If you're intrigued by the strange and bizarre, here's one to pique your interest: geographic tongue. It's a rare condition that causes the appearance of red patches on the tongue surface, surrounded by grayish-white borders, and which look a lot like continents on a map (hence the name). But although it may look odd, geographic tongue won't harm your health.

The condition is also known as benign migratory glossitis, so named because it's not cancerous and the patches seem to move or “migrate” around the tongue surface. The most common causes are thought to be stress or hormonal disruptions in those predisposed to the condition. Many researchers believe zinc or vitamin B deficiencies in the body contribute to its occurrence. It also seems more prevalent among non-smokers and pregnant women, as well as occurring as a family trait.

The red patches are created by the temporary disappearance of some of the papillae, tiny bumps on the tongue's top surface. The patches can abruptly appear during a flareup and then disappear just as suddenly. But as “angry” as the patches may look, geographic tongue is not considered a health danger. It isn't normally painful, although people can experience stinging or numbing sensations emanating from the patches that can be mildly uncomfortable.

Because it's also rare, you're not likely to encounter it personally. But if you or a loved one does begin to notice red patches on the tongue, there are a few things you can do to lessen any accompanying irritation. For one, cut out foods like tomatoes, citrus fruits, eggplant, mint or highly spicy or acidic foods, all of which have been known to increase discomfort. You might also avoid astringents like alcohol or mouthwashes that likewise irritate the patches when they occur.

Although geographic tongue can't be cured, your dentist can help you manage symptoms when they arise with the help of prescribed anesthetic mouthwashes, antihistamines or steroid lozenges. These not only can help lower any discomfort or irritations, they may also lessen the duration of a flareup.

For the most part, geographic tongue usually causes more embarrassment than physical discomfort. But with a little help from your dentist, you can keep it to a minimum. Geographic tongue may be odd, but it's nothing to worry about.

If you would like more information on geographic tongue, 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.”

If we were playing word association with the term “oral hygiene,” you'd probably answer “brushing.” And you would be right—brushing cleans tooth surfaces of accumulated bacterial plaque, a thin biofilm most responsible for dental disease.

But brushing is only half of the oral hygiene equation: You also need to remove dental plaque between teeth where brushing can't reach. And, that requires that other practice—flossing.

Unfortunately, brushing is more popular than its hygienic sibling because many people find traditional thread flossing more difficult and messier than brushing. That can make it tempting to skip flossing—but then you're only getting half the benefit of oral hygiene for reducing the risk of tooth decay or gum disease.

There is, however, a way to floss that doesn't involve a roll of thread: oral irrigation. This form of flossing uses a countertop device that directs a pressurized spray of water between teeth through a handheld wand. The directed spray loosens and then flushes away accumulated plaque.

Oral irrigators (also known as water flossers) have been an important tool for decades in dental offices, and have been available for home use since the 1960s. In the last few years, though, the devices have become more compact and easier to use. More importantly, studies have shown they're as effective in removing between-teeth plaque as regular flossing.

These irrigation devices are especially useful for people wearing braces. The attached brackets and wires make it extremely difficult to maneuver flossing thread between teeth. Because of this (as well as similar difficulties in brushing), patients are more susceptible to dental disease while undergoing orthodontic treatment.

But a 2008 study showed that oral irrigators are quite effective for braces wearers in removing between-teeth plaque. It found those who used an irrigator after brushing removed five times the amount of plaque than those that only brushed.

Even if you're not wearing braces, you may still find an oral irrigator to be a useful flossing alternative. Speak with your dentist for recommendations on what to look for in an oral irrigator and tips on how to use it. It could make a positive difference in your dental health.

If you would like more information on how best to keep your teeth and gums clean, 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 “Cleaning Between Your Teeth.”

Heartburn is a big problem: Each year we Americans spend around $10 billion on antacid products, twice as much as for over-the-counter pain relievers. It's an even bigger problem because many indigestion sufferers actually have acid reflux or GERD (gastroesophageal reflux disease), a chronic disease that can cause physical harm—including to teeth.

That's why we've joined with other healthcare providers for GERD Awareness Week, November 17-23, to call attention to the causes and consequences of this disease. In addition to the harm it poses to the esophagus (the “tube” leading from the mouth to the stomach through which food passes), GERD could also damage your teeth to the point of losing them.

GERD is usually caused by the weakening of the lower esophageal sphincter, a ringed muscle located at the junction between the esophagus and the stomach. It acts as a “one-way valve” allowing food into the stomach, but not back into the esophagus. If it weakens, powerful stomach acid can come back into the esophagus and possibly even the mouth. The latter scenario poses a danger to teeth's protective layer of enamel.

Although tough and durable, enamel softens after prolonged contact with acid. Oral acid isn't all that unusual—acid levels typically rise right after eating, causing a temporary softening of enamel. Our saliva, however, goes to work to bring down those acid levels and stabilize enamel.

But if stomach acid enters the mouth because of GERD, the increased acidity can overwhelm saliva's ability to neutralize it. This can lead to enamel erosion, tooth decay and ultimately tooth loss. The enamel damage can be so pronounced that dentists are often the first to suspect GERD.

