Archive for the ‘Drug Concerns’ Category

Ask the Gentle Dentist-Bulimia and its affect on oral and systemic health

And Burning mouth syndrome

Bulimia or Bulimia nervosa is a psychological eating disorder that usually affects women starting in the teen years and continuing into adulthood.  Bulimia is a condition where a person overeats with large quantities of food. They usually feel that they cannot stop eating or control what and how much they eat.  To compensate for their overeating and potential weight gain they will then purge by self induced vomiting.  Over exercising and the use of laxatives is also common to avoid weight gain.  These women usually have an inaccurate view of their bodies and are influenced by the gaunt look that is popular in fashion and culture.

This disorder can exist in a constant cycle from a few times per week to even daily. Common problems that bulimics face is gastric reflux (heart burn), esophagus inflammation, dehydration, constipation and oral trauma from sticking a finger down the throat.

The upper front teeth are severely worn down due to the fact that strong acid from the stomach passes across the teeth surface, eroding the enamel from the teeth.  The wear is caused mostly by tooth brushing after one of these episodes as it microscopically breaks down the fragile matrix in the enamel.  Teeth can appear very thin, uneven and tattered on the edges.  They may even appear dark on the edges where light shines through them.

Treatment for bulimia consists of psychological therapy to help these people get over the habit and to create a better self image of themselves.

If they are in therapy we as dentists want to also stop the effect it has on the teeth.  I have made thin plastic trays like bleaching trays that go over the teeth.  The patient fills them with fluoridate to remineralize the teeth.  Porcelain dental veneers also help to rebuild the areas that have the erosion of enamel.

Bulimics are very quiet and discrete in what they do, but if you notice that the one you love seems to overeat and then dismiss themselves from the meal you might be direct and lovingly confront them.  Tell them that you noticed a change in their behavior and that you have concerns about their health.  The affected individual needs to know they are loved and matter.

A well informed and observant dentist can see the effects from constant purging when examining the teeth.  If you are making an appointment for the teenager you suspect to may be wise to discretely give the dentist a heads up to take notice if there are any changes in the appearance of the upper front teeth.  Many times the message is received more openly if it comes from a dentist or dental hygienist rather than from a family member. I have diagnosed a few young women who had this disorder and the way we handled it was critically important to letting the patient know the damage they are doing to their bodies and teeth and that they matter.  It really takes a lot of time to effectively talk to a practicing bulimic and not have them get defensive, yet get the message across.

If you suspect that your wife or daughter is practicing this, you can give me a call to discuss the situation.  We can be the objective observer and direct their treatment accordingly.  We have a psychologist we work with to help treat the bulimia.  Our phone number is 586-247-3500 or you can email me privately at DrAntolak@TheGentleDentist.com.

Question: I have had a burning tongue for the last 6 months or so and don’t know what to do about it.  I am a 60 year old female and wonder what it caused from.   Could you please provide some information for me to treat this irritating and painful situation

Answer: If you have a perfectly normal looking tongue, but as the day wears on, the burning sometimes seems to progress. You may even experience some tastes that have no apparent cause. If you are having these mysterious and irritating sensations, you may be suffering from burning tongue syndrome, also known as burning mouth.

Causes and Possible Solutions

Although burning tongue is not a common condition, sufferers are generally older women. Only about four or five percent of American adults suffer from it. It’s not known exactly what causes the condition, although there are many factors. In some cases, more than one cause may be at work.

Sometimes the cause is as simple as irritation from various sources. One culprit may be your toothpaste or mouth rinse. To test this, switch toothpastes to a plain fluoride toothpaste, without any tartar-control or tooth-whitening ingredients. Also, stop using any mouth rinses except plain water or salt water. If you wear dentures or other oral appliances, they may be irritating to mouth tissues and contributing to burning mouth. If you suspect this, let us know right away so we can check them out and adjust them as necessary. Another source of irritation is acidic drinks, like soda pop, citrus, and tomato beverages. Try eliminating them from your diet, and see if your symptoms improve.

Certain hormone-related conditions can also be causes. Fluctuating hormone levels during menopause can lead to burning mouth, and the high blood sugar levels that occur with diabetes can also be irritating to oral tissues. Managing these conditions can sometimes help relieve burning mouth symptoms.

Another thing to consider is medications that you may have begun taking at about the time your symptoms began. Some drugs can cause burning tongue as a side effect.  Blood pressure medications,  antidepressants and diuretics can cause dry mouth, which can lead to a burning sensation. Talking with your physician about changing medications may do the trick.

