Since the 1950s fluoride has played an important role in the fight against tooth decay as an additive to hygiene products and many public water supplies. But although a proven cavity fighter, some have questioned its safety over the years.
To date, though, the only substantiated health risk from fluoride use is a condition known as enamel fluorosis, which occurs when too much fluoride is ingested during early tooth development as the mineral embeds in the tooth structure. Fluorosis can cause changes in the enamel’s appearance, ranging from barely noticeable white streaking to darker visible staining and a pitted texture.
Fluorosis is primarily a cosmetic problem and not a serious health issue. The staining on otherwise sound teeth, however, is permanent and more severe cases may require extensive bleaching treatment to improve appearance. The best strategy is to prevent fluorosis by monitoring and limiting your child’s fluoride intake, until about age 9.
Tooth decay is a more serious condition than fluorosis so we’re not advocating you eliminate fluoride but that you keep your family’s intake within safe levels. The first step is to determine just how much that intake is now, particularly if you drink fluoridated water. If you have public water, you may be able to find its fluoridation level online at apps.nccd.cdc.gov or call the utility directly.
You should also be careful about the amount of toothpaste your child uses to brush their teeth. Children under two need only a trace (a “smear”) on the brush, and children between the ages of 2 and 6 a pea-sized amount. And, they should brush no more than twice a day.
Another possible concern is infant formula, especially mixable powder. While the formula itself doesn’t contain fluoride, water mixed with it may. If you live in an area with increased fluorosis risk, consider breast-feeding (breast milk has little fluoride), using ready-to-feed formula, or mixing powdered formula with bottled water labeled “de-ionized,” “purified,” “demineralized” or “distilled.”
We’ll be glad to help assess your family’s current fluoride intake and advise you on making adjustments to bring it into normal ranges. Taking in the right amount of fluoride assures you and your children receive the most benefit and protection from it, while avoiding future smile problems.
If you would like more information on managing your family’s fluoride intake, please contact us today to 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.”
“You need a root canal,” isn’t something you want to hear during a dental visit. But whatever your preconceptions about it may be, the fact is root canal treatments don’t cause pain — they alleviate it. What’s more, it may be your best chance to save a tooth that’s at high risk for loss.
First of all, root canal treatments address a serious problem that may be occurring inside a tooth — tooth decay that’s infiltrated the pulp chamber. If it’s not stopped, the decay will continue to advance through the root canals to the bone and weaken the tooth’s attachment. To access the pulp and root canals we first administer a local anesthesia and then create an opening in the tooth, typically in the biting surface.
After accessing the pulp chamber, we then remove all the pulp tissue and clean out any infection. Â We then fill the empty pulp chamber and root canals with a special filling and seal the opening we first created. The procedure is often followed some weeks later with a laboratory made crown that permanently covers the tooth for extra protection against another occurrence of decay and protects the tooth from fracturing years later.
Besides stopping the infection from continuing beyond the roots and saving the tooth from loss, root canal treatments also alleviate the symptoms caused by decay, including tenderness and swelling of surrounding gum tissue and sensitivity to hot and cold foods or pressure when biting down. And, it reduces pain — the dull ache or sometimes acute pain from the tooth that may have brought you to our office in the first place.
General dentists commonly perform root canal treatments; in more complicated cases they’re performed by an endodontist, a specialist in root canal treatments. Afterward, any discomfort is usually managed with non-steroidal anti-inflammatory drugs (NSAID) such as ibuprofen or aspirin.
Root canal treatments are a common procedure with a high rate of success. Undergoing one will end the pain and discomfort your infected tooth has caused you; more importantly, your tooth will gain a new lease on life.
If you would like more information on root canal treatments, 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 “Common Concerns about Root Canal Treatment.”
While there’s usually a period of months between implant placement and the permanent crown, a new technique known as same-day tooth replacement installs both the implant and a temporary crown during the same visit. But be advised — it does have its risks and isn’t for everyone.
Successful same-day replacements require special attention during the three phases for implants: the removal (extraction) of the existing tooth; placement of the implant in the bone; and attachment of the crown, the visible tooth, to the implant. The tooth extraction lays the foundation for the entire process; the extraction procedure must be performed carefully to avoid undue damage to the socket. In addition, if infection or disease has compromised the site, an implant may not be possible immediately.
The implant must then be placed in the bone so that it’s stable and immovable. All implants stabilize with time as the bone grows and adheres to them, but we need greater stability for a same-day tooth replacement when an extraction is performed.
Our last consideration is positioning the implant so that the attached crown blends in naturally with the surrounding gum tissue and adjacent teeth. We must place it at the proper depth below the gum tissues so that the crown appears to emerge from them in the proper tooth length.
