When it comes to patient comfort, one of the most important developments of the 21st century has been sedation dentistry, which enables you to relax in both mind and body allowing you to focus on feeling peaceful rather than anxious. And the prescription medications we use are some of the safest on the “therapeutic index” (the scale pharmacists and health professionals use to measure the safety of medications.) However, it is critical that we are aware of any medications you are already taking and your medical health and history, so let us know all about you so that we can avoid adverse (negative) reactions. Please note that we will take a full history to gain this information prior to any treatment or sedation — our utmost concern is your safety. During this time, it is vital that you are honest and feel comfortable sharing your responses to our questions. It's also our way of getting to know you and the first stage in relieving your anxiety. We will need to know all about:

• All medical conditions for which you are currently being treated.
• All prescription medications you are taking.
• Over-the-counter (OTC) medications, remedies, or vitamins and/or supplements you are taking. This even includes aspirin, St. John's Wort, and Kava Kava. (Why? If taken daily for good heart health, aspirin thins your blood and thus may interfere with blood coagulation. And St. John's Wort and Kava Kava may be beneficial in helping relieve depression, but they can negatively impact how oral sedation medications work.)
• Foods and drinks you consume, such as alcohol and even grapefruit (juice or the fruit), can negatively impact how your body responds to both your treatment and sedation medications.
• And lastly, we need to know if you are a tobacco user — especially if you are a smoker. In addition to increasing your risks for oral and other cancers, tobacco can negatively influence the effectiveness of sedation medications.

To learn more about this topic, read the article “Oral Sedation Dentistry.” Or you can contact us today to discuss your questions or to schedule an appointment.

We know from research extending back to the 1930s that very small amounts of fluoride in drinking water can significantly reduce dental caries (cavities) with no negative health effects. Fluoridated water is currently available to 70% of all Americans. However, we have also learned that excess fluoride from combined sources can result in staining of teeth called “fluorosis.”

What is the optimum fluoride concentration for healthy teeth?
A fluoride concentration of about 0.7-1.20 milligrams per liter (mg/L), or .7 to 1.2 ppm (parts per million), in the water supply seems to be optimum for dental health without causing negative effects. This concentration is about the same as a grain of salt in a gallon of water. An amount of 1 ppm was originally considered the safe standard, but since today Americans have access to more sources of fluoride than they did when water fluoridation was first introduced, the recommended amount has been reduced to .7 mg/L or .7 ppm.

The crucial amount to measure is the quantity of fluoride that is swallowed. Generally, the optimal level of fluoride per day from all sources is thought to be about .06 milligrams per kilogram of body weight, or about a sixth of the weight of a grain of salt for every two pounds of body weight.

It is probably not possible to calculate the precise amount of fluoride each person ingests per day, because the amount depends on more than just the amount of tapwater you drink. Bottled waters, soft drinks and juices also contain fluoride. Breast milk and cow's milk are very low in fluoride, but infant formulas may contain higher levels. Foods found to have high fluoride content include teas, dry infant cereals and processed chicken, fish and seafood products. Toothpaste can contribute to a child's total fluoride intake if the child swallows it.

What are the effects of too much fluoride?
Dental fluorosis produces a “mottling” of the outer coating of the tooth, the enamel. Mottling may show as staining ranging from small white striations to stained pitting and severe browning of the enamel surface.

The first six to eight years of life is the most risky time for development of dental fluorosis. Parents need to monitor their children to make sure they use small amounts of fluoride toothpaste (an amount the size of a pea on the brush is recommended). Watch for white spots on the enamel (hard outside coating) of your child's teeth. White spots from fluorosis mean it is time to pay attention to how much fluoride your child is getting from various sources, and to cut back on the total. You want fluoride's protection against cavities for your child's teeth, without the unsightliness of dental fluorosis from too much fluoride.

Contact us today to schedule an appointment to discuss your questions about fluoride. You can also learn more by reading the Dear Doctor magazine articles “Fluoride & Fluoridation in Dentistry” and “New Fluoride Recommendations.”

An important consideration prior to having any cosmetic dentistry is to understand both the pros and the cons of each particular dental procedure. And while porcelain laminate veneers are among the most aesthetic means of creating a beautiful, more pleasing smile, they are permanent and non-reversible and should be maintained properly.

On average, you can expect porcelain veneers to last anywhere between 7 and 20+ years. However, much of that depends whether or not you care for them properly in addition to the quality of the dental porcelain, the craftsmanship, and placement of them. How long your veneers last can also depend to some extent upon how you age. This is because the gum tissues attached to the living tooth that your veneers are cemented to may shrink or pull away from the tooth exposing its root surface. If this occurs, you should see your dentist for an evaluation, as it may require veneer replacement. Or, the issue might be resolved through some minor periodontal (gum) plastic surgery.

Porcelain veneers are a low maintenance solution for solving a multitude of cosmetic dental challenges, but they do require that you protect them during sports or vigorous activity. You should also wear an oral appliance or mouthguard (nightguard) to protect them from grinding or any other involuntary damage during sleep.

To learn more about porcelain veneers, continue reading the Dear Doctor article, “Porcelain Veneers.” If you are ready to see what cosmetic dentistry can do for you, contact us to schedule a consultation.

A pregnant woman has a lot to think about while preparing to welcome a new member of her family. It's important to think about her oral health as well. She is sharing her body with the developing infant, so problems with her health — including her dental health — can affect the baby. The following facts will help you understand the relationship between oral health and pregnancy.

1. A baby's primary (baby) teeth begin to form during the sixth week of pregnancy. They begin to form their enamel (the hard outer layer of the teeth) and dentin layer (just under the enamel) at about the third or fourth month. The calcium, phosphorous, and protein that are needed for these structures must all be provided by the mother's diet.
2. A good diet for a pregnant mother, in order to provide for both her needs and those of the fetus (the developing baby), includes whole grains, fruits, vegetables — including green leafy vegetables — proteins and dairy products. A doctor may also recommend iron and/or folic acid supplements.
3. If the mother's diet does not provide enough calcium for the baby's bones and teeth, it will come from calcium stored in her bones — not from her teeth. The old idea that a mother's teeth lose calcium during pregnancy has been found to be a myth.
4. Progesterone, a normal female hormone, is elevated during pregnancy. This hormone stimulates production of prostaglandins, substances that cause inflammation in gum tissues if the bacteria that cause periodontal (gum) disease are present. The resulting swelling, redness, and sensitive gum tissues, called pregnancy gingivitis, are common during the second to eighth months of pregnancy.
5. The bacteria involved in periodontal disease can affect whole body conditions such as heart disease and strokes, diabetes, and respiratory diseases. The inflammation resulting from such bacteria can also cause premature delivery (birth before 37 weeks of pregnancy) or low birth weight in the baby.
6. Periodontal disease is also related to pre-eclampsia, or high blood pressure, during pregnancy.
7. Dental x-rays do not expose the mother to very high radiation, but in any case every precaution is taken to minimize exposure to the fetus. These include a leaded apron that shields the baby from exposure.
8. Most drugs commonly used in dentistry, including local anesthetics, can safely be given to pregnant women without affecting the fetus. However, it is important to let your dentist know you are pregnant before embarking on any treatment to make sure anything that is done will be safe for the fetus and its developing teeth.

Contact us today to schedule an appointment to discuss your questions about pregnancy and your oral health. You can also learn more by reading the Dear Doctor magazine article “Pregnancy and Oral Health.”

Scientists don't know much about sleep even though it has been extensively studied. We do know that several hours of deep, restful sleep per night are essential for a healthy life.

Many people remain tired and unrefreshed, even after a full night's sleep. About a third of them are affected by sleep related breathing disorders (SRBD). Dentists can play a significant role in helping patients overcome these disorders, which range from frequent snoring to severe Obstructive Sleep Apnea (OSA). If you think you may have such a disorder, read on.

Under normal conditions, your upper airway is open, allowing air to flow from your nose, through your throat, and into your lungs. If you suffer from SRBD, you experience frequent reductions in the flow of air to your lungs during sleep. You may not be aware of it, but sometimes your breathing may even stop for brief periods. These reductions happen when your tongue and other soft tissues in the back of your throat collapse backwards and block your upper airway or windpipe. You may briefly awaken as many as 50 times per night because of these breathing lapses. These brief awakenings, called micro-arousals, keep you from reaching the deep stages of sleep your body needs.

The resulting reduced oxygen flow to your heart and to your brain can cause serious damage. You will also be tired during the day and experience a lack of energy, even if you sleep for seven or eight hours per night. This constant drowsiness puts you at greater risk for accidents.

Because dentists generally see their patients at six-month or other regular intervals, we are in a good position to screen and refer patients with suspected SRBD to physicians for diagnosis and treatment. Dentists can also treat SRBD in a number of ways.

• One of these is Oral Appliance Therapy (OAT), in which a device that looks something like an orthodontic retainer holds your lower jaw in a forward position relative to your upper jaw, preventing your tongue and soft tissue from collapsing into your airway.
• Another consists of breathing equipment called Continuous Positive Airway Pressure (CPAP). The CPAP is a mask connected to a machine that pushes air into your lungs.
• Other treatments include oral surgery or orthodontia. The goal of these techniques is to increase the volume of air passing through your upper airway by pushing your tongue forward.

Medical insurance usually covers the cost of much of these treatments.

Contact us today to schedule an appointment to discuss your questions about sleep disorders and their treatments. You can also learn more by reading the Dear Doctor magazine article “Sleep Disorders and Dentistry.”

Guidelines regarding the concentration of fluoride in water have recently been changed by the US Government's Department of Health and Human Services (HHS) and the Environmental Protection Agency (EPA). These agencies recommended a reduction of fluoride in water supplies to 0.7mg/L, modifying the original recommendations provided in 1962 by the US Public Health Service.

What is fluoride, and why add it to water supplies?
Fluoride is a chemical form of fluorine, a naturally occurring element. For decades, scientists have carried out studies on the effects of fluoride in water, and they have proved that fluoride strengthens tooth surfaces and makes them resistant to decay. A fluoride concentration of about one milligram per liter (1 mg/L), or 1 part per million (1ppm), in the water supply is associated with substantially fewer cavities. This concentration of fluoride (equivalent to a grain of salt in a gallon of water) has been found to have no negative health effects.

