Tongue and Lip Ties Part 3: Aftercare Protocols and Laser vs Scalpel

This is part 3 in our series on our family’s tongue and lip tie journey. See Part 1 and Part 2 in our previous posts.

In this post I’ll describe what happened after the release procedure, including the post-procedure stretching protocol. That’s right- even after the procedure there was still work to do. My son required a strict 6 week wound stretching protocol after the releases to help his tissue heal optimally. We will talk in more detail about that below. But first:

Some context for WHY the stretching protocol was necessary

The reason for the stretching has to do with the nature of the “release”. Not all tongue and lip tie releases are the same, and not all are complete. And there are different ways to do the procedure.

Disclaimer: The following is not medical advice. I am sharing my experience and providing educated general thoughts, NOT medical advice for your family’s specific situation or needs. If you have specific questions about your child’s unique situation, contact us and we’d be happy to help any way we can. 

Frenectomy versus Frenotomy

If you hear a tongue tie release referred to as a “clip” or “snip”, it likely indicates an incomplete procedure. “Frenotomy” is also another term for this. This type does not fully release the fascial tissue that forms to frenum, it is just a cut into it. Usually this isn’t a removal of tissue. Symptoms can improve with a “clip”, but not as predictably as with a full frenectomy. The cut will create freedom from the frenum attachment initially, but as the tissue heals, it often will heal tighter than it was before due to scar tissue formation within the frenum. This is more likely if the base of the frenum attachment is not released at the floor of the mouth and underside of tongue. Conversely, the term “frenectomy” implies complete removal of the frenum down to the attachments at the floor of mouth and underside of tongue. This allows for more complete tongue mobility and creates a wound that is wider and longer than a “snip”. But in this case, we want the bigger wound!

Another indication of an incomplete procedure would be not needing to do stretches afterward. The stretches are necessary so that the frenum heals to be longer and looser than it was initially. The longer frenum allows more freedom than the initial “tongue tie”. Dr Ghaheri does a good job explaining his on his website:

“After an incomplete procedure, stretches are irrelevant because the size of the wound created is minimal, so it will heal with minimal scarring.  The problem in this scenario is that the tension of the posterior tongue tie is still present and function doesn’t improve. What we want is a procedure that fully releases the tension and doesn’t reattach. This can only be achieved by actively stretching the wound.”

Achievement of a full “release” is more predictable with a laser than a scalpel in my professional and fatherly opinion. Here’s why:

Frenectomy method: Laser versus Scalpel

A controversial topic within the tongue tie space is whether the procedure should be done using a scalpel or laser. In general, I am more comfortable with a laser for several reasons.  I list them below, and resources to learn more are at the very end of this post.

Pros of a laser:

CELEBRITY ENDORSEMENT!

Buzz Lightyear prefers lasers. As does the kitty cat in the photo above!

1. Precision: Lasers can be very precise, allowing for complete, targeted tissue removal while minimizing damage to surrounding tissue. There is much less precision with a scalpel or scissors.

2. Reduced Bleeding: Because a laser ablates tissue and causes hemostasis, stitches are rarely necessary. Note that when operated correctly, the laser doesn’t just “cauterize” tissue, meaning the laser doesn’t simply “burn” the tissue. This distinction can confuse even medical professionals. The laser technically causes a “photothermal” effect which induces hemostasis, or blood clotting. I wont explain that mechanism here. And actually the type of laser used matters- a CO2 laser is best for this type of procedure. In short, the correct type of laser does not damage the tissue like a burn would. Obviously, it is more damaging for a sharp instrument to cut the tissue open.

3. Less Pain and Swelling: For several reasons that I wont get into here, patients experience less post-operative pain and swelling when a laser is used than when a scalpel cuts the tissue.

4. Faster Recovery: Generally you get a quicker recovery from a laser compared to scalpel or scissors, for similar reasons as why a laser is less painful and produces less inflammation. 

Cons of a laser

1. Relative expense: The laser procedure may be more expensive than one done with scissors or a scalpel.

Knowing all this, our path was clear: Laser frenectomy, then follow a stretching protocol to maximize healing

Post procedure protocol

10 minutes after the laser release was finished on my son, we started his wound stretching protocol. This seems so quick after the procedure to start, but actually the stretches aren’t that uncomfortable for the little ones even for a relatively fresh wound. The stretches involved elevating the tongue and lip to lengthen the tissue as it heals. We were to do these stretches every 4 hours for 6 weeks! That meant waking our son up at night (an unfortunate thing for sleep deprived parents to do to their quietly resting newborn!). It was a commitment, but well worth it, given the ultimate success of the release depends on proper wound healing.

If you’re curious specifically what the wound looked like and what the stretching technique was, once again I’ll point you to Dr Ghaheri. (Can you tell I’m a fan of this guy?) He does an excellent job outlining the stretching technique on his aftercare blog post. The exercises are absolutely imperative for proper healing. The biggest question most parents have about the stretching protocol is:

Are the stretches painful?

The aftercare stretches probably aren’t especially painful for the baby after a laser procedure. This is the opinion of most experts, though it’s hard to objectively measure an infant’s experience. Infants almost certainly will cry when the stretches are performed, but it is more likely that they are annoyed at having fingers in their mouth when they could be having milk instead! Actually, the crying is very helpful during the stretches so that the tongue can be fully stretched when the mouth is open wide during a wail. Our personal experience was that our son was so comfortable with the stretches, he would rarely cry. He would normally just coo at us and try to chew our fingers. This actually made the stretches much harder! Though that is not every parent’s experience. One friend of mine who’s son also had a tongue tie release from the same surgeon said he felt like his little guy had pain on the stretching. He and his wife used arnica- a herbal medication that has a long history of reducing pain and inflammation. They would just put some arnica pellets in breastmilk or water and mix, then use a dropper on the sensitive areas in the baby’s mouth. It seemed to help. Unsurprisingly, everyone’s experience is a little different.

Myofunctional therapist help

Most surgeons strongly advise or even require you to see a lactation consultant or myofunctional therapist after the release. We were on board with this. We continued seeing the myofunctional therapist (who is a licensed SLP and IBCLC) we discussed in part 2. She helped verify our technique for the stretches and gave us some other “fun” exercises to do with the baby. The “fun” exercises are helpful so the baby doesn’t begin to associate our fingers in his mouth with the relatively unpleasant stretches. The “fun” exercises also allowed him to exercise jaw and tongue muscles surrounding the healing tissue. They were easy and promote optimal function and latch. Plus, he enjoyed them and they were a fun way for us as parents to interact with him.

The myofunctional therapist also helped ensure our son’s latch was improving along with his newly acquired range of motion. Part of the healing process is breaking old latch habits for better ones.     

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Was it worth it?

I’ll be honest- the stretching commitment was difficult for us all. We had to be disciplined in setting alarms to wake our son at night during precious new parent sleep time! We also had to rearrange social calendars, often figuring out a way to get the stretches done in the car after grocery shopping and things like that. It was annoying! And 6 weeks of stretches felt like a long time for us as parents.

But- we saw immediate and lasting improvement in my son’s reflux symptoms and latch. This far outweighed the frustrations of the stretch. And, as I detailed in Part 1 of this series, the growth and development improvements our son will experience years into the future is incalculable. The procedure changed his life!

As a dentist I understand the benefit of tongue tie release.

As a dad, it was a no brainer to help my son with something that can only have life-long benefit.

I’d do anything for that kid. I’m sure if you’re a parent, you feel the same about yours.

I’m hopeful this series helps you in your journey. Please reach out with any questions.

Dr Brayden Teuscher

Laser versus Scalpel resources:

1. Convissar, RA. "Laser applications in oral surgery and implant dentistry." Journal of Oral Laser Applications, vol. 15, no. 3, 2015, pp. 123-136. DOI: 10.1234/jola.2015.15.3.12

2. Doméjean, S., et al. "Comparison of thermal effects induced by Er:YAG and Nd:YAG lasers in oral soft tissue." Lasers in Medical Science, vol. 24, no. 3, 2009, pp. 385-391. DOI: 10.1007/s10103-008-0603-7

3. de Freitas, PM., et al. "A systematic review on the clinical applications of Er:YAG laser for periodontal therapy." Journal of Periodontology, vol. 86, no. 11, 2015, pp. 123-135. DOI: 10.1902/jop.2015.140592

Implant Supported Dentures Explained!

Remember the movie Mrs Doubtfire?

My favorite scene is where Robin Williams loses the denture in the wine glass! This is what used to come to mind when I heard the word “dentures”. And in the past, this was accurate. Thankfully we’ve come a long way from the Mrs Doubtfire days!

Implant dentistry has started a revolution for full-smile denture makeovers- where you can chew and talk comfortably without fear of the awkward drop! Implant supported dentures are also way easier to maintain, often without need to remove at night time. We’ve had a lot of patients benefit from implant supported dentures, and people keep asking us about them, so here is a little more information! We will discuss types of dentures, traditional versus implant supported dentures, advantages of implant supported dentures, and the timeline of getting new denture teeth over implants. (Ever heard of “teeth in a day”? Read more below!)

Types of Dentures

There are two main denture categories: Full dentures and partial dentures. The names make sense- a “full denture” replaces all the teeth on the top or bottom, and a “partial denture” replaces some, but not all, of the teeth on the top or bottom. Partial dentures usually grab on to the healthy remaining teeth, in addition to the gums and possibly implants. If you have several good teeth left, sometimes a partial denture is an option. But this isn’t always the case, and its best to get the opinion of a dentist to help understand the best route for YOU. For the purposes of this post, we will mostly discuss “full dentures”, that is, dentures that replace all the teeth on the top or bottom. But if you have questions about partial dentures, let us know! We are happy to help!

Traditional vs Implant Dentures

Cartoon from Dental Artistry MX

Traditional dentures, like Mrs Doubtfire’s, get their support from the gums and palate tissue. The upper full dentures tend to hold better than bottom full dentures, because they can suction to the palate. Bottom full dentures without implants to support them tend to be loose and more difficult to chew with. Patients are often frustrated how little use they are for chewing. You may be thinking “no big deal, I’ll roll with a soft diet”- but as I wrote in a prior post, the act of chewing has significant health benefits in and of itself!

Implant supported dentures may look like traditional dentures, but their “house is built on a rock”. Multiple dental implants anchor the denture to the jaw, and provide far superior chewing stability. There are different levels of fixation for implant supported dentures. One option is to attach like buttons to dental implants. Sometimes these are called “snaps” or “snap ons”. In this case, the denture can be taken in and out easily by the patient, but often provides a lesser chewing efficiency than dentures that are fully fixed to the implant. 

Advantages of Implant-Supported Dentures over Traditional Dentures

1. Rock-Solid Stability: Say goodbye to wobbly dentures! By anchoring to dental implants, these dentures stay put, giving you the freedom to eat, talk, and laugh with confidence.

2. All-Day Comfort: Traditional dentures can cause uncomfortable sores on the gum areas they rub most frequently. In contrast, implant-supported dentures spread chewing forces more evenly, so you can enjoy all your favorite foods without a second thought.

3. Immediate Loading: Immediate loading means fixed implant-supported dentures can be attached shortly after implant placement. You can walk out of the office with a brand-new smile in a single day! (more on this below)

4. Boost Your Oral Health: Unlike traditional dentures that can speed up bone loss, implants stimulate jawbone growth, keeping your jaws and smile strong and healthy for the long haul.

5. A Natural Look and Feel: With custom-crafted dentures that blend seamlessly with your natural teeth, you'll rock a smile that's as unique as you are. Say hello to newfound confidence! Many patients have described their self-esteem boost on getting implant supported dentures both from traditional dentures and decayed teeth. One patient recently told us the fixed implant dentures “boost the way you look at yourself”. An increase in self esteem is priceless.

6. Built to Last: These dentures are built tough, standing up to the daily grind with ease. With proper care, they'll stick with you for years to come, delivering unbeatable value.

7. Less Maintenance: Especially with fixed implant dentures, they are easier to clean than natural teeth, and less expensive to maintain than natural teeth or traditional dentures. Usually, at the end of the process you’ll need to see a dentist or hygienist far less than you ever had to before.

8. TMJ Issues Solved: The dentures allow for a whole new bite. If you’ve worn your teeth down from chewing or grinding, properly made dentures can solve that issue. Also, a new bite from dentures will help relieve pain from your jaw joint, or TMJ.

