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ALittleFluorideGoesaLongWayinProtectingYourFamilysTeeth

A popular Sixties-era hair cream touted their product with the tagline, "A little dab'll do ya!" In other words, it didn't take much to make your hair look awesome.

Something similar could be said about fluoride. Tiny amounts of this "wonder" chemical in hygiene products and drinking water are widely credited with giving people a big boost in protection against tooth decay.

A Colorado dentist is credited with first noticing fluoride's beneficial effects early in the Twentieth Century. Although many of his patients' teeth had brownish staining (more about that in a moment), he also noticed they had a low incidence of cavities. He soon traced the effect to fluoride naturally occurring in their drinking water.

Fast forward to today, and fluoride is routinely added in trace amounts to dental care products and by water utilities to the drinking water supply. It's discovery and application have been heralded as one of the top public health successes of the Twentieth Century.

Fluoride, though, seems a little too amazing for some. Over its history of use in dental care, critics of fluoride have argued the chemical contributes to severe health problems like low IQ, cancer or birth defects.

But after several decades of study, the only documented health risk posed by fluoride is a condition called fluorosis, a form of staining that gives the teeth a brown, mottled appearance (remember our Colorado residents?). It's mainly a cosmetic problem, however, and poses no substantial threat to a person's oral or general health.

And, it's easily prevented. Since it's caused by too much fluoride in prolonged contact with the teeth, fluorosis can be avoided by limiting fluoride intake to the minimum necessary to be effective. Along these lines, the U.S. Public Health Service recently reduced its recommended amounts added to drinking water 0.7 milligrams per liter (mg/L) of water. Evidence indicated fluoride's effectiveness even at these lower amounts.

You may also want to talk with your dentist about how much fluoride your family is ingesting, including from hidden sources like certain foods, infant formula or bottled water. Even if you need to reduce your family's intake of fluoride, though, a little in your life can help keep your family's teeth in good health.

If you would like more information on the benefits of fluoride in dental care, 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 “Fluoride & Fluoridation in Dentistry.”

BothToothDecayorGumDiseaseCouldBecomeSomethingFarWorse

While mouth pain can certainly get your attention, what exactly hurts may be difficult to identify. It might seem to emanate from a single tooth, or a group of teeth. Then again, it might not be clear whether it's coming from teeth or from the gums.

Still, it's important to pinpoint the cause as much as possible to treat it correctly. One of the main questions we often want to answer is whether the cause originates from within a tooth or without.

In the first case, tooth decay may have entered the pulp at the center of the tooth. The pulp contains nerve bundles that can come under attack from decay and transmit pain signals. Incidentally, if the pain suddenly goes away, it may simply mean the nerves have died and not the infection.

The decay can also spread into the root canals leading to the root and supporting bone, and then make the jump into the gum tissues. One possible sign of this is the one mentioned earlier—you can't quite tell if the pain is from the tooth or the surrounding gums.

The root canals could also serve as a transportation medium for infection in the other direction. In that case, gum disease has advanced into the bone tissues around a tooth near its roots. The infection can then cross into the tooth. Again, both a tooth and the gum tissue around it can become diseased.

We have effective treatments for individual occurrences of interior tooth decay or gum disease: The former usually requires a root canal treatment to remove infected tissue and fill and seal the tooth from future infection; we alleviate gum disease by removing the dental plaque causing it and helping the gum tissues to heal. But combined tooth and gum infection scenarios are more difficult to treat, have a poorer prognosis and may require specialists.

To reduce the risk of either tooth decay or gum disease developing into this greater problem, it's best to take action at the first sign of trouble. So, see your dentist as soon as possible when you encounter oral pain or if you notice swollen or bleeding gums. The earlier we treat the initial outbreak of disease, be it tooth decay or gum disease, the better your chances of a successful and happy outcome.

If you would like more information on tooth pain, 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 “Confusing Tooth Pain.”

VanHalensPassingRemindsUsoftheDangersofOralCancerandHowtoHelpPreventIt

Fans everywhere were recently saddened by the news of musical legend Eddie Van Halen's death. Co-founder and lead guitarist for the iconic rock group Van Halen, the 65-year-old superstar passed away from oral cancer.

Van Halen's rise to worldwide fame began in the 1970s with his unique guitar style and energetic performances, but behind the scenes, he struggled with his health. In 2000, he was successfully treated for tongue cancer. He remained cancer-free until 2018 when he was diagnosed with throat cancer to which he succumbed this past October.

Van Halen claimed the metal guitar picks he habitually held in his mouth caused his tongue cancer. It's more likely, though, that his heavy cigarette smoking and alcohol use had more to do with his cancers.

According to the American Cancer Society, most oral cancer patients are smokers and, as in Van Halen's case, are more likely to beat one form of oral cancer only to have another form arise in another part of the mouth. Add in heavy alcohol consumption, and the combined habits can increase the risk of oral cancer a hundredfold.