The Center for Disease Control (CDC) says that fluoridated water is one of the ten most effective public health measures of the 20th Century. The optimal amount of fluoride necessary to make teeth resistant to decay turns out to be between 0.7 and 1.20 milligrams per liter (mg/L). A certain amount of fluoride occurs naturally in water supplies, and communities have added fluoride to bring the amount up to the optimal recommendations.

How does fluoride you drink get into your teeth?
The fluoride you drink in your water is deposited in your bones. Bone is an active living substance that is constantly broken down and rebuilt as a normal body process. As this happens the fluoride is released into the blood, from which it can enter the saliva and act on the tooth surface.

What about fluoride from other sources?
Americans now have access to many sources of fluoride in addition to the water they drink. These include foods, beverages and toothpaste. As a result, dentists have begun to notice an increased prevalence of a condition known as Dental Fluorosis.

What is Dental Fluorosis?
Dental Fluorosis can occur when teeth, particularly in children, receive too much fluoride. This condition is a mottling or uneven staining of the tooth surface enamel. There may be small white spots or extensive brownish discolorations. The mottled enamel is still resistant to decay, but it may be unattractive in appearance.

What is the idea behind the new guidelines?
With the new guidelines, fluoride is kept at the lower end of the scale of the optimal concentration for strengthening teeth against decay. At this end, there is room to add consumption of fluoride from other sources such as foods or toothpaste. In short, it is the best of both worlds.

Contact us today to schedule an appointment to discuss your questions about fluoride. You can learn more by reading the Dear Doctor magazine articles “Fluoride & Fluoridation in Dentistry” and “New Fluoride Recommendations.”

If you see blood when you brush or floss your teeth, it generally indicates a problem with your oral health. You may think you are brushing too hard, but this is not usually why gums bleed. The usual culprit is dental plaque.

Plaque is the sticky, whitish film of bacteria that forms on your teeth every day. If you brush regularly, you probably remove most of it — but some may remain behind and accumulate where your teeth meet your gums, particularly between your teeth. As the bacteria build up, along with by-products of their metabolism (the chemical reactions that maintain their lives), they cause inflammation, called gingivitis, in the adjacent gums.

Bleeding gums are an early symptom of gingivitis. Continuing contact with plaque at the gum line can cause your gum tissue to separate from nearby teeth, creating pockets in which the inflammation becomes even worse. The process leads to periodontal disease (“peri” – meaning around, “odont” – tooth). The increasing infection can eat away the bone that anchors the teeth, leading to possible tooth loss. Periodontal disease is not an uncommon problem. About 90% of the population has bleeding gums at some time or another, and approximately 10% go on to develop periodontal disease.

When you lose bone around your teeth, the gums separate from the tooth and “pockets” form between your teeth and gums. The inflammation and infection may continue within the pockets even if your gums have stopped bleeding when you brush. That's why it is important to have regular dental exams — to check up on and stop periodontal disease before it has a chance to cause serious damage.

There may also be other reasons for bleeding gums that have to do with your general state of health. Women who have elevated levels of hormones caused by birth control pills or pregnancy may experience an increased response to plaque that makes their gums bleed more easily. Increased bleeding in your gums can also be caused by some diseases or as a side effect of some medications.

The most important way to prevent bleeding gums is to learn proper brushing and flossing techniques so that you effectively remove plaque from your teeth on a daily basis. If you are not sure you are using the right techniques, make an appointment and have us demonstrate at your next dental visit.

With all the best intentions, some plaque may remain. Plaque that is allowed to stay on your teeth hardens into a substance called tartar or calculus. This must be removed periodically with a professional cleaning by me or by our hygienist.

With not too much effort, you can ensure that your teeth are clean and plaque free, and your healthy gums no longer bleed.

Contact us today to schedule an appointment to discuss your questions about bleeding gums. You can also learn more by reading the Dear Doctor magazine article “Bleeding Gums.”

It used to be that when it came to treating tooth decay (cavities), your primary option was to have the tooth decay removed and filled with a metal amalgam (silver-colored filling). This treatment sometimes requires a special shape cut called an “undercut” to be drilled into the tooth to hold it in. Unfortunately, it can also involve removal of some healthy tooth structure. Silver amalgam fillings still have limited applications and are still used in back teeth where they don't show in the smile. This is because they are strong and resist biting well; however, over time they can fatigue and fracture.

Older restorative concepts were based upon the development of strong and stiff materials such as gold, which tends to be unyielding and therefore contributed to failures of the remaining tooth substance around restorations (e.g., decay or cracking). Newer concepts tend to get away from the “stronger and stiffer is better” concept and have moved towards safety principles using materials that involve mimicking the properties of natural tooth structure. In fact, it is now clearly established that a new “biomimetic approach” (“bio” – life; “mimetic” – mimicking) to dentistry is possible through the use of tooth-like materials such as composite resins and porcelains. And unlike metal alloys, these newer materials bond directly to the remaining enamel and dentin of which the teeth themselves are made, which both stabilize and strengthen teeth.

These techniques are also suitable for children's teeth and can incorporate fluoride to reduce further decay. But perhaps best of all, using these materials and more modern technologies can restore proper tooth function and normal wear while producing results that appear indistinguishable from natural teeth.

To learn more, continue reading the Dear Doctor magazine article “The Natural Beauty of Tooth Colored Fillings.” You can also contact us today to schedule an appointment to discuss your specific questions about replacing your metal fillings with tooth-colored ones.

According to the Centers for Disease Control and Prevention (CDC), community water fluoridation has been a safe and healthy way to prevent tooth decay effectively for over 65 years now. In fact, the CDC has recognized water fluoridation as one of the 10 great public health achievements of the 20th century.

It all began back in the 1930's when it was discovered that fluoride had oral health benefits. However, community water fluoridation did not begin until January 25, 1945, when Grand Rapids, Michigan became the first city to add fluoride to its municipal water system. Before it was officially rolled out in other cities, Grand Rapids was compared to other cities or “controlled groups” that had not added fluoride to their water so that scientific research could assess the relationship between tooth decay and fluoride. Well, you can guess the results — it was proven that fluoride helped reduce tooth decay when added to ordinary tap water. On November 29, 1951, the National Academy of Sciences’ National Research Council (NRC) declared water fluoridation safe, effective, and beneficial based upon the results of their findings and the fact that there was a dramatic decline in tooth decay in the children of Grand Rapids.

Ever since, fluoride has continued to play a critical role as a simple, safe, effective way to provide improved oral health by helping reduce tooth decay in the United States. This reality is still being demonstrated with each new generation benefiting from better oral health than the previous generation.

As for identifying when the time is right to introduce fluoride to your children's oral health program, ask us. Most children get the right amount of fluoride to help prevent cavities if they drink water that contains fluoride. And if by chance you live in an area where your tap water is not fluoridated, brush your children's teeth with no more than a pea-sized amount of fluoride toothpaste twice a day and ask your dentist about fluoride supplements and treatment.

Learn more on this topic by reading the Dear Doctor article, “Fluoride And Fluoridation In Dentistry.”

If you are insecure about your misaligned crooked teeth, then you may be a perfect candidate for clear orthodontic aligners. This system is an alternative to traditional braces that uses a sequence of individual, clear, removable “trays” that fit over your teeth to gradually straighten them. Each tray is completely clear and covers all the teeth thus making it virtually invisible. Each tray is designed to slightly move the teeth until the teeth are in proper alignment. Typically, each tray must be worn for 20 hours a day for 2 weeks before progressing to the next tray in the sequence with each tray moving you closer towards your goal — perfectly aligned teeth.

However, clear orthodontic aligners are not for everyone. If you are interested and wonder if they can benefit you, contact us so that we can schedule an appointment for a thorough evaluation to assess your specific situation. Below, we have briefly outlined some situations when they will and will not work.

Clear orthodontic aligners work if...

• You have mild to moderate crowding or spacing issues between teeth
• Back teeth fit together properly

They may not be the right choice if...

• You have moderate to severe crowding or spacing issues between teeth
• When your bite does not align properly (for example, if you have a large over-, under-, or cross-bite)
• When your teeth are “rotated” way out of position; such misaligned teeth will require special or complex techniques to rotate them back into position, or to pull them down into place or to fill the space left after pulling a tooth to resolve excessive crowding of teeth

Want to learn more?

Contact us today to discuss your questions or to schedule an appointment. You can also learn more about this topic by reading the article “Clear Orthodontic Aligners.”

What does the term “two-implant overdentures” mean?
For more than a century, complete dentures were the only care option for edentulous (toothless) people. As a solution, these left a lot to be desired, particularly for the lower jaw. Now dental technology has developed a better alternative that combines two strategically placed dental implants and a traditional lower denture that has been modified to fit over the two implants — thus the term.

What are the problems with traditional dentures?
The problem is that when you lose teeth, the bone that supported the missing teeth begins to shrink away. This is known as resorption, and it is the reason that dentures fitted too soon after teeth are lost quickly become loose. Bone loss happens most rapidly during the first year and is four times greater in the lower jaw than in the upper.

Why not just use dental adhesives to hold dentures tightly to the lower jaw?
Zinc, a major ingredient in most dental adhesives, has been associated with neurological disorders and may be unsafe. In addition, dental adhesives are expensive and the cost of frequent usage adds up.

Besides dental adhesives, are other health problems associated with dentures?
Yes, edentulism has been related to poor nutrition. Many edentulous people switch to soft foods with high fat content because they find healthier foods like vegetables and proteins difficult to chew.

What are dental implants?
Dental implants are replacements for the roots of teeth, the parts that are below the gumline and anchored in bone. They are usually covered with a crown that shows above the line of the gums.

What are the benefits of implants?
Most importantly, implants reduce the amount of bone resorption. Studies have shown about 75% less resorption in parts of the jaw with implants compared to areas without them. Since most of the bone loss occurs within the first year after tooth loss, it is important to place implants within this time period.

Is a complete set of dental implants a good solution for edentulism?
Yes, it can be a good solution, but it is not for everyone. Some patients, who have lost a great deal of bone support, need another solution for cosmetic reasons that offer more facial support like an implant overdenture. In addition, depending on their resources and insurance, some people require a less expensive solution.

Why does the two-implant overdenture work better for the lower jaw?
Based on differences in bone volume, density and other factors, we think that four to six implants are needed to retain an upper implant overdenture. Thus a two-implant overdenture is a good solution to consider for a lower jaw, but other options might be preferred for an upper jaw.

