Are You Tongue Tied?

Tongue Tied or Ankyloglossia is defined as a person having a short lingual frenum (membrane connecting under side of tongue to the floor of mouth) that prevents full range movement of the tongue. Being tongue tied can cause problems with breast feeding, speech development, eating, and swallowing. It can also prevent good hygiene since the tongue plays an important role in sweeping food and debris from the teeth. The tongue is one o f the most important muscles for speech and swallowing.

Poor oral and dental hygiene because of limitations in tongue mobility or habitual incorrect tongue posture usually results in messy eating habits, with food debris remaining on teeth and lips, and causing dental caries. Commonly, excessive saliva is dealt with by the patient in different ways. Whereas the younger child may dribble profusely, older patients will maladapt, keeping their mouth small during speech, reducing the length of utterances or slurping loudly. Involuntary splashing of saliva during speech occurs frequently and embarrassingly.

Diagnosis can usually be done at a routine visit to our dental office. Early detection is best, therefore, we recommend that children be seen on their first birthday. The following characteristics are common on individuals who are tongue tied:

• V-shaped notch at tip of the tongue.
• Inability to stick out the tongue past the upper gums.
• Inability to touch the roof of the mouth.
• Inability to move the tongue from side to side.
• An infant being tongue tied can often lead to frustration when breast feeding because the infant is unable to latch on or may cause nursing mother significant pain.

Not all patients who have Ankyloglossia need to have treatment. This all depends on how limited the movement of the tongue is. If treatment is needed our standard of care is to remove the membrane to allow the tongue to move freely. The procedure is called a frenulectomy. This is a simple procedure that can be done by using a laser after a topical anesthetic is placed. The procedure takes less than a few minutes to complete and does not need any stitching. Some offices perform this with a scalpel which would then need stitching. This procedure can also be done by just “clipping” the membrane, but the membrane can eventually grow back. This is why our standard is removal with our Waterlase laser. This procedure can be done as early as newborn through adulthood and does not require complicated aftercare...maybe some oral rinses.

If left untreated, adult patients may find that they snore because of the Ankyloglossia. When the tongue does not have free motion it may block the patients airway. Having a frenulectomy is normally a simple procedure with rarely any complications. If you or your child has any of the above symptoms, this simple procedure should be considered because of its many long term benefits, which include:  restoring ease of speech, better nutrition, and self esteem.

Oral Piercings - What You Should Know

Piercing has been practiced in many cultures for many centuries. Body piercing was often identified with royalty and portrayed courage and virility. Egyptian pharaohs pierced their navels as a rite of passage. Roman soldiers pierced their nipples to show their manhood.

Oral piercings remain on the fringe of mainstream fashion, making the process appealing for individuals who want to make a statement or just think its cool!  Despite safety precautions and diligent care, piercing isn’t completely risk-free.

As with traditional earrings, oral piercings come in a variety of styles including rings, barbells, and studs. However, piercing your tongue, cheek, or lips involves a lot more risk than piercing your earlobes. We do get questions from patients at our office concerning these piercings. These patients have asked us if these oral piercings can affect their dental health in some way.

The most obvious oral health concern is infection. This is true of all piercings regardless where they are on the body, but related to dental health, oral piercings can increase risks of gum disease if they are not properly monitored. If your tongue piercing, lip piercing, medusa piercing, or other oral piercing comes in contact with your gums, this can cause irritation that may also lead to gum disease.

Mouth jewelry can crack or chip your teeth if you aren’t careful, so that is another concern to keep in mind. In a dental journal, a study found that approximately 47 percent of people who have a barbell tongue piercing will experience a chipped or cracked tooth within four years of getting that piercing. In some cases, a tongue piercing can cause you to salivate more than usual, which is a normal physiological response. While this is not a severe problem, it may affect your ability to speak as well as your ability to chew and swallow.

Before considering having any sort of oral piercing, take a few minutes to learn about the risks....

                    Infection: Our mouths are filled with zillions of bacteria, putting you at significant risk
                    for infection after an oral piercing.     
Prolonged Bleeding: Sometimes blood vessels are punctured by the needle during piercing which can result in serious blood loss.

Pain and Swelling: Both pain and swelling are typical side effects of oral piercings. In some extreme cases, the tongue can swell up so much that it can block your airway.

Chipped or Cracked Teeth: When a tooth makes contact with oral jewelry it can often lead to tooth damage.

Injury To Your Gums: Metal jewelry can injure your gum tissue and cause your gums to recede, putting you at greater risks of decay and gum disease, and leaving your mouth much less attractive.

