Posts for category: Oral Health
Periodontal (gum) disease is an infectious disease that progressively weakens the attachment of supporting tissues to the teeth, including gums, ligaments and bone. If not stopped, the loss of attachment will eventually lead to bone and tooth loss.
A thin layer of plaque that builds up on teeth (mainly due to poor oral hygiene habits) is the main breeding ground for the bacteria that cause gum disease. Our main treatment goal is to remove as much of this plaque as possible from tooth and gum surfaces. Much of the plaque can be removed using special hand or ultrasonic instruments that deep clean dental surfaces, including the roots. But while effective, these manual techniques may not address the full extent of infection, especially if the disease is well advanced.
If severe bone loss has already occurred, deep pockets of infection may have developed. As bone loss progresses, teeth with multiple roots may also develop an anatomical problem known as furcation invasions where the roots of the tooth branch off. If there continues to be signs of disease, like gum inflammation, bleeding or pus formation, it’s these hard to reach areas that may still be a problem even after extensive treatment. If so, we may need to take a different approach with antimicrobial or antibiotic products.
The most effective antimicrobial substance for reducing bacteria in biofilm is a chlorhexidine mouthrinse. The typical 0.12% solution is only available by prescription — if taken for a prolonged time it can result in tooth staining, affected taste or mouth irritation. To assure the solution reaches below the gum line, it will need to be applied by us in the office, followed up flushing irrigation of the affected area.
Another alternative is topically applied antibiotics that can stop or even reverse the progression of gum disease. There’s evidence that topical applications can penetrate into these deeper areas of infection. A common antibiotic used in this way is tetracycline, which has been shown to stop inflammation and infection.
These treatments don’t eliminate the need for mechanical cleaning, and the prolonged use of antibacterial products can have a detrimental effect on “good” bacteria (needed, for example, to complete the digestive process). It will depend on the extent of the gum disease to determine how successful conservative treatment may be. It’s also important that you contribute to your own dental health with a renewed daily oral hygiene habit.
If you would like more information on treatments for gum disease, 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 “Treating Difficult Areas of Periodontal Disease.”
If you’re in the habit of making New Year’s resolutions, perhaps you’ve made familiar promises like losing weight, running a 5k race or joining a gym. How about this one: “I resolve this year to take better care of my teeth.” Better yet, you needn’t wait for the next January 1st — you can begin better oral hygiene habits today.
Although maybe not as glamorous as other self-improvement habits, oral hygiene still promises huge benefits not only for your teeth and gums, but also for your general health and possibly your wallet. Daily brushing and flossing reduces your risk of tooth decay and periodontal (gum) disease, which can in turn reduce your long-term dental care costs. Besides, clean teeth just look better!
If brushing your teeth hasn’t been a regular habit for you, here are a few tips to get you on the right track:
Pick the right brush. For most people, a soft bristled, multi-tufted toothbrush is the best choice. If you’re not sure what kind of brush to use, ask us for recommendations.
Look for the basics in toothpaste. Store shelves are filled with toothpastes promising everything from teeth whitening to tartar control. Just be sure of two things: that the product contains fluoride (proven to reduce the risk of tooth decay) and it has the American Dental Association’s Seal of Approval. If you have sensitive teeth, ask us about toothpaste options that address this or other special situations.
Easy does it with the technique. Over-vigorous brushing can harm your teeth’s enamel and cause gum recession. Hold the brush handle between your fingertips with no more pressure than you would hold a pencil. Position the brush-head at the gum line at about a 45-degree angle and gently clean all your tooth surfaces. If you’re trying this approach for the first time, the task should take about two minutes.
Visit your dentist twice a year to keep on track. Think of your dental healthcare team as your “personal trainers” in oral hygiene. Besides monitoring your overall dental health and removing hard to reach plaque through semi-annual cleanings, they’ll also coach you on your new lifetime habit of better oral hygiene.
If you would like more information on oral hygiene, 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 “Oral Hygiene.”
They work hard, and put in lots of time on the field and at home. They learn the rules of the game — as well as the unwritten rules of sportsmanship and teamwork. They receive the proper training, and wear appropriate protective equipment. But sometimes, in spite of everything, kids who participate in sports can be subject to injury. Fortunately, in today's dentistry there are a variety of treatments, as well as preventive measures, which can help.
When faced with serious dental injury, time is of the essence in saving teeth. So, don't delay — come in to see us immediately! If treated promptly, it's possible for teeth which have been dislodged — or even knocked out of the mouth — to be put back in position and stabilized. Afterwards, follow-up treatment will ensure that the tooth has the best chance of recovery.
The treatment of kids' dental injuries is sometimes different than that of adults. For example, in adults, a root canal would generally be necessary, followed by a tooth restoration (crown). But some kids may not need this treatment, since their teeth are still developing. Also, replacing a missing primary (baby) tooth may not be recommended, since it may hinder development of the permanent teeth. Based on his or her individual circumstances, we can develop an appropriate treatment plan for your child.
