Teeth whitening is an extremely popular remedy for a lackluster smile, and with good reason: It works! So what's the best way to whiten teeth? We recommend in-office whitening treatments or at-home bleaching with custom-made flexible plastic trays. Either of these techniques will give you faster results than over-the-counter products while giving us the opportunity to monitor your individual response to the whitening process.

In-office whitening can produce dramatic results in just one visit. The bleaching solutions used in this process are the strongest available, so we will take precautions to protect your gums before we start. We will then brush the bleach onto your teeth and leave it there for about an hour. Once the session is finished and the bleach is rinsed from your teeth, you will be delighted by the results! If you want your teeth to reach their maximum brightness, a second treatment can be scheduled.

At-home bleaching with custom-made flexible plastic trays is also very effective, though you will bear a greater responsibility for sticking to the treatment regimen. We will first make a mold of your teeth that will be used to fabricate the bleaching trays. When the trays are ready, we will provide a prescription-strength bleaching solution in gel form. We will show you how to line the trays with the gel and then fit them over your teeth. You will generally need to repeat the bleaching process daily for about an hour until your desired results are achieved — usually about two weeks.

Both methods above have advantages over OTC (over-the-counter) whitening products. The most important is that we can verify that your tooth discoloration is purely a cosmetic problem and not the result of an infection or other dental problem requiring treatment. Also, we can monitor your reaction to the whitening process and make adjustments as needed. Finally, we are always available for any questions that come up before, during or after bleaching.

If you are interested in learning more about teeth whitening, please contact us today to schedule an appointment for a consultation. For more information on teeth whitening, please see the Dear Doctor magazine articles “Important Teeth Whitening Questions Answered” and “Tooth Whitening Safety Tips.”

For decades, dental amalgam — the common “silver” fillings found in the mouths of millions — was the best option for restoring teeth after the removal of decay. This time-tested material is still going strong, but in recent years it's had serious competition from newer restoration techniques that use tooth-colored substances to make fillings. If you've heard of these new materials and want to know more, you can start with the following five facts.

1) Filling materials must match the properties of natural teeth.

When properly cared for, teeth are strong, resilient, and superbly functional. A good filling material should mimic the strength and durability of natural teeth under biting forces. It should also last a long time in the mouth, be relatively easy to place, and be economical in cost. In the past, amalgam fillings were the best choice to do the job. But that was thenâ?¦

2) Tooth-colored filling materials offer similar benefits, plus aesthetic appeal.

Composite resins and dental porcelains are tough, durable materials that have been found to hold up well under years of use. Unlike traditional silver fillings, however, they match the appearance of natural teeth quite closely. This means that even a restoration in the front of the mouth may be virtually undetectable. And who wouldn't like that?

3) Tooth-colored resins may allow more conservative treatment in decay removal.

In order to keep them securely in place, amalgam (silver) fillings may require “undercutting,” which removes more of the tooth structure. The process involved in bonding tooth-colored restorations, however, generally requires removal of less tooth material. This means a stronger base for rebuilding the tooth's structure.

4) Different treatment methods are used for different degrees of tooth restoration.

Small cavities can be treated by direct “chairside” techniques, which are very similar to the methods used for traditional amalgam (silver) fillings: in one brief visit, it's all done. When a greater volume of tooth structure must be replaced, we may be able to create a larger tooth-colored filling in a longer visit. Or, we might need to have a special restoration made to match your teeth; then, you can come back to have it securely bonded for a natural and long-lasting result.

5) Both amalgam and tooth-colored fillings are safe and effective.

Each has advantages and disadvantages in particular cases. But as the technology of tooth-colored filling systems evolves, some dental researchers have heralded the beginning of the “post-amalgam era.” Are tooth-colored fillings right for your individual situation? We're the ones to ask.

If you would like more information about tooth-colored fillings, 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 “The Natural Beauty of Tooth-Colored Fillings.”

Don't ignore tooth pain hoping it goes away. No matter how mild or fleeting it may be, it's a sign that something's wrong. Healthy teeth shouldn't cause discomfort because the parts containing the nerves — the interior pulp and the dentin around it — are shielded by dental enamel and gums.

