Preventing tooth decay is mostly about the basics: daily brushing and flossing followed by regular dental cleanings and checkups. But there’s also a bigger picture: your own personal risk profile for decay based on factors you can modify directly — and those you can’t.
The first type of factor usually involves habits and behavior that either work with your mouth’s natural defenses to fight decay or against it. Besides regular hygiene, your diet is probably the most important of these you can modify for better dental health.
A diet rich in fresh vegetables, protein and dairy products boosts strong, healthy teeth resistant to decay. Conversely, bacteria thrive on the sugar in many snack foods, while sodas, sports or energy drinks elevate acid levels that soften and erode the minerals in your teeth’s enamel.
Lifestyle habits like tobacco use or excessive alcohol consumption also increase your decay risk. Not only do they promote plaque buildup (the thin film of bacteria and food particles that feeds the decay process), but tobacco especially can impede the body’s natural prevention and healing properties.
Conscientious hygiene practices, a dental-friendly diet and modified lifestyle habits all can help you prevent decay. But diligence may not be enough — there are other possible factors you can’t control or may find difficult to change. For example, you may have a genetic propensity toward certain bacteria that cause decay. You may have a condition like gastric reflux that increases the mouth’s acid level. You may also be taking medications that reduce saliva flow, the mouth’s natural acid neutralizer.
But if we know which of these indirect risk factors affect you, we can compensate with extra measures. If enamel strength is a problem we can topically apply fluoride; we can also reduce chronic bacterial levels with prescription rinses. If you have restricted saliva flow, we can attempt to modify your prescriptions through your doctor or prescribe aids that increase saliva.
The key is to investigate your complete risk factor profile through a thorough dental examination. Once we know everything about your mouth, life and health that increases your decay risk, we can put in place a balanced strategy of prevention and treatment just for you. Doing so will greatly increase your chances for keeping your teeth decay-free and healthy.
If you would like more information on preventing and treating 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 “Tooth Decay: How to Assess Your Risk.”
Although a variety of foods provide energy-producing carbohydrates, sugar is among the most popular. It’s believed we universally crave sugar because of the quick energy boost after eating it, or that it also causes a release in our brains of serotonin endorphins, chemicals which relax us and make us feel good.
But there is a downside to refined sugars like table sugar or high-fructose corn syrup: too much in our diets contributes to conditions like cardiovascular disease, diabetes, and dental disease. On the latter, sugar is a primary food source for oral bacteria; the more sugar available in the mouth the higher the levels of bacteria that lead to tooth decay and gum disease.
Moderating your intake of refined sugars and other carbohydrates can be hard to do, given that many processed foods contain various forms of refined sugar. A diet rich in fresh fruits and vegetables helps control sugar intake as well as contribute to overall health. Many people also turn to a variety of sugar substitutes: one study found roughly 85% of Americans use some form of it in place of sugar. They’re also being added to many processed foods: unless you’re checking ingredients labels, you may be consuming them unknowingly.
Sugar substitutes are generally either artificial, manufactured products like saccharin or aspartame or extractions from natural substances like stevia or sorbitol. The good news concerning your teeth and gums is that all the major sugar substitutes don’t encourage bacterial growth. Still, while they’re generally safe for consumption, each has varying properties and may have side-effects for certain people. For example, people with phenylketonuria, a rare genetic condition, can’t process aspartame properly and should avoid it.
One alcohol-based sweetener in particular is of interest in oral care. A number of studies indicate xylitol may actually inhibit bacterial growth and thus reduce the risk of tooth decay. You can find xylitol in a variety of gum and mint products.
When considering what sugar substitutes to use, be sure you’re up to date on their potential health effects for certain individuals, as well as check the ingredients labels of processed foods for added sweeteners. As your dentist, we’ll also be glad to advise you on strategies to reduce sugar in your diet and promote better dental health.
If you would like more information on your best options for sweeteners, 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 “Artificial Sweeteners.”
Let’s say you’re traveling to Italy to surprise your girlfriend, who is competing in an alpine ski race… and when you lower the scarf that’s covering your face, you reveal to the assembled paparazzi that one of your front teeth is missing. What will you do about this dental dilemma?
Sound far-fetched? It recently happened to one of the most recognized figures in sports — Tiger Woods. There’s still some uncertainty about exactly how this tooth was taken out: Was it a collision with a cameraman, as Woods’ agent reported… or did Woods already have some problems with the tooth, as others have speculated? We still don’t know for sure, but the big question is: What happens next?
Fortunately, contemporary dentistry offers several good solutions for the problem of missing teeth. Which one is best? It depends on each individual’s particular situation.
Let’s say that the visible part of the tooth (the crown) has been damaged by a dental trauma (such as a collision or a blow to the face), but the tooth still has healthy roots. In this case, it’s often possible to keep the roots and replace the tooth above the gum line with a crown restoration (also called a cap). Crowns are generally made to order in a dental lab, and are placed on a prepared tooth in a procedure that requires two office visits: one to prepare the tooth for restoration and to make a model of the mouth and the second to place the custom-manufactured crown and complete the restoration. However, in some cases, crowns can be made on special machinery right in the dental office, and placed during the same visit.
