Oral Health for Older Patients

The demographic of older adults, 65 years of age and older is growing and likely will be an increasingly large part of many dental practices in the coming years. People are living longer; the average life expectancy for Americans is 78.7 years.  Many older patients take prescription medications for their medical conditions.  People want to save their teeth as long as they can to improve and sustain the quality of their life. 

Oral health impacts the health of the rest of the body and it is true that the condition of the health also impacts your oral health.

Here are some reasons that older patients’ dental care is so important:

Heart Disease

·       Studies have shown that maintaining good oral hygiene is a powerful weapon against heart attacks, strokes, other heart disease conditions

·       According to the American Academy of Periodontology (AAP), patients with periodontal disease are twice (2x) more likely to have heart disease

Diabetes

·       According to the American Diabetes Association, diabetes occurs when the body’s blood glucose exceeds normal level

·       Type 2 Diabetes is more common in older adults

·       Type 2 diabetics are at greater risk for periodontal disease.  High blood sugar can lead to gum infection and tooth loss

Dry Mouth-lack of production of saliva in the mouth

·       Dry mouth can be a side effect of taking prescription and over the counter medications

·       Dry mouth can be a side effect of cancer treatment that use radiation to the head and neck area

·       Tooth and root decay are common with dry mouth condition

·       Gum infection and periodontal disease

Gum Disease

·       Gum tissues surrounding teeth become infected due to build up of plaque

·       Gum disease is one of the reasons people have tooth loss

·       Studies show that 68% of those 65 years or older Americans have periodontal disease. It can destroy gums, bone, and ligaments that support teeth

·       Gum disease may be related to the cause of some health problems; heart disease, diabetes, pneumonia, and other health issues

Denture-Induced Stomatitis

·       Inflammation of the gum tissues under an ill-fitting denture

·       Inflammation of the gum tissues due to poor oral hygiene

Some Dental Health Risks in Older Patients

·       Tooth Decay-according to the Center for Disease Control (CDC), about 96% of the adults aged 65 and older have had at least one cavity previously.  About 20% currently have untreated tooth decay.

·       Root decay- gum tissues recede and root surfaces become exposed and susceptible to root decay and may lead to tooth loss

·       Dry Mouth-reduced saliva production in the mouth may be caused by medications as well as cancer treatment that use radiation to the heads and neck areas.  Dry mouth increases tooth and root decay

·       Gum Disease-Untreated gum disease (inflammation of gum tissue and bone loss) would lead to tooth loss

Here are some expert tips from the American Dental Association that are good guideline to follow:

·       Brush 2x per day with a toothbrush, use fluoride-containing toothpaste and floss daily

·       Rinse with an antiseptic mouthwash once or twice per day

·       If you wear full or partial dentures, remember to clean them daily

·       Take the dentures out of the mouth for at least 4 hours every day, and it is best to remove them at night

·       Drink water-it helps to prevent tooth decay

·       Quit smoking-increases problems with gum disease, tooth decay and tooth loss

·       Visit the dentist on a regular schedule, every 6 months, for a complete dental check-up, cleaning and oral exam

·       Eat a healthy, well-balanced diet

Dr. Anna Lee is a general & cosmetic dentist in Glendora, CA.  She is experienced in all phases of dentistry.  She treats patients of all ages.  If you have not had a dental check up for a while, it is time to call for a dental examination now.   Call our office at 626-335-5114 for a dental appointment or visit us at www.annaleedds.com

What is Vaping?

    

Vaping means smoking an e-cigarette.  E-cigarettes are battery-powered devices that deliver cigarettes electronically and in an array of flavors and vapors.  The 3 most common ingredients in e-cigarettes are propylene glycol, vegetable glycerin, and nicotine.  These are harmful ingredients that may cause harm to your health and your dental health.  Center of Disease Control (CDC) reports that there is an increase of e-cigarette use, especially among kids; an increase of 78% among high school students and an increase of 49% among the middle school students between 2017 and 2018.  This is a big concern and more studies are needed to find out the effects of long term exposure to e-cigarettes.

