Losing body fat can increase you long you live. A body mass index is a measure of your body fat based on dividing weight and height. A body mass index of 25 to 29.9 takes three years off of your life span. A body mass index of 30 or above takes seven years off of your life. Extra weight can increase the risk of heart disease, diabetes, and high blood pressure. Flossing your teeth can keep you healthier. The same bacteria that can cause periodontal disease can cause an immune response that will make your arteries swell, constrict blood flow, and collect plaque. These issues can increase your risk of cardiovascular disease.

Being optimistic can increase your life span by seven and a half years. This positive attitude and outlook boosts the body's immune system and helps it to handle stress better. Not smoking can also increase your life span. People that quit smoking by age 35 live 6 to 8 years longer than people who continue to smoke. Giving up smoking can decrease the risks of lung cancer, heart disease, stroke, chronic bronchitis, and emphysema.

Health Voice - http://healthvoice.blogspot.com/

How many teeth do dogs and cats have, anyway?
Dogs start out with 28 deciduous (baby) teeth, cats start out with 26 deciduous teeth. By six months of age, these baby teeth fall out and are replaced by permanent teeth, 42 in the dog and 30 in the cat.

Will I find the deciduous teeth, and what happens when they don't fall out on their own?
You may or may not find the teeth as they fall out. As dogs play and chew on toys, you might see a tooth. Likewise, as a cat grooms, you may find a tooth in the fur. If the deciduous teeth don't fall out and the permanent teeth erupt under them, this can lead to problems, such as increased tartar formation, malocclusion problems, and gingival (gum) irritation.

When should dental care start with my pet?
The earlier the better. With the help of your Veterinarian, be on the lookout for retained deciduous teeth and malocclusion (bad bite) problems. Your Veterinarian can teach you how to care for your pet's teeth and gums early on.
 

Once a tooth has died, it tends to become brittle and will eventually break down without proper treatment from your dentist. Since the tooth has died, it may not feel sensitive to the patient and is often ignored. As a dentist, I routinely see patients who have broken off the entire crown of a necrotic tooth! Though the tooth may still be saved after it has broken off, unfavorable fractures may require extraction.

A dark shadow around the root of a tooth indicates a tooth abscess (infection) or other pathology.

Using X-Rays to Diagnose Dental Problems

X-rays are a vital aspect to dental diagnosis and treatment. Many potentially injurious conditions would go undetected were it not for the regular utilization of X-rays. Modern X-ray film, equipment and technique make dental radiation safe and effective tools to ensure optimal dental health.

For example, an X-ray of a patient who hasn't been to a dentist in two years can reveal a build-up of tartar (calculus). The calculus is visible on the X-ray as wisps or thorns projecting from the sides of the teeth underneath the gums where you cannot see them. These “thorns of calculus” are a major cause of puffy and bleeding gums (gingivitis), which leads to bone loss and periodontal disease. A dental prophylaxis (cleaning) can make your teeth brighter and squeaky clean once again!

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Pressure at the bracket produces pressure and tension (pulling) at the root of the tooth, causing remodeling of bone and tooth movement. This type of force combination is called a couple, which is defined as two equal and opposite forces acting on a mass.

A couple is a necessary way to move teeth since the braces are attached at the crowns of the teeth, and not at their center of resistance. The center of resistance would be the most ideal position from which to apply forces and move teeth. However, the center of resistance is located at the roots and would therefore be an impossible place to attach a bracket and apply a force.

There is a time lag from the moment pressure and forces are applied until actual tooth movement occurs. The delay in tooth movement is mainly due to how the body removes bone adjacent to the tooth. Bone is many times not removed immediately next to the tooth, but rather a distance away from the root. Therefore it may take the cells a period of 1-2 weeks before bone is removed close to the tooth.

After the initial phase of nearly no tooth movement, the bone then undergoes significant changes, and the tooth begins to move more rapidly. This will usually occur over the next 2-3 weeks, and is also dependant on the amount of force still active on the tooth.

While there are other factors involved in determining the frequency of appointments, the process just described is often the basis for how often appointments are made. Early in treatment, the orthodontist may use a flexible wire that also has a longer activation time. The wire provides a way to keep a gentle force active over a long period of time. Therefore, appointments could be scheduled anywhere from 4-12 weeks apart. Later in treatment, as the wires become less flexible, the time between appointments may be scheduled 4-6 weeks apart for more frequent activation and to keep the forces active.

The length of orthodontic treatment is also related to how the teeth move. There are many variables that may contribute to variation in the length of treatment, including growth, cooperation, and differences in tooth movement. However, since there is a biological limit on the rate of movement, many patients that have similar problems with crowding and a bite that is off will tend to have similar treatment times.

We then stabilize this more ideal relationship with an appliance that fits on the lower teeth. The appliance, called an orthotic, creates a bite that supports the ideal muscle relationship, allowing the patient to chew and function where their muscles are at rest.

How do you confirm that the muscles are in the right place?

There are a number of methods that we use to identify the ideal bite.

1) We use a K-7 Evaluator that allows us to measure the electrical impulses in the muscles, and to track the movement of the jaw in three dimensions during chewing and biting exercises.

2) We use a process called a Phonetic Bite, which uses the relationship of the jaws while pronouncing ‘S’ sounds, to determine the preferred position of the lower jaw, and to preserve that position as the ideal.

3) We also use an Autonomic Nervous System (ANS) Test to track the body’s subconscious response to certain stimuli. When the bite is in an unhealthy position, the nervous system may not be able to function at maximum efficiency in the face of trauma (even perceived minor traumas like scratching your arm). Through the ANS test we are able to observe improvements in the nervous system as a response to support of the ideal bite.

Will I have to wear the orthotic for the rest of my life?

Some patients choose to utilize a long-term orthotic to stabilize the bite and the muscles. Many others choose to have their teeth restored or orthodontically moved to support the healthy muscular and structural relationship. We often recommend treatment by a chiropractor or massage therapist during this process to support the whole body in a smooth transition to a healthy position.

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Why would someone need Neuromuscular or Orthopedic dental treatment?

When you bite down, your teeth fit together like puzzle pieces. This “bite” forces your muscles and jaw into a certain position which may not be ideal. Often the habitual bite relationship is not ideal and leads to muscle spasms and inflammation on the Temporomandibular Joint (TMJ).

Teeth grinding is often a response to the muscle spasms. Grinding wears down the teeth, and as the teeth become shorter the muscles continue to shorten as well. This causes the tension in the muscles to increase, as do the forces on the teeth, often resulting in chipping and breaking teeth. 

As the wear continues, the lower jaw also begins to shift backward, putting pressure on the Temporomandibular Joint, which is just in front of the ear. There are many blood vessels and nerve endings in this area, and the jawbone compresses them when the lower jaw shifts this way. Severe headaches, pressure behind the eyes, tinnitus (ringing), vertigo (dizziness), numbness in the fingers and ear congestion may result. A “bad bite” can also lead to spasm of the facial muscles, often showing up as tightness and pain in the muscles of the head and neck. 

Orthopedically, the force of gravity on your body is designed to bisect the center of your spine. The angle of your bite, your shoulders, your hips, etc. all impact this relationship. Whether through changes occurring to your bite from wear or through the anatomy with which you were born, your body will adapt the way it channels gravity in order to keep you chewing effectively – this is a valuable survival mechanism. As this occurs, many people unknowingly adopt a forward head posture, tilted pelvis, or canted shoulders leading to head, neck, shoulder and back tension and pain.

