Smile Enhancements for Healthy Aging

Earlier this month, we discussed common dental problems which affect us as we grow older and how to address them.  In this installment, we will describe three popular methods to improve both the appearance and the function of your teeth. At the end of this article, we will reinforce what we believe to be the best ways to improve the health and beauty of your smile.

smile enhancementsYou may be surprised to hear about the first popular procedure which has increased in frequency over the past several years.  Once considered only appropriate for adolescents and teenagers, orthodontics has become an excellent means for adults (even those well into their 60s) to improve their smile, take years off their facial appearance, and improve their self-esteem.  This, in turn, improves their overall outlook on life. Alternatives to the metal braces commonly seen in the past have grown in popularity as they have become more comfortable, effective and invisible.  In our office, Invisalign™ orthodontics has proven to be a discrete and successful method for adults to address bite issues and crooked teeth.  Even patients who had braces as a teenager find the system an excellent way to realign teeth which have relapsed over the years.

invisalign, smile enhancements

Invisalign™orthodontic treatment, combined with either tooth bleaching and/or bonding, can help you to achieve your dream smile, improve your appearance, help you look younger, and feel a renewed sense of self confidence.  In addition, a properly aligned bite serves to preserve your overall health and well-being.  Teeth which are not aligned and bites which are not properly balanced are much more at risk for a variety of dental issues.  These issues include tooth fractures, tooth wear, loosening teeth, gum recession, ineffective chewing ability as well as a variety of jaw, neck, and shoulder pain and headaches.

The second popular dental enhancement which has steadily gained in popularity over the last twenty-five plus years is implants. Titanium implants have evolved and become a staple in the replacement of missing teeth for those who wish for comfort, convenience, and excellent appearance. Implants can be used in a number of different ways to replace missing teeth. The simplest way, of course, is for replacing a single missing tooth. But implants can also be used to replace a series of missing teeth or even an entire arch of missing teeth. Contrary to popular opinion, the placement of implants does not involve significant discomfort and their success rate is very high.

implant, smile enhancements

There are many patients who have struggled with dentures for years. Such patients have had as few as two implants placed to stabilize their existing dentures. The benefits of such procedures are astounding for those who have struggled to eat and speak with loose plates for years. We even see patients who are about to lose all their remaining teeth in one or both arches. Such patients can have their hopeless teeth removed, four implants placed, and a set of teeth mounted on those implants all in a single appointment. That procedure is called “All-On-Four” and requires collaboration between a prosthetic dentist, an implant surgeon and a laboratory technician.  The results in these cases are life changing.

The third popular smile enhancement involves bonding or porcelain to restore worn, broken, or otherwise damaged teeth. “Bonding” utilizes tooth-colored filling material which is placed on one or a group of teeth to restore natural appearance, shape, and color. Similarly, porcelain is used in more advanced cases for those patients who wish to have the most long-lasting and cosmetic solution to their dental problems. Porcelain can be used to cover the entire tooth or limited areas of the tooth as needed in any given situation. The porcelain is bonded to the teeth which results in a very strong, cosmetic, and natural result.

Bonding and porcelain can be used to enhance smiles in a number of different ways. Teeth which have mild misalignment can be made to look perfectly aligned instantly using these materials. Similarly, problems with symmetry, proportion, color and shape can all be addressed using these materials. The next time that you are in our office, make sure to look at some of the photographs on our walls which exhibit the results gained by using these materials.

