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BEYOND TEETH: WHAT'S INSIDE YOUR MOUTH Good oral health goes beyond brushing and flossing. Find out more about the inside of your mouth and the role its various structures play in speech and digestion. By Connie Brichford Medically reviewed by Niya Jones, MD, MPH Your mouth is made up of more than just teeth, so good oral health goes beyond simply brushing and flossing. In addition to your teeth, your mouth is made up of gums, oral mucosa, the upper and lower jaw, the tongue, salivary glands, the uvula, and the frenulum. All of these structures play an important role when it comes to good dental health and are routinely examined when you receive dental care. The Oral Mucosa When you open your mouth and look in the mirror, everything that isn’t a tooth is covered by a protective lining called the oral mucosa, which is a mucous membrane similar to the mucous membranes that line your nostrils and inner ears. The oral mucosa plays an essential role in maintaining your oral health, as well as your overall health, by defending your body from germs and other irritants that enter your mouth. A tough substance called keratin, also found in your fingernails and hair, helps make the oral mucosa resistant to injury. The Gums Your gums are the pinkish tissue that surrounds and supports your teeth. Also covered by oral mucosa, gums play a critical role in your oral health. Healthy gums are firm, cover the entire root of the tooth, and do not bleed when brushed, poked, or prodded. Gum disease can ultimately lead to tooth loss, so taking care of your gums by flossing daily is just as essential to dental care as brushing your teeth. The Upper and Lower Jaw Your jaws give your face its shape and your mouth the structure it needs for chewing and speech. Human jaws are made up of several bones: The upper jaw contains two bones that are fused to each other and to the rest of your skull, while the lower jawbone is separate from the rest of the skull, enabling it to move up and down when you speak and chew. The Tongue The tongue is a powerful muscle covered in specialized mucosal tissue that includes your taste buds. The tongue is not just important to your oral health — it's also considered an integral part of the body's digestive system — it's responsible for moving food to your teeth, and when chewed food is ready to be swallowed, the tongue moves it to the back of the throat so it can proceed into the esophagus. In babies, the tongue and the jaw work together to enable the infant to breastfeed.Additionally, the tongue plays an essential role in the ability to speak by shaping the sounds that come out of your mouth. The Salivary Glands You have three sets of salivary glands in your mouth and neck: the parotid, submandibular, and sublingual glands. These glands produce saliva, which contains special enzymes that help break down food, making it easier for you to swallow. Saliva is critical to good oral health, because it protects your teeth and gums by rinsing away food particles and bacteria and by helping to counteract acidic foods that can wear down the protective enamel on your teeth. The Uvula The uvula is the small flap of tissue which hangs down at the back of your throat. The uvula is composed of muscle fibers as well as connective and glandular tissues. Like other soft tissue structures in the mouth, the uvula is covered by oral mucosa. The uvula has long been a source of curiosity for scientists as all of its functions are not yet fully understood. However, it seems to play some role in speech and in keeping the mouth and throat moist. The Frenulum Linguae The frenulum is a flap of oral mucosa that connects the tongue to the floor of the mouth. This tissue allows the tongue to move about as it does its job. If an infant is born with a frenulum that is too short, or not elastic enough, he or she can have trouble breastfeeding. A short frenulum can also affect speech. The next time you’re brushing your teeth, spend a minute looking at the parts of the mouth that lie farther inside the oral cavity. Knowing what these structures do and what they look like can help you to maintain optimal oral health.
BENEFITS OF MAINTAINING YOUR TEETH Most people know that maintaining good dental health into old age has many benefits. Those most important include comfort of the teeth and gums, the ability to enjoy food, and a better appearance. Studies have shown that those individuals who have poor dental health have a higher mortality rate than those who were in better dental health. Moreover we can point to the impact of nutrition as the most likely contribution to health. The elderly like younger patients should see their dentist at least twice a year for check ups and cleanings. All cavities, gum disease, and other dental infections should be treated promptly. Patients wearing full or partial dentures should have them evaluated for proper comfort and fit. Dentures that have been worn for many years may not fit well anymore. This happens because the jawbone under the denture can become worn away over time. Loose dentures make it difficult to eat, speak, and do not support the face as well. A loose denture begins to need more and more adhesive to stay in place. Your dentist can sometimes remedy the problem by relining the denture, but a new denture should be made about every 5 to 7 years, or when the dentures cannot be used comfortably. In some cases, implants can be used to help secure the dentures. This is usually needed in the lower jaw and is sometimes the only way to help the patient stabilize and use their denture. Remember, maintaining good dental health along with proper nutrition is a key factor in living a long healthy life.
