Bulimia Nervosa

People with eating disorders can suffer from oral health problems as well. This is because many of the behaviors associated with anorexia nervosa and bulimia nervosa-such as binge eating, self-induced vomiting, and use of diuretics or laxatives-cause changes in the mouth.

For example, repeated episodes of vomiting, which is common in people with bulimia, releases harmful stomach acids that wear away tooth enamel and lead to gingivitis and tooth decay. Other problems, such as poorly fitting fillings and braces, are another byproduct of such eating disorders.

Brushing after episodic vomiting is actually more harmful than one would think. The best practice is to rinse thoroughly with a neutral solution such as baking soda and water.

Bad Breath (Halitosis)

An estimated sixty-five percent of Americans have bad breath. Over forty-million Americans have “chronic halitosis,” which is persistent bad breath. Ninety percent of all halitosis is of oral, not systemic, origin.

Americans spend more than $1 billion a year on over the counter halitosis products, many of which are ineffective because they only mask the problem.

What causes bad breath?
Bad breath is caused by a variety of factors. In most cases, it is caused by food remaining in the mouth – on the teeth, tongue, gums, and other structures, collecting bacteria. Dead and dying bacterial cells release a sulfur compound that gives your breath an unpleasant odor. Certain foods, such as garlic and onions, contribute to breath odor. Once the food is absorbed into the bloodstream, it is transferred to the lungs, where it is exhaled. Brushing, flossing and mouthwash only mask the odor. Dieters sometimes develop unpleasant breath from fasting.

Periodontal (gum) disease often causes persistent bad breath or a bad taste in the mouth, and persistent bad breath may mean a sign that you have gum disease.

Gum disease is caused by plaque – the sticky, often colorless, film of bacteria that constantly forms on teeth. Dry mouth or xerostomia may also cause bad breath due to decreased salivary flow. Saliva cleans your mouth and removes particles that may cause odor. Tobacco products cause bad breath, stain teeth, reduce your ability to taste foods and irritate your gum tissues. Bad breath may also be a sign that you have a serious health problem, such as a respiratory tract infection, chronic sinusitis, postnasal drip, chronic bronchitis, diabetes, gastrointestinal disturbance, liver or kidney ailment.

Bad breath may also be caused by medications you are taking, including central nervous system agents, anti-Parkinson drugs, antihistamines/decongestants, anti-psychotics, anti-cholinergics, narcotics, anti-hypertensives, and anti-depressants.

Caring for bad breath

Daily brushing and flossing, and regular professional cleanings, will normally take care of unpleasant breath. And don’t forget your often overlooked tongue as a culprit for bad breath. Bacterial plaque and food debris also can accumulate on the back of the tongue. The tongue’s surface is extremely rough and bacteria can accumulate easily in the cracks and crevices.

Eliminating periodontal disease and maintaining good oral health helps to reduce bad breath. If you have constant bad breath, make a list of the foods you eat and any medications you take. Some medications may contribute to bad breath.

Improperly cleaned dentures can also harbor odor-causing bacteria and food particles. If you wear removable dentures, take them out at night and clean them thoroughly before replacing them.

If your dentist determines that your mouth is healthy and that the odor is not oral in nature, you may be referred to your family physician or to a specialist to determine the cause of the odor and possible treatment. If the odor is due to gum disease, your dentist can either treat the disease or refer you to a periodontist, a specialist in treating gum tissues. Gum disease can cause gum tissues to pull away from the teeth and form pockets. When these pockets are deep, only a professional periodontal cleaning can remove the bacteria and plaque that accumulate.

Mouthwashes are generally ineffective on bad breath. If your bad breath persists even after good oral hygiene, there are special products your dentist may prescribe, including “Zytex,” which is a combination of zinc chloride, thymol and eucalyptus oil that neutralizes the sulfur compounds and kills the bacteria that causes them. In addition, a special antimicrobial mouth rinse may be prescribed. An example is chlorhexidine, but be careful not to use it for more than a few months as it can stain your teeth. Some antiseptic mouth rinses have been accepted by the American Dental Association for their breath freshening properties and therapeutic benefits in reducing plaque and gingivitis. Instead of simply masking breath odor, these products have been demonstrated to kill the germs that cause bad breath. Ask your dentist about trying some of these products.