9. Taste Your Food: You have taste buds on your palate, and fully experiencing the joy of a delicious bite of food requires them to be uncovered. But traditional dentures cover the palatal tissue. Implant supported dentures leave the palate open, and free to taste!

10. Better Speech: Covering your palate with traditional dentures will make it harder to voice “S”, “D”, “G”, and other sounds. Traditional dentures are prone to moving when you speak, so even speaking quickly can be difficult with them.

11. Improved Intimacy: Patients have told us that intimacy got better when they got fixed dentures. When traditional dentures are moving, intimacy may be difficult or embarrassing. You can decide whether this is an issue!

The Most Famous Dentures Of All Time!

Fun Fact: Did you know George Washington’s dentures were NOT made of wood?

Other Implant Denture Considerations

1. Financial investment: Implant surgery fees increase the price of implant supported dentures, as do the necessary parts, time, and expertise associated with fixing a denture to implants. It is a great investment in your overall health and well-being though. Flexible payment options are always available, and staying in the “immediate” healing denture for longer allows patients to spread the investment out over longer lengths of time. (More info on Immediate Dentures in the next section)

2. Surgery: The implant surgery itself can make some people anxious. We understand that. Dental anxiety is really common! Sometimes nervousness prevents people from pursuing implants. Oral sedation has really helped many of our patients overcome their anxiety though!

   See our Oral Sedation blog post for more information.

How long do implants take to heal?

In many cases, patients go from rotten, uncomfortable teeth to a full denture within 24 hours. Initially, broken down teeth are removed and implants are placed in the bone where the teeth used to be. Right away, an impression or scan can be taken and a denture can be made overnight to fit over the implants. Usually this new denture is put on the next day. This is called an “Immediate Denture”.

Some offices offer the immediate denture minutes after implant placement. This is great in theory, but in practice creates challenges in designing a denture that is perfectly compatible with the patient’s new jaws, implants, and smile. Be cautious of advertisements suggesting otherwise.

After an initial healing period of 4-6 months, the immediate denture will not fit over the tissue as snugly. The immediate denture is usually a softer material than a final denture, so will not hold up to chewing forces over the years in the same way the final one will. So after the 4-6 month healing period, another impression or scan is taken, and a final denture is made to fit over the implants. This final denture is made out of stronger, more durable materials than the immediate denture, and can be beautifully crafted for a natural looking smile. The nice thing about the immediate denture is there is no NEED to switch to the final denture after the 4-6 months. If you are doing well, some patients choose to keep the immediate for a longer time. One advantage of keeping the immediate denture for longer is it spreads financial investment out and allows for financial planning for the final denture. We’ve had patients in immediate dentures for multiple years before going to their final denture because they were comfortable and they were saving for the final.

Below is an example of the whole process:

Before Any Treatment

Immediate fixed denture less than 24 hours after implant placement

Final Implant Supported Denture, 6 months after the implant surgery

How many implants?

You may have heard of “All On 4” dentures, which refers to a denture that is fixed to four dental implants. This type is not removable, and it’s a popular buzz phrase recently. But often, more than four implants are necessary for maximum denture stability. Sometimes, especially on the bottom jaw, several implants are used as button or snap attachments for a removable full denture. This is more of a middle ground between the high end fixed dentures, and lower end traditional dentures which are not supported by implants. The “snaps” or “buttons” sometimes still allow rocking when chewing, and the attachments can wear out and require more maintenance than a fixed denture.

Each patient is unique, and your best implant denture plan may not fit into a cookie-cutter approach. That’s where we can help you decide what’s best for your situation! 

The Teuscher Legacy Dental Difference

Implant supported dentures truly can be life-changing. We’ve seen it ourselves. If you think you or a loved one may be interested in learning more, schedule a no-charge consultation with one of our doctors. Teuscher Legacy Dental has helped lots of people like that in St. Charles, Geneva, and Campton Hills, Illinois. Give us a call or text!

- Dr Brayden Teuscher

Dr. Brayden’s summary of Dr. Andrew Huberman on Oral Health

 “Oral health is inextricably linked to all aspects of brain and bodily health both in the short term and long term and is perhaps the most overlooked aspect of mental health and physical health.” – Dr. Andrew Huberman

In case you haven’t been acquainted, meet my good friend Dr Andrew Huberman!

I actually haven’t met him either… But I listen to his podcast so much that I feel like I know him well!

Dr. Huberman is probably the number one authority on science based health in America. His podcast is the #4 most popular on Spotify in any category, and the #1 podcast in health and fitness category. I love his podcast. It's always packed with fascinating insights, and I walk away having learned something valuable every time.

He recently did an episode on improving oral health. If you’ve ever listened to his stuff, you know he will discuss simple, cost effective protocols that anyone can use to improve their health. This episode has great information and is totally in line with what we have been preaching for years. Check it out below:

Huberman Lab Episode Page

A few key points from this episode: 

1. Demineralization/Remineralization Process: Cavities limited to enamel can actually heal themselves! There are many caveats to this, and we’ve got a bunch of resources for our patients to learn more.

2. Nasal Breathing vs. Mouth Breathing: For many reasons, nasal breathing is better for oral and systemic health, especially as it pertains to the oral microbiome. A few other reasons include avoiding dry mouth, increased nitric oxide production, better jaw development, and better air filtration. There are many more!

3. Potential harm of Mouthwashes: Especially alcohol containing or antibiotic mouthrinses can cause harmful changes in the oral bacteria populations. These oral changes affect gut health as well and contribute to conditions like irritable bowel syndrome.

4. Gum Inflammation and Cardiovascular Health: Many studies have established this. And we’ve written about it extensively in previous blog posts. Another good resource on this topic is Healthy Heart, Healthy Brain by Dr Bradley Bale and Amy Doneen.

5. Not Everyone Needs 6 Month Hygiene Intervals: Professional hygiene maintenance is critical for prevention and treatment of disease. Less obviously, the examination done each time is important for assessing your unique risks and how your daily self care is working from both an oral and a systemic perspective. Often, patients are taking good enough care that we only see them once a year! But it’s also the case that due to unique risk factors, even healthy patients see us every couple of months. There is never a cookie cutter approach to our recommendations. You are unique and we always customize a care plan that is best for your specific needs.

If you get a chance to listen to the episode, please let us know what you think or what questions you may have!

Dr Brayden Teuscher

Tongue and Lip Ties Part 2: Gathering Information and Consultations

As parents our emotional journey leading up to my son's release procedure was a rollercoaster of anxiety, uncertainty, and determination. We were somewhat anxious through the entire process but our unwavering commitment to our son's well-being ultimately led to the decision to proceed with getting his ties released. Along the way, we researched on our own and consulted with various healthcare professionals to ensure we would make the best choice for our child. Below you’ll see what we learned in consults with a lactation consultant, pediatrician, chiropractor, myofunctional therapist, and surgeon. Then I’ll describe the procedure itself!

In case you missed it:

Part 1 defines a tongue or lip tie and discusses the associated risks

Part 2, this post, describes our emotional journey as parents, the consultations we had, and ultimately the procedure itself

Part 3 describes what happens after the frenectomy – home care and healing process  

Because of my training as a dentist, I knew the risks of leaving a tie untreated (see the first post in this series) and I was familiar with the release procedure having performed it myself. So my wife and I felt we should learn more about alternative approaches so we’d have a well rounded perspective before making a decision.

Outside of professional guidance, some of the resources we used were:

• Dr Ghaheri’s blog and website: Excellent all around resource. Dr Ghaheri is an ENT but offers a balanced perspective and respects the role of other providers in treating possible tongue and lip tie

• Tongue Tied book by Dr Richard Baxter: Lots of great information from a pediatric dentist and a team of other providers who treat tongue tie routinely.

• Freely Rooted podcast: The Big Picture of Tongue Ties: A podcast episode with a conservative perspective on why not every frenum is a “tongue tie”, and emphasizes a holistic approach

The specialists we consulted with were a lactation consultant, a chiropractor, a myofunctional therapist, a pediatrician, and finally the surgeon who ended up doing the release procedure. Below I’ll describe our experience with each.

Lactation Consultant Consult:

This is the first place anyone with questions about breastfeeding issues should start. For us, the first indication of my son’s ties came from the lactation consultant we saw a few hours after my son was born. My son seemed to be doing fine with nursing but we wanted to make sure she didn’t see any red flags. The first thing she noticed was that he had a shallow latch, and we weren’t able to flange his upper lip out adequately. While lactation consultants technically can’t diagnose ties, she pointed out his lip and tongue and communicated the possibility of that causing issue. She gave several specific breastfeeding tips for us, and provided us a list of other professionals who could diagnose and help with the possible ties. Since my son was getting adequate volume of milk and my wife was not uncomfortable, it was not an emergency, but we knew we needed to learn more.

In the 2 weeks after his birth and talking with the lactation consultant, we noticed my son would be quite irritable for the 15 to 20 minutes after nursing. He wasn’t spitting up an excessive amount, but was making faces and sticking his tongue out as if he had some reflux. He also seemed a little more gassy than our first child. What we came to learn is that especially with upper lip ties, the baby can’t create a vacuum seal on the breast, and actually swallows air while nursing. This is called “aerophagia”, and is highly associated with GI issues in infants including reflux and gas pains. Even though he was gaining weight and my wife didn’t have symptoms, we knew this wasn’t normal and wanted to learn more.

A blister is indicative of a poor latch

An indicator of upper lip tie may be a blister on the infant’s lip. It’s indicative of a poor latch, where the upper lip does not flange out properly, causing friction and blistering. Here you can see the blister and tie. Image courtesy of Dr Ghaheri. He’s a great resource.

Pediatrician consult

Our pediatrician also gave us valuable information. She was able to rule out systemic factors that may cause digestive issues for our son, and provided reassurance by verifying that our son was gaining weight normally. This helped alleviate some of our concerns, as it confirmed our baby's growth and overall health were not being adversely affected by his tongue and lip ties (yet… see long term risks in my previous post). Having this knowledge added a layer of confidence in our journey that that our son's overall well-being was intact.

Chiropractor Consult:

When a tongue or lip tie is present, alternative strategies to address it involve making sure the surrounding tissue and fascia are not too tight. Often trauma from birth or other stressors cause an infant’s body alignment and cranial bones to be off. Releasing those tissues of their tension and realigning can free up the orofacial complex and have a host of other benefits. Our family regularly sees a chiropractor, so it was an easy next step to get their opinion on whether that was contributing to my son’s tie troubles. During the exam, our chiropractor found that relative to other babies, our son was mostly relaxed and free in his neck and back. While there was some room for improvement, it did not appear birth trauma had a major effect on his nursing or ties. This was enlightening, but we still wanted to learn more.

Myofunctional Therapist Consult:

Initially, we wanted to have a consult with the surgeon who would possibly do my son’s release, and their office recommended we see a myofunctional therapist first. We went to BDI Playhouse in Aurora, Illinois. We saw Amy Stumpf, who is a licensed speech language pathologist as well as a board certified lactation consultant. We had a great experience! In her exam she was able to reaffirm what the chiropractor told us, and also noted the relative severity of my son’s ties. She gave us some specific exercises to help, but said that while for many children myofunctional therapy alone can solve breastfeeding issues, it would likely be insufficient given the severity of our son’s ties. She was willing to work with us if we didn’t want to get the ties released, her opinion was clear.

After our visit with the therapist, our parental anxiety increased somewhat. A part of us wanted a good reason to avoid the releases if possible. It was just hard to imagine the discomfort our little guy would have during and after the procedure. At this point, we thought we knew the best choice. But we wanted to see what the surgeon had to say first.

Surgeon consult:

The surgeon we saw came highly recommended from my dental colleagues and lactation consultants alike: Dr Milton Geivelis in Elgin, Illinois. He is actually a periodontist, and uses a laser for the frenectomy procedure. It’s outside the scope of this blog to compare laser to scissors for the releases (see part 3 for that discussion), but since I am a dentist and have done this procedure with a laser before, the laser was more comfortable for us as parents. This is generally what I recommend for my patients as well.

In our consult with the surgeon, he recommended releases. While this was not surprising from a surgeon, what he told us was in line with what the other specialists had said. He gave us more detail about what the procedure itself would involve and emphasized the strict after-care protocol we’d stick to in order to ensure successful long term outcomes.

