Your saliva and why it�s so important

You probably don’t give too much thought to the saliva in your mouth but, if you think of it like a bloodstream you’ll realize how important it is.

Like blood, saliva helps build and maintain the health of the soft and hard tissues.

It removes waste products from the mouth and offers first-line protection against microbial invasion that might lead to disease.

Saliva is derived from blood and therefore can also be used to detect disease.

Saliva enhances enamel protection by providing high levels of calcium and phosphate ions. It contains the minerals that maintain the integrity of the enamel surface and helps protect against caries.

When salivary flow is reduced, oral health deteriorates – much in the same way body tissues suffer if blood circulation is disrupted.

Patients with dry mouths (xerostomia) experience difficulty chewing, speaking and swallowing. A major cause of dry mouth is medication – almost eighty percent of the most commonly prescribed medications lead to dry mouth.

Chewing gum after a snack or meal stimulates salivary flow, clearing food from the mouth and neutralizing plaque acid.

Your saliva is important to your oral health both for preventing disease and in helping to diagnose problems.

The early years of dentistry and teeth

Although there have been huge advances in dental care in recent years, there are records of people dealing with teeth going back over thousands of years.

Here are some of the key dates from the early years in the development of dentistry.

5000 BC: A Sumerian text describes �tooth worms� as the cause of dental decay.

2600 BC: Hesy-Re, an Egyptian scribe, often called the first �dentist�, dies. An inscription on his tomb includes the title �the greatest of those who deal with teeth, and of physicians.�

500-300 BC: Hippocrates and Aristotle write about dentistry, including the eruption pattern of teeth, treating decayed teeth and gum disease, extracting teeth with forceps, and using wires to stabilize loose teeth and fractured jaws.

166-201 AD: The Etruscans practice dental prosthetics using gold crowns and fixed bridgework.

500-1000: During the Early Middle Ages in Europe, medicine, surgery, and dentistry, are generally practiced by monks, the most educated people of the period

700: A medical text in China mentions the use of �silver paste,� a type of amalgam.

1130-1163: A series of Papal edicts prohibit monks from performing any type of surgery, bloodletting or tooth extraction. Barbers often assisted monks in their surgical ministry because they visited monasteries to shave the heads of monks and the tools of the barber trade � sharp knives and razors � were useful for surgery. Following the edicts, barbers assume the monks� surgical duties: bloodletting, lancing abscesses, extracting teeth, etc.

1210: A Guild of Barbers is established in France. Barbers eventually evolve into two groups: surgeons who were educated and trained to perform complex surgical operations; and lay barbers, or barber-surgeons, who performed more routine hygienic services including shaving, bleeding and tooth extraction.

1400s: A series of royal decrees in France prohibit lay barbers from practicing all surgical procedures except bleeding, cupping, leeching, and extracting teeth.

Periodontal disease: what it is and how to avoid it

Periodontal disease is an infection of the tissues that support your teeth.

There is a very slight gap (called a sulcus) between the tooth and the gum.

Periodontal diseases attack this gap and cause a breakdown in the attachment of the tooth and its supporting tissues.

When the tissues are damaged, the sulcus develops into a pocket and, as the disease gets more severe, the pocket usually gets deeper.

The two major stages of periodontal disease are gingivitis and periodontitis.

Gingivitis is a milder and reversible form of periodontal disease that only affects the gums. Gingivitis may lead to periodontitis, which is a more serious, destructive form of periodontal disease.

There are several factors that have been shown to increase the risk of developing periodontal disease:
– Systemic diseases such as diabetes
– Some types of medication
– Crooked teeth
– Bridges that no longer fit properly
– Fillings that have become defective
– Smoking
– Pregnancy

And there are a number of warning signs that can suggest a possible problem:
– Gums that bleed easily
– Red, swollen, tender gums
– Gums that have pulled away from the teeth
– Persistent bad breath or taste
– Permanent teeth that are loose or separating
– Any change in the way your teeth fit together when you bite
– Any change in the fit of partial dentures

However, it�s also possible to have periodontal disease with no warning signs.

