Posts for: July, 2014
If you occasionally notice mildly irritating red patches on the top surface of your tongue, you may be one of the three percent or less of the population with a condition called benign migratory glossitis. It’s also known as “geographic tongue” because the red patches often resemble land masses on a world map.
While the symptoms may be discomforting, geographic tongue isn’t a cause for serious concern. The red patches are caused by the temporary loss of papillae, tiny bumps that grow on the surface of the tongue, which may appear and disappear repeatedly over a short time period (ranging from hours to days). As its medical name implies, this form of glossitis isn’t cancerous or contagious; it’s referred to as “migratory” because the red patches often appear to move around while changing size and shape. An outbreak can cause a mild burning or stinging sensation, and some people also encounter numbness in the patchy areas.
While there isn’t a firm consensus as to geographic tongue’s exact cause, there do appear to be triggers for it including stress, hormonal changes and mineral or vitamin deficiencies (particularly zinc and Vitamin B). There also seems to be a connection with psoriasis, a skin ailment characterized by redness and scaling — a number of people will experience both conditions. Geographic tongue appears more often in middle-aged, non-smoking adults, particularly women during hormonal fluctuations (as during pregnancy or ovulation). Individuals with deep grooves on their tongues called fissures are more susceptible as well.
There’s no cure for the condition, but there are some treatments that can help alleviate any accompanying irritation. Depending on what we find during examination, we may prescribe anesthetic mouthrinses, antihistamines, steroid ointments or other treatments to help manage discomfort. It may also be helpful to limit your intake of foods during outbreaks that may increase irritation, including high acidic foods like tomatoes or citrus fruit, as well as eggplant, mint, spicy foods and alcohol (including certain mouthwashes).
If you experience these occasional patchy outbreaks on your tongue, please schedule a visit with us for a full examination. We may be able to reduce your discomfort and certainly put your mind at ease.
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.”
When a permanent tooth has been injured, our first priority should be to save it. A root canal treatment (where the interior pulp of the tooth is removed and the pulp chamber and root canals are filled and sealed) is usually the best approach for tooth preservation.
An immature permanent tooth, however, presents a different challenge. While the pulp is less essential to a mature tooth’s vitality, it serves a critical purpose in the tooth’s early development before early adulthood. The pulp produces layers of dentin necessary for the tooth’s root system development. Completely removing the pulp at this stage may retard root development and cause the tooth to eventually weaken, and become brittle and darkened.
For younger teeth, we should therefore use alternative techniques that preserve as much healthy pulp as possible. One of these alternatives is Indirect Pulp Therapy, used when the pulp hasn’t been exposed by the trauma. With this technique we remove as much damaged dentin as possible while preserving the harder dentin closer to the pulp. After applying an antibacterial agent to protect against infection, and then filling and sealing the tooth, the pulp can continue to produce dentin in a normal way.
If pulp exposure has occurred, some form of pulpotomy — the partial removal of any damaged or infected pulp — would be in order. Our goal here is to leave as much of the pulp as possible, and then apply substances that stimulate the remaining pulp to create dentin. The most common type of growth substances are calcium hydroxide or mineral trioxide aggregate (MTA).
If the pulp isn’t at all salvageable, we may then turn to a procedure known as apexification. After removing the pulp we insert MTA at the root end of the tooth, then fill and seal the remaining interior as in a regular root canal treatment. The MTA will help the surrounding bone to heal and continue to grow around the root to further support the tooth.
Recent research into pulp stem cells promises further advances in this area. The regenerative qualities of stem cells could eventually help us “engineer” root development. Until then, there are still effective ways to give a young, damaged tooth a fighting chance to survive.
If you would like more information on preserving injured teeth, 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 “Saving New Permanent Teeth After Injury.”