Information about Mouthguards

Key points:

  • TMJ disorder dentist DenverMouthguard use has been shown to reduce the risk of sport-related dental injuries
  • An ANSI/ADA standard exists for Athletic Mouth Protectors and Materials
  • The ADA Council on Access, Prevention and Interprofessional Relations and the ADA Council on Scientific Affairs encourage patient education about the benefit of mouthguard use.
  • A product earns the ADA Seal of Acceptance by providing scientific evidence that demonstrates safety and efficacy, which the ADA Council on Scientific Affairs carefully evaluates according to objective requirements.

Background

The ADA has taken an active stance since the mid-1990s recognizing the preventive value of orofacial protectors, endorsing their use by those who engage in recreational and sports activities; and encouraging widespread use of orofacial protectors with proper fit, including mouthguards.1

Both the ADA Council of Scientific Affairs and the Council on Access, Prevention and Interprofessional Relations recognize that dental injuries are common in collision or contact sports and recreational activities.2 Numerous surveys of sports-related dental injuries have documented that participants of all ages, genders and skill levels are at risk of sustaining dental injuries in sporting activities, including organized and unorganized sports at both recreational and competitive levels. While collision and contact sports, such as boxing, have inherent injury risks, dental injuries are also prevalent in non-contact activities and exercises, such as gymnastics and skating.3-5

The Councils promote the importance of safety in maintaining oral health and the use of a properly fitted mouthguard as the best available protective device for reducing the incidence and severity of sports-related dental injuries. The Councils are committed to oral health promotion and injury prevention for sports participants.

Standards

It is necessary that mouthguards actually perform as required, i.e. to keep teeth safe.  An important step was therefore the work of the ADA with ANSI in developing a standard for Athletic Mouth Protectors and Materials.  However, as recently as 2009, a study of commercially available products found none that met current ANSI and ADA standards for impact attenuation.6

Utilization

It is important for mouthguards to be safe however to be effective, they also have to be used.  Reasons given for why mouthguards are not used include awareness, cost, and lack of requirement for their use.7

Raising Awareness

There have been several “Patient Pages” in JADA to be used by dentists to help engage patients in conversation about mouthguards, facilitating discussion to encourage their use.  Each underscores the importance of mouthguard use and informs consumers about the 3 types that are available – ready-made, boil and bite, and custom made.8-12 

Recent trends to increase ‘realism’ in video games has resulted their incorporating more actual player behaviors including what they do with their mouthguards while at the free throw line.13  While perhaps not the most desirable behavior, it raises the profile and awareness of mouthguards. Further, by having a sport idol model their use, it serves to increase their ‘coolness’ factor.

Overcoming Barriers with the ADA Seal of Acceptance

While still being able to highlight the benefit of custom fit mouthguards, dentists can also recommend the use of over-the-counter mouthguards with the ADA Seal of Acceptance.  Look for the ADA Seal—your assurance that the product has been objectively evaluated for safety and efficacy by an independent body of scientific experts, the ADA Council on Scientific Affairs.  A product earns the ADA Seal for athletic mouthguards by providing scientific evidence, which is evaluated according to objective requirements, demonstrating the safety and efficacy of ready-to-use and mouth-formed (boil-and-bite) mouthguards.

To qualify for the Seal of Acceptance, the company must provide evidence that:

  • The product components are safe for use in the mouth and do not harm or irritate oral soft tissues.
  • Mouth-formed appliances can be prepared by the average person with low risk of injury to oral hard or soft tissues, or damage of orthodontic appliances.
  • The mouthguard is free of sharp or jagged edges.
  • The mouthguard passes tests outlined by the American National Standards Institute/American Dental Association for hardness, ability to resist tearing and withstand impact; as well as a measurement of the amount of water absorbed.14

Comparison finds custom mouthguards made by dentists to perform best;15 having an over-the-counter option that meets ANSI/ADA standards helps with the cost barrier to engagement while still affording the consumer with a safe method of protecting their teeth.

Summary

Dentists are encouraged to ask patients if they participate in team sports or other activities with risks of injury to the teeth, jaw and oral soft tissues (mouth, lip, tongue, or inner lining of the cheeks). The Councils recommend that people of all ages use a properly fitted mouthguard in any sporting or recreational activity that may pose a risk of injury. The Councils also recommend educating patients about mouthguards and orofacial injury risks, including appropriate guidance on mouthguard types, their protective properties, costs and benefits. The key educational message is that the best mouthguard is one that is utilized during sport activities.