Contact us today to schedule an appointment to discuss your questions about dentures and implants. You can also learn more by reading the Dear Doctor magazine article “Implant Overdentures for the Lower Jaw.”

Of major importance in all wedding day plans is to ensure that you have your special day captured on film. And it is that fact that influences most brides and grooms to take a long and hard look in the mirror to observe their smiles. Not only do wedding dates motivate many brides and grooms to address concerns regarding their smile, it also serves as the perfect time for their parents to pursue their smile makeover dreams so that they too feel good about themselves in your wedding photos.

A proper smile makeover should have a two-fold design plan that ensures you obtain optimal functionality and oral health while creating the cosmetic look you want. Starting with the basics, a thorough dental cleaning is the least expensive way to remove stains and freshen both your smile and breath. We will also use this consultation to learn about your concerns, goals, expectations, and wedding day timeline to create the action plan for future treatments in reaching your smile makeover goals. You may also want to discuss whitening your teeth during your appointment, as whitening teeth is an effective way to brighten your smile a few shades in as few as 1 to 2 appointments plus whitening while at home.

If your smile makeover is a bit more challenging, relax. There are a wide variety of tools and techniques available that include bonding, veneers, crowns, bridges, and dental implants for restoring your smile. Or we may work closely with a specialist such as an orthodontist to straighten your teeth or a periodontist for periodontal plastic surgery that can alter your gum tissues and their relationship with your teeth. The most important tip to remember is to schedule your first dental appointment soon after you become engaged so that you have plenty of time prior to the big day to attain your picture perfect wedding day smile.

Want to learn more?

Contact us today to discuss your smile makeover questions or to schedule an appointment. You can also learn more by reading the Dear Doctor article, “Planning Your Wedding Day Smile.”

“Smile, and the world smiles with you,” the old saying goes. For people who are afraid to smile because they don't like how their smile looks, the twenty-first century offers a myriad of solutions. Smiling shows your teeth in their various shapes, colors, and sizes, your gums and gum line, your tooth alignment, spacing, and bite all in relation to the rest of your face. Any of these can now be improved.

Through the knowledge, skills, and combined experience of our dental team, it is now possible to make teeth whiter, brighter, and more evenly aligned, to alter tooth shape and size, and to make the teeth and gum line more proportionally balanced. Here are some options for cosmetic dentistry:

• Polish. Remove unwanted stains on outside tooth surfaces by having your teeth polished.
• Teeth Whitening. If teeth are stained or have just lost their luster, whitening is a safe and effective way to lighten a smile.
• Porcelain veneers. Applying a thin layer of dental porcelain restorative material to replace stained or damaged tooth enamel can truly change a smile.
• Porcelain crowns. If teeth are damaged by decay or trauma, porcelain crowns can replace the parts of the teeth that show above the gum line.
• Orthodontics. For teeth that are not in their correct and functional position, a variety of orthodontic techniques can be used including traditional braces, clear aligners and more—to improve crooked teeth or a malaligned bite.
• Dental implants. Nothing ruins a smile more than missing teeth. Entire teeth can be replaced, including the roots and the crowns, using dental implants. These are exact replicas of the natural teeth and can be made to match their neighbors exactly.

To learn more about all types of cosmetic dentistry, read “Cosmetic Dentistry, a Time for Change.” Or if you prefer, you can contact us to discuss your questions or to schedule an appointment.

When it comes to sensitive gums during pregnancy, Nancy O'Dell, the former co-anchor of Access Hollywood and new co-anchor of Entertainment Tonight, can speak from her own experience. In an interview with Dear Doctor magazine, she described the gum sensitivity she developed when pregnant with her daughter, Ashby. She said her dentist diagnosed her with pregnancy gingivitis, a condition that occurs during pregnancy and is the result of hormonal changes that increases blood flow to the gums. And based on her own experiences, Nancy shares this advice with mothers-to-be: use a softer bristled toothbrush, a gentle flossing and brushing technique and mild salt water rinses.

Before we continue we must share one important fact: our goal here is not to scare mothers-to-be, but rather to educate them on some of the common, real-world conditions that can occur during pregnancy. This is why we urge all mothers-to-be to contact us to schedule an appointment for a thorough examination as soon as they know they are pregnant to determine if any special dental care is necessary.

Periodontal (gum) disease can impact anyone; however, during pregnancy the tiny blood vessels of the gum tissues can become dilated (widened) in response to the elevated hormone levels of which progesterone is one example. This, in turn, causes the gum tissues to become more susceptible to the effects of plaque bacteria and their toxins. The warning signs of periodontal disease and pregnancy gingivitis include: swelling, redness, bleeding and sensitivity of the gum tissues. It is quite common during the second to eighth months of pregnancy.

Early gum disease, if left untreated, can progress to destructive periodontitis, which causes inflammation and infection of the supporting structures of the teeth. This can result in the eventual loss of teeth — again, if left untreated. Furthermore, there have been a variety of studies that show a positive link between preterm delivery and the presence of gum disease. There has also been a link between an increased rate of pre-eclampsia (high blood pressure during pregnancy) and periodontal disease. Researchers feel this suggests that periodontal disease may cause stress to the blood vessels of the mother, placenta and fetus.

To learn more about this topic, continue reading the Dear Doctor magazine article “Pregnancy and Oral Health.” And if you want to read the entire feature article on Nancy O'Dell, continue reading “Nancy O'Dell.”

Model Christie Brinkley's smile has been a symbol of America's optimism since the seventies. Particularly well known for being the cover model for three consecutive Sports Illustrated Swimsuit editions, Brinkley still has a fresh-faced American girl-next-door beauty that starts with her cheerful smile, which transmits the message that all is well.

Brinkley's modeling career began when she was “discovered” in Paris in the seventies, at the age of 18. As she explained in an interview with Dear Doctor magazine, it was like a fairy tale. She had gone to study art in Paris, where a fashion designer spotted her walking down the street. “He told me later he immediately thought, ‘That's the girl!’” she said.

Brinkley attributes her famous smile to a combination of good genetics (she inherited her mother's “beautiful straight teeth”), combined with the intelligence to practice good oral hygiene and have regular dental appointments. She never needed to have work done to prepare her for the modeling life; but as a teenager, she said, she wished she could wear braces because she thought the “coolest kids had them.”

Although dental restorations were not needed to enhance her beautiful natural smile, she did have two dental implants after she fractured two rear molars in a bad helicopter crash while back-country skiing, and she says she is thankful for dental implant technology because it looks and feels so natural.

Brinkley said that her smile led directly to her assignment as spokesperson for a brand of oral rinse and mouthwash products. She is also concerned about the environment. Her company Christie, Inc. is designing environmentally friendly products.

Her advice to everyone is to smile more. “I think a smile makes EVERYONE beautiful! It's the greatest gift we give each other... It's an expression of friendship, love and peace!”

If you have questions about your smile, contact us today to schedule an appointment. Or you can learn more by reading the Dear Doctor magazine article “Christie Brinkley's Supermodel Smile.”

Temporomandibular Disorder (TMD), which was formerly known as Temporomandibular Joint Disorder (TMJ), is a condition that is unusual in that it frequently is quite hard to diagnose, because it often mimics many other conditions. For this reason, many healthcare professionals refer to it as “the great imposter.” The condition arises when there are problems inside the temporomandibular joint and the muscles that attach to it causing pain. The pain is most often due to muscle spasm, thereby limiting the ability to open and close the jaw and to function normally. TMD can impact anyone and has a wide range of similar symptoms.

One of the common causes of TMD is stress, and it may manifest itself through clenching or grinding of teeth while awake or asleep. These habits are often completely subconscious until pointed out by a dental professional or sleeping partner. With stress-induced TMD, the pain often comes and goes in cycles. In other words, it may be present when you are stressed, seem to disappear for a while, and then reappear when you are stressed again. Another cause of TMD can be from an injury or trauma, such as a blow to the jaw. However, regardless of the cause of TMD, the pain is real and needs to be treated properly.

If you feel that you might have TMD, please let us know so that we can address your concerns, starting with a full history and conducting a thorough examination. Or if you are in constant or severe pain, contact us immediately to schedule an appointment. You can learn more about the signs, symptoms, and treatment options for TMD by reading “TMD — Understanding The Great Imposter.”

If you have ever had halitosis (bad breath), you know it can cause you to feel self-conscious and embarrassed. And while the odor is typically a primary concern, determining what is causing it is a task we can assist you with resolving. This is especially true when you experience bad breath outside of those times when you've just consumed pungent foods and drinks such as coffee, garlic or raw onions. For example, it is quite a different scenario to have family members, friends, co-workers or even total strangers consistently complaining or using body language to denote your bad breath. If the later best describes your situation — and be honest with yourself — then you need a thorough dental exam to discover the ultimate cause (or causes) of your halitosis. This is especially important because so many people are unaware that there can be numerous oral and/or general health concerns triggering their bad breath.

Most unpleasant mouth odors arise from the more than 600 types of bacteria found in the average mouth, with several dozens of these bacteria being the primary culprits for producing foul odors. And while food particles left between teeth can be key contributors to bad breath, the tongue or more specifically, the back of the tongue, is the most common location. Dry mouth is another cause for bad breath, as evident by the dreaded morning breath we all experience from mouth breathing as we sleep. Bad breath is also caused by certain medical conditions such as liver disease, lung infections, diabetes, kidney infections or failure and cancer.

The good news is that we can work with you to develop an effective treatment for your bad breath. And if necessary, we can work with your physician on a total treatment plan should your condition be due to health conditions outside your mouth. However, if your bad breath originates in your mouth, we may recommend any or all of the following to return your mouth to optimal oral health:

• Oral hygiene instruction to learn the proper ways to brush, floss, scrape your tongue and use mouthwashes
• Denture hygiene instruction for proper cleaning and maintenance of both full and partial dentures and bridgework
• Periodontal (gum) therapy that includes professionally cleaning your teeth (scaling), smoothing your teeth's root surfaces (root planning) and possible antibiotic therapy
• Removal of tooth decay where large, open cavities (caries) are present
• Repair of broken fillings
• Removal of wisdom teeth (third molars) with gum flaps
• Treatment of yeast infections (candidasis)

To learn more about the causes and treatments for halitosis, read the Dear Doctor article, “Bad Breath — More Than Just Embarrassing.”

