Posts for: January, 2020
While celebrating all that a new year brings, take a moment to remember the New Year's Day birthday of a true American patriot: the legendary Paul Revere. Ironically, he became a legend some 80 years after his midnight trek to warn colonists of approaching British troops, thanks to Henry Wadsworth Longfellow's 1861 poem “Paul Revere's Ride.” He was much better known to his fellow Bostonians as a prosperous silversmith, engraver—and “artificial teeth” maker.
That's right. Among his many business endeavors, Revere's résumé also included dental prosthetics, specifically custom dentures made of ivory. For the time, his work was state-of-the-art technology that far surpassed older tooth replacement methods.
But when we compare Revere's foray into the dental arts and today's restorations, his high quality 18th Century dentures were the proverbial “horse and buggy,” while modern denture technology seems like “supersonic transport.” Not only are today's dentures made of superior materials that are more “toothlike” in appearance, the means to create them using digital technology gives wearers a more secure and comfortable fit.
The modern denture—an appliance that replaces multiple or all lost teeth—is composed of a polymer base, usually acrylic that is colored to resemble gum tissue. Attached to this base are the prosthetic (“false”) teeth that replace those lost along the jaw. These new teeth are usually made of a durable dental material like porcelain that looks and functions like real teeth.
The basic design of today's denture hasn't changed much in the last century. What has changed is our ability to create dentures that follow an individual jaw contours much more precisely. Using the latest digital technology, we're able to obtain highly accurate impressions of the mouth to guide the manufacturing process. Fit is critically important for how dentures feel and function in the mouth. If they are too loose, they become uncomfortable and limit which foods you can eat.
If that weren't enough, recent advancements with dental implants have taken dentures to an entirely new level, beyond anything imaginable in Revere's day. We're now able to create dentures that connect or are permanently affixed to implants set within the jaw, which makes them more stable and secure. An implant-supported denture also helps prevent bone loss, a weakness of traditional dentures, causing them to loosen over time.
As amazing as they are, we wouldn't have the modern version of dentures without craftsmen like Paul Revere who helped advance the cause of dental restoration. So, lift a glass of holiday cheer this season to this hero of the American Revolution—and of American dentistry.
The ongoing opioid addiction epidemic has brought together government, law enforcement and healthcare to find solutions. The focus among doctors and dentists has been on finding ways to reduce the number of opioid prescriptions.
Opioids (or narcotics) have been a prominent part of pain management in healthcare for decades. Drugs like morphine, oxycodone or fentanyl can relieve moderate to extreme pain and make recovery after illness or procedures much easier. Providers like doctors and dentists have relied heavily on them, writing nearly 260 million narcotic prescriptions a year as late as 2012.
But although effective when used properly, narcotics are also addictive. While the bulk of overall drug addiction stems from illegal narcotics like heroin, prescription drugs also account for much of the problem: In 2015, for example, 2 million Americans had an addiction that began with an opioid prescription.
The current crisis has led to horrific consequences as annual overdose deaths now surpass the peak year of highway accident deaths (just over 54,000 in 1972). This has led to a concerted effort by doctors and dentists to develop other approaches to pain management without narcotics.
One that’s gained recent momentum in dentistry involves the use of non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs like acetaminophen, ibuprofen or aspirin work by dilating blood vessels, which reduces painful inflammation. They’re available over the counter, although stronger doses require a prescription.
NSAIDs are effective for mild to moderate pain, but without the addictive properties of narcotics. There are some adverse health consequences if taken long-term, but limited use for pain or during post-procedure recovery is safe.
Many dentists are recommending NSAIDs for first-line pain management after most dental procedures. Narcotics may still be prescribed, but in a limited and controlled fashion. As part of this new approach, dentists typically combine ibuprofen and acetaminophen: Studies have shown the two work together better at reducing pain than either one individually.
Still, many aren’t eager to move away from the proven effectiveness of narcotics to primarily NSAIDs. But as these non-addictive drugs continue to prove their effectiveness, there’s hope the use of addictive opioids will continue to decrease.
While sports like football, basketball and soccer have exploded in popularity over the last few decades, many Americans still have a soft spot for the granddaddy of them all: baseball. While technology has changed many aspects of the game, many of its endearing traditions live on.
Unfortunately, one baseball tradition isn’t so endearing and definitely hazardous to health—tobacco, primarily the smokeless variety. Players and coaches alike, even down to the high school level, have promoted or at least tolerated its use.
But there are signs this particular baseball tradition is losing steam. Not long ago, the San Francisco Giants became the first major league baseball team to prohibit tobacco in its home stadium—on the field as well as in the stands. The move was largely in response to a law passed by the City of San Francisco, but it does illustrate a growing trend to discourage tobacco use in baseball.
While smoking, chewing or dipping tobacco can certainly impact a person’s overall health, it can be especially damaging to the teeth, gums and mouth. Our top oral health concern with tobacco is cancer: Research has shown some correlation between tobacco use (especially smokeless) and a higher risk of oral cancer.
You need look no further than the highest ranks of baseball itself to notice a link between tobacco and oral cancer. Although from different eras, Babe Ruth and Tony Gwynn, both avid tobacco users, died from oral cancer. Other players like pitcher Curt Schilling have been diagnosed and treated for oral cancer.
Cancer isn’t the only threat tobacco poses to oral health. The nicotine in tobacco can constrict blood vessels in the mouth; this in turn reduces the normal flow of nutrients and disease-fighting immune cells to the teeth and gums. As a result, tobacco users are much more susceptible to contracting tooth decay and gum disease than non-users, and heal more slowly after treatment.
That’s why it’s important, especially in youth baseball, to discourage tobacco use on the field. While most of baseball’s traditions are worthy of preservation, the chapter on tobacco needs to close.