There is some speculation that burning mouth syndrome is caused by damage or irritation to the nerves that control taste and sensation on the tongue and mouth. Some medications for controlling the nervous system, such as antidepressants, anticonvulsants, or pain medications, can help. Your physician may be able to prescribe these for you after a thorough exam.

Some people have experienced relief by rinsing their mouths with water and capsaicin (sometimes called capsicum). Capsaicin is the ingredient that makes hot peppers hot, and it’s used in pain-relief creams meant for treating nerve and muscle pain. You can try mixing about one part hot sauce with two or three parts water, rinsing your mouth with the mixture, and then spitting it out. Start by doing this every two or three hours for the first day or two, then tapering off to once or twice a day. Rinsing with this mixture will probably cause a burning sensation, and it’s thought that this burning temporarily interferes with the body chemicals that transmit pain messages. If you try this, though, be very careful. Once you get out the hot sauce and start working with it, don’t touch your nose or eyes until you’ve spit the mixture out and washed your hands thoroughly. Also, some people are sensitive to capsaicin, so if the burning is severe, stop using it immediately.

There are some other coping methods that may bring relief. If you drink alcoholic products or smoke, try to stop because these both irritate and dry out oral tissues. Avoid cinnamon and mint products. Chewing sugar-free gum or sucking on sugar-free candies or ice chips might also help. Vitamin deficiencies can be a contributing factor, so try taking a multivitamin supplement if you’re not doing that already.

If you’re suffering from burning in your mouth, let us know. We’ll want to check your mouth for sores, irritations, or other conditions that might be causing the pain. In some cases, we may want to work with your physician in determining the best course of treatment for you.

Dr. Antolak can be reached at DrAntolak@TheGentleDentist.com or call the office at (586)247-3500. If you have any questions that you would like answered you can do it also by writing at Ask The Dentist  15055 22 Mile #2, Shelby Twp. Michigan  48315 (Macomb County)

This article is from the Academy of General Dentistry newsletter that I get and thought it was valuable for men.

Now to answer the question—-Men are less likely than women to take care of their physical health and, according to surveys and studies, their oral health is equally ignored. Good oral health recently has been linked with longevity. Yet, one of the most common factors associated with infrequent dental checkups is just being male. Men are less likely than women to seek preventive dental care and often neglect their oral health for years, visiting a dentist only when a problem arises. When it comes to oral health, statistics show that the average man brushes his teeth 1.9 times a day and will lose 5.4 teeth by age 72. If he smokes, he can plan on losing 12 teeth by age 72. Men are also more likely to develop oral and throat cancer and periodontal (gum) disease 

Why is periodontal disease a problem?

Periodontal disease is a result of plaque, which hardens into a rough, porous substance called tartar. The acids produced and released by bacteria found in tartar irritate gums. These acids cause the breakdown of fibers that anchor the gums tightly to the teeth, creating periodontal pockets that fill with even more bacteria. Researchers have found a connection between gum disease and cardiovascular disease, which can place people at risk for heart attacks and strokes. See your dentist if you have any of these symptoms:

• Bleeding gums during brushing
• Red, swollen or tender gums
• Persistent bad breath
• Loose or separating teeth

Do you take medications?

Since men are more likely to suffer from heart attacks, they also are more likely to be on medications that can cause dry mouth. If you take medication for the heart or blood pressure, or if you take antidepressants, your salivary flow could be inhibited, increasing the risk for cavities. Saliva helps to reduce the cavity-causing bacteria found in your mouth.

Do you use tobacco?

If you smoke or chew, you have a greater risk for gum disease and oral cancer. Men are affected twice as often as women, and 95 percent of oral cancers occur in those over 40 years of age.

The most frequent oral cancer sites are the tongue, the floor of the mouth, soft palate tissues in back of the tongue, lips and gums. If not diagnosed and treated in its early stages, oral cancer can spread, leading to chronic pain, loss of function, irreparable facial and oral disfigurement following surgery and even death. More than 8,000 people die each year from oral and pharyngeal diseases. If you use tobacco, it is important to see a dentist frequently for cleanings and to ensure your mouth remains healthy. Your general dentist can perform a thorough screening for oral cancer.

Do you play sports?

If you participate in sports, you have a greater potential for trauma to your mouth and teeth. If you play contact sports, such as football, soccer, basketball and even baseball, it is important to use a mouthguard, which is a flexible appliance made of plastic that protects teeth from trauma. If you ride bicycles or motorcycles, wear a helmet.

