Breathing: You hardly notice it unless you're consciously focused on it—or something's stopping it!

So, take a few seconds and pay attention to your breathing. Then ask yourself this question—are you breathing through your nose, or through your mouth? Unless we're exerting ourselves or have a nasal obstruction, we normally breathe through the nose. This is as nature intended it: The nasal passages act as a filter to remove allergens and other fine particles.

Some people, though, tend to breathe primarily through their mouths even when they're at rest or asleep. And for children, not only do they lose out on the filtering benefit of breathing through the nose, mouth breathing could affect their dental development.

People tend to breathe through their mouths if it's become uncomfortable to breathe through their noses, often because of swollen tonsils or adenoids pressing against the nasal cavity or chronic sinus congestion. Children born with a small band of tissue called a tongue or lip tie can also have difficulty closing the lips or keeping the tongue on the roof of the mouth, both of which encourage mouth breathing.

Chronic mouth breathing can also disrupt children's jaw development. The tongue normally rests against the roof of the mouth while breathing through the nose, which allows it to serve as a mold for the growing upper jaw and teeth to form around. Because the tongue can't be in this position during mouth breathing, it can disrupt normal jaw development and lead to a poor bite.

If you suspect your child chronically breathes through his or her mouth, your dentist may refer you to an ear, nose and throat (ENT) specialist to check for obstructions. In some cases, surgical procedures to remove the tonsils or adenoids may be necessary.

If there already appears to be problems brewing with the bite, your child may need orthodontic treatment. One example would be a palatal expander, a device that fits below the palate to put pressure on the upper jaw to grow outwardly if it appears to be developing too narrowly.

The main focus, though, is to treat or remove whatever may be causing this tendency to breathe through the mouth. Doing so will help improve a child's ongoing dental development.

If you would like more information on treating chronic mouth breathing, 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 “The Trouble With Mouth Breathing.”

There are a few mouth conditions so rare most of us have never heard of them. Geographic tongue would fall into this category, affecting only one to three percent of the population. Even so, these irregular reddish patches resembling land masses on a map (hence the name) might be alarming at first glance—but they pose no danger and usually cause very little discomfort.

Geographic tongue is also known as benign migratory glossitis. As its clinical name implies, the unusual red patchy areas (often surrounded by a grayish white border) aren't cancerous nor contagious. The patches also appear to change shape and move around ("migrate") the tongue.

The reddish appearance comes from the temporary disappearance of tiny bumps on the tongue surface called papillae, which can leave the tongue smooth to the touch in affected areas. The lost papillae may reappear again a few hours or days later, and may occasionally disappear again. While it's not painful, you can experience a stinging or burning sensation emitting from these patchy areas.

We're not sure how and why geographic tongue erupts, but it's believed high emotional or psychological stress, hormonal imbalance or certain vitamin deficiencies might be factors in its cause. There may also be a link between it and psoriasis, a condition that can cause dry, itchy patches on the skin.

If you're one of the rare individuals who has episodes of geographic tongue, the good news is it's harmless, only mildly uncomfortable and usually temporary. The bad news, though, is that there's no known cure for the condition—but it can be managed to ease discomfort during outbreaks.

It's been found that highly acidic and spicy foods, as well as astringents like alcohol or some mouthrinses, can increase the level of discomfort. By avoiding these or similar foods or substances, you can reduce the irritation. Your dentist may also be able to help by prescribing anesthetic mouthrinses, antihistamines or steroid ointments.

For the most part, you'll simply have to wait it out. Other than the mild, physical discomfort, the worst part is often simply the appearance of the tongue. But by watching your diet and other habits, and with a little help from us, you can cope with these irritations when it occurs.

If you would like more information on geographic tongue and similar oral issues, 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 “Geographic Tongue: No Cause for Alarm.”

Along with daily brushing and flossing, limiting your child’s sugar consumption is an important way to prevent tooth decay. We all know the usual suspects: candy, sugar-added snacks and sodas. But there’s one category you may not at first think fits the profile—juices. But even natural juices with no added sugar can raise your child’s risk of tooth decay if they’re drinking too much.

Tooth decay is caused by certain strains of bacteria in the mouth, which produce acid. Sugar in any form (sucrose, fructose, maltose, etc.) is a primary food source for these bacteria. When there’s a ready food source, bacteria consume it and produce abnormally high levels of acid. This can cause the mineral content of tooth enamel to dissolve faster than saliva, which neutralizes acid, can reverse the tide.

Juices without added sugar still contain the natural sugar of the fruit from which they originate. The American Academy of Pediatrics conducted a study of the effect of these natural juice sugars on dental health. Their conclusion: it can have an effect, so the amount of juice consumed daily by a child should be restricted according to age.

They’ve since published guidelines to that effect:

• Under age 1 (or any child with abnormal weight gain): no juice at all;
• Ages 1-3: no more than 4 ounces a day;
• Ages 4-6: no more than 6 ounces a day;
• Ages 7-18: no more than 8 ounces (1 cup) a day.

