When do you think is the earliest age that tooth decay can start? Would you be surprised to learn that the answer is… just two months!
In spite of our best efforts, throughout the world tooth decay remains the most common chronic disease of childhood. And the unfortunate truth is, it’s largely preventable. Tooth decay is caused by harmful bacteria living in the mouth. These bacteria produce acids as a byproduct of feeding on the sugar we consume. The acids attack the hard enamel surfaces of the teeth, eventually making the small holes we know as cavities.
For thousands of years, these bacteria have been thriving in the carbohydrate-rich environment of our mouths. Kids aren’t born with these germs — often, however, they are passed directly from caregiver to child. But there are things you can do to keep from passing the bacteria to your children. For example, don’t share toothbrushes; don’t put items in baby’s mouth after you have licked them or put them in yours; and, if you have untreated dental disease, try to avoid kissing the baby’s lips. (And for goodness sake, don’t pre-chew a baby’s food, no matter what any celebrity may suggest.)
One effective way to control tooth decay is by reducing the amount of sugar in the diet. Sodas and candy aren’t the only culprits — fruit juices are also high in sugar. And remember, it’s not just what your child eats or drinks that matters, but when they consume it. Given time, saliva will neutralize and wash away the acids that bacteria produce. But if kids are constantly taking in sugar, the saliva can’t keep up. So give those little teeth a break — limit sugar to mealtimes, and avoid sweet treats at other times of day.
What other steps can you take to stop tooth decay before it starts? It helps to identify kids who may be more susceptible to dental disease. Given the same diet with the same oral hygiene practices, some children are much more likely than others to develop tooth decay. If these high-risk kids receive preventive treatments — such as fluoride varnishes, help with diet modification, and other measures — early tooth decay can be successfully prevented, and even reversed in some cases.
If you’re concerned that dental treatment may be too scary for little ones, you should know that we put a great deal of effort into making office visits as stress-free as possible. We have plenty of tricks to keep youngsters happy — and distracted — while we take care of business. You can help too… by maintaining a positive outlook and setting a good example.
If you would like more information about cavity prevention for children, please contact us or schedule an appointment. You can learn more in the Dear Doctor magazine article “Taking the Stress Out of Dentistry for Kids.”
What if you had orthodontic treatments to enhance your smile — and nobody knew about it until it was all done?
That (almost) happened to British singer, cover girl and television personality Cheryl Cole. Since her big break in 2002, on the British reality show Popstars: The Rivals, Cole has had a successful music career, taken turns judging both the British and American versions of The X Factor, and graced the covers of fashion magazines like Elle and Harpers Bazaar.
And somewhere along the way, Cole wore an orthodontic appliance. It very nearly went undetected… until a colleague spilled the beans. That’s when Cole was forced to divulge her secret: For a period of time, she had been wearing clear aligners on her teeth. Until her frenemy’s revelation, only a few people knew — but when you compare the before-and-after pictures, the difference in her smile is clear.
So what exactly are clear aligners? Essentially, they consist of a series of thin plastic trays that are worn over the teeth for 22 hours each day. The trays are custom-made from a computerized model of an individual’s mouth. Each tray is designed to move the teeth a small amount, and each is worn for two weeks before moving on to the next in the series. When the whole series is complete, the teeth will have shifted into their new (and better aligned) positions.
Besides being virtually unnoticeable, aligners are easy to remove. This makes it easy to keep the teeth clean — and can come in handy for important occasions (like cover-photo shoots and acceptance speeches). But don’t remove them too frequently, or they won’t work as planned. If that’s a possibility (with teens, for example), aligners are available with “compliance indicators” to ensure they’re being worn as often as they should be. They can also be made with special tabs to hold a place for teeth that haven’t fully erupted (come in) yet — another feature that’s handy for teens.
So if you need orthodontic work but prefer to stay “under the radar,” ask us whether clear aligners could be right for you. Cheryl Cole did… and the results gave her something more to smile about.
If you would like more information on clear aligners, please contact us or schedule an appointment for a consultation. You can learn more about this topic in the Dear Doctor magazine articles “Clear Orthodontic Aligners” and “Clear Aligners for Teenagers.”
Your gums are red around the margins and bleed whenever you brush or floss but there's minimal to no pain... You: (select the most appropriate answer[s])
- are brushing or flossing too vigorously
- have an accumulation of dental plaque where the teeth meet the gums
- are using a toothbrush that's too firm
- are experiencing early signs of gum disease
- should see your dentist if this persists for more than 6 months
Kudos if you picked b) and d). The most common cause of bleeding gums is the accumulation of dental plaque (bacterial deposits) at the gum line, which is an early sign of periodontal (from the Latin “peri” – around, and the Greek “odont” – tooth) disease. It is usually painless so people tend to underestimate the risk of allowing gum disease to progress and become a more significant problem.
It's a common misconception that bleeding gums are caused by brushing or flossing too vigorously or using a toothbrush that's too firm. This is sometimes the case, but the abrasion would probably cause noticeable pain. Instead, it's likely that you're not brushing and flossing effectively enough, allowing bacterial deposits to accumulate at the gum line and feed on food particles that haven't been adequately flushed from your mouth.
The bacterial deposits form a whitish film that is hard to detect when you look in the mirror. But you will notice bleeding and redness and eventually inflammation of the gums — an immune response to disease-causing bacteria that flourish in the plaque. As the biofilm grows, with time it also hardens (calcifies), making it increasingly difficult to dislodge. Eventually, only professional cleaning can remove it and sometimes antibiotics are needed. If no action is taken, gum disease will progress, and eventually cause loss of the underlying bone that anchors the teeth.
