You use toothpaste every day — don't you? But how much do you really know about what's inside the tube: namely, the white, sticky stuff that keeps your teeth clean and your breath fresh? Take this True/False quiz and find out!
True of false: Powdered charcoal, brick dust and crushed bones were once ingredients in toothpaste. TRUE
Many years ago, these gritty abrasive materials were used to make toothpaste. Today, abrasives are still used — but they're much gentler. Compounds like hydrated silica or alumina, calcium carbonate, and dicalcium phosphate have proven effective at cleaning and polishing tooth surfaces without damaging the enamel.
True of false: Fluoride was first introduced into toothpaste in 1955. FALSE
Arguably toothpaste's most important ingredient, fluoride was used as early as 1914. But its mass-marketing debut came with the Crest brand in the mid-1950s. Today, no toothpaste without fluoride can receive the American Dental Association's Seal of Approval. That's because it has been shown to strengthen tooth enamel and help prevent tooth decay.
True of false: Detergent is a common ingredient of toothpaste. TRUE
But it isn't the same kind you do laundry with. Detergents — also called surfactants, because they act on the surfaces of liquids — help to loosen and break down deposits on your teeth, which can then be rinsed away. Like other health and beauty products, many toothpastes use a gentle detergent, derived from coconut or palm kernel oil, called sodium lauryl sulfate.
True of false: Whitening toothpastes work, to some degree, on all stains. FALSE
Whether the whitening agents in toothpaste will work for you depends on why your teeth don't look white in the first place. The abrasives and enzymes in these toothpastes can help remove “extrinsic” stains: those on the surface of your teeth. But for “intrinsic” stains — that is, internal discoloration — they probably won't help. In that case, you may need to get professional bleaching treatments.
True of false: Toothpastes made for sensitive teeth have substances that block pain transmission. TRUE
Potassium nitrate and strontium chloride can block the sensation of pain that may occur when dentin — the material that makes up most of the inside of teeth, and is normally covered by enamel — becomes exposed. Fluoride, too, helps reduce sensitivity. But the benefits of reduced tooth sensitivity may take a few weeks to really be felt.
If you have questions about toothpastes or oral hygiene, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine article “Toothpaste — What's In It?”
One of the great benefits that patients with implants enjoy is their imperviousness to decay: unlike a natural tooth, bacteria have no effect on the materials in an implant’s construction. That doesn’t mean, however, you can become lax in your hygiene habits — although the implants may not be susceptible to disease, the surrounding gum tissue and bone are. If those tissues become infected you could start to lose the implant attachment and, as it progresses, the implant itself.
In fact, the gum tissue that surrounds the implant may be more susceptible to infection than those around natural teeth. Teeth maintain a connection with the jawbone through the periodontal ligament. Besides securing the tooth, the gum tissue has fibrous attachments to the tooth to help the gum tissue endure a lot of wear and tear and resist the invasion of bacteria and food particles. Implants are anchored directly into the jawbone (where bone eventually grows and attaches to the titanium implant surface) and don’t develop an attachment with the ligament. Implants, therefore, don’t have the benefit of resistance to bacteria and food particles that natural teeth receive through these fibrous attachments.
As a result, patients with implants need to establish a conscientious habit of effective oral hygiene. Daily removal of bacterial plaque from teeth surfaces through brushing and flossing (and semi-annual office cleanings and checkups) greatly reduce the risk of infection and subsequent inflammation. It’s also important to monitor the condition of your gums, especially around implants. If you begin to notice bleeding, red or swollen gums, or other signs of possible gum disease, you should contact us as soon as possible for an assessment.
Proper care for implants and their supporting tissues is just as necessary, and perhaps more so, than it is for natural teeth. By providing that care, you’ll help ensure years of effective service from your implants.
If you would like more information on hygiene practices with implants, 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 “Infections Around Implants.”
Dental implants have quickly become the restoration of choice for two basic reasons: they effectively restore the lost function of missing teeth and simultaneously rejuvenate the smile with their life-like appearance.
Achieving a life-like appearance, however, isn’t always a simple matter. A restoration in what we dentists call the “Smile Zone” (the upper front area that displays both teeth and the gum line when you smile) requires careful planning and technique to ensure they appear as life-like as possible.
Our first concern is whether there’s enough bone to fully anchor an implant. Bone is a living, dynamic tissue that goes through cycles of dissolving (resorption) and growth. The normal forces of biting and chewing transmit through healthy teeth and stimulate growth in the bone. When the teeth are missing and no longer transmit this pressure, the bone will eventually resorb only and not grow.