Finally, let us reiterate the best ways to ensure healthy aging at least as far as oral health is concerned.  As we grow older, we are all more prone to have decay which can sometimes develop very quickly.  It is not uncommon for adult patients to have some gum recession which results in the exposure of root surfaces.  Such surfaces are very prone to decay and must be carefully monitored both at home and in the dental office.  In addition, as our gums recede, food is more likely to lodge between the teeth creating another cause for decay developing.  Increased use of medications and other medical issues may lead to a condition of dry mouth.  Without the buffering effects of saliva, the likelihood for increased dental decay as well as gum disease is highly likely.

dental care, smile enhancements

So what is one to do to prevent an increase in gum disease and dental decay? Here are our favorite as well as most effective recommendations:

  1. Use an electric toothbrush and brush where the teeth and gums meet.
  2. Clean between your teeth with an appropriate sized tool. Large spaces require a proxy brush and smaller spaces require fluffy floss.
  3. Brush before bed!
  4. Rinse with a fluoride mouthwash especially before bed.  During this month we have been handing out Listerine Zero which is a good product found in the grocery store but any similar product which includes no alcohol can be used.
  5. Have regular checkups! This is the best way to make sure that small problems do not become big ones! In the past few years, we have seen more and more patients who have returned after extended periods with more severe problems. Regular checkups will save you money and give you more peace of mind.

In closing, cosmetic dentistry may be key to a person’s health in later life.  Here is a quote from a cosmetic dentist in Texas:

“We often hear older patients just wanting things patched up as opposed to getting something aesthetic. They may have the idea that they are not worth it, or their families have the idea that they are too old for cosmetic dentistry. This may lead to an attitude that things are ending.

“Improving an older person’s mouth can bring them more happiness and joy, not only by improving chewing efficiency, but also bringing joy back. They will want to smile more.”

If you have any questions concerning this article or any other dental questions, please call our office at 908.359.6655 or contact us via our website at www.designsfordentalhealth.com.

 

 

A Healthy Mouth and Healthy Aging

For over 20 years, September has been designated healthy aging month. This is an annual celebration of the positive side to growing older. During this month, a variety of sources provide Inspiration and ideas for baby boomers and adults aged 45 and above to help them to improve their physical, mental, social, as well as financial well-being.  It is our hope that we at Designs For Dental Health can provide some pertinent information to contribute to our fellow baby boomers.

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It is interesting to note that there are over 76 million baby boomers today over the age of fifty and the first of the 82 million Generation X-ers are about to reach that milestone in 2015.  Why not use September as a time to look back on where you’ve been and consider what you might truly like to do with the rest of your life.  If you’re happy and fulfilled with what you’re currently doing, keep on keeping on!  If not, this is definitely the time to make a change.  From my point of view, I’m happy to keep on doing what we, as your dental care providers, love to do most.  Help to keep you healthy! dreamstime_l_21764121

So, with that in mind, here’s our question for you today: How’s your smile? 

  

First of all, research supports the idea that those who smile more are just plain happier.  Secondly, those with a healthy mouth are much less likely to develop a myriad of diseases commonly suffered by those of us in the 60+ population. So ask yourself- when is the last time that you had a comprehensive dental examination to determine your overall oral health and the best methods used to maintain it?  I promise to provide such a comprehensive examination free of charge for anyone over age 55 who has been a patient in our practice for more than 5 years and who requests it.  That’s right!  All you have to do is ask! I’ll sit down with you for as long as it takes to discuss your concerns and desires.  Then, we’ll do a comprehensive examination including an oral cancer screening, evaluation of your teeth, gums, and bite. Together, we’ll discuss any options that might be available to you to improve your dental health and from that discussion we will arrive at the best treatment plan for you.

 

Consider this – a mere 60 years ago, it was assumed that we would lose all of our natural teeth as we aged.  Now we know that a healthy mouth and teeth will help you to not only look good, but to eat delicious and nutritious foods, to speak clearly and to be confident.  An excellent quality of life demands a vibrantly healthy mouth.  Just consider the fact that those whose oral health is subpar are at risk for various serious medical conditions including: heart disease, stroke, diabetes, pneumonia, cancer, and various other diseases which are common in older adults.

 

What are some common oral health problems?

 

  1. Dry mouth.   Reduced salivary flow is most commonly the result of cancer treatments, the use of certain medications, and certain diseases. Dry mouth is a significant cause of decay and gum disease in older patients because saliva serves to buffer acids that are produced as we eat.  Without the protection of these buffers, rapidly advancing problems occur. 

