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Posts for category: Oral Health

By Christopher Couri, DDS, MS
July 14, 2021
Category: Oral Health
Tags: dental injury  
TakeTheseImmediateActionstoSaveaKnocked-OutTooth

Accidents do happen, especially if you or a family member has an active lifestyle. One such risk, especially for someone playing a contact sport, is having a tooth knocked out.

But as extreme as this injury can be, it doesn't necessarily mean the tooth is lost forever. Gum (or periodontal) cells remaining on the tooth root can regenerate and regain their attachment with the periodontal ligament that holds teeth in place. But you have to act quickly—the longer the tooth is out of the socket, the more likely these cells will dry out and die.

So, by doing the following within 5-20 minutes of the injury (and the earlier the better), that knocked-out tooth has a reasonable chance of survival.

Locate and clean the tooth. Your first priority is to find the missing tooth and clean it of any debris with clean water. Be sure not to touch the root of the tooth and only handle the tooth by the crown (the visible part of a tooth when it's in the mouth).

Insert the root end into the empty socket. Still holding the tooth by the crown, insert the opposite root end into the empty socket. Orient the crown properly, but don't worry about getting it in just right—the follow-up with the dentist will take care of that. You will, however, need to apply some pressure to get it to seat firmly.

Secure the tooth. Place a piece of clean gauze or cloth between the reinserted tooth and its counterpart on the other jaw. Then, have the person bite down on the cloth and hold it. This will help secure the tooth in place while you travel to the dentist.

Seek dental care immediately. It's important to see a dentist immediately to adjust the tooth's position and to possibly splint the tooth to better secure it while it heals. If a dentist isn't available, then visit a local emergency room instead.

Taking these actions on the scene could mean the difference between saving and losing a tooth. But act quickly—the sooner you initiate first aid for a knocked-out tooth, the better its chances for long-term survival.

If you would like more information on what to do during dental emergencies, 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 “When a Tooth is Knocked Out.”

By Christopher Couri, DDS, MS
June 14, 2021
Category: Oral Health
Tags: gum recession  
GumRecessionCanHarmYourOralHealthandYourSmile

Your gums don't just attractively frame your teeth—they protect them as well. If they shrink back (recede) from their normal covering, portions of the teeth could become exposed to bacteria and other hazards.

Unlike the visible crown, which is protected by enamel, the tooth root depends largely on the gums as a shield against bacteria and other hazards. When the gums recede, it exposes the roots and makes them more susceptible to disease or trauma. It may also cause sensitivity to hot and cold foods as the now exposed dentin gets the full brunt of temperature and pressure sensations once muffled by the gums.

There are actually a number of causes for gum recession. In rare cases, a tooth may not have erupted normally within its bony housing, which inhibits the gums from covering it fully. Thinner gum tissues, passed down genetically, are also more susceptible to recession. And a person can even damage their gums and cause them to recede if they brush too aggressively.

The most common cause, though, is advanced periodontal (gum) disease. This bacterial infection arises from dental plaque, a thin biofilm that accumulates on tooth surfaces, usually because of poor hygiene practices. As the infection and resulting inflammation in the gums worsens, they lose their attachment to teeth resulting in a number of harmful outcomes that include recession.

The first step then in treating gum recession is to treat the underlying problem as much as possible. In the case of gum disease, effective treatment could stop mild to moderate recession and sometimes reverse it. For more extensive recession, a patient may need gum grafting surgery to help regenerate lost gum tissue.

You can help prevent gum disease, and thus lower your risk for recession, with daily brushing and flossing to remove bacterial plaque. Likewise, see your dentist at least twice a year for dental cleanings to remove any residual plaque and tartar (hardened plaque).

You should also visit your dentist promptly if you notice swollen or bleeding gums, or more of your teeth surfaces showing. The earlier your dentist diagnoses and begins treatment for gum recession, the better your chances for a healthy and more attractive outcome.

If you would like more information on maintaining good gum 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 “Gum Recession.”

By Christopher Couri, DDS, MS
June 04, 2021
Category: Oral Health
Tags: oral hygiene  
ManagingOralHealthIsanImportantPriorityforHIV-AIDPatients

Forty years have passed since the first reported case of Acquired Immune Deficiency Syndrome (AIDS), and it and the human immunodeficiency virus (HIV) that causes it are still with us. About 1.2 million Americans are currently infected with HIV, with 50,000 new cases diagnosed each year.

The emergence of antiretroviral drugs, though, has made it possible for many with HIV to live normal lives. Even so, the virus can still have a profound effect on health, including the teeth and gums. Because of its effect on the immune system, HIV+ patients are at greater risk for a number of oral conditions, like a fungal infection called candidiasis ("thrush").

Another common problem is chronic dry mouth (xerostomia), caused by a lack of saliva production. Not only does this create an unpleasant mouth feel, but the absence of saliva also increases the risk for tooth decay and periodontal (gum) disease.

The latter can be a serious malady among HIV patients, particularly a severe form of gum disease known as Necrotizing Ulcerative Periodontitis (NUP). With NUP, the gums develop ulcerations and an unpleasant odor arising from dead gum tissue.

