They seemingly pop up out of the blue inside your mouth: tiny sores that are sometimes painful — and always annoying. Then, in about a week to ten days these small, irritating lesions are gone.
They're known as canker sores: the most common break out in the linings of the mouth, including the cheeks, lips, under the tongue or even the back of the throat. Medically known as aphthous ulcers, you'll recognize these round lesions by their yellow-gray center surrounded by a red “halo.”
You might feel a tingling sensation a couple of days before an outbreak. Once they appear they usually last a week to ten days; during that time they can cause discomfort especially while eating or drinking.
We don't know fully what causes canker sores, but it's believed they're related to abnormalities in the immune system, the processes in the body that fight infection and disease. High stress or anxiety and certain acidic or spicy foods like citrus fruit or tomato sauce also seem to trigger them.
Most people experience canker sores that range in intensity from slight discomfort to sometimes severe pain. But about 20-25% of people, mostly women, have an acute form known as recurrent aphthous stomatitis (RAS). Thought to be hereditary, RAS produces clusters of ulcers that are almost always painful, and which come and go on a regular basis.
Our main treatment goal with canker sores is to decrease discomfort while the outbreak runs its course and promote rapid healing. There are over-the-counter ointments that often prove effective. For more resistant symptoms we can also prescribe topical or injectable steroids or other medications.
Canker sores are rarely concerning as a significant health issue. You should, however, take an outbreak seriously if it hasn't healed within two weeks, if the outbreaks seem to be increasing in frequency or severity, or you're never without a sore in your mouth. In these cases, we may need to take a tissue sample of the lesion to biopsy for signs of cancer, pre-cancer or some other skin disease.
More than likely, though, the canker sore will be benign albeit annoying. With effective treatment, though, you can get through the outbreak with only a minimal amount of discomfort.
If you would like more information on treating canker sores, 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 “Mouth Sores.”
Dental implant technology has advanced at such an astounding rate in recent years that you can now walk into a dentist's office with a problem tooth and out the same day with a new one. Unfortunately, not all dental situations allow for this possibility.
For example, you might be considering an implant many years after losing a tooth. But there's a potential problem: there might not be enough supporting bone. While an implant might still be possible, inadequate bone complicates the matter.
Because implants are essentially tooth root replacements, they require a certain amount of bone for stability and the best attractive outcome. As a general rule, implants need to be surrounded by at least 1.5-2.0 millimeters of healthy bone to support an implant. But you might not have enough if your tooth has been missing for awhile, regardless if you have or haven't worn dentures or other restorations.
That's because bone has a life cycle in which older cells die and newer ones form to take their place. As we chew or bite, the force generated travels up through the teeth to the bone to stimulate this new growth. Without a tooth the bone doesn't receive this stimulus, which can slow the growth rate. Over time the affected bone can lose its volume and density.
If we find you've experienced loss to the point your bone won't support an implant, that doesn't automatically mean this popular restoration is out of the picture. But it will require us first performing a procedure known as augmentation or bone grafting to help rejuvenate some of the lost bone.
With grafting, we place processed bone grafting material in the jaw through a minor surgical procedure to form a scaffold for new bone to grow upon. After several months this can result in several millimeters of new growth maintaining the width of the underlying bone, which in turn may be able to support an implant.
Bone grafting is quite common, often performed at the same time as tooth extraction if there's going to be a time lag before installing an implant. Even if performed later, though, it can successfully rejuvenate lost bone and make it possible for you to take advantage of durable, life-like implants.
If you would like more information on dental implants, 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 Implants after Previous Tooth Loss.”
When die-hard music fans hear that their favorite performer is canceling a gig, it’s a big disappointment—especially if the excuse seems less than earth-shaking. Recently, British pop sensation Dua Lipa needed to drop two dates from her world tour with Bruno Mars. However, she had a very good reason.
“I’ve been performing with an awful pain due to my wisdom teeth,” the singer tweeted, “and as advised by my dentist and oral surgeon I have had to have them imminently removed.”
The dental problem Lipa had to deal with, impacted wisdom teeth, is not uncommon in young adults. Also called third molars, wisdom teeth are the last teeth to erupt (emerge from beneath the gums), generally making their appearance between the ages of 18-24. But their debut can cause trouble: Many times, these teeth develop in a way that makes it impossible for them to erupt without negatively affecting the healthy teeth nearby. In this situation, the teeth are called “impacted.”
A number of issues can cause impacted wisdom teeth, including a tooth in an abnormal position, a lack of sufficient space in the jaw, or an obstruction that prevents proper emergence. The most common treatment for impaction is to extract (remove) one or more of the wisdom teeth. This is a routine in-office procedure that may be performed by general dentists or dental specialists.