Here are some common reasons that teeth ache:

1. Gum Recession. Over time, gums can recede. Improper or excessive brushing can affect them, especially if you are genetically predisposed by having thin gums. When gums retreat, dentin can, or eventually will, be exposed. Besides its susceptibility to sensation, dentin is also more vulnerable to erosion and decay than enamel.
2. Tooth Erosion/Decay. When acid-producing oral bacteria get the upper hand, they can eat through the tooth's protective enamel to the dentin. You may start feeling sensitivity as the decay gets deeper and closer to the pulp (nerves). Only removal of the decay and filling the cavity can stop the process.
3. Old/Loose/Lost Filling. Fillings seal off areas of past decay. If they don't fit right or are dislodged altogether, air or food particles can slip inside and irritate exposed nerve endings. A crevice to hide in makes it prime real estate again for bacteria, too.
4. Cracked Tooth. Teeth grinding and jaw clenching can have a similar impact on teeth that a miner's pick has on rock. At first thin lines in your enamel can develop, then cracks develop that may expose the dentin, and finally the tooth might fracture, exposing the pulp. The earlier this process is caught, the better.
5. Pulp Tissue Infection/Inflammation. This can be caused by deep decay or trauma and suggests your tooth may be in its death throes. Sometimes the pulp infection travels into the surrounding periodontal (peri – around; odont – tooth) tissues and causes an abscess to develop. This absolutely requires immediate attention.
6. Residual Sensitivity from Dental Work. Removal of decay before placing a filling can cause tooth sensitivity. It can take 1-4 weeks or so to improve.
7. Sinus Pain. Congestion can cause “referred” pain in the upper teeth. When the congestion subsides, the pain should, too.

As you can see, it's risky to discount tooth pain and “wait ‘til it goes away.” Our office can help you determine the origin of your pain and the best course of action to resolve it. When in doubt, it's always better to err on the side of caution!

If you would like more information about tooth pain and ways to prevent or treat it, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Tooth Pain? Don't Wait!” and “Sensitive Teeth.”

If a glance in the mirror reveals stained or discolored teeth that are detracting from your self-confidence, it's time to do something about it. The first step is to make an appointment for an office visit to find out how we can help you.

External (extrinsic) stains that form on the surfaces of teeth are usually caused by beverages such as red wine, tea, coffee as well as unhealthy habits like tobacco use. Extrinsic stains generally come in shades of browns, black or grays, but may even be orange or green from color producing bacteria.

Internal (intrinsic) stains are part of the structure of the tooth and cannot be removed by polishing. Among their causes are excessive fluoride levels or tetracycline antibiotics given in childhood and during tooth formation. Teeth do become more yellow and discolored as we age. Discoloration of individual teeth may be indicative of tooth decay, or teeth that have had root canal treatment and have literally lost their vitality tend to darken over time. Internal discoloration comes in a variety of shades and hues from yellows, grays, browns, and even some reds or pink.

Five Ways to lighten, whiten and brighten stained or discolored teeth

1. Change your habits. Reduce or stop consuming or using foods, drinks or tobacco if they are staining your teeth.
2. Improve your daily oral hygiene. Make sure to brush your teeth well, twice a day. Change to a toothpaste that contains a mild abrasive. Some toothpastes also contain tooth whiteners.
3. Visit our office for a professional cleaning and polish. Routine scaling and polishing will remove most superficial external stain and discoloration. Sometimes ultrasonic cleaning (by high frequency vibration) and polishing with slightly abrasive pastes may just do the trick.
4. Treatment for internal stain and discoloration. Brown colored decaying teeth need to have the decay removed and the teeth restored. Stained old and leaking fillings may also need to be replaced.
5. Tooth whitening by bleaching. Bleaching or tooth whitening is a safe and effective way to brighten stained teeth. Internal tooth bleaching can whiten even discolored root canal treated teeth. Ask us for more information about this technique.

If your mirror tells you that your smile needs attention, there's no time like the present to get started. Get back your bright, white smile and your self-confidence as well.

Contact us today to schedule an appointment to discuss your questions about tooth staining and its treatments. You can also learn more by reading the Dear Doctor magazine article “Tooth Staining.”

Edentulism — the complete loss of all the permanent teeth — is a condition that affects over one-quarter of all Americans over the age of 65. For many seniors, it can be a devastating blow to their confidence and self-image. Worse, if left untreated, it may lead to nutritional problems, periodontal disease, and bone loss.

Fortunately, an affordable, time-tested treatment option is available: full denture prosthetics, or false teeth. Denture technology has changed over time, but one aspect of the process remains the same: making a superior set of dentures requires an equal blend of science and art.

To replicate the look of a patient's natural teeth, a dentist must make many choices: What size should the new teeth be? How much of them should show above the gum line? How should they be spaced? Photographs of the patient before tooth loss can help in making the decisions. We will use these, combined with clinical acumen and an artist's eye, to achieve the best aesthetic results.

But dentures not only simulate the teeth and gums they replace — they also help support the facial skeleton and the soft tissues of the lips and cheeks. Balancing the muscular forces of the jaws and tongue, they help restore natural functions like speech and eating. In order to perform these tasks properly, it is essential that they be well crafted.

At each stage of their progress, from temporary wax rims through the hard plastic resins of the final product, the dentures are carefully custom-fitted to the contours of the patient's mouth. Their bite must be balanced, meaning that upper and lower dentures come together to properly stabilize each other. This ensures that they will be comfortable to wear and will function properly.