It�s therefore important to have regular dental checkups and periodontal examinations.

If you have developed periodontal disease, the treatment will depend on how far it has progressed.

You can take steps to prevent periodontal disease from becoming more serious or recurring.

Good dental hygiene practices such as brushing twice a day, cleaning between your teeth, eating a healthy diet and having regular visits to the dentist will make a huge difference.

Root canal treatment

Root canal therapy is an important treatment that can save a tooth with a diseased nerve and which in the past would probably have needed to be removed.

Inside each tooth is the ‘pulp’ which runs like a thread down through the root and provides nutrients and nerves to the tooth. It is the soft tissue that contains nerves, blood vessels and connective tissue.

If the pulp is diseased or injured, the pulp tissue dies.

The most common cause of pulp death is a cracked tooth or a deep cavity. Both of these problems can let bacteria enter the pulp.

So, if you don’t remove it, your tooth gets infected and you could lose it.

After the dentist – or endodontist (a dentist who specializes in problems of the pulp) – removes the pulp, the root canal is cleaned and sealed off to protect it. Then your dentist places a crown over the tooth to help make it stronger.

Most of the time, a root canal is a relatively simple procedure involving one to three visits with little or no discomfort.

Your restored tooth could last a lifetime, if you continue to care for your teeth and gums and enjoy regular checkups.

Making the most of your smile

Your smile is a major factor in the impression people get when they meet you.

And the good news is that you now don’t have to settle for a smile spoiled by stained, chipped, or misshapen teeth.

Advances in dental treatment mean there is a wide range of choices to help you get the smile that you want. Here are some of the options:
– Tooth whitening (bleaching) can help brighten teeth that have become discolored or stained. It can be done in the dental office or with a system the dentist can give you to use at home
– Bonding improves the appearance of teeth that have become chipped, broken, cracked or stained. This is done by bonding tooth-colored materials to the tooth surface
– Enamel shaping involves modifying teeth to improve their appearance by removing or contouring enamel
– Veneers are thin custom-made shells of tooth-colored materials designed to cover the front side of teeth. They are used to treat spaces between teeth and teeth that are chipped, stained or poorly shaped.
– Braces may be needed if teeth are crooked, crowded or do not meet properly – and not just for kids

Even small changes can have a big impact on your smile and so make a huge difference to how you look and how you feel about yourself.

If you’d like an even better smile, your dentist will be able to give you information about the options available.

Maintaining proper nutrition as an older adult

Maintaining proper nutrition is important for everyone, young or old but many older adults find it difficult to eat a balanced diet.

They may avoid meats, raw vegetables and fresh fruits because they have trouble chewing or swallowing.

These problems can be caused by painful teeth, ill-fitting dentures, dry mouth or changes in facial muscles.

Others find their sense of taste has changed, sometimes due to a disease or certain medications.

As a result, older adults often have diets lacking in calcium, protein and other nutrients essential to dental and overall health.

A balanced diet has to be based on the five food groups:
– Milk and dairy products
– Breads and cereals
– Meats and dried beans
– Fruits
– Vegetables

Sometimes a multi-vitamin or mineral supplement will help but it�s best to use supplements only after discussion with your physician.

If your teeth are stopping you from eating the food you enjoy � or that you need for good health � your dentist will be able to help you find a solution.

Should you be concerned about thumbsucking?

Some children suck on their thumbs and parents often wonder if it is harmful.

Sucking on something is a child’s natural reflex. It can help them feel more secure so they start to suck on their thumbs, fingers, pacifiers or other objects.

Since thumbsucking is relaxing, it may also help them sleep.

However, after the permanent teeth come in, sucking may cause problems with the proper growth of the mouth and the alignment of teeth. It can also cause changes in the roof of the mouth.

Whether or not dental problems will result depends on the intensity of the sucking.

