Craig S. Karriker, DMD, P.A.- 400 South Granard Street, Gaffney, SC 29341, (864) 487-0710

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By Craig S. Karriker, DMD, PA
June 20, 2021
Category: Oral Health
Tags: thumb sucking  
ThumbSuckingandTongueThrustingCouldCauseaPoorBite

There are many things to be concerned about with your infant. Thumb sucking shouldn't be one of them—at least not yet. Practically universal among young children, the habit normally fades by age four with no real harm.

If it persists beyond that age, however, it can lead to a poor bite (malocclusion). Late thumb sucking may also have a connection with another problem—the inability of a child to transition from an infantile swallowing pattern to an adult pattern.

A baby while swallowing thrusts their tongue forward to help create a seal around a breast or bottle nipple during nursing. This normally changes about age 4, though, to a positioning of the tongue against the roof of the mouth when swallowing. But if they don't transition and continue to thrust the tongue forward, it can place undue pressure on the front teeth and cause them to develop too far forward.

The result may be an open bite, in which a gap exists between the upper and lower teeth even when the jaws are shut. An open bite can also happen with late thumb sucking, but instead of the tongue, their thumb presses against the teeth.

As to thumb-sucking, parents should encourage their child to stop the habit beginning around age 3, if they haven't already begun to do so. The best approach is to use some form of positive reinforcement such as praise or treats. The sooner the habit ceases after age 4, the lower their risk for developing an open bite.

You may also need to be alert to continued tongue thrusting while swallowing, which may still continue even after they no longer suck their thumb. In that case, your child may need orofacial myofunctional therapy (OMT), a series of exercises directed by a trained therapist to retrain the muscles involved with swallowing. This therapy could further help a child properly transition to an adult swallowing pattern.

Open bites can be corrected orthodontically later in life. But by being alert to your child's oral habits, as well as the way they're swallowing, you and your dentist may be able to intervene and eliminate or at least lessen the development of this type of problem bite.

If you would like more information on how to manage thumb sucking, 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 “How Thumb Sucking Affects the Bite.”

By Craig S. Karriker, DMD, PA
June 15, 2021
Category: Oral Health
Tags: oral health  
AlthoughItSoundsExoticThisMouthSoreIsntaBigConcern

Most of what goes on inside our mouths—good or bad—is fairly predictable. But every now and then, people encounter something out of the ordinary. A good example is lichen planus.

Lichen planus are rare skin lesions that can occur on various parts of the skin, including inside the mouth. The name comes from their lacy appearance, which resembles a fungus that grows on rocks or trees called lichen.

Being similar in appearance, though, is all that lichen planus has in common with its fungal namesake. It's believed that the sores are caused by a reaction of the immune system mistaking some of the body's cells as foreign.

But don't let the exotic sounding name alarm you—true lichen planus is considered a benign mouth sore. You may not even realize you have it until your dentist notices and points it out. But the lesions can sometimes cause mild pain or burning, especially if they occur near the gums or if you indulge in spicy or acidic foods.

As we said, these lesions aren't considered dangerous. But in a small number of cases, oral cancer was found to develop later. It's unclear whether the lesions were related to the cancer, or if what were diagnosed as lichen planus lesions were actually pre-cancerous cells mimicking the appearance of the benign sore.

In any event, your dentist will probably continue to monitor the lesions and possibly conduct regular oral cancer screenings to be on the safe side. You may also want to stop using tobacco or alcohol products to further decrease your risk of oral cancer.

As to managing lichen planus, it starts with a daily habit of brushing and flossing. You'll also want to avoid spicy or acidic foods like citrus fruits, tomatoes, peppers or caffeinated drinks, especially during flareups. If the lesions are causing discomfort, your dentist may also prescribe a topical steroid to apply to them.

Since it's quite possible you won't know if you have lichen planus (as well as other types of mouth sores) unless your dentist observes them, you should keep up regular dental visits. Having your dentist check your entire mouth, not just your teeth and gums, will help both of you stay on top of your oral health.

If you would like more information on mouth sores, 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 “Lichen Planus.”

By Craig S. Karriker, DMD, PA
May 26, 2021
Category: Oral Health
Tags: tmj disorders  
WhatWeCanLearnFromThoseWithChronicJawPainandDiscomfort

Temporomandibular joint disorder (TMD) is an umbrella term for a number of chronic jaw problems. These conditions cause recurring pain for 10 to 30 million Americans, especially women of childbearing age.

But even after decades of treatment and research, a full understanding of TMD's underlying causes eludes us. That doesn't mean, however, that we haven't made progress—we have indeed amassed a good deal of knowledge and experience with TMD and how best to treat it.

A recent survey of over a thousand TMD patients helps highlight the current state of affairs about what we know regarding these disorders, and where the future may lie in treatment advances. Here are a few important findings gleaned from that survey.

Possible causes. When asked what they thought triggered their TMD episodes, the top answers from respondents were trauma, stress and teeth clenching habits. This fits in with the consensus among experts, who also include genetic disposition and environmental factors. Most believe that although we haven't pinpointed exact causes, we are over the target.

