Marijuana and Your Oral Health

One of the things I noticed on this past election day is that marijuana was legalized in Massachusetts, our neighbor to the north, and is now legal for recreational use by almost one-quarter of the US population. The use of medical marijuana  is legal in 20 more states, including Connecticut.  So here’s some information about marijuana smoking and your oral health.

According to a 2014 survey from the National Institute on Drug Abuse (NIDA), around 22.2 million Americans report using the drug in the past month.   The first thing we need to do is understand that there are no stereotypes. Marijuana crosses all cultures, ages, genders, and socioeconomics. It is not a poor man's drug or a rich man's drug, and to most who use it, it isn't even a drug.

Some of my patients who use marijuana need compassion. Those who use marijuana to waylay the side effects of cancer, MS, fibromyalgia, and a host of other painful diseases just need support, for which its use is legal in Connecticut (and 19 other states, in addition to the 8 where it’s outright legal). This becomes a risk-benefit scenario, where the patient wants comfort, not a list of dos and dont's from the dentist.

However, on the flipside of compassion, we need to know that marijuana harms the oral cavity.

Do your homework! One study suggests frequent use of marijuana may triple the risk of severe gum disease. Tobacco is already known to raise the risk of periodontal disease. Researchers in New Zealand wanted to know if marijuana had a similar effect. Their study included 903 people. Some had smoked marijuana an average of once a week for 15 years. They were three times as likely to have severe gum disease as nonsmokers of marijuana. Reuters Health News service reported on the study on February 5, 2008. It was published in the Journal of the American Medical Association.

Marijuana's harmful effects on the mouth include an increased risk of mouth cancer. "Drug Abuse" reports that marijuana has been found to have a higher concentration of cancer-producing ingredients than cigarettes. Pot smokers typically hold the smoke in the lungs and mouth for longer periods of time, increasing the effects on the mucous lining in the mouth and exposure to the cancer-causing agents. The tar found in marijuana has developed tumors on the skin of animals in laboratory tests.

A report by the American Medical Student Association says that marijuana users tend to get sick more frequently than those who don't smoke it. In addition to the lowered immune system and chemical poisons produced by the THC that linger in the mouth, marijuana users undergo personality changes that lead to poor hygiene. They lack energy and lose interest in everyday activities that were once important, such as brushing, flossing, and rinsing. The smoke from marijuana causes bad breath, and the lack of mouth care eventually produces additional problems for teeth and gums.

Marijuana can lead to higher incidences of cavities (caries), and it can cause cotton-mouth (xerostomia). Because of marijuana's side effects of dry mouth and hunger, most people turn to soft drinks and carbohydrates to stave off these side effects. This leads to plaque retention and a higher incidence of caries.

I know that despite some of these increased risks, many of my patients do, and probably more will use marijuana in the future.  In truth, I can’t say it’s worse than smoking two packs of cigarettes per day, or drinking a quart of liquor per day, or smoking methamphetamine, which are all really, really bad for your mouth.

But it doesn’t have a positive effect on the oral cavity.

Keep smiling,

 

Dr. Elzbieta W. Basil, DMD is a private practice dentist with offices in West Hartford Center and Downtown New Britain, Connecticut.  She is a Clinical Instructor at the UConn School of Dental Medicine, and has won several awards naming her regional “Best Dentist” and “Top Dentist.” She is an active member of the Connecticut State Dental Association and the American Dental Association. Tel: 860-561-2121

Marijuana and Your Oral Health

One of the things I noticed on this past election day is that marijuana has been legalized in Massachusetts, our neighbor to the north, and is now legal for recreational use by almost one-quarter of the US population. The use of medical marijuana  is legal in 20 more states, including Connecticut.  So here’s some information about marijuana smoking and your oral health.

According to a 2014 survey from the National Institute on Drug Abuse (NIDA), around 22.2 million Americans report using the drug in the past month.   The first thing we need to do is understand that there are no stereotypes. Marijuana crosses all cultures, ages, genders, and socioeconomics. It is not a poor man's drug or a rich man's drug, and to most who use it, it isn't even a drug.

