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. 

Toothpaste: It Does More Than Clean Teeth

Toothpaste: it whitens, brightens, deodorizes, removes stains, and restores and protects enamel. But toothpaste’s cleaning capabilities work wonders on many things besides our teeth. The same ingredients that help polish our pearly whites can also soothe some common ailments, make household items sparkle, and even get rid of stains and pungent smells. Try out these fifteen tricks with a white, non-gel toothpaste (unless otherwise noted), and watch that cavity-fighting, breath-freshening tube of wonder work its magic

1.  Relieve irritation from bug bites, sores, and blisters. These skin irritations all tend to weep and, in the case of bug bites, often itch. Apply a drop of toothpaste to a bug bite or insect sting to stop the itching and decrease any swelling. When applied to sores or blisters, it dries them up, thus allowing the wound to heal faster. It’s best when used overnight.

2.  Soothe a stinging burn. For minor burns that don’t involve an open wound, toothpaste can deliver temporary cooling relief. Apply it delicately to the affected area immediately after a burn develops; it temporarily relieves the sting and prevents the wound from weeping or opening.

3.  Decrease the size of a facial blemish. Want to speed up the healing of a zit? Apply a tiny dot of toothpaste to the affected area at night before bed. Wash it off in the morning.

4.  Clean up your fingernails. Our teeth are made of enamel, and toothpaste is good for them, so it stands to reason that toothpaste would also be good for our fingernails. For cleaner, shinier, and stronger nails, simply scrub the underneath and tops of fingernails with a toothbrush and toothpaste.

5.  Keep hair in place. Gel toothpastes contain the same water-soluble polymers that many hair gels are made of. If you’re looking to style and hold an extreme hair creation, try gel toothpaste as your go-to product if you’re out of regular hair gel. (This is also a great trick for making baby barrettes stay in place.)

6.  Scrub away stinky smells. Garlic, fish, onion, and other pungent foods can permeate the skin cells on our hands. Scrubbing hands and fingertips briefly with toothpaste removes all traces of smelly odors


7.  Remove stains. Toothpaste can make tough stains on both clothing and carpets disappear. For clothes, apply toothpaste directly to the stain and rub briskly until the spot is gone, then wash as usual. (Note that using a whitening toothpaste on colors can sometimes bleach the fabric.) For carpet stains, apply toothpaste to the stain and scrub it with an abrasive brush, then rinse immediately.

8.  Spruce up dirty shoes. This tactic works great on running shoes or scuffed-up leather shoes. As with carpet stains, apply toothpaste directly to the dirty or scuffed area, then scrub with a brush and wipe clean

9.  Remove crayon stains on painted walls. Rub a damp cloth with toothpaste gently on the marked-up wall and watch the Crayola marks disappear.

10.  Make silver jewelry and other silver pieces sparkle. Rub toothpaste onto jewelry and leave overnight. Wipe clean with a soft cloth in the morning. Make diamonds shine by giving them a gentle scrub using a toothbrush, toothpaste, and a little water. Rinse thoroughly to remove all traces of toothpaste. Do not use this method on pearls, as it will damage their finish.

11.  Remove scratches on DVDs and CDs. This remedy has been used with mixed success rates, but it seems to work fairly well on shallow scratches and smudges. Apply a thin coating of toothpaste to the disc and rub gently, then rinse clean.

12.  Tidy up piano keys before tickling them. Piano keys retain oil from the skin, which then attracts dust and dirt. Clean away grime gently with a damp, lint-free cloth and toothpaste; after rubbing in the toothpaste, wipe the keys clean with a second lint-free cloth.

13.  Deodorize baby bottles. If baby bottles develop a sour-milk smell, a good cleaning with some toothpaste and a bottle scrubber will clean away residue and deodorize. Always make sure to rinse well.

14.   Remove the burned crust on irons. For those of you who still use an iron, you may find that after time, the plate of the iron develops a burned crust. The silica in toothpaste gently grinds away this rusty-looking layer.

15.  Defog goggles. Scuba divers, swimmers, and triathletes may already know about this handy little trick: Rub a small spot of toothpaste into each lens of your goggles, then rinse thoroughly, and voila! There’ll be no need to ever buy expensive defogger gels again. Avoid rubbing too vigorously, though, as the abrasive ingredients in toothpaste could scratch the lenses.

16. Clean your headlights.  Use toothpaste to clean the headlights on vehicles that have become yellow and foggy over the years.  Apply a generous amount (Crest seems to be popular) to the area of the headlight that needs to be cleaned. Grab a dry soft cloth and rub the toothpaste in a circular motion making sure to apply a good amount of pressure until the grime comes off. Rinse the headlight off with water and wipe it with a wet cloth.

Now your toothpaste could actually save you time and money over the course of a year, not to mention help reduce your shopping time and cleaning-supply collection!!

