Among our most common diseases, tooth decay can be a big problem at any age: in the U.S., one in four children 5 and under has some form of the disease, as well as ninety percent of those 60 and older — and a quarter of those have suffered complete tooth loss.
Fortunately, we now know what needs to be done on a regular basis to prevent tooth decay. Unfortunately, many are uninformed about all they need to do to lower their risk.
Here, then, are 5 questions to ask yourself to see if you’re on the right prevention path or not.
Do I brush and floss daily? If not, you’re aiding and abetting the “enemy” — bacteria that cause tooth decay. Bacteria that make up plaque feed on any food remnants that adhere to tooth surfaces. Brushing at least once daily (twice is better) removes plaque, while flossing removes plaque between teeth that can’t be reached with a brush. Removing plaque will lower your mouth’s acid levels that cause a loss of minerals to the enamel surface.
Do I use the proper techniques for brushing and flossing? While it’s important to establish daily hygiene habits, if you’re not performing them properly you won’t realize the full benefit from your efforts. But don’t dismay — we can train you in the proper techniques for brushing and flossing your teeth.
Do I use fluoride toothpaste? This naturally-occurring chemical strengthens tooth enamel and makes it more resistant to decay. You can increase fluoride’s absorption rate into enamel by using hygiene products that contain it.
Do I constantly snack between meals? Saliva neutralizes acid remaining in the mouth after eating in about 30 to 60 minutes. If you’re constantly snacking or sipping acidic beverages, however, saliva can’t do this effectively. It’s best to limit snacking to a few, specific times and restrict acidic beverages to meal time only.
Do I visit the dentist for cleanings and checkups? While brushing and flossing reduce plaque, it can’t remove it from hard-to-reach places below the gums or harder deposits (calculus) that have developed. A professional cleaning twice a year removes the plaque and calculus left from daily hygiene. We can also gauge the health of your teeth and determine if tooth decay or gum disease may be developing.
If you would like more information on tooth decay prevention, 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 “Tooth Decay: How to Assess Your Risk.”
A “gummy” smile, in which the upper gums are too prominent, is a common condition. There are several causes for gummy smiles — determining which one is the first step to having your appearance changed.
Although perceptions vary from person to person, most dentists agree a gummy smile shows 4 mm or more of gum tissue, and the amount is out of proportion with the length of the crown (the visible tooth). Teeth normally erupt through the gums during childhood and continue development until early adulthood, shrinking back from the tooth until stabilizing in place.
This typically produces a crown length of about 10 mm, with a “width to length” ratio of about 75-85%. But variations can produce differences in the relationship between teeth and gums and the width to length ratio of the teeth. The teeth may appear shorter and the gums more prominent. Worn teeth, caused by aging or grinding habits, may also appear shorter.
If tooth to gum proportionality is normal, then the cause may be upper lip movement. When we smile, muscles cause our lips to retract 6-8 mm from the lip’s resting position. If the amount of movement is greater (meaning the lip is hypermobile), it may show too much of the gums. The upper jaw can also extend too far forward and cause the gums to appear too prominent.
There are a number of ways to improve gummy smiles, depending on the cause. Periodontal plastic surgery known as crown lengthening removes and reshapes excess gum tissue to reveal more of the tooth. Lip hypermobility can be reduced with Botox injections (to paralyze the muscles) or in some cases with surgery to reposition the muscle attachments. Orthognathic surgery can be used to surgically reposition an overextended upper jaw. Other cosmetic enhancements such as orthodontics, bonding or porcelain restorations can also prove effective.
The first step is to obtain an accurate diagnosis for your gummy smile. From there, we can devise the best treatment approach to bring your smile back into a more attractive proportion.
If you would like more information on minimizing a gummy smile, 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 “Gummy Smiles.”
Lasers have transformed our everyday lives, especially in healthcare. These intense beams of light of a single wavelength have revolutionized all manner of diagnostics and treatments, from general surgery to cosmetic therapy.
Dentistry has also been influenced by the laser revolution. Here are just a few of the areas where they’re growing in use and popularity.
Early disease detection. Laser instruments can take advantage of “fluorescence,” the tendency of bacteria to “glow” when exposed to certain wavelengths of light. This is proving more effective in detecting early tooth decay in pits and fissures (very tiny areas in a tooth’s biting surface) than traditional needle-like probing instruments called dental explorers. Newer lasers can now detect the same fluorescent qualities in soft tissues, which may reduce the detection time for oral cancer and make the difference between life and death.
