Cosmetic Procedures

Bonding

An alternative to veneers is a process called bonding, in which a tooth-colored material that looks like the enamel of your teeth is molded and shaped, and then hardened and polished. Bonding can be used to improve the color of a tooth, or close unsightly gaps.
Bonding is generally not as permanent a process as veneers, and can be vulnerable to the same kind of staining your natural teeth are prone to. Bonding can also be more prone to chips and cracks than veneers.
Caps are generally preferred to bonding when such a procedure isn’t deemed to be effective in the long run.

Crowns & Bridges

Crowns
Crowns are synthetic caps, usually made of a material like porcelain, placed on the top of a tooth.
Crowns are typically used to restore a tooth’s function and appearance following a restorative procedure such as a root canal. When decay in a tooth has become so advanced that large portions of the tooth must be removed, crowns are often used to restore the tooth.
Crowns are also used to attach bridges, cover implants, prevent a cracked tooth from becoming worse, or an existing filling is in jeopardy of becoming loose or dislocated. Crowns also serve an aesthetic use, and are applied when a discolored or stained tooth needs to be restored to its natural appearance.
Procedures
A tooth must usually be reduced in size to accommodate a crown. An impression is made of the existing tooth and an impression is made. The impression is sent to a special lab, which manufactures a custom-designed crown. In some cases, a temporary crown is applied until the permanent crown is ready. Permanent crowns are cemented in place.
Crowns are sometimes confused with veneers, but they are quite different. Veneers are typically applied only to relatively small areas.
Caring For Your Crowns
With proper care, a good quality crown could last up to eight years or longer. It is very important to floss in the area of the crown to avoid excess plaque or collection of debris around the restoration.
Certain behaviors such as jaw clenching or bruxism (teeth grinding) significantly shorten the life of a crown. Moreover, eating brittle foods, ice or hard candy can compromise the adhesion of the crown, or even damage the crown.

Bridges

Bridges are natural-looking dental appliances that can replace a section of missing teeth. Because they are custom-made, bridges are barely noticeable and can restore the natural contour of teeth as well as the proper bite relationship between upper and lower teeth.

Bridges are sometimes referred to as fixed partial dentures, because they are semi-permanent and are bonded to existing teeth or implants. Some bridges are removable and can be cleaned by the wearer; others need to be removed by a dentist.

Porcelain, gold alloys or combinations of materials are usually used to make bridge appliances.

Appliances called implant bridges are attached to an area below the gum tissue, or the bone.

Cosmetic Fillings

There are alternative, natural-looking materials to conventional silver-colored fillings – materials made from porcelain and composite resins, which are colored to match natural tooth enamel. Unfortunately, few materials can match the strength and durability of dental amalgam and such, may need more frequent replacement. Common amalgam alternatives include:

  • Composite fillings — As stated, composite fillings are just what the name implies: a mixture of resins and fine particles designed to mimic the color of natural teeth. While not as strong as dental amalgam, composite fillings provide a pleasing aesthetic alternative. Sometimes, composite resins need to be cemented, or bonded to a tooth to allow for better adhesion.
  • Ionomers — Like composite resins, these materials are tooth-colored. Ionomers are made from a combination of various materials, including ground glass and acrylic resins. Ionomers are typically used for fillings near the gum line or tooth root, where biting pressure is not a factor. They are more fragile than dental amalgam, however. A small amount of fluoride is released by these compounds in order to facilitate strengthened enamel in the affected area.
  • Porcelain (ceramic) — This material is usually a combination of porcelain, glass powder and ceramic. Candidates for porcelain fillings are typically crowns, veneers and onlays and inlays. Unlike ionomers, porcelain fillings are more durable but can become fractured if exposed to prolonged biting pressures.

Implants

Before development of dental implants, dentures were the only alternative to replacing a missing tooth or teeth. Implants are synthetic structures that are placed in the area of the tooth normally occupied by the root. Implants are anchored to the jawbone or metal framework on the bone and act as a foundation for an artificial tooth or permanent bridge. In some cases, implants can be used to attach dentures.

Not everyone is a candidate for a dental implant. For a successful implant to take hold, a candidate must have proper bone density and have a strong immune system.

In general, good candidates who have dental implants can expect high success rates with the procedure.

The procedure can take several visits. During the first visit, an anchor is placed into the jawbone and the site is allowed to heal for several weeks or months. This gives your tissue time to grow around the anchor to more firmly hold it in place.

During a follow-up visit, an artificial, natural-looking tooth is fitted over the implanted anchor.

Types of implants

Various types of implants include full upper and lower, anterior, posterior, and single-tooth:

Full upper replacements

The upper set of teeth is replaced with implants. Procedure steps include:

  • Missing tooth roots are replaced with implants, which are covered under the gum line.
  • A healing period of up to six months allows implants to take.
  • The implants are uncovered and extensions attached.
  • Replacement teeth are affixed to the implants and extensions.

In some cases, full upper replacements can be removed.

Anterior replacement

Implants are used to replace the front teeth (also called incisors and cuspids). Procedure steps include:

  • Missing tooth roots are replaced with implants, which are covered under the gum line.
  • A healing period of up to six months allows implants to take.
  • The implants are uncovered and extensions attached.
  • Replacement teeth are affixed to the implants and extensions.

