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By Howard D. Klein, DMD
August 18, 2019
Category: Oral Health
Tags: oral health   tooth decay  
ToothHealThyselfMaySoonBeaReality

Although dental care has made incredible advances over the last century, the underlying approach to treating tooth decay has changed little. Today’s dentists treat a decayed tooth in much the same way as their counterparts from the early 20th Century: remove all decayed structure, prepare the tooth and fill the cavity.

Dentists still use that approach not only because of its effectiveness, but also because no other alternative has emerged to match it. But that may change in the not-too-distant future according to recent research.

A research team at Kings College, London has found that a drug called Tideglusib, used for treating Alzheimer’s disease, appears to also stimulate teeth to regrow some of its structure. The drug seemed to cause stem cells to produce dentin, one of the tooth’s main structural layers.

During experimentation, the researchers drilled holes in mouse teeth. They then placed within the holes tiny sponges soaked with Tideglusib. They found that within a matter of weeks the holes had filled with dentin produced by the teeth themselves.

Dentin regeneration isn’t a new phenomenon, but other occurrences of regrowth have only produced it in tiny amounts. The Kings College research, though, gives rise to the hope that stem cell stimulation could produce dentin on a much larger scale. If that proves out, our teeth may be able to create restorations by “filling themselves” that are much more durable and with possibly fewer complications.

As with any medical breakthrough, the practical application for this new discovery may be several years away. But because the medication responsible for dentin regeneration in these experiments with mouse teeth is already available and in use, the process toward an application with dental patients could be relatively short.

If so, a new biological approach to treating tooth decay may one day replace the time-tested filling method we currently use. One day, you won’t need a filling from a dentist—your teeth may do it for you.

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

By Howard D. Klein, DMD
August 08, 2019
Category: Oral Health
Tags: oral hygiene   dentures  
DoYourDenturesandMouthaFavorTakeThemOutatNight

People who’ve lost all their teeth have benefitted from a solution that’s been around for generations: removable dentures. These appliances have helped millions of people chew and eat food, speak, and smile confidently.

But for all their benefits (including affordability) there’s still some things you need to do to get the most out of them like cleaning them daily or having us check them regularly for damage and wear. And, there’s one thing you shouldn’t do: wear them around the clock. Not removing them when you sleep at night can harm your oral health and reduce your dentures’ longevity.

Dentures are fitted to rest on the gums and the bony ridges that once held your natural teeth. This exerts pressure on the underlying bone that can cause it to gradually dissolve (resorb). This loss in bone volume eventually loosens your denture’s fit. If you’re wearing them all the time, the process progresses faster than if you took them out each night.

The under surfaces of dentures are also a prime breeding ground for bacteria and fungi. Besides unpleasant odors and irritation, these microorganisms are also the primary cause for dental disease. Research has found that people who sleep in their dentures have higher occurrences of plaque, a thin film of bacteria and food remnants that cause periodontal (gum) disease. They’re also more prone to higher levels of yeast and the protein interleukin-6 in the blood, which can trigger inflammation elsewhere in the body.

To avoid these and other unpleasant outcomes, you should develop a few important habits: remove and rinse your dentures after eating; brush them at least once a day with dish or anti-bacterial soap or a denture cleanser (not toothpaste, which can be too abrasive); and take them out when you sleep and place them in water or an alkaline peroxide-based solution.

Be sure you also brush your gums and tongue with an extra soft toothbrush (not your denture brush) or wipe them with a clean, damp washcloth. This will help reduce the level of bacteria in the mouth.

Taking these steps, especially removing dentures while you sleep, will greatly enhance your well-being. Your dentures will last longer and your mouth will be healthier.

If you would like more information on denture care and maintenance, please contact us or schedule an appointment for a consultation.

By Howard D. Klein, DMD
July 29, 2019
Category: Oral Health
EatingDisordersMayContributetoDamagedTeethandGums

While most dental problems are caused by disease or trauma, sometimes the root problem is psychological. Such is the case with bulimia nervosa, an eating disorder that could contribute to dental erosion.

Dental erosion is the loss of mineral structure from tooth enamel caused by elevated levels of acid in the mouth, which can increase the risk for decay and eventual tooth loss. While elevated acid levels are usually related to inadequate oral hygiene or over-consumption of acidic foods and beverages, the practice of self-induced vomiting after food binging by bulimic patients may also cause it. Some of the strong stomach acid brought up by vomiting may remain in the mouth afterward, which can be particularly damaging to tooth enamel.

It’s often possible to detect bulimia-related erosion during dental exams. The bottom teeth are often shielded by the tongue during vomiting, so erosion may be more pronounced on the unshielded upper front teeth. The salivary glands may become enlarged, giving a puffy appearance to the sides of the face below the ears. The back of the mouth can also appear red and swollen from the use of fingers or objects to induce vomiting.

Self-induced vomiting may not be the only cause for dental erosion for bulimics. Because the disorder causes an unhealthy focus on body image, bulimics may become obsessed with oral hygiene and go overboard with brushing and flossing. Aggressive brushing (especially just after throwing up when the tooth enamel may be softened) can also damage enamel and gum tissue.

Treatment must involve both a short — and long-term approach. Besides immediate treatment for dental erosion, a bulimic patient can minimize the effect of acid after vomiting by not brushing immediately but rinsing instead with water, mixed possibly with a little baking soda to help neutralize the acid. In the long-term, though, the eating disorder itself must be addressed. Your family doctor is an excellent starting point; you can also gain a great deal of information, both about eating disorders and treatment referrals, from the National Eating Disorders Association at their website, www.nationaleatingdisorders.org.

