Forty years have passed since the first reported case of Acquired Immune Deficiency Syndrome (AIDS), and it and the human immunodeficiency virus (HIV) that causes it are still with us. About 1.2 million Americans are currently infected with HIV, with 50,000 new cases diagnosed each year.
The emergence of antiretroviral drugs, though, has made it possible for many with HIV to live normal lives. Even so, the virus can still have a profound effect on health, including the teeth and gums. Because of its effect on the immune system, HIV+ patients are at greater risk for a number of oral conditions, like a fungal infection called candidiasis ("thrush").
Another common problem is chronic dry mouth (xerostomia), caused by a lack of saliva production. Not only does this create an unpleasant mouth feel, but the absence of saliva also increases the risk for tooth decay and periodontal (gum) disease.
The latter can be a serious malady among HIV patients, particularly a severe form of gum disease known as Necrotizing Ulcerative Periodontitis (NUP). With NUP, the gums develop ulcerations and an unpleasant odor arising from dead gum tissue.
Besides plaque removal (a regular part of gum disease treatment), NUP may also require antibiotics, antibacterial mouthrinses and pain management. NUP may also be a sign that the immune system has taken a turn for the worse, which could indicate a transition to the AIDS disease. Dentists often refer patients with NUP to a primary care provider for further diagnosis and treatment.
Besides daily brushing and flossing, regular dental cleanings are a necessary part of a HIV+ patient's health maintenance. These visits are also important for monitoring dental health, which, as previously noted, could provide early signs that the infection may be entering a new disease stage.
It's also important for HIV+ patients to see their dentist at the first sign of inflamed, red or bleeding gums, mouth lesions or loose teeth. Early treatment, especially of emerging gum disease, can prevent more serious problems from developing later.
Living with HIV-AIDS isn't easy. But proper health management, including for the teeth and gums, can help make life as normal as possible.
If you would like more information on dental care and HIV-AIDS, 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 “HIV-AIDS & Oral Health.”
In an ideal world, your family's dental needs would mesh seamlessly with the family budget. Alas, it's not always that way, and it can often be a head scratcher figuring out how to pay for needed dental work.
You can reduce treatment costs with dental insurance, which could conceivably cut your bill in half. But dental policies often have payment caps and coverage limitations on materials and procedures. And unless someone else like an employer is paying for it, you'll have to subtract the premiums you're paying from any benefits you receive to reveal what you're actually saving.
Even with dental insurance, you can still have a remaining balance that exceeds what you can pay outright. You may be able to work out a payment plan with the dentist for extended treatments like braces, but this might not be possible in other cases.
That leaves financing what you owe with loans or credit cards. For the latter, it's highly likely your dentist accepts major credit cards. But since many cards charge high interest rates, you could pay a hefty premium on top of your treatment charges the more you extend your payments on a revolving account over time.
Your dentist may also participate with a healthcare credit card. Although similar to a regular credit card, it only pays for healthcare costs like dental fees. Interest rates may also be high like regular cards, but some healthcare cards offer promotional periods for paying a balance over a designated time for little to no interest. But late payments and overextending the promotional period could nullify this discount.
You might save more on interest with a loan that has a fixed interest rate and payment schedule rather than a credit card with revolving interest (although credit cards may be more suitable for smaller expenditures while a fixed loan works better for larger one-time charges). One in particular is a healthcare installment loan program, one of which your dentist might be able to recommend, which is often ideal for paying dental costs.
Paying for your family's needed dental care can be financially difficult. But you do have options—and your dentist may be able to assist you in making the right choice.
Since his breakout role as Dr. Doug Ross in the 90's TV drama ER, George Clooney has enjoyed a blockbuster career as an award-winning actor, director and producer. He's still going strong, as seen in the recent film The Midnight Sky, which Clooney directed and starred in. This sci-fi drama set a record as the most-watched movie on Netflix for the first five days after its late December release. And although now well into middle age, Clooney still possesses a winsome charm epitomized by his devil-may-care smile.
But he didn't always have his enigmatic grin. Early on, his struggles pursuing his burgeoning acting career triggered a stressful habit of grinding his teeth. This took a toll, as his teeth began to look worn and yellowed, giving his smile—and him—a prematurely aged appearance.
Clooney's not alone. For many of us, our fast-paced lives have created undue stress that we struggle to manage. This pent-up stress has to go somewhere, and for a number of individuals it's expressed through involuntary grinding or gritting of the teeth. This may not only lead to serious dental problems, but it can also diminish an otherwise attractive smile.
There are ways to minimize teeth grinding, the most important of which is to address the underlying stress fueling the habit. It's possible to get a handle on stress through professional counseling, biofeedback therapy, meditation or other relaxation techniques. You can also reduce the habit's effects with a custom-made oral device that prevents the teeth from making solid contact during a grinding episode.
