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Mouth Guards and Maintenance

Once you have had your mouth guard adjusted to fit your teeth you must learn to properly maintain your mouth guard. A mouth guard should only be worn during sport practices and games. Do not chew on the mouth guard because you could weaken the effectiveness of the plastic or laminated material.

Your dentist should make sure that your mouth guard does not have sharp edges

because it could irritate or damage the gum tissue or cheeks. After wearing your mouth guard, check it for damage. If your mouth guard is damaged, replace it so it doesn?t irritate the gum tissue. Your mouth guard will last longer if you properly care for it.

After wearing your mouth guard, you should clean it with cool water and use your toothbrush and toothpaste to eliminate bacteria that may develop during usage. Rinse your mouth guard and place it in a container to keep it until the next practice or game at room temperature.

Be sure to visit your dental professional for regular dental appointments and to discuss any concerns or questions you have regarding mouth guard usage in sports.

Please call Dr. Jeffrey Fester in Roswell, GA, 770.587.4202 to schedule a free consultation.

Burning Mouth Syndrome – What is it?

Introduction

Burning mouth syndrome (BMS) is a complex, vexing condition in which a burning pain occurs that may involve your tongue, lips or widespread areas of your whole mouth, without any obvious reason.

The disorder has long been associated with a variety of other conditions — including menopause, psychological problems, nutritional deficiencies and disorders of the mouth, such as oral thrush and dry mouth (xerostomia). Some researchers have suggested dysfunctional or damaged nerves as a possible cause. But the exact cause of burning mouth syndrome is often difficult to pin down, and pain may continue for months or years.

Treatment of burning mouth syndrome is highly individualized and depends on your particular signs and symptoms and on the underlying cause or causes, if they can be identified. Most people with burning mouth syndrome can control their symptoms through tailored treatment plans.

Other names sometimes used for burning mouth syndrome include scalded mouth syndrome, burning tongue syndrome, burning lips syndrome, glossodynia and stomatodynia.

Signs and symptoms

Photographs showing burning mouth syndrome

The main symptom of burning mouth syndrome is a burning sensation involving your tongue, lips, gums, palate, throat or widespread areas of your whole mouth. People with the syndrome may describe the sensation in the affected areas as hot or scalded, as if they had been burned with a hot liquid.

Other symptoms may include:

  • Dry mouth
  • Sore mouth
  • A tingling or numb sensation in your mouth or on the tip of your tongue
  • A bitter or metallic taste

Some people with burning mouth syndrome don’t wake up with mouth pain, but find that the pain intensifies during the day and into the evening. Some have constant daily pain, while others feel pain on and off throughout the day and may even have periods in which they feel no pain at all.

Burning mouth syndrome affects women seven times as often as men. It generally occurs in middle-aged or older adults. But it may occur in younger people as well.

Causes

The possible causes of burning mouth syndrome are many and complex. Each of the following possible causes applies to only a small portion of all people who complain of a burning mouth. Many people have multiple causes. Identifying all of the causes is important so that your doctor can develop a treatment plan tailored for you. Possible causes include:

  • Dry mouth (xerostomia). This condition can be related to use of certain medications, including tricyclic antidepressants, central nervous system depressants, lithium, diuretics and medications used to treat high blood pressure. It can also occur with aging or Sjogren’s syndrome, an autoimmune disease that causes both dry mouth and dry eyes.
  • Other oral conditions. Oral yeast infection (thrush) is a common cause of a burning mouth that may also occur with other causes, such as diabetes, denture use and certain medications. Geographic tongue, a condition that causes a dry mouth and a sore, patchy tongue, also may be associated with burning mouth syndrome.
  • Psychological factors. Emotional disorders, such as anxiety and depression, are often associated with burning mouth syndrome, as is an extreme fear of cancer. Although these problems can cause a burning mouth, they may also result from it.
  • Nutritional deficiencies. Being deficient in nutrients, such as iron, zinc, folate (vitamin B-9), thiamin (vitamin B-1), riboflavin (vitamin B-2), pyridoxine (vitamin B-6) and cobalamin (vitamin B-12), may affect your oral tissues and cause a burning mouth. These deficiencies can also lead to vitamin deficiency anemia.
  • Irritating dentures. Dentures may place stress on some of the muscles and tissues of your mouth. The materials used in dentures also may irritate the tissues in your mouth.
  • Nerve disturbance or damage (neuropathy). Damage to nerves that control taste and pain in the tongue may also result in a burning mouth.
  • Allergies. The mouth burning may be due to allergies or reactions to foods, food flavorings, other food additives, fragrances, dyes or other substances.
  • Reflux of stomach acid (gastroesophageal reflux disease). The sour- or bitter-tasting fluid that enters your mouth from your upper gastrointestinal tract may cause irritation and pain.
  • Certain medications. Angiotensin-converting enzyme (ACE) inhibitors, used to treat high blood pressure, may cause side effects that include a burning mouth.
  • Oral habits. These include often-unconscious activities such as tongue thrusting and teeth grinding (bruxism), which can irritate your mouth.
  • Endocrine disorders. Your oral tissues may react to high blood sugar levels that occur with conditions such as diabetes and underactive thyroid (hypothyroidism).
  • Hormonal imbalances, such as those associated with menopause. Burning mouth syndrome occurs most commonly among postmenopausal women, although it affects many other people as well. Changes in hormone levels may affect the composition of your saliva.
  • Excessive irritation. Irritation of the oral tissues may result from excessive brushing of your tongue, overuse of mouthwashes or consuming too many acidic drinks.

Often, more than one cause is present. Despite careful evaluation, doctors are sometimes unable to find the cause of burning mouth symptoms.

When to seek medical advice

If you have persistent pain or soreness in your tongue, lips, gums or other areas of your mouth, see your doctor. Your doctor can search for the possible cause or causes to guide treatment.

Screening and diagnosis

Your doctor will review your medical history, examine your mouth and ask you to describe your symptoms, your oral habits and your oral care routine. In addition, he or she will likely perform a general medical examination, looking for signs of any associated conditions.

As part of the diagnostic process, you may undergo some of the following tests:

  • Complete blood cell count (CBC). This common blood test provides a count of each type of blood cell in a given volume of your blood. The CBC measures the amount of hemoglobin, the percentage of blood that’s composed of red blood cells (hematocrit), the number and kinds of white blood cells, and the number of platelets. This blood test may reveal a wide variety of conditions, including infections and anemia, which can indicate nutritional deficiencies.
  • Other blood tests. Because nutritional deficiencies are one cause of a burning mouth, your doctor may collect blood samples to check blood levels of iron, zinc, folate (vitamin B-9), thiamin (vitamin B-1), riboflavin (vitamin B-2), pyridoxine (vitamin B-6) and cobalamin (vitamin B-12). Also, because diabetes may cause a burning mouth, your doctor may check your fasting blood sugar level.
  • Allergy tests. Your doctor may suggest allergy testing to see if you may be allergic to certain foods, additives or even substances in dentures.
  • Oral swab culture or biopsy. If your doctor suspects oral thrush, he or she may take a small tissue sample (biopsy) or an oral swab culture to be examined in the laboratory.

Because burning mouth syndrome is associated with such a wide variety of other medical conditions, your doctor may refer you to a specialist for screening and diagnosis and possibly treatment. Your health care team may include a dermatologist, dentist, psychiatrist, psychologist or a doctor who specializes in ear, nose and throat problems (otolaryngologist).

Treatment

Treatment triggers improvement in symptoms for most people with burning mouth syndrome. But the type of treatment depends on the underlying cause.

