My Blog

Posts for: August, 2021

By Trish Palmeri, DDS
August 30, 2021
Category: Oral Health
Tags: dry mouth  
ChronicDryMouthIsMoreSeriousThananUnpleasantFeeling

It's normal to have occasional mouth dryness—that "cotton mouth" feeling when you first wake up or after eating a spicy meal. It soon dissipates, though, leaving you no worse for wear other than the memory of an unpleasant sensation.

For some, though, the unpleasant sensation becomes a chronic condition known as xerostomia, in which their mouth feels dry most of the time. And, it can have far-reaching consequences beyond a mere irritation if not treated.

Among the numerous causes for xerostomia, the most common appears to be over-the-counter and prescription medication. An estimated five hundred medications have dry mouth as a potential side-effect, from antihistamines to antidepressants. And because people over 65 are more likely to take medications, they also have a high occurrence of xerostomia.

A person with certain systemic diseases like Parkinson's Disease or undergoing radiation or chemotherapy for cancers of the head and neck may also encounter dry mouth. For example, an autoimmune disease called Sjögren's syndrome, primarily affecting postmenopausal women, can dry out the mouth's mucous membranes.

Chronic dry mouth isn't normal, and often a sign of a health problem that should be examined. And it can lead to more problems with your oral health. Because dry mouth is most likely a reduction in saliva, which helps buffer decay-causing acid and provides antibodies to fight bacteria, having less of this vital fluid can increase your risk for both tooth decay and gum disease.

So, what can you do if you're plagued by persistent dry mouth? If you suspect your medications may be a factor, talk with your doctor about whether one of them may be the underlying cause for your symptoms. You may be able to switch to an alternate medication without dry mouth side-effects.

You can also increase your water intake during the day, including drinking more before and after taking medication. And there are a number of products like the artificial sweetener xylitol found in gums and candies that can boost saliva. Your dentist may also be able to recommend products that increase saliva.

Above all, be sure you keep up daily brushing and flossing, as well as regular dental cleanings. Taking care of chronic dry mouth could help you avoid dental problems later.

If you would like more information on preventing and treating chronic dry mouth, 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 “Dry Mouth.”


By Trish Palmeri, DDS
August 20, 2021
Category: Oral Health
Tags: oral hygiene  
ManagingOralHealthIsanImportantPriorityforHIV-AIDPatients

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.”


By Trish Palmeri, DDS
August 10, 2021
Category: Dental Procedures
Tags: dental implants  
DentalImplantsCouldHelpPreserveBoneAfterToothLoss

Losing teeth can make it more difficult to eat, not to mention the effect it can have on your smile. But that could be just the beginning of your problems. Missing teeth can contribute to extensive bone loss within your jaws and face. Here's why.

Bone is like any other living tissue—cells develop, function and eventually die, and new cells take their place. Forces generated during chewing stimulate this new growth, helping the jawbone maintain its normal volume and density.

But you lose this stimulus when you lose teeth. This can cause a slowdown in bone cell regrowth that can eventually diminish bone volume. And it can happen relatively quickly: you could lose a quarter or more of jawbone width around a missing tooth within a year.

As this loss continues, especially in cases of multiple missing teeth, the bone can eventually erode to its base level. This loss of dental function can make chewing more difficult, place more pressure on the remaining teeth and adversely affect facial appearance. It could also prevent an implant restoration to replace missing teeth.

Dentures and other forms of dental restoration can replace missing teeth, but not the chewing stimulus. Dentures in particular will accelerate bone loss, because they can irritate the bony gum ridges they rest upon.

Dental implants, on the other hand, can slow or even stop bone loss. Implants consist of a metal post, typically made of titanium, imbedded into the jawbone at the site of the missing tooth with a life-like crown attached. Titanium also has a strong affinity with bone so that bone cells naturally grow and adhere to the implant's surface. This can produce enough growth to slow, stop or even reverse bone loss.

This effect may also work when implants are combined with other restorations, including dentures. These enhanced dentures no longer rest on the gums, but connect to implants. This adds support and takes the pressure off of the bony ridge, as well as contributes to better bone health.

If you've lost a tooth, it's important to either replace it promptly or have a bone graft installed to help forestall any bone loss in the interim. And when it's time to replace those missing teeth, dental implants could provide you not only a life-like solution, but a way to protect your bone health.

If you would like more information on dental implants, 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 “The Hidden Consequences of Losing Teeth.”