Ready To Take The Next Step?

If you want to address your own concerns with bad breath, contact us today to schedule a consultation for an examination and treatment plan. You will find yourself smiling and laughing more once you are confident you have a clean, healthy mouth.

Cleaning dentures is an important part of wearing them. However, did you know that recent research has revealed a link between denture hygiene and overall health? The evidence shows that oral bacteria have been implicated in chronic obstructive pulmonary (lung) disease, bacterial endocarditis (“endo” – inside; “card” – heart), generalized infections of the respiratory tract and other systemic diseases. While it is never our intent to frighten you, we feel it is important that we share some important tips on maintaining and caring for your dentures so that your oral health does not negatively impact your general health.

Our first tip focuses on fit, as denture slippage is an experience that anyone who wears dentures dreads. So if your dentures seem to slip or you have started increasing the amount of adhesive you are using to achieve the same level of denture retention that you had when first fitted, you need to make an appointment with us soon. Otherwise, an ill-fitting denture can cause discomfort, embarrassment and contribute to other oral health issues.

Next, we must focus on cleaning your dentures. It is critical that you clean your dentures daily. However, you should never use harmful or abrasive cleansers. Nor should you ever place your dentures into boiling water! The best method for cleaning is to soak them daily in a non-abrasive denture cleaner. And when you remove them, gently brush them with a soft-bristled toothbrush.

Our last tip concerns how long you wear your dentures each day. Even if your dentures are extremely comfortable — for example, you forget they are in — you should not wear them 24 hours a day. Why? Because you will develop a chronic yeast infection called, “denture stomatitis” due to stagnation that develops under dentures when the lubricating and antibacterial effects of saliva are impeded. Unfortunately, the constant pressure on the gum tissues caused by wearing dentures can accelerate jawbone loss over time. Give your mouth and tissues a rest by sleeping without your dentures in your mouth.

To learn more tips, continue reading the Dear Doctor magazine article “Top Ten Tips For Denture Care & Maintenance.” Or you can contact us today to schedule an appointment to discuss your questions.

Vanna White has been a household name for the last 27+ years and is best known as the first female co-host of the game show, Wheel of Fortune. She radiates a warm, friendly, down-home appeal and says when describing herself, “what you see is what you get!” While this is quite true, there is so much more to her. She has received a star on the famous Hollywood Walk Of Fame, has starred in an NBC movie and written a book. She is even featured in The Guinness Book of World Records as TV's most frequent clapper, and most recently started her own line of yarn called Vanna's Choice with half of the proceeds going to St. Jude Children's Research Hospital. And while any one of these accolades could serve as the highlight of a lifetime for most, for Vanna they fall slightly short. Her favorite job is being mother to her son, Nicholas, and daughter, Giovanna.

The following are excerpts taken from an exclusive interview in Dear Doctor magazine, the premier oral healthcare resource for patients and consumers.

What is the secret to her dazzling smile?
Vanna's oral healthcare routine is the same today as it has been since her childhood — and one everyone can follow. She brushes her teeth at least twice a day (morning and at bedtime) and flosses her teeth daily. She also has strong feelings about flossing. “I think that flossing is the most important thing. I believe that dental floss helps a lot as it keeps your gums strong and looking younger.”

What about bleaching, has she done it?
Absolutely! Vanna bleaches her teeth once or twice a year to help retain her naturally white teeth and to offset any discoloration from coffee and an occasional glass of red wine. “I have done over-the-counter and professional bleaching, but I do like the trays my dentist made because they fit perfectly.” She also states, “Anything you can do professionally is probably better because I would assume that a dentist's ingredients are stronger than over-the-counter products.”

Has she had any cosmetic dentistry?
When it comes to answering a question about cosmetic dentistry, Vanna is just as open and honest as she is about everything else — a trait for which she is known. “I had a bridge put in probably 30 years ago, where I had a tooth pulled and there was a space. And I did have a little tiny chip on one of my front teeth years ago that my dentist fixed. But that is it. Again, I feel very fortunate to have good teeth. The braces [from her childhood] straightened them out and there has been no need for any cosmetics since then.”

Does she do anything to protect her teeth?
While she admits to occasionally forgetting to use her nightguard, a protective mouthguard worn during sleep, she firmly believes in their need. “I do sleep in a nightguard because I grind my teeth. I have a filling in the back that probably has been filled five times from grinding.” She added, “Both of my children do have mouthguards that they wear for their sports.”

Want a smile like Vanna's?
Contact us today to schedule an appointment or to discuss your questions about bleaching, cosmetic dentistry or mouthguards. You can also learn more about Vanna by reading the entire interview in the Dear Doctor article, “Vanna White — The Smile Defining America's Favorite Game Show — Wheel Of Fortune.”

We pride ourselves on educating our patients regarding oral health and dental treatment. This is why we are providing you with these frequently asked questions (FAQs) regarding root canals. Our belief is that by being informed about this important dental treatment, you will be more comfortable should you ever require a root canal.

Exactly what is root canal treatment?

A root canal treatment is an endodontic procedure (“endo” – inside: “dont” – tooth) in which the living pulp tissues are housed, including the nerves. When a severely decayed or damaged tooth begins to hurt, it is because the pulpal tissues are inflamed or infected, and the response of the nerves is varying degrees of pain — letting you know something is wrong. If the pulp is dead or dying it must be removed and the root canal of the tooth is filled and sealed to stop infection and to save the tooth.

Who typically performs them?

Endodontics is a specialty within dentistry that specifically deals with the diagnosis and treatment of diseases and disorders of root canal issues affecting a tooth's root or nerve. While endodontists are dentists who specialize in root canal treatment, general dentists may also perform root canal treatment and are usually the dentists you will consult with when you first have tooth pain and who will refer you to an endodontist if necessary.

What are the symptoms of a root canal infection?

Root canal symptoms and the character of the pain may vary depending on the cause. For example, symptoms may be:

• Sharp, acute pain that is difficult to pinpoint
• Intense pain that occurs when biting down on the tooth or food
• Lingering pain after eating either hot or cold foods
• Dull ache and pressure
• Tenderness accompanied by swelling in the nearby gums

Does root canal treatment hurt?

A common misconception is that a root canal treatment is painful when, in actuality, it is quite the opposite. The pain associated with a root canal occurs prior to treatment and is relieved by it — not visa versa.

If you have tooth pain, you may or may not need a root canal treatment. Contact us today (before your symptoms get worse) and schedule an appointment to find out what's causing the problem. And to learn more about the signs, symptoms, and treatments for a root canal, read the article “Common Concerns About Root Canal Treatment.”

Nightly snoring can be a sign of a dangerous condition called sleep apnea (from “a” meaning without and “pnea” meaning breath). When someone snores the soft tissues in the back of the throat collapse onto themselves and obstruct the airway, causing the vibration known as snoring.

If the obstruction becomes serious, it is called obstructive sleep apnea, or OSA. In such cases the flow of air may be stopped for brief periods, causing the person to wake for a second or two with a loud gasp as he attempts to catch his breath. This can cause heart and blood pressure problems, related to low oxygen levels in the blood. The obstruction and mini-awakening cycle can occur as many as 50 times an hour. A person with this condition awakens tired and faces the risk of accidents at work or while driving due to fatigue.

Studies show that sleep apnea patients are much more likely to suffer from heart attack, congestive heart failure, high blood pressure, brain damage and strokes.

What can be done to treat OSA?
Snoring, apnea, and OSA occur more frequently in people who are overweight. So start with losing weight and exercising.

At our office, we can design oral appliances to wear while sleeping that will keep your airway open while you sleep. These appliances, which look like sports mouth guards, work by repositioning the lower jaw, tongue, soft palate and uvula (soft tissues in the back of the throat); stabilizing the lower jaw and tongue; and increasing the muscle tone of the tongue.

Another approach is to use a Continuous Positive Airway Pressure (CPAP) bedside machine. These machines send pressurized air through a tube connected to a mask covering the nose and sometimes the mouth. The pressurized air opens the airway so that breathing is not interrupted.

Much less frequently, jaw surgeries may be recommended to remove excess tissues in the throat. These would be done by specially trained oral surgeons or ear, nose and throat specialists.

Diagnosis and treatment of OSA is best accomplished by joint consultation with your physician and our office. Contact us today to schedule an appointment to discuss snoring and OSA. You can learn more by reading the Dear Doctor magazine articles “Sleep Disorders and Dentistry” and “Snoring and Sleep Apnea.”

Worldwide it is generally accepted that the best method for permanently replacing a missing tooth is with a dental implant. However, one fact that can affect the timing of placement of dental implants is that the person should be fully mature. In this case, it means that growth is complete, in particular the jawbones have completed growing. And while we are sensitive to teens who may beg for a dental implant to replace a missing, damaged or traumatized tooth, parents or caregivers should know that research and experience have shown that it is better to wait.

The main reason it is best to wait is because natural teeth grow and move with the jaws as they mature whereas implants don't. Natural teeth change positions and move with the jaws as the jaws grow, implants don't. They are fused to the bone in one position and as the jawbone grows, they get left behind and appear to sink as the adjacent teeth and jawbone grow in harmony.

Although it is not really possible to determine exactly when a person has finished growing, it is generally best to wait until the jaw is fully matured and developed. However, we are the most qualified, along with our orthodontic colleagues to “guesstimate” based on family history, age and genetics. Specialized radiographs (x-rays) of the skull and jaws may also be helpful in determining the timing of jaw growth completion and when implants can be placed.

Dental implants are a permanent solution to a dental problem and thus should not be used until all growth is complete. Think about it. Your young child gets a beautifully restored smile through a dental implant...and for a year or two it looks fantastic. However, as your child's jaws continue to grow, everyone begins to notice gaps between the implant and adjacent teeth. So it makes sense to avoid this eventuality; by just waiting until late teens when beautifully restored crowns on properly positioned dental implants should last for many many years.

To learn more on this subject, read the Dear Doctor article, “Teenagers & Dental Implants.” You are also welcome to contact us to discuss your questions or to schedule an appointment.

The CDC (Centers for Disease Control and Prevention) calls fluoridation of drinking water one of the ten most important public health measures of the 20th century, along with such measures as vaccination and motor-vehicle safety.

A fluoride concentration of about one milligram per liter (1 mg/L), or 1 part per million (1ppm), in the water supply is associated with substantially fewer cavities. This concentration of fluoride (equivalent to a grain of salt in a gallon of water) has been found to have no negative health effects.

