Friday, September 23, 2016

Any Time, Any Place: Cam Newton's Guide to Flossing

When is the best time to floss your teeth: Morning? Bedtime? How about: whenever and wherever the moment feels right?

For Cam Newton, award-winning NFL quarterback for the Carolina Panthers, the answer is clearly the latter. During the third quarter of the 2016 season-opener between his team and the Denver Broncos, TV cameras focused on Newton as he sat on the bench. The 2015 MVP was clearly seen stretching a string of dental floss between his index fingers and taking care of some dental hygiene business... and thereby creating a minor storm on the internet.

Inappropriate? We don't think so. As dentists, we're always happy when someone comes along to remind people how important it is to floss. And when that person has a million-dollar smile like Cam Newton's - so much the better.

Of course, there has been a lot of discussion lately about flossing. News outlets have gleefully reported that there's a lack of hard evidence at present to show that flossing is effective. But we would like to point out that, as the saying goes, "Absence of evidence is not evidence of absence." There are a number of reasons why health care organizations like the American Dental Association (ADA) still firmly recommend daily flossing. Here are a few:

  • It's well established that when plaque is allowed to build up on teeth, tooth decay and gum disease are bound to follow.
  • A tooth brush does a good job of cleaning most tooth surfaces, but it can't reach into spaces between teeth.
  • Cleaning between teeth (interdental cleaning) has been shown to remove plaque and food debris from these hard-to-reach spaces.
  • Dental floss isn't the only method for interdental cleaning... but it is recognized by dentists as the best way, and is an excellent method for doing this at home - or anywhere else!

Whether you use dental floss or another type of interdental cleaner is up to you. But the ADA stands by its recommendations for maintaining good oral health: Brush twice a day for two minutes with fluoride toothpaste; visit your dentist regularly for professional cleanings and checkups; and clean between teeth once a day with an interdental cleaner like floss. It doesn't matter if you do it in your own home, or on the sidelines of an NFL game... as long as you do it!

If you would like more information about flossing and oral hygiene, please visit our website at, or contact us here, or schedule an appointment for a consultation.

Keeping up Good Hygiene Still a Necessity with Dental Implants

Dental implants are widely considered the most durable tooth replacement option, thanks in part to how they attach to the jaw. But durable doesn't mean indestructible - you must take care of them.

Implants have a unique relationship to the jawbone compared to other restorations. We imbed a slender titanium post into the bone as a substitute for a natural tooth root. Because bone has a special affinity with the metal, it grows to and adheres to the implant to create a secure anchor. This unique attachment gives implants quite an advantage over other restorations.

It isn't superior, however, to the natural attachment of real teeth, especially in one respect: it can't match a natural attachment's infection-fighting ability. A connective tissue attachment made up of collagen fibers are attached to the tooth root protecting the underlying bone. An elastic gum tissue called the periodontal ligament lies between the tooth root and the bone and attaches to both with tiny collagen fibers. These attachments create a network of blood vessels that supply nutrients and infection-fighting agents to the bone and surrounding gum tissue.

Implants don't have this connective tissue or ligament attachment or its benefits. Of course, the implants are made of inorganic material that can't be damaged by bacterial infection. However, the gums and bone that surround them are: and because these natural tissues don't have these same biologic barriers to infection and perhaps access to the same degree of antibodies as those around natural teeth, an infection known as peri-implantitis specific to implants can develop and progress.

It's therefore just as important for you to continue brushing and flossing to remove bacterial plaque that causes infection to protect the gums and bone around your implants. You should also keep up regular office cleanings and checkups. In fact, we take special care with implants when cleaning them by using instruments that won't scratch their highly polished surfaces. Such a scratch, even a microscopic one, could attract and harbor bacteria.

There's no doubt dental implants are an excellent long-term solution for restoring your smile and mouth function. You can help extend that longevity by caring for them just as if they're your natural teeth.

If you would like more information on caring for dental implants, please visit our website at, or contact us here, 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."

Tuesday, September 6, 2016

Help Your Child Develop Good Oral Habits and Avoid Bad Ones

We all have habits: things we do every day often without consciously thinking. Some of them are good; some not so much. And many of them took root in childhood.

That's why it's important to help your child form good habits in their formative years, especially regarding oral health. Here are 4 areas to focus on developing good dental habits - and avoiding bad ones.

Keep teeth and gums clean. The best defense against dental disease is stopping plaque, a thin film of bacteria and food particles, from building up on tooth surfaces. That means brushing and flossing each day, along with regular dental cleanings and checkups. You should begin cleaning your child's teeth as soon as they appear in the mouth with a clean towel or rag at first and later brushing them. Eventually, teach your child to brush and floss for themselves. Dental visits should also begin around their first birthday.

