More than likely your great-grandparents, grandparents and even your parents had a common dental experience: when one of their teeth developed a cavity, their dentist removed the decayed portion (and maybe a little more) through drilling and then filled the cavity. In other words, treatment was mainly reactive—fix the problem when it occurred, then fix it again if it reoccurred.
You may have had similar experiences—but the chances are good your dentist’s approach is now quite different. Today’s tooth decay treatment is much more proactive: address first the issues that cause tooth decay, and if it does occur treat it with an eye on preventing it in the future.
This approach depends on maintaining equilibrium between two sets of competing factors that influence how your teeth may encounter tooth decay. This is known as the caries balance (caries being another name for tooth decay). On one side are factors that increase the risk of decay, known by the acronym BAD: Bad Bacteria that produce acid that dissolves the minerals in tooth enamel; Absence of Saliva, the body’s natural acid neutralizer; and Dietary Habits, especially foods with added sugars that feed bacteria, and acid that further weakens enamel.
There are also factors that decrease the risk of tooth decay, known by the acronym SAFE: Saliva and Sealants, which focuses on methods to boost low salivary flow and cover chewing surfaces prone to decay with sealant materials; Antimicrobials, rinses or other substances that reduce bad bacteria populations and encourage the growth of beneficial strains; Fluoride, increased intake or topical applications of this known enamel-strengthening chemical; and Effective Diet, reducing the amount and frequency of sugary or acidic foods and replacing them with more dental-friendly choices.
In effect, we employ a variety of techniques and materials that inhibit BAD factors and support SAFE ones. The foundation for prevention, though, remains the same as it was for past family generations—practice effective oral hygiene by brushing and flossing daily and regular dental cleanings and checkups to keep bacterial plaque from accumulating and growing. Your own diligent daily care rounds out this more effective way that could change your family history of tooth decay for you and future generations.
Academy Award-winning actress Kathy Bates knows how important it is to present your best face to the world — and one of the most important features of that face is a beaming smile. But there came a point when she noticed something was a little off. “I've always had good teeth, but it seemed to me as I was getting older that they weren't looking as good,” Kathy explained in a recent interview with Dear Doctor magazine.
That's when she decided it was time to take action. Kathy had orthodontic treatment when she was in her fifties, and she keeps her smile bright with tooth whitening treatments. She uses a kit provided by her dentist with a safe, effective whitening solution.
Of course, a bright, healthy smile looks great anywhere — whether you're on the red carpet or “off the grid.” And you don't have to be a Hollywood star to have professional whitening treatments. In fact, teeth whitening is one of the most popular and affordable cosmetic treatments modern dentistry offers.
The basic options for professional teeth whitening include in-office bleaching or take-home kits. Both types of dentist-supervised treatments offer a safe and effective means of getting a brighter smile; the main difference is how long they take to produce results. A single one-hour treatment in the office can make your teeth up to ten shades lighter — a big difference! To get that same lightening with at-home trays, it would take several days. On the plus side, the take-home kit is less expensive, and can achieve the same results in a bit more time.
It's important to note that not all teeth can be whitened with these treatments. Some teeth have intrinsic (internal) stains that aren't affected by external agents like bleaches. Also, teeth that have been restored (with bonding or veneers, for example) generally won't change color. And you can't necessarily whiten your teeth to any degree: Every tooth has a maximum whiteness, and adding more bleach won't lighten it beyond that level. Most people, however, find that teeth whitening treatments produce noticeable and pleasing results.
What about those off-the-shelf kits or in-the-mall kiosks? They might work… or they might not. But one thing's for sure: Without a dentist's supervision, you're on your own. That's the main reason why you should go with a pro if you're considering teeth whitening. We not only ensure that your treatment is safe — we can also give you a realistic idea of what results to expect, and we will make sure that other dental problems aren't keeping you from having a great-looking smile.
How often does Kathy Bates see her dentist for a checkup and cleaning? “I go about every four months,” she noted. “I'm pretty careful about it.” And if you've seen her smile, you can tell that it pays off. If you would like more information about teeth whitening, please contact us or schedule an appointment. You can learn more in the Dear Doctor magazine articles “Important Teeth Whitening Questions Answered” and “Teeth Whitening.”
As if the preteen years didn’t give kids and their parents enough to think about, new oral health concerns loom on the horizon. Along with major changes to the body, brain and emotions, additional risk factors for tooth decay and gum disease appear during adolescence — the period of development starting around age 10 and extending through the teen years that marks the transition from childhood to adulthood.
Even with declining rates of tooth decay across the nation, the cavity rate remains high during adolescence. According to the American Academy of Pediatrics, 1 in every 5 adolescents has untreated tooth decay. What’s more, the onset of puberty — usually beginning around age 10-11 in girls and 11-12 in boys — brings changes in hormone levels that can affect gum health.