But what happens if the root isn’t viable — for example, if the tooth is deeply fractured, or completely knocked out and unable to be successfully re-implanted?
In that case, a dental implant is probably the best option for tooth replacement. An implant consists of a screw-like post of titanium metal that is inserted into the jawbone during a minor surgical procedure. Titanium has a unique property: It can fuse with living bone tissue, allowing it to act as a secure anchor for the replacement tooth system. The crown of the implant is similar to the one mentioned above, except that it’s made to attach to the titanium implant instead of the natural tooth.
Dental implants look, function and “feel” just like natural teeth — and with proper care, they can last a lifetime. Although they may be initially expensive, their quality and longevity makes them a good value over the long term. A less-costly alternative is traditional bridgework — but this method requires some dental work on the adjacent, healthy teeth; plus, it isn’t expected to last as long as an implant, and it may make the teeth more prone to problems down the road.
What will the acclaimed golfer do? No doubt Tiger’s dentist will help him make the right tooth-replacement decision.
If you have a gap in your grin — whatever the cause — contact us or schedule an appointment for a consultation, and find out which tooth-replacement system is right for you. You can learn more in the Dear Doctor magazine articles “Dental Implant Surgery” and “Crowns & Bridgework.”
Since the discovery a century ago of its beneficial effect on tooth enamel, fluoride has become an important part of tooth decay prevention. It's routinely added to toothpaste and other hygiene products, and many water utilities add minute amounts of it to their drinking water supplies. Although there have been questions about its safety, multiple studies over the last few decades have eased those concerns.
Children especially benefit from fluoride during their teeth's developing years. Some children are at high risk for decay, especially an aggressive form known as Early Childhood Caries (ECC). ECC can destroy primary (baby) teeth and cause children to lose them prematurely. This can have an adverse effect on incoming permanent teeth, causing them to erupt in the wrong positions creating a bad bite (malocclusion).
For children at high risk for decay, dentists often recommend applying topical fluoride directly to the teeth as added protection against disease. These concentrations of fluoride are much higher than in toothpaste and remain on the teeth for much longer. Topical applications have been shown not only to reduce the risk of new cavities, but to also stop and reverse early decay.
Children usually receive these applications during an office visit after their regular dental cleaning. There are three different ways to apply it: gel, foam or varnish. To prevent swallowing some of the solution (which could induce vomiting, headache or stomach pain) the dentist will often insert a tray similar to a mouth guard to catch any excess solution. Varnishes and a few gels are actually painted on the teeth.
The American Dental Association has intensely studied the use of topical fluoride and found its application can result in substantial decreases in cavities and lost teeth. They've concluded this benefit far outweighs the side effects from ingesting the solution in children six years and older. With proper precautions and waiting to eat for thirty minutes after an application, the possibility of ingestion can be reduced even further.
While topical fluoride can be effective, it's only one part of a good dental care strategy for your child. Consistent daily brushing and flossing, a nutritious diet low in added sugar, and regular dental visits still remain the backbone of preventive care.
We all experience the occasional bout of bad breath from dry mouth or after eating certain foods. Chronic halitosis, on the other hand, could have an underlying health cause like periodontal (gum) disease, sinus infections or even systemic illnesses like diabetes. Anyone with persistent halitosis should undergo a thorough examination to determine the root cause.
If such an examination rules out a more serious cause, it’s then possible the particular population of bacteria that inhabit your mouth (out of a possible 600 or more strains) and your body’s response makes you more susceptible to halitosis. After feeding on food remnants, dead skin cells or post-nasal drip, certain types of bacteria excrete volatile sulfur compounds (VSCs) that give off an odor similar to “rotten eggs.”
In this case, we want to reduce the bacterial population through plaque removal, which in turn reduces the levels of VSCs. Our approach then is effective oral hygiene and perhaps a few cleanings — the basics every person should practice for good oral health — along with a few extra measures specific to chronic halitosis.
This calls for brushing and flossing your teeth daily. This will remove much of the plaque, the main breeding and feeding ground for bacteria, that has accumulated over the preceding twenty-four hours. In some cases, we may also recommend the use of an interproximal brush that is more adept in removing plaque clinging to areas between the teeth.
You may also need to pay special attention in cleaning another oral structure contributing to your bad breath — your tongue. The back of the tongue in particular is a “hideout” for bacteria: relatively dry and poorly cleansed because of its convoluted microscopic structure, bacteria often thrive undisturbed under a continually-forming tongue coating. Simply brushing the tongue may not be enough — you may also need to use a tongue scraper, a dental device that removes this coating. (For more information, see the Dear Doctor article, “Tongue Scraping.”)
Last but not least, visit our office for cleanings and checkups at least twice a year. Professional cleanings remove bacterial plaque and calculus (hardened plaque deposits) you’re unable to reach and remove with daily hygiene measures. Following this and the other steps described above will go a long way toward eliminating your bad breath, as well as enhancing your total oral health.
If you would like more information on treating chronic bad breath, 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 “Bad Breath: More Than Just Embarrassing.”
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