Full lower replacement

The lower set of teeth is replaced with implants. Full lower replacement usually only uses four to six implants (near the front), which are used to anchor a denture. This obviates the need for denture adhesive.

Posterior replacement

Implants are used to replace the bicuspids and molars (the back teeth). Procedure steps include:

  • Missing tooth roots are replaced with implants, which are covered under the gum line.
  • A healing period of up to six months allows implants to take.
  • The implants are uncovered and extensions attached.
  • Replacement teeth are affixed to the implants and extensions.

Single tooth replacement

Procedure steps include:

  • Missing tooth root is replaced with an implant, which remains covered under the gum line.
  • A healing period of up to six months allows the implant to take.
  • The implant is uncovered and an extension attached.
  • Replacement tooth is affixed to the implant and extension.

Invisalign

Invisalign’s® invisible, removable, and comfortable aligners will give you the beautiful straight teeth you’ve always wanted. And best of all, no one can tell you’re wearing them. Invisalign is great for adults and teenagers.

What is Invisalign®?

  • Invisalign® is the invisible way to straighten your teeth without braces.
  • Invisalign® uses a series of clear, removable aligners to straighten your teeth without metal wires or brackets
  • Invisalign® has been proven effective in clinical research and in orthodontic practices nationwide.

How Does Invisalign® Work?

  • You wear each set of aligners for about 2 weeks, removing them only to eat, drink, brush, and floss.
  • As you replace each aligner with the next in the series, your teeth will move little by little, week by week – until they have straightened to the their final position
  • You’ll visit us about once every 6 weeks to ensure that your treatment is progressing as planned.
  • Total treatment time averages 9 – 15 months and the average number of aligners during treatment is between 18 – 30, but both will vary from case to case.

How Are Aligners Made? You’d Be Amazed…

  • The aligners are made through a combination of our expertise and 3-D computer imaging technology.

Oral Health Topics

Flouride

For decades, fluoride has been held in high regard by the dental community as an important mineral that is absorbed into and strengthens tooth enamel, and thereby helping to prevent decay of tooth structures.

In nearly every U.S. community, public drinking supplies are supplemented with sodium fluoride because the practice is acknowledged as safe and effective in fighting cavities.

Some private wells may contain naturally fluoridated water.

Fluoride has come under some recent scrutiny by public health officials, some of whom question how effective it is in preventing cavities.

Bottled Water and Home Water Treatment Systems

The American Dental Association has maintained that consistent use of bottled water could result in individuals missing the benefits of optimally fluoridated water. Moreover, the ADA has held that some home water treatment systems change fluoridated water supplies for the worse.

Enamel Fluorosis

According to the American Academy of Pediatric Dentistry, a child may face a condition called enamel fluorosis if he or she gets too much fluoride during the years of tooth development. Too much fluoride can result in defects in tooth enamel.

Water Fluoridation

If you’re wondering how fluoridated your community’s water supply is, chances are you can get the latest information by visiting the Centers for Disease Control and Prevention (CDC) web site.

A feature called “My Water’s Fluoride” allows consumers to check out basic information about their water system, including the number of people served by the system and the target fluoridation level. Optimal levels recommended by the U.S. Public Health Service and CDC for drinking water range from 0.7 parts per million (ppm) for warmer climates to 1.2 ppm for cooler climates to account for the tendency for people to drink more water in warmer climates.

Toothpaste Warning Labels

The American Dental Association has stated that the FDA-required warning labels on toothpaste packaging, which state that poison control centers should be contacted if one swallows fluoride toothpaste, “could unnecessarily frighten parents and children, and that the label greatly overstates any demonstrated or potential danger posed by fluoride toothpastes.”

The Preventitive Program

Both natural teeth and teeth with restorations survive best in an oral environment that is clean and where the intake of harmful foods is controlled. Our program is designed to help prevent new cavities, preserve teeth that have been restored and manage periodontal disease. At the initial visit oral hygiene instructions are reviewed and are reinforced at subsequent recall visits. The following are helpful recommendations:

  1. Brush your teeth twice a day in a circular motion with a soft bristled toothbrush aimed at the gum
  2. Floss every night in an up and down motion while keeping the floss in a U-shape and against the tooth surface
  3. Avoid smoking
  4. Avoid sticky sugary foods
  5. Eat a balanced diet
  6. Use antiseptic and fluoride rinses as directed
  7. Sealants placed on young permanent teeth

Tobacco

What effects can smoking have on my oral health? Are cigars a safe alternative to cigarettes? Are smokeless tobacco products safe? The American Dental Association has some alarming news that you should know on its web site at www.ada.org.

The American Dental Association states that it “has long been a leader in the battle against tobacco-related disease, working to educate the public about the dangers inherent in tobacco use and encouraging dentists to help their patients break the cycle of addiction. The ADA has continually strengthened and updated its tobacco policies as new scientific information has become available.”