How do I know if I have a “bad bite?”

Here are some more symptoms you might notice with a “bad bite”:

• Tooth grinding and clenching
• Flat, worn teeth
• Chipped or broken teeth
• Retruded chin or overbite
• Short lower third of the face
• Short, square looking teeth
• Missing teeth
• Receding gums
• Cavities occurring at the gum line
• Snoring or sleep apnea
• Recurring shoulder, neck or back tension

For many years "Sensodyne" was considered as the best toothpaste for sensitive teeth treatment. Today, you can find in the market many teeth sensitivity toothpaste brands. Due to the different way of action of the active ingredients between brands, the best sensitivity toothpaste for each person can be identified only after trial. When testing a toothpaste for sensitive teeth, you must have in mind that most of the sensitivity toothpastes do not show results immediately but only after being used for a period of at least two weeks.
 

Other sensitive teeth remedies include:

Dentist prescribed fluoride gels or high fluoride level toothpastes, work by enhancing the enamel remineralization, 'closing' the dentine microtubules.

Fluoride varnishes may be applied on sensitive teeth by your dentist in more severe cases of teeth sensitivity.

 

The inflammation starts to destroy the gingival and connective tissues, causing the gums to separate from the tooth and retreat towards the roots of the teeth. Actually, it is not only the bacteria that cause the tissue damage and periodontal gum recession, but also the body’s immune system effort to fight the dental plaque bacteria.

Aggressive tooth brushing / Hard toothbrush / Wrong way of brushing or flossing. They all can damage the thin gum tissue causing it to break down. The improper mechanical use of the toothbrush is a key cause for gum recession.

o Increased pressure on the toothbrush or dental floss will only harm gingival tissue without increasing the cleaning action of brushing or flossing.

o The same applies to the use of a hard toothbrush that will make things worse if any other reason co insists.

o Wrong way of brushing such as making large horizontal movements over the teeth is damaging not only the gums but it is also abrading the cementum exposing the dentin and causing sensitive teeth.

Damage to the gums caused by improper brushing is progressively accumulated over the years, resulting in receding gum line. Older women after menopause can suffer from osteoporosis. Loss of mass from alveolar bone that is supporting the gums and teeth can cause gingival recession.

Other possible causes of receding gums include:

Poor oral hygiene. Inadequate brushing or flossing may not directly causing gum recession, but it allows the overgrowth of mouth bacteria and the accumulation of dental plaque, causing gingivitis and potentially periodontitis.

Mouth trauma or injury could make the gums to recede. Other forms of trauma, such as oral piercing that rub against gum tissue can also cause the gums to recede.
Occlusion problems / Misaligned or crooked teeth. Receding gums may occur when teeth are crooked or fillings and crowns are placed without properly balancing the bite. If the teeth do not come together properly, excessive forces are placed on certain parts of the teeth and that may cause trauma to the bone and gums.

Grinding or/and clenching teeth is also putting teeth under excessive pressure, sometimes resulting in gum

Mouthguards used during sporting activites....we notice the college and professional football players placing and replacing them as the game unwinds.  But have you ever wondered about how, where, and with what materials these mouthguards are made?

BENEFITS OF BEING CUSTOM FITTED

Custom fitted mouthguards offer a superior fit.  This fit correlates to having greater oxygen exchange and makes speech a bit better understood.  It also better protects the athlete's teeth....which, after all, is the purpose of the mouthguard in the first place.

To be custom fitted the guard must be made using an impression of the teeth.  Taken at your dental office, this impression is poured with stone so that an exact image of the full arch is at hand.  Then with a laboratory device that incorporates heat and suction the plastic from which the guard is made is molded onto the model.

THE MATERIAL ITSELF

This plastic has shock absorbing properties, is laminated for superior strength, and is designed not to abrade the teeth in any way.  The copolymer sheet is multi layered.  It is of uniform density to resist breakage and wear....yet comfortably soft. 

If colors are important to you, they come in every color imaginable.....patterns of colors like stripes, polka dots, triangles.  Why they even have a copolymer sheet that makes you appear to have fangs!

Off dental topic for this blog for sure.  But I am simply aghast at the decision to release vaccine for the H1N1 virus for use in our Texas prison system.  Not that prisoners are not humans that are due health care, but with the current shortage of vaccine, it seems a poor decision to deliver to this population long before children, pregnant women, people with compromised health situations, etc. have the same opportunity.

CONFINED ENVIRONMENT

I realize that an epidemic in a confined environment is highly likely to spread, but, under the circumstances it seems that not until ample vaccine is in supply would this setting be high enough on the priority list to receive this commodity.  My thoughts wander to the system that sets the order in which vaccine shipments are sent out.  Is it simply first come, first served?  Or do the larger orders carry more weight than the smaller allotments?

Hopefully with the news media alerting the public to this decision, the discussion with be re-attended and the priorities re-set.  Watch dog journalism plays a vital role in our system accountability.  Thanks for "listening"....thanks for allowing me to get this off of my chest.

In an effort to stay true to  a dental hygienists' calling to remain preventative, I was amazed to read this fact in a recent edition of "RDH Magazine".

MILITARY STANDARDS

"At the start of World War II, the military had standards for service requiring the presence of 12 functional teeth.  The number of men disqualified for dental reasons far exceeded expectations, and the dental fitness standard was dropped in October of 1942.  The majority of people applying for military service have traditionally been in their late teens and early 20's, yet back then they could not meet the requirement of having 12 functional teeth."

Only twelve!?!?  How sad.  Once the wisdom teeth have been extracted, we have full dentition at 28 teeth.  Functional alludes to the fact that for a tooth to be in function, it must occlude (chew) against its mate on the opposite arch.  Without function, a person has problems nourishing their body.  Not to speak of issues with speech and a less than full smile line.

It has been suggested that hygienists might well fit the role of risk factor manager.  Patients come to see the dentist/dental hygienist to make sure that they are healthy, that they have no holes in their teeth, no cancerous lesions, and no pus pockets.  They hope that we don't use 'that pick thing' and wonder why we have to leave the x-ray room while they have to stay in there.  Our diagnostic tools have been limited to some 'pick things' and E-speed film.

UPDATED DIAGNOSTICS

That was prior to the standard of care shifting to KaVo (R) laser testing for detection of decay and digital radiographs.  We also have in our array of diagnostics saliva testing.  Saliva testing can also  be a genetic marker for other health issues. 

Further evidence that the mouth is truly attached to head and neck and thus the rest of the body!  A paradigm shift  indeed.

Biomimetics is the process of imitating biological processes.  Through biomimetics it is possible to create synthetic enamel.  This process is not yet perfected, but great progress is being made in reconstruction of this insulating tooth tissue.

MATURE ENAMEL

Mature enamel after the tooth has erupted into the mouth does not contain cells and does not remodel.  It does not have the potential to regenerate.   So this effort to replicate enamel is a huge step toward repairing areas of enamel that have been weakened and eroded due to decay or wear. 

The structure of enamel at high magnification resembles a perfect pattern for knitting or crochet.  Enamel is 2.5 millimeters (a millimeter is about the thickness of a dime)...it is mineralized....and translucent.  Enamel is a natural bioceramic...hard yet resistant to fracture and wear.  It has contradictory mechanical properties...flexibility and hardness.

THE DEVELOPMENT OF ENAMEL

Amelogenesis is the development of enamel.  It begins in humans during the third trimester of pregnancy.  Six months after birth the enamel is fully mineralized and the organic matrix is degraded and removed.  Both decay (caries) and erosion are the result of enamel mineral loss due to an acidic environment in the mouth.  Caries formation specifically involves the presence of bacteria.

