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Thank you for coming!

Wow! What an amazing 4 days! I’m so grateful for those of you who were able to make it out to see me. If I can answer any questions please feel free to email me at: alan@meadfamilydental.com! See you next year!

Everyone loves the upper

“Dentures aren’t a replacement for teeth. They’re a replacement for no teeth.”

—a very smart dentist

Some people have enough trouble with their teeth that they decide to have them taken out. Typically these people have been high risk for tooth decay and/or periodontal disease for a long time. The risk factors they had (tough bugs, low saliva flow, pop consumption, smoking, etc) overcame their ability to maintain their teeth. Many of these patients slowly lose teeth over time and finally come to a decision that they’re going to have their teeth removed. Sometimes they have a plan, sometimes they don’t. Most are just tired of what they perceive as a losing battle.

upper and lower denture coolTraditionally, these people have dentures made. A denture is a plastic prosthesis made to look a lot like teeth. Dentures can be made to look VERY realistic and in most cases they are more cosmetic than the patient’s existing teeth. However, dentures cannot function like natural teeth. And you take them out. They aren’t attached like your teeth.

Teeth are supported by bone in your jaw. This bony ridge is called alveolar bone or just the alveolus. The alveolar bone is only there to support the teeth, so once the teeth are removed the bone tends to shrink. It shrinks a lot at first, right after the teeth are removed. Some people tend to lose a lot of alveolar bone after their teeth are removed, some people less. Usually it will continue to shrink away throughout a patient’s life, which will require dentures to be relined or even remade over time.

In the best case scenario, an upper denture fits like a suction cup over the alveolar bone that’s left after teeth are removed. Upper dentures can be very stable when they fit well because they have a lot of surface area to cover. It’s kind of like a snowshoe. The more area you can cover, the more stable you’ll be on the snow. Some patients that have had lots of trouble with their teeth in the past find an upper denture to be a real improvement. Especially if it fits well and looks nice. Often people start their denture experience with the upper and then choose to do the same with the lower. I cannot tell you how many times I’ve had patients that were disappointed by lower dentures even after having a well fitting upper denture made.

It's like a horseshoe, balancing on a tightrope, in a hurricane.

It’s like a horseshoe, balancing on a tightrope, in a hurricane.

The lower denture is horseshoe shaped, like the shape of your lower jaw. So already you’re starting at a disadvantage from the upper. The upper has a bunch of surface area to keep it stable. A lower denture doesn’t. The lower is balancing on a “U” shaped ridge of bone with no suction. Furthermore, you’ve got your lips on one side and your tongue on the other side. Your lips and tongue are muscular structures that are constantly moving while you speak, chew, swallow, play saxophone and whatever else you might do. By doing your normal, everyday thing your lips and tongue are constantly working to move your lower denture around.

If you’re getting the feeling that lower dentures are a nightmare, you’re right. I’ve gotten to a point where I won’t recommend them unless the patient is willing to have dental implants placed. Dental implants can be used to hold a hold denture in place or even can be used to completely replace the teeth, with no need for a removable denture.

It's like this...except worse.

It’s like this…except worse.

Having an upper denture is like having a full sized spare tire. It’s not as good as the wheel that was factory installed, not even close. But it looks about right and you can learn to get by with it. The lower denture is like a half inflated donut spare. It kind of looks like a wheel, but you can barely function with it. Some folks even adapt to it, but they definitely won’t be going highway speeds.

Did you find this post discouraging? Did it make you grateful to have teeth? I’d love to hear about it! You can share any Mead Family Dental post with a “Like” on Facebook, a “+1″ on Google+ or you can even “Tweet” it with Twitter! All you need to do is hover over the heart shaped button next to the title of the post. Or you can leave a comment by clicking on the balloon shaped icon next to the title.

If you’re looking for a dentist in Saginaw, we’re always happy to accept new patients! You can request an appointment online or call the office at (989) 799-9133. And, as always, you can email me at alan@meadfamilydental.com. I always answer my own emails!

I’m a sell out and proud of it!

what a sell out!

what a sell out!

I’ll be speaking at the Michigan Dental Association annual session again this year. We’re more than a month away and one of my courses has already sold out! How exciting is that! There’s still room in my two other courses: “Be Found and Be Remarkable: ” and “Addiction, Drug Seekers and the Michigan Automated Prescription System: Shedding Light on a Silent Epidemic.” If you’re interested in seeing what these courses are about or signing up, go to the Michigan Dental Association’s Annual Session page. It’s got all the details on a dental meeting that is amazing every single year!

And thanks to those that have made me a sell out again this year!

