Today’s dental care has advanced leaps and bound over the last century. But these advances are tiny steps compared to what many believe may be coming in the next few decades. This optimism arises from our growing understanding of deoxyribonucleic acid (DNA), the chain-like molecule that houses the genetic instructions for the growth, function and reproduction of every cell in the body.
As researchers unlock the secrets of this vast genetic blueprint unique to each individual the possible applications from this knowledge are astounding. Here are just a few possibilities that could one day impact everyone’s oral health.
Preventing tooth decay. This rampant disease, triggered by bacteria (particularly Streptococcus mutans), can cause extensive damage in otherwise healthy teeth. There’s already some indications from the study of genomics that we may be able to stop or at least hinder this disease in its tracks. Already we’re seeing advances in gene therapy that might be able to inhibit the growth of Strep mutans and reduce its colonies in the mouth.
Growing new teeth. Composed of various layers, a natural tooth is part of a dynamic system of bone and gum ligaments that allow movement, protection and nourishment. Although dental implants are the closest and most advanced artificial approximation we now have to them, implants still can’t fully measure up to the function and capabilities of a natural tooth. But further insight into the genetic code may one day allow us to reproduce a living replacement tooth for a lost one.
Harnessing saliva for detecting disease. The impact of genomics related to the mouth could impact more than just the mouth itself. Researchers have discovered that saliva contains genetic information similar to blood, urine and other bodily fluids with markers for various disease conditions. Unlike other fluids, though, saliva is relatively easy to collect. The key is new equipment and testing protocols to take advantage of the information already available in a single drop of saliva.
These examples illustrate the range of possibilities for better health in the future: a reduction in dental disease early in life; new and better ways to restore missing teeth; and quicker ways to diagnose dangerous health conditions.
If you would like more information on new developments in dental care, 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 “The Future of Dentistry: A Sneak Preview of Your Dental Future.”
Ever since childhood, when her career as a model and actress took off, Brooke Shields has enjoyed worldwide recognition — through advertisements for designer jeans, appearances on The Muppet Show, and starring roles in big-screen films. But not long ago, that familiar face was spotted in an unusual place: wearing a nasal anesthesia mask at the dentist's office. In fact, Shields posted the photo to her own Instagram account, with the caption “More dental surgery! I grind my teeth!” And judging by the number of comments the post received, she's far from alone.
In fact, researchers estimate that around one in ten adults have dental issues that stem from teeth grinding, which is also called bruxism. (Many children also grind their teeth, but it rarely causes serious problems, and is often outgrown.) About half of the people who are teeth grinders report problems like persistent headaches, jaw tenderness and sore teeth. Bruxism may also result in excessive tooth wear, and may damage dental work like crowns and bridges; in severe cases, loosened or fractured teeth have been reported.
Researchers have been studying teeth grinding for many years; their findings seem to indicate that it has no single cause. However, there are a number of factors that play a significant role in this condition. One is the anatomy of the jaw itself, and the effect of worn or misaligned teeth on the bite. Another factor relates to changes in brain activity that occur during the sleep cycle. In fact, nocturnal (nighttime) bruxism is now classified as a sleep-related movement disorder. Still other factors, such as the use of tobacco, alcohol and drugs, and a high level of stress or anxiety, can make an individual more likely to experience bruxism.
What can be done for people whose teeth grinding is causing problems? Since this condition may have many causes, a number of different treatments are available. Successful management of bruxism often begins by striving to eliminate the factors that may cause problems — for example, making lifestyle changes to improve your health, creating a soothing nighttime environment, and trying stress-reduction techniques; these may include anything from warm baths and soft music at bedtime, to meditation and mindfulness exercises.
Several dental treatments are also available, including a custom-made occlusal guard (night guard) that can keep your teeth from being damaged by grinding. In some cases, a bite adjustment may also be recommended: In this procedure, a small amount of enamel is removed from a tooth to change the way it contacts the opposite tooth, thereby lessening the biting force on it. More invasive techniques (such as surgery) are rarely needed.
A little tooth grinding once in a while can be a normal response to stress; in fact, becoming aware of the condition is often the first step to controlling it. But if you begin to notice issues that could stem from bruxism — or if the loud grinding sounds cause problems for your sleeping partner — it may be time to contact us or schedule an appointment. You can read more about bruxism in the Dear Doctor magazine article “Stress and Tooth Habits.”
The development of antibiotic drugs is widely considered one of the greatest medical achievements of the last century. Their widespread use has turned life-threatening diseases like cholera, strep throat or bacterial meningitis into manageable, treatable ones. It’s no exaggeration to say antibiotics changed the face of healthcare, including dentistry.
But this gleaming sword for fighting dangerous diseases has a double edge because our biological “enemies” can adapt to the microscopic attacks against them.Â This has created an ironic conundrum: as antibiotics have proliferated in both the amount and frequency used they’ve become less effective against ever-resistant organisms.