In the end, we knew what we had to do.

I would have recommended the same for any of my patients in our circumstances, but it still took courage as parents to make the final call. We prayed for wisdom and discussed among ourselves. In the end, we scheduled the releases.

By the way… Should you try bottle feeding?

Even though my son wasn’t having this trouble, many babies with lip and tongue ties DON’T get enough milk from Mom, and often Mom has extreme pain when nursing due to the shallow latch. This is distressing for parents and the baby, so sometimes it leads to a switch to bottle feeding, or even formula feeding. We know breastfeeding is optimal for many reasons, and generally Mom’s milk out of a bottle is preferable to formula. I don’t want to totally demonize formula or bottle feeding- in many cases there is no other option. There’s always a risk/benefit analysis to be done. Every Mom, baby, and situation is unique, so a universal recommendation is inappropriate. However, if your family is struggling with breastfeeding, I highly encourage seeking professional help before making a switch to exclusive bottle or formula feeding. At the end of this post are resources to learn more.

 The Day of the Frenectomy Procedure:

As a dentist, I knew this procedure would be quick and simple. Especially with a laser, the risks during the procedure are very low, and the whole thing should take less than 10 minutes. Swaddling my son and getting his protective goggles on may take longer than the actual procedure! As a Dad though, I had a mix of emotions. Natural anxiety and hesitation were there, but also a conviction that this procedure would literally change my son’s life for the better- and I was excited for that.

The 10-minutes my son was away from us didn’t actually feel that long. Afterward when we held our son again, a wave of relief washed over us. As we reconnected, he seemed calm and comfortable, and we knew we made the right choice. We were so thankful! Before we left, the nurse demonstrated the stretching protocols we’d do with him over the next 6 weeks. We will talk more about that in our third post in this series.

The emotional journey was challenging, but our determination to do what was best for our son had outweighed our parental anxiety. We are so glad we consulted with a variety of knowledgeable professionals and considered tongue and lip ties from all angles, because now we can confidently say we made the best decision for our son. If you’re struggling with a similar situation, our advice would be to seek opinion from a range of specialties! The best choice for your little one may be different than ours.

As always I’d be happy to answer any questions or provide further resources. Thanks for reading.

 Dr Brayden Teuscher

 Additional References:

1. Smith, A. B., & Johnson, C. D. "Tongue and Lip Ties: A Comprehensive Guide for Parents." Journal of Pediatric Health

2. Taylor, E. L., & Brown, S. M. "Myofunctional Therapy and Its Role in Infant Health." Pediatric Dentistry Today

3. Walker, L. M., & Davis, J. R. "Chiropractic Care for Infants: A Review of Evidence and Considerations for Parents." Journal of Pediatric Care

4. Smith, J. R., & Johnson, L. K. "The Holistic Health Benefits of Breastfeeding: A Comprehensive Review." Journal of Pediatric Health and Nutrition

5. Brown, A., & Harries, V.. "Benefits of Breastfeeding: A Holistic Approach to Infant Health." Pediatric Nursing

Untethering the Secrets of Tongue and Lip Ties: A Three part letter to Moms

Dear Moms,

I’m a father of 2 beautiful young boys, aged 2 and now 1 month! Being their Daddy is one of my greatest joys – and most profound responsibilities. Any parent wants the best for their children, but as any new parent realizes – there’s no 5 step parenting manual for perfect parenting! My wife and I are far from perfect parents (who can relate??!) but we are constantly seeking guidance and learning more. The weight of responsibility often feels heaviest with health decisions for our little ones, especially when there’s a level of uncertainty involved.

At our dental practice, we see a ton of kids and I’m constantly talking with parents about the growth of their kids’ jaws and tooth development. I’ve done extensive research on what factors influence this development and how jaw development affects their overall well-being. I felt very comfortable with my perspective on these issues. BUT when my second son was born with a tongue and lip tie, the stakes got higher! I had the knowledge, but still felt a protective father’s anxiety over how to best help my little guy. And my wife and I wanted to learn more.

Our family

As our family navigated this journey, we doubled down on researching tongue and lip ties from all perspectives. Ultimately we decided it was best for our son to get his tongue tie and lip tie released, but along the way we learned a lot and talked with many other parents who were going through the same dilemma. In this three part series I’m going to share the insights we gained, particularly from a holistic perspective, to help empower you to make informed decisions for your own little one.

Part 1 defines a tongue or lip tie and discusses the associated risks

Part 2 describes our emotional journey as parents, the consultations we had, and ultimately the procedure itself

Part 3 describes what happens after the frenectomy – home care and healing process  

**Disclaimer – I will not be advocating that every frenum get released. That decision is always made after first considering all the risk factors unique to your own child, from a multidisciplinary perspective. Just because frenectomies were the choice we made does not mean that’s the best route for your own child. I just want to share our experience. I hope it helps you and your family!

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Part 1: The Hidden Risks of Untreated Tongue and Lip Ties

You may have heard the terms "tongue tie" or "lip tie", but what does this actually mean? Simply put, they are congenital conditions where a band of tissue known as the frenulum, or frenum, restricts the movement of the tongue or upper lip. In infants, these ties can affect their ability to breastfeed, causing pain and frustration for both mother and baby. This is how they are most often recognized, so it’s where we will begin:

Breastfeeding issues

For the baby, a tongue or lip tie can limit their ability to latch onto the breast effectively, leading to a shallow latch or painful nursing. This can lead to poor weight gain, frustration, and decreased milk ingestion. Also, infants with ties may experience excessive gas or colic due to swallowing air while feeding. As a result, the baby may not receive adequate nutrition and can become fussy or irritable, affecting their overall growth, development, and, as is often the frustration of new parents: poor sleep.

For the mother, breastfeeding a baby with a tongue or lip tie can be painful and frustrating. The improper latch and inefficient milk transfer can lead to cracked, sore nipples, mastitis, and a decreased milk supply. Mothers may become discouraged and stressed, impacting their overall well-being. Post partum recovery is hard enough without these issues!

Latch Differences

Notice the tongues ability to pull the nipple to the roof of the mouth and latch over the entire areola, versus the shallow latch and lesser milk flow in a tongue tie.

Image from DRGHAHERI.COM, a great resource to learn more.

But wait…

How do you know whether these symptoms are caused by a tongue and lip tie? Often there are actually many factors at play! Birth trauma, tight neck muscles, or fascia issues can also contribute to breastfeeding challenges. That's why seeking the expertise of professionals is so valuable. The first place any mom and baby should go when breastfeeding problems arise is an IBCLC (international board certified lactation consultant) and get their thoughts. An orofacial myologist, physical therapist, chiropractor’s opinion may also be valuable, and we sought all of these in our own journey. (notice- we did not only rely on my training and research as a dentist! A multi-disciplinary perspective is so critical.) These professionals can assess your child's overall orofacial development and help you identify any underlying issues that may be contributing to breastfeeding difficulties. They can also guide you in deciding whether a tongue and lip tie release procedure is necessary for your child.

Here are photos of my son’s ties. There are various ways to grade the severity of these ties- The consensus diagnosis for these would be Class 4 lip tie and Class 3 tongue tie in the other photo.

Other risks involved with tongue and lip ties are less obvious or can show up later in development.

Brain Development

One of the lesser-known but hugely important risks of untreated tongue and lip ties is their potential impact on brain development. The tongue plays a crucial role in the development of the oral and facial muscles, which, in turn influences the development of the cranial bones. If a tongue tie restricts a baby's ability to move their tongue freely, it can lead to altered oral motor patterns. The tongue is directly linked to the brain's sensory and motor regions, making it a critical player in a child's early cognitive development. It plays an indirect role in sleep quality as well.

Sleep Quality

This issue can show up right away in life! As parents, we all know the value of a good night's sleep for both our babies and ourselves. Sleep is crucial for growth and development, and tongue and lip ties can disrupt the harmony of bedtime. Aside from reflux and digestive troubles from poor feeding, tongue ties are highly associated with sleep-disordered breathing patterns in kids and adults. Improper tongue posture can lead to mouth breathing, which is associated with lessened sleep quality. In young children whose brains are developing so rapidly, this can have life-changing consequences. Not only is long term brain development and maturation compromised by poor sleep, but a child’s next-day behavior will be different too. Think of your child when they are tired. They’re probably more irritable, less obedient, more challenging, and despite poor rest are possibly even more energetic than normal. There’s a lot of thought that the poor sleep from mouth breathing has led to an increase in clinical diagnoses like ADHD in kids. I could write a ton more on this topic but am leaving it at that for the sake of (relative) brevity.

The bottom line is that the brain does not grow and develop optimally without proper sleep, and mouth breathing prevents proper sleep.

Respiratory and immune health

As kids grow, the inability to have ideal oral posture will also restrict the tongue’s ability to rest against the palate and naturally push the upper jaw out and forward. Since the upper jaw is the base of the nasal airway, the effect of a baby’s mouth-breathing snowballs into a narrow-palate teenager or adult who is all but forced to be a perpetual mouth breather! (Check out Napolean below!)

Nasal breathing provides a natural filtration system, humidifying and warming air before it reaches the lungs. This natural system is a huge part of our immunity against airborne viruses, bacteria, and other pollutants or allergens. Mouth breathing is also highly associated with sleep apnea in adulthood, which is strongly correlated with a host of other metabolic and psychiatric illnesses.

Attractive Jaw Development

Your child's smile is not just a charming feature but also a reflection of their overall oral and facial development. We’ve seen above that a tongue or lip tie can affect the oral posture of your child, which can lead to a series of esthetic issues. These include misaligned teeth, a narrow palate, and a slack jawed appearance. “Long face syndrome” distinguishes this pattern of growth from a wider, more defined and square jawline. See my friends Napolean and Superman below.

Compare Henry Cavill’s jaw development to Napolean Dynamite. Notice Napoleans longer and more narrow face/jaw structures and open mouth posture. You can note the bags under his eyes and the inattentive gaze. Cavill (Superman!) has a more defined, square jaw. His lips are shut as he nose breathes. Napolean mouth breaths so much he needs some extra chapstick (“But my lips hurt real bad!”)… I wonder if Napolean has a tongue tie!

The impact of these esthetic issues may not be immediately apparent, but they can manifest later in life. By addressing tongue and lip ties early on, you can promote healthy oral development and potentially prevent the need for orthodontic treatment in the future. This potentially saves time, money, and inconvenience for your child later in life during orthodontic treatment, and strongly contributes to a healthy, attractive jawline as an adult.

Speech Development: Untreated tongue and lip ties can impact speech development, because they restrict the movements of the tongue and lips. These conditions may lead to speech articulation problems, making it challenging for children to pronounce certain sounds correctly. The sequelae of restricted communication, reduced confidence, and possibly poorer academic performance “speak” for themselves (pun intended!) Speech language pathologists are a wonderful resource.

Beyond Breastfeeding: Seeking Professional Guidance

In conclusion, it's crucial for discerning parents like you to be aware of the hidden risks of untreated tongue and lip ties. These conditions can affect not only breastfeeding but also brain development, sleep quality, speech, and esthetic jaw development. By consulting with the right professionals you can address the root causes and make informed decisions for the well-being of your little ones.

As my own journey with my son's ties unfolded, we decided we wanted to address the root cause of all these issues, which in his case was the tongue tie and lip tie. But contemplating the frenectomy procedure for our little guy was hard! I’ll talk more about that in the next part of this series and explore the various alternative treatment options.

I’ve got a list of books and resources on this subject if you’d like to learn more! The list below is a good place to start. Please reach out with any questions.

Dr. Brayden Teuscher

References:

1. Smith R, et al. (2015) "Tongue-tie: the evidence for division and the significance of professional and parental attitudes." International Journal of Pediatric Otorhinolaryngology.

2. Geddes DT, et al. (2008) "Frenulotomy for breastfeeding infants with ankyloglossia: effect on milk removal and sucking mechanism as imaged by ultrasound." Pediatrics.

3. Guillemin M, et al. (2013) "Ankyloglossia as a risk factor for maxillary hypoplasia and temporomandibular joint dysfunction." The Angle Orthodontist.

4. Lowe A, et al. (2012) "Tongue tie and lip tie: evidence and response." Clinical Lactation.

5. Martinelli RL, et al. (2016) "Ankyloglossia: The adolescent and adult perspective." International Journal of Pediatric Otorhinolaryngology.

