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Posts for category: Oral Health

By James V Gagne, DMD
August 30, 2021
Category: Oral Health
Tags: oral health  
DontIgnoreChronicMouthBreathing-ItCouldDisruptJawDevelopment

Although the air we breathe has one destination—the lungs—it can arrive there via two possible routes: through the nose or the mouth. In terms of survival, it matters little through which path air travels—just so it travels one of them!

In terms of health, though, breathing through the nose is more beneficial than through the mouth, and is our default breathing pattern. The nasal passages filter minute noxious particles and allergens. Air passing through these passages also produces nitric oxide, a gaseous substance that relaxes blood vessels and improves blood flow.

On the other hand, chronic mouth breathing during childhood can impact oral health. While breathing through the nose, the tongue rests against the roof of the mouth and thus becomes a mold around which the upper jaw and teeth develop. But mouth breathing places the tongue on the lower teeth, which deprives the upper jaw of support and can lead to an abnormal bite.

So why would people breathe through their mouth more than their nose? Simply put, it's more comfortable to do so. Because breathing is so critical for life, the body takes the path of least resistance to get air to the lungs. If obstructions caused by allergic reactions or swollen tonsils or adenoids are blocking the nasal pathway, the action moves to the mouth.

But chronic mouth breathing can often be treated, especially if addressed in early childhood. This may require the services of an ear, nose and throat specialist (ENT) and possible surgical intervention to correct anatomical obstructions. It's also prudent to have an orthodontist evaluate the bite and institute corrective interventions if it appears a child's jaw development is off-track.

Even after correcting obstructions, though, it may still be difficult for a child to overcome mouth breathing because the body has become habituated to breathing that way. They may need orofacial myofunctional therapy (OMT), which retrains the muscles in the face and mouth to breathe through the nose.

Chronic mouth breathing isn't something to be ignored. Early intervention could prevent future oral and dental problems and help the person regain the overall health benefits for nose breathing.

If you would like more information on overcoming chronic mouth breathing, 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 “The Trouble With Mouth Breathing.”

PlaqueRemovalistheTopPriorityforPreventingorTreatingGumDisease

Tooth loss is often the unfortunate conclusion to a case of untreated periodontal (gum) disease—incentive enough to try either to prevent it or aggressively treat an infection should it occur. In either case, the objective is the same: to remove all plaque from dental surfaces.

Dental plaque (and its hardened form, tartar) is a thin buildup of bacteria and food particles on tooth surfaces. It's a ready food source for sustaining the bacteria that cause gum disease. Removing it can prevent an infection or “starve” one that has already begun.

Your first line of prevention is brushing and flossing your teeth daily to remove any accumulated plaque. Next in line are dental cleanings at least twice a year: This removes plaque and tartar that may have survived your daily hygiene.

Plaque removal is also necessary to stop an infection should it occur. Think of it as a more intense dental cleaning: We use many of the same tools and techniques, including scalers (or curettes) or ultrasonic devices to loosen plaque that is then flushed away. But we must often go deeper, to find and remove plaque deposits below the gums and around tooth roots.

This can be challenging, especially if the infection has already caused damage to these areas. For example, the junctures where tooth roots separate from the main body of the tooth, called furcations, are especially vulnerable to disease.

The results of infection around furcations (known as furcation involvements or furcation invasions) can weaken the tooth's stability. These involvements can begin as a slight groove and ultimately progress to an actual hole that passes from one end to the other (“through and through”).

To stop or attempt to reverse this damage, we must access the roots, sometimes surgically. Once we reach the area, we must remove any plaque deposits and try to stimulate regrowth of gum tissue and attachments around the tooth, as well as new bone to fill in the damage caused by the furcation involvement.

Extensive and aggressive treatment when a furcation involvement occurs—and the earlier, the better—can help save an affected tooth. But the best strategy is preventing gum disease altogether with dedicated oral hygiene and regular dental visits.

If you would like more information on preventing and treating gum disease, 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 “What are Furcations?

By James V Gagne, DMD
August 10, 2021
Category: Oral Health
Tags: oral hygiene   oral health  
CelebrateNationalFreshBreathDayWithBetterDentalCare

We Americans spend billions on oral hygiene products each year, primarily to fight tooth decay and gum disease. But there's also a secondary motive—to freshen our breath. Our obsession with our breath's olfactory quality has even given rise to National Fresh Breath Day on August 6.

Bad breath is usually not a serious health issue, but it can be a big deal in other respects. In a recent Match.com survey, more than a third of its 5,000 respondents said fresh breath was their top concern during a date.

Romance aside, bad breath can also adversely affect other social and career relationships. Given that, it's no wonder we buy mints and mouthwashes by the ton. Unfortunately, much of what people purchase only masks breath odor without addressing the underlying cause.

While serious conditions like diabetes, liver disease or cancer can give rise to it, the primary source of bad breath is oral bacteria. Many of the hundreds of bacterial strains inhabiting our mouths generate volatile sulfur compounds (VSCs) with a smell akin to rotten eggs or decaying animal or vegetable matter. The longer these bacteria remain in the mouth, the more VSCs and their unpleasant odors they create.

