One of the true enjoyments many of us have in life as we age is eating. We have more time to cook or we just look forward to going out to eat. But some of us enjoy eating more than others. Why? For many, they have a lower denture that wobbles. And no matter what they do, that lower denture just doesn’t feel right.
It’s problem for denture wearers and the question usually goes like this: Why does my upper denture feel secure but my lower denture doesn’t?
The answer is in your anatomy. You have a palate on the upper, a large area where your denture rests. And because of that, the upper denture fits like a suction cup. The lower doesn’t work that way, because your tongue is in the way. The lower denture just doesn’t stand a chance with a tongue whose muscles move when we talk, when we swallow, and when we eat.
In previous columns, I’ve talked about dental implants to replace an entire arch (upper or lower) of teeth with teeth that are fixed in place. They are great, but may not be affordable for some. However, there is a solution that may do just enough to make you comfortable and start enjoying your food again. It’s the two-implant “snap.”
A two-implant snap works this way. Two implants are placed into the front part of your lower jaw, spaced about an inch apart. Included in those implants are receptacles that hold a snap, the same kind of snap that holds a jacket together, the same kind of snap that holds an infant’s clothes together. The other part of the snap is then attached to the inside of the denture. So instead of the denture floating up and down, it now snaps into place. Two snaps are the minimum. A good candidate for the two-implant snap has some remaining lower ridge and has enough room in the existing denture to hold the snap. If you want additional snaps in the back for even more stability, they can be placed at the same time or added later on.
The surgery for the two-implant snap is minimal, sometimes not even requiring an incision. And it won’t break the bank, costing $5-7000 depending on the quality of the lower ridge and the usability of the existing denture.
Our bodies thrive when we eat the correct foods. If you are changing your food choices because your dentures just don’t do the job, think “snap.”
Tuesday, November 23, 2010
Monday, October 11, 2010
Thin Gums Lead to Sensitive Teeth
When you eat ice cream, do your teeth feel so sensitive that you dare not take another bite?
Gum recession can become a gradually worsening problem as we get older. It occurs because the underlying gum tissue on the bone may be thin and have a poor blood supply.
So while our gum tissue stretched over our teeth when we were younger, the tissues get thinner and thinner as we get older and gradually go away, producing exposure of the root surface.
This can present a number of problems.
First, the root exposure gives you that "long in the tooth" look. Second, the root exposure often produces tooth sensitivity.
Very simply, the top part of our tooth is covered with enamel. Enamel provides a nice thermal layer, like a blanket. But the root doesn't have enamel, so when we eat cold or sweet things, we feel it right into our roots and sometimes right into our bone.
Third, because the root surface is not covered by tough, hard enamel, it tends to wear away.
You can feel that yourself if you have recession. Put your fingernail on your root surface (if it isn't too sensitive) and you may feel your root actually is gouged. And the deeper the gouge, the more sensitive the tooth may be.
And, of course, the deeper the gouge, the weaker the tooth may be.
Yes, I have seen teeth that have been gouged so deeply that the tooth eventually broke.
What can be done about that? There is a procedure called soft-tissue grafting. Soft tissue is placed underneath your thin gum tissue to make it thicker. Thicker gum tissue has a better blood supply. And if your tissue is thicker, it is more likely to cover your exposed roots.
For years we took soft-tissue grafts from the roof of the mouth, but we don't have to do that as much anymore. There are specific tissues that come from a tissue bank, perfectly safe, that can be used to replace your missing gum tissue.
The second change is that we can extract growth factors from a small amount of your blood to speed healing.
Long in the tooth? It can be corrected, improving sensitivity and your smile.
Gum recession can become a gradually worsening problem as we get older. It occurs because the underlying gum tissue on the bone may be thin and have a poor blood supply.
So while our gum tissue stretched over our teeth when we were younger, the tissues get thinner and thinner as we get older and gradually go away, producing exposure of the root surface.