  2. Darkened teeth.   Our teeth tend to darken with time as the pulp in our teeth recedes and the outer layer of enamel becomes thinner, thus allowing the darker dentin to show through. There are various methods available to whiten the teeth for a more youthful appearance.  These techniques do not harm teeth and most patients are extremely happy with their whiter, more beautiful smiles. 

  3. Root decay. As the gums recede, exposure of the tooth roots result. Exposed root surfaces are less resistant to decay than enamel and decay here is quite common. Good brushing and plaque removing habits go a long way to protect these surfaces. In addition, the judicious use of fluoride rinses can be most helpful to protect these exposed surfaces. 

  4. Gum disease. Inflammation of the gums and resulting bone loss in more advanced cases is quite common in adults over the age of 50.  Gum disease is worsened by poorly fitting tooth restorations, less than ideal dietary choices, and certain diseases like anemia, cancer, and diabetes.  The best way to fight gum disease is to practice excellent oral hygiene and have regular dental exams and cleanings as recommended in your particular case. 

  5. Tooth loss. Gum disease is the number one cause of tooth loss; however, teeth which have broken due to old, large silver fillings or simple attrition require prompt attention to avoid unnecessary loss of teeth!  Restoring a broken tooth is always better and less expensive than losing a tooth and later trying to replace it. 

  6. Uneven jawbone. This common problem is a result of premature tooth loss.  Once a tooth is lost, the bone previously around that root vanishes and teeth adjacent to and opposing the missing tooth will shift.  This causes an uneven bite and places for food and bacteria to become trapped. 

  7. Oral cancer. Routine examinations are essential to identify possible cancerous conditions in the mouth. Always report unusual lumps or bumps or discolorations to your dentist or hygienists promptly! 

So what is the best way to maintain your good oral health?  It’s the same regardless of your age!    

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  1. Brush at least twice a day with good quality toothpaste as recommended by your dentist or hygienist. The most important time to brush is just before bed!! 

  1. Floss or otherwise thoroughly clean between your teeth at least one time each day. 

  1. Visit your dentist or hygienist on a regular basis as recommended by them for regular cleanings and oral examinations.  

  1. Use appropriate rinses or fluorides or other such adjuncts as recommended by your dental professionals. 

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If you have any questions about healthy aging month or would like a complementary comprehensive examination please call us at 908.359.6655 or contact us via our website at www.DesignsForDentalHealth.com

Alzheimer’s Disease And The Oral-Systemic Connection

Infections in the mouth are now considered as potential risk factors for the progression of Alzheimer’s disease. Studies have shown that inflammation – like that which results from dental disease like periodontitis (gum disease) – has a role in the development of dementia and Alzheimer’s disease. Inflammation caused by specific bacteria in the mouth cause an inflammatory cascade throughout  the body which impacts our systemic health.

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A dental infection can cause severe illness requiring hospitalization.  Such infections are more common than most people might think. Some months ago, one of our patients postponed an appointment during which a tooth infection was to have been treated.   This infection was found on an x-ray, and this patient had no pain or other obvious symptoms of a problem.  Several days after the original appointment we received a call from the patient that she had developed severe swelling over her eye.  This infection ultimately resulted in this patient’s being hospitalized for four days and requiring IV (intravenous) antibiotics.

Just to be clear, oral diseases which are more chronic in nature than the example above may not only be direct causes of systemic disease. They indirectly cause an increase in severity especially in those diseases which are known to be inflammatory in nature.  It is clear that eliminating oral inflammation reduces the inflammatory impact on many systemic inflammatory diseases including cardiovascular disease, diabetes, and rheumatoid arthritis. Although Alzheimer’s disease is generally not considered to be inflammatory disease, inflammation does have a role in accelerating the progression of this disease.

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CBS News’ 60 Minutes produced a wonderful show about aging                                   which presents interesting information about Alzheimer’s Disease.