Oral Piercing

Oral piercing (usually on the tongue or around the lips) is one of the more disturbing fashion trends in recent years. Many people fail to realize that that even precautions taken during the installation of a piece of piercing jewelry are not enough to stave off harmful, long-term consequences such as cracked or chipped teeth, swelling, problems with swallowing and taste, and ugly scars. Add to this the possibility of choking on a piece of dislodged jewelry and one has to ask if the risks are warranted.

But the most serious long-term health problems from oral piercing come in the form of damage to the soft tissues such as the cheeks, gums and palate, as well as opportunistic infections. Any kind of body piercing may also put you at risk of contracting deadly infectious diseases such as HIV and hepatitis.

A common form of body piercing involves the tongue. Tongue piercings have been known to cause blocked airways (from a swollen tongue). In some cases, a tongue piercing will cause uncontrolled bleeding.

Some states actually regulate or ban oral piercing, so ensure that you are not breaking any laws.

TMJ

What is TMJ/TMD?

The temporomandibular joint (TMJ) is the joint connecting the lower jaw (mandible) to the skull (temporal bone). The lower jaw and the skull are connected by a number of muscles and ligaments, which function in harmony with each other if the lower jaw is in the correct position. The head of the jaw bone (lower jaw) is called the condyle and it fits into the concavity of the temporal bone called the glenoid fossa. The TM joint resembles a ball and socket with the round condyle being the ball and the glenoid fossa of the temporal bone being the socket. For normal joint function to occur, a piece of cartilage called an articular disc acts as a cushion or shock absorber between the two bones.

When the lower jaw opens and closes, the disc stays between the condyle and the glenoid fossa of the temporal bone at all times. When this happens, this is a normal healthy TMJ and the patient can open wide without any discomfort and without any noise. With a normal opening, the patient should be able to get three fingers between the upper and lower front teeth when the mouth is open as wide as possible. In cases where the TM joint is functioning normally with the disc in the proper position, the muscles of the head, neck and shoulders function relatively pain-free.

What is TMD?

Temporomandibular disorder (TMD) is the condition referring to a joint that is not normal.

The position of your teeth can affect the position of your jaw joints. Each jaw joint is a ball and socket joint. When functioning properly, the ball and socket do not actually touch because a thin disc of cartilage rides between them. The disc acts as a cushion and allows the joint to move smoothly. Each disc is held in place and guided by muscles and ligaments. If your bite is not right, as in cases where the following may occur: deep overbite, lower jaw too far back, narrow upper jaw or upper front teeth crooked and tipped backwards, this can cause the jaw to become dislocated. Typically the disc is pulled forward. The lower jaw then has a tendency to go back too far and the top of the lower jaw, which resembles a ball (condyle), presses on the nerves and blood vessels at the back of the socket and causes pain.

Usually, the protective disc (cartilage) is displaced forward and no longer serves as a cushion between the condyle (lower jaw) and the bony socket (skull) and eventually this can lead to the condyle rubbing against the bony socket. This can cause a problem called osteoarthritis.

Mild displacements cause a clicking or popping sounds in the jaw joint.

When the disc becomes displaced, this is what causes the various noises within the jaw joints such as clicking and popping sounds. Patients must be aware that any noises or pain that occur during the opening and closing of the jaw is an indication that the jaw joints have become dislocated. Patients are advised to seek treatment as soon as possible to avoid allowing the problem to get worse.

More severe displacement can be very painful and eventually can cause permanent damage to the joint. An unstable bite can cause both jaw joint displacement and muscle strain and pain. Many seemingly unrelated symptoms results, which are collectively known as craniomandibular dysfunction. These symptoms include headaches, neck aches, ringing in the ears, stuffiness in the ears, pain behind the eyes, ear pain, shoulder and lower back pain, dizziness and fainting, difficulty swallowing, and tingling of the fingers and hands. These symptoms include:

  • Headaches
  • Neck aches
  • Ringing in the ears
  • Stuffiness in the ears
  • Pain behind the eyes
  • Ear pain
  • Shoulder and lower back pain
  • Dizziness and fainting
  • Difficulty swallowing
  • Tingling of the fingers and hands

Symptons of TMJ

TMJ disorders have been called the “Great Impostors” due to the fact that many of the symptoms have overlapping characteristics, which often mimic other conditions. Because these symptoms masquerade so many other conditions, many people travel from medical doctor to medical specialist in search of a cure. Most patients never think to contact a dentist since the symptoms are primarily medical in nature.

TMJ symptoms may include any of the following:

  • Headaches
  • Earaches, congestion or ringing in the ears
  • Clicking, popping or grating sounds when opening and closing the mouth
  • Limited jaw opening or locking
  • Neck pain or stiffness
  • Dizziness and fainting
  • Pain when chewing
  • Facial pain
  • Difficulty closing the teeth together
  • Tired jaws when chewing
  • Numbness in hands
  • Difficulty in swallowing

Signs that you may have a TMJ problem:

