Sunnybrook Dental - Olathe, KS Dentist Blog
Osteoporosis is a major health condition affecting millions of people, mostly women over 50. The disease weakens bone strength to the point that a minor fall or even coughing can result in broken bones. And, in an effort to treat it, some patients might find themselves at higher risk of complications during invasive dental procedures.
Over the years a number of drugs have been used to slow the disease’s progression and help the bone resist fracturing. Two of the most common kinds are bisphosphonates (Fosamax) and RANKL inhibitors (Prolia). They work by eliminating certain bone cells called osteoclasts, which normally break down and eliminate older bone cells to make way for newer cells created by osteoblasts.
By reducing the osteoclast cells, older bone cells live longer, which can reduce the weakening of the bone short-term. But these older cells, which normally wouldn’t survive as long, tend to become brittle and fragile after a few years of taking these drugs.
This may even cause the bone itself to begin dying, a relatively rare condition called osteonecrosis. Besides the femur in the leg, the bone most susceptible to osteonecrosis is the jawbone. This could create complications during oral procedures like jaw surgery or tooth extractions.
For this reason, doctors recommend reevaluating the need for these types of medications after 3-5 years. Dentists further recommend, in conjunction with the physician treating osteoporosis, that a patient take a “drug holiday” from either of these two medications for several months before and after any planned oral surgery or invasive dental procedure.
If you have osteoporosis, you may also want to consider alternatives to bisphosphonates and RANKL inhibitors. New drugs like raloxifene (which may also decrease the risk of breast cancer) and teriparatide work differently than the two more common drugs and may avoid their side effects. Taking supplements of Vitamin D and calcium may also improve bone health. If your physician still recommends bisphosphonates, you might discuss newer versions of the drugs that pose less risk of osteonecrosis.
Managing osteoporosis is often a balancing act between alleviating symptoms of the disease and protecting other aspects of your health. Finding that balance may help you avoid future problems, especially to your dental health.
If you would like more information on osteoporosis and dental care, 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 “Osteoporosis Drugs & Dental Treatment.”
A blow to the face can result in a variety of injuries to your jaws and the temporomandibular joints (TMJs) that join the lower jaw to the skull. Only a thorough examination can determine the type and extent of the injury, and how to treat it.
The pain you feel in your jaw may indicate a direct injury, usually near the joint. This could mean the joint head (condyle) has dislocated, or moved out of the joint space. It could also mean you’ve fractured your lower jaw, most commonly just below the head of the joint.
Jaw pain can also indicate structures near the jaw and joint have been damaged and the jaw is indirectly affected. In some cases a damaged tooth may be radiating pain signals through the jaw (along similar nerve paths). More likely, trauma to soft tissue near the jaw joint has swelled with inflammation, putting pressure on the joint and temporarily stopping the condyle from seating fully in the joint space.
Any of these injuries can also cause painful muscle spasms, a defensive reaction from the body that causes muscles on either side of the jaw to limit movement preventing further damage (a natural splint, if you will). Thus, the pain may be compounded by a diminished range of motion when you try to chew or speak.
It’s important, therefore, to determine the exact cause of pain and limited movement before commencing treatment. Spasms and inflammation are usually treated with muscle relaxant drugs and anti-inflammatory pain relievers. In the case of a dislocation, gentle manipulation can ease the condyle back into the joint space. A fracture would require more extensive treatment, including repositioning broken bone and immobilizing the jaw from movement to allow healing. In the most severe cases, surgical treatment may be necessary to internally immobilize the joint.
If you sustain an injury that results in jaw swelling and pain, you should see us without delay. The sooner we can diagnose and begin the proper treatment for your injury, the less likely you’ll encounter long-term problems and the sooner you’ll be pain and swelling free.
If you would like more information on the causes and treatment of jaw pain, 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 “Jaw Pain.”
Basketball isn't a contact sport—right? Maybe once upon a time that was true… but today, not so much. Just ask New York Knicks point guard Dennis Smith Jr. While scrambling for a loose ball in a recent game, Smith's mouth took a hit from an opposing player's elbow—and he came up missing a big part of his front tooth. It's a type of injury that has become common in this fast-paced game.
Research shows that when it comes to dental damage, basketball is a leader in the field. In fact, one study published in the Journal of the American Dental Association (JADA) found that intercollegiate athletes who play basketball suffered a rate of dental injuries several times higher than those who played baseball, volleyball or track—even football!
Part of the problem is the nature of the game: With ten fast-moving players competing for space on a small court, collisions are bound to occur. Yet football requires even closer and more aggressive contact. Why don't football players suffer as many orofacial (mouth and face) injuries?
The answer is protective gear. While football players are generally required to wear helmets and mouth guards, hoopsters are not. And, with a few notable exceptions (like Golden State Warriors player Stephen Curry), most don't—which is an unfortunate choice.
Yes, modern dentistry offers many different options for a great-looking, long lasting tooth restoration or replacement. Based on each individual's situation, it's certainly possible to restore a damaged tooth via cosmetic bonding, veneers, bridgework, crowns, or dental implants. But depending on what's needed, these treatments may involve considerable time and expense. It's better to prevent dental injuries before they happen—and the best way to do that is with a custom-made mouthguard.