Most people have only minor issues as they make the adjustment to wearing dentures; but for some, it's more troublesome. There are various options available to those patients, including implant-supported hybrid dentures. We can recommend alternatives based on your individual needs and preferences.

If you would like more information about dentures, 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 “Removable Full Dentures.”

One went over the handlebars of his mountain bike. Another got an elbow going for a lay-up. For a third, it was that tricky maneuver on her new snowboard...

These are just a few of the ways that kids' teeth can be injured. (No doubt, parents can think of plenty more.) The good news is that modern dentistry offers more options than ever for treating the injury and restoring the appearance and function of the teeth.

Teeth that are fractured or dislodged are a serious condition that requires immediate, comprehensive treatment. The majority of dental injuries, however, are less severe: most often, they involve chipped teeth. If chips occur in the upper front teeth — as some 80% of dental injuries do — even small flaws can have a big affect on the appearance. And, especially in the teenage years, appearance can mean everything.

In many cases, small chips in the teeth can be repaired effectively using a procedure called “bonding.” In this treatment, we use a tooth-colored material made by mixing a plastic matrix and a glass-like filler, which provides adequate strength and aesthetic qualities similar to the natural teeth. In fact, this composite material can be matched to an individual's tooth color so accurately that it's hard to notice any difference.

Composite resins can be successfully bonded to most healthy teeth — and they offer some advantages over other restoration methods, particularly for children and teenagers. The bonding procedure avoids making tiny “undercuts” in the natural substance of the tooth, while metal fillings need to “lock in” to the tooth's structure. This means that bondings generally require less tooth preparation, which usually makes bonding a quick and relatively easy method of restoration.

It's true that, over time, some bonded restorations may not stand up to the tremendous biting forces of the jaw as well as porcelain restorations — but in young people whose permanent teeth have large pulp (nerve) chambers, the removal of too much tooth structure could compromise the long-term health of the tooth. Later on, we can look at performing a different type of restoration.

If you have questions about cosmetic bonding or sports-related dental injuries, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Repairing Chipped Teeth” and “An Introduction to Sports Injuries & Dentistry.”

Some people are planners, and others just go with the flow. Some spend all winter in the gym, and others try and lose ten pounds right before beach season. Some have every detail of their wedding day planned out months in advance, and others... don't.

No matter which kind of person you are, you'll want to look your best for your wedding day. And that includes sporting a bright, healthy-looking smile. Depending how much time you have beforehand, there's a range of dental treatments that can help you look and feel great — not just that day, but every day. Here's a rundown of what you can do in the time remaining before your big day.

Time Left: Up to two years. If you've planned this far in advance, congratulations! You probably have time for almost any needed dental treatment — including orthodontics, which can straighten misaligned teeth and correct a bad bite. But even if you don't have quite so much time, don't despair: Clear aligners and tooth-colored or tongue-side braces, if recommended, can make orthodontic appliances nearly invisible.

Time Left: Six months to one year. Many dental treatments, like periodontal plastic surgery or tooth implants, can achieve remarkable results in this time. Periodontal surgery can give you a less “gummy” smile and greatly improve the aesthetics of your teeth. Tooth implants are modern dentistry's best option for replacing missing teeth. Natural-looking implants have a success rate of 95%, and can last a lifetime.

Time left: Three or four months. There's plenty you can do! If the roots are intact, a crown can be placed on a damaged tooth to restore its appearance and function. Or, missing teeth can be replaced via bridgework, which supports a false tooth from abutments on either side. Stained or discolored teeth can also be dramatically lightened with veneers, where a porcelain shell replaces the tooth's outermost layer of enamel. Tooth implants are still a possibility, under the right circumstances. We can evaluate your individual situation and come up with the best option to replace missing teeth.

Time left: Six weeks or so. You still have time for some basic, yet effective, treatments. Small chips or discolored fillings can be restored with tooth-colored materials that securely bond to the teeth themselves. You can also brighten your teeth by several shades using the techniques of bleaching. In-office whitening treatments are the fastest, but take-home kits, used under our supervision, offer similar results in a longer time.

Have even less time? At the very least, come in for a thorough cleaning right before the date! This will help remove many surface stains and freshen up your smile. Be sure to call in advance so that you're able to get an appointment. Then, smile for the camera!

If you would like more information about a wedding-day smile makeover, please contact us or schedule an appointment to discuss your treatment options. You can learn more in the Dear Doctor magazine article “Wedding Day Smiles.”

It is not uncommon to have one or more teeth that are particularly sensitive to heat, cold, or pressure. If you have such a tooth, you probably want to know what caused it and what you can do about it. Here are some frequently asked questions, and their answers.

