Although dental care is our primary focus, we dentists are also on the lookout for other health problems that may manifest in the mouth. That's why we're sometimes the first to suspect a patient may have an eating disorder.
Eating disorders are abnormal dietary patterns that can arise from mental or emotional issues, the most common being anorexia nervosa and bulimia nervosa. Each has different behaviors: Anorexics abnormally restrict their food intake (“self-starvation”), while bulimics typically eat heavily and then induce vomiting (“binge and purge”).
Although bulimics are more likely to binge and purge, anorexics may also induce vomiting. That practice in particular can leave a clue for dentists. While vomiting, powerful stomach acid enters the mouth, which can then soften and erode tooth enamel.
It's the pattern of erosion a dentist may notice more than the erosion itself that may indicate an eating disorder. A person while vomiting normally places their tongue against the back of the lower teeth, which somewhat shields them from acid. The more exposed upper teeth will thus tend to show more erosion than the bottom teeth.
A dentist may also notice other signs of an eating disorder. Enlarged salivary glands or a reddened throat and tongue could indicate the use of fingers or objects to induce vomiting. Lack of oral hygiene can be a sign of anorexia, while signs of over-aggressive brushing or flossing may hint of bulimia.
For the sake of the person's overall well-being, the eating disorder should be addressed through professional counseling and therapy. An excellent starting point is the website nationaleatingdisorders.org, sponsored by the National Eating Disorders Association.
The therapy process can be lengthy, so patients should also take steps to protect their teeth in the interim. One important measure is to rinse out the mouth following purging with a little baking soda mixed with water. This will help neutralize oral acid and reduces the risk of erosion. Proper brushing and flossing and regular dental visits can also help prevent dental disease.
An eating disorder can be traumatic for both patients and their families, and can take time to overcome. Even so, patients can reduce its effect on their dental health.
If you would like more information on eating disorders 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 “Bulimia, Anorexia & Oral Health.”
Breastfeeding is nature's way of providing complete nourishment to a newborn in their first years of life. It can also have a positive impact on their emerging immune system, as well as provide emotional support and stability. But although nursing comes naturally to an infant, there are circumstances that can make it more difficult.
One example is an abnormality that occurs in one in ten babies known as a tongue tie. A tongue tie involves a small band of tissue called a frenum, which connects the underside of the tongue with the floor of the mouth. The frenum, as well as another connecting the inside of the upper lip with the gums, is a normal part of oral anatomy that helps control movement.
But if the frenum is too short, thick or taut, it could restrict the movement of the tongue or lip. This can interfere with the baby acquiring a good seal on the breast nipple that allows them to draw out milk. Instead, the baby may try to chew on the nipple rather than suck on it, leading to an unpleasant experience for both baby and mother.
But this problem can be solved with a minor surgical procedure called a frenotomy (also frenectomy or frenuplasty). It can be a performed in a dentist's office with just a mild numbing agent applied topically to the mouth area (or injected, in rare cases of a thicker frenum) to deaden it. After a few minutes, the baby's tongue is extended to expose the frenum, which is then snipped with scissors or by laser.
There's very little post-op care required (and virtually none if performed with a laser). But there may be a need for a child to “re-learn” how to breastfeed since the abnormal frenum may have caused them to use their oral muscles in a different way to compensate. A lactation expert may be helpful in rehabilitating the baby's muscles to nurse properly.
A restrictive frenum isn't necessarily a dire situation for an infant—they can continue to feed with a bottle filled with formula or pumped breastmilk. But employing this minor procedure can enable them to gain the other benefits associated with breastfeeding.
If you would like more information on tongue ties and other oral abnormalities in children, 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 “Tongue Ties, Lip Ties and Breastfeeding.”
A wave of madness is about to sweep across Indianapolis and onto television screens across America—March Madness, that is. That's right: After its cancellation in 2020 due to COVID-19, the famed NCAA men's basketball tournament is back with all 68 games scheduled to be played in and around Indianapolis. As you can imagine, there will be numerous health precautions, and not just for the pandemic—there should also be mouthguards aplenty.
Why mouthguards? Although you might think football and hockey would be rougher on players' teeth, gums and jaws, basketball actually tops the list of sports with the most dental injuries. Such an injury occurring from a split-second contact with another player could take years to overcome.
Fortunately, mouthguards are a proven way to reduce sports-related mouth injuries among professional and amateur basketball athletes. Made of a pliable plastic, mouthguards cushion against blunt forces to the mouth generated during play (and not only formal games—practices and scrimmages too).
But while wearing a mouthguard is a no-brainer, choosing one can be a little intimidating. True, they all work on the same principle, but there are dozens of types, designs and price ranges.
We can, however, distill them down to two basic categories: “boil and bite” and custom mouthguards. You'll find the first kind online or in a local retail sporting goods store. It's named so because you first place it in hot water to soften it, and then place it in the mouth and bite down to create an individual fit.