References

  1. American Dental Association, Policy Statement on Orofacial Protectors. Transactions; 1995. p. 613.
  2. ADA Council on Access, Prevention and Interprofessional Relations; Council on Scientific Affairs. Using mouthguards to reduce the incidence and severity of sports-related oral injuries. J Am Dent Assoc 2006;137(12):1712-20; quiz 31.
  3. Fasciglione D, Persic R, Pohl Y, Filippi A. Dental injuries in inline skating – level of information and prevention. Dent Traumatol 2007;23(3):143-8.
  4. Knapik JJ, Marshall SW, Lee RB, et al. Mouthguards in sport activities : history, physical properties and injury prevention effectiveness. Sports Med 2007;37(2):117-44.
  5. Kumamoto DP, Maeda Y. A literature review of sports-related orofacial trauma. Gen Dent 2004;52(3):270-80; quiz 81.
  6. Gould TE, Piland SG, Shin J, Hoyle CE, Nazarenko S. Characterization of mouthguard materials: physical and mechanical properties of commercialized products. Dent Mater 2009;25(6):771-80.
  7. O’Malley M, Evans DS, Hewson A, Owens J. Mouthguard use and dental injury in sport: a questionnaire study of national school children in the west of Ireland. J Ir Dent Assoc 2012;58(4):205-11.
  8. For the dental patient. Do you need a mouthguard? J Am Dent Assoc 2001;132(7):1066.
  9. Mouthguards lower dental injuries. J Am Dent Assoc 2002;133(3):278.
  10. For the dental patient. The importance of using mouthguards. Tips for keeping your smile safe. J Am Dent Assoc 2004;135(7):1061.
  11. For the dental patient. Keep sports safe–wear a mouthguard. J Am Dent Assoc 2012;143(3):312.
  12. For the dental patient. Protecting teeth with mouthguards. J Am Dent Assoc 2006;137(12):1772.
  13. Stephen Curry’s mouth guard routine gets video game treatment.  2015.
  14. ANSI/ADA Standard No.99-2001(R2013) Athletic mouth protectors and materials. Chicago: American Dental Association.
  15. DeYoung AK, Robinson E, Godwin WC. Comparing comfort and wearability: custom-made vs. self-adapted mouthguards. J Am Dent Assoc 1994;125(8):1112-8.

ADA Resources

Other Resources

Prepared by: Center for Scientific Information, ADA Science Institute
Reviewed by: ADA Council on Access, Prevention and Interprofessional Relations
Last Updated: October 25, 2016

Disclaimer

Content on ADA.org is for informational purposes only, is neither intended to and does not establish a standard of care, and is not a substitute for professional judgment, advice, diagnosis, or treatment. ADA is not responsible for information on external websites linked to this website.

Aging and Dental Health

Key Points

  • The demographic of older adults (i.e., 65 years of age and older) is growing and likely will be an increasingly large part of dental practice in the coming years.
  • Although better than in years past, the typical aging patient’s baseline health state can be complicated by comorbid conditions (e.g., hypertension, diabetes mellitus) and physiologic changes associated with aging.
  • Older adults may regularly use several prescription and/or over-the-counter medications, making them vulnerable to medication errors, drug interactions or adverse drug reactions.
  • Potential physical, sensory, and cognitive impairments associated with aging may make oral health self-care and patient education/communications challenging. 
  • Dental conditions associated with aging include dry mouth (xerostomia), root and coronal caries, and periodontitis; patients may show increased sensitivity to drugs used in dentistry, including local anesthetics and analgesics.

The Federal Interagency Forum on Aging-Related Statistics projects that by the year 2030, the number of U.S. adults 65 years or older will reach 72 million, representing nearly 20% of the total U.S. population; this is an approximate doubling in number as compared to the year 2000.1 Older adults are, therefore, a growing patient demographic for dental practices. Increased numbers of older adults are retaining their natural teeth compared with previous cohorts.2 According to a 1999-2004 National Health and Nutrition Examination Survey (NHANES), approximately 18% of adults aged 65 years or older with retained natural teeth have untreated caries3 while a 2009-2012 NHANES found that 68% of these patients have periodontitis.4 Consideration of the overall clinical and oral health context of aging patients is important in order to provide optimum dental care.

The health status of adults older than age 65 years can be quite variable, ranging from functional independence to frail or cognitively impaired.5-8 According to the U.S. Administration on Aging, over 40% of noninstitutionalized adults aged 65 years or older assessed their health as excellent or very good (compared to 55% for persons aged 45 to 64 years).9 Most older persons have at least one chronic condition and many have multiple conditions.9 In the time period up to and including 2013, the most frequently occurring conditions among older persons were: hypertension (71%), arthritis (49%), heart disease (31%), any cancer (25%), and diabetes (21%).9 A 2015 report by the World Health Organization listed conditions common to older age, including hearing loss, cataracts and refractive errors, back and neck pain and osteoarthritis, chronic obstructive pulmonary disease, diabetes, depression, and dementia.10, 11

Physiologic changes that are age related include changes to cellular homeostasis, including regulation of body temperature and blood and extracellular fluid volumes; decreases in organ mass; and decline in or loss of body system functional reserves.5, 12 Changes to the gastrointestinal system include decreases in intestinal blood flow and gastric motility and increased gastric pH. Renal, cardiovascular, respiratory, central nervous, and/or immune systems may show decreased function (e.g., decreases in glomerular filtration, cardiac output, lung capacity, sympathetic response, cell-mediated immunity).12 These changes may have an effect on medication absorption and metabolism or an individual’s sensitivity to certain medications (See “Medication Considerations”).13

Physical changes associated with aging include decreased bone and muscle mass.12 Osteoarthritis may result in limitations in mobility.14Visual changes may include age-related macular degeneration, presbyopia, cataracts, glaucoma, or diabetic retinopathy.5, 14 Patients may experience age-related hearing loss, which may affect their ability to communicate.5, 14 Postural reflexes can become dampened, and falls become more common in elderly individuals.5, 12, 13 