A groovy story

broken tooth betterThis is the story of a tooth. A very groovy tooth. It’s also about the patient who is attached to that tooth. You see, I saw this patient last week. She presented to my office with a “broken tooth.”

All dentists know that what a patient thinks of as “a broken tooth” can range from a tiny chip to a huge piece missing. When I saw her on the schedule I didn’t know what to expect, but I did know that she hadn’t been seen at our office for almost 5 years and she had some previous treatment recommended that hadn’t been completed.

The patient told me that she had broken the tooth when she was chewing on something kind of hard. The tooth hadn’t been hurting her before it broke, but now that it was broken, it was kind of sensitive. Especially when she chewed.

this is how the tooth presentedThen I took a look. This was a seriously broken tooth! About half of the back side of  the tooth had broken off and it was broken all the way down to the gum line. I was actually a little surprised that the tooth didn’t hurt more. Usually when you’ve got a break this big it’s because 1) there is a large cavity that had undermined that part of the tooth or 2) the tooth had a large filling that had come out. The records showed that the tooth had never had a filling before, but we had recommended cleaning out and filling the pits and fissures (aka: grooves) on the bite surface of the tooth. You’ll notice in the photo that this tooth has very darkly stained grooves. This patient is a high risk for tooth decay due to her diet and these deep grooves are a large risk factor for her as well.

You’re probably thinking, “hey wait a second, doc. Almost half of that tooth is broken off. Those pits and fissures couldn’t have caused that! They’re just little tiny grooves! It must have been an olive pit or something!” I was thinking the same thing. So I decided to do a little detective work.

same tooth 2008I had a photo taken with an intraoral camera of this tooth from April 2008. It actually showed a little bit of failing pit and fissure sealant hanging in there. Even then you could see those dark grooves. This visit in 2008 was when we recommended she have those grooves cleaned out and filled.

Unfortunately, that didn’t happen. The story picks back up at the beginning of February, 2013. A big piece of the tooth came off when she was eating something hard while watching the Super Bowl. It started hurting a little bit after that, and she knew she’d have to do something.

enamel and dentinThe tooth did have a lot of decay, and the decay had undermined the broken part of the tooth. How do I know that? Take a look at this photo of the same tooth at a different angle. The hard, outer layer of tooth is called enamel and is much more resistant to decay than the softer, inner layer of tooth, called dentin. Grooves are weakened areas in the enamel and many grooves communicate right into the dentin.

Decay causing bacteria cover the teeth, but they prefer deep, dark wet places. Places like pits and fissures. crack tooth finalAnd since these grooves are actually weakened areas, the bugs and the acid they produce can slip right through the harder enamel layer and start decaying the dentin. You can actually see the path the decay took over time, right through these deep grooves into the soft, defenseless dentin. Over a period of years, this decay grew into a big cavity and undermined the enamel layer above it. Then, on Super Bowl Sunday, the patient bit onto the tooth just right, and crack! The tooth broke away leaving this soft, affected dentin layer. 

So that’s my groovy story. It’s kind of a sad story, because the patient is either going to need a root canal and a crown or she’s going to lose the tooth. But like all good stories, this one has a moral. The moral of this story is to have your grooves evaluated! If you’ve got deep pits and fissures, you have a greater risk for this type of decay. And, left untreated, it can cause a lot of dental strife!

Did you find this post groovy? Mysterious? I’d love to hear about it! You can share any Mead Family Dental post with a “Like” on Facebook, a “+1″ on Google+ or you can even “Tweet” it with Twitter! All you need to do is hover over the heart shaped button next to the title of the post. Or you can leave a comment by clicking on the balloon shaped icon next to the title.

If you’re looking for a dentist in Saginaw, we’re always happy to accept new patients! You can request an appointment online or call the office at (989) 799-9133. And, as always, you can email me at alan@meadfamilydental.com. I always answer my own emails!

 

 

How is gum disease like the Incredible Hulk?

"I never pictured gum disease being this green before."

“I never pictured gum disease being this GREEN before.”

Most everyone knows about the Incredible Hulk. Mild mannered scientist Bruce Banner was accidentally exposed to deadly gamma rays, but instead of killing him the radiation gave him strange super powers. When he gets injured or angry, he turns into a gigantic, green, immensely strong and almost mindless rage monster. And the angrier he gets, the stronger he gets! Chaos ensues with him attacking and smashing anyone and anything that gets in his way. Cars are thrown, buildings are brought down and cities are often leveled. He only stops smashing things when his fury burns out, he calms down and he turns back into the mild mannered scientist again, wondering what he’s done this time.