Some of my patients who use marijuana need compassion. Those who use marijuana to waylay the side effects of cancer, MS, fibromyalgia, and a host of other painful diseases just need support, for which its use is legal in Connecticut (and 19 other states, in addition to the 8 where it’s outright legal). This becomes a risk-benefit scenario, where the patient wants comfort, not a list of dos and dont's from the dentist.

However, on the flipside of compassion, we need to know that marijuana harms the oral cavity.

Do your homework! One study suggests frequent use of marijuana may triple the risk of severe gum disease. Tobacco is already known to raise the risk of periodontal disease. Researchers in New Zealand wanted to know if marijuana had a similar effect. Their study included 903 people. Some had smoked marijuana an average of once a week for 15 years. They were three times as likely to have severe gum disease as nonsmokers of marijuana. Reuters Health News service reported on the study on February 5, 2008. It was published in the Journal of the American Medical Association.

Marijuana's harmful effects on the mouth include an increased risk of mouth cancer. "Drug Abuse" reports that marijuana has been found to have a higher concentration of cancer-producing ingredients than cigarettes. Pot smokers typically hold the smoke in the lungs and mouth for longer periods of time, increasing the effects on the mucous lining in the mouth and exposure to the cancer-causing agents. The tar found in marijuana has developed tumors on the skin of animals in laboratory tests.

A report by the American Medical Student Association says that marijuana users tend to get sick more frequently than those who don't smoke it. In addition to the lowered immune system and chemical poisons produced by the THC that linger in the mouth, marijuana users undergo personality changes that lead to poor hygiene. They lack energy and lose interest in everyday activities that were once important, such as brushing, flossing, and rinsing. The smoke from marijuana causes bad breath, and the lack of mouth care eventually produces additional problems for teeth and gums.

Marijuana can lead to higher incidences of cavities (caries), and it can cause cotton-mouth (xerostomia). Because of marijuana's side effects of dry mouth and hunger, most people turn to soft drinks and carbohydrates to stave off these side effects. This leads to plaque retention and a higher incidence of caries.

I know that despite some of these increased risks, many of my patients do, and probably more will use marijuana in the future.  In truth, I can’t say it’s worse than smoking two packs of cigarettes per day, or drinking a quart of liquor per day, or smoking methamphetamine, which are all really, really bad for your mouth.

But it doesn’t have a positive effect on the oral cavity.

Keep smiling,

 

Dr. Elzbieta W. Basil, DMD is a private practice dentist with offices in West Hartford Center and Downtown New Britain, Connecticut.  She is a Clinical Instructor at the UConn School of Dental Medicine, and has won several awards naming her regional “Best Dentist” and “Top Dentist.” She is an active member of the Connecticut State Dental Association and the American Dental Association. Tel: 860-561-2121

How to Survive Your Sweet Tooth.

Halloween candy.  You know it and I know it.  If you’re not sneaking it from your kids, you’re probably eating the leftovers you gave out at your door, or that somebody brought to the office coffee room. 

Thanks to years of education from parents, teachers, dental hygienists, and dentists like myself, most of you are already are aware that eating candy (and drinking sugary drinks) can contribute to tooth decay. But if your house is now full of delicious Halloween candy, and you enjoy the taste of delicious treats (mmmmmm, chocolate), by following a few common sense practices you can maintain healthy teeth.

Here are a few tips that can help prevent cavities for those of you, like myself, who have a sweet tooth:

Brush Often

While this might seem obvious, a busy schedule or forgetfulness often prevents you from brushing as often as you should. To keep your teeth clean, you should carry a portable or disposable toothbrush with you at all times. Portable toothbrushes are perfect for busy adults, such as sales representatives and insurance agents, who are on the road during the day. They allow you to quickly visit the restroom after eating a sugary dessert or snack and remove any food or sugar on the teeth.

