How Menopause Affects Your Oral Health and What You Can Do About It

Women experience many changes during menopause, some of which can show up in the mouth. This makes menopause a particularly important time for a woman to focus on dental health and hygiene. 

The connection between menopause and oral health is complex. Teeth, gums and bones are extremely susceptible to the hormonal changes taking place during this time of life. Some of these changes are subtle, so your dentist may be the first to notice.  Here are some potential changes both you and Dr. Morrison should keep an eye on:

Loss of bone in the oral cavity

Many women experience a loss of bone tissue in the oral cavity.  The reason is unclear, but a decrease in hormones is the suspected culprit. A past history with gingivitis and periodontal disease is another reason often considered relevant. In order to avoid losing teeth as you age, you'll want to maintain regular visits with your dentist so that you catch these problems early.

Burning mouth syndrome

First the good news: only about 1% of people experience a burning sensation in the mouth, known as “burning mouth syndrome”. The bad news is that the prevalence of burning mouth syndrome is significantly higher in menopausal and postmenopausal women (43%) than in premenopausal women (6%). The symptoms may vary from minor discomfort to intense pain. Treatment can include nutritional supplements, medication, the adjustment of dentures and other oral appliances, and nerve stimulation if the cause is believed to be nerve-related. But the answer to the cause and proper treatment remain elusive.

Dry Mouth

Dryness of the mouth, or xerostomia, is a common symptom for menopausal women. Salivary flow rates are influenced by estrogen levels and women in menopause have lower flow rates of saliva than menstruating women.  Saliva helps your body's ability to fight off minor infections, maintain a healthy balance of bacteria in the oral environment and prevent cavities.  When saliva flow is reduced, women are more susceptible to problems such plaque formation, caries, and periodontal disease.  

Gingivitis and periodontitis

Postmenopausal women present with periodontal or gum disease more frequently and in more severe form than other women. The primary cause is bacterial plaque, which can increase with reduced saliva flow.  Regular dental care to remove bacterial plaque under the gum-line is especially important.  Women taking estrogen supplements during and after menopause are at risk for gingivitis or periodontitis, than women not pursuing hormone therapy.  So, taking care of your mouth, visiting the dentist, and being aware of a dry mouth are keys to keeping you gum-disease free. 

Can HRT Improve Oral Health for Women in Menopause? 

Hormone Replacement Therapy (HRT) has helped women manage an array of menopause-related issues, including reducing hot flashes and improving heart health. Can we add improving oral health to that list?  It's very likely.  HRT is proven to be effective in preventing bone loss - which is linked to tooth loss.   And because the mouth contains estrogen receptors, HRT has been shown in some studies to prevent the likelihood or worsening of oral health issues such as  burning mouth syndrome, dry mouth, dental caries and periodontal disease.  In studies comparing women on HRT with those who are not, women on HRT had better dental outcomes including lower rates of periodontal disease, accelerated healing of periodontal disease, fewer teeth lost, fewer oral symptoms such as dry or painful mouth, and lower dental costs than those who did not use HRT.

What You Can Do

All women, but especially women in menopause, should make good dental care a part of their healthy lifestyles.  Let our staff know of any changes in your health - including symptoms of menopause, whether you are receiving HRT and  if you have been diagnosed with osteoporosis.  Also, alert us to any new symptoms you may have such as dry or painful mouth, or bleeding gums. 

Because menopausal and postmenopausal women present with periodontal disease more frequently and in more severe form, it is also very important for you to stay on track with your dental exams and cleanings to identify and begin to treat gum disease at its earliest possible stage. 

The dips in progesterone and estrogen that accompany menopause affect every woman differently. And for those who pursue hormone therapy, perhaps less still. Staying on top of symptoms and keeping your communication lines open with your doctor and dentist will help keep you ahead of the curve when it comes to your oral  health.   

If you have questions don't hesitate to talk with Dr. Morrison or your Dental Hygienist.  Is it time for your dental cleaning and exam?  Contact us so we can get you scheduled!  