The Hulk was one of my favorites when I was growing up. Reading through my comics I would cringe at the stupid bad guys, thinking “dude, you’re making him angry!” So how, exactly, is a comic book antihero similar to gum disease? Stay with me on this one…

Let’s start with the immune system. Your body is constantly being invaded by viruses (think cold season), bacteria and lots of other nasties that you can’t even see. Lucky for you, your immune system is constantly on the lookout and mostly takes care of these attacks without you ever being aware of them.

The immune system has two main parts: the adaptive immune system and the innate immune system. The adaptive immune system is what most people think of when someone mentions “the immune system” and its definitely the part that gets all the headlines. The adaptive immune system is the part of the immune system that learns to recognize individual types of invaders and remembers them so they’re easier to fight the next time they’re encountered. The adaptive immune system is the part that makes vaccines possible and our understanding of it has probably saved more lives than any other kind of medicine.

The innate immune system is a little bit different. It doesn’t recognize specific invaders, it only recognizes the things that it runs into as “self” and “not self.” If the cells of the innate immune system recognize something as “not self,” they attack the invader. In other words, this part of the immune system can’t say, “hey, I recognize you! You’re a chicken pox virus!” It only thinks, “this thing ain’t me! So I have to kill it!”

If you’ve ever had a sliver, you’ve seen the innate immune system hard at work. The redness, pain and swelling that surrounds a sliver are all signs that the innate immune system is fighting the good fight for you. These signs are called inflammation. Inflammation is your body’s reaction to some kind of injury or pathogenic invasion. The cells of your innate immune system have some amazing weapons, kind of like the Incredible Hulk. These cells will dump toxic chemicals on invading microbes or if they can’t to that, they’ll swallow them whole!

Inflammation is usually a good thing and can be the first step in healing an injury or an infection. However, too much of this inflammatory response can actually cause damage to the tissues that the immune system is trying to protect!

Gum disease is primarily a problem with inflammation. It’s actually an inflammatory reaction to biofilm on your teeth and below your gums. The plaque and debris that we try to brush and floss off of our teeth is pretty sticky stuff. It doesn’t really want to be removed. And if it’s left there long enough, it will harden. This hardened plaque is called calculus or tartar. This calculus acts kind of like a barnacle stuck to the surface of your teeth. Worse than that, it usually gets stuck below the gum line. It’s just about impossible for you to remove by yourself. To remove it a dentist or dental hygienist has to use special tools to break it loose from the surface of your teeth.

"Don't make me angry. You wouldn't like me when I'm angry."

“Don’t make me angry. You wouldn’t like me when I’m angry.”

So imagine this calculus on the surface of the roots of your tooth like a bunch of tiny slivers. Your innate immune system recognizes it as a bad guy, but cannot remove it. This makes the innate immune system mad. Kind of like when Bruce Banner gets mad. And the madder your innate immune system gets, the stronger the reaction it creates to try and remove this invader. It starts dumping the toxic chemicals it uses to kill bad bacteria and other bugs into the tissues supporting your teeth! These chemicals, along with toxins from the biofilm itself, start to break down the tissues that support your teeth. It’s kind of like you have an angry Hulk smashing around in your gum tissues, but he’s not able to get rid of the bad guys. And this makes him really angry! So instead, he starts attacking YOU!

In the comic books the Hulk only stops his rampage when he calms down. And this goes for your inflammatory response as well. The very best way to calm our “periodontal Hulk” is to remove the junk stuck to the roots of the teeth. If we can remove this stuff, we can usually calm down that response and stop the active destruction of your gums. Just like the end of every Hulk comic, there’s often a lot of destruction to clean up after the Hulk is gone. Many patients have to deal with the severe loss of bone and the supporting tissues of the teeth even after we’ve cleared up the inflammation of active gum disease.

So, what’s the best way to prevent Bruce Banner from turning into the Hulk? Prevention! Don’t make him mad, right? Brushing, flossing and regular visits to the dentist can help you avoid the ravages of gum disease. Catching problems before they become destructive is the best, but even if you have gum disease, it’s not too late to treat it!

Did you find this post incredible? Did it make you angry? I’d love to hear about it! You can share any Mead Family Dental post with a “Like” on Facebook, a “+1″ on Google+ or you can even “Tweet” it with Twitter! All you need to do is hover over the heart shaped button next to the title of the post. Or you can leave a comment by clicking on the balloon shaped icon next to the title.

If you’re looking for a dentist in Saginaw, we’re always happy to accept new patients! You can request an appointment online or call the office at (989) 799-9133. And, as always, you can email me at alan@meadfamilydental.com. I always answer my own emails!

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