Braces (Orthodontia)

Braces are applied to teeth for various reasons, including poorly aligned jaws, crooked, crowded and missing teeth, or a bad bite (also called malocclusion).

Various things can cause teeth to become crooked or jaws misaligned, including thumb-sucking or a traumatic injury. Some conditions are inherited.

Children between the ages of 7 and 14 are typical candidates for braces because their facial structures are still developing. Adult braces usually entail additional procedures because their faces
have already fully developed.

  • About Braces

Orthodontics deals with corrections involving jaw and teeth alignment. An orthodontist is a dental professional who diagnoses and applies braces.
Braces employ the use of wires and are usually one of three types:

  1. Metal Braces which employ the use of metal strips, or bands.
  2. Metal or plastic brackets that are cemented or bonded to teeth.
  3. Brackets that attach to the back teeth (also called “lingual” braces)
  • Invisalign™ Invisible Braces

With Invisalign® there are no metal wires or brackets, only clear, surgical grade aligners that are worn (much like whitening trays). It is easy to maintain your dental hygiene, they are a great way to straighten teeth and have a beautiful smile.

  • Procedures

Orthodontic procedures, also called “orthodontia,” are complex processes.

In most cases, a dentist will need to make a plaster cast of the individual’s teeth and perform full X-rays of the head and mouth.

After orthodontic appliances are placed, they need to be adjusted from time to time to ensure that they continue to move the teeth into their correct position.

Retainers are used following braces to ensure that teeth remain in position.

  • Aesthetic and Comfort Issues

Modern dental technology have vastly improved appearance issues with orthodontia.

Braces today are made from extremely lightweight and natural-colored materials. The materials that braces attach to-brackets-are bonded to the surfaces of teeth but can be later removed.

People can expect to wear braces for about two years-less or more in some cases. Adults are usually required to wear braces for longer periods of time.

Because orthodontic appliances need to be adjusted from time to time to ensure they continue to move the teeth into their correct position, they can create pressure on the teeth and jaws. This mild discomfort usually subsides following each orthodontia adjustment.

Hygiene issues

People who wear braces must be diligent in ensuring that food particles and other debris do not get trapped in the network of brackets and wires. In addition, brackets can leave stains on enamel if the area surrounding them is not cleaned on a daily basis.

Daily oral hygiene such as brushing, flossing and rinsing are a necessity. Some people with orthodontic appliances can benefit from using water picks, which emit small pressurized bursts of water that can effectively rinse away such debris.

Another caveat: Braces and sticky foods don’t mix. Crunchy snacks and chewy substances should be avoided at all costs because they can cause orthodontia to be loosened or damaged

Space Maintainers

Space maintainers are nifty devices that can help teeth grow in normally following premature tooth loss, injury or other problems.

The devices can help ensure that proper spaces are maintained to allow future permanent teeth to erupt.

If your child loses a baby tooth early through decay or injury, his or her other teeth could shift and begin to fill the vacant space. When your child’s permanent teeth emerge, there’s not enough room for them. The result is crooked or crowded teeth and difficulties with chewing or speaking.


Brushing is the most effective method for removing harmful plaque from your teeth and gums. Getting the debris off your teeth and gums in a timely manner prevents bacteria in the food you eat from turning into harmful, cavity causing acids.

Most dentists agree that brushing three times a day is the minimum; if you use a fluoride toothpaste in the morning and before bed at night, you can get away without using toothpaste during the middle of the day. A simple brushing with plain water or rinsing your mouth with water for 30 seconds after lunch will generally do the job.

Brushing techniques

Since everyone’s teeth are different, see me first before choosing a brushing technique. Here are some popular techniques that work:

  1. Use a circular motion to brush only two or three teeth at a time, gradually covering the entire mouth.
  2. Place your toothbrush next to your teeth at a 45-degree angle and gently brush in a circular motion, not up and down. This kind of motion wears down your tooth structure and can lead to receding gums, or expose the root of your tooth. You should brush all surfaces of your teeth – front, back, top, and between other teeth, rocking the brush back and forth gently to remove any plaque growing under the gum.
  3. Don’t forget the other surfaces of your mouth that are covered in bacteria – including the gums, the roof and floor of your mouth, and most importantly, your tongue. Brushing your tongue not only removes trapped bacteria and other disease-causing germs, but it also freshens your breath.
  4. Remember to replace your brush when the bristles begin to spread because a worn toothbrush will not properly clean your teeth.
  5. Effective brushing usually takes about three minutes. Believe it or not, studies have shown that most people rush during tooth brushing.

