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Posts for category: Oral Health

By Dr. Aaron Tropmann & Dr. Gary Oyster
February 11, 2019
Category: Oral Health
Tags: geographic tongue  
ThoseRedPatchesonYourTongueareNothingtobeAlarmedAbout

If you've ever been alarmed to find oddly-shaped red patches on your tongue, you can relax for the most part. Most likely, you're part of a small fraction of the population with a condition known as geographic tongue.

The name comes from the irregular shape of the patches that seem to resemble land formations on a map. Its medical name is benign migratory glossitis, which actually describes a lot about the condition. The patches are actually areas of inflammation on the tongue (“glossus” – tongue; “itis” – swelling) that appear to move around or migrate. They're actually made up of areas where the tiny bumps (papillae) you normally feel have disappeared: the patches feel flat and smooth compared to the rest of the tongue.

We're not sure why geographic tongue occurs. It often runs in families and seems to occur mostly in middle-aged adults, particularly women and non-smokers. It's believed to have a number of triggers like emotional stress, hormonal disturbances or vitamin or mineral deficiencies. There may also be a link between it and the skin condition psoriasis. Under a microscope the red patchiness of both appears to be very similar in pattern; the two conditions often appear together.

The bad news is we can't cure geographic tongue. But the good news is the condition is benign, meaning it's not cancerous; it's also not contagious. It poses no real health threat, although outbreaks can be uncomfortable causing your tongue to feel a little sensitive to the touch with a burning or stinging sensation. Some people may also experience numbness.

Although we can't make geographic tongue go away permanently, you should come by for an examination to confirm that is the correct diagnosis. Once we know for sure that you do have migratory glossitis, we can effectively manage discomfort when it flares up. You should limit your intake of foods with high acidity like tomatoes or citrus fruits, as well as astringents like alcohol or certain mouthrinses. We can also prescribe anesthetic mouthrinses, antihistamines or steroid ointments if the discomfort becomes more bothersome.

It may look strange, but geographic tongue is harmless. With the right care it can be nothing more than a minor annoyance.

If you would like more information on benign migratory glossitis, 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 “Geographic Tongue.”

By Dr. Aaron Tropmann & Dr. Gary Oyster
January 12, 2019
Category: Oral Health
WhatIsABabyToothWorth

For most people, raising kids is an expensive proposition. (A recent estimate by the U.S. Department of Agriculture puts the average tab at almost a quarter of a million dollars before they turn 18.) But if you’ve been keeping up with parenting news lately, you may have come across an even more jaw-dropping fact: According to a survey by the Sunstar group, a maker of oral hygiene products, when the tooth fairy makes a pickup in New York City, she (or her parental surrogate) leaves an average of $13.25 per tooth!

That compares to $9.69 per tooth in Los Angeles, $5.85 in Chicago and $5.02 in Boston — and it’s a far higher rate than most other polls have shown. But it brings up a good question: What's a baby tooth really worth? Ask a dentist, and you may get an answer that surprises you: A lot more than that!

A child’s primary (baby) teeth usually begin coming in around the age of 6 to 9 months, and start making their exits about the time a child reaches six years; by the age of 10 – 13, they’re usually all gone. But even though they will not last forever, baby teeth are far from disposable — and they deserve the same conscientious care as adult teeth. Here’s why:

Primary teeth play the same important roles in kids’ mouths as permanent teeth do in the mouths of adults: they allow kids to bite and chew effectively, speak normally and smile brightly. Their proper functioning allows children to get good nutrition and develop positive social interactions as they grow toward adolescence — and those are things it’s difficult to put a price tag on.

But that’s not all baby teeth are good for. Each one of those little pearly-whites serves as a guide for the permanent tooth that will succeed it: It holds a space open in the jaw and doesn’t let go until the grown-up tooth is ready to erupt (emerge) from beneath the gums. If primary teeth are lost too soon, due to disease, decay or accidents, bite problems (malocclusions) can develop.

