My Blog

Posts for: August, 2018

By Drs. Heller & Meersand
August 23, 2018
Category: Oral Health
SeekImmediateTreatmentforthisAdvancedFormofGingivitis

It takes only a short time neglecting your oral hygiene before you begin to notice some unpleasant things with your gums: swelling, redness or even bleeding. These are all signs of gingivitis, a periodontal (gum) disease that arises from bacterial plaque, a thin biofilm that builds up on tooth surfaces when a person doesn't brush or floss.

Fortunately, early stages of gingivitis can be treated effectively with comprehensive plaque removal during one or more office visits. If, however, it's not dealt with early, it can develop into something much more serious: acute necrotizing ulcerative gingivitis (ANUG). This form does more than leave you with unattractive teeth and gums and terrible breath — it could eventually cause you to lose your teeth.

ANUG is also known as trench mouth, a common ailment among front line World War I soldiers without access to proper dental care and hygiene. It's most prevalent today among individuals who are under a great deal of stress, not sleeping or eating well and haven't cleaned or properly cared for their teeth for an extended period of time. Tobacco smokers also seem more susceptible than non-smokers to the disease, perhaps because smoke dries the mouth and changes the bacterial environment.

Unlike common gingivitis, ANUG can be quite painful. In effect, the gum tissues begin to die (necrotize), especially the triangular peaks between teeth known as papillae. Besides the other symptoms of gingivitis, the tissues may become yellowish.

ANUG can be treated effectively. The first step is to relieve the symptoms of pain and inflammation through medication. The focus then shifts to treating the underlying cause, bacterial plaque. Besides plaque removal common in any treatment for gum disease, we may also need to initiate antibiotic therapy. Metronidazole is a common antibiotic that's been demonstrated effective against the specific bacterial strain associated with ANUG. We might also combine this with an antibacterial mouth rinse containing chlorhexidine.

The final step belongs to you: to keep ANUG or any other gum disease from reoccurring, it's important for you to adopt a daily regimen of brushing and flossing, along with regular dental visits for thorough teeth cleaning and checkups. Taking this proactive approach will help ensure you won't suffer from this painful and unattractive form of gingivitis again.

If you would like more information on acute gingivitis, 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 “Painful Gums in Teens & Adults.”


By Drs. Heller & Meersand
August 13, 2018
Category: Oral Health
Tags: bad breath  
10TipstoTameBadBreath

National Fresh Breath Day is celebrated in August, but who doesn’t want fresh breath every day? Everyone has bad breath once in a while, so here are some tips to fight it.

1. Step up your oral hygiene routine.
Good oral hygiene is the first line of defense against bad breath. Brush your teeth morning and night and floss daily to remove much of the tiny food debris and plaque (colonies of oral bacteria) that can cause bad breath.

2. Don’t neglect your tongue.
A coated tongue can be a source of bad breath, so brush your tongue as well as your teeth or use a tongue scraper, which can be purchased in the oral health aisle of your local pharmacy.

3. Clean around your braces.
If you have braces, use an interdental brush or a water flosser to free trapped food particles.

4. Pay attention to your oral appliances.
If you wear dentures, be sure to clean them thoroughly every day, and brush your gums and the inside of your mouth as well. Bridgework also needs special attention: Clean carefully around the bridge and under the false tooth, as food can get stuck there.

5. Tackle dry mouth.
Dry mouth, a major cause of bad breath, can result from numerous medications, salivary gland problems, or breathing through the mouth instead of the nose due to sinus problems, sleep apnea, or other conditions. If your mouth is chronically dry, chew sugarless gum to stimulate saliva production, or ask about an over-the-counter or prescription saliva substitute.

6. Avoid extreme dieting.
Weight loss diets that advocate a stringent reduction in carbohydrates can lead to “keto breath.” This foul-smelling breath happens when the body burns fat instead of glucose for fuel.

7. Quit smoking.
In addition to smelling like cigarettes, people who smoke have less—as well as lower quality—saliva, which contributes to bad breath and poor oral health. If you need help quitting, talk with us or call (800) QUIT-NOW.

8. Be aware that some foods and beverages can leave stinky breath.
These include garlic, onions, strong spices, coffee, alcohol, cheese, and canned fish.

9. Keep up with regular dental visits.
Professional dental cleanings are necessary to get rid of hardened plaque (tartar) that can’t be removed by your brushing and flossing routine at home. We also check for gum disease, another cause of bad breath.

10. See your doctor.
Certain medical conditions like acid reflux, diabetes, and respiratory infections can cause bad breath. If you have an untreated health condition, make an appointment with your medical doctor.

If you are concerned about bad breath, please contact our office or schedule a consultation. You can learn more in the Dear Doctor magazine article “Bad Breath: More Than Just Embarrassing.”


By Drs. Heller & Meersand
August 03, 2018
Category: Dental Procedures
Tags: dental implants   diabetes  
DiabetesDoesntHavetoStopYouFromAcquiringDentalImplants

One of the best and most successful tooth replacement choices available is the dental implant. No other restorative method is as similar in both form and function to a real tooth as an implant; and with a success rate of 95-plus percent after ten years, it’s one of the most durable.

But there can be extenuating circumstances that make obtaining an implant difficult or sometimes impossible. One possible problematic situation is the systemic disease diabetes.

Diabetes is a hormonal condition in which the body is unable to sufficiently regulate the amount of glucose (a basic sugar that provides energy to the body’s cells) within the blood stream. Normally, the pancreas produces the hormone insulin to reduce excess glucose. But diabetes interferes with this insulin production: if you have Type 1 diabetes, the pancreas has stopped producing insulin altogether; if you have the more common Type 2, the body doesn’t produce adequate insulin or it doesn’t respond sufficiently to the insulin produced.

Over time diabetes can affect other areas of health, especially wound healing. Because the condition gradually causes blood vessels to narrow and stiffen, the normal inflammatory response to disease or trauma can become prolonged. This in turn slows the rate of wound healing.

Slow wound healing can have a bearing on the recovery period just after implant surgery, especially the necessary integration process that takes place between the bone and the titanium metal implant that provides its signature strength. If that process is impeded by slow wound healing caused by diabetes, the risk increases dramatically for implant failure.

That’s the worst case scenario if you have diabetes, but only if your condition is out of control. If, however, you have your blood sugar levels well regulated through medication, diet and exercise, then your chances for implant success could easily be on par with someone without diabetes.

So if you’re diabetic and are considering dental implants for missing teeth, it’s important to discuss the possibility of obtaining them with both your dentist and the physician caring for your diabetes. With your overall healthcare team working together, there’s no reason why diabetes should stop you from enjoying this premiere restoration for missing teeth.

If you would like more information on obtaining dental implants, 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 “Dental Implants & Diabetes.”