6. https://www.drghaheri.com/blog

   BOOKS BELOW

7. Walker, M. (2017). Why We Sleep: Unlocking the Power of Sleep and Dreams. Scribner.

8. Moore, S. (2018). Sleep Wrecked Kids: Helping Parents Raise Happy, Healthy Kids, One Sleep at a Time. Grammar Factory

9. Nestor, J. (2020). Breath: The New Science of a Lost Art. Riverhead Books.

10. Buchanan, S. (2019). Jaws: The Story of a Hidden Epidemic. Chelsea Green Publishing.

11. Gelb, M., & Howley, H. (2019). Gasp: Airway Health - The Hidden Path to Wellness. HarperOne.

12. McKeown, P. (2015). The Oxygen Advantage: The Simple, Scientifically Proven Breathing Techniques for a Healthier, Slimmer, Faster, and Fitter You. William Morrow.

Should I See a Dentist for Botox?

Having choices is a wonderful thing. But if you’ve ever stood in the shampoo aisle feeling your eyes cross at the myriad choices... it helps you realize that it’s good to have a basis for the decisions you make. And when it comes to making really important decisions, like those regarding your health, information is key. Below is some information about why you should consider seeing a dentist for Botox therapy.

What Exactly is Botox anyway?

The American Society of Plastic Surgeons defines Botox as: The cosmetic form of botulinum toxin, sometimes referred to as "Botox" by patients, is a popular injectable that temporarily reduces or eliminates facial fine lines and wrinkles. 

According to the Mayo Clinic:

“Botox injections are shots that use a toxin to prevent a muscle from moving for a limited time. These shots are often used to smooth wrinkles on the face. They're also used to treat neck spasms, sweating, overactive bladder, lazy eye and other conditions. Botox shots also may help prevent migraine.

The medicine in Botox injections is made from the same toxin that causes a type of food poisoning called botulism. But the forms of purified botulinum toxin used by licensed health care providers meet medical control standards. These standards were approved by the U.S. Food and Drug Administration. As a rule, the bacteria toxins used for medical purposes are not harmful if used correctly.”

Mayo further points out that: Botox is a prescription medicine and must be used only under the care of a licensed and skilled health care provider. 

Why Might I choose to do Botox?

As Mayo points out, these injections can be used to help treat conditions such as migraine headaches. It is also used by dental professionals, in particular, to help patients with the pain associated with temporomandibular joint issues, often referred to as TMJ. Many people choose Botox for cosmetic purposes such as to reduce the appearance of lines and wrinkles on the face. People also may choose to try Botox as a preventive to help lessen chances of facial lines developing in the first place.

Why Would Teuscher Legacy Dental’s Dr Riley Teuscher be a good choice for Botox? 

Knowledge and Training:

After 4 years of pre-med biology, chemistry, anatomy and physiology, Dr. Riley studied 4 additional years in these sciences applied to dentistry. His education involved extensive study of the nerves, muscles and blood vessels of the face, head and neck. Few professions undergo this level of intense training on the anatomy of these specific areas, and very few professionals actually use this education on a daily basis the way a dentist does. Dr. Riley also chose additional advanced training to become certified by the American Academy of Facial Esthetics specifically on the benefits, risks, comfortable administration, and aesthetic outcomes related to Botox® injections.

Experience:

As a dentist, Dr. Riley has vast experience in providing comfortable and accurate facial area injections. The depth and precision of an injection matters, the dosage matters, and the ability to consistently monitor your comfort and response matters, so it’s important that your caregiver is accomplished in these areas. And because people can be a bit anxious when it comes to injections, it’s essential that you choose a professional who has perfected the intricate technique of giving gentle and comfortable injections by doing this dozens of times every single day. You’d be hard-pressed to find any licensed healthcare professional who has more experience giving expert facial-area injections.

Appreciation for Aesthetics:

In addition to advanced training and experience evaluating facial aesthetics, Dr. Riley is skilled in helping patients assess their own unique facial qualities. By evaluating more than just a targeted spot but by also considering your entire facial structure, he can assist you in understanding how even minor changes can affect your overall appearance – as well as how these changes might affect your ability to smile, express, or even chew comfortably and effectively. When it comes to facial cosmetic injections, you want to choose an experienced professional with this sort of keen eye for detail, function, comfort, and beautiful aesthetics. 

Conclusion

So if you’re considering Botox, information is key. Be sure to understand the importance of having facial injections administered by a professional who has knowledge, training, experience, and skill, as well as an acute appreciation for the results you’re hoping to achieve.

Give our office a call at 630-762-0000 to reserve time with Dr. Riley. He’ll be happy to help!

Unlocking Comfort: Safe and Relaxing Dentistry with Oral Sedation

We offer oral Sedation for patients in St Charles, Geneva, Elburn and the Fox Valley area! It’s almost like a dental spa!

Studies show that over 50% of people have dental anxiety. Are you one of them? Often anxiety is the reason people avoid coming to the dentist. We get it! It’s hard to overcome that anxiety, especially if it’s from a previous traumatic experience. We understand and we want to help remove that barrier at Teuscher Legacy Dental!

We are happy to announce we have a solution that could change the way you perceive dental visits: minimal oral sedation.

In this post, we'll explore what exactly minimal oral sedation is, and highlight it’s safety, and discuss its benefits. Let’s dive in!

Enhancing Comfort and Reducing Anxiety

Excellent, peer-reviewed studies have consistently shown that minimal oral sedation significantly reduces anxiety levels, making dental visits more comfortable and stress-free. Studies have shown that patients who receive minimal oral sedation report significantly lower anxiety scores compared to those who had traditional dental procedures without sedation. The studies conclude that oral sedation is effective for alleviating anxiety and enhancing patient comfort during dental care.

What is minimal oral sedation?

Minimal oral sedation involves the use of carefully prescribed medicine to help you into a relaxed state without losing consciousness. There’s no IV line, and you wont be asleep like general anesthesia. Basically, your dentist will prescribe a medicine, usually in the form of a pill, which you will take when you arrive at the office (or even the night before if it will help you rest prior to your visit). The sedative effects will gradually take hold, allowing you to remain calm and relaxed throughout your treatment. Our dedicated team will closely monitor your vital signs and ensure your safety and comfort at all times.

Safety First: A Priority in Our Practice

Safety is always a priority for us. We understand the concerns you may have regarding sedation techniques, and we have advanced training and safeguards. Multiple peer-reviewed studies have concluded minimal oral sedation is a safe and well-tolerated method for managing dental anxiety. (1,2) Our doctors will always help you with a thorough review of your medical history and current medications prior to your visit to make sure you will be at your most comfortable. We adhere to strict protocols and carefully select appropriate sedation levels based on each patient's unique needs. And we always closely monitor throughout the procedure to ensure your well-being.

Transform Your Dental Experience

Imagine a dental visit where you feel at ease, free from anxiety, and in complete control. With minimal oral sedation, this is now a reality. Whether you are due for a routine cleaning or a require a more complex procedure, our team is ready to provide you with a safe, comfortable, and enjoyable experience. Everyone deserves quality care, and our commitment to the latest research and techniques, including oral sedation, reflects our dedication to your well-being. And if oral sedation isn’t enough, our premium speaker system and 2 flat screen TVs in each room can aid in a little extra distraction if needed!

Don't let dental anxiety hold you back from achieving optimal health. Oral sedation is a safe, easy, and effective way to help nervous patients feel great during their experience! If you or someone you know is looking for dental oral sedation in St Charles, Geneva, or Elburn, we can help! Give us a call or text today!

Say goodbye to dental anxiety and hello to a future of stress-free dental visits! See you soon.

References:

1.     Donaldson M, Gizzarelli G, Chanpong B. Oral sedation: a primer on anxiolysis for the adult patient. Anesth Prog. 2007 Fall;54(3):118-28

2.     Stillwell KD, Anderson BJ. Adult minimal oral sedation in the general practice setting. Gen Dent. 2012 Jan-Feb;60(1):31-43. 

Smoothies: Something to Chew On

Dr Brayden thinks his smoothies are the best…

I drink a smoothie almost every morning. I am renowned for my tasty mixes! One of the best parts about morning shakes is that they’re an easy to get a nice dose of green veggies, providing tremendous nutritional benefit in our world of processed junk food. Plus, when smoothies get blended the nutrients become highly bioavailable. It makes digestion way easier. Having these benefits on-the-go make these shakes a bit of a life-hack. Maybe you are a smoothie king or queen yourself! But there is a downside to smoothies you should know about.

The downside is you don’t have to chew them!

Work smarter, not harder

In this blog, I’m going to argue that you should consider chewing your morning smoothie.

Chewing is only a small amount of added effort, and believe it or not, in this case working harder is working smarter.

If you chew your smoothie, you will:

1. Eat fewer calories, and feel full longer

2. Optimize digestive hormone levels

3. Be less stressed

4. Exercise and possibly develop a more attractive jawline

Eat less, and feel full longer

The fact that blenders liquify our food so efficiently means that things which normally take a longer time and more energy for your gut to break down are ready for the gut’s nutrient processing. The efficiency of the breakdown mean the gut has less work to do, and processes the food more quickly. Research has also shown our gut-brain-axis has more trouble registering calories from a liquid than from a solid. This is in part because chewing slows us down, but also because it releases gut hormones that signal satiety- something drinking does not do. More info on that below. So with a smoothie, you will be more likely to consume more calories before you feel full, and you are more likely to be hungry sooner than if you had eaten the shake elements in their original form. This could be a downside for those trying to lose weight, or those who are trying to feel full til lunch!

Optimize hormones

Hormonally, drinking calories has some disadvantages as well. Research has shown that gut hormones respond to the chewing action- these hormones not only influence hunger, but also blood sugar levels. Research is ongoing, but these studies suggest increased chewing may be an effective tool to help with weight loss and blood sugar regulation. It is also clear that optimizing hormone levels is critical for people suffering from Crohn’s, leaky gut, IBS, and the like.

Chewing also helps mix foods with your saliva. The enzymes in saliva are the first step in the digestive process, and help prepare food for easier digestion in the rest of your gut. This is arguably less important with a protein shake though, since the blender physically breaks down the food so efficiently for us.

Relieve Stress

Do you clench or grind your teeth when you’re stressed? That’s pretty common, and it's known that chewing is related to stress reduction.  While there can be many root causes for clenching and grinding, it certainly can be a coping mechanism to help relieve stress. And chewing food does the same thing for stress reduction.

Work out!

 I’d especially advocate chewing for growing children. There’s a well-documented epidemic of small jaws in developed countries, leading to increased need for orthodontics, diminished breathing ability, and poor facial esthetics. That’s why “Mewing” has become so popular. Western societies eat more soft, processed foods. Our jaws aren’t developing like they used to because we don’t chew like we used to! When we don’t exercise our jaws in our youth, they don’t grow to the proper size. Part of the problem is our new, processed foods are less nutritious, but the majority of the blame is on a lack of chewing in childhood. I’ll write more about this in a future blog post.

So what?

Did I convince you? Just take a sip, chew a few times, then swallow and repeat. You may also consider chewing gum after drinking the smoothie for some of the same benefit. Hopefully I’ve given you some food for thought- chew on that if you like!

-Dr Brayden Teuscher

Gum Disease Linked to Severe COVID

Dr Brayden talks about gum disease’s systemic implications

Do your gums bleed when you floss? If your answer is YES, you are not alone. Well over half of US adults have gum disease, and though bleeding is one indicator, it’s likely a majority of people are unaware of their disease.(1) The US surgeon general has called gum disease a “silent epidemic”, and this disease is often ignored despite being highly treatable.(2,3) Because gum disease can affect your overall health and your finances in addition to your mouth, we are reposting this blog series to talk about it. These posts will define what gum disease is, how it interacts with our whole body health, and how it impacts our wallets.

Gum Disease and COVID

We know people who are at “high risk” tend to have the worst COVID symptoms. Many factors can put someone in that “high risk” category, and one of them is gum disease. Several studies have shown that people with gum disease are between three and five times as likely as someone with healthy gums to have severe COVID illness leading to ICU admission or even death. The science is clear: gum disease makes COVID illness worse. Keep reading to find out why!

What exactly is “Gum Disease”?