Older adults may also demonstrate a spectrum of cognitive acuity, ranging from not at all affected to mild cognitive impairment to frank dementia.5 Dementia is a syndrome characterized by progressive deterioration in multiple cognitive domains, severe enough to interfere with daily functioning.5, 14 Older patients with poor cognitive health will have difficulty managing medications, medical conditions, or other self-care, including dental hygiene.14

According to data from NHANES, 39% of people aged 65 years and older reported using 5 or more prescription drugs (“polypharmacy”) in the prior 30 days during the year 2011 through 2012.15 Ninety percent of people 65 years of age and older reported using any prescription drug in the prior 30 days.15 The high prevalence of polypharmacy among older adults may lead to inappropriate drug use, medication errors, drug interactions or adverse drug reactions.5, 13 The average older adult takes 4 or 5 prescription drugs; in addition, these individuals may also be taking 2 or 3 over-the-counter (OTC) medications.13 A review of older dental patients’ medical history and current medications, both prescription and OTC medications/supplements,16, 17 should be done regularly.5, 13

Drugs most commonly prescribed in elderly patients include “statin” drugs for hypercholesterolemia; antihypertensive agents; analgesics; drugs for endocrine dysfunction, including thyroid and diabetes medications; antiplatelet agents or anticoagulants; drugs for respiratory conditions (e.g., salbutamol); antidepressants; antibiotics; and drugs for gastroesophageal reflux disease and acid reflux.13 The most frequently taken OTC medications by older adults include analgesics, laxatives, vitamins, and minerals.13

Older adults frequently show an exaggerated response to central nervous system drugs, partly resulting from an age-related decline in central nervous system function and partly resulting from increased sensitivity to certain benzodiazepines, general anesthetics, and opioids.13, 18 The American Geriatrics Society has published a 2015 update to the Beers Criteria for potentially inappropriate medication use in older adults.19 Beers Criteria potentially inappropriate medications have been found to be associated with poor health outcomes, including confusion, falls, and mortality. One change of note to the 2015 Beers Criteria includes the addition of opioids to the category of central nervous system medications that should be avoided in individuals with a history of falls or fractures.19

General

Xerostomia affects 30% of patients older than 65 years and up to 40% of patients older than 80 years; this is primarily an adverse effect of medication(s), although it can also result from comorbid conditions such as diabetes, Alzheimer’s disease, or Parkinson’s disease.5, 8, 20Xerostomia, while common among older patients, is more likely to occur in those with an intake of more than 4 daily prescription medications.5 Dry mouth can lead to mucositis, caries, cracked lips, and fissured tongue.8 Recommendations for individuals with dry mouth include drinking or at least sipping regular water throughout the day5, 8and limiting alcoholic beverages and beverages high in sugar or caffeine, such as juices, sodas, teas or coffee (especially sweetened).8 

Older adults are at increased risk for root caries because of both increased gingival recession that exposes root surfaces and increased use of medications that produce xerostomia; approximately 50% of persons aged older than 75 years of age have root caries affecting at least one tooth.2, 21, 22 Ten percent of patients 75 to 84 years of age are affected by secondary coronal caries; this is likely related to the prevalence of restorations in the older population.20 Adoption of good oral hygiene, which includes use of rotating/oscillating toothbrushes, and the use of topical fluoride (i.e., daily mouth rinses, high fluoride toothpaste and regular fluoride varnish application), as well as attention to dietary intake have been recommended in the literature.8, 20, 22

Because cardiovascular disease is common among older individuals, it has been suggested by Ouanounou and Haas that the dose of epinephrine contained in anesthetics should be limited to a maximum of 0.04 mg.13 The authors13 recommend that even without a history of overt cardiovascular disease, the use of epinephrine in older adult patients should be minimized because of the expected effect of aging on the heart. They recommend monitoring blood pressure and heart rate when considering multiple administrations of epinephrine-containing local anesthetic in the older adult population.13

Cognitive Limitations Affecting Dental Care and Self-Care

Patients with severe cognitive impairment, including dementia, are at increased risk for caries, periodontal disease, and oral infection because of decreased ability to engage in self-care.14 Education of the caregiver, as well as the patient, is an important part of the prevention and disease management phase of dental care.5, 14

Communication during the dental appointment may be challenging when the older adult has cognitive impairments. It is recommended that the number of people, distractions, and noise in the operatory be minimized when providing care to a patient with dementia, although a trusted caregiver in the room may provide reassurance to the patient.23 Patients should be approached from the front at eye level and use of nonverbal communication, such as smiling and eye contact, is important.23 The dentist should begin the conversation by introducing himself or herself. Because a patient with cognitive limitations may become overloaded with information easily, instructions should be simple and sentences short, such as, “Please open your mouth.”23

Because cognitive impairment or dementia can affect a patient’s ability to follow instructions following oral surgery, it is recommended that practitioners ensure local hemostasis (i.e., sutures, local hemostatics, socket preservation techniques) prior to dismissal from the dental practice.14

Dentate patients with cognitive limitations should be encouraged to brush their teeth two or more times daily; use of an electric or battery-operated toothbrush should be considered.14 The same oral care routine should be followed consistently, as possible.14 In patients with removable prosthetic devices, the device(s) should be removed, inspected, and cleaned before bed and returned to the mouth in the morning.14

