If you're intrigued by the strange and bizarre, here's one to pique your interest: geographic tongue. It's a rare condition that causes the appearance of red patches on the tongue surface, surrounded by grayish-white borders, and which look a lot like continents on a map (hence the name). But although it may look odd, geographic tongue won't harm your health.
The condition is also known as benign migratory glossitis, so named because it's not cancerous and the patches seem to move or “migrate” around the tongue surface. The most common causes are thought to be stress or hormonal disruptions in those predisposed to the condition. Many researchers believe zinc or vitamin B deficiencies in the body contribute to its occurrence. It also seems more prevalent among non-smokers and pregnant women, as well as occurring as a family trait.
The red patches are created by the temporary disappearance of some of the papillae, tiny bumps on the tongue's top surface. The patches can abruptly appear during a flareup and then disappear just as suddenly. But as “angry” as the patches may look, geographic tongue is not considered a health danger. It isn't normally painful, although people can experience stinging or numbing sensations emanating from the patches that can be mildly uncomfortable.
Because it's also rare, you're not likely to encounter it personally. But if you or a loved one does begin to notice red patches on the tongue, there are a few things you can do to lessen any accompanying irritation. For one, cut out foods like tomatoes, citrus fruits, eggplant, mint or highly spicy or acidic foods, all of which have been known to increase discomfort. You might also avoid astringents like alcohol or mouthwashes that likewise irritate the patches when they occur.
Although geographic tongue can't be cured, your dentist can help you manage symptoms when they arise with the help of prescribed anesthetic mouthwashes, antihistamines or steroid lozenges. These not only can help lower any discomfort or irritations, they may also lessen the duration of a flareup.
For the most part, geographic tongue usually causes more embarrassment than physical discomfort. But with a little help from your dentist, you can keep it to a minimum. Geographic tongue may be odd, but it's nothing to worry about.
If you would like more information on geographic tongue, 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 “Geographic Tongue: No Cause For Alarm.”
For over half a century now, community water systems have been adding fluoride to drinking water to help reduce the risk of tooth decay. Numerous long-term studies have demonstrated the soundness of this practice, prompting the U.S. Centers for Disease Control to call water fluoridation one of the ten most effective public health measures of the 20th Century.
In the 1960s, after years of study into the teeth-strengthening effects of fluoride, the U.S. Public Health Service recommended that drinking water utilities add fluoride at a rate of between 0.7 and 1.20 milligrams per liter (mg/L) or parts per million (ppm) of water. This recommendation held fast until 2015 when the service changed the recommendation to no more than 0.7 mg/L.
Why the change to guidelines that had been in place for over fifty years? The revision was in response to an increasing occurrence of dental fluorosis. This condition happens when the teeth absorb more fluoride than necessary, leading to discoloration of the surface enamel, creating effects like small white spots or brownish “mottling.”
Dental fluorosis is the only known health condition caused by fluoride. As such, it doesn't damage the tooth itself, and is mainly a cosmetic problem. But it can still be avoided if fluoride intake is kept at moderate levels.
The original recommendation was sound science when first introduced. Since then, though, the prevalence of fluoride in everyday life has grown, with the chemical commonly found in dental care products like toothpastes or mouthrinses, as well as many processed foods and beverages and even infant formula. Our society's overall intake of fluoride has been growing as a result.
The new recommendation came after several years of research to verify water fluoridation levels of 0.7 mg/L would still be effective in the fight against tooth decay while lowering the risk of dental fluorosis. With this adjustment, this important and safe measure for keeping your family's teeth protected against disease is safer than ever.
Heartburn is a big problem: Each year we Americans spend around $10 billion on antacid products, twice as much as for over-the-counter pain relievers. It's an even bigger problem because many indigestion sufferers actually have acid reflux or GERD (gastroesophageal reflux disease), a chronic disease that can cause physical harm—including to teeth.
That's why we've joined with other healthcare providers for GERD Awareness Week, November 17-23, to call attention to the causes and consequences of this disease. In addition to the harm it poses to the esophagus (the “tube” leading from the mouth to the stomach through which food passes), GERD could also damage your teeth to the point of losing them.
GERD is usually caused by the weakening of the lower esophageal sphincter, a ringed muscle located at the junction between the esophagus and the stomach. It acts as a “one-way valve” allowing food into the stomach, but not back into the esophagus. If it weakens, powerful stomach acid can come back into the esophagus and possibly even the mouth. The latter scenario poses a danger to teeth's protective layer of enamel.
Although tough and durable, enamel softens after prolonged contact with acid. Oral acid isn't all that unusual—acid levels typically rise right after eating, causing a temporary softening of enamel. Our saliva, however, goes to work to bring down those acid levels and stabilize enamel.
But if stomach acid enters the mouth because of GERD, the increased acidity can overwhelm saliva's ability to neutralize it. This can lead to enamel erosion, tooth decay and ultimately tooth loss. The enamel damage can be so pronounced that dentists are often the first to suspect GERD.
