Archive for June, 2009
ANOTHER DIMENSION
Tuesday, June 30th, 2009
One dimensional is when you’re boring, two dimensional is this newsprint you’re reading and three dimensional is our physical world. The fourth dimension might be a parallel universe and the Fifth Dimension is some old rock group.
We will need to reserve the sixth dimension, however, for the relationship between your upper and lower jaws. That’s called the occlusal vertical dimension (OVD), the distance between your upper and lower jaws when your teeth meet. That distance is important, because it relates to the stress experienced by your temporomandibular joints (TMJ’s). Just imagine if your teeth weren’t there (some of you don’t have to imagine), when you closed your mouth until your jaws bumped together, your lower lip would overlap your upper lip (like Gabby Hayes). But you would also experience a lot of stress and even pain in your TMJ’s.
That’s a drastic example however. In most cases, the vertical dimension is lost gradually through tooth loss and attrition. If too many teeth are lost, the remaining teeth start to collapse because they can’t stand up to the immense stress produced in chewing. This category could also include the loss of support around the teeth through gum and bone recession due to gum disease.
There are many reasons for excessive wear on the biting surfaces of the teeth, such as abrasive foods in the diet, like lemons. Lemon juice is great, but just don’t chew them. Grinding your teeth at night is another biggie. There can be many reasons and many remedies for this malady. It is best to have your dentist evaluate it.
Finally, extensive dental work can actually be the cause of compromising the OVD. As crowns and fillings are ground down to fit your bite, great care must be taken to make sure they aren’t reduced too much. If the crowns are covered with porcelain they can be very abrasive to your other teeth unless they are made from the non-abrasive low fusing porcelain. Ask for it.
Also, you can get a lot of wear on dental materials that are used to replace and fill teeth. Plastic denture teeth are especially susceptible to wear. They are more comfortable, but need to be changed often. Some white filling materials can be easily worn down. I recommend and use the latest generation of white filling material, called DiamondLite, which combines the microcrystalline PEX resin matrix and ceramic nanofillers to give three times the wear resistance of any of the other materials.
Your TMJ stress is directly proportional to the loss of OVD, and that stress will determine the health and function of your jaws in the future. And any chiropractor will tell you that it also has far reaching effects in your neck and spine and the rest of your body.
Most people over 30 have varying degrees of overclosure, but fortunately, the biting surfaces of your teeth can be built back up to their normal height. So if you want to impress your dentist, on your next checkup ask him to evaluate your occlusal vertical dimension.
Dr. Moulton’s article was published in the Desert Valley Times, February 2006
Tags: bone recession, chiropractor, DiamondLite, gum disease, non-abrasive low fusing porcelain, occlusal vertical dimension, OVD, overclosure, plastic denture teeth, TMJ, tooth loss, white filling material
Posted in Dentistry | 1 Comment »
A Hard Subject
Tuesday, June 30th, 2009
Did you know that bone is considered an organ? I don’t know if each individual bone is an organ or the skeletal system as a whole, but it is an interesting and complex tissue that plays an important role to your teeth as well as the rest of your body. It might seem like a hard, inert substance, but it is actually a live and vital tissue. It houses many types of cells, a blood supply and nerves, and it is in a constant state of flux and regeneration. There are basically four types of bone tissue in the body: 1) compact or cortical bone which comprises the thick outer covering, 2) trabecular bone which is the honeycomb inner bone, 3) marrow, which is the soft middle that produces blood cells, and 4) a specialized type of bone tissue called alveolar bone which supports the teeth. We will cover alveolar bone next time.
As a tissue, bone is subject to disease and should receive the proper care and maintenance. To appreciate this, it might help to understand what goes on in there. Your bone is constantly being remodeled in response to its environmental conditions. Cells called osteoclasts dissolve the calcium phosphate structure of the bone and return it to the blood. Osteoblasts are cells which deposit the calcium back into the bone. In this way, the shape and density of the bone can be altered as the body’s demands vary. For instance, if you do a lot of weight-bearing exercise, as well as your muscle mass increasing, your bone density will also increase to meet the requirement for more strength.
