What does November make you think of? Pumpkins? Turkeys? Dry leaves and frosty mornings? How about cigarette butts?

If you’re wondering about the last item, remember that November 15 is the date of the Great American Smokeout—a day set aside for those who want to take the first steps toward quitting the tobacco habit. While the percentage of smokers in the U.S. has dropped to less than 16% in recent years, according to the American Cancer Society there are still some 38 million Americans who smoke cigarettes. Smoking causes over 480,000 deaths every year, and is the leading preventable cause of death in the U.S.

Even if it doesn’t kill you, the effects of tobacco use can be devastating to your entire body—including your mouth. Whether you smoke cigarettes or use chewing tobacco, your risk of oral cancer is greatly increased, as is your chance of developing periodontal (gum) disease. What’s more, smoking can mask the symptoms of gum disease, so your condition is actually worse than it appears. Severe gum disease is one reason why smokers tend to lose more teeth than non-smokers.

In addition, because smoking interferes with the natural healing process, smokers have a much greater chance of dental implant failure. Tobacco use also can lead to increased amounts of plaque, which results in tooth decay and other oral health problems. It also stains your teeth, reduces your senses of smell and taste, and gives you bad breath.

Ready to quit yet? If so, there are lots of resources to help you on the road to a healthier life. The American Cancer Society, sponsor of the Smokeout, can help you make a plan to quit tobacco—and stay off it. It’s not easy, but over a million Americans do it every year. See their website for more information, plans and tips on quitting. Your health care professionals are also a great source of information and help when it’s time to get off the tobacco habit. Feel free to ask us any questions you may have.

And here’s the good news: The moment you quit, your body begins to recover from the effects of tobacco use. In just one year, you’ll have cut your risk of heart attack and stroke in half. After 5 to 15 years, your risk of stroke, coronary heart disease, and several other conditions is the same as someone who has never smoked.

If you have questions about smoking and oral health, please contact our office or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Smoking and Gum Disease” and “Dental Implants and Smoking.”

Not coincidentally, GERD Awareness Week overlaps with the Thanksgiving holiday. Many people get acid indigestion from time to time, especially during this month of major feasting, but if you suffer from more than occasional acid reflux, you may be among the 20 percent of U.S. adults with gastroesophageal reflux disease, or GERD. For many individuals, painful heartburn often accompanies acid reflux; however, for others there are few or no symptoms. In the latter situation, dentists may be the first to suspect GERD based on what we see during a regular dental exam.

With GERD, acid washes up from the stomach into the esophagus or throat, and even into the mouth. If the condition is not treated, the repeated contact with acid can lead to ulcers and cause pre-cancerous cell changes along the esophagus lining. In addition, the acids can eat away at tooth enamel and harm the soft tissues of the mouth, which may result in severely eroded teeth and chronic gum disease. Unfortunately for those who have relatively minor symptoms, GERD may go undetected until serious damage has been done. For this reason, diagnosis and treatment of GERD is very important.

You can play a big role in managing your GERD symptoms. Besides taking any over-the-counter or prescription medication your doctor recommends, you can help control acid reflux by eating smaller meals, avoiding foods and beverages that trigger heartburn, refraining from eating within three hours of bedtime, and resisting the urge to recline right after eating. Also, quitting smoking and taking off extra weight can help greatly.

Further, it is important to take steps to protect your teeth if you suffer from GERD. Here are some tips:

• Neutralize acid by chewing on an antacid tablet or rinsing your mouth with half a teaspoon of baking soda mixed into a cup of water.
• Don't brush your teeth immediately after an episode of acid reflux, as this could damage the weakened tooth enamel. Instead, rinse your mouth with water to dilute the acid and wait an hour before you brush to allow your saliva to rebuild the minerals on the surface of your teeth.
• Schedule regular dental visits to monitor the health of your teeth and gums. Depending on your specific situation, we may recommend a particular treatment to help strengthen your teeth.

Our goal is to help you preserve your teeth for life, so be sure to tell us if you have been diagnosed with GERD or any other medical condition. If you have questions, contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “GERD and Oral Health” and “Tooth Decay: How to Assess Your Risk.”

The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.

In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?

The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.

Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.

So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”

Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.

If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”

If you’re thinking about getting dental implants, you’re in good company. Dentists have placed more than 3 million of these popular devices since their introduction in the early 1980s.

But if you have multiple missing teeth, you might think the cost of all those individual implants could put them out of your league. Yes, replacing multiple teeth with individual implants can be quite expensive—but implant technology isn’t limited to one tooth at a time. A few well-placed implants can impart their proven durability and stability to other types of restorations.

For example, we can incorporate implants into a bridge for a series of missing teeth. Conventional bridges are normally fixed in place by altering and then crowning natural teeth on each side of the missing teeth gap with a fixed row of prosthetic (false) teeth in the middle to fill it. Instead, two implants placed at the ends of the gap can support the bridge rather than natural teeth. This not only provides greater stability for the bridge, it also avoids permanent altering the natural teeth that would have been used.

Implants can also support a fixed bridge to restore complete tooth loss on a jaw. The new bridge is attached to a few strategically placed implants along the jaw line to equally distribute biting forces. This can result in a strong hold with excellent durability.

We can also use implants to improve traditional dentures. Dentures normally rest directly on the gums’ bony ridges, depending on a snug fit for stability. But bone loss, a natural consequence of missing teeth, can still occur while wearing dentures, which may in fact accelerate the rate of loss due to the appliance’s constant pressure and friction against the gums.

Instead, just a few implants placed along the jaw can, with attachments built into the denture, hold it securely in place. This not only decreases the pressure on the gums, but the natural bone growth that occurs around the implant may even deter bone loss.

Depending on your situation, there could be a viable restoration solution involving implants. Visit our office for a complete examination and evaluation to see if implants could help change your smile forever.

If you would like more information on implant restorations, 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 “Dental Implants 101: the Most Significant Innovation in the Past Century.”