Mouth Ulcers.... Where do they come from?

Recurrent ulcers in the mouth occur in approximately 20-40% of the US Population.
Individuals who have a decreased thickness in the lining of the mouth are more prone to these ulcers. The duration of these ulcers generally last between 7-10 days. These ulcers can occur as single or multiple lesions and do not occur on the lips or gums directly around the teeth. The most common reasons ulcers appear is from trauma or from food irritants.
Trauma such as an external hit or blow or a pencil or toothbrush scraping the in inside of the mouth can cause an ulcer. Certain foods such as chocolate, tomatoes, citrus, peanuts,coffee and strawberries just to name a few, can be irritating to the oral mucosa (inside lining of the mouth). Sodium Laurel Sulfate(SLS) a highly effective surfactant used in many cleaning products requiring the removal of residues is found in toothpaste in lower concentrations. Studies have suggested that SLS in toothpaste caused recurrent aphthous ulcers, commonly referred to as canker sores. The preliminary study "showed a statistically significant decrease in the number of ulcers from 14.3 after using the SLS containing dentifrice to 5.1 ulcers after brushing with SLS free dentifrice". So if you are experiencing recurrent mouth ulcers, try using an SLS free toothpaste such as "Biotene. For the occasional ulcer, try products such as Orabase or Colgate Total and Canker Cover to control pain. A common holistic approach often recommended by Dr. Caldwell is to use honey applied to the area several times a day.

Dental Educational Program a Success!

Another successful year for Tillie the Tooth!

The dental educators from our office educated over 4000 students in Fort Bend County public and private schools this past year. With a hands-on approach and many visual aides, the students interact as they learn about good oral hygiene habits and nutrition. Tillie is a large animated Molar who presents with food and plaque on her that the students volunteer to brush off. Others are chosen to help with flossing. Nutritional snacks are discussed all in a fun and humorous way. At the end, the students are given toothbrushes and handouts to take home.

This program has been presented in area schools by Debbie Snelling, RDH and Anne Pencak RDA since 1989.

Sports Safety and Mouth

We see many injuries during this time of the year that are related to contact sports, especially in those sports that do not require the players to wear mouth guards, such as baseball and basketball. It is estimated by dentists that up to 40% of dental injuries occur while playing sports. Wearing a mouth guard is the best way to prevent many of these injuries and a trip to the dentist or emergency room. Boil and Fit mouth guards are available at sporting goods stores and many new styles are available that are a much better fit than previously. Another option is to have a custom sports mouth guard made in our office. I recently spoke to our local Little League Board of Directors who agreed with my concerns of our youth's safety. Their suggestion to me was to bring the topic up with the National Board of the Little League Association. This is a topic that I am very passionate about. I am committed to spreading the word about the use of mouth guards in contact sports other than football and hockey. A mouth guard can go for miles in keeping your child's smile!

Dental Xrays for Children

I am frequently asked about the necessity of Dental Xrays for children. I often tell parents who are concerned about the radiation that the exposure is less than they would recieve if they flew in an airplane. The American Academy of Pediatric Dentistry as well as the ADA have endorsed guidelines for prescribing radiographs in Children. First and foremost, the reasons for dental xrays is for the ability to detect dental decay. Taking bitewing xrays at the first dental visit is recommened if the proximal surfaces (sides) cannot be probed or seen. The frequency of Xrays depends on the child's risk for decay. I take Bitewing Xrays (cavity detecting) once a year, unless the child has recurrent decay, then I retake the Bitewings at the six month checkup. Most decay starts on the interproximal surfaces of the teeth and without detection and treatment these lesions can quickly grow in size effecting the pulp and creating the need for pulp therapy and more extensive restorations. Xrays are also needed to measure growth and development as well as rule out any abnormalities so that they can be treated early on. Detection of supernumary teeth or missing teeth early in life gives us the ability to develop a treatment plan and possibly avoid extensive or unnessary treatment later. For example, if we detect a permanent tooth is missing in a child early on, every effort is made to keep the primary tooth in place as long as possible, avoiding more expensive or complex treatment at a later date.

Approximately fifty percent of my patients develop decay between their primary teeth, so detecting decay early while it is small will be much easier and less expensive to treat overall.

Avulsed or (Knocked Out Tooth)

Recently, one of my young adult patients arrived at my office promptly at 8am with his permanent tooth in hand that had been completely knocked out in a hockey game the night before. This was a neighborhood "pick up" game and the usual protective equipment was not worn. His tooth had been out of its natural environment for more than twelve hours and re-implantation of his tooth was not an option. It was hard to tell him that it was too late to re-implant the tooth, if only he would have called me immediately after the accident. Of course this young man will have a false tooth placed and most likely an implant at a later date, but there is nothing better than saving that natural tooth.
A permanent tooth that has been completely avulsed (knocked out), in most cases can be re-implanted if it is done so during the first 2-4 hours. Handle the tooth gently, place the tooth back into the socket if possible by handling the crown portion of the tooth or have the patient hold the tooth in his or her mouth (the natural environment) until seeking care. If this treatment is not an option then, gently rinse the tooth and place it in milk, or water. Avoid cleaning or rubbing the tooth as this could destroy the connective fibers that help anchor the tooth in the socket.
Seek treatment as soon as possible to increase your chances of a successful re-implantation.
My procedure for re-implantation is a dental splint with arch wire and composite for 7-10days. The splint is then removed after tooth is stable and then I refer to an Endodontist for further evaluation.