Posts for tag: oral health

By Guy H. Gattone, DDS
December 10, 2017
Category: Oral Health
Tags: oral health   hiv  
LivingwithHIVincludesKeepingaCloseWatchonYourOralHealth

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. ┬áIn 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.”

TakeProactiveStepstoProtectYourOralHealthDuringCancerTreatment

Cancer treatment can consume all of your focus to the exclusion of other health issues. But these other issues still need attention, especially how treating cancer could affect other parts of your body. That definitely includes your teeth and gums.

Treatments like radiation or chemotherapy eradicate cancer cells disrupting their growth. Unfortunately, they may do the same to benign cells — “collateral damage,” so to speak. This could cause a ripple effect throughout the body, including in the mouth. Radiation, for example, could damage the salivary glands and result in reduced salivary flow. Because saliva neutralizes acid and diminishes bacterial growth, your risk for tooth decay as well as periodontal (gum) disease could increase.

While you may be able to recover from reduced salivary flow after treatment, your health could suffer in the meantime, even to the point of tooth and bone loss. Fortunately, there are some things we can do before and during your treatment.

If you can, have any necessary dental work performed well before you begin cancer treatment. You’ll be more resistant to side effects if you can start treatment with as healthy a mouth as possible.

Keep up your regular dental visits if at all possible, or see us if you begin seeing signs of dental disease. By staying on schedule, we’ll have a better chance of detecting and treating problems before they advance too far; we may also be able to provide preventive measures like topical fluoride applications to help keep your teeth resistant to disease. If you need more extensive treatment like tooth extraction or surgery we may need to coordinate with your cancer treatment provider.

Above all, continue to practice daily brushing and flossing to remove plaque, the main cause of dental disease. Drink plenty of water or take substances that boost salivation. And be sure to eat a nutritious diet while also reducing or eliminating tobacco or alcohol from your lifestyle.

Taking these steps will help protect your teeth and gums during cancer treatment. As a result, you have a better chance for maintaining your dental health during this critical time in your life.

If you would like more information on dental care during cancer treatment, 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 “Oral Health During Cancer Treatment.”

By Guy H. Gattone, DDS
February 19, 2017
Category: Oral Health
ExpertAdviceVivicaAFoxonKissingandOralhealth

Is having good oral hygiene important to kissing? Who's better to answer that question than Vivica A. Fox? Among her other achievements, the versatile actress won the “Best Kiss” honor at the MTV Movie Awards, for a memorable scene with Will Smith in the 1996 blockbuster Independence Day. When Dear Doctor magazine asked her, Ms. Fox said that proper oral hygiene was indeed essential. Actually, she said:

"Ooooh, yes, yes, yes, Honey, 'cause Baby, if you kiss somebody with a dragon mouth, my God, it's the worst experience ever as an actor to try to act like you enjoy it!"

And even if you're not on stage, it's no fun to kiss someone whose oral hygiene isn't what it should be. So what's the best way to step up your game? Here's how Vivica does it:

“I visit my dentist every three months and get my teeth cleaned, I floss, I brush, I just spent two hundred bucks on an electronic toothbrush — I'm into dental hygiene for sure.”

Well, we might add that you don't need to spend tons of money on a toothbrush — after all, it's not the brush that keeps your mouth healthy, but the hand that holds it. And not everyone needs to come in as often every three months. But her tips are generally right on.

For proper at-home oral care, nothing beats brushing twice a day for two minutes each time, and flossing once a day. Brushing removes the sticky, bacteria-laden plaque that clings to your teeth and causes tooth decay and gum disease — not to mention malodorous breath. Don't forget to brush your tongue as well — it can also harbor those bad-breath bacteria.

While brushing is effective, it can't reach the tiny spaces in between teeth and under gums where plaque bacteria can hide. But floss can: That's what makes it so important to getting your mouth really clean.

Finally, regular professional checkups and cleanings are an essential part of good oral hygiene. Why? Because even the most dutiful brushing and flossing can't remove the hardened coating called tartar that eventually forms on tooth surfaces. Only a trained health care provider with the right dental tools can! And when you come in for a routine office visit, you'll also get a thorough checkup that can detect tooth decay, gum disease, and other threats to your oral health.