But what if teeth grinding has already taken a toll on your teeth making them look worn down? Do what Clooney did—put a new “face” on your teeth with dental veneers. These thin layers of porcelain are bonded to teeth to mask all sorts of blemishes, including chips, heavy staining and, yes, teeth that appear shortened due to accelerated wearing. And they're custom-designed and fashioned to blend seamlessly with other teeth to transform your smile. Although they're not indestructible, they're quite durable and can last for years.
Veneers can correct many mild to moderate dental defects, but if your teeth are in worse shape, porcelain crowns may be the answer. A crown, which bonds to a prepared tooth to completely cover it, allows you the advantage of keeping your natural tooth while still enhancing its appearance.
Although different in degree, both veneers and crowns require permanently altering the teeth, such that they will require a dental restoration from then on. But if you're looking for an effective way to transform your worn or otherwise distressed teeth into a beautiful smile, it's a sound investment.
Just like George Clooney, your smile is an important part of who you are. We can help you make it as appealing as possible with veneers or other dental enhancements. Call us today to get started on the path to a more attractive smile.
If you would like more information about dental veneers and other smile enhancements, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Porcelain Veneers.”
Osteoporosis is a serious bone weakening disease in older adults that can turn a minor fall into a major bone fracture. But the condition could also impact dental treatment—triggered ironically by the drugs used to treat osteoporosis rather than the disease itself.
From the Latin for “porous bone,” osteoporosis causes bone to gradually lose mineral structure. Over time the naturally-occurring spaces between mineralized portions of the bone enlarge, leaving it weaker as a result.
Although there's no definitive cure for osteoporosis, a number of drugs developed over the last couple of decades can inhibit its progress. Most fall into two major categories, bisphosphonates and RANKL inhibitors.
These drugs work by inhibiting the normal growth cycle of bone. Living bone constantly changes as cells called osteoblasts produce new bone. A different type, osteoclasts, clear away older bone to make room for these newer cells. The drugs selectively destroy osteoclasts so that the older bone, which would have been removed by them, remains for a longer period of time.
Retaining older cells longer initially slows the disease process. But there is a downside: in time, this older bone kept in place continues to weaken and lose vitality. In rare instances it may eventually become detached from its blood supply and die, resulting in what is known as osteonecrosis.
Osteonecrosis mostly affects two particular bones in the body: the femur (the long bone in the upper leg) and the jawbone. In regard to the latter, even the stress of chewing could cause osteonecrosis in someone being treated for osteoporosis. It can also occur after tooth extractions or similar invasive procedures.
If you're taking a bisphosphonate or RANKL inhibitor, you'll want to inform your dentist so that the necessary precautions can be taken before undergoing dental work more invasive than routine cleanings or getting a filling or crown. If you need major dental work, your dentist or you will also need to speak with your physician about stopping the drug for a few months before and after a dental procedure to minimize the risk of osteonecrosis.
Fortunately, the risk for dental problems while undergoing treatment for osteoporosis is fairly low. Still, you'll want to be as prepared as possible so that the management of your osteoporosis doesn't harm your dental health.
If you would like more information on osteoporosis and 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 “Osteoporosis Drugs & Dental Treatment.”
Have you ever woken up in the morning and felt like your mouth was filled with cotton? We've all had bouts of occasional dry mouth, but the unpleasantness usually goes away after we eat or drink something.
But what if you have dry mouth all the time? In that case, it's more than unpleasant—it could be increasing your risk of dental disease. That's because your dry mouth symptoms are being caused by a lack of adequate saliva. Besides providing antibodies to fight harmful bacteria, saliva also neutralizes mouth acid that can cause tooth decay.
Your decrease in saliva could be caused by smoking or moderate to heavy alcohol consumption. It could also be a side effect of medications you're taking, one reason why older people, who on average take more prescription drugs than other age groups, have a high incidence of dry mouth.
So, what can you do to alleviate chronic dry mouth?
Watch what you eat and drink. Certain foods and beverages can worsen chronic dry mouth. Try to avoid or limit alcohol and caffeinated drinks like coffee, tea or soft drinks, as well as salty or spicy foods.
If you use tobacco, quit. Tobacco, especially smoking, can dry out your mouth, as well as damage your salivary glands. Abstaining from tobacco can alleviate dry mouth and help prevent dental disease.
Drink more water. Simply drinking water ensures your body has an ample supply for producing saliva. It's also beneficial for your dental health in general, as it can help buffer your mouth's acid levels and rinse away food remnants that could become food for bacteria.
Speak to your doctor. If you suspect a drug that you're taking may be causing dry mouth, discuss with your doctor alternative medications that may minimize this side effect. Simply changing prescriptions could alleviate your dry mouth symptoms.
You can also try saliva stimulants, both over-the-counter and prescription, to help your mouth produce more saliva. And be sure you also keep up daily habit of brushing and flossing to clear away bacterial plaque and lower your risk of dental disease.
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