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Five Reasons Why Your Child (or You) Should Have A Custom-Fitted Mouth Guard

The American Dental Association (ADA) recommends the use of mouth guards in 27 sports/exercise activities. If your kids (or you) are involved in any sort of sports or exercise activity where contact with another player, a ball, or the ground is possible, ask us about having a custom-fitted mouth guard made for them. Here are some reasons why this is so important:

Reduce Injury to Teeth, Mouth and Gums

The American Dental Association (ADA) estimates that athletes who don’t wear mouth guards are 60 times more likely to suffer dental injury than those who do and that “a full third of all dental injuries are sports related.” Properly fitted mouth guards protect the soft tissues of the cheeks, gums and tongue by covering the sharp surfaces of the teeth that can cause lacerations on impact. They also reduce the potential for tooth injury, jaw damage or jaw joint fracture and displacement by cushioning against impact, absorbing and distributing the forces that can cause serious injury.

Reduce Risk of Concussion

The risk of playing sports without a mouth guard aren’t just limited to injuries to the teeth, mouth or gums. According to a study in the peer-reviewed journal, General Dentistry, you may be able to significantly reduce their risk of a mild traumatic brain injury (MTBI), better known as a concussion with a custom-fitted mouth guard.

Not All Mouth Guards Created Equally

There are three basic categories of mouth guards. Stock mouth guards come in limited sizes; they’re relatively inexpensive, but they provide the least level of protection. “Boil and bite” mouth guards can be customized after purchase to the wearer’s bite, but they don’t always provide complete coverage of back teeth.

Custom mouth guards are designed by Dr. Morrison and made from a unique impression of your child's teeth. They’re more expensive, but provide the highest level of protection from injuries. Our mouth guards are made from the highest quality dental-grade material and provide a comfortable and flawless fit. Because they hug the teeth, they won't fly out when your child falls or is tackled. They are also durable and will offer consistent thickness for shock absorption. 

Custom Mouth Guards More Likely to be Worn

Custom-made mouth guards allow athletes to breathe easy, communicate clearly, and even hydrate with it in place - making it more likely they are worn. Custom-fitted mouth guards are also advised for a child with braces because they won’t interfere with orthodontic treatment.

Cost of Injury vs. Cost of Mouth Guard

A mouth guard properly fitted in our office costs little in comparison to the cost of treatment after a dental injury, or other injury such as a concussion or broken jaw.

As you get your child ready for Summer and Fall sports, consider coming in to have a custom-made and properly fitted mouth guard made for your child to lower the injury risk to their mouth and brain. Find out if your dental insurance will cover the cost of the mouth guard. If you are uninsured, consider our in-office dental savings plan, which provides 15% off the cost of the mouth guard.

If you have questions about mouth guards, or would like to schedule an appointment with us to have an expertly-fitted mouth guard made for your child, contact our office today at 919 755 3450.

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Pregnant? Don't Forget About Your Oral Health

For some pregnant women, a dental visit is not top priority.  We understand - you have a lot on your plate!  Between doctor visits, preparing for baby’s arrival, and managing pregnancy symptoms, scheduling a routine dental visit may not seem too important. 

Plus – you might be concerned about whether it’s safe to visit the dentist. Or, you may not want to take more time off of work.  Cost can also be an issue - prenatal visit co-pays and getting the nursery ready can really add up.  Why spend more at the dentist - right? 

Well, we’re here to tell you – dental visits are not only safe but an important part of your prenatal care!  Pregnancy affects your mouth in many ways and the link between gingivitis and systemic illness suggest that untreated gum disease can affect the health of your unborn baby as well as lower your immune system.  In fact, gum disease has been inked to gestational diabetes, pre-eclampsia and premature delivery. 

Gingivitis, Cavities and More!

When your expecting, your body undergoes many changes - some of these are dental related.  Due to pregnancy hormones, you may experience pregnancy gingivitis, which can cause gum sensitivity and bleeding while brushing or flossing.  Symptoms include bad breath, and swollen, red sensitive gums that bleed easily. The rise in hormone levels can also cause the gums to swell, trapping food which irritates your gums.

Pregnant women also have an increased risk of tooth decay.  Eating more carbohydrates, snacking between meals, or increased acid in the mouth from vomiting due to morning sickness, will put your teeth at a higher risk for decay.