This touches on the subject of the most common disease of the bone, low bone density, or osteoporosis. The cause is simple chemistry. If the blood becomes too acidic, it will dissolve the minerals out of your tissues, the most common one being the calcium phosphate in your bones. The reason for acid blood is another easy one to figure out; it’s just what goes into your body. Different things have been shown to have an effect on the blood pH, or acid level.
Let’s start with the things that make your blood too acidic. At the very top of the list are drugs. I’m not just talking methamphetamines, but over-the-counter and prescription drugs also. The mechanism by which drugs enter your muscles, nervous system and brain is called a pH gradient. The blood must become more acidic than those other tissues in order to ‘download’ the drug. To be very effective, every drug must cause the blood to become acidic, and the more acidic, the faster and more potent the drug’s effects will be. Obviously, psychotropic drugs like meth and LSD are quite destructive. The constant and prolonged use by the meth addict leaves him emaciated, literally dissolving him from the inside. But caffeine, tobacco, and alcohol are also very potent drugs associated with constant and prolonged use. They all cause the blood to become very acidic. I might be sounding a little picky, but remember where we’re going with this. That acidity in your blood must be neutralized, and your body does it with the calcium from your bones!
A close second on the list of things that make your blood acidic is soda pop. The carbonation, caffeine, sugar, and phosphoric acid drive your blood acidity through the roof. Diet soda is every bit as bad, and energy drinks like Red Bull and Rock Star are the absolute worst in that category. So called “soft” drinks are so harmful that they should only be available by prescription, and then no doctor in his right mind would prescribe it for you. So you need to be your own doctor and don’t give yourself permission to buy soda for you or your children.
Constant exposure to fluoride replaces the calcium in your bones making them more brittle. According to the Journal of the American Medical Association, there is an increase in hip fractures in areas with water fluoridation.
Food wise, you can pretty much guess how they affect your blood pH. Sugar, artificial sweeteners, additives, and processed foods will make your blood more acid. Conversely, natural raw fruits, vegetables, whole milk, and eggs will not only reduce the acidity, but provide a natural source of minerals that will replenish your body.
Who gets osteoporosis and what do you do about it? You don’t wake up one day and BAM, you have osteoporosis. That last Coke didn’t just push you over the edge. It’s a disease of the elderly because it takes a lifetime of sodas, coffee, cigarettes, martinis, and finally, that shopping list of prescription medications. Of course, the sooner in life you break the pattern, the better chance you have to preserve the integrity and health of your bones. But it is never too late to take charge. Take responsibility for your health! Eat properly and exercise. Look up your prescriptions on the internet and see if they interact with each other, and you decide if you want to gamble on the side effects. It’s appalling to see drug companies try to induce people to use drugs they don’t even need on TV and tragically comical to listen to the required disclaimers. “You might turn blue and burst into flames, but go ahead and try it. It may be just what you need!” Most of my patients that take aspirin are self-medicating because of a TV ad. Don’t do that!
Many physicians have gone drugless and have written books to expose the drug companies’ control of American health care. In Dr. Jerry Avorn’s book, ‘Selling Sickness’, he talks about how drug companies invent diseases so they can sell more drugs. In his book, ‘Taking Control of Your Health’, Dr. Joseph Mercola says, “the most common cause of death in America is the fatally flawed medical system that focuses on using toxic and expensive pharmaceutical band-aids that in no way, shape, or form treat the underlying cause of the disease.”
I believe there certainly is a place for drugs such as medical emergencies, serious infections and high blood pressure, but not as a way of life. The price tag is too high. They are poisonous to your body. Their side effects are usually much worse than any benefit or relief they claim to give. They are pulling the calcium out of your bones and redistributing it into your kidneys, gall bladder, and joints, leaving your bones weak and crippling your body.
Next week we will talk about what drugs are being peddled for osteoporosis and their alarming effects.