Adjacent teeth could also be affected with bone loss if the extraction was difficult and a bone graft was not placed into the extraction socket to preserve bone. This not only puts adjacent teeth at risk of gum and bone loss but can also have implications for the final smile appearance. This bone also supports the triangular tissue between teeth known as papillae which give teeth their arched appearance. If the bone isn’t adequate, there’s less hope that the papillae will regenerate.
With these concerns it’s very important to consider how the implant and crown emerges from the gums in the Smile Zone. Recent developments in implant design are helping in this regard. The design change of the top of the implant re-orients the gum tissues in relation to the implant from vertical to horizontal, which dentists call “platform switching.” This provides greater stabilization where bone mass is limited, and helps create a more aesthetically pleasing result. There are also other techniques, such as surgical tissue grafting of the papillae that can further enhance the final appearance.
Although creating a natural, life-like appearance in the Smile Zone is difficult, it’s not impossible. It’s important first to undergo a complete dental examination and profile, where we can advise you on your best options to achieve a beautiful smile.
If you would like more information on the relation of implants to the aesthetics of your smile, 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 “Implant Aesthetics.”
Dentists go to great lengths to save an adult permanent tooth. Even though restoration technology is incredibly advanced, none can completely replace the biological function of natural teeth. Treating a diseased tooth to preserve it is a high priority in dentistry.
It would seem, though, that a child’s primary (baby) tooth might not warrant the same treatment. Since the tooth eventually detaches from the jaw to make way for a permanent tooth, why save it?
It is worth the effort, because primary teeth provide more than a chewing function: they also serve as guides for their permanent successors. When they’re lost prematurely, the permanent teeth may not come in correctly, leading to a malocclusion (poor bite). Other areas of development, like speech and dental bone growth, may suffer as well from the longer time gap between the premature loss and the permanent tooth eruption.
Saving an infected primary tooth should be considered, especially if significant time remains in its lifespan. Due to differences between primary and permanent teeth, though, the treatment approach isn’t the same. For example, the body gradually absorbs the roots of a primary tooth (a process called resorption) as the permanent tooth beneath erupts applying pressure to the primary roots (this is what enables its eventual detachment). Dentists must factor this process into their diagnosis and treatment plan for a primary tooth.
The level of treatment may vary depending on how deep the infection has advanced. If the decay is limited to the tooth’s outer layers and only partially affects the pulp, the innermost layer of the tooth, a dentist may remove as much soft decay as possible, apply an antibacterial agent for any remaining hardened infection, and then restore the tooth with filling materials.
For deeper infection, the dentist may remove some or all of the pulp, disinfect and clean the area, and then fill and seal the empty space with a filling. A filling material like zinc oxide/eugenol paste should be used that’s capable of resorption by the body to coincide with the natural root resorption. After treatment, the tooth should continue to be monitored for changes in appearance or gum swelling, just in case the infection returns or advances.
Although it may seem counterintuitive, treating a primary tooth as you would its successor is worth the effort. Your child will reap the health benefits, both now and long after the primary tooth is gone.
If you would like more information on endodontic treatment for 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 “Root Canal Treatment for Children’s Teeth.”
We all know that dentistry can do amazing things these days to give you the smile you've always dreamed of. With the latest cosmetic and restorative dental techniques, it is possible to achieve amazingly natural-looking results. But how do we map out the best route to a better smile? And how do we know that the results will hold up over time?
Every individual has a unique set of conditions in his or her mouth and it is our job to figure out how you have come to your present state, dentally speaking. We need to correct or at least manage any factors that could risk the success of your treatment. These risk factors fall into four basic categories:
Periodontal Risk — This involves the condition of the structures that support your teeth, including your gum and bone tissue. It's important to establish good periodontal health before we perform any restorative or cosmetic procedures.
Biomechanical Risk — This has to do with the structural integrity of your teeth. We will look at whether any tooth structure has been lost due to decay, and take steps to reduce your susceptibility to decay if necessary.
Functional Risk — This relates to your bite: how your teeth, muscles and jaw joints are functioning. For example, do you have excessive tooth wear or joint pain? If so, you are at a higher risk in this category and we need to figure out why.
Aesthetic Risk — This is the most subjective of the categories as beauty is in the eye of the beholder. Still, if you display a lot of your teeth and gums when you smile, any issues you have (gum recession, for example) will be that much more visible and affect your smile more. We will have to take this into account when we plan your treatment.
Only when we have determined how best to minimize your risk in all four of these categories can we restore or enhance your smile in a way that will not only look great but also last as long as possible.
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