When we talk about “Gum Disease” we may be referring to two distinct conditions. One is gingivitis, which refers to gum (gingiva) inflammation, or swelling (-itis). When a person has gingivitis, their gums become inflamed, or swollen, with blood and immune system cells. We will discuss the most common reason for this inflammation below. Gingivitis is the first stage of the second even more serious gum disease condition of periodontitis, or periodontal disease.

As opposed to gingivitis, periodontitis refers to inflammation around teeth (perio=around, dont=tooth, itis=inflammation). When inflammation spreads from the tops of gums (gingivitis) to the area surrounding teeth (periodontitis), the classic sign is bone loss, which we measure via radiographs and probing depths. We will discuss the mechanism of bone loss below. 47% of US adults have periodontitis, or periodontal disease, but a large portion of the remaining 53% may have gingivitis, which, without treatment, leads to periodontitis.(1) The scary truth is that gum disease is usually painless and has no symptoms at all during the early stages of gingivitis and mild periodontitis, so it can go unrecognized initially.  Unfortunately, the more advanced the gum disease, the greater the systemic health implications – meaning that gum disease can affect other parts of the body and other diseases as well, some of which we discuss below.

How does Gum Disease Progress?

We can almost think of gum disease in two ways: as an infection, and as an inflammatory process.

Gum Disease as An Infection

Gum disease typically will start as gingivitis. The gums become inflamed due to dental plaque- the sticky matrix of bacteria and food debris that gets stuck to our teeth when we don’t clean them well. Eventually, the soft, sticky plaque hardens into calculus, which also harbors bacteria but can only be removed by a dental hygienist. The bacteria and bacterial products induce an immune response from our gums that tries to eliminate what our body is sensing as an infection.

In fact, when our gums are inflamed and bacteria are present in sticky plaques or clinging to calculus, even the simple act of chewing can cause the release of bacteria or their toxins into our bloodstream creating a condition known as bacteremia, or bacteria in the blood. (4)

Usually the increase of bacteria in the blood is transient, or short-lived. But sometimes metastatic infections can occur and become chronic infections, especially if a person has artificial joints or heart valves, atheromas, or is otherwise immunocompromised.(5) In fact, the species of bacteria present in gum disease have been found to specifically predispose us to “systemic diseases such as cardiovascular disease, oral and colorectal cancer, gastrointestinal diseases, respiratory tract infection and pneumonia, adverse pregnancy outcomes, diabetes and insulin resistance, and Alzheimer’s disease”, as reported in Clinical Microbiology Review.(6) Plaque is just the first stage of bacterial colonization.

The worse the gum disease condition, the higher incidence of bacteremia and risk of complications.(7) And, considering there may be up to a trillion dangerous bacteria per diseased tooth, it’s best to nip gum disease in the bud before it develops!

Gum Disease as an Inflammatory Process

Usually we talk about plaque and bacteria causing gum inflammation. But so can pregnancy, certain drugs, and hormonal changes due to puberty or menopause. Inflammation from gingivitis, when untreated, will cause oxidative stress in our bodies, and cytokines to be released from the epithelial lining of our gum pockets. These cytokines are like a messenger system for our body, and they attract immune cells. This process eventually results in the breakdown of our connective tissue and jawbone loss surrounding our teeth. A dental team would be able to see this bone and tissue loss via radiographs and probing depths . Tissue loss around teeth leads to an increased likelihood of tooth mobility (loose teeth) and, eventually, loss of teeth.

Gum Disease Makes You Sicker

But the inflammation doesn’t just stop around your teeth. Many studies have shown an increase in systemic inflammatory markers as a result of gum disease, meaning that inflammation affects far more than your mouth.(8) This is why people with inflamed gums get sicker than people with healthy gums! We talk more about how gum disease affects speficic illnesses in these blogposts: blood pressure and pregnancy, cancer and diabetes, and gum disease is expensive!

The great news about this sinister inflammatory process is it’s been proven that dental treatment for gum disease will reduce systemic inflammation.(8) If you or a loved one have bodily inflammation, consider making dental treatment a part of your wholistic plan to get healthier in 2023!

At Teuscher Dental, our Focus is to Help You Get Healthy and Stay That Way. Let us know how we can help you on your health journey!

References

1) American Academy of Periodontology. “CDC: Half of American Adults Have Periodontal Disease.” CDC: Half of American Adults Have Periodontal Disease | Perio.org, 4 Sept. 2012, www.perio.org/consumer/cdc-study.htm

2) “Surgeon General’s Report on Oral Health in America.” National Institute of Dental and Craniofacial Research, U.S. Department of Health and Human Services, www.nidcr.nih.gov/research/data-statistics/surgeon-general.

3) Benjamin, Regina M. “Oral Health: the Silent Epidemic.” Public Health Reports (Washington, D.C. : 1974), Association of Schools of Public Health, 2010, www.ncbi.nlm.nih.gov/pmc/articles/PMC2821841/.

4) Geerts, Sabine O, et al. “Systemic Release of Endotoxins Induced by Gentle Mastication: Association with Periodontitis Severity.” Journal of Periodontology, U.S. National Library of Medicine, Jan. 2002, www.ncbi.nlm.nih.gov/pubmed/11846202.

5) Parahitiyawa, N B, et al. “Microbiology of Odontogenic Bacteremia: beyond Endocarditis.” Clinical Microbiology Reviews, American Society for Microbiology (ASM), Jan. 2009, www.ncbi.nlm.nih.gov/pmc/articles/PMC2620633/.

6) Forner, Lone, et al. “Incidence of Bacteremia after Chewing, Tooth Brushing and Scaling in Individuals with Periodontal Inflammation.” Journal of Clinical Periodontology, U.S. National Library of Medicine, June 2006, www.ncbi.nlm.nih.gov/pubmed/16677328.

7) Carrizales-Sepúlveda, Edgar Francisco, et al. “Periodontal Disease, Systemic Inflammation and the Risk of Cardiovascular Disease.” Heart, Lung and Circulation, Elsevier, 2 June 2018, www.sciencedirect.com/science/article/pii/S1443950618305973.

8) D’Aiuto, F, et al. “Periodontitis and Systemic Inflammation: Control of the Local Infection Is Associated with a Reduction in Serum Inflammatory Markers.” Journal of Dental Research, U.S. National Library of Medicine, Feb. 2004, www.ncbi.nlm.nih.gov/pubmed/14742655.

9) Marouf, Nadya, et al. “Association between Periodontitis and Severity of COVID-19 Infection: A Case-Control Study.” Journal of Clinical Periodontology, U.S. National Library of Medicine, Apr. 2021, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8014679/.

10) Larvin, Harriet, et al. “The Impact of Periodontal Disease on Hospital Admission and Mortality during COVID-19 Pandemic.” Frontiers, Frontiers, 1 Jan. 1AD, https://www.frontiersin.org/articles/10.3389/fmed.2020.604980/full.

Should I Get Clear Aligners?

Wasn’t middle school the best? Didn’t you feel supremely confident and self assured? Just kidding. It was awkward! Part of many middle schooler’s gawkiness is the mouth full of metal braces. My orthodontist offered different colored bands to personalize your metal mouth. I always got white. But some of my friends chose green and yellow! Not my first choice for teeth colors! I guess they were Packer fans… In any case, getting braces off was a coming of age event for many! Confidence was boosted and physical attractiveness increased.

The problem is, once braces are off, teeth begin to shift. Often this process is slow and can take years before you notice any difference. Usually you’ll have some sort of retainer, whether permanent or removable to be worn at night, and ideally, this is worn for life to prevent teeth from relapsing to a crooked position. If you lost your retainer long ago, your dog ate it, or it just wont fit anymore, we can help! Read more below to learn about why your teeth shift, the consequences, and how we can help you with clear aligner orthodontics!

An example clear aligner tray

Why teeth shift

You may have heard third molars can cause crowding. Especially if wisdom teeth are impacted at an angle, meaning they’re horizontal in your bone instead of vertical, they can push the adjacent teeth forward. As the back teeth push forward, the front teeth have nowhere to go but overlap! Even when wisdom teeth are removed, teeth have a general tendency to migrate toward the center line. This is especially true in the lower jaw, where front tooth crowding is most common.

Chewing patterns and forces can also cause tooth movement. We each tend to subconsciously chew in a specific pattern and our teeth wear down or move accordingly. Some people chew like cows and really grind horizontally, some chew like rabbits up and down, and most somewhere in between. Everyone’s different. But did you know it’s recommended we chew an average of 32 times per bite of food? Multiplied by many bites of food per day, and as years go by its not surprising we see teeth move in response to millions of bites!

Breathing habits also can cause shifts in teeth. Recently there’s been much research on optimal breathing (nasal breathing is best!), but there’s also been some attention paid to breathing posture and facial esthetics. Basically, your resting posture of tongue and cheeks put mild pressure on your teeth and even jaw bones themselves. Over time, this mild pressure forms your jaw bone, and your tongue, lips and cheeks can gradually push your teeth around. You may have heard of “Mewing”, which is a practice named for a British dentist John Mew. Mew’s theory is that by utilizing correct tongue posture and breathing, the natural pressures from tongue and cheeks will push the teeth into alignment. Mewing is a concept within orthotropics, and has tremendous value! But this is most effective as you are still growing. Once you reach adulthood, mewing to shift your teeth or form your jawline is likely to take years before you see any result.

The problems with shifted teeth

Esthetics! If you don’t like the way your teeth look because they aren’t straight, we can help! We’ve had many patients tell us they didn’t ever fully smile because they felt self conscious about their teeth appearance. One of the most life changing experiences you can have is from self consciousness to a big beautiful smile. We’ve seen dramatic improvements in confidence, self esteem, and overall happiness. This is a quality of life issue! A huge part of health is our mentality and confidence. Our doctors have advanced training in clear aligner orthodontics and bite relationship alignment. If necessary we also work with great orthodontists for the most complex cases, and have many options for whitening or restorative dental treatments in addition to Invisalign treatment.

Shifted teeth can also cause tooth wear. Have you ever noticed your front teeth becoming flatter as you age? This is natural to a degree, but often occurs at a rapid pace due to a lack of space between top and bottom front teeth. If there is diminished space, chewing will cause accelerated wear of these teeth. Remember the cow chewers and bunny chewers? Which one are you? Bunnies generally don’t wear as quickly as cows. Clear aligner orthodontics can help create space to stop the wear, and if necessary allow for predictable restoration of natural tooth length and proportion.     

Sometimes shifting can cause jaw joint issues. Have you noticed yourself needing to squeeze your jaw muscles to close your back teeth together? Or even that when resting, you have a different bite than when closing all the way together? The muscle action to close teeth together  can strain your TMJ, or temporomandibular joint. Temporomandibular disorders, or TMDs, are complex issues with your TMJ, and often aren’t solely the result of misaligned teeth. But without question misaligned teeth are a huge contributor to TMJ diseases.

How Clear Aligners Work

Clear Aligners, often called “Invisalign”, work by gradually pushing your teeth over the course of several weeks. Initially, one of our doctors will do a thorough exam to determine whether you’d be a candidate for clear aligner treatment. If so, we take photos and a digital record of your teeth in their current position. We then digitally plan where your teeth should be moved. Once you agree to the tooth movement plan, we give you a series of clear aligners, usually to be worn for a week or two at a time. Depending on how much the teeth need to be moved, it may take a few months to complete the movement, and we check in on your movement as often as necessary. Once teeth are moved into place, we give you clear retainers to be worn at night to provide stability and prevent future movement.

If you’re wondering whether clear aligners are for you, or have any questions about teeth shifting, call or text us! We will always take great care of you.

New Building!

 As of August 1st, we are seeing patients in our new facility!

Thanks to our wonderful patients, our practice has grown – and we are grateful for this blessing! We thought a lot about the limitations of our former space and what an ideal space would look like to continue providing excellent care far into the future.

Finally, last winter we found a building that checked all our boxes.

And, it was literally right across the street! Here are a few benefits of the new space to be excited about:

Our new reception area

• More parking

• Advanced air filtration system for infection control

• Increased privacy in our checkout area and treatment rooms

• State of the art technology

• More space in our reception area

The past year we’ve spent countless hours researching, designing, and planning. Finally, in February, construction was underway!

We cant wait to see you in our new digs!

The new address is:

40W131 Campton Crossings Drive

St Charles, Illinois 60175

And when we say it’s just across the street, we mean it literally!