  • Dry mouth (xerostomia). Treating the cause of your dry mouth — Sjogren’s syndrome, use of medications or some other cause — may relieve burning mouth symptoms. In addition, drinking more fluids or taking a medication that promotes flow of saliva may help.
  • Other oral conditions. If the cause is oral thrush, treatment is with oral antifungal medications such as nystatin (Mycostatin) or fluconazole (Diflucan). If you wear dentures, your dentures may also need to be treated.
  • Psychological factors. For a burning mouth that may be caused by or associated with psychological factors such as anxiety and depression, your doctor may recommend antidepressant therapy or psychiatric therapy or both together. Selective serotonin reuptake inhibitors (Prozac, Zoloft, others) may cause less dry mouth than other antidepressant medications.
  • Nutritional deficiencies. You may be able to correct nutritional deficiencies by taking supplements of B vitamins and minerals such as zinc and iron.
  • Irritating dentures. Your dentist may be able to adjust your dentures so they are less irritating to your mouth. If your dentures contain substances that irritate your oral tissues, you may need different dentures. You may also improve symptoms by practicing good denture care, such as removing dentures at night and cleaning them properly.
  • Nerve disturbance or damage (neuropathy). Your doctor may suggest medications that affect your nervous system and control pain, including benzodiazepines such as clonazepam (Klonopin), tricyclic antidepressants such as amitriptyline or nortriptyline (Pamelor, Aventyl), or anticonvulsants such as gabapentin (Neurontin). For pain relief, your doctor may also suggest rinsing your mouth with water and capsaicin — the active ingredient in hot peppers, which also is called capsicum.
  • Allergies. Avoiding foods that contain allergens that may irritate the tissues of your mouth may help.
  • Certain medications. If a medication you’re taking is causing a burning mouth, using a substitute medication, if possible, may help.
  • Oral habits. Tongue thrusting and teeth grinding (bruxism) can be helped with mouth guards, medications and relaxation techniques.
  • Endocrine disorders. If a burning mouth is associated with conditions such as diabetes or hypothyroidism, treating those conditions may improve your symptoms.

If doctors can’t identify the cause of your symptoms, they may still recommend trying oral thrush medications, B vitamins or antidepressants. These medications have proved effective in treating burning mouth syndrome.

Coping skills

Burning mouth syndrome can be painful and frustrating. The good news is that it’s a treatable condition. Although it may take time, with the help of a team of health professionals, you can usually find a treatment plan that’s right for you.

In the short term, you may gain some relief by avoiding irritating substances, such as alcohol-based mouthwashes, cinnamon or mint products, and cigarette smoke. Chewing on ice chips or sugar-free gum also may help. So can keeping your dentures out all night and brushing your teeth with baking soda instead of toothpaste. Ask your doctor for other tips to manage your pain and discomfort.

Smart Snacks For Healthy Teeth

What’s wrong with sugary snacks, anyway?

Sugary snacks taste so good — but they aren’t so good for your teeth or your body. The candies, cakes, cookies and other sugary foods that kids love to eat between meals can cause tooth decay. Some surgary foods have a lot of fat in them, too. Kids who consume sugary snacks eat many different kinds of sugar every day, including table sugar (sucrose) and corn sweeteners (fructose). Starchy snacks can also break down into sugars once they’re in your mouth.

How do sugars attack your teeth?

Invisible germs called bacteria live in your mouth all the time. Some of these bacteria form a sticky material called plaque on the surface of the teeth. When you put sugar in your mouth, the bacteria in the plaque gobble up the sweet stuff and turn it into acids. These acids are powerful enough to dissolve the hard enamel that covers your teeth. That’s how cavities get started. If you don’t eat much sugar, the bacteria can’t produce as much of the acid that eats away enamel.

How can I “snack smart” to protect myself from tooth decay?

Before you start munching on a snack, ask yourself what’s in the food you’ve chosen. Is it loaded with sugar? If it is, think again. Another choice would be better for your teeth. And keep in mind that certain kinds of sweets can do more damage than others. Gooey or chewy sweets spend more time sticking to the surface of your teeth. Because sticky snacks stay in your mouth longer than foods that you quickly chew and swallow, they give your teeth a longer sugar bath.