Dental Implants: Are They the Right Solution For You?

Dental Implants are the modern day solution to missing teeth. Dentures have progressed a long way since ivory prosthetics, but many people with missing teeth are still looking for a better solution. Dental implants are designed to provide a foundation for replacement teeth that look, feel and function like natural teeth. The person who has lost teeth regains the ability to eat virtually anything and can smile with confidence, knowing that teeth appear natural and that facial contours will be preserved. The implants are tiny titanium posts which are placed into the jawbone where teeth are missing. The bone bonds with the titanium, creating a strong foundation for artificial teeth. In addition, dental implants can help preserve facial structure, preventing the bone deterioration which occurs when teeth are missing.

Benefits of Dental Implants

The mouth is restored as closely as possible to its natural state. By replacing the entire tooth, including the root, it is possible to replicate the function of natural teeth, with a strong, stable foundation that allows comfortable biting and chewing. In addition, nothing in the mouth looks, or feels artificial.

Implants preserve the integrity of facial structures.

By preventing the loss of bone that would normally occur with the loss of teeth, the facial structures remain intact. This is particularly important when all of the teeth are missing, as the lower one-third of the face collapses if implants are not placed to preserve the bone.

Your smile is improved when replacement teeth look more like natural teeth.

Even when only one tooth is missing, long term esthetics are usually much better with an implant supported replacement tooth than with a traditional tooth supported bridge. This is particularly important in the front of your mouth, where preventing a visible bone defect is critical for natural appearance.

Adjacent teeth are not compromised to replace missing teeth.

Tooth replacement with traditional tooth-supported bridges requires grinding down the teeth adjacent to the missing tooth/teeth, so that the bridge can be cemented onto them. This tooth structure can never be replaced and the long-term health of these teeth is compromised. Partial dentures have clasps that hook onto adjacent teeth, putting pressure on them as the partial rocks back and forth. Eventually these teeth can loosen and come out as a result of this pressure. Replacing missing teeth with implant supported crowns/bridges does not involve the adjacent natural teeth, so they are not compromised, or damaged.

Overall quality of life is enhanced with replacement teeth that look, feel and function like natural teeth.

With implant supported replacement teeth, the appearance of the smile is more natural and the teeth function more like natural teeth. The result is increased comfort and confidence when smiling, speaking, and eating. If dentures and partials are replaced with implant supported teeth, the overall enhancement in quality of life is even more significant, with an ability to eat all types of foods, elimination of messy adhesives, and improved speech, comfort and appearance.

Convenient oral hygiene.

It is much easier to care for an implant supported crown, which can be cleaned like a natural tooth. In comparison, a tooth supported bridge requires the use of a floss threader for proper cleaning. It is also more convenient to clean a full set of implant supported replacement teeth than a traditional denture.

Improved appearance.

Since implants preserve bone, preventing deterioration of the facial structures, appearance is improved. Collapse of the lower one-third of the face caused by complete tooth loss can be visually corrected and the remaining bone preserved. The appearance of wrinkles around the mouth caused by posterior bite collapse, or complete facial structure collapse is virtually eliminated.

Restored self-esteem and renewed self-confidence.

Many of the people who now enjoy the benefits of implant supported replacement teeth state that their self esteem and self confidence have been restored as a result of improved appearance, function, comfort, and health.

Dental Implant Procedure

For most patients, the placement of dental implants involves two surgical procedures. First, implants are placed within your jawbone by your dentist or Oral Surgeon referred by our office. For the first three to six months following surgery, the implants are beneath the surface of the gums, gradually bonding with the jawbone. You should be able to wear temporary denture and eat a soft diet during this time. At the same time, your restorative dentist designs the final bridgework or denture, which will ultimately improve both function and aesthetics.

After the implant has bonded to the jawbone, the second phase begins. Your dentist (me) will uncover the implants and attach a small healing collar. At this point, I can then start making your new teeth after an impresion is taken. Then posts or attachments can be connected to the implants. The replacement teeth are then made over the posts or attachments. The entire procedure usually takes six to eight months. Most patients do not experience any disruption in their daily life.

If you feel implant dentistry is the choice for you, we ask that you undergo a dental/radiographic examination and health history. During these consultation visits, your specific needs and considerations will be addressed by myself. Your questions and concerns are important to us and our team will work with you very closely to help make your procedure a success.

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.

Dry Tooth Brushing

Tooth brushing is necessary for optimal dental health. It helps prevent tooth decay, disease and tooth loss. While you're taught to use fluoride-enhanced toothpaste for brushing several times a day, you may also add the benefits of dry brushing, which means that you can also brush several times a day without water or toothpaste. Used in combination, wet and dry brushing may help protect your oral health and reduce chances of cavities, plaque buildup and periodontal or gum disease.

