Take Care of Your Teeth While Wearing Braces

So, you just got your braces on, and you're wondering why you should continue visiting your general dentist since you’re seeing your orthodontist every other month. Patients always ask us if they should continue to see their dentist while in orthodontic treatment. In short, the answer is yes. While you are wearing braces, it is essential that you take care of your teeth and gums so it is crucial to keep up with your regular visits with your dentist in addition to going in for your regular orthodontic adjustments . 

One of the best reasons to visit your dentist while you undergo orthodontic treatment is to remove plaque and tartar. Having braces provides additional nooks and crannies in which food particles and bacteria can hide. Eventually, plaque and tartar can form around your brackets, bands or other appliances which can lead to cavities. Having your teeth professionally cleaned can help ensure most, if not all, plaque and tartar is removed. Even if you are undergoing clear aligner treatment, dental checkups and cleanings are equally as important.

The next reason to visit a dentist is to help protect your teeth from decalcification, or the loss of calcium in your teeth. A potentially serious condition in which white spots on your tooth surfaces, decalcification is irreversible and if left untreated, can lead to cavities. Decalcification is preventable; patients who cut down on sugary sweets and acidic foods, practice good oral hygiene, and visit their dentist regularly can help prevent decalcification.

The final reason we recommend visiting your dentist while you have braces is this: cavities can prolong your treatment. If you are interested in completing your orthodontic treatment on time and without any delays, visiting your dentist every six months or as recommended can go a long way toward making that a realistic goal. Your dentist can provide fluoride treatments or other treatments that strengthen your teeth and protect them from cavities. Making sure to visit your dentist will help ensure your teeth look their best once your braces come off.

Don't Stress About Halloween Candy

 

It's almost Halloween! Costume stores are springing up, yards are decorated with ghoulish décor, and our day of sweet indulgence without guilt is almost here. Everywhere you look, there's your favorite candy or chocolate wrapped in scary yet appealing packaging. Well, to all the sweet tooth Halloween lovers -both adults and kids- here are some practical tips from a Dentist who shares your love for most things sweet.

Sort the candy. When you are raiding your five-year-old's candy bag at 2 in the morning, separate the stack into two parts. Place the taffy, the caramels, the gummy bears, anything that is sticky, chewy or sour into the first pile. All of the other candy goes into the second pile.

Avoid the first pile. Dental cavities have a proven cause-and-effect relationship with extended exposure to sugary or sour substances. Oral bacteria thrives in this environment and converts these substances to acid that can, in turn, lead to cavities.

Watch your family’s consumption of these sweet treats during this season. A great tip is to leave the candy wrappers in a visible area so that you remember how many of these ghoulish confections you’ve eaten. The greatest danger candy poses for teeth is when patients "graze" on it all day.

Chew sugar-free gum to help you ration your sweet intake. Ingredients like Xylitol and Sorbitol, low calorie sweeteners found in some gum, can actually be beneficial to your oral health. Research has shown that these sweeteners starve destructive bacteria, allowing your mouth to replenish minerals to your teeth. Get advice from your Dentist on the frequency and amount recommended.

Talk to your kids about oral health. This is a great time to reinforce the twice-a-day brushing routine and the daily 'oh-so-dreaded flossing regime. Always remember, children will mostly do as they see. The most ideal scenario would be to brush after the consumption of candy. If that’s not possible, then encourage your child to eat the candy within a few minutes instead of snacking throughout the day, and then wash away some of the sugar by drinking a glass of water. And remember, Halloween is a great time to call your dentist and get the family scheduled for a check-up!

In the words of Robert Louis Stevenson, "There is only one difference between a long life and a good dinner; that in the dinner, the sweets come last." Enjoy the sweets in moderation and have fun this Halloween!

The High Price of Avoiding the Dentist

 

Many people cite cost as one of the main obstacles in their quest for dental care. However, skipping regular check-ups to save a few dollars can prove to be an expensive decision in the long run. An attempt to save money by limiting dental care to just brushing a few times a day, flossing, and restricting sugary foods may seem like a good idea at first. This is a mistake nobody should make though. One of the principal reasons for visiting a dentist is to prevent problems or stop existing dental issues from worsening. The long term expense and pain associated with avoiding regular dental visits far outweigh any costs associated with preventative care.

For example, if a cavity is not stopped early on, the tooth may become severely decayed resulting in pain and either the need for a crown or entire tooth extraction.

A crown is a tooth-shaped cover fashioned in a laboratory and fitted onto the damaged tooth which is shaped so the crown can securely be affixed to it. A crown will be at least $500 and easily up to $1000 or more depending on the necessary procedures and materials used.

