Barley malt, corn syrup, maltodextrin — these and over fifty other label ingredients are all names for refined sugar. Under its various aliases, this sweet carbohydrate is tucked away in three-quarters of packaged foods in the U.S.
Although in recent years the general health effects from too much sugar have gained the spotlight, its effect on dental health has been known for decades. Accumulated sugar in the mouth is a prime food source for bacteria that cause tooth decay and gum disease.
For both general and oral health, people have been looking to artificial alternatives to satisfy their sweet tooth. But do they have their own issues that can impact overall health? Here is an overview of some of the more popular brands of artificial sweeteners and their effect on health.
Saccharin — One of the most widely used artificial sweeteners, saccharin is often used under the names Sweet’N Low or Sugar Twin in low-calorie foods because it contains no calories. According to the Food and Drug Administration (FDA) there are no associated health risks with consuming saccharin in recommended servings.
Aspartame — used commonly in beverages as Equal or NutraSweet, aspartame is unsuitable for cooking because its chemical structure breaks down under high heat. Although generally safe for consumption, it can affect people with a rare condition known as phenylketonuria that can’t adequately break down its chemicals.
Sucralose — marketed as Splenda, this sweetener is made by chemically altering refined table sugar so the body can’t process it. This may be one reason it has the most recognized natural flavor profile among consumers and is a market leader. It’s stable at high temperatures, so it’s often used in cooked or baked goods.
Stevia/Erythritol — this combination of an extract from the extremely sweet herb stevia and the sugar alcohol erythritol is marketed as Truvia. Unlike other calorie-free artificial sweeteners, this and other alcohol-based sweeteners have a low calorie level due to sugar alcohol’s characteristic of slow and incomplete absorption during digestion.
Xylitol — although all the previously mentioned sweeteners won’t promote bacterial growth like refined sugar, the sugar alcohol xylitol — often added to chewing gum and mints — has an added benefit: it may actually reduce levels of bacteria most likely to cause decay.
If you would like more information on the effect of sweeteners on dental health, 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 “Artificial Sweeteners.”
The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.
In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?
The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.
Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.
So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”
Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.
If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”
Enamel — that tough, outermost tooth layer — protects your teeth from all sorts of hazards, from bacterial attack to temperature extremes. But although the hardest substance in the human body, enamel has a mortal enemy — acid. High acid levels can cause the minerals in enamel to dissolve, a process called de-mineralization. And although saliva can neutralize these levels in approximately 45-60 minutes and restore some of the enamel’s lost minerals, a constant acidic environment can overwhelm this natural mechanism.
That’s why you should be careful with the amount and frequency of acidic foods and drinks like citrus fruits or coffee. You should be especially concerned about your intake of sodas, energy drinks or sports drinks. The latter in particular are designed to replace fluids and nutrients during intense exercise or sports events, but are often consumed as a regular beverage. And all these drinks mentioned are often sipped on throughout the day, resulting in a constant wash of acid in your mouth that can interrupt the protective response of saliva.
There’s one other source for high mouth acidity that comes not from outside the body but from within. GERD — Gastro Esophageal Reflux Disease — is a condition in which digestive acid refluxes (flows back) into the esophagus. While chronic acid reflux can damage the lining of the esophagus and lead to ulcers or even cancer, it may also pose a danger to teeth if the acid regularly rises into the mouth. Individuals encountering this will know it by the awful, acrid taste of vomit in their mouth.
To reduce the chances of high mouth acid due to food intake, limit the consumption of acidic foods and beverages to meal times and sports drink consumption to strenuous exercise or sporting events. Better yet, consider the greatest hydrator of all, water — with a neutral pH of 7.
If you’re experiencing chronic heartburn or other GERD symptoms, make an appointment to see your primary care doctor or a gastroenterologist as soon as possible. Many treatments are effective and will not only improve your general health but may also help preserve your tooth enamel.
If you would like more information on the effect of acid in the mouth and how to reduce it, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Dentistry & Oral Health for Children” and “GERD — Gastro Esophageal Reflux Disease.”
Your dentures have served you well over the years. Lately, though, you’ve noticed the fit loosening in the lower denture. It’s not a new problem: you’ve had them refitted a few times already. But now it seems to be growing worse and you’re having more trouble chewing food or speaking clearly.
The problem isn’t all wear and tear with your dentures — the bone in your jaw is shrinking. A denture applies forces that are compressive. Natural teeth produce forces when we chew that travel through the tooth root and stimulate the bone to grow. Without teeth, there’s no such force to stimulate the bone. As a result, new bone cells don’t replace older cells at a healthy rate and bone volume diminishes over time. Because traditional dentures are supported by the gum ridges, the constant compressive forces on the gums can also contribute to bone loss.
As mentioned, we can refit dentures by lining them with new acrylic material. Eventually, though, it may be necessary to consider a new set of dentures that match the altered contours of your jaw. But continuing bone loss might lead to the same fate for your new dentures as your previous pair.
There’s a relatively new alternative, though, that could provide greater denture stability and help deter bone loss: implant overdentures. They’re actually a union between a traditional denture and a dental implant, a tooth replacement approach introduced over thirty years ago.
With this option, two strategically-placed implants are surgically inserted into the jaw bone. We then manufacture a denture (or retrofit your current dentures, if possible) with fittings that connect to the implants. Once in the mouth, the dentures gain their main support from the implants rather than the gum ridge, which relieves pressure on the bone. And because the titanium implant has a natural affinity with bone, new bone will grow and attach itself to it, increasing its stability and stopping bone loss.
Although more expensive than traditional dentures, implant overdentures are more affordable than individual teeth replaced by implants and are very cost-effective over time. What’s more, they can restore the comfort and confidence to eat, speak and smile that you once enjoyed when you had your own teeth.
If you would like more information on implant-supported dentures, 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 “Implant Overdentures.”
Dental implants are popular with both patients and dentists for their durability and likeness to natural teeth. That natural look, though, can be difficult to attain, especially in what’s known as the “smile zone” — the area of the mouth where teeth are most visible when you smile.
Our biggest concern is the upper front teeth, where the gums are most visible, especially if you smile widely. It takes considerable skill, experience and artistry to position implants in this area so that they appear to naturally emerge from the gums and blend well with other teeth.
To obtain that natural look, we must first assess whether or not there’s enough bone present, which tends to dissolve (resorb) when a tooth is missing, to sufficiently anchor the implant in the right position. There also needs to be sufficient bone around adjacent teeth to support the tiny triangles of gum tissue between teeth called papillae. Without the papillae an unattractive black hole may result between the implant and an adjacent tooth or implant.
Another factor we must consider is the type of gum tissue you have. Everyone generally inherits one of two types of tissue from their parents: thin or thick. The type you have can influence the way the implant appears to emerge from the gums. If you have thick gums, they’re easier to work with and can cover more of the implant. Thinner tissues aren’t quite as easy and are less forgiving if an implant isn’t placed as precisely as possible.
In recent years, improvements in implant design have sought to provide greater stability around bone and gum tissues to offset some of the issues we’ve mentioned. A variation on the design of the top of the implant (where the crown is attached) changes the direction of growth for gum tissues from a horizontal orientation to a vertical one, which can help with the final appearance.
The first step, if you’re considering dental implants for a tooth in the smile zone, is to visit us for a complete examination to see if any of these factors may have an impact on your situation. We can then advise you on the best course of action to achieve the most attractive smile possible.
If you would like more information on 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 “Implant Aesthetics.”
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