More than 20 million people in the United States use electronic cigarettes or e-cigs as an alternative to tobacco smoking. While many users believe "vaping" is a healthier alternative to regular cigarettes, recent research into the health effects of e-cigs could put a damper on that belief. There's particular concern among dentists that this popular habit could harm users' dental health.
E-cigs are made with a chamber that holds the liquid vaping solution and a heating mechanism to heat the liquid and vaporize it. Users inhale the vapor, which contains nicotine and flavorings, as they would a traditional cigarette.
The nicotine alone can be problematic for dental health as we'll see in a moment. But the vapor also contains aerosols that some research indicates could damage the inner skin linings of the mouth in a similar fashion to the smoke of traditional cigarettes. One study by researchers with the Université Laval in Quebec, Canada found evidence that e-cig vapor increased the death rate of mouth cells, and led to greater cell irregularities over time.
According to other studies, there's evidence that e-cig vapor may disrupt the balance of the oral microbiome, the communities of both beneficial and harmful bacteria that normally live in the mouth. The imbalance in favor of more harmful bacteria could increase the risk for dental disease, particularly periodontal (gum) disease.
Finally, nicotine from e-cigs seemed to create similar conditions in the mouth as it does with tobacco. Nicotine in any form can constrict blood vessels and reduce the body's ability to fight infection and to heal. Research indicates both forms of nicotine increase the risk for dental disease and make treatment more difficult.
These findings only identify conditions created by e-cigs that could be problematic for future dental health. Although we don't fully understand the long-term health effects of this new habit, based on the evidence so far the mouth may not fare so well. It's looking like e-cigs may be no safer for your teeth and gums than the cigarettes they replace.
If your sleeping partner snores, it could be more than an annoyance: it could be a sign of sleep apnea. This occurs when air flow into the lungs becomes obstructed in the throat for a few seconds during sleep. The obstruction can take many forms, but a common one arises from the tongue relaxing against the back of the throat, producing snoring sounds as air attempts to pass through this restricted area.
Sleep apnea can cause severe problems: lower daily energy levels and mood from poor sleep; lower oxygen saturation that could affect brain function; and increased risk for cardiovascular disease. So, if you’re awakened by your partner’s snoring (or they’re complaining about yours!), it’s important to have it checked and treated.
This begins with a visit to us for a complete oral examination. Like many dentists, we’re well trained in the anatomy and structures of the mouth, as well as the causes and treatment of sleep apnea. We’ll examine your mouth, take into account any possible symptoms you’re experiencing and, if your suspicions are correct, refer you to a sleep physician to diagnose if you have sleep apnea.
Treatment will depend on its cause and severity. An oral appliance worn during sleep is the recommended first treatment for mild to moderate sleep apnea that involves the tongue as an obstruction. We develop a custom appliance that helps move your tongue away from the back of the throat, reducing both apnea and snoring sounds. For more advanced sleep apnea you could benefit from a Continuous Positive Airway Pressure (CPAP) machine. This device generates continuous air pressure through a mask worn while sleeping that helps keep the airway open.
Of course, there are other causes for obstruction, some of which may require surgical intervention to relieve the problem. Abnormally large tonsils, adenoids or excessive soft tissue can all restrict air flow. Surgically removing or altering these structures could help reduce airway restriction.
Whatever type or degree of sleep apnea you or your partner may have, there are solutions. The right treatment will not only improve overall health, it will help both of you get a better night’s sleep.
If you would like more information on sleep apnea and how to treat it, 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 “If You Snore, You Must Read More!”
When die-hard music fans hear that their favorite performer is canceling a gig, it’s a big disappointment—especially if the excuse seems less than earth-shaking. Recently, British pop sensation Dua Lipa needed to drop two dates from her world tour with Bruno Mars. However, she had a very good reason.
“I’ve been performing with an awful pain due to my wisdom teeth,” the singer tweeted, “and as advised by my dentist and oral surgeon I have had to have them imminently removed.”
The dental problem Lipa had to deal with, impacted wisdom teeth, is not uncommon in young adults. Also called third molars, wisdom teeth are the last teeth to erupt (emerge from beneath the gums), generally making their appearance between the ages of 18-24. But their debut can cause trouble: Many times, these teeth develop in a way that makes it impossible for them to erupt without negatively affecting the healthy teeth nearby. In this situation, the teeth are called “impacted.”