When a tooth extraction is necessary, the cost of the actual extraction is tiny compared with the next step: Either an implant or a bridge to replace the missing tooth.

A bridge consists of the actual artificial tooth bridging the missing-tooth gap, as well as crowns (in most cases) on the adjoining teeth to add support. Bridges can cost as much as $1000 or more.
A dental implant, which often requires the expertise of an oral surgeon, consists of a metal post affixed to the bone which then can be fitted with an artificial tooth and can cost in excess of $2000.

More serious problems can develop as well, such as severe gum disease leading to breakdown of bone and support tissues, eventually culminating in tooth loss and the need for at least partial dentures or multiple implants, both running in the many thousands of dollars.

Crowns, implants, bridges, and dentures are not just financial burdens for people without dental insurance. Of course coverage varies from plan to plan, but those with dental insurance are generally not covered fully or even very much on these types of procedures and so must personally bear much of the cost.

Conversely, a check-up typically runs somewhere between $50 and $100. The cost of the restorative procedures outlined above clarifies the true dental bargain that a regular check-up represents.

Root Canal Myths

Root canal therapy is considered to be the most feared dental procedure. Does that surprise you? A survey conducted by the American Association of Endodontists reveals that most people with a fear of the dentist base their fear on someone else's experiences, not their own.

The inaccurate information about root canal therapy prevents patients from making an informed decision regarding their teeth. There are many patients that go as far as requesting that a tooth is extracted, rather than save it with a root canal. Before you believe the hype, take a look at the top root canal myths, and learn the truth for yourself.

Myth #1: Root Canal Therapy Is Painful
Root canal therapy is almost always preformed because a tooth is causing pain from an irreversible condition. Pulpitis, an infected pulp, broken teeth, or a slowly dying nerve are all common reasons for root canal therapy. Root canal therapy is used to alleviate pain. Most people who have root canal therapy admit they did not experience any pain during the appointment and felt better afterward. If you are suffering from pain on the day of your appointment, your apprehension and fear may heighten the sensations you feel during the procedure.

Myth #2: Completing a Root Canal Requires Several Appointments
Root canal therapy may be completed in one to two appointments. Factors that determine the number of appointments necessary to complete a root canal include:

• The extent of the infection
• The difficulty of the root canal
• Whether a referral to a root canal specialist, known as an endodontist, becomes necessary

Restoring the tooth after root canal therapy is necessary in order to ensure the tooth functions properly. The appointments necessary to completely restore the tooth, in essence, should not be considered part of the root canal process.

Myth #3: Root Canal Therapy Causes Illness
The idea that bacteria trapped inside an endodontically-treated tooth will cause illness, such as heart disease, kidney disease, or arthritis, stems from research conducted by Dr. Weston Price from 1910 to 1930 -- almost 100 years ago. Recent attempts to confirm Dr. Price's research has been unsuccessful in proving that root canal treatment causes illness. Bacteria can be found in the mouth at anytime. Even teeth free from decay and gum disease have tested positive for bacteria.

Myth #4: Teeth Need to Hurt Before Root Canal Therapy Becomes Necessary
Teeth that require root canal therapy are not always painful. In fact, teeth that are already dead may require root canal therapy to prevent the tooth from becoming infected. Your dentist will examine your teeth thoroughly during your regular check-up. It is usually during this routine appointment where your dentist will discover a tooth that has died or is on its way. Tests used to confirm a dead tooth include:

• Temperature testing
• Percussion testing
• Using a pulp vitality machine

Myth #5: The Benefits of Root Canal Therapy Don't Last Very Long
A common misconception is that the benefits of root canal therapy don't last very long after the procedure has been completed. This myth originated after patients experienced their tooth breaking months after a root canal was performed on their tooth. When the nerve is removed from the inside of the tooth, the blood supply is eliminated from inside the tooth. The tooth eventually becomes brittle, and depending on the size of the filling used to close the tooth after the root canal, the forces from grinding, eating, and even talking may cause the tooth to break. Failing to have a crown placed on the tooth may cause this to happen. Technically, it is not the root canal that has failed; it is the restoration on the tooth that has failed.

As part of my team,  I have the pleasure of working with Dr. Kevin Gremillion, a dentist whose practice is restricted to endodontics, performing root canals in my office.  Having Dr. Gremillion on site eliminates the inconvienience of having to go elsewhere if a root canal is required during a visit.

Pregnancy Gingivitis

Pregnancy can bring many wonderful new joys to an expectant mothers’ life. Pregnancy gingivitis is not one of them.