Some women also experience “pregnancy tumors,” which are benign growths of tissue along the gums and between the teeth that may be related to excess plaque.  These sound scary but they are not cancerous.  Your dentist will be able to diagnose what’s normal or what’s not during your exam.

Finally, any infection in your mouth not only puts stress on your body from the pain, but may spread to the rest of your body as well.  Periodontal disease or an infection may result in low birth weight, premature birth, or even preeclampsia, a rare but life-threatening condition.

Prevention Is Key 

In addition to scheduling your routine dental cleaning and exam, be sure to keep up your home care routine.  Brush thoroughly with fluoride toothpaste twice a day. Vomiting due to morning sickness can create acidic environment, which means you need to brush even more.  Don't forget to floss - your gums need extra care during this time.   

You will also want to eat well to protect your baby's teeth. Diet deficiencies during pregnancy may cause changes in baby’s tooth formation and leave their teeth at greater risk for decay later in life. Choose foods that are high in calcium, vitamins and minerals.  

Dental Treatment and Safety While Pregnant
If you need dental treatment, like a filling or crown, while your're pregnant, don't worry.  Technology has made great strides in the dental field and today's procedures and medications are more gentle and safer than ever before.  We recommend that you have any non-emergency dental work done during the second trimester - when morning sickness has subsided and before it becomes too uncomfortable to lie on your back for long periods of time.  

Thanks to digital x-rays, should these be required, the exposure to radiation is lower than ever.  The added reassurance of a lead apron (which covers your abdomen and neck) reduces your exposure even further.  

Dental anesthetics is also safe fore use during pregnancy.  Fortunately, lidocaine, which is the most commonly used local anesthetic during dental treatments, is  considered to have almost no negative effect on the mother and  fetus. In addition, the changes of any local anesthetics used in dental treatments for pregnant women having a negative affect on pregnant women and their fetuses appears to be very low.   

At Jeff M. Morrison & Associates, DDS, we want to provide our patients who are pregnant (or who think they may be) with the best possible care.  Be sure to  share the following important information with us when you schedule:

• Let us know if you are pregnant (or you suspect you may be) 
• Let us know what month you are in when you make your appointment. 
• Tell us if you are having a high-risk pregnancy or you have some other medical condition or concern such as vomiting due to morning sickness. 
• Let us know if there is any change in the medications you take or if you have received any special advice from your physician. 
• Keep us informed of any changes in your mouth such as swelling, redness or bleeding gums. 

 

If you’ve been putting off your dental visit, go ahead and make that call!  Concerned about cost?  Some dental benefit plans have special maternity programs with additional services like extra cleanings or discounts on oral health prescriptions.  If you don't have dental insurance, our in-office St. Mary's Street Dental Savings Plan provides discounted preventive care, as well as 15% off all other general or cosmetic dental care. 

Our friendly staff an be reached at 919 755 3450 if you have questions or want to schedule an appointment. You can also request an appointment online . 

Five Reasons to Start Flossing Your Children's Teeth Early

According to the Academy of General Dentistry (AGD), flossing is the single most important weapon against plaque.  Gaining an early start on flossing can significantly reduce cavity-causing bacteria in your child's mouth, leading to healthier teeth and gums.   Here are five great reasons to start flossing early:

Flossing Gets Rid of Plaque

Plaque is a soft, sticky film that constantly builds up on your teeth and contains millions of bacteria. When your child eats, the bacteria in plaque use the sugars in the food to produce acids that eat away at the tooth enamel. Repeated attacks cause the enamel to break down, eventually resulting in a cavity (or hole) in the tooth surface.  

30% of Tooth Surface Not Reached by Brushing

Brushing cleans the surface of the teeth - but about 30% of your child's tooth surface is unreachable by their toothbrush.  That's why flossing is so important.  It removes plaque and tiny amounts of food debris in between teeth.  

Dental Hygiene Visits Are Easier For Your Child

Plaque that is not removed daily by brushing and flossing between teeth can eventually harden into tartar around the gum line. Flossing allows you to remove the plaque that causes tartar while it's in its early form: sticky, soft and pliable.   Once plaque becomes tartar, it can't be removed without professional help.  Most kids (and adults) don't enjoy the scraping the Dental Hygienist must do to remove tartar.    