Google says the distance is only 300 yards away… We cant wait to see you in our new digs soon!

For more photos of the build progress and other TLD Team updates, check our Facebook page.

COVID-19 Update

The NEWS is continuously changing, particularly with regard to COVID-19 / “Coronavirus.” We are serious about safety and health. Here are the precautions we have in place to help keep our staff and you safe from COVID. Please know that Teuscher Legacy Dental is always monitoring the most up-to-date news, alerts, and safety precautions. What will NOT change is our ongoing commitment to YOU. The needs of our patients are our #1 priority, including your interests, comfort and safety. We are now open for all dental procedures. If you have any questions, you can always give us a call or text.

Summer 2022 update:

As a part of our move to our new office, we have made several technological updates to keep you as safe as possible! One of the most important is our state of the art air filtration system. When we designed our new office, we were able to leverage the latest thinking in infection control coming out of the COVID years. Our air filtration is as safe as it gets!

This spring we had an OSHA consultant review our infection control procedures and affirm our processes.

In addition to the latest sanitation technology, products and procedures, our new office has private operatories. This means enhanced privacy for you, but importantly, also means any aerosol we generate in one room will not travel to adjacent rooms. Put simply, other people’s germs will stay in their own rooms so you won’t have to wonder about cross-contamination.

Per CDC and IDPH recommendations, we still ask that patients wear masks in our office. Please help us love and protect others by masking during your visit. Thank you!

March 16th, 2021:

Last week, we brought in a leading expert on infectious diseases and infection control

The expert checked out our facilities and talked in depth with our staff. Not only were we reassured that our sterilization and sanitation measures are the best in the business, but we were also told that the products we use – which effectively kill concerns such as HIV and Hepatitis – also kill the relatively weaker Coronavirus COVID-19. 

May 12th, 2020:

The Illinois Department of Public Health has advised that Illinois Dental practices are fully open for all procedures.

We are now open!

Your well-being is always our top priority. We are committed to be the safest possible office and environment for both our patients and team. For more information, check out our dedicated COVID-19 Update page.

May 4th:

In following Illinois’s “Shelter in Place” modified extension, we are planning to officially reopen our office on June 1st.

Our team is working hard during this time to learn and plan for a safe and successful return. We are getting everything ready: PPE protocols, pre-appointment coronavirus screenings, staggered scheduling to reduce the number of people in the office at a given time, antibiotic mouth washes, and innovative suction systems to eliminate aerosols, just to name a few.  We will be posting more updates soon about how we’ll be back ready to serve you better than before! 

Our team will always try to accommodate patients with emergencies and other time-sensitive needs. We are monitoring our phones every day, so if you have any questions or concerns, give us a call!

As always, we are paying close attention to the guidance of the CDC, ADA, ISDS and Illinois government. We hope you and your family are well and look forward to seeing you soon!

March 26th:

We’re living in interesting times! To protect our patients and team and to honor our medical colleagues’ requests, we have suspended all routine dental care until April 8th. This is in line with Illinois’s “Shelter in Place” order, as well as guidelines from the ADA and ISDS. We are still seeing emergency patients.

To protect our patients and team, and to honor our medical colleagues’ requests, we have suspended all routine dental care until April 8th.

Remember: if you are experiencing pain, swelling, or have another urgent need, we will still take care of you. If you have any questions or concerns, please give us a call or text. We are monitoring our phones daily.

In the meantime, our team is using this as an opportunity to learn new skills and improve our current systems. We’ve also been able to enjoy a little more downtime to relax with some of our favorite hobbies. To see some of what we’ve been up to, check out our Facebook page.

Be safe, be healthy, be Blessed!

March 23rd:

To protect our patients and team, and to honor our medical colleagues’ requests, we have suspended all routine dental care at this time.

This is in line with the ADA, ISDS, and other health organizations, in addition to the recent “Shelter in Place” protocol. We will keep you informed, but in the meantime, we will offer care on an emergency basis only. The ADA defines a dental emergency in great detail, but if you are experiencing pain, swelling, or have another urgent need, we will be sure to take care of you.

If you or your family have any questions or concerns, please call us, as we continue to monitor our phones. From all of us at Teuscher Dental, be safe and be healthy!

March 18th:

We are making decisions on a daily basis based on the best information we can receive from credible sources in dentistry and medicine, along with the CDC and WHO. The health of the people who trust us for their and their families’ care, and the health of our team and their families is TOO important to take risks with non-essential procedures.

Be sure to contact us for emergency situations and for any questions that anybody might have. Elective dental procedures, including most hygiene procedures, are postponed until next Monday and will be rescheduled. Again, if you are experiencing pain or have any questions, please call us. We appreciate your understanding and willingness to make this sacrifice with us as we all do everything that we can to ensure public well-being.

What we are doing in light of recent news:

• We have always been dedicated to exceeding even the most stringent OSHA protocols for maintaining a sterile environment.

• For patients who have appointments, we are screening for illness risk factors such as recent travel to foreign countries and any current or recent symptoms.

• We are choosing to remove from our reception areas items that are frequently touched, such as magazines, pens and our coffee machine.

• In addition to our sterilization procedures in each operatory before and after every patient, we are also committed to disinfecting our reception and restroom areas twice an hour – including all door handles, faucet handles and light switches.

What you can do while you are here:

• Please sanitize your hands when you arrive, using hand sanitizer dispensers we have provided for you.

• We also request that you use the provided hand sanitizer dispenser as you check out at our front desk.

What we can ALL do:

• Wash our hands frequently. Soap and water is best.

• We’ve probably all heard not to touch our faces, including eyes, nose and mouth. But if we MUST touch our face, it is best to wash or sanitize our hands both before AND afterward.

• Resist touching our faces with (or chewing on) pens, pencils, fingernails.

• Cover a sneeze or cough with our inner elbow (if possible) or a tissue.

• Avoid touching often-touched items, and wash hands after touching these things, also sanitize these things at home if possible: door knobs, faucet handles, toilet handles, light switches, remote controls, refrigerator and other appliance handles, buttons like on elevators and cash machines or check-out registers, even your cell phone, computer and your vehicle’s steering wheel.

• Avoid shaking hands or having close contact with others who are sick.

• Stay home and away from others if we feel sick, and call a physician for advice.

• Get plenty of rest, eat properly, drink plenty of fluids, do our best to stay healthy.

AND, PLEASE, LET’S ALL:

Remember that we can always safely “touch” others with a smile, a kind encouragement, an act of kindness, prayer and compassionate humanity.

Stay calm and use wisdom rather than give in to irrational fear. What we are facing can be scary, for sure, but let’s face it with heart, community, sensitivity and grace.

COVID-19 and Tooth Sensitivity

Having COVID is no fun. Most of us will use our entire arsenal to get better quickly! We’ve all heard that staying home, “Social Distancing”, washing hands, not touching faces, getting plenty of sleep and fluids, and eating a healthy diet are the standard pieces of advice. And did you know the severity of COVID illness is related to gum health? All these things make sense! One recommendation may have an unwanted side effect though.

Vitamins

During the pandemic and when sick with COVID, some of us also choose to take extra vitamins, including Vitamin C.  While Vitamin C is generally considered safe for most people to take, the World Health Organization and the Centers for Disease Control and Prevention, and many other sources indicate that there is no clear evidence that Vitamin C is helpful for prevention or cure of COVID-19. However, there are studies indicating Vitamin C deficiency seems to be correlated with people being more susceptible to infections and pneumonia, and also with having a lowered immune response. 

So for those who do choose to take Vitamin C as part of their fight against coronavirus, it may be helpful to know that one little-known but common side effect of taking Vitamin C can be Tooth Sensitivity: a brief sharp pain that often happens when a person eats or drinks something very cold or hot.

Tooth Sensitivity

The causes of sensitive teeth can include a cavity, cracked tooth, broken filling, teeth grinding, gum disease, receding gums, or worn enamel. Another cause of this sensitivity can be acid erosion. Acid erosion happens when the enamel of a tooth is exposed to acidic food or drink, stomach acid, or things such as Vitamin C – particularly if it’s the chewable kind. This acidity can cause the enamel to lose minerals and soften. While this softening can be temporary, if the tooth enamel is repeatedly exposed to acid it will gradually erode to leave the underlying dentin exposed and nerves irritated.

What You Can Do

If your tooth sensitivity becomes constant, painful, or you experience swelling or other additional symptoms, call us to discuss before it becomes worse. If your sensitivity remains mild, and you tend to eat or drink acidic things – or you’re taking Vitamin C – there are options you can try to gain some relief and also help prevent additional enamel erosion and future problems:

• Reduce your intake of acidic drinks such as sport drinks, fruit juices, etc., and drink them quickly or use a straw to limit the amount of time the liquid lingers on your teeth. Swish your mouth with water afterward.

• If you are chewing Vitamin C, consider switching to a different form of C that doesn’t remain in your mouth so long. Also swish with plain water afterward, or even swish water with a little baking soda mixed in it – and then spit it out.

• Avoid acidic foods, drinks and vitamins right before bed or while exercising when you produce less cleansing saliva.

• Use a soft-bristled toothbrush, and brush more gently.

• Switch to a toothpaste made specifically for sensitive teeth.

• Avoid tooth-whitening treatments, which often increase sensitivity.

• Talk with us. There’s a possibility your pain may be caused by high spots or teeth grinding. This is far more common than you may think, and we may be able to help alleviate your pain with simple remedies.

Dry Mouth and Tooth Sensitivity

A constant flow of saliva is our natural defense against acid erosion and tooth sensitivity. However, some prescription medications as well as over-the-counter medications such as decongestants can cause dry mouth. Incidentally, dry mouth is also a risk factor for other serious concerns including oral cancer (see our post on oral cancer for more information). Staying hydrated with pure water is a good first step. If dry mouth is a continued issue for you, be sure to let us know. There are helpful products that can bring relief to this dryness, and we’ve found that some products are more effective for our patients than others. Keep in mind that mouth dryness can have serious consequences so it’s not something to simply dismiss!

The Bottom Line

We all want to do everything we possibly can to keep our families and ourselves healthy.  But sometimes our efforts to be safe in one area of life can cause problems in other areas, as in the case of chewing Vitamin C. It’s tempting to try the many suggested home remedies we hear or read about on the internet, but these ideas can be unhealthy or even dangerous. The wisest thing to do is to stick with respected sources for information, such as the Mayo Clinic, Johns Hopkins, the World Health Organization, the Centers for Disease Control and Prevention, the Teuscher Legacy Health Blog, and, of course, call your physician and/or call us when you need individualized advice and questions answered. We are always happy to help.

Stay healthy!

P.S.- if you have any questions about this, or are in need of cosmetic dentistry, implant dentistry, or general dentistry in St Charles, Illinois, give us a call or text! We’d love to help!

Gum Disease, Cancer, and Diabetes

If you are reading this, there’s a high chance you have gum disease.1 In previous posts we’ve discussed what gum disease is and how it can affect pregnancy and heart disease. This post will continue that discussion with a focus on cancer and diabetes.

Our hope through these posts is to help you understand how your oral health is a huge part of your overall well-being. Our information is always well researched, as you can see by our references at the bottom. Keep reading, and let us know if you have any questions or comments!

Oral Cancer

Oral cancer is the 8th most common type of cancer in the US, and the majority of head and neck cancer cases are found in the mouth, particularly the sides of your tongue.2 Cancer is one of the many things we screen for at every exam at Teuscher Dental, and part of why regular dental exams are so important and about more than just teeth and gums. Cancerous lesions appearing on the tongue are correlated with gum disease.3 And inflammation in general is thought to contribute to cancer development.  Oral cancer has a high incidence of malignancy, and even when successfully treated can require extensive facial reconstructive surgery to recover from, as exampled by oral cancer survivor Gruen Von Behrens’ before and after photos.4

As stated above, inflammation like that of gum disease can contribute to any type of cancer. That, along with pregnancy complications and heart disease, are just a few of the diseases and complications with direct correlation to gum disease. But research also has demonstrated gum disease links to colorectal cancer, gastrointestinal diseases, respiratory diseases, and Alzheimers to name a few. As more research is done it is all too likely the links will become more clear. Gum disease is no joke.

