Humanity has been waging war against tooth decay for millennia — with this relentless opponent often getting the better of us.
Over the last century, however, significant treatment advances have turned the tide of battle in our favor. Perhaps the greatest of these advancements is our deeper grasp of the disease process — new understandings that have altered our treatment strategy. Rather than wait for cavities to occur and then repair the damage, we now focus on stopping the damage from occurring in the first place.
Prevention starts by reducing factors that contribute to tooth decay. We can signify these detrimental factors with the acronym BAD:
Bad Bacteria. Millions of bacteria inhabit our mouths at any one time, but only a few strains produce the acid that causes decay. We want to reduce their population by removing dental plaque (where they feed and grow) through daily brushing and flossing, and, at a minimum, semi-annual office cleanings.
Absence of Saliva. This important fluid neutralizes acid and strengthens tooth enamel. Some people, however, suffer from reduced saliva flow. We want to find the cause (for example, a side effect of certain prescription drugs) and then improve saliva flow.
Dietary Habits. A diet heavy in sugar and acid (particularly sodas and soft drinks) gives bacteria a ready food source and increases the mouth’s acidic level. Chronic high acid levels in particular are often too great for normal saliva flow to overcome and neutralize. Reducing the amount and frequency of these food items creates a healthier oral environment.
Reducing BAD factors is only half of our prevention focus. We also want to promote SAFE factors that enhance tooth health and strength: Sealants, especially for children, that shield tooth surfaces from decay; Antimicrobial rinses that target and rid the mouth of acid-producing bacteria and give healthy bacteria room to develop; Fluoride, a proven enamel-strengthening chemical available in dental products, many drinking water systems and as a topical application in dental offices; and an Effective diet that’s rich in nutrients and low in sugar and acid as already mentioned.
Keeping the focus on reducing BAD factors and promoting SAFE factors will greatly increase your chances of personally winning the war against tooth decay.
If you would like more information on the prevention and treatment of tooth decay, 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 “Tooth Decay: How to Assess Your Risk.”
On the big screen, Australian-born actress Margot Robbie may be best known for playing devil-may-care anti-heroes—like Suicide Squad member Harley Quinn and notorious figure skater Tonya Harding. But recently, a discussion of her role in Peter Rabbit proved that in real life, she’s making healthier choices. When asked whether it was hard to voice a character with a speech impediment, she revealed that she wears retainers in her mouth at night, which gives her a noticeable lisp.
“I actually have two retainers,” she explained, “one for my bottom teeth which is for grinding my teeth, and one for my top teeth which is just so my teeth don't move.”
Clearly Robbie is serious about protecting her dazzling smile. And she has good reasons for wearing both of those retainers. So first, let’s talk about retainers for teeth grinding.
Also called bruxism, teeth grinding affects around 10 percent of adults at one time or another, and is often associated with stress. If you wake up with headaches, sore teeth or irritated gums, or your sleeping partner complains of grinding noises at night, you may be suffering from nighttime teeth grinding without even being aware of it.
A type of retainer called an occlusal guard is frequently recommended to alleviate the symptoms of bruxism. Typically made of plastic, this appliance fits comfortably over your teeth and prevents them from being damaged when they rub against each other. In combination with stress reduction techniques and other conservative treatments, it’s often the best way to manage teeth grinding.
Orthodontic retainers are also well-established treatment devices. While appliances like braces or aligners cause teeth to move into better positions, retainers are designed to keep teeth from moving—helping them to stay in those positions. After active orthodontic treatment, a period of retention is needed to allow the bite to stabilize. Otherwise, the teeth can drift right back to their old locations, undoing the time and effort of orthodontic treatment.
So Robbie has the right idea there too. However, for those who don’t relish the idea of wearing a plastic appliance, it’s often possible to bond a wire retainer to the back surfaces of the teeth, where it’s invisible. No matter which kind you choose, wearing a retainer can help keep your smile looking great for many years to come.
If you have questions about teeth grinding or orthodontic retainers, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Teeth Grinding” and “The Importance of Orthodontic Retainers.”
We've all had them — tiny sores that pop up seemingly out of nowhere under the tongue or the inside of the cheek. They're named aphthous ulcers, but are more commonly known as canker sores. For some people, they can be a recurring irritation.
Round with a yellow-gray center surrounded by reddened skin, aphthous ulcers seem to coincide with periods of anxiety or stress, or as a result of some minor trauma. Many people will feel a tingling or painful sensation a few hours or days before the ulcers appear. Once they appear they usually persist for a week to ten days before finally drying and healing. In the meantime they can be painful, especially while eating or drinking.
One form known as recurrent aphthous stomatitis (RAS) affects about a quarter of the population with outbreaks of multiple ulcers that occur regularly. RAS ulcers are usually one centimeter or more in size — the larger the sore the more painful they tend to be.