Again, these are guidelines—you should also discuss the right limits for your individual child with your dentist or pediatrician. And if you’re wondering what kind of beverages pose less risk of tooth decay, you can look to low or non-fat milk. And, of course, don’t forget water—besides containing no sugar, nature’s hydrator has a neutral pH, so it won’t increase acidity in the mouth.

Tooth decay is one of the biggest health problems many kids face. But with good teeth-friendly habits, including restricting sugar intake in any of its many forms (including juices) you can go a long way in reducing their risk of this destructive disease.

If you would like more information on best dental care practices for children, please contact us or schedule an appointment for a consultation.

Lots of people don’t know that April is National Stress Awareness Month; don’t fret if you’re one of them. For many, stress is already a common feature of everyday life. According to the American Psychological Association, 62% of Americans are stressed at their jobs, and stress has been estimated to cause the loss of some 275 million working days every year.

In addition to its other negative physical and mental consequences, stress can also spell trouble for your oral health. It may lead to the problems of teeth clenching and grinding, which dentists call bruxism. A habitual behavior that can occur in the daytime or at night, bruxism is thought to affect perhaps one in ten adults. While the evidence that stress causes bruxism is not conclusive, there’s a strong case for the linkage.

Bruxism sometimes causes symptoms like headaches, soreness or pain in the jaw muscles or joints, and problems with fully opening the mouth. It can be detected in the dental office by excessive tooth wear, and/or damage to tooth surfaces or dental work. Grinding or tapping noises heard at night may indicate that someone is grinding their teeth while sleeping. In children, nighttime bruxism is common and not necessarily a reason for concern; in adults, it may be more troubling.

So what can you do if you’re experiencing this problem? If you find yourself clenching and grinding during the daytime, simply becoming more aware of the behavior and trying to limit it can help. A bit of clenching during times of stress isn’t abnormal, but excessive grinding may be reason for concern. Many of the same techniques used to relieve stress in other situations—such as taking a step back, talking out your issues, and creating a calmer and more soothing environment—may prove helpful here as well.

Occasionally, prescription drugs may cause bruxism as an unwanted side effect; in this case, a medical professional may recommend changing your medication. The use of stimulants like coffee and mood altering substances like alcohol and illicit drugs have also been associated with teeth grinding—so if you’re having this issue, consider foregoing these substances and making healthier lifestyle choices.

There are also a number of dental treatments that can help protect your teeth from excessive grinding. The most common is an occlusal guard or “night guard.” This is a custom-fabricated appliance made of plastic that fits comfortably over your teeth. Usually worn at night, it keeps your teeth from actually coming into contact with each other and being damaged. Occasionally, additional treatments such as bite adjustment or orthodontics may be recommended to help solve the problem.

If you would like more information about teeth clenching and grinding, please call our office to schedule a consultation. You can learn more in the Dear Doctor magazine articles “Teeth Grinding” and “When Children Grind Their Teeth.”

People with diabetes have special concerns when it comes to dental care. In fact, 1 in every 5 cases of total tooth loss is linked to this widespread health condition. November is National Diabetes month, so it’s a good opportunity for us to answer some frequently asked questions about oral health and diabetes.

Q. Can I get a dental implant to replace a missing tooth even if I have diabetes?

A number of studies have shown that people with diabetes can be good candidates for dental implants, but there are some concerns regarding dental implant treatment, which involves minor surgery. Wounds tend to heal more slowly in people with diabetes, who are also more infection-prone than those without diabetes. In diabetic individuals with poor glucose control, research has also shown that it takes longer for the bone to heal after implant placement. We will take these (and other) factors into account when planning your implant treatment. However, in many situations even poorly controlled diabetes does not necessarily preclude dental implant treatment.

Q. I’ve heard people with diabetes have a higher risk for gum disease. Is that true?

Yes. Research shows that people with diabetes are more susceptible to periodontal (gum) disease, especially when their diabetes is poorly controlled. The reverse is also true: untreated periodontal disease can worsen blood sugar levels. So it’s important to manage both of these inflammatory conditions. If you notice the early signs of gum disease, such as inflamed or bleeding gums, please bring this to our attention. Early gum disease (gingivitis) is much easier to treat than more advanced forms—which can eventually lead to tooth loss.

Q. If I have diabetes, how can I protect my oral health?

Keep doing your best to control your blood sugar levels with exercise and a healthy diet—and stick to an effective daily oral hygiene routine, which includes both brushing and flossing and coming in for regular dental checkups and cleanings. Make sure to let us know what medications you are taking and update us on any changes. If you notice any mouth sores, swelling or inflammation, bring this to our attention as soon as possible.

If you have additional questions about diabetes and oral health, please contact us or schedule an appointment for a consultation.