SYNTHETIC ENAMEL

Researchers are working towards using synthetic enamel for use as a future alternative dental restorative material.    Through stem cell biology we have the potential to regenerate not just enamel, but the entire tooth.  Regeneration of an entire tooth is possible!

This advancement  may lead to patients receiving a dental device (a night guard for example) that contains the appropriate organic and inorganic materials for release into the oral cavity that will help enamel to regrow overnight!

Trident (R), known for its innovations in sugar free gum, has done it again.  They have improved their product line by creating Trident (R) Xtra Care.  This variety of gum has Recaldent, also known as CPP-ACP, in it.  This is a  unique form of calcium derived from milk that remains in the plaque layer for up to three hours after chewing.  This promotes remineralization of tooth enamel and thus helps to reduce dental caries.  Since Recaldent is derived from milk, this product is not recommended for those with a milk allergy.   It is digestible for patients with lactose intolerance.

Xylitol

Trident (R) with xylitol (a natural sweetener) helps to protect teeth by neutralizing the acids produced by plaque.  With reduction of acid levels, the rate and pace of dental decay is also reduced.  Trident (R) White works to help whiten teeth by using a patented surfactant technology that disperses and prevents stains.

Increased saliva flow = decreased acidity level

Chewing sugar free gum is not harmful to your teeth.  It promotes salivary output and with an increase in saliva flow there is a related decrease in acid levels in the mouth.  Since decay (cavities) are caused by an acidic state in the mouth, any activity or product that brings the mouth back into a basic (alkaline) state is preferred.

Just note that there is a reason behind each and every question.  It is important that you take the time to fill out your medical history form as thoroughly as possible.  One little question that is asked is about  "Allergic Reactions". 

We use latex gloves regularly during our dental appointments.  Sometime reactions may increase over time.  There are alternatives to latex so if you have ever had any reaction to latex please let your health professional know in advance.  Reactions to latex may be simple as a mild skin irritation to a life threatening condition know as anaphylactic shock.  We take our  medical history forms and your health very seriously, we hope that you do do. 

If you would like to learn more about latex allergies, check out:  http://www.ada.org/public/topics/latex_allergy_faq.asp

Teeth brushing
Brush your teeth at least twice a day. Use a soft-tufted brush and a toothpaste that contains fluoride. The head of the brush should be small enough to get into all the areas of the mouth. Spend at least two minutes brushing, covering all areas (the inside, outside, and biting areas of each tooth). Pay particular attention to where the teeth meet the gum. Get a new toothbrush every 3-4 months.

Many people find that an electric toothbrush does a better job than the traditional toothbrush, and so they have become popular.

Flossing
Floss your teeth at least once a day after brushing, and preferably twice a day. Some people who have not flossed before are surprised as to how much extra debris and food particles can be removed by flossing in addition to brushing.

If you are not sure how to floss, then ask your dentist or dental hygienist. Briefly: the usual floss looks a bit like cotton thread. Cut off about 40 cm. Wind the ends round your middle fingers of each hand. Then grab the floss between the thumbs and first finger to obtain a tight 3-4 cm section which you can pull between teeth. Gently scrape the floss against the sides of each tooth from the gum outwards. This will clean the narrow spaces between the teeth which toothbrushes cannot get to. Use a fresh piece of floss each time.

Some people prefer floss 'tape' which slides between teeth more easily than normal floss. Also, some people use disposable plastic 'forks' with a small length of floss between the two prongs. The plastic fork may be easier to hold and manipulate. However, they are expensive.

The gums may bleed a little when you first begin to floss. This should settle within a few days. If it persists then see a dentist as regular bleeding after flossing may indicate early gum disease.

Other general tips
Other things which are important to keep your teeth and gums healthy are:

• If you smoke, try to stop. Gum disease is more common in smokers than non-smokers.
• Eat a well balanced healthy diet. In particular, you should limit the amount of sugary foods and drinks that you have. Sugars and sugary foods in the mouth are the main foods that bacteria thrive on to make acid which can contribute to tooth decay.
• If children need medicines, wherever possible use sugar free medicines.
• Have regular dental checks at intervals recommended by your dentist (this is normally at least once a year). A dentist can detect excessive build up of plaque and remove calculus. Early gum disease can be detected and treated to prevent it from getting worse.

Other things you can do if you have bad breath
The measures above are usually sufficient to look after your teeth and to prevent bad breath. However, if you still have bad breath coming from your mouth then the following extra measures will usually cure the problem.

Mouthwashes
Consider using a mouthwash each day. Chemicals in the mouthwash aim to kill bacteria and/or neutralise any chemicals that cause bad breath. It is difficult to advise on which mouthwash is the most effective. A number of clinical trials have shown that various ingredients are good at reducing bad breath. These include: chlorhexidine, cetylpyridinium chloride, chlorine dioxide, zinc chloride and triclosan. The various mouthwashes that you can buy usually contain one or more of these ingredients, plus various other ingredients.

Note: some people are reluctant to use a chlorhexidine-containing mouthwash long-term. This is because it has an unpleasant taste, can give rise to a burning sensation in the mouth if used too frequently, and can cause (reversible) staining of the teeth.

Note: some mouthwashes contain alcohol as one of their ingredients. There is some concern that long-term use of alcohol-containing mouthwashes may be a risk factor in the development of mouth cancer.

Young children should not use a mouthwash if they may swallow it.

Tongue cleaning
Consider cleaning the back of your tongue each day. Some people do this with a soft toothbrush dipped in mouthwash (not toothpaste). An easier and better way is to buy a special plastic tongue scraper from a pharmacy. You need to place it as far back as you can and then gently scrape forward to clear the tongue of any coating. A review in 2006 (cited at the end) concluded that ... "tongue scrapers or cleaners are slightly more effective than toothbrushes as a means of controlling halitosis in adults".

Chewing gum
Some people chew sugar free gum after each meal. It is not clear how well gum helps to reduce bad breath but chewing gum increases the flow of saliva. Saliva helps to 'flush' the mouth to help clear any debris remaining from the meal.

If you have dentures and have bad breath
You may not be cleaning them properly. Ask your dentist for advice on cleaning dentures.

Morning bad breath
Most people have some degree of bad breath after a night's sleep. This is normal and occurs because the mouth tends to get dry and stagnate overnight. This usually clears when the flow of saliva increases soon after starting to eat breakfast.  This should be followed with brushing and flossing.

Foods, drinks and medicines
Chemicals in foods can get into the bloodstream, and then be breathed out from the lungs. Most people are familiar with the smell of garlic, spicy foods and alcoholic drinks on the breath of people who have recently eaten or drunk these. Various other foods and medicines can cause a smell on the breath. This type of bad breath is temporary and easily cured by not eating the food. (However, some people eat spiced food every day and as a result will constantly have a typical smell on their breath.)

If a medicine is causing the problem then discuss possible alternatives with your doctor. Medicines that have been associated with bad breath include: betel, chloral hydrate, nitrites and nitrates, dimethyl sulphoxide, disulphiram, some chemotherapy drugs, phenothiazines and amphetamines.

Smoking
Most non-smokers can tell if a person is a smoker by their breath which 'smells like an ashtray'. Stopping smoking is the only cure for this type of bad breath. Smoking also increases the risk of developing gum disease, another cause of bad breath.

Crash dieting or fasting
Can cause a 'sickly sweet smell' on the breath. This is due to chemicals called ketones being made by the breakdown of fat. Some ketones are then breathed out with each breath.

