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One of the most common clues that you might have anemia is found in your smile. If you’ve noticed that your gums are suddenly paler than they used to be, it could be a sign that you’re anemic. What does this mean for your general health—and your oral health?

There are several types of anemia, which have can be caused by different medical conditions and which can cause different symptoms. The most common form of anemia, and one of the most easily treated, is iron-deficiency anemia.

Iron is essential to our health. Why? It’s all about the red blood cells. First, some biology.

Every cell in your body needs energy to live and to function. Cells get this energy from the foods we eat, which are broken down into a simple sugar called glucose. Glucose molecules are transported by our blood cells to reach all parts of the body. But that’s only the first step.

Energy is released into the cells when the chemical bonds holding glucose molecules together are broken. And this requires oxygen. Once inside our cells, glucose and oxygen react, breaking the chemical bonds of the glucose molecules, reconfiguring their atoms to create carbon dioxide and water byproducts—and releasing energy into a form your cells can use.

So, how do we move this oxygen from our lungs to our cells to start the process? That would be our red blood cells again. But this process can’t happen without adequate iron. More biology!

Red blood cells contain a protein called hemoglobin, and hemoglobin contains iron. In fact, well over half of the iron in our body is found in our red bloods cells. And here’s the key to iron’s importance: iron attracts oxygen molecules.

Hemoglobin picks up oxygen in our lungs and delivers it throughout the body, where it becomes glucose’s essential partner in fueling our cells. Without enough iron, your body won’t be able to create the red blood cells it needs so that all of your cells, tissues, and organs can get the oxygen they need to function efficiently.

When might you suspect that you’re anemic? Your gums, the lining of the mouth, the inside of your lower eyelids, and your skin can take on a paler hue—the classic sign of anemia. But other symptoms which you might not necessarily associate with anemia are also common, including:

• Fatigue
• Heart palpitations
• Cold hands and feet
• Dizziness
• Irritability
• Difficulty Concentrating
• Pica (the desire to eat non-food items)

And because anemia affects the whole body, your oral health isn’t immune. It’s not just a matter of pale gums. Iron deficiencies can cause:

• Sores and ulcers in the mouth
• Cracks on the sides of the mouth
• Pain, redness, and/or swelling of the tongue
• Loss of papillae (those little bumps on your tongue which hold your taste buds)
• Tooth damage caused by pica
• Dry mouth, which increases your risk for cavities, gum disease, oral infections, and bad breath

Iron-deficiency anemia can have several causes, among them insufficient iron in the diet, medical conditions which cause bleeding (such as ulcers), heavy menstruation, pregnancy, or growth spurts in children and teenagers. Treatment will depend on the cause of your anemia. It might be as simple as a change in diet or an iron supplement, or it might require further treatment options. Do consult with Dr. Nymberg before taking iron supplements, as too much iron causes iron toxicity, which can be very dangerous.

If Dr. Nymberg and our team suggest that you might be anemic, or if you notice changes you think might be caused by anemia, see your physician for a simple blood test. Besides iron-deficiency anemia, there are other forms of anemia and other diseases which can mimic these symptoms, so it’s important to get a doctor’s diagnosis. If you have been diagnosed with anemia, let our Mason dental team know.

One last “if”: If you do have iron-deficiency anemia, don’t delay treatment. The sooner your red bloods cells are back at their peak, the sooner you—and your gums—will be back in the pink!

When working out, studying late, or any time we feel like a bit of a boost would come in handy, energy drinks are a common go-to for many teens and adults. Energy drinks promise more focus and vitality, all wrapped up in clever names and eye-catching graphic designs. What they can’t promise, though, is a drink that’s good for your dental health.

Why? Because most energy drinks come with a high concentration of caffeine, acids, and/or sugar.

• Caffeine Consequences

Before we talk about your dental health, a word about caffeine. Too much caffeine in a short period can leave us jittery, anxious, irritable, and sleepless. A cup of coffee has about 100 mg of caffeine, and some energy drinks have three to four times that much.

While the recommended daily limit for adults who aren’t pregnant is 400 mg of caffeine, doctors suggest a much lower limit for children and teenagers. Among other reasons, sleep is especially important for developing brains and bodies, and caffeine interferes with healthy sleep.

You might have to go online to find out how various energy drinks measure up and compare in terms of caffeine, but taking the time to check them out is well worth it. Now, back to your dental health!

• Acid Attacks

Many energy drinks are very acidic. The tart flavors of energy drinks might please your palate, but they attack your enamel.

Our mouths are their healthiest when our saliva is neutral, balanced between acidic and basic on the pH scale. That’s somewhere around a 7 on a scale of 0-14, where lower numbers mean more acidic conditions. That burning feeling we get from acid reflux when stomach acids back up? That’s because stomach acid is a 1-2 on the pH scale.  Many energy drinks rate an eye-opening (and not in an energetic way!) 1.5-3.5 on the pH scale, which means your teeth are bathing in acids.

Even tooth enamel, the strongest substance in the body, can’t stand up to these acids, because acids break down the mineral structure of your enamel. If your teeth are more sensitive to heat and cold, if they appear darker as the white outer layer of enamel thins, if your dentist has discovered weak spots in your enamel—you might be experiencing demineralization. Once enamel is gone, it can’t be replaced.

• Surplus Sugar

A well-known source of quick energy is sugar. A little more biology and chemistry here—sugar is a food which our bodies can break down quickly. And when sugar molecules break down, this breakdown releases energy—energy which we use to fuel essential bodily functions. This quick burst of sugar energy is why many energy drinks contain lots of added sugar. Some brands have more than 60 grams of sugar per serving—and 60 grams is almost 5 tablespoons!

