oral health

Do you have trouble swallowing certain foods? Are you constantly thirsty? Is your saliva thick or foamy? Do you have bad breath?

If you answered yes to any of these questions, you may have xerostomia. It’s a fairly common problem, and it could lead to serious health issues down the road if it’s not addressed by a dentist soon.

One of every four people has xerostomia, also known as dry mouth. It’s caused by decreased saliva production, which can happen as you age or as the result of an underlying health condition. The lack of saliva can hamper your quality of life in a variety of ways, and it also may cause damage to your teeth.

“In the absence of saliva, you’re going to be at higher risk of dental decay,” said Patricia Robinson, team-leader dental hygienist at Gentle Dental Associates in Ann Arbor. “I see this occurring quite a bit with my patients.”

Saliva is the mouth’s first defense against cavities, rinsing teeth of the bits of food that can lead to the growth of bacteria. But for many people, saliva production declines as they get older. And that can lead to xerostomia, or dry mouth.

Dry mouth often is uncomfortable, making it difficult to eat and digest certain foods. It can make it hard to taste and enjoy meals, and it can give you bad breath. In extreme cases it can even cause painful cracks and sores in the mouth and leave your tongue, lips and other tender tissues parched.

More significantly, dry mouth increases your risk of chronic and pervasive tooth decay because there’s not enough saliva to flush icky bacteria from your mouth.

So, what can you do about it?

“Bring your concerns to your dentist or your dental hygienist,” Robinson said. “We’ll look at the symptoms and signs and make some suggestions.”

RELATED: How do I avoid bad breath?

For example, here are 10 things you can do to counteract dry mouth:

• brush and floss your teeth every day to reduce bacteria buildup on your teeth
• chew sugarless gum to stimulate your salivary ducts and increase saliva production
• drink plenty of water to keep your body hydrated
• use fluoride toothpaste to reduce risk of cavities
• avoid dry foods such as bread, crackers and dry, salty snacks
• limit caffeine and alcohol – even mouthwash with alcohol – because they reduce saliva production
• breathe through your nose instead of your mouth
• use lip moisturizers to relive drying and cracking
• sleep with a humidifier in your room to keep the air from getting dry
• visit the dentist regularly for exams

RELATED: I drink a lot of coffee. Could it be hurting my smile?

Saliva production tends to decline in people after age 65, so dry mouth is more common in older people. Dry mouth also can be a side effect of medications or cancer treatment and can be a byproduct of smoking.

In addition to constant thirst, bad breath, foamy saliva and difficulty swallowing, other common symptoms of dry mouth include an irritated tongue, burning mouth, dry lips and nasal passages, sore throat, hoarseness and cavities.

Your dentist will look for symptoms of dry mouth and can prescribe medicine or other products to ease the inconvenience and prevent tooth decay. If you are dealing with dry mouth, call 734-975-0100 to schedule an appointment that will improve your quality of life and prevent painful dental problems before it’s too late.

About one of every six people say they floss their teeth at least once a day, according to a recent survey conducted in partnership with the American Dental Association (ADA). But that doesn’t mean they’re using dental floss for the job.

More than 60 percent of Americans say they sometimes use their fingernails to get food and gunk out of their teeth. And that’s not the only unsafe and unsanitary tool people admit to using.

Here are 10 more things people use to floss their teeth, according to ADA surveys:

• folder paper or cards
• cutlery
• safety pins
• strands of hair
• twigs
• toenails
• matchbooks
• loose electrical wires
• screwdrivers
• pocket knives

The list makes you wonder if the 8 percent of Americans who never floss with anything are better off! However, lack of flossing is a key contributor to gum and bone disease, or periodontitis, which affects nearly one of every two adults age 30 and up, according to the U.S. Centers for Disease Control.

Not only is gum disease bad for your mouth, but it also is linked to other serious health problems like cancer and heart disease. Yet, many people with periodontitis don’t even know they have it.

“Because the nerve endings in the gum and bone tissue around the teeth are not particularly sensitive, there normally is no pain when those sites present with infection. The problem is thus ignored,” said Dr. Debby Hwang, a periodontist with Gentle Dental Associates in Ann Arbor.