The connection between fluoride and oral health was confirmed in the first half of the 20th century, and by 1955 the first clinically proven fluoride toothpaste was launched. Fluoride-containing toothpastes are common today, along with other fluoride-containing products.

Protective Effects of Fluoride
Ongoing studies have shown that fluoride has both a systemic (through the body) effect and a local effect at the tooth surfaces. Tooth decay takes place as part of a kind of active war between de-mineralization and re-mineralization, in which acids produced by bacteria in plaque (a biofilm in your mouth) soften and dissolve the minerals (de-mineralization) in the tooth's surface. At the same time, the saliva bathing the tooth acts to re-harden the tooth's surface by adding minerals back (re-mineralization). If fluoride is present in the biofilm and in the saliva, it protects against de-mineralization.

The fluoride you drink in your water is deposited in your bones. Bone is an active living substance that is constantly broken down and rebuilt as a normal body process. As this happens the fluoride is released into the blood, from which it can enter the saliva and act on the tooth surface. The fluoride in toothpastes and products like rinses is delivered directly to the tooth surface. Fluorides can also be eaten in foods with high fluoride content such as teas, dry infant cereals and processed chicken, fish and seafood products.

Problems with Over-use
Eating or swallowing too much fluoride can contribute to a discoloration of teeth called dental fluorosis, which varies in appearance from small white striations to stained pitting and severe brown mottling of the enamel. To avoid this effect, monitor children's tooth brushing to make sure they use only a small amount of fluoride toothpaste and do not swallow it.

Adding fluoride to water has been controversial because some people believe that it may cause other harmful effects. However, most health experts believe that fluoridated water carries no significant health risks and significantly contributes to public health by preventing tooth decay.

Contact us today to schedule an appointment to discuss your questions about fluoride. You can also learn more by reading the Dear Doctor magazine article “Fluoride & Fluoridation in Dentistry.”

People always wonder when it is appropriate to contact their dentist. To answer this, we have put together the following list to provide some guidelines for you and your family. However, your calls are always welcome! Our goal is simply to give you some clear scenarios that illustrate when you should give us a call or come in to our office.

For Bite Related Problems

1. Early or late loss of baby teeth.
2. Difficulty in chewing or biting.
3. Mouth breathing.
4. Finger sucking or other oral habits.
5. Crowding, misplaced, crooked or even missing teeth.
6. Jaws that shift, jaw joints that “pop” or “click” or are uncomfortable.
7. Any change causing speech difficulty.
8. Cheek or tongue biting.
9. Protruding teeth — large overbite.
10. Teeth that meet in an abnormal way or don't meet at all.
11. Facial imbalance or asymmetry.
12. Grinding or clenching of teeth.

For Injuries And Immediate Care

1. Knocked out permanent tooth: Call us immediately. You need to take action within 5 minutes of the injury for best results.
2. Injuries to lips, cheeks, tongue or gums that appear to require stitches: Call us for instructions as soon as possible.
3. Tooth injury — if a tooth has shifted from its original position: Call us to tell us you are on your way to our office and see us within 6 hours of the injury.
4. Chipped or broken tooth that is still in its original position: See us within 12 hours of the injury.
5. A knocked out baby tooth: Call us as soon as possible.
6. Bleeding without any significant tears in tissue that could require stitches: Call us for instructions.

What To Do Now

If any of the above describe you or another member of your family, then contact us today to discuss your questions or to schedule a consultation. You can also learn more about treating dental injuries by reading the Dear Doctor article, “The Field-Side Guide To Dental Injuries.”

If you've lost one or more of your teeth due to tooth decay, trauma, gum disease or a failed root canal, there are a variety of ways that our office can help you to restore your smile and increase your confidence. Crowns, conventional bridges and dentures aren't your only options for replacing missing teeth. Dental implants, surgically placed below the gums, are another alternative for replacing missing teeth.

Getting Started: If you would like to explore the option of having dental implants to replace one or more teeth, you will first need a comprehensive exam. The ideal candidate for implants is in good general and oral health. Adequate bone in your jaw is needed to support an implant. Smokers and those with uncontrolled chronic diseases like diabetes may not be good candidates for dental implants because healing may be impaired or slow. In addition, dental implants aren't appropriate for children or teens until their jaw growth is complete.

The Process: Dental implant surgery can be performed in our office using either a local or general anesthetic. The implants actually replace tooth roots; they are placed into the bone surgically. Generally made of commercially pure titanium, this metal has the remarkable ability to fuse with the bone as it heals forming a union known as osseointegration (“osseo” – bone; “integration” – to fuse with). This process takes two to six months depending upon many factors of which bone quality is the most important.

The next step is to place an abutment (a small connector) which attaches the implant to the crown. The crown is the part of the tooth that is normally seen in the mouth above the gums.

Assessment of your individual situation and deciding if dental implants are right for you takes knowledge and experience. Contact us today to schedule an appointment to discuss any questions you may have regarding dental implants. Read more about this topic in the Dear Doctor magazine article “Dental Implants: Options for Replacing Missing Teeth.”

Ensuring that your children have good oral health is (or should be) the goal of every parent or caregiver. But how confident are you about this topic? The following true/false quiz will help you evaluate your expertise while learning more about keeping your child's teeth healthy.

Questions

1. All children older than 6 months should receive a fluoride supplement every day.
2. Parents should start cleaning their child's teeth as soon as the first tooth appears.
3. Parents should start brushing their child's teeth with toothpaste that contains fluoride at age 3.
4. Children younger than 6 years should use enough toothpaste with fluoride to cover the toothbrush.
5. Parents should brush their child's teeth twice a day until the child can handle the toothbrush alone.
6. Young children should always use fluoride mouthrinses after brushing.

Answers

1. False. Check with your child's physician or dentist about your children's specific fluoride needs. If your drinking water does not have enough fluoride to help prevent cavities, parents of a child older than 6 months should discuss the need for a fluoride supplement with a physician or our office.
2. True. Start cleaning as soon as the first tooth appears by wiping the tooth every day with a clean, damp cloth. Once more teeth erupt, switch to a small, soft-bristled toothbrush.
3. False. Parents should start using toothpaste with fluoride to brush their children’s teeth at age 2. Only use toothpaste with fluoride earlier than age 2 if the child's doctor or our office recommends it.
4. False. Young children should use only a pea-sized amount of fluoride toothpaste. Fluoride is important for fighting cavities, but if children younger than 6 years swallow too much fluoride, their permanent teeth may develop white spots. Using no more than a pea-sized amount of toothpaste with fluoride can help prevent this from happening.
5. True. Because children usually do not have the skill to brush their teeth well until around age 4 or 5, parents should brush their young children's teeth thoroughly twice a day. You should continue doing this until the child can demonstrate a proper brushing technique.
6. False. Fluoride mouthrinses have a higher concentration of fluoride than toothpaste containing fluoride. Children younger than 6 years of age should not use fluoride mouthrinses unless your child's doctor or our office recommends it. Young children tend to swallow rather than spit it out, and swallowing too much fluoride before age 6 may cause the permanent teeth to have white spots.

Learn More

If you feel you missed too many of the above questions, read the Dear Doctor article, “Oral Hygiene Behavior.”

You just came in to have your teeth cleaned, but our hygienist is asking you about your general state of health and what medications you are taking. Meanwhile you are wondering why she doesn't just get on with the cleaning.

Dental hygienists are health care professionals who are trained and licensed to preserve your general as well as your oral health. That's why our hygienist begins your visit by asking you about your health history. Some health problems or medications may require special precautions during a dental cleaning. A hygienist also needs to know about your dietary history and other general health questions.

Our hygienist will examine the skin in and around your mouth for sores, lumps, and other areas that could be signs of oral cancer or other problems. She is trained to spot this disease and others.

Dental hygiene is individualized to your own situation. There is not a “one size fits all” solution. During your cleaning, our hygienist will also evaluate the health of your gums and teeth, checking for tooth decay and for inflammation (gingivitis) and bleeding. She will measure the space between your teeth and the surrounding gums, looking for pockets that form when the gums detach from the teeth. Such pockets indicate periodontal disease and can lead to serious problems.

After your health assessment and examination, the actual cleaning will begin. Your dental hygienist will remove deposits of plaque and calculus by using a technique called scaling. Plaque is a biofilm, a film of bacteria that builds up on your teeth. The reason you brush and floss every day is to remove this film from the surfaces of your teeth and gums and from between your teeth. Plaque that is not removed hardens into a mineralized substance called tartar or calculus, and this is what the hygienist removes by scaling.

The next step is a polish to remove surface stains from your teeth and to give your teeth the slick feeling that you identify as clean.

Finally, our hygienist will discuss your state of oral health with you and make suggestions for improvement. Most hygiene appointments take about 45 minutes to an hour. As you can see, during this appointment a lot must be done to preserve your oral health.

If you are in need of a dental cleaning, contact our office today to schedule an appointment. You can learn more about your visit to the hygienist by reading the Dear Doctor magazine article “Dental Hygiene Visit.”

At some point in every person's life, they will experience bleeding gums or gingivitis, a mild inflammation of the gingiva (gums), which is the first stage of periodontal (gum) disease. For example, when was the last time you were brushing or flossing your teeth and noticed that your gums were bleeding or that when you spit and rinsed there was some blood? When this occurs, it is a sign that you have gum disease, as healthy gum tissues do not bleed. And no, it is highly unlikely that your bleeding is from brushing too hard. You would have to use extreme force to make healthy gum tissues bleed. However, this is exactly how most people discount or ignore this warning sign.

If this sounds like you or another member of your family, here's what you can expect when you see us for treatment. Depending on the severity of your periodontal disease, all of these treatment options may not be necessary.

Behavior change: We will collect a thorough medical history to obtain facts about your oral hygiene, eating and other personal habits such as alcohol and tobacco use to determine their impact on your periodontal disease. Proper brushing and flossing techniques are necessary for everyone, whether you have early or late stage gum disease; however, you must commit to a good daily oral health routine if you want to achieve success and thus keep you mouth and teeth healthy.

Calculus (tartar) removal: Cleaning is not just your responsibility. We'll clean and polish your teeth to remove calculus (tartar), the calcified deposits of bacterial products that become glued to the teeth and roots that you can’t remove. In fact, routine visits to see us for a thorough cleaning will help ensure that all the unhealthy calculus (tartar) is removed from your teeth.