What causes teeth to become sensitive?
The most common cause of sensitivity is exposure of the tooth's dentin, a layer of the tooth's structure that is just below the outer protective layer (the enamel).

The dentin is sensitive but the enamel layer is not. Why?
The enamel is composed of minerals that are hard and protective. It is not living tissue and has no nerve supply. The dentin layer underneath is bone-like living tissue that does contain nerve fibers. It is protected by enamel above the gum line and by gum tissue in the area of the tooth's root, below the gum line. If the tooth's protective covering is reduced, the nerve fibers in that section of the dentin are exposed to changes in temperature and pressure, which they conduct to the inner pulp layer (nerve) of the tooth. The sensations that reach the tooth's interior pulp layer cause pain.

What causes exposure of the dentin layer in teeth?
Often the dentin is exposed by receding gums, causing areas of the tooth that are normally below the gum surface to be uncovered.

What makes gums recede?
One cause of receding gums is excessive, rough brushing techniques. This is particularly common in individuals who have a family history of thin gum tissues. Removing the film of bacteria called plaque requires only gentle action with a soft brush. This is one reason that we stress the value of learning proper and effective brushing techniques. Gum recession becomes worse after the uncovered dentin of the tooth's root is exposed to erosion from sweet and acidic foods and beverages, such as fruit juices.

Doesn't tooth sensitivity indicate decay?
Decay can also cause tooth sensitivity. As decay destroys a tooth's structure, it eventually invades the inner pulp of the tooth, causing greater and greater pain.

How can you prevent or reduce tooth sensitivity?
As we mentioned above, learn proper brushing techniques; we would be happy to demonstrate them. Use a toothpaste that contains fluoride, which increases the strength of the tooth's protective coating. In more serious cases, we can apply a fluoride varnish or a filling material as a barrier to cover sensitive areas. If you experience long-term tooth sensitivity, make an appointment for an assessment and diagnosis so that we can determine the cause and proper treatment.

Contact us today to schedule an appointment to discuss your questions about sensitive teeth. You can also read the Dear Doctor magazine article “Sensitive Teeth.”

If you've lost one or more of your teeth due to tooth decay, trauma, gum disease or a failed root canal, there are a variety of ways that our office can help you to restore your smile and increase your confidence. Crowns, conventional bridges and dentures aren't your only options for replacing missing teeth. Dental implants, surgically placed below the gums, are another alternative for replacing missing teeth.

Getting Started: If you would like to explore the option of having dental implants to replace one or more teeth, you will first need a comprehensive exam. The ideal candidate for implants is in good general and oral health. Adequate bone in your jaw is needed to support an implant. Smokers and those with uncontrolled chronic diseases like diabetes may not be good candidates for dental implants because healing may be impaired or slow. In addition, dental implants aren't appropriate for children or teens until their jaw growth is complete.

The Process: Dental implant surgery can be performed in our office using either a local or general anesthetic. The implants actually replace tooth roots; they are placed into the bone surgically. Generally made of commercially pure titanium, this metal has the remarkable ability to fuse with the bone as it heals forming a union known as osseointegration (“osseo” – bone; “integration” – to fuse with). This process takes two to six months depending upon many factors of which bone quality is the most important.

The next step is to place an abutment (a small connector) which attaches the implant to the crown. The crown is the part of the tooth that is normally seen in the mouth above the gums.

Assessment of your individual situation and deciding if dental implants are right for you takes knowledge and experience. Contact us today to schedule an appointment to discuss any questions you may have regarding dental implants. Read more about this topic in the Dear Doctor magazine article “Dental Implants: Options for Replacing Missing Teeth.”

If you are the parent or caregiver of a special needs child or a child with a chronic disease, you face additional challenges when it comes to life's everyday routines. This includes establishing and maintaining good oral health so that your child is not at risk for other healthcare issues due to poor oral hygiene. For these reasons, our office has put together real-world advice that will make a difference in the life of your child.

The visit to our office that can make the biggest difference is your child's first one. However, be sure to contact us in advance of your child's appointment to let us know the details of your child's special needs or chronic disease state. This will give us the opportunity to contact your child's primary care physician or one of his/her specialists before starting treatment to obtain any medical information or special instructions. It will also enable us to be prepared so that we can pay special attention to these needs, as well as to make any necessary modifications to our office and/or equipment. Our primary focus is to work with you and your child's healthcare team towards the same goal. We all want your office visit to go smoothly and comfortably so that your child's first dental experience is a positive one.

Depending on the age of your child and his/her special needs, we most likely will start a gentle process of training and education. For example we will teach your child how to brush properly. It is important that you sit in and participate in this educational process so that you can reinforce this training at home. And little things count; before working with your child at home, you should set the stage so that it will be a comfortable setting with adequate light, fresh water for rinsing, and a mirror. You also need to have all of your supplies handy, such as a toothbrush, toothpaste, floss and rubber gloves (if needed).

