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Posts for category: Oral Health

MinimallyInvasiveDentistryANewApproachtoPreventingandTreatingDecay

Since the late 19th Century, dentists have used established protocols to successfully prevent and treat tooth decay. But there've been changes to this approach the last few years to improve its effectiveness, changes we now refer to as Minimally Invasive Dentistry or MID.

The older approach for treating dental caries (tooth decay) follows the protocols established by Dr. G.V. Black, considered the father of modern dentistry. Black advocated removing not only decayed structure but also some of the healthier but vulnerable portions of a tooth, to avoid further decay and make the tooth easier to clean. This resulted in larger fillings, although they've become smaller as dental techniques have advanced.

MID, on the other hand, aims to remove as little tooth structure as possible while still effectively treating and preventing future decay. To achieve that goal we begin first with a complete assessment of a patient's individual decay risk, known as Caries Management By Risk Assessment (CAMBRA).

With CAMBRA, we're looking at other factors besides individual tooth health: a patient's hygiene, lifestyle and dietary habits; the types and amount of bacteria present; and the quality of saliva flow, needed to neutralize mouth acid. With these the results we develop a customized prevention and treatment strategy.

MID also focuses on detecting dental caries as early as possible. Besides traditional x-rays, we're beginning to use other methods like dental microscopes, laser fluorescence, infrared photography or optical scanning. Early detection leads to early intervention, and with techniques that are much less invasive than the traditional approach.

The new approach also changes how we repair decayed teeth. We're increasingly using air abrasion, a technology that uses fine particles in a pressurized air stream to remove softer decayed tooth material and less healthy structure than the traditional dental drill. We're also using composite resin and other advanced materials for filings: these tooth-colored materials are stronger than previous versions and are quickly taking the place of metal amalgam, requiring less structural removal to accommodate them.

MID's core principles are early disease detection, proactive prevention and treatment with less structural removal. With this enhanced approach to effective dentistry, we're keeping your teeth healthy with minimal discomfort, lower costs and less long-term impact.

If you would like more information on the benefits of the MID approach, please contact us or schedule an appointment for a consultation.

ActorDavidRamseyDiscussesBabyBottleToothDecay

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.”

DontForgetHiddenFluorideSourcesYourFamilyCouldbeIngesting

In the last half century, fluoride has become an effective weapon against tooth decay. The naturally occurring mineral helps strengthen enamel, the teeth's hard, protective cover.

Although it's safe for consumption overall, too much during early tooth development can lead to fluorosis, a brownish, mottled staining in enamel. To avoid it, a child's daily consumption of fluoride should optimally be kept at around 0.05-0.07 milligrams per kilogram of body weight, or an amount equal to one-tenth of a grain of salt per two pounds of weight.

The two main therapeutic fluoride sources have limits to help maintain this balance: utilities that fluoridate drinking water are required to add no more than 4 parts fluoride per million (ppm) of water; toothpaste manufacturers likewise only add a small amount of fluoride compared to clinical gels and pastes dentists apply to teeth for added decay protection.

But drinking water and toothpaste aren't the only sources of fluoride your child may encounter. Even if you have a non-fluoridated water supply, you should still keep a close watch on the following items that could contain fluoride, and discuss with us if you should take any action in regard to them.

Infant formula. The powdered form especially if mixed with fluoridated water can result in fluoride concentrations 100 to 200 times higher than breast or cow's milk. If there's a concern, use fluoride-free distilled or bottled spring water to mix formula.

Beverages. Many manufacturers use fluoridated water preparing a number of packaged beverages including sodas (two-thirds of those manufactured exceed .6 ppm), soft drinks and reconstituted fruit juices. You may need to limit your family's consumption of these kinds of beverages.

Certain foods. Processed foods like cereals, soups or containing fish or mechanically separated chicken can have high fluoride concentrations, especially if fluoridated water was used in their processing. When combined with other fluoride sources, their consumption could put children at higher risk for fluorosis.

Toothpaste. Although mentioned previously as a moderate fluoride source, you should still pay attention to how much your child uses. It doesn't take much: in fact, a full brush of toothpaste is too much, even for an adult. For an infant, you only need a smear on the end of the brush; as they grow older you can increase it but to no more than a pea-sized amount.

If you would like more information on fluoride and how it strengthens 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 “Fluoride & Fluoridation in Dentistry.”

