When it comes to your oral healthcare, we strive to provide state-of-the-art care along with education to both our patients and community. One way we do this is by taking a moment to answer some of the questions we are most often asked about a certain topic. And one topic that almost always ignites questions is the subject of lumps and bumps in the mouth.

Help! I just found a small lump in my mouth — what should I do?
Not to alarm you, but your first priority is to contact us as soon as possible to schedule an appointment so that we can review it. Most often, we will know what it is by taking a history, knowing how long it's been there and what it looks like. Depending on what we find, we may want to take a biopsy so that we can determine exactly what it is and how we need to treat it.

What is involved in having a biopsy performed?
A biopsy is a normal and routine procedure that is used to definitively diagnose and confirm exactly what the abnormal lump, bump or other tissue is. It is typically performed with local anesthesia so that a small tissue sample can be removed without any pain for examination under a microscope. Depending on the size of the wound, it may require two to three sutures (stitches), leaving a flat and flush surface that heals in a few days to a week. The procedure usually lasts between 10 and 15 minutes with the lab results processed within a few days.

Does this mean I have cancer?
No, the chances are slim that you actually have cancer. However any change or sore in the mouth that does not heal in a week or two should be evaluated by a dentist and if necessary biopsied. If it is pre-cancerous and removed, it could save your life. The most important fact you need to remember is that no one can tell for sure what the abnormal tissue growth is until an expert in oral pathology (“patho” – disease; “ology” – study of) examines it under a microscope. While it is human nature to be concerned, until you have the facts, you are suffering needlessly.

To learn more about this topic, continue reading the Dear Doctor magazine article “Common Lumps and Bumps In The Mouth.” Or you can contact us today to schedule an appointment to discuss your specific questions so that we can put your mind at ease.

We'd like to take a moment to clarify why it is so important to wear the retainer(s) given to you after your orthodontic treatment. These devices, which literally “retain” your teeth in their new and improved positions, are not just for kids. Anyone who has recently had their teeth moved through orthodontics needs to wear them for the prescribed length of time. Here's why:

Though your teeth may now look perfectly aligned, research has shown that there is no “right” position for your teeth to be in that can assure they don't move again — no matter what age you are when treated for malocclusion (“mal” – bad; “occlusion” – bite). In fact, most people will see changes to their bite and tooth alignment as they get older, with or without orthodontic treatment.

For one thing, there is a natural tendency for bottom front teeth to undergo a gradual “uprighting” with age. This can cause them to crowd as they move toward the tongue. And it happens regardless of whether wisdom teeth are present.

In the case of teeth that have been straightened recently, a type of “memory” of their original position may cause them to drift back to it. This tendency gradually lessens, but it may be a problem for up to 18 months.

That's why it's crucial to follow our instructions for wearing retainers. Keep in mind that the plan we have given you is designed to achieve the best possible results in your individual case. Some people will need to wear retainers 24 hours per day, some just at night, and still others on an as-needed basis. You may have received a removable retainer or one that is secured to the back of your teeth. The important thing is to secure the results you've worked so hard to achieve.

If you have any questions about orthodontic retainers, please contact us, or schedule an appointment for an orthodontic consultation.

You can read more about this topic in the Dear Doctor magazine article “The Importance of Orthodontic Retainers.”

A pregnant woman has a lot to think about while preparing to welcome a new member of her family. It's important to think about her oral health as well. She is sharing her body with the developing infant, so problems with her health — including her dental health — can affect the baby. The following facts will help you understand the relationship between oral health and pregnancy.

1. A baby's primary (baby) teeth begin to form during the sixth week of pregnancy. They begin to form their enamel (the hard outer layer of the teeth) and dentin layer (just under the enamel) at about the third or fourth month. The calcium, phosphorous, and protein that are needed for these structures must all be provided by the mother's diet.
2. A good diet for a pregnant mother, in order to provide for both her needs and those of the fetus (the developing baby), includes whole grains, fruits, vegetables — including green leafy vegetables — proteins and dairy products. A doctor may also recommend iron and/or folic acid supplements.
3. If the mother's diet does not provide enough calcium for the baby's bones and teeth, it will come from calcium stored in her bones — not from her teeth. The old idea that a mother's teeth lose calcium during pregnancy has been found to be a myth.
4. Progesterone, a normal female hormone, is elevated during pregnancy. This hormone stimulates production of prostaglandins, substances that cause inflammation in gum tissues if the bacteria that cause periodontal (gum) disease are present. The resulting swelling, redness, and sensitive gum tissues, called pregnancy gingivitis, are common during the second to eighth months of pregnancy.
5. The bacteria involved in periodontal disease can affect whole body conditions such as heart disease and strokes, diabetes, and respiratory diseases. The inflammation resulting from such bacteria can also cause premature delivery (birth before 37 weeks of pregnancy) or low birth weight in the baby.
6. Periodontal disease is also related to pre-eclampsia, or high blood pressure, during pregnancy.
7. Dental x-rays do not expose the mother to very high radiation, but in any case every precaution is taken to minimize exposure to the fetus. These include a leaded apron that shields the baby from exposure.
8. Most drugs commonly used in dentistry, including local anesthetics, can safely be given to pregnant women without affecting the fetus. However, it is important to let your dentist know you are pregnant before embarking on any treatment to make sure anything that is done will be safe for the fetus and its developing teeth.