Use a Mouthrinse

It’s not  a substitute for brushing, but use a mouthrinse to remove as much sugar and sticky residue as possible. While mouthrinses that contain fluoride are ideal, even swishing plain water around your mouth can help when no other option is available.

Chew Sugar-Free Gum After

If you chew a sugar-free gum after eating sweets it will help clean your teeth. The gum will increase the production of saliva, aiding in removing any sugar coating the teeth.

Opt for Less Sugary Alternatives

Obviously, fruits are a healthy way to satisfy a craving for sweets, but for those who don't want to substitute a banana for a donut, there are still some choices you can make to lessen the risk of cavities. For example, a piece of a chocolate bar will not coat the mouth in sticky sugar for quite as long as a candies containing caramel or gooey taffy.  And, please, don't suck for a long time on a lollipop.

The key to prevent cavities after eating sugary foods is simply to prevent the mouth from remaining coated in the acid-forming sugars and other carbohydrates found in sweets after eating—just keep the toothbrush moving.

Keep smiling,

 

Dr. Elzbieta W. Basil, DMD is a private practice dentist with offices in West Hartford Center and Downtown New Britain, Connecticut.  She is a Clinical Instructor at the UConn School of Dental Medicine, and has won several awards naming her regional “Best Dentist” and “Top Dentist.” She is an active member of the Connecticut State Dental Association and the American Dental Association. Tel: 860-561-2121

Tips for Dental Emergencies While Traveling Abroad

Are you planning a trip outside the U.S.?   Don't have your vacation ruined by a toothache.

Before flying overseas, I strongly recommend a visit for a thorough dental examination, especially if you are traveling to a developing country or isolated areas without access to safe dentistry. 

Emergency dental care abroad may be hard to find, painful, expensive, and even dangerous. Most of us take for granted the high U.S. standards for equipment sterilization, infection control and safety. We seldom think about the fact that sterile instruments, gloves, disposable needles and safe water are not always the standard in many parts of the world. Dentists practicing in the U.S. are held to high standards of care and must follow infection control guidelines for disease prevention. The standards for educating and licensing dental professionals also vary in foreign countries. In the U.S., dentists have been educated in accredited schools and have taken national and state boards prior to receiving a license to practice.

Before Your Trip:

Schedule an appointment with your dentist giving adequate time to complete any necessary dental treatment. Pressure changes especially during air travel can cause pain in an untreated tooth.

• Have decayed or cracked teeth treated
• Congested with sinus problems? It may be from or affecting your teeth
• Schedule a cleaning, especially if you have any type of periodontal (gum) disease or bad breath
• Sensitive teeth should be checked before you travel
• Complete all root canal treatments

Tips for Issues While Traveling: 

Along with your passport, carry travel information including names and phone numbers of organizations to contact in case of a dental or medical emergency. Some good sources to contact in an emergency are:

• A local hotel concierge.
• Americans living in the area or an American military base.
• The International Assoc. For Medical Assistance To Travelers — a network of doctors and medical institutions around the world – (www.iamat.org).
•  American Consulate or American Embassy in the country you are visiting.

Don't let a dental emergency dampen your vacation. Be sure to have your teeth in great shape prior to leaving home!

Keep smiling,

 

Dr. Elzbieta W. Basil, DMD is a private practice dentist with offices in West Hartford Center and Downtown New Britain, Connecticut.  She is a Clinical Instructor at the UConn School of Dental Medicine, and has won several awards naming her regional “Best Dentist” and “Top Dentist.” She is an active member of the Connecticut State Dental Association and the American Dental Association. Tel: 860-561-2121

Repairing a Chipped Tooth is Easy (and Smart)

A chipped tooth in your smile can make an impression — and it’s not a good one!

Take, for instance, the dim-witted character Lloyd Christmas in the “Dumb and Dumber” film franchise. Lloyd’s chipped front tooth was a conscious choice by actor Jim Carrey to make his character appear unhinged every time he opened his mouth.

