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Sometimes It’s Good to Be a Quitter: Smoking and Oral Health

SometimesItsGoodtoBeaQuitterSmokingandOralHealth

Each November, the American Cancer Society urges smokers to kick the habit for just one day, because if you can quit for one whole day, you can quit for another whole day. Put enough whole days back to back and you’re no longer a smoker!

According to the U.S. Centers for Disease Control, cigarette smoking is the leading preventable cause of death in the United States. It harms nearly every organ of the body, causing lung disease, heart disease and diabetes, as well as cancer of the lung, kidney and bladder.

Smoking also causes problems in your mouth. Aside from the more obvious problems of bad breath and yellowed teeth, smoking raises the risk of cancer of the mouth and throat. It can increase the buildup of plaque and tartar, which can lead to cavities and gum disease. Smoking interferes with healing, so treatments may not work as well. The majority of smokers have gum disease and they are more likely to lose teeth from advanced gum disease.

Quitting isn’t easy, but it’s the best thing you can do for your health. Who wouldn’t want fresher breath, younger-looking skin and a better sense of taste and smell?

Even for people who have smoked for a long time, the effects of smoking start to reverse themselves when you quit. Your heart rate, blood pressure and carbon monoxide levels in the blood return to normal shortly after quitting. Studies are showing that in just one year, the risk for heart disease is cut in half. 10 years later the risk of oral cancer is about equal to that of a nonsmoker. In 15 years, the risk of heart disease is the same as for a nonsmoker.

Need help quitting? Talk with your dentist or doctor. You can also visit the American Cancer Society website. If you have any questions about smoking and oral health, please contact our office or schedule a consultation. To learn more, read the Dear Doctor magazine article “Strategies to Stop Smoking.”

Clear Aligners Make it Easier for Teenagers to have Their Teeth Straightened

ClearAlignersMakeitEasierforTeenagerstohaveTheirTeethStraightened

Braces can change a person’s life — not just their appearance but their dental health as well. To be honest, though, wearing braces are, well, kind of a drag — especially for teenagers.

Braces can be restrictive and confining; you’ll also have to give up certain favorite foods for a while. But more than any of that, they’re just plain unattractive. Even being able to choose colors for the brackets and elastic bands can’t fully ease a teenager’s embarrassment when they smile.

There is, however, an alternative to braces: clear aligners. And they could make orthodontic treatment during this difficult phase of their life much easier to handle.

Clear aligners are a set of clear plastic trays that can be taken in and out of the mouth. Each of the custom-designed trays is slightly smaller than the previous one in the series. After wearing the first tray for a couple of weeks (at least 20 to 22 hours a day), the patient switches to the next tray in the series. They repeat this process until they’ve worn all the trays. The gradual change from tray to tray moves the teeth to the desired position.

Clear aligners have some distinct advantages over braces, especially for younger patients. They can be removed for cleaning or for a rare special event. They don’t limit movement as much as braces. And, they’re nearly invisible — other people may not even notice them. And newer aligners are now designed with tiny “power ridges” that increase their movement capabilities. This has made them more useful for teenagers with complicated bite problems and other issues.

There are cases, though, where braces may be the better choice: where you need more control over tooth movement or the patient needs jaw surgery to achieve proper tooth alignment. And their removability could be an issue if the patient won’t leave them in their mouth for the necessary time each day.

To find out if clear aligners might be a viable option for your teenager, visit us for a complete orthodontic examination. We can then discuss your best option — clear aligners or braces — to achieve the most desirable outcome for your teenager.

If you would like more information on treating bite problems in teenagers with clear aligners, 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 “Clear Aligners for teens.”

Saving a Diseased Primary Tooth Could Mean Better Oral Health Later in Life

SavingaDiseasedPrimaryToothCouldMeanBetterOralHealthLaterinLife

It’s often best health-wise to preserve even the most troubled tooth—including a child’s primary (“baby”) tooth. If that sounds like too much effort for a tooth that lasts only a few years, there’s a big reason why—if it’s lost prematurely, the incoming permanent tooth above it could erupt out of position.