Here’s a link to view this show: 

www.CBSnews.com/news/living-to-90-and-beyond/

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Research has identified five specific pathways by which gum disease and oral infections seem to influence the progression of Alzheimer’s disease:

1. Bacteria from the mouth can directly enter the bloodstream.

2. These bacteria cause systemic (whole body) inflammation impacting Alzheimer’s disease.

3. The bacteria P. gingivalis plays a role in the formation of blood clots and thereby cardio vascular disease and strokes which are both risk factors for Alzheimer’s disease.

4. Germs from the mouth can travel directly to the brain.

5. Some people have a genetic predisposition which can increase the effects of oral inflammation

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To summarize, the ways by which oral infections and periodontal disease affect disease progression is not always direct. However, the link between diseases of the mouth and body is established, and the evidence is clear that maintaining a healthy oral environment is crucial to minimize the progression of various systemic diseases including Alzheimer’s disease.

If you have any questions about the oral-systemic connection or diseases of the mouth, feel free to call us at 908.359.6655 or contact us via our website at www.DesignsForDentalHealth.com

Snoring, Sleep Apnea and Dentistry

Continuing our discussion concerning the health connection between the mouth and the body, we will review the condition known as Obstructive Sleep Apnea, its common symptoms and what can be done to minimize the potentially devastating effects of this disease.

Obstructive Sleep Apnea or OSA is a potentially serious sleep disorder in which patients repeatedly stop and restart breathing during sleep. The throat muscles intermittently relax during the sleep cycles, and the airway becomes  temporarily blocked.  The muscles normally support the soft palate and tongue. When these muscles relax, the airway either narrows or closes as a breath is taken, and the flow of air is blocked. As a result the blood level of oxygen is reduced, the nervous system thereby senses impaired breathing and awakens the patient so that an open airway is restored. These events can occur as many as forty or even more times each hour throughout the night. The end result is an inability to reach the normal, deep, restful and necessary phases of sleep.  This lack of quality sleep results in sleep deprivation.

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People with sleep apnea usually snore (often loudly), may wake during the night with  gasping or choking, or may seem to stop breathing periodically according to their bed partners. OSA is most commonly seen in middle-aged and older adults and people who are overweight.  Men are more frequently affected, but women and children may also exhibit symptoms of Sleep Apnea.

Common signs and symptoms of obstructive sleep apnea include:

  • Snoring (often loudly)
  • Episodes of interrupted breathing during sleep
  • Abrupt  awakenings during the night
  • Daytime drowsiness
  • Dry mouth or sore throat in the morning
  • Morning headaches
  • Mood changes including depression or irritability insomnia

In addition, certain factors increase the likelihood of a patient’s having Obstructive Sleep Apnea.  Those with one or more of these signs are urged to speak with their primary care physician about the need to be tested for OSA. These factors include:

  • Being overweight
  • Having a neck size greater than 17 inches for men and 16 inches for women
  • Having high blood pressure especially if resistant to medications
  • Having a narrow airway possibly due to enlarged tonsils and/or adenoids
  • Chronic nasal congestion
  • Diabetes — type I or 2
  • Family history of sleep apnea
  • Smoking
  • Frequent use of alcohol

 

If a patient is unaware of their Sleep Apnea condition or if is left untreated, a variety of complications may develop.  Conditions associated with OSA include:

  • Cardiovascular problems including high blood pressure, coronary artery disease, heart attack, as well as heart failure and stroke and heart arrhythmias.
  • Daytime drowsiness, fatigue and irritability as well as difficulty concentrating.
  • Children with OSA may have problems in school and commonly have attention or behavior disorders.
  • Sleep deprived partners — commonly bed partners may choose to sleep in a separate room.

 

In addition to seeking the advice of your doctor, there are steps that you can take to at least minimize the effects of OSA.

  • Try to sleep on your side
  • Avoid drinking alcohol close to bedtime
  • If you are drowsy, avoid driving or using machinery
  • If you are overweight  lose weigh
  • Exercise regularly
  • Quit smoking
  • Use nasal decongestant

If you are diagnosed as having Obstructive Sleep Apnea, there are three traditional therapies which are used to control this condition.   The first is positive airway pressure in which a device called a CPAP is worn over the nose and/or mouth while you sleep.   It employs a steady stream of air to maintain an open airway.