A child who vigorously sucks their thumb is more likely to have difficulties than one who rests their thumb passively in their mouth. Young children who suck their thumbs aggressively may even cause problems with their baby teeth.

If you notice changes in your childs primary teeth, consult your dentist.

Usually children will stop sucking their thumbs between the ages of about two and four. They should have ceased sucking by the time the permanent front teeth are ready to erupt.

If your child is continuing to suck their thumbs, here are some tips:

– Praise them for not sucking, instead of scolding them when they are
– If they are sucking because they feel insecure, focus on correcting the cause of the anxiety
– For older children, involve them in choosing the method of stopping

If necessary, your dentist can help by encouraging the child and explaining what could happen to their teeth if they do not stop sucking.

How Osteoporosis medications can affect your dental health

Osteoporosis is a disease that weakens bones and increases the risk of fractures.

It affects about 10 million Americans of whom 8 million are women and another 34 million are at risk of developing it.

So this is a disease that affects more women than cancer, heart disease and stroke combined.

But what does it have to do with your dental care?

Well, many people in these categories are treated with a group of prescription drugs called oral bisphosphonates. Studies have reported that these drugs reduce bone loss, increase bone density and reduce the risk of fractures.

But some people have been alarmed and confused by recent news reports about oral bisphosphonates because of uncommon complications that have been linked to these drugs.

The drugs have been associated with osteonecrosis of the jaw (ONJ), a rare but potentially serious condition that can cause severe destruction of the jawbone.

The true risk posed by oral bisphosphonates remains uncertain, but researchers seem to agree that it appears very small.

Given the risks associated with osteoporosis and the proven benefits of oral bisphosphonate therapy, you should not stop taking these medications before discussing the matter fully with your physician.

If your physician prescribes an oral bisphosphonate, its important to tell your dentist so that your health history form can be updated.

In this case, some dental procedures, such as extractions, may increase your risk of developing ONJ, so your dentist needs to be able to take your full health picture into account.

How sedation and general anesthesia can make your visit to the dentist easier

While local anesthetics are often used in dental treatment, there is sometimes a need for anti-anxiety agents – such as nitrous oxide – or sedatives to help people relax during dental visits.

Dentists may use these agents to induce “minimal or moderate sedation”.

In this case, the patient reaches a relaxed state during treatment but can respond to speech or touch.

Sedatives can be administered before, during or after dental procedures by mouth, inhalation or injection.

More complex treatments may require drugs that can induce “deep sedation”.

This reduces consciousness and causes a loss of feeling which helps to reduce both pain and anxiety.

Sometimes patients undergo “general anesthesia” where the drugs lead to a temporary loss of consciousness.

A dentist may recommend deep sedation or general anesthesia for certain procedures with children or with adults who have severe anxiety or for people who have difficulty controlling their movements.

While these techniques to control pain and anxiety are used to treat tens of millions of patients safely every year, its important that you let your dentist know anything that might affect your ability to benefit from them for example, tell them about any illnesses or health conditions, whether you are taking any medications and if you’ve had any problems with allergic reactions to medications.

Choosing the right mouthwash to meet your needs

These days many people like to use a mouthwash and there is a huge range of options to choose from.

The key to choosing the right one for your needs is being clear about what you are using it for.

Many people opt for mouthwash because they want to have fresh breath.

But many mouthwashes contain alcohol which can cause the mouth to dry. It’s best to minimize the chances of suffering from dry mouth as it can increase your risk of tooth decay and gum disease.

Therefore if you want fresh breath, a breath spray or drops may meet your needs better.

Another reason for using mouthwash is when you’ve been told you have a gum disease such as gingivitis. In this case, you’ll need to choose a mouthwash that contains ingredients known to kill the bacteria that cause gingivitis.

If you like to use a mouthwash that improves your oral health, use one that contains fluoride.

Read the directions of your mouthwash and make sure you spit it out.

Don’t assume that the most expensive mouthwashes are best. Think carefully about your needs and check the ingredients.

Your dentist will be able to advise you on the best choice of mouthwash.