Flossing Can Save Money and Time

In an era of rising health care costs and diminishing insurance benefits, it pays to take steps to reduce your dental expenses. Flossing is inexpensive, easy and takes under a minute.  Compare this to the costs (missed work, cost of care) associated with having a cavity filled.

Early Oral Hygiene Routines Lead To Better Outcomes

Teaching your child to floss when they start to brush will help them develop a strong oral hygiene routine that will have a significant impact on their dental health.   

How To Help Your Child Floss

Once a child’s teeth start to fit closely together, usually between the ages of two and six, parents should get their children in the habit of flossing daily.  Here are some tips on helping your child become a good flosser:

• Learning Curve.  Because flossing requires more hand-eye coordination and dexterity than most young children have, they will need help with flossing from an adult until they can start doing it on their own.  As a general rule, when your child starts to learn cursive (around second or third grade), they’re skilled enough to floss solo.  
• Good habits take time to develop.  Give your kids some positive reinforcement.  A combination of gentle reminders and praise when kids floss (both with help and on their own), will keep them excited about taking care of their teeth.
• Be a good example.  Brushing and flossing your teeth alongside your kids will reinforce good habits to them and enable you make sure that they are doing it correctly.
• Follow up.  Even older kids can use some follow-up.  Make sure your older kids and teens have dental floss available, are using proper flossing technique, and are flossing each day. 
• Fun Flossing Tools.  The best flossing tools for children are the ones that will make flossing a fun and a life-long daily habit. Winding dental floss around little fingers can be tricky.   Luckily, kid-friendly floss sticks are available in a wide variety of colors, shapes and characters. 

Our Dental Hygienists are trained to teach flossing skills to our youngest patients, and will happily give you some tips to help at home.  Is it time for their cleaning and exam?  Give our office a call at 919 755 3450 or schedule online.  

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Seven Benefits of a Dental Cleaning and Exam

Professional dental cleanings aren’t just for keeping your smile bright; they can have a significant impact on your oral health and your overall health, as well. Brushing and flossing at home are essential, but to ensure teeth and mouth are healthy and thoroughly clean, you should schedule regular check-ups and dental cleanings at least twice a year (more often if you have periodontal disease).

Here are seven reasons professional cleanings are so important: 

Prevent plaque, which leads to cavities

The whitish film that builds up on your teeth is called plaque and it is the leading cause of tooth decay. This acidic substance eats away at the tooth enamel and, if left unattended, can lead to cavities. Plaque can be removed by brushing, flossing and dental cleanings.

Stop tooth loss

Gum disease, which starts with built-up plaque, is a major cause of tooth loss in adults. As gum disease advances, plaque moves further down the tooth where it can destroy the supporting bone in your jaw, causing teeth to loosen and fall out. Luckily, the chance of this happening to you can be greatly reduced through regular dental cleanings combined with good oral hygiene habits.

Brighten your smile

Drinking coffee, tea and wine or using tobacco can stain your teeth. A dental cleaning can remove built-up stains and leave you with freshly polished teeth. The result? A whiter, brighter smile!

Freshen your breath

Good oral hygiene is the best way to prevent persistent bad breath. Even if you brush and floss regularly, getting a cleaning is a great way to keep your mouth healthy and odor-free.  Also, some medical and dental conditions, such as dry mouth, periodontal disease and diabetes, can cause bad breath.   Dr. Morrison will discuss this during the exam if you have concerns about bad breath. 

Boost your overall health

Studies have shown a strong connection between your oral and overall health. Poor oral hygiene can cause periodontal disease, which is linked to cardiovascular disease, strokes, rheumatoid arthritis, Alzheimer's Disease and many other problems. Regular dental cleanings may help lower your risk for some diseases, like heart disease and stroke. 

Save money

Get the most value from your dental benefits. Most dental plans have low or no co-payments/coinsurance for dental cleanings and oral exams. If you take advantage of your benefits now, you may be able to save money in the long run by helping to protect your oral health and potentially avoiding more costly and extensive procedures. If you are a member of our St. Mary's Dental Savings Plan, you receive two discounted cleanings each year, as well as discounted treatment, should that become necessary. 

