As we age we become more susceptible to dental diseases. A common but often initially unnoticed problem for seniors is root decay.
We’re all familiar with tooth decay in the crown, the visible tooth above the gum line. Bacteria feeding on leftover sugar in the mouth produce acid, which at high levels erodes the teeth’s protective enamel. This forms cavities and, if untreated, deeper infection within the tooth that could reach the bone via the root canals.
But decay can also directly attack a tooth’s roots below the gum line. Roots are made of dentin and covered by a very thin layer of mineralized tooth structure called cementum. Cementum, which is much softer than enamel, is often lost because of its thinness, thus exposing the root’s dentin. This can make the area more susceptible to decay than the enamel-covered crown. Normally, though, the roots also have the gums covering them as added protection against bacterial infection.
But gum recession (shrinkage), a common experience for people in their later years, can expose the root surfaces. As a result, the roots become much more susceptible to decay. And an ensuing infection could spread more quickly into the interior of the tooth than decay originating in the crown.
That’s why it’s important to remove the decayed material and fill the root cavity to prevent the infection’s spread. While similar to a crown filling, the treatment can be more difficult if the root cavity extends below the gum line. In this case, we may need to perform a surgical procedure to access the cavity.
There are other things we can do to help prevent root cavities or limit their damage. We can apply fluoride varnish to strengthen the teeth and provide extra protection against cavities, or prescribe a fluoride rinse for use at home. We can also keep an eye out and treat periodontal (gum) disease, the main cause for gum recession.
The most important thing, though, is what you do: brush and floss thoroughly each day to remove bacterial plaque and limit sugary or acidic foods in your diet. Preventing decay and treating cavities as soon as possible will help ensure you’ll keep your teeth healthy and functional all through your senior years.
The red, scaly rash suddenly appearing on your face doesn’t cause you much physical discomfort, but it’s still embarrassing. And to make matters worse treating it as you would other skin ailments seems to make it worse.
Your ailment might be a particular skin condition known as peri-oral dermatitis. Although its overall occurrence is fairly low (1% or less of the population worldwide) it seems to be more prevalent in industrialized countries like the United States, predominantly among women ages 20-45.
Peri-oral dermatitis can appear on the skin as a rash of small red bumps, pimples or blisters. You usually don’t feel anything but some patients can have occasional stinging, itching or burning sensations. It’s often misidentified as other types of skin rashes, which can be an issue when it comes to treatment.
Steroid-based ointments that work well with other skin ailments could have the opposite effect with peri-oral dermatitis. If you’re using that kind of cream out of your medicine cabinet, your rash may look better initially because the steroid constricts the tiny blood vessels in the skin. But the reduction in redness won’t last as the steroid tends to suppress the skin’s natural healing capacity with continued use.
The best treatment for peri-oral dermatitis is to first stop using any topical steroid ointments, including other-the-counter hydrocortisone, and any other medications, lotions or creams on it. Instead, wash your skin with a mild soap. Although the rash may flare up initially, it should begin to subside after a few days.
A physician can further treat it with antibiotic lotions typically containing Clindamycin or Metronidazole, or a non-prescription, anti-itch lotion for a less severe case. For many this clears up the condition long-term, but there’s always the possibility of relapse. A repeat of this treatment is usually effective.
Tell your dentist if you have recurring bouts of a rash that match these descriptions. More than likely you’ll be referred to a dermatologist for treatment. With the right attention—and avoiding the wrong treatment ointment—you’ll be able to say goodbye to this annoying and embarrassing rash.
Most of us think of insurance as a means to protect us and our families from unforeseen loss. While that’s the general definition, some insurance plans — like dental — don’t quite work that way.
The typical dental plan actually works more like a discount coupon for dental services. Most are part of an employer-based benefit package and usually “fee-for-service”: the insurance company pays for part or sometimes the entire bill after your dental visit based on a fee schedule laid out in the policy.
A plan’s benefits depend on what the insurer offers to cover and what level of coverage your employer (or you) are willing to pay for. Typically, the more items covered under the policy, the higher the premium. Any deductibles (the amount you must pay out of pocket before receiving any plan benefits) can also affect the premium — the lower the deductible, the higher the premium.
The benefits may also be limited due to what a patient’s dentist charges for services. Most insurers pay benefits based on what they determine to be the “usual, customary and reasonable” (UCR) fee for a particular service. The dentist’s fees are most often higher, however, resulting in the patient paying a higher percentage of the bill.
Still, a dental plan can work to your financial advantage, especially if it’s employer-based with premiums paid by your employer. It may not be advantageous, however, if you’re paying the premiums. For example, a person without insurance might spend on average $200 a year for basic dental care (mostly preventative — checkups and cleanings), while a person with insurance may have those expenses covered, but are paying yearly premiums of $500 or more for the plan.