A nutritious diet equals healthy teeth. The saying, "You are what you eat," is especially true about teeth. Help your child form a nutritious diet habit by providing meals rich in fresh fruits and vegetables, quality protein and dairy products. You should also restrict their sugar intake, a primary food for bacteria that cause tooth decay; try to limit sweets to mealtimes and avoid constant snacking.

Avoid habits with Hidden Dangers. Actually, this one is about you - and what you might be doing to increase your child's risk for dental disease. Avoid actions that increase the chances of transmitting oral bacteria from you to your infant, like kissing on the lips or licking a pacifier to clean it. You should also avoid giving your child night-time bottles or sippy cups filled with milk, formula or any sweetened liquid - likewise for pacifiers dipped in something sweet.

Steer them away from future bad habits. As children become teenagers, they're eager to stretch their wings. While this is normal and good, they can get into habits with dire consequences for oral health. You should by all means steer them away from tobacco use or oral piercings (tongue and lip bolts especially can wreak havoc on tooth structure) that can harm their teeth and gums.

If you would like more information on dental care for children, please contact us or schedule an appointment for a consultation. If you would like to learn more about this topic, please visit our website at, or contact us here, or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article "Dentistry & Oral Health for Children."

Topical Fluoride Adds Extra Protection against Tooth Decay

Protecting a child's primary ("baby") teeth from tooth decay should be a top priority. If one is lost prematurely due to decay, it could cause the permanent tooth to misalign when it comes in.

The basic prevention strategy for every child is daily brushing and flossing and regular dental visits. But children at higher risk for decay may need more: Â additional fluoride applied to teeth enamel during office visits.

This natural mineral has been shown to strengthen enamel, teeth's protective layer against decay, especially during its early development. Enamel is composed of calcium and phosphate minerals interwoven to form a crystalline structure called hydroxyapatite. Fluoride joins with this structure and changes it to fluorapatite, which is more resistant to mouth acid than the original structure.

We mostly receive fluoride through fluoridated drinking water and dental care products like toothpaste. Topical fluoride takes it a step further with a stronger dose than found in either of these sources. It can be applied with a foam, varnish or gel using an isolation tray (foam or gel) or painted onto the enamel (varnish or gel).

But does topical fluoride effectively reduce the occurrence of decay? Research indicates yes: a recent review of 28 studies involving over 9,000 children found an average 28% reduction in decayed teeth in children who underwent topical fluoride treatments.

There is, though, one potential side effect: children who swallow the fluoride substance can become sick and experience headache, stomach pain or vomiting. This can be avoided with proper precautions when applying it; the American Dental Association also recommends using only varnish for children younger than 6 years. It's also recommended that children receiving gel or foam not eat or drink at least thirty minutes after the treatment (those who receive the varnish aren't restricted in this way).

Topical fluoride is most effective as part of an overall prevention strategy. Besides daily hygiene and regular dental visits, you can also help reduce your child's decay risk by limiting the amount of sugar in their diet. Sealants, which are applied to the nooks and grooves of teeth where plaque can build up, may also help.

If you would like more information on fluoride gels and other clinical treatments to prevent tooth decay, please visit our website at, or contact us here, or schedule an appointment for a consultation.

Friday, September 2, 2016

How we Treat your Jaw Pain Depends on the Cause

Chronic jaw pain can make eating, speaking or even smiling difficult. What's more, finding the right treatment approach can be just as difficult.

This is because TMD (Temporomandibular Disorder: named for the joints on either side of the lower jaw) actually describes a wide range of possible problems with the joints and connecting muscles. Any of them can result in impaired jaw function, radiating pain or even headaches.

We'll need to conduct a full dental and facial exam to accurately diagnose your jaw pain's cause. Even then, the way may still not be clear: there's considerable debate among dentists about the best treatment approach. Two basic schools of thought prevail, one conservative and non-invasive and the other more aggressive and interventional.

The conservative approach seeks to alleviate symptoms in a variety of ways, including recommending softer foods to give muscles and joints time to relax, applying cold and heat to ease soreness, massage of the jaw joint muscles, gentle stretching and jaw exercises. We may also prescribe medications like ibuprofen and other non-steroidal anti-inflammatory drugs for pain and swelling relief, and sometimes muscle relaxers to reduce spasms. If your pain stems from clenching or grinding habits, we could fit you with a custom bite guard you wear while you sleep to reduce the forces on your teeth.

