Primary Immune Deficiency and Oral Health

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Children with Primary Immune Deficiency (PID) are particularly subject to development of periodontal dise

ase. According to a new study. PID diseases (more than 200 in number) are genetic disorders that compromise the immune system. Compromised immune systems make people with PID subject to a number of serious infections. One of these infections is Epstein-Barr Virus, which often increases the risk of cancer. Some of the diseases are terminal.

PID can be diagnosed in people of all ages, whether the disorder is inherent at birth or acquired at some later time. It affects approximately 1 in 10,000 people, and is most commonly found in children.

Children are born with no natural protection from the oral microbiota that cause periodontal disease. This, combined with an immune system that is compromised by PID, makes them patients more likely to develop severe infections and to develop periodontal disease. PID also makes these children less likely to benefit from periodontal treatment. As a result of ineffective periodontal treatment, many patients experience early tooth loss.

The report of the study concluded, “children with PIDs have a more severe response to dental caries, which can potentially lead to advanced periodontal disease. However, if the PID is controlled and good oral hygiene and interceptive treatment are achieved early on, the high susceptibility does not necessarily result in tooth loss.”

The researchers suggest that further study is needed to better understand the connection between PID and periodontitis and other oral diseases in order to improve PID disease management and dental care and prevention of disease.

If you, your child, or another family member has PID, it is important to inform your dentist and work actively to prevent and manage oral effects of the disease.

Vaping Cannabis?

If you use Cannabis (for whatever purpose), you should know that vaping cannabis increases the possible health and oral health effects. Cannabis has some of the same potentially dangerous side effects in your mouth as tobacco. Those effects are compounded when you use tobacco and cannabis vaping - paid - Depositphotos 104915416 s-2019

Decades ago, marijuana smoking was calming. The forms of cannabis in use today can actually increase blood pressure and heart rate. The health implications of this are significant.

Cannabis can also create serious complications in the dental office. If you are having a procedure that requires pain management, the drugs we use cause the same effects as the cannabis. Thus, it makes you resistant to the desired effects of local anesthetics.

Cannabis can also suppress the immune system. Some heavy users have reported paranoia or anxiety when in stressful situations, such as sitting in a dental chair.

When you add vaping to cannabis, you exacerbate the possible side effects. Most people experienced relatively few side effects from smoking pot years ago. But when used in an electronic cigarette or a vaping device today, you introduce additional chemicals into your mouth and lungs.

There is little to no regulation of how cannabis is grown or processed. Some growers use insecticides, fertilizers, and other chemicals during the growing process. Molds often form that are contained with the use of fungicides. These can enter your mouth and lungs when inhaled. It also may produce certain new chemicals that are carcinogenic. Finally, vaping is introduced to your mouth at temperatures of approximately 350 to 400 degrees Fahrenheit, which can damage oral tissues in several ways.

Please be careful what information you trust online --  some is accurate, some is not. If we know that you are using cannabis, especially if you are vaping it, we can look for problems when conducting your oral exam. Finding and treating problems early always produces the best outcomes. My best suggestion is that you think twice before vaping cannabis. And please tell us if you are using cannabis before any procedure. We don’t judge and we keep your information secure. We always want to provide safe, effective, and comfortable dental care. 

Signs You Are Losing a Filling

How do you know that you are losing a filling?


How long do fillings last?

We wish fillings would last forever, but they are actually temporary. The life of a filling depends upon the filling material, the condition of the tooth, your oral hygiene practices, and the foods and beverages you consume. In general, a dental filling can be expected to last for 5 to 10 years. Some fillings can last as much as 15 years.lost dental filling - paid - shutterstock 108759404


What causes a filling to go bad?

All fillings will weaken over time. Large fillings are more susceptible to damage and loss than smaller ones. Many factors contribute to weakening our fillings, including

  • Bruxism – Teeth grinding can seriously damage fillings in molars (in particular).
  • Accidents and trauma
  • Using your teeth as tools (opening things with your teeth)
  • Poor oral hygiene – The bacteria and acids in your mouth will damage the seams where the filling meets tooth material
  • Dry mouth
  • Smoking, and
  • Alcohol consumption.

How do I know I’m losing a filling?

There are a number of common signs and symptoms of a loose, weak or lost filling. Among the most common are:

  1. Pain in the tooth (often aching) similar to that of a new cavity.
  2. Increased sensitivity to heat or cold, sometimes the sensitivity will be triggered by sweets, as well. Loss or damage of the insulating enamel allows temperature changes to the tooth’s pulp, which causes the pain.
  3. Pain or discomfort when eating. Food particles or liquids can creep under the compromised filling.
  4. The contours of the tooth feel different. Often, your tooth will feel that the surface texture of the tooth is different. It is likely that your tongue will be drawn to that tooth.
  5. Change in your bite. When you close your mouth, the way your teeth fit together (occlusion) may feel different.
  6. Discoloration. Some dental fillings become discolored when they are decomposing. Sometimes they will appear dark; sometimes they look yellow.
  7. Biting down on the hard piece of filling that has fallen/is falling out of the tooth. This often happens when people are eating hard or chewy foods.
  8. You feel a hole in the tooth where the filling has been dislodged.
  9. Food becomes stuck in the crevices of the tooth.
  10. Floss Shedding. This is a common way to discover damage to fillings between teeth. These are difficult to see. When your dental floss shows signs of shredding when removed, it is likely because the edges have become rough and are catching the dental floss.
  11. Bad breath/bad taste. You may notice that you still have bad breath or a bad taste in your mouth after brushing. This is caused by the decay that is occurring around the margins of a loose filling.

