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Posts for tag: oral health

By Philip Girgis DDS
October 29, 2018
Category: Oral Health
Tags: oral health  
HaveTeethorJawProblemsCheckedBeforeYourNextFlightorDive

Among the “to-do” items on your pre-dive checklist like “Pack wetsuit” or “Fill scuba tanks,” be sure to add one other: “Check my dental health status.”

While that may seem like an odd concern, the changes in atmospheric pressure you encounter while diving (or flying, for that matter) could amplify oral sensitivity and intensify pain if you have pre-existing teeth or jaw problems.

The reason for this is the effect of basic physics on the body. All anatomical structures, including organs, bones and muscles, equalize external pressures the body encounters. We don’t notice this at normal atmospheric pressure, but when we encounter an extreme — either lower pressure during air flight or higher pressure during a scuba dive — we may feel the effects of the pressure on any structure with a rigid-walled surface filled with either air or fluid. These structures can’t equalize the pressure as fast as other areas, resulting in pain or discomfort. This is known medically as “barotrauma,” or more commonly as a “squeeze.”

One structure in particular could have an effect on your upper teeth and jaws: the sinus cavities of the skull, particularly the maxillary sinuses just below the eyes. Their lower walls are right next to the back teeth of the upper jaw and, more importantly, share the same nerve pathways. It’s quite possible, then, for pain from one area to be felt in the other, commonly known as “referred pain.” A toothache could then be felt in the sinus region, and vice-versa.

During a squeeze, then, pain levels from existing problems in the teeth and jaws that were previously tolerable (or even unnoticed) may well become amplified as the pressure from the sinus cavity impinges upon the jaw. That dull toothache you’ve been having may suddenly become excruciating at 30,000 feet — or 30 meters under the surface.

That’s why it’s important to see us if you’ve experienced any signs of tooth decay, gum disease or TMD, including pain, before your next dive or air flight. And, if you encounter any significant pain while flying or diving, be sure you consult with us as soon as possible when you return. Taking action now could help you avoid a miserable, and potentially dangerous, flying or diving experience in the future.

If you would like more information on pressure changes and 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 “Pressure Changes can Cause Tooth and Sinus Pain.”

By Philip Girgis DDS
July 01, 2018
Category: Oral Health
Tags: oral health  
OralHealthCanProveChallenginginYourSeniorYears

A focus on dental care in senior citizens is just as important as it is for children. Indeed, oral health in your later years can be a major factor in your quality of life.

For one, aging effects on other parts of the body can make dental care more challenging. Some hygiene tasks once performed easily become harder — arthritis, for example, or loss of muscle strength may make it difficult to hold a toothbrush or floss. In such cases, you may need to find new ways to make the task easier: a power toothbrush with a larger handle; pre-loaded floss holders or a water flosser; or adaptations to a manual brush to make it easier to hold, like attaching a tennis ball or bike handle.

Other age-related conditions — and their treatments — can negatively impact oral health. Less saliva production, which is a consequence of aging or certain drugs, increases the risk of tooth decay or periodontal (gum) disease. Older adults often develop gastric reflux problems that can introduce tooth enamel-eroding stomach acid into the mouth. And medications called bisphosphonates, often prescribed to treat osteoporosis, may interfere in rare cases with bone healing after tooth extraction or similar procedures.

Prior dental work can also prove challenging to treating dental disease. It becomes more difficult to preserve teeth threatened with decay if there are significant restorations or appliances to work around. Pain perception can also diminish with age, so that dental disease may not be noticed until later stages when significant damage has already occurred.

Oral care requires more attention as we grow older, or as we care for older family members. Your best defense against disease is to continue regular six-month visits with us. In addition to normal cleanings and checkups, we’ll also screen for oral cancer (a more prevalent occurrence in older adults), review your prescriptions or other supplements and medications for any possible side effects to oral health, check the fit of any dentures or other restorations and evaluate the effectiveness of your hygiene.

While other age-related conditions may capture the majority of your attention, you shouldn’t allow that to neglect your dental care. With your continued efforts, along with our support and your family’s, you can continue to enjoy good oral health throughout your lifetime.

If you would like more information on dental care for senior adults, please contact us or schedule an appointment for a consultation.

By Philip Girgis DDS
April 12, 2018
Category: Oral Health
EatingDisordersMayContributetoDamagedTeethandGums

While most dental problems are caused by disease or trauma, sometimes the root problem is psychological. Such is the case with bulimia nervosa, an eating disorder that could contribute to dental erosion.

Dental erosion is the loss of mineral structure from tooth enamel caused by elevated levels of acid in the mouth, which can increase the risk for decay and eventual tooth loss. While elevated acid levels are usually related to inadequate oral hygiene or over-consumption of acidic foods and beverages, the practice of self-induced vomiting after food binging by bulimic patients may also cause it. Some of the strong stomach acid brought up by vomiting may remain in the mouth afterward, which can be particularly damaging to tooth enamel.

It’s often possible to detect bulimia-related erosion during dental exams. The bottom teeth are often shielded by the tongue during vomiting, so erosion may be more pronounced on the unshielded upper front teeth. The salivary glands may become enlarged, giving a puffy appearance to the sides of the face below the ears. The back of the mouth can also appear red and swollen from the use of fingers or objects to induce vomiting.

Self-induced vomiting may not be the only cause for dental erosion for bulimics. Because the disorder causes an unhealthy focus on body image, bulimics may become obsessed with oral hygiene and go overboard with brushing and flossing. Aggressive brushing (especially just after throwing up when the tooth enamel may be softened) can also damage enamel and gum tissue.