Abscessed Tooth

[vc_row][vc_column width=”1/1″][vc_column_text]An abscessed tooth is a pocket of pus, usually caused by some kind of infection and the spread of bacteria from the root of the tooth to the tissue just below or near the tooth.

In general, a tooth that has become abscessed is one whose underlying pulp (the tooths soft core) has become infected or swollen. The pulp contains nerves, blood vessels and connective tissue, and lies within the tooth. It extends from the crown of the tooth, to the tip of the root, in the bone of the jaws.

An abscessed tooth can be an extremely painful condition.

In some cases, antibiotics are administered in an attempt to kill an infection. If antibiotics are ineffective and an abscess is shown to be damaging the pulp or lower bony structures, a root canal procedure may be needed to remove the dead pulp and restore the tooth to a healthy state.[/vc_column_text][/vc_column][/vc_row]

Advantages of Dental Implants

[vc_row][vc_column width=”1/1″][vc_column_text]The least costly and most commonly used method by dentists to restore a patient’s dentition is the removable denture. The downside of the removable denture is the inconvenience of daily removal and maintenance. Dental implants on the contrary are securely anchored to your jaw bone. The dental implant itself is made of Titanium, a very strong, corrosion-resistant, natural element that is perfectly biocompatible with bone. The implant is placed within the upper and/or lower jaw to act as a direct or indirect anchor for the replacement teeth.

Natural Looking. Teeth replaced with dental implants offer a more natural look and feel for the patient. As the implant fuses with the bone in the jaw and the prosthesis is securely anchored. Dental Implants provides a nateral looking solution for replacing missing teeth.

No Movement. Due to this enhanced anchorage offered of the dental implants, a solution that cannot be attained from a removable prosthesis (no need for messy adhesives). With dental implants, a person can feel secure that their teeth will not move.

Comfort. Because your implant supported replacement teeth are not resting directly on the tissue of your mouth, you don’t develop uncomfortable sore spots. On the other hand, removable dentures can cause inflammation of the mouth tissues that are under the denture itself, primarily if not removed every night when sleeping and if not cleaned on a daily basis.

Stimulation of bone growth: Keeping your teeth helps to preserve your jaw bones. Once a tooth is lost, one of the major problems that face dentists that treat edentulous patients is the continuing loss of jaw bone. The result of all this bone loss over time is that removable dentures start fitting less and less well. As the tissue under the denture starts to shrink and pull away from the underside of the denture, it leaves less and less support underneath the removable prosthesis. This is when all the problems associated with an ill-fitting denture start to show. One of the most fascinating and important properties of titanium, the material from which dental implants are made, is that it attracts the growth of bone cells.

Chewing Function: Due to the lack of permanent anchorage, removable dentures can move or slip while eating, therefore making eating a difficult and less than desirable task. The ability to chew foods improves dramatically with dental implants.

Taste Sensation: A complete upper removable denture covers the entire roof of the mouth. Your tongue and the roof of your mouth are covered with thousands of tiny taste buds. Once the roof of the mouth is covered with the removable denture, food becomes less easy to taste, more difficult to sample and enjoy. With an implant-supported prosthesis, the roof of the mouth is not covered and food can be tasted by all the taste receptors in the mouth.

Phonetics. Removable dentures can slip and slide around in the mouth. A complete, upper denture, and some designs of upper partial dentures, cover the roof of the mouth. Both can result in interference with the normal phonetic movements of the tongue, causing difficulty in normal speech.

Nutritional uptake by digestive system. Digestion begins in the mouth. Teeth subject food to the mechanical process of grinding, breaking it down into smaller and smaller pieces. Almost simultaneous with the smelling and chewing of food, saliva secretes onto and mixes with it. The enzymes in the saliva begin the further digestive breakdown of food. Now, if the step of mastication (grinding) of food were to be reduced due to inefficiency of a removable denture, the digestive process would be altered and food would not get properly digested further along the digestive tract.