Repair a Chipped Tooth for Aesthetics & Health

Luckily, it’s easy to repair this type of dental injury. Dentists like West Hartford dentist Dr. Elzbieta W.Basil, DMD have several options at their disposal depending on the nature of the damage and whether you’ve been able to locate and save the otherwise intact fragment.

It’s essential for your oral health as well as your appearance to make a dental appointment for assessment and repair of a chipped tooth. If dental pulp at the core of the tooth is exposed, your tooth could become sensitive to heat and cold, and pressure, causing persistent discomfort. The pulp could also become contaminated, resulting in a need for root canal treatment.

Option 1: Bonding — Rejoin or Re-create the Fragment

Dental cosmetic bonding is the fastest and most cost-effective option to fix a chipped tooth. According to the internet Jim Carrey had a chipped tooth repaired in his youth; and, he asked his dentist temporarily remove the repair it for the movie.   Bonding involves application of a composite resin material that Dr. Elzbieta W. Basil, DMD is highly skilled in coloring and shaping to match the original tooth.  Minimal or no removal of existing tooth structure is required.

If you were able to save the fragment of tooth and it is otherwise unspoiled, a dentist can use bonding to seamlessly reattach it. Otherwise, depending on the extent of tooth loss, bonding material can be used to replace the lost portion.  And that’s where your practitioner’s skill will shine the most.

Option 2: Veneer — Cover the Chip

A dental veneer can be used to mask the entire front of the damaged tooth. This is a thin, custom-made porcelain shell placed on the front of the tooth to give it a new face. Some removal of existing tooth surface could be required in order to properly  to fit a veneer to make it flush with it’s neighbors.

Option 3:  Crown — Cover the Entire Tooth

A crown may be the best choice if you have a somewhat large chip. A dental crown will fully encase the tooth visible above the gum line and a skilled dentist can shape and size it to match the original.  The porcelain or ceramic material should be colored to match your other teeth. Some of the existing tooth surface will be removed to allow the crown to fit over it.

Prevention

Oral mishaps will occur, but you can substantially reduce the risk of damaging your teeth by wearing a custom fitted mouth guard for sports, a night guard if you grind or clench your teeth while you sleep—and  please don’t chomp on ice, popcorn kernels or hard candies…and don’t use your teeth as a tools for cutting, holding and opening things!

Keep smiling,

 

 

Dr. Elzbieta W. Basil, DMD is a private practice dentist with offices in West Hartford Center and Downtown New Britain, Connecticut.  She is a Clinical Instructor at the UConn School of Dental Medicine, and has won several awards naming her regional “Best Dentist” and “Top Dentist.” She is an active member of the Connecticut State Dental Association and the American Dental Association. Tel: 860-561-2121

What You Should Know About Receding Gums

Recently, I received several questions about receding gums, so I thought I'd blog about it.  Receding gums is also known as “gingival recession.”   Ideally, healthy, pink gum tissue normally covers the root of the tooth. This can become exposed when the gum is pushed back or if the tooth is in an abnormal position.

 

Receding gums are common and often unnoticed at an early stage. There are many risk factors, but age is a main one – 88% of people older than 65 have receding gums in at least one tooth--hence the term "long in the tooth" to refer to an older person. 

Since gums protect fragile tooth roots from bacteria, plaque and other insults, the main concern with receding gums is that when the roots of the teeth become exposed, they are at risk for decay, infection, and loss. Treatment can stop or reverse the process of gum recession if begun at an early stage. 

If the recession is severe and the patient has symptoms such as tooth sensitivity, pain, or infection, a variety of treatment options are available. These include deep cleaning, medicine to fight infections, and even tissue grafts. 

What are the gums?

The gums are also known as the gingivae. The gingiva is the moist pink tissue in the mouth that meets the base of the teeth. There are two such gums - one for the upper, and one for the lower set of teeth. 