Physical and Sensory Limitations Affecting Dental Care and Self-Care

Patients with Hearing Loss:  Dental care providers should speak slowly, clearly, and loudly when talking with older patients to enhance hearing and understanding.23 It is important to make sure that speaking loudly and slowly does not introduce a patronizing or condescending tone of voice.23 Yellowitz in The ADA Practical Guide to Patients with Medical Conditions14 advises the following in communicating with patients with hearing loss and/or hearing aids:

  • In patients who read lips, face the patient while speaking, speak clearly and naturally; and make sure your lips are visible (remove mask). Be at the same level as the patient.
  • Gain the patient’s attention with a light touch or signal before beginning to speak. Be sure the patient is looking at you when you are speaking and avoid technical terms. Use written instructions and facial expressions.
  • Inform the patient before starting to use dental equipment or when equipment is changed, resulting in an altered experience, e.g., vibrations from a low-speed versus a high-speed handpiece. 
  • In patients with hearing aids, minimize background noise when speaking. Avoid sudden noises and putting your hands close to the hearing aid(s). Patients may want to adjust or turn off the hearing aid(s) during treatment.
  • Written and illustrated materials and websites can be used to help explain dental information, procedures, and postoperative instructions


Patients with Visual Loss:  Age-related visual impairment, such as cataracts, glaucoma or presbyopia, can diminish a person’s ability to process nonverbal conversational cues that frequently are communicated visually.23 Ensure the patient can clearly see demonstrations and read written materials, including appointment cards and instructions.14 The following tools and strategies14 can assist visually impaired older adults in the dental office:

  • Large-print magazines in the waiting room
  • Good lighting throughout the office; add spot/task lighting in areas used for completing forms
  • Large print on prescription bottles
  • Install blinds or shades to reduce glare
  • Use contrasting colors on door handles, towel racks, and stair markers

Patients with Physical Limitations/Loss of Mobility:  Osteoarthritis or rheumatoid arthritis in the hand, fingers, elbow, shoulder, and/or neck can affect a person’s ability to maintain good quality oral health self-care.14 Modification of manual toothbrush handles (e.g., with Velcro® straps or attaching a bicycle handlebar grip) or use of an electronic toothbrush with a wide, grippable handle can help accommodate for lost mobility.14 Floss holders or interdental cleaners/brushes can aid in cleaning between teeth.14Increasing the frequency of dental cleanings and examinations can help promote optimal maintenance of oral hygiene.

Prepared by: Center for Scientific Information, ADA Science Institute
Last Update: June 14, 2017

Disclaimer
Provided by ADA.org – Content on ADA.org is for informational purposes only, is neither intended to and does not establish a standard of care, and is not a substitute for professional judgment, advice, diagnosis, or treatment. ADA is not responsible for information on external websites linked to this website.

New Artist in Residence Program at McGlone Dental Care

By Meg Benjamin

We moved into our new location in June and the aesthetic of the building is very hip with an open, industrial, modern vibe.  As we started thinking about how we wanted the building to look and were shopping for décor that would match the great vibe we’ve created , we decided instead of purchasing stock art for the walls, we would reach out to local artists to see if we could get any interested in displaying local art on a rotating basis.  That’s how our “Artist in Residence Program” was born!

The response from local artists, after just one post on a local community site, was amazing!  We got more artists interested than we have months left to display art this year.  We are currently booked with artists to display their art on the walls of McGlone Dental Care through October of next year. 

All the artist’s work that is displayed here is for sale.  We have a price list and description of each piece that is hung on our walls.  If a piece sells we only ask that the artist donate 10% of their profit to an animal non-profit organization in Denver.  We really like the Denver Dumb Friend’s League, but if an artist has their own non-profit they like to give to, that’s ok too.

In June when we started the “Artist in Residence Program”, our first artist Brett Cremeens partnered with us to display his art here.  Brett uses acrylic’s, pencil, oil, White Out (Yes! White out that you are used to using for corrections), among other things on all types of surfaces.  He creates art on paper, canvas, exterior and interior walls, denim jackets, and even doors.  Brett painted the tooth logo that is painted prominently on the back of our building.  He has also painted a beautiful, colorful sea turtle on the inside back door of our office.  We have used bright colors mixed with neutrals to make the art pop on our walls. We also have several exposed brick walls that make a great back drop for any art.

July brings us a new artist, Elizabeth Erickson.  She is a photographer that prints her art on metal and standard print material.  Most of her images that are hung in our building are nature inspired.  She doesn’t specialize in one type of photography. She photographs, stills, nature, families, family events, weddings, Bar/Bat Mitzvah’s and more.  Her pieces are currently on display and are all for sale. If you’d like to stop in to take a peek, please do.

Here is our upcoming schedule of artists who will be displaying their art through the rest of the year at McGlone Dental Care:

September & October we will be featuring Jamie Lollback’s art.  She specializes in product, art and portrait photography.  We are excited to see what she comes up with to hang on our walls this fall.  If you’d like a preview click here (link – www.jamiejolollback.com).