By Stewart Dental
June 28, 2016
Category: Oral Health
NoGleeinToothGrinding

Sure, it’s big news when celebs tweet selfies from the dental office… if you’re still living in the 20th century. But in Hollywood today, it’s harder to say who hasn’t posted snaps of themselves in the dentist’s chair than who has. Yet the pictures recently uploaded to Twitter by Mark Salling, the actor and singer who regularly appears as Noah “Puck” Puckerman on the popular TV series Glee, made us sit up and take notice.

“Getting my chipped tooth fixed. Also, apparently, I’m a big grinder,” read the caption. The photo showed a set of upper front teeth with visible chips on the biting surface. What’s so special about this seemingly mundane tweet? It’s a great way of bringing attention to a relatively common, but often overlooked problem: teeth clenching and grinding, also called bruxism.

Although bruxism is a habit that affects scores of people, many don’t even realize they have it. That’s because the condition may only become active at night. When the teeth are unconsciously ground together, the forces they produce can wear down the enamel, cause chipping or damage to teeth or dental work (such as veneers or fillings), or even loosen a tooth! While it’s common in children under 11 years old, in adults it can be a cause for concern.

Sometimes, mouth pain, soreness and visible damage alert individuals to their grinding habits; other times, a dental professional will notice the evidence of bruxism during an exam or cleaning: tooth sensitivity and telltale wear and tear on the chewing surfaces. Either way, it’s time to act.

Bruxism is most often caused by stress, which can negatively impact the body in many ways. It may also result from bite problems, the overuse of stimulating substances (caffeine, alcohol, tobacco, and illegal drugs), and as a side effect of certain medications. Sometimes, simply becoming aware of the habit can help a person get it under control. Common methods of stress reduction include exercise, meditation, a warm bath or a quiet period before bedtime; these can be tried while we monitor the situation to see if the problem is going away.

If stress reduction alone doesn’t do the trick, several other methods can be effective. When bruxism is caused by a minor bite problem, we can sometimes do a minor “bite adjustment” in the office. This involves removing a tiny bit of enamel from an individual tooth that is out of position, bringing it in line with the others. If it’s a more serious malocclusion, orthodontic appliances or other procedures may be recommended.

When grinding is severe enough to damage teeth or dental work, we may also recommend a custom-made night guard (occlusal guard), which you put in your mouth at bedtime. Comfortable and secure, this appliance prevents your teeth from being damaged by contacting each other, and protects your jaw joints from stresses due to excessive grinding forces.

Whether or not you have to smile for a living, teeth grinding can be a big problem. If you would like more information about this condition, call our office to schedule a consultation for a consultation.

PrudentUseofX-RaysinChildrenProvidesthemostBenefitattheLowestRisk

It’s important for your child’s current and future health that we watch out for tooth decay. Taking x-rays is a critical part of staying one step ahead of this common disease.

But while x-ray imaging is commonplace, we can’t forget it’s still a form of radiation that could be potentially harmful, especially for a child whose tissues are rapidly developing. We must, therefore, carefully weigh the potential benefits against risk.

This concern has given birth to an important principle in the use of x-rays known as ALARA, an acronym for “As Low As Reasonably Achievable.” In basic terms, we want to use the lowest amount of x-ray energy for the shortest period of time to gain the most effectiveness in diagnosing tooth decay and other conditions.

A good example of this principle is a common type of radiograph known as a bitewing. The exposable x-ray film is attached to a plastic devise that looks like a wing; the patient bites down on it to hold it in place while the x-ray exposure takes place. Depending on the number of teeth in a child’s mouth, an appointment usually involves 2 to 4 films, and children are typically spaced at six months apart. Frequency of x-rays depends on your child’s tooth decay risk: lower risk, less need for frequent intervals.

Each bitewing exposes the child to 2 microsieverts, the standard unit for radiation measurement. This amount of radiation is relatively low: by contrast, we’re all exposed to 10 microsieverts of background radiation (natural radiation occurring in the environment) every day or 3,600 microsieverts annually. Even two appointments of four bitewings each year is a fraction of a percent of the background radiation we’re exposed to in the same year.

This conservative use of x-rays is well within safe parameters for children. As x-ray technology continues to advance (as with the development of digital imaging) we anticipate the exposure rate to diminish even more. Prudently used, x-rays remain one of our best tools for ensuring your child’s teeth are healthy and developing normally.

If you would like more information on the use of x-rays with children, 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.”