Posts for category: Oral Health
Considering all the intensive conditioning, practice and training they do, most people would expect elite athletes to be… well… healthy. And that’s generally true — except when it comes to their oral health. A major study of Olympic contenders in the 2012 London games showed that the oral health of athletes is far worse than that of the general population.
Or to put it more succinctly: “They have bodies of Adonis and a garbage mouth.”
That comment, from Dr. Paul Piccininni, a practicing dentist and member of the International Olympic Committee’s medical commission, sums up the study’s findings. In terms of the numbers, the report estimates that about one in five athletes fared worse in competition because of poor oral health, and almost half had not seen a dentist in the past year. It also found that 55 percent had cavities, 45 percent suffered from dental erosion (excessive tooth wear), and about 15 percent had moderate to severe periodontal (gum) disease.
Yet, according to Professor Ian Needleman of University College, London, lead author of the study, “Oral health could be an easy win for athletes, as the oral conditions that can affect performance are all easily preventable.”
Many of the factors that had a negative impact on the athletes are the same ones that can degrade your own oral health. A follow-up paper recently published in the British Journal of Sports Medicine identified several of these issues. One is a poor diet: The consumption of excessive carbohydrates and acidic foods and beverages (including sports drinks) can cause tooth decay and erosion of the protective enamel. Another is dehydration: Not drinking enough water can reduce the flow of healthy saliva, which can add to the damage caused by carbohydrates and acids. The effects of eating disorders (which are more commonly seen in certain sports, such as gymnastics) can also dramatically worsen an individual’s oral health.
Sound familiar? Maybe it’s because this brings up some issues that dentists have been talking about all along. While we don’t mean to nag, this study does point out that even world-class competitors have room for improvement with their oral hygiene. How about you? Whether you’re a triathlete in training, a weekend warrior or an armchair aficionado, good oral health can have a major effect on your well-being.
If you have additional questions about oral health, please contact us or schedule an appointment for a consultation. For more information, see the Dear Doctor magazine article “Good Oral Health Leads to Better Health Overall.”
When he isn’t among the ten players vying for position on the basketball court, Cole Aldrich of the New York Knicks sometimes lets his dangle behind one ear. Mason Plumlee, who plays for the Brooklyn Nets, slips his snugly inside one of his socks during off times. Other players can be seen at timeouts gnawing on them nervously, or tucking them into spandex waistbands. But when the whistle blows, they go into the mouth before the players get on the court.
We’re talking about protective mouthguards, of course. According to a recent story in the New York Times, only a handful of basketball players wore them regularly a few years ago. Today, more and more are wearing them, both in practice and during games. What’s the reason for the change?
Partly, it’s the result of better design and improved construction; today’s mouthguards are more comfortable and better-fitting than ever. Part of it comes from mounting evidence that they work: Research studies have consistently demonstrated the benefits of wearing a mouthguard — not only to protect the teeth, but also to reduce the risk of concussion. And partly, it stems from the growing acceptance that safety is an important aspect of all athletic activity.
If the pros are doing it — shouldn’t you be too? While you may think that only contact sports (such as football) are risky, the fact is that “non-contact” sports like baseball and basketball account for the majority of dental injuries. In fact, the American Dental Association recommends you wear a mouthguard when you participate in activities like handball, soccer, surfing and weight lifting — as well as boxing, skydiving, martial arts and “extreme sports” — whatever that may mean to you.
What’s the best kind of mouthguard? It’s the one that you actually wear, of course! And the most comfortable and best-fitting mouthguard is the one that’s custom-made for you by your dentist. Sure, you can pick up an off-the-shelf mouthguard at a big box store; but it can’t offer you the same level of protection and comfort you’ll get from a mouthguard that is made from a model of your own teeth. Custom-made mouthguards from your dentist are reasonably priced — and by preventing dental trauma, they can save an untold amount of hurt… both to your body and to your pocketbook.
So take a tip from the pros: Get a custom-made mouthguard, and wear it every time you play. But when you’re done playing… how about putting it away in a case?
If you would like more information about custom-made athletic mouthguards, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “An Introduction to Sports Injuries & Dentistry” and “Athletic Mouthguards.”
Many people have questions about the proper use of antibiotics — especially today, as the overuse of these medications has become a concern. It isn’t necessary for most people to take antibiotics before having a dental procedure. But for a few — notably, those with particular heart conditions and, in some cases, joint replacements — pre-medication is advisable. The question may be even more confusing now, because the standard recommendations have recently changed — so let’s try and sort things out.
First, why would anyone need antibiotics before dental treatment? Essentially, it’s because of the chance that an open wound could allow bacteria from the mouth to enter the bloodstream. For people in good health, the body is capable of quickly containing and neutralizing the bacterial exposure. But people with some types of heart disease, heart transplants, and/or total joint replacements have a greater likelihood of developing a bacterial infection, which can be dangerous — or even life-threatening. The same may be true of people whose immune systems are compromised.