November & December we are excited to have Tom Lybeck share his art with us and our patients.  Tom uses oils to paint beautiful, vibrant paintings.  The categories he paints are landscapes, birds, animals, western scenes, predators (the animal kind) and gospel type paintings.  He also produces prints and cards from his art.  For a sneak peek at Tom’s style and art click here http://www.doublevisionart-design.com.

As of now, we have November and December of 2018 open for a local artist to display their art.  If you or someone you know may be interested in partnering with McGlone Dental Care, please give Meg a call at 303-759-0731.  We hope our Artist in Residence Program will be a big hit and a win-win for everyone!

 

Celiac Disease

Celiac Disease’s Toll on Your Teeth

By: Bonnie Schiedel

After Michelle B. was diagnosed with celiac disease in early 2009, she made sure to tuck all nine of her extracted teeth into her handbag when she was referred to the Celiac Disease Center at Columbia University in New York. She wondered if the dental problems with which she had been plagued since her early twenties – repeated cavities, root canals, infections and extractions – could possibly have something to do with celiac disease.

“I kept all my teeth because I just knew something wasn’t right,” explains the 38-year-old resident of Maplewood, New Jersey.

The clinic examined them and found they all had abnormalities associated with celiac disease, like enamel defects, structural defects and calcium deficiency.

“I knew something bigger was wrong than just my teeth, but I was still shocked by the link.”

Celiac disease and teeth? Really? If that’s news to you, you’re not alone – it’s quite possible that your doctor, dentist and hygienist have never heard of that link either. Among celiac disease’s curious mix of symptoms, oral health problems have only recently been shown to be one of them.

The first American study that looked at a connection between celiac disease, dental enamel defects and canker sores was published in The Journal of Clinical Gastroenterology in 2009. Meantime, the very first clinical guidelines for dentists that outlined celiac disease and dental problems was published in 2011, in the Journal of the Canadian Dental Association.

It’s hard to pin down the number of celiac patients affected by oral health issues – the studies have been generally been small – but the 2009 study found that dental enamel defects were found in 87 percent of the children with diagnosed celiac disease compared to 33 percent of non-celiac kids, and that 42 percent of celiac patients, both adults and kids, had frequent bouts of canker sores, versus 22 percent of the non-celiac patients.

Why is it happening?

Just why celiac disease can do a number on your teeth and mouth is, like so much else associated with the frustrating condition, far from clear. “We don’t know what the exact mechanism is, but there are two theories,” says Dr. Peter Green, a gastroenterologist and director of the Celiac Disease Center, who co-authored the 2009 study.

First, because celiac disease means that the body has trouble absorbing key nutrients, including vitamin D and calcium, that could translate to poor tooth enamel formation in childhood.

The second theory points to the immune system: Celiac patients have a substance in the blood known as tTG antibodies, and those antibodies may have some kind of influence on the development of the enamel, he says. (Non-celiac gluten sensitivity and oral health problems have not been studied, says Green.)

Part of the reason why the celiac-oral health connection isn’t on the radar of many health professionals is that dental enamel defects and canker sores – the two most common ways celiac disease affects the mouth – have a number of other causes, too.

“Dental enamel defects could also could be due to excess fluoride, genetics or certain antibiotics [like tetracycline],” explains Alexandra Anca, a Toronto dietitian who co-authored the Canadian clinical guide for dentists, and is scientific adviser for the Canadian Celiac Association’s professional advisory board. “Because of this, I don’t think many dentists are fully aware that celiac disease might be an issue.”

Unfortunately, medical doctors may not yet be in the know either. Even Green, the medical director of a prominent celiac research and treatment center, only recently recognized the connection. “It’s a big step forward for me to develop insight [into this link,]” he admits.

“The mouth, unfortunately, is a bit of a ‘no man’s land’ for physicians. It’s considered to be in the realm of dentists and oral pathologists, and its place in general medicine and gastroenterology has been forgotten.” He adds: “It’s not often you would look in people’s mouths during an exam. Now my group does. We ask about canker sores now, too.”

Greater awareness of the issue may be on the horizon. When Dr. Ted Malahias, a dentist in Groton, Connecticut, who also co-authored the 2009 paper, talks to fellow dental professionals at conferences, he says they are receptive and excited about finding a new piece to the puzzle for patients with stubborn dental issues. “It gets their curiosity going,” he says.

Your Action Plan

Problems like canker sores and atrophic glossitis (see “Watch Your Mouth,” for an explanation of specific celiac-related mouth troubles) are often related to vitamin and mineral deficiencies or immune response, says Malahias, and will likely improve once the celiac disease is addressed with the gluten-free diet.

Likewise, if a child who has dental enamel defects on his or her baby teeth is diagnosed with celiac disease before age 7 (when the enamel is forming on the permanent adult teeth), following a gluten-free diet should mean that dental enamel defects aren’t part of the adult teeth, he says.

However, if you’re an adult with dental enamel defects stemming from long-term, undiagnosed celiac disease, you are stuck with weakened tooth enamel. “The gluten-free diet can’t change the enamel,” he says.

If you have been diagnosed with celiac disease, you are following the gluten-free diet, and your teeth and mouth are fine, you have nothing to worry about, reassures Anca. (If you are diagnosed but cheat on your diet, oral health problems may be in your future, though.)

