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TopicalFluorideOffersaProtectiveBoosttoChildrenatHighRiskforDecay

You're doing all the right things helping your child avoid tooth decay: daily brushing and flossing, regular dental visits and a low-sugar diet. But although occurrences are low, they're still getting cavities.

Some children still struggle with tooth decay even with proper dental care. If this is happening to your child, your dentist may be able to give them an extra preventive boost through topical fluoride.

Fluoride has long been recognized as a proven cavity fighter. Often added in small amounts to toothpastes and drinking water, fluoride strengthens tooth enamel against acid attacks that create cavities. With topical fluoride, a dentist applies a varnish, foam or gel containing a more concentrated amount of the chemical directly to the teeth.

The effectiveness of this method in reducing tooth decay is well-founded: A number of scientific studies involving thousands of children and adolescents found an average 28% reduction in occurrences of decay among those who received the treatment compared to those who didn't.

Still, many parents have concerns about the higher fluoride concentrations in topical applications. But even at this greater amount, fluoride doesn't appear to pose any long-term health risks. The most adverse effects—vomiting, headaches or stomach pain—usually occur if a child accidentally ingests too much of the solution during treatment.

Dentists, however, go to great lengths to prevent this by using guards to isolate the solution during an application. And in the case of a foam or gel application, parents can further lower the risk of these unpleasant side effects by not allowing their child to eat or drink for at least thirty minutes after the procedure.

The evidence seems to indicate that the benefits of regular topical fluoride applications for children at high risk outweigh the possible side effects. By adding this measure to your prevention strategy, you can further protect your child from this danger to their current and future dental health.

If you would like more information on tooth decay prevention for your child, 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 Gels Reduce Decay.”

ItTakesBothYouandYourHygienisttoKeepYourSmileHealthyandBeautiful

To have a beautiful, healthy smile you’ll need to keep those pearly whites clean and plaque-free. Good dental hygiene, though, isn’t a solo act: It’s a duet best performed by you and your dental health provider. While you’re responsible for brushing and flossing every day, your dental hygienist gives your teeth a thorough cleaning every six months (or more). The American Dental Hygienists Association commemorates every October as National Dental Hygiene Month to recognize both the importance of hygiene and the professionals who assist you in keeping your teeth as clean as possible.

The focus for this emphasis on brushing, flossing and professional cleaning? A slick, slimy substance called dental plaque. This thin film of bacteria and food particles builds up on tooth surfaces after eating and gives rise to infections that cause tooth decay and gum disease. And it doesn’t take long without proper brushing and flossing, for a gum infection called gingivitis to start in only a matter of days. Daily hygiene reduces your risk of that happening: Brushing removes plaque from the broad, biting surfaces of the teeth, while flossing takes care of the areas between teeth that brushing can’t access.

So, if you can remove most of the plaque yourself, why see a dental hygienist? For two reasons: First, while daily hygiene takes care of the lion’s share of plaque, it’s difficult to clear away all of it. Over time, even a small amount of missed plaque can increase your disease risk. However, a professional cleaning that uses special hand tools and ultrasonic equipment can easily clean away this leftover plaque.

Second, some of the soft plaque can interact with saliva to form a hardened, calcified form called calculus or tartar. It can harbor bacteria just like the softer version, and it’s next to impossible to dislodge with brushing and flossing. Again, a trained hygienist with the right tools can effectively break up and remove calculus.

There are also additional benefits that come from regular dental visits to your hygienist. For one, hygienists can provide practical instruction and tips to help you brush and floss more effectively. And, after cleaning your teeth, they can point out areas with heavy plaque and calculus deposits. That can help you focus more of your future brushing and flossing efforts on those areas.

So, a shout-out to all the dental hygienists out there: These dedicated professionals work hard to keep your teeth clean. And a big high-five to you, too: Without your daily commitment to brushing and flossing, your smile wouldn’t be as beautiful—and healthy.

If you would like more information about best dental hygiene practices, please contact us to schedule a consultation. To learn more, read the Dear Doctor magazine articles “Dental Hygiene Visit” and “10 Tips for Daily Oral Care at Home.”

AmericasDentistsGotTalent-forFixingDamagedorMissingTeeth

A recent episode of “America’s Got Talent” featured an engaging 93-year-old strongman called The Mighty Atom Jr. The mature muscleman’s stunt: moving a full-sized car (laden with his octogenarian “kid brother,” his brother’s wife, plus Atom’s “lady friend”) using just his teeth. Grinning for host Howie Mandel, Atom proudly told the TV audience that his teeth were all his own; then he grasped a leather strap in his mouth, and successfully pulled the car from a standstill.

We’re pleased to see that the Atom has kept his natural teeth in good shape: He must have found time for brushing and flossing in between stunts. Needless to say, his “talent” isn’t one we’d recommend trying at home. But aside from pulling vehicles, teeth can also be chipped or fractured by more mundane (yet still risky) activities — playing sports, nibbling on pencils, or biting too hard on ice. What can you do if that happens to your teeth?