If you're diagnosed with GERD, here's what you can do to protect your teeth.

• Manage your GERD symptoms through medication, avoidance of spicy/acidic foods, alcohol, caffeine or tobacco products, and maintaining an optimum weight;
• Stimulate saliva by drinking more water, using saliva boosters, or (with your doctor's consent) changing from medications that may be restricting saliva flow;
• Speak with your dentist about strengthening your enamel with special toothpastes or mouthrinses containing extra fluoride or amorphous calcium phosphate (ACP).

You should also brush and floss daily to lower your risk of dental disease, but with one caveat: Don't brush your teeth during or immediately after a reflux episode, as you might remove microscopic bits of softened enamel. Instead, rinse your mouth with water mixed with a half-teaspoon of baking soda (an acid neutralizer) and wait about an hour to brush. The extra time also gives saliva time to further neutralize any remaining acid.

GERD can be unpleasant at best and highly destructive at worst. Don't let it ruin your teeth or your smile.

If you would like more information about GERD and dental health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “GERD and Oral Health” and “Dry Mouth.”

Thousands of years ago, our ancestors could only expect to live between 30 and 40 years. But steady improvements in lifestyle and medical care have increased human life expectancy to almost 80 years.

Although a welcome development, it does raise a question: Are our teeth up to the added years? Even though quite resilient, it's natural for teeth to wear after years and tens of thousands of meals biting and chewing.

Fortunately, there have also been phenomenal advances in dental restorations that can effectively replace teeth we lose along the way. Even so, the most advanced artificial replacements can't restore the full benefit of natural teeth to oral and general health. The ideal goal is to preserve and protect our natural teeth for as long as possible.

Here are 4 areas worthy of your attention in protecting your teeth throughout your lifetime.

Dental disease. Tooth decay and periodontal (gum) disease are the top causes for poor dental health and tooth loss. They're caused by bacteria living and feeding primarily in dental plaque, a thin biofilm on tooth surfaces. Brushing and flossing daily, along with regular dental cleanings, removes this disease-causing plaque. You should also seek treatment as soon as possible at the first sign of dental disease.

Bite correction. A poor bite is more than a smile problem: Teeth out of alignment and not engaging normally with their counterparts on the other jaw may increase tooth wear and make hygiene more difficult to perform. Orthodontic treatment, even if undertaken later in life, can help maintain your teeth's long-term health and longevity.

Bad habits. Your teeth are tough, but not indestructible. Protect them by avoiding harmful habits or practices like crunching ice, gnawing on pencils, nails or other hard objects, cracking open nuts or using your teeth as tools. Not engaging in these kinds of habits will help reduce wear and help you also avoid chipping and fractures.

Teeth grinding. Involuntarily clenching or grinding your teeth, often while sleeping, can accelerate dental wear. If you suspect you have this habit, take steps first to deal with stress, the number one cause of adult teeth grinding. Your dentist can also fashion a mouth guard that prevents your teeth from making solid contact with each other and thus help reduce wearing to your teeth.

If you would like more information on tooth wear, 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 “How and Why Teeth Wear.”

After years battling disease, your troubled tooth reached its useful life's end. It's been extracted, and we've replaced it with a life-like dental implant. So now, as far as the implant goes, disease is no longer an issue…right?

Sorry, no—though not to the same degree as a natural tooth, an implant could be endangered by gum disease. Although the implant's materials can't be infected, the supporting gums and bone can.

In fact, there's a particular type of gum disease associated with implants known as peri-implantitis (“peri” around an implant; “itis” inflammation) that first affects the gums surrounding an implant. Although peri-implantitis can arise from an excess of dental cement used to affix the crown to the implant, it most commonly starts like other forms of gum disease with dental plaque.

Dental plaque, and its hardened form calculus (tartar), is a thin, bacterial biofilm that builds up on teeth surfaces. It can quickly accumulate if you don't remove it every day with proper brushing and flossing. The bacteria living in plaque can infect the outer gum tissues and trigger inflammation.

Gum disease around natural teeth can spread quickly, but even more so with implants. That's because the natural attachment of the gums helps supply antibodies that impede infection. Implants, relying solely on their connection with the bone, don't have those gum attachments. As a result, peri-implantitis can move rapidly into the supporting bone, weakening the implant to the point of failure.

The good news, though, is that peri-implantitis can be treated successfully through aggressive plaque removal and antibiotics. But the key to success is to catch it early before it progresses too far—which is why you should see your dentist at the first sign of gum swelling, redness or bleeding.

You can also prevent peri-implantitis by practicing daily brushing and flossing, including around your dental implant. You should also see your dentist twice a year (or more, if they advise) for cleanings and checkups.

Dental implants overall have a greater than 95% success rate, better than any other tooth restoration system. But they still need daily care and regular cleanings to ensure your implants are on the positive side of those statistics.

If you would like more information on caring for your dental implants, please contact us or schedule an appointment for a consultation.