Preserving a decayed primary tooth could include procedures similar to a root canal treatment, commonly used in adult permanent teeth with inner decay. However, we may need to modify this approach to protect the primary tooth’s pulp. This innermost layer plays a critical role in early dental development.

Because an adult tooth has reached maturity, removing diseased pulp tissue has little effect on its permanent health. But the pulp contributes to dentin growth (the layer between it and the outer enamel) in primary and young permanent teeth, so removing it could ultimately compromise the tooth’s long-term health.

Our goal then with a child’s tooth is to remove as much diseased tissue as possible while involving the pulp as little as possible. What techniques we use will depend on how much of the pulp has become infected.

For example, if decay has advanced to but hasn’t yet penetrated the pulp, we may remove all but a small amount of the decayed structure just next to the pulp to avoid its exposure. We may then apply an antibacterial agent to this remaining portion and seal the tooth to curb further infection.

If on the other hand the pulp has become infected, we may try to remove only the infected portion and leave the remaining pulp intact. We’ll only be able to do this, however, if we deem the remaining pulp healthy enough to remain infection-free after the procedure. If not, we may need to remove the entire pulp as with a traditional root canal. This option, though, is a last resort due to the possible effect on dentin growth and the tooth’s long-term health.

As you can see attempts to preserve a primary tooth can be quite involved. But if we can help it reach its full life span, it could mean better dental health for a lifetime.

If you would like more information on caring for primary teeth, 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 “Root Canal Treatment for Children’s Teeth.”

Julianne Hough Shares a Video – and a Song – After Wisdom Teeth Come Out

JulianneHoughSharesaVideo-andaSong-AfterWisdomTeethComeOut

Once upon a time, celebrities tried hard to maintain the appearance of red-carpet glamour at all times. That meant keeping the more mundane aspects of their lives out of the spotlight: things like shopping, walking the dog and having oral surgery, for example.

That was then. Today, you can find plenty of celebs posting pictures from the dentist on social media. Take Julianne Hough, for example: In 2011 and 2013, she tweeted from the dental office. Then, not long ago, she shared a video taken after her wisdom teeth were removed in December 2016. In it, the 28-year-old actress and dancer cracked jokes and sang a loopy rendition of a Christmas carol, her mouth filled with gauze. Clearly, she was feeling relaxed and comfortable!

Lots of us enjoy seeing the human side of celebrities. But as dentists, we’re also glad when posts such as these help demystify a procedure that could be scary for some people.

Like having a root canal, the thought of extracting wisdom teeth (also called third molars) makes some folks shudder. Yet this routine procedure is performed more often than any other type of oral surgery. Why? Because wisdom teeth, which usually begin to erupt (emerge from beneath the gums) around age 17-25, have the potential to cause serious problems in the mouth. When these molars lack enough space to fully erupt in their normal positions, they are said to be “impacted.”

One potential problem with impacted wisdom teeth is crowding. Many people don’t have enough space in the jaw to accommodate another set of molars; when their wisdom teeth come in, other teeth can be damaged. Impacted wisdom teeth may also have an increased potential to cause periodontal disease, bacterial infection, and other issues.

Not all wisdom teeth need to be removed; after a complete examination, including x-rays and/or other diagnostic imaging, a recommendation will be made based on each individual’s situation. It may involve continued monitoring of the situation, orthodontics or extraction.

Wisdom tooth extraction is usually done right in the office, often with a type of anesthesia called “conscious sedation.”  Here, the patient is able to breathe normally and respond to stimuli (such as verbal directions), but remains free from pain. For people who are especially apprehensive about dental procedures, anti-anxiety mediation may also be given. After the procedure, prescription or over-the-counter pain medication may be used for a few days. If you feel like singing a few bars, as Julianne did, it’s up to you.

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.”

What You Can Do to Support Your Child’s Dental Development

WhatYouCanDotoSupportYourChildsDentalDevelopment

Your child’s teeth and gum development is truly a wonder. In just a little more than two decades they’ll gain and lose one set of teeth, while the subsequent permanent set will grow in coordination with other facial and oral structures. All of these structures will finally reach maturity sometime in early adulthood.

