Most childhood sicknesses are highly treatable and quickly fade from memory afterward. But there's one viral infection that can reappear years later, albeit in a different form and this time it might not be as forgettable. It could even impact your dental care.
Varicella, more commonly known as chicken pox, is a viral infection that mainly affects children. Fortunately, the itchy blisters and other symptoms associated with it usually clear up on their own. But the virus itself, varicella zoster virus (VZV), can remain behind and become dormant.
Fast-forward a few decades, and the child once with chicken pox is now an adult, usually over 50. In 20-30% of former chicken pox patients, the virus reactivates as a new infection known commonly as shingles.
Shingles often begins with an itching, burning or numbing sensation on the skin that develops into a severe rash. Because of its effect on surface nerves, the rash often takes on a striped or belt-like pattern on the skin. A shingles outbreak can also cause fever, fatigue and pain, the latter of which in rare cases can be quite severe.
Shingles in its early stages is also highly contagious, transmitted easily through either physical contact with the skin lesions or through airborne secretions. This is especially troubling for certain groups: pregnant women, patients undergoing cancer or other serious disease treatment, or those with compromised immune systems. For them, shingles can pose a significant risk for complications.
Because of its easy transmission, and the danger it can pose to certain groups, dentists typically postpone treatment—even routine dental cleanings—for patients experiencing a shingles outbreak, especially a facial rash. Once their outbreak subsides, those procedures can be rescheduled.
If you develop what you think is shingles, you should seek medical attention as soon as possible. Certain prescribed antiviral medications can ease the symptoms and hasten recovery, but they're most effective if started within three days of the onset of the disease. There's also an effective vaccination for shingles recommended for people over 60 to help avoid the disease altogether.
One other thing! If you do develop shingles and have an upcoming dental appointment, let your dentist know. Better to reschedule your visit after you've recuperated than to put others' health at risk.
If you would like more information on shingles and 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 “Shingles, Herpes Zoster.”
Between the final game of the World Series in late October and spring training in February, major league baseball players work on their skills preparing for the new season. Reporters on a Zoom call to the New York Yankees' training camp wanted to know what star outfielder Aaron Judge had been doing along those lines. But when he smiled, their interest turned elsewhere: What had Aaron Judge done to his teeth?
Already with 120 homers after only five seasons, Judge is a top player with the Yankees. His smile, however, has been less than spectacular. Besides a noticeable gap between his top front teeth (which were also more prominent than the rest of his teeth), Judge also had a chipped tooth injury on a batting helmet in 2017 during a home plate celebration for a fellow player's walk-off home run.
But now Judge's teeth look even, with no chip and no gap. So, what did the Yankee slugger have done?
He hasn't quite said, but it looks as though he received a “smile makeover” with porcelain veneers, one of the best ways to turn dental “ugly ducklings” into “beautiful swans.” And what's even better is that veneers aren't limited to superstar athletes or performers—if you have teeth with a few moderate dental flaws, veneers could also change your smile.
As the name implies, veneers are thin shells of porcelain bonded to the front of teeth to mask chips, cracks, discolorations or slight gaps between teeth. They may even help even out disproportionately sized teeth. Veneers are custom-made by dental technicians based on a patient's particular tooth dimensions and color.
Like other cosmetic techniques, veneers are a blend of technology and artistry. They're made of a durable form of dental porcelain that can withstand biting forces (within reason, though—you'd want to avoid biting down on ice or a hard piece of food with veneered teeth). They're also carefully colored so that they blend seamlessly with your other teeth. With the right artistic touch, we can make them look as natural as possible.
Although porcelain veneers can accommodate a wide range of dental defects, they may not be suitable for more severe flaws. After examining your teeth, we'll let you know if you're a good candidate for veneers or if you should consider another restoration. Chances are, though, veneers could be your way to achieve what Aaron Judge did—a home run smile.
If you would like more information about porcelain veneers, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Porcelain Veneers: Strength & Beauty As Never Before.”
We're all interested in how our toothpaste tastes, how it freshens breath or how it brightens teeth. But those are secondary to its most important function, which is how well our toothpaste helps us remove dental plaque, that thin bacterial film on teeth most responsible for both tooth decay and gum disease.
Daily brushing and flossing clear away dental plaque, resulting in a much lower risk for dental disease. But while the mechanical action of brushing loosens plaque, toothpaste helps complete its removal. It can do this because of two basic ingredients found in nearly every brand of toothpaste.
The first is an abrasive (or polishing agent), a gritty substance that boosts the effectiveness of the brushing action (which, by the way, alleviates the need for harmful aggressive brushing). These substances, usually hydrated silica, hydrated alumina or calcium carbonate, are abrasive enough to loosen plaque, but not enough to damage tooth enamel.