  1. Clenching and grinding of the teeth (bruxism) is a common sign of TMJ disorder. The clenching and grinding of the teeth put additional stress on already tired, overworked muscles and can result in pain being referred to the head, neck, face, shoulder or back.
  2. Headaches are one of the most common complaints of TMJ sufferers and these headaches are frequently so severe they can be confused with migraine headaches. TMJ headaches are most often felt in the temple area, behind the eyes and at the back of the head with pain radiating to the neck and shoulders. Migraine headaches are mainly on one side with the patient suffering from visual disturbances and being extremely sensitive to light. The treatment for migraine headaches is much different from headaches caused by dislocated joints.
    If you suspect a migraine headache, then a referral should be made to a neurologist. If the TMJ (jaw joint) is the problem, a referral should be made to a dentist or dental specialist with training in the diagnosis and treatment of these disorders. An excellent reference for dentists experienced in the treatment of patients with TM joint disorders would be to consult the website of the American Academy of Craniofacial Pain.
  3. One of the most common signs of a TMJ problem is a jaw joint making noise such as clicking, popping or grating sounds. This clicking sound occurs when the condyle (top of the lower jaw) moves forward when the patient opens the mouth and the condyle slips on and off the dislocated disc. The grating sound, called crepitus, is the sound of bone rubbing on bone and occurs later on when the dislocated discs become completely deformed. The purpose of the disc is to act like a protective cushion between the two bones of the lower jaw (condyle) and the skull (glenoid fossa). When the protective disc is permanently dislocated or distorted, the two bones contact each other and this causes loud noises, which are referred to as crepitus.
    Another sign of TM joint dysfunction occurs when the jaw either locks open or closed. Our objective in the treatment of TMJ disorders is to try and correct the problem of the dislocated disc early when the jaw is clicking and not wait until the later stages when the grating sound is louder and the patient may experience an extremely painful situation if the jaw locks open or closed.
  4. If the patient suffers from ear pain, ringing or buzzing in the ears, fullness or a stuffy feeling without any ear infection, then this could be related to a structural problem within the TM joint. Other symptoms include a loss of hearing, dizziness and loss of balance. If the condyle is too far back and the disc dislocated forward, this can cause some of the muscles of mastication to go into spasm which can cause any of the symptoms as mentioned above. If your medical doctor or ENT (ear, nose and throat) specialist can find no apparent reason for the ear problems, these patients should be referred to a dentist with training in the diagnosis and treatment of patients with these problems.
  5. Sleep disturbances are common in patients suffering from dislocated jaw joints. The brain frequently does not allow the patient to reach the deep stages of sleep and they are awakened many times during the night. The patient does not awaken feeling well rested and refreshed, but rather they often feel tired and listless with an obvious lack of energy to face the new day. Often, the reason the patient cannot sleep is that they are awakened due to the pain they are suffering from severe muscle contractions, muscle spasms and trigger points caused by the dislocated jaw joints or clenching and bruxing habits.
  6. Depression is another common sign of patients who suffer from TM joint dysfunction for an extended period of time. These patients suffer constantly from chronic pain with no obvious solution in sight. Depression is a problem for both the medical and dental profession to try and solve. If the pain is originating from a tumor (very rare), an infection, systemic disease, nutritional deficiency, allergies or traumatic injuries, then the medical profession should be consulted. However, if the problem is a dislocated jaw or clenching or grinding habits causing TM joint pain, a properly trained member of the dental profession should be involved in the diagnosis and treatment.

If you have any of the above symptoms, you could possibly have a problem with your jaw (TMJ).

Self Assement Test

Here are a few questions you may want to ask yourself, to help determine if you have any symptoms:

Do you get an unusual amount of headaches? Y N
Do you have a grating, clicking or popping sound in either or both jaw joints, when you chew or open and close your mouth? Y N
Do you have pain or soreness in any of the following areas: jaw joints, upper jaw, lower jaw, side of neck, back of head, forehead, behind the eyes or temples? Y N
Do you have sensations of stuffiness, pressure or blockage in your ears? Is there excessive wax buildup? Y N
Do you ever have ringing, roaring, hissing or buzzing sounds in your ears? Y N
Do you ever feel dizzy or faint? Y N
Do your fingers, hands or arms sometimes tingle or go numb? Y N
Are you tired all the time, fatigue easily or consider yourself chronically fatigued? Y N
Are there imprints of your teeth on the sides of your tongue? Y N
Does your tongue go between your teeth when you swallow? Y N
Do you have difficulty in chewing your food? Y N
Do you have any missing back teeth? Y N
Do you clench your teeth during the day or at night? Y N
Do you grind your teeth at night? (Ask your family.) Y N
Do you ever awaken with a headache? Y N
Have you ever had a whiplash injury? Y N
Have you ever experienced a blow to the chin, face or head? Y N
Have you reached the point where drugs no longer relieve your symptoms? Y N
Does chewing gum worsen your symptoms? Y N
Is it painful to stick your “pinky” fingers into your ears with your mouth open wide and then close your mouth while pressing forward with your “pinky” fingers? Y N
Does your jaw slide to the left or right when you open wide? (Look in a mirror.) Y N
Are you unable to insert your first three fingers vertically into your mouth when it is open wide? Y N
Is your face crooked and not symmetrical? Y N

If you answered yes to some of these symptoms, you may have a TMJ disorder (TMD) Consult your dentist for an examination.

