Why Do I Have A Black Line Under My Crown?
Black lines around the edge of older crowns are a common problem that I see. They are almost never a problem initially with a crown but can show up after several years. Black lines are almost always preceded by some slight amount of gum recession. Your gums usually recede slightly over the course of your life and tend to progress more quickly on teeth with crowns. When they do recede, the margin (area where the crown meets the tooth) of the crown and the enamel/root surface also becomes visible. On back teeth it usually isn’t noticeable but on front teeth it can become a significant cosmetic problem. Depending on the specific type of crown you have, there can be a couple of different reasons for this black line developing.
Common Reasons For A Black Line Around A Crown
- The first, and most common reason for the black line is a tooth that has a porcelain fused to metal (PFM) crown on it. These types of crowns are made up of two separate materials: metal inside and a porcelain covering. The black line occurs when the gums recede and the metal starts to reflect through the tooth surface. In some cases the metal can even stain the tooth where it touches it.
- The second reason for a black line is if a cavity has started on the tooth surface where it meets the crown. These areas will usually start as brown and progress to a dark black color. If it is a cavity, you should have it taken care of as soon as possible. Crowns that get under crowns can progress rapidly and easily lead to a root canal or tooth loss if not treated.
- The last reason for a black line is if the margin has become stained. Teeth can stain for a variety of reasons but we see it most often with people who drink coffee, teas, red wine, and dark colored sodas.
How Can You Fix The Black Line?
Unfortunately in almost every case a new crown is needed to fix the problem. If the area is small enough your dentist can sometimes place a filling over the stained area but you usually don’t get a great cosmetic result. The filling material usually allows some of the stain to show through and it doesn’t match terribly well with porcelain.
If you do decide to get the crown replaced, your dentist will remove the old crown, any stained areas, and move the margin right to the edge where the gums meet the tooth. Most crowns on front teeth today are made out of porcelain and don’t have the same problems with black lines that some of the older PFM crowns did. Ask your dentist what material they would recommend on the tooth to get you the best result. I personally like to use EMax (lithium disilicate) crowns in cases like these but there are several other crown options out there that can work equally well.
Do Wisdom Teeth Cause Your Teeth To Crowd?
There is a pretty common misconception out there that when your wisdom teeth start to come in the
y push your other teeth forward leading to crowding of your front teeth. Many dentists and oral surgeons believed this for years and recommended removing your wisdom teeth to protect against this. Quite a few long term studies were done (over as long as a 25 year period) and have proved that this is a myth.
The reason why people believe this is because there is another process going on that does cause your teeth to crowd in the front. This effect is known as “mesial drift”. Mesial drift is the phenomenon of your teeth moving forward slowly over your lifetime. Mesial drift occurs both with and without wisdom teeth. In fact, it occurs even when there aren’t any back teeth present at all. I see a lot of adult patients who complain that their teeth have progressively gotten more crowded as they get older. This happens to almost everyone unless they wear a retainer consistently.
Does this mean you shouldn’t get your wisdom teeth out? No! In fact, there are a lot of other good reasons to get your wisdom teeth out but crowding is not one of them. These reasons include…
- Difficulty in keeping them clean because of their location. This usually leads to decay.
- Irritation or infection of the gum tissue around them.
- Resorption of the roots of the teeth in front them.
- Loss of bone around the teeth in front of them.
- Higher risk of cysts or growths around them
Everything You Need To Know About Fluoride
Ready to learn the truth about fluoride? Your dentist, doctor (medical or homeopathic), or next door neighbor likely don’t know as much about it as they claim to. I’m going to cut through all the misinformation out there and give you the real story, based on the most current scientific evidence.
Why Is The Truth About Fluoride So Confusing?
Dentistry has been a bit behind the times on getting good research about the things that we dentists recommend. There is a ton of misinformation out there about fluoride. On one side you’ve got the people who claim that fluoride is the best thing since sliced bread while on the other side you’ve got people who believe fluoride is a giant government conspiracy for mind control. The truth actually lies somewhere in the middle (minus the mind control part). Dental schools currently teach a lot of the pro-fluoride misinformation while internet forums and homepathic doctors preach a lot of the anti-fluoride misinformation. It shocks me that you can barely find anyone with a reasonable and scientific explanation as to it’s risks and benefits when it comes to using it in dentistry.
