We’ve come a long way since the early 1980s when we first identified the HIV virus. Although approximately 35 million people worldwide (including a million Americans) now have the virus, many are living relatively long and normal lives thanks to advanced antiretroviral drugs.
Still, HIV patients must remain vigilant about their health, especially their oral health. In fact, problems with the teeth, gums and other oral structures could be a sign the virus has or is moving into the full disease stage, acquired immunodeficiency syndrome (AIDS). That’s why you or a loved one with the virus should maintain regular dental checkups or see your dentist when you notice any oral abnormalities.
One of the most common conditions among HIV-positive patients is a fungal infection called candidiasis (or “thrush”). It may appear first as deep cracks at the corners of the mouth and then appear on the tongue and roof of the mouth as red lesions. The infection may also cause creamy, white patches that leave a reddened or bleeding surface when wiped.
HIV-positive patients may also suffer from reduced salivary flow. Because saliva helps neutralize excess mouth acid after we eat as well as limit bacterial growth, its absence significantly increases the risk of dental disease. One of the most prominent for HIV-positive patients is periodontal (gum) disease, a bacterial infection normally caused by dental plaque.
While gum disease is prevalent among people in general, one particular form is of grave concern to HIV-positive patients. Necrotizing ulcerative periodontitis (NUP) is characterized by spontaneous gum bleeding, ulcerations and a foul odor. The disease itself can cause loosening and eventually loss of teeth, but it’s also notable as a sign of a patient’s deteriorating immune system. The patient should not only undergo dental treatment (including antibiotics), but also see their primary care physician for updates in treating and managing their overall symptoms.
Above all, HIV-positive patients must be extra diligent about oral hygiene, including daily brushing and flossing. Your dentist may also recommend other measures like saliva stimulators or chlorhexidine mouthrinses to reduce the growth of disease-causing bacteria. Together, you should be able to reduce the effects of HIV-induced teeth and gum problems for a healthier mouth and better quality of life.
If you would like more information on oral care for HIV-AIDS patients, 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 “HIV-AIDS & Oral Health.”
Dental implants are widely considered by both dentists and patients as the premier choice for replacing missing teeth. Unfortunately, implants aren’t the appropriate choice for teenagers with missing teeth.
That’s because their jaws won’t fully finish most of their growth and development until early adulthood. An implant placed too early could become misaligned as the jaw matures. The best approach for a teenager is a temporary restoration until they’re old enough for an implant.
There are a couple of good options. One is a removable partial denture (RPD), prosthetic (false) teeth set in an acrylic base that mimics gum tissue at the locations of the missing teeth. RPDs, which stay in place by way of metal clips that fit over other teeth, are easy to wear and maintain.
On the downside, an RPD can break if you bite into something too hard. They can lose their fit and may need to be replaced with a new one. And, some teens aren’t quite keen on wearing a “denture.”
Another option is a bonded or Maryland bridge, a kind of fixed bridge. We bond dental material to the back of a prosthetic tooth with portions of the material extending out from either side of it.Â We then bond these extending tabs to the back of the teeth on either side of the prosthetic tooth to hold it in place. Unlike traditional bridges, we can eventually remove it without any permanent alterations to the teeth it’s attached to.
Before we undertake a bonded bridge, though, we must make sure the gums and bone of the surrounding teeth are free from periodontal (gum) disease and are healthy and strong enough to support the bridge. We also need to be sure the patient doesn’t have a deep bite or a teeth grinding habit, which could cause the teeth to make contact with the tabs and break them.
The patient also needs the maturity to responsibly perform diligent oral hygiene: this type of bridge has a tendency to build up disease-causing plaque, so brushing twice and flossing once every day is critical. Not doing so increases the risk of tooth decay or periodontal (gum) disease, which could complicate a future implant.
We can discuss these options after a thorough dental examination of your teenager. Either way, we’ll be able to restore your teen’s smile until we can undertake a more permanent restoration.
The long-running hit show Dancing with the Stars has had its share of memorable moments, including a wedding proposal, a wardrobe malfunction, and lots of sharp dance moves. But just recently, one DWTS contestant had the bad luck of taking an elbow to the mouth on two separate occasions—one of which resulted in some serious dental damage.
Nationally syndicated radio personality Bobby Bones received the accidental blows while practicing with his partner, professional dancer Sharna Burgess. “I got hit really hard,” he said. “There was blood and a tooth. [My partner] was doing what she was supposed to do, and my face was not doing what it was supposed to do.”
Accidents like this can happen at any time—especially when people take part in activities where there’s a risk of dental trauma. Fortunately, dentists have many ways to treat oral injuries and restore damaged teeth. How do we do it?
It all depends on how much of the tooth is missing, whether the damage extends to the soft tissue in the tooth’s pulp, and whether the tooth’s roots are intact. If the roots are broken or seriously damaged, the tooth may need to be extracted (removed). It can then generally be replaced with a dental bridge or a state-of-the-art dental implant.
