What To Do If You Have A Holiday Dental Emergency

Christmas peanut brittle. What a treat! That is until you feel a different sort of crunch. Now you've done it; you've broken a tooth on Christmas Day. During the holidays, we often indulge in food we don't normally eat: chestunts, walnuts, hard candy and other foods that can sometimes damage sensitive teeth, dental work or gums. So this holiday, be dental aware. Remember to chew hard foods slowly and not use your teeth to open or cut any type of hard shell.  From a chipped tooth to a lost filling, a dental emergency can hamper any celebration. Knowing what to do in a dental emergency can minimize the pain and discomfort until you get to a dentist.

Many household first-aid kits contain items for medical emergencies, such as cuts and sprains. But dealing with a dental emergency requires other supplies. Here is a list of common items you can keep in your medicine cabinet if a need arises.

• Dental pain relievers. Dental pain is often a result of inflammation and pressure on various tissues and nerves of the face, so the best over-the-counter pain relievers are non-steroidal anti-inflammatory drugs. These include ibuprofen or naproxen. Over-the-counter dental anesthetic gels, pastes and liquids can also alleviate dental pain.
• Temporary dental cement. This can be used to replace a filling or secure a crown. A piece of softened sugarless gum can also work as a temporary filling.
• Soft dental floss. Use floss immediately to remove objects stuck between teeth.
• A denture repair product. If you are a denture wearer ask your dentist for this product to temporarily fix any broken, missing or worn parts of a denture.

Remember, these remedies are temporary until you are able to contact your dentist and should not take the place of seeing your dentist!

Do It Yourself Dentistry

The lore of do-it-yourself home dentistry used to involve a pair of pliers from Dad's handy old tool box. Or...better yet...string wrapped around a tooth on one end, and to a door knob on the other. Swing the door closed, and voila, you saved your self a trip to the dentist. 

The recent economic woes in the U.S. have led to an increased accounts of DIYers perfoming their own dentistry at home. A recent survey of dentists points to an increase in this type of behavior. So, perhaps it is not a surprise that the most popular technique involves Super Glue.

As amusing as it sounds, patients use many dangerous methods to save themselves a trip the to the dentist, from emery boards to power tools (i.e. dremel tools). I have been told by a patient that Super Glue worked better than Krazy Glue. Obviously he's had some experience in differentiating between the two in their effectiveness.

It is true that cyanocrylate, the generic name for Super Glue and Krazy Glue, which contains acrylic resins methyl-2-cyanocacrylate or 2-octal cyanoacrylate, is used by physicians for wound repair. In fact, cyancrylate bonds very well to surfaces that are moist and non-porous. Sounds perfect for that dental crown that keeps coming out, right?

Unfortunately, that notion is wrong and here’s why. The crown is a non-porous surface and can be moistened, but the tooth, despite being very moist, is also very porous. Therefore, the adhesion between the two is negligible and will not last. But the real danger is forcing the cyanocrylate down into the tubules of the tooth and killing the tooth. This will ultimately lead to the need for a root canal or even the loss of the tooth due to resorbtion.

What most people may not know is that a dental crown does not stay in place via adhesion. It remains in place for years merely by mechanical retention. Mechanical retention is best explained like this: Imagine placing an identical glass over another identical glass. Pick up the upper glass and the one below comes with it, and the two "stick" together as you lift the top glass.

Now try that with two identical bowls stacked face down on top of each other. It’s impossible to pick the bottom bowl by lifting the one placed on top. This is an illustration of the effects (and success) of mechanical retention.

So if that crown keeps falling off, it's not due to a lack of adhesion - it's due to the shape of the prepared tooth lacking in retentive features. Dentists typically don't actually use glues, we use cements to prevent saliva from seeping between the crown and tooth, which prevents tooth decay. In this light, I hope you see the futility of using a product like Super Glue in your mouth. It's not at all about stickiness - it's about the shape of the tooth and the tightness of the fit - that keeps the crown from falling off.

And because the human body has a high moisture content, cyanoacrylate adhesives will bond very effectively to the skin and other body parts. Getting glue on your fingers can bond the crown to your finger. It can be removed but it certainly can complicate the process. Your best choice is to see your dentist as soon as possible.

My Child Has Shark Teeth?