I remember when I was in school that fluoride was put up on a pedestal as the best possible thing for our patients, with no discussion of the downsides to using it in various ways. None at all. They didn’t teach us about any of the latest scientific studies or even encourage us to look at them. All we were told was that the CDC called water fluoridation one of the 10 greatest public health achievements of the 20th century (we’ll get to that in a little bit), therefore water fluoridation was obviously a great thing… right?
What Is Fluoride?
First, what is fluoride? Fluoride is the negative ion of fluorine, the lightest halogen gas on the periodic table. Fluoride is a naturally occurring mineral found in many different sources around the world. It can be found in certain mineral deposits, usually in the form of calcium fluoride and is also found in varying concentrations in seawater and fresh groundwater. In seawater it is typically found at around 1 part per million (ppm) while in fresh groundwater it can range anywhere from 0.01 ppm to 0.3 ppm. Occasionally some fresh water sources have extremely high levels of fluoride (up to about 10 ppm). For comparison, most areas that fluoride their water try to keep it around 0.8-1.2ppm.
How Does Fluoride Work?
Fluoride, when applied in the correct form and concentration is known to strengthen teeth. So how does this work? Your tooth enamel is made up of small crystals of primarily hydroxyapatite. This crystals are packed very densely and there is an extremely small amount of water left (only about 4%). In comparison, your bones have about 30% water. When acid starts breaking down the crystals in your enamel, your body works to rebuild those crystals, if conditions are right. This is known as remineralization. If fluoride is present during this process it creates a slightly different crystal made up of fluoroapatite. These crystals tend to be larger and grow more quickly. They’re also less prone to being broken down by acid. This is why the presence of fluoride helps reduce cavities.
The History of Water Fluoridation
In the 19th and early 20th century, scientists noticed that some people had brown, mottled teeth that seemed to be more resistant to cavities. This staining was called the “Colorado Brown Stain”. Eventually scientists figured out that the people who developed this staining were people who were exposed to high levels of fluoride in their drinking water (naturally occuring). This brown staining is known today as fluorosis.
Over time they worked out what they thought were the optimal levels of fluoride in the drinking supply. These levels limited the occurrence of fluorosis but they thought it would also reduce cavities. The first test program was done in Grand Rapids Michigan in 1945 and quickly spread throughout the United States over the next 15 years. Approximately 2/3 of water supplies are fluoridated in the United States today.
Many other countries also fluoridate their water supplies or add fluoride to their salt.
Does Water Fluoridation Reduce Cavities?
Here is where it gets interesting. Early studies and evidence indicated significant reductions in occurrence of cavities. This was before fluoride containing toothpastes and mouthrinses were regularly used. Most of these studies were done before 1975 and weren’t terribly scientific. The Cochrane Collaboration did a review of all the available scientific literature out there and came to the conclusion that there is “very little evidence” proving the effectiveness of water fluoridation on cavity reduction. This doesn’t mean that it doesn’t work, but rather that there are literally no quality studies to make any conclusions from. Also, many of the studies were done in a time when oral health was treated very differently. New, quality studies would really need to be done to get an accurate picture of how effective it is.
There are, however, several other ways we can look at the effect of water fluoridation to see if it is actually effective today. The Cochrane Collaboration did another review about the effect of fluoride supplementation on cavity incidence. Fluoride supplementation is somewhat similar to water fluoridation in that children take a fluoride supplement that increases levels of fluoride in their whole body (as opposed to topical application of fluoride). The study found that fluoride supplements did decrease the levels of decay but only when compared to no fluoride use. When topical fluoride was used (as with fluoride toothpaste) there was no difference in cavity incidence between the two!
One study compared two neighboring towns in Canada. One removed fluoride from their water supply while the other left fluoride in it. Cavity rates actually went down in the town where fluoride was removed while the town that left fluoride in the water supply had the same levels of decay.
A 2007 article looked at decay rates in countries both with and without water fluoridation. All these countries had varying exposure of their populations to fluoride. The authors found that decay rates in all countries dropped significantly over the last 3 decades, whether or not the water supplies were fluoridated.