Bad breath isn't just a turn-off for kissing — It can indicate a possible problem in your mouth. So listen to what award-winning kisser Vivica Fox says: Paying attention to your oral hygiene can really pay off! For more information, contact us or schedule an appointment for a consultation. You can read the entire interview with Vivica A. Fox in Dear Doctor's latest issue.

By Guy H. Gattone, DDS
June 30, 2016
Category: Oral Health
Tags: oral hygiene   oral health  
4ThingsYouShouldbeDoingtoMaintainaHealthyMouth

Regular dental visits are an important part of maintaining healthy teeth and gums. But it’s what goes on between those visits — daily hygiene and care — that are the real ounce of prevention.

Here are 4 things you should be doing every day to keep your mouth healthy.

Use the right toothbrush and technique. Brushing with fluoride toothpaste at least once every day is a must for removing plaque, a thin film of bacteria and food particles which is the main cause of dental disease. Your efforts are more effective if you use a soft-bristled, multi-tufted brush that’s replaced often, especially when bristles become splayed and worn. To remove the most plaque and avoid damaging your gums, brush with a gentle, circular motion for at least two minutes over all tooth surfaces.

Don’t forget to floss. Your toothbrush can get to most but not all the plaque on your teeth. Flossing — either with flossing string, pre-loaded flossers or a water irrigator — helps remove plaque from between teeth. Don’t rely on toothpicks either — they can’t do the job flossing can do to remove plaque.

Mind your habits. We all develop certain behavioral patterns — like snacking, for instance. Constant snacking on foods with added sugar (a major food source for bacteria) increases your disease risk. Consider healthier snacks with fresh fruits or dairy, and restrict sugary foods to mealtimes (and the same for sports and energy drinks, which have high acid levels). Stop habits like tobacco use, excessive alcohol consumption or chewing on hard objects, all of which can damage your teeth and gums and create a hostile environment in your mouth.

Watch for abnormalities. If you pay attention, you may be able to notice early signs of problems. Bleeding, inflamed or painful gums could indicate you’re brushing too hard — or, more likely, the early stages of periodontal (gum) disease. Tooth pain could signal decay. And sores, lumps or other spots on your lips, tongue or inside of your mouth and throat could be a sign of serious disease. You should contact us if you see anything out of the ordinary.

If you would like more information on how to care for your teeth and gums, 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 “10 Tips for Daily Oral Care at Home.”

TheTimeIntervaltoReplantaKnockedOutToothCanAffectitsLongevity

Contrary to what you might think, a knocked out tooth doesn’t inevitably mean tooth loss. Time is of the essence — the shorter the interval between injury and replanting the tooth, the better the tooth’s long-term survival. The longer the interval, on the other hand, the less likely the tooth can survive beyond a few years. That phenomenon is due to the mouth’s natural mechanism for holding teeth in place.

The tooth root maintains its attachment with the jaw bone through an intermediary tissue known as the periodontal ligament. Tiny fibers from one side of the ligament securely attach to the tooth root, while similar fibers attach to the bone on the opposite side of the ligament. This maintains stability between the teeth and bone while still allowing incremental tooth movement in response to mouth changes like tooth wear.

While the ligament fibers will attempt to reattach to a replanted tooth’s root, the longer the tooth is out of the socket the less likely the fibers will fully reattach. An “ankylosis” may instead form, in which the root attaches directly to the jaw bone without the periodontal ligament. In this situation the body no longer “recognizes” the tooth and begins to treat it like a foreign substance. In all but the rarest cases, the tooth root will begin to resorb (dissolve); at some point (which varies from patient to patient) the attachment becomes too weak for the tooth to remain in place and is lost.

Ideally, a knocked out tooth should be replanted within 5 minutes of the injury (for step-by-step instructions, refer to The Field-Side Guide to Dental Injuries available on-line at www.deardoctor.com/dental-injuries). Even if you pass the 5-minute window, however, it’s still advisable to attempt replanting. With a subsequent root canal treatment (to remove dead tissue from the inner tooth pulp and seal it from infection), it’s possible the tooth can survive for at least a few years, plenty of time to plan for a dental implant or similar tooth replacement.

If you would like more information on treatment for a knocked out tooth, 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 “Knocked Out Tooth.”



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Guy H. Gattone, DDS

(708) 429-7500
6700 West 167th Street, Suite 1 Tinley Park, IL 60477