Posts for: May, 2018
There’s been a growing awareness about the effects of gluten, a protein found in grains like wheat, rye and sometimes oats, on certain people. An estimated 1 in 133 Americans have Celiac Disease (CD), a gluten-related disorder that causes the body’s immune system to work against itself. And if you have CD, you could eventually face dental problems like enamel pitting and erosion.
When a person with CD consumes gluten, their immune system mistakenly identifies the protein as malicious and attacks it. The attack occurs in the membranes that line the digestive system, which in the process destroys cilia, tiny hair-like structures that aid in food absorption. This disrupts the body’s normal absorption of nutrients, which can lead to a number of systemic conditions including intestinal cancer.
Because of the lack of nutrients, your teeth’s enamel may develop defects. You may begin to see dull spots or pitting, or chalky grooves in its normally shiny surface: this is a sign you’ve lost surface enamel crystals (decalcification). You may also be more susceptible to outbreaks of aphthous ulcers (canker sores).
Because symptoms can be misdiagnosed or go unnoticed, it may be years before you know you have CD. You can, however, get a definitive diagnosis through a blood test for gluten antibodies, which is then confirmed with a biopsy of a tissue specimen from the intestine.
While there’s ongoing research for CD-related medication, there’s currently only one recognized treatment for it — remove gluten from your diet. This is much harder than it sounds, and requires knowing what you can and can’t eat, along with strict monitoring of food package labeling. Thankfully, the world is becoming better educated in this respect as more food manufacturers are clearly labeling products containing gluten and restaurants are providing gluten-free menu options.
Once you have dietary controls in place, your dental issues can be treated as any other person, with one exception: none of the products used in treatment like polishing paste or fluoride gels should contain gluten, and must be verified before using.
CD is a serious condition that could even become life-threatening. Knowing you or someone in your family has it will help you protect both your overall health and your teeth.
If you would like more information on the gluten’s effect on dental 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 “Gluten & Dental Problems.”
You’re considering dental implants and you’ve done your homework: you know they’re considered the best tooth replacements available prized for durability and life-likeness. But you do have one concern — you have a metal allergy and you’re not sure how your body will react to the implant’s titanium and other trace metals.
An allergy is the body’s defensive response against any substance (living or non-living) perceived as a threat. Allergic reactions can range from a mild rash to rare instances of death due to multiple organ system shutdowns.
A person can become allergic to anything, including metals. An estimated 17% of women and 3% of men are allergic to nickel, while 1-3% of the general population to cobalt and chromium. While most allergic reactions occur in contact with consumer products (like jewelry) or metal-based manufacturing, some occur with metal medical devices or prosthetics, including certain cardiac stents and hip or knee replacements.
There are also rare cases of swelling or rashes in reaction to metal fillings, commonly known as dental amalgam. A mix of metals — mainly mercury with traces of silver, copper and tin — dental amalgam has been used for decades with the vast majority of patients experiencing no reactions. Further, amalgam has steadily declined in use in recent years as tooth-colored composite resins have become more popular.
Which brings us to dental implants: the vast majority are made of titanium alloy. Titanium is preferred in implants not only because it’s biocompatible (it “gets along” well with the body’s immune system), but also because it’s osteophilic, having an affinity with living bone tissue that encourages bone growth around and attached to the titanium. Both of these qualities make titanium a rare trigger for allergies even for people with a known metal allergy.
Still, implant allergic reactions do occur, although in only 0.6% of all cases, or six out of a thousand patients. The best course, then, is to let us know about any metal allergies you may have (or other systemic conditions, for that matter) during our initial consultation for implants. Along with that and other information, we'll be better able to advise you on whether implants are right for you.
If you would like more information on the effects of metal allergies on dental implants, 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 “Metal Allergies to Dental Implants.”
For decades, traditional braces were the only orthodontic choice for moving misaligned teeth. Although they’re quite effective, they can cause discomfort and, for teens especially, embarrassment due to their noticeable metallic appearance.
In recent years, though, technology has produced an alternative to braces that’s proven effective for many types of patients. Besides being less cumbersome and disruptive to everyday life than braces, clear aligners have another advantage that appeals to teens — they’re much less visible.
Introduced in the late 1990s, clear aligners are a system of individual trays made of nearly invisible polyurethane plastic worn over the upper teeth. The trays are computer-generated based on the patient’s individual mouth structure captured in photographs and x-rays. Each tray in the sequence is incrementally smaller in size; the patient begins wearing the first aligner in the series for about two weeks, 20 to 22 hours a day. They then switch to the next tray in the series for about the same amount of time, and continue in this fashion until they’ve worn each aligner in the series.
Besides their improvement in appearance, aligners also have another advantage: unlike traditional braces, aligners can be removed from the mouth for eating or on a limited basis for rare important social occasions. Brushing and flossing are also much easier with aligners, which don’t pose the same access problems as traditional braces.
Clear aligners were once only effective with select types of orthodontic patients, which didn’t always include teens. Over the last decade, however, significant changes to design and additional implements have widened their application to more patients, especially teens. For example, we can now add tiny “power ridges” to the aligner design that give greater precision over desired tooth movement to create a more controlled and efficient force on the teeth. More recent aligners are also being produced with a thinner, more comfortable material.
A thorough orthodontic exam will tell whether your teen is a good candidate for clear aligners. If so, they’ll benefit from a more comfortable and less embarrassing experience while gaining a new smile for life.
If you would like more information on clear aligners, 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 “Clear Aligners for Teens.”