Catch problems early

At your cleaning we can usually catch minor problems, such as broken fillings and fractures, at the earliest possible stage - before they come time consuming, expensive and sometimes painful. Many medical conditions, some of them life-threatening (such as oral cancer), can be detected in their early stages during a routine oral exam. Often problems can go unnoticed because patients are unaware of symptoms, or a patient does not have noticeable symptoms until the advanced stages.

At Jeff M. Morrison & Assoc., DDS, we take every opportunity to educate our patients and keep them up-to-date with the best ways to care for their oral health. Our goal is to prevent problems from occurring - and if they do, to address them at the earliest possible stage. If you have any questions about your dental health please make an appointment with us today. You can schedule online or call us at 919 755 3450.

Worried About Thumbsucking? You Probably Don't Need To

As a dentist I get a lot of questions about thumb sucking - a very common childhood activity that occurs in about 80% of infants and children. It's been observed in utero starting as early as 15 weeks of gestation and is pretty common in the first three months of life. About 30% of children still suck their thumb at age one. Most give it up spontaneously between the age of 2 and 4, with little if any damage as a result. The habit no longer serves its purpose so they stop. About 12% of children are still sucking their thumb at age 4.

I’ve never encouraged parents to get overly concerned about stopping their small child from thumb-sucking. It's a normal behavior up to age 4 and can even have an adaptive value in that it can provide a sense of security and helps children self-soothe. And anyway, parents aren’t usually successful in getting their child to stop — their peers are. It's when their friends at their preschool or playgroup bring the habit up that children are motivated to stop.

So when should parents start to worry? According to the American Dental Association, children who vigorously suck their thumbs, suck for a long duration, and continue to do so beyond age four, risk causing damage that may require orthodontic treatment to correct. The thumb can exert pressures upon teeth, bone, and soft tissues in the mouth causing problems with positioning of teeth and growth of the jaws. The most obvious consequences of a persistent thumb sucking habit are:

• Pushing the upper front teeth (incisors) out and the lower incisors in causing a "buck tooth" smile.
• Preventing the front teeth from erupting all the way together causing an openbite.
• Stopping the lower jaw from developing normally, resulting in a recessive or “weak” chin.
• Narrowing of the soft tissue in the palate of the mouth, resulting in a crossbite.

However, before getting too worried, parents should keep in mind that the likelihood of changes in dentition depends on genetics as well as the duration and intensity of sucking. Tooth movement generally requires 4-6 hours of force per day. So thumb sucking for a few minutes before falling asleep - even for a child who is 4 or 5 - is not normally going to be a problem.  If the thumb sucking stops while your child is still growing, most of the dental problems that may have occurred can self-correct, but sometimes the help of a dentist or an orthodontist is required to correct the position of the teeth and align the jaws.

The American Dental Association recommends that parents start encouraging their children to stop sucking their thumb after age 4 — but even then, they advocate a gentle, positive approach. Here are five tips we offers parents to proactively encourage their child to stop a damaging thumb sucking habit.

1. Explain to your child the damage their habit is causing to their mouth and teeth. Kids today are smarter than you think. Pictures of buck teeth and openbites go a long way helping drive home the point.
2. Develop a program with your child’s input to stop the habit. Let them be proactive in determining the best way to correct their own problem. They are more likely to cooperate if they have a choice in the process. Suggest aids like wearing a sock on their hand when they go to bed, or a band aid on their thumb while watching TV to remind them at times when they may unconsciously put their finger in their mouth. With some children, there is a blanket or stuffed animal that goes hand in hand with thumb sucking. It's difficult to stop one, without removing the other. I know it sounds like a double whammy… but it's often what's needed to be successful.  Try letting them pick out a new blanket or plush toy - one they don't associate with sucking their thumb, to help them through the transition.  
3. Set up a calendar to track progress with small rewards at the end of every day, week and/or month acting as an incentive. With older children, offer a larger incentive after the habit has stopped for at least 4-6 weeks. Anyone (including myself) who has tried to stop a persistent habit knows it can be emotionally stressful and very hard work.  Expect some tears and even tantrums as your child figures it out.  A new Lego or special day at the park is definitely in order once they succeed.  
4. If you notice your child relapsing, work on alleviating what's causing the stress and anxiety which underlies the thumb sucking, rather than the habit itself.  You already know they can stop sucking their thumb if the environment is right - so work on that.  
5.  Children always respond more favorably to positive praise vs. negative criticism. In addition to reminding them to take their thumb out of their mouth, praise them when they are proactively decreasing or eliminating the habit.  Catching them in the act of NOT sucking their thumb (and praising them), will have a much greater impact than catching them doing it and then telling them to stop.  

