ChildrenwithChronicHealthConditionsmayNeedExtraDentalCare

Proactive dental care is an essential part of childhood growth. But that care can be much harder for children with chronic health issues than for healthier children.

“Chronic condition” is an umbrella term for any permanent and ongoing health issue. Asthma, Down’s syndrome, cystic fibrosis, congenital heart defects and many others fall under this umbrella, with varying symptoms and degrees of intensity. But they all have one common characteristic — a long-term effect on all aspects of a child’s health.

That includes the health of a child’s teeth and gums. Here, then, are a few areas where a chronic health condition could impact dental care and treatment.

Ineffective oral hygiene. Some chronic conditions like autism or hyperactivity disorder (ADHD) that affect behavior or cognitive skills can decrease a child’s ability or willingness to brush or floss; some conditions may also limit their physical ability to perform these tasks. Parents and caregivers may need to seek out tailored training for their child’s needs, or assist them on a regular basis.

Developmental defects. Children with chronic conditions are also more likely to have other developmental problems. For example, a child with Down, Treacher-Collins or Turner syndromes may be more likely to develop a birth defect called enamel hypoplasia in which not enough tooth enamel develops. Children with this defect must be monitored more closely and frequently for tooth decay.

Special diets and medications. A child with a chronic condition may need to eat different foods at different times as part of their treatment. But different dietary patterns like nutritional shakes or more frequent feedings to boost caloric intake can increase risk for tooth decay. Likewise, children on certain medications may develop lower saliva flow, leading to higher chance of disease. You’ll need to be more alert to the signs of tooth decay if your child is on such a diet or on certain medications, and they may need to see the dentist more often.

While many chronic conditions raise the risk of dental disease, that outcome isn’t inevitable. Working with your dentist and remaining vigilant with good hygiene practices, your special needs child can develop and maintain healthy teeth and gums.

If you would like more information on dental care for children with chronic health conditions, 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 “Managing Tooth Decay in Children with Chronic Diseases.”

By James B. Howell, D.M.D.
April 25, 2017
Category: Oral Health
ActorDavidRamseySaysDontForgettoFloss

Can you have healthy teeth and still have gum disease? Absolutely! And if you don’t believe us, just ask actor David Ramsey. The cast member of TV hits such as Dexter and Arrow said in a recent interview that up to the present day, he has never had a single cavity. Yet at a routine dental visit during his college years, Ramsey’s dentist pointed out how easily his gums bled during the exam. This was an early sign of periodontal (gum) disease, the dentist told him.

“I learned that just because you don’t have cavities, doesn’t mean you don’t have periodontal disease,” Ramsey said.

Apparently, Ramsey had always been very conscientious about brushing his teeth but he never flossed them.

“This isn’t just some strange phenomenon that exists just in my house — a lot of people who brush don’t really floss,” he noted.

Unfortunately, that’s true — and we’d certainly like to change it. So why is flossing so important?

Oral diseases such as tooth decay and periodontal disease often start when dental plaque, a bacteria-laden film that collects on teeth, is allowed to build up. These sticky deposits can harden into a substance called tartar or calculus, which is irritating to the gums and must be removed during a professional teeth cleaning.

Brushing teeth is one way to remove soft plaque, but it is not effective at reaching bacteria or food debris between teeth. That’s where flossing comes in. Floss can fit into spaces that your toothbrush never reaches. In fact, if you don’t floss, you’re leaving about a third to half of your tooth surfaces unclean — and, as David Ramsey found out, that’s a path to periodontal disease.

Since then, however, Ramsey has become a meticulous flosser, and he proudly notes that the long-ago dental appointment “was the last we heard of any type of gum disease.”

Let that be the same for you! Just remember to brush and floss, eat a good diet low in sugar, and come in to the dental office for regular professional cleanings.

If you would like more information on flossing or periodontal disease, please contact us today to schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Understanding Gum (Periodontal) Disease.”

By James B. Howell, D.M.D.
April 10, 2017
Category: Oral Health
GumDiseaseCouldAffectMorethanYourTeethandGums

If you have periodontal (gum) disease, it's important for you to know its effects aren't limited to your mouth. A number of studies demonstrate gum disease can affect the rest of your body — and what may be going on elsewhere could likewise stimulate gum disease.

Here are 3 diseases or conditions that seem to share a link with gum disease.

Diabetes. This chronic disease results from the body's inability to interact properly with insulin, the hormone necessary for turning glucose (sugar) into energy, or producing enough of it. There's clear evidence that having diabetes increases your risk of gum disease and vice-versa. If you have diabetes, it's important that you keep it under control for your gum's sake as much as for your overall health.

Cardiovascular disease. Like diabetes, this group of heart and blood vessel diseases has a related characteristic with gum disease: inflammation. This natural function of the immune system limits tissue damage caused by disease or injury. But in both CVD and gum disease, inflammation can become chronic and itself cause damage. Further, some types of bacteria associated with gum disease can contribute to a higher risk of CVD. Minimizing gum disease occurrence with good oral hygiene could positively impact your risk of CVD.

