If your dentist found tooth decay on your last visit, you might have been surprised. But tooth decay doesn't occur suddenly—it's a process that takes time to unfold.
It begins with bacteria—too many, that is. Bacteria naturally live in the mouth, but when their populations grow (often because of an abundance of leftover sugar to feed on) they produce high amounts of acid, a byproduct of their digestion. Too much acid contact over time softens and eventually erodes tooth enamel, making decay easier to advance into the tooth.
So, one important strategy for preventing tooth decay is to keep your mouth's bacterial population under control. To do that, here are 4 common-sense tactics you should perform between dental visits.
Practice daily hygiene. Bacteria thrive in dental plaque, a thin film of food particles that builds up on teeth. By both brushing and flossing you can reduce plaque buildup and in turn reduce disease-causing bacteria. In addition, brushing with a fluoride toothpaste can also help strengthen tooth enamel against acid attacks.
Cut back on sugar. Reducing how much sugar you eat—and how often –deprives bacteria of a prime food source. Constant snacking throughout the day on sweets worsens the problem because it prevents saliva, the body's natural acid neutralizer, from reducing high acid levels produced while eating. Constant snacking doesn't allow saliva to complete this process, which normally takes about thirty minutes to an hour. To avoid this scenario, limit any sweets you eat to mealtimes only.
Wait to brush after eating. Although this sounds counterintuitive, your tooth enamel is in a softened state until saliva completes the acid neutralizing process previously described. If you brush immediately after eating you could brush away tiny particles of softened enamel. Instead, rinse your mouth out with water and wait an hour for saliva to do its work before brushing.
Boost your saliva. Inadequate saliva flow could inhibit the fluid's ability to adequately neutralize acid or provide other restorative benefits to tooth enamel. You can improve flow with supplements or medications, or by drinking more water during the day. Products with xylitol, a natural sugar alternative, could give you a double benefit: chewing gums and mints containing it could stimulate more saliva flow and the xylitol itself can inhibit bacterial growth.
When die-hard music fans hear that their favorite performer is canceling a gig, it’s a big disappointment—especially if the excuse seems less than earth-shaking. Recently, British pop sensation Dua Lipa needed to drop two dates from her world tour with Bruno Mars. However, she had a very good reason.
“I’ve been performing with an awful pain due to my wisdom teeth,” the singer tweeted, “and as advised by my dentist and oral surgeon I have had to have them imminently removed.”
The dental problem Lipa had to deal with, impacted wisdom teeth, is not uncommon in young adults. Also called third molars, wisdom teeth are the last teeth to erupt (emerge from beneath the gums), generally making their appearance between the ages of 18-24. But their debut can cause trouble: Many times, these teeth develop in a way that makes it impossible for them to erupt without negatively affecting the healthy teeth nearby. In this situation, the teeth are called “impacted.”
A number of issues can cause impacted wisdom teeth, including a tooth in an abnormal position, a lack of sufficient space in the jaw, or an obstruction that prevents proper emergence. The most common treatment for impaction is to extract (remove) one or more of the wisdom teeth. This is a routine in-office procedure that may be performed by general dentists or dental specialists.
It’s thought that perhaps 7 out of 10 people ages 20-30 have at least one impacted wisdom tooth. Some cause pain and need to be removed right away; however, this is not always the case. If a wisdom tooth is found to be impacted and is likely to result in future problems, it may be best to have it extracted before symptoms appear. Unfortunately, even with x-rays and other diagnostic tests, it isn’t always possible to predict exactly when—or if—the tooth will actually begin causing trouble. In some situations, the best option may be to carefully monitor the tooth at regular intervals and wait for a clearer sign of whether extraction is necessary.
So if you’re around the age when wisdom teeth are beginning to appear, make sure not to skip your routine dental appointments. That way, you might avoid emergency surgery when you’ve got other plans—like maybe your own world tour!
If you would like more information about wisdom tooth extraction, please call our office to arrange a consultation. You can learn more in the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”
While the term “plastic surgery” might bring to mind face lifts or tummy tucks, not all procedures in this particular surgical field are strictly cosmetic. Some can make a big difference in a person’s health.
One example is periodontal plastic surgery, which corrects gum tissue loss around the teeth. Although these procedures can indeed improve appearance, they more importantly help save teeth.
Gum loss is most often a consequence of periodontal (gum) disease, a bacterial infection arising from a thin film of food particles on the teeth called dental plaque. As the disease weakens the gums’ attachment to teeth, they shrink back or recede, exposing the area around the roots. Without the protective cover the gums provide the roots, they become more susceptible to decay.