This unfortunate situation has been helped along by a widespread, misguided practice in the medical profession, created by a “better safe than sorry” philosophy, to use them to treat any illness. This has morphed in recent decades into using antibiotics as a preventive measure in those not even exhibiting signs of disease, which then evolved into using antibiotics as a feed additive for livestock. As a result, antibiotic drugs have made their way into the food chain to accelerate, in many people’s opinion, bacterial and viral resistance.
What can we do then as “super-bugs” are on the rise, like Methicillin-Resistant Staphylococcus Aureus (MRSA) which is resistant to the most common antibiotics?
Certainly, continuing research into creating new antibiotics that address resistance is vital. But it won’t be enough: we — both healthcare providers and patients — must also change our approach and attitude toward antibiotics. This means putting in place better prescription guidelines that reduce the application of antibiotics for only those conditions where it’s absolutely necessary. And, we must restrict their use as a preventive measure, particularly in regard to their use in livestock feed.
This will take a change in everyone’s mindset, our professional standards and guidelines, and perhaps our laws. Thankfully, many are seeing the looming danger, and change is already happening. But time is of the essence, and the future depends on it — not just for people today but also for tomorrow’s generations.
If you would like more information on prudent antibiotic use, 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 “Antibiotics: Use and Abuse.”
Oral and facial clefts are among the most common and heartbreaking of birth defects. Clefts make feeding or even breathing difficult and can affect speech development.
But there's one other profound effect: an “abnormal” face caused by a cleft can have devastating consequences for a person's self-image and social relationships.
About 1 in 700 U.S. babies are born with some type of visible gap or “cleft.” It can occur in their upper lip, soft and hard palate, nose or occasionally extending to the cheek or eye region. We typically classify clefts as “unilateral” (affecting only one side of the face) or “bilateral” (affecting both sides).Â We're not completely sure on the root causes, but research so far has uncovered links with the mother's possible exposure to toxic substances, nutrient or vitamin deficiencies, or infections during fetal development.
Taking steps during pregnancy to minimize these exposures is certainly helpful. But what can be done for children born with a cleft?
A great deal, thanks to the development of surgical repair techniques over the last century. The surgical approach relies on the fact that the tissues required to repair the cleft already exist. They're simply distorted by the cleft break.
Even so, the road to restoration is a long and arduous one. Lip repairs usually take place at 3-6 months of age; palate (roof of the mouth) clefts are undertaken at 6-12 months. As the child's jaw and mouth structure develops, further surgeries may be needed to match earlier repairs with development.
Cleft repairs also require a team of specialists including a maxillofacial (oral) surgeon, orthodontist and general dentist. The latter plays an important role during the process, ensuring the child maintains good dental health through prevention and treatment of disease and dental work for at risk teeth.
The road to a normal life is difficult — but well worth it. A repaired cleft vastly improves a child's health and well-being. Moreover, it restores to them something the rest of us might take for granted — a normal face and smile.
Dental implants are by far the best way to replace missing teeth. But they do more than improve your smile: they can restore your ability to eat, chew and talk properly, especially if the teeth replaced are in the back of your mouth. What’s more, they can improve the entire look of your face by restoring facial height and cheek support lost because of the missing teeth.
There is, however, one obstacle to overcome before receiving dental implants — a lack of sufficient bone at the implant site. Bone loss usually occurs when teeth have been missing for some time. This is because when we chew the forces generated by the teeth stimulate continual bone growth to make up for older bone that has dissolved (resorbed). This stimulation doesn’t occur after teeth are lost, which slows the rate of bone growth. Over time the amount of healthy bone diminishes.
Without enough bone for support, implants can’t be placed properly. Fortunately, some of the bone can be regenerated through techniques that place bone grafting material at the site to stimulate and serve as a scaffold for new bone.Â The new bone will eventually replace the graft.
For missing upper back teeth with bone loss, we can take advantage of facial anatomy to grow the bone needed for implants. This area of the face is where the maxillary sinuses, air spaces lined with a tissue membrane, are located on either side just above the upper jaw. After determining their exact size and location through detailed x-ray imaging, we can surgically access the area inside the mouth just above the missing teeth.
The sinus cavity is an area where bone growth can occur by placing a bone graft between the floor of the sinus and the sinus membrane. Sometimes bone growth enhancers are used to stimulate and speed up regeneration. The procedure can usually be performed with local anesthesia (much like a routine tooth filling), with only mild discomfort afterward for a few days managed by an anti-inflammatory drug like ibuprofen and a decongestant for sinus swelling.
After six to seven months, we re-evaluate the area to see if sufficient bone has returned for implant surgery. If so, you will be well on your way to achieving a new look and better function through dental implants.
If you would like more information on building new bone through sinus surgery, 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 “Sinus Surgery.”
This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.