What do I need to do?

The most important thing to do is to call right away and make an appointment to see your dentist. If you have lost or are losing a filling, the sooner you address the problem the less likely it will cause significant damage.

It is also important to see your dentist to confirm that a weakened filling is the problem. There are other dental issues that can cause most of these symptoms. You will want to address any other problems (an abscess, for example) as soon as possible to limit damage to your teeth and gums.

For future reference, you might want to try to consider your activities and the foods or beverages you have consumed that caused or contributed to the loss of the filling. If you know what caused the problem you can avoid that behavior and protect other fillings.

Once the immediate problem with the filling has been addressed, it is wise to schedule and keep appointments with your dentist and/or hygienist twice each year. Additional filling weakening is often identified during these exams. Addressing them as soon as possible may minimize damage to the tooth.

When do you brush your teeth in the morning?

When you brush your teeth in the morning actually should depend on what you eat and drink for breakfast. For years, some people have believed we should brush before breakfast; others say we should brush after breakfast. There are also people who say it doesn’t matter.senior-woman-brushing-teeth-and-drying-hair SM - paid - storyblocks - SYLbk6DpBj

Now, we are being told that it depends not only on brushing before or after breakfast but also on what you eat and drink for breakfast. So, what have we been missing?

Brushing and breakfast

If you brush before breakfast you get rid of morning-mouth – your breath is better and it doesn’t affect the flavor of your breakfast. But you leave food particles in your mouth that can stain or harm your teeth or gums.

It might be better to brush before breakfast because brushing after eating something acidic (coffee, fruit) can harm the enamel of your teeth. For this reason, the American Dental Association's (ADA) recommendation is that we wait 60 minutes after eating those foods before brushing. If you cannot wait that long, you should swish with water to dislodge food particles, bacteria and acids so they don’t sit on your teeth all day.

Brushing and coffee or Juice

Many of us drink coffee in the morning. But coffee is very acidic and can harm the enamel of your teeth. When we brush just after drinking coffee, we just spread that acid all over our teeth and might weaken tooth structure. Allowing 30 minutes between drinking coffee and brushing gives your mouth time to wash away the acid (with saliva) and neutralize any that remains in your mouth.

What about coffee sippers? Sipping coffee throughout the day subjects your teeth to a constant onslaught of the acid in the coffee upon your teeth. It increases the risk of stains and keeps the acid on your teeth continually.

What about orange juice and other acidic fruit juices? These acids should be treated in the same way as coffee.

A solution

Is the best solution to brush both before and after breakfast? Maybe. But brushing between your morning and evening brushing and flossing should be gentle to ensure you don’t damage gum tissues. The goal is just to remove food debris and acid.

If you have questions, ask your dentist or dental hygienist to explain. They will be able to make good suggestions that are appropriate for your oral health.


Children’s Dental Visits Amid the COVID-19 Pandemic

Researchers at the C S Mott Children’s Hospital at Michigan Medicine conducted a national poll in January in an effort to understand what is happening to children’s dental health -- particularly children’s preventive dental care - during the COVID-19 pandemic. asian boy with dentist - SM - paid - shutterstock 1730214226


Safety of Visiting a Dentist During the Pandemic

Those polled were parents of children ages 3 - 18 were asked how they felt about taking their children to a dentist. 

  1. ⅔ felt it was safe to get pediatric preventive care during the pandemic

  2. 19% were uncertain

  3. 14% believed it was unsafe.


What Happened When They Tried to Make an Appointment?

40% had not tried to get a preventive care appointment during the pandemic. Of these parents

40% were trying to protect their children from COVID-19 and 28%did not make an appointment because their children were not experiencing dental problems at the time.


The 60% of parents who tried to make an appointment for preventive care encountered challenges:

  • ⅓ said it was harder to get preventive care

  • 24% faced a delay when trying to make an appointment

Another 7% of parents said they were unable to get an appointment for their children when they tried. This was the case mostly for parents with Medicaid (15%). It was true for only 4% of those with private dental benefits and 5% of those with no insurance.


There Was Also Good News

More than 25% of the parents polled said their child had improved in at least one aspect of oral care since the beginning of the pandemic. These changes were mostly related to brushing, flossing, and avoiding sugary drinks: 

  • 16% were brushing more often

  • 11% were flossing more often

  • 9% were using fluoride rinse more often

  • 15% were drinking fewer sugary beverages.

All of these changes, of course, help to prevent tooth decay. 


Why Do Preventive Visits Matter So Much for Children?

There are many reasons that preventive dental visits are important for children. Among the most common reasons for dental care are these:

  • To prevent cavities and tooth decay.

  • To remove accumulated tartar and plaque.

  • To deal with small problems before they become bigger, more painful, or more costly to fix.

  • Good oral health supports good general health.

  • To teach a child that oral health is important.

  • Children who have checkups are more likely to have a more positive attitude about visiting the dentist. 


Sources: Dr Bicuspid (; C.S. Mott Children's Hospital National Poll on Children's Health at Michigan Medicine


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