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Chronic teeth grinding or Bruxism is a condition that many people suffer from but are mostly unaware of.Fotolia_4104434_XS-300x184  Bruxism can occur during the day or night but for most people occurs at night. This habit can cause significant damage to the teeth and cause discomfort to the structures that hold your jaw and TMJ in place. Although many speculate what causes people to clench and grind often times there is no clear cause for it and may resolve on its own.

 Common signs that you may be grinding your teeth are:

  • Flattening of biting surfaces of teeth
  • Pain in jaw muscles and temples
  • Pain when biting in molar area
  • Scalloping or indentation of the sides of tongue
  • Scooping out of flat part of teeth along gum line
  • Popping and clicking of the jaw
If you are suffering from symptoms consistent with a chronic bruxer your dentist may recommend treatment with an appliance called a nightguard. A nightguard is a tray that overlays the upper or lower teeth separating them slightly. This helps protect wear of the biting surfaces of the teeth and relieves pressure on the jaw joint and surrounding muscles.]]>

cavity free mouth and, all the great tools available to help you do so. Fotolia_5327278_XS-resized-600 Next comes the last part, maintenance of your repertoire of home care tools. So if you’ve ever wondered ‘How to keep my toothbrush clean?’ then read on..

Your toothbrush is the most important tool in your home care regimen so keeping it clean and up to date is very important. Here are the basics:

1. Whether using an electric toothbrush or a manual toothbrush it should be replaced every 3 months. The easiest way is to change your brush or electric toothbrush head with the change of the seasons or if the bristles begin to look splayed or frayed. 2. While brushing your teeth your brush is cleaning all the debris, plaque and bacteria that you’ve accumulated over the day. After brushing you should sanitize your toothbrush, we recommend rinsing it with Listerine then rinsing with water and letting air dry. 3. And lastly, When storing your toothbrush you want to store it head up allowing it to air dry in an area away from an open toilet. If you can store it in a medicine cabinet or something similar that is best.

Many of our patients own and use appliances at home whether they be retainers, Invisalign aligners, nightguards or sleep apnea oral appliances, these appliances need special care to maintain them and keep them clean.

1. In the morning upon removal of the appliance you should use a wet toothbrush to gently clean off the appliance, stay away from abrasive toothpastes when cleaning any appliance made of acrylic or soft rubbery material as the toothpaste may cause it to become porous and more susceptible to bacteria buildup. 2. Many of your appliances can be soaked in a chlorhexidine mouth rinse or Listerine for a period of time to help reduce bacteria build up as well. Please check with your dentist before you do so as some of these rinses may stain certain materials 3. Also, for clear retainers and Invisalign aligners, often over time the aligners may discolor due to normal wear. You can place your retainer or aligner in a small glass of water with a cap full of hydrogen peroxide, this will help clear up the stain on the aligner.]]>

Fotolia_40413702_XS-200x300The studies were spurred on by the increase in consumption of sports and energy drinks, especially by adolescents. The study warned that both sports drinks and energy drinks have pH levels that are at a level of acidity that can cause demineralization or weakening of the enamel. Also, they found that they both contain citric acid, included to help improve the taste and shelf life of the drink, which can also have an effect on enamel. The study showed, that although both sports and energy drinks are acidic enough that if  excessively consumed they can cause damage to dental enamel, energy drinks have a “significantly greater potential for enamel dissolution than sports drinks”. The study also brought to light some interesting information:

  • ” Approximately 30-50%  of adolescents and young adults in the U.S. consume energy drinks and that 51-62% of adolescents consume at least one sports drink per day”
  • Energy drinks are a fairly new and quickly growing product and there haven’t been many studies on the effects of energy drinks. One statistic showed that energy drinks are such a growing market that “200 new brands of energy drinks were launched in 2007 alone”. Also, because of new flavors and formulations are being created so frequently and the vast differences even between effects of flavors of the same brand, it is very difficult to generalize about these effects.
  • Different flavors within the same brand had different levels of acidity.
  • Of all the drinks tested “Gatorade Blue was found the highest titratable acidity” Also, Red Bull Sugar Free, Monster Assault, 5-Hour Energy, Von Dutch, and Rock Star had higher acidity than Red Bull, Rip It, Full Throttle Fury and MDX.
So what does this mean, should we stop drinking energy drinks? In my opinion that is not what this study means at all. These products when consumed excessively have the potential to create a more cavity prone mouth. So like all things they should be consumed in moderation. Also, due to the acidity of these products it is recommended by the Academy of General Dentistry to wait at least an hour to brush your teeth after consuming a sports or energy drink.    
A comparison of sports and energy drinks—Physiochemical properties and enamel dissolution; By Poonam Jain, BDS, MS, MPH; Emily Hall-May, MS; Kristi Golabek; Ma Zenia Agustin, PhD