You should also think about when and how often you eat snacks. Do you nibble on sugary snacks many times throughout the day, or do you usually just have dessert after dinner? Damaging acids form in your mouth every time you eat a sugary snack. The acids continue to affect your teeth for at least 20 minutes before they are neutralized and can’t do any more harm. So, the more times you eat sugary snacks during the day, the more often you feed bacteria the fuel they need to cause tooth decay.

If you eat sweets, it’s best to eat them as dessert after a main meal instead of several times a day between meals. Whenever you eat sweets — in any meal or snack — brush your teeth well with a fluoride toothpaste afterward.

When you’re deciding about snacks, think about:

  • The number of times a day you eat sugary snacks
  • How long the sugary food stays in your mouth
  • The texture of the sugary food (Chewy? Sticky?)

If you snack after school, before bedtime, or other times during the day, choose something without a lot of sugar or fat. There are lots of tasty, filling snacks that are less harmful to your teeth—and the rest of your body — than foods loaded with sugars and low in nutritional value. Snack smart!

Low-fat choices like raw vegetables, fresh fruits, or whole-grain crackers or bread are smart choices. Eating the right foods can help protect you from tooth decay and other diseases. Next time you reach for a snack, pick a food from the list inside or make up your own menu of non-sugary, low-fat snack foods from the basic food groups.

How can you snack smart? Be choosy!

Pick a variety of foods from these groups:

  • Fresh fruits and raw vegetables
    • Berries
    • Oranges
    • Grapefruit
    • Melons
    • Pineapple
    • Pears
    • Tangerines
    • Broccoli
    • Celery
    • Carrots
    • Cucumbers
    • Tomatoes
    • Unsweetened fruit and vegetable juices
    • Canned fruits in natural juices
  • Grains:
    • Bread
    • Plain bagels
    • Unsweetened cereals
    • Unbuttered popcorn
    • Tortilla chips (baked, not fried)
    • Pretzels (low-salt)
    • Pasta
    • Plain crackers
  • Milk and dairy products:
    • Low or non-fat milk
    • Low or non-fat yogurt
    • Low or non-fat cheese
    • Low or non-fat cottage cheese
  • Meat, nuts and seeds:
    • Chicken
    • Turkey
    • Sliced meats
    • Pumpkin seeds
    • Sunflower seeds
    • Nuts
  • Others (these snacks combine foods from the different groups):
    • Pizza
    • Tacos

Remember to:

  • Choose sugary foods less often
  • Avoid sweets between meals
  • Eat a variety of low or non-fat foods from the basic groups
  • Brush your teeth with fluoride toothpaste after snacks and meals

Note to parents

The foods listed in this leaflet have not all been tested for their decay-causing potential. However, knowledge to date indicates that they are less likely to promote tooth decay than are some of the heavily sugared foods children often eat between meals.

Candy bars aren’t the only culprits. Foods such as pizza, breads, and hamburger buns may also contain sugars. Check the label. The new food labels identify sugars and fats on the Nutrition Facts panel on the package. Keep in mind that brown sugar, honey, molasses and syrups also react with bacteria to produce acids, just as refined table sugar does. These foods also are potentially damaging to teeth.

Your child’s meals and snacks should include a variety of foods from the basic food groups, including fruits and vegetables; grains, including breads and cereals; milk and dairy products; and meat, nuts and seeds. Some snack foods have greater nutritional value than others and will better promote your child’s growth and development. However, be aware that even some fresh fruits, if eaten in excess, may promote tooth decay. Children should brush their teeth with fluoride toothpaste after snacks and meals. (So should you!)

Please note: These general recommendations may need to be adapted for children on special diets because of diseases or conditions that interfere with normal nutrition.

Gingivitis: New Insights Into Inflammation And Periodontal Diseases

At the forefront of dentistry today is an increasing knowledge of the role of chronic inflammation and the changes it can cause in both the oral cavity and systemically.

Now you can gain a new level of understanding with these informative articles to help you more effectively treat your patients with gingival inflammation. Originally appearing in the July 2004 Supplement to the Compendium of Continuing Education in Dentistry entitled, “Gingivitis: An Inflammatory Periodontal Disease” these articles are available to you online at www.ColgateProfessional.com.