Many parents become alarmed when they look in their child's mouth and see the permanent teeth growing behind the baby teeth. What went wrong? Aren't the permanent teeth supposed to grow under the baby teeth and push them out? While shark teeth sound scary, it really looks worse than it is. When permanent teeth grow behind baby teeth, instead of pushing them up and out, this is known as shark teeth.

Shark teeth is actually a fairly common occurrence, and generally happens in the front teeth. They can happen in the molars and incisors, although this is fairly rare. Needless to say, this occurs when a child is losing his or her teeth, generally around age 6.

How Shark Teeth Occur
There are a few guesses as to why shark teeth occur. Some dentists believe that this occurs because the roots of the baby teeth don't get dissolved like they normally should and the permanent teeth have nowhere else to go, so they just come into the mouth where there is the least amount of resistance. Some dentists say that the permanent teeth start growing in behind the baby teeth because there is too much crowding in the lower jaw. Another theory says that because the permanent teeth develop behind the baby teeth, this is simply a slight deviation from normal and they just didn't make it as far forward as they should have. I think that all of these are good explanations as to why this phenomenon occurs. I personally think that all three are possible explanations and any of them might be true for a specific individual.

Treating Shark Teeth
As long as your child's other teeth looked okay, your child will probably be asked by the dentist to wiggle the affected baby tooth to try and get it to come out on its own. If after three weeks the tooth is still hanging on, then it will probably be up to the dentist to take care of it.

Sometimes a stubborn baby tooth needs to be removed professionally by a dentist. With the baby teeth out of the way, the permanent teeth has a chance to move into its correct position. This occurs naturally as the child talks, eats, and plays with the new tooth with his or her tongue.

If it appears that the emerging secondary tooth won't have enough room to develop normally even if the baby tooth is removed, the dentist may decide to slim down neighboring baby teeth with a simple procedure called disking, to make sufficient room. In addition, other baby teeth may be removed to make room for the secondary teeth as well.

Pediatric shark teeth are a normal, treatable condition in children and a consult with a dentist can tell you if any intervention is necessary. Many shark teeth resolve on their own, leaving the child with a beautiful smile and a small prize for the tooth fairy.

　

Holidays And Your Dental Care

Holiday treats and special foods are something many of us look forward to eating. The sweet treats and ever so tempting desserts can be a challenge for your teeth. But if you are careful your teeth don’t have to suffer while you enjoy the holiday foods. Having holiday dental problems is not a fun way to start the new year.

Why Do Sweet Foods And Drinks Cause Cavities?
Everyone has bacteria lurking in their mouth. This bacteria uses the sugars in the treats to grow and multiply. Unfortunately the result are acids which break down the tooth enamel. The bacterial film, also known as plaque, builds up on teeth. I usually tell kids that the bacteria are "tooth bugs" and the stuff they leave behind after digesting sugar is"poop" ...this usually gets their attention! Between the plaque and the acids, your teeth are more susceptible to tooth decay. Your gums are also more apt to become irritated and develop gingivitis. This doesn’t mean that treats are to be avoided totally. It just means a little preparation is needed. Having snacks throughout the day without brushing is what causes problems because the "tooth bugs" are still on your teeth. Every time you eat a sugary treat when these "tooth bugs" are still on your teeth, the acid (poop) attacks your teeth and breaks down the enamel. It’s not just the immediate eating time, but those acids are present in your mouth and on your teeth for up to twenty minutes after you eat.

Tips For Holiday Oral Hygiene

1. If you are going to have some cookies or other sweet treats, eat them as part of your meal. Saliva in your mouth helps break down food and also carry those harmful acids away from your teeth. This way the saliva you produce for regular meals will clean your mouth of food better. As a result there will be fewer acids in your mouth that can harm your teeth.
2. Lots of fruits on your holiday treat list? Fruits can be good for your health, but the acids in fruit can be harmful to your teeth. That doesn’t mean give up eating fruit.
3. After you eat fruit, rinse with water before you brush. The fruit acids can make your tooth enamel softer and more prone to cavities. By rinsing with water before brushing, you dilute the effects of the fruit acid and minimize the attack on your teeth.
4. Rinse your mouth with water or chew xylitol sugarless gum if you are unable to brush after eating. This will get rid of many of the food particles. You will also increase the amount of saliva in your mouth which is part of the natural cleansing process of your mouth.
5. If you have excessive dental work such as crowns, fillings or braces, you may want to avoid holiday treats like caramel or taffy. Sticky and chewy treats can pull old crowns, old fillings or orthodontic brackets. Definitely not part of holiday cheer.
6. On the other extreme, hard treats like nuts and peanut brittle can also break teeth. Unless you want to follow in President George Washington’s footsteps remember nutcrackers are made for cracking nuts. George Washington learned the hard way and ended up with dentures.

