The vast majority of teeth and gum problems stem from two dental diseases: dental caries (tooth decay) and periodontal (gum) disease. But although these dental diseases are all too common in our society, there’s a good chance you can prevent them from harming your own dental health.
That’s because we know the primary cause for both of them—dental plaque, a thin film of bacteria and food particles that can build up on tooth surfaces usually as a result of poor oral hygiene. Remove this plaque build-up daily and you dramatically decrease your risk for disease.
The primary way to do this is with a daily habit of brushing and flossing. While regular dental cleanings remove plaque and tartar (calcified plaque) from hard to reach places, it’s your regular practice that removes the bulk of daily buildup. Interrupting plaque buildup helps keep disease-causing bacteria at bay.
That also means performing these two hygiene tasks thoroughly. For example, you should brush all tooth surfaces, especially in the rear and along the entire gum line (a complete brushing should take at least 2 minutes). And by the way, “thorough” doesn’t mean “aggressive”—a gentle circular motion is all you need. If you scrub too hard, you run the risk over time of damaging your gums.
And while many people discount flossing as a hard and unpleasant task, it’s still necessary: at least half of the plaque in your mouth accumulates between the teeth where brushing can’t reach effectively. If you find flossing too difficult, you can take advantage of tools to make the task easier. A floss threader will make it easier to get floss through your teeth; you could also use an oral irrigator, a device that emits a pressurized spray of water to loosen and flush away some plaque.
Along with dental visits at least twice a year, daily brushing and flossing is the best way to reduce your risk of both tooth decay and gum disease. Avoiding these two diseases will help ensure your smile is attractive and healthy throughout your life.
If you would like more information on preventing dental disease, 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 “Daily Oral Hygiene: Easy Habits for Maintaining Oral Health.”
The reason for extracting a tooth may be all too obvious — the tooth is too decayed or damaged to attempt saving. The reason for extracting a wisdom tooth, on the other hand, may not be so apparent: from the perspective of pain or reduced function, you may not notice a thing. Our recommendation to remove a wisdom tooth is based primarily on what may be occurring out of view below the gum line and its potential threat to adjacent teeth.
Teeth grow and develop below the gum line in the jaw, and then push their way through the gums as they appear in the mouth (eruption). After a normal eruption, the enamel-covered crown is visible above the gum line; the remaining tooth root (about two-thirds of the tooth’s length) resides below the gum line. Because wisdom teeth, or third molars, erupt rather late between ages 17 and 25, they may lack the room to erupt properly due to crowding from other teeth that have already erupted. This can cause the wisdom tooth not to erupt fully through the gums, leaving the crown trapped below the gum line, a condition known as impaction. For the tooth, impaction increases the chances of infection, cyst formation and gum disease around it.
An impacted wisdom tooth can also cause problems for the adjacent teeth as well. The impacted tooth may begin to press against the roots of other teeth; the resulting pressure can damage the other roots, increasing the risk for disease or future tooth loss. A person may not even know they have this problem since there’s often little to no noticeable pain or symptoms.
It may seem counterintuitive, but the best time to remove a wisdom tooth is when it’s not causing immediate problems. There will be, however, signs found during examination (particularly x-rays or CT scan) that future problems are in the making. By extracting an impacted wisdom tooth at the appropriate time, we can avoid more serious problems in the future and improve oral health.
If you would like more information on wisdom teeth and your oral health, 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 “Removing Wisdom Teeth.”
Cavities can happen even before a baby has his first piece of candy. This was the difficult lesson actor David Ramsey of the TV shows Arrow and Dexter learned when his son DJ’s teeth were first emerging.
“His first teeth came in weak,” Ramsey recalled in a recent interview. “They had brown spots on them and they were brittle.” Those brown spots, he said, quickly turned into cavities. How did this happen?
Ramsey said DJ’s dentist suspected it had to do with the child’s feedings — not what he was being fed but how. DJ was often nursed to sleep, “so there were pools of breast milk that he could go to sleep with in his mouth,” Ramsey explained.
While breastfeeding offers an infant many health benefits, problems can occur when the natural sugars in breast milk are left in contact with teeth for long periods. Sugar feeds decay-causing oral bacteria, and these bacteria in turn release tooth-eroding acids. The softer teeth of a young child are particularly vulnerable to these acids; the end result can be tooth decay.