But there are ways to reduce that risk by making some important lifestyle changes. Here's how:

Quit tobacco. Giving up tobacco, whether smoked or smokeless, vastly lowers your oral cancer risk. It's not easy to kick the habit solo, but a medically supervised cessation program or support group can help.

Limit alcohol. If you drink heavily, consider giving up alcohol or limiting yourself to just one or two drinks a day. As with tobacco, it can be difficult doing it alone, so speak with a health professional for assistance.

Eat healthy. You can reduce your cancer risk by avoiding processed foods with nitrites or other known carcinogens. Instead, eat fresh fruits and vegetables with antioxidants that fight cancer. A healthy diet also boosts your overall dental and bodily health.

Practice hygiene. Keeping teeth and gums healthy also lowers oral cancer risk. Brush and floss daily to remove dental plaque, the bacterial film on teeth most responsible for dental disease. You should also visit us every six months for more thorough dental cleanings and checkups.

One last thing: Because oral cancer is often diagnosed in its advanced stages, be sure you see us if you notice any persistent sores or other abnormalities on your tongue or the inside of your mouth. An earlier diagnosis of oral cancer can vastly improve the long-term prognosis.

Although not as prevalent as other forms of cancer, oral cancer is among the deadliest with only a 60% five-year survival rate. Making these changes toward a healthier lifestyle can help you avoid this serious disease.

If you would like more information about preventing oral cancer, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “How a Routine Dental Visit Saved My Life” and “Strategies to Stop Smoking.”

ThereAreaSeveralPossibleCausesforaGummySmile

Besides straight and translucent teeth, an attractive smile has another important component: balance. In a great smile, the visible areas of the teeth and gums are in balanced proportion to one another.

But what is the ideal proportion between teeth and gums? Although aesthetic appeal is largely “in the eye of the beholder,” dental professionals typically consider a properly sized tooth to be around 10 mm in visible length. As for the upper gums, no more than 4 mm of tissue should show when smiling. Teeth appearing shorter than 10 mm or the gums displaying more than 4 mm can create an effect called a “gummy smile.”

Fortunately, there are different approaches for correcting a gummy smile, depending on what's causing the appearance of gumminess. Not only are there different causes, but they can be diverse in nature.

Obviously, an actual excess of gum tissue can cause a smile to look gummy—but so can shortened teeth. One possible solution called crown lengthening could help correct either possibility. During the procedure, we remove any excess gum tissue or reposition the gums after reshaping the underlying bone to reveal more of the tooth crown. Worn or shortened teeth can also be made to look longer with porcelain veneers.

A gummy smile could also be caused by a hypermobile lip, in which the lip rises higher than normal while smiling. We may be able to prevent this temporarily by injecting Botox into the lip muscles, which paralyzes them and inhibits their ability to move upward. A more permanent approach is to surgically restrict the upward movement of the lip muscles.

The gums may also seem too prominent if the upper jaw is longer in proportion to the face. One way to correct this is orthognathic surgery, a procedure that moves the upper jaw to a higher position on the skull. This can reduce the jaw profile with the face and subsequently affect how much of the gums show while smiling.

These solutions range from relatively minor to significantly invasive. The first step, though, is to find out what's really behind your gummy smile before taking the next step to make it more attractive.

If you would like more information on improving a gummy smile, 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.”

TemporarySmilesforTeensWaitingonDentalImplants

Here's some good news: Teenagers are less likely than adults to lose teeth to dental disease. But there's also a flip side. Teens can still lose teeth, more likely from traumatic injury.

Fortunately, there are several options for replacing lost teeth like dentures or bridges. But the choice considered best by most dentists and patients is a dental implant. An implant tooth looks and functions like the real thing—and it's durable, capable of lasting for years, if not decades.

But there's a hitch with teens getting an implant: Even though they may have all their permanent teeth by adolescence, their jaws are still growing and developing. Natural teeth, with their attachment to the jaws by way of a periodontal ligament, can keep pace with this growth—but implants can't.

That's because an implant doesn't have this attachment to gum tissue like natural teeth, but to the jawbone alone. Hence, an implant tooth can't keep up with jaw development, and may eventually look like it's "sunk" into the gums in relation to the teeth around it.

It's best, then, to wait until a teen's jaws have fully developed before attempting an implant. In the meantime, though, they don't have to endure a smile marred by missing teeth, but can replace them with a temporary restoration. The two most common options are a partial denture or a modified bridge.

The partial denture is a lightweight version that's quite affordable. Although not as durable as other types of dentures, the appliance is only intended to last until the patient is old enough for a permanent implant.

The modified bridge is a prosthetic tooth with strips of dental material extending behind it that are bonded to the backs of the teeth on either side to hold it in place. It's likewise not as durable as a traditional bridge, but it can fill the bill until time to place an implant.

Although this adds an additional step in a teen's restorative journey after losing a tooth, it's necessary—waiting to place an implant after jaw maturity will help ensure a long-lasting result. In the meantime, a temporary tooth replacement will help them to enjoy a normal smile.

If you would like more information on dental restorations for teens, 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 Implants for Teenagers.”





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