Sometimes, though, obstacles can arise: disease, trauma or even genetics can derail normal development and endanger future health. So although nature does most of the heavy lifting, there are things you should do to keep your child’s dental development on track.

For instance, begin oral hygiene practices before their first teeth come in. By wiping their gums after feeding with a clean damp cloth, you can help reduce the numbers of disease-causing bacteria in the mouth. Once teeth appear switch to brushing.

There are also habits to avoid. Don’t kiss your baby directly on the lips—you may transfer to them your own mouth bacteria, which their young immune system can’t yet adequately handle. Also, avoid putting them to bed with a sleep-time bottle filled with sugary fluids (including milk or formula) because the constant contact between the sugar and their teeth could increase their risk for tooth decay, the number one dental disease in young children.

Of course, not all prevention efforts depend on you alone—we’re your partner in helping to keep your child’s dental development progressing normally. We can provide preventive treatments like sealants or topical fluoride to reduce the risk of tooth decay, while continually monitoring for signs of the disease that may require treatment. We also look for signs of emerging bite problems that may require intervention before their effects worsen.

This is all part of regular dental visits, usually at six-month intervals, which are best begun around your child’s first birthday. Not only does this enable us to stay ahead of dental problems, it also helps your child become more comfortable with dental visits and increase the likelihood they’ll continue the habit in adulthood.

As we said, nature is responsible for most of this amazing development without any help from us. But we can assist development and hopefully prevent issues that could diminish their dental health in years to come.

If you would like more information on supporting your child’s dental development, please contact us or schedule an appointment for a consultation.

Bad Breath in Children

BadBreathinChildren

Even the sweetest children don’t always have sweet-smelling breath. If your child has persistent bad breath, it may be for one of the following reasons:

POOR ORAL HYGIENE HABITS. Bad breath often results from bacteria on the teeth and tongue that is not effectively removed during brushing and flossing.

  • Tip: To encourage thorough cleaning as children are developing their oral hygiene habits, try handheld flossers that are colorful and easy to use, sing or play music to make brushing time fun, or try an electric toothbrush with a timer or a tooth-brushing app that keeps kids brushing for a full two minutes.

PLAQUE BUILDUP, TOOTH DECAY AND GUM DISEASE: Plaque, a sticky bacterial biofilm, can build up on tooth surfaces, between the teeth and under the gum line and can lead to tooth decay and gum disease. These conditions may result in bad breath.

  • Tip: Stay on top of your child’s oral hygiene at home, and keep up with regular dental visits for professional cleanings and checkups.

POST-NASAL DRIP: This common cause of foul-smelling breath in children results when excessive mucus is produced and drips down the back of the throat.

  • Tip: Schedule an appointment with your child’s pediatrician to determine and treat the cause.

MOUTH BREATHING. Breathing through the mouth instead of the nose can cause a dry mouth. This can lead to increased oral bacteria, which can cause bad breath. If children breathe through the mouth all the time, not just because of a temporary cold or allergies, your child is at greater risk for tooth decay and gum disease.

  • Tip: If your child is a chronic mouth breather, schedule a dental visit so we can check for any adverse effects on dental health. Note that over time, habitual mouth breathing may lead to poor alignment of the teeth. An ear, nose and throat (ENT) specialist can treat problems with tonsils, adenoids and sinuses — common causes of mouth breathing.

FOREIGN OBJECT IN THE NOSE. It wouldn’t be the first time a child has stuck a pea or other small object up their nose â?? or their sibling’s nose — only to find that it won’t come back out. A foreign body in the nasal passage can cause infection and lead to bad breath.

  • Tip: Don’t try to remove the object at home, as part of it may remain in the nasal passage. A medical professional will have the right equipment to dislodge the object more comfortably.

MEDICATION. Children who take antibiotics for a long time may develop a fungal infection (thrush) in the mouth. Other medications can cause bad breath due to the way they break down in the body.

  • Tip: Call your pharmacist if you have a question about medications and bad breath.

MEDICAL CONDITION. Infections of the throat, sinus or tonsils can cause bad breath, as can more serious health conditions.

  • Tip: If your child’s breath is unpleasant for an extended period of time, get it checked out by a health professional.