But if, like Michelle B., you haven’t been diagnosed with celiac disease but have been battling bad teeth, it’s worth a conversation with your doctor, particularly if you have a close family member with celiac disease, or you have any possible celiac symptoms (classic symptoms include abdominal distension and pain, and chronic diarrhea).

This is especially true for kids. “There are many factors that can cause dental enamel defects, but if the medical history indicates there is something else is going on, or there’s a family history of celiac disease, we recommend parents talk to their family doctor about getting their child tested for celiac disease,” says Malahias.

“In kids, the dental enamel defects can be an early warning sign of celiac.” (Michelle B. is keeping a very close eye on her 8-year-old son’s dental visits, but so far all is well.)

Michelle B.’s advice: “You just have to keep on pursuing the truth. My gut, no pun intended, was telling me there was something else going on. If your doctor or dentist doesn’t want to take the time to help you find an answer, you have to find someone who will. Eventually I put the pieces together, but it was a very long road.”

See also: Celiac Disease: Watch Your Mouth

 

*Information courtesy of www.allergiceliving.com

Easing Dental Fear in Adults

What Causes Dental Phobia and Anxiety?

If you fear going to the dentist, you are not alone. Between 9% and 20% of Americans avoid going to the dentist because of anxiety or fear. Indeed, it is a universal phenomenon.

Dental phobia is a more serious condition than anxiety. It leaves people panic-stricken and terrified. People with dental phobia have an awareness that the fear is totally irrational, but are unable to do much about it. They exhibit classic avoidance behavior; that is, they will do everything possible to avoid going to the dentist. People with dental phobia usually go to the dentist only when forced to do so by extreme pain. Pathologic anxiety or phobia may require psychiatric consultation in some cases.

Other signs of dental phobia include:

  • Trouble sleepingthe night before the dental exam
  • Feelings of nervousness that escalate while in the dental office waiting room
  • Crying or feeling physically ill at the very thought of visiting the dentist
  • Intense uneasiness at the thought of, or actually when, objects are placed in your mouth during the dental treatment or suddenly feeling like it is difficult to breathe

Fortunately, there are ways to get people with dental anxiety and dental phobia to the dentist.

What Causes Dental Phobia and Anxiety?

There are many reasons why some people have dental phobia and anxiety. Some of the common reasons include:

  • Fear of pain. Fear of pain is a very common reason for avoiding the dentist. This fear usually stems from an early dental experience that was unpleasant or painful or from dental “pain and horror” stories told by others. Thanks to the many advances in dentistry made over the years, most of today’s dental procedures are considerably less painful or even pain-free.
  • Fear of injections or fear the injection won’t work. Many people are terrified of needles, especially when inserted into their mouth. Beyond this fear, others fear that the anesthesia hasn’t yet taken effect or wasn’t a large enough dose to eliminate any pain before the dental procedure begins.
  • Fear of anesthetic side effects. Some people fear the potential side effects of anesthesia such as dizziness, feeling faint, or nausea. Others don’t like the numbness or “fat lip” associated with local anesthetics.
  • Feelings of helplessness and loss of control. It’s common for people to feel these emotions considering the situation — sitting in a dental chair with your mouth wide open, unable to see what’s going on.
  • Embarrassment and loss of personal space. Many people feel uncomfortable about the physical closeness of the dentist or hygienist to their face. Others may feel self-conscious about the appearance of their teeth or possible mouth odors.
  • The key to coping with dental anxiety is to discuss your fears with your dentist. Once your dentist knows what your fears are, he or she will be better able to work with you to determine the best ways to make you less anxious and more comfortable. If your dentist doesn’t take your fear seriously, find another dentist.
  • If lack of control is one of your main stressors, actively participating in a discussion with your dentist about your treatment can ease your tension. Ask your dentist to explain what’s happening at every stage of the procedure. This way you can mentally prepare for what’s to come. Another helpful strategy is to establish a signal — such as raising your hand — when you want the dentist to immediately stop. Use this signal whenever you are uncomfortable, need to rinse your mouth, or simply need to catch your breath.


* Information courtesy of www.webmd.com/oral-health

McGlone Dental Care is officially open in the Rosedale/Harvard Gulch neighborhood!

We are open for business and our building remodel is beautiful. If you are in the neighborhood, please stop in for a tour. We will be hosting an open house soon, so check back for details about that.

This morning our first patient was Father Ronald Cattany. Before we started his dental service, he blessed all of us and our building by walking through the entire building; including the bathroom & closets, outside of the building and parking lot blessing our new space with Exorcised Holy water. He even blessed all of our cars. It was a magical moment for Dr. Greg McGlone and his staff. There may have even been a few tears shed!

Please follow us on Facebook – https://www.facebook.com/McGloneDental/ for more updates about our move, the building remodel and upcoming events, including the addition of some other services and featured artists to our menu of offerings.

Jaw-dropping facts about TMJ/TMD disorders

Understanding TMJ/TMD Disorders

TMJ disorder dentist DenverMore than 15 percent of American adults suffer from chronic facial pain, such as jaw pain, headaches or earaches.

The source of these aches and pains may be related to one or both of the temporomandibular (TM) joints. Located on each side of the head, these joints work together, with a complex system of muscles, ligaments, discs and bones, to make different movements for chewing and speaking.