Dr. Moulton’s article was published in the Desert Valley Times, December 2007
Tags: acid level, alcohol, alveolar bone, artificial sweeteners, blood acidity, blood pH, bone tissue, caffeine, calcium, calcium phosphate, carbonation, compact bone, cortical bone, Dr. Joseph Mercola, eggs, fluoride, hposphoric acid, Jerry Avorn, Journal of the American Medical Association, low bone density, LSD, marrow, methamphetamines, milk, natural raw fruits, osteoblasts, osteoclasts, Osteoporosis, pH gradient, prescription drugs, processed foods, psychotropic drugs, Red Bull, Rock Star, soda pop, tobacco, trabecular bone, vegetables
Posted in Health | No Comments »
The Care and Feeding of the Mouth
Tuesday, June 30th, 2009
Perhaps the most requested and beneficial thing we do in our office is to show people how to care for their teeth and gums, and yet it’s sometimes surprising when we come across someone that has never learned these things. So let’s give the subject a quick once-over.
BRUSHING: This is the most basic and effective of oral care methods, but a quick once-over won’t do the job in this department. Three whole minutes (four for braces) is longer than you realize, so check the clock to get a better feel for that length. That will give you enough time to clean every aspect of the teeth, the outside and inside as well as the top, angling the bristles toward the gum and using a circular scrubbing motion. A rotary brush works much better and some, like the Rotadent, have an orthodontic tip for those with braces.
Unfortunately, too many people think that’s all they need, but brushing alone is usually not enough to ward off gum disease, which is way more dangerous than cavities.
FLOSSING, ETC: I’m listing these activities in order of decreasing importance, but flossing is a very close second. Don’t underestimate it because it could literally be a matter of life and death for those with a tendency for gum disease. Flossing could add years to your life expectancy by preventing secondary infections that could affect your heart and cause strokes. Work the floss back and forth so it gently passes between the teeth and doesn’t snap into the gum, injuring it. Then you wrap it against one tooth and floss back and forth, going under the gum as far as you can without feeling any pain, and then you do the same thing against the other tooth. Continue between all the teeth including behind the last teeth. In some cases, there are fixed bridges or orthodontic wires that prevent the floss from going between the teeth, so you have to use floss threaders or plastic-tipped floss like Superfloss to go underneath. When you first begin flossing, you may experience some bleeding, but don’t be discouraged. That will go away as the gums heal. The etc. refers to cleaning aids you work in between your teeth, like toothpicks, stimudents and proxabrushes. Those are great, but just be gentle.
DENTAL CLEANINGS: You notice this is all the way down to third on the list. As important as regular cleanings are, good home care is by far the most effective means of preventing decay and gum disease. But no matter how good a job you do, tarter will still form on your teeth, and that’s nothing but a housing project for bacteria. So dental cleanings top off that 1-2-3 punch called dental hygiene. If it’s been a while, you may need more than one visit to get all the tartar off, but then regularly scheduled cleanings will prevent any further gum damage. Also, there is a tendency to think that if you are seeing an orthodontist regularly for braces, you’re covered in the dental department, but it’s actually even more important to see your general dentist for periodic cleanings.
DIET: You know the drill (no pun intended). Sugar is the thing to avoid. That is what feeds the bacteria that cause decay and gum disease, especially if it’s in a form that is sticky or liquid, like candy or soda. If you go sugarless, it is very important to avoid toxic sweeteners like aspartame, also sold as NutraSweet and sucralose, also sold as Splenda. Xylitol is an excellent natural sugar made from berries. It’s good for diabetics, and it actually prevents decay and gum disease. It’s manufactured by a company called Xlear. Chewing gum has a natural cleansing action. Don’t chew it for more than ten minutes at a time, however, because it can stress the supporting structures of the teeth and jaws. Also, almost all brands contain sugar and/or aspartame except Spry gum, which contains xylitol. That’s also made by Xlear, and is sold at Valley Nutrition health food store. It’s the only kind you should chew.
You notice we didn’t talk about mouthwash. It’s not only unecessary, the alcohol in it can actually harm your white fillings and your children if they swallow it.
