Posts for: July, 2021
Forty years have passed since the first reported case of Acquired Immune Deficiency Syndrome (AIDS), and it and the human immunodeficiency virus (HIV) that causes it are still with us. About 1.2 million Americans are currently infected with HIV, with 50,000 new cases diagnosed each year.
The emergence of antiretroviral drugs, though, has made it possible for many with HIV to live normal lives. Even so, the virus can still have a profound effect on health, including the teeth and gums. Because of its effect on the immune system, HIV+ patients are at greater risk for a number of oral conditions, like a fungal infection called candidiasis ("thrush").
Another common problem is chronic dry mouth (xerostomia), caused by a lack of saliva production. Not only does this create an unpleasant mouth feel, but the absence of saliva also increases the risk for tooth decay and periodontal (gum) disease.
The latter can be a serious malady among HIV patients, particularly a severe form of gum disease known as Necrotizing Ulcerative Periodontitis (NUP). With NUP, the gums develop ulcerations and an unpleasant odor arising from dead gum tissue.
Besides plaque removal (a regular part of gum disease treatment), NUP may also require antibiotics, antibacterial mouthrinses and pain management. NUP may also be a sign that the immune system has taken a turn for the worse, which could indicate a transition to the AIDS disease. Dentists often refer patients with NUP to a primary care provider for further diagnosis and treatment.
Besides daily brushing and flossing, regular dental cleanings are a necessary part of a HIV+ patient's health maintenance. These visits are also important for monitoring dental health, which, as previously noted, could provide early signs that the infection may be entering a new disease stage.
It's also important for HIV+ patients to see their dentist at the first sign of inflamed, red or bleeding gums, mouth lesions or loose teeth. Early treatment, especially of emerging gum disease, can prevent more serious problems from developing later.
Living with HIV-AIDS isn't easy. But proper health management, including for the teeth and gums, can help make life as normal as possible.
If you would like more information on dental care and HIV-AIDS, 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.”
Not all toothaches are alike: Some are sharp and last only a second or two; others throb continuously. You might feel the pain in one tooth, or it could be more generalized.
Because there are as many causes as there are kinds of dental pain, you can expect a few questions on specifics when you come to us with a toothache. Understanding first what kind of pain you have will help us more accurately diagnose the cause and determine the type of treatment you need.
Here are a few examples of dental pain and what could be causing it.
Temperature sensitivity. People sometimes experience a sudden jolt of pain when they eat or drink something cold or hot. If it only lasts for a moment or two, this could mean you have a small area of tooth decay, a loose filling, or an exposed root surface due to gum recession. If the pain lingers, though, you may have internal decay or the nerve tissue within the tooth has died. If so, you may require a root canal treatment.
Sharp pain when chewing. Problems like decay, a loose filling or a cracked tooth could cause pain when you bite down. We may be able to solve the problem with a filling (or repair an older one), or you may need more extensive treatment like a root canal. In any event, if you notice this as a recurring problem, don't wait on seeing us—the condition could worsen.
Dull pain near the jaw and sinuses. Because both the jaws and sinuses share the same nerve network, it's often hard to tell where the pain or pressure originates—it could be either. You may first want to see us or an endodontist to rule out tooth decay or another dental problem. If your teeth are healthy, your next step may be a visit with a physician to examine your sinuses.
As you can see, tooth pain can be a sign of a number of problems, both big and small. That's why it's important to see us as soon as possible for an examination and diagnosis. The sooner we can treat whatever is causing the pain, the sooner your discomfort will end.
If you would like more information on treating dental pain, 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 “Tooth Pain? Don't Wait!”
You've just finished your daily brushing and flossing. How did you do? Swiping your tongue across your teeth can generally tell you: It's a good sign if it glides smoothly; but if it feels rough and gritty, you better take another run at it.
This "tongue test," however, only gives you a rough idea of how well you're removing plaque, that thin bacterial film on teeth most responsible for dental disease. Plaque, though, can be sneaky, "hiding" in the nooks and crannies on the biting surfaces of teeth, around the gum line and in between teeth.
So, how do you know if you're clearing out any plaque holdouts? An effective way is to use a plaque disclosing agent. This over-the-counter dental product consists of a swab, tablet or solution, which contains a dye that's reactive to plaque.
After brushing and flossing as usual, you apply the solution to your teeth for about 30 seconds. You then take a look in the mirror: Any remaining plaque will be stained a bright color that makes it stand out. There are also agents with two colors of dye, one that stains older plaque and one for newer plaque.
The plaque staining not only helps you see how well you've been brushing and flossing, it can also show you areas in need of improved hygiene. For example, if you notice a scalloped pattern around the gum line, that may mean your brush isn't getting into that area effectively. In this way, you can use a disclosing agent to fine-tune your hygiene.
Repeated use of a disclosing agent is safe, but just remember the dye color can be vivid. It does wear off in a few hours, though, so perhaps schedule it for a day off around the house. You should also avoid swallowing any solution or getting any of it on clothing.
The ultimate test, though, is a thorough dental cleaning with your dentist at least every six months. They can verify whether you've been fairly successful with your brushing and flossing, or if you have room for improvement. If you do use a disclosing agent, you can also discuss that with them in working out better strategies to protect your teeth from tooth decay and gum disease.
If you would like more information on improving your oral hygiene, 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 “Plaque Disclosing Agents.”