A malocclusion (“mal” – bad; “occlusion” – bite) can result when permanent teeth don’t erupt in their proper locations. “Crowding” is a common type of malocclusion that can occur when baby teeth have been lost prematurely. The new, permanent teeth may come in too close together because neighboring teeth have shifted into the gap left by the prematurely lost tooth, creating an obstruction for the incoming teeth. In other cases, the permanent teeth may emerge in rotated or misplaced positions.

Bite problems make teeth harder to clean and thus more prone to disease; they may also cause embarrassment and social difficulties. The good news is that it’s generally possible to fix malocclusion: orthodontists do it every day. The bad news: It will almost certainly cost more than $13.25 per tooth. Alternatively, baby teeth in danger of being lost too soon can often be saved via root canal treatment or other procedures.

We’re not advocating giving big money to toddlers — but we do want to make a point: The tooth fairy’s payout: a few dollars. A lifetime of good checkups and bright smiles: incalculable.

If you have questions or concerns about baby teeth, please call our office to schedule a consultation.

By Dr. Aaron Tropmann & Dr. Gary Oyster
January 02, 2019
Category: Oral Health
DontNeglectOfficeCleaningswithDentalImplants

Semi-annual office cleanings are important for keeping teeth healthy and disease-free. If you’ve replaced some of your teeth with dental implants, though, you may be thinking they don’t need as much attention from your hygienist.

It’s quite the opposite — cleaning around implants is important, and actually requires additional attention. The reason for this relates to both how dental implants attach to the jaw and their constructive materials.

Natural teeth are held in place by the periodontal ligament with tiny fibers that attach to the teeth on one side of it and to the jawbone on the other. The ligaments and the gingival (gum) fibers (which are also attached to the tooth) provide some disease resistance to the teeth through its rich blood vessel and collagen network. Dental implants, on the other hand, anchor directly into the jawbone. The titanium integrates with the bone, which naturally attracts to the metal and grows around it, which provides the implant’s eventual attachment strength. The implant doesn’t attach to the gum tissue and won’t develop the same relationship with the periodontal ligament as natural teeth.

Bacterial plaque, the primary cause for tooth decay and periodontal (gum) disease, can collect on an implant crown just as readily as on a natural tooth. Although the materials that make up an implant can’t be affected by a plaque-induced infection, the gum tissues and supporting bone around it can. In fact, because implants lack the disease resistance of the gingival fibers and the ligament attachment, an infection can turn rapidly into a condition known as peri-implantitis that could cause bone and tissue loss and lead to the loss of the implant.

Your hygienist understands the importance of removing plaque and calculus (hardened plaque deposits) from around your dental implant. This often calls for different instruments made of plastics or resins that won’t scratch the implant’s highly polished surface. Scratches provide a haven for bacteria to collect and make it more difficult to dislodge them. Likewise, if the hygienist uses ultrasonic equipment that loosens plaque through vibration, the hygienist will often use nylon or plastic tips to minimize damage to the implant.

And don’t forget your own personal hygiene habits — they’re just as important with dental implants as with natural teeth. Keeping plaque under control, both at home and with your dentist, is crucial to longevity for your dental implants.

If you would like more information on maintaining and cleaning 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 Implant Maintenance.”

By Dr. Aaron Tropmann & Dr. Gary Oyster
December 23, 2018
Category: Oral Health
FifthHarmonysCamilaCabelloChipsaToothbutConcertStillWorthIt

Everyone loves a concert where there's plenty of audience participation… until it starts to get out of hand.├é┬áRecently, the platinum-selling band Fifth Harmony was playing to a packed house in Atlanta when things went awry for vocalist Camila Cabello. Fans were batting around a big plastic ball, and one unfortunate swing sent the ball hurtling toward the stage — and directly into Cabello's face. Pushing the microphone into her mouth, it left the “Worth It” singer with a chipped front tooth.