Inflammation is the localized, protective response of the body to injury or infection. The classic clinical signs that characterize inflammation are heat, redness, swelling, pain, and loss of function.

During inflammation, cells and their secreted chemicals attempt to destroy, dilute, or wall off the injurious agent. A series of biochemical events cause the blood vessels to dilate and become more permeable, resulting in the activation of the complement, clotting and kinin systems. The end result of inflammation is the return of function by the regeneration or repair of the affected tissue.

In some instances, inflammation may continue for a prolonged period of time, producing untoward consequences for localized tissue as well as the entire body.The purpose of this article is to provide a basic and simplified understanding of how the inflammatory process functions in the human body.

CE2 — Periodontal Inflammation: From Gingivitis to Systemic Disease?

Frank A. Scannapieco, DMD, PhD

There has been a resurgence of interest in recent years in the systemic effects of oral infections such as periodontal diseases. The study of the various means by which periodontal infections and inflammation may influence a variety of systemic conditions is collectively referred to as periodontal medicine.

The periodontium responds to toothborne biofilm (dental plaque) by the process of inflammation. Dental biofilms release a variety of biologically active products, such as bacterial lipopolysaccharides (endotoxins), chemotactic peptides, protein toxins, and organic acids. These molecules stimulate the host to produce a variety of responses, among them the production and release of potent agents known as cytokines.

These include interleukin-1 beta, interleukin-8, prostaglandins, and tumor necrosis factor-alpha. There is a spectrum of periodontal response to these molecules, from mild gingivitis to severe destructive periodontitis. These and other host products and responses may influence a variety of important disease pathways, including atherosclerosis, mucosal inflammation, and premature parturition. The purpose of this article is to review the possible biological pathways by which periodontal diseases may influence these disease processes.

For more information on Periodontal Disease, please call Dr. Jeffrey Fester in Roswell, GA, 770.587.4202 to schedule a free consultation.

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Am I a Candidate for Tooth Whitening?

Am I a Candidate for Tooth Whitening?

Almost anyone whose permanent teeth have come in can qualify for tooth whitening. Your dentist will be able to assess your oral health and recommend the whitening method that’s best for you. Depending on the type and severity of the staining, he or she may suggest one or more of the following treatments:

  • A professional cleaning to remove external staining caused by food and tobacco
  • Use of a whitening toothpaste to help remove surface stains between dental visits
  • For extra results, use of a convenient, affordable whitening gel or whitening strips
  • Bleaching (in-office or at-home) for more stubborn stains or yellowing
  • Veneers or bonding to fix irregular or damaged teeth or to achieve specific results

Ask your dentist which whitening technique is best for you.

  • Teeth that are yellow respond best to bleaching. Brown or gray teeth, or teeth striped or mottled from tetracycline or too much fluoride, may not whiten evenly when bleached.
  • People with periodontal disease or particularly sensitive teeth may want to avoid chemical whitening techniques that can irritate tender gums.
  • Bleaching is not recommended if you have tooth-colored fillings, crowns, caps or bonding in your front teeth — the bleach will not change the color of these materials, making them stand out in your newly whitened smile. You may want to investigate other options, like veneers or bonding with your dentist.
  • In some cases involving serious tooth or jaw problems, a crown or cap recommended to correct orthodontic problems may also result in a whiter and more appealing smile.

If you are interested in finding out if you are a candidate for tooth whitening, call  Dr. Jeffrey Fester in Roswell, GA 770.587.4202 for a free consultation!

Keys to Controlling Bad Breath

Keys to Controlling Bad Breath

If you’re serious about learning what’s causing your bad breath, consider scheduling an appointment with your dental professional. Given your full medical and dental history along with an oral examination, your dentist should be able to identify the culprit. The causes of bad breath are numerous and include certain foods, alcohol or cigarettes, poor oral hygiene, periodontal disease, diabetes, dry mouth, sinus or throat infections, lung infections or abscesses, kidney/liver failure, gastrointestinal issues and severe dieting.

