Dealing with Acid Reflux (GERD)? Watch Your Teeth!
So, you have just come home from a great night of Mexican food – the bean dip was fabulous, chips and salsa were great, and the enchiladas, beyond compare! Now you are dealing with that familiar burning pain in your chest, those feelings of regurgitation: the symptoms of Gastroesophageal Reflux Disease (GERD). What you may not realize is that the same acid that is causing you such discomfort may actually be eating away at the enamel of your teeth, making you susceptible to tooth decay.
GERD is a common problem today and occurs when ring of muscle between the esophagus and the stomach fails to close, allowing the contents of the stomach to flow back up into the esophagus. The high acidity of the stomach contents is what 
causes the burning sensation in the chest. Eventually the acid can eat away at the lining of the esophagus, producing even more serious complications.
What effect does all this extra acid have on your mouth? Saliva in your mouth is designed to maintain the proper pH balance (levels of acidity or alkalinity) in your mouth. For example, eating sugar causes the acid level of your mouth to rise, putting your teeth at risk. The saliva in your mouth works to restore the balance after sugar consumption. Imagine the effect of continual acid coming up from your stomach due to GERD and entering your mouth – the acidic assault should make dental news headlines as much as the warnings about highly acidic foods, drinks, and sugar.
Acid eats at the enamel that protects your teeth. When the enamel begins to wear off, the sensitive inner layer of your teeth, called dentin, is exposed. This can produce symptoms of tooth erosion, which include:
â— Toothache 
â— Bad breath
â— Spots on teeth
â— Sensitivity to hot, cold, or sweet
Tooth decay can lead to more serious dental issues which could lead to permanent damage or loss of teeth requiring the care of cosmetic dentistry. Because of the serious effects of excess acid in the mouth NY dental professionals recommend following a strict regimen to deal with GERD quickly. Certain dietary and lifestyle choices contribute to GERD, including eating chocolate, peppermint, fried or fatty foods, coffee, and alcoholic beverages. Smoking has also been shown to relax the muscle that contributes to GERD.
If you have been diagnosed with GERD, or you are experiencing the symptoms, you should let your dentist know. If you have already suffered damage to your teeth, you may want to visit a cosmetic dentist. Manhattan area dentists are well equipped both to protect your teeth from damage, and to help you recover your beautiful smile.
What Exactly Are Teeth Anyway?
With a few exceptions, teeth don’t heal by themselves. Every cartoon with an elderly character will show them taking out their false teeth. For many Americans, teeth simply don’t stand the test of time. They contain one of the few tissues in the body that is finite. Most people have heard of enamel from toothpaste ads, but that tissue is only 1 of the 4 that comprise a tooth. Enamel, dentin, cementum, and pulp are the four major tissues that round out a mouth full of pearly whites. Most of the previous blog entries talk about a specific dental disorder or problem and offer remedies to it. This one will be a bit of primer, a basic introduction to what teeth are, and what can go wrong for each part.
Dental pulp is soft tissue in the center of the tooth; it contains the nerve, blood and lymphatic vessels, and connective tissue. The pulp forms the main bulk, or core, of each tooth and extends almost the entire length of the tooth. It is covered by enamel on the crown portion and by cementum on the roots. The pulp consists of cells, tiny blood vessels, and a nerve and occupies a cavity located in the center of the tooth. If the pulp becomes infected, it is removed by root canal.
Cementum is the thin surface layer of bone like material covering the tooth’s root. It is yellowish and softer than either dentin orenamel. The fibers of the periodontal membrane, which holds the tooth in lace, are embedded in cementum. Deposition of cementum continues throughout life, especially in response to stresses. When the tooth’s crown is gradually worn down, new cementum is deposited on the roots so that the tooth can slowly rise to maintain a good bite.
Elephant tusks (Ivory) are solid dentin. Ivory was the preferred material for billiard balls, as dentin has an elastic quality
Dentin is the yellowish tissue that makes up the bulk of all teeth. It is harder than bone but softer than enamel and consists mainly of apatite crystals of calcium and phosphate. Sensitivity to pain, pressure, and temperature is transmitted via the tubes to and from the nerve in the pulp. Secondary dentine, is a less well-organized form of tubular dentine, is produced throughout life as a patching material where cavities have begun, where the overlying enamel has been worn away, and within the pulp chamber as part of the aging process.
Veneers are often the only solution to severely worn enamel.
Enamel is the hardest tissue in the body. It covers part of or the entire crown of the tooth. Enamel is not living and contains no nerves. The thickness and density of enamel vary over the surface of the tooth; it is hardest at the biting edges, or cusps. Normal enamel may vary in color from yellow to gray. The surface enamel is harder and contains more fluoride than the underlying enamel. It is very resistant to tooth decay. Enamel is also finite. Worn enamel is a symptom of most dental problems: erosion, attrition, abrasion, and the first part of the tooth to decay from cavities. A loss of enamel over time can lead to transparent and fragile teeth. Sensitive teeth can be relieved with desensitizing toothpastes, which often contain ingredients such as potassium nitrate, potassium chloride or potassium citrate seem to make the tooth less receptive to pain. In the case of severely worn enamel, veneers are often the only option.
