CSI: Dental Crime Stoppers

Crime-time TV shows have introduced a new term to the American lexicon: petechial hemorrhaging. This happens when blood vessels burst leaving tiny, flat, round, red or purple bruises where blood has pooled in the tissue. They don't blanch or fade color when pressed.

On TV, it's evidence an evil-doer strangled the hapless victim. Closer to home, you can see it on your arm where your bratty brother gave you an Indian burn, or in your own mouth. Your own mouth? Let’s examine the evidence.

The most common cause of petechiae is trauma. For example, chewing on a pencil or toothbrush ruptures blood vessels when you push the object against the roof of your mouth. Petechiae can also form if you eat rough, hard foods like chips or crackers. An ill-fitting denture or a jagged, rough filling can cause tiny blood vessels to break.


Petechiae can also be caused by blood disorders, systemic diseases and vitamin C deficiency, and the mouth is often the first place a disease appears.

If the petechiae are caused by a trauma like eating crackers, the bruises usually go away without treatment in a few days. However, an area that is continually traumatized from a habit like chewing pencils or an intentional injury jeopardizes your health.

If you notice anything unusual in your mouth, it is best to let us take a look to rule out a serious condition that needs treatment. Catching a condition in its early stage can be key to your good health, just like catching the butler in the library with the rope right before the credits roll.


Houston dentist
Minh Nguyen, D.D.S.

Kids with cancer - How to Protect Their Teeth

When a child is diagnosed with cancer, everyone's life turns upside down. As your dental care professionals, we can help with your child's dental needs while he or she is undergoing treatments.

We need to begin an oral care program two weeks before your child starts cancer treatments because there are several procedures we cannot perform if your child has already begun radiation or chemotherapy.


We can identify and take care of most existing dental needs so your child's cancer treatment won't be delayed. For example, if your child has an oral infection, cancer treatments will be postponed.


If your child wears braces or a retainer, we need to examine it. An ill-fitting appliance can damage soft oral tissues and provide bacteria an opportunity to cause a gum infection. We can provide you with information about the daily care of an orthodontic device.

Your child needs to maintain a consistent, rigorous daily oral care routine. Start by using xylitol products as soon as possible before treatments begin. Using xylitol five or more times a day will help build a healthier grouping of bacteria in the mouth. Stock up on toothbrushes, too. Switching to a new one about three days after a chemo treatment will provide less contamination when the white blood cell count goes down and your child is least resistant to infection. And come visit us often. The best time is just before a chemo treatment when we can apply fluoride varnish or send fluoride trays home with you to help prepare the teeth for their difficult journey.

We can recommend minor dietary changes to eliminate or minimize foods and supplements that can cause tooth decay.

You can be confident that your child will receive excellent professional medical and dental care before, during and after cancer treatments.


Houston dentist
Minh Nguyen, D.D.S.

Diabetics: Hold the Mayo

There are over 24 million diabetics in the U.S., and another 57 million are teetering on the edge. Diabetics are at risk for developing or worsening their periodontitis (perio), a chronic dental inflammation that prevents their bodies from controlling their blood sugar levels.

Periodontitis destroys a tooth's surrounding support structures and can result in irreversible jawbone and tooth loss [X-ray shows healthy bone level vs jawbone bone loss]. We cannot yet cure perio; we can only manage it.

Like perio, diabetes is an inflammatory disease.

Over 80 percent of diabetics who have perio also show signs of developing heart disease and strokes, which are also inflammatory diseases. The oral infection uses your bloodstream to travel to other parts of your body.


Research is showing that type 2 diabetes and perio are locked into a relationship in which a poorly controlled diet provides sugars and carbohydrates to the bacteria associated with perio. When the inflammation in your mouth becomes more severe, your body overreacts to the acids produced by the bacteria. The chemicals produced by perio make your body more resistant to insulin and keep your blood sugar levels out of balance.

A healthy diet and good oral care can help break you out of that vicious cycle.

As you work with your physician to eat a healthy diet, we will help restore your dental health by treating your perio and regularly monitoring your progress.


Houston dentist
Minh Nguyen, D.D.S.

Do You Feel Safe in Our Office?

Look around when you enter your exam room. Do you see equipment out of place? soiled hand towels? a dirty countertop? Of course not. The dental assistant makes sure your room is clean, disinfected and ready for you. If you have any anxiety, our assistant tries to help you know that everything will be OK. He or she sincerely cares about your well being and your experience in our office.

One of your dental or dental hygiene assistant's many functions is to make sure we use the proper disinfectants and sterilization products, that our employees have infection control training, evaluates our office infection control protocols and monitors our office for compliance with state and federal regulations. Dental assistants regularly attend training classes to keep up with new techniques and information.


The Dental Assisting National Board (DANB) maintains a list of 70 functions a dental assistant can perform; however, every state can add functions that have been approved by their state.

A few of the DANB functions are managing infection control, ordering supplies, taking X-rays, applying sealant, taking impressions and updating medical histories.

Even though patients are highly informed people, they might not want to ask about the treatment plan. In some states, a dental assistant helps by answering questions so that the patient has the information needed to make an informed decision about their dental health care.