The shocking truth is that pregnancy gingivitis affects anywhere from 50 to 70 percent of pregnant women, and those with the disease are 7 times more likely to go into preterm labor, preclampsia and have low-birth weight babies! Premature infants are at greater risk for short and long term complications, including disabilities and impediments in growth and mental development. Additionally, if an expectant mom had untreated tooth decay and/or consumed a lot of sugar, their children have 4 times the risk of developing tooth decay.

Pregnancy gingivitis is characterized by swelling/inflammation of the gums, and is caused by a bacterial film that grows on the teeth, resulting in plaque buildup. This plaque irritates the gum tissue, making them tender, bright red, swollen, sensitive, and easy to make bleed. These infected and swollen gums harbor disease causing bacteria, which release toxins that can attack ligaments, gums, and bones surrounding your teeth to create infected pockets similar to large infected wounds in the oral cavity. These pockets provide access to your bloodstream and allow bacteria to travel throughout your body. Since the bacteria that cause gingivitis can enter the bloodstream, they are able to travel down to the uterus. This triggers the body to produce prostaglandins, which is a natural fatty acid that normally controls inflammation and smooth muscle contraction. When a woman is pregnant, her level of prostaglandins increases, and peaks when she goes into labor. It is possible that if extra prostaglandins are produced when the body is reacting to infected gums, a pregnant woman’s body may think it is a signal to go into labor sooner than expected, thus causing a baby to be born too early.

Ultimately then, hormonal changes during pregnancy affect the body’s natural response to dental plaque, which affect how gum tissues react to the bacteria in plaque; thus resulting in a higher chance of pregnant women getting gingivitis.  If you already have gingivitis going in to a pregnancy, it will likely get worse during pregnancy if you do not seek treatment. Although the gingivitis generally subsides shortly after birth, it should nonetheless be periodically monitored by your dentist (during and after pregnancy), in order to prevent the gingivitis from turning into the more serious (and irreversible) form known as periodontitis.

The following are guidelines suggested by the American Academy of Pediatrics (AAP), in response to the increased concern about oral health during pregnancy:

1) Oral Health Education – DO have consultations with your dentist before, during and after your pregnancy. Early intervention is key, but ongoing care is just as important!
2) Oral Hygiene – DO brush and floss regularly – and properly. It is especially important to try and always brush after meals and snacks, especially sugary ones. Also, have more frequent dental cleanings than you normally would (2-3 during your pregnancy is about right). This will greatly increase the amount of plaque that is removed from the teeth and gums, thereby lowering your risk.

3) Nutrition – DON’T eat junk. This is good advice in general during your pregnancy, but just know that proper diet and nutrition during pregnancy will limit sugar intake which, in turn, will minimize plaque build up.

4) Treat Tooth Decay – DO try and have all urgent dental work completed prior to becoming pregnant. Although, it is safe to perform certain emergency dental procedures during your pregnancy, it is best to have it done prior to becoming pregnant, and especially prior to it becoming an emergency dental treatment!

5) Transmission of Bacteria – DON’T share food and utensils, so as not to potentially transmit bacteria known to cause tooth decay.

6) Use of Xylitol Gum – DO chew gum. Expectant mothers, and everyone, are encouraged to chew xylitol gum (around 4x/day), since research suggests that it may decrease the rate of tooth decay. Chewing sugarless gum increases saliva and thus increases the production of salivary enzymes that help equalize the Ph in the mouth and thus reduce cavity growth.

To sum up, pregnancy gingivitis is a real and prevalent threat but, so long as you take the appropriate steps, it can be managed with relative ease. 

Eating Disorders Affect Oral Health

The National Eating Disorders Association (NEDA) estimates that in the United States, nearly 10 million women and 1 million men are affected by anorexia or bulimia. Millions more suffer from binge-eating disorders. With so many men and women suffering from eating disorders, more dentists are becoming the first line of defense when it comes to recognizing these problems in patients. Although parents may not know that their children have an eating disorder, they often ensure that their children have regular dental appointments. In such cases, a dentist may spot the warning signs of an eating disorder and be able to point parents in the right direction to get help.

Anorexia and bulimia nervosa have a profound effect on the teeth. Well known dental consequences of these disorders are:

• Eventual tooth loss.
• Erosion of the enamel on the "tongue side" of the teeth as a result of teeth being bathed in stomach acid.
• Worn-away enamel, which make dental fillings appear to be raised and teeth appear dark.
• Possible bone loss from osteoporosis.
• Jagged edges on the biting surfaces of the top teeth.
• Altered bite such that lower teeth hit the roof of the mouth.
• Bleeding gums and burning tongue.
• Decreased salivary flow (dry mouth) and swollen glands.
• Sensitivity and soreness in the teeth, mouth, throat, tongue and gums.

