TOOTH TRUTHS

By "DocNurse" Norma Stephens Hannigan


BRUSHING UP ON DENTAL HEALTH.  Talking about teeth has got to be one of the most boring topics in the world, right?   Everyone knows you should brush, floss, go to the dentist to get your teeth cleaned and not eat too many sweets.  For a long time we only worried about getting cavities and losing teeth if we didn’t brush enough.  But now there is much more evidence that disease in the mouth may lead us down a road to disease in other organs of the body.

THE UGLY TRUTH ABOUT PLAQUE.  Let’s start with the basics.  Plaque forms from the bacteria naturally in your mouth.  If it is not brushed away on a regular basis, it turns to an acid/sugar mix that breaks down (decays) the enamel on your teeth.  There is a nerve in each tooth; if the tooth is decayed, it can become infected, press on the nerve and cause you pain.  Food stuck between the teeth causes gingivitis – inflammation (swelling and redness) of the gums that may eventually become like a chronic infection.  Your gums hold your teeth in place, so if the gums are not sturdy and strong, the teeth will get wobbly and loose and eventually fall out.

WHY SHOULD I CARE IF MY TEETH FALL OUT?  For one thing, a smile missing some of its teeth is like an old, banged up grill on your truck.  But more importantly, missing teeth can cause problems for chewing.  If you can’t chew well, there is more danger of choking on food.  When there are spaces left from missing teeth, your other teeth may spread out, changing your bite.  The gap left by the missing teeth can fill with food and lead to that bacteria buildup mentioned before.  No matter which option you choose for replacing the missing teeth, it’s an expensive proposition and some things, like tooth implants, where they anchor a false tooth into your jaw bone, may not be covered by your insurance (if you’re even one of the few who are lucky enough to have dental insurance).

WHAT ELSE CAN GO WRONG INSIDE MY MOUTH?  Smoking can cause discoloration of teeth and loss of teeth as well.  When you smoke, the blood supply to tissues is decreased, making the tissue less healthy and more likely to develop disease.  Chewing tobacco increases the risk of cancer in the mouth where the tobacco is placed to 50 times that of people who don’t use it.  Drinking alcohol and using tobacco together further increases your risk of developing cancer somewhere in the head and neck.

HOW CAN MY TEETH AFFECT THE REST OF MY BODY?  When you have tooth and gum disease, it’s like having an infection that won’t go away.  This infection causes inflammation inside of blood vessels as far away as the heart, brain and kidneys.  There have been several studies over the past decade or so looking at the connection between the health of a person’s other organs and their teeth.  For the most part, the studies have shown that people with gum/tooth (periodontal) disease are more at risk for having a heart attack, stroke and kidney disease.  For people with diabetes, a disease in which there is too much sugar in the blood, it is now believed that gum and tooth disease makes it harder for the person to control his/her blood sugar and that when those people have their dental problems taken care of, their blood sugar levels often get better.  Chronic lung disease, the kind that smokers often have, also gets worse with gum and tooth disease.  It’s possible that some of the bacteria that is associated with the gum disease may travel to the lungs and cause the linings of the lungs to get swollen, making it harder for one to breathe.  In a recent study at Case Western Reserve University in Cleveland, it was found that people with periodontal disease and missing teeth were twice as likely to have kidney disease than those without the disease.  In another study, men with gum disease were found to have higher risk of developing lung, kidney, pancreas and white blood cell cancer (leukemia).  While bad breath usually is related to decayed teeth, gum disease or sinus problems, it may also be a sign of liver or kidney disease.  Even simple heartburn can make you have a bad taste in your mouth and will sometimes give you bad breath.

TAKE A BITE OUT OF DISEASE.  The current and traditional wisdom says you should be brushing at least twice a day and flossing daily.  If you can swing it, brushing after each meal is even better.  It may not be practical while you’re on the road, though, so at least the morning and nighttime brushings are essential.  It’s even recommended that you brush your tongue!  Some dental health sources suggest that you use a soft toothbrush because it can get under and around the gums without causing damage to them or the enamel.  Others say that it doesn’t really matter – a medium or hard toothbrush doesn’t really wear away your teeth.  Bottom line: use a toothbrush that is comfortable enough for you to use twice a day.  The toothpaste you use should be one with fluoride because, according to the American Dental Hygienists Association, “Fluoride works by stopping or even reversing the tooth decay process.  It keeps the tooth enamel strong and solid by preventing the loss of (and enhancing the re-attachment of) important minerals from the tooth enamel.”  Fluoride actually combines with plaque and saliva and doesn’t allow the breakdown process to occur.  The purpose of flossing is to get rid of food and plaque between your teeth.  The type of floss you use is up to you – it comes in mint flavor, no flavor, thin, thick – you get to pick!  Flossing should be done at least once a day.

WHAT ABOUT THE STUFF I MISS?  That’s where the dentist comes in.  The current recommendation is to have your teeth cleaned every 6 months.  Some dentists will seal your teeth with fluoride to keep them strong and healthy.  Decay can start in a tooth without you even knowing it.  The dentist will take x-rays to see if there is decay starting and fix the tooth before it gets painful or falls out.  Oh, I see, you’re afraid to go to the dentist.  Many dentists now have special treatments for people who are fearful of their visits.  When you call to make your appointment, ask about any help they can give you – it will be worth it in the long run.  Keep smiling!

~ Dr. Norma Stephens Hannigan, who recently graduated with a Doctor of Nursing Practice degree, teaches at Columbia University in New York and has treated many truck drivers at the various clinics she has worked over the years.  She currently writes from her home in Newburgh, New York.