Enjoy the sugarplums and all the rest of the holiday season treats, just remember to do so in moderation. Floss and brush your teeth at least twice a day. Enjoy the holiday season and don’t forget to smile.

Does Tabacco Really Have an Effect on Oral Health?

I'm going  to sound like a broken record, but you have been told a thousand times that smoking is bad for your health and you should really quit. And I know you’re probably really sick and tired of hearing about it and you think that you can quit whenever you’re ready. Studies have shown that tobacco addiction is worse than heroin and it takes the average smoker 8 quit attempts before they are actually successful.

So, we all know that smoking is the leading cause of preventable death in North America and if you continue to smoke it will kill you and in the best case scenario, make you constantly sick! But have you ever thought what the effects of smoking have on your mouth, teeth and gums and what people around you might not be saying but FOR SURE are thinking?

Tobacco Is Dangerous For Your Teeth

Tobacco contains many substances known to be destructive to your body`s cells and tissues. Smokers have more hardened dental plaque than non-smokers, and heavy smokers have more calculus than light smokers. Calculus is tartar or a form of hardened dental plaque

Narrowing Of The Blood Cells

The Nicotine in tobacco causes something called vasoconstriction or narrowing of the blood vessels.
Blood circulation – certainly an important function – has been shown to decrease as much as 70% in your mouth during the smoking of a cigarette. Tobacco smoking, furthermore, also affects your body`s immune system.

 

Gum Disease

Young people who think that smokeless ‘chewing tobacco’ is somehow safer than lighting up are putting themselves at terrible risk of illness too! Chewing tobacco releases a variety of chemicals into the body and often cause mouth sores, cracked and bleeding lips and gums, and can lead to cancer of the throat, mouth and gums.

What You Can Do

If you’re not too worried about the long term effects of smoking on your body, lungs and heart, at least now you’re clear on the effect of smoking on your teeth, mouth and gums. Take this advice: visit your dentist and get a thorough checkup and teeth cleaning and remember to quit smoking!!

Gingivitis vs. Peridontitis...Yes There is a Difference

Gingivitis is a formal term for "bleeding" of the gums, which is reversible by proper flossing and brushing. Periodontitis means there is some degree of irreversible breakdown of the bone under the gum. Dentist have a tool , a perio probe,  which is basically a dip stick we use to measure the depth of the collar of gum around each tooth. A good measurement is "3" and NO bleeding. If we get bleeding with a value of 3, then that is gingivitis and we "slap" your hand and lecture you about flossing these areas more. Usually the bleeding is between the teeth and you can access these areas only by flossing. Brushing, alone, does not do the trick.

Now if we measure a "4" or "5" or higher, and we have bleeding, then we are having some degree of bone loss. This is not good and not reversible. The dentist has to "clean"or scale and root plane under the gums. The patient really cannot access these areas. However, once we are able to clean these areas, chances are good, healing occurs and the patient can access these areas. So, my point is, not all cleanings are the same. It is vital and so important, time is taken each year or as needed to measure these areas and explain these readings to you.

Finally, if a patient has dental insurance and the contract says "100% payment for a cleaning," please note that means your gums are healthy with NO bleeding. The definition of "prophylaxis" in the context of dentistry, means to clean above the gums. Moderate to severe Gingivitis and Periodontitis places the patient under another category with your insurance. Instead of 100% payment for preventive work, this changes to the basic category which could mean paying a deductible and a percentage (usual 20%) for the treatment. So don't think the dentist is pulling a fast one on you. Invest a little now to clean them properly and get into the habit of proper home oral hygiene.

Complete Crown Restoration in One Appointment!

Everyone's time is important so taking the time to have dental work done is not high on most people's list. Fortunately, the latest in dental technology has made it so our patients spend less time in the dental chair getting broken teeth restored. 