The gingiva is a dense tissue with a good supply of blood vessels beneath a moist surface. The surface is called mucous membrane. It is joined to the rest of the mouth lining but is pink instead of shiny red.  The gums tightly surround the teeth up to the neck of each one and are firmly attached to the jaw bone. The gums usually cover the roots of the teeth, protecting them as they are more fragile than the rest of the teeth. 

Gingival recession exposes the fragile tooth roots to bacteria, plaque, and other forms of decay. 

Why do gums recede?

Poor oral hygiene and periodontal disease are linked to gingival recession. But receding gums can happen in people with good standards of oral hygiene, too.

Broadly, there are two causes of receding gums:

• Physical wear of the gums
• Inflammation of the gum tissues - this is a reaction of the immune system

Some people are more prone to receding gums because of inherited factors. These factors include their tooth position and gum thickness. 

Physical wear of the gums by vigorous tooth brushing or use of hard bristles is a common cause of receding gums.  People with this problem might otherwise have good oral hygiene. The teeth and gums otherwise appear healthy when receding gums are caused by over-brushing.  This type of recession often affects the left side more. This is because most people use a toothbrush in their right hand and so put more pressure on the left gums. The pattern also tends to affect the side gums more than the front. 

Other physical factors that push the gums back include lip piercings, misaligned teeth, and damage caused by dental treatment. 

As far as inflammation goes, some people are more prone to the inflammatory causes of receding gums. Thinner gum tissue makes inflammation caused by plaque more likely. The gums are more delicate in some people. 

Related to inflammation, periodontal disease is a common cause of gum recession. Periodontal disease causes the loss of the supporting bone around a tooth through an inflammatory reaction. The gum recession tends to affect all the teeth in a similar way. 

Periodontal disease is caused by plaque buildup. Plaque is a sticky film that forms on the teeth. Bacteria, mucus, cells, and other particles are involved in the formation of plaque.

When plaque builds up on teeth, it causes:

• Inflamed gums known as gingivitis. This condition can lead to periodontitis
• Periodontitis results in spaces between the gums and teeth and loss of connective fibers and bone around the tooth roots. This leads to receding gums

Tartar is hardened plaque and cannot be removed by tooth brushing. Instead, it must be removed at a dentist's office, generally by the hygienist, but sometimes by scaling by the dentist. 

Problems caused by receding gums

Many people with receding gums have no concern about them early on. Many others are unaware that they have recession.

For some, though, the concern may be about:

• Appearance
• Fear of tooth loss
• Sensitivity due to exposed tooth roots

Assessing concerns about the way gums look may include checking how much of the gums are exposed.  For some people, the gums show when talking and smiling. Others have a different lip line that does not expose the gums to view. 

Treatment for receding gums

Most of the time, mild gum recession does not need treatment. Dentists may simply give advice about prevention and offer to monitor the gums. Teaching people how to brush gently but effectively is a good early intervention. 

For people who do need treatment, a number of options are available:

• Desensitizing agents, varnishes, and dentine bonding agents: These aim to reduce any sensitivity that may develop in the exposed tooth root. This treats the nerve symptoms and helps to keep normal oral hygiene by allowing brushing of sensitive teeth to continue
• Composite restoration: Tooth-colored composite resins are used to cover the root surface. They can also close black gaps between teeth.  I happen to be proud of my skill in this area.
• Pink porcelain or composite: This is the same pink color of the gums.
• Removable gingival veneers made from acrylic or silicone.
• Orthodontics: Treatments designed to move the position of teeth can correct the gum margin.
• Surgery: Tissue is grafted from elsewhere in the mouth and heals over the gum recession. 

Keep smiling,

 

 

Dr. Elzbieta W. Basil, DMD is a private practice dentist with offices in West Hartford Center and Downtown New Britain, Connecticut.  She is a Clinical Instructor at the UConn School of Dental Medicine, and has won several awards naming her regional “Best Dentist” and “Top Dentist.” She is an active member of the Connecticut State Dental Association and the American Dental Association. Tel: 860-561-2121