Here are some ways you can visually check your TM joint:

  • Put your fingers inside your ears. Open and close several times. If the jaw clicks or cracks, or if you feel a grinding sensation.
  • While looking in a mirror, open very slowly, notice whether or not your jaw swings to one side while opening and closing. Is there any pain present?
  • Slide your jaw from side to side, make note of any pain you may experience.

Check for muscle sensitivity:

Place your fingers in front of your ears on the joint and apply pressure.

  • Also apply pressure to the cheek area
  • If you notice discomfort or pain have your jaw joint checked by a dentist who treats patients with jaw joint disorders!

Tooth Care

What is Tooth Decay?

Plaque is an insidious substance-a colorless, sticky film that blankets your teeth and creating an environment in which bacteria erode tooth enamel, cause gum irritation, infection in inner structures such as pulp and the roots, and in extreme cases, tooth loss.

Some of the biggest culprits causing plaque are foods rich in sugar and carbohydrates, including soda beverages, some juices, candy and many kinds of pasta, breads and cereals.

Plaque also can attack fillings and other restorations in your mouth, which can lead to more costly treatment down the road.

Plaque is one of the biggest causes for tooth decay. It also causes your gums to become irritated, inflamed, and in some cases, bleed. Over time, the decay process may cause your gums to pull away from your teeth, a condition called receding gums. In addition, the long-term decay process can lead to infections in your gums and can eat away at the bone structures under the teeth.

Inside your teeth, decay can gradually destroy the inner layer, or dentin, the pulp, which contains blood vessels, nerves and other tissues, and the root.

Periodontal disease is advanced gum disease. This serious condition occurs when the structures that support your teeth-the gums, the bone, break down from the infection. Pain, hypersensitivity and bleeding are some of the signs of periodontal disease.

Simple Preventative Measures

The two best defenses against tooth decay and gum disease are a healthy, well-balanced diet and good oral hygiene, including daily brushing with fluoride toothpaste, flossing and rinsing. Most public drinking water contains fluoride, but if you are unsure of your water supply, then use a good quality mouth rinse containing fluoride.

A good way to help your oral health between brushing is chewing sugarless gum; this stimulates your body’s production of saliva, a powerful chemical that actually neutralizes plaque formation and rinses decay-causing food particles and debris from your mouth.

In some cases, our office can prescribe anti-cavity rinses or apply special anti-cavity varnishes or sealants to help fight decay.

Brushing

Brushing is the best way to remove cavity-causing plaque and other debris from your teeth.

Plaque, a colorless, sticky substance, reacts with the bacteria and decaying food particles in your mouth and when left on the teeth long enough, begins to erode the enamel.

It is recommended that you brush your teeth three times a day, usually after meals and before bedtime.

Techniques

How long you spend brushing your teeth is as critical as how often you brush your teeth.

Here are some technique tips for brushing:

  • Many people simply brush for a few seconds, spit, and place the toothbrush back in the cup. It is very important to spend at least 2-3 minutes brushing your teeth. This helps to ensure that the brush doesn’t miss hard-to-reach or often neglected surfaces.
  • Use short, circular motions and brush at a 45-degree angle.
  • Brush all surfaces of your teeth-the sides and chewing surfaces-as well as the lower portions near the gum line.
  • Gently brush other areas of your mouth, including your gums, tongue and “roof” of your mouth. These can be prime areas for bacteria to hide.
  • Choose toothbrushes with soft, round-headed bristles Avoid big-headed toothbrushes. Dental associations recommend that you buy a toothbrush with a compact head-1″ by 1/2″-so you can easily reach the small areas of your mouth.
  • Some toothbrushes today have wide handles. This helps you control the toothbrush better. So, choose a toothbrush with a handle that is long enough and wide enough for you to handle.
  • You should replace your toothbrush at least four times a year – more often if you have been sick.

Flossing

What Is Flossing?

Floss comes in a variety of materials and colors, but essentially, it is a very thin cord you hold between fingers of each hand and insert between adjoining teeth. The cord, or floss, helps loosen debris by gently moving it up and down and back and forth between the teeth.

Flossing is a proven method for loosening debris from hard-to-reach surfaces of your teeth and gum lines. Next to brushing, flossing is a highly effective method for removing plaque on tooth surfaces your brush can’t reach very well.

Another benefit of flossing is increasing blood circulation in your gums. Gum stimulation is a necessary means of keeping your gum tissues healthy; strong gums are the foundation of your teeth.

How Often To Floss

Our office recommends that you practice flossing once a day. Many people find that flossing at night is an easy bedtime routine; moreover, nighttime flossing helps to protect your teeth during sleep, when harmful plaque can do a lot of damage.

Types of Floss

Dental floss comes in a variety of materials, colors, and even flavors. Waxed varieties are slipperier, allowing people with extremely tight spaces between their teeth to floss more easily. Popular flavors of floss include wintergreen and cinnamon. Waxed floss does tend to fray more than unwaxed floss.

A type of material called wide floss can be effective for people with large spaces between their teeth, or for people with delicate bridge work.

Floss can be purchased in small self-dispensing boxes. Floss can also be purchased in special, single-use holders, a useful invention people who have a hard time wrapping floss around their fingers, including those with dexterity problems or arthritis.