You should also consider one other factor: our first priority as dentists is to pursue the best course of treatment for your particular dental needs, which may not always align with what your policy covers. At the same time, we understand the limitations you may be under with your plan — we work in this world every day. We’ll certainly assist you in navigating the insurance waters to achieve the best care for what you can afford.
If you would like more information on dental insurance and other financial arrangements, 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 Insurance 101.”
It's no secret that many of Hollywood's brightest stars didn't start out with perfectly aligned, pearly-white teeth. And these days, plenty of celebs are willing to share their stories, showing how dentists help those megawatt smiles shine. In a recent interview with W magazine, Emma Stone, the stunning 28-year-old star of critically-acclaimed films like La La Land and Birdman, explained how orthodontic appliances helped her overcome problems caused by a harmful habit: persistent thumb sucking in childhood.
“I sucked my thumb until I was 11 years old,” she admitted, mischievously adding “It's still so soothing to do it.” Although it may have been comforting, the habit spelled trouble for her bite. “The roof of my mouth is so high-pitched that I had this huge overbite,” she said. “I got this gate when I was in second grade… I had braces, and then they put a gate.”
While her technical terminology isn't quite accurate, Stone is referring to a type of appliance worn in the mouth which dentists call a “tongue crib” or “thumb/finger appliance.” The purpose of these devices is to stop children from engaging in “parafunctional habits” — that is, behaviors like thumb sucking or tongue thrusting, which are unrelated to the normal function of the mouth and can cause serious bite problems. (Other parafunctional habits include nail biting, pencil chewing and teeth grinding.)
When kids develop the habit of regularly pushing the tongue against the front teeth (tongue thrusting) or sucking on an object placed inside the mouth (thumb sucking), the behavior can cause the front teeth to be pushed out of alignment. When the top teeth move forward, the condition is commonly referred to as an overbite. In some cases a more serious situation called an “open bite” may develop, which can be difficult to correct. Here, the top and bottom front teeth do not meet or overlap when the mouth is closed; instead, a vertical gap is left in between.
Orthodontic appliances are often recommended to stop harmful oral habits from causing further misalignment. Most appliances are designed with a block (or gate) that prevents the tongue or finger from pushing on the teeth; this is what the actress mentioned. Normally, when the appliance is worn for a period of months it can be expected to modify the child's behavior. Once the habit has been broken, other appliances like traditional braces or clear aligners can be used to bring the teeth into better alignment.
But in Stone's case, things didn't go so smoothly. “I'd take the gate down and suck my thumb underneath the mouth appliance,” she admitted, “because I was totally ignoring the rule to not suck your thumb while you're trying to straighten out your teeth.” That rule-breaking ended up costing the aspiring star lots of time: she spent a total of 7 years wearing braces.
Fortunately, things worked out for the best for Emma Stone: She now has a brilliant smile and a stellar career — plus a shiny new Golden Globe award! Does your child have a thumb sucking problem or another harmful oral habit? For more information about how to correct it, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine article “How Thumb Sucking Affects the Bite.”
Sports drinks have been widely touted as an ideal way to replenish carbohydrates, electrolytes and, of course, fluids after a strenuous event or workout. But the mixtures of many popular brands often contain acid and added sugar, similar to other types of soft drinks. This can create an acidic environment in the mouth that can be damaging to tooth enamel.
Of course, the best way to replenish fluids after most strenuous activities is nature’s hydrator, water. If, however, you or a family member does drink the occasional sports beverage, you can help reduce the acid impact and help protect tooth enamel by following these 3 tips.
Avoid sipping a sports drink over long periods. Sipping on a drink constantly for hours interferes with saliva, the bodily fluid responsible for neutralizing mouth acid. But because the process can take thirty minutes to an hour to bring the mouth to a normal pH, saliva may not be able to complete neutralization because of the constant presence of acid caused by sipping. It’s best then to limit sports drinks to set periods or preferably during mealtimes.
Rinse your mouth out with water after drinking.Â Enamel damage occurs after extended periods of exposure to acid. Rinsing your mouth out immediately after consuming a sports drink will wash away a good amount of any remaining acid and help normalize your mouth’s pH level. And since water has a neutral pH, it won’t add to the acid levels.
Wait an hour to brush after eating. As mentioned before, saliva takes time to neutralize mouth acid. Even in that short period of time, though, acid can soften some of the mineral content in enamel. If you brush during this “soft” period, you may inadvertently brush away some of the minerals. By waiting an hour, you give saliva time not only to neutralize acid but also restore mineral strength to the enamel.
If you would like more information on sports and energy drinks and their effect on 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 “Think Before you Drink.”
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