It’s thought that perhaps 7 out of 10 people ages 20-30 have at least one impacted wisdom tooth. Some cause pain and need to be removed right away; however, this is not always the case. If a wisdom tooth is found to be impacted and is likely to result in future problems, it may be best to have it extracted before symptoms appear. Unfortunately, even with x-rays and other diagnostic tests, it isn’t always possible to predict exactly when—or if—the tooth will actually begin causing trouble. In some situations, the best option may be to carefully monitor the tooth at regular intervals and wait for a clearer sign of whether extraction is necessary.
So if you’re around the age when wisdom teeth are beginning to appear, make sure not to skip your routine dental appointments. That way, you might avoid emergency surgery when you’ve got other plans—like maybe your own world tour!
If you would like more information about wisdom tooth extraction, please call our office to arrange a consultation. You can learn more in the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”
Tooth sensitivity can be disheartening: you’re always on your guard with what you eat or drink, and perhaps you’ve even given up on favorite foods or beverages.
The most common cause for this painful sensitivity is dentin exposure caused by receding gums. Dentin contains tiny open structures called tubules that transmit changes in temperature or pressure to the nerves in the pulp, which in turn signal pain to the brain. The enamel that covers the dentin, along with the gum tissues, creates a barrier between the environment and dentin to prevent it from becoming over-stimulated.
Due to such causes as aggressive over-brushing or periodontal (gum) disease, the gum tissues can recede from the teeth. This exposes portions of the dentin not covered by enamel to the effects of hot or cold. The result is an over-stimulation of the dentin when encountering normal environmental conditions.
So, what can be done to relieve painful tooth sensitivity? Here are 3 ways to stop or minimize the symptoms.
Change your brushing habits. As mentioned, brushing too hard and/or too often can contribute to gum recession. The whole purpose of brushing (and flossing) is to remove bacterial plaque that’s built up on tooth surfaces; a gentle action with a soft brush is sufficient. Anything more than two brushings a day is usually too much — you should also avoid brushing just after consuming acidic foods or liquids to give saliva time to neutralize acid and restore minerals to the enamel.
Include fluoride in your dental care. Fluoride has been proven to strengthen enamel. Be sure, then, to use toothpastes and other hygiene products that contain fluoride. With severe sensitivity you may also benefit from a fluoride varnish applied by a dentist to your teeth that not only strengthens enamel but also provides a barrier to exposed dentin.
Seek treatment for dental disease. Tooth sensitivity is often linked to tooth decay or periodontal (gum) disease. Treating dental disease may include plaque removal, gum surgery to restore receded gums, a filling to remove decay or root canal therapy when the decay gets to the tooth pulp. These treatments could all have an effect on reducing or ending your tooth sensitivity.
If you would like more information on the causes and treatments for sensitive teeth, 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 “Tooth Sensitivity.”
It’s hard to imagine, but little more than a century ago today’s “minor” bacterial and viral infections were often deadly. This changed with the advent of antibiotics, drugs which kill disease-causing microbes. Decades after the development of penicillin and similar antibiotics, we routinely rely on them for treating infection. They’re quite prominent in dental care in treating advanced forms of periodontal (gum) disease or reducing bacteria that cause tooth decay.
But the age of antibiotics may be in danger: their overuse in medicine and the food industry has led to the rise of resistant microbial strains — “superbugs” — that no longer respond to first line antibiotics or, in some cases, to second or third line drugs. The U.S. Center for Disease Control (CDC) estimates more than two million people annually will contract one of these superbugs of which more than 20,000 will die. If current practices continue, the growth of resistant strains (as well as allergic reactions among users of antibiotics) will increase. The answer is a more modified use of antibiotics.
For healthcare providers, this means adopting new protocols in which we attempt to prescribe antibiotics that specifically target an identified microbe (which we’ve determined through more rigorous diagnostic testing), and in limited amounts. We must also rein in the practice of antibiotic use in the food industry, routinely administered to livestock to prevent disease or to enhance growth. Many countries, including the U.S., are now moving toward a more limited practice in which only animals that are demonstrably sick receive antibiotics. This will limit their release into the greater environment, which is a contributing factor to growing microbial resistance.
Patients also play a role in the better use of antibiotics. We must first change the perception that antibiotics are a “cure-all” — the answer to every illness. It’s also important for patients who’ve been prescribed antibiotics to complete the course of treatment, even if after a day or two they feel better; stopping antibiotic treatment prematurely increases the chances targeted microbes develop a resistance to that particular drug.
Altering our perception and use of antibiotics will require a tremendous effort for all of society. But making these changes will help ensure antibiotics continue to serve humanity as an important health benefit well into the future.
This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.