Function

Dry tooth brushing is often suggested by dentists so that you can actually see the area of the teeth you've brushed without your vision being hampered by foaming toothpaste. This method also enables you to see where areas of the gum may be reddened or irritated by brushing, or to help determine whether or not your gums are bleeding after you've brushed.

Benefits

Gently dry tooth brushing offers a number of benefits for oral health. Many people miss the lower inside arch of the lower jaw, where plaque buildup often occurs fastest. The gentle action of dry brushing may help reduce the amount of plaque buildup in this area, and also massage the gums for oral health. Dry brushing the gums may help reduce gum sensitivity and bleeding. Toothpastes provide bacteria-fighting properties that help protect against decay and cavities.

Procedure

Using a dry toothbrush without any toothpaste on it, start brushing the teeth by reaching the toothbrush so that the bristles clean the teeth located on the inside of the lower jaw. Continue to gently brush in an up and down motion, moving from the top of the teeth to the bottom to help remove tartar and plaque. Hold the bristles of the toothbrush at a 45-degree angle, suggests the American Dental Hygienists' Association. You can then brush up and down or in a circular motion on the surface of two to three teeth at a time.

Combination Wet and Dry Brushing

You can combine the benefits of dry and wet brushing by dry brushing first, then wet brushing. By using a gentle abrasive action of brushing the surface of the teeth without toothpaste and water may help reduce the amount of germs, plaque and tarter on the teeth. Then follow the dry brushing with a good brushing using water and toothpaste for the benefits provided by fluoride, as well as fresher breath.

Cautions

Individuals diagnosed with receding gums or sensitive teeth may find dry brushing irritating so talk to your dentist about dry brushing if you've been diagnosed with either.

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!

George Washington's "Not-So-Wooden-Teeth"

Today our nation celebrates George Washington's birthday. An interesting dental fact about him was that Washington's teeth were NOT made out of wood, as the rumor states. Instead, the first President's teeth were made out of gold, elephant ivory, hippopotamus tusk, and human teeth!

President Washington lost his teeth at a relatively early age, his first tooth when he was 22 years old. He suffered from poor dental health throughout his younger years. Despite the fact that he used tooth powder daily, over the next 35 years he would lose the rest of his teeth. Toothaches were a common problem for Washington, especially after he had bouts of small pox, malaria and the flu. Back in the 1700's, there were no antibiotics such as we have today. Treatments for illnesses in those days included blood-letting and remedies such as the use of mercurous chloride, which is known to destroy the teeth.

During his life, Washington had nine different dentists. Even his physician extracted teeth for him. His dentists made him many sets of false teeth but he hated wearing them because his dentures were uncomfortable. One dentist, John Greenwood, was able to make teeth for Washington that were comfortable and he became his favorite dentist. Washington had two sets of false teeth (dentures) made by Dr. Greenwood. They were carved from the finest hippopotamus ivory and gold. One of the sets was donated to the University of Maryland Dental School in Baltimore, the oldest dental college in the world. The dental school in turn loaned one of the dentures to the Smithsonian in 1976 for a bicentennial exhibit. The denture was stolen from a storage area of the Smithsonian (presumably for its gold content) and has never been recovered.

Because of his responsibilities as a general and then as President, it was inconvienient for Washington to travel to New York where John Greenwood had his office.  Instead, he had to send his teeth through the mail to be repaired or adjusted. But sometimes he fixed his own dentures.  He wrote letters to John Greenwood describing a problem he was having with his teeth and asked for the right tools to fix them.  He requested files to adjust his teeth, scrapers to clean them, and pincers to fasten the wires.  Once he even asked for material to make an impression of his mouth for new dentures.

By the time Washington was inaugurated as the first President in 1789, he had only one natural tooth left in his mouth.  He wore dentures made by John Greenwood during his presidency.  He was elected to a second term as President, but delivered a very short two paragraph inaugural address, probably because his mouth was bothering him.

For me, the most interesting part of the story about George’s teeth is the mechanism of their fabrication. The upper and lower gold plates were connected by springs which pushed the upper and lower plates against the upper and lower ridges of his mouth to hold them in place. Washington actually had to actively close his jaws together to make his teeth bite together. If he relaxed, his mouth would pop open. There is speculation that this is the reason that the Father of Our Country always looks so stern in his portraits. Take a look at a dollar bill. George isn’t upset - he’s just trying to keep his teeth in!!!

Many pictures were painted of George Washington during his lifetime.  These portraits show how his face changes as he ages and loses his teeth.  In 1795, Rembrandt Peale painted a portrait of Washington that shows his mouth puffy and swollen.  The most famous portrait of Washington was painted by Gilbert Stuart, but he had to pack cotton in Washington's mouth to make him look better.

George Washington died in 1799, and was buried with a set of dentures made by John Greenwood.