EARLY DETECTION OF ORAL CANCER CAN INCREASE SURVIVABILITY FROM LESS THAN 50% to 90% ViziLite Plus TM used as Screening Technology Every hour of every day, in the United States, one American dies of oral cancer. This deadly disease is the sixth leading cause of cancer deaths with no significant improvement in the survival rate in the past 40 years; in fact, while the American Cancer Society recently reported that overall cancer deaths and incidence have decreased, the oral cancer death rate increased by 5.5% and the incidence increased by 1.5%. More than 50 percent of patients diagnosed with oral cancer will die within five years. If discovered in its early stages, oral cancer is 90 percent curable, but less than 50 percent curable if discovered in its later stages. To help achieve early detection, we offer patients the benefits of ViziLite Plus TM with TBlue630 Oral Lesion Identification and Marking System, a technology cleared by the FDA for identifying oral abnormalities in patients at increased risk for oral cancer. ViziLite Plus, marketed by Zila Pharmaceuticals is a medical breakthrough that helps professionals detect oral abnormalities that could be early indicators of cancer. ViziLite Plus was developed to improve the traditional method of detecting oral abnormalities. Once pre-cancer or cancer can be seen or felt by a healthcare practitioner, it has possibly already advanced to the late stages where it is considerably less curable. In fact, 70% of oral cancer lesions detected with the traditional exam are detected late, in stage III and IV when the five-year survival rate is 57%. ViziLite Plus is an easy, painless and non-invasive examination. The exam is a three-step process and takes only a few minutes. First, the patient rinses with a raspberry-vinegar flavored solution to prepare for the exam after which the dentist snaps the ViziLite Plus lightstick, activating it so that it glows. The dentist then places the lightstick in a retractor and shines it in the patient's mouth while examining the oral tissue for abnormalities. Abnormal tissue will glow a blue-white color. Once the dentist has ruled out trauma as a cause, the TBlue630 Oral Lesion Marking System, a bluish dye, will be applied to the lesion to help the dentist visualize the precise extent of the lesion. Oral cancer is more prevalent than cervical cancer; it's common practice for women to get a mammogram and Pap smear every year. ViziLite Plus is a screening technology that we have incorporated into our daily practice; it's a way we show our patients that their overall health is important and that dentists and hygienists do so much more than merely checking for cavities. Patients considered high-risk for oral cancer are: age 40 and older, users of smoking or chewing tobacco, currently or within the past 10 years and users of one or more alcoholic drinks daily, including one beer, one glass of wine or one drink of spirits. Patients with any combination of these risk factors, and patients with a personal history of oral cancer, are considered at highest risk. Alarmingly, 27% of oral cancer victims have no lifestyle risk factors. If you have any mouth sores that don't seem to heal or see any suspicious marks or discolorations on your lips, cheeks, tongue, palate or gum tissue, call our office and ask about early cancer detection.
PREVENTING TOOTH DECAY Tooth decay [caries, cavities] is probably the most prevalent disease, affecting almost everyone during his or her lifetime. The good news is that it isn’t life threatening and is essentially preventable. The tooth decay process starts with dental plaque [sticky mixture of bacteria, food & debris]. Bacteria [germs], which naturally live in everyone’s mouth, but thrive in plaque, utilize carbohydrates from your diet, especially refined sugar [sucrose] to produce acid. Acid, if produced frequently, will demineralize [dissolve] the tooth enamel structure, which is the hardest substance in the human body. From there the acid will continue to eat through the underlying dentin layer until the bacteria and their waste products reach the pulp [nerve]. Left untreated, tooth decay can lead to root infection and eventually loss of your tooth. There are visible signs of a cavity. Initially, it will appear as a small white spot, which in time will turn brown. As the decay continues, a hole in the tooth may become apparent. There are also warning symptoms such as sensitivity while brushing or to hot or cold foods or to breathing in air. Of course a painful toothache is a definite sign. Prevention The most important prevention technique is daily removal of plaque with flossing and brushing. If possible, good oral hygiene should be practiced after every meal. Using fluoride to strengthen the enamel and help remineralize teeth is a highly reliable prevention tool. Use only a fluoride, ADA recommended toothpaste. At our office, we give topical fluoride treatment to children up to age 18. We can also fabricate custom trays to be used at home with a gel fluoride for adults who have rampant caries or who are more predisposed to having tooth decay. We also recommend fluoride drops or vitamins for infants who don’t live where the public water supply is fluoridated. Call our office to see if your water is fluoridated. Diet is significant in caries prevention. . Studies have shown that the nature and frequency of sugar intake is more important that the amount. If the sugary food is very sticky like caramel, gummy bears or jam, it will remain on the teeth for a longer period of time. If you or your children are constantly snacking on sugary foods, there is a continuous acid attack on your teeth. What do we do to prevent this potential problem? Avoid having sugar in your mouth for long periods of time. Stay away from sucking candies and chewing gum [unless sugarless] and refrain from drinking soda pop regularly [unless diet]. Try to cut down on the number of snacks per day. If you must snack, substitute foods that most like but don’t promote tooth decay. Examples are popcorn, pretzels, fruits, nuts, cheese, pizza and vegetables. Consuming sugary foods with a meal or for dessert has a less detrimental effect, because increased salivary flow during meals helps to wash the food away. Also, it is usually nearer the time that most people will brush their teeth. Keeping this in mind, it is better for children to eat sweets at a time and place that allows them to brush soon afterwards. As your children are growing, make sure they get plenty of calcium [dairy products] so that their tooth enamel develops properly. Finally, because you may be asymptomatic and unaware of the beginning of tooth decay, it is critical that you visit our office every 6 months for a check-up. Some cavities are hard to detect, especially those between the teeth. Sometimes, only bitewing x-rays can discover them. We will also give you a professional prophylaxis [cleaning], which is an important part of prevention.