To learn more tips, continue reading the Dear Doctor magazine article “How To Care for the Oral Health of Children with Disabilities and Special Needs.” Or, you can contact us today to schedule an appointment or to discuss your questions about your child's special oral healthcare needs.

We have learned that an important part of oral health is education — but more importantly, making it fun to learn so that you retain (and apply) what you learn! For this reason, we have put together the following self-test so that you can quickly access your knowledge on the subject of mouthguards.

1. The first sport to use (and require) protective mouthguards was:
   1. football
   2. boxing
   3. baseball
   4. ice hockey
2. Research conducted by the American Dental Association (ADA) found that individuals are ___ times more likely to damage their teeth when not wearing a mouthguard while engaged in contact sports or rigorous physical exercise.
   1. 10
   2. 20
   3. 40
   4. 60
3. As a rule of thumb, females do not require mouthguards because they are not as physically active as their male counterparts.
   1. True
   2. False
4. The American Academy of General Dentistry (AAGD) reports that mouthguards prevent more than ______ injuries to the mouth and/or teeth each year.
   1. 200,000
   2. 300,000
   3. 400,000
   4. 500,000
5. Which of the following sports or activities does the ADA recommend that participants wear protective mouthguards:
   1. acrobatics
   2. bicycling
   3. handball
   4. all of the above
6. The US Centers for Disease Control (CDC) reports that more than ______ sports-related injuries end-up in the emergency room each year with injury or damage to the teeth and mouth.
   1. 275,000
   2. 425,000
   3. 600,000
   4. 735,000
7. Over-the-counter mouthguards are just as effective as professionally made mouthguards.
   1. True
   2. False
8. In addition to the trauma of having a tooth (or teeth) knocked out, individuals who have suffered from this type of injury may end up spending ______ per tooth over a lifetime for teeth that are not properly preserved and replanted according to the National Youth Sports Foundation for Safety.
   1. $10,000 to $20,000
   2. $15,000 to $25,000
   3. $25,000 to $35,000
   4. Less than $10,000

Answers: 1) b, 2) d, 3) b, 4) a, 5) d, 6) c, 7) b, 8) a

You can learn more about the importance of mouthguards when you continue reading the Dear Doctor magazine article “Athletic Mouthguards.” And if you have already experienced a dental injury, it may not be too late. However, we need to evaluate the damage so that we can establish a plan for restoring optimal oral health. Contact us today to learn more about protecting your mouth and teeth or to schedule an appointment.

Sucking their fingers or thumbs makes young babies feel secure and is completely normal behavior. Babies have been observed to suck their fingers or thumbs even before they are born. But like many comforting habits, over-doing pacifier, thumb, or finger sucking habits may be harmful.

Stop Pacifier Use by 18 Months

Studies have shown that pacifier use after the age of two may cause long-term changes in a child's mouth. We recommend that pacifier use should stop by about 18 months. A pacifier habit is often easier to break than finger or thumb sucking.

Stop Thumb and Finger Sucking by Age Three

Most children naturally stop thumb and finger sucking between two and four years of age, but some children continue this habit much longer. This may cause their upper front teeth to tip towards their lips or to come into position improperly. It can also cause their upper jaw to develop incorrectly. The American Academy of Pediatric Dentistry recommends that children stop these habits by age three.

Use of Behavior Management to Encourage Quitting

We offer creative strategies for gentle ways to cut back and stop pacifier use, including behavior management techniques that use appropriate rewards given at predetermined intervals. Meanwhile, make periodic appointments with us to carefully watch the way your child's teeth and jaws develop.

When your child is old enough to understand the possible results of a sucking habit, just talking about what may happen to teeth as a result can often encourage him/her to quit. As a last resort, a mouth appliance that blocks sucking may be needed.

If you are worried about your child sucking a pacifier, thumb, or fingers, please visit us to put your mind at rest. For more information read “Thumb Sucking in Children” in Dear Doctor magazine. Contact us today to schedule an appointment to discuss your questions about children's thumb sucking.

People always wonder when it is appropriate to contact their dentist. To answer this, we have put together the following list to provide some guidelines for you and your family. However, your calls are always welcome! Our goal is simply to give you some clear scenarios that illustrate when you should give us a call or come in to our office.

For Bite Related Problems

1. Early or late loss of baby teeth.
2. Difficulty in chewing or biting.
3. Mouth breathing.
4. Finger sucking or other oral habits.
5. Crowding, misplaced, crooked or even missing teeth.
6. Jaws that shift, jaw joints that “pop” or “click” or are uncomfortable.
7. Any change causing speech difficulty.
8. Cheek or tongue biting.
9. Protruding teeth — large overbite.
10. Teeth that meet in an abnormal way or don't meet at all.
11. Facial imbalance or asymmetry.
12. Grinding or clenching of teeth.