Health risks of Vaping
Nicotine is delivered through vaping.  Nicotine is an addictive substance that is also a carcinogen, and it is known to cause cancer.  Nicotine can cause tumor growth in the following:
Lung cancer
Gastrointestinal cancer
Pancreatic cancer
Breast cancer
Some early studies show data that vaping may cause bodily harm:
Impacts the health of the lungs and DNA
Damages the blood cells
Increases the risk of heart disease
Weakens the immune system
Dental health risks of Vaping
The 3 most common ingredients in e-cigarettes are propylene glycol, vegetable glycerin, and nicotine.
Oral tissues exposed to a mixture of propylene glycol and flavoring ingredients in e-cigarettes can lead to dry mouth.
Research shows when teeth are exposed to a mix of vegetable glycerin and flavoring ingredients, teeth have four times more bacteria than teeth that have not been exposed to e-cigarettes.
Vaping can cause deterioration of tooth enamel, cavities, periodontal disease, gum recession, tooth loss, and other dental health problems.
White spots on the teeth-these are decalcifications that show the beginning of enamel softening
Red or white patches on the gums or the inside of the cheek.  They can be precancerous cells and sometimes they do become cancer cells.
Oral thrush-white patches on the tongue or mouth or redness inside the mouth. This can be a sign of thrush.

Vaping increases the risk of periodontal disease. These are some of the symptoms to look out for:
Ongoing bad breath (halitosis)
Red, puffy, bleeding gums
Receding gums
Tender or swollen gums
Teeth mobility

Minimize the risk of developing dental problems
Stop vaping
Brush with fluoridated toothpaste at least twice per day.  Wait 20 minutes before brushing your teeth after vaping
Floss daily
Avoid dry mouth, drink water often.  Use a moisturizing mouth spray containing xylitol, which helps to stimulate saliva production.
See the dentist every 4 to 6 months for check-up and cleaning.
Researches

The increased number of people vaping as an alternative to traditional cigarette smoking is a growing concern.  More studies are being done now to find out the health and dental health risks of vaping.     Food and Drug Administration (FDA) asked the National Academies of Sciences, Engineering, and Medicine (NASEM) to report on the potential public health consequences of vaping. NASEM researchers were unable to find any link between e-cigarette use and periodontal disease.  They provided limited evidence that e-cigarette aerosol can cause cell damage in oral tissue.
More researches are needed to find out the long term health and dental health impacts of vaping and e-cigarettes. 

Dr. Anna Lee is a general & cosmetic dentist in Glendora, CA.  She is experienced in all phases of dentistry.  She treats patients of all ages.  If you notice any of the symptoms of periodontal disease, call our office for a dental checkup.  Call our office at 626-335-5114 for a dental appointment or visit us at www.annaleedds.com.

What is Burning Mouth Syndrome (BMS)?

                         

Burning mouth syndrome (BMS) is known as "burning tongue (or lips) syndrome."  It is a chronic dental condition that is often described as a burning sensation felt on the tongue, lips, cheeks, the roof of the mouth and the back of the mouth or throat.  For some patients, the discomfort is constant that lasts for months or years, while others may suffer from occasional discomfort.  The intensity of discomfort varies from person to person because the syndrome affects everyone differently.  BMS affects both men and women, but it seems to be more common in women during or after menopause.