A number of issues can cause impacted wisdom teeth, including a tooth in an abnormal position, a lack of sufficient space in the jaw, or an obstruction that prevents proper emergence. The most common treatment for impaction is to extract (remove) one or more of the wisdom teeth. This is a routine in-office procedure that may be performed by general dentists or dental specialists.
It’s thought that perhaps 7 out of 10 people ages 20-30 have at least one impacted wisdom tooth. Some cause pain and need to be removed right away; however, this is not always the case. If a wisdom tooth is found to be impacted and is likely to result in future problems, it may be best to have it extracted before symptoms appear. Unfortunately, even with x-rays and other diagnostic tests, it isn’t always possible to predict exactly when—or if—the tooth will actually begin causing trouble. In some situations, the best option may be to carefully monitor the tooth at regular intervals and wait for a clearer sign of whether extraction is necessary.
So if you’re around the age when wisdom teeth are beginning to appear, make sure not to skip your routine dental appointments. That way, you might avoid emergency surgery when you’ve got other plans—like maybe your own world tour!
If you would like more information about wisdom tooth extraction, please call our office to arrange a consultation. You can learn more in the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”
There are a lot of ways to improve the appearance of your teeth. Some methods can be quite involved like crowns or bridgework, which require extensive alteration of teeth to accommodate them.
Other methods, though, can achieve stunning results with less tooth reduction or alteration to your teeth. Porcelain veneers are one such alternative that literally puts a new face on your teeth. A dental veneer is a thin layer of restorative material (usually porcelain) that is bonded to the outside of a tooth to cover blemishes. They’re an excellent choice for dealing with otherwise healthy teeth with mild to moderate chipping, wearing, staining or slight misalignment.
Veneers can be fashioned to match the shape and texture of the prepared tooth, as well as coloring that blends with neighboring teeth. They’re created by skilled dental lab technicians who use porcelain powder mixed with water to create layers of pliable porcelain laminated together to achieve the appropriate thickness and shape. The veneer is then oven-fired to produce a strong, durable product.
Their use in various dental situations does require some tooth preparation, though normally not as much as other restorative measures — usually no more than 0.5 mm of surface enamel. Removing this small amount will ensure the veneer doesn’t look too thick and bulky once bonded to the tooth.
There are some situations, though, where veneers aren’t the best choice: because they’re mainly a cosmetic solution, they can’t remedy problems like poor tooth position and bite or large discrepancies in root position. And teeth that are heavily decayed may require more extensive dental work to repair and preserve them.
In the right situation, though, veneers can make a huge difference to your smile and last for years, as long as you practice effective oral hygiene and don’t subject them to abnormal biting force (no cracking hard shell nuts with them — they can shatter). In skilled hands, veneers can transform your teeth from embarrassing to dazzling.
If you would like more information on porcelain veneers, 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 “Smile Design Enhanced with Porcelain Veneers.”
Oral appliances run the gamut from night guards and retainers to full or partial dentures. Millions of people depend on them for restoring or maintaining dental health.
Today's user-friendly appliances reflect the latest advances in technology. But that doesn't mean you can simply "place them and forget them." Their longevity depends on taking care of them.
The most important aspect of appliance care is keeping them clean. Although bacteria have no effect on an appliance's materials, they can accumulate on its surfaces and raise the risk your natural teeth and gums will be infected. To reduce that risk you should clean your appliance every day.
The best way is with a countertop ultrasonic cleaner. These units emit high frequency sound vibrations that loosen plaque (a thin film of bacteria and food particles) from even the appliance's tiniest crevices. Most units cost between $40 and $60, and pose less of a scratching risk to the appliance's surfaces than manual cleaning.
If you'd prefer to use a brush, there are some dos and don'ts to follow. You can use a cleaner especially designed for your appliance, but less expensive mild dish detergent or hand soap (with an antibacterial agent) will work too. Don't use toothpaste — most contain an abrasive ingredient for removing plaque from enamel that could leave microscopic scratches on your appliance. Use a soft-bristle toothbrush (but not the one you use for your natural teeth) or one designed for your appliance.
While boiling kills bacteria, the high heat can soften and warp the plastic material in an appliance. This could alter how the appliance fits in your mouth, making them loose and uncomfortable to wear. You should also avoid bleach: it can whiten acrylic or nylon designed to mimic the red color of real gum tissue.
Unless we've advised you otherwise, don't wear the appliance around the clock, a practice that raises the chances of bacterial accumulation. And be sure you also brush and floss your natural teeth every day.
Keeping both your mouth and your appliance clean helps ensure the best oral health possible — and that your appliance will last longer.
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