Medical causes
Other medical causes are uncommon. Some people with nose problems can get bad breath. For example, a polyp in your nose, sinusitis or a 'foreign body' stuck in a nostril (occurs most commonly in children) can cause a bad smell. In this situation the smell tends to occur only, or more severely, when you breathe out through your nose. It is not so noticeable when you breathe out through your mouth. Infections or tumours of the lung, throat, mouth or tonsils are sometimes a cause. Other causes are rare.

However, in these 'medical' cases, there are usually other symptoms that would indicate the cause. For example, a blocked nose, sinus pain, chest symptoms, fever, etc. If you are otherwise well and have no other symptoms apart from bad breath, the bad smell is likely to be coming from a build up of bacteria within the mouth and other 'medical' causes are unlikely.

Bad breath coming from within the mouth
In most people who have bad breath the bad smell is thought to come from bacteria within the mouth. As the bacteria break down proteins and other debris in the mouth, they release foul smelling gases. One or more of the following may contribute to the build up of bacteria and bad breath:

--Food stuck between teeth. Normal teeth brushing may not clear bits of food which can get stuck between teeth. The food then rots and becomes riddled with bacteria. Regular flossing can clear and prevent this problem.
--Plaque, calculus and gum disease. Dental plaque is a soft whitish deposit that forms on the surface of teeth. It forms when bacteria combine with food and saliva. Plaque contains many types of bacteria.

--Calculus, sometimes called tartar, is hardened calcified plaque. It sticks firmly to teeth. Gum disease means infection or inflammation of the tissues that surround the teeth. If your gums look inflamed, or regularly bleed when you clean your teeth, you are likely to have gum disease. The severity can range form mild to severe.
--Coating on the back of the tongue. In some people, a 'coating' develops on the back part of the tongue. It is not clear why this occurs. It may be from mucus that drips down from the back of the nose ('post nasal drip'). The coating can contain many bacteria. This explains why bad breath can sometimes occur in people with otherwise good oral hygiene.
 

Pregnancy gingivitis is common during pregnancy because hormonal changes during pregnancy may exaggerate the body's normal response to dental plaque. This hormonal increase exaggerates the way the gum tissues react to the bacteria in plaque, resulting in an increased likelihood that a pregnant woman will develop pregnancy gingivitis if her daily plaque control is not adequate. Pregnancy generally worsens any existing gum problems, sometimes dramatically. However, most cases of pregnancy gingivitis can be prevented with proper oral hygiene.

There is a special need for good oral hygiene to prevent pregnancy gingivitis. With superior oral hygiene, pregnancy gingivitis can be almost entirely avoided. 

When we are around the age of 6, we all begin the process of losing our baby teeth, all 20 of them over the next 6 or so years.  Concurrently, we begin getting our adult teeth.  This whole process lasts until approximately 17-21 years of age.  In the interim we may or may not go through the processs of orthodontia to straighten malaligned teeth.  If malaligned teeth have been straightened, it is highly recommended to have the wisdom teeth removed at the first glimpse of the wisdom teeth beginning to errupt.  The erruption of wisdom teeth increases the risk of undoing everything that braces achieved.  Wisdom teeth, because they are the last to come in and because they are the furthest back in our mouth, are highly unpredictible.  They may come in straight and with plenty of room but more times than not they create a crowded environment, can create incredible discomfort and pain and are very difficult to keep hygienic.

For more information a good site to check out is:  http://www.ada.org/public/topics/wisdom_teeth.asp

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Crest® Glide® Deep Clean Dental Floss Broader Fiber delivers up to 90% more micro-textured surface area than Glide Original Dental Floss
Coolant creates a cooling sensation that leaves your mouth feeling fresh and clean
Slides easily between teeth
Designed to reduce "snapping" into gum line
Extra soft and comfortable on fingers and gums
Wide construction makes it easy to grip
 

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Crest® Glide® Original Slides easily between teeth and resists shredding
Helps prevent gingivitis, for healthy teeth and gums
 

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Effectively removes plaque and food particles
Slides easily between teeth and resists shredding
 

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Satin-like finish
Burst of mint flavor
 

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Oral-B® UltraFloss® Patented interlocking network of spongy nylon fibers actually change shape to help remove plaque
Premeasured 18" lengths
Natural, fresh mint flavor
 

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Oral-B® SuperFloss® Easy insertion with stiff end threader
Soft filament brush
Mint SuperFloss encourages compliance
 

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Oral-B® Stages Kids' Flossers Contoured handles make it easy to grip and maneuver between teeth
Popular Disney characters and designs encourage compliance
Individually wrapped for easy dispensing

Gingivitis

In the early stages of periodontal disease, your gums may be red and bleed easily. This is the stage called gingivitis, and is usually due to inadequate oral hygiene. Paying more attention to brushing and flossing your teeth, and regular visits to your dentist, can reverse this condition.

Periodontitis

Left untreated, gingivitis advances to periodontitis. As the bacteria continue multiplying and excreting more and more acid, plaque spreads below your gum line, creating little spaces between the gums and the teeth. Left there long enough, the plaque hardens into tartar (also called calculus).

Now it can’t be removed by brushing or flossing, but must be professionally removed. It continues breaking down and destroying tissue and bone. As a result, the gums separate more from the teeth, and infection develops in the pockets, enlarging them. The teeth become loose. Unless something is done, this vicious cycle becomes ongoing. More bacteria multiply, creating more space for more bacteria to multiply. At first you’ll feel pain, but after the nerves within the affected teeth have died, there’ll be no pain and you might think the problem is resolved. But the sad truth is that your teeth will continue to decay and loosen until they fall out by themselves or require removal.

Connection to heart disease

Unfortunately, losing your teeth is not the only eventuality with periodontitis. Studies show a clear correlation between gum disease and heart disease, highlighting the fact that people with gum disease have a 25 percent greater risk of heart disease than those with healthy gums.

Although scientists have just begun to understand how one disease affects another, they now believe that inflammatory gum disease releases pro-inflammatory chemicals into the bloodstream, triggering a systemic inflammatory response. In other words, inflammation in one area of the body can cause inflammation in another. Additionally, people with poor oral health and missing and decayed teeth tend to suffer from poor nutrition. Why? Because eating a nutritious diet high in fiber, fruits and vegetables is more difficult for them. This too can affect heart health.

Preventing and treating gum disease

To prevent it, good dental hygiene is absolutely essential. There is no way around this. We must all brush at least twice a day and floss every night to keep the number of bacteria from multiplying out of control. In addition, twice-yearly visits to a dentist for cleaning and check-up is essential. Why?

Because although brushing and flossing removes plaque, that sticky coating that forms on the teeth, few of us can remove it all. A dentist can clean off accumulated plaque, and the plaque which has been there so long that it has turned into tartar (calculus). Once tartar has formed, it has to be removed with a special implement called a scaling tool.

A twice-yearly check-up will find small areas of decay so they can be repaired before they grow large and threaten the tooth’s life. Your dentist will use a probe to find pockets forming between the gums and teeth, where bacteria could gain a foothold.

If you have developed the deep pockets typical of periodontitis, your dentist will clean these as often as every two months until the infection can be brought under control. Additionally, root planing may be needed, where the infected base around the root of your tooth is removed.