Because teeth and gum tissue reflect a person's health, the dentist may be the first to detect an eating disorder. Too often, neither the medical community nor the patients realize the serious impact that eating disorders have on teeth. Irreversible damage -- even total loss of all teeth -- is possible if left untreated. Some dental offices work with health professionals in their area that treat patients' eating disorders, specifically anorexia and bulimia nervosa, because dental care is part of the recovery program.

A key element in this treatment program is education. For patients with eating disorders, we do not recommend the standard dental hygiene guidelines. For example, since many bulimic patients follow a pattern of binge eating then purging, often regurgitating food and stomach acid, it is important that they do not brush their teeth afterwards. Doing so would only encourage even more erosion of the dental enamel because the patient would actually be scrubbing his or her teeth with acidic solution. In such cases, we suggest that our patients simply rinse their mouth with water or with a solution of sodium bicarbonate (baking soda and water). The baking soda rinse neutralizes the acid by raising the pH level in the mouth. Brushing the tongue with baking soda may also be recommended.
Dental treatments can and should begin during recovery in order to protect the teeth. If diagnosed and treated at an early stage, enamel loss may be replaced with tooth-colored materials known as composite resins. These resins are sculpted into place -- duplicating or improving the appearance of the missing enamel.

In some cases more extensive dental treatment may be required, depending upon the extent of the damage to the teeth. There may be the need for dental restorations, such as overlays, tooth crowns or veneers, especially if a proper bite needs to be achieved.

Sometimes, eating disorders are not discovered until it is too late and irreversible damage has been done to the body as well as the teeth. According to NEDA, early detection of the disease may ensure a successful recovery period for the body and teeth.

Why Does the pH in your Mouth Even Matter?

Who would have thought Ph levels can help prevent tooth decay in your mouth? Visiting our practice regularly has probably turned you into a cavity prevention expert , right? Well, there’s always more than meets the eye...especially when it comes to the little things we can do to keep our mouths healthy. Even those of us who are diligent brushers and flossers, we sometimes find ourselves with some tooth decay. Here’s one more little snippet of information that may help you. While it is true that things like flossing, brushing for at least 2 minutes twice a day, coming in to our practice for regular checkups, using mouthwash, and avoiding sugary foods help immensley with prevent cavities, there are other things we can do. New discoveries show that the pH levels in our mouths actually have a lot more to do with tooth decay than we may realize, and maintaining normal pH levels can be helpful in fighting off cavities and gum disease.


Exactly What Is pH?
To put it simply, pH is a measure of acidity… The lower the pH, the higher the acidity, and the higher the pH, the higher the alkaline levels. The pH scale runs from 1 to 14, and in the middle of the scale is the neutral number 7, being most like water. This is where we want our mouths to be. While we know that sugar feeds the bacteria that produces acids and turns into cavities, it is actually prolonged acidic oral pH that can cause tooth decay and a demineralization of your enamel.

Confused?...Here's the breakdown:

Heading off the domino effect means intercepting those pH levels before they get out of hand. Ever heard of a pH test strips? They’re like the sticks you dip into your swimming pool, except they’re for your mouth. You can buy them at your local pharmacy and then try these remedies at home!

• Fresh Lemon and/or Lime Juice: Lemons and limes are acidic until they react with the sodium bicarbonate released by the pancreas. Upon entering the intestinal tract lemon and lime juice have alkaline properties. However, since both lemons and limes can erode tooth enamel, if you spice up your water with these delicious flavor accents, make sure you drink with a straw placed at the back of your mouth!
• Take your multivitamins: Take a high quality multivitamin that contains both the essential vitamins and minerals.
• Eat those leafy greens: Dark green vegetables and “green drinks” contain a high abundance of chlorophyll—a strong detoxifier and immunity–building agent.
• Avoid refined carbohydrates and sugar: Eliminate all processed foods, and when you opt for grains, make sure they’re “whole.”

If you have any additional questions about how to keep your mouth healthy, call our office and set up an apppointment to talk to me or one of my trained staff. We can work together to prevent tooth decay!

We Care For Your Children's Smiles!

Every parent knows that taking care of the littlest members of the family is a full-time job! Along with diaper changes, bath time, and medical checkups, parents also need to take care of their children’s teeth. But what are the best ways to go about caring for teeth (and baby gums!) during those early years?