Pregnancy. While certainly not a disease, pregnancy does trigger hormonal changes in the mother that in turn could elevate her risk of gum disease, particularly pregnancy gingivitis. Not only does this pose problems for the mother's teeth and gums, some studies connect gum disease to the increased possibility of early, pre-term birth. A sharper focus on dental care during pregnancy not only benefits the mother but may also be important for the health of the baby.

These aren't the only conditions that can be affected by gum disease: others like osteoporosis, respiratory disease or rheumatoid arthritis also share links with the disease. If you have any systemic condition like these, it pays to be extra vigilant in preventing and treating gum disease.

If you would like more information on periodontal (gum) disease, 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 “Good Oral Health Leads to Better Health Overall.”

By James B. Howell, D.M.D.
April 02, 2017
Category: Dental Procedures
JasonDerulosIdealMatch

When the multi-platinum recording artist, songwriter and TV personality Jason Derulo was recently asked about his ideal woman, his answer covered a remarkably broad spectrum. "There’s no specific thing," he said, "so I think it’s unfair to say what my ‘type’ is." But it turns out that there is one thing the So You Think You Can Dance judge considers essential: A beautiful smile.

"I’m not into messy teeth," Derulo said. "If the grill has spaces and different colors, it’s not my vibe."

As it turns out, he may be on to something: A number of surveys have indicated that a bright, healthy smile is often the first thing people notice when meeting someone new. Yet many are reluctant to open up that big grin because they aren’t satisfied with the way their teeth look. If you’re one of them, consider this: Modern cosmetic dentistry offers a variety of ways to improve your smile — and it may be easier and more affordable than you think.

For example, if your smile isn’t as bright as you would like it to be, teeth whitening is an effective and economical way to lighten it up. If you opt for in-office treatments, you can expect a lightening effect of up to 10 shades in a single one-hour treatment! Or, you can achieve the same effect in a week or two with a take-home kit we can custom-make for you. Either way, you’ll be safe and comfortable being treated under the supervision of a dental professional — and the results can be expected to last for up to two years, or perhaps more.

If your teeth have minor spacing irregularities, small chips or cracks, it may be possible to repair them in a single office visit via cosmetic bonding. In this process, a liquid composite resin is applied to the teeth and cured (hardened) with a special light. This high-tech material, which comes in colors to match your teeth, can be built up in layers and shaped with dental instruments to create a pleasing, natural effect.

If your smile needs more than just a touch-up, dental veneers may be the answer. These wafer-thin coverings, placed right on top of your natural teeth, can be made in a variety of shapes and colors — from a natural pearly luster to a brilliant "Hollywood white." Custom-made veneers typically involve the removal of a few millimeters of tooth enamel, making them a permanent — and irreversible — treatment. However, by making teeth look more even, closing up spaces and providing dazzling whiteness, veneers just might give you the smile you’ve always wanted.

If you would like more information about cosmetic dental treatments, please call our office to arrange a consultation. You can learn more in the Dear Doctor magazine article “Cosmetic Dentistry — A Time for Change.”

By James B. Howell, D.M.D.
March 18, 2017
Category: Oral Health
Tags: oral health   cancer  
BeAlerttotheUnintendedConsequencesofCancerTreatmenttoOralHealth

Thanks to treatments like chemotherapy and radiation, your chances of surviving cancer are greater than ever. These treatments, however, often produce unwelcome side effects. Treating throat or oral cancer, for example, could damage your mouth's salivary glands or bone.

Saliva is essential to oral health, providing antibodies to curb the growth of disease-causing bacteria and neutralizing acid, which can erode enamel. But salivary glands damaged during cancer treatment may not be able to produce enough saliva. The resulting “dry mouth” creates an environment conducive to bacterial growth and elevated acid levels.

You can help reduce the effects of dry mouth during your treatment (and after, if the damage is permanent) by drinking more water or by using substances that stimulate saliva. Cutting back on acidic foods and beverages will also help lower your mouth's acidity. And be sure to keep up daily oral hygiene and regular dental visits.

The more ominous threat to oral health during cancer treatment, though, is osteoradionecrosis. This occurs when radiation targets specific areas of bone. The bone can lose blood supply and living cellular tissue, which inhibit its ability to heal or replenish itself. If this occurs in the jawbone of teeth that may be lost, the bone tissue could be adversely affected during healing.

Depending on your treatment needs, your risk for osteoradionecrosis might be unavoidable if teeth are to be lost. It's important we discuss that risk because it could impact future dental treatment. In the worst case, before cancer treatment, we may not be able to save affected teeth and your restorative options might be limited.

If your risk of osteoradionecrosis is minimal, though, we may be able to restore any resulting damaged or missing teeth with a wide range of options like dental implants or crowns before or after your cancer treatment.

As with other aspects of health, taking care of your teeth and gums while undergoing cancer treatment can be challenging; some problems may be unavoidable. But with a proper dental treatment plan during and after chemotherapy and radiation, we can minimize those problems and help to eventually restore your smile.

If you would like more information on smile restoration after cancer, please contact us or schedule an appointment for a consultation.





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Louisville, KY Cosmetic Dentistry
James B. Howell, D.M.D.
3936 Dutchmans Lane
Louisville, KY 40207
(502) 899-7766

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