This can present a number of problems.
First, the root exposure gives you that "long in the tooth" look. Second, the root exposure often produces tooth sensitivity.
Very simply, the top part of our tooth is covered with enamel. Enamel provides a nice thermal layer, like a blanket. But the root doesn't have enamel, so when we eat cold or sweet things, we feel it right into our roots and sometimes right into our bone.
Third, because the root surface is not covered by tough, hard enamel, it tends to wear away.
You can feel that yourself if you have recession. Put your fingernail on your root surface (if it isn't too sensitive) and you may feel your root actually is gouged. And the deeper the gouge, the more sensitive the tooth may be.
And, of course, the deeper the gouge, the weaker the tooth may be.
Yes, I have seen teeth that have been gouged so deeply that the tooth eventually broke.
What can be done about that? There is a procedure called soft-tissue grafting. Soft tissue is placed underneath your thin gum tissue to make it thicker. Thicker gum tissue has a better blood supply. And if your tissue is thicker, it is more likely to cover your exposed roots.
For years we took soft-tissue grafts from the roof of the mouth, but we don't have to do that as much anymore. There are specific tissues that come from a tissue bank, perfectly safe, that can be used to replace your missing gum tissue.
The second change is that we can extract growth factors from a small amount of your blood to speed healing.
Long in the tooth? It can be corrected, improving sensitivity and your smile.
Monday, September 13, 2010
My Teeth Continue to Have Cavities!
You thought the days of cavities were over when you were a kid. But what happens as we get older? We get cavities again--one of those miracles of aging gracefully.
The problem with cavities in an adult is that they happen in the most inaccessible areas, usually on the exposed root at the gum line. Those cavities are difficult to treat. There is no dentist who enjoys treating those cavities and they tend to recur because the problem that caused the cavities remains.
What’s the problem? When we were young our saliva had a neutral pH. That means the mouth generally wasn’t acidic. Our saliva glands don’t work as well as they used to and many of the medications that are taken for the chronic diseases that we are treated for cause dry mouth. People with dry mouths get a lot of cavities.
Here’s what you can do about it: 1) Talk with your doctor and determine whether you might be able to withdraw from some of those medications.. 2) Reduce the sugar in your diet. Sugar comes in many forms. Processed food has sugar. Candies, cakes, sweets? You know them all. Sugar increases the incidence of decay. 3) Measure the acid level of your mouth. Your dentist may be able to help you with that, or you can go to the drugstore and buy nitrazine test paper. Put a small piece of this acid-detecting paper in your mouth. Once the paper is wet, it will turn a certain color and you can measure the color of the paper against a color chart and determine your pH (acid level).
Here are some new approaches: One is xylitol. Xylitol is a sugar. You can buy it in any health food store. Xylitol has been shown to remineralize decaying tooth structure. The second is a rinse which neutralizes the pH. If you don’t produce enough saliva, you can buy a rinse that does. Your dentist will recommend one to you or your pharmacist will. You are looking for a rinse with a pH of 7.0 or as close to that as possible. A simple home remedy is to use baking soda rinses. Their pH is higher, but will neutralize acids very fast. Take a tablespoon of baking soda, mix it in 8 ounces of water, and just rinse with a mouthful of it and spit out. Most only need do this 3 or 4 times a day. The third is to eat more raw vegetables. The fourth is to use the new calcium phosphate products which assist in the remineralization of enamel. You can look them up on the internet.
With diligence to detail, you can reverse the trend of tooth decay in your own mouth, saving money, discomfort, and tooth loss.
The problem with cavities in an adult is that they happen in the most inaccessible areas, usually on the exposed root at the gum line. Those cavities are difficult to treat. There is no dentist who enjoys treating those cavities and they tend to recur because the problem that caused the cavities remains.
What’s the problem? When we were young our saliva had a neutral pH. That means the mouth generally wasn’t acidic. Our saliva glands don’t work as well as they used to and many of the medications that are taken for the chronic diseases that we are treated for cause dry mouth. People with dry mouths get a lot of cavities.
