Karen P. Meyers, DDS

Birmingham, MI

1875 Southfield Rd, Birmingham, MI  48009
Phone: 248-646-2450
Experience Excellence in Dental care

Older Mouths: Optimum Oral Health in the Golden Years

older lady pretty teethSeptember begins “National Healthy Aging Month”. This is the time  of year where we  focus on the specific oral health concerns of some of our older patients. Just like the rest of our bodies, our mouths go through changes that can sometimes be challenging, but that can be overcome with renewed attention to dental hygiene and collaboration with our dental practitioners.

One of the biggest changes in older mouths is dryness of the mouth, also known as xerostomia. A dry mouth can be the result of a medical condition, most notably diabetes. Typically, dry mouth is an unintended consequence of taking medications for a variety of conditions: heart disease, diabetes, high blood pressure, certain allergies, and even Parkinson’s Disease.

Whatever the cause, a dry mouth invites disaster into our mouths. We may not think much about saliva, but a sufficient amount of saliva is needed for a healthy mouth. Dry mouth is a symptom of insufficient saliva.

Why is saliva so critical? Saliva coats the teeth and mouth. When it is not there in abundance, the teeth are not bathed and rinsed regularly, and bacteria and food particles “hang out” for too long in the mouth. This brings on a whole host of complications: halitosis (bad breath), cavities and even worse, issues with our gums and more serious infections.

Signs of dry mouth are pretty easy to spot: they can include bad breath (especially when others tell us that our breath smells or offer us breath mints), increased thirst, and dry or cracked lips.

How can dry mouth be treated?

Obviously, you can’t quit taking medications that contribute to dry mouth. But you can do the following to combat dry mouth:

  • Be sure you are getting regular dental care, scheduling cleanings for every six months at a minimum. If your plaque buildup is significant between cleanings, this interval may need to be decreased.
  • Talk to your physicians and your dentist about the combinations of medications you are taking and the side effects that are occurring. It is possible to tweak your drugs so that the xerostomia is lessened.
  • Increase the amount of water you drink, so that you actually feel a moist mouth.
  • Add a third teeth brushing mid-day, so that you are getting rid of bacteria and food particles and not allowing them to settle on your teeth and gums.
  • Consider using an oral rinse, but only if it does not contain alcohol, which can dehydrate a mouth.
  • If it helps you, you can suck on sugarless candies or chew sugarless gum.

Special Patients Need Special Care: Autism and Oral Health

autism ribbon

If you or a family member is on the autism spectrum, you are aware that seemingly mundane, ordinary tasks can become complicated when you are also managing autism and its manifestations. A visit to the dentist, which could provoke anxious feelings in anybody, can become a near crisis for our patients with autism.

But just because something is difficult doesn’t mean it’s impossible. Every person needs regular dental care. Moreover, prevention is far more effective than crisis treatment in both primary health care and in the oral health milieu as well.

What can you do to help make visits to the dentist an easier experience when there are special circumstances? Here are some ideas:

·       Communicate with your dentist and their staff prior to making any appointments.

·       If you are making an appointment for a loved one with autism, be sure that the dentist and her staff understand the scope of their behaviors. Do they communicate effectively? Do they react to verbal and social cues? Do they have any repetitive behaviors? How do they perform their oral health maintenance at home? Do they have any particular sensitivities (to noise, to bright lights, to tastes or textures)? How do they respond to being touched? Are there parts of the face or body where they are more open to touch than others?

·       Schedule a “pre-appointment” where the patient comes, checks in, sits in the chair, meets the dentist and her staff, gets to see the instruments (unless you think seeing the instruments would provoke anxiety) and ask any questions. During this time, the parent or caregiver should determine where he or she should position himself during the dental exam. Does the patient derive comfort from a constant touch on the part of the caregiver or is just being nearby better? Perhaps there need to be several pre-appointments before the “actual” appointment.

·       Be sure that all elements of the pre-appointments and the actual appointment remain the same. Familiarity breeds contentment with this population. So, the person who welcomes the patient to the office and signs them in should be the same every time. The patient should go into the same examination room every time. The same staff should be working on the patient every time.

·       Work with the dentist to deal with any sensitivities. If bright light is a problem, the patient will need to have dark sunglasses. If noise sensitivity is an issue, noise-blocking head phones will be necessary. If the patient is averse to crowds, then an appointment slightly before or after hours would be ideal.

·       Consider alternatives, even if they seem silly. If the patient can’t tolerate the dentist’s chair, try the regular chair. It’s not ideal, but it could work.

·       Consider breaking up cleaning and treatment appointments into smaller time blocks if necessary.

·       Consider anesthetic medication if the treatment is vital and the patient cannot tolerate it.