We get all the sugar we require for our daily energy needs from the natural sugars found in fruits, dairy, even some vegetables and grains. With added sugars, we’re just adding empty calories, affecting the balance of our blood sugar and hormones, and increasing the risk of chronic health conditions—all while providing a convenient food source for the bacteria in plaque.

Because, just like our bodies find it easy to convert sugar to energy, the oral bacteria which cause cavities find it easy to convert sugar to acids. And just like the acids in foods, these acids attack the tooth’s mineral structure and break down its strength. Eventually, the weak spots in enamel grow larger and deeper and become cavities.

While most labels don’t let you know how much caffeine you’re getting, or the pH of the liquid inside, you can see how much sugar is being added to your diet with every can or bottle. Do look for added sugars before you choose your beverages.

If you have several energy drinks a day, a soft drink or two, plus the occasional sports drink—you’re bathing your teeth in acids and sugar all day long. With any beverage high in sugars and acids, limit your consumption. Rinse with water afterward, and don’t brush for about an hour to give your enamel time to remineralize after being exposed to the acids in your drink.

Better yet, choose healthier alternatives. Water is still the best way to hydrate. Try adding protein and carbs to your diet for more energy. Make sure you’re getting the vitamins you need with a balanced diet. If you see signs of enamel erosion, talk to Dr. Nymberg. The temporary boost you get from a bottle of caffeine, acids, and sugar might seem tempting, but it can have long-lasting consequences for your dental health!

When you have a tooth extracted, your body immediately sets to work to help protect the affected area. The blood that collects at the site of the extraction clots to cover and protect the wound. This is a normal response, and protects the nerves and bone that have been exposed with the removal of your tooth. Normally, the gum tissue will close over the area within a few weeks.

But sometimes the clot becomes dislodged or moved before you have a chance to heal. The result is that the nerves and bone in the extraction site are exposed to air and outside substances. Bacteria can contaminate the wound and lead to pain, infection, and further damage. This condition is known as dry socket.

There are certain activities that should definitely be avoided so you are not at risk for dry socket.

• Straws and suction: The action of using a straw causes suction that can dislodge the clot. You can still enjoy the soothing coolness of a milkshake, but use a spoon.
• Spitting: You might be tempted to rinse and spit immediately to clean your mouth, but spitting can also dislodge the clot. We will let you know how to clean your mouth and teeth for the next few days.
• Smoking: Not only does smoking provide a suction effect that can remove the clot, but smoking and chewing tobacco can slow healing as well.

There are also steps you can take to aid the healing process.

• Caring for your extraction site

Dr. Nymberg will give you instructions on caring for your mouth and teeth for the next few days. Gentle care for the extraction site is vital. And treat yourself gently as well. Rest if you need to, and avoid activities that might impact your wound.

• Think about your diet

Stick to soft foods for the first day or so and chew on the side opposite your extraction site. Carbonated and caffeinated beverages should be avoided, as well as food like peanuts or popcorn that lodge in the teeth.

• Watch for symptoms of dry socket

How do you know if you have a dry socket? Monitor your pain and the appearance of the site after the extraction. For the first few days, you might feel some pain in the immediate area. Pain that intensifies after three or four days is usually not a result of the extraction. An unpleasant odor or taste in your mouth could be a sign of dry socket. You might look in the mirror and notice that the clot is no longer there, or appears to have been dislodged. If any of these symptoms occur, call our Mason office at once. If you are experiencing dry socket, the extraction site needs to be cleaned and protected from further injury, and we can prescribe antibiotics if needed.

Dry socket is a rare occurrence, but if you have any symptoms that concern you, we want to hear about them. We will work with you to make your extraction go as smoothly as possible. Talk to us about your concerns before any procedure, and we will provide detailed information for the healing process. Keep us in the loop as you recuperate, and we will work together to make your recovery a speedy one.

According to the American Association of Pediatric Density, roughly one in five children suffers from canker sores. Canker sores are small sores that appear inside the cheeks, on the lips, on the surface of the gums, and under the tongue.

Even though, canker sores are not contagious, they do tend to run in families. There are several reasons your child may be suffering from canker sores including:

• Children who have Vitamin B12, iron, and folic acid deficiencies tend to get canker sores more often than children who have normal levels of these vitamins and minerals.
• Children who suffer from food allergies are also at a higher risk for developing canker sores. It’s difficult to determine what your child may be allergic to. If you feel strongly that the canker sores are related to an allergy, then a visit to an allergist is highly recommended.
• Biting their lip or cheek can also result in a canker sore.
• Any injury to mouth, where the skin breaks can cause a canker sore.
• Brushing their teeth too hard can also be a problem.
• Your child may be sensitive to an ingredient in their toothpaste. Try switching toothpastes and see if it makes a difference.
• Emotional disturbances and stress are also factors to consider.

If your child has frequent canker sores a visit to our Mason office will be beneficial. Canker sores are painful and usually last about 14 days. Dr. Nymberg may recommend one or a few of the following treatment options:

• Avoid food that is acidic, salty, and spicy.
• A toothbrush with soft bristles may be helpful.
• Avoid mouthwash and toothpaste that contain SLS.
• Do not feed your child foods that they may be allergic to.

Canker Sore Remedies

• Eating yogurt that contains Acidophilus will relieve the pain and help the canker sore heal faster.
• Put one teaspoon of baking soda in an eight-ounce glass of lukewarm water. Have your child gargle and swish it around his or her mouth several times a day. Not only does this remedy relieve the pain, the canker sore could be gone in as little as 24 hours.
• Place a wet tea bag on the sore and hold it there for a few minutes several times a day. This remedy will help with the pain and quickly heal the sore.
• Camphor, Benzocaine, Lidocaine, and Orajel are over-the-counter medications that can help.

If you have questions about your child’s canker sore, contact Dr. Nymberg to schedule an appointment.