This condition, technically known as “early child caries,” is referred to in laymen’s terms as “baby bottle tooth decay.” However, it can result from nighttime feedings by bottle or breast. The best way to prevent this problem is to avoid nursing babies to sleep at night once they reach the teething stage; a bottle-fed baby should not be allowed to fall asleep with anything but water in their bottle or “sippy cup.”
Here are some other basics of infant dental care that every parent should know:
- Wipe your baby’s newly emerging teeth with a clean, moist washcloth after feedings.
- Brush teeth that have completely grown in with a soft-bristled, child-size toothbrush and a smear of fluoride toothpaste no bigger than a grain of rice.
- Start regular dental checkups by the first birthday.
Fortunately, Ramsey reports that his son is doing very well after an extended period of professional dental treatments and parental vigilance.
“It took a number of months, but his teeth are much, much better,” he said. “Right now we’re still helping him and we’re still really on top of the teeth situation.”
If you would like more information on dental care for babies and toddlers, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “The Age One Dental Visit” and “Dentistry & Oral Health for Children.”
Today’s healthcare patients are asking questions. They want to know the “why” behind the “what” that their care providers are recommending for their health.
There’s a similar trend in dentistry — and it’s one we dentists encourage. We want you to know the “why” behind your treatment options — because you’re as much a participant in your own dental health as we are. The more informed you are, the better equipped you’ll be to make decisions to maintain or improve your health and the appearance of your smile.
As your dental care partner, it’s also essential we help you develop a long-term care plan based on your needs. There are aspects of dental care that are routine: daily brushing and flossing, an oral-friendly diet, and regular dental cleanings and checkups to assess your oral health. But we also need to think strategically, especially if you have risk factors that could impact your future dental health.
To do this we follow a four-step dental care cycle. In Step 1 we identify all the potential risk factors you personally face. These include your potential for dental disease, which could lead to bone and tooth loss, and the state of your bite and jaw structure that could complicate future health. We’ll also take into account any factors that could now or eventually affect your smile appearance.
Once we’ve identified these various factors, we’ll then assess their possible impact on your health in Step 2, not just what may be happening now but what potentially could happen in the future. From there we move to Step 3: treating any current issues and initiating preventive measures to protect your future health.
In Step 4 we’ll monitor and maintain the level of health we’ve been able to reach with the preceding steps. We’ll continue in this stage until we detect an emerging issue, in which we’ll then repeat our cycle of care.
Maintaining this continuum will help reduce the chances of an unpleasant surprise in your dental health. We’ll be in a better position to see issues coming and help reduce their impact now so you can continue to have a healthy mouth and an attractive smile.
If you would like more information on planning your dental treatment, 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 “Successful Dental Treatment: Getting the Best Possible Results.”
For over a century dentists treated tooth decay by removing both diseased portions of the tooth and healthy structure deemed at risk for future decay. In the 1970s, though, a new approach emerged, known as Minimally Invasive Dentistry (MID). This practice protocol attempts to preserve as much of the healthy structure as possible.
Before MID, dentists followed a decay treatment protocol developed in the 19th Century. A part of this became known as extension for prevention calling for dentists to remove healthy structure considered vulnerable to decay. Besides reducing the tooth's volume, this practice also resulted in, by today's standards, larger than necessary fillings.
It was thought that removing this additional material would make it easier to clean bacterial plaque, the source of decay, but later, research showed the practice couldn't guarantee the teeth wouldn't be reinfected.
Since then we've learned a lot more about teeth and have developed new ways to detect decay at earlier stages. X-ray imaging, for example, has transitioned largely from film to digital technology, providing more detailed images at greater magnification. This, along with laser fluorescence and infrared cameras, has made it easier to detect the first tiny stages of decay.
We can also limit tooth decay damage by boosting enamel strength with fluoride applications and sealants or reducing decay-causing bacteria with anti-bacterial rinses. We've also seen advancement in techniques like air abrasion that remove decayed tooth material while leaving more healthy structure intact better than using a traditional dental drill.
Restoring teeth after treatment has also improved. While dental metal amalgam is still used for some fillings, the main choice is now composite resin. These new tooth-colored dental materials require less tooth preparation (and thus less material loss) and bond well to the remaining structure, resulting in a stronger tooth.
Following a MID protocol leads to less intervention and less time in the dentist's chair. It also means preserving more of a natural tooth, an important aim in promoting long-lasting dental health.
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