Dental caries treatment. Lasers have become an alternative to the dental drill in treating teeth with dental caries (decay). Although with larger cavities lasers are somewhat slower than the conventional drill, they truly shine when it comes to early enamel caries and small cavities because they can be quite precise in the amount of tooth structure they remove. This feature allows them to be less invasive than a dental drill.
Periodontal treatment. Periodontal (gum) disease is an infection caused mainly by bacterial plaque and calculus (hardened plaque deposits) that have adhered to tooth surfaces. Lasers are emerging as an alternative to conventional periodontal (gum) surgery to treat voids or spaces below the gum line called periodontal pockets that have formed because of gum tissue detachment as supporting bone is lost. With their ability to target and destroy infected tissue without damaging nearby healthy tissue, lasers can achieve similar outcomes as traditional techniques but with less tissue damage and discomfort to patients afterward.
Research and development into laser technology continues to perfect these and other applications that promise to make dental procedures less invasive and more comfortable for patients.
For people with edentulism (total loss of teeth), removable dentures is a viable option for regaining both lost function and an attractive appearance. From the moment they begin wearing them, denture wearers can chew food, speak and smile with confidence.
But there are downsides to dentures, especially if they’re not cared for properly. Dentures put pressure on the gums and bony ridges of the jaw, which can cause bone to dissolve (resorb) and decrease its volume over time. Without proper maintenance they can also become a breeding ground for bacteria and fungi that not only lead to bad breath but, in cases of partial dentures, can increase the risk of dental disease. They could also contribute to serious systemic diseases.
You can reduce some of these risks by following these 3 important denture maintenance tips. Doing so will help extend the life of your dentures, as well as keep your mouth healthy.
Clean your dentures at least once a day. In addition to taking your dentures out and rinsing them with water after eating, you should also brush them daily with dish detergent, antibacterial soap or denture cleaner — but not toothpaste, which is too abrasive. Effervescent (fizzing) cleaning tablets also aren’t a viable substitute for manual brushing in removing disease-causing plaque from denture surfaces.
Take your dentures out at night while you sleep. Wearing dentures 24/7 can hasten bone loss, as well as increase your chances of dental disease or even more serious illnesses. A recent study, for example, found nursing home patients who left their dentures in at night were twice as likely to experience serious complications from pneumonia as those who didn’t. While you sleep, store your dentures in water or in a solution of alkaline peroxide made for this purpose.
Brush your gums and tongue every day. Keeping your gum surfaces clean will help reduce the levels of bacteria and other microbes that can cause disease. You can either use an extra-soft tooth brush (not the one you use to clean your dentures) or a damp washcloth.
If you’ve had the misfortune of losing all or most of your teeth (a condition called edentulism), you still have effective options for restoring lost form and function to your mouth. There is, of course, the traditional removable denture that’s been the mainstay for edentulism treatment for decades. If you haven’t experienced significant bone loss in the jaw, though, a fixed bridge supported by titanium implants could be a better choice.
But what if bone loss has ruled out an implant-supported fixed bridge? There’s still another option besides traditional dentures — a removable “overdenture” that fits “over” smaller diameter implants strategically placed in the jaw to support it.
A removable, implant-supported bridge offers a number of advantages for edentulism patients with significant bone loss.
Speech Enhancement. Any denture or bridge supported by implants will have a positive impact on speech ability, especially involving the upper jaw. But patients who’ve previously worn removable dentures may not see a dramatic difference but will still be able to benefit from the greater stability of the denture, particularly if the dentures were previously unstable.
Hygiene. A removable denture allows better access to implant sites for cleaning. Better hygiene reduces the risk of gum disease and further bone loss.
Long-Term Maintenance. Regardless of which type of implant supported restoration is used, it will eventually require some maintenance. A well-designed removable overdenture can make any future maintenance easier to perform.
Aesthetics. For personal satisfaction, this is often the ultimate test — how will I look? As a product of the evolving art of facial aesthetics, removable dentures supported by implants can replace lost tissues and restore balance to the face, and often produce a remarkable smile “makeover.”
To find out which restoration option is best for you, you should first undergo a thorough examination to determine the status of your facial and jaw structures, particularly the amount of bone mass still present. Ultimately, though, the decision should be the one that best fits your functional needs, while fulfilling your desires for your future smile.
If you would like more information on tooth restoration options, 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 “Fixed vs. Removable: Choosing Between a Removable Bridge and a Fixed Bridge.”
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