Finally, it is imperative to work as a team with your dental health practitioners in order to improve the oral health maintenance at home. Depending on the severity of the autism, self-care like teeth brushing and flossing may be difficult and may require the assistance of a caregiver. Work with the dentist and her staff to learn tips for assisting, including the best standing and sitting positions for the parent or caregiver and even ways to increase greater self-care.

 

Tigers, Tobacco and Teeth:

baseball in gloveIt’s a great time to go to a baseball game. But as your oral health care practitioners, there is one element of baseball that makes us crazy. No, it’s not losing the game, it’s not rain delays, it’s not even Cracker Jack (although, please, can you go easy on it?).

No, it’s the sight of those fabulous baseball players spitting. When they do, we can see the clear (or brown) evidence of their usage of smokeless chewing tobacco.

The number of Americans who smoke has been decreasing every year, because of tremendous public relations on the part of not only the Surgeon General, but caring adults, the public, and health care providers who routinely remind their patients not to smoke. That is working.

But the Centers for Disease Control and Prevention tell a different story about chewing tobacco. Chewing tobacco use has not decreased. The CDC further reports that in 2013 a whopping 14.7% of teenage boys reported using smokeless products. It is possible that these boys see their baseball heroes openly using chewing tobacco. It is also probable that the boys enjoy the significant “high” of snuff. It is a more concentrated delivery system of nicotine than cigarettes and the nicotine of smokeless tobacco stays in your bloodstream longer than the nicotine inhaled from smoking.

This is no kids’ stuff. Smokeless tobacco is far from harmless. It contains carcinogens (cancer-causing elements) and contributes to gum diseases, complications following tooth extraction, and significantly, tongue, mouth and throat cancer. Oral cancer has a survival rate of 50%. And smokeless tobacco usage has also been shown to increase the risk for heart disease, high blood pressure and stroke.

Former San Diego Padre and Baseball Hall of Famer Tony Gwynn suffered from multiple surgeries to deal with cancer of the salivary gland, a likely result of his constant use of smokeless tobacco. He lost his battle to cancer and died too young at the age of 54.

Both the American Medical Association and the American Dental Association have called on baseball commissioner Bud Selig to eradicate the use of chewing tobacco and to decrease its visibility on television as a starting measure.

We love baseball and we love the Tigers, but we think it’s time to call three strikes on chewing tobacco.

The Summer Question: How Wise is it to Keep My Wisdom Teeth?

Summer is often the time when people make decisions about wisdom teeth removal, particularly college students and those who are on an academic calendar. So, now is a perfect opportunity for a mini-lesson on wisdom teeth.

The so-called wisdom teeth are the final set of molars that develop in young adults. They begin to erupt and mature in people’s late teens or early twenties, hence the name wisdom teeth, although we know plenty of people in this age group who have not hit their peak of wisdom.

wisdom tooth xrayFor lots of people, there is plenty of room in their mouths and the wisdom teeth can fit right in and become part of their dental landscape. But most people’s mouths just don’t have enough room to accommodate these teeth. As a result, the teeth either are coming in misaligned or are completely impacted.

Misaligned wisdom teeth begun to erupt at the gum line at an odd angle, either twisted or angled, or the teeth could possibly even be completely horizontal. These misaligned teeth do not aid in eating and are detrimental to the alignment of the other teeth, causing crowding, possibly damaging adjacent teeth or even abutting the jawbone or any of the nearby nerves, which could cause pain and infection.

In an even more serious case, wisdom teeth can be not just misaligned, but completely impacted.  Impacted wisdom teeth may not even erupt beyond the gum line, but often lie completely beside the jawbone or within the gum tissue. A partially impacted wisdom tooth could create a hole in the gum, which becomes an entry point for bacteria and infection.  Partially erupted teeth don’t aid eating, but become a magnet for tooth decay and gum disease. In short, they are not beneficial at all.

Extracting Wisdom Teeth

If you and the dentist decide that your wisdom teeth need to be removed, a plan for extracting them will be developed. Often, a referral to an oral surgeon will be made. We have very good relationships with extremely skilled oral surgeons, known for their gentleness and their capability.

If your wisdom teeth have already fully erupted, their extraction is a fairly simple affair, akin to taking out any other teeth and it is possible to do without an oral surgeon.

If your wisdom teeth are partially or fully impacted, their removal requires incisions and stitches and is a more complex procedure.

For any extraction, local anesthesia will be administered to the area. Depending on your anxiety and pain tolerance as well as the complexity of the procedure, other pain-relief measures will be used including general anesthesia and anti-anxiety medications, either given orally or intravenously.

What Do I Do if my Wisdom Teeth Hurt Right Now?