Taking care of your teeth

To take better care of your oral health, it is important to floss daily, brush your teeth with fluoride toothpaste twice daily and visit your dentist at least twice a year for cleanings. Here are some tips to better dental health:

• Use a soft-bristled toothbrush to reach every surface of each tooth. If the bristles on your toothbrush are bent or frayed, buy a new one.
• Replace your toothbrush every three months or after you’ve been sick.
• Choose a toothpaste with fluoride. This can reduce tooth decay by as much as 40 percent.
• Brush properly. To clean the outside surfaces of your teeth, position the brush at a 45-degree angle where your gums and teeth meet. Gently move the brush in a circular motion using short, gentle strokes. To clean the inside surfaces of the upper and lower front teeth, hold the brush vertically. Make several gentle strokes over each tooth and its surrounding gum tissue. Spend at least three minutes brushing.
• Floss properly. Gently insert floss between teeth using a back-and-forth motion. Do not force the floss or snap it into place. Curve the floss into a C-shape against one tooth and then the other.

Dr. Antolak treats his dental patients in a relaxed, friendly atmosphere where you are treated like a guest in the home.  His motto is to “relax while we take care of your smile”. He specializes in cosmetic dentistry, implant dentistry and general dentistry using sedation dentistry if necessary for his high fear patients. He has been treating patients for the past 21 years and is located in Shelby Township, Macomb county Michigan

Here it is again….January…. and with the beginning of the New Year in Shelby township macomb county Michigan, usually follows New Years Resolutions.  They usually range from living a smoke free life, eating better, loosing weight, exercising more, going back to church, drinking less, getting out of debt, spending more time with family, being more organized, volunteering, and even getting back to see the dentist.  (This last one wasn’t on any list, but I think it is important.)   I am sure that these are just a few of the many resolutions that people have.  It usually takes a plan and commitment to stick to the plan for the changes to take place with any consistency.   For those who smoke or live with a smoker I would like to expand on living a smoke free life in this month’s article. 
According to the American Heart Association, about 46 million American adults smoke cigarettes.  This breaks down to 23 percent of adult men and 19 percent of adult women. Most smokers are either actively trying to quit or want to quit. Since 1965, more than 49 percent of all adults who have ever smoked have quit. Leading a smoke free life:  Smoking and using spit tobacco are  habits that significantly affect one’s health and well being. 
Why Quit?:
Cigarette smoking causes 87 percent of lung cancer deaths. Lung cancer is the leading cause of cancer death in both men and women. Smoking is also responsible for most cancers of the larynx, oral cavity and pharynx, esophagus, and bladder.
Tobacco smoke contains thousands of chemical agents, including over 60 substances that are known to cause cancer.
According to the Surgeon General:  Cigarette and tobacco smoke, high blood cholesterol, high blood pressure, physical inactivity, obesity and diabetes are the six major independent risk factors for coronary heart disease that you can modify or control.

There are many oral conditions that are negatively affected by tobacco use which include:   periodontal disease, healing with dental implants, oral surgery and high risk for oral cancer.
The Good News:

• After one year off cigarettes, the excess risk of coronary heart disease caused by smoking is reduced by half. After 15 years of abstinence, the risk is similar to that for people who’ve never smoked. 
  
• In 5 to 15 years, the risk of stroke for ex-smokers returns to the level of those who’ve never smoked.
  
• Male smokers who quit between ages 35 to 39 add an average of 5 years to their lives. Female quitters in this age group add 3 years. Men and women who quit at ages 65 to 69 increase their life expectancy by 1 year.
  

The Plan:
In any method used to be smoke free the person really needs to want to quit.  The motivation needs to come from “within” rather than from an outside source such as a  spouse.  It needs to be done for yourself and as a result of your effort others will benefit. 

Both acupuncture and hypnotism can effective non-drug methods used to be tobacco free.  There is little scientific evidence that shows these methods are more effective than the use of pharmaceuticals.  For those patients who desire a more holistic approach these methods may be for you.

There are a number of pharmaceutical approaches used for a smoking cessation program.  These include nicotine replacement therapies such as nicotine gum or the patch,  the use of zyban, an antidepressant, and a new smoking cessation aide called Chantix. I have current patients who have used Chantix with remarkable results.  According to Jonathan Foulds, the director of the Tobacco Independence Program, “Chantix appears to target the nicotine receptors in the brain that are involved in producing the rewarding effects from smoking. Chantix is believed to work via two mechanisms:”

 

 

It is exciting for us to team up with those who want to get control of their lives and finally be smoke free.    Give us a call at (586) 247-3500 or email me at DrAntolak@TheGentleDentist.com for more information on this or previous articles.  Please submit questions you may have about dental related topics to the same address on the internet.  If you would like to write us, out address is 15055 22 Mile #2,  Shelby Twp.  MI 48315.

Dr. Robert Antolak practices implant, cosmetic and general dentistry in a relaxed “homey” environment where you are  made to feel like family.