Bacteria mainly thrive in a thin film of food particles known as dental plaque. It can build up quickly on tooth and gum surfaces, particularly with ineffective or non-existent oral hygiene. Dental plaque also causes tooth decay or gum disease, which may also contribute to unpleasant mouth odors.

Chronic dry mouth, in which the body isn't producing enough saliva, also encourages bacterial growth. Among its many functions, saliva's antibacterial compounds reduce bacterial populations. Without sufficient saliva, though, VSC-producing bacteria can run amok.

There's nothing wrong with swishing some mouthwash or popping a breath mint before a big meeting. But if you really want to alleviate bad breath, it's better to take direct action against the oral bacteria causing it.

The best thing you can do is maintain a daily regimen of brushing and flossing to remove dental plaque. This should also include cleaning the top surface of your tongue, which can be a prime hiding place for bacteria, particularly at the back of the tongue. You can simply brush your tongue with your toothbrush or use a special tongue scraper.

You should also keep up regular dental visits, which include cleanings to remove any residual plaque and tartar (hardened plaque). You should also see the dentist to treat any occurring dental diseases or conditions, including chronic dry mouth.

Fresh breath has everything to do with a clean, healthy mouth. Keeping it so can help you avoid those embarrassing odors.

If you would like more information about how to better keep your breath fresh, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Bad Breath: More Than Just Embarrassing.”

By James V Gagne, DMD
July 11, 2021
Category: Oral Health
Tags: tooth decay  
WhatYouCanDoToHelpYourChildAvoidToothDecay

So, when should you begin taking measures to prevent tooth decay in your child's teeth? When their teeth first begin to show? When all of their primary (baby) teeth are in? Or, wait until their permanent teeth begin erupting?

Actually, tooth decay can be a problem as early as two months of age, before a child's first tooth even comes in. In essence, then, dental disease prevention should be on your radar soon after your child is born. Here's what you can do to prevent the damage of tooth decay to their teeth now and its impact on their dental health in the future.

Start oral hygiene during nursing. Brushing and flossing are lifetime habits that reduce the risk of dental disease. When your children are young, you'll have to perform these tasks for them, ultimately training them to perform them on their own. But even earlier, before their first tooth, you'll want to clean their gums after feedings with a wet cloth to reduce disease-causing bacteria.

Initiate dental visits by age 1. It's appropriate on or before their first birthday, when most children already have a few primary teeth, to begin regular dental visits for cleanings and checkups. Seeing the dentist every six months at an early age will help your child stay well ahead of tooth decay. And starting visits early increases the likelihood it will become a regular part of their lives into adulthood.

Protect against decay. You and your dentist are partners in protecting your child from dental disease. Besides daily oral hygiene, you can also help by providing a dental-friendly diet, and especially restricting sugary snacks and avoiding sweetened liquids in bedtime bottles (including breast milk or formula). In addition to routine care, your dentist can also provide other measures to fight decay, like sealants or topical fluoride.

It's also important for you to set an example for your child to follow. Children soak up what's important to their parents—in this case, watching you take care of your teeth and seeing the dentist as a friend and ally against dental disease. That's your end goal: preventing dental disease now, and instilling the value of dental care that will last your child a lifetime.

If you would like more information on helping your child avoid tooth decay, 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 “Taking the Stress Out of Dentistry for Kids.”

By James V Gagne, DMD
July 01, 2021
Category: Oral Health
Tags: tmj disorder  
YourToothacheMightActuallybeUnrelatedtoYourTeeth

When you see your dentist about mouth pain, you expect to hear that it's a decayed or fractured tooth, or maybe a gum infection. But you might be surprised if your dentist tells you there's nothing going on inside your mouth to cause the pain.

It's not that far-fetched: The pain could be originating elsewhere. This is known as referred pain, where pain radiates from its origin to another part of the body.

Unless there's an obvious oral cause for the pain, it's best not to undertake any treatment involving the mouth until we've pinpointed the actual cause. That said, the cause is usually not too far away.

Facial nerve disorders. The trigeminal nerve courses on either side of the face from the upper skull through the cheeks and ends around the lower jaw. But if portions of the nerve's protective sheathing become damaged, the slightest touch on the face could trigger prolonged pain. Because of its proximity to the jaw, the pain can often be misidentified as a toothache.

Jaw joint pain. When joints connecting the lower jaw to the skull become traumatized and inflamed, a condition known as Temporomandibular joint disorder (TMD), the pain can radiate toward the jaw. In some cases, the person may easily mistake the muscle pain and spasming for a toothache.

Ear infection. As with TMD, your "toothache" may actually stem from an ear infection or congestion radiating pain into the jaw. It can also happen in the opposite direction—ear pain could actually be the referred pain of an infected back tooth—emphasizing the importance of precisely determining the originating source of any pain in the jaws or face.

Sinus pain. The large maxillary sinuses are located on either side of the face just above the back of the upper jaw. Because of its proximity, pain from a sinus infection can seem to be coming from one of the back molars. And as with ear infections, frequent sinus infections could in fact be caused by an infected tooth penetrating through the sinus floor.

These and other examples of possible referred pain illustrate how "tricky" a presumed toothache can be. Finding the true source of oral or facial pain will ensure you receive the proper treatment for lasting relief.

If you would like more information on oral or facial pain diagnosis and treatment, please contact us or schedule an appointment for a consultation.