Continuous Positive Air Pressure (CPAP)

Continuous Positive Air Pressure (CPAP)

The second is a dental appliance which is designed to hold the jaw in a downward and forward position.  In this position, the tongue and soft tissue at the back of the mouth are held  to effectively maintain an open airway. These devices are also used to minimize or eliminate snoring.

                                      Sleep Appliance
                                              Somnodent Sleep Appliance

Third, there are various surgical procedures which may be appropriate for some patients.

If you have any questions about obstructive sleep apnea or the oral appliances which are used to treat this disease, please call us at 908.359.6655 or via our website at www.DesignsForDentalHealth.com

 

 

 

Gum Disease, Inflammation, and Your Health

All of our body’s organ systems are interconnected. What happens in one system can and often does affect other systems. One prominent and currently emphasized interrelationship is the one between periodontal (gum) disease and cardiovascular disease. And in particular, it is inflammation which is the common link between these two conditions.

Inflammation by itself is not a bad thing. Acute inflammation is the body’s normal response to injury and infection. This type of inflammation is experienced as redness, pain and swelling. Immediately after an injury, there is a biochemical reaction which improves blood flow to the affected area. Nerve and other cells send out signals to recruit white blood cells which help fight foreign bodies. This acute inflammation is absolutely necessary for normal good health.

There is another kind of inflammation which is our main concern in this article. That is chronic inflammation which is also known as low–grade or systemic inflammation. This inflammation is long–lasting and examples include autoimmune disorders like rheumatoid arthritis and lupus. In these cases the body mistakenly initiates an inflammatory response even though there is no actual infection or injury to be fought. Other examples of chronic inflammation include inflammatory bowel diseases like ulcerative colitis and Crohn’s disease.

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Chronic “hidden” inflammation occurs throughout the body when something engages the immune system. This engagement varies from person to person but may include repeated or prolonged infection, smoking and gum disease. Obesity also makes one prone to inflammation as fat cells turn out inflammatory proteins called cytokines. Most people don’t know that they are inflamed. There is a test which measures the inflammatory marker called the C–reactive protein but it is not used routinely to determine increased risk of associated diseases. The important point is that inflammation is the primary cause for most of our serious chronic diseases including cardiovascular disease, diabetes, cerebrovascular disease, rheumatoid arthritis, and Alzheimer’s disease to name but a few.

As far as the connection between gum disease and cardiovascular disease, research indicates that heart disease, clogged arteries, stroke and bacterial endocarditis may all be linked to oral health. Researchers believe that gum–disease–producing bacteria enter the bloodstream and make their way to the heart. And just as these bacteria create chronic inflammation and damage of the gums and bone around the teeth, the same bacteria can cause a similar response in the blood vessels. Inflammation can begin and accelerate the build-up of plaques with in blood vessels – called atherosclerosis or hardening of the arteries. These plaques decrease the flow of blood to both the heart and the brain, and if such a plaque breaks free can result in a heart attack or stroke.

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What can you do? Roughly 75% of adults have some form of gum disease and 30 % have moderate to advanced periodontitis. Those with more advanced gum disease are much more likely to develop associated inflammation-related heart disease or stroke or the other inflammation-related illnesses. Having a thorough periodontal examination and following up with necessary gum disease periodontal therapy is the best first step. Avoid the obvious creators of inflammation which have been proven to be unhealthy. Prime examples are smoking and heavy drinking of alcohol.

