Get a grip on your dental health

Posted by Dr. Edward Magida | Filed under , ,

With all we know about dental disease - its causes and its treatment - there is no good reason that anyone should end up losing most or all of their teeth.

Teeth can last a lifetime, and all it takes is the commitment to take care of them.

However, I must still prescribe dentures and partial dentures to my patients when they need them. I do it, but deep down I always get an uneasy feeling, worrying that the patient will eventually have problems with them.

Over the past 12 years, I have treated hundreds of patients with dentures who are either homebound, or reside in nursing homes.

Many of these people had their teeth removed years ago, and now their jawbones have shrunk tremendously. It's harder to make a denture stable when the jawbone is hardly there.

I wish that these people were never talked into having their teeth removed. If the teeth remained, the bone would not have shrunk.

I can be of limited help to them. If the denture is still intact but loose, I will reline the denture, which will make it fit the new, shrunken shape of the gums. If, however, the person has lost too much bone over the years, then even this procedure cannot create miracles. Or bone, for that matter. If the bone is gone, the foundation for the denture, even the most perfect denture, is compromised.

So, what's a person to do?

Think suction cups.

Have you ever seen an octopus? Their arms are lined with suction cup like suckers that create great holding power for the octopus, which puts the creature at a great advantage.

Now those suction cups have been recreated on dentures.

People who have poorly fitting dentures can improve their quality of life with suction cup dentures because chewing is made easier. And that's important. The simple fact is that if dentures don't fit well a person cannot properly chew food, and instead of eating a variety of nutritious foods, the person ends up eating only soft foods.

However, when the underside of the denture is made with all these little suction cups, the retention of the denture improves.

Here's how they work: As the person places the denture, the suction cups engage the gum tissue and grab on, much like a plunger would if you pressed it against the floor. The net result of all these little suckers is a denture that has dramatically more hold. You really have to see these dentures to realize how superior they are compared to the normal type.

If you or anyone you know is having a problem with dentures that don't fit properly, you owe it to yourself to find out about the "dentures from the deep," suction cup dentures. They are truly phenomenal.

Easy solutions to a common problem

Posted by Dr. Edward Magida | Filed under , , , ,

Do you find your co-workers offering you mints or gum all the time? Do meetings end up with you alone at one end of the table? Don't fret, you could be one of the millions of people who have bad breath. Many people don't even know they are offensive to others because most times you cannot smell your own breath.

If you were to believe all the commercials, then all you would need to do would be to use this mouthwash or that and your problems would be solved. Or would it be? Bad breath is a condition that cannot be cured - only controlled. Most breath care products don't really control the problem. They only temporarily cover things up. After about 15-20 minutes the problem starts to come back because the cause of the problem has not been addressed.

The cause of bad breath is bacteria. The oral cavity harbors millions and millions of odor causing bacteria. As the bacteria digest the foods that pass through our mouths, they give off a gas, methyl mercaptan that contains sulfur. Sulfur is the compound that gives rotten eggs their awful smell. It is this sulfur-containing gas which causes a person's breath to smell bad.

So what is a person to do? Trying to eliminate the bacteria from your mouth is impossible. The bacteria recolonize within hours. Most of the mouthwashes that are available have alcohol in them. Alcohol is a good drying agent, but not the best at killing off the bugs in your mouth. In fact, as the alcohol dries out your mouth, the bacteria tend to proliferate on the dried out oral tissues.

Good oral hygiene is a must when you want to beat bad breath. Brushing 2-3 times daily as well as flossing are needed to control bacteria and the plaque they produce. One largely overlooked area of oral hygiene is the tongue. The top of the tongue, especially towards the back, has many ridges and grooves on it. The bacteria in your mouth thrive in these grooves. What also tends to happen on your tongue is that a coating develops on it. The coating is made up of food debris, bacterial plaque, and bits and pieces of dead tissue from the inside of your mouth. If you clean off the top of your tongue on a daily basis, then most of the gas-producing bacteria will be eliminated for most of the day. There are products called tongue scrapers that will help you do this.

The last piece of the oral hygiene puzzle is to use a mouthwash and toothpaste that contains Chlorine dioxide. There are several on the market. The key thing here is twofold. Because there is no alcohol, the mouth rinse will not dry out your mouth and cause bacteria to multiply at a faster rate. The chlorine dioxide is a compound that has been proven to remove the sulfur gases in your mouth for many hours. It is much more effective at controlling bad breath than any other product on the market.

To gauge the extent of the bad breath and also to measure the effectiveness of the treatment, there is an instrument called a halimeter. This instrument is extremely sensitive to sulfur molecules and measures them in parts per billion.

Many times an initial assessment i .

Most times treating bad breath simply requires changing the way a person performs oral hygiene procedures. The problem is easily solved.

The dentist's role in eating disorder therapy

Posted by Dr. Edward Magida | Filed under , , , , , , , ,

Read any women's magazine these days and sooner or later you will encounter an article about eating disorders. Eating disorders are more widespread than ever and getting worse every year.

Often it is a dentist who is the first health professional to recognize the problem.

Dental complications of anorexia and bulimia vary in complexity depending upon the length and severity of the eating disorder and may include the following:

Enamel erosion, called "perimylolosis," is the most common problem and is caused by chronic exposure of enamel to hydrochloric acid of the purge cycle. The most common area involved are the back surfaces of the upper front teeth, but all teeth can be affected. The front teeth over time may appear shorter because the thin edges wear away first and eventually, even when a person closes their teeth together, the front teeth no longer touch.

Over time, the back teeth may become affected as their cusp tips, the pointy areas that grind the food, become rounded off.

Erosion can be accelerated by excessive toothbrushing, especially right after purging when the enamel has been softened and is more susceptible to mechanical wear.

Cavities, caused by the intake of the high caloric foods during the binge cycle and compounded by eroded and weakened enamel.

Hypersensitivity to hot, cold and sweets due to exposure of the dentin, which is the layer of tooth structure under the enamel that is in direct connection with the nerve of the tooth.

Apparent "eruption" of amalgam (silver) fillings, which happens as the enamel around the fillings erodes and makes the fillings seem to grow out of the tooth.

Salivary abnormalities, inducing enlarged parotid glands and reduced flow of salvia, causing "dry mouth" (xerostomia). If the patient is receiving treatment for depression, antidepressant drugs may exacerbate the problem.

Increased risk of gum disease related to reduced salivary flow, nutritional deficiencies, and trauma to the soft tissue in the mouth.

A patient with an eating disorder must be open and honest when it comes to answering questions about their problems. The dentist must be made aware of the person's medical history, nutritional status, previous dental treatment, extent of the binge/purge cycle and whether the person is currently in therapy, The dentist may request permission to consult with the therapist to discuss dental treatment objective, medications and issues of compliance and progress. As in any such situation, confidentiality is strictly adhered to.

Dental care for the eating disorder patient does not deviate markedly from any other patient, and includes:

Emergency treatment and pain management, thorough tooth cleaning and/or periodontal therapy, basic restorative care to restore tooth function, re-evaluation prior to cosmetic or complex treatment.

Extensive oral rehabilitation and elective cosmetic treatment should be delayed until the eating disorder had been controlled.

Cosmetic bonding, porcelain laminate veneers, porcelain crowns and bridges, as well as orthodontic treatment to correct color contour bite and spacing problems are often a powerful motivating factor in a patient's recovery.

By working closely with the psychotherapist and other members of the health professional team, the dentist can help in the intervention, treatment recovery and continued health of the eating disorder patient.