Evaluation: Usually after three or four weeks, we will want to see you to evaluate your progress and to see the response of your gingival tissues to the treatment thus far. And depending on the severity of your gum disease, we may need another follow-up exam to decide the best maintenance and monitoring regimen necessary to keep your mouth healthy.

Occlusal or Bite Therapy: This treatment, if necessary, usually occurs once your gum tissues have been stabilized and the inflammation and infection have been controlled. It is during this phase that we will address loose teeth or teeth that have shifted or drifted in position.

Surgical Therapy: For more severe cases of gum disease, you may need periodontal plastic surgery to repair and regenerate gum and bone tissue and their attachment to the teeth. It may also be necessary to replace missing teeth with dental implants.

If you are ready to talk to us about the current state of your mouth (or the mouth of another member of your family), contact us today to schedule an appointment. The first step towards achieving optimal oral health could start with this simple call. Or, you can learn more by reading, “Understanding Gum Disease.”

A number of factors can lead to dental caries (tooth decay). To find out if you are at high risk, ask yourself these questions.

Is plaque visible in my mouth?
Dental plaque is a whitish film of bacteria that collects on your teeth. If it is clearly visible, it means that there is a lot of it. Among the bacteria in the plaque are those that produce tooth decay, particularly in an acidic environment. (A normal mouth is neutral, measured on the pH scale, midway between the extreme acidic and basic ends of the scale.)

Do I have a dry mouth?
Saliva protects your teeth against decay by neutralizing an acidic environment and adding minerals back to the outer surface of enamel of your teeth, so reduced saliva is a high risk for caries. Many medications can cause dry mouth as a side effect.

Do I eat a lot of snacks, particularly unhealthy ones?
Frequently eating sugars, refined carbohydrates, and acidic foods promotes the growth of decay-producing bacteria. The more frequently you eat, the longer your teeth are bathed in sugars and acids. Acidic foods not only promote bacterial growth, they also directly cause erosion of the tooth's hard surface by softening and dissolving the minerals in the enamel.

Do I wear retainers, orthodontic appliances, bite guards or night guards?
These appliances are recommended for various conditions, but they tend to restrict the flow of saliva over your teeth, cutting down on the benefits of saliva mentioned above.

Do my teeth have deep pits and fissures?
The shape of your teeth is determined by your heredity. If your teeth grew in with deep grooves (fissures) and pits in them, you are at higher risk for bacterial growth and resulting decay.

Do I have conditions that expose my teeth to acids?
If you have bulimia (a psychological condition in which individuals induce vomiting), or GERD (Gastro-Esophageal Reflux Disease), your teeth may be frequently exposed to stomach acids that can cause severe erosion to your teeth.

Do I already have cavities?
Visible cavities can range from those only visible with laser technology or x-ray examination to those a dentist can see with a naked eye. If you already have small cavities, you are at high risk for developing more.

Do I have white spots on my teeth?
White spots are often the first sign of decay in a tooth's enamel. At this point, the condition is often reversible with fluorides.

Have I had a cavity within the last three years?
Recent cavities point to a high risk of more cavities in the future, unless conditions in your mouth have significantly changed.

If you have any of these indications of high risk, contact us today and ask us for suggestions for changing the conditions in your mouth. You can also learn more by reading the Dear Doctor magazine article “Tooth Decay.”

Nearly everyone has snored at some point in life. However, if your sleeping partner routinely tells you that you suffer from this problem, you really should take action to confirm or deny your suspicions. You may be like one of the 50 to 70 million people in the US alone that suffer from Obstructive Sleep Apnea (OSA), a medical condition in which the upper airway (the back of your throat) collapses during sleep thus limiting your intake of oxygen. And this condition is serious. If left untreated, OSA can lead to a stroke, impotence, an irregular heartbeat, heart attacks, high blood pressure, and other forms of heart disease.

The first and most important step you should take if you snore is to obtain a thorough examination by both your primary-care physician and our office. We have completed specialized training in sleep medicine so that we can not only diagnose but also thoroughly treat your sleep disorders.

If you are diagnosed with this problem, relax. We have many ways we can treat your condition. One of the most common methods is to provide you with oral appliance therapy. This first line of treatment involves our making a customized oral appliance (mouthpiece) that will hold your lower jaw forward. By doing this, we can move your tongue away from the back of your throat so that your airway is less likely to get blocked while you sleep. (It is this blockage that causes the infamous snoring sound.)

Another option we may consider using to treat your sleep apnea if it is moderate to advanced is a Continuous Positive Airway Pressure (CPAP) machine. These machines require you to sleep with a mask over your nose and/or mouth and produce continuous pressure in your windpipe so that your tongue is forced forward away from your airway. Not only can these machines potentially eliminate your snoring, but they can also give you the restful night's sleep that you have been missing.

The last and most permanent solution for treating certain non-responsive cases of sleep apnea is surgery. This option is typically reserved for the most advanced cases to eliminate or reduce an obstruction to the airway.

Contact us today to discuss your questions about sleep apnea or to schedule an appointment. You can also learn more about sleep apnea when you continue reading the Dear Doctor magazine article “Sleep Disorders & Dentistry.”

In times of stress, people have many ways to comfort themselves. For adults, it can be habits such as eating, drinking, or smoking. For children, it is often sucking their thumb, fingers, or a pacifier. Babies have been observed in scans to suck on their fingers and thumbs even before they are born. It makes them feel secure.

When is thumb sucking a problem?
Sucking on fingers or thumbs can be a problem when it is done too vigorously and too long. A young child's jaws are soft and can change their shape to make room for the thumb if the child sucks too hard and too often. If thumb, finger or pacifier habits continue too long, the upper front teeth may tip toward the lip or not come into the correct position in the mouth.

How do you know if your child falls into the group that will suffer from the results of too much thumb sucking? It's best to visit our office so we can check on how the child's teeth and jaws are developing.

What can be done about thumb and finger sucking?
Most children naturally stop sucking their thumbs, fingers, or pacifiers between the age of two and four. The pacifier habit is easier to break than the thumb or finger sucking habit, probably because it is always easier to find their fingers or thumbs. It is a good idea to try to transfer your child's habit to a pacifier at an early age. The next steps are to cut down pacifier usage and gradually stop by 18 months.

If your child is still engaging in these habits at age three, we can recommend strategies for cutting back and stopping. Remember that positive reinforcement, in which a child is rewarded for the desired behavior, always works better than punishment for the behavior you don't like.

Also remember that finger and thumb sucking is normal. Help your child to feel safe, secure, and comfortable as the behavior will probably disappear by itself. If you are worried about your child's sucking a pacifier, thumb or fingers, please visit us to put your mind at rest.

Contact us today to schedule an appointment to discuss your questions about children's thumb sucking. For more information, read “Thumb Sucking in Children” in Dear Doctor magazine.

Test yourself on your knowledge of this dental procedure.

1. A root canal is
1. A canal shaped structure in the root of your tooth
2. A blood vessel carrying blood from your gum to your tooth
3. An instrument used by your dentist in performing dental surgery
2. Which of these are symptoms of root canal infection?
1. Sharp, acute and intense pain, which is difficult to pinpoint
2. Sharp pain when biting down on your tooth or on food
3. Lingering pain after eating hot or cold foods
4. Dull ache and pressure
5. Tenderness (accompanied by swelling) in the nearby gums
6. All the above
3. If you don't feel any pain you do not have a root canal infection.
1. True
2. False
4. Root canal treatment is a very painful experience.
1. True
2. False
5. Root canal treatment is called endodontic therapy. What does this word mean?
1. Bringing the end of your problems
2. Inside your tooth
3. Fighting gum disease
6. You need root canal treatment if
1. The inside or pulp of your tooth becomes inflamed or infected
2. Your tooth needs to be gently moved in order to correct your bite
3. Acid erosion is damaging your tooth
7. During root canal treatment the canals in your teeth are cleaned out and sealed off.
1. True
2. False
8. Who is qualified to perform root canal treatment?
1. General dentists
2. Endodontists
3. Both of the above

1. a. A root canal is a canal shaped space within the root of a tooth that holds the tooth's pulp — which contains the tooth's nerves and blood vessels.
2. f. — all of the above
3. False. It is possible to have an infection that has stopped hurting but is still present and causing damage.
4. False. Root canal treatment doesn't cause pain, it relieves it.
5. b. The word comes from roots meaning “inside” and “tooth.”
6. a.
7. True. A small opening is made in the chewing surface of your tooth to gain access to the pulp. Dead and dying tissue is removed and the pulp is cleaned and disinfected. The canals are shaped and then sealed with filling materials to prevent future infection.
8. c. All general dentists have received training in endodontic treatment and can perform most endodontic procedures. They often refer people needing complicated root canal treatment to endodontists, who have had specialized training in endodontic diagnosis and treatment.

Your car comes with a maintenance manual that tells you when to get an oil change, rotate the tires, and perform other necessary tasks. By following the manual's directions you can keep your car running in good condition for many years. Too bad a manual doesn't come with your teeth and gums!

Such a manual would concentrate on a few basic tasks we call oral hygiene and teeth cleanings. Both tasks are mainly dedicated to removing dental plaque or biofilm from the surfaces of your teeth and the surrounding gums. Plaque is now referred to as a biofilm, a film composed of bacteria, that naturally forms in your mouth. Studies have shown that dental plaque causes periodontal disease (gum disease) and dental caries (tooth decay).

Tips for Daily Removal of Dental Plaque
The way you hold your toothbrush is crucial to your ability to remove plaque effectively. We recommend that you hold it in your fingertips as you would a pen or pencil. Use small motions and pressure. Brushing too hard can damage gum tissues. Use a soft bristled brush, hold it at about a 45 degree angle to the gum line and then use a gentle scrubbing motion. Studies have shown some electric toothbrushes to be more efficient at plaque removal than hand-held brushes; but in general how you use the brush is more important than what kind of brush it is.

To remove plaque deposits from the hard-to-reach areas between your teeth, floss at least once a day. Wrap the floss around each tooth surface and gently move it up and down for a few strokes, cleaning the sides of your teeth where they face each other.

You can use an antibacterial mouthrinse to get help reduce the bacterial plaque or biofilm that you missed in brushing and flossing.