Fotolia_38233787_XS-300x199diagnosed with this sleep disorder but have not sought treatment. And, many do not fully understand exactly what sleep apnea is. Sleep apnea is a condition where an individual stops breathing for ten seconds or more during sleep. This typically can happen between ten and sixty times in a single night. The two types of sleep apnea are: Obstructive sleep apnea, which is the most common type of apnea; and Central sleep apnea. Obstructive sleep apnea is due to relaxation of the muscles around the throat causing an obstruction of air flow in to the nose and mouth. And, Central sleep apnea is caused by a disruption in the signal from the brain that controls breathing. Besides not being able to get a good nights rest, sleep apnea sufferers may be more prone to higher blood pressure and a decreased flow of oxygen to the brain. This may cause fatigue during the day and if left untreated can lead to impaired daytime function.  If you have a weakened heart already, sleep apnea can aggravate your condition by placing stress on your heart while you sleep.  This can lead to heart attack and possibly stroke. The gold standard for treatment of most sleep apnea patients is use of a Continuous Positive Airway Pressure system or more commonly known as CPAP. This type of machine provides constant pressure to help keep the airway open. Some patients are unable to tolerate the CPAP system and then are prescribed by their sleep physicians to have an oral appliance made to help keep the airway open. This appliance is made at your dental office. Your dentist will then  fit adjust and monitored your treatment with the oral appliance.  ]]>

Over the last few years there has been an increase or reported cases of MRSA infections. Many of my patients ask me about the risk of oral MRSA infections and how it can effect them. Our mouths are home to over 300 different types of bacteria. Fotolia_17801369_XS-200x300In a healthy mouth, these bacteria work together to create a healthy oral environment. But, as in any other system, if things go awry and the balance becomes upset then we find different types of bacteria take advantage of this and begin to thrive.

So does the average person have MRSA in their mouth?

Studies have shown that the population that has the highest incidence of MRSA colonization are elderly patients in nursing homes as well as patients with advanced malignant diseases  suffering from reduced salivary flow rate.

What can they do to reduce the amount of bad bacteria in our mouths?

MRSA tends to like to grow on the porous surfaces of dentures as well as being found in plaque in the mouth. Some studies have shown that a good way to clean MRSA infected dentures is with a chlorhexidine oral rinse as well as soaking the dentures in chlorhexidine for 10 minutes once a week. Dentures should be cleaned daily with a stiff brush and soap and water, not toothpaste. And even, if you wear dentures you should be cleaning your gums and remaining teeth as well. Some studies also suggest microwaving your dentures for 3 minutes. However, I don’t suggest this if you have any portion of your denture that is metal.

What kind of risks are there if you have MRSA in your mouth?

There are no studies that offer clear associations of MRSA colonization in the mouth causing systemic and dental problems. Although, the bacteria having been found in some orofacial abscesses as well as some infections located on the gingiva and corners of the mouth commonly associated with denture wear. So although there have been few instances of this type of bacteria found in oral infections the concern is for the potential for these strains to re-colonize at other body sites or become a source of cross-infection to other patients or hospital/nursing home staff.
The ecology of Staphylococcus species in the oral cavity; A. J. Smith, M. S. Jackson and J. Bagg Staphylococcus aureus in the oral cavity: a three-year retrospective analysis of clinical laboratory data; A.J. Smith, D. Robertson, M. K. Tang,  M. S. Jackson, D. MacKenzie & J. Bagg MRSA infection; K. Valand & P.M. McLoughlin