While sports like football, basketball and soccer have exploded in popularity over the last few decades, many Americans still have a soft spot for the granddaddy of them all: baseball. While technology has changed many aspects of the game, many of its endearing traditions live on.

Unfortunately, one baseball tradition isn’t so endearing and definitely hazardous to health—tobacco, primarily the smokeless variety. Players and coaches alike, even down to the high school level, have promoted or at least tolerated its use.

But there are signs this particular baseball tradition is losing steam. Not long ago, the San Francisco Giants became the first major league baseball team to prohibit tobacco in its home stadium—on the field as well as in the stands. The move was largely in response to a law passed by the City of San Francisco, but it does illustrate a growing trend to discourage tobacco use in baseball.

While smoking, chewing or dipping tobacco can certainly impact a person’s overall health, it can be especially damaging to the teeth, gums and mouth. Our top oral health concern with tobacco is cancer: Research has shown some correlation between tobacco use (especially smokeless) and a higher risk of oral cancer.

You need look no further than the highest ranks of baseball itself to notice a link between tobacco and oral cancer. Although from different eras, Babe Ruth and Tony Gwynn, both avid tobacco users, died from oral cancer. Other players like pitcher Curt Schilling have been diagnosed and treated for oral cancer.

Cancer isn’t the only threat tobacco poses to oral health. The nicotine in tobacco can constrict blood vessels in the mouth; this in turn reduces the normal flow of nutrients and disease-fighting immune cells to the teeth and gums. As a result, tobacco users are much more susceptible to contracting tooth decay and gum disease than non-users, and heal more slowly after treatment.

That’s why it’s important, especially in youth baseball, to discourage tobacco use on the field. While most of baseball’s traditions are worthy of preservation, the chapter on tobacco needs to close.

If you would like more information on the oral health effects of tobacco, please contact us or schedule an appointment for a consultation.

The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.

In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?

The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.

Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.

So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”

Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.

If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”

When a woman learns she's pregnant, her first thought is often to do everything possible to protect the new life inside her. That may mean making lifestyle changes like avoiding alcohol or quitting smoking.

Some women may also become concerned that their regular dental visits could pose a risk to their baby. But both the American Congress of Obstetricians and Gynecologists and the American Dental Association say it's safe for pregnant women to undergo dental exams and cleanings—in fact, they're particularly important during pregnancy.

That's because pregnant women are more susceptible to dental infections, particularly periodontal (gum) disease, because of hormonal changes during pregnancy. The most common, occurring in about 40% of expectant mothers, is a form of gum disease known as pregnancy gingivitis. Women usually encounter this infection that leaves the gums tender, swollen and easy to bleed between the second and eighth month of pregnancy.

Untreated, pregnancy gingivitis could potentially advance below the gum line and infect the roots. It could also have an unhealthy effect on the baby: some studies show women with severe gum disease are more prone to give birth to premature or underweight babies than women with healthy gums.

But it can be stopped effectively, especially if it's treated early. Regular dental checkups and cleanings (at least every six months or more frequently if your dentist recommends) can help an expectant mother stay ahead of a developing gum infection.

With that said, though, your dentist's approach to your care may change somewhat during pregnancy. While there's little concern over essential procedures like gum disease treatment or root canal therapy, elective restorations that are cosmetic in nature might best be postponed until after the baby's birth.

So, if you've just found out you're pregnant, let your dentist know so they can adjust your care depending on your condition and history. And don't be concerned about keeping up your regular dental visits—it's a great thing to do for both you and your baby.

If you would like more information on dental care during pregnancy, 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 “Dental Care During Pregnancy: Maintaining Good Oral Hygiene Is More Important Than Ever.”

While your teeth and gums can take a lot, they still face dangers like dental disease. Your teeth are also affected by aging-related wear and tear.

And, something else could put your teeth at risk: teeth grinding. This is an involuntary habit afflicting one in ten adults in which they grind or clench their teeth, often while they’re asleep. This generates higher than normal biting forces that can cause sore jaw joints, accelerated teeth wear and damage to the ligaments that hold teeth in place. In the worst case, you could eventually lose teeth.

So how do you know you’re grinding your teeth, especially if you’re asleep? You might notice your jaw being unusually sore after you wake up or your jaw muscles feel tired. Your dentist may also notice higher than normal tooth wear during a regular checkup. One of the best indicators, though, might be your sleeping partner or family: Teeth gnashing together can be loud enough to disturb others’ sleep.

In treating adult teeth grinding, it’s best to first determine the underlying cause. One of the most prominent reasons is chronic stress: If you’re under high pressure from situations at work or at home, pent-up stress can vent through physical outlets like teeth grinding. You can manage high stress through relaxation techniques, biofeedback or group therapy, which could in turn reduce teeth grinding.

Teeth grinding could also be related to a sleep disorder, such as problems with shifting between nightly sleep cycles. Certain psychoactive drugs are often associated with teeth grinding too. And, because of alterations in brain chemistry, tobacco users are twice as likely to grind their teeth as non-users. So, receiving treatment for a medical condition or making certain lifestyle changes could help lessen a grinding habit.

Many of these approaches take time to alleviate teeth grinding. For immediate relief, your dentist can create a custom mouthguard you wear while you sleep to reduce the effects of teeth grinding. The guard prevents the upper and lower teeth from making contact while biting down, which reduces the forces against them.

The damage from teeth grinding is often cumulative. If diagnosed early, though, we may be able to stop or minimize the damage before it goes too far.

If you would like more information on teeth grinding, 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 “Teeth Grinding.”

The U.S. Centers for Disease Control and Prevention calls it “one of the ten most important public health measures of the 20th Century.” A new vaccine? A cure for a major disease? No—the CDC is referring to the addition of fluoride to drinking water to prevent tooth decay.

Fluoride is a chemical compound found in foods, soil and water. Its presence in the latter, in fact, was key to the discovery of its dental benefits in the early 20th Century. A dentist in Colorado Springs, Colorado, whose natural water sources were abundant with fluoride, noticed his patients' teeth had unusual staining but no tooth decay. Curious, he did some detective work and found fluoride in drinking water to be the common denominator.

By mid-century, fluoride was generally recognized as a cavity fighter. But it also had its critics (still lively today) that believed it might also cause serious health problems. Ongoing studies, however, found that fluoride in tiny amounts—as small as a grain of sand in a gallon of water—had an immense effect strengthening enamel with scant risk to health.

The only condition found caused by excess fluoride is a form of tooth staining called fluorosis (like those in Colorado Springs). Fluorosis doesn't harm the teeth and is at worst a cosmetic problem. And it can be avoided by regulating the amount of ingested fluoride to just enough for effectively preventing tooth decay.

As researchers have continued to learn more about fluoride, we've fine-tuned what that amount should be. The U.S. Public Health Service (PHS), which sets standards for fluoride in drinking water, now recommends to utilities that fluoridate water to do so at a ratio of 0.7 mg of fluoride to 1 liter of water. This miniscule amount is even lower than previous recommendations.

The bottom line: Fluoride can have an immense impact on your family's dental health—and it doesn't take much. Excessive amounts, though, can lead to dental staining, so it's prudent to monitor your intake. That means speaking with your dentist about the prevalence of fluoride in your area (including your drinking water) and whether you need to take measures to reduce (or expand) your use of it.

If you would like more information on how best fluoride benefits your family's dental health, 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 “Fluoride & Fluoridation in Dentistry.”