The more aggressive approach is much more invasive. These methods include altering the bite or teeth position with orthodontics or dental work or surgically altering the joints themselves or the shape of the jaw. If you're recommended one of these more aggressive treatments, you should know they're not commonly used to treat TMD and they're irreversible. There's also no guarantee you'll gain relief from your symptoms, so by all means get a second opinion before undergoing any procedures.

For most people the best course of treatment is to start with the least invasive techniques, which are usually very successful. If they don't relieve your pain and limited function, we may then consider escalating treatment to more irreversible procedures to help you find relief from this unwelcome condition.

If you would like more information on jaw joint pain and how to treat it, please contact us or schedule an appointment for a consultation. If you would like to learn more about this topic, please visit our website at, or contact us here, or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article "Seeking Relief from TMD."

Encourage Your Child to Stop Thumb Sucking by Age 4

There's something universal about thumb sucking: nearly all babies do it, and nearly all parents worry about it. While most such worries are unfounded, you should be concerned if your child sucks their thumb past age of 4 - late thumb sucking could skew bite development.

Young children suck their thumb because of the way they swallow. Babies move their tongues forward into the space between the two jaws, allowing them to form a seal around a nipple as they breast or bottle feed. Around age 4, this "infantile swallowing pattern" changes to an adult pattern where the tip of the tongue contacts the front roof of the mouth just behind the front teeth. At the same time their future bite is beginning to take shape.

In a normal bite the front teeth slightly overlap the bottom and leave no gap between the jaws when closed. Â But if thumb sucking continues well into school age, the constant pushing of the tongue through the opening in the jaws could alter the front teeth's position as they erupt. As a result they may not fully erupt or erupt too far forward. This could create an open bite, with a gap between the upper and lower teeth when the jaws are closed.

Of course, the best way to avoid this outcome is to encourage your child to stop thumb sucking before they turn four. If, however, they're already developing a poor bite (malocclusion), all is not lost - it can be treated.

It's important, though, not to wait: if you suspect a problem you should see an orthodontist for a full evaluation and accurate diagnosis. There are even some measures that could discourage thumb sucking and lessen the need for braces later. These include a tongue crib, a metal appliance placed behind the upper and lower incisors, or exercises to train the tongue and facial muscles to adopt an adult swallowing pattern. Often, a reward system for not sucking their thumbs helps achieve success as well.

Thumb-sucking shouldn't be a concern if you help your child stop before age 4 and keep an eye on their bite development. Doing those things will help ensure they'll have both healthy and straight teeth.

If you would like more information on Thumb sucking, please contact us or schedule an appointment for a consultation. If you would like to learn more about thumb sucking and how it affects the bite, please visit our website at, or contact us here, 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."

Friday, August 26, 2016

Implants can Support a Total Tooth Replacement Restoration

You may be familiar with a dental implant used to replace a single tooth - but implant technology can do much more. Implants can also support other restorations including total teeth replacement on a jaw.

The reason they're so versatile is because implants replace the tooth root as well as the visible crown. We use a metal post, usually made of titanium, which we surgically implant in the jawbone as a root substitute. Because of a special affinity with titanium, bone around the implant grows and adheres to it and creates a durable bond.

With a single tooth replacement (the implant's original purpose when they were introduced in the 1980s) we attach a life-like porcelain crown to the individual titanium post. But with their continuing development we've adapted implants for other applications, like using a few strategically-placed implants as a stable platform for removable dentures or fixed bridges.

We're now able to use implants to support and fix a full prosthetic (false) dental arch. Though similar in appearance to a removable denture, this particular prosthesis is permanently joined to the supporting implants with retaining screws.

Of course, the application requires careful pre-planning, which includes making sure you have enough healthy bone to support the implants. We'll also need to determine how many implants you'll need (usually four to six for this application) and create a surgical guide to place them in the best location for supporting the prosthesis. A dental technician will then create the prosthesis to match your jaw ridge contours and facial structure.

Using implants this way has a benefit other types of restorations can't provide: they may help stop future bone loss. The jawbone life cycle depends on stimulation from the attached tooth as you bite and chew - stimulation that ends when you lose the tooth. Traditional dentures and other restorations can't replicate that stimulation. Implants, on the other hand, directly encourage bone growth and can stop gradual bone loss.

If you need some form of total teeth replacement, consider one supported by implants. You may find they'll provide an excellent long-term solution to both function and appearance.

If you would like more information on the different applications for dental implants, please visit our website at, or contact us here, or schedule an appointment for a consultation.