There are many who advocate an “anti-inflammatory” diet. Many of the recommended foods would be typical of Mediterranean cuisine and certainly represent good nutrition. Such a diet would include:

• Generous amounts of fruits and vegetables

• Using healthy fats like olive oil

• Eating small portions of nuts

• Drinking red wine in moderation

• Eating fish regularly

• Limiting or eliminating red meat

If you would like more information about inflammation, gum disease and your health, please feel free to contact us by telephone at 908.359.6655 or via our website at www.DesignsForDentalHealth.com

Crooked Teeth and Sleep Apnea

As I mentioned in our last blog, we will be describing various connections between oral health and systemic (or total body) health. Today, I’d like to report on a very interesting class which I attended about a week ago. This was an Invisalign Study Club meeting which was meant to increase our skills in planning Invisalign orthodontic cases. But, every now and then, we watch a gifted speaker provide you with much more information than the announced topic would suggest.

My longtime patients know that I have been a lifelong student of dentistry and especially occlusion’s (the bite’s) role in preserving dental health for the long term. I have studied the various connections between occlusion and overall health including TMD and head/neck pain, occlusion and advancing gum disease, as well as occlusion and the airway to name but a few.

Well, at this particular lecture, the speaker showed slides of various patients with crowded teeth as well as some with narrow dental arches. Many of these patients, like many of those I see every day in my office, have what we call, tori, on the inside of their lower jaws. Patients are often aware of these tori, most are generally not bothered by them, but some ask if they should be concerned about them. I had always considered these to be a sign of patients who are chronic clenchers of their teeth, and many of them are. However, the speaker made a legitimate case for the chronic growth of these tori in patients whose teeth are tipped towards the tongue.

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But perhaps I am getting off of the point. The combination of people who have narrow jaws and tooth crowding are very likely to have sleep apnea. I have always known that there is a connection between narrow jaws and sleep apnea, but this presentation made it so clear that patients like those described above do not have adequate space in their mouth for their tongues. As a result, their tongues are forced back into their airways, and the result is sleep apnea.

Such patients may have had orthodontics when they were children,and had four teeth extracted because of their crowding. Such patients are quite likely to have sleep apnea because their jaws are narrow and their teeth have been moved back to where the tongue wants to be to close the space created by the extracted teeth. The tongue is thereby forced to rest towards the airway. Now, I am considering whether or not to treat such patients orthodontically to expand their arches. This is one means of improving their airways and reducing their likelihood of developing obstructive sleep apnea.

When such patients come to my office, they must be carefully screened for obstructive sleep apnea, high blood pressure, adult onset diabetes, cardiovascular disease and other systemic issues which are related to obstructive sleep apnea.

If you have a bite which sounds like the type that I have described above, please contact us so that we can perform a proper screening for obstructive sleep apnea. If you have any questions about your occlusion or sleep apnea, please feel free to contact us by telephone at 609.359.6655 or via our website at www.DesignsForDentalHealth.com

Healthcare Versus Sickcare and the Mouth–Body Connection

Our current healthcare system should more aptly be named “ sick care.” It seems to me that the times are changing and we are at the beginning of a new kind of healthcare which might be called “Integrative Medicine.”

Integrative Medicine focuses on health and wellness rather than just the treatment of disease. Such “healthcare” is dependent on a different relationship between doctors and patients – including dentists. Patients are not just seen when treatment for illness is required. But, this kind of doctoring involves a closer relationship with each patient to determine the specifics of his or her current condition, risk factors, concerns, medical history, family history, nutrition, etc. In this way, the “whole person” is evaluated and using “alternative” medicine as well as traditional “evidence–based” medicine, appropriate personalized care can be provided. Wellness, rather than disease, is emphasized. Prevention rather than just treatment for illness is provided. Wellness and healing are the primary goals.

Did you know that a healthy mouth can add 7.5 years to your life?

From our dental perspective, you may notice some changes in the emphasis of our treatment. We’ll want to stay current with your overall health, the medicines which you are using and your goals for your desired level of well-being.

We hope provide you with adequate information so that you may better understand the interconnectedness of you your “oral” health and your “body” health. Such a relationship is referred to as the oral–systemic connection and explains the relationship between oral–dental health and various body systems’ health issues including:

  •         Heart disease
  •         Diabetes
  •          Pregnancy and childbirth issues
  •         Obstructive sleep apnea
  •         Oral cancer
  •         Inflammatory disease
  •          Nutrition and the ability to chew
  •         Chronic disease
  •         Emotional health and confidence
  •          Etc.