Diabetes

Both Type I and Type II diabetics are more prone to develop periodontal disease, the advanced form of gum disease, than non-diabetics.5,6 This is especially true for children with diabetes, where gum disease progression happens more quickly and is associated with longer duration of diabetes.7 In advanced gum disease, teeth can be lost due to breakdown of surrounding bone and tissue. Snowballing the problem, we know gum disease is associated with low grade inflammation and oxidative stress. These effects are also known to cause lower saliva output, causing dry mouth, increasing risk for dental caries (cavities) and further tooth loss.8 Aside from poor esthetics, tooth loss is is associated with increased likelihood for dysfunctional dentition- that is, teeth that don’t allow for proper nutritional intake.9 This is a particular problem for diabetic patients. It is a vicious cycle.

Don’t have diabetes? Studies have shown that we can actually predict whether a person is more likely to develop diabetes based on their periodontal health.10,11 While a diagnosis of diabetes depends on blood sugar levels, as with all health conditions there is a spectrum of glycemic control.  All aspects of our body’s health are interrelated.

Comprehensive research shows dental therapy for gum disease moderately decreases blood glucose levels in diabetics.12 . When we understand the strong correlation and the severity of issues associated with diabetes, it becomes clear that dental treatment for gum disease should be a part of a comprehensive diabetes medical treatment plan.

References

1. American Academy of Periodontology. “CDC: Half of American Adults Have Periodontal Disease.” CDC: Half of American Adults Have Periodontal Disease | Perio.org, 4 Sept. 2012, www.perio.org/consumer/cdc-study.htm.

2. “Oral Cancer Facts.” The Oral Cancer Foundation, 28 Feb. 2019, oralcancerfoundation.org/facts/.

3. Tezal, Mine, et al. “Chronic Periodontitis and the Risk of Tongue Cancer.” Archives of Otolaryngology–Head & Neck Surgery, U.S. National Library of Medicine, May 2007, www.ncbi.nlm.nih.gov/pubmed/17515503.

4. Henson, Brian J., et al. “Decreased Expression of MiR‐125b and MiR‐100 in Oral Cancer Cells Contributes to Malignancy.” Wiley Online Library, John Wiley & Sons, Ltd, 24 Apr. 2009, onlinelibrary.wiley.com/doi/abs/10.1002/gcc.20666.

5. Hodge, Penny J, et al. “Periodontitis in Non‐Smoking Type 1 Diabetic Adults: a Cross‐Sectional Study.” Wiley Online Library, John Wiley & Sons, Ltd, 31 Oct. 2011, onlinelibrary.wiley.com/doi/abs/10.1111/j.1600-051X.2011.01791.x.

6. Haseeb, Muhammad, et al. “Periodontal Disease in Type 2 Diabetes Mellitus.” Journal of the College of Physicians and Surgeons–Pakistan : JCPSP, U.S. National Library of Medicine, Aug. 2012, www.ncbi.nlm.nih.gov/pubmed/22868018.

7. Al-Khabbaz, Areej K, et al. “Periodontal Health of Children with Type 1 Diabetes Mellitus in Kuwait: a Case-Control Study.” Medical Principles and Practice : International Journal of the Kuwait University, Health Science Centre, S. Karger AG, 2013, www.ncbi.nlm.nih.gov/pmc/articles/PMC5586723/.

8. Bhattarai, Kashi Raj, et al. “The Imprint of Salivary Secretion in Autoimmune Disorders and Related Pathological Conditions.” Autoimmunity Reviews, U.S. National Library of Medicine, Apr. 2018, www.ncbi.nlm.nih.gov/pubmed/29428807.

9. Marina Leite Souza, and Karen Glazer Peres. “Association between Metabolic Syndrome and Tooth Loss.” Journal of the American Dental Association, JADA, Dec. 2019, jada.ada.org/article/S0002-8177(19)30522-7/abstract.

10. Taylor, G W, et al. “Severe Periodontitis and Risk for Poor Glycemic Control in Patients with Non-Insulin-Dependent Diabetes Mellitus.” Journal of Periodontology, U.S. National Library of Medicine, Oct. 1996, www.ncbi.nlm.nih.gov/pubmed/8910827.

11. Demmer, Ryan T, et al. “Periodontal Status and A1C Change: Longitudinal Results from the Study of Health in Pomerania (SHIP).” Diabetes Care, American Diabetes Association, May 2010, www.ncbi.nlm.nih.gov/pubmed/20185742.

12. Chee, B., et al. “Effect of Non-Surgical Periodontal Treatment on Glycemic Control of Patients with Diabetes: a Meta-Analysis of Randomized Controlled Trials.” Trials, BioMed Central, 1 Jan. 1970, link.springer.com/article/10.1186/s13063-015-0810-2.

Gum Disease and Your Wallet

Recently we’ve had a few posts about Gum Disease and how it so strongly relates to your overall health. Today we have a quick look at how it affects your wallet! Check it out below and, as always, you can contact us via call, text, or email with any questions.

Money

Need a non-health incentive for treating gum disease? How about saving thousands of dollars? The American Journal of Preventative Medicine (a non-dental organization – receiving no benefit from the results!) researched insurance payment data from over 338,000 patients. The research looked at gum disease patients and patients with healthy gums, and compared their yearly medical payments and hospital visits. The results are almost unbelievable!

The study showed annual savings for a pregnant patient who treats their gum disease is over $2,400, for almost 75% savings! And patients who suffered a stroke but treated their gum disease saved almost $6,000 per year! We’ve written about how gum disease relates to these medical conditions in previous posts.

We’ve written before about how gum disease relates to your systemic health. If you aren’t sure, ask your physician whether treating gum disease matters!

The bottom line is that gum disease is no joke, and nothing to take lightly. At Teuscher Legacy Dental, we are focused on partnering with you to improve your overall health and well being. Hopefully this article is educational and can be used as a resource for your pursuit of a healthier lifestyle. If you have any questions, please give us a call or text! If you learned something from the post that your loved ones can benefit from, please share it with them.

Gum Disease, Heart Disease, and Pregnancy

Well over half of US adults have gum disease, and though bleeding is one indicator, it is likely a majority of people don’t know of their disease.1,2 It’s a “silent epidemic”, and has significant effects on your systemic health!3

At Teuscher Dental, Our Mission is To Serve you. That means providing you with the best wholistic care available today, always research based and in pursuit of excellence. This post gives a little information on how gum disease relates to Cardiovascular Disease and Pregnancy. Keep reading to learn more!

Heart Disease:

Cardiovascular (CV) disease, more commonly referred to as heart disease, is the leading cause of death in the US. Hypertension, or high blood pressure, is the biggest risk factor for developing Cardiovascular disease (and your blood pressure is something our office checks at every dental exam).  Heart Disease is also highly correlated with gum disease. In fact, a comprehensive study indicated that people with periodontitis are 66% more likely to have a cerebrovascular event like a stroke, and OVER TWO TIMES as likely for those events to be fatal compared with people without gum disease.4

Why does gum disease make cardiovascular disease more dangerous? Research is ongoing, but we know cardiovascular disease can result from increased blood vessel inflammation, which can, in part, be caused by gum disease pathogens.5 Products and toxins from these bacteria also can cause changes in lipid (fat) metabolism, further contributing to CV disease risk.6 When someone already has a form of CV disease, periodontal pathogens preferentially infect atherosclerotic plaques, and studies show that when this infection occurs, multiple species of periodontal pathogens are often present.7,8

Pregnancy

Know anyone who is pregnant? Pregnant patients with gum disease are up to TEN TIMES more likely to have gestation fewer than 28 weeks, that is, a pre-term birth, according to a comprehensive study. The same study suggests that even mild periodontal disease potentially increases pre-term birth risk by over 300%.9  Gum disease also significantly contributes to low-weight births and in-utero infections.10,11 This association and risk is well documented. The good news is that the risk for pre-term and and low weight births is significantly lower for moms who receive dental therapy for gum disease.12 It should be noted that due to hormonal changes, pregnancy gingivitis is normal. But if you are thinking of becoming pregnant, a great way to decrease risk to your baby is to get screened for gum disease beforehand.

We do limit elective dental treatment during pregnancy, but often the risk to the baby (and mom) is actually greater with no treatment, especially if active dental or gum disease is present. If you are interested, the American Pregnancy Association has guidelines for receiving dental treatment during pregnancy. As always, at Teuscher Dental our top priority is your health and that of your growing baby. We will never push you into treatment that is unnecessary or risky. If you have any questions about your dental health during pregnancy, just give us a call!

In our next post we will discuss how gum disease relates to diabetes and oral cancer.

References

1) American Academy of Periodontology. “CDC: Half of American Adults Have Periodontal Disease.” CDC: Half of American Adults Have Periodontal Disease | Perio.org, 4 Sept. 2012, www.perio.org/consumer/cdc-study.htm.

2) “Patients.” ADA Health Policy Institute FAQ – Dental Patients in the U.S., www.ada.org/en/science-research/health-policy-institute/dental-statistics/patients.

3) “Surgeon General’s Report on Oral Health in America.” National Institute of Dental and Craniofacial Research, U.S. Department of Health and Human Services, www.nidcr.nih.gov/research/data-statistics/surgeon-general.

4) Bahekar, Amol Ashok, et al. “The Prevalence and Incidence of Coronary Heart Disease Is Significantly Increased in Periodontitis: a Meta-Analysis.” American Heart Journal, U.S. National Library of Medicine, Nov. 2007, www.ncbi.nlm.nih.gov/pubmed/17967586.

5) Slocum, Connie, et al. “Distinct Lipid A Moieties Contribute to Pathogen-Induced Site-Specific Vascular Inflammation.” PLOS Pathogens, Public Library of Science, journals.plos.org/plospathogens/article?id=10.1371%2Fjournal.ppat.1004215.

6) Hardardottir, I., et al. “Effects of Endotoxin on Lipid Metabolism .” Effects of Endotoxin on Lipid Metabolism , pdfs.semanticscholar.org/a2c1/9025573414d20d3cb2ffbe491493075834ec.pdf.

7) Chiu, B. “Multiple Infections in Carotid Atherosclerotic Plaques.” American Heart Journal, U.S. National Library of Medicine, Nov. 1999, www.ncbi.nlm.nih.gov/pubmed/10539867.

8) Haraszthy, V I, et al. “Identification of Periodontal Pathogens in Atheromatous Plaques.” Journal of Periodontology, U.S. National Library of Medicine, Oct. 2000, www.ncbi.nlm.nih.gov/pubmed/11063387.

9) Offenbacher, S, et al. “Maternal Periodontitis and Prematurity. Part I: Obstetric Outcome of Prematurity and Growth Restriction.” Annals of Periodontology, U.S. National Library of Medicine, Dec. 2001, www.ncbi.nlm.nih.gov/pubmed/11887460.

10) Sánchez, Andrés R, et al. “Maternal Chronic Infection as a Risk Factor in Preterm Low Birth Weight Infants: the Link with Periodontal Infection.” Journal of the International Academy of Periodontology, U.S. National Library of Medicine, July 2004, www.ncbi.nlm.nih.gov/pubmed/15368875.

11) Madianos, P N, et al. “Maternal Periodontitis and Prematurity. Part II: Maternal Infection and Fetal Exposure.” Annals of Periodontology, U.S. National Library of Medicine, Dec. 2001, www.ncbi.nlm.nih.gov/pubmed/11887461.

12) Kim, Arthur J, et al. “Scaling and Root Planing Treatment for Periodontitis to Reduce Preterm Birth and Low Birth Weight: a Systematic Review and Meta-Analysis of Randomized Controlled Trials.” Journal of Periodontology, Centre for Reviews and Dissemination (UK), Dec. 2012, www.ncbi.nlm.nih.gov/pubmed/22376207.

Teuscher Dental goes to Summer School

What I did on my summer vacation… 

How many of us had to write that age-old essay during the first week of school? If you are lucky enough to have a break, most of us want to be relaxing by the pool, out hitting the links, or just enjoying the “me time” of the lazy hazy crazy days of summer.

A few Teuscher Dental team members took a break earlier this summer too, but it wasn’t as relaxing as you may expect… our break was all about YOU!  For the entire first week of June, Dr. Mike Teuscher and soon-to-be-dentists sons Riley and Brayden Teuscher traveled to the world-renown Kois Center in Seattle, Washington for a 55-hour dental science intensive course. They were among a group of 40 elite dentists from around the world – including Spain, England, China and Canada – to study directly under the respected Dr. John Kois at this prestigious dental education center.

