1313 Lyndon Lane, Suite 214, Louisville, KY 40222, (502) 425-2442

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By Howard D. Klein, DMD
May 20, 2019
Category: Oral Health
Tags: oral health   GERD  
DontLetGERDRuinYourTeethsHealth

Gastroesophageal reflux disease (GERD) is a digestive disorder that can lead to a number of serious health problems. One of them, tooth erosion, could ruin your dental health.

Your stomach uses strong acids to break down food during digestion. A ring of muscle just above the stomach called the esophageal sphincter works as a one-way valve to allow food contents into the stomach but prevent acid from traveling back up through the esophagus.

GERD occurs when the esophageal sphincter weakens and starts allowing acid into the esophagus and potentially the mouth. The acid wash can eventually damage the esophageal lining, causing pain, heartburn, ulcers or even pre-cancerous cells.

Acid coming up in the mouth can cause the mouth’s normally neutral pH to slide into the acidic range. Eventually, these high acid levels soften and erode tooth enamel, increasing the risk of decay and tooth loss.

Accelerated erosion is often a sign of GERD—in fact, dentists may sound the first warning that a patient has a gastrointestinal problem. Unfortunately, a lot of damage could have already occurred, so it’s important to take steps to protect your teeth.

If you’ve been diagnosed with GERD, be sure to maintain good oral hygiene practices like brushing or flossing, especially using fluoride toothpaste to strengthen enamel. But try not to brush right after you eat or during a GERD episode: your teeth can be in a softened condition and you may actually brush away tiny particles of mineral. Instead, wait about an hour after eating or after symptoms die down.

In the meantime, try to stimulate saliva production for better acid neutralization by chewing xylitol gum or using a saliva booster. You can also lower mouth acid by rinsing with a cup of water with a half teaspoon of baking soda dissolved in or chewing on an antacid tablet.

You can also minimize GERD symptoms with medication, as well as avoiding alcohol, caffeine or spicy and acidic foods. Try eating smaller meals, finishing at least three hours before bedtime, and avoid lying down immediately after eating. Quitting smoking and losing weight may also minimize GERD symptoms.

GERD definitely has the potential to harm your teeth. But keeping the condition under control will minimize that threat and benefit your health overall.

If you would like more information on the effects of GERD 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 “GERD and Oral Health.”

By Howard D. Klein, DMD
May 10, 2019
Category: Oral Health
Tags: tooth decay   toothache  
HeresWhattoDoifYourChildhasaToothache

What should you do if your child complains about a toothache? Before calling our office, try first to learn what you can about the toothache.

You should first ask them where exactly the pain is coming from — one particular tooth or a generalized, dull ache. Also try to find out, as best they can tell you, when they first noticed the pain. Try then to look at the tooth or area where they indicate the pain is coming from: since tooth decay is a prime cause for tooth pain, you should look for any obvious signs of it like brown spots or cavities. You should also look at the gums around the teeth for any redness or swelling, a sign of an abscess or periodontal (gum) disease.

If you notice any of these signs, the pain persists for more than a day, or it has kept the child awake during the night, you should have us examine them as soon as possible. If you notice facial swelling or they’re running a fever, please call and we will see them immediately. If it’s definitely tooth decay, it won’t go away on its own. The longer we wait to treat it, the worse its effects in the mouth.

In the meantime, you should also try to alleviate the pain as best you can. If when looking in the mouth you noticed food debris (like a piece of hard candy) wedged between the teeth, try to gently remove it with dental floss. Give them ibuprofen or acetaminophen in an appropriate dosage for their age to relieve pain, or apply an ice pack on and off for about 5 minutes at a time to the outside of their jaw.

If any of these remedies stops the pain within an hour, you can wait until the next day to call for an appointment. If the pain persists, though, then an abscess could be developing — you should call that day to see us.

Regardless of when the pain stops, or whether you see any abnormal signs, it’s still important your child see us for an accurate diagnosis. Their toothache maybe trying to tell you something’s wrong — and the earlier a problem is found and treated, the better the outcome.

If you would like more information on dental problems in young children, 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 “A Child’s Toothache.”

JulianneHoughSharesaVideo-andaSong-AfterWisdomTeethComeOut

Once upon a time, celebrities tried hard to maintain the appearance of red-carpet glamour at all times. That meant keeping the more mundane aspects of their lives out of the spotlight: things like shopping, walking the dog and having oral surgery, for example.

That was then. Today, you can find plenty of celebs posting pictures from the dentist on social media. Take Julianne Hough, for example: In 2011 and 2013, she tweeted from the dental office. Then, not long ago, she shared a video taken after her wisdom teeth were removed in December 2016. In it, the 28-year-old actress and dancer cracked jokes and sang a loopy rendition of a Christmas carol, her mouth filled with gauze. Clearly, she was feeling relaxed and comfortable!

Lots of us enjoy seeing the human side of celebrities. But as dentists, we’re also glad when posts such as these help demystify a procedure that could be scary for some people.