If you are concerned about your child’s breath, schedule a visit. We are happy to remind your child of proper brushing techniques and check for other problems that need to be addressed.

For more on young children’s oral health, read “How to Help Your Child Develop the Best Habits for Oral Health” and “Why See a Pediatric Dentist?

Monitoring Your Child’s Thumb Sucking Could Help Avoid Future Bite Problems

MonitoringYourChildsThumbSuckingCouldHelpAvoidFutureBiteProblems

Although distressing to many parents, infants and toddlers sucking their thumb is a common if not universal habit. Most children phase out of it by around age 4, usually with no ill effects. But thumb-sucking continuing into late childhood could prove problematic for a child’s bite.

Thumb sucking is related to how young children swallow. All babies are born with what is called an infantile swallowing pattern, in which they thrust their tongues forward while swallowing to ensure their lips seal around a breast or bottle nipple when they nurse. Thumb-sucking mimics this action, which most experts believe serves as a source of comfort when they’re not nursing.

Around 3 or 4, their swallowing transitions to a permanent adult swallowing pattern: the tip of the tongue now positions itself against the back of the top front teeth (you can notice it yourself when you swallow). This is also when thumb sucking normally fades.

If a child, however, has problems transitioning to an adult pattern, they may continue to thrust their tongue forward and/or prolong their thumb-sucking habit. Either can put undue pressure on the front teeth causing them to move and develop too far forward. This can create what’s known as an open bite: a slight gap still remains between the upper and lower teeth when the jaws are shut rather than the normal overlapping of the upper teeth over the lower.

While we can orthodontically treat an open bite, we can minimize the extent of any treatments if we detect the problem early and intervene with therapies to correct an abnormal swallowing pattern or prolonged thumb sucking. For the former we can assist a child in performing certain exercises that help retrain oral and facial muscles to encourage a proper swallowing pattern. This may also help diminish thumb sucking, but we may in addition need to use positive reinforcement techniques to further discourage the habit.

To stay ahead of possible problems with thumb sucking or the swallowing pattern you should begin regularly taking them to the dentist around their first birthday. It’s also a good idea to have an orthodontic evaluation around age 6 for any emerging bite problems. Taking these positive steps could help you avoid undue concern over this common habit.

If you would like more information on managing your child’s thumb-sucking habit, 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 “How Thumb Sucking Affects the Bite.”

Margot Robbie Knows: A Great Smile Is Worth Protecting

MargotRobbieKnowsAGreatSmileIsWorthProtecting

On the big screen, Australian-born actress Margot Robbie may be best known for playing devil-may-care anti-heroes—like Suicide Squad member Harley Quinn and notorious figure skater Tonya Harding. But recently, a discussion of her role in Peter Rabbit proved that in real life, she’s making healthier choices. When asked whether it was hard to voice a character with a speech impediment, she revealed that she wears retainers in her mouth at night, which gives her a noticeable lisp.

“I actually have two retainers,” she explained, “one for my bottom teeth which is for grinding my teeth, and one for my top teeth which is just so my teeth don’t move.”

Clearly Robbie is serious about protecting her dazzling smile. And she has good reasons for wearing both of those retainers. So first, let’s talk about retainers for teeth grinding.

Also called bruxism, teeth grinding affects around 10 percent of adults at one time or another, and is often associated with stress. If you wake up with headaches, sore teeth or irritated gums, or your sleeping partner complains of grinding noises at night, you may be suffering from nighttime teeth grinding without even being aware of it.

A type of retainer called an occlusal guard is frequently recommended to alleviate the symptoms of bruxism. Typically made of plastic, this appliance fits comfortably over your teeth and prevents them from being damaged when they rub against each other. In combination with stress reduction techniques and other conservative treatments, it’s often the best way to manage teeth grinding.

Orthodontic retainers are also well-established treatment devices. While appliances like braces or aligners cause teeth to move into better positions, retainers are designed to keep teeth from moving—helping them to stay in those positions. After active orthodontic treatment, a period of retention is needed to allow the bite to stabilize. Otherwise, the teeth can drift right back to their old locations, undoing the time and effort of orthodontic treatment.