What is TMD?

Temporomandibular Disorder (TMD) refers to a variety of conditions that affect TM joints, jaw muscles and facial nerves. TMD may occur when the jaw twists during opening, closing or side-motion movements. People with TMD may experience these symptoms:

  • pain in or around the ear
  • headaches and neck aches
  • tenderness of the jaw or jaw muscles
  • jaw pain or soreness that is more prevalent in the morning or late afternoon
  • jaw pain when chewing, biting or yawning
  • difficulty opening and closing the mouth
  • clicking or popping noises when opening the mouth
  • sensitive teeth when no other dental problems can be found

TMD affects more than twice as many women (particularly those of childbearing age) as men and is the most common non-dental related chronic facial pain.

What causes TMD?

  • Arthritis
  • Improper bite (how teeth fit together)
  • Jaw dislocation or injury

Stress and TMD

Stress is thought to be a factor in TMD. Even strenuous physical tasks, such as lifting a heavy object or stressful situations, can aggravate TMD by causing overuse of jaw muscles, specifically clenching or grinding teeth (also known as bruxism).

What can I do to treat TMD?

Diagnosis is an important step before treatment. However, because the exact causes and symptoms of TMD are not clear, diagnosing these disorders can be confusing. At present, there is no widely accepted, standard test to correctly identify TMD.

Other dental conditions, such as a toothache or sinus problems, can cause similar symptoms. Scientists are also exploring how behavioral, psychological and physical factors may combine to cause TMD.

In about 90 percent of the cases, says the Delta Dental Plans Association, your description of symptoms, combined with a simple physical examination of face and jaw by your dentist, provides useful information for diagnosing these disorders.

Your dentist may also take x-rays and make a cast of your teeth to see how your bite fits together, or may request specialized x-rays for the TM joints. Your complete medical history may be reviewed, so it is important to keep your dental office record up-to-date.

Your dentist will recommend what type of treatment is needed for your particular problem or refer you to a specialist, such as specially trained facial pain experts. You may also want to check with your physician about TMD-type symptoms.

Your dentist may also recommend one of the following:

Modify the pain. This can mean resting the joint, taking a non-steroidal anti-inflammatory drug, such as aspirin or ibuprofen, or applying moist heat to the painful areas.

Practice relaxation techniques. Biofeedback or relaxation training may help to manage stress. Your dentist may prescribe a nightguard to prevent your teeth from grinding during sleep.

Fix poorly aligned teeth. Your dentist may suggest some adjustment, including orthodontic treatment, to correct teeth alignment.

If you think you have TMD

Keep in mind that for most people, discomfort from TMD will eventually go away whether treated or not. Simple self-care practices, such as exercising to reduce teeth-clenching caused by stress, can be effective in easing TMD symptoms.

If more treatment is needed, it should be conservative and reversible. Avoid, if at all possible, treatments that cause permanent changes in the bite or jaw. If irreversible treatments are recommended, be sure to get a reliable second opinion.

Many practitioners, especially dentists, are familiar with the conservative treatment of TMD.

Pain clinics in hospitals and universities are also a good source of advice and second opinions for these disorders.

Always check your specific dental benefits coverage before undergoing any dental treatment.

Information courtesy of the Academy of General Dentistry and the American Dental Association.

What Does Soda Do to Your Teeth?

If you’re like about one-half of the American population, you drink at least one sugary drink on a daily basis — and there’s a good chance it’s soda. Drinking high-sugar soft drinks is most commonly associated with obesity, type 2 diabetes, and weight gain. But sodas can also have ill effects on your smile, potentially leading to cavities and even visible tooth decay. 

Teenage Life

Men are more likely to drink soda and sugary drinks. Teenage boys drink the most and get about 273 calories from them per day. That number only falls to 252 calories in their 20s and 30s.

How Soft Drinks Hurt Your Teeth

When you drink soda, the sugars within interact with bacteria in your mouth to form acid. This acid attacks your teeth. Both regular and sugar-free sodas also contain their own acids, and these attack the teeth too. With each swig of soda, you’re starting a damaging reaction that lasts for about 20 minutes. If you sip all day, your teeth are under constant attack. 

Erosion and Cavities

There are two main dental effects of drinking soda: erosion and cavities.

Erosion begins when the acids in soft drinks encounter the tooth enamel, which is the outermost protective layer on your teeth. Their effect is to reduce the surface hardness of the enamel.

While sports drinks and fruit juices can also damage enamel, they stop there. 

Soft drinks, on the other hand, can also affect the next layer, dentin, and even composite fillings. This damage to your tooth enamel can invite cavities. Cavities, or caries, develop over time in people who drink soft drinks regularly. When combined with poor oral hygiene, the results can be disastrous.

Mountain Dew Mouth

Perhaps one of the most extreme examples of the dental effects of soft drink consumption is known as “Mountain Dew Mouth,” a phenomenon most common in Central Appalachia. This condition is caused by very high consumption of soft drinks, including its namesake, Mountain Dew.

Those who suffer from it experience visible tooth decay, as acids from the soda essentially eat away the enamel to leave behind disturbing results.

