Dr. Bob's Blog

Posts for: July, 2021

DontIgnoreChronicMouthBreathing-ItCouldDisruptJawDevelopment

Although the air we breathe has one destination—the lungs—it can arrive there via two possible routes: through the nose or the mouth. In terms of survival, it matters little through which path air travels—just so it travels one of them!

In terms of health, though, breathing through the nose is more beneficial than through the mouth, and is our default breathing pattern. The nasal passages filter minute noxious particles and allergens. Air passing through these passages also produces nitric oxide, a gaseous substance that relaxes blood vessels and improves blood flow.

On the other hand, chronic mouth breathing during childhood can impact oral health. While breathing through the nose, the tongue rests against the roof of the mouth and thus becomes a mold around which the upper jaw and teeth develop. But mouth breathing places the tongue on the lower teeth, which deprives the upper jaw of support and can lead to an abnormal bite.

So why would people breathe through their mouth more than their nose? Simply put, it's more comfortable to do so. Because breathing is so critical for life, the body takes the path of least resistance to get air to the lungs. If obstructions caused by allergic reactions or swollen tonsils or adenoids are blocking the nasal pathway, the action moves to the mouth.

But chronic mouth breathing can often be treated, especially if addressed in early childhood. This may require the services of an ear, nose and throat specialist (ENT) and possible surgical intervention to correct anatomical obstructions. It's also prudent to have an orthodontist evaluate the bite and institute corrective interventions if it appears a child's jaw development is off-track.

Even after correcting obstructions, though, it may still be difficult for a child to overcome mouth breathing because the body has become habituated to breathing that way. They may need orofacial myofunctional therapy (OMT), which retrains the muscles in the face and mouth to breathe through the nose.

Chronic mouth breathing isn't something to be ignored. Early intervention could prevent future oral and dental problems and help the person regain the overall health benefits for nose breathing.

If you would like more information on overcoming chronic mouth breathing, 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 Trouble With Mouth Breathing.”


DentalTreatmentDependsonWhatsReallyCausingYourToothPain

Not all toothaches are alike: Some are sharp and last only a second or two; others throb continuously. You might feel the pain in one tooth, or it could be more generalized.

Because there are as many causes as there are kinds of dental pain, you can expect a few questions on specifics when you come to us with a toothache. Understanding first what kind of pain you have will help us more accurately diagnose the cause and determine the type of treatment you need.

Here are a few examples of dental pain and what could be causing it.

Temperature sensitivity. People sometimes experience a sudden jolt of pain when they eat or drink something cold or hot. If it only lasts for a moment or two, this could mean you have a small area of tooth decay, a loose filling, or an exposed root surface due to gum recession. If the pain lingers, though, you may have internal decay or the nerve tissue within the tooth has died. If so, you may require a root canal treatment.

Sharp pain when chewing. Problems like decay, a loose filling or a cracked tooth could cause pain when you bite down. We may be able to solve the problem with a filling (or repair an older one), or you may need more extensive treatment like a root canal. In any event, if you notice this as a recurring problem, don't wait on seeing us—the condition could worsen.

Dull pain near the jaw and sinuses. Because both the jaws and sinuses share the same nerve network, it's often hard to tell where the pain or pressure originates—it could be either. You may first want to see us or an endodontist to rule out tooth decay or another dental problem. If your teeth are healthy, your next step may be a visit with a physician to examine your sinuses.

As you can see, tooth pain can be a sign of a number of problems, both big and small. That's why it's important to see us as soon as possible for an examination and diagnosis. The sooner we can treat whatever is causing the pain, the sooner your discomfort will end.

If you would like more information on treating dental pain, 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 “Tooth Pain? Don't Wait!


GumSwellingCanHappenWithBraces-HeresHowtoAvoidIt

A few months into wearing braces you may notice your gums are swollen. It's likely you've developed periodontal (gum) disease.

Gum disease is a bacterial infection that usually begins with dental plaque. This thin, accumulated biofilm on teeth is filled with bacteria that cause dental disease. The more of it that remains on your teeth, the higher your risk for a gum infection.

In addition to regular dental cleanings, the best way for a person to reduce their gum disease risk is to remove plaque on a daily basis through brushing and flossing. Unfortunately, wearing braces complicates this: The brackets and wires affixed to your teeth can get in the way of your toothbrush and regular dental floss. As a result, you can easily miss plaque hidden around these bits of hardware.

Aside from gum disease, the braces themselves can irritate your gums. This irritation inflames the gums and may even cause more tissue to grow. Compound this overgrowth with a possible gum infection and it's no wonder your gums are severely swollen.

To lessen the chances of swollen gums with braces, you'll need to beef up your daily hygiene efforts. Simply put, it will typically take more time than normal to thoroughly clean around your braces. A few specialized tools, though, might make it easier.

An interproximal brush with a narrower head than a regular toothbrush is useful for accessing tight places around brackets. And a floss threader or a water flosser (which uses pressurized water to loosen and remove plaque) may help you better maneuver around wires to remove plaque between teeth.

Keeping your teeth clean as possible will certainly help you avoid gum swelling due to disease. But swelling from tissue overgrowth may not be resolved until your braces come off. In severe cases, it may even be necessary to remove the braces to treat the gums before resuming orthodontic treatment.

In any case, be as thorough as possible with your oral hygiene efforts during orthodontics and see your regular dentist for cleanings every six months. When you have completed orthodontic treatment, cleanings every six months are usually recommended. It's the best way to keep your gums healthy while you're wearing braces.

If you would like more information on dental care while wearing braces, 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 “Gum Swelling During Orthodontics.”