As an inexpensive option, boil and bite mouthguards provide a level of protection. But they also tend to be bulky and uncomfortable, which can tempt players to wear them less. And the softer plastic (compared to custom guards) allows for a lot of jaw (and in turn, teeth) movement, which can cause teeth to loosen over time.
Custom mouthguards, on the other hand, are created by dentists based on impressions made of the wearer's mouth. As such, the fit tends to be more precise, requiring less material than the boil and bite variety, thus affording a greater degree of comfort. And there's less potentially damaging jaw movement with a custom mouthguard. As you might imagine, custom mouthguards are more expensive, but compared to the potential treatment cost for a sports-related dental injury, it's money well spent.
Investing in a custom mouthguard for your family basketball (or football, hockey or baseball) player is a sound way to protect their dental health. And that's not madness at all.
Kathy Bates has been a familiar face to filmgoers since her Oscar-winning performance as Annie Wilkes in Misery. She's best known for playing true-to-life characters like Wilkes or Barbara Jewell in last year's Richard Jewell (for which she earned her fourth Oscar nomination). To keep it real, she typically eschews cosmetic enhancements—with one possible exception: her smile.
Although happy with her teeth in general, Bates noticed they seemed to be “moving around” as she got older. This kind of misalignment is a common consequence of the aging process, a result of the stresses placed on teeth from a lifetime of chewing and biting.
Fortunately, there was an orthodontic solution for Bates, and one compatible with her film career. Instead of traditional braces, Bates chose clear aligners, a newer method for moving teeth first introduced in the late 1990s.
Clear aligners are clear, plastic trays patients wear over their teeth. A custom sequence of these trays is developed for each patient based on their individual bite dimensions and treatment goals. Each tray in the sequence, worn in succession for about two weeks, places pressure on the teeth to move in the prescribed direction.
While clear aligners work according to the same teeth-moving principle as braces, there are differences that make them more appealing to many people. Unlike traditional braces, which are highly noticeable, clear aligners are nearly invisible to others apart from close scrutiny. Patients can also take them out, which is helpful with eating, brushing and flossing (a challenge for wearers of braces) and rare social occasions.
That latter advantage, though, could pose a problem for immature patients. Clear aligner patients must have a suitable level of self-responsibility to avoid the temptation of taking the trays out too often. Families of those who haven't reached this level of maturity may find braces a better option.
Clear aligners also don't address quite the range of bite problems that braces can correct. Some complex bite issues are thus better served by the traditional approach. But that gap is narrowing: Recent advances in clear aligner technology have considerably increased their treatability range.
With that said, clear aligners can be an ideal choice for adults who have a treatable bite problem and who want to avoid the appearance created by braces. And though they tend to be a little more expensive than braces, many busy adults find the benefits of clear aligners to be worth it.
The best way to find out if clear aligners could be a viable option for you is to visit us for an exam and consultation. Like film star Kathy Bates, you may find that this way of straightening your smile is right for you.
If you would like more information about tooth straightening, please contact us or schedule a consultation.
Dentists remove millions of teeth each year, often because of tooth decay or gum disease. But disease isn't the only reason—a tooth extraction might make it easier to straighten a crooked smile.
Realigning teeth for therapeutic or cosmetic reasons is a regular undertaking in dentistry, but the process itself often differs from person to person. Each individual patient requires their own treatment plan taking into account factors like the kind of bite problem involved, the size of the jaw and the space available to move teeth.
This plan could indeed involve removing teeth. For example, an abnormally small jaw could cause crowding. Not only can crowding move teeth out of position, it may also leave little to no room for moving teeth. Although dentists can minimize crowding by influencing jaw development in early childhood, removing teeth for more space is usually the only option available to older adolescents and adults.
Similarly, teeth can fail to erupt properly and remain partially or fully submerged beneath the gums (known as impaction). There is an orthodontic method for pulling an impacted tooth fully onto the jaw, but only if the tooth isn't too far out of alignment. Otherwise, it may be better to remove the impacted tooth and then correct any gaps with braces or a dental implant.
There's also a situation on the opposite side of the spectrum that could benefit from teeth removal—when one or more permanent teeth fail to form, known as congenitally missing teeth. This can cause gaps in the smile or a “lopsided” appearance where a tooth on one side of the jaw is present while its counterpart on the opposite side of the jaw is missing.
The missing tooth can be replaced by an implant, bridge or other restoration. But another option may be to remove the existing counterpart tooth, and then close the gaps. This can result in a much more attractive smile that might be simpler and less costly than replacing the missing tooth.
Again, the decision to remove teeth to improve smile appearance depends on the patient and their particular dental condition. But in the right situation, it could make straightening a smile easier and more effective.
If you would like more information on orthodontic treatments, 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 “Removing Teeth for Orthodontic Treatment.”
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