Here’s what you can do about it: 1) Talk with your doctor and determine whether you might be able to withdraw from some of those medications.. 2) Reduce the sugar in your diet. Sugar comes in many forms. Processed food has sugar. Candies, cakes, sweets? You know them all. Sugar increases the incidence of decay. 3) Measure the acid level of your mouth. Your dentist may be able to help you with that, or you can go to the drugstore and buy nitrazine test paper. Put a small piece of this acid-detecting paper in your mouth. Once the paper is wet, it will turn a certain color and you can measure the color of the paper against a color chart and determine your pH (acid level).
Here are some new approaches: One is xylitol. Xylitol is a sugar. You can buy it in any health food store. Xylitol has been shown to remineralize decaying tooth structure. The second is a rinse which neutralizes the pH. If you don’t produce enough saliva, you can buy a rinse that does. Your dentist will recommend one to you or your pharmacist will. You are looking for a rinse with a pH of 7.0 or as close to that as possible. A simple home remedy is to use baking soda rinses. Their pH is higher, but will neutralize acids very fast. Take a tablespoon of baking soda, mix it in 8 ounces of water, and just rinse with a mouthful of it and spit out. Most only need do this 3 or 4 times a day. The third is to eat more raw vegetables. The fourth is to use the new calcium phosphate products which assist in the remineralization of enamel. You can look them up on the internet.
With diligence to detail, you can reverse the trend of tooth decay in your own mouth, saving money, discomfort, and tooth loss.
Monday, May 3, 2010
Bad Teeth? Think Hybrid
Bad Teeth? Think Hybrid
Dr. Lee Sheldon
You have a bad tooth. You go to the dentist. Get the filling. Then the tooth hurts. You need a root canal and a crown. That’s okay if it happens once or twice. What happens if you go through this sequence again and again? Are there other answers?
Yes, there is another answer, an answer that doesn’t decay, that has a better success rate than any form of tooth replacement, a dental implant. Along with the implant you’ll need a crown and a post to hold the crown onto the implant. Okay, you say, a dental implant will work, but I’m having this problem again and again and again. I can’t afford a dental implant for every tooth that goes bad. Well, there’s lots of good news here. You don’t have to replace every bad tooth with an implant.
Other people who have bad teeth, rather than continuing to replace them, opt out of the dental system. They wait for the ultimate to happen and then they think that they’ll have to have dentures. Why? Dentures are less expensive, they don’t wear out readily, and it’s the only answer that they know of.
What would happen if you combine the lower cost of denture materials with dental implants? You would have a tooth replacement system called a “hybrid.” You would have a dental implant-supported denture, with all the security of implants supported by bone, and a denture fastened to those implants. It wouldn’t move, wouldn’t cause denture sores. It would be smaller so that the roof of your mouth isn’t covered. You would chew almost the way you did when you had healthy natural teeth. You wouldn’t have to have your dentures removed if you had surgery. You wouldn’t have to think about what you can and cannot order on the menu. And in the event that a tooth broke, it would be a simple repair.
Implant-supported hybrid dentures are nothing new. They’ve been around for over twenty-five years. They’re generally used to replace full arches of missing teeth. Almost everyone who is missing teeth still has enough bone support for a hybrid. And with the modern dental CT-scans, we can often find good implant-supporting bone that we couldn’t see on traditional x-rays. So if you’ve been missing teeth for years, you still qualify for a hybrid. And hybrids are cost-effective, costing roughly half of what a full arch of implant-supported crowns would cost.
Some of the happiest patients we have are patients who found an answer to the continual downward spiral of dental disease. They found hybrids, and are smiling and chewing better than they have in years. If you’ve always thought that there must be an easier answer to the continual path of tooth after tooth after tooth going bad, talk to your dentist about a hybrid.