So what does all this tell us? Fluoridation of the water was likely effective in 1945 because there wasn’t widespread use of fluoride toothpaste or mouthrinses. Today, with the common use of fluoride toothpastes, professional fluoride varnish applications every 6-12 months, and fluoride mouthrinses, water fluoridation appears to be mostly ineffective. In addition to being mostly ineffective today, it also carries multiple risks that are just now starting to be known (we’ll cover these in a little bit).
Is Fluoride In Toothpaste Effective?
Compared to water fluoridation, fluoride in toothpaste is pretty straightforward. Most toothpastes contain between 1000-1500 parts per million of fluoride. Study after study has shown a benefit to topically using fluoride in toothpaste. The Cochrane Collaboration did a review on how well fluoride toothpaste works in reducing cavities in children and came to the conclusion that on average, consistent use of fluoride toothpaste over 1000 ppm reduces cavities by approximately 24%. This included 79 separate studies with around 73,000 total children studied. There really isn’t any doubt, whatsoever that fluoride in toothpaste is effective.
The Dangers of Fluoride
Systemic (fully body) fluoride exposure has several possible dangers. Systemic fluoride exposure is most often the result of water fluoridation, high levels of naturally occurring fluoride in the water, and eating / swallowing toothpaste. Fortunately, topical exposure of your teeth to fluoride does not carry these same risks.
- Fluorosis – Fluorosis is the most common side effect from excess fluoride exposure. Fluorosis shows up as white or brown spots on teeth. Lower levels of fluoride exposure cause minimal speckling while high levels cause an extreme brown mottling of the teeth that can cause significant cosmetic problems. It’s estimated that a water fluoride level of 0.7 ppm (lower than many municipal supplies) will cause fluorosis that is noticeable in 12% of people! Most water supplies are fluoridated to around 1 ppm, which likely carries even higher rates of fluorosis. I personally see patients with fluorosis all the time in my dental practice. I’ve seen higher and higher rates of children with fluorosis over the years.
- Underactive thyroid – Another recent study found a link between water fluoride levels over 0.3 ppm and higher rates of underactive thyroid glands (nearly 30% higher). This study was based in England and compared rates of hypothyroidism in populations with fluoridated water vs those that didn’t. The study included information from almost every general medical practice in England. While not a perfect study, it does bring up some very serious concerns about the possibility of thyroid disorders as related to fluoride exposure.
- ADHD – Another recent study showing possible harm from water fluoridation. Researchers compared data of average fluoride exposure from water fluoridation and compared it to rates of ADHD diagnoses. Those areas with higher levels of fluoride exposure, had higher levels of ADHD diagnoses, even after controlling for many other variables. As with the study on thyroid problems, this didn’t prove any causation but also brings up a possible serious complication of water fluoridation.
- Reduced IQ – It has been suspected for some time that fluoride can be slightly neurotoxic to the developing brain. Harvard recently completed a study along with researchers in China that studied IQ levels compared to fluoride levels in the water supply. On average IQ’s were 7 points lower in populations with fluoride in the water supply. The level of IQ impairment was directly related to the level of fluoride in the water system.
- Overdose – Overdoses from fluoride are pretty rare. The amount of fluoride needed to create an overdose are quite a bit more than you’d find in a tube of toothpaste, so even if you manage to eat the entire thing, you’re still probably fine. The danger of a fluoride overdose comes from the fact that fluoride combines with calcium and makes it unavailable to your body. Calcium is used for many different things in your body and low fluoride levels (hypocalcemia) can literally kill you.
The Centers for Disease Control (CDC) And The American Dental Association (ADA) Stance
Despite all this evidence, these two huge organizations still claim that there is no credible evidence of harm by water fluoridation and that they believe it is highly effective in reducing decay. Why is this? Honestly, I’m not quite sure. The scientific evidence is quite clear about the harms and limited effectiveness of water fluoridation today. These types of claims are one of the reasons why I started this website. There is a serious lack of real information out there about certain dental issues facing people today. Big organizations like these don’t change quickly and in the meantime can cause real harm.
My Fluoride Conclusions
My personal opinion is that fluoride should be removed from the water supply. It likely has little effect on decay rates today and has a high incidence of adverse effects compared to it’s effectiveness. Instead, there should be an emphasis on education about topical fluoride products such as toothpaste, mouthrinses, and professional applications of fluoride varnish.