For Injuries And Immediate Care

1. Knocked out permanent tooth: Call us immediately. You need to take action within 5 minutes of the injury for best results.
2. Injuries to lips, cheeks, tongue or gums that appear to require stitches: Call us for instructions as soon as possible.
3. Tooth injury — if a tooth has shifted from its original position: Call us to tell us you are on your way to our office and see us within 6 hours of the injury.
4. Chipped or broken tooth that is still in its original position: See us within 12 hours of the injury.
5. A knocked out baby tooth: Call us as soon as possible.
6. Bleeding without any significant tears in tissue that could require stitches: Call us for instructions.

What To Do Now

If any of the above describe you or another member of your family, then contact us today to discuss your questions or to schedule a consultation. You can also learn more about treating dental injuries by reading the Dear Doctor article, “The Field-Side Guide To Dental Injuries.”

Recent research has revealed that there is a link between cardiovascular (“cardio” – heart; “vascular” – blood vessel) disease (CVD) and periodontal (gum) disease. The link is Inflammation. This is why it is important to learn more about this important relationship so that you can take proactive steps to improving your health and life.

What causes periodontal disease?
Simply put, irregular and ineffective brushing and flossing are the root causes of periodontal disease. Over time and when bacterial biofilms (dental plaque) are left unchecked, they lead to the emergence of a small set of highly pathogenic (“patho” – disease; “genic” – causing) organisms that are consistently associated with periodontitis (“peri” – gum; “odont” – tooth; “itis” – inflammation) or gum disease.

Is periodontal disease common or am I one of the few who have it?
It is a quite common disease, with mild to moderate forms of it impacting 30 to 50% of US adults. More severe cases affect 5 to 15%. One of the reasons these numbers are so high is because periodontal disease is a silent, painless disease that often occurs without any symptoms.

So how does my gum disease link to potential heart disease?
Inflammation is a characteristic of chronic disease. People with moderate to severe periodontitis have increased levels of systemic (general body) inflammation. If left untreated, the same bacterial strains that are commonly found in periodontal pockets surrounding diseased teeth have been found in blood vessel plaques of people with CVD.

This all sounds bad...is there any good news?
Yes! Research has revealed that if periodontal disease is treated, inflammation and infection can be reduced. This also reduces the risk for heart attacks and strokes, both of which are common results of CVD. All it may take is a thorough exam for gum disease and thorough dental cleaning. During your exam, we can also make sure you are brushing and flossing properly so that you are effectively removing bacterial biofilm. But if you have severe periodontal disease, you may need deeper cleanings and more advanced treatment to save your teeth and your heart.

To learn more on this subject, continue reading the Dear Doctor magazine article “The Link Between Heart & Gum Diseases.” You can also contact us today with any questions or to schedule an appointment.

We tend to think of aspirin as a harmless medication. It is dispensed over the counter and is the most widely used OTC medication in the U.S. We take it without thinking we may be exposing ourselves to risks. But in certain situations aspirin can cause dangerous side effects.

What is aspirin, and how does it work?
The chemical name for aspirin is acetylsalicylic acid. It is used to reduce mild pain, inflammation and fever. When you take an aspirin, it blocks the formation of prostaglandins, substances your body creates that are associated with inflammation. Prostaglandins cause inflamed tissues to become red and swollen, but they also serve protective purposes, such as forming a barrier that protects the stomach from the acid it produces to digest your food. That's why long-term aspirin use can sometimes cause stomach bleeding and ulceration or other health problems.

Why do cardiac patients take aspirin?
Another effect of aspirin is to prevent blood platelets from clumping together. Blood platelets are structures in the blood, smaller than white or red blood cells, that aid clotting by sticking together at the site of an injury. This effect of aspirin can cause prolonged bleeding, but it may be beneficial to people who have cardiovascular (from cardio, meaning heart; and vascular, meaning vessel) disease with narrowed blood vessels.

Aspirin can keep blood flowing in the obstructed vessels and thus prevent heart attacks and strokes; but it can also increase the risk for strokes that are caused by bleeding in the brain. Most physicians attempt to lower such risks by asking their patients to keep their daily aspirin consumption to a low dose 81 mg “baby” aspirin.

How does aspirin affect your teeth and gums?
Be sure to let your medical and dental professionals know you are taking aspirin, and how much you take. Also tell us about other OTC medications you take, including herbal medications and supplements, because they may interact with aspirin to cause side effects.