Interference With Normal Oral Function: The presence of jewelry in your mouth can cause excessive saliva flow, make it more difficult to chew or swallow, and impede your ability to speak correctly.

Blood-borne Diseases: The National Institutes of Health have identified oral piercings as possible factors in transmitting hepatitis B, C, D, and G.

Endocarditis: The wound that is created from an oral piercing gives the bacteria in your mouth the opportunity to enter your bloodstream where they can travel to the heart, putting you at risk of endocarditis, an inflammation of the heart valves and tissues.
Because there are so many risks surrounding oral jewelry, even after the initial wound has healed, the safest decision you can make is to avoid oral piercings altogether. However, if you or a loved one has an oral piercing, make sure you come in and see us at the first sign of pain or trouble so that any potential ‘bigger’ problems can be avoided.

If you are you a parent with a child who may be considering oral piercing, we understand! Sometimes kids won’t listen to a parent, but they may listen to a healthcare professional. Don’t hesitate to contact our office if you feel like it would be appropriate. We’re here to help.

Should I Brush or Floss First?

Some argue that flossing should come first because, when flossing, plaque and bits of food are loosened and should be brushed away after you’ve finished flossing. Undeniably, flossing is nasty. It’s very important, but kind of gross. Even in the cleanest mouth, the bacteria that you find under your gum line, known as anaerobes, is pretty smelly. You get stuff on your hands, you get stuff on the mirror and in general, it’s messy. So if you floss first, then you can brush the nastiness away. Fluoride from the toothpaste will make better contact if food wedged in between the teeth is removed before brushing.

The argument for brushing first and then flossing is that brushing your teeth first removes the bulk of the plaque on the teeth. Flossing afterward forces the remaining bit of fluoride left on the teeth from brushing into the in-between spaces.

What do I think? As long as you’re asking this question, it means you’re doing both, and that’s what matters. The synergy between flossing and brushing (and not the order in which you do them) will lengthen your life, improve your cognitive abilities, and will keep your teeth healthy and beautiful. Unfortunately, if people are going to do one or the other, they’re going to brush. Flossing tends to be thought of as secondary, maybe because we’ve been told since childhood the same phrase over and over, “Brush, then floss.”

Imagine staining only the front and back of a fence, but neglecting to paint the insides – sure, you’ve stained the front and back of the fence, but the insides are going to rot. The same goes with teeth – if you neglect to floss, you can still get cavities in between. It’s a widespread myth that you can get away with brushing only. Flossing cleans out the parts of the teeth that the toothbrush cannot reach. Brushing without flossing can result in cavities, gum disease, and even heart disease.

So, whether you brush first or floss first is your preference! I recommend that you stick with whatever works for you so that you stay in the habit of always brushing and flossing.

Don't Let Your Oral Care Take a Vacation While Travelling

It can be hard to give your oral care the attention it deserves when you’re travelling for business or pleasure. You’re away from home, and you’re out of your routine. But the health of your mouth shouldn’t be compromised. Here are some suggestions for maintaining good oral care while travelling.

1. Pack properly

The travel container you keep your toothbrush in should be large enough to provide air circulation. Don’t use a case that holds your brush tightly, and make sure that the container has holes for drainage and ventilation. Before and after your trip, be sure to clean your case! Do you know that a third of travellers never wash out their toothbrush cases.

　

2. Dry out your brush A brush that stays wet breeds bacteria. If you can, take your toothbrush out of its travel case as soon as you reach your destination. Standing your brush upright in a cup will allow the water to drain away from the bristles. (Just make sure it’s not kept where the maid could knock it into the toilet!). Take your toothbrush out of its travel container as soon as you get home.



3. Look for portable oral hygiene products
A collapsible toothbrush, a disposable tooth flosser or a roll of floss isn’t difficult to fit into your purse or carry-on. Floss is very compact, so you can take it with you when you travel.

　

4. Have a back-up plan
Depending on your destination, it might be a good idea to pack extra oral care supplies. They’ll come in handy if you run out and can’t buy replacements. Some hotels will stock disposable toothbrushes at the desk. Remember that in a pinch, without paste, you can still brush with water. You’ll still be removing plaque from your teeth, as long as you brush properly.



5. Keep it clean
Always remember to wash your hands well before handling your toothbrush or flossing your teeth. And if the local water isn’t safe to drink, that means it’s not safe for oral care either. Use bottled or boiled water instead.