Birth To 18 Months: No Toothpaste Required!
Oral care is important to everyone—no matter what their age. Our office recommends that you begin cleaning your children’s teeth as soon as the teeth begin to come in. For babies younger than 18 months, the best way approach is to use a wet cloth or gauze...without toothpaste. Gently rub their teeth and gums with a cloth over your fingertip. This, along with nursing and/or drinking water, is all the oral hygiene that your child needs at the infant stage. Once your child has more of a "full set" of teeth, your can use a small, soft toothbrush to brush your child’s teeth with water.


When To Start Toothpaste? 18 months old!
In general, children should not use toothpaste until they are at least 18 months old - and when you do start using toothpaste, make sure it is a safe "children’s toothpaste" made especially for young ones. Young children have different dental needs than grown-ups—and children’s toothpaste is made for this purpose.


What To Look For In A Children’s Toothpaste:



SAFE TO SWALLOW: Most young children tend to swallow while brushing, rather than spitting out the toothpaste—so we recommend that your children’s toothpaste is formulated with this in mind.
USE ONLY A PEA-SIZED AMOUNT: Don’t use too much toothpaste—just squeeze a small, pea-size (or smaller) amount onto the toothbrush. Your child doesn’t need much toothpaste to be effective, and you don’t want your child to swallow too much toothpaste.
CONSIDER LOW-FLUORIDE CHILDREN’S TOOTHPASTE: Fluoride is an important element of keeping teeth healthy and strong, but too much fluoride can be harmful for young children. Several varieties of children’s toothpaste have lower amounts of fluoride or are fluoride-free.
FUN FLAVORS: Try some different flavors of toothpaste and see what your child likes. Some children—especially at the toddler stage—are very picky about flavors and might be reluctant to use a certain flavor of toothpaste. So be prepared to buy a few different varieties of children’s toothpaste and see which one is your child’s favorite.

When can my child use adult toothpaste?
We typically recommend switching to adult toothpaste with fluoride when your child is able to spit out most of their toothpaste after brushing. This usually happens around age 4-6. However, they should still only be using a "pea-size" amount.


Rember!
Brushing your child’s teeth is part of parenting, and you need to start at a young age. By taking the time each day—before bedtime and in the morning—to clean your child’s teeth with a specially formulated children’s toothpaste, you will be helping to create a lifetime of healthy dental habits and happy smiles! Check out this great instructional video to help you get started!
http://www.youtube.com/watch?v=RvyLAjSJhow

Are You Tongue Tied?

Tongue Tied or Ankyloglossia is defined as a person having a short lingual frenum (membrane connecting under side of tongue to the floor of mouth) that prevents full range movement of the tongue. Being tongue tied can cause problems with breast feeding, speech development, eating, and swallowing. It can also prevent good hygiene since the tongue plays an important role in sweeping food and debris from the teeth. The tongue is one o f the most important muscles for speech and swallowing.

Poor oral and dental hygiene because of limitations in tongue mobility or habitual incorrect tongue posture usually results in messy eating habits, with food debris remaining on teeth and lips, and causing dental caries. Commonly, excessive saliva is dealt with by the patient in different ways. Whereas the younger child may dribble profusely, older patients will maladapt, keeping their mouth small during speech, reducing the length of utterances or slurping loudly. Involuntary splashing of saliva during speech occurs frequently and embarrassingly.

Diagnosis can usually be done at a routine visit to our dental office. Early detection is best, therefore, we recommend that children be seen on their first birthday. The following characteristics are common on individuals who are tongue tied:

• V-shaped notch at tip of the tongue.
• Inability to stick out the tongue past the upper gums.
• Inability to touch the roof of the mouth.
• Inability to move the tongue from side to side.
• An infant being tongue tied can often lead to frustration when breast feeding because the infant is unable to latch on or may cause nursing mother significant pain.

Not all patients who have Ankyloglossia need to have treatment. This all depends on how limited the movement of the tongue is. If treatment is needed our standard of care is to remove the membrane to allow the tongue to move freely. The procedure is called a frenulectomy. This is a simple procedure that can be done by using a laser after a topical anesthetic is placed. The procedure takes less than a few minutes to complete and does not need any stitching. Some offices perform this with a scalpel which would then need stitching. This procedure can also be done by just “clipping” the membrane, but the membrane can eventually grow back. This is why our standard is removal with our Waterlase laser. This procedure can be done as early as newborn through adulthood and does not require complicated aftercare...maybe some oral rinses.

If left untreated, adult patients may find that they snore because of the Ankyloglossia. When the tongue does not have free motion it may block the patients airway. Having a frenulectomy is normally a simple procedure with rarely any complications. If you or your child has any of the above symptoms, this simple procedure should be considered because of its many long term benefits, which include:  restoring ease of speech, better nutrition, and self esteem.