Every adult should have a periodontal exam once a year, and it is even better when that exam is done by a gum specialist known as a periodontist. At Gentle Dental Associates, periodontist Debby Hwang examines each adult patient once a year at no additional cost.

What is gum disease?

Bacteria naturally builds up in your mouth over the course of a day. If not removed, the bacteria cause plaque and, over time, tartar along and under your gum line. Eventually, that plaque and tartar can cause inflammation of your gums. That’s called gingivitis, an early stage of gum disease.

Symptoms of gingivitis include bad breath, caused by bacteria and bits of decaying food stuck in your teeth, and gums that are red, swollen or bleeding. The good news is that gingivitis can be reversed with attention from a dentist or a periodontal specialist.

But it also can progress into periodontitis, which is an advanced stage of gum disease when the damaged tissue pulls away from the teeth and creates gaps or pockets for even more bacteria. Those pockets can cause permanent damage to the bones in your jaw, loosening teeth and even causing them to fall out.

How gum disease leads to bigger problems

In addition to causing jaw bone and tooth damage, people with gum disease have a higher risk of other serious diseases. The bacteria that cause periodontitis can travel through the bloodstream to other parts of the body, or the body may work so hard to fight periodontitis that other organs are exposed to threats.

There’s evidence connecting periodontal inflammation to heart attack, stroke, pre-term/low-birthweight infants, chronic obstructive pulmonary disease, pneumonia, osteoporosis and cancers of the lung, skin, breast, kidney, pancreas and blood.

“Basically, no part of the body is isolated somehow from other parts,” Hwang said. “If there is a problem in one location, then there is potential for a problem in another spot.”

What you can do to prevent periodontitis

Nearly half of Americans have some level of gum disease, and it afflicts more than two-thirds of adults age 65 and older. It’s so prevalent because people often are lax in their daily oral hygiene or they may neglect a regular semi-annual visit to the dentist.

Many people just aren’t aware of periodontitis and how damaging it can be. But you should know that it is preventable. The best way to prevent gum and bone disease is by daily brushing and flossing, along with regular dental checkups.

Brushing and flossing gets rid of bacteria before it can build up, and your dentist can remove plaque in hard to reach places that regular brushing and flossing miss. Still, the vast majority of people do not floss regularly. For example, surveys find that 20 percent of adults say they only floss when something is stuck in their teeth, and nearly half admit they lie to their dentist about how often they floss.

For many people, daily flossing just takes too much time, hurts too much or is too gross. Unfortunately, the alternative could end up being much worse.

“Using only a toothbrush is like washing only half your body when showering,” Hwang said. “It’s best to do a complete cleanse.”

In addition to daily brushing and flossing (with floss, not toothpicks or fingernails), every adult should have a periodontal exam once a year by a gum specialist known as a periodontist. Call to schedule your gum health evaluation.

Just because you may have great-looking, healthy teeth does not necessarily mean that your gums and jaw bones are healthy, since the microorganisms that cause cavities are different than the bacteria that cause gingivitis and periodontitis.

As a child growing up in Taiwan, Angela Chao didn’t like to brush her teeth. Oral hygiene in her community was not a big priority, and her parents “had more challenges to face than my stubborn hatred for the spicy mint of toothpaste.”

The result, of course, is that Chao developed many cavities as a middle schooler. A fear of doctors made her hesitant to visit the dentist, though she eventually did get fillings. But several years later, after moving to the United States, those fillings failed and her teeth began breaking apart.

Still wary of the dentist, “it wasn’t until the pain stopped me from eating and smiling and caused me to avoid social interaction that I decided to do something,” she said.

Chao went to Gentle Dental Associates in Ann Arbor for a consultation and was advised to get a dental implant. Skeptical at first, she did her own research on implants and other options for replacing missing teeth, then talked with other people who had gotten implants.

She decided to go through with the procedure.

“I told myself that if I don't do it now, then when?” said Chao, now in her 50s. “Getting an implant was an easy choice for me over other options.”

Chao is like 170 million other adults in America who are missing teeth. Half of adults age 20-64 are missing at least one permanent tooth, according to the latest national survey data from the National Health and Nutrition Examination Survey.