Can You Cure A Cavity Without A Filling?
Many people wonder if it is possible to fix a cavity without doing a filling. As with many things in dentistry, the answer is a big “It depends”.
The good news is that there are some situations where a cavity is somewhat reversible. The bad news is that the solution isn’t so simple as just taking a pill . It takes some behavior change and work!
The one specific situation in which cavities are reversible are early stage cavities where the structure of the tooth hasn’t started to break down. Once there is an actual hole, inside or out of the tooth, it has to be fixed with a filling. Many times these early stage cavities will look like a bright white spot on the tooth. This indicates that the minerals have started to be removed from the enamel layer of the tooth. In order to “fix” this cavity you have to get your mouth environment to a state that promotes healing of the tooth. This healing process is known as remineralization. Instead of minerals being taken away, they are added back to the demineralized area of enamel. Usually if you’ve developed an early stage cavity, you are creating an environment in your mouth that promotes the opposite.
So here is what you need to do…
- Avoid sugary and acidic drinks altogether. Water is your friend here. While you can avoid developing cavities when you drink these occasionally, it is really difficult to remineralize a tooth while doing this.
- Limit snacking as much as possible. Remember it isn’t as much about how much sugar or acid you have, but how often.
- Brush twice a day with fluoride toothpaste for two minutes. You want to remove all the plaque on your teeth. This plaque keeps your tooth from being able to take up minerals as well as providing an environment for bacteria to product more acid.
- Use a fluoride containing mouthrinse once a day, at a time separated from brushing by at least 30 minutes.
- Ask your dentist for a prescription strength toothpaste with a higher level of fluoride. This will help remineralize the tooth faster.
Do these things and you stand a good chance of either halting the progression of the cavity entirely or even reversing it.
My Tooth Doesn’t Hurt… Do I Really Need A Filling?
I get asked some version of this question all the time! It usually goes, “Hey Doc, my tooth doesn’t hurt. Why would I get a filling if I’m not having a problem?”
Let’s compare it to another type of health problem. Let’s say your physician tells you that you have early stage heart disease. How would you feel if he or she said, “Well you’re not having any pain so let’s just wait until it hurts to do anything.” Guess what, by the time it hurts you’re having a heart attack! No one thinks this is a good idea!
Cavities are very similar. Early and mid stage cavities usually have no symptoms that go along with them. This doesn’t mean that you shouldn’t get them treated. By the time you are having symptoms you usually need extensive treatment that could include crowns and/or root canals. These are far more expensive than just a filling and also significantly reduce the lifespan of your tooth. In the worst cases you can end up even losing the tooth.
Another thing people get really frustrated about is when they have cavities that didn’t hurt, then they get them treated, and afterwards the teeth are sensitive or hurt. I can understand the frustration! Nothing hurt before and now they do. Unfortunately this is sometimes part of the process. Every time a tooth is drilled on it can irritate the nerve of the tooth. Everyone’s teeth respond differently to this process and some people have zero symptoms while other people have severe symptoms. I wish this never happened but its unavoidable in certain situations. Even knowing this, it’s still better to get those cavities treated. Waiting will usually cause those cavities to get bigger which will lead to even more problems when you do eventually get them treated.
Can Osteoporosis Medications Cause Dental Problems?
There is a certain class of osteoporosis medications known as bisphosphonates that have been linked with a rare but very serious side effect known as osteonecrosis of the jaw. To understand why this happens, you first need to know a little about how bones work and what these medications do.
How Bones Work
Most people think of bones as a solid, unliving object that creates a frame for your body. In actuality this couldn’t be further from the truth. They are constantly creating and breaking down new bone cells. Your bones contain specific cells known as osteoblasts and osteoclasts. Osteoblasts create new bone while osteoclasts break it down. For most healthy people these cells break down and create bone at approximately the same rate so that your bones stay at a constant density. For people with osteoporosis, their body resorbs bone at a faster rate than it replaces it. Over time this causes their bones to become less dense and more prone to fractures. This most commonly occurs in women after menopause.