It is our intention to write a series of blog articles about the different connections between diseases of the various body systems and oral health. We will also ask your help by keeping us apprised of your current health and all medicines including non-–prescription supplements which you are taking. We will also, with your permission, keep your primary health professional abreast of your dental condition so that your overall wellness can better be served.

We will offer newer options for your care in our office including DNA testing to better determine your risks of developing chronic oral diseases which research has proven can have detrimental effects on your overall health. It is our goal to help you achieve a higher and more informed level of oral health that has been the norm during the first three decades of my practice of dentistry.

Feel free to ask us about anything “new” which you notice during your upcoming visits. We welcome your comments and thoughts on the subject. Feel free to call us at 908-359-6655 or via our website www.DesignsForDentalHealth.com for questions and additional information. 

Oil Pulling – A Dentist’s View

I first heard about oil pulling several years ago when one of my more “holistic” patients asked about it. Recently, the subject has been raised with increasing frequency. “Oil pulling” is an ancient Indian folk remedy in which oil is used as a kind of mouthwash. This technique is touted to improve oral health as well as provide many incredible detoxification benefits.

What is oil pulling and how does it work?

A tablespoon of oil is placed in the mouth and is swished around the teeth for twenty minutes. During this swishing process, bacteria that are present on the teeth and soft tissues of the mouth become trapped in the oil. Certain bacteria like Streptococcus Mutans cause gingivitis and dental decay, and eliminating them certainly leads to improved oral health. After the twenty minutes, the oil is expectorated (spit out) into the trash, not the sink or the toilet so as to avoid causing a clog.

Various different oils are recommended. The original technique apparently called for sesame oil, but more recently there seems to be a trend toward using coconut and sometimes sunflower oil. It is very important that the oil not be swallowed as all the collected bacteria could lead to systemic illness if ingested. Some people recommend performing this technique every day, while others suggest that four to five times a week is adequate.

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So what are the professed benefits of oil pulling?

This technique acts as an antibacterial and antiviral system, and so detoxifies the mouth and indirectly the entire body. The potential benefits of this treatment include:

  • Whiter teeth
  • Healthier teeth and gums
  • Improvement of acne, eczema, psoriasis and other skin conditions
  • Clearing sinuses and helping allergy sufferers
  • Eliminating halitosis
  • Helping with general pain issues
  • And many more

Is there any truth to all of these claims?

As a matter of fact, there is reason to believe that this technique does provide detoxification benefits. This is one of a number of methods which can be used to clean the mouth so thoroughly that the body is better able to heal itself. Apparently there is a study which was published in 2008 in which oil pulling using sesame oil resulted in a significant reduction in Streptococcus Mutans after two weeks. However, this technique was not as effective as chlorhexidine mouthwash which is commonly recommended by dentists and periodontists to control gum inflammation. In addition, a serious limitation of this technique is that the oil only travels about one millimeter deep into the gums around the teeth, and the more damaging infections are more than three millimeters deep. This technique should not be used by people with active gum disease.

The most interesting thing about this technique is that it highlights the fact that as our oral health improves, so does our general health. Everything in the body is connected. So that improvement in the sinuses, the throat, the cardiovascular system, the skin and various other body systems is a very positive byproduct. When the mouth is healthier, the level of inflammation in the body is reduced, the body is better able then to heal, and we feel better and look better.

Oil pulling may be considered as an alternative to an excellent oral homecare regimen. Such a regimen would include brushing for two minutes twice each day and especially before bed, flossing between the teeth regularly, and perhaps using a WaterPik with an antimicrobial agent on a regular basis as well. Ideally people should have their dentist or hygienist recommend an oral care system specifically designed for him or her. In addition, nowadays we even have a DNA test which can determine specifically which bacteria are present in each patient’s mouth, and if they have the specific marker which might make them more susceptible to periodontal disease.

