Posts for category: Oral Health
It’s indisputable that fluoride has revolutionized dental care. Decades of research have overwhelming shown this natural, enamel-strengthening chemical has decreased tooth decay.
Too much fluoride, though, can cause enamel fluorosis, a permanent staining of tooth enamel. In its mildest form, the teeth develop faint whitish streaks; in more severe cases, the staining is noticeably darker and the teeth appear pitted. The teeth themselves aren’t damaged, but the unsightly staining could require cosmetic treatment. Children under age 9 (when permanent teeth enamel matures) are especially at risk of fluorosis due to over-fluoridation.
Because of fluoride’s prevalence in hygiene products and many drinking water supplies, it’s not always easy to know if your child is receiving too much. There are two areas, though, that bear watching.
First, you should limit the serving quantity of fluoride hygiene products, particularly toothpaste. Children tend to swallow rather than spit out toothpaste after brushing, so they ingest more fluoride. We recommend a small “smear” of toothpaste on the brush for children under two, and a pea-sized amount for children two to four.
The other concern is your drinking water. Three-quarters of America’s water systems add fluoride, usually to a recommended level of 0.70 PPM (parts per million). To know if your water supply adds fluoride and at what levels, you can contact your local water utility or health department, or check the Center for Disease Control’s website for their “My Water’s Fluoride” program (http://apps.nccd.cdc.gov/MWF/Index.asp). This site will have information if your water system participates in the program.
If your area exceeds recommended levels or is at high risk for fluorosis, we recommend reducing the use of tap water in infant formula. Besides breast-feeding (human breast milk is low in fluoride), you can use either ready-to-feed formula, or mix powdered formula with water specifically labeled “de-ionized,” “purified,” “de-mineralized,” or “distilled.”
One thing you should not do is eliminate your use of products containing fluoride — this may increase your child’s risk of tooth decay. The consequences of decay can be serious and have a life-long effect — and far outweigh the risks of fluorosis staining.
If you would like more information on fluoride and your infant, 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 Development and Infant Formula.”
If your infant is extra cranky and seems to want to chew everything in sight, it's a good bet that the first tooth is on the way! For parents, this is cause for both celebration and concern. After all, no parent wants to see a child suffer even a little bit. Decades ago, when a teething infant showed signs of discomfort, a parent might have rubbed some whisky or other strong liquor on the child's gums — a misguided and dangerous practice. There are far safer, more effective ways to help your child through this exciting yet sometimes uncomfortable phase of development. Here are our top five teething remedies:
Chilled rubber teething rings or pacifiers. Cold can be very soothing, but be careful not to freeze teething rings or pacifiers; ice can actually burn the sensitive tissues of the mouth if left in place too long.
Cold, wet washcloths. These are great for gnawing on. Make sure the washcloth is clean and that you leave part of it dry to make it more comfortable to hold.
Cold foods. When your child is old enough, cold foods such as popsicles may soothe sore gums. However, make sure you confine them to mealtimes because sugars can cause tooth decay — even in very young children.
Gum massage. Massaging inflamed gums with your clean finger can help counteract the pressure from an erupting tooth.
Over-the-counter medicine. If teething pain persists, you can give your baby acetaminophen or ibuprofen, but check with a pharmacist or this office for the correct dosage. The medicine should be swallowed and not massaged into the sore areas, as this, too, can burn.
So when does it all begin? Some babies start teething as early as three months or as late as twelve months, but the typical time frame is between six and nine months. Usually the two lower front teeth erupt first, followed by the two upper front teeth. The first molars come in next, followed by the canines (eyeteeth). Most children have all 20 of their baby teeth by age 3.
If you have any questions about teething or the development of your child's teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Teething Troubles.”
Because its symptoms can be easy to overlook, gum disease is sometimes called a “silent” malady. But don't underestimate this problem! Untreated periodontal disease can progress into a serious condition, possibly leading to tooth loss and even systemic (whole-body) health issues. With proper preventive measures and appropriate treatment, however, the disease can be controlled.
The root cause of periodontal disease — actually, a group of related diseases, all of which affect the tissues surrounding the teeth — is the buildup of bacterial plaque (also referred to as biofilm) around the gums. While hundreds of types of bacteria live in the mouth, only a comparatively few are thought to be harmful. But when oral hygiene (namely, brushing and flossing) is inadequate, the environment in the mouth becomes favorable to those harmful types.
The disease often begins with inflammation of the gums called gingivitis. It symptoms include bad breath, bleeding gums, and soreness, redness, or tenderness of the gum tissue. However, in some people these early warning signs are ignored, or masked by the effects of harmful habits like smoking.