Bisphosphonates
Bisphosphonates (also known as antiresorptive agents) work by slowing down the process of resorption and equalizing the ratio again. The main goal with them is to keep any further bone loss from happening. Some common bisphosphonate medications include Actonel, Atelvia, Boniva, Didronel, and Fosamax which are all taken by mouth or Boniva IV, Prolia, or Reclast which are given to patients in an IV.
Some patients also receive these medications when being treated for certain types of cancer including multiple myeloma, prostate, bone, and metastatic form of cancer. Most cases of osteonecrosis develop in these cancer patients because they receive high doses of the IV form.
What Does Any Of This Have To Do With Dentistry?
Some people who have taken bisphosphonate medications develop a condition known as osteonecrosis of the jaw after surgical dental treatment. Examples of surgical dental treatment include tooth extractions (most commonly), periodontal surgery, or endodontic surgery. Osteonecrosis of the jaw occurs because the bone isn’t able to heal correctly as a result of the bisphosphonate medications. Bone healing is a complicated process that involves both the osteoclasts and osteoblasts. As we talked about before, the bisphosphonate medications interfere with osteoclasts ability to function. Osteonecrosis usually starts as a small area that won’t heal after surgery and oftentimes progresses to destruction of a large part of the bone. In some cases you can end up with a jaw fracture or losing a large portion of the jawbone.
Now it’s important to understand that not everyone who takes bisphosphonate medications and has dental surgery will develop osteonecrosis. It’s actually a pretty rare complication, but such a severe one that we try to avoid any chance of it happening. The biggest risk factors for developing osteonecrosis include using the IV versions of these medications (about 90% of cases), taking them for an extended period of time (usually 5 years or longer) and longer and more traumatic surgical treatments.
What Can You Do If You’ve Taken Bisphosphonates Or Are About To Start?
Don’t stop taking your osteoporosis medications. The benefits of taking them usually outweigh the risks.
Keep regular dental appointments with your dentist so that you can address any problems before they become a big problem leading to tooth loss.
Maintain a good diet and good oral hygiene.
Try to quit smoking and limit alcohol use. Both of these are risk factors.
If you do have oral surgery, it is usually recommended to stop the bisphosphonate medications during the healing period.
If you know you’re going to start receiving bisphosphonates, especially the IV version, get a full dental check-up and have any work done before starting.
How Do You Know If You’ve Developed Osteonecrosis Of The Jaw?
Osteonecrosis of the jaw usually develops shortly after a surgical procedure. The area typically doesn’t heal and you have exposed bone. You can have swelling of the gum tissue around the area as well as develop infections and have drainage from the area. There aren’t any tests for it but most surgeons will diagnose osteonecrosis if the area hasn’t healed within 8 weeks. Most people have pain associated with the area but in rare cases it is just a non-healing area with no pain.
How Is It Treated?
Most cases of osteonecrosis of the jaw are treated without surgery. Your surgeon will usually prescribe antibiotics, special mouthrinses, and medications to manage the pain. Usually it runs it’s course over several months and resolves on it’s own. The amount of bone destruction is different in each case.
Gummy Smiles
Do you or someone you know have a gummy smile? Wondering what causes it or whether there can be anything done to fix it? We’re going to cover everything you need to know!
First, a “gummy smile” isn’t really a technical term and doesn’t have any one specific definition. Most dentists consider a smile “gummy” when 4 mm or more of gum tissue shows above the top of the front teeth when a person is smiling. That said, it can be very different between people when a smile is considered “natural” and when it is considered “gummy”. A big part of it is the ratio between the size of the teeth, lips, and gum tissue showing. Many people consider a gummy smile a big cosmetic issue. Good news though! There are definitely some things that can be done to correct a gummy smile in most people!
There are several reasons why people have gummy smiles and each is treated differently.
Reason #1: Teeth that are too small or haven’t erupted far enough
When teeth are first coming into your mouth (erupting) they usually push through to a certain point and then stop moving. The gum tissue then moves upwards throughout the course of early adulthood. In some people the teeth don’t erupt fully. This makes them look small. In most of these cases, the best option is what is known as “crown lengthening” surgery done by a periodontist. During this type of surgery the periodontist removes several millimeters of bone around most of the front teeth. Because there already was excess bone around the teeth, this doesn’t compromise the support of the tooth at all. Once the bone is removed, the gum tissue also shrinks back. You are able to see the entire “crown” of the tooth finally which usually has a more natural shape.