The other ingredient, a detergent, works much the same way as the product you use to wash greasy dishes—it breaks down the parts of plaque that water can't dissolve. The most common, sodium lauryl sulfate, a safe detergent found in other hygiene products, loosens and dissolves plaque so that it can be easily rinsed away.
You'll also find other ingredients to some degree in toothpaste: flavorings, of course, that go a long way toward making the brushing experience more pleasant; humectants to help toothpaste retain moisture; and binders to hold bind all the ingredients together. And many toothpastes also contain fluoride, a naturally-occurring chemical that strengthens tooth enamel.
You may also find additional ingredients in toothpastes that specialize in certain functions like reducing tartar buildup (hardened plaque), easing tooth or gum sensitivity or controlling bacterial growth. Many toothpastes also include whiteners to promote a brighter smile. Your dentist can advise you on what to look for in a toothpaste to meet a specific need.
But your first priority should always be how well your toothpaste helps you keep your teeth and gums healthy. Knowing what's in it can help you choose your toothpaste more wisely.
If you would like more information on oral hygiene products and 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 “Toothpaste: What's in It?”
Although we've advanced leaps and bounds over the years treating dental disease, our strategy for preventing them hasn't changed much. That's because these prevention basics are quite effective—and as the old saying goes, "If it ain't broke, don't fix it."
The core of an effective dental disease prevention strategy is mind-numbingly simple—brush and floss every day. These twin cleaning tasks remove accumulated dental plaque, a thin, bacterial film on tooth surfaces that's the primary oral disease driver.
True, there have been innovations concerning the "tools of the trade," i.e., toothbrushes, toothpastes and flossing devices. But what really makes this prevention strategy work is a consistent daily habit of oral hygiene.
In a way, simply "showing up" for daily oral hygiene goes a long way. But you can go even farther if you perform these tasks with greater proficiency—becoming a hygiene "ninja," of sorts.
Here, then, are 4 tips to improve your brushing and flossing prowess.
Be thorough when you brush. Try to cover all of your tooth surfaces when you brush, being sure to work the bristles into all the nooks and crannies and around the gum lines. A thorough brushing should take about 2 minutes.
Easy does it. Hard scrubbing may work on floors, but not your teeth—aggressive brushing can damage your enamel and gums. Brush gently and let the mild abrasives in your toothpaste do the heavy work of plaque removal.
Don't forget to floss. Although you may not like this "other hygiene task," flossing is necessary to remove plaque between teeth that your brush can't reach. Be sure, then, that you floss at least once a day.
Take the "tongue test." Wondering how well you're doing with your oral hygiene? A quick way to find out is by swiping your tongue across your teeth: If they feel gritty rather than smooth, you may have left some plaque behind.
Be sure to also ask your dentist for additional tips on better brushing and flossing. Improving your technique can help you put even more distance between you and dental disease.
If you would like more information on daily care for 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 “Daily Oral Hygiene.”
For several decades, dentists have been saving teeth from tooth decay following a few basic guidelines: 1) Identify decay as soon as possible; 2) Thoroughly remove decayed tooth structure; and 3) Fill any cavities. With millions of diseased teeth rescued, observing these simple steps have proven a rousing success.
But as with most things, even this successful protocol isn't perfect. For one, some healthy tissue gets removed along with the diseased portions. The average percentage of "collateral damage" has dropped over the years, but it still happens—and a reduction in healthy tissue can make a tooth less structurally sound.
Another drawback, at least from the patient's perspective, is the dental drill used for removing decay and preparing cavities for filling. Many people find drilling unpleasant, whether from its vibrations in the mouth or its high-pitched whine. The drill's burr head design also contributes to greater healthy tissue loss.
But those weaknesses have lessened over the last few years, thanks to innovations on a number of fronts.
Better risk management. Tooth decay doesn't occur out of thin air—it arises out of risk factors unique to an individual patient like personal hygiene, bacterial load, saliva production or even genetics. Taking the time to identify a patient's "tooth decay risk score" can lead to customized treatments and practices that can minimize the occurrence of decay.
Earlier detection. Like other aspects of dental health, the sooner we detect decay, the less damage it causes and the more successful our treatment. X-rays remain the workhorse for detecting decay, but now with improvements like digital film and better equipment. We're also using newer technologies like laser fluorescence and infrared technology that can "see" decay that might otherwise go undetected.
Less invasive treatment. The dental drill is now being used less with the advent of air abrasion technology. Air abrasion utilizes a concentrated spray of particles to remove diseased tooth structure more precisely than drilling. That means less healthy tissue loss—and a more pleasant (and quieter!) experience for the patient.
In effect, "less is more" could describe these improvements to traditional decay treatment. They and other methods promise healthier teeth and happier patients.
If you would like more information on current treatments for tooth decay, 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 “Minimally Invasive Dentistry: When Less Care is More.”
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