Ouch! Cabello finished the show nevertheless, and didn't seem too upset. “Atlanta… u wild… love u,” she tweeted later that night. “Gotta get it fixed now tho lol.” Fortunately, dentistry offers a number of ways to make that chipped tooth look as good as new.

A small chip at the edge of the tooth can sometimes be polished with dental instruments to remove the sharp edges. If it's a little bigger, a procedure called dental bonding may be recommended. Here, the missing part is filled in with a mixture of plastic resin and glass fillers, which are then cured (hardened) with a special light. The tooth-colored bonding material provides a tough, lifelike restoration that's hard to tell apart from your natural teeth. While bonding can be performed in just one office visit, the material can stain over time and may eventually need to be replaced.

Porcelain veneers are a more long-lasting solution. These wafer-thin coverings go over the entire front surface of the tooth, and can resolve a number of defects — including chips, discoloration, and even minor size or spacing irregularities. You can get a single veneer or have your whole smile redone, in shades ranging from a pearly luster to an ultra-bright white; that's why veneers are a favorite of Hollywood stars. Getting veneers is a procedure that takes several office visits, but the beautiful results can last for many years.

If a chip or crack extends into the inner part of a tooth, you'll probably need a crown (or cap) to restore the tooth's function and appearance. As long as the roots are healthy, the entire part of the tooth above the gum line can be replaced with a natural-looking restoration. You may also need a root canal to remove the damaged pulp material and prevent infection if the fracture went too far. While small chips or cracks aren't usually an emergency (unless accompanied by pain), damage to the tooth's pulp requires prompt attention.

If you have questions about smile restoration, please contact us and schedule an appointment. You can read more in the Dear Doctor magazine articles “Porcelain Veneers: Strength & Beauty As Never Before” and “Porcelain Crowns & Veneers.”

By Dr. Aaron Tropmann & Dr. Gary Oyster
December 13, 2018
Category: Oral Health
Tags: tooth decay  
MinimallyInvasiveDentistryANewApproachtoPreventingandTreatingDecay

Since the late 19th Century, dentists have used established protocols to successfully prevent and treat tooth decay. But there've been changes to this approach the last few years to improve its effectiveness, changes we now refer to as Minimally Invasive Dentistry or MID.

The older approach for treating dental caries (tooth decay) follows the protocols established by Dr. G.V. Black, considered the father of modern dentistry. Black advocated removing not only decayed structure but also some of the healthier but vulnerable portions of a tooth, to avoid further decay and make the tooth easier to clean. This resulted in larger fillings, although they've become smaller as dental techniques have advanced.

MID, on the other hand, aims to remove as little tooth structure as possible while still effectively treating and preventing future decay. To achieve that goal we begin first with a complete assessment of a patient's individual decay risk, known as Caries Management By Risk Assessment (CAMBRA).

With CAMBRA, we're looking at other factors besides individual tooth health: a patient's hygiene, lifestyle and dietary habits; the types and amount of bacteria present; and the quality of saliva flow, needed to neutralize mouth acid. With these the results we develop a customized prevention and treatment strategy.

MID also focuses on detecting dental caries as early as possible. Besides traditional x-rays, we're beginning to use other methods like dental microscopes, laser fluorescence, infrared photography or optical scanning. Early detection leads to early intervention, and with techniques that are much less invasive than the traditional approach.

The new approach also changes how we repair decayed teeth. We're increasingly using air abrasion, a technology that uses fine particles in a pressurized air stream to remove softer decayed tooth material and less healthy structure than the traditional dental drill. We're also using composite resin and other advanced materials for filings: these tooth-colored materials are stronger than previous versions and are quickly taking the place of metal amalgam, requiring less structural removal to accommodate them.

MID's core principles are early disease detection, proactive prevention and treatment with less structural removal. With this enhanced approach to effective dentistry, we're keeping your teeth healthy with minimal discomfort, lower costs and less long-term impact.

If you would like more information on the benefits of the MID approach, please contact us or schedule an appointment for a consultation.