If the roots are healthy but the pulp is exposed, the tooth may become infected—a painful and potentially serious condition. A root canal is needed. In this procedure, the infected pulp tissue is removed and the “canals” (hollow spaces deep inside the tooth) are disinfected and sealed up. The tooth is then restored: A crown (cap) is generally used to replace the visible part above the gum line. A timely root canal procedure can often save a tooth that would otherwise be lost.
For moderate cracks and chips, dental veneers may be an option. Veneers are wafer-thin shells made of translucent material that go over the front surfaces of teeth. Custom-made from a model of your smile, veneers are securely cemented on to give you a restoration that looks natural and lasts for a long time.
It’s often possible to fix minor chips with dental bonding—and this type of restoration can frequently be done in just one office visit. In this procedure, layers of tooth-colored resin are applied to fill in the parts of the tooth that are missing, and then hardened by a special light. While it may not be as long-lasting as some other restoration methods, bonding is a relatively simple and inexpensive technique that can produce good results.
If you would like more information about emergency dental treatment, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor articles “The Field-Side Guide to Dental Injuries” and “Knocked Out Tooth.”
Our main focus as your dentist is to keep your teeth and gums healthy and functional. But there’s another important aspect of care — your teeth’s appearance. It’s not just a superficial concern: your smile can have a profound effect on your self-image, as well as your personal and professional relationships.
This is the realm of cosmetic dentistry: served by both specialists and general dentists, it focuses on altering your teeth’s appearance with treatments as basic as teeth whitening or as comprehensive as dental implants. The goal, however, is the same: a new, more attractive smile.
In a way, cosmetic dentistry begins with you and oral hygiene. The twin tasks of brushing and flossing to remove dental plaque not only lowers your risk for tooth decay or periodontal (gum) disease, they also improve the appearance of the tooth surface. There are, however, circumstances where otherwise healthy or repaired teeth may need extra cosmetic attention due to chipping, misshape or staining. In these cases, a truly cosmetic approach may be necessary.
One approach is to cover a tooth’s blemishes. Veneers, for example, are thin, layered pieces of dental porcelain shaped and colored like natural teeth that are bonded to the outside of an unattractive tooth. In other cases, a tooth may require a life-like porcelain crown that completely covers it to gain the same effect.
Missing teeth, of course, pose a different challenge, but here there are a wide range of solutions: dental implants, fixed bridgework or removable full or partial dentures. Advancements in dental materials and techniques can produce new teeth that are so life-like and natural that they’re imperceptible from the real thing.
Â These and other measures like orthodontics can all be used to turn a smile you find embarrassing into one you’re confident to share with the world. It begins, though, with both you and us taking a good, close look at your current smile — a smile analysis, if you will.
After assessing both your current needs and your expectations for change, we can develop an appropriate treatment plan. It might be quite simple or with multiple treatment stages, but it will be the best plan for you. Through cosmetic dentistry we have the means to help you achieve a new, more confident smile.
If you would like more information on the many ways to transform your smile, 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 “Cosmetic Dentistry: A Time for Change.”
Although we begin our New Year's resolutions with high hopes, many of them fall by the wayside by the end of January. It simply takes tremendous willpower to lose weight or exercise more. So to improve your resolution success rate, why not throw in some with a little more zing, like trying every item on the menu at your favorite restaurant or learning a new magic trick every month? Or how about this one: Resolve to do four things this year to change your smile.
Okay, it doesn't have to be exactly four. But we just happen to have four suggestions—one for each quarter of the new year—that can make your smile the best it can be in 2020.
Brighten up your smile. A professional whitening procedure can improve a stained, dingy smile. Our advanced bleaching techniques give your teeth that brighter look that could last for years with proper care and regular touchups. We can also control the level of whiteness to give your teeth a softer natural look or one that's dazzling bright.
Fix a chipped tooth with bonding. You may have a great smile, except for that one tooth that's missing a little piece. We can repair minor chips and other defects with composite resin material bonded directly to the tooth. Composite resin can be color-matched and shaped to fit the tooth being repaired so that it looks completely natural. Best of all, we can transform your tooth's appearance in just one visit.
Gain a new look with veneers. If you have one or more teeth with mild to moderate chipping, staining or misalignment, dental veneers could change their appearance altogether. These thin wafers of dental porcelain are bonded to the front of teeth to permanently mask imperfections. They're so lifelike, others will have a hard time telling the difference between your teeth with veneers and those without.
Straighten your smile. It's never too late to have a crooked smile straightened. And you might not even have to wear braces: Clear aligners are computer-generated plastic trays worn in sequence to straighten teeth. They're removable, so you can take them out to eat or clean your teeth. Best of all, they're hardly noticeable—and they can give you a more attractive smile.
These and other cosmetic treatments are relatively easy ways to make a big impact on your appearance. Be resolved, then, that with a little help from us this can be the year you'll gain a more attractive smile through the art of dentistry.
If you would like more information about smile enhancements, please contact us or schedule an appointment. To learn more, read the Dear Doctor magazine articles “Cosmetic Dentistry: A Time for Change” and “Beautiful Smiles by Design.”
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