The best way to make sure you are brushing correctly is to have a dental professional demonstrate for you. We would be happy to demonstrate the correct techniques in your own mouth so that you can see how it feels, and you can copy the methods we use.

Professional Maintenance Schedule
Your car needs to go into the shop from time to time for professional maintenance. Your teeth also need a regular schedule of maintenance from a professional dentist or hygienist. Over time, plaque that you do not manage to clean off your teeth accumulates and forms hard deposits called calculus or tartar. If left on your teeth these deposits cause inflammation of your gum tissues and can lead to infection, abscesses, and even tooth loss. During a professional cleaning a technique called scaling removes these substances. For more advanced forms of gum disease, root planing is used to remove deposits of calculus below the gum line.

Contact us today to schedule an appointment to discuss your questions about oral hygiene. You can also learn more by reading the Dear Doctor magazine article “Oral Hygiene Behavior.”

Having someone tell you that you have bad breath can be humiliating, but it can also be a sign that you need to see your dentist. Bad breath (or halitosis) can be a sign of an underlying dental or health problem, so before you run out and stock up on breath mints, make an appointment with our office. Using breath fresheners will only disguise the problem and not treat the root cause.

It's important to remember that if you have bad breath, you're not alone — it's the third most common reason people seek a dental consult. We use a systematic approach to determine the cause of your halitosis and offer a solution.

Causes: Ninety percent of mouth odors come from mouth itself — either from the food you eat or bacteria that may be present. Most unpleasant odors originate from proteins trapped in the mouth that are processed by oral bacteria. When left on the tongue, these bacteria can cause an unpleasant smell. Dry mouth, sinus problems, diet and poor oral hygiene can also cause bad breath. In rare cases, a medical condition may be the cause.

Treatment: The best solution will depend on determining the real cause of your halitosis. If bad breath emanates from the mouth, it most commonly is caused by gum disease or even tooth decay, which need to be treated to correct the problem. If halitosis is of systemic (general body) origin, a more detailed examination might be needed from a physician. But the solution may also be as simple as demonstrating how to effectively remove bacterial plaque from your teeth, or offer instruction on proper tongue cleaning. If the cause is gum disease, we may suggest a deep cleaning and possible antibiotic therapy.

Contact us today to schedule an appointment to discuss any questions you may have regarding bad breath. Read more about this topic in the Dear Doctor magazine article “Bad Breath: More Than Just Embarrassing.”

We have learned that an important part of oral health is education — but more importantly, making it fun to learn so that you retain (and apply) what you learn! For this reason, we have put together the following self-test so that you can quickly access your knowledge on the subject of mouthguards.

1. The first sport to use (and require) protective mouthguards was:
   1. football
   2. boxing
   3. baseball
   4. ice hockey
2. Research conducted by the American Dental Association (ADA) found that individuals are ___ times more likely to damage their teeth when not wearing a mouthguard while engaged in contact sports or rigorous physical exercise.
   1. 10
   2. 20
   3. 40
   4. 60
3. As a rule of thumb, females do not require mouthguards because they are not as physically active as their male counterparts.
   1. True
   2. False
4. The American Academy of General Dentistry (AAGD) reports that mouthguards prevent more than ______ injuries to the mouth and/or teeth each year.
   1. 200,000
   2. 300,000
   3. 400,000
   4. 500,000
5. Which of the following sports or activities does the ADA recommend that participants wear protective mouthguards:
   1. acrobatics
   2. bicycling
   3. handball
   4. all of the above
6. The US Centers for Disease Control (CDC) reports that more than ______ sports-related injuries end-up in the emergency room each year with injury or damage to the teeth and mouth.
   1. 275,000
   2. 425,000
   3. 600,000
   4. 735,000
7. Over-the-counter mouthguards are just as effective as professionally made mouthguards.
   1. True
   2. False
8. In addition to the trauma of having a tooth (or teeth) knocked out, individuals who have suffered from this type of injury may end up spending ______ per tooth over a lifetime for teeth that are not properly preserved and replanted according to the National Youth Sports Foundation for Safety.
   1. $10,000 to $20,000
   2. $15,000 to $25,000
   3. $25,000 to $35,000
   4. Less than $10,000

Answers: 1) b, 2) d, 3) b, 4) a, 5) d, 6) c, 7) b, 8) a

You can learn more about the importance of mouthguards when you continue reading the Dear Doctor magazine article “Athletic Mouthguards.” And if you have already experienced a dental injury, it may not be too late. However, we need to evaluate the damage so that we can establish a plan for restoring optimal oral health. Contact us today to learn more about protecting your mouth and teeth or to schedule an appointment.

If you asked a room full of parents about their opinions on thumb sucking and pacifiers, the odds are good that you would get a wide variety of opinions. The truth is that this habit is a perfectly normal behavior in babies and young children; however, it is something that parents and caregivers should monitor. This is why we want to share a few basic myths and facts to set the record straight.

So how early does thumb sucking start?
It is interesting to note that thumb sucking for some babies actually starts before birth. This fact is proven quite often when expectant mothers “see” their unborn child sucking fingers or a thumb during a routine mid to later term sonogram. Sucking for babies is absolutely normal; it provides them with a sense of security. It is also a way they test, make contact and learn about their world.

At what age should a parent be concerned if their child still sucks a pacifier, finger or a thumb?
Recent studies have shown that if a sucking habit continues after the age of two, there may be some long-term changes in the mouth that have can have a negative impact on jaw development and/or with the upper front teeth. (It can cause these upper front teeth to become “bucked” or protrude forward towards the lips.) The American Academy of Pediatric Dentistry recommends that parents and caregivers encourage children to cease this habit by about age three.

Do children ever stop this habit on their own?
Absolutely! If left alone, many children will naturally stop sucking their fingers or thumb between the ages of two and four. The main points to remember are that sucking habits are totally natural and should stop on their own. You should not make it a problem unnecessarily. If, however, your child is getting older and still seems dependant upon this habit, feel free to contact us today to schedule an appointment for your child or to discuss your specific questions about pacifiers and finger or thumb sucking. You can also learn more about this topic by continuing to read the Dear Doctor magazine article “Thumb Sucking in Children.”

How much do you know about dental implants? Test yourself with this quiz.

1. Earliest recorded attempts at using dental implants were from
1. Medieval England
2. The ancient Mayans
3. U.S.A. in the 1950s
2. Dental implants are called endosseous. What does this mean?
1. They fuse with the bone
2. They are inside the mouth
3. They are not real teeth
3. What are most dental implants made of?
1. Aluminum
2. Titanium
3. Steel
4. What part of the tooth does an implant replace?
1. The implant is the root replacement
2. The implant is the root plus the crown
3. The implant is the crown
5. What is the success rate of dental implants?
1. 50 percent or less
2. 75 percent
3. 95 percent or more
6. What could cause an implant to fail?
1. Smoking or drug use
2. Poor bone quality and quantity at the implant site
3. Both of the above
7. What is a tooth's emergence profile?
1. The implant and crown's shape as it emerges from beneath the gum line
2. A measure of the urgency of the tooth replacement
3. A measure of the time it takes for you to be able to chew on the new implant
8. What are some of the factors that go into the aesthetics of designing the crown?
1. Choice of materials
2. Color matching
3. Both of the above

1. b. The concept of dental implants goes back to the Mayan civilization in 600 AD.
2. a. The word endosseous (from endo meaning within and osseo meaning bone) refers to the implant's ability to fuse with or integrate with the bone in which it is placed.
3. b. Most implants are made of a titanium alloy, a metallic substance that is not rejected by the body and is able to fuse with the bone.
4. a. The term “implant” refers to the root replacement, which is anchored in the gum and bone. A crown is put around the implant where it emerges from the gumline.
5. c. The majority of studies have shown long term success rates of over 95 percent.
6. c. Factors that could cause an implant to fail include general health concerns such as smoking and drug use, osteoporosis, or a compromised immune system; poor bone quality or quantity; and poor maintenance such as lack of proper brushing and flossing.
7. a. The emergence profile has a lot to do with the implant's natural appearance. It involves the way the crown, which attaches to the implant, seemingly emerges through the gum tissue like a natural tooth.
8. c. Choices such as materials, color, and position can be worked out in the design of a customized temporary crown, which acts as a template or blueprint for a final crown.

Contact us today to schedule an appointment to discuss your questions about dental implants. You can also learn more by reading the Dear Doctor magazine article “Matching Teeth & Implants.”

If you've ever looked through a magazine and viewed the perfectly aligned white smiles of celebrities and models, you may be already familiar with the look of porcelain veneers. To achieve a picture-perfect smile, many Hollywood stars choose porcelain veneers (thin-layers of porcelain) that are bonded to the front of teeth allowing for the alteration of tooth position, shape, size and color. By fixing imperfections, as well as whitening them, veneers offer celebrities a perfect smile that, when maintained properly, can last for several decades.

Evaluation: If porcelain veneers sound appealing, our office can help you decide if you're a good candidate for them. We will ensure you have sufficient tooth structure, that your teeth are in more or less a normal position, and that symmetrical gum contours are present, allowing for proper “framing” of the teeth, necessary for a beautiful smile.

The Process: Once it's been determined that you're a good candidate for veneers, our office will begin a smile analysis using computer imaging to digitally replicate your smile and then fabricate a mock-up smile made of tooth-colored wax. We will work with you to determine the right color and shade for your veneers. You can choose the brightest, whitest “Hollywood smile” or opt for a more natural color and enhanced look.

Next Steps: After your initial appointment, it typically takes the laboratory one week to fabricate your porcelain veneers. The insertion of your veneers can be done with or without a local anesthetic. We will place the veneers on your teeth with a light-sensitive resin, which sets with the use of a white light, effectively bonding them to your teeth. While you may initially experience some tooth sensitivity to hot or cold, this will disappear after a few days. Maintaining your perfect smile requires simple brushing and flossing techniques and routine check ups.

Contact us today to schedule an appointment to discuss any questions you may have regarding porcelain veneers. Read more about this topic in the Dear Doctor magazine article “Smile Design, Enhanced by Porcelain Veneers.”

The best method for permanently replacing a missing tooth is with a dental implant. But did you know that there are two main techniques for placing implants? Implants can be placed either using a one stage or a two stage surgical technique, and as their names suggests, one is performed in one step while the other requires a second surgery.