Taking extra care during all these phases, including the angle of crown attachment, will increase our chances of success. We still run a risk of implant damage or failure, however, from biting forces before the implant fully integrates with the bone. This means avoiding chewy foods and other situations that might increase the force on the implant. We may also use a temporary crown that’s slightly shorter than adjacent teeth so it won’t make full contact with the opposing tooth.
If you’d like to know if you’re a good candidate for a same-day tooth replacement, see us for a detailed examination. After reviewing your needs, we’ll be able to discuss with you the risks and benefits for a new look in one day.
If you would like more information on same-day tooth replacement, 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 “Same-Day Tooth Replacement with Dental Implants.”
You have a great smile: beautiful white teeth all perfectly aligned. But unbeknownst to you, periodontal (gum) disease might even now be damaging your gum tissues, setting the stage for future tooth and bone loss — and a ruined smile.
While it’s easy to miss the early stage of this disease caused by bacterial plaque on tooth surfaces, there are a few signs if you pay close attention. Bleeding gums after moderate brushing or flossing could indicate normally resilient gum tissues have begun to weaken. You may also notice a slight redness and swelling around the margins of the gums and a bad taste or breath. As it progresses, you may experience painful abscesses (infected pockets that develop between the gums and tooth) and loose teeth, a late sign of tissue detachment and bone loss. If you are a smoker, nicotine reduces swelling and bleeding of the gums, removing signs you have a disease. If you smoke, you need to see your dentist regularly.
While renewed daily oral hygiene is important for stopping gum disease, you may also need professional care to bring it under control. The main treatment calls for the manual removal of plaque and calculus (hardened deposits of plaque) that are sustaining the infection. Dentists and hygienists both can perform scaling, which removes plaque and calculus at or just below the gum line, and root planing to clean accessible root surfaces.
In more advanced cases, though, you may need the services of a periodontist, a specialist in treating diseased or injured gums, bone and other connective tissues that support the teeth. They’re also skilled in more advanced treatments like gum flap surgery that more fully exposes a tooth’s root area for plaque and calculus (or tartar) removal, or tissue grafting procedures that improve the health and appearance of damaged gums.
If you suspect you have gum disease, the place to start is with your family dentist. They can determine if your case will respond to basic scaling, root planing or antibiotic treatment. If the disease appears more advanced or with complications, they will most likely refer you to a periodontist for treatment.
If you’ve already seen bleeding, swelling or redness, see your dentist as soon as possible. The sooner you begin treatment for any case of gum disease, the less likely it will lead to the loss not only of your teeth but your beautiful smile.
If you would like more information on the treatment of periodontal (gum) 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 “When to See a Periodontist.”
Cosmetic and restorative dentistry is filled with a varied array of procedures, materials and techniques that can address any shortcoming with your smile. Whatever your condition, there’s a means to correct or enhance your smile.
The real question, though, is whether we’re both, patient and dentist, on the same page as to what’s best to enhance your smile. Dentists have a different perspective on smile outcomes than the average layperson. We’re clued into aspects like tooth alignment with facial features or gum-to-lip distance influenced by our professional training and experience. You, though, may see your smile in terms of other features that define beauty like mouth expressions or lip shape.
Bridging these differing points of view requires open and honest communication. Here are three considerations to make that happen.
Build trust between you and your dentist. It’s natural for us to have differing views on what constitutes proper smile aesthetics based on the perspectives previously mentioned. Working through those perspectives to arrive at a unified plan requires trust that both of us desire the same outcome: a beautiful smile you’re happy to display to the world.
“Seeing” your future smile can help ease your misgivings. It’s one thing to try to imagine a certain treatment outcome — it’s quite another to actually see it beforehand. And you can, through computer simulation that takes a picture of your current face and smile and then augments them digitally so you can see how your smile will appear after proposed treatment. It’s also possible in some cases for you to wear temporary or “provisional” restorations so that not only can you see how they look, but also how they feel and function in the mouth.
Understand what “type” of restoration patient you are. Although everyone is different, we can usually characterize patients and their expectations in two ways. Some patients are “perfect-minded” — they want restorations that offer the maximum symmetry, regularity and tooth brightness. Others are more “natural-minded” in that the changes they seek don’t drastically alter their natural appearance, but are just enough to look different and create a sense of character. Knowing what you really want — a drastic change or a subtle enhancement — will help you communicate your desires more clearly and help us design the treatment options that best fit your expectations.
If you would like more information on fostering communication between dentists and patients, 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 “Great Expectations.”
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