The exact cause of BMS is unclear and is still being researched.  Dentists and physicians work together may recommend medications and treatment plans to provide relief of symptoms.
Signs & symptoms of BMS
Burning sensation on the tongue, lips, cheeks, the roof of the mouth, back of the mouth or throat
Dry or sore mouth
Tingling or numb sensation throughout the mouth and tongue
A bitter or metallic taste
Causes of BMS

The possible causes of BMS are many and complex.  Many patients have multiple causes.
Dry mouth
-use of certain medications for treating high blood pressure, Sjogren's syndrome (an autoimmune disease), antidepressants and other medications may cause dry mouth
Oral conditions
-oral yeast infection (thrush) is a common cause of a burning mouth
-geographic tongue causes dry mouth, sore, patchy tongue
Irritating dentures
-materials used to fabricate dentures may cause allergy reaction in some patients
-dentures may place stress on some muscles and tissues of the mouth
Oral habits
-tongue thrusting
-teeth grinding (bruxism) can irritate the mouth
-excessive brushing of the tongue
-allergic reactions to the ingredients in the toothpaste or mouthwash

Other medical and health conditions have been linked to burning mouth syndrome:
Nutritional deficiency-vitamin B, iron, zinc
Endocrine disorders-diabetes, hypothyroidism
Hormonal imbalances in women during and after menopause
Reflux of stomach acid (gastroesophageal reflux disease)-the sour or bitter-tasting fluid that enters the mouth from the upper gastrointestinal (GI) tract may cause irritation and pain in the mouth
Neuropathy-damage to nerves that control taste and pain in the tongue may cause a burning sensation in the mouth
Allergy-allergic reactions to foods, food flavorings, food additives, dyes or other substances
Psychological problems-depression and anxiety may contribute to the development of BMS
Treatment of burning mouth syndrome
Identifying all the causes is important for the dentist and physician to develop a treatment plan to treat the patient.
Dry mouth-the dentist may advise that you drink more fluids or may suggest saliva replacement products
Oral thrush-treat with oral antifungal medications
Irritating dentures-polish sharp edges of broken partials/dentures, replace broken teeth and make sure the dentures fit well in the mouth
Oral habits-wear a night guard for teeth grinding at night
Eliminate the use of mouthwash, tobacco, acidic liquids (fruit juice), soda, coffee for 2 WEEKS, and see if there is any improvement.

If the dentist determines that no oral conditions are causing the burning sensation in the mouth, consult with the physician.  The physician may order blood tests to look for other medical and health conditions that may be the cause of the burning sensation.
Helpful Tips to soothe the burning sensation
Chew sugarless gum
Sip water or suck on ice chips
Avoid alcohol, tobacco products, smoking cigarettes
Avoid hot or spicy foods
Avoid acidic foods (citrus foods and juices)

Dr. Anna Lee is a general & cosmetic dentist in Glendora, CA.  She is experienced in all phases of dentistry.  She treats patients of all ages.  If you have symptoms of Burning Mouth Syndrome, call our office for a dental checkup.  Call our office at 626-335-5114 for a dental appointment or visit us at     www.annaleedds.com.

Is Bad Breath Impacting You?

Bad breath is also known as halitosis. It is described as a foul smell and an unpleasant odor. Bad breath is caused primarily by bacteria and food particles that become trapped in the oral cavity and emit an unpleasant odor. Almost everyone experiences bad breath one time or another, whether it is after a meal filled with onions or morning breath when you get up in the morning. According to Harvard Medical School, 30% of the population struggles with some degree of bad breath daily. Bad breath may result from oral problems and poor dental hygiene habits, medical problems, types of foods we eat, unhealthy lifestyle habits and other factors.

                                                    

    Some Causes of Bad Breath

Oral problems and poor dental hygiene habits

• Poor oral hygiene; not brushing and flossing daily
• Food particles remain in the mouth, promoting bacterial growth between teeth, around the gums and on the tongue
• Bacteria on the tongue
• Odor-causing bacteria and food particles may cause bad breath if dentures are not properly cleaned
• Gum infection caused by periodontal disease
• Infection in the mouth results from the growth of bacteria. Teeth, gums, bone and surrounding tissues of the mouth can all become infected by different groups of bacteria that vary in smell. Many of these bacteria produce a foul smell that alters taste sensation and cause bad breath.
• Yeast infection caused by ill-fitting dentures
• Dental cavities