While a majority of people age 20-39 still have a full set of teeth, only one of every three people age 40-64 do. The primary causes of tooth loss include cavities and periodontal disease, which both stem from poor oral hygiene and lack of consistent dental care.

A missing tooth can cause several problems.

“If a tooth is missing, then chewing becomes less efficient and the neighboring teeth alongside the space may be subject to over-function and eventual fracture,” said Dr. Debby Hwang, a periodontist at Gentle Dental Associates. “An absent front tooth also may hinder cosmetics and speech.

“Replacing a tooth can protect the remaining teeth, allow for normal eating and digestion, restore any speaking deficits and contribute to psychological health.”

There are three options for replacing a missing tooth:

• A removable denture is a cost-effective choice, but it needs to be taken out every night and is relatively fragile, so it might not provide full chewing function. Chao preferred to have a permanent replacement instead of something removable.
• A fixed bridge fuses a fake tooth to adjacent teeth and is not removable. The neighboring teeth get crowns that are fused to a fake tooth in the middle. Chao wanted to avoid cutting into her healthy, natural teeth to support a bridge.
• A dental implant involves a titanium anchor that’s placed into the bone where the tooth is missing. The jaw bone grows around the anchor, which is then capped with a crown several months later. It’s like having your own tooth back.

An implant is typically a long-term solution that, unlike the other options, does not rely on neighboring teeth for support and cannot decay, Hwang said. Plus, many people are surprised by the lack of discomfort they experienced during and after the procedure.

A dental implant is the most-costly option to replace a missing tooth, at least initially. But because it doesn’t decay or break it often can be the most cost-effective solution over the long term. If something breaks in a bridge, for example, you have to replace all three teeth. It’s also more likely to get cavities with a bridge because you can’t floss in between those teeth.

Because a dental implant is fixed into the jaw, it can be a “high-value, high-return choice,” Hwang said.

Chao was able to afford dental implants because her family had put aside money to pay for health care costs. If you have a Health Savings Account through your employer, that can be a great way to cover the cost.

Many employers also allow people to put money into a flexible spending account (FSA) for health care, and that “use-it-or-lose-it” money has to be spent by the end of the year or it’s gone. If you have an FSA, that can be a good way to pay for implants before the end of 2018 — or a good place to put money in 2019 to pay for implants next year.

The reward of being able to smile and laugh and eat with ease again has been well worth the cost to Chao.

“I don’t have to worry about my smile anymore,” she said. “Chewing food is becoming easier and my posture and my facial features are slowing coming back in balance since I had my implants done. I am very happy!”

Dreading the dentist ranks right up there with being scared of snakes and afraid of heights as the biggest fears of Americans. Now, a new study finds that fear of the dentist has a clear, negative impact of people’s oral health.

One of every eight people has dental phobia, and they are more likely to have decayed or missing teeth, the study concludes. People scared of the dentist also tend to have more negative feelings like sadness, tiredness and lethargy, lead author Dr. Ellie Heidari said.

“This phobia can have a major impact on a person’s quality of life,” she said. “An action as simple as smiling will be avoided due to embarrassment of their poor teeth.”

While extreme dental anxiety is relatively rare, as many as 80 percent of Americans are at least a little afraid of going to the dentist. Unfortunately, that fear hinders people’s oral health because they put off regular teeth cleanings. Nearly a quarter of people who suffer from some level of dental anxiety do not get regular dental treatment, and upwards of 10 percent avoid going to the dentist entirely.

That’s a problem because “regular dental attendance is central for maintenance of oral health as well as avoiding dental pain,” Heidari said.

So what can be done about dental anxiety? First, let’s look at some of the causes. People worry about going to the dentist for any number of reasons: maybe they had a painful experience in the past, or maybe they’re scared by the sadistic, drill-happy dentist stereotype portrayed in movies. For some people the cost of dental care can give them pause, and for others it might be embarrassment about the health of their teeth.

“Another one is fear of the unknown,” said Dr. Neha Kuthiala, DDS, a dentist at Gentle Dental Associates, an Ann Arbor practice that offers free consultations. “It’s a situation where you’re asked to sit with your mouth open and you can hear things and feel things but you have no idea what is being done to you.

