Posts for: February, 2014
In recent years, the number of teenagers with eating disorders has increased dramatically. According to the National Association of Anorexia Nervosa and Associated Disorders (ANAD), as many as 24 million Americans suffer from some form of eating disorder and 95% of those who have eating disorders are between the ages of 12 and 25.
There are many long-term problems associated with eating disorders, including osteoporosis, infertility and anemia. Another unfortunate side-effect involves dental health. If your child suffers from bulimia nervosa, an eating disorder characterized by a cycle of food binges and vomiting, his or her teeth may show signs of tooth erosion.
Tooth erosion occurs when the tooth surface loses enamel after exposure to acid. It affects more than 90% of individuals with bulimia and 20% of individuals with anorexia nervosa, a disorder that involves starvation. There is often overlap between the two diseases — those with anorexia may sometimes binge and purge, and those with bulimia may try to restrict their food.
Each disorder results in dental diseases for different reasons. In bulimia, tooth erosion is caused by vomit, which is highly acidic and damaging. The frequency that a person engages in this activity will determine how much the teeth are affected. Usually, we will notice this erosion on the upper front teeth. In more severe cases, the salivary glands can become enlarged, causing puffiness on the side of the face. Anorexics, on the other hand, may have dental problems because they are often negligent about grooming and hygiene in general, including oral hygiene.
Every time your teenager visits our office, we will conduct a thorough examination, which includes looking out for the specific signs of eating disorders. If we do find that your teenager has severe tooth erosion, we'll be sure to discuss our findings with you. We may recommend a sodium fluoride mouth rinse to strengthen tooth enamel and reduce its loss. Most importantly, you should speak with your child and seek guidance from a professional to help deal with the issue.
If you would like more information about eating disorders and oral health, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Bulimia, Anorexia and Oral Health.”
All children encounter sickness as they grow; thankfully most of these conditions are relatively mild and fade away in short order. But some children endure more serious, longer lasting conditions. The health of children with chronic diseases can be impacted in numerous ways, including the health of their teeth and gums.
Unfortunately, dental care is often pushed to the side as caregivers understandably focus on the primary disease. In addition, many chronic conditions involving behavior, such as autism, attention deficit and hyperactivity disorder (ADHD) or intellectual disabilities, may inhibit the child’s ability to cooperate with or even perform daily oral hygiene. Many special needs children have an acute gag reflex that makes toleration of toothpaste, spitting matter from the mouth, or keeping their mouths open more difficult. However difficult it may be, though, it’s still important to establish daily hygiene habits to reduce the risk of tooth decay and gum disease.
There are techniques for building a daily routine for children with physical and behavioral limitations. For example, using “modeling and shaping” behavior, you (or perhaps a sibling) brush your teeth with your child to demonstrate how it should be done. If there’s a problem with cooperation, you can also position the child “knee to knee” with you as you brush their teeth. In this way you’ll be able to meet their eyes at a level position and lessen the chance of a confrontation.
We encourage all children to have their first dental visit before their first birthday. This is especially true for children with chronic conditions. The Age One visit helps establish a benchmark for long-term care; it then becomes more likely with regular visits to discover and promptly treat dental disease. This is especially important for special needs children who may have congenital and developmental dental problems, like enamel hypoplasia, a condition where the teeth have not developed sufficient amounts of enamel.
Teeth are just as much at risk, if not more so, in children with chronic diseases. Establishing daily hygiene and regular checkups can reduce that risk and alleviate concern for their long-term oral health.
If you would like more information on oral healthcare for children with chronic diseases, 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 “Managing Tooth Decay in Children With Chronic Diseases.”
Your dental care would be much more limited without our ability to see “below the surface” with x-ray imaging. But since x-rays passing through the body are a form of radiation, could your exposure from them be hazardous to your health?
It depends on exposure dosages and, of course, the amount you have been exposed to over your lifetime. But, decades of research have demonstrated that exposure to dental x-rays during your regular office visits are only a fraction of the radiation you normally encounter from the natural environment every year.
X-rays have the ability to pass through body tissues, but at different rates for soft tissue like skin and muscle and hard tissue like bone. This effect creates shadows on exposed film; the differentiation is in such detail that a trained technician can interpret not only internal structures, but defects such as fractured bone or, in the case of dentistry, signs of tooth decay and bone loss from gum disease.
But like other energy sources in our environment, x-rays do emit radiation that in high doses can be dangerous to living tissue. The amount of exposure is measured in millisieverts (mSv), a unit that allows for comparison of doses from different sources of radiation. Scientists have calculated that we’re normally exposed to between 2 and 4.5 mSv every year.
By contrast, a single digital periapical image taken of a tooth is equal to 1 microsievert (μSv), or one thousandth of an mSv; a full mouth series (between 18 and 20 images) creates an exposure of 85 μSv, or 85/1000 of one mSv. In addition, advances in technology have further reduced the radiation exposure from x-ray imaging. For example, digital imaging has reduced exposure during full mouth x-rays from seven to ten days of equal exposure from normal background radiation to half a day, and with no loss in image quality.
In effect, dental x-rays pose little to no risk for patients. Still, understanding that x-ray imaging does expose patients to radiation, dentists follow certain protocols and safety precautions. For example, dentists will place a lead apron around their patients’ chest area during an x-ray exposure.
As your dentist, we’re happy to address any concerns you may have about x-ray radiation exposure. But rest assured, the x-ray devices used in your dental care, so necessary in the fight against tooth decay and other diseases, are safe and reliable.
If you would like more information on the use of x-ray technology and safety, 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 “X-Ray Frequency and Safety.”
When you think of saliva, the word “amazing” probably doesn’t come to mind. But your life and health would be vastly different without this “wonder” fluid at work in your mouth.
Saliva originates from a number of glands located throughout the mouth. The largest are a pair known as the parotids, located just under the ears on either side of the lower jaw, which produce a thin and watery liquid. The sublingual glands under the tongue produce thicker saliva with a mucous secretion; the saliva from the submandibular glands located under the lower jaw has a consistency somewhere between that of the parotids and the sublingual glands. All these different consistencies of saliva combine to produce a fluid rich in proteins, enzymes, minerals and antibodies.
Saliva performs at least five basic functions in the mouth. First, it washes away food particles after eating and reduces the amount of sugar available for decay-causing bacteria to consume. It protects and disinfects the mouth with antibodies, proteins and enzymes that fight against and help prevent the growth of bacteria. Saliva neutralizes high acidity levels in the mouth, necessary to prevent enamel erosion from acid; and when enamel has softened due to acidity (de-mineralization), the calcium and other minerals in saliva help restore some of the enamel’s lost minerals (re-mineralization). Saliva also aids in digestion by lubricating the mouth and helping the body break down starches in food with its enzymes.
In recent years, scientists have also gained insight into another property of saliva that promises better disease diagnosis in the future. Like blood and urine, saliva contains biological markers for disease. As more diagnostic machines calibrated to these specific markers are developed and used, it could signal a more effective way to identify conditions from saliva samples that are easier to collect than other bodily fluids.
Its less than glamorous image aside, your mouth would be quite a different (and unhealthy) place without saliva. And, developments in diagnostics could make this unsung fluid even more valuable in maintaining your health.
If you would like more information on the importance of saliva to 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 “Secrets of Saliva.”