Learn more about “Mountain Dew Mouth” »

Unfortunately, children are most at risk for suffering the teeth-damaging effects of soft drinks, as their vulnerable enamel is not fully developed.

*Information courtesy of  www.healthline.com

What’s all the Hype about Teeth Whitening?

By Meg Benjamin

Here at McGlone Dental Care, we have patients asking to have teeth whitening done every week.  Everyone seems to want a whiter, brighter smile these days, but worry that teeth whitening may damage their teeth.  While using, whitening toothpaste can erode your enamel and cause your gums to recede, having professional teeth whitening treatments is less abrasive than whitening toothpastes, and doesn’t cause as much damage to your teeth or enamel.

Our teeth whitening is not done in the office.  We don’t have a “Zoom” machine.  If you want to whiten your teeth, it’s not a quick fix.  You can, however, whiten your teeth in the privacy of your own home.  Our teeth whitening process (only 2 very short visits) will only cost you $200 total.  We realize that may be quite a bit lower than other dentists in the area.  We keep our prices low because we want our patients to feel like they are being taken care of. If they feel well taken care of, they will come back for other, more intensive services in the future.  Most insurance does not cover any teeth whitening service, trays, in office whitening, or a ZOOM treatment.  If you schedule an appointment for teeth whitening to be done here or any place, make sure you can personally pay the charge out of pocket. 

Teeth Whitening Denver

At McGlone Dental Care, your teeth whitening treatment is completely customized to your teeth/mouth.  You’re may be wondering…how is that possible?  Here are the steps that we take to make sure that you have the best teeth whitening experience.  First, we have you come in for us to make a mold of your upper and lower teeth.  This is step 1.  Once the molds (you’ll get two molds, one for the upper teeth & a second one for your lower teeth) are hardened, we then pour a clear solution on both molds and wait for the clear solution to harden up on the molds.  Then we pull the trays off each mold and trim them up.  Once they are trimmed and ready for you to use, we will call you to let you know they are done, it’s time for you to pick them up. 

You will then come in to pick-up your trays and two tubes of whitening gel with directions on how to use them together.  Each tube we give you should last for about three whitening treatments.  I’m sure you’ve heard the statement, “a little goes a long way”.  It’s true in this case!  You only need to put one small dab of the solution onto each tooth area of your trays.  In fact, you should only whiten the teeth that are visible when you smile or talk.  Why whiten the teeth in the very back of your mouth that no-one can see?  If you whiten this way, your whitening gel will last a little bit longer.  You may be able to get four treatments out of one tube.

This treatment is done at home, most of the time, while you are sleeping or during a “quiet” time.  Quiet time is any time where you won’t be talking, eating, or doing anything else with your mouth than maybe meditating, napping, listening to music with headphones, or anything else you can do with your mouth closed.  You can sleep in the trays, if it doesn’t bother you.  After use, clean both trays with warm water.  Let dry, and store the trays in the container they came in, with the trays on top of the molds.  Keep in a drawer or handy place so you can locate them when it’s time to repeat.  Make sure you store the gel in a dark, cool place.  The refrigerator is a great place to store your gel.  The fridge or anywhere cool and dark will work for storing your solution.

So really, what is all the hype about?!  I believe that now-a-days, everyone wants to have a great smile.  They want it to shine bright!  Here are a few theories of what I think may be going on.  The baby boomers are getting older, living longer and want to look more youthful.  The 40+ set is doing all they can to NOT age (me included).  The millennial generation is trying to prevent this thing called “aging” and are doing this and other things to set back the clock now for when they are older.  They want to look 25 forever!  I hate to burst their bubble! 

Whatever you’re your theory is on teeth whitening, we are happy to help you slow down the aging process, prevent the look of aging now and into the future, or just make you feel more confident, and good about yourself, no matter your age.

For more information or to schedule an appointment to get your very own custom made trays, give us a call – 303-759-0731.

McGlone Dental Care’s New Building – Coming Soon to the Rosedale Neighborhood!

By Meg Benjamin

We are so excited about our new building in the Rosedale neighborhood.  We are in the remodeling stage of the project and hope that all the work will be complete by April or May at the latest.  We did most of the demo, had the exterior of the building painted and planned and executed the landscaping over the summer and fall months. 

We had to be patient and wait for permits and asbestos tests to be done before the professionals could get into the new building and make our vision a reality.  The new building is being designed to fit into the current neighborhood.  We have exposed some of the brick walls and uncovered hardwood floors that will be refinished.  The new building faces West and has a great mountain view from the lobby/reception area.  That’s a view we are excited to see every day & share!

We plan to have 4 rooms; 3 opatories and 1 skin care (and possible) massage room.  Skin care you ask?  I have many talents and being an Esthetician is one of my many capabilities that I’m excited to be able to share once we move.  The details are still being worked out, but we do plan on offering skin care services to include; Many types of facials, facial waxing services and others to be announced later.   It’s an exciting time for McGlone Dental Care as we make plans to expand our business and move into a new building.

We will be posting more about the remodel as it progresses. We are just at the beginning of the project now.  So stay tuned to see our progress and hear about when we will be moving to our new building!  We couldn’t be more excited to be in a neighborhood and have the opportunity to become that neighborhood’s “go to dental and skin care practice”.