Dr. Lee Sheldon
You have a bad tooth. You go to the dentist. Get the filling. Then the tooth hurts. You need a root canal and a crown. That’s okay if it happens once or twice. What happens if you go through this sequence again and again? Are there other answers?
Yes, there is another answer, an answer that doesn’t decay, that has a better success rate than any form of tooth replacement, a dental implant. Along with the implant you’ll need a crown and a post to hold the crown onto the implant. Okay, you say, a dental implant will work, but I’m having this problem again and again and again. I can’t afford a dental implant for every tooth that goes bad. Well, there’s lots of good news here. You don’t have to replace every bad tooth with an implant.
Other people who have bad teeth, rather than continuing to replace them, opt out of the dental system. They wait for the ultimate to happen and then they think that they’ll have to have dentures. Why? Dentures are less expensive, they don’t wear out readily, and it’s the only answer that they know of.
What would happen if you combine the lower cost of denture materials with dental implants? You would have a tooth replacement system called a “hybrid.” You would have a dental implant-supported denture, with all the security of implants supported by bone, and a denture fastened to those implants. It wouldn’t move, wouldn’t cause denture sores. It would be smaller so that the roof of your mouth isn’t covered. You would chew almost the way you did when you had healthy natural teeth. You wouldn’t have to have your dentures removed if you had surgery. You wouldn’t have to think about what you can and cannot order on the menu. And in the event that a tooth broke, it would be a simple repair.
Implant-supported hybrid dentures are nothing new. They’ve been around for over twenty-five years. They’re generally used to replace full arches of missing teeth. Almost everyone who is missing teeth still has enough bone support for a hybrid. And with the modern dental CT-scans, we can often find good implant-supporting bone that we couldn’t see on traditional x-rays. So if you’ve been missing teeth for years, you still qualify for a hybrid. And hybrids are cost-effective, costing roughly half of what a full arch of implant-supported crowns would cost.
Some of the happiest patients we have are patients who found an answer to the continual downward spiral of dental disease. They found hybrids, and are smiling and chewing better than they have in years. If you’ve always thought that there must be an easier answer to the continual path of tooth after tooth after tooth going bad, talk to your dentist about a hybrid.
Wednesday, April 14, 2010
Obstructive Sleep Apnea
Can’t Wear a CPAP mask? Your dentist may help..
Obstructive sleep apnea (OSA) is a chronic condition when it causes disturbances in sleep three or more nights a week. It occurs in males twice as often as in females. As we age, we lose muscle tonus in many areas of the body, including the mouth and throat. And just as you may be a little flabby in your belly, you also become flabby in the muscles controlling your airway. The usual scenario is this: You fall asleep on your back. Your tongue falls back toward your throat. Your soft palate and your pharynx also collapse a bit. You start to snore as the air that you inhale goes through the airway that is now narrowed because of the muscle collapse. What happens if those airway muscles completely collapse? You stop breathing. Of course, you won’t let your body do this for too long, so you wake up just enough to tighten the muscles in your airway and start breathing again.
This process can occur several times per hour. The more you are awakened out of a deep sleep, the more tired you’re likely to be the next day. But is doesn’t stop there. OSA increases the risk for high blood pressure, heart attack, stroke, obesity, and diabetes.
The first-line treatment for OSA is CPAP (Continuous Positive Airway Pressure), a nasal and/or oral mask connected by hose to a machine that gently blows air into your airway to keep it from collapsing. Despite its effectiveness, many with OSA, particularly in its mild or moderate form, find the CPAP to be a nuisance and don’t use it.
An increasingly popular alternative to CPAP for those who cannot use it is an oral appliance. This device, worn on top of the teeth, opens your jaw and moves it forward, thus opening your airway.
You can try it yourself. Take a deep breath and feel the air going through the airway. Now thrust your lower jaw forward and take another deep breath. Do you feel a difference? You’ve just opened your airway. The oral appliance opens the airway in the same fashion, stopping snoring and alleviating obstructive sleep apnea for many. And for those who don’t like CPAP, it seems to be better accepted.