If you have been told to take aspirin because of a cardiac condition or procedure, be sure to follow your recommended treatment. Do not suddenly discontinue aspirin therapy; doing so can increase your risk for heart attack and stroke. Ask us if you should stop taking aspirin before a major dental or oral surgery, but do not stop taking it on your own. We will consult with your physician about your medical condition and let you know our recommendation. In most cases you can continue your aspirin therapy without causing excessive bleeding during the dental procedure.

Contact us today to schedule an appointment. You can also learn more by reading the Dear Doctor magazine article “Aspirin: Friend or Foe?”

In today's fast-paced society, nearly everyone is looking for reliable solutions to resolve problems almost instantly. Unfortunately, in many situations, bad breath cannot be cured that quickly. This is why we want to provide you with the following rules of thumb for treating your bad breath.

• Use a soft-bristled brush and a proper technique to clean your teeth at least twice a day, in the morning when you wake and before you go to bed.
• Floss your teeth at least once daily to remove the bacterial plaque and food particles between your teeth, as these are two known causes of bad breath and tooth decay.
• Clean your tongue, as it can often be the main culprit with too many odor-producing bacteria living on its surface. To clean your tongue, use a tongue scraper obtainable from a local drug or discount store, or brush your tongue with your toothbrush. Remember, a healthy tongue should be pink in color and not have a yellowish or brownish coating.
• Chew a sugar-free gum that contains xylitol, a natural, sugar-free sweetener that actually has been shown to help prevent caries (cavities) while improving your breath.
• Change your eating and drinking habits. Drinking plenty of tap water will not only keep your mouth hydrated (a dry mouth is another cause of bad breath), but it also can help prevent caries if you live in an area with fluoridated water. And by adding plenty of crunchy fruits and veggies such as carrots, celery and apples, you stimulate the production of saliva; thus keeping your mouth moist and rinsed out.

And last but not least, you can contact us today to schedule a consultation for an examination, cleaning and treatment plan. Or, you can learn more when you read the Dear Doctor article, “Bad Breath — More Than Just Embarrassing.”

Most people think of bone as rock-solid, but it's actually a living tissue that's constantly changing. This has significant implications for your oral health, general health, and appearance — if you are one of the 70% of Americans missing at least one tooth.

Throughout the day, your top and bottom teeth make hundreds of fleeting contacts with each other. These small stresses are transmitted though the periodontal ligament (“peri” – around; “odont” – tooth) that supports each tooth in its socket like a hammock. Think of it as a gentle push on the hammock, which causes the tooth to gently bump the underlying bone. The bone then builds up in the spot that's receiving stress to counteract it. This constant remodeling of bone is what allows bone to stay healthy and strong.

When a tooth is lost, the bone does not receive that gentle stress. It reacts by literally melting away. Sometimes this happens fairly quickly — in a matter of months. After the tooth-supporting bone is lost, the jawbone itself begins the same process of deterioration. This could eventually change the shape of the face, as the distance from nose to chin can decrease — even if only a few back teeth are missing. The results aren't pretty. But the good news is, there's a way to prevent all this.

Dental implants, which function as substitute tooth roots, actually save underlying bone when teeth are lost. They do this because they are made of titanium, which fuses to the bone in which it's set, stabilizing it. The implant is topped by a realistic-looking crown, which replaces the part of the missing tooth that was visible in the mouth. Together, they look and function just as your natural tooth did.

If you are missing a lot of teeth, implants can also be used to anchor bridges or even removable dentures while providing that same bone-saving benefit. And when you consider that they are so durable they should never need replacement, implants are a great investment.

If you have any questions about dental implants, please contact us, or schedule an appointment for an implant consultation.

You can read more about this topic in the Dear Doctor magazine article “The Hidden Consequences of Losing Teeth.”

Your self-image has a lot to do with how you feel about your appearance — and particularly your smile. If you are unhappy with the way you look, cosmetic dentistry may be the answer to your problems.

1. What do we mean by cosmetic dentistry? The word “cosmetic” refers to beneficial changes in appearance. Thus cosmetic dentistry is all dental work that restores or improves a person's appearance.
2. What is a cosmetic dentist? Every dentist learns to do procedures in a way that conserves or improves a patient's appearance. Some dentists continue to study and specialize in procedures that are done specifically for the purpose of enhancing a person's appearance.
3. What is a smile analysis? The first step to improving your smile, this analysis involves a study of all the elements of your smile — teeth appearance and alignment, gums, jaws — and also your facial features and how they all fit together.
4. How can I choose the right cosmetic dentist? Ask your dentist about his or her training and experience. Ask for photos of previous work. You may need to select more than one person, working as a team to take best advantage of each one's experience, skills, and training.
5. What can be done to improve a smile using 21st century techniques? We are fortunate to live in times in which numerous options are available. These include making teeth whiter; altering their size, shape, balance, color, and alignment; filling in parts of teeth that are missing because of decay or injury; and even replacing teeth that are missing entirely.
6. How can chipped or discolored front teeth be restored? This can often be done by bonding with composite resin.
7. How can damaged back teeth be restored? Back teeth with cavities or traumatic injuries can now be repaired with non-metallic tooth-colored material that bonds to the tooth substance.
8. What techniques can be used to correct more severe problems? Porcelain veneers, thin layers of porcelain material, can be used to change the appearance of misshapen or undersized teeth. Porcelain crowns can be used to replace the part of the tooth that rises above the gums.
9. How can we change the position of teeth that do not meet together well? Orthodontists are dentists who specialize in correcting malocclusions (bad bites). They use traditional braces or clear aligners to move teeth into more attractive and functional positions.
10. What if some teeth are missing? A dental implant replaces the root of a missing tooth. A porcelain crown that looks just like a natural tooth can then be connected to the implant.