At one time, people with a broad range of heart problems and artificial joints were advised to pre-medicate; today, new research indicates that fewer people need to take this step. Antibiotics are currently recommended before dental procedures if you have:
- An artificial heart valve, or a heart valve repaired with artificial material
- A history of endocarditis
- A heart transplant with abnormal heart valve function
- Cyanotic congenital heart disease (a birth defect where blood oxygen levels are lower than normal) that hasn’t been fully repaired — including children with surgical shunts and conduits
- A congenital heart defect that has been completely repaired with artificial material or with a device — but only for the first six months after the repair procedure
- Repaired congenital heart disease with residual defects, such as leakage or abnormal flow
In addition, not everyone who has an artificial joint needs antibiotic premedication. Instead, your health care providers will rely on your individual medical history to determine whether this step is required in your situation. However, having a compromised immune system (due to diabetes, cancer, arthritis, chemotherapy and other factors) is still an indication that antibiotics may be needed.
The question of whether or not to pre-medicate is an important one — so it’s vital that you share all relevant medical information with your doctors and dentists, and make sure everyone is in the loop. That way, the best decisions can be made regarding your treatment.
While you do all you can to provide your child healthy meals and snacks at home, they still face tempting choices for unhealthy fare when they’re away. Unfortunately, their school campus could be one of those places with food choices that raise their risk for dental disease.
Thankfully, that situation is beginning to change. The U.S. Department of Agriculture (USDA) issued regulations a few years ago tightening minimum health standards for snacks available on school grounds. Called the Smart Snacks in Schools initiative, it promotes whole grains, fruits, vegetables and low-fat dairy products, while discouraging snacks with empty calories, fat, sugar and excessive salt. This is good news in particular for preventing tooth decay in children and teenagers.
Unfortunately, the initiative may not go far enough. There are a few “loopholes”: it allows for chocolate milk with added sugar as long as it’s fat-free; high schools can also sell beverages like sports and energy drinks, which are low in sugar but high in enamel-harming acid. So, although the general nutrition of snacks in schools may be improving, you should still remain alert to poor choices that may fall through the cracks.
For one thing, you can advocate for better nutrition policies in your child’s school. The USDA initiative is a minimum standard — schools can exceed them and eliminate borderline snacks allowed under the federal regulations.
You can also provide your child snack alternatives to the school vending machine. A little creativity and fun can go a long way: a dash of cinnamon or parmesan cheese on popcorn instead of butter; finger sandwiches made of real cheese on whole-grain bread (with some whimsical shaping with a cookie-cutter); or bite-sized fruits and vegetables like grapes, baby carrots or nuts. The more healthy (and enjoyable) snacks you can send with them, the less chance they’ll turn to a less nutritious choice in the vending machine.
A healthier approach to snacking depends on setting good examples, providing ample selections and accentuating the positive about healthy foods. Choosing nutritious foods, at home and away, is a key building block for healthy teeth and gums.
If you would like more information on nutrition 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 “Snacking at School.”
Eating disorders cause more than psychological harm. The binge-purge cycle of bulimia or the self-starvation patterns of anorexia can also injure the physical body, especially the mouth.
For example, nine in ten people with bulimia will experience tooth enamel erosion from stomach acid entering the mouth from induced vomiting. Although purging is less frequent with anorexic patients, one in five will also develop erosion.
An eating disorder isn't the only reason for enamel erosion: you can have high acid levels from over-consuming sodas, energy drinks or certain foods, or not properly brushing and flossing every day. But erosion related to an eating disorder does produce a distinct pattern in the teeth. When a person vomits, the tongue moves forward and presses against the bottom teeth, which somewhat shields them from acid contact. This can create less erosion in the lower front teeth than in others.
Eating disorders can cause other oral effects. Stomach acid contact can eventually burn and damage the mouth's soft tissues. The salivary glands may become enlarged and cause puffiness along the sides of the face. The use of fingers or other objects to induce gagging can injure and redden the back of the throat, the tongue and other soft tissues.
It's important to stop or at least slow the damage as soon as possible. To do so requires both a short– and long-term strategy. In the short-term, we want to neutralize mouth acid as soon as possible after it enters the mouth, especially after purging. Rather than brushing, it's better to rinse out the mouth with water or with a little added baking soda to neutralize the acid. This will at least help reduce the potential damage to enamel.
In the long-term, though, we need to address the disorder itself for the sake of both the person's overall well-being and their oral health. You can speak with us or your family physician about options for counseling and therapy to overcome an eating disorder. You may also find it helpful to visit the website for the National Eating Disorders Association (nationaleatingdisorders.org) for information and a referral network.
If you would like more information on how eating disorders can affect 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 “Bulimia, Anorexia & Oral Health.”