Your safety and our staff safety are in his or her capable hands.

You, your dental assistant and I form a strong team that works towards optimal dental care for you.

Look around when you leave your exam room; aren't you glad it didn't look like that when you came in?

Houston dentist
Minh Nguyen, D.D.S.

Blech! Dragons Breath!

You brushed your teeth, but 20 minutes later your dragon's breath is back. Halitosis (bad breath) refers to stinky sulfur compounds that accumulate especially at the back of your tongue.
Halitosis has several causes and treatments, including—

Diet—digested foods such as hi-protein foods, coffee, tea, acidic foods, cookies, candy, garlic and onions are absorbed into the bloodstream, carried to your lungs and exhaled.

• Eat fewer offending foods and drink more water.

Inadequate oral hygiene—food particles between your teeth and trapped in the grooves on your tongue ferment and produce sulfur compounds.

• Brush twice each day with an anti-bacterial or baking soda toothpaste and floss once each day or after each meal.
• Thoroughly clean dental appliances.
• Use a tongue scraper to remove trapped food and bacteria from the back of your tongue.  
• Avoid mouth rinses that contain alcohol. Use mouthwashes that contain xylitol and essential oils such as tea tree and spearmint that help freshen breath.
• Chew xylitol gum between brushings. Xylitol is an ingredient in some mouth rinses, toothpastes and gels.

Inadequate oral care lets biofilm build up on your teeth and below your gumline. Most of the sulfur compounds that cause bad breath come from bacterial compounds deteriorating gum tissue.

• A professional cleaning above and below the gumline removes bacteria and dead tissue.

Medicines—can cause xerostomia (dry mouth).

• Change medications, if possible.
• Saliva helps to clean the mouth, so, use products made with xylitol to stimulate saliva flow and kill oral bacteria.
  

Medical conditions—stomach or intestinal conditions such as the flu and Crohn's contribute to halitosis.

• Add more alkaline foods to your diet.
• Drink plenty of water.

If our suggestions don't help, don't be embarrassed to ask us about stinky breath.

Houston dentist
Minh Nguyen, D.D.S.

Kids Teeth: Blinded by the White

Peer pressure can have a tremendous impact on your 'tween or teen's self-esteem. One of the trends we see is children under the age of 18 whitening their teeth. Whitening at this stage in their tooth development is risky.
Self-esteem is fragile. Your child might have a nice smile, but dark teeth, for example. They may feel as if their dark teeth kisses goodbye that invitation to sit next to a special someone during the pep assembly.

A child who has both primary and permanent teeth and who uses an over-the-counter whitening product without your knowledge can end up with teeth of drastically different shades of white. That's because primary teeth have a thinner layer of enamel than permanent teeth.

Whitening agents can wear away enamel, especially if improperly used on primary teeth where the enamel is thinner. An indication is that suddenly your child's teeth are sensitive to cold beverages or foods, or a sharp pain stabs down the center of their teeth. They might also complain that their gums tingle or hurt from the whitening agent.


Not following directions or improper application could also result in serious damage to tissues that help support the teeth as well as a tooth's root.

Some teens who have become addicted to whitening experience extreme tooth sensitivity and have teeth with blue-ish, translucent edges [top photo].


There's not a lot of research yet on the long-term effects of whitening at this age level, but some think that there is a possibility of permanently damaging the tooth pulp (contains nerves and blood).

If your 'tween or teen wants to whiten, let us examine his or her teeth to determine if whitening will be safe and appropriate. We can identify dental problems that will need to be addressed prior to whitening, then, create a whitening procedure suitable for your child.
 
Houston dentist
Minh Nguyen, D.D.S.

Wobbly Denture Wobegone

If you have a removable dental appliance, there is a high likelihood that you will develop denture stomatitis. Stomatitis refers to inflammation.

The inflammation can appear as patches of small red sores or tiny bruise-like spots underneath the denture [bottom image].

We're not sure exactly what causes denture stomatitis, but we often see it in patients who have poorly-fitting dentures, have trouble keeping their oral tissues clean and don't remove their dentures at bedtime.


Some patients have bad breath, a stinging sensation or notice changes in their ability to taste foods.

Denture stomatitis typically affects patients who fall into two or more categories: they—

• are over 60 years old,
• wear a dental appliance including a partial or full denture,
• live in a nursing home,
• have type 2 diabetes,
• have an organ transplant or weak immune system,
• take steroids (orally or by inhaler) or antibiotics, or they
• receive cancer therapy.

Denture stomatitis isn't contagious. However, studies show that oral bacteria can be inhaled into the lungs and cause pneumonia, or they can travel through the bloodstream into artificial joints, the kidneys, and into the heart and contribute to a heart attack or stroke.

Denture stomatitis is easily treated by thoroughly cleaning and sanitizing the denture, removing it at bedtime, and applying topical medications. A wobbly, ill-fitting denture can be stabilized with implants (metal posts surgically embedded into the jawbone).

If you notice anything unusual in your mouth, please call immediately and schedule an appointment. Early diagnosis and treatment are the keys to healthy teeth and body.

Houston dentist
Minh Nguyen, D.D.S.