“Dental work is not something people want to have done. It’s just one of those things.”

But whether you want to get dental work or not, going to the dentist is vital for your oral health. And there’s no reason a trip to the dentist can’t be pleasant. In fact, here are three ways to make seeing a dentist a smooth, stress-free experience:

*Get preventative care before it’s too late — It’s better to fill a cavity than to wait and have to remove the tooth later. “The thing with avoiding the dentist or waiting until you have pain is that a lot of times by that point you need something that costs more than preventative care would have,” Kuthiala said. “Coming in for a preventative cleaning tends to save you in the long run.”

*Commit to consistent home care — You may not have to floss every single day (although that’s not a bad idea), but you should do it more than once a month. The better you follow the advice of your dentist and hygienist, the better results you’ll have when you go in for a checkup. “A lot of people are feeling very judged on their oral hygiene and any existing cavities or anything that might be diagnosed at the dental office,” Kuthiala said. “As long as patients are doing their part at home and cleaning to their best of their ability, that’s all they can do.”

*Talk with your dentist about your anxiety — Share what you’re worried about. At the same time, a good dentist will take time to talk with anxious patients before looking into their mouths. “If we know the reason for anxiety, a lot of the time we can work with the patient to alleviate that,” Kuthiala said.

The dentist can have a big impact on your level of anxiety simply by treating patients as people rather than procedures. That can include keeping patients up to speed on the progress of a procedure and talking about what they’re doing each step of the way, or giving patients control by allowing them to stop a procedure any time they feel uncomfortable.

In addition, scheduling patients with the same hygienist and dentist every visit is a proven way to ease anxiety. Also, distractions like office music or a TV in the operating room can take people’s minds off their fear.

Of course, providing nitrous oxide, or laughing gas, can be a good option for some anxious patients, too.

“We’re all aware of how people don’t like to come to the dentist,” Kuthiala said. “We try our best to treat them with a gentle touch.

“There’s much more to that person than just whatever it is that you’re working on (in their mouth). We want to treat patients as the person, not just the tooth.”

Our team at Gentle Dental will tell you that good oral hygiene is important, not only for looks, but for general health as well. Poor oral hygiene can lead to a variety of dental and medical problems such as gum disease, bone loss, heart disease, strokes, and infection. In fact, we recently read a nine-year study which reported a spike in hospitalizations due to dental infections since 2008. Previous studies have shown that oral problems are responsible for hundreds of thousands of emergency room visits annually. The new report, however, published in the September 2013 issue of the Journal of Endodontics, focused on patients who were hospitalized due to periapical abscess, an infection that results from bacteria invading the pulp of the tooth. Periapical abscess is a common result of untreated tooth decay that, if untreated, can be dangerous if it spreads.

Besides periapical abscesses, we want you to know about other common dental infections, which include:

• Dental caries (cavities that form on children’s teeth)
• Gingivitis (inflammation of the gums)
• Periodontitis (gum tissue around the molar teeth, or any erupting tooth that becomes swollen and infected)
• Pulpitis (inflammation or infection of the pulp, which is the center of the tooth)

Although these infections can be caused by poor dental care and not visiting our office on a regular basis for checkups, they may also affect people with underlying medical conditions such as autoimmune disorders. In some cases, infections can progress to the point which swelling becomes life threatening. Regular checkups and cleanings at Gentle Dental can easily prevent these infections and other mouth problems and give you peace of mind.

If you have any questions about this study or to schedule your next appointment, please give us a call at our convenient Ann Arbor office today! Dr. Dagostin, Dr. Hwang, Dr. Lacin, Dr. Lechner, and Dr. Wang, as well as our entire team, look forward to working with you!

With winter sports underway, we wanted to remind our patients about the importance of wearing a mouth guard while you’re on the court or the field. Here are some frequent questions we hear from our patients about mouth guards.

Q: What are mouth guards?

A: Mouth guards are a flexible, removable device made of soft plastic, and are adapted to fit comfortably to the shape of the upper teeth.

Q: Why are mouth guards so important?