Luckily, the most common dental injuries aren't nearly as serious — they typically involve chipped or cracked teeth. Most can be repaired by reattaching the broken piece, or using a tooth-colored restoration. If a large part of the structure of a permanent tooth is missing, a crown or “cap” may be placed on the visible part, above the gum line. Smaller chips, even in primary teeth, can be successfully repaired by cosmetic bonding with composite resin materials.
Finally, if your child is involved in athletic activities — or if you are — consider obtaining a custom-made mouthguard. Numerous studies have shown that this protective gear can help prevent many dental injuries. Unlike the off-the-shelf types found in some sporting-goods stores, the ones we provide are individually fabricated from an exact model of the teeth. They're strong, fit comfortably, and offer superior protection at a reasonable cost.
If you have questions about the treatment of sports-related dental injuries, or about mouthguards, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Trauma & Nerve Damage to Teeth” and “Mouthguards.”
When your baby’s first teeth erupt in the mouth, it’s a big step in their development. Unfortunately, you may not have much opportunity to celebrate — you’re too busy tending to your infant whose experience is anything but pleasant.
Commonly known as teething, the eruption process usually begins between six and nine months of age, although some children may begin as early as three months or as late as twelve. Not all teeth come in at the same time: it usually begins with the two lower front teeth, then the two upper front teeth, followed by the molars and then the canines (eye teeth). By age three, most children have all twenty of their primary teeth.
Each child’s teething experience is different and may vary in length of time and intensity. The usual signs are heightened irritability, biting and gnawing accompanied by gum swelling, ear rubbing, drooling and sometimes facial rashes. Babies also may have disturbed sleeping patterns and a decreased appetite. Occasionally, this discomfort can be intense.
There are some things you can do to ease this discomfort. Provide your baby a clean, chilled (not frozen) rubber teething ring, chilled pacifier or wet washcloth to gnaw on. Cold foods, like popsicles for older children can also be soothing, though you should limit sugary foods to lower the risk of tooth decay. You can also finger massage swollen gums to counteract the pressure coming from the erupting tooth, or administer pain relievers like baby acetaminophen or ibuprofen. You can use products with Benzocaine®, a numbing agent, for children two years or older — but you should never use alcohol for children of any age for inflamed gums.
Be sure to also set up a Year One dental examination around their first birthday. This is an important first step in your child’s long-term dental care, and a good opportunity to check their teething progress. And, by all means, if you have concerns about your child’s experience with teething, don’t hesitate to call our office.
Teething is a normal part of your child’s development. There’s much you can do to help make it as comfortable and pain-free as possible.
If you would like more information on teething, 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 “Teething Troubles.”
What and how you eat and drink has a significant impact on the health of your teeth and gums. Therefore, an effective oral hygiene regime must take your diet into account.
Acid is your teeth's enemy; it can erode their protective enamel coating (a process called demineralization). Certain foods and beverages (such as citrus drinks and coffee) contain it, and it's produced by bacteria in your mouth that feed on dietary sugar and release acid as a byproduct (a process called fermentation). Your allies are foods and beverages that neutralize acids, provide minerals and vitamins to repair tooth enamel, and stimulate saliva.
Sugar & Decay
Sugars, the leading promoter of dental decay, exist in many forms in our diet. Some occur naturally, while others — referred to as “free sugars” — are added by the manufacturer, cook or consumer. The latter are most often linked with decay. Soft drinks are the primary source of dietary free-sugars in the U.S.
Sugars in fruit, vegetables, milk and unprocessed, starch-rich foods such as rice, potatoes and whole grains, do not appear to be harmful to teeth. Note, however, that dried fruits contain a highly concentrated sugar level and can stick to tooth surfaces. The sugar substitutes xylitol and sorbitol appear not to promote decay. In fact, there's evidence that chewing xylitol-sweetened gum three to five times daily for at least five minutes (after meals) stimulates saliva flow, which helps protect against decay.
Acids & Erosion
In addition to eroding tooth enamel, acidic foods and beverages create an environment where it's easier for decay-promoting bacteria to flourish. Saliva can reduce acidity but it must have time to work, at least 30–60 minutes. That's why behaviors that maintain acid levels, such as sipping coffee throughout the day, can be harmful.
Saliva is a front-line defense against erosion and decay. It helps remove food particles and contains minerals that help neutralize acid and promote remineralization of the tooth surface. Foods that stimulate saliva and/or contribute essential minerals include:
- Cheese — stimulates saliva and is rich in calcium, contributing to the re-calcification of teeth and protecting against the loss of calcium,
- Cow's milk — contains decay-counteracting calcium, phosphorous and casein,
- Plant foods — are fibrous and require chewing, which mechanically stimulates saliva,
- Water — keeps you hydrated, which is important for saliva production and preventing dry mouth (a condition that promotes acid-producing bacteria), and helps wash away food particles; fluorinated water bestows the protective properties of fluoride (a compound that makes tooth enamel more resistant to acid erosion and promotes re-calcification).
As you can see, brushing and flossing effectively is just part of the oral hygiene equation.
If you would like more information about nutrition and oral hygiene, 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 “Nutrition & Oral Health.”