Flossing Techniques

Most people who floss wrap 1-2 inches of floss around a finger on each hand, and use the floss in between on their teeth. The important thing is that you leave plenty of floss in between to allow you to maneuver inside your mouth.

One effective way is to break off about a foot of floss. Wrap one end of the floss a few times around the middle finger of each hand. You can use your forefinger and thumbs to maneuver the floss inside your mouth.

Press the floss in between two teeth and gently press downward (or upward if doing an upper set of teeth). Next, glide the floss up and down a few times against the surfaces of both teeth, carefully doing so at and below the gum line as well. Repeat this procedure for each tooth, taking up the slack when floss becomes worn or frayed.

Don’t be alarmed if your gums slightly bleed the first time you floss. This is normal and will cease when your gums become used to flossing.

For Those with Special Needs

Those who have a hard time holding on to a piece of floss or a toothbrush can try supplementing the toothbrush handle with a rubber handle grip or ball, or even lengthening the handle with a stick or piece of plastic.

Floss can also be tied into a tiny loop on either side, making it easier to grasp and control the floss with your fingers.

Flossing Alternatives

There are several alternatives to flossing for those who find it too difficult, too painful (sensitive gums or gum disease) or ineffective (those people with braces or delicate bridge work). But remember one thing: Never use a toothpick as a substitute for flossing. Toothpicks can tear delicate gum tissue and may damage existing dental restorations.

One popular flossing alternative is called a water pick, or irrigator.

Water picks use powerful tiny bursts of water to blast away food particles and other debris in hard-to-reach areas of your mouth. Dentists use professional-grade water picks when preparing a tooth for restoration, or in general cleaning and exams.

People with painful gum disease or highly sensitive gums may find water picks useful for supplementing their brushing regimen. And people with orthodontia, including braces, have found water picks quite useful because toothbrush bristles often get stuck.

Antibacterial rinses (over-the-counter and by prescription) are somewhat effective.

Flouride Facts

For decades, fluoride has been held in high regard by the dental community as an important mineral that is absorbed into and strengthens tooth enamel, thereby helping to prevent decay of tooth structures.

In nearly every U.S. community, public drinking supplies are supplemented with sodium fluoride because the practice is acknowledged as safe and effective in fighting cavities.

Some private wells may contain naturally fluoridated water.

What Is Fluoride?

Fluoride is a safe compound found throughout nature-from the water we drink and air we breathe, to many kinds of foods.

Why Is Fluoride Important To Teeth?

Fluoride is absorbed into structures, such as bones and teeth, making them stronger and more resistant to fractures and decay. A process in your body called “remineralization” uses fluoride to repair damage caused by decay.

How Do I Get Fluoride?

Just drinking public water will provide a certain measure of fluoride protection. But for years, health professionals have endorsed the practice of supplementing our intake with certain dietary products, and topical fluorides in many toothpastes and some kinds of rinses. Certain beverages such as tea and soda may also contain fluoride. Certain kinds of dental varnishes and gels may also be applied directly to teeth to boost fluoride intake.

Fluoride Safety

It is generally NOT safe to swallow toothpastes, rinses, or other products containing topical fluoride. In rare cases, some people may be overexposed to high concentrations of fluoride, resulting in a relatively harmless condition called fluorosis, which leaves dark enamel stains on teeth.

Mouth Rinses

Mouth rinses can have therapeutic benefits; others are only cosmetic in nature. Some have both attributes. The Food and Drug Administration even classifies mouth rinses this way.

In general, some therapeutic rinses with fluoride have been shown to actually fight cavities, plaque and gingivitis formation.

On the other hand, cosmetic rinses merely treat breath odor, reduce bacteria and/or remove food particles in the mouth. They do nothing to treat periodontal disease or prevent gingivitis.

In any case, make sure and look for indication on the label of a mouth rinse that is accepted by the American Dental Association.

Surgery or oral disease sometimes leads to complications for which a good quality therapeutic rinse is indicated. Even people who have difficulty brushing (because of physical difficulties such as arthritis) can benefit from a good therapeutic mouth rinse.

Caution: Even rinses that are indicated to treat plaque or cavities are only moderately effective. In fact, regular rinsing with water and use of good quality fluoride toothpaste are actually just as or more effective. Some rinses have even been known to causes severe irritation of the soft tissues in the mouth and other problems such as fluoride toxicity, discoloration or overly-sensitive teeth and gums (due in part to high fluoride and alcohol content).

Sealants

Sealants are liquid coatings that harden on to the chewing surfaces of teeth and are showing a great deal of effectiveness in preventing cavities-even on teeth where decay has begun.

The pits and grooves of your teeth are prime areas for opportunistic decay. Even regular brushing sometimes misses these intricate structures on the chewing surfaces of your teeth.

The sealants are applied to the chewing surfaces and are designed to prevent the intrusion of bacteria and other debris into the deep crevices on the tops of teeth.

Sealants actually were developed about 50 years ago, but didn’t become commonly used until the 1970s. Today, sealants are becoming widely popular and effective; young children are great candidates for preventative measures like sealants (especially on molars) because in many cases, decay has not set in. Even on teeth where decay is present, sealants have been shown to fight additional damage.