Like having a root canal, the thought of extracting wisdom teeth (also called third molars) makes some folks shudder. Yet this routine procedure is performed more often than any other type of oral surgery. Why? Because wisdom teeth, which usually begin to erupt (emerge from beneath the gums) around age 17-25, have the potential to cause serious problems in the mouth. When these molars lack enough space to fully erupt in their normal positions, they are said to be “impacted.”

One potential problem with impacted wisdom teeth is crowding. Many people don’t have enough space in the jaw to accommodate another set of molars; when their wisdom teeth come in, other teeth can be damaged. Impacted wisdom teeth may also have an increased potential to cause periodontal disease, bacterial infection, and other issues.

Not all wisdom teeth need to be removed; after a complete examination, including x-rays and/or other diagnostic imaging, a recommendation will be made based on each individual’s situation. It may involve continued monitoring of the situation, orthodontics or extraction.

Wisdom tooth extraction is usually done right in the office, often with a type of anesthesia called “conscious sedation.”  Here, the patient is able to breathe normally and respond to stimuli (such as verbal directions), but remains free from pain. For people who are especially apprehensive about dental procedures, anti-anxiety mediation may also be given. After the procedure, prescription or over-the-counter pain medication may be used for a few days. If you feel like singing a few bars, as Julianne did, it’s up to you.

If you would like more information about wisdom tooth extraction, please call our office to arrange a consultation. You can learn more in the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”

By Howard D. Klein, DMD
April 20, 2019
Category: Oral Health
Tags: oral health   cold sore  
IrritatingColdSoreOutbreakscanbeControlledThroughMedication

Although normally benign, a cold sore outbreak can be irritating and embarrassing. Understanding why they occur is the first step to minimizing outbreaks.

The typical cold sore (also known as a fever blister) is caused by the Herpes Simplex Virus (HSV) Type I, medically known as “Herpes Labialis” because it occurs on or around the lips. This virus is not to be confused with HSV Type II, which causes a genital infection. Unlike most viruses, HSV Type I can cause a recurring sore outbreak in certain people. Most viruses tend to occur only once because the body produces anti-bodies to prevent further attack; it’s believed HSV Type I, however, can shield itself from these defenses by hiding in the body’s nerve roots.

These cold sore outbreaks often occur during periods of high stress, overexposure to sunlight or injuries to the lip. Initially you may have an itch or slight burning around the mouth that escalates into more severe itching, redness, swelling and blistering. The sores will break out for about a week to ten days and then scab over and eventually heal (unless they become infected, in which case the healing process may go longer). You’re contagious between the first symptoms and healing, and so can spread the virus to other people.

In recent years, anti-viral prescription medications have been developed that can effectively prevent HSV outbreaks, or at least reduce the healing time after an occurrence. The most common of these are acyclovir and valcyclovir, proven effective with only a few possible mild side effects. They can be taken routinely by people with recurring cold sores to suppress regular outbreaks.

While HSV Type I cold sores are more an aggravation than a health danger, it’s still important for you to see us initially for an examination if you encounter an outbreak. It’s possible for a more serious condition to masquerade as a cold sore or blister. A visit to us may also get you on the right track to reducing the frequency of outbreaks, as well as minimizing discomfort when they do occur.

If you would like more information on the treatment of cold sores, 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 “Cold Sores.”

By Howard D. Klein, DMD
April 10, 2019
Category: Dental Procedures
Tags: fillings  
DentalAmalgamContinuestobeaDurableandSafeToothFilling

Recently, a number of new filling materials that mimic tooth color have come into popular use and, so far, have proven more durable than past versions. Even so, the traditional metal-based dental amalgam remains a viable choice, especially for less visible back teeth and their higher biting forces.

Used for more than a century, dental amalgam is a metal alloy composed of silver, mercury, tin and copper. The mixture is carefully proportioned so that potentially hazardous mercury is kept to a minimum and bonded with the other metals. Amalgam in its initial form is quite pliable so that it can be molded into the tooth structure under repair. Afterward it sets hard to form a durable filling that can withstand the daily force generated when we bite and chew food.

Besides durability, dental amalgam rarely causes an allergic reaction in a patient, and it’s easy for trained dentists to apply. On the downside, however, it can cause temporary temperature sensitivity in the tooth just after filling, and the tooth itself may require some removal of healthy structure to help keep the filling in place. And from an aesthetic point of view, its metallic appearance is considered unattractive especially for front teeth.

The presence of mercury in amalgam has also raised concerns over the years. “Free” mercury — atoms that escape through vapor emitted by the metal — can enter the bloodstream and potentially harm the nervous system. But after extensive study and research, U.S. and international health bodies including the American Dental Association have concluded any free mercury released during chewing is extremely low and well below any harmful levels. These studies have also found no ill effects in either children or adults with dental amalgam fillings.

Deciding on the type of filling material to use — dental amalgam or a newer composite resin, resin ionomer or glass ionomer — depends on a number of factors including the location of the teeth to be filled, the extent of decay and your personal preferences. Taking these into account, we’ll be happy to discuss which type of filling will suit you best for repairing decayed teeth.

If you would like more information on filling material options including dental amalgam, 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 “Silver Fillings — Safe or Unsafe?





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