If you have any questions about oil pulling or would like information about developing a homecare regimen for yourself, please feel free to contact us by telephone at 908.359.6655 or via our website at www.DesignsForDentalHealth.com

All-on-4®, A Dental Miracle

All–on–4® is the name for a technique used in the total rehabilitation of patients who have lost or will soon lose all of their teeth in one or both arches. This system was developed in the 1990s through studies which were funded by Nobel Biocare which has been a corporate leader in the implant industry since the early 1980s.

The All-on-4® treatment concept is a miracle because patients arrive at their dentist’s office in the morning with either no teeth or teeth which cannot be saved in one or both arches.  At that appointment, the implant surgeon (usually a periodontist or oral surgeon), the prosthetic dentist (in this case, me) and a lab technician work collaboratively.  A few hours later the patient leaves the office with a complete set of teeth which are not removable, which function well and which look amazing.

In addition, no grafting is required before placing the implants with this system. Therefore, most patients who have been told that they are not good candidates for implants because of a lack of bone, or large sinuses, or other anatomical circumstances are perfect candidates for the All–on–4® procedure.

There is no grafting, and no lengthy healing time required. Four implants are placed in each treated jaw. This procedure takes advantage of the dense bone which is available in the front of both the top and bottom jaws and places two implants there. Two more implants are placed in the back of the jaws and at an angle to both avoid sensitive anatomic areas as well as to take advantage of available dense bone there. Permanently fixed bridges can then be secured to these four implants immediately because of the solid primary stability which is gained by these strategically placed implants.

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The full dental bridge which is attached to these implants is not removable, has no coverage of the palate, and can be used immediately to eat a complete diet without restriction. After four to six months, a final fixed prosthesis is placed over the implants once total healing is assured.

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The advantages of All–on–4® are many:

1. Get implants in one day with minimal surgery.

2. Entire procedure completed in one location and one day.

3. Avoid the expense and healing time of bone grafting.

4. Have fixed, not removable teeth.

5. Have a complete new set of teeth which look and feel natural – Smile Again!

6. Have the ability to again eat all the foods that you desire.

If you have any questions about the All–on–4® procedure or if you know someone who would benefit from it, please contact us at 908.359.6655 or via our website at www.designsfordentalhealth.com

Your Shimbashi Number And Your Bite

I am writing this article in honor of Dr. Henry “Hank” Shimbashi, a practicing dentist and researcher from Edmonton, Alberta who passed away this week. Dr. Shimbashi was a very influential friend of comprehensive restorative dentists and his research is used every day in offices like mine where problems with the bite and TMJ’s are treated.

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As a result of his research, the Shimbashi number was established to indicate an ideal relationship between the upper and lower jaws. When there is an optimal position of the lower jaw relative to the upper jaw, the muscles which are connected to them will also be at their optimal length and can function ideally.

If the relationship between the upper and lower jaws is altered, one or more of the many muscles of the head, neck and face may be overworked causing them to go into spasm — i.e., be painful. This can happen if the lower jaw is too close to or far from the upper jaw, too far forward or back, or shifted in any direction relative to the upper jaw.

Dr. Shimbashi’s research measured muscle activity in over 500 patients. He found that there was an ideal vertical dimension at which the jaw muscles functioned at their maximum potential. In addition, at this ideal position, patients had no symptoms of muscle pain. This vertical dimension was found to be universally applicable in all age groups and all races.

This simple number which we use is the measurement from the gum line of the upper front tooth to the gum line of the lower front tooth. Dr. Shimbashi found this ideal distance to be approximately 19 mm plus or minus one mm (about three quarters of an inch) when a patient bites.  In our office, we often see patients with bite problems whose Shimbashi number is significantly less than ideal  measuring as little as 10 mm or even less. In such patients, the lower front teeth are often nearly completely covered by the upper teeth. Such patients are much more likely to develop tooth and pain problems resulting from their bad bites.

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So what is your Shimbashi number?  If you have any questions about your bite as a result of this article, please feel free to call our office at 908.359.6655 or via our website at www.DesignsForDentalHealth.com