So Robbie has the right idea there too. However, for those who don’t relish the idea of wearing a plastic appliance, it’s often possible to bond a wire retainer to the back surfaces of the teeth, where it’s invisible. No matter which kind you choose, wearing a retainer can help keep your smile looking great for many years to come.

If you have questions about teeth grinding or orthodontic retainers, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Teeth Grinding” and “The Importance of Orthodontic Retainers.”

Dental Care of Prime Importance for Children with Special Health Needs

DentalCareofPrimeImportanceforChildrenwithSpecialHealthNeeds

Children’s ailments come and go, and thankfully most are relatively minor. Some children, however, have impaired health caused by a more serious, chronic disease. For them, the condition impacts not only their overall well-being, but also their dental health.

This often occurs because the specific healthcare needs of children with these chronic conditions are given greater priority over dental health. Besides the treatment focus, children with special healthcare needs may have physical, mental or behavioral limitations that can make it difficult to keep up with oral hygiene and care.

Children with autism or attention deficit and hyperactivity disorder (ADHD) may have a difficult time practicing (or cooperating with) oral hygiene tasks. Some may not have the physical ability to perform effective brushing and flossing without assistance. In these cases, it’s important for parents or caregivers to seek out instruction and training that will optimize their children’s hygiene and so reduce the chance of dental disease.

Certain medications for chronic conditions can increase mouth dryness, or they’re acidic or sweetened with sugar, any of which can increase the child’s risk for tooth decay or periodontal (gum) disease. Parents or caregivers should consult with their physicians about these medications or if they could be administered at mealtime to minimize their effect on the mouth.

Finally, there’s the direct effect some conditions may have on a child’s teeth and gums. Children with severe gag reflexes due to their condition may not be able to tolerate toothpaste or be able to spit it out completely. Other conditions can give rise to dental defects such as enamel hypoplasia in which not enough enamel develops to adequately protect the teeth.  Such defects call for special dental attention and closer monitoring of teeth and gum health.

The key is to see us and the other healthcare providers for your child’s chronic condition as part of an overall team. Sharing information and regarding both dental and general care as part of a comprehensive strategy will help to prevent dental problems from developing and improve their health.

If you would like more information on dental care for children with chronic 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 “Managing Tooth Decay in Children with Chronic Diseases.”

Your Child Isn’t in Danger from X-Rays Thanks to the ALARA Principle

YourChildIsntinDangerfromX-RaysThankstotheALARAPrinciple

Your child’s dental care wouldn’t be the same without x-ray imaging. It’s one of our best tools for finding and treating tooth decay.

But since x-rays emit radiation, is your child in any danger when they’re exposed?

X-rays, an invisible form of electromagnetic energy, will form images on exposed film after passing through the body. Because it takes longer for x-rays to pass through dense tissue like teeth and bones, the corresponding areas appear lighter on the film than less dense tissue like the gums. We can detect decay because the diseased tooth structure is less dense and thus appears darker against healthier tooth structure.

The downside of x-rays, though, is the radiation they emit could potentially alter cell structure and increase the risk of future cancer, especially with children. That’s why we follow a principle known as ALARA when using x-ray imaging. ALARA is an acronym for “as low as reasonably achievable,” meaning the doses for an x-ray session will be as low as possible while still gaining the most benefit.

Advances in technology, particularly the development of digital processing, has helped reduce the amount of radiation exposure. We’re also careful with what types of x-rays we use. The most common type is the bitewing, a device with the film attached to a long piece of plastic that the child holds in their mouth while biting down.

Depending on the number of our patient’s teeth, we can usually get a comprehensive view with two to four bitewings.  A typical bitewing session exposes them to less radiation than what they’re receiving from natural environmental background sources each day.

Keeping the exposure as low and as less frequent as possible greatly reduces health risks while still getting the full benefit of early decay detection. Still, if you have concerns about your child’s x-ray exposure, we’ll be happy to discuss our approach and all the precautions we take using x-ray imaging.

If you would like more information on x-ray diagnostics and your child, 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 “X-Ray Safety for Children.”