We all have millions of microorganisms in our mouth, representing hundreds of different species of mostly helpful, but some harmful, bacteria. Research has shown that total oral bacteria increases between ages 11 and 14, and new types of bacteria are introduced, including some that are not friendly to teeth and gums. Some unfamiliar microbes trigger an exaggerated inflammatory response to dental plaque, so gum bleeding and sensitivity are experienced by many children in this age group. In fact, “puberty gingivitis,” which peaks around age 11-13, is the most common type of gum disease found during childhood.
A combination of hormones, lifestyle changes and poor oral hygiene habits raises the risk of oral health problems among adolescents. A more independent social life may be accompanied by a change in eating habits and easier access to snacks and beverages that are sugary, acidic (like sports drinks and soda) or full of refined carbohydrates — none of which are tooth-healthy choices. And as children move toward greater independence, parents are less likely to micromanage their children’s personal care, including their oral hygiene routines. Good oral hygiene can keep dental plaque at bay, lowering the chance of having gingivitis and cavities. But let’s face it: Adolescents have a lot to think about, and keeping up with their oral health may not be top of mind.
To help your preteen stay on top of their oral health, keep healthy snacks at home for your children and their friends and make sure you are well stocked with supplies such as new toothbrushes, floss and toothpaste. In addition, most preteens (and teens) can benefit from gentle reminders about oral hygiene routines.
For optimal oral health through all stages of life, make sure your preteen keeps up with professional teeth cleanings and exams, and talk with us about whether fluoride treatments or sealants may be appropriate for your child.
For more on your child’s oral health, read “How to Help Your Child Develop the Best Habits for Oral Health” and “Dentistry & Oral Health For Children” in Dear Doctor magazine.
So, you’ve just acquired an attractive restoration with dental implants. You may be thinking at least with these teeth you won’t have to worry about dental disease.
Think again. While the implants and their porcelain crowns are impervious to decay the surrounding gums and bone are still vulnerable to infection. In fact, you could be at risk for a specific type of periodontal (gum) disease called peri-implantitis (inflammation around the implant).
Bacterial plaque, the thin bio-film most responsible for gum disease, can build up on implant crowns just as it does on natural tooth surfaces. If it isn’t removed with daily brushing and flossing and regular dental cleanings the bacteria can trigger an infection in the gums.
Besides weakening gum tissues, gum disease can also cause bone loss, of critical importance to dental implants. An implant depends on the bone they’re inserted in to hold them in place. If the bone around an implant becomes infected it could begin to be lost or dissolve (resorb), which could lead to loss of the implant.
That’s why it’s critical to keep the natural tissue structures supporting your implants infection-free. Not only is daily hygiene a must, but your implants and any remaining natural teeth should undergo professional cleaning at least twice a year or more if your dentist recommends it.
Cleanings involving implants will also be a bit different from natural teeth. While the dental materials used in the crown and implant post are quite durable, regular cleaning instruments can scratch them. Although tiny, these scratches can become hiding places for bacteria and increase your risk of infection.
To avoid this, your hygienist will use instruments (known as scalers and curettes) usually made of plastics or resins rather than metal. The hygienist may still use metal instruments on your remaining natural teeth because their enamel can tolerate metal without becoming scratched creating a smoother surface.
While keeping implants clean can sometimes be a challenge, it’s not impossible. Implants on average have a long-term success rate above 95%. With both you and your dentist caring and maintaining these state-of-the-art restorations, you may be able to enjoy them for decades.
If you would like more information on caring for dental implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Implant Maintenance: Implant Teeth must be Cleaned Differently.”
Your gums not only support and protect your teeth they also help present them in a visually attractive way. But some people’s gums seem to stand out too much — what’s commonly called a gummy smile — which diminishes their smile appeal. There’s no precise definition, but as a rule of thumb we consider a smile too gummy if four or more millimeters (about an eighth of an inch) of the gums show.
Fortunately, there are some techniques to improve a gummy smile. Which technique is best for you, though, will depend on why the gums are prominent — and causes vary. For example, you could have a gummy smile because your teeth appear too short compared to your gums.
Permanent teeth normally erupt to about 10 mm of visible length. But less than that, say 8 mm, could skew the visible proportion of gums to teeth too much toward the gums. Teeth can also appear shorter due to accelerated wear caused by grinding habits. Another cause could be the amount of upper lip rise when you smile. The lip may rise too high in a condition called hypermobility. This could reveal too much of the gums when you smile.
It’s important then to match the treatment to the cause. For example, we can enhance the appearance of shorter teeth through a surgical procedure known as crown lengthening.Â During this procedure a surgeon reshapes the gum tissues and underlying bone to expose more of the tooth’s length.
For upper lip hypermobility, we can restrict movement with Botox, a drug that paralyzes tiny parts of the involved muscles. This approach, though, will wear off in a few months — a more permanent solution is surgery to reposition the muscle attachments so as to prevent excessive movement.
If you’re concerned about a gummy smile, see us for a full examination and consultation. Once we know the reason why, we can offer a solution that will make your smile more attractive.
If you would like more information on enhancing the appearance of your gums, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Gummy Smiles.”
This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.