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Your Dental Visit

When you first visit a new dentist, part of your initial exam is an assessment of your "bite" - the way teeth meet as the jaws close. Later, after a filling or placement of a dental crown, your bite will be tested again to be sure the tooth restoration fits well with other teeth. Nearly all dental patients have "been there." And there's good reason for this attention to bite.

Chewing, tooth wear and joint function all depend on the balanced opposition of teeth in each jaw. Any disruption of a good bite, either by broken, loose, or lost teeth, is trouble in need of repair. In the worst-case scenario - the jaws themselves present skeletal problems - orthodontic treatment is considered. However, most malocclusions (bad bites) are treatable right in your dentist's office.

Your dentist will first locate ill-fitting teeth by routine bite analysis. You will bite down on a sheet of special paper that marks teeth with uneven wear. If this doesn't tell your dentist enough, he or she may take impressions, from which study models are built. This gives your dentist a very visual demonstration of what's wrong.

High points in enamel that interfere with normal contact may be filed away. Eroded fillings call for replacements. Lost teeth need a bridge or dental implants to prevent opposing teeth from overgrowth. There are any number of solutions to a bad bite, all important to your dental health.

Anytime you notice a change in your chewing habits, or feel more pressure than usual on a solitary tooth, bring it to your dentist's attention. You'll notice the abnormality, maybe before your dentist detects it. Since you'll be working together, tell your dentist your suspicions and, if it's broken, it can be fixed.

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How To Stop Dry Mouth: What You Should Know

Saliva, which contains essential protein molecules, electrolytes, and minerals, is critical to good oral dentistry health. Saliva lubricates and cleanses the mouth, preserves and bathes tooth structure, neutralizes acids that cause cavities, limits growth of bacteria, viruses, and fungi, dissolves and breaks down food, assists with taste, keeps the mouth moist (no dry mouth which helps with speaking and eating), and facilitates the retention of dentures.

Research has shown that healthy, unmedicated older adults do not have any significant decrease in saliva flow. Loss of saliva and dry mouth are not the result of normal aging, but are instead associated with illness, disease, medication treatments, and medication.

Reduced saliva flow increases the harmful effects of the organisms of the mouth, causing dental cavities, bleeding gums, plaque, burning mouth, pain, soft tissue infections, and cracks. In addition, an individual may have difficulty speaking, tasting, and swallowing food. Dentures do not fit well or feel comfortable when saliva is reduced.

Older adults take many over-the-counter and prescription medications for chronic medical conditions and disorders. For many of these medications, decrease in saliva flow is a common side effect. In fact, over 500 prescriptions and over-the-counter medications cause dry mouth (xerostomia). The medications most often associated with dry mouth are:

• tricyclic antidepressants
• antipsychotics
• antianxiety
• antihistamines
• decongestants
• antihypertensives
• diuretics
• antiparkinsonism
• anticholinergics

Although medication use is frequently associated with dry mouth, certain medical diseases, conditions, or treatments reduce saliva flow. Examples are

• head and neck radiation treatment for cancer
• Sjögren's syndrome
• poorly controlled diabetes
• bone marrow transplantation
• HIV
• cystic fibrosis
• scleroderma
• amyloidosis
• sarcoidosis
• vitamin deficiency
• thyroid disorders
• mental stress and depression

By Denise J. Fedele, DMD, MS