Posts for: August, 2013
Your teeth are under constant attack from bacteria that normally live in your mouth. When these bacteria thrive, they create acid that begins to dissolve the minerals in your enamel (the outer layer of your teeth). In your defense, your saliva protects against these bacteria and adds minerals back to your enamel. Let's take a look at this ongoing battle, and what you can do to sway it in a positive direction.
The outer covering of your teeth, the enamel, is made mainly of the minerals calcium and phosphate. The enamel protects the interior layer of your teeth, the dentin, which is similar in composition to bone. Although it is the hardest substance in your body, the enamel is still vulnerable to attack.
Your mouth is normally full of saliva, which washes over your teeth and maintains a balance between acids and bases. The terms “acids” and “bases” refer to a scientific measurement, the pH scale. Your mouth's pH is usually in the middle of the scale — neither acidic nor basic, but neutral. This is important in controlling the bacteria in your mouth.
You may be surprised to know how many bacteria live in everyone's mouth. More bacteria live in a single mouth than the number of people who have ever lived on earth. Some of these bacteria can cause tooth decay. Let's call them “bad bacteria.”
When the bad bacteria attach themselves to dental plaque — a film that builds up on your teeth every day — they begin to consume sugars that are in your mouth from foods that you have eaten. As the bacteria break down these sugars and turn them into energy, acid is produced as a by-product. This turns the saliva from neutral to acidic.
At a certain level of acidity, minerals in your enamel start to dissolve. This is called “de-mineralization.” It means that more calcium and phosphate are leaving the tooth's surface than are entering it. Early de-mineralization of the enamel shows up as white spots on a tooth.
Fortunately, healthy saliva can return calcium and phosphate to the enamel, or re-mineralize it. De-mineralization and opposing re-mineralization are constantly battling in your mouth. However, if too much enamel is de-mineralized, bacterial acid can go on to attack the next layer of your teeth, the dentin. As this process continues, you develop a dental cavity.
How can you protect your teeth? The first level of defense is regular removal of plaque, so that the bad bacteria do not get a foothold. In an office visit we may also recommend products such as sealants, antibacterial agents, topical fluoride, calcium and phosphate supplements, pH neutralizers, special toothpaste and rinses, which may help your particular situation.
Contact us today to schedule an appointment to discuss your questions about tooth decay. You can learn more by reading the Dear Doctor magazine article “Tooth Decay — The World's Oldest & Widespread Disease.”
Periodontal disease is the leading cause of tooth loss in adults. A recent survey by the Centers for Disease Control and Prevention showed that nearly half of Americans older than 30 had some signs of periodontal disease. That's more than 64 million people.
How much do you know about this potentially serious disease? Take our quiz and find out.
True or False: Gum Disease is caused by bacteria in the mouth
TRUE. Of the hundreds of types of bacteria that occur naturally in the mouth, only a small percentage are harmful. But when oral hygiene (brushing and flossing) is lacking, these can build up in a dental plaque, or biofilm. This often causes inflammation of the gums, the first step in the progression of gum disease.
True or False: Gum disease is more prevalent among younger people
FALSE. Gum disease is most often a chronic disease, meaning that it progresses over time. Statistics show that as we age, our chances of developing gum disease increase, as does the disease's severity. In fact, according to the study mentioned above, about 70% of adults 65 and over have mild, moderate or severe periodontitis, or gum disease.
True or False: Bleeding of the gums shows that you're brushing too hard
FALSE. You might be brushing too hard — but any bleeding of the gum tissue is abnormal. Gum sensitivity, redness and bleeding are typically the early warning signs of gum disease. Another is bad breath, which may be caused by the same harmful bacteria. If you notice these symptoms, it's time for a checkup.
True or False: Smokers are more likely to develop gum disease
TRUE. Not only are smokers more likely to develop gum disease, but in its later stages they typically show more rapid bone loss. Smoking also prevents the warning signs of gum disease - bleeding and swelling of the gum tissues - from becoming apparent. Other risk factors for developing the disease include diabetes and pregnancy (due to hormonal changes). Genetics is also thought to play a role in who gets the disease — so if you have a family history of gum disease, you should be extra vigilant.