HELP! I BROKE MY TOOTH! Almost every day we get a call from a patient who has broken a tooth, and generally it means that to save the tooth, we have to place a crown or permanent restoration over it to keep it from breaking further. Sometimes the tooth can't be saved and that is a real bummer! What causes teeth to break? Well, there are several factors, one of which we see in almost all tooth fractures. The most common contributing factor is Silver amalgam fillings- these fillings have the unique property of enlarging as they age. So, there seems to be some outward pressure on the tooth and if someone bites just the right (or wrong) way, you hear that crack! Now this tooth broke in several planes at once, and had to be removed; there wasn't enough sound tooth structure to save it! So an implant or bridge needed to be done. This is a more common sort of fracture. The inside aspect of the tooth just shears away. Luckily, this tooth can be saved with a crown, after first making sure there is no decay present. The second common factor is bruxism- the habit of grinding or clenching the teeth. Many bruxers break teeth that don't even have fillings in them, but they always have a higher percentage of broken teeth than people who don't brux or clench. If you or someone you know does grind their teeth and are worried about a tooth or some teeth, don't hesitate to give us a call and we will be glad to check it out for you! Don't wait until it hurts!
A BEAUTIFUL SMILE IS PRECIOUS AND PRICELESS Did you know that the shape, shade, length and spacing of your teeth could significantly affect your smile? And our smiles can greatly affect our self-esteem and confidence. Common conditions that impact negatively on your smile include broken, cracked or worn teeth, discolored teeth, missing teeth, crooked teeth, decayed teeth, gaps between your teeth and/or "gummy smiles." The good news is that with modern technology and improved materials, these situations can be dramatically changed to create natural looking and long-lasting beautiful smiles. Each patient and each specific circumstance must be evaluated on its own merits. Factors such as occlusion [bite], oral habits, available space, health of the gum tissue, severity of the problem and patient expectation must be taken into consideration while planning your cosmetic makeover. Depending on the situation, there are a variety of choices that all result in excellent esthetic outcomes. For whiter natural teeth, in-office or at-home bleaching [whitening] techniques are available. Repairing teeth or closing spaces may be accomplished with tooth-colored composite resin bonding, porcelain veneers or porcelain crowns. These procedures vary in time and cost and have differences in longevity and appearance. If you're not satisfied with your smile or want to learn if you're a good candidate for any of these remarkable techniques, call our office for a cosmetic consultation.
WHITENING YOUR SMILE How we look and how we perceive ourselves has much to do with our self-esteem. When the color of our teeth makes us embarrassed to smile, it’s probably time to get our teeth whitened [bleached]. As one ages, teeth may darken from coffee, tea, smoking, berries and other substances that get into microcracks in the enamel causing discoloration. Some people have gray or brown bands on their teeth caused by an early childhood fever or tetracycline medication taken when the tooth enamel was forming. In some parts of the country where fluoride is found in natural high concentrations in the drinking water, individuals have developed teeth with bright white patches or dark brown blotches [mottled enamel or fluorosis]. Everyone is not a candidate for bleaching. Teeth discolored from aging have the best results. If you have tooth colored resin or composite fillings in your front teeth, they will not change color from bleaching and will “stick out like a sore thumb” after the procedure. If you would like to have your teeth whitened, call it to our attention at your next check-up visit. If you are not a good candidate, we can suggest alternatives such as bonding or porcelain veneers. There are various options to whitening your teeth. Bleaching can be an in-office procedure [chairside]. It may involve several appointments of 30-60 minutes each. The bleaching agent is applied to your teeth and activated with a special light. There is also an at-home procedure wherein you will wear a custom-made mouthguard, filled with a bleaching gel, as per instructions from your dentist. Some toothpastes have added whitening agents and can be used as an adjunct to the other two procedures. In any case, there is no reason to ever again suffer the embarrassment of discolored teeth.