6. Try treats for your teeth
Does travelling make it tricky to brush your teeth right after a meal? Pack some tooth treats to help you keep your mouth clean. Sugarless gum sweetened with xylitol will stimulate the flow of saliva, which helps to cleanse your teeth. Bacteria and bits of food will also stick to the gum instead of to your mouth. Sucking sugarless candies with green tea extract, or drinking green tea, can protect your teeth. Research suggests green tea may help to destroy the bacteria that cause cavities.


7. Watch what you’re eating
When we go on vacation, we often change our eating habits. We tend to indulge ourselves a lot more. I guess I can’t begrudge somebody some snacks and good times. But the frequency of sugar exposure is very important. Try to limit the number of times you treat yourself to sweets in a day. Each exposure will make a difference to the health of your teeth.

　

Ten Great Dental Resolutions for the New Year

When was the last time you managed to keep a New Year’s resolution? Most of us would be lucky to keep just one. I believe the key to sticking to a goal is picking one that is both reasonable and attainable. If you haven’t yet picked a NewYear’s resolution, consider setting one that will improve your oral health!

For example, resolve to brush three times and floss once a day. Good oral hygiene only takes a few minutes a day, and can make a big difference in your oral health and overall health too! I have listed a few oral health-themed resolutions for you and your family.

1.    Stop eating sweet snacks! Although we all crave sweets, snacking on them definitely makes us predisposed to tooth decay. Constantly dosing yourself with sucrose tends to expose your teeth  to a more acidic environment since the bacteria coating your teeth easily metabolize sucrose. Acids are a byproduct of their metabolism.

2.    Have at least two dental cleanings a year. I find that the majority of patients, although they mean to, actually do not achieve this goal. It turns out that on the average they have about one cleaning every 8-10 months. For this reason, I advocate scheduling our patients recall appointments with my hygienist immediately after their cleaning, while they are still in the chair. Although many patients prefer a six month call to remind them that it is time, this practice is more likely to result in cleanings scheduled less frequently than every six months.

3.    Go ahead and restore that tooth that your dentists keeps reminding you to crown. Why wait until it starts hurting? Although few patients look forward to having a crown done, procrastinating is not a good idea. With our Cerec technology, crown procedures are more comfortable and completed in one appointment!!

4.     Stop chewing on hard things that can result in chipped or cracked teeth. Chewing on ice cubes, bones, hard candies, pens, pipe stems or finger nails can definitely damage your teeth.

5.    Stop smoking!!!! Aside from the obvious health problems associated with smoking, it's bad for the health and appearance of your teeth. Smoking is associated with bad breath, yellowing of teeth, staining of teeth, periodontal disease and oral cancer.

6.    Start using a good electric tooth brush. Although many people feel that a standard tooth brush is all they need, most benefit from using a good electric model. Most require less time and technique to do a thorough job.

7.    Although most people would benefit from wearing a night gurard, few choose to wear one. As a dentist practicing for 20 years,  I see a majority of patients experiencing wear and chipping of their teeth associated with bruxism, also called grinding of teeth. Most are unaware of this activity, which occurs while you sleep, but wear patterns of anterior teeth are a definite tell-tale sign of this night-time activity. If your anterior teeth are displaying wear at the edges  most likely a night guard would be beneficial.

8.    If you have whitened your teeth more than a year ago then its time to perform a touch up. These can easily be performed in an hour or two if you have a set of custom whitening trays or come into our office and we can schedule a whitening after a regular cleaning using our 20-minute Sinsational Smile system.   

9.     Start cleaning the plaque from between your teeth. Forty percent of tooth surfaces are not cleaned by brushing alone. Using floss, stimudents  or a small interdent brush will clean the areas that your brush misses. You can also use a Waterpik appliance that will tend to reduce the amount bacteria found in crevicular fluid. Reducing plaque between your teeth will definitely lessen gingival inflammation and give your gums a healthier appearance.

10. Improve your smile. Although this sounds like a blatant plug for cosmetic dentistry I truly believe it is not without merit. I have witnessed the change in patients after having some minor cosmetic modifications of the their anterior teeth. Once whatever was making them self conscious about their smile is fixed they seem to smile more easily and more frequently. There are plenty of articles proposing that happy people are probably healthier. Stress and worry can cause us to lose sleep, weaken our immune systems and develop health problems. If having an attractive smile encourages us to smile more then just possibly we will experience more happiness. If minor tooth movement, whitening or minor bonding might help, why not go ahead and treat yourself to a better smile this year.