There are other reasons that gums may bleed, such as elevated hormone levels in women, a side effect of certain medications, or a systemic (bodily) disease. Whatever the cause, it's important to get a professional diagnosis promptly and take appropriate therapeutic action as needed. Optimally, with good oral hygiene and regular checkups, you can avoid this problem entirely!
If you would like more information about preventing or treating bleeding gums, 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 “Bleeding Gums.”
Australian heartthrob Hugh Jackman has won international recognition for his work on stage, screen and television, including his long-running portrayal of Wolverine in the X-Men film series, and his Academy-Award-nominated starring role in Les Miserables. Oh, and did we mention he was named the “sexiest man alive” by People magazine in 2008? So when Jackman once said “I have shocking teeth”… what did he mean?
“[My dentist] looked at my teeth and went, ‘Oh, my God, you've got gray teeth,’” the actor stated. The proposed cure: tooth whitening. But what if the action hero's teeth were brightened too much — would his look still convey his trademark rugged charm? To see how that issue was resolved, let's look a little closer at various methods of tooth whitening.
All Whitening Isn't the Same
Everyone has seen the kind of over-the-counter tooth whitening strips advertised in magazines and sold in drug stores. Most dentists agree that, given enough time, they can work in many cases. But there may be problems, too.
One is that unless you know what's actually causing the darkening, you can't be sure if there is an underlying issue that needs treatment — a root-canal problem, for example. Bleaching a diseased tooth is like painting over a rusty car: it camouflages the problem, but doesn't fix it. That's one reason why, before any whitening treatment is attempted, it's important to have a complete dental examination, with x-rays.
Another is that without professional supervision, it's more difficult to control the degree of whitening you will end up with. For safety reasons, over-the-counter whitening products have the least concentrated bleaching agent, and will probably require weeks of use to produce noticeable results. The next step up — a custom-designed, at-home bleaching kit from our office — will likely produce results twice as fast.
The Professional Advantage
At-home bleaching done under our supervision uses stronger whitening agents with a flexible plastic tray that's custom-made to fit your teeth. It's a cost-effective way to achieve several shades of whitening in a relatively short time. Plus, with the advantage of our experience and guidance, you can get excellent results safely and efficiently.
If you want the fastest and most controllable whitening, however, in-office whitening treatments are the best way to go. According to one study, using the most concentrated whiteners in a safe clinical setting produced a six-shade improvement in just three office visits! This would have required a week or more of at-home bleaching, or upwards of 16 daily applications of the over-the-counter whitening products!
In-office whitening also offers the greatest degree of control over the outcome. That's why it was the method Hugh Jackman chose for his treatments. By adjusting the concentration of the bleaching solution and the treatment time, Jackman's dentist made sure his teeth were pleasingly light — but still looked completely natural. And in our office, we can do the same for you.
So whether you're looking for a dazzlingly bright smile or a more subtle enhancement, the best way to start is to call our office for a consultation. For more information, see the Dear Doctor magazine articles “Important Teeth Whitening Questions Answered” and “Teeth Whitening.”
If you have noticed that one or more of your teeth have lost some of the surrounding pink gum tissue so that part of the root surface is now uncovered, you are experiencing gum recession. It's a very common problem — in fact millions of Americans have some degree of gum recession. Fortunately, there are very effective methods of treating it.
Gum recession can be unsightly, but there are more serious concerns. Tooth root surfaces exposed by gum recession can become sensitive to temperature and pressure changes and can decay or wear away. In very severe cases, teeth can actually be lost. That's because gum or “gingival” tissue as it is medically known is supposed to encircle and firmly attach to the necks of the teeth and the underlying bone. This forms a protective barrier that is resistant to the abrasive action of foods during eating, biting and chewing.
Gum tissue is largely made of a fibrous protein called collagen, covered by a layer of another very resilient protein called keratin (nails and hair are also made of it). Yet it is still possible for this tough tissue to lose its grip on the teeth it protects. Here are some of the ways this can happen:
- Ineffective oral hygiene — inadequate removal of dental bacterial plaque (biofilm) with daily brushing and flossing.
- Excessive brushing (and flossing) — too hard, or for too long.
- Habits — holding foreign objects between the teeth, such as bobby-pins, nails etc that press on the gum tissues.
- Oral appliances and ornaments — badly fitting removable partial dentures and orthodontic appliances (braces), or tongue bolts and oral piercings can apply pressure to the gums.
Treatment will depend in part on whether the recession is stable or progressive. For example, an older person might have a few areas of gum recession but there are still adequate zones of attached protective gum tissue and the exposed tooth root surfaces are healthy. In this case, there may not be reason to do anything but monitor the situation. On the other hand, a teenager with a history of fairly rapid gum recession (over a period of months) usually requires immediate treatment. The dental specialty of periodontics (“peri” – around; “odont” – tooth) has developed predictable surgical techniques to deal with recession.
Free Gingival Grafting, for example, involves taking a very thin layer of skin from the palate, where the tissue is identical to gum tissue, and transplanting it to the area where gum has been lost. Both sites will heal in a very predictable and uneventful manner. The free gingival graft is so-called because it is “freed” from the donor (original) site completely. It is crucial to make sure individuals with gum recession correct faulty hygiene habits prior to this (or any) treatment so that they will not jeopardize their future results.
If you are concerned about gum recession, please contact us or schedule an appointment for a consultation. You can also learn more about gum recession and gingival grafting by reading the Dear Doctor magazine article “Periodontal Plastic Surgery.”
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