Application

Sealants are applied by first cleaning the tooth surface. The procedure is followed by “etching” the tooth with a chemical substance, which allows the sealant to better adhere. After the sealant is applied, a warm light source is directed to the site to promote faster drying. Sealants usually need re-application every five to 10 years.

X-Rays

X-rays, also called radiography, provide an important tool that shows the condition of your teeth, roots, jaw, and overall facial bone composition. X-rays can reveal the advanced nature of periodontal disease, as well as tumors and abscesses.

There are three basic kinds of X-rays:

  • Bitewings are the most conventional kind of dental X-rays and are used to spot cavities and decay.
  • Periapical X-rays are broad pictures of an entire tooth structure and are used to spot deep tooth problems, such as impacted teeth, bone loss, and abscesses.
  • Panoramic X-rays are designed to capture an entire mouth, and have been used to spot tumors and cysts, as well as wisdom teeth.
  • Radiation Concerns

Patients have little reason to be concerned about the health effects of dental X-rays; chances are you receive more radiation from sunlight in one day than one sitting involving dental X-rays.

Exposure to radiation is extremely brief and minimal. Safety precautions such as high-speed film minimize exposure time, and lead aprons prevent exposure to surrounding areas of the body such as the head, neck and upper chest.

Denture Care

Dentures today are made from very advanced materials designed to give you a natural appearance.

However, keep in mind that just like your teeth, dentures should be cared for with the same diligence. This means daily brushing and regular visits to your dentist.

Regular visits to your dentist are critical. Your dentist also can make minor adjustments that ensure that your dentures continue fitting naturally and comfortably.

Just like natural teeth, dentures need to be cleansed of plaque, food particles and other debris. Keeping your dentures in top shape will also help keep the soft tissues of your mouth healthy; an unclean or malformed denture can cause infections and irritation.

Cleaning Techniques

Remember to rinse and brush your dentures after every meal, and soak them in denture solution overnight. This also allows your gums to breathe while you sleep.

Here are some simple techniques for keeping your dentures clean:

  • People can brush their dentures in a variety of ways. Some people use soap and water or a slightly abrasive toothpaste. Popular denture pastes and creams also can be used.
  • Avoid using highly abrasive chemicals or pastes, or vigorously brushing with hard bristled toothbrushes. These can scratch or even crack dentures.
  • Hold your dentures gently to avoid loosening a tooth.
  • Clean your dentures with cool or tepid water over a water-filled sink. Hot water may warp a denture. A small washcloth placed in the bottom of the bowl will ensure that your denture isn’t damaged if it falls.
  • Soak your dentures overnight in any commercially available product like Efferdent or Polident, and remember to rinse your dentures before placing them back in your mouth.
  • Remember to use a separate toothbrush to clean your own natural teeth, as well as all of your gum tissues. In lieu of a toothbrush, a soft washcloth may be used to wipe your gums.

Over time, even daily care of your dentures may require them to be cleaned by the dentist. A powerful ultrasonic cleaner may be used to remove hard accumulations of tartar and other substances.

Emergency Care

Emergency Care

A knocked out tooth or bitten tongue can cause panic in any parent, but quick thinking and staying calm are the best ways to approach such common dental emergencies and prevent additional unnecessary damage and costly dental restoration. This includes taking measures such as application of cold compresses to reduce swelling, and of course, contacting our office as soon as possible.

Temporary or Permanent Crown Came Off/Knocked Off

If ther is no post in it, try to place it back on the tooth and bring it with you to your appointment if you cannot.

Broken, Knocked Out, Fractured, or Displaced Tooth

A broken, fractured or displaced tooth is usually not a cause for alarm, as long as decisive, quick action is taken.

If the tooth has been knocked out, try to place the tooth back in its socket while waiting to see your dentist.

First, rinse the mouth of any blood or other debris and place a cold cloth or compress on the cheek near the injury. This will keep down swelling.

If you cannot locate the tooth back in its socket, hold the dislocated tooth by the crown – not the root. Next, place it in a container of warm milk, saline or the victim’s own saliva and keep it in the solution until you arrive at the emergency room or dentist’s office.

For a fractured tooth, it is best to rinse with warm water and again, apply a cold pack or compress. Ibuprofen may be used to help keep down swelling.

If the tooth fracture is minor, the tooth can be sanded or if necessary, restored by the dentist if the pulp is not severely damaged.

If a child’s primary tooth has been loosened by an injury or an emerging permanent tooth, try getting the child to gently bite down on an apple or piece of caramel; in some cases, the tooth will easily separate from the gum.

Women and Tooth Care

Women have special needs when it comes to their oral health. That’s because the physical changes they undergo through life-things like menstruation, pregnancy and childbirth, breast-feeding and menopause-cause many changes in the body, some harmful to teeth and gums.

Lesions and ulcers, dry sockets, as well as swollen gums, can sometimes occur during surges in a woman’s hormone levels. These periods would be a prime time to visit the dentist. Birth control pills have been shown to increase the risk of gingivitis, and hormone replacement therapy has been shown to cause bleeding and swollen gums. Gum disease can also present a higher risk for premature births.

