ENAMEL LOSS

What the heck is enamel, anyways?  Enamel is the thin, translucent, hard outer layer of the teeth that protects them from the daily stress of chewing, biting and grinding; temperature of hot and cold foods and drinks; and erosive acids.  Despite being the strongest material in your body, a variety of factors can cause enamel erosion or loss of enamel.  Loss of enamel increases teeth sensitivity, exposes stains on teeth, increases vulnerability to cavities and decay, and creates rough and irregular teeth edges and dents on teeth surfaces.

Enamel loss is primarily caused by erosive acids that wear away enamel over time.  Excessive consumption of soft drinks, which contain high amounts of phosphoric and citric acids, and other acidic drinks and foods such as fruit drinks and sour foods or candies, is the leading cause of acid-related enamel loss.  Coke, for example, contains citric and phosphoric acids.  Frequent consumption of medicines and supplements containing high acid content, including aspirin, antihistamines and vitamin C supplements also cause enamel loss.

Environmental factors in the mouth, or the physical wear and tear from daily friction and stress on the teeth, are another contributing factor of enamel loss.  Environmental causes of enamel loss include friction from clenching or grinding your teeth, especially during sleep, and wear and tear from brushing your teeth too hard, improper flossing, biting hard objects or chewing tobacco.

Low saliva production is also another cause of enamel loss.  Saliva strengthens both your teeth and their enamel by coating them with calcium and other strengthening minerals.  Saliva also protects against enamel loss by diluting and washing away erosive acids and other wastes left over from foods and drinks and also by producing substances that fight against mouth bacteria and disease that can cause enamel loss.  While a healthy amount of saliva production can protect enamel from erosive effects of acidic foods and drinks, excessive consumption of acidic foods and drinks decreases saliva production and saliva's ability to strengthen teeth and enamel.  Excessive plaque can also contribute to enamel loss, so regular brushing, flossing, dental checkups and cleanings are essential!!!  Toothpastes with fluoride in them can strengthen and remineralize slight to moderate enamel breakdown; a great way to protect your enamel!

HELP, MY TONGUE IS BURNING!!!

This painful condition is called burning mouth.  This is a painful sensation felt in almost all the areas of the tongue.  Usually the burning sensation worsens as the day progresses.  Some of my patients experience a tingling or numb sensation in their mouth or on the tip of the tongue.  Some experience dry mouth, increased thirst, a general soreness in the mouth and a bitter or metallic taste in the mouth.  Other names are scalded mouth syndrome, burning tongue syndrome, burning lips syndrome, glossodynia and stomatodynia.  Burning tongue basically affects the tongue, gums, lips, inside of the cheeks, roof of the mouth and other areas of the mouth.  Sometimes people affected with burning tongue lose their sense of taste temporarily.  Some causes of burning tongue are:  hormonal abnormalities, diabetes, menopause, medications, tobacco use, and the list goes on and on.

Now the most important part of this week's subject.  What should people do who are experiencing this very bothersome syndrome?  Unfortunately, there's no one sure way to treat burning mouth syndrome.  Good solid research on how to treat it is lacking.  Your treatment depends solely on your individual symptoms.  We also need to take into consideration any underlying conditions that may be causing your discomfort.

Obviously, replacing poorly fitting dentures or correcting a vitamin deficiency may help.  If you are lucky enough to pinpoint the cause and can get it treated, your burning mouth syndrome symptoms should improve.

If your cause can't be found, treatment can be extremely challenging.  Unfortunately, there's no known cure for the syndrome.  So, like many medical conditions, practitioners are left with controlling the symptoms.  Treatment options could include:  saliva replacement products, medications that block nerve pain, certain antidepressants, cognitive behavioral therapy, specific oral rinses or lidocaine, capsaicin (a pain reliever made from chili peppers).

DENTURE AND PARTIAL UPGRADES

Over a period of time, your denture will need to be relined or rebased.  I will discuss these procedures below.  In general, a full denture (which replaces all your teeth) or partial (which hooks onto at least a couple remaining teeth) will remain functional for a period of approximately seven to ten years.  At that time, they should be evaluated for possible replacement.

Let's take a look at why dentures and partials loosen with time,.  First, when teeth are lost, jawbone starts to melt away or atrophy, leaving a gap or space under your partial or denture.  When the jawbone is no longer directly stimulated by the chewing pressure a tooth provides to the bone, the bone, as a result, atrophies.  As the bone atrophies, the space under your denture and partial cause it to shift and become loose.  Extra food will also pack into this newly created space.

As long as the space isn't too large, it can be filled in with new acrylic (a process called a reline).  When the space gets excessive a denture may need rebasing.  Rebasing means making a new plastic base while keeping the existing denture teeth.   On the other hand, when the denture teeth become worn, a new denture or partial should be made.

As a side note, I highly recommend people with full dentures have an oral cancer evaluation once a year.  Sores, irritations and new found red or white lesions under dentures that don't heal should be evaluated by a dentist.