Medical problems and Bad Breath

• Respiratory tract infections: bronchitis, pneumonia, chronic sinus infection, post nasal drip
• Diabetes
• Chronic acid reflux (GERD)
• Liver or kidney problems
• Dry mouth: saliva is produced to moisten the mouth. It neutralizes acids produced by plaque and wash away dead cells accumulate on the tongue, gums, and cheeks. If not removed, these cells decompose and can cause bad breath.
• Dry mouth may be a side effect of medications
• Dry mouth is caused by salivary gland problems
• Dry mouth is caused by mouth breathing

Types of foods we eat and Bad Breath

• Garlic, onions, spices, and coffee can cause bad breath diet is high in protein and sugar associated with bad breath

Unhealthy lifestyle habits and Bad Breath

• Smoking and use of tobacco products
• Poor oral hygiene habits

Other factors and Bad Breath

• Metabolic disorders can cause a distinctive breath odor as a result of chemicals they produce
• Chronic Acid Reflux (GERD)
•  

                                             Treatment of Bad Breath

The American Dental Association (ADA) recommends the followings:

• Brush 2x/day with a fluoride-containing toothpaste
• Floss between teeth daily 
• Use an antibacterial mouth rinse
• Brush the tongue to remove bacteria that contribute to oral odors (especially in the back of the tongue)
• Remove dentures or removable dentures at night and brush them with a denture cleanser before replacing them the next morning
• Chew sugar-free gum or suck on sugar-free candies to stimulate salivary flow
• Talk to your dentist about your concerns:
• A thorough health history
• List of medications and supplements you are taking
• Determine the cause of bad breath: oral cause or medical cause
•  

                                    Some Prevention of Bad Breath

• Practice good oral hygiene: brush 2x/day, floss daily, use an antibacterial mouth rinse, clean the tongue
• Drink sufficient amount of water daily (6 to 8-ounce glasses)
• Chew sugarless gum can stimulate saliva production
• Quit smoking and avoid tobacco products
• Adjust the diet: onions, garlic, spices, sugary foods, protein, and coffee can cause bad breath
• Regular dental visit and dental cleaning with your dentist and dental hygienist
•  

In most cases, your dentist can treat the cause of bad breath. If your dentist determines that bad breath is not caused by oral problems, you may be referred to your physician to determine the odor source and treatment. 

Dr. Anna Lee is a general & cosmetic dentist in Glendora, CA. She is experienced in all phases of dentistry. She treats patients of all ages. If you notice that you have bad breath, don’t hesitate to call for a dental examination. Bad breath problems can be treated, so you can smile, talk and get close to your loved ones with confidence without being embarrassed about your breath. Call our office at 626-335-5114 or visit us at www.annaleedds.com.

What is Vaping?

                                                                 

Vaping means smoking an e-cigarette.  E-cigarettes are battery-powered devices that deliver cigarettes electronically and in an array of flavors and vapors.  The 3 most common ingredients in e-cigarettes are propylene glycol, vegetable glycerin, and nicotine.  These are harmful ingredients that may cause harm to your health and your dental health.  Center of Disease Control (CDC) reports that there is an increase of e-cigarette use, especially among kids; an increase of 78% among high school students and an increase of 49% among the middle school students between 2017 and 2018.  This is a big concern and more studies are needed to find out the effects of long term exposure to e-cigarettes.