Good daily care

Maintaining good oral hygiene at home and seeing your dentist twice a year for cleanings will help you to avoid many of these unpleasant oral conditions. To avoid gum disease and keep your teeth and gums in tip-top shape, here are a few tips:

· Brush at least twice daily

· Use a fluoride toothpaste to protect against decay

· Use a toothbrush with soft bristles that has a head small enough to comfortably reach all around your mouth

· Floss between all teeth, curving the floss around each neighboring tooth to contact the curving surfaces

Take good care of your teeth and your gums! It’s one more way to protect yourself from having a heart attack.

There are three products available through your dentist's office that work to reduce tooth sensitivity resulting from whitening.

ACP (Amorphous Calcium Phosphate)

Amorphous Calcium Phosphate is an added ingredient in some brands of peroxide bleaching gels.  ACP is also an ingredient in some of the polishes now used in dental offices during your cleaning (prophylaxis) by your dental hygienist.  It actually nourishes and replenishes the tooth much like lotion nourishes and replenishes dry skin.

Potassium Nitrate

Potassium Nitrate is another ingredient that is present in some whitening gels.  It works by blocking the nerve transmission to the brain that originates when a stimulus touches a sensitive spot on your tooth.  Potassium Nitrate can also be used alone in gel form.  This gel would be placed in your custom fitted whitening tray and settled onto your teeth for 10-30 minutes prior to and/or  following whitening.  Combinations of Fluoride and Potassium Nitrate work in the same manner. 

Fluoride

Fluoride, either in gel form delivered via a custom fitted whitening tray or in prescription strength toothpaste form, remineralizes the tooth.  It also aids in the recovery of enamel microhardness that results from the  whitening process.  Calcium Peroxide and Carbamide Peroxide in combination have been found to recalcify incipient lesions and to increase surface microhardness while simultaneously whitening teeth.

If potential tooth sensitivity is keeping you from whitening, please know that there are helpful products available.

Scaling and root planing, a procedure done for patients who have periodontal pocket depths of greater than 4 millimeters in several areas of the mouth, is aided by the application of local anesthesia to allow for patient comfort during this procedure.  The dentist can inject the patient all across the upper and lower quadrants on one side of the mouth to create this level of comfort.  The patient will feel numb especially on the lower lip and half of the tongue for up to 4 hours following injections.  The upper teeth are also numbed, which requires 6-7 injection sites.  The tissues where the local anesthetic is injected can afterward be sore and tender.

An Option

Enter Oraqix (R)....a gel that contains lidocaine and prilocaine.  It has a 30 second onset and a 20 minute duration.  It can not numb the tooth, but does effectively numb the periodontal tissue surrounding the tooth.  There is no residual numbness of the the lip and tongue.  No tenderness at injection sites.

The clinician first applies the gel to the tissue surrounding the tooth....waits 30 seconds....and then goes back into the subgingival pocket with the gel.  That way the tissue is numbed prior to the deeper application into the pocket allowing comfort to reign.  Oraqix (R) can be reapplied if needed so that  tissue numbness  resides.

Check it out for yourself at:  www.oraqix.com.

Although gingival bleeding is a clinical symptom of both scurvy and periodontitis, the two conditions are distinct disease entities. Unlike for scurvy, which is caused by vitamin C deficiency, the etiological agents in periodontitis are dental plaque bacteria, especially gram-negative microorganisms, including Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis. An inflammatory response to the overgrowth of periodontal bacteria in general, and to certain species in particular, leads to microulceration in the epithelium-facing tooth surface in periodontal pockets, opening a route for the bacteria to the circulation. In periodontitis, bacteria and their components are commonly spread in circulating blood. The continued local or systemic bacterial stimulus causes release of proinflammatory mediators, which may have a role in the pathogenesis of atherosclerosis and stroke. Accordingly, findings suggesting a role of periodontitis in cardiovascular diseases (CVD) add a new perspective to the importance of oral status for systemic health.

Vitamin C has long been a candidate for modulating periodontal diseases, although the exact role of vitamin C deficiency in periodontitis is not known. Even though low vitamin C intake does not cause periodontitis, it is known that additional vitamin C is required during infectious diseases and tissue regeneration. Avitaminosis-C is associated primarily with defective collagen synthesis, causing tissue dysfunction such as impaired wound healing and ruptured capillaries because of insufficient support of the capillary walls by the connective tissues. Regeneration of collagen to maintain the integrity of the tooth attachment elements is especially important for periodontal health. Since vitamin C is involved in the synthesis of intercellular substances such as collagen fibers found in various forms of connective tissues and the matrix of bone and teeth, and since vitamin C has immunomodulating functions influencing the susceptibility of a host to infectious diseases, it is rational to hypothesize that a low vitamin C concentration in serum is a risk factor for periodontal diseases.

The role of a low vitamin C concentration in plasma as a risk factor for periodontitis needs reevaluation. First, the concerted action of intensified susceptibility to infections together with quantitative and qualitative changes in dental plaque microbiota favors the growth of fastidious periodontopathogenic species. This leads to an altered oral-periodontal ecosystem and increased risk for development of periodontitis. Second, due to the irreversible nature of the destruction of tooth-supporting tissues, untreated periodontitis increases the infectious burden, even after the correction of the vitamin C deficiency. The aim of the study was to clarify how vitamin C relates to periodontitis in two culturally different populations with very different plasma vitamin C concentrations.

 © 2003 American Society of Microbiology

The US Public Health Service (PHS) has, since 1962, recommended that public water supplies contain between 0.7 and 1.2 milligrams of fluoride per liter of drinking water (mg/L) to help prevent tooth decay. (Some natural water sources have fluoride levels within this range, or even higher.)

Fluoridation is now used in the public drinking water supplied to about two thirds of Americans. The types of fluoride added to different water systems include fluorosilicic acid, sodium fluorosilicate, and sodium fluoride.

The US Environmental Protection Agency (EPA) has set a maximum amount of fluoride allowable in drinking water of 4.0 mg/L. Long-term exposure to levels higher than this can cause a condition called skeletal fluorosis, in which fluoride accumulates in the bones. This can eventually result in joint stiffness and pain, and can lead to weak or brittle bones in older adults.

The EPA also set a secondary standard of no more than 2.0 mg/L to help protect children (under the age of 9) from dental fluorosis. In this condition, fluoride collects in developing teeth, preventing tooth enamel from forming normally and resulting in permanent staining or pitting of teeth.

Today a vital part of restorative dentistry is the anesthesia and analgesia.  These practices were not always available to the dental patient.  Can you even imagine having a filling done or a tooth extracted with full sensation?

Relief is in sight

Ether was introduced in 1842 by Morton.  Wells brought nitrous oxide (laughing gas) to the treatment plan in 1844.  But these were used only for extractions and other surgical procedures, leaving the restorative patient to "go it alone" without the aid of diminished sensation.

In 1884, Carl Koller discovered the analgesic properties of cocaine.   Later that same year, William S. Halsted introduced conduction anesthesia by injecting cocaine to block the nerve in the lower jaw.  Cocaine completed its task well, but its addictive properties deemed it less than acceptable.  1905 saw procaine created by Einhorn and Uhfelder in Germany.  They later mixed procaine with small amounts of epinephrine and thus found a safe, highly effective agent for local anesthesia. 

These local anesthetics are deposited near a nerve and create a chemical barrier that prevents the pain impulse from reaching the brain.  The average duration of modern local anesthetics is four hours....ample time for the dental procedure to be completed. 

New options

A new product, OraVerse (R) is injectable phentolamine mesylate.  It accelerates reversal of soft-tissue anesthesia.  The recovery time with this product is fifty five percent faster than traditional local anesthetics.  The drawback is that irregular heart rhythms may manifest in the form of tachycardia, bradycardia, and other cardiac arrhythmias.