A: Mouth guards protect not just the teeth, but the lips, cheeks, and tongue, and help protect athletes from head and neck injuries, as well as concussions and jaw fractures. Increasingly, organized sports are requiring mouth guards to prevent injury to their athletes and research shows us that most oral injuries occur when athletes are not wearing mouth protection.

Q: When should I wear my mouth guard?

A: Whenever you are in an activity with a risk of falls or of head contact with other players or equipment. This includes football, baseball, basketball, soccer, wrestling, hockey, and even gymnastics.

Q: How do I choose a mouth guard that is right for me?

A: We encourage you to choose a mouth guard that you can wear comfortably. You can select from several options in mouth guards. First, preformed or “boil-to-fit” mouth guards are found in sports stores. Otherwise, we can talk about your options for a custom mouthguard, which will be more comfortable to wear, and more effective in preventing injuries this winter. Please give us a call if you have any other questions or ask us on Facebook!

The dreaded cold and flu season is here again! After recovering from your cold, one of the most important steps you can take to avoid becoming reinfected is replacing your toothbrush!

Germs can linger on the bristles, and you risk prolonging your sickness by continuing to use the same toothbrush. Be smart - keep a spare, just in case! To protect your toothbrush from bacteria all year long, consider the following tips:

• Wash your hands before and after brushing
• Allow the brush to air dry after each use, harmful bacteria dies after being exposed to oxygen
• Store the toothbrush in an upright position to allow water to drain and dry faster
• Replace your toothbrush every 3-4 months. Worn bristles are less effective in properly cleaning your teeth, and can actually be damaging to teeth if used too long!

We hope these tips help! Feel free to give us a call or ask us on Facebook if you have any questions!

One of the most common questions we hear is, “is there a difference between a dental implant and a dental bridge?”

Both implants and bridges are permanent, non-removable replacements for your missing tooth, or teeth. The biggest difference between an implant and a bridge is how your new teeth are held in place. While a bridge may be used to literally bridge the gap created by one or more missing teeth, help maintain the shape of your face, and alleviate stress in your bite, implants provide a strong foundation for fixed (permanent) or removable replacement teeth that are made to match your natural teeth.

Visually, there is little difference between the two, but they both have different advantages. Bridges, which can be made from gold, alloys, porcelain, or a combination of these materials are bonded onto surrounding teeth for support. A bridge can help restore your smile, as well as your ability to properly chew and speak. They can also maintain the shape of your face and prevent remaining teeth from drifting out of position. If you can replace a missing tooth or teeth with a bridge, the major advantage is that your solution is immediate because you do not need surgery to successfully complete this procedure.

There are many benefits to dental implants as well, but the biggest advantage of an implant is that you do not use the neighboring teeth to support the replacement of the missing tooth. Just like bridges, they provide improved appearance, self-esteem, comfort, speech and oral health, as well as the ability to eat all your favorite foods with confidence and without any pain. As for how long they last? Implants are extremely durable and with good care, can last a lifetime.

To learn more about dental implants and bridges, or to schedule an appointment to select the option that's right for you, we invite you to give us a call!

Taking care of your oral health involves a daily regimen of brushing, flossing, and rinsing to prevent tooth decay and bacterial infections. Though you may have asked us which toothbrush to use, few patients ask about mouthwash.

However, different mouthwashes you might choose will have varying effects on your oral health. So which type is best for you?

Gum Health

Antiseptic mouthwashes are designed to reduce the majority of bacteria on and near the gum line. Using an antiseptic mouthwash can help decrease your chances of developing gingivitis. If possible, look for a mouthwash with antibacterial or antimicrobial ingredients.

Fluoride

Fluoride is beneficial for oral health and can help prevent tooth decay. If you drink a lot of bottled water without fluoride, we may recommend that you purchase a rinse with fluoride in it.

Bad Breath

Although mouthwash is designed to prevent bacterial build-up within the mouth, many people use it to combat bad breath. Most mouthwashes will help eliminate the bacteria that cause bad breath, and some are specifically designed to do so.

However, if bad breath is a chronic problem that requires daily treatment with a mouth rinse, contact our office to discuss your symptoms.