There are ways to ease the discomfort of an ulcer outbreak and help hasten their healing. A number of over-the-counter products can be used in minor cases to numb the area temporarily and cover it to facilitate healing. We can also apply steroids or inject other medications for more severe cases. You may also find curbing your eating of certain foods like tomato sauce, citrus or spicy dishes can help.
For the most part aphthous ulcers aren't dangerous. In some situations, though, you should seek dental or medical evaluation: a sore that doesn't heal within two weeks; increases in severity, frequency or duration of ulcers; or when you don't seem to ever be without an ulcer in your mouth. We may need to perform tests, including tissue biopsy, to make sure there aren't any underlying systemic conditions causing the ulcers.
More than likely, though, you'll only need relief from the aggravation caused by aphthous ulcers. Among the many remedies, there's one right for you.
If you would like more information on aphthous ulcers or other mouth sores, 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 “Mouth Sores.”
October is National Dental Hygiene Month. It comes as no surprise that good dental hygiene habits are best acquired early in life—and with good reason, as tooth decay is the most common disease among children. In fact, a full 43 percent of U.S. children have cavities, according to a 2018 report from the U.S. Centers for Disease Control. So how do you start young children on the path to a lifetime of good oral health? Here are five tips for instilling good dental hygiene habits in your kids:
Set a good example. Good—and bad—habits often start at home. Research shows that when young children notice other family members brushing their teeth, they want to brush, too. So let your child see you brushing and flossing your teeth, and while you’re at it model good nutritional choices for optimal oral health and use positive language when talking about your own dental visits. The example you set is a powerful force in your child’s attitude toward oral care!
Start early. You can start teaching children brushing techniques around age two or three, using a toothbrush just their size with only a pea-sized amount of fluoride toothpaste. If they want to brush by themselves, make sure you brush their teeth again after they have finished. Around age six, children should have the dexterity to brush on their own, but continue to keep an eye on their brushing skill.
Go shopping together. Kids who handpick their own oral hygiene supplies may be more likely to embrace the toothbrushing task. So shop together, and let them choose a toothbrush they can get excited about—one in their favorite color or with their favorite character. Characters also appear on toothpaste tubes, and toothpaste comes in many kid-friendly flavors.
Make dental self-care rewarding. Why should little ones care about good dental hygiene? Young children may not be super motivated by the thought of a long-term payoff like being able to chew steak in their old age. A more tangible reward like a sticker or a star on a chart each time they brush may be more in line with what makes them tick.
Establish a dental home early on. Your child should start getting regular checkups around age one. Early positive experiences will reinforce the idea that the dental office is a friendly, non-threatening place. Children who get in the habit of taking care of their oral health from an early age have a much better chance of having healthy teeth into adulthood.
If you have questions about your child’s dental hygiene routine, call the office or schedule a consultation. You can learn more in the Dear Doctor magazine articles “Do Babies Get Tooth Decay?” and “How to Help Your Child Develop the Best Habits for Oral Health.”
Chronic stress can cause any number of physical problems like back pain, insomnia or stomach ulcers. In the mouth, it can also be the cause of teeth grinding or clenching habits that may lead to pain and tooth damage.
Besides toothaches and jaw pain, stress-related teeth grinding may also be causing your teeth to wear at a faster than normal rate. While the teeth can withstand normal forces generated from biting and chewing, a grinding habit could be subjecting the teeth to forces beyond their normal range. Over time, this could produce excessive tooth wear and contribute to future tooth loss.
Here, then, are some of the treatment options we may use to stop the effects of stress-related dental habits and provide you with relief from pain and dysfunction.
Drug Therapy. Chronic teeth grinding can cause pain and muscle spasms. We can reduce pain with a mild anti-inflammatory pain reliever (like ibuprofen), and spasms with a prescribed muscle relaxant drug. If you have sleep issues, you might also benefit from occasional sleep aid medication.
A Night or Occlusal Guard. Also known as a bite guard, this appliance made of wear-resistant acrylic plastic is custom-fitted to the contours of your bite. The guard is worn over your upper teeth while you sleep or when the habit manifests; the lower teeth then glide over the hard, smooth surface of the guard without biting down. This helps rest the jaw muscles and reduce pain.
Orthodontic Treatment. Your clenching habit may be triggered or intensified because of a problem with your bite, known as a malocclusion. We can correct or limit this problem by either moving the teeth into a more proper position or, if the malocclusion is mild, even out the bite by reshaping the teeth in a procedure known as occlusal (bite) equilibration.
Psychological Treatment. While the preceding treatments can help alleviate or correct dental or oral structural problems, they may not address the underlying cause for a grinding habit — your psychological response to stress. If you’re not coping with stress in a healthy way, you may benefit from treatments in behavioral medicine, which include biofeedback or psychological counseling.
If you would like more information on dental issues related to stress, 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 “Stress & Tooth Habits.”
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