Contact us today to schedule an appointment to discuss your questions about cosmetic dentistry. You can also learn more by reading the Dear Doctor magazine article “Cosmetic Dentistry: A time for change.”

If you like soft drinks and carbonated colas, beware. Acids in these drinks may be dissolving the minerals in your teeth — a process called chemical erosion. And don't think that natural fruit juices or sports and high energy drinks are any better than sodas. They also contain acids that dissolve the surface enamel of your teeth. Once your enamel is lost, it is gone forever. It cannot naturally recover.

Sadly, teeth in children and teenagers — an age group most likely to drink large quantities of soda and juices — may be more easily eroded by acids. These youngsters have not had long-term exposure to fluorides which harden tooth enamel and protects them from acid erosion.

The Difference between Erosion and Decay
Chemical erosion is not the same as tooth decay (cavities). In chemical erosion, acids in your mouth react directly with minerals in the outer enamel of your teeth. In the case of tooth decay, bacteria in dental plaque (a bacterial film that forms on your teeth) utilize the sugars in the drinks and produce acids that attack your teeth.

After Acidic Exposure, Wait 30 Minutes to an Hour before Brushing
You may think that the solution to chemical erosion is to brush the acidic solution from your teeth as soon after drinking them as possible. But tooth brushing immediately after can actually accelerate chemical erosion and make it worse. After they are bathed in an acidic solution, minerals in the tooth surface become partially dissolved. Brushing at this time may brush away the affected layer. If you wait a half hour to an hour, your saliva will have time to neutralize the acids and harden the tooth surface by adding minerals back into it.

Drinks Less Likely to Cause Dental Erosion
Instead of drinking colas and sports drinks, stick to water and/or milk, which have the added benefit of supplying calcium to help add minerals back to the tooth surface.

If you must sip on juices or soft drinks, try to do so only at mealtimes. This is preferable to drinking them all day long, which leaves your teeth constantly bathed in an acid solution. Avoid swishing the drinks in your mouth, and sip them with a straw to reduce contact between acidic drinks and your teeth.

Contact us today to schedule an appointment to discuss your questions about acid erosion of teeth. You can also learn more by reading the Dear Doctor magazine article “Dental Erosion.”

Twenty-first Century techniques can create a replacement for a missing or damaged tooth that looks exactly like a natural tooth and actually fuses with the bone of your jaw. How does this amazing technology work? Test your knowledge on these questions.

What is a dental implant?
A dental implant is actually a replacement for the root of a tooth. In the natural tooth, the root is the part of the tooth below the gum line that is suspended in the bone by ligaments that attach the root to the bone. An implant is a root like substitute that is directly attached to the bone by a process referred to as osteointegration. An implant crown is then attached to the implant and is the visible part that we see above the gum tissues.

What is a modern dental implant made of?
Most are made of titanium. This metal is not rejected by the body and in fact fuses with the bone in which the implant is anchored, making it extremely stable.

How long do implants last?
A successful implant can last a lifetime. Factors that can affect an implant's success are smoking, certain drugs, osteoporosis, a history of radiation treatment, or a compromised immune system. We will evaluate all your conditions of dental and general health before deciding on an implant for you.

What makes the crown look like a real tooth?
The new crown looks real if it matches the shape and color of adjacent natural teeth. Its appearance also depends on what we as dentists refer to as the emergence profile (the way the crown seems to emerge from the gum tissue).

What is the function of a temporary crown?
A customized temporary crown can allow details of color, shape, and emergence profile to be worked out during this “temporary” phase of treatment. It can also test whether the tooth will function correctly for speech, biting and chewing. After these details are worked out, the temporary crown can be used as a blueprint for the permanent one.

What is the first step to getting a dental implant?
Make an appointment with us for a full assessment, diagnosis, and plan for placing the implant and crown.

Contact us today to schedule an appointment to discuss any additional questions about dental implants. You can also learn more by reading the Dear Doctor magazine article “Dental Implants, Your Third Set of Teeth.”