Having a Cerec restoration performed is initially not much different than having a filling done. Just as with a filling, the decay is removed, or the faulty filling and the decay are removed. Following decay removal, the computer (CAD-CAM) of the Cerec acquisition unit captures an image of the prepared tooth. We utilize a corded wand to take the photograph. The computer then can be used to design the final restoration as seen on the monitor. Once all designing is completed, the details of the design are sent wirelessly to the milling unit. At the milling unit, the final restoration is located within a precision-made all-ceramic block. It takes about 10-15 minutes for the restoration to be milled. Once the restoration has been fabricated it is placed on the tooth. The restoration is bonded to the tooth which creates a very strong final result. 

The Cerec restorations are beautiful, they enhance the strength of teeth, and they re-establish the proper function for teeth. Since these are accomplished within the office in less than two hours, there is no need for a temporary crown, which may fall out, and there is no need for a second office visit to receive the final restoration. Hundreds of our patients have come to greatly appreciate this wonderful technology.

The Importance of Flossing

Flossing is relatively easy, right? So why are there so many people who don’t do it? Here at my practice, me and my team want to be sure you understand how important it is.

Flossing removes bacteria between your teeth that...if left alone...turns into plaque, and then tartar. Tartar buildup can be hard on your teeth and gums and can only be removed through professional cleanings. If tartar is not removed it can cause gum swelling or bleeding, commonly called gingivitis, which is the first stage of gum disease. The American Dental Association recommends flossing at least once each day as part of your oral care routine.

Is There A “Rule of Thumb” For Flossing Frequency?

I've come to the conclusion that I should tell all my patients to floss seven times a day....that way perhaps they will do it once a day.  A little overkill?..Maybe...but at least they know that my goal is to get them to floss. There are lots of ways to properly floss. One good idea is to first use your toothbrush to spread your toothpaste around in your mouth. Then, without rinsing, floss before you brush because the floss can carry the fluoride in your toothpaste to places in your mouth where your toothbrush can’t reach. It is best to floss at night, before you go to bed. That way you don’t have to worry about the bacteria from your day’s meals sitting in between your teeth for 8 hours.

Why Are There So Many Floss Choices And Techniques?

For something as simple as a piece of string rolled up inside a plastic container, how is it that there so many varieties? Waxed or unwaxed?…Mint or cinnamon?…Flat or rounded…? Regular floss or a floss wand? We understand that this myriad of choices might make it seem impossible to choose. Luckily, there really isn’t a wrong choice! The only reason there are so many choices is because there are so many different types of mouths and teeth. All you have to do is find the thickness, flavor and type that you like the best and you’re good to go! Our team reminds you that the type you use isn’t nearly as important as your regularity in using it. So, pick a flavor, set your routine, and get flossing! Keep your teeth healthy and clean!

Use Your Dental Insurance Before The End Of The Year!

2011 is quickly coming to a close and my team has been letting all my patients know how important it is to make sure they use their dental benefits before the end of the year. Most dental insurance plans run on a calendar year and there are several reasons why you should schedule an appointment by the end of the year:

Get All You Can Out Of Your Yearly Maximum

Most insurers give you a certain amount of money each year, if you don't use it all, you lose it.

Use Your Deductible

The deductible is the amount you have to pay out of pocket before your insurance company starts to pay. This fee varies but it starts again at the beginning of each year. You will want to make sure you get everything you can out of this before the new year starts over.

Dental Treatments Matter

Don't delay important dental treatments because of money. Dental problems tend to worsen (and become more expensive) the longer they go untreated. We see many patients with significant problems that would have otherwise been mnimal if they had come in earlier.

If you have any questions about insurance, please do not hesitate to call my office! We would be happy to work with you to discuss what your insurance plan will cover.

When Should A Child First See the Dentist?

Parents frequently ask me when their young child should first see the dentist. The American Dental Association (ADA) recommends that children be seen shortly after their first tooth erupts and no later than their first birthday. As any parent knows, many babies and toddlers are not ready to cooperate with a full dental exam at this young age.

My dental office may perform visual exams on children who are very young while the child sits comfortably in the parent’s lap.  In the first couple years, the mouth is so small and the teeth are so few that a quick visual exam may be able to tell us what we need to know without having to perform a full exam with tools. At this age, we find it most helpful to have a discussion with the parents on proper dental care for young teeth and how to avoid any major problems, like baby bottle tooth decay.

In our office we try to keep these first few dental appointments calm and fun so that the child can associate the dentist with a positive experience. We don’t force young children to cooperate in ways that make them fearful because dentistry is often associated with anxiety anyway. I have treated many adult patients who still have dental anxiety due to unpleasant childhood experiences at the dentist.
As a team, parents and my dental staff can work together to make going to the dentist an enjoyable and fear free experience for your children.