Reason #2: Worn teeth
Many people develop worn teeth over the course of their life as a result of grinding or acid erosion. When the teeth become worn they also move downwards bringing the gum tissue and bone down with them. This creates a much bigger ratio of gum tissue to tooth resulting in a gummy smile. The best course of action in these cases is to use braces to move the teeth back up to where they should be and then placing crowns on them to restore their correct size and shape.
Reason #3: Lips that are too short
Some people simply have an upper lip that is too short. Of all the reasons for a gummy smile, this one is the most difficult to treat effectively. It’s hard to make a short lip any longer. Some of the previous treatment options can be used to correct it slightly (when appropriate) but for the most part, these are difficult to treat fully.
Reason #4: Lips that move too much when smiling
As opposed to a short lip, some people have lips that move way too much! This is known as lip hypermobility. When they smile, the muscles pull the lips back way further than most people do. The best solutions for lip hypermobility is botox injections (to paralyze some of these muscles) or surgery to correct some of the muscle attachment issues. It is usually best to see a periodontist first for options with this.
Reason #5: An upper jaw that is too long
Some people have good proportions of their lips and teeth but have a face that is simply too long. This is technically known as maxillary vertical excess. The solution for this is jaw surgery in combination with an orthodontist and oral surgeon. The actual surgery is pretty rough. The surgeon breaks the upper jawbone (maxilla) and resets it in a better position. You are usually wired shut for 6 weeks following surgery and this is then following by additional orthodontics.
Why Do I Have A Metallic Taste In My Mouth?
A relatively common complaint I hear from some of my patients is that they have a developed a metallic taste in their mouth. This taste can best be described as the same taste you’d get by sucking on some coins. Most come to me wondering if there is something badly wrong. They’ve heard all the crazy rumors that a metallic taste is the sign of brain cancer or something else equally unlikely. Don’t worry! The most common causes of a metallic taste aren’t anything terrible like that.
Before we take a look at the most common reasons for a metallic taste, you should understand how your sense of taste actually works. The technical term for this is “parageusia”. Interestingly enough, your sense of taste is determined by the sensations from your taste buds, the nerves responsible for your sense of smell, and how your brain interprets these signals. It’s a highly complicated system and can be hijacked by a lot of different things.
Reason #1: Medications
Many medications have a side effect of causing a metallic taste in your mouth. The most common offenders include antihistamines, antibiotics, antifungals, anti-psychotics, bisphosphonate osteoporosis medications, some blood pressure medications, glaucoma medications, corticosteroids, diabetes medications, diuretics, gout medications, muscle relaxers, drugs for Parkinson’s disease, seizure medications, thyroid medications, and certain stimulants. This is a huge list and includes many many common medications that people take. Usually the altered taste sensation will go away once the medicine is stopped. Talk to your dentist or physician for possible replacements if it is really bothersome.
Reason #2: Sinus Problems
Because your sense of taste is linked to your sense of smell, sinus problems can cause altered taste sensations. Pressure in your sinuses makes it difficult for your body to process smells correctly. Usually once the sinus problems resolve, the altered taste will go away. Common reasons for sinus problems are allergies, colds, and the flu. Take decongestants to help reduce some of the symptoms associated with it.
Reason #3: Pregnancy
Many women have a metallic taste in their mouth in early pregnancy as a result of the significant hormone changes that occur. This generally goes away later on in the pregnancy and definitely after you give birth.
Reason #4: Food Allergies
Some people have mild food allergies to common foods such as shellfish or nuts. While not causing full body symptoms, they can present as an altered sense of taste.
Reason #5: Poor oral hygiene
Infections in the mouth from gum disease can alter the sensation of taste in your mouth. If you can get the infection cleared up, the taste problems will go away.
Reason #6: Multivitamins
Multivitamins (and also prenatal vitamins, etc) have a high level of certain metals in them. When taking them, this metal can be secreted in high levels in your saliva causing you to have the classic taste of metal in your mouth.