Treatment must involve both a short — and long-term approach. Besides immediate treatment for dental erosion, a bulimic patient can minimize the effect of acid after vomiting by not brushing immediately but rinsing instead with water, mixed possibly with a little baking soda to help neutralize the acid. In the long-term, though, the eating disorder itself must be addressed. Your family doctor is an excellent starting point; you can also gain a great deal of information, both about eating disorders and treatment referrals, from the National Eating Disorders Association at their website, www.nationaleatingdisorders.org.

The effects of bulimia are devastating to mental and physical well-being, and no less to dental health. The sooner the disorder can be treated the better the person’s chance of restoring health to their mind, body — and mouth.

If you would like more information on the effect of eating disorders on oral 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 “Bulimia, Anorexia & Oral Health.”

By Philip Girgis DDS
February 26, 2018
Category: Oral Health
Tags: oral health   nutrition   tmj disorders  
AdjustYourDiettoAccommodateTMDtoMaximizeNutrition

Eating is one of the pleasures — and necessities — of life, but people who suffer from temporomandibular joint disorders (TMD) may find eating no pleasure at all — and they may not be eating the right nutritional balance of foods.

TMD is a collection of conditions that affect the jaw joints, connecting muscles and other related facial structures. If you've been diagnosed with TMD, you're probably not only acquainted with severe pain, but also difficulty opening your jaw as widely as normal. This can make it difficult to chew certain foods.

There are a number of effective treatments for TMD, including thermal therapy (hot or cold packs), joint exercise, medication or surgery (as a last resort). But these treatments often take time to make a noticeable difference. In the meantime, you may still need to change what and how you eat to ensure you're getting the nutrients your body needs.

The overall strategy should be to soften and reduce the chewing size of your food. With fruits and vegetables, you'll want to peel and discard any hard or chewy skins, and then chop the fruit flesh into smaller pieces. Steam or cook vegetables like greens, broccoli or cauliflower until they're soft and then chop them into smaller portions. You might also consider pureeing your fruit (and some vegetables) to make smoothies with ice, milk or yogurt, or vegetable-based soups.

Treat meat, poultry or seafood in much the same way, especially biting sizes. Besides cooking meats to tenderness, include moisteners like broths, gravies or brazing liquids to further make them easier to chew.

Dairy foods are an important source of nutrition: eat milk-based products like yogurt or cheese as much as you can handle. If you have problems with these or also nut butters, then consider meal replacement beverages like instant breakfast or whey protein beverages.

And don't forget whole grains. Although some can be hard to chew, you can prepare them in hot cereal form (like oatmeal) to tenderize them. You can also prepare thin bread toast and cut into smaller pieces.

Hopefully, your treatment will bring your TMD symptoms under manageable control. Until then (and after, if need be) adjust your diet to eat the foods that keep you healthy.

If you would like more information on maintaining a healthy diet with TMD, please contact us or schedule an appointment for a consultation.

By Philip Girgis DDS
October 13, 2017
Category: Oral Health
Tags: oral health  
OralHealthConcernsforPreteens

As if the preteen years didn’t give kids and their parents enough to think about, new oral health concerns loom on the horizon. Along with major changes to the body, brain and emotions, additional risk factors for tooth decay and gum disease appear during adolescence — the period of development starting around age 10 and extending through the teen years that marks the transition from childhood to adulthood.

Even with declining rates of tooth decay across the nation, the cavity rate remains high during adolescence. According to the American Academy of Pediatrics, 1 in every 5 adolescents has untreated tooth decay. What’s more, the onset of puberty — usually beginning around age 10-11 in girls and 11-12 in boys — brings changes in hormone levels that can affect gum health.

We all have millions of microorganisms in our mouth, representing hundreds of different species of mostly helpful, but some harmful, bacteria. Research has shown that total oral bacteria increases between ages 11 and 14, and new types of bacteria are introduced, including some that are not friendly to teeth and gums. Some unfamiliar microbes trigger an exaggerated inflammatory response to dental plaque, so gum bleeding and sensitivity are experienced by many children in this age group. In fact, “puberty gingivitis,” which peaks around age 11-13, is the most common type of gum disease found during childhood.

A combination of hormones, lifestyle changes and poor oral hygiene habits raises the risk of oral health problems among adolescents. A more independent social life may be accompanied by a change in eating habits and easier access to snacks and beverages that are sugary, acidic (like sports drinks and soda) or full of refined carbohydrates — none of which are tooth-healthy choices. And as children move toward greater independence, parents are less likely to micromanage their children’s personal care, including their oral hygiene routines. Good oral hygiene can keep dental plaque at bay, lowering the chance of having gingivitis and cavities. But let’s face it: Adolescents have a lot to think about, and keeping up with their oral health may not be top of mind.

To help your preteen stay on top of their oral health, keep healthy snacks at home for your children and their friends and make sure you are well stocked with supplies such as new toothbrushes, floss and toothpaste. In addition, most preteens (and teens) can benefit from gentle reminders about oral hygiene routines.

For optimal oral health through all stages of life, make sure your preteen keeps up with professional teeth cleanings and exams, and talk with us about whether fluoride treatments or sealants may be appropriate for your child.

For more on your child’s oral health, read “How to Help Your Child Develop the Best Habits for Oral Health” and “Dentistry & Oral Health For Children” in Dear Doctor magazine.