The Single Tooth Anesthesia (STA) System (R)  is another option.  It is a computer controlled local dental anesthetic system.  It has real time visual and audible feedback technology which allows the clinician to easily obtain proper needle placement.

With research and technology, options continue to be studied.  All of this with your comfort in mind.

The aphthous ulcer appears as a white or yellow oval with an inflamed red border. Sometimes a white circle or halo around the lesion can be observed. The gray-, white-, or yellow-colored area within the red boundary is due to the formation of layers of fibrin, a protein involved in the clotting of blood. The ulcer, which itself is often extremely painful, especially when agitated, may be accompanied by a painful swelling of the lymph nodes below the jaw, which can be mistaken for toothache; another symptom is fever. A sore on the gums may be accompanied by discomfort or pain in the teeth.

I went to the University of NM Dental Hygiene School, and as part of my curriculum--I learned how to administer local anesthetic.   After I graduated from UNM I moved to Palm Springs, CA, where I was also licensed to give local anesthetic.  For almost 10 years I gave local anesthetic on an almost daily basis.  Giving injections to dental patients became second nature to me.  I feel so sad about this law here in Texas. 

I see on a daily basis how, if I could practice dental hygiene to my full capacity and level of education,  it could benefit my dentist SO MUCH.  On days that we are busy I see myself just walking in the operatory and giving anesthesia for him.  It saves him a trip down the hall, 2 pairs of gloves and probably about 20 minutes--each time.  How much is that worth??  A lot i say.  On any given day I figure I could save him about one hour worth of waiting and therefore be able to increase his overall production on a daily basis. 

When I used to give local anesthetic I would use a 30 gauge needle for patient comfort.  I would change the needle frequently because it gets dull after a few injections.  Go slow and easy...and the patients love you.  Maybe I need to get more involved in my state legislature to see why something so beneficial is not yet allowed in this state. 

Clear plastic retainer
Bonded retainer (non-removable)
Traditional wire retainer

A clear plastic retainer is normally placed on the upper teeth one or two days after the braces are removed. It resembles the Invisalign appliance. It is normally worn only at night and lasts an average of 24 months. After it wears out your orthodontist may replace it with a traditional wire retainer.

A bonded retainer is normally placed on the tongue side of the lower teeth after the braces are removed. It is a wire bonded to the teeth with composite. It is important to floss under the wire daily with floss threaders. Sometimes this type of retainer will be used for the upper teeth, but normally this is not possible because it would interfere with your bite. A bonded retainer will remain in place for several years or indefinitely. 

A traditional wire retainer is normally placed after discontinuing use of either the clear retainer or bonded retainer. This type of retainer has the added benefit of being adjustable so that minor tooth movement is possible. Sometimes a wire retainer can be worn full time instead of braces to correct mild crowding.
 

Tooth whitening products contain with hydrogen peroxide or carbamide peroxide.  There are some products that work by way of enzymatic whitening ingredients.  In the end, hydrogen and carbamide peroxide work in the same chemical manner.  Carbamide peroxide breaks down into hydrogen peroxide and urea.  It is the hydrogen peroxide that is responsible for the whitening activity.

STAIN  MOLECULE IS NOT ACTUALLY REMOVED FROM THE TOOTH

Hydrogen peroxide works by diffusion through the enamel.  It oxidates... breaking the bonds in the stain molecules.  The effect is that the stain molecule becomes unseen by the eye...invisible.  The stain molecule is not actually removed from the tooth.  Thus this is not an abrasive process that thins and weakens the enamel.  Any stain contained within the tooth (not simply on the surface of the tooth) is labeled intrinsic.

Surfactants in the whitening agent then lift and remove surface (extrinsic) stain.  In-office and at-home whitening treatments have the same mechanism chemically.  The difference is in their concentration or potency.  The speed at which the whitening occurs is in direct proportion to the concentration of the whitening agent.

Whitening is safe and affordable.  It can literally take years off of your smile in a short period of time.  Definitely worth investigating!

Waterpik (R), a brand known for decades, has once again improved its scope and reach to further improve your dental health.  Recently the company released its Orthodontic Tip (R).  The Waterpik Orthodontic Tip (R) features a tapered brush on the end.  This allows for irrigating and brushing around the orthodontic hardware simultaneously.  This tip is included in the packaging for the Waterpik (R) Ultra  as well as the Waterpik (R) Ultra Cordless dental water jets.

THREE TIMES AS EFFECTIVE

Studies published by the "American Journal of Orthodontics and Dentofacial Orthopedics" showed that brushing and using the Waterpik (R) dental water jet with an orthodontic tip was three times as effective as brushing and flossing.  Improving the end result of any tooth cleansing regimen directly translates into a reduction in the bacterial load in the mouth and fewer issues with gum (gingiva) and tooth infections.  With an increase in bacterial load, cavities (decay) and gum (gingival) inflammation followed by infection is highly likely.

An added bonus is that using the Waterpik (R) actually feels like a massage to the oral tissues.  It stimulates blood flow into and out of the tissues.  Increased blood flow correlates with increased oxygenation.  Oxygen brings renewal to the tissues on a cellular level.  Another win/win situation!

Survey the equipment options at:  www.waterpik.com.  Water Pik is based in our very own Fort Collins, Colorado.

AAOS now states that "Given the potential adverse outcomes and cost of treating an infected joint replacement, the AAOS recommends that clinicians consider antibiotic prophylaxis for all joint replacement patients prior to any invasive procedure that may cause bacteremia."

The 2003 advisory statement recommended antibiotic prophylaxis for all patients within the first two years after replacement surgery only; after two years, the recommendation for prophylaxis was limited to patients who had comorbidities that might plae them at increased risk for hematogenous total joint infection (i.e. immunocompromised patients).

Specific dental procedures that may potentially cause bacteremia are not identified in the new statement.  In the 2003 statement, the following procedures were identified as a higher incidence of bacteremia:  dental extractions; periodontal procedures, including surgery, subgingival placement of antibiotic fibers/strips, scaling and root planing, probing, recall maintenance; dental implant placement and replantation of avulsed teeth; endodontic (root canal) instrumentation or surgery only beyond the apex; initial placement of orthodontic bands but not brackets; intraligamentary and intraosseous local anesthetic injections; prophylactic cleaning of teeth or implants where bleeding is anticipated. 

In short, if you have a joint replacement, you need antibiotic premed for the rest of your life for most dental procedures.

Just when you thought you had heard it all, technology comes through again!

I am sure that you remember having to have your teeth numbed at the dentist office.  Whether you are having a filling, a crown, a root canal, or any other procedure that requires anesthesia, local anesthetic delivered via a needle has been the standard of care for decades now.  Enter Gum Ease (R).

Cryoanesthesia

This product uses cryoanesthesia to produce a numbing effect in the mouth.  The device is placed overnight in a temperature controlled freezer and is kept at 22 degrees Fahrenheit.  It is taken directly from the freezer and placed immediately in the sulci (just inside the lips).  A regional pain block is achieved by the application of extreme cold to the maxillofacial nerves.  The nerve fibers are chilled and can no longer transmit pain impulses to the brain.

It takes only four minutes to take effect.  This does not in any way damage the tissue inside the lips where the Gum Ease(R) device rests.  It usually takes two devices to provide anesthesia for most average length dental procedures. 

Check it out for yourself @ www.olympicdmd.net.