There are several symptoms of wisdom teeth problems. You may be experiencing pain around the area of an erupting wisdom tooth, or even notice a cyst on the gum near where the tooth should be or a flap of skin above the erupting tooth. You could have pain in the jaw, sensitivity in the area when eating or drinking or what feels like a constant ache that will not go away.

Obviously, don’t suffer in silence! Please call us right away so we can evaluate the nature of your mouth pain. In the meantime, you can try some of these at home remedies to give yourself some immediate short-term relief:

  • Place a cold pack on your face near the pain for about 15-20 minutes at a time.
  • Do not put heat on your face (heat causes swelling).
  • You may under certain circumstances take over-the-counter pain medications (but not aspirin for children) like ibuprofen or naproxen.
  • You can rinse your mouth out every few hours with saltwater.

Dental Anxiety: Sensible and Sensitive Solutions

anxiety

Dental anxiety or dental phobia is real. Statistics vary, but one study indicates that at least 9% of the population not only fear going to the dentist, but they put off dealing with dental issues, even serious ones, because of their fears. Some people with dental anxiety report sleeplessness the night before an appointment and jittery behavior, even nausea.

Don’t let your discomfort or anxiety stop you from coming to us. Poor dental care can lead to a whole host of other problems. Instead, let’s work together to get a handle on the nature of your fears.

Why do people fear going to the dentist?

·          Fear of pain

·          Feelings of lack of control

·          Discomfort of a person or persons “invading your space”

·          Fear that anesthesia will be insufficient

·          Nervousness about barriers to communication

·          Previous negative experiences at the dentist

·          General nervousness or anxiety or panic disorders

 What can our patients do to alleviate dental anxiety?

 ·          Tour first, drill second. If you have not been to the dentist in a while, come just for a consultation. We’ll go over what will happen, show you the equipment, and take all of the surprise element out of your future appointment. Sometimes, knowing exactly what will transpire can lessen the anxiety.

·          Communicate! Please share your nervousness with everybody in our office and don’t be embarrassed. Try to tell us if you can what you are most afraid of. Often just talking about it and knowing that we hear you will really tamp down your anxiety.

·          Come up with a cue for when you’re feeling overwhelmed. Prior to even letting us look inside your open mouth, work out with the dentist and the staff a signal that you are feeling nervousness or worse, pain, and we will stop the procedure immediately. The most common signal is just holding up your palm: the traditional “stop” signal.

·          Devise a plan that you can handle. If you feel that you can only tolerate 30 minutes in the dentist’s chair, but your upcoming procedure takes an hour, perhaps there is a way to divide the procedure into smaller chunks of time.

·          Breathe. When you’re nervous, you tend to hold your breath, which just makes your pain receptors more sensitive. Train yourself to take long, slow breaths, maybe each one lasting 10 seconds (you can count slowly to ten).

·          If the sounds of the drill or other dental noises stimulate your anxiety, ask about bringing in music with headphones. You can even listen to the dialogue from a downloaded funny movie. Whatever it takes to distract and calm works for us.

·          Think very carefully about what time of day works best for you when scheduling any visits to the dentist. Are you a morning person or are you so frazzled in the morning that a dental procedure would send you over the edge? Do you take anti-anxiety medicine that needs time to kick in? Choose an appointment time with your mental well-being in mind.

 

What Goes in Your Mouth Stays in Your Mouth: Eating Right for Optimal Dental Health

When you are choosing a healthy, balanced diet, there are so many benefits: better cardiovascular health, maintaining or attaining appropriate weight, but you should also be aware that your choices of food and drinks also can have an effect on your teeth and gums.

In general, following the guidelines of the US Department of Agriculture is a good bet. These include eating more fruits and vegetables, choosing whole grains, consuming low-fat dairy foods, lean meats and proteins and limiting fats and sweets.

woman eating yogurt

When choosing what to eat for meals and snacks, consider these things:

  • Is the food sticky or gummy?
  • Does the food or drink have a high sugar content?
  • Is the food or drink a good source of nutrition or empty calories?
  • Does the food or drink contribute to acid reflux, which can cause damage to tooth enamel?
  • Is the food particularly acidic (even healthy foods like tomatoes can break down tooth enamel)?

Too sweet!

Your body metabolizes sugars and carbohydrates for food, and your mouth turns carbohydrates into oral bacteria. So, watching your added sugar intake is good for your waistline, keeps diabetes at bay and is better for your teeth and gums.

Look out for high sugar and carbohydrate-rich ingredients in your food, and particularly note where this ingredient is listed, as prepared foods list ingredients by order of volume. In other words if the ingredients list sugar near the top of the ingredients list, that means there is quite a bit of sugar in the item than if sugar were listed near the bottom of the ingredients list.