Treatment of Bad Breath

It is important to conduct thorough oral hygiene at home twice daily utilizing tooth brushing with a fluoride antibacterial toothpaste and flossing to remove food debris and plaque on teeth, bridgework and implants, and brushing the tongue to remove odor-causing bacteria. A published study reported that tongue and tooth brushing in combination with dental flossing significantly decreased bleeding of the gum tissue over a two week period of time as well as reduced bad breath (1). Another clinical study conducted by the University of Buffalo dental researchers confirmed that brushing twice a day with an antibacterial toothpaste and using a tooth brush with a tongue cleaner can eliminate bad breath (2).

Tongue Cleaning is the Key to Fresher, Cleaner Breath

Cleaning your tongue is very important. You can purchase a Colgate 360 toothbrush with the tongue cleaner on the back of the toothbrush for cleaning both your teeth and tongue. After tooth brushing your upper and lower teeth with an antibacterial toothpaste, flip the toothbrush over to the tongue cleaner and place the tongue cleaner in the posterior region of the tongue and move it forward to the anterior section of the tongue. After you have scraped that portion of the tongue, rinse the tongue brush off with warm water to remove any odor causing bacteria. Then replace the tongue brush in the next posterior section again and repeat as described above again.

Consult your dentist or dental hygienist when choosing oral hygiene aids to help you eliminate plaque and odor causing bacteria and review the techniques that should be utilized at home. Also, ask your dental professional what oral hygiene care products they would consider you use to help eliminate bad breath (antibacterial toothpaste, antiseptic mouth rinse, tongue brushes or scrapers and interproximal cleaning devices). The key to a clean, fresh mouth is optimal oral hygiene conducted at home on a regular basis and professional recommendations discussed with you by your dental professional.

If you are concerned about bad breath, call  Dr. Jeffrey Fester in Roswell, GA 770.587.4202 for a free consultation!

What Is the Right Way to Brush?

What Is the Right Way to Brush?

Proper brushing takes at least two minutes — that’s right, 120 seconds! Most adults do not come close to brushing that long. To get a feel for the time involved, try using a stopwatch. To properly brush your teeth, use short, gentle strokes, paying extra attention to the gumline, hard-to-reach back teeth and areas around fillings, crowns or other restoration. Concentrate on thoroughly cleaning each section as follows:

  • Clean the outer surfaces of your upper teeth, then your lower teeth
  • Clean the inner surfaces of your upper teeth, then your lower teeth
  • Clean the chewing surfaces
  • For fresher breath, be sure to brush your tongue, too
Oral Hygiene - Brushing Teeth (top) Oral Hygiene - Brushing Teeth (bottom) Oral Hygiene - Brushing Tongue
Tilt the brush at a 45° angle against the gumline and sweep or roll the brush away from the gumline. Gently brush the outside, inside and chewing surface of each tooth using short back-and-forth strokes. Gently brush your tongue to remove bacteria and freshen breath.

What Type of Toothbrush Should I Use?

Most dental professionals agree that a soft-bristled brush is best for removing plaque and debris from your teeth. Small-headed brushes are also preferable, since they can better reach all areas of the mouth, including hard-to-reach back teeth. For many, a powered toothbrush is a good alternative. It can do a better job of cleaning teeth, particularly for those who have difficulty brushing or who have limited manual dexterity.

How Important is the Toothpaste I Use?

It is important that you use a toothpaste that’s right for you. Today there is a wide variety of toothpaste designed for many conditions, including  cavities, gingivitis, tartar, stained teeth and sensitivity. Ask your dentist or dental hygienist which toothpaste is right for you.

How Often Should I Replace My Toothbrush?

You should replace your toothbrush when it begins to show wear, or every three months, whichever comes first. It is also very important to change toothbrushes after you’ve had a cold, since the bristles can collect germs that can lead to reinfection.