My Blog

Posts for: December, 2017

By Don Fortner, DMD
December 19, 2017
Category: Oral Health
Tags: oral health   hiv  
LivingwithHIVincludesKeepingaCloseWatchonYourOralHealth

We’ve come a long way since the early 1980s when we first identified the HIV virus. Although approximately 35 million people worldwide (including a million Americans) now have the virus, many are living relatively long and normal lives thanks to advanced antiretroviral drugs.

Still, HIV patients must remain vigilant about their health, especially their oral health. ┬áIn fact, problems with the teeth, gums and other oral structures could be a sign the virus has or is moving into the full disease stage, acquired immunodeficiency syndrome (AIDS). That’s why you or a loved one with the virus should maintain regular dental checkups or see your dentist when you notice any oral abnormalities.

One of the most common conditions among HIV-positive patients is a fungal infection called candidiasis (or “thrush”). It may appear first as deep cracks at the corners of the mouth and then appear on the tongue and roof of the mouth as red lesions. The infection may also cause creamy, white patches that leave a reddened or bleeding surface when wiped.

HIV-positive patients may also suffer from reduced salivary flow. Because saliva helps neutralize excess mouth acid after we eat as well as limit bacterial growth, its absence significantly increases the risk of dental disease. One of the most prominent for HIV-positive patients is periodontal (gum) disease, a bacterial infection normally caused by dental plaque.

While gum disease is prevalent among people in general, one particular form is of grave concern to HIV-positive patients. Necrotizing ulcerative periodontitis (NUP) is characterized by spontaneous gum bleeding, ulcerations and a foul odor. The disease itself can cause loosening and eventually loss of teeth, but it’s also notable as a sign of a patient’s deteriorating immune system. The patient should not only undergo dental treatment (including antibiotics), but also see their primary care physician for updates in treating and managing their overall symptoms.

Above all, HIV-positive patients must be extra diligent about oral hygiene, including daily brushing and flossing. Your dentist may also recommend other measures like saliva stimulators or chlorhexidine mouthrinses to reduce the growth of disease-causing bacteria. Together, you should be able to reduce the effects of HIV-induced teeth and gum problems for a healthier mouth and better quality of life.

If you would like more information on oral care for HIV-AIDS patients, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “HIV-AIDS & Oral Health.”


UnderstandingtheAgingProcessLeadstoMoreEffectiveOrthodontics

If you’ve ever looked at younger photos of yourself, you’re sure to notice differences with your present appearance. Of course, your basic features might appear much the same. But maybe your lips seemed a little thicker back then, or your nose a bit less prominent.

This is because your facial features don’t stop growing when you reach adulthood—they continue to change throughout your life. For example, lips reach their maximum thickness by around age 14 for girls or age 16 for boys; they’ll remain at that level of thickness for a few years before gradually thinning throughout adulthood. The nose will also continue to grow, becoming more prominent especially as changes in the lower part of the face can make the chin appear shorter.

Although each of us ages at different rates and in different ways, these general physical trends are somewhat predictable. That’s why we can use the knowledge of how our facial physiology changes with age to fine tune orthodontic or other cosmetic dental treatments. The most optimum approach is to consider treatment in the early stages of bite development during childhood or early adolescence.

This means we’re doing more than correcting a patient’s current bite: we’re also taking into account how tooth movement now might affect the jaw and facial structures later in life. By incorporating our understanding of age-related changes into our treatment we might be able to provide some hedge against the effects of aging.

This approach starts with early comprehensive dental care, preferably before a child’s first birthday, and an orthodontic evaluation at around age 6 to assess bite development. It may also be necessary to initiate interceptive treatment at an early age to lessen or even eliminate a growing bite problem to help ease the extent of future treatment. And if a bite requires correction, early evaluation can help create a timetable for effective treatment in later years.

Taking this approach can correct problems now affecting both dental health and appearance. But by acknowledging the aging process in our treatments, we can build the foundation for a beautiful smile well into the future.

If you would like more information on keeping an attractive smile throughout your life, please contact us or schedule an appointment for a consultation.