Limit the following:

  • All sugars (cane, brown, powdered)
  • Concentrated fruit juice
  • Corn sweeteners and corn syrup
  • Honey
  • Molasses
  • Glucose
  • Dextrin

Eat lots of the following foods because they contain great nutrients for your teeth:

  • Any calcium-rich foods like milk, cheese, yogurt, leafy greens, almonds, calcium-fortified foods (except fruit juices, which just contain too much sugar)
  • Any foods which contain phosphorous, like poultry, fish, lean meats, eggs and milk
  • Fruits and vegetables that contain Vitamin C and Vitamin A (the water in fruits counteracts the sugars, by the way).
  • Drink lots of water, the best thing for your teeth!

Regarding snacks, nutrition experts vary in their advice. Many recommend snacks between meals and for certain blood sugar issues (diabetes and hypoglycemia), snacking is imperative. The issue with snacks is really a matter of choice. If your go-to snack is a sweet or even a high-carbohydrate snack, then you are adding those elements back into your mouth. If you choose a healthier snack, then you are treating your mouth, your teeth as your gums as your best friends for life!

Brush your teeth after meals…and swimming, too!

swimming mouth in waterYou know that good dental care includes regular brushing and flossing. These activities remove the bacteria from the surface of the teeth, bacteria that can erode your dental enamel, allowing caries (cavities) to form.

 

But the truth is that we need to brush our teeth when we come into contact with anything that is harmful to our dental enamel.  One culprit that we may not necessarily consider is pool water.

 

Swimmers whose faces are submerged in the water whether for fun or for lap swimming increase their teeth’s exposure to the pool water. In general, exposure to pool water isn’t so damaging. What can  cause deleterious effects, however, is pool water that has low pH, which is a measure of the water’s acidity. When the pool water pH dips too low, the water becomes acidic and can erode teeth enamel.

 

Typically, well-maintained public pools have regular maintenance schedules, often times required by public health authorities. These maintenance routines include testing the pH and adding chemicals to the pool to restore the pool water to appropriate pH levels, which range between 7.2 and 7.8. However, swimming in a privately owned swimming pool means that you must assess if the pool water is being regularly monitored and appropriately treated.

 

“Pool teeth” isn’t pretty; it can include teeth sensitivity, staining and enamel loss.  To prevent this, make sure you are swimming in a well-maintained pool. If you are the owner, be sure to monitor pH and adjust the chemicals if necessary.

 

If you are swimming somewhere and your eyes begin to burn or your nose burns, this is a sign that the pH is too low. When the pH is too low, the chlorine is also not working appropriately and is not disinfecting appropriately, allowing harmful bacteria to thrive, in addition to contributing to the dental enamel decay. If you find yourself in this situation, we recommend you end your swimming session and pick up your toothbrush!

 

If you want to take real control of the situation, you can purchase pool pH test strips and run the tests wherever you swim.

Your Toothache Could be Your Sinuses Acting Up!

Toothaches can be so painful!

Most times, you should call your dentist when experiencing tooth pain. But did you know that sinusitis (sinus infection) sometimes feels like a toothache?

Sinuses are the cavities behind the cheeks, eyes, nasal bones and forehead.  Their function is to filter and warm the air you breathe in and to make it moister.  Sinuses also create “empty” space in our skulls to lighten the weight of our heads.

Sinuses do occasionally get infected. There are very small holes that connect the sinuses to your nasal passages. These can easily become plugged. When this occurs, the sinuses can’t drain properly. Mucus accumulates. As a result, your head begins to feel heavy and pain radiates to all of the areas that the sinuses touch due to the increased pressure.

Typically, a sinus-related toothache is bilateral, which means you feel it on both sides of your face. Also, normally when you have a toothache, if you bite down, your pain will increase a lot! But, when you have a sinus infection, this does not occur. Biting down doesn’t make your pain worse.

headacheOther Symptoms of sinusitis:

  • pain or pressure in your face
  • headache pain that worsens when you move your head
  • productive cough (where you cough up phglegm), particularly bothersome in the morning and at night
  • green or yellow mucus
  • stuffy nose
  • fever
  • bad breath (halitosis)

Films’ Attention to Detail, but not Dental….

Are Hollywood actors’ teeth too white and straight?  Does it make it hard to relate to them or see them as the characters they portray?  This article talks about the movies that were Oscar contenders this year and how some of the roles demanded some dental realism that was completely missing.

Here’s the link to a funny article from The Globe and Mail about this issue:  “Molar Opposites”

 

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Karen P Meyers, DDS 
1875 Southfield Road, Birmingham, MI  48009

Phone: 248-646-2450

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