Gum disease is chronic; that means, if left alone, it will worsen over time. Periodontitis, as it progresses, causes damage to the ligament that helps hold the tooth in place, as well as bone loss. This may become increasingly severe, and ultimately result in the loss of the tooth. Severe periodontitis is also associated with whole-body (systemic) inflammation, which has been linked to an increased incidence of cardiovascular diseases, like stroke and heart attack.
But there's no reason to allow gum disease to progress to this stage! Prevention — that is, regular daily brushing and flossing as well as regular dental cleanings — is a primary means of keeping this problem at bay. Plus, every time you have a regular dental checkup, your gums are examined for early signs of trouble. Of course, if you notice the symptoms of gum disease, you should come in for a check-up as soon as you can.
There are a number of effective treatments for gum disease. One of the most conservative, routine ways are those regular dental cleanings we referred to earlier, usually called scaling and root planning. Using hand-held and ultrasonic instruments, the buildup of plaque (tartar) is carefully removed, sometimes under local anesthesia. A follow-up evaluation may show that this treatment, carried out on a regular schedule, is all that's needed. Or, it may be time for a more comprehensive therapy.
If you have concerns about gum disease, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Understanding Gum (Periodontal) Disease” and “Warning Signs of Periodontal (Gum) Disease.”
You have a toothache… or do you? That's not a facetious question — sometimes it's difficult to determine if it's your tooth that hurts, your gums or both. It's even difficult at times to pinpoint which tooth may be hurting.
This is because the pain can originate from a variety of causes. Determining the cause is the first step to not only alleviating the pain, but also treating the underlying condition. Those causes generally follow one of two paths: either the problem originates within a tooth and spreads to the gums and other tissue, or it begins with infected gum tissues and can spread to the teeth.
We refer to the first path as endodontic, meaning it originates from within a tooth. Most likely the tooth has decayed (also referred to as a cavity), which if untreated can progress, allowing bacteria to infect the tooth pulp (living tissue inside the tooth that contains nerve fibers). Pain results as the nerves become inflamed and sensitive, though often varying in quality (sharp or dull) or frequency (constant or intermittent); outside stimuli, like temperature or pressure, may also trigger pain.
Although likely originating with one tooth, it may be difficult to pinpoint which one is actually causing it; you might even feel pain in your sinus cavity radiating upward from the tooth. An untreated infection will continue to spread to surrounding soft tissue, or result in a painful abscess, an infected pocket of bacteria between the tooth and gums.
The other path is periodontal, meaning the infection originates in the gum tissues. A thin layer of dental plaque known as biofilm develops and sticks to teeth at the gum line, which can lead to infection of the gum tissue, which then becomes inflamed and painfully sensitive. The untreated infection can then progress along the tooth and invade the pulp through the accessory root canals.
Knowing the source of an ache will determine the best course of treatment, whether a root canal, root planing, or a combination of these or other procedures. It's also the best, most efficient way to relieve you of that unpleasant mouth pain.
If you would like more information on the various causes of tooth pain, 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 “Confusing Tooth Pain.”
Sports drinks have grown in popularity since University of Florida football trainers developed Gatorade® in the 1960s. They're widely viewed as a convenient fluid and nutrient replacement after strenuous workouts. Recently, another beverage has become wildly popular — the energy drink, whose high caffeine promises heightened concentration and physical ability.
While energy drinks have raised health concerns, sports drinks are widely regarded as safe. Both kinds of drinks, however, may be a cause for concern when it comes to your dental health.
While both are substantively different, they do have one thing in common — both beverages contain high levels of citric and other acids to improve taste and shelf life. This high acidity can have a detrimental effect on tooth enamel.
When the mouth becomes too acidic after eating or drinking (4 or lower on the pH scale), the tooth's outer protective enamel begins to erode, a process known as demineralization. Saliva with its neutral pH of 7 can neutralize this over-acidity in about thirty minutes to an hour after eating and the enamel will actually begin to remineralize. But when there's an overabundance of acid, as with these beverages, saliva's neutralizing ability becomes inhibited. The mouth remains too acidic for a longer period, resulting in greater erosion of the enamel.
Generally speaking, we don't recommend energy drinks at all. If, however, you occasionally take in a sports drink, add the following precautions, if possible: combine the drink with a mealtime and rinse your mouth with pH-neutral water to wash away residual acid from the sports drink; and wait an hour before brushing your teeth — since some demineralization occurs before saliva neutralizes the acid, you could brush away some of the softened enamel before it can remineralize.
Finally, consider this: pure, clean water is still the best hydrator in the world. Replenishing your fluids with it after exercise might also be the better choice for your dental health.
If you would like more information on the effects of sports and energy drinks on oral health, 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 “Think Before you Drink.”