Links to other disorders. Two-thirds of survey respondents also reported suffering from three or more other pain-related conditions, including fibromyalgia, rheumatoid arthritis and chronic headaches. These responses seem to point to possible links between TMD and other pain-related disorders. If this is so, it could spur developments in better diagnostic methods and treatment.

The case against surgery. Surgical procedures have been used in recent years to treat TMD. But in the survey, of those who have undergone surgery only one-third reported any significant relief. In fact, 46% considered themselves worse off. Most providers still recommend a physical joint therapy approach first for TMD: moist heat or ice, massage and exercises and medications to control muscle spasms and pain.

These findings underscore one other important factor—there is no “one size fits all” approach to TMD management. As an individual patient, a custom-developed action plan of therapy, medication, and lifestyle and diet practices is the best way currently to reduce the effects of TMD on your life.

If you would like more information on TMD management and treatment, 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 “Chronic Jaw Pain and Associated Conditions.”

By Craig S. Karriker, DMD, PA
May 06, 2021
Category: Oral Health
Tags: gum recession  
GumRecessionCanHarmYourOralHealthandYourSmile

Your gums don't just attractively frame your teeth—they protect them as well. If they shrink back (recede) from their normal covering, portions of the teeth could become exposed to bacteria and other hazards.

Unlike the visible crown, which is protected by enamel, the tooth root depends largely on the gums as a shield against bacteria and other hazards. When the gums recede, it exposes the roots and makes them more susceptible to disease or trauma. It may also cause sensitivity to hot and cold foods as the now exposed dentin gets the full brunt of temperature and pressure sensations once muffled by the gums.

There are actually a number of causes for gum recession. In rare cases, a tooth may not have erupted normally within its bony housing, which inhibits the gums from covering it fully. Thinner gum tissues, passed down genetically, are also more susceptible to recession. And a person can even damage their gums and cause them to recede if they brush too aggressively.

The most common cause, though, is advanced periodontal (gum) disease. This bacterial infection arises from dental plaque, a thin biofilm that accumulates on tooth surfaces, usually because of poor hygiene practices. As the infection and resulting inflammation in the gums worsens, they lose their attachment to teeth resulting in a number of harmful outcomes that include recession.

The first step then in treating gum recession is to treat the underlying problem as much as possible. In the case of gum disease, effective treatment could stop mild to moderate recession and sometimes reverse it. For more extensive recession, a patient may need gum grafting surgery to help regenerate lost gum tissue.

You can help prevent gum disease, and thus lower your risk for recession, with daily brushing and flossing to remove bacterial plaque. Likewise, see your dentist at least twice a year for dental cleanings to remove any residual plaque and tartar (hardened plaque).

You should also visit your dentist promptly if you notice swollen or bleeding gums, or more of your teeth surfaces showing. The earlier your dentist diagnoses and begins treatment for gum recession, the better your chances for a healthy and more attractive outcome.

If you would like more information on maintaining good gum health, 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 “Gum Recession.”

By Craig S. Karriker, DMD, PA
April 26, 2021
Category: Oral Health
ThisMinorDentalProcedureCouldMakeBreastfeedingEasierforanInfant

Breastfeeding is nature's way of providing complete nourishment to a newborn in their first years of life. It can also have a positive impact on their emerging immune system, as well as provide emotional support and stability. But although nursing comes naturally to an infant, there are circumstances that can make it more difficult.

One example is an abnormality that occurs in one in ten babies known as a tongue tie. A tongue tie involves a small band of tissue called a frenum, which connects the underside of the tongue with the floor of the mouth. The frenum, as well as another connecting the inside of the upper lip with the gums, is a normal part of oral anatomy that helps control movement.

But if the frenum is too short, thick or taut, it could restrict the movement of the tongue or lip. This can interfere with the baby acquiring a good seal on the breast nipple that allows them to draw out milk. Instead, the baby may try to chew on the nipple rather than suck on it, leading to an unpleasant experience for both baby and mother.

But this problem can be solved with a minor surgical procedure called a frenotomy (also frenectomy or frenuplasty). It can be a performed in a dentist's office with just a mild numbing agent applied topically to the mouth area (or injected, in rare cases of a thicker frenum) to deaden it. After a few minutes, the baby's tongue is extended to expose the frenum, which is then snipped with scissors or by laser.

There's very little post-op care required (and virtually none if performed with a laser). But there may be a need for a child to “re-learn” how to breastfeed since the abnormal frenum may have caused them to use their oral muscles in a different way to compensate. A lactation expert may be helpful in rehabilitating the baby's muscles to nurse properly.

A restrictive frenum isn't necessarily a dire situation for an infant—they can continue to feed with a bottle filled with formula or pumped breastmilk. But employing this minor procedure can enable them to gain the other benefits associated with breastfeeding.

If you would like more information on tongue ties and other oral abnormalities in children, 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 “Tongue Ties, Lip Ties and Breastfeeding.”