There are many oral appliances available for OSA. There are simple snoring appliances. There are also adjustable appliances that you or your dentist can adjust to put your jaw in the most ideal position to open your airway. The use of such an appliance may not just make you a less noisy bed partner, it may save you from daytime fatigue as well as reduce your risk of some serious diseases.
Lee N. Sheldon, DMD
Obstructive sleep apnea (OSA) is a chronic condition when it causes disturbances in sleep three or more nights a week. It occurs in males twice as often as in females. As we age, we lose muscle tonus in many areas of the body, including the mouth and throat. And just as you may be a little flabby in your belly, you also become flabby in the muscles controlling your airway. The usual scenario is this: You fall asleep on your back. Your tongue falls back toward your throat. Your soft palate and your pharynx also collapse a bit. You start to snore as the air that you inhale goes through the airway that is now narrowed because of the muscle collapse. What happens if those airway muscles completely collapse? You stop breathing. Of course, you won’t let your body do this for too long, so you wake up just enough to tighten the muscles in your airway and start breathing again.
This process can occur several times per hour. The more you are awakened out of a deep sleep, the more tired you’re likely to be the next day. But is doesn’t stop there. OSA increases the risk for high blood pressure, heart attack, stroke, obesity, and diabetes.
The first-line treatment for OSA is CPAP (Continuous Positive Airway Pressure), a nasal and/or oral mask connected by hose to a machine that gently blows air into your airway to keep it from collapsing. Despite its effectiveness, many with OSA, particularly in its mild or moderate form, find the CPAP to be a nuisance and don’t use it.
An increasingly popular alternative to CPAP for those who cannot use it is an oral appliance. This device, worn on top of the teeth, opens your jaw and moves it forward, thus opening your airway.
You can try it yourself. Take a deep breath and feel the air going through the airway. Now thrust your lower jaw forward and take another deep breath. Do you feel a difference? You’ve just opened your airway. The oral appliance opens the airway in the same fashion, stopping snoring and alleviating obstructive sleep apnea for many. And for those who don’t like CPAP, it seems to be better accepted.
There are many oral appliances available for OSA. There are simple snoring appliances. There are also adjustable appliances that you or your dentist can adjust to put your jaw in the most ideal position to open your airway. The use of such an appliance may not just make you a less noisy bed partner, it may save you from daytime fatigue as well as reduce your risk of some serious diseases.
Lee N. Sheldon, DMD
Monday, March 29, 2010
NUTRITION and Periodontal Disease
NUTRITION and Periodontal Disease
The area that doctors and researchers are studying very carefully is chronic inflammation. In fact, chronic inflammation may very well be the common link to all of the chronic degenerative diseases—arthritis, heart disease, some forms of cancer, and periodontal disease to name just a few. I mention periodontal disease, because as a periodontist, that is what I see on a frequent basis.
Periodontal disease is that disease which causes a loss of the supporting bone for the teeth. Also known as pyorrhea and gum disease, periodontal disease robs the person of his or her teeth, resulting in loss of mouth function, loss of support of the facial tissues, and discomfort in eating.
So why bring this up in this column. The facts are changing in regard to this disease. For years, we have emphasized controlling plaque. You know—Floss your teeth, brush your teeth. “But you showed me how to floss my teeth last time!! “ Well, get even more used to the lecture, because we have even more information that links gum disease to overall disease. Your body’s immune response to plaque in your mouth results in chronic inflammation. That chronic inflammation not only destroys the bone supporting your teeth, it also destroys tissues all over the body. Yes, that’s right, all over the body.