American Dental Association Approval

The ADA reviews mouth rinses for safety and effectiveness. A mouthwash with the ADA Seal of Approval will meet strict criteria, and will have scientific evidence or clinical studies that support the claims of the manufacturer. If possible, select a mouthwash that bears the ADA Seal of Approval to ensure you are using a quality rinse.

Considerations

If you are unsure as to which mouthwash is right for you, contact our office or ask our dentist or dental hygienist at your next appointment. Also, be sure to keep mouthwash out of the reach of children, as it contains alcohol and other substances that could be harmful to them. Avoid letting children under age six use a mouth rinse, and discontinue use if you experience a burning sensation in the soft tissues of your mouth.

Perhaps you don't even know you grind your teeth. Maybe a spouse or loved one woke you up in the middle of the night and made you aware of what was happening.

For many people, teeth grinding is a habit and a mechanical reflex; when they’re awakened and informed they were grinding their teeth, they have no recollection of it at all. According to the American Dental Association, this is the nightly situation for roughly ten percent of Americans. From young children to the elderly, teeth grinding, known in the dental community as bruxism, is a serious concern.

Many people who grind their teeth in their sleep have no idea they're doing it. In fact, when they wake up in the morning they feel no jaw pain and their teeth are fine: if it hadn’t been for someone telling them about it, the teeth grinding would have gone unnoticed.

There are other people, however, who wake up with jaw pain, shoulder and neck pain, and headaches. Teeth grinding can cause a host of dental complications. From cracked teeth and receding gums to a misaligned jaw, teeth grinding is not something to take lightly.

Preventive measures are the key to combating bruxism, and our office can set you on the path to a healthy and safe night sleep.

The Reasons for Teeth Grinding

There are many reasons for teeth grinding. For some people, it’s a habit they acquired when they were a child and never grew out of. On the other hand, some research claims that the condition is related to stress, anxiety, or some other type of psychiatric issue.

Still other studies point to everything from poor muscle control or over-eating before bed to gastro-esophageal issues. However, the root cause of the teeth grinding is less important than identifying preventive measures against it.

Common solutions to teeth grinding include:

• Wearing a protective nightguard
• Stress management techniques
• Medications and muscle relaxers

When you make an appointment at our office, we will assess your situation and determine what the best course of action is. Teeth grinding is a dental concern that can cause serious health issues down the road, so be sure to take preventive measures today.

You may not understand it, and the more you think about it the less you want to believe it, but you’re positive you have a cavity, and a painful one, too. How did this happen? You brush twice a day and floss regularly. You rinse with hydrogen peroxide, just like the dentist recommended. In fact, you can’t remember the last time you had a cavity, but you think it was when you were a little kid, back when you ate sugary cereals like Lucky Charms and Cocoa Puffs for breakfast. In all seriousness, you thought only kids got cavities. Weren’t you supposed to have outgrown these things the way teenagers outgrow acne?

The Signs and Symptoms of a Cavity

It’s believed that roughly 90% of Americans will get at least one cavity in their lifetime. Those other ten percent, it seems, can eat as much pie, cake, and sugary cereals and sweets as they want. That’s not really true; just a stab at dental humor, and it was as bad as the pain your cavity is probably giving you.

When a cavity is in its initial stages, you will often be symptom-free and experience no discomfort at all. It’s not until the tooth decay has reached a certain level that you will begin to notice the signs and symptoms. While a toothache and sensitivity to hot and cold foods and liquids are surefire signs that you have a cavity, there are lesser-known symptoms as well. If you’re experiencing any of these warning signs, you may want to consider making an appointment with our office as soon as possible:

• Persistent bad breath or a bad taste in the mouth
• When you bite down, there is a sticky, tarry feeling
• Puss or discharge around a tooth
• A visible discoloring, usually black or brown
• Small pits or holes in the tooth

Routine dental care is important. While good oral hygiene, a healthy diet, and regular cleanings at the dentist will deter the formation of cavities, they do not constitute a foolproof practice. A cavity can occur at any time, no matter what your age. Bacteria causes tooth decay, and no amount of brushing, flossing, and rinsing will eradicate all the bacteria from your mouth. If you think you may have a cavity, please contact our office immediately.