Contact us today to schedule an appointment to discuss your questions about pregnancy and your oral health. You can also learn more by reading the Dear Doctor magazine article “Pregnancy and Oral Health.”

Tooth decay is not trivial. It's a worldwide epidemic, one of the most common of all diseases — second only to the common cold. It affects more than one fourth of U.S. children of ages 2 to 5 and half of those 12 to 15. Among adults, tooth decay affects more than ninety percent of those over age 40.

Prevention of cavities starts with a healthy diet and effective brushing and flossing, but it is much more complex than that. Three strategies for reducing dental caries (tooth decay) include:

Protect with Fluoride and Sealants
This works best when fluoride is applied to the crystalline coating of your child's teeth just after they push through the gums (erupt). The fluoride becomes incorporated into the tooth's surface and acts as a barrier to decay. Studies have shown that low doses of fluoride are safe and effective.

Dental sealants are used as a companion to fluoride because they seal tiny pits and fissures in the tooth's structure, creating an even stronger barrier.

Modify Oral Bacteria
Every mouth contains bacteria, no matter how well you clean your teeth. Not all bacteria cause tooth decay. The problem bacteria are those that produce acid as a byproduct of their life processes. We can identify acid-producing bacteria in your mouth, you can reduce their concentrations using antibacterial mouthrinses such as chlorhexidine, and pH neutralizing agents (substances that reduce the amount of acid).

Reduce Sugars in Your Diet
Bacteria in your mouth ferment sugars and other carbohydrates, producing acids that eat into the mineralized outside structure of your teeth, the enamel. So eating fewer sugars — particularly added sugars such as those in juices, sodas, candy and other sweets — will help prevent decay. Your total sugar intake should be less than fifty grams, or about ten teaspoons, per day. If you begin to read labels showing sugar content of common foods, you may be surprised at the amount you consume without knowing it.

If you must snack between meals, non-sugary snacks like raw vegetables and fresh fruits create a better environment for your teeth.

Xylitol, an “alcohol sugar” used in some chewing gums and dental products, has been shown to reduce decay-producing bacteria.

Try these easy strategies to keep your teeth healthy and functional throughout your lifetime.

Contact us today to schedule an appointment to discuss your questions about tooth decay. You can learn more by reading the Dear Doctor magazine article “Tooth Decay.”

Dentistry has ventured into the new area of sleep medicine by helping snorers — and their exasperated sleeping partners — with custom-made anti-snoring devices. These oral appliances, which resemble orthodontic retainers or sports mouthguards, keep the snorer's airway clear and the bedroom quiet. To see how they work, you have to understand the mechanics of snoring.

Snoring occurs when the upper airway (back of the throat) becomes blocked by the tongue or other soft-tissue structures, such as large tonsils or a long soft palate. The vibrating of these obstacles creates the sound we call snoring.

Snoring is often worse when sleeping on one's back because that position encourages the lower jaw to fall back and the tongue to close off the airway. This is where Oral Appliance Therapy comes in. These custom-fitted devices are designed to keep the upper airway open during sleep by pulling the lower jaw forward, which in turn brings the tongue away from the throat. Dentists, and our office in particular, are the only source for Oral Appliance Therapy.

People who snore should have a thorough examination to rule out Obstructive Sleep Apnea (OSA), a potentially dangerous condition in which airflow can be cut off completely for 10 or more seconds (“a” – without; “pnea” – breath), reducing blood-oxygen levels. Chronic, loud snoring is a common finding with OSA.

Please remember that sleep is an integral part of health and well-being. In fact, we spend about a third of our lives doing it. If you are snoring or have any sleep-related breathing disorders that are waking you or your bed partner, be sure to tell our office. There are plenty of examples of the havoc wreaked by sleep-deprived individuals. Remember the Exxon Valdez?

If you have any questions about Oral Appliance Therapy, please contact us or schedule an appointment for a consultation.

To learn more about the topic of oral appliance therapy, please see the Dear Doctor magazine article “Sleep Disorders & Dentistry.”