Posts for: May, 2018

By John W. Cox DDS
May 22, 2018
Category: Oral Health
Tags: saliva  
DiseaseDetection-SalivasNewRole

For over a century now, health providers have depended on blood and urine samples to diagnose many forms of disease. Very soon, though, we may routinely use a different bodily fluid that's easier and cheaper to collect: saliva.

Secreted by six hundred or more glands in the mouth, saliva performs a number of important functions for digestion and overall oral health. Saliva lubricates the mouth to make food easier to swallow. Its enzymes begin the digestion process breaking down food even before we swallow. It also helps wash out food particles that could build up as plaque on the teeth and harbor disease-causing bacteria.

In terms of dental health, its greatest role is as a neutralizer of food acid. It's natural after we eat for the acid levels in the mouth to rise above normal. If acid remains in contact with enamel for an extended period of time it can soften the enamel's minerals and make it easier for them to erode. Within thirty minutes to an hour after eating, saliva neutralizes acid and restores the mouth's normal pH level. Saliva also contains calcium and phosphate materials, which helps restore some of the minerals the enamel may have lost from the acid contact.

But we're discovering saliva can do even more: we can now use it as an indicator for certain conditions in the body. Like blood or urine, saliva contains molecules that can serve as biological markers for different types of disease. By employing devices calibrated to detect these markers, we can use saliva to uncover cancer, diabetes or other systemic conditions.

As these particular devices are manufactured and become more available, the use of saliva for disease diagnosis will rise. In the future, you may not need a trip to the bathroom or wince at a needle stick — a swab of your saliva will do!

If you would like more information on saliva's role in your health, 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 “Saliva: How it is Used to Diagnose Disease.”


Implant-SupportedDenturesCouldContributetoBetterBoneHealth

For generations, dentures have helped people avoid the dire consequences of total teeth loss. Now, implant technology is making them even better.

Composed of life-like prosthetic teeth fixed within a plastic or resin gum-colored base, dentures are manufactured to fit an individual patient’s mouth for maximum fit, comfort and performance. But dentures also have a critical drawback—they can’t stop bone loss in the jaw.

Bone is constantly regenerating as older cells dissolve and then are replaced by newer cells. In the jawbone, the forces generated when we chew travel through the teeth to the bone and help stimulate this new cell growth. When teeth are missing, though, the bone doesn’t receive this stimulus and may not regenerate at a healthy rate, resulting in gradual bone loss.

Dentures can’t transmit this chewing stimulus to the bone. In fact, the pressure they produce as they rest on top of the gums may actually accelerate bone loss. Over time then, a denture’s once secure and comfortable fit becomes loose.

In the past, most patients with loose dentures have had them relined with new dental material to improve fit, or have new dentures created to conform to the changed contours of the jaws. But implant technology now offers another alternative.

Implants are in essence a tooth root replacement. Dentists surgically implant a titanium metal post directly into the jawbone that naturally attracts bone cells to grow and adhere to it over time (a process called osseointegration). This not only creates a secure and lasting hold, it can also stop or even reverse bone loss.

Most people know implants as single tooth replacements with a porcelain crown attached to the titanium post. But a few strategically placed implants can also support either removable or fixed dentures. Removable dentures (also called overdentures) usually need only 3 or 4 implants on the top jaw and 2 on the bottom jaw for support through built-in connectors in the dentures that attach to the implants. A fixed bridge may require 4-6 implants to which they are permanently attached.

There are pros and cons for each of these options and they’re both more expensive than traditional dentures. In the long run, though, implant-supported dentures could be more beneficial for your bone health and hold their fit longer.

If you would like more information on implant-supported dental work, please contact us or schedule an appointment for a consultation.


TeenswithMissingTeethmayneedaTemporaryFixUntilTheyreOlder

Dental implants are widely considered by both dentists and patients as the premier choice for replacing missing teeth. Unfortunately, implants aren’t the appropriate choice for teenagers with missing teeth.

That’s because their jaws won’t fully finish most of their growth and development until early adulthood. An implant placed too early could become misaligned as the jaw matures. The best approach for a teenager is a temporary restoration until they’re old enough for an implant.

There are a couple of good options. One is a removable partial denture (RPD), prosthetic (false) teeth set in an acrylic base that mimics gum tissue at the locations of the missing teeth. RPDs, which stay in place by way of metal clips that fit over other teeth, are easy to wear and maintain.

On the downside, an RPD can break if you bite into something too hard. They can lose their fit and may need to be replaced with a new one. And, some teens aren’t quite keen on wearing a “denture.”

Another option is a bonded or Maryland bridge, a kind of fixed bridge. We bond dental material to the back of a prosthetic tooth with portions of the material extending out from either side of it.  We then bond these extending tabs to the back of the teeth on either side of the prosthetic tooth to hold it in place. Unlike traditional bridges, we can eventually remove it without any permanent alterations to the teeth it’s attached to.

Before we undertake a bonded bridge, though, we must make sure the gums and bone of the surrounding teeth are free from periodontal (gum) disease and are healthy and strong enough to support the bridge. We also need to be sure the patient doesn’t have a deep bite or a teeth grinding habit, which could cause the teeth to make contact with the tabs and break them.

The patient also needs the maturity to responsibly perform diligent oral hygiene: this type of bridge has a tendency to build up disease-causing plaque, so brushing twice and flossing once every day is critical. Not doing so increases the risk of tooth decay or periodontal (gum) disease, which could complicate a future implant.

We can discuss these options after a thorough dental examination of your teenager. Either way, we’ll be able to restore your teen’s smile until we can undertake a more permanent restoration.

If you would like more information on tooth replacement options for teenagers, please contact us or schedule an appointment for a consultation.




420 Harper Ave
Lenoir, NC 28645

405 Main Street
Valdese, NC 28690

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