Health risks of Vaping
Nicotine is delivered through vaping.  Nicotine is an addictive substance that is also a carcinogen, and it is known to cause cancer.  Nicotine can cause tumor growth in the following:
Lung cancer
Gastrointestinal cancer
Pancreatic cancer
Breast cancer
Some early studies show data that vaping may cause bodily harm:
Impacts the health of the lungs and DNA
Damages the blood cells
Increases the risk of heart disease
Weakens the immune system
Dental health risks of Vaping
The 3 most common ingredients in e-cigarettes are propylene glycol, vegetable glycerin, and nicotine.
Oral tissues exposed to a mixture of propylene glycol and flavoring ingredients in e-cigarettes can lead to dry mouth.
Research shows when teeth are exposed to a mix of vegetable glycerin and flavoring ingredients, teeth have four times more bacteria than teeth that have not been exposed to e-cigarettes.
Vaping can cause deterioration of tooth enamel, cavities, periodontal disease, gum recession, tooth loss, and other dental health problems.
White spots on the teeth-these are decalcifications that show the beginning of enamel softening
Red or white patches on the gums or the inside of the cheek.  They can be precancerous cells and sometimes they do become cancer cells.
Oral thrush-white patches on the tongue or mouth or redness inside the mouth. This can be a sign of thrush.

Vaping increases the risk of periodontal disease. These are some of the symptoms to look out for:
Ongoing bad breath (halitosis)
Red, puffy, bleeding gums
Receding gums
Tender or swollen gums
Teeth mobility

Minimize the risk of developing dental problems
Stop vaping
Brush with fluoridated toothpaste at least twice per day.  Wait 20 minutes before brushing your teeth after vaping
Floss daily
Avoid dry mouth, drink water often.  Use a moisturizing mouth spray containing xylitol, which helps to stimulate saliva production.
See the dentist every 4 to 6 months for check-up and cleaning.
Researches

The increased number of people vaping as an alternative to traditional cigarette smoking is a growing concern.  More studies are being done now to find out the health and dental health risks of vaping.     Food and Drug Administration (FDA) asked the National Academies of Sciences, Engineering, and Medicine (NASEM) to report on the potential public health consequences of vaping. NASEM researchers were unable to find any link between e-cigarette use and periodontal disease.  They provided limited evidence that e-cigarette aerosol can cause cell damage in oral tissue.
More researches are needed to find out the long term health and dental health impacts of vaping and e-cigarettes. 

Dr. Anna Lee is a general & cosmetic dentist in Glendora, CA.  She is experienced in all phases of dentistry.  She treats patients of all ages.  If you notice any of the symptoms of periodontal disease, call our office for a dental checkup.  Call our office at 626-335-5114 for a dental appointment or visit us at www.annaleedds.com.

Bruxism

Bruxism is a condition that people grind or clench their teeth.   People who grind or clench their teeth during the day and during their sleep regularly are likely to have dental problems, headaches, facial or jaw pain, and temporomandibular joint disorder.   Awake bruxism is teeth grinding or clenching during the day. Sleep bruxism is teeth grinding or clenching during sleep.  People who have sleep bruxism may have other sleep disorders, such as snoring and sleep apnea.

The exact cause of bruxism is unclear.  These are possible causes of bruxism:

·       Stress & anxiety

·       Abnormal bite, malocclusion (teeth do not meet properly when the jaw closes)

·       Missing or crooked teeth

·       Sleep disorders: snoring, sleep apnea

Signs & symptoms of bruxism may include:

·       Teeth grinding or clenching may be loud enough to wake up your sleep partner

·       Teeth that are flattened, fractured, chipped or loose

·       Worn tooth enamel, exposing deeper layers of your tooth

·       Increased tooth pain or sensitivity

·       Tired or tight jaw muscles, or a locked jaw that won’t open or close completely

·       Jaw, neck or face pain or soreness

·       Pain that feels like an earache

·       Dull headache starting in the temples

·       Sleep disruption

·       Wake up in the morning with jaw pain

Dangers of bruxism

·       Wear down tooth enamel, damage to dental fillings and crowns

·       Tension-type headaches

·       Facial or jaw pain

·       Temporomandibular joint disorder

Factors increase risk of bruxism

·       A study in the November 2016 issue of the Journal of the American Dental Association suggests that teeth grinding is also associated with alcohol and tobacco use.  People who drink alcohol and use tobacco are twice likely to grind their teeth.