But if you think that’s all, just hang on here a little longer. While plaque is necessary in the start of periodontal disease, there are other factors that will worsen it and worsen the chronic inflammation in the rest of your body. What is that, pray tell? NUTRITION !!! In fact, nutrition can play a positive or a negative role depending on how positively or negatively you eat. You already know what the bad things are, highly processed food, fast food. Have you ever seen what a McDonald’s hamburger looks like 4 years after it’s cooked. I have one. It looks exactly the same as when I bought it, bun included. I’ll show you. How good is that for you?
The American Heart Association recommends 4-5 servings a day of fresh vegetables and 4-5 servings a day of fresh fruits on a 2000 calorie diet. Yes, that means 8-10 servings (a serving is usually a half cup of a dense fruit or vegetable or a full cup of a leafy vegetable) of delicious fruits and vegetables. That will reduce your risk of heart disease, and it will also reduce your risk of other degenerative diseases, including periodontal disease.
“But I take my vitamins,” you say. Sorry. Vitamins don’t cut it. A multivitamin has generously 50-75 nutrients in it. A whole fruit or vegetable—over 12,000 nutrients that have been identified already. Some studies on vitamins A, C, and E were stopped because those people taking the vitamins were doing worse than those who weren’t.
Whole foods is the answer. And there are also whole foods supplements that you may take to help.
So, just before you brush and floss, have an apple, eat some grapes, dip some carrots in peanut butter (unprocessed). Eat the good foods. They may save more than your teeth.
Lee N. Sheldon, DMD
The area that doctors and researchers are studying very carefully is chronic inflammation. In fact, chronic inflammation may very well be the common link to all of the chronic degenerative diseases—arthritis, heart disease, some forms of cancer, and periodontal disease to name just a few. I mention periodontal disease, because as a periodontist, that is what I see on a frequent basis.
Periodontal disease is that disease which causes a loss of the supporting bone for the teeth. Also known as pyorrhea and gum disease, periodontal disease robs the person of his or her teeth, resulting in loss of mouth function, loss of support of the facial tissues, and discomfort in eating.
So why bring this up in this column. The facts are changing in regard to this disease. For years, we have emphasized controlling plaque. You know—Floss your teeth, brush your teeth. “But you showed me how to floss my teeth last time!! “ Well, get even more used to the lecture, because we have even more information that links gum disease to overall disease. Your body’s immune response to plaque in your mouth results in chronic inflammation. That chronic inflammation not only destroys the bone supporting your teeth, it also destroys tissues all over the body. Yes, that’s right, all over the body.
But if you think that’s all, just hang on here a little longer. While plaque is necessary in the start of periodontal disease, there are other factors that will worsen it and worsen the chronic inflammation in the rest of your body. What is that, pray tell? NUTRITION !!! In fact, nutrition can play a positive or a negative role depending on how positively or negatively you eat. You already know what the bad things are, highly processed food, fast food. Have you ever seen what a McDonald’s hamburger looks like 4 years after it’s cooked. I have one. It looks exactly the same as when I bought it, bun included. I’ll show you. How good is that for you?
The American Heart Association recommends 4-5 servings a day of fresh vegetables and 4-5 servings a day of fresh fruits on a 2000 calorie diet. Yes, that means 8-10 servings (a serving is usually a half cup of a dense fruit or vegetable or a full cup of a leafy vegetable) of delicious fruits and vegetables. That will reduce your risk of heart disease, and it will also reduce your risk of other degenerative diseases, including periodontal disease.
“But I take my vitamins,” you say. Sorry. Vitamins don’t cut it. A multivitamin has generously 50-75 nutrients in it. A whole fruit or vegetable—over 12,000 nutrients that have been identified already. Some studies on vitamins A, C, and E were stopped because those people taking the vitamins were doing worse than those who weren’t.
Whole foods is the answer. And there are also whole foods supplements that you may take to help.
So, just before you brush and floss, have an apple, eat some grapes, dip some carrots in peanut butter (unprocessed). Eat the good foods. They may save more than your teeth.
Lee N. Sheldon, DMD
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