Nutritional balance is further indirectly enhanced by the stability of an implant-supported prosthesis. As one is more confident to enjoy a varied and healthy diet, and you are not restricted to what you can eat due to unstable removable dentures.

Misplacing or loss of the prosthesis. Removable dentures can easily be misplaced and lost. There are ample stories of domestic pets ‘eating’ the patients prosthesis (dogs and cats are attracted to the saliva that coats the prosthesis. However, with a fixed, implant-supported prosthesis , your likelihood of loss is next to nil.[/vc_column_text][/vc_column][/vc_row]

A Tip for the Sweet Tooth

[vc_row][vc_column width=”1/1″][vc_column_text]Everyone knows that sweets are bad for your teeth. But, did you know that the amount of sweet food you eat is not as important as the length of time your teeth are exposed to sweets? Eat sweets at mealtime rather than between meals. The amount of saliva produced at that time will help protect your teeth.

If you cannot avoid sweets between meals, choose something with less sugar like nuts and seeds, peanut butter, popcorn, plain yogurt. Sticky sweets that stay in your mouth for longer periods of time like toffee or hard candies should be avoided as snacks.

Vitamins, Minerals and Your Teeth
Just like our bodies, our teeth and gums need certain essential vitamins and minerals to stay healthy and strong. Babies, children and adults all need ample amounts of the minerals calcium and phosphorous, and the vitamins A, C and D to ensure proper tooth development and strength.

Calcium, aided by phosphorous and vitamin D, is the main component of teeth and bones. It’s what helps keep them strong. Vitamin A is necessary for the formation of tooth enamel, and vitamin C is essential for healthy gums.

Nursing mothers should keep in mind that their diet may influence the growth of the newly-forming teeth of their baby. A nursing mother’s diet should include foods from all of the food groups.

An adequate intake of the proper vitamins and minerals helps in the development of healthy teeth. A lack or absence of these minerals can lead to disease.

Fluoride is an important mineral for tooth decay prevention. Fluoride strengthens the enamel of young developing teeth, and acts with calcium and phosphorous to restore and harden enamel in mature teeth. Fortunately for our teeth, fluoride has been added to almost half of the drinking water in Canada. If your drinking water comes from a well, you may want to have your water tested for the presence of natural fluoride. Contact your local health unit for more information.

As with the overall health of our body, a good diet is the best way to ensure dental nutrition. Strong teeth need a variety of whole grain breads and cereals, fruits and vegetables and lean meats, in addition to milk products. Toothhealthy snacks also include nuts and seeds, peanut butter, cheese, plain yogurt and popcorn.[/vc_column_text][/vc_column][/vc_row]

Allergy to Latex

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Latex allergy is a hypersensitivity to the naturally occurring protein found in rubber which may cause symptoms to arise. These symptoms may be as mild as skin irritations (contact dermatitis), hives, itchy eyes, runny nose, to more severe occurrences such as asthma and life-threatening anaphylaxis.

The symptoms and signs associated with anaphylaxis include:

  • Difficulty breathing
  • Dizziness
  • Confusion
  • Wheezing
  • Nausea
  • Vomiting
  • Rapid or weak pulse
  • Loss of consciousness
  • Shock
  • Respiratory failure
  • Circulatory failure

Many medical and dental supplies contain latex, including gloves, blood pressure cuffs, urinary catheters, dental dams and material used to fill root canals, as well as tourniquets and equipment for resuscitation. The tendency to develop allergies to latex appears to be an inherited trait, and as with other allergies, the more intense and frequent the exposure to latex, the more likely one is to develop an allergy to it. Healthcare workers have a greater chance (up to 10%) to develop a latex allergy due to their repeated exposure to rubber based products. However, in recent years, there has been a move to decrease the addition of powder in these gloves (powder was used to ease the ability to put on the gloves and decrease perspiration of the hands within the latex gloves), and this appears to have decreased the occurrence amongst healthcare professionals of latex allergies.

Other groups at risk include those who have had various surgeries, especially those involving the nervous system and genitourinary tract system. Children with spina bifida also appear to have a higher occurrence of developing latex allergies.

If you have a known sensitivity or allergy to latex or any related items, please notify our office. Non-latex substitutes can be found for all of the latex-containing items that are normally used.[/vc_column_text][/vc_column][/vc_row]

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