If you're diagnosed with GERD, here's what you can do to protect your teeth.
- Manage your GERD symptoms through medication, avoidance of spicy/acidic foods, alcohol, caffeine or tobacco products, and maintaining an optimum weight;
- Stimulate saliva by drinking more water, using saliva boosters, or (with your doctor's consent) changing from medications that may be restricting saliva flow;
- Speak with your dentist about strengthening your enamel with special toothpastes or mouthrinses containing extra fluoride or amorphous calcium phosphate (ACP).
You should also brush and floss daily to lower your risk of dental disease, but with one caveat: Don't brush your teeth during or immediately after a reflux episode, as you might remove microscopic bits of softened enamel. Instead, rinse your mouth with water mixed with a half-teaspoon of baking soda (an acid neutralizer) and wait about an hour to brush. The extra time also gives saliva time to further neutralize any remaining acid.
GERD can be unpleasant at best and highly destructive at worst. Don't let it ruin your teeth or your smile.
If you would like more information about GERD and dental health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “GERD and Oral Health” and “Dry Mouth.”
Kathy Bates has been a familiar face to filmgoers since her Oscar-winning performance as Annie Wilkes in Misery. She's best known for playing true-to-life characters like Wilkes or Barbara Jewell in last year's Richard Jewell (for which she earned her fourth Oscar nomination). To keep it real, she typically eschews cosmetic enhancements—with one possible exception: her smile.
Although happy with her teeth in general, Bates noticed they seemed to be “moving around” as she got older. This kind of misalignment is a common consequence of the aging process, a result of the stresses placed on teeth from a lifetime of chewing and biting.
Fortunately, there was an orthodontic solution for Bates, and one compatible with her film career. Instead of traditional braces, Bates chose clear aligners, a newer method for moving teeth first introduced in the late 1990s.
Clear aligners are clear, plastic trays patients wear over their teeth. A custom sequence of these trays is developed for each patient based on their individual bite dimensions and treatment goals. Each tray in the sequence, worn in succession for about two weeks, places pressure on the teeth to move in the prescribed direction.
While clear aligners work according to the same teeth-moving principle as braces, there are differences that make them more appealing to many people. Unlike traditional braces, which are highly noticeable, clear aligners are nearly invisible to others apart from close scrutiny. Patients can also take them out, which is helpful with eating, brushing and flossing (a challenge for wearers of braces) and rare social occasions.
That latter advantage, though, could pose a problem for immature patients. Clear aligner patients must have a suitable level of self-responsibility to avoid the temptation of taking the trays out too often. Families of those who haven't reached this level of maturity may find braces a better option.
Clear aligners also don't address quite the range of bite problems that braces can correct. Some complex bite issues are thus better served by the traditional approach. But that gap is narrowing: Recent advances in clear aligner technology have considerably increased their treatability range.
With that said, clear aligners can be an ideal choice for adults who have a treatable bite problem and who want to avoid the appearance created by braces. And though they tend to be a little more expensive than braces, many busy adults find the benefits of clear aligners to be worth it.
The best way to find out if clear aligners could be a viable option for you is to visit us for an exam and consultation. Like film star Kathy Bates, you may find that this way of straightening your smile is right for you.
If you would like more information about tooth straightening, please contact us or schedule a consultation.
After years of research, we're confident in saying that brushing and flossing daily are essential for maintaining a healthy mouth. A mere five minutes a day performing these tasks will significantly lower your risk of dental disease.
We're also sure about the essentials you'll need to perform these tasks: a soft-bristled toothbrush using fluoride toothpaste, and a roll (or picks) of dental floss. The only deviation might be a water flosser appliance instead of flossing thread.
Unfortunately, some folks deviate even more from the norm for both of these tasks. One of the strangest is a social media trend substituting regular toothpaste with substances containing activated charcoal. The proponents of brushing with charcoal claim it will help whiten teeth and kill harmful microorganisms. People brushing with a black, tarry substance also seem to make for good “gross-out” videos.
There's no substantial evidence to support these claims. Perhaps proponents of charcoal's whitening ability are assuming it can remove stains based on its natural abrasiveness. It could, however, remove more than that: Used over time, charcoal could wear down the protective enamel coating on your teeth. If that happens, your teeth will be more yellow and at much greater risk for tooth decay.
When it comes to flossing (or more precisely, removing food material from between teeth), people can be highly inventive, substituting what might be at hand for dental floss. In a recent survey, a thousand adults were asked if they had ever used household items to clean between their teeth and what kind. Eighty percent said they had, using among other things twigs, nails (the finger or toe variety) and screwdrivers.
Such items aren't meant for dental use and can harm tooth surfaces and gum tissues. Those around you, especially at the dinner table, might also find their use off-putting. Instead, use items approved by the American Dental Association like floss, floss picks or toothpicks. Some of these items are small enough to carry with you for the occasional social “emergency.”
Brushing and flossing can absolutely make a difference keeping your teeth and gums healthy. But the real benefit comes when you perform these tasks correctly—and use the right products for the job.
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