Fortunately, we have a number of ways to repair cracked or chipped teeth. One of the easiest and fastest is cosmetic bonding with tooth-colored resins. Bonding can be used to fill in small chips, cracks and discolorations in the teeth. The bonding material is a high-tech mixture of plastic and glass components that’s extremely lifelike, and can last for several years. Plus, it’s a procedure that can be done right in the office, with minimal preparation or discomfort. However, it may not be suitable for larger chips, and it isn’t the longest-lasting type of restoration.

When more of the tooth structure is missing, a crown (or cap) might be needed to restore the tooth’s appearance and function. This involves creating a replacement for the entire visible part of the tooth in a dental lab — or in some cases, right in the office. It typically involves making a model of the damaged tooth and its neighbors, then fabricating a replica, which will fit perfectly into the bite. Finally, the replacement crown is permanently cemented to the damaged tooth. A crown replacement can last for many years if the tooth’s roots are in good shape. But what if the roots have been dislodged?

In some cases it’s possible to re-implant a tooth that has been knocked out — especially if it has been carefully preserved, and receives immediate professional attention. But if a tooth can’t be saved (due to a deeply fractured root, for example) a dental implant offers today’s best option for tooth replacement. This procedure has a success rate of over 95 percent, and gives you a natural looking replacement tooth that can last for the rest of your life.

So what have we learned? If you take care of your teeth, like strongman Atom, they can last a long time — but if you need to move your car, go get the keys.

If you would like more information about tooth restoration, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine article “Crowns & Bridgework.”

DentalSealantsGiveChildrenanAddedBoostAgainstToothDecay

Although adults are more prone to dental disease, children aren't immune from one particular infection, tooth decay. Some children, in fact, are at higher risk for an aggressive form called early childhood caries (ECC).

There are a number of things you can do to help your child avoid this destructive disease, especially daily brushing and flossing to remove bacterial dental plaque, the underlying cause for tooth decay. It's also important for your child to see a dentist regularly for professional dental cleanings and checkups.

But some of their teeth, particularly the back molars, may need some extra attention to fully protect them against decay. This is because larger teeth like molars have numerous pits and crevices along their biting surfaces that can accumulate dental plaque difficult to remove by brushing alone. The added plaque increases the presence of bacteria around the tooth, which increases the risk of decay.

To minimize this possibility, dentists can apply a dental sealant to "smooth out" those pits and crevices in the molars and make it more difficult for plaque to accumulate. This is a quick and painless procedure in which a dentist brushes a liquid plastic resin or similar material onto the teeth's biting surfaces. They then apply a curing light to harden it into a durable coating.

About one-third of children—mostly those considered at higher risk for tooth decay—have undergone sealant treatment. But the American Dental Association and the American Academy of Pediatric Dentistry recommend this preventive measure for all children between ages 5 and 7, and then later between 11 and 14 when additional molars come in. Although there is a moderate cost per tooth for sealant application, it's much less than the potential expense of treating an infected tooth.

Combined with daily oral hygiene and other preventive measures, sealants can reduce the chances of damaging tooth decay. Keeping your child's teeth healthy is an important part in maintaining their dental health today—and tomorrow.

If you would like more information on preventive dental care for children, please contact us or schedule an appointment for a consultation.

3WaystoCorrectMissingFrontTeeth

Roughly 75% of American adults are missing at least one tooth, mostly from disease, trauma or extraction for other dental reasons. A few missing teeth, though, never erupted in the first place.

It’s a rare occurrence, but sometimes people are born without certain teeth, usually back molars or premolars that may not be as visible. Occasionally, though, it’s the more visible upper lateral incisors positioned on either side of the central incisors (the two front teeth on either side of the midline of the face).

Missing incisors can lead to poor bites and create difficulties for speech development and nutrition. But these highly visible (or in this case, “invisible”) teeth can also detract from an otherwise attractive smile.

There are ways, however to correct a smile with missing lateral incisors. Here are 3 of those ways.

Canine substitution. We can fill the vacancy created by the missing incisors by orthodontically moving the canines (the “eyeteeth,” normally next to them) into the space. Braces can close the gap in a conservative way, while possibly correcting any existing bite problems. Because canines are larger than incisors, its often necessary to re-contour them and restore them with a crown, veneer or bonding material to look more natural.

Fixed bridge. A second way to fill the space is with a dental bridge. A bridge consists of a series of crowns fused together in a row. The middle crowns replace the missing teeth; the end crowns cap the natural teeth on either end of the gap, which establishes support for the bridge. Another variation is a cantilever bridge in which only one natural tooth is capped for support. With either type, though, the capped teeth will be permanently reduced in size to accommodate the crowns.

Dental implants. This popular restoration is also a favorite for correcting missing incisors. Implants provide a life-like and durable replacement for missing teeth, while not requiring any alterations to existing teeth as with a bridge. But they are more expensive than the other options, and they require adequate space between the adjacent teeth for insertion, as well as healthy bone for proper placement and anchorage. This is also an option that must wait until the jaw has fully matured in early adulthood.

If you would like more information on treating congenitally missing 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 “When Permanent Teeth Don't Grow: Treatment Options for Congenitally Missing Lateral Incisors.”





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