Below is a small list of problems that can cause the failure:

--One or more extra canals may be present that the dentist was unable to detect.  Dead, or partially alive tissue hidden inside the tooth can cause abscesses or ongoing bouts of pain and may lead to failure.

--A fractured root may cause failure of a root canal.  Teeth will dead nerves are brittle.  A fractured tooth usually means loss of the tooth.

--Hypersensitivity to the materials used to fill the canals may cause the patient to "reject" the tooth.  This is a very rare occurrence.  The gutta percha and cement used to bind the gutta percha to the inside of the canal and to seal the apex have both been formulated to have benign characteristics.

Most of the time, local anesthesia works very well during a root canal treatment appointment.  This is especially true if you are not already in pain when you arrive at the endodontist's office.  On the other hand, inflamed tissue (hot, red, swollen and painful) is acidic in nature.  The anesthetic is very pH sensitive.  If the tissue is too acidic fewer anesthetic molecules convert to a diffusible form.  A hot tooth is one in which the nerve is alive, but badly inflamed.  The tooth in generally already painful, to hot/cold stimulus.  In this case, much more anesthesia is required and is sometimes not sufficient until the infection can be resolved by an antibiotic so that anesthesia can be injected into a more basic environment,. 

The best way to prevent tooth pain is to be proactive and not let a tooth get badly infected and if needed getting root canal treatment before the infection is out of control.  In most scenarios, there is no pain during root canal treatment, at all.

When you put a piece of food in your mouth, the chemicals in it alert the taste buds to carry "taste messages" through your nerve cells to your brain. It is in your brain that you actually become aware of the taste of something.

Since your food and your tongue must be moist for the taste buds to start working, your body sends out saliva to mix with any dry foods. To understand how this works, you can try an experiment. Wipe your tongue very dry and then put a lump of sugar in your mouth. Do you find that you cannot taste the sugar? That's because your body hasn't yet started to produce the saliva to dissolve the sugar for you to taste. However, in a minute or two, when that saliva is produced, you are able to taste it.

You have about 3,000 taste buds on your tongue!

Sensodyne is a toothpaste long known for its desensitizing effects on teeth.  It has proven effective for years and years in those areas where the root surface (cementum) has become exposed due to gum (gingival) recession.  Since cementum is abundant in nerve endings, it can react to cold and touch stimuli.  Eroded enamel exposing dentin (also abundant in nerve endings) can also be reactive to the same stimuli.

Sensodyne Iso-Active Foaming Gel

Now Sensodyne has incorporated an iso-active system to increase its dispersion to these sensitive areas.  Its foaming action generates twice the volume of ordinary toothpaste.  Sensodyne Iso-Active Foaming Gel is a truly unique expanding foaming gel.  This combination makes for a more rapidly dispersed and penetrating dentrifice.

This technology allows the dentrifice to remove significantly more bacteria than ordinary toothpaste, more effectively removing the cause of bad breath.  It is recommended that you use Sensodyne twice daily for 8 weeks, brushing for 2 minutes per session.  Only after this amount of time should you pause to evaluate whether this product has taken care of your sensitivity problems or whether you need to call your favorite dentist to have things evaluated.

Xerostomia (pronounced zero stow me ah) is a condition that is characterized by dry mouth.  The saliva (spit) can be thick and ropey and/or decreased in volume.  Saliva is a lubricant that allows us to swallow effectively....like oil in your automobile's engine.  Without it the tissues of the mouth get overly dry and actually stick to themselves.  If you have ever had dry eyes or dry skin, multiply that by ten and you can only imagine how irritating that would be.

Saliva is also a buffering agent....working to maintain a basic pH in the mouth.  Without its presence, the mouth leans towards being more acidic than is healthy for the teeth and the tissues.  Couple this with the acidity of the things that we may choose to eat and drink, and the recipe for decay and tissue ulcerations accelerates.  Without the full effect of saliva as a buffer, the bacteria that naturally live in our mouths proliferate.  Each and every time that these micro-organisms reproduce, they put off an acid.  This acid etches, or weakens, the tooth which leads to decay.

Dry mouth can cause difficulty in speaking.  A person can have an alteration in taste of their food and drink choices since the taste buds are impacted by reduced saliva presence.  A foul odor can develop due to the increase in bacteria and the acidity level.

There are artificial saliva drops and sprays that can be purchased over the counter to supplement.  It is always a good idea to sip, sip, sip on water.  But please make sure that the water has a pH of 8.5-9 (basic).  Check with your city water department to learn the pH of tap water.  If you are a bottled water fan, check to make sure that you know the pH.  Many bottled waters are acidic in nature.  This knowledge of water pH is for all, not just those who suffer with xerostomia.

Using a humidifier where you sleep or work can add moisture to the air and, upon inhalation, can be helpful in increasing the moisture content in your body tissues.  Caffeine has a drying effect.  So deciding to reduce or eliminate caffeine from your diet can greatly help the situation.  Keeping the lips protected with a non-petroleum based balm is another step towards relief. 

For many people, their prescription medication is the cause of their xerostomia.  Check with your prescribing physician and pharmacist for alternative medications that are not as drying.  Or possibly changing your dosage slightly may help.  Combinations of prescription meds can also trigger symptoms.

Understanding your options is empowering!  Ask your dental, dental hygienist, or dental assistant if you ever have a question concerning oral health.  We are here for you.

Each year 1.2 million Americans are diagnosed with cancer.  400,000 of those diagnosed will have oral complications from cancer treatments.  One hundred percent of patients with cancers whose treatment includes head and neck radiation will have oral complications.  Cancer is beginning to be considered a chronic disease, rather than always a fatal one.

Primary complications include:  mucositis/stomatitis (mouth sores), pain, infection, salivary gland disfunction, rampant decay/demineralization, taste alterations, and trismus (continuous contraction of the muscles of the jaw which can lead to gnashing and grinding of the teeth).  Secondary complications include:  dehydration, dysgeusia (difficulty swallowing), malnutrition, and systemic infection.  The good news is that  many of these complications can be prevented!

First-have a thorough dental cleaning (prophylaxis) prior to chemotherapy.  Chemotherapy is acidic.  It basically creates burns in the tissue.  The trick is to neutralize the tissues of the mouth.  Rinse with 1/4 teaspoon of baking soda and 1/4 teaspoon of salt in 1 quart of warm water every 1/2 to 2 hours.  This rinsing regimen is best monitored by someone other than the patient.  It's easy to forget how long it's been since the last rinse or to decide that staying on top of this rinse regimen can not be that helpful when you step back and take a look at the many decisions being made by a cancer patient.

Seems too simple, but honoring the pH system that our bodies need to stay healthy is powerful!

Melanotic Macule.  A freckle on the lip.   The lower lip is more often the site where a melanotic macule is found.  It is simply due to sun exposure and is painless, but constant.  It does not fade in color or come and go.

The Melanotic Macule can also be found on the gum tissue inside the mouth, on the palate of the mouth, or in the cheek area (buccal muscosa).  To be sure that it is not pre-cancerous or cancerous, it can be biopsied to exclude the diagnosis of malignant melanoma.  Once the biopsy report  shows Melanotic Macule, there is no treatment recommended.

Prevention would be to keep a lip balm with Sun Protective Factor (SPF) on your lips at times that you are in the great outdoors.  Once the Melanotic Macule has developed, lip balm will not cause it to vanish or to diminish.

Apthous ulcers-AKA canker sores.

Most of us have, at one time or another, had rounds with these bothersome spots in our mouths. 

