Posts for: September, 2013
Chewing tobacco has a certain cachet among its users, especially young boys and men, who believe using it makes them appear macho or “cool.” They also believe this “smokeless” variety (as it's often marketed by tobacco companies) is safer than cigarettes or cigars.
Unfortunately, nothing could be further from the truth. In reality, chewing tobacco is harmful to your health — and especially your oral health. Regular use of these products can lead to severe dental and mouth conditions resulting in disease, disfigurement, or even death.
Like the smoked variety, chewing tobacco infuses its users with nicotine, a chemical stimulant naturally produced by the tobacco plant. The body responds to the stimulant's effect and begins to crave it, leading to addiction.
The problem, though, is the other ingredients in chewing tobacco: more than thirty other substances known to cause various kinds of cancer, including oral. Oral cancer alone is extremely dangerous: many patients suffer partial or complete loss of oral tissue and facial structures, including the tongue, lower jaw or even the face. Some even lose their lives — statistics show that only half of those with oral cancer survive more than five years after diagnosis.
Although cancer may be the most harmful effect of chewing tobacco, it isn't the only one. Researchers have found tobacco users have higher rates of tooth decay and gum disease than non-users. Tobacco also causes cosmetic and hygiene problems, including tooth staining and chronic bad breath.
If you're a tobacco user in any form, and especially chewing or spit tobacco, as your dentist we would advise you to consider quitting the habit. Giving up tobacco will not only improve your oral health and appearance, it may even save your life.
If you would like more information on the dangers of chewing tobacco, 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 “Chewing Tobacco.”
Root canal treatments are an important method for stopping the disease process within an infected tooth and ultimately saving it. However, one of the few side effects could have an aesthetic impact on your smile. Leftover blood pigments or the filling materials themselves can cause a darkening of the tooth — the tooth could eventually stand out in an unsightly way from surrounding teeth.
There is, however, one possible solution: a whitening technique known as internal or non-vital bleaching can lighten a darkened, non-vital tooth. For this procedure, we would insert a bleaching mix (usually sodium perborate mixed with hydrogen peroxide) into the pulp chamber of the darkened tooth for a short period of time. The chemical reaction of the mix whitens the tooth from within.
Our first step is to make sure by x-rays that the root canal filling in the tooth is still intact and still has a good seal. We then create a small opening in the rear of the tooth just above the root canal filling, irrigate it with water to remove any debris, and then add a special cement at the point where the root canal filling begins to seal it from any leakage of the bleaching solution into the root canal filling.
We then insert the bleaching solution into the empty pulp chamber. This is covered with a cotton pellet, which is then sealed in with a temporary filling. We repeat this application over a number of days until we see a noticeable change in the tooth color (normally after one to four visits). At this point, we would remove any residual solution and apply a permanent filling to seal the tooth.
This procedure can be performed instead of more extensive procedures such as veneers and crowns as a cover for the discolored tooth, or as a way to lighten teeth before applying a veneer or crown to help prevent discoloration from showing through. Either way, non-vital bleaching can help remove unsightly discoloration and restore vibrancy to your smile.
If you would like more information on internal or non-vital bleaching, 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 “Whitening Traumatized Teeth.”
Even before your infant's first tooth emerges, you can take steps to reduce the risk for cavities!
Cavities occur when decay-causing bacteria living in the mouth digest carbohydrates (sugars) introduced into the mouth via food and beverages. This produces acid, which can eat through the protective enamel surface of teeth and attack the more vulnerable dentin below. Infants aren't born with decay-promoting bacteria; however, they can acquire them from their caregiver(s) through close contact, for example:
- Kissing on the mouth
- Sharing food
- Sharing eating utensils (e.g., a spoon or glass)
- Cleaning off a pacifier by mouth
Tooth decay is the most common chronic childhood disease! It can start as soon as the first tooth erupts — which generally happens around age 6 to 9 months but can be as early as 3 months or as late as 1 year. Besides being potentially painful, severe tooth decay may cause your child to lose the affected primary (baby) tooth before it's due to fall out on its own. That, in turn, can raise the risk of orthodontic problems because primary teeth maintain space for permanent teeth, which also use them as their guide for coming in properly.
It's important to clean your child's teeth regularly once they appear and to refrain from certain feeding activities that have been linked with early tooth decay. For example, use of a sleep-time bottle containing a liquid with natural or added sugars, such as formula or juice, can result in a pattern of severe decay once referred to as “baby bottle tooth decay.” These days, the term early childhood caries (ECC) is more commonly used to also encompass decay linked to continuous sippy-cup use, at-will breast-feeding throughout the night, use of a sweetened pacifier, or routine use of sugar-based oral medicines to treat chronic illness.
We recommend that you schedule a dental visit for your baby upon eruption of his or her first tooth or by age 1. This first visit can include risk assessment for decay, hands-on instruction on teeth cleaning, nutritional/feeding guidance, fluoride recommendations, and even identification of underlying conditions that should be monitored. Your child's smile is a sight to behold; starting early improves the odds of keeping it that way!
If you would like more information about infant dental care, 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 “Age One Dental Visit.”
Dental plaque (a film of bacteria that forms on your teeth) is known to be the main cause of periodontal (gum) disease. When the bacteria settle on your teeth they form a whitish film called biofilm. Those that are not removed cause formation of “pockets,” areas of separation between the teeth and their surrounding gums, in which plaque hardens into deposits known as calculus or tartar. The purpose of having your teeth cleaned regularly by a trained professional hygienist is to remove deposits of plaque and calculus. Removal of hard deposits on your teeth is called “scaling.” This can be done either by using hand-held scalers or by newer technology: ultrasonic power scalers.
Let's take a look at the strengths and weaknesses of both types of instruments.
How they work: These instruments use the energy