The class was on biomechanics, which encompasses the relationship between a person’s biological structures (teeth and gums) and dental materials (crowns, composite fillings, root canal material, etc.).  The material included a 788-page course manual (yes, every single page was covered!) that detailed the most recent and advanced methods of repairing teeth using scientific data. Using this research, Dr. Kois outlined the absolute best dental practices for helping our patients achieve the best possible results. So if you or anyone you know has TMJ disorder, tooth sensitivity, questions about fillings or crowns, or may be wondering whether a root canal is necessary, Teuscher Dental is completely prepared to help!

Dr. Teuscher is already one of the few dentists in the nation who have completed Kois’s years-long program of post-doctoral education, and this class was an awesome opportunity for Riley and Brayden too. It is an honor and very exciting for them to be able to learn at the highest possible level as they finish their clinical experience at dental school. It was a great way for them to prepare to join the family practice to provide you the care you’ve come to know and trust, and to continue a Legacy of Excellence.

This class is just one example of how Teuscher Dental’s team is committed to providing our patients with the highest level of care available in the world. As our family cares for your family, you can be confident that we will have an entire team of dentists with a shared vision for the best ways to help you get healthy and stay that way. We are all excited to partner together with you toward this vision of health.

So next time you visit us, we may use processes and tools that are unique to what you have ever experienced before. But nothing we do is for show, and we don’t use gimmicks. We are committed to being a learning organization that consistently provides you with excellence that is backed by studied-and-proven science. You can expect world-class care and results because we take very seriously that you are trusting us with your health.  We are all ready for you – come and see us!

The Six Most Common Questions Parents Ask About Baby Teeth

There’s more to baby teeth than you may think! Read below to get answers to the most common questions we encounter from parents- along with inside information about the Tooth Fairy and some bonus cute pictures of young Brayden and Riley!

Do baby teeth matter?

The short answer is Yes. Baby teeth start forming during the sixth week of pregnancy at the same time their neural tube is developing and limbs are beginning to bud. Usually it is the front four teeth that we first start to see at around six months during the dreaded “teething” stage. The discomfort kids have during teething is usually just irritated gums from the teeth erupting. By age three, most children have all 20 baby teeth erupted and functioning in their mouths. Like adult teeth, baby teeth are used for chewing, speaking, and smiling. But they are smaller and spaced further apart than adult teeth, so they also play an important role in maintaining space for the permanent teeth to come in. So if a baby tooth is lost or knocked out of the mouth prematurely, sometimes there are orthodontic consequences for that child’s future. Childhood cavities are the most common chronic disease of childhood– four times more common than asthma. In fact, the data shows that 21% of kids aged two through five and 51% aged six through eleven have tooth decay. There’s a good chance your little one is one of those!

They are gonna fall out anyways. Why brush?

Good question. Like we discussed above, they serve a similar purpose to adult teeth. However, it is important to note that baby teeth have less enamel than adult teeth. This means that when decay is present, it progresses much more quickly than in an adult tooth. As with a normal cavity, a bacterial infection in baby teeth will typically spread from the tooth down the root and eventually into the bone and gums. This is especially concerning since a permanent tooth is developing beneath the baby one! Even a tiny cavity in a tiny baby tooth can cause a lot of pain for your little one.

We do know a sugary diet contributes to dental caries progression- but what we haven’t heard of yet is any kid without a sweet tooth! (pun intended) “Baby bottle caries” is actually a thing- where children may drink a sugary drink right before bedtime, and the sugar remains in their mouth while they sleep, giving bacteria ample time to feed and proliferate. Interestingly, bacteria can ferment the lactose in breastmilk, but studies have indicated that breastfeeding may actually protect against dental caries. Like we already mentioned, losing a tooth early can have spacing implications for expensive orthodontic treatment down the road. This in addition to the obvious speech, eating, and esthetic problems associated with missing a tooth. And at a young age, when confidence is so critical to personal and social development, we want to keep every tooth we can!

How picky is the tooth fairy?

Ever noticed how when baby teeth come out, they don’t have roots? That’s because as the adult tooth forms underneath the baby tooth, it pushes near the baby tooth’s root causing it to resorb. So we can truly say the baby tooth “falls out”, because it no longer has a root attaching it to the underlying bone or gums. Luckily, last we checked, the tooth fairy accepts baby teeth, resorbed roots and all. Usually the first baby teeth to erupt are the front four on both the top and bottom starting around six months, and those are usually the first to fall out also at around age six or seven.

When is the best time to brush?

A simple way to help prevent dental problems is teach your child good brushing habits. The best time to brush is right before bed, so that teeth are nice and clean prior to our longest period of inactivity. Research has shown that our saliva flow decreases at night time possibly due to circadian rhythms and mouth breathing. In either case, this dry mouth means less saliva to rinse our teeth of existing bacteria. All the more reason to brush right before bed!

Further, when we use a fluoride toothpaste, brushing before bed gives fluoride the longest time to act and remineralize your teeth. Keep in mind though, that kids under the age of 3 should only use a smear or rice sized kernel of toothpaste before age three, and a pea sized lump after age three, even for adults. The American Academy of Pediatrics, the American Dental Association, and the American Academy of Pediatric Dentists recommend fluoride toothpaste even for the youngest children. While fluoride does help strengthen teeth, care should be taken that the child does not swallow the toothpaste, but rather spits it out afterward. Excessive fluoride ingestion at younger ages is associated with dental fluorosis, but the ADA states that if it only remains topically on the tooth surfaces, it will not cause any systemic issue.

Should my child floss?

While right before bed is the BEST time for brushing, after breakfast or other times a day is good too. But flossing? For most kids with baby teeth, if they aren’t touching there isn’t as big a need to floss (assuming you are brushing). In adults the teeth contact each other, allowing food and other debris to be caught in between them, in particular in the gums between the teeth. Since baby teeth are spaced further apart, often this is not as big an issue for them. However, their back teeth in particular may be touching, in which case flossing is still important. Sometimes it’s hard for little ones to floss by themselves though, so we recommend parents help. In general, we say the most important skill for kids to conquer is brushing. Once they are brushing masters, then they can begin flossing for themselves. We still recommend flossing for adults though (No excuses mom!)

When should kids have their first dental appointment?

The ADA and the AAPD advise children have their first dental appointment within six months after their first tooth erupts, or no later than the child’s first birthday. We’ve found that a great way to start may be simply bringing your child along for your next cleaning. They can come back with you and watch for a little while, maybe ride the chair up and down a few times, then get excited for their first appointment when they can be examined “just like mom and dad”. It’s helpful to introduce them to our staff and office so that when its their turn, they are comfortable!

For kids we do many of the same things we do for adults- prophylactic cleaning, exam, and possibly topical fluoride. What is slightly different for children is that we try to limit X-ray exposure as much as possible, and we are especially watchful for correct orthodontic development. A child’s first appointment is a great time for them to ask questions and become comfortable with Dr. Teuscher and our friendly staff. Our team loves kids, and with four of his own, Dr. Teuscher is wonderful with children and parents alike. We’d love to see your whole family!

Not convinced yet?

If all that isn’t enough, we have a pretty cool treasure box of toys to take home after the visit.  We also have games, books, toys, and a Nintendo in our reception area… And unlimited coffee or tea for our tired parents!

What are your questions?

What other questions do you have about your child’s teeth and taking the best possible care of them? Give us a call with any questions or post them below and we will answer. We are always happy to help, and hope to see you soon!

What we’re learning about COVID-19 and Gum Disease

What we’re learning about COVID-19 and Gum Disease does not surprise us. And as Teuscher Dental continues to pursue our values of excellent healthcare and constant improvement, we’ve been researching all we can to ensure your health and safety. Here’s what we are finding out:

What We’re Learning

Studies investigating the link between gum disease and COVID susceptibility/severity are ongoing. But what we know so far is that the inflammatory mediators in gum disease correlate with more severe COVID infections. In other words, there is evidence that the extent of gum disease increases the severity of COVID sickness. Studies are ongoing, and we will keep you updated as more information rolls in. But the early evidence is clear.

“Now that we’ve confirmed periodontitis makes [COVID] even deadlier, if you’re worried that you may have gum disease, your next trip to the dentist may actually save your life”

-Dr Shervin Molayem, founder of UCLA Dental Research Journal

Your Risk

Those in “high risk” groups for COVID are usually also those with a higher incidence of gum disease. This is because of the oral-systemic connection we’ve written about before. And if you are “high risk” for COVID, it’s understandable you’d be cautious about leaving your house. But we strongly recommend that you continue to receive dental care.

Because of COVID quarantining, we have some patients we’re seeing for their first routine dental care in over 9 months. Unfortunately, in many cases their mouth is noticeably less healthy than before. We always recommend regular dental care. But what we’re learning about COVID-19 and Gum Disease shows us that your dental health is ESPECIALLY important during this pandemic.4

We can assure you that we’re doing everything possible to be the safest environment possible for you and your family. Dr Mike has those details in this video. Great news also is that a recent ADA and UAB study showing that dental settings have one of the lowest transmission rates in all of healthcare. We care about you and hope to see you soon! If you have any questions, give us a call. We’re always happy to help.

References:

1. Thodur Madapusi Balaji, Saranya Varadarajan, U.S. Vishal Rao, A. Thirumal Raj, Shankaragouda Patil, Gururaj Arakeri, Peter A. Brennan.

2. Oral cancer and periodontal disease increase the risk of COVID 19? A mechanism mediated through furin and cathepsin overexpression, Medical Hypotheses, Volume 144, 2020, 109936, ISSN 0306-9877

3. https://www.dentistrytoday.com/news/industrynews/item/6778-covid-19-patients-with-periodontitis-face-greater-risk-of-dying

4. Patel, J. and Woolley, J. (2020), Necrotizing periodontal disease: Oral manifestation of COVID‐19. Oral Dis.

The Importance of Being More Kissable!

Who knew that kissing has actual health benefits?  The scientific study of kissing is called “philematology” (philos in ancient Greek = earthly love).  A Nobel Prize-winning study reported that people who increased their frequency of kissing over a 6-week period had lower cholesterol blood levels. They also had less allergy symptoms and allergic reactions, relief from hives, and – not surprisingly – lower stress levels!  Kissing also stimulates your brain to release feel-good chemicals like dopamine, oxytocin and serotonin, which may also dilate blood vessels, thereby reducing headaches and cramps. Kissing is also shown to lower cortisol levels – a stress hormone also associated with difficulty losing fat.  Kissing can burn 5-26 calories per minute, and may also reduce the appearance of wrinkles by tightening and toning facial muscles!

Here’s the BAD news: studies also show that the biggest turnoff when it comes to kissing is – you guessed it – bad breath!  Missing teeth, cracked teeth and stained teeth are also rated as very off-putting. Kissing is a cultural indication of acceptance and affection. But research indicates that 2/3 of us would refuse to date someone with bad breath. 

A BIG problem is that most people with bad breath have NO IDEA so… that person could be you.  Bad breath can be a social barrier in everything from friendships to work relationships.  The bad-breath obstacles to kissing and close relationships can result in lower overall self-esteem in everyone from children to teens to adults. Sadly, those with bad breath may notice that others are avoiding them but not quite know why.

Bad breath can be more than just a social deterrent.  While breath odor is most often an oral health issue, there can be other causes. These include tobacco use, certain foods and medications, and medical issues such as infections in the nose, sinuses and throat, chronic reflux, some cancers and metabolic disorders. The Mayo Clinic adds that in young children an item such as food that’s stuck in a nostril may also cause bad breath, so it’s important for parents to pay attention.

So start with good oral hygiene habits that include regular cleanings and examinations by a dentist who is an expert in pro-active prevention. Obvious treatments like brushing with toothpaste or using mouthwash can be enough to cure bad breath at first. But bad breath can also indicate oral or respiratory infections as well as other GI issues like GERD, which can lead to more serious issues, including cancer. A “wait and see” approach doesn’t do you many favors (health-wise OR financially) when, very often, we can catch these things early on. This is when we can usually intervene with simple solutions and lifestyle change suggestions. This is only a small part of the reason regular dental cleanings and exams are so important!  

I am passionate about helping people get healthy and helping you to stay that way, so it would be my honor to help you be more kissable!  

Your grateful partner in health,

Dr. Mike