They usually present themselves on the gum tissue either on the lip or tongue side of the teeth-on nonkeratinized (movable) tissue zones.  The etiology is unknown, however elevated antibodies suggest an autoimmune link.  They can occur with other systemic diseases such as Behcets Syndrome, Crohn's disease, ulcerative colitis, or cyclic neutropenia.  Good news-these lesions are not contagious.  They are self-limiting, usually subsiding in 7-10 days.

There are some topical ointments that can be purchased over the counter that can ease the discomfort and slightly shorten the duration of an apthous ulcer.  Many times ulceration occurs as a result of a slight trauma to the tissue.  A slip with the toothbrush or a crispy tortilla chip gone errant can be the culprit.  Eating lots of citrus, elevated stress levels, and hormonal changes add to the possibility of having yet another bout with canker sores.

Above is a description of Minor Apthous Ulcers.  There are two other categories to consider:  Major Apthous Ulcers and Herpetiform Apthous Ulcers.   Major are larger than 1 centimeter, deeper than minor lesions, last several weeks, and can produce scarring.  They present more toward the posterior (back) of the mouth.  Herpetiform are not related to the Herpes virus.  They are very tiny (1-2 millimeters) and occur in clusters.

Hopefully this is a non-topic for most patients.  But it is most helpful information if you suffer often or with Major or Herpetiform.  Knowledge is power!

I want to whiten my teeth but I've heard stories about how harmful it is to your teeth and gums.  What's the truth? 

 It seems everyone is interested in whiter teeth these days.  Contrary to popular belief, "whitening" does no harm to your teeth and gum tissues.  The drugstore variety of "bleaching kits" are not nearly as strong as what you get through your dental office but, even at that, it is strongly advised that you follow directions carefully.  The Zoom Whitening in the dental office, as well as, Zoom's whiten-at-home version, have strong whitening agents that should be carefully supervised.  The dental professionals watch for any reaction in the patient.  This seldom occurs but its best to keep watch for any adverse reactions.  Unfortunately, there are two possible problems that can occur.  If the solution is allowed to get onto the gums or even the lips without being carefully wiped off after application, some "burning" of the tissues can occur.  This can be uncomfortable for a couple of days but definitely not a permanent situation.   The other problem is tooth sensitivity.  This is a relatively minor occurrence but a definite possibility in some instances.  Sensitivity can be controlled by limiting the "bleaching" time to thirty minutes a day, and even skipping a day between applications.  Any sensitivity that occurs would be evident only for a day or two after the "bleaching" session.

  The best advice for anyone interested in brighter, whiter teeth, is to call your dental office and  schedule a Zoom evaluation.  Then SMILE---YOU'RE GOING TO  LIKE THE RESULTS!

Everyone wants to have a beautiful smile, but, let's face it, it can get expensive.  So you want to know what you can do to have that beautiful smile without spending a bunch of moolah, right?

  To Start With, "whitening" is the least expensive and most effective process for enhancing your smile.  The very least expensive procedure are the whitening strips available at your local drugstore.  They are inexpensive and for some very effective, but for others not as effective.  But they do work for some, so it's worth a try, if you really cannot afford more.  Of course, the product cannot be as potent as that which would come from your dental office, for obvious reasons...you are on your own and not under the dentist's care.  But, at least, this would be a start.

  Even more effective would be the Zoom Treatment at your dental office.  They have a "take-home" version of this if you don't think you have 2-3 hours to spend at the dental office.  The "take-home" variety works the same, it's just not as quick.  Zoom Whitening is very effective, but a little more expensive.  You walk in with yellow teeth and you walk out with gorgeous white teeth.  (However, this varies with each patient)  Wonderful results are the usual results. 

  Simply getting whiter, brighter teeth and not having to "sell the farm"  certainly will give you something to smile about!!!

Check out page 2 on this site.... 

http://www.ada.org/public/events/ncdhm/sample_articles.pdf

The dental patient might experience pericoronitis as the third molars (wisdom teeth) erupt or after eruption.  This condition arises when an operculum or a flap of tissue from the retromolar pad extends over the crown of the erupting tooth.  Food can become impacted under this tissue covering, producing an acute infection.  Symptoms include halitosis (bad breath) from the collection of debris beneath or around the tissue, pain associated with the edema and sensitivity of the area, and the inability to obtain complete jaw closure due to tissue thickness and irritation.  Treatment ranges from tooth extraction to excision of the tissue tag to simple debridement of the area.  Antibiotics might be required for extensive inflammation. 

There is no real need for third molars, unless you have lost other molars to trauma....extraction can be done painlessly with anethesia.  You can elect to have no memory of it at all.  We have fabulous oral surgeons that will help you.  Over the long haul, you will save money because cleaning these teeth is almost impossible and restoring decayed third molars is a constant battle.

Trust me...it is a nice thought.  But modern chemistry has not come up with a substitute for the mechanical removal of plaque.  Plaque is a thick, sticky, and a tricky substance.  I tell my patients this analogy....

Plaque is a very sticky film, just like the scum around the bathtub or on shower doors....you could take a water hose to it all day long (just like oil on your garage floor)....but it will still be there...you must scrub it (mechanical stimulation--just a gentle rub will do it) with a toothbrush AND floss.  Everyone knows that to clean the bathtub scum you need at least a good grit sponge, same with plaque.  A toothbrush will ONLY clean the front and back of your teeth....NOT the sides, (the in-between spots), which is where I spend 80% of time time cleaning teeth, these spots are the danger zones for periodontal disease.  Floss once a day, at night time is best.  See your dental hygienist regularly, at least every six months. 

Take advantage of your dental insurance.  If they cover two cleanings per year...do it!!  It will be worth it....  If you have pending dental treatment don't let you insurance benefits slip away year after year....use it or lose it. 

At present a diagnosis of gingivitis or periodontitis is based on clinical findings.  A diagnosis of gingivitis or periodontitis implies that the actual level of the soft tissue attached to the tooth root is at or near the cementoenamel junction (where the actual crown of the tooth actually meets the root of the tooth--usually marked by the start of the gum tissue--there is usually a demarcation line that can be felt by a fingernail if you have recession--a line, so to speak).  A diagnosis of periodontitis implies that an apical migration of the epithelial attachment has taken place--not always the gum tissue itself--but underneath the gum.  The migration usually creates a deeper gingival sulcus (periodontal pocket) between the tooth and epithelium.  The formation of the periodontal pocket with it's relatively inaccessible subgingival plaque creates the need for periodontal therapy (deeper more frequent "cleanings" or in many cases scaling and root planing).  Approximately 80% of all adult have at least one "site" of periodontal disease and or a periodontal pocket. 

And....I ended up with a mouth full of fillings.  Why?  Because I am such a groovy person!  Well, my TEETH are groovy.  Those grooves allowed for stain deep down in the pits of the grooves.  Stain provided a rough surface for plaque to adhere to and plaque gave way to decay.....  

Here is a good site to check out regarding sealants.....It is never too late......to be.....PROACTIVE.....having a....PREVENTIVE attitude.

http://ada.org/prof/resources/pubs/jada/patient/patient_80.pdf

 This site discusses Kicking the Habit and Keeping Your Smile Healthy:  Tobaco Threats, and A Dozen Ways to Kick the Habit.

http://ada.org/prof/resources/pubs/jada/patient/patient_26.pdf

After you click on the URL below, scroll down to the bottom of the page.  You should not have to click play or anything.  Just give it a second and then you will see it.

http://www.edwardbyrne.com/plaque.htm