In milder cases of gum recession, treating the infection often results in the gums regaining their normal attachment to teeth. But with more advanced recession, natural gum healing may not be enough to reverse it. For such situations grafting donor tissue to the recessed area can help stimulate new tissue growth.
While gum tissue grafts can come from an animal or other human, the most likely source is from the person themselves. In one type of procedure, free gingival grafting, the surgeon locates and completely removes (or “frees”) a thin layer of skin resembling gum tissue, typically from the roof of the mouth, shapes it and then transplants it by suturing it to the recession site. Both donor and recipient sites heal at about the same rate in two to three weeks.
Another technique is known as connective tissue grafting. In this procedure the surgeon partially removes the donor tissue from its site while leaving a portion containing blood vessels intact. The palatal tissue is still used and transported to fit beneath the tissue that’s still attached to the blood supply. This connective tissue graft is then positioned and sutured to the recipient site while still maintaining its blood supply connection at the donor site. Maintaining this connection facilitates healing and increases the chances the graft will “take” and become firmly attached to the new site.
Grafting procedures require advanced techniques and skills. But with them we may be able to restore gum attachment to teeth with an impact on appearance and dental health that’s well worth the effort.
If you would like more information on treating gum 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 “Periodontal Plastic Surgery.”
Anybody can contract periodontal (gum) disease if they don't brush and floss every day. Inadequate hygiene allows a thin film of disease-causing bacteria and food particles called plaque to build up.
But while we're all at risk for gum disease, some people are more so. This is especially true for those with diabetes, heart disease or other systemic conditions. The common denominator among all these conditions is inflammation, the body's defensive response to disease or injury.
When tissues become infected or damaged, the body causes swelling at the site to isolate the affected tissues, clear out diseased or dead cells and start tissue repair. Inflammation also produces redness, pain and, particularly with gum tissues, bleeding.
Inflammation is an important part of the body's ability to heal itself. It's possible, though, for the inflammatory response to become chronic. If that happens, it can actually begin doing more harm than good.
We're learning that chronic inflammation is a factor in many systemic diseases. For example, it can interfere with wound healing and other issues associated with diabetes. It also contributes to fatty deposit buildup in arterial blood vessels, which can lead to heart attacks or strokes. And in gum disease, chronic inflammation can cause gum detachment, followed by bone and tooth loss.
We're also learning that inflammation can create connections between these various health conditions. If you have an inflammatory disease like heart disease or diabetes, your risk for gum disease not only increases but it may also be difficult to bring under control. Likewise, if you have persistent gum disease, the associated inflammation could aggravate or even increase your risk for other systemic diseases.
Researchers hope continued discoveries about the interrelationship of inflammation with various conditions will lead to better treatment strategies, including for gum disease. In the meantime, getting prompt treatment for any inflammatory condition, especially gum disease, could help your treatment prospects with other conditions.
If you would like more information on connections between dental disease and other health conditions, 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 “The Link between Heart & Gum Diseases.”
When you look at the top row of a normal smile, you'll see symmetrical pairs: the central incisors in the middle, flanked by the lateral incisors and the canine (or eye) teeth on the outside of them.
Sometimes, though, teeth may not form as they should: in fact, it's one of the more common congenital defects with one in five people having missing or deformed teeth, often the upper lateral incisors. In the latter case, it's not uncommon for the eye teeth to drift into the missing lateral incisors' spaces next to the central incisors. This creates a smile even a layperson can tell is off.
There is a way to treat this with orthodontics and cosmetic dentistry that will transform that person's smile while restoring better mouth function too. It's often a long process, however, that's best begun early and must be precisely timed with dental development.
Using braces, we move the drifted teeth back to their proper positions, which will make room for a future dental restoration. It's usually best to begin this treatment during late childhood or early adolescence. The next step is to fill the newly-created space with prosthetic (false) teeth.
Dental implants are an ideal choice since they're durable and life-like, and won't require permanent alteration of adjacent teeth. They do, however, require a certain amount of bone volume at the site to support them; if the volume is insufficient we may have to place a bone graft to stimulate new growth.
It's also best not to install implants until the jaw has finished development, usually in the late teens or early adulthood. In the interim between tooth repositioning and implants we can customize a retainer or other removable appliance with a false tooth to occupy the space. This not only enhances the smile, it also prevents the repositioned teeth from drifting back.
These steps toward achieving a new smile take time and sometimes a team of specialists. But all the effort will be rewarded, as a person born without teeth can have a new smile and improved oral health.
If you would like more information on treating dental development deficiencies, 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 “When Permanent Teeth Don't Grow.”
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