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Posts for: October, 2021

By Eric Romano DDS
October 24, 2021
Category: Oral Health
Tags: tooth wear  
3DentalProblemsThatCouldBeCausingExcessiveDentalWear

If you do the right things—keep your teeth clean, see the dentist regularly, and eat a "tooth-friendly" diet—you stand a good chance of having healthy teeth and gums later in life. Even so, after eating well over 75,000 meals by age 70, you can expect some wear from all that biting and chewing.

But there's normal wear—and then there's excessive wear, which can be caused by a variety of factors. When it occurs, accelerated wear can increase your risk of dental disease—and your shorter-toothed smile can make you look older than your actual age.

Here are 3 dental problems that can lead to accelerated tooth wear, and what you can do about them.

Tooth decay. This dental disease can severely weaken a tooth's protective enamel surface, which can in turn increase wear. You can minimize your chances of developing tooth decay by brushing and flossing your teeth daily and undergoing regular dental cleanings. And the sooner you receive treatment for any diagnosed decay, the less likely your enamel will suffer significant damage.

Poor bite. Properly aligned teeth mesh well together while biting and chewing, which minimizes wearing. But misalignments put undue stress on teeth that can lead to accelerated wear. By correcting a bite problem through orthodontics, we can properly align teeth so that they interact with each other normally for less wear.

Teeth grinding. This unconscious habit of gnashing or grinding teeth (often during sleep) can produce abnormally high biting forces. Among other adverse outcomes, this can also increase teeth wearing. If you grind your teeth, there are therapeutic methods that could reduce the habit. You can also obtain a custom night guard to reduce biting forces while you sleep.

If you've already experienced excessive dental wear, there are cosmetic options like porcelain veneers or dental bonding that can restore your smile to a more youthful appearance and help protect your teeth. But if you haven't reached that point, you can make sure you don't by taking care of your teeth and gums and seeking prompt dental treatment for problems leading to accelerated wear.

If you would like more information on teeth wear, 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 “How and Why Teeth Wear.”


By Eric Romano DDS
October 14, 2021
Category: Oral Health
Tags: osteoporosis  
OsteoporosisCanCauseComplicationsForSomeTypesofDentalWork

October 20th is World Osteoporosis Day, putting the spotlight on this degenerative bone condition and the impact it has on millions of people. Not only does it significantly increase the risk of potentially life-threatening fractures, but it can also indirectly affect dental health.

This connection arises from the use of certain treatment drugs that ultimately could lead to complications following some forms of dental work. These particular drugs, mainly bisphosphonates like Fosamax™ and RANKL inhibitors like Prolia™, destroy bone cells called osteoclasts, whose function is to clear away worn out regular bone cells (osteoblasts). With fewer osteoclasts targeting them, more older osteoblast cells survive longer.

In the short-term, a longer life for these older cells helps bones afflicted by osteoporosis to retain volume and density, and are thus less likely to fracture. Long-term, however, the surviving osteoblasts are less elastic and more brittle than newly formed cells.

In the end, these longer living cells could eventually weaken the bone. In rare situations, this can result in parts of the bone actually dying—a condition known as osteonecrosis. The bones of the body with the highest occurrences of osteonecrosis are the femur (the upper leg bone) and, of specific concern to dental care, the jawbone.

The effect of these medications on the jawbone actually has a name—drug-induced osteonecrosis of the jaw (DIONJ). Fortunately, there's only a 1% risk of it occurring if you're taking these drugs to manage osteoporosis. It's also not a concern for routine procedures like cleanings, fillings or crown placements. But DIONJ could lead to complications with more invasive dental work like tooth extraction, implant placement or periodontal surgery.

It's important, then, that your dentist knows if you're being treated for osteoporosis and the specific drugs you're taking. Depending on the medication, they may suggest, in coordination with your physician, that you take a "drug holiday"—go off of the drug for a set period of time—before a scheduled dental procedure to ease the risk and effects of osteonecrosis.

Because infection after dental work is one possible consequence of osteonecrosis, it's important that you practice thorough oral hygiene every day. Your dentist may also prescribe an antiseptic mouth rinse to include with your hygiene, as well as antibiotics.

You may also want to talk to your doctor about alternative treatments for osteoporosis that pose a lower risk for osteonecrosis. These can range from traditional Vitamin D and calcium supplements to emerging treatments that utilize hormones.

Osteoporosis can complicate dental work, but it doesn't have to prevent you from getting the procedures you need. Working with both your dentist and your physician, you can have the procedures you need to maintain your dental health.

If you would like more information about osteoporosis and dental care, please contact us or schedule a consultation.


By Eric Romano DDS
October 04, 2021
Category: Oral Health
Tags: facial pain  
ThereMayBeaSolutionToYourFacialPain

Physical pain is unpleasant—but not knowing why you're hurting makes it worse. Thousands of people encounter such as experience when parts of their face suddenly and mysteriously erupt in pain.

Often, though, the mystery can be quickly solved—more than likely, it's a nerve disorder known as trigeminal neuralgia (TN). Typically seen in people over 50 (and in more women than men), TN is a chronic condition that produces brief episodes of acute, spasmodic pain.

The source of this pain is the trigeminal nerve, which courses down each side of the face. Each nerve consists of three distinct branches that serve the upper, middle and lower areas of the face and jaw.

Physicians usually find that a blood vessel has come in contact with the nerve at some point, and the resulting pressure has damaged the nerve's outer insulative layer (myelin sheath). This causes the nerve to become hypersensitive at the point of contact, overreacting in a sense to the slightest touch (even a wisp of wind) on the face and jaw.

TN isn't the only source of facial pain. It can also accompany other conditions like TMD, which is why it's important to undergo a diagnostic examination. If you are diagnosed with TN, there are a number of ways to manage it. The most conservative approach (and the one usually tried first) is the use of medications to block pain signals from the nerve to the brain or to lessen abnormal nerve firing.

If medication proves ineffective or there are other factors related to age and health, you may be a candidate for a surgical solution. In one such procedure, a surgeon inserts a thin needle into the affected nerve and selectively damages some of its fibers to prevent the transmission of pain signals. Another procedure relocates the impinging blood vessel, which then allows the nerve to heal.

These surgical methods are effective but they can cause side-effects in rare cases like numbness or hearing impairment. It's best then to discuss with your doctor which approach would be best for you and your life situation. Ultimately, though, there are ways to relieve you of this painful condition.

If you would like more information on treating facial pain, 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 “Trigeminal Neuralgia.”