Besides plaque removal (a regular part of gum disease treatment), NUP may also require antibiotics, antibacterial mouthrinses and pain management. NUP may also be a sign that the immune system has taken a turn for the worse, which could indicate a transition to the AIDS disease. Dentists often refer patients with NUP to a primary care provider for further diagnosis and treatment.

Besides daily brushing and flossing, regular dental cleanings are a necessary part of a HIV+ patient's health maintenance. These visits are also important for monitoring dental health, which, as previously noted, could provide early signs that the infection may be entering a new disease stage.

It's also important for HIV+ patients to see their dentist at the first sign of inflamed, red or bleeding gums, mouth lesions or loose teeth. Early treatment, especially of emerging gum disease, can prevent more serious problems from developing later.

Living with HIV-AIDS isn't easy. But proper health management, including for the teeth and gums, can help make life as normal as possible.

If you would like more information on dental care and HIV-AIDS, 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 “HIV-AIDS & Oral Health.”

By Christopher Couri, DDS, MS
May 15, 2021
Category: Oral Health
Tags: tooth decay  
WhatYouCanDoToHelpYourChildAvoidToothDecay

So, when should you begin taking measures to prevent tooth decay in your child's teeth? When their teeth first begin to show? When all of their primary (baby) teeth are in? Or, wait until their permanent teeth begin erupting?

Actually, tooth decay can be a problem as early as two months of age, before a child's first tooth even comes in. In essence, then, dental disease prevention should be on your radar soon after your child is born. Here's what you can do to prevent the damage of tooth decay to their teeth now and its impact on their dental health in the future.

Start oral hygiene during nursing. Brushing and flossing are lifetime habits that reduce the risk of dental disease. When your children are young, you'll have to perform these tasks for them, ultimately training them to perform them on their own. But even earlier, before their first tooth, you'll want to clean their gums after feedings with a wet cloth to reduce disease-causing bacteria.

Initiate dental visits by age 1. It's appropriate on or before their first birthday, when most children already have a few primary teeth, to begin regular dental visits for cleanings and checkups. Seeing the dentist every six months at an early age will help your child stay well ahead of tooth decay. And starting visits early increases the likelihood it will become a regular part of their lives into adulthood.

Protect against decay. You and your dentist are partners in protecting your child from dental disease. Besides daily oral hygiene, you can also help by providing a dental-friendly diet, and especially restricting sugary snacks and avoiding sweetened liquids in bedtime bottles (including breast milk or formula). In addition to routine care, your dentist can also provide other measures to fight decay, like sealants or topical fluoride.

It's also important for you to set an example for your child to follow. Children soak up what's important to their parents—in this case, watching you take care of your teeth and seeing the dentist as a friend and ally against dental disease. That's your end goal: preventing dental disease now, and instilling the value of dental care that will last your child a lifetime.

If you would like more information on helping your child avoid tooth decay, 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 “Taking the Stress Out of Dentistry for Kids.”

By Christopher Couri, DDS, MS
May 05, 2021
Category: Oral Health
Tags: mouthguard  
ProtectYourTeethandGumsDuringPhysicalActivities

As part of his "New Frontier," President Kennedy greatly expanded the President's Council on Physical Fitness. Sixty years later, it's still going strong—now as the President's Council on Sports, Fitness & Nutrition (PCSFN)—supporting physical activity and nutrition initiatives for better health. That would also include your mouth: Healthy teeth and gums are an important part of a healthy body.

The PCSFN designates each May as National Physical Fitness and Sports Month to spotlight the important role sports and exercise play in maintaining overall physical fitness. And what's good for the body is also generally good for your mouth.

But while you're out on the field or in the gym, there are some potential pitfalls to watch for that could create problems for your teeth and gums. Here are a few of them, and what you should do to avoid them.

Neglecting oral hygiene. As spring weather warms up, many of us are eager to rush out the door for exercise and other physical activities. But don't leave before taking care of one important item—brushing and flossing your teeth. These hygiene tasks clean your teeth of dental plaque, the thin bacterial film most responsible for tooth decay and gum disease. Plaque should be removed daily, so take the time to brush and floss before you kick off your busy day.

Sports drinks. A quick scan around sports or fitness venues and you're likely to see plenty of sports drinks in attendance. Although marketed as a fluid and nutrient replacement after physical exertion, most sports drinks also contain sugar and acid, two ingredients that could harm your teeth. Try not to constantly sip on sports drink, but drink a serving all at one time (preferably with a meal). Better yet, unless your physical activity is especially strenuous or prolonged, opt instead for water, nature's original hydrator.

Blunt force contact. A pickup basketball game is a great form of physical exercise. But a split-second blow to the face could damage your teeth and gums to such extent that it could impact your dental health for years to come. If you're a regular participant in a contact sport, wearing a mouthguard will significantly lower your risk for oral injuries. And for the best comfort and protection, have us fit you with a custom-made mouthguard—it could be a wise investment.

Our bodies (and minds) need regular physical activity to stay healthy—so by all means, get out there and get moving. Just be sure you're also looking out for your teeth and gums, so they'll stay as healthy as the rest of your body.

If you would like more information about protecting your dental health during physical activity, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Think Before You Drink” and “Athletic Mouthguards.”