With a one-stage procedure, a healing abutment is placed at the time of surgery. An abutment is a connector that attaches the implant from the bone into the mouth and which protrudes through the gum tissues. Following a 3 to 6 month healing period in which the implant fuses to the bone, a crown is then placed on the implant restoring the immediate appearance of a healthy, normal tooth. One-stage implant systems are generally used when the bone quality is good, guaranteeing good initial implant stability. They are also used when cosmetics is not a concern, such as the back areas of the mouth.

Under special conditions an implant can be placed and a crown placed on top of it at the same time. However, this is a very special circumstance requiring ideal conditions and surgical experience as well as crown fabrication know-how. It is generally safer and wiser not to subject an implant to biting forces until it is fully healed and integrated with the supporting bone.

A two-stage procedure is typically used for replacing teeth where there is no immediate need for a cosmetic solution and when more of a margin of safety is required. With this approach, the implant(s) are placed into the jawbone and the gum tissues cover them. They are not exposed to the mouth, but stay buried and left to heal. Once healed, a second surgery is performed to attach an abutment for securing the crown in place. This approach is used when there is poorer bone quality or quantity. This may make it necessary to regenerate bone around the implant at the time of its placement. There may also be other health considerations dictating that a two-stage approach may be indicated.

Depending on your individual situation and medical status, our implant team will determine which approach is best for you. To learn more about these two procedures, read the Dear Doctor article, “Staging Surgery In Implant Dentistry.” You are also welcome to contact us to discuss your questions or to schedule an appointment.

Early Detection of Oral Cancer Increases Survival Rates by 400 Percent! Take This Quick and Easy Self-Test NOW!

As with other forms of cancer, the chances of surviving oral cancer are greatly increased when you catch it in its early stages. In fact, survival rates are as high as 81 percent when oral cancer is detected early, compared to a survival rate of 17 percent or less with late intervention. And while nothing can take the place of a thorough oral cancer screening by a dentist or physician, regular self-exams at home can increase the likelihood that an oral cancer lesion will be detected early.

The American Association of Oral and Maxillofacial Surgeons recommends the following procedure for oral cancer self-exams:

As you examine your mouth, you are looking for the following:
 

• reddish patches



• white patches



• raised, lumpy, or thickened areas



• a sore that fails to heal within about two weeks, or that bleeds easily



Now you know what to look for. Time to start checking.


• Use a flashlight or other bright light to see inside your mouth.



• Remove any dental appliances (retainers, dentures).



• Facing a mirror, look and feel inside your lips and at your front gums.



• Pull your cheek out to see the inside, as well as the back gums.



• Tilt your head back and check the roof of your mouth.



• Put out your tongue and check all surfaces, particularly the sides and underneath.



• Feel for lumps or enlarged lymph nodes in both sides of the neck and under the lower jaw.


Other signs of oral cancer include a chronic sore throat, hoarseness, and difficulty chewing or swallowing.

If your self-exam reveals anything suspicious, see your healthcare provider immediately.


Source: The National Oral Cancer Awareness Program

If you think you might have sleep apnea, see your physician immediately. She and your dentist can work together with you to find a comfortable, effective solution.

• Lose weight if you are overweight.



• Eliminate nasal congestion.



• Make sure your sleeping environment is quiet, dark, and maintains a steady, comfortable temperature.



• Avoid large meals right before bedtime.



• Avoid strenuous exercise within two to three hours of bedtime.



• Avoid alcohol or sleeping pills within four hours of bedtime.



• Avoid caffeine, nicotine or any other stimulants within four hours of bedtime.

Our blog will keep you up to date with the latest information from the dental field including advancements in treatment, new procedures and practical dental health advice from Dr. Mark and his staff.

We hope you find our blog to be a great resource for keeping up to date with proper tooth care and dental needs.

We welcome feedback and encourage you to comment on our posts.

-- The Forest Hills Dental Team

Given the fact that baby-boomers are now reaching the age of retirement, understanding senior healthcare is becoming a top priority to many people. Discover your level of expertise in the area of oral health by taking the following true/false test.

True or False Self Assessment

1. All people eventually lose their teeth as they age.
2. Yellow teeth are a sign of gum disease.
3. If you have dentures, you no longer need regular dental check-ups.
4. Periodontal (gum) disease is a big problem that affects 3 out of 4 adults.
5. Electric toothbrushes can be a great option for seniors with arthritis or other debilitating conditions.

Answers

1. False: Your teeth are meant to last your lifetime.
2. False: Yellow teeth typically denote stained teeth from diet, medication, smoking, or growing older. And while they may not appear attractive, older, yellow teeth can in fact be healthy and free of gum disease. However, if your yellow teeth bother you, ask us if teeth whitening could be right for freshening up your smile while making you appear younger.
3. False: For those individuals who wear complete upper and lower dentures, you will always need routine dental exams, typically once a year so that you can be screened for cancer, as well as other oral conditions (i.e. candadiasis), to ensure the you obtain and maintain optimal oral health.
4. True: 75% of all adults over the age of 35 will experience some form of periodontal disease, a condition in which the gums become inflamed and infected. If left untreated, gum disease causes the bone that supports the teeth to deteriorate until the teeth are loosened and/or eventually lost (either they fall out on their own or must be removed). On a positive note, you can prevent gum disease by having good oral hygiene that includes flossing daily and brushing at least twice a day with a proper technique and fluoride toothpaste.
5. True: Under normal conditions, what matters most is not so much the type of toothbrush used (manual, electric or battery powered toothbrush), but rather how you use it. However, if you are unable to use a manual toothbrush effectively for proper brushing, then a power toothbrush may be able to facilitate proper cleaning more easily.

Want To Learn More?

If you feel you missed too many of the above questions, read the Dear Doctor article, “Oral Hygiene Behavior.” Or, contact us today to discuss your questions or to schedule a consultation. ]]>Sat, 05 May 2012 04:01:16 -0500http://www.foresthillsdental.com/blog/post/too-much-pressure-how-to-ward-off-sinus-pain.html

If you engage in frequent air travel, you have probably experienced pain in your ears and sinuses related to pressure changes. The pain is caused by “barotraumas” (from baro meaning pressure — also the root of the word “barometer” — and trauma meaning injury) and is also called a “squeeze.” Divers also sometimes experience this discomfort or pain.

The cause of barotraumas is air pressure (or water pressure, in the case of divers) on the outside of your body that is not equal to the pressure inside your body. Normally when pressure outside your body changes, your organs such as your blood, bones, and muscles transmit the changes equally from outside to inside. Some structures in your body, such as your middle ear spaces and your sinus cavities (spaces in the facial bones of the skull), don't transmit the pressure as well because they are filled with air and have rigid walls. The maxillary (upper jaw) sinuses are pyramid-shaped spaces in the bone located below your eyes, on either side of your nose.

You have probably tried to stop such pain in your ears by yawning, chewing, or moving your jaw back and forth. These maneuvers, called “clearing,” allow air to move from the back of your throat into your ear canals so that the pressure can equalize. Similarly, your sinuses have small openings near their lower borders, so that you can clear pressure changes within them. If you have a head cold or flu and the membranes lining your sinuses are swollen and inflamed, they may close off the openings and make it difficult to clear these spaces. This can sometimes lead to intense pain.

Because the lower walls of these sinuses are adjacent to your upper back teeth, these teeth share the same nerves as the maxillary sinuses. This sharing sometimes causes pain felt in your back teeth to be perceived as pain in the sinuses, or vice versa. Pain felt a distance from its actual stimulus because of shared nerves is called “referred pain.”

Be sure to make an appointment with us if you experience pain in any of your teeth. Any defect in a filling or tooth can allow air to enter the tooth. It could be referred pain from your sinuses, or the result of pressure changes on trapped air within a filling or a tooth. Such pain, called barodontalgia (from baro meaning pressure, don't meaning tooth, and algia meaning pain) is an early sign of injury in a tooth.

Contact us today to schedule an appointment to discuss your questions about tooth and sinus pain. You can also learn more by reading the Dear Doctor magazine article “Pressure Changes Can Cause Tooth & Sinus Pain.”

Periodontal (gum) diseases are sometimes called “silent” because those who have them may not experience painful symptoms. But certain signs point to the existence of these common diseases. If you are experiencing any of the symptoms below, it is time to visit our office so these problems can be treated before they lead to serious infection and loss of teeth.

Gums that bleed during the brushing of teeth. Some people think that gums bleed from brushing too hard. In fact, healthy gum tissues will not bleed with normal brushing. The usual cause of bleeding gums is an accumulation of dental plaque in the areas where your teeth meet your gums. Plaque is a film of bacteria, called a biofilm, which accumulates on your teeth. If you are not brushing and flossing effectively, plaque irritates your gum tissues and causes an inflammation and swelling called gingivitis. This causes your gums to bleed easily on contact with a toothbrush or floss.

Gum tissues that appear red and swollen. If plaque is allowed to accumulate for 24 hours or more, the inflammation in your gum tissues becomes chronic. The continuous presence of bacteria makes it impossible for your body's natural defenses to fight the infection. Chronic inflammation leads to a breakdown of the normal attachment between the teeth and the gums, causing the formation of “pockets.” Inside these pockets the infection continues to attack the tissues that support your teeth. Eventually this can lead to a breakdown of the bone that surrounds your teeth.

Bad breath. Bad breath is another sign of accumulated plaque. The bacteria in plaque may emit gases that have an unpleasant odor.

Gums that are sensitive to hot or cold. Chronic inflammation can also cause the gums to recede, exposing the roots of the teeth in which nerves may be close to the surface, leading to sensitivity to heat and cold.

Teeth that are getting loose, or a painful area in the gums. If you experience these symptoms, the infection has progressed a long way from the “silent” stage. It is time to seek immediate professional help.

If you answered “yes” to any of the above questions, a professional dental examination is in order. With daily removal of plaque by effective brushing and flossing, along with frequent professional cleanings to remove any plaque that you were unable to catch, you will go a long way to preventing periodontal disease. Also, be aware that smoking tends to mask the effects of gum disease. Generally, if you smoke your gums will not bleed when brushing or flossing, nor will they show signs of swelling.

Contact us today to schedule an appointment to discuss your questions about gum disease. You can also learn more by reading the Dear Doctor magazine articles “Bleeding Gums” and “Warning Signs of Periodontal (Gum) Disease.”