No matter what method you try, be sure to explain it to your child and enlist them as a partner. Don't forget that we - your dental team - are partners in this as well. Our Dental Hygienists and I have talked to thousands of children over the years about thumb sucking and we can kindly and compassionately offer them support and encouragement from a different perspective.

If you have successfully helped your child stop sucking their thumb please share your strategies. Don't hesitate to contact us via our website or give our office a call at 919.755.3450 if there is any way we can help.

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Can Dietary Changes Reverse Periodontal Disease?

If you've been told you have inflammation of the gums or even periodontal disease, we have some good news for you.  Simple dietary changes may help to reverse this disease.

A little background first:  there are two types of gum disease: gingivitis and periodontitis.  Gingivitis is the swelling of the gums that is caused by the accumulation of bacteria along the gum line. If the gingivitis is left untreated, it leads to periodontitis. Symptoms of periodontal disease include receding gums, inflammation along the gum line, pain, and sensitivity to changes in temperature.  Eventually this disease can lead to bone and tooth loss.  Almost 50 percent of adults over age 30 in the United States have some form of periodontal (gum) disease based on findings by the Center of Disease Control and Prevention.

It's clear that that sugar leads to tooth decay, and that a healthful diet supports oral and systemic health alike.   What's new is that research is has demonstrated that eating certain foods can actually reverse conditions like periodontal (gum) disease.   It makes sense - a periodontal lesion is essentially a wound, and certain nutrients must be available for optimal wound healing.   Further,  periodontal disease, like heart disease or rheumatoid arthritis, is an inflammatory condition and some food studies have shown that certain foods decrease inflammation.  Here's what two recent studies on oral inflammation have shown: 

Just this past July, BMC Oral Health published a small study demonstrating the impact of diet on periodontal inflammation – a hallmark of gum disease – where the gums appear red and puffy.  For four weeks, test group participants followed a diet that was low in carbs and rich in Omega-3 fatty acids, vitamins C and D, and fiber.  A control group followed their normal eating habits.   By the end, those who ate the “oral health optimized diet” improved greatly with respect to inflammation.  In fact, the inflammation in the experimental group decreased to approximately half that of the baseline values.  These changes were not noted in the control group, which did not follow the "oral health optimized diet."

This builds on a 2009 study in the Journal of Periodontology, which looked at “The impact of the Stone Age diet on gingival condition in the absence of oral hygiene.” “Gingiva” is the clinical term for the gums.  Here, participants followed a "paleo"-type diet for four weeks and didn’t brush their teeth or otherwise follow normal hygiene habits.  A paleo-type diet includes anything we could hunt or find – meats, fish, nuts, leafy greens, fresh vegetables, and seeds. The results showed that those following the paleo-type diet had a decrease in tongue bacteria and gum disease symptoms improved. What made the difference?  In both studies, the researchers believe the lack of refined sugar and hyper-processed foods led to the decreased inflammation.

These are just the latest in a growing body of research connecting the dots between our oral health and diet.  Our message to our patients with periodontal disease is that eating healthier may, in a relatively short amount of time, lead to a decrease in gum inflammation and a slowing or even stopping of the progression of the disease.   Because many people with periodontal disease may be at risk for other inflammatory conditions, such as heart disease, these simple dietary changes may have an even greater impact on their overall health.   

Just to be perfectly clear - dietary changes are NOT an alternative to the ongoing treatment of periodontal disease.    It's vital that we continue to monitor and provide you with care.   If you have periodontal disease, we invite you consider these dietary changes as a complement to the oral therapy that you receive in the dental office and the recommended oral hygiene regiment we advise you follow at home.    Questions?  Concerns?  Give our friendly staff a call at 919 755 3450 or schedule online.   

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