Here at the dental office we can provide a high-quality mouthguard that's fabricated from an exact model of your mouth, so it fits perfectly. Custom-made mouthguards offer effective protection against injury and are the most comfortable to wear; that's vital, because if you don't wear a mouthguard, it's not helping. Those "off-the-rack" or "boil-and-bite" mouthguards just can't offer the same level of comfort and protection as one that's designed and made just for you.
Do mouthguards really work? The same JADA study mentioned above found that when basketball players were required to wear mouthguards, the injury rate was cut by more than half! So if you (or your children) love to play basketball—or baseball—or any sport where there's a danger of orofacial injury—a custom-made mouthguard is a good investment in your smile's future.
If you would like more information about custom-made athletic mouthguards, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Athletic Mouthguards” and “An Introduction to Sports Injuries & Dentistry.”
Most of our patients know a thing or two about stress. Whether you’re dealing with chronic stress, or a brief stressful life circumstance, we all encounter it from time to time. Most people associate stress with heart attacks or ulcers, but do you know how stress can affect your oral health?
Stress may negatively affect your oral health in indirect ways.
For starters, stress can cause folks to reach for coping strategies that aren’t so good for your teeth (or the rest of your body). Junk food, sweets, cigarettes, or alcohol are just a few examples. When these substances interact with your teeth, they can do a lot of damage in the way of gum disease and tooth decay.
Secondly, when we are stressed, we tend to stop making positive health behaviors a priority. Let’s say you’re in the hospital after a car accident; your brushing and flossing routine will not be forefront on your mind. Even a minor bout of stress from a tough day can have us reaching for our cozy bed and some relieve instead of taking the time to brush first.
And of course, keeping up with routine dental visits may fall completely off our priority list while under stress. This can prevent us from finding the early signs of decay and can cause more pain and stress later on.
How does stress affect our mouths directly?
Well, lots of folks grind their teeth as a physical way to deal with stress. You may be doing it without even realizing it! Ask a partner or someone who knows you well to tell you if you have this habit. And if you do, you should definitely be wearing an occlusal guard to help protect your teeth while you sleep. Chronic grinding will wear down the teeth, and it can break fillings/crowns/bridges, and/or cause sensitivity and inflammation.
Also, when we are stressed we have higher levels of stress hormones, such as cortisol and adrenaline, that put our body in a “flight or fight” state. This causes our blood pressure and blood sugar to increase, and our digestive and immune function to decrease. When our immune system isn’t functioning as it should, this can make periodontal disease more likely. It can also slow down the healing of other oral issues or injuries we may have.
What can you do about it? The best thing you can do to prevent the stress of oral health issues is to maintain good dental hygiene and visit us regularly for routine visits. We want what’s best for you — and that includes a healthy mouth for a lifetime!
Typically, when a parent brings a young child to the dentist, the last discussion they’re expecting to have is one centered on braces and orthodontic appliances. Yet, even at young ages, a talk about braces, sagittal expanders, and retainers can indeed be front and center when a child is diagnosed with a crossbite. The question then is what to do about it, how soon should intervention take place, and what the complications are that can arise if nothing is done at all. Let’s get some answers.
What Exactly Is a Crossbite?
Imagine for a moment you’re sitting in front of a nice soup bowl with a wide flat brim, and inside that bowl is hearty chowder you’d like to keep warm until you’re ready to devour it. So, you grab another bowl designed exactly like the first, and hover it upside-down over the bowl containing the soup. As you slowly lower it, you try to line up the brims so when they rest together they form a nice even seal. Unfortunately, given the soup is hot, you don’t quite get the brims to line up perfectly, and the edge of the top bowl ends up resting just slightly to the left of the lip on the bottom bowl. The way these two bowls now rest unevenly atop one another is exactly what you would see in a person with a crossbite. A crossbite can affect several teeth, or a single tooth, and can occur on either one side of the mouth or both. Simply put, if any one tooth (or several teeth) lies nearer the tongue or cheek instead of coming together evenly, you’re likely dealing with a crossbite.
So, What To Do About It And When?
The dental community is split on when to initiate treatment for a crossbite, with some suggesting treatment should begin as soon as it is noticed (sometimes as early as age three!), while others suggest parents should wait until a child’s sixth year molars have arrived. Despite the difference of opinion as to when treatment should begin, dentists and orthodontist are in agreement that the condition cannot be left untreated. Doing so presents a host of complications for the child later in life including gum and tooth wear, uneven jaw development that can lead to temporomandibular joint disorder (TMD), and facial asymmetry – something no parent or child wants.
What Does Crossbite Treatment Look Like?
Crossbite treatment generally involves adjusting the spread of a child’s teeth with dental appliances so the bite pattern matches evenly on all sides. Depending on the type of crossbite a child has, this can be done with dental expanders that resemble orthodontic retainers, and include a screw that is tightened nightly to “spread” a child’s bite to the prescribed width. Additionally, dental facemasks, braces and/or clear aligners may be used – particularly when a single tooth is out of alignment.
Crossbites are generally regarded as genetic in nature, and they’re not overly common. It is, however, a condition that needs to be treated before permanent damage to a child’s facial and oral development occurs. So, if you find yourself at the other end of a discussion about having your little one wear a dental expander, be sure you listen and get however many opinions regarding that advice as you require. Your child, and your wallet, will thank you long into the future.
Dr. Dan practices a certain scope of orthodontics with Invisalign treatment, and he would be happy to answer any questions you might have about crossbites and orthodontics! Ask us at your next appointment!
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