Where Did Toothpaste Come From?

To understand the history of toothpaste, we have to start in the present for a second. Today's toothpastes are rather smooth, which is very unlike the substances used in years past. As you'll see in a moment, the very essence of early tooth care was "abrasion," and it stayed this way for a very long time. And even though "abrasion" is still a component in modern toothpastes, it's much prevalent than it used to be.

We probably don't know exactly when a substance was first used on teeth. Research suggests that the Ancient Egyptians first developed a dental cream as far back as 3000-5000 BC. The ingredients of this dental cream was comprised of powdered ashes from oxen hooves, myrrh, egg shells, pumice, and water (the actual "toothpaste" was likely a powder at first, with the water probably added at the time of use). You can imagine the taste, but it probably worked by "scraping away" the bad stuff off teeth.

Later, in Greece and Rome, we see more abrasives being added to the powder mixture, like crushed bones and oyster shells. More cleaning power, for sure, but still, the taste... Well, maybe it's not so bad. We know the Romans added flavoring, perhaps to help with bad breath and to make their paste more palatable. This flavoring was more or less powdered charcoal and bark, although I'm not sure how tasty charcoal is.

Around the same general timeframe time (500 BC or so), China and India were using a powder/paste as well. The Chinese were very progressive in adding flavoring, going with Ginseng, herbal mints, and salt. This probably tasted a lot better than the early Egyptians version.

So skipping forward, like many other inventions and customs, toothpaste" eventually worked its way westward. These "powder/pastes," used together with early toothbrushes (chewing sticks), made it so people centuries ago were most likely doing a bedtime routine similar to ours.

So now we have these crude powders/pastes until the 1800's. We see ingredients change somewhat, with soap being added in the early 1800's, and in the 1850's, we find an actual "paste" sold in jars (Colgate gets involved with mass production of this in 1873). These pastes still used fairly abrasive ingredients, which definitely scrapes away the bad stuff, but...also was damaging to enamel, the protective outer layer on teeth...not good!

In 1914, the most prolific component of all was introduced -- fluoride!  WWII saw the development of a lead/tin storage tube that, combined with the fact that lead leaks into the toothpaste, leads to the development of plastic tubes.

Abrasion is significantly reduced during this time as well -- more synthetic ingredients were added (such as sodium lauryl sulphate, which is a foaming agent), as well as sweeteners. Also, fluoride toothpaste became the ideal standard during the late 1950's and 1960's. The 1980's to present day have seen all kinds of additions ... gels, whitening agents, toothpaste for sensitive teeth and so on. It's almost hard to keep up, really. If you go back in history, it's very interesting that Ancient Romans, the Egyptians, the Chinese, in general terms, were doing what we do today.

So, has all this advancement been beneficial? In general terms, yes, it has. Good-tasting toothpaste , sold in tubes is convenient, and adding fluoride has certainly helped.  I've been asked about my opinion of toothpaste a lot. In general terms, I feel the more natural you can get, the better off you are. But my belief is that you are more likely to brush if you like the taste of your toothpaste! But no matter what brand of toothpaste you choose, it's certain you are getting better tooth care (and better tasting toothpaste) than our predecessors did. And that's a great thing!

Want Healthy Gums? Hit the Dairy Aisle.

Consumers have long known that including dairy in their diets can help maintain healthy bones and even help promote weight loss. However, a study published in the Journal of Periodontology, the official publication of the American Academy of Periodontology (AAP), demonstrated that routine intake of dairy products may also help promote periodontal health. The study analyzed the periodontal health of 942 subjects and determined that those who regularly consumed dairy products such as milk, cheese and yogurt had a lower instance of gum disease. This study reinforces what much of the public already knows – the importance of dairy in helping achieve a healthy lifestyle, including a healthy mouth.


Periodontal, or gum, disease is a chronic bacterial infection that affects the gums and bone supporting the teeth. Periodontal disease is a major cause of tooth loss in adults and has been connected to the development of heart disease and increased risk of stroke, and can contribute to complications from diabetes, respiratory disease or osteoporosis.

Millions of adults already suffer from periodontal disease and by regularly consuming dairy products such as cheese and milk, something many people do each day, the risk of developing gum disease may decrease. These findings are important since maintaining healthy gums is a critical component to maintaining a healthy body.