·       Stress, anxiety, anger,  and frustration

·       Personality type:  person who is aggressive, competitive or hyperactive can increase the risk of bruxism

·       Smoking tobacco, drinking caffeinated beverages or alcohol, or use of recreational drugs may increase the risk of bruxism.

·       Bruxism can be associated with some mental health and medical conditions: Parkinson’s disease, dementia, gastroesophageal reflux disorder (GERD), epilepsy, sleep apnea and attention deficit disorder.

Treatment for bruxism

·       Recommend a sleep study to rule out an airway issue

·       Mouth guard fitted by the dentist.  Mouth guard is worn to protect the teeth

·       Dietary changes

·       life style changes

Prevention

·       Stress and anxiety management may help reduce or prevent bruxism

·       Good sleep hygiene: cool dark, quiet room to sleep in

·       Avoid foods and drinks that contain high concentration of caffeine or alcohol

Bruxism can create serious problems for oral health. If you notice that you grind or clench your teeth during the day or you wake up in the morning with jaw pain, call for a consultation with Dr. Anna Lee.  She can help you, diagnose the problem and provide treatment options.  Dr. Anna Lee is a general & cosmetic dentist in Glendora, CA.  Call our office at 626-335-5114 for a dental checkup or visit us at www.annaleedds.com.

Tips to overcome Dental Fear

Many people are fearful of going to the dentist.  The reason may be that you had a bad dental experience; the dental injection was painful, you were not numb enough during the treatment, or the dental visit was too long.  These are legitimate reasons that cause people to be afraid of seeking dental treatment. Dental fears are not uncommon.                                                                                                                             

Here are some tips to overcome dental fear:

Communication with the dentist & dental team

·       Talk with your dentist & dental staff and let them know you are fearful of the dental visit.

·       Start with simple treatment with short appointments.

·       You may feel more in control if you take part in decisions about your treatment. Ask the dentist to explain the procedure before the treatment.

·       Some patients want to know everything about the treatment. Tell your dentist to explain what is happening at every stage of the dental procedure.

·       Hand signal such as “thumbs up” or “thumbs down” tells the dentist to continue or stop the procedure.  Thumbs up means to continue the procedure.  Thumbs downs means stop.

·       Discuss fees and finance before the treatment.

Pain Control

·       Research has shown that pain is one of the main reasons people avoid seeing the dentist.

·       Make sure you tell the dentist if you are not numb enough before or during the dental procedure.

·       Minimize pain with using topical anesthetics. It is applied with a Q-tip to numb an area of the mouth before the injection.

·       Ask for pain medication prescriptions if needed after an extensive dental procedure.

Use Distraction

·       Watch a funny video to help you relax before the treatment

·       Wear head phone and listen to music during the treatment

·       Squeeze a stress ball

·       Imagine your happy place and visualize yourself at a relaxing place

Practice relaxation Techniques

·       Relaxation exercises: take a big breath and letting it out very slowly

·       Relax your muscle & slow your heart rate

Sedative may be needed before the procedure

·       Some patients take Valium to relax prior to the treatment

·       Sedatives help people feel calmer and more relaxed during the treatment

Bring a companion during appointments

·       Bring a friend or family member to the dental appointment for support

·       Friend or family member keeps you company during the treatment

·       Keep your mind off any unpleasant thoughts

Reward Yourself

·       Buy something nice or do something fun to reward yourself for overcoming the fear of the dental treatment

·       Rewards can help you to relate dental visits with fun activities

Dental fears are not uncommon. Finding a dentist who listens and understands your dental fears is important. Dental visits should not just be getting the dental treatment done; it should also be creating a positive experience.   Dr. Anna Lee is a general & cosmetic dentist in Glendora, CA.  She listens and understands your dental fears.  Dr. Lee and her team can help you to reduce your dental fears. Call our office for a dental visit at 626-335-5114 or visit us at www.annaleedds.com.