own set of challenges for maintaining optimum dental health. But taking proactive steps and acting quickly when problems arise will help meet those challenges as they come.
If you would like more information on dental care for older adults, 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 “Aging & Dental Health.”
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