The effects of bulimia are devastating to mental and physical well-being, and no less to dental health. The sooner the disorder can be treated the better the person’s chance of restoring health to their mind, body — and mouth.

If you would like more information on the effect of eating disorders on oral 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 “Bulimia, Anorexia & Oral Health.”

By Howard D. Klein, DMD
July 19, 2019
Category: Oral Health
HealthySmilesforAlfonsoRibeiroandFamily

If there's anything that makes Alfonso Ribeiro happier than his long-running gig as host of America's Funniest Home Videos, it's the time he gets to spend with his family: his wife Angela, their two young sons, and Alfonso's teenaged daughter. As the proud dad told Dear Doctor–Dentistry & Oral Health magazine, "The best part of being a father is the smiles and the warmth you get from your children."

Because Alfonso and Angela want to make sure those little smiles stay healthy, they are careful to keep on top of their kids' oral health at home—and with regular checkups at the dental office. If you, too, want to help your children get on the road to good oral health, here are five tips:

  • Start off Right—Even before teeth emerge, gently wipe baby's gums with a clean, moist washcloth. When the first teeth appear, brush them with a tiny dab of fluoride on a soft-bristled toothbrush. Schedule an age-one dental visit for a complete evaluation, and to help your child get accustomed to the dental office.
  • Teach Them Well—When they're first learning how to take care of their teeth, most kids need a lot of help. Be patient as you demonstrate the proper way to brush and floss…over and over again. When they're ready, let them try it themselves—but keep an eye on their progress, and offer help when it's needed.
  • Watch What They Eat & Drink—Consuming foods high in sugar or starch may give kids momentary satisfaction…but these substances also feed the harmful bacteria that cause tooth decay. The same goes for sodas, juices and acidic drinks—the major sources of sugar in many children's diets. If you allow sugary snacks, limit them to around mealtimes—that gives the mouth a chance to recover its natural balance.
  • Keep Up the Good Work—That means brushing twice a day and flossing at least once a day, every single day. If motivation is an issue, encourage your kids by letting them pick out a special brush, toothpaste or floss. You can also give stickers, or use a chart to show progress and provide a reward after a certain period of time. And don't forget to give them a good example to follow!
  • Get Regular Dental Checkups—This applies to both kids and adults, but it's especially important during the years when they are rapidly growing! Timely treatment with sealants, topical fluoride applications or fillings can often help keep a small problem from turning into a major headache.

Bringing your kids to the dental office early—and regularly—is the best way to set them up for a lifetime of good checkups…even if they're a little nervous at first. Speaking of his youngest child, Alfonso Ribeiro said "I think the first time he was really frightened, but then the dentist made him feel better—and so since then, going back, it's actually a nice experience." Our goal is to provide this experience for every patient.

If you have questions about your child's dental hygiene routine, call the office or schedule a consultation. You can learn more in the Dear Doctor magazine article “How to Help Your Child Develop the Best Habits for Oral Health.”

By Howard D. Klein, DMD
July 09, 2019
Category: Oral Health
Tags: oral health   bulimia  
ErosionandOtherProblemsmaybeSignsofBulimia

The mouth isn’t an island unto itself — problems there may be indicative of deeper physical or emotional issues.  The condition of a family member’s teeth and gums, for example, could be signs of bulimia, an eating disorder.

Characterized by food binging and purging through self-induced vomiting, bulimia can also have a severe effect on the teeth. Regular inducement of vomiting introduces stomach acid into the mouth that can attack and soften the mineral content of tooth enamel. As a result, 90% of bulimics develop enamel erosion.

The erosion pattern often differs from that produced by other high acid causes like the over-consumption of sodas. Because the tongue instinctively covers the back of the bottom teeth during vomiting, they’re often shielded from much of the acid wash. Bulimics are much more apt to exhibit heavier erosion on the upper front teeth, particularly on the tongue side and biting edges.

Bulimia and similar disorders produce other signs as well, like soft tissue ulceration or swollen salivary glands that exhibit puffiness of the face. The roof of the mouth, throat and back of the tongue may appear roughened from the use of fingers or objects to induce gagging.

Unlike sufferers of anorexia nervosa who tend to be negligent about their hygiene (which itself increases their risk of dental disease), bulimics have a heightened sensitivity to their appearance. This concern may prompt them to aggressively brush right after purging, which can cause more of the softened enamel to be removed.

Treating the dental consequences of bulimia requires a two-pronged approach. In the short term, we want to lessen the impact of stomach acid by discouraging the person from brushing immediately after purging — better to rinse with water and a little baking soda to buffer the acid and wait about an hour before brushing. We may also suggest a sodium fluoride mouth rinse to help strengthen and re-mineralize the enamel.

In the long-term, though, the disorder itself must be addressed through professional help. One good source is the National Eating Disorders website (nationaleatingdisorders.org). Besides information, the association also provides a toll-free helpline for referrals to professionals.

As with any eating disorder, bulimia can be trying for patients and their families. Addressing the issue gently but forthrightly will begin their journey toward the renewal of health, including their teeth and gums.

If you would like more information on the effect of eating disorders 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 “Bulimia, Anorexia & Oral Health.”





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