Some research has shown that women may be more likely to develop dry mouth, eating disorders, jaw problems such as temporomandibular joint disorders, and facial pain-all of which can be difficult from a physical and emotional standpoint.

Taking care of your oral health is essential, and can go a long way to helping you face the physical changes in your body over the years.

Seinors and Oral Health

Good Oral Hygiene

More and more people today are avoiding the need for dentures as they grow older, bucking the notion that false teeth are a normal part of growing older.

In fact, there’s usually no reason for you NOT to keep your teeth your entire life, providing you maintain a healthy balanced diet and practice good oral hygiene.

Another desirable side effect of good oral hygiene: avoiding more serious problems such as hypertension, cardiovascular disease, diabetes, and even stroke. Indeed, medical research is beginning to show that a healthy mouth equates to a healthy body.

And just because you’re getting older doesn’t mean you can relax on your daily routine. This means brushing twice a day, flossing, and rinsing.

Dexterity and Arthritis

People who suffer from arthritis or other problems of dexterity may find it difficult and painful to practice good oral hygiene.

Thankfully, industry has responded with ergonomically designed devices such as toothbrushes and floss holders that make it easier to grasp and control.

You can also use items around the house to help you. Inserting the handle of your toothbrush into a small rubber ball, or extending the handle by attaching a small piece of plastic or Popsicle stick may also do the trick.

Floss can also be tied into a tiny loop on either side, making it easier to grasp and control the floss with your fingers.

One popular flossing alternative is called a water pick, or irrigator.

Water picks use powerful tiny bursts of water to blast away food particles and other debris in hard-to-reach areas of your mouth. Dentists use professional-grade water picks when preparing a tooth for restoration, or in general cleaning and exams.

Risks

Having to wear dentures is one of the risks of poor oral hygiene. Older adults also may be at risk for such oral problems as:

  • Gingivitis – a condition that occurs when bacteria and plaque invade below the gum line, causing inflammation of the soft tissues and, sometimes, bleeding. Advanced gingivitis can lead to formation of a substance called tartar (also called calculus), which is a hard and crusty coating that can usually only be removed by scraping.
    Periodontal (gum) disease – Usually the advanced stages of gingivitis, gum disease begins with infections in the gums that can spread to the teeth and bones. Advanced forms of gum disease can lead to a host or problems that can only be treated by extreme measures such as extraction.
  • Dry mouth – Older adults sometimes experience diminished production of saliva and a condition called dry mouth, which leads to problems such as swallowing or speech difficulty. Certain kinds of medications and even cancer treatment can cause dry mouth. One of the more serious consequences of dry mouth is greater susceptibility to cavities and other oral problems because saliva acts as a natural rinsing agent in the mouth.
  • Oral cancer – Older adults are more prone to certain kinds of oral cancer. There are risks factors such as tobacco use and alcohol, and even heredity. But avoiding use of cigarettes, chewing tobacco and minimizing your intake of alcohol can go a long way ion defending against some kinds of oral cancer. Early signs of oral cancer are unusual lumps, patches or lesions, as well as unexplained or chronic bleeding.

Nutrition and Your Teeth

It has long been known that good nutrition and a well-balanced diet is one of the best defenses for your oral health. Providing your body with the right amounts of vitamins and minerals helps your teeth and gums-as well as your immune system-stay strong and ward off infection, decay and disease.

Harmful acids and bacteria in your mouth are left behind from eating foods high in sugar and carbohydrates. These include carbonated beverages, some kinds of fruit juices, and many kinds of starch foods like pasta, bread and cereal. While no links have been actually made between gum disease and a poor diet, nutrition problems (including obesity and overeating) can create conditions that make gum disease easier to contract.

Children’s Nutrition and Teeth

Good eating habits that begin in early childhood can go a long way to ensuring a lifetime of good oral health.

Children should eat foods rich in calcium and other kinds of minerals, as well as a healthy balance of the essential food groups like vegetables, fruits, dairy products, poultry and meat. Fluoride supplements may be helpful if you live in a community without fluoridated water, but consult with our office first. (Be aware that sugars are even found in some kinds of condiments, as well as fruits and even milk.)

Allowing your children to eat excessive amounts of junk food (starches and sugars)-including potato chips, cookies, crackers, soda, even artificial fruit rollups and granola bars-only places them at risk for serious oral health problems down the road, including obesity, osteoporosis and diabetes. The carbonation found in soda, for example, can actually erode tooth enamel. Encourage your child to use a straw when drinking soda; this will help keep at least some of the carbonated beverage away from the teeth.

Adult Nutrition and Teeth

There’s no discounting the importance of continuing a healthy balanced diet throughout your adult life.

If you develop a weight problem, change your diet and get regular exercise. Be aware that some so-called fad diets have been known to cause serious deficiencies in recommended levels of minerals and vitamins.

Of course, good oral hygiene helps ensure that harmful bacteria and plaque-the sticky substance that coats your teeth during sleep and after meals-are effectively minimized. Adults also are encouraged to avoid eating “sticky” foods such as caramels and dried fruits because they leave behind stubborn substances on teeth and only encourage needless plaque formation.