This concludes the reading for dental anatomy 101. I hope that it provides a greater understanding to the past and future blog entries. And if you didn’t much care for the anatomy of your chompers, there is good news. With good dental hygiene, the dentist won’t have to bother you with any of these terms and explanations; you can just take a free toothbrush and be on your way.
Healthy Mouth, Happy Heart!
Cardiovascular disease claims the lives of about 2,400 people every day. New medical guidelines published in the American Journal of Cardiology encourage medical and dental professionals to cooperatively diagnose and manage patients who are at risk for heart disease and stroke. According to the American Academy of Periodontology, healthy gums can ward off heart disease and prevent you from becoming a statistic.
Most people have experienced gingivitis, which is the mildest form of gum disease. If gingivitis is left untreated, it can progress and involve the deeper tissues surrounding the teeth. Gum disease leads to inflammation and bleeding, which allows oral bacteria to access the bloodstream. Research has suggested that some of these bacteria can cause blood clots in the arteries, which may contribute to blockages that lead to stroke.
Research conducted at several major universities, including the State University of New York at Buffalo, has concluded that inflammation is a common factor underlying both cardiovascular and periodontal disease. What does this mean for people living with heart disease or those at risk? Ultimately, controlling both conditions simultaneously leads to improved overall health for patients. Don’t be surprised if your dentist refers you to a cardiologist, or if your physician sends you to the dentist’s office for an evaluation.
Are you at risk for developing heart disease? There are a number of steps you can take to positively impact your health:
- If you take Statin – type medications for high cholesterol, take them consistently.
- Keep up with your medical and dental checkups.
- Eat a healthy diet. It’s good for your gums and your heart.
- Tell your dentist if you are being treated by a physician.
- Brush and floss regularly, and have regular dental cleanings.
- If your dentist tells you that you have periodontal disease, follow through with the recommended treatment… it could save your life!
Most people realize that their dental checkups are important, but people who have or are at high risk for periodontal conditionsshould be seen for more frequent exams and cleanings? Sometimes this additional service is covered by insurance and sometimes it isn’t – regardless, rest assured that your dentist is making recommendations that are in your best interests. We look forward to seeing you at your next visit and would be happy to help answer any questions you may have about managing your risks for cardiovascular or periodontal disease, and improving your overall health.
Grinding and Clenching
Unexplained soreness of the jaw or neck muscles and persistent headaches could be an indication that
you are suffering from bruxism, or grinding and clenching of the teeth. The problem is treatable and more common that you may realize, even though most people are completely unaware that they do it.
Frequently, people who clench and grind their teeth do so during sleep, and learn about it from their sleep partner. Sometimes bruxism is discovered when clients ask their dentist about pain or an odd sensation that their teeth are loose. However, the habit can create a long list of symptoms from mild to significant and can be quite destructive to the teeth themselves as well as to supporting structures, causing the gum recession and bone loss which can eventually cause teeth to be lost. Among people who chronically grind, fractured teeth and damage to the nerves which can require root canal therapy are common. Unfortunately, this treatable behavior can exist for a long time before it is diagnosed, because many of the symptoms can be easily overlooked or ignored, and may be thought to have another cause. Consider bringing to your dentist’s attention any of the following symptoms:
Earache
Headaches or Migraines
Loose teeth
Changes in the way your teeth fit together
Sensitive teeth
Tinnitus
Gum recession
Neck pain
Insomnia
Soreness of the jaw or neck
Bruxism is thought to run in families but it is also be a common response to stress, anxiety and depression. Other causes of the habit include bite problems, eating disorders, excessive alcohol use, and medical conditions such as Parkinson’s disease and obsessive compulsive disorder. Ideally, treating bruxism involves managing or eliminating the cause but obviously, this is not always possible and treatment for the behavior and its symptoms often focuses on interruption of the grinding, relieving stress on the jaw joint and and preventing damage to the teeth .
Careful examination of the teeth may reveal fine cracks, wear facets in the tooth anatomy, and otherwise unexplained changes in the bone around the teeth. These findings, along with a thorough medical history will help your dentist diagnose bruxism and suggest a treatment plan. Most frequently, a hard
plastic occlusal splint is custom made to fit the teeth. Worn while sleeping, this “nightguard †protects the teeth by covering their surface and enabling them to glide easily. The night guard is form-fitting, covers all of the upper teeth and prevents them from shifting over time which ultimately prevents gradual changes in how teeth fit together. A different type of FDA approved appliance called an NTI (Nociceptive Trigeminal Inhibition system) fits only over the upper front teeth and prevents the back teeth from touching at all. Other treatment options including biofeedback, hypnosis, dietary supplements and (rarely) Botox injections are less well known and have had mixed or questionable results.
People who have been grinding their teeth for a long time may have significantly damaged their teeth; in severe cases they can even be worn down to the gum line. The damage may have left teeth sensitive and susceptible to cavities, and may have even caused changes in the shape of your face or the way you feel about your smile. The first step in addressing these issues is always to treat the bruxism so that no further damage occurs; and the good news is that there are several cosmetic options that can improve the function of your teeth as well as their appearance. Your cosmetic dentist may suggest crowns, veneers or bonding as part of your complete treatment plan.
Unexplained symptoms may not be as mysterious as you think… why not talk to your dentist about bruxism and what treatment options may be right for you? You deserve a beautiful, pain-free smile!