Reason #7: Treatment for cancer
Chemotherapy and radiation treatment can cause havoc with both the actual taste buds as well as the nerves that are responsible for transporting these signals. Symptoms can range anywhere from a total loss of taste sensation to just mildly altered taste.
Reason #8: Brain (Central Nervous System) Problems
This is the most unlikely reason, but are usually the most serious causes of a metallic taste in your mouth. Common conditions include Bell’s Palsy, Brain cancer, Parkinson’s Disease, Stroke, and Dementia or Alzheimer’s disease. All of these cause this metallic taste by altering the neurons that either transport the sensations or the actual neurons in the brain.
If you’re not able to figure out the specific reason for your metallic taste or it continues for a long period of time, please see your dentist or physician for an evaluation.
Brush Your Teeth… For Your Kids?
Most parents want to give their kids the best possible start in life. Did you know that one way you can do this, is to keep your own mouth healthy? You might think, what does the health of my mouth have to do with my child’s health? When your mouth is unhealthy, whether from cavities or gum disease, it builds up high levels of “bad bacteria”. Both the amount and the kind of bacteria are entirely different when you have active infection and disease in your mouth.
The really interesting part about all this, is that you can pass on these “bad bacteria” to your children. Children don’t start out with a certain set of bacteria in their body. They slowly acquire them over time. For mouth bacteria, it is usually a result of a transfer from their parents. These bacteria get passed on through any transfer of saliva. This usually happens by sharing cups, silverware, or food. This transfer happens most often between the child and their primary caregiver. These bad bacteria increase your child’s risk of developing certain dental health problems. Cavities in particular, tend to develop much more easily in children whose parents also have active cavities.
So what can you do to give your child the best start?
- Chew xylitol gum during the last several months of pregnancy. This reduces the levels of cavity causing bacteria and you are less likely to pass them on to your child.
- Brush and floss regularly.
- Limit sugar intake. The bacteria who feed on sugars thrive in the presence of more sugar.
- If you do have active cavities, try to avoid any activities that share saliva. This includes sharing the same utensils, trying your child’s food beforehand, cleaning of pacifiers in your mouth, kissing on the mouth, etc.
- Additionally, if you have any active cavities or gum disease, get them taken care of by your dentist.
Sinus Toothaches
During certain times of the year, I start seeing a lot of patients who are having a vague toothache around their upper back teeth. Sometimes, they do have an actual toothache but in many other cases they have what is known as a “sinus toothache”. To understand why this happens you first have to understand how your teeth and sinuses are related.
The roots of the upper molar teeth sit in very close relation to your maxillary sinuses. They are usually separated by an extremely thin layer of bone or in some cases a paper thin membrane of tissue. The x-ray above shows just how close the roots of your molars are to your sinuses.
Sinus pressure can develop for several different reasons. The most common reasons include allergies, colds, or the flu, all of which swell the tissues around your sinuses and stop them from draining. Excess mucus continues to build up leading to a rise in pressure. When you start to develop pressure in your sinuses this also puts pressure on the nerves and ligaments that go into and surround the root of your tooth. This is what gives you the feeling of a toothache. This pain can range anywhere from a dull ache to biting pain to sensitivity to hot and cold. Everyone’s teeth respond a bit differently to this pressure.
So how do you know if it is a sinus toothache or a real toothache?
If you’ve recently developed sinus pressure as well as a dull toothache around your upper molars, it’s more likely than not that you’re dealing with a sinus toothache. One way you can test this is by bending over and quickly standing back up. If you feel that same tooth pain when you do this, that is a pretty good indicator that it is a sinus toothache as opposed to a regular toothache. Jumping jacks or other activities where your head moves quickly can also trigger this pain.
Now that you know it’s sinus pressure, what can you do about it?
- For medications you can use antihistamines and decongestants to help reduce some of the pressure in your sinuses.
- Stay hydrated. This will make the mucus thinner, flow more easily, less likely to build up pressure.
- Use a humidifier in the room you are in.
- Sit in a bathroom with a hot shower on several times a day. The steam will help open the sinus passages.
- Sometimes a saline spray will help.
- Use a Neti pot as directed, to help rinse your nasal passages.
If you’ve done all these things, the pressure seems to have lifted, but you are still having a toothache, it’s time to go see your dentist to check to see if something else is going on.