Dr. Moulton’s article was published in the Desert Valley Times, September 2007
Tags: aspartame, bacteria, brushing, cavities, dental cleanings, dental hygiene, fixed bridges, floss threaders, flossing, gum disease, mouthwash, NutraSweet, orthodontic wires, orthodontist, Rotadent, Splenda, sucralose, tarter, Xlear, Xylitol
Posted in Dentistry | No Comments »
The New Order
Tuesday, June 30th, 2009
In the olden days, there seemed to be an order of things that would prompt a person to go see their dentist for care.
The first concern for most patients was pain, followed by appearance, decay, gum disease, and missing back teeth, respectively. Many patients would only seek dental treatment when they were experiencing extreme pain, or if they were not happy with the look of their front teeth. Cavities, gum problems, and spaces where teeth were extracted were often ignored.
With all of the new information we know about gum disease, it is necessary to change our list of priorities.
Pain is still the front-runner and greatest cause for concern. If a patient has a tooth-ache, it often means that there is an infection present, whether it is within the tooth itself, or the gums that surround the tooth. Dental infections can be very serious and should be taken care of immediately.
Periodontal, or gum disease, is the second most important priority. According to recent studies, more than half of all people over 18 have at least the early stages of periodontal disease. Periodontal disease is an infection that destroys the gum surrounding your teeth and also destroys the supporting bone that holds your teeth in place. Unlike most diseases that give us early warning signs, gum disease progresses silently, often without pain. It may develop slowly or progress quite rapidly. Not only is the loss of gum and bone a concern, but studies have proven that gum disease may increase your risk of a variety of health problems, including:
Heart disease
Weakened immune system
Diabetes
Stroke
Lung Disease
Preterm, low birth babies
Respiratory disease
Osteoporosis
Gastric ulcer
If you are already experiencing any of these health concerns, it is very important to maintain good oral health by visiting your dentist regularly.
Tied for third on the new list are decay and appearance. I’m sure most of you know that if decay is not kept under control, it can actually spread to other teeth in your mouth. Also, if decay is left in a tooth long enough, it will eventually reach the nerve of the tooth, often causing an abscess, or infection, in the bone. The tooth will then need a root canal, or may need to be extracted.
We all understand how prominent appearance has become in our society. Everyone wants to have a beautiful smile to share. There are many ways to achieve the smile you have been wanting, including whitening, “invisible” braces,
porcelain veneers, etc. Just remember that a beautiful smile is more than straight, white teeth. It is important to make your entire oral health a priority.
As before, missing back teeth are last on the list. But that doesn’t mean they are less significant than the other things.
When a tooth is lost and not replaced as soon as possible, the remaining teeth can drift out of position and change the bite. This can lead to cavities, gum disease, bite problems, and TMJ (joint problems in the jaw). All of your teeth work together to help you chew, speak, and smile. When teeth are missing, it is difficult to do these things. Even the loss of back teeth can cause your bite to shift and your face to look older. Fortunately, missing teeth can be replaced in several ways, including implants, bridges, and removable appliances.
As you may have noticed, the dental concerns we have discussed can often times be interrelated. Gum disease can cause tooth loss, and tooth loss can cause gum disease. A “tooth-ache” can be caused by gum disease as often as it can be caused by decay. Loss of teeth, swollen, red gums, and decay all affect our appearance.
Evidence shows that it is time to let go of the ‘old school’ mentality and embrace the new order of things. We cannot stress enough how important it is to visit your dentist to have oral examinations and cleanings done regularly. By keeping these recare appointments you will increase your chances of a healthy smile, but most importantly, a long, healthy life.
Dr. Moulton’s article was published in the Desert Valley Times, June 2007
Tags: abscess, Bridges, decay, Diabetes, gastric ulcer, gum disease, heart disease, Implants, infection, invisible braces, lung disease, missing teeth, Osteoporosis, periodontal disease, porcelain veneers, removable appliances, respiratory diesease, root canal, stroke, tooth-ache, weakened immune system
Posted in Dentistry | 1 Comment »