True or False: The effects of gum disease are limited to the mouth
FALSE. Numerous studies suggest that there is a relationship between periodontal health and overall health. Severe gum disease, a chronic inflammatory disease, is thought to increase the risk of cardiovascular diseases like heart attack and stroke. It may also lead to complications in pregnancy, and problems of blood-sugar control in diabetics.
So if you have any risk factors for gum disease, or if you notice possible symptoms, don't ignore it: let us have a look. We can quickly evaluate your condition and recommend the appropriate treatments if necessary. With proper management, and your help in prevention, we can control gum disease.
If you have concerns about gum disease, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Understanding Gum (Periodontal) Disease” and “Warning Signs of Periodontal (Gum) Disease.”
Many Hollywood luminaries use porcelain veneers to enhance their smiles. Take actress and singer Hilary Duff, who, according to People magazine, had veneers placed on her two front teeth after chipping them on a microphone during what must have been an extremely energetic performance.
Well, you don't have to be a Hollywood star to benefit from a smile enhanced with porcelain veneers. If you have small chips, cracks, slight tooth rotations or minor spacing problems, veneers may be able to give you back your smile — or an even better one.
The word “veneer” refers to a super-thin covering, and in dentistry a veneer is a thin layer of porcelain that replaces your natural tooth enamel. Porcelain is the material of choice because of its strength, translucency, and ability to resist erosion.
In the right hands, dental porcelain can mimic tooth enamel perfectly. To make veneers, a skilled dental technician will mix porcelain powder (in a shade specified by the dentist) with water and then fire the material in an oven like pottery; the porcelain is built up in layers for a truly lifelike effect.
Before a veneer is bonded to a tooth, often we need to remove a tiny bit of the tooth's existing enamel so that the final effect will not be too bulky. The procedure is virtually painless and can be completed in as little as two visits. Because enamel is removed, this particular cosmetic treatment is not reversible. Sometimes veneers can be added directly onto the tooth surface without any tooth reduction and therefore are reversible if used in this way.
Once you have veneers, please keep in mind that while extremely strong, porcelain veneers are not indestructible; you won't want to do things like crunch ice or break nuts open with your teeth. And if you are a teeth-grinder, you should wear a nightguard to protect your beautiful new smile. With proper care, your veneers will last 20 years or more.
If you would like more information about porcelain veneers, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Smile Design Enhanced With Porcelain Veneers.” Dear Doctor also has more on “Cosmetic Dentistry: A Time For Change.”
In a healthy tooth, a coating of enamel protects the crown — the part above the gum line — and a layer of cementum protects the tooth root below the gum line. Enamel and cementum are inert (nonliving) substances that do not respond to stimuli such as heat or cold; however, dentin, the living tissue below them, does. Dentin contains numerous microscopic tubules that readily transmit stimuli toward the nerve-filled center of the tooth (pulp tissue). Loss of protective enamel or cementum leaves dentin exposed to all sorts of stimuli in the oral environment, which can trigger “dentinal hypersensitivity” — anything from a mild twinge to shooting pain.
Fortunately, there are many options for treating hypersensitivity. The key to selecting the most appropriate one(s) is determining the cause(s). Some of the more common reasons for sensitivity due to dentin exposure include:
- Enamel erosion caused by an “acid attack” related to external (extrinsic) causes — i.e., consumption of acidic beverages/food — or internal causes — i.e., regurgitation of stomach acids due to gastroesophageal reflux disease [GERD] or the eating disorder bulimia
- Using an overly abrasive brush or toothpaste, brushing incorrectly or too frequently, or brushing too soon after an “acid attack” — all of which can result in a loss of enamel
- Tooth decay (dental caries or cavities)
- Tooth fracture or chipping: tooth grinding (bruxism) is a common cause
- Worn fillings
- Gum recession, due to age or improper tooth brushing, that exposes the tooth root
- Gum disease, which can result in gum recession
Sensitivity can also occur following a procedure like treating a cavity. Normally it subsides within a couple of weeks or so but if it continues there may be another underlying cause.
Whatever the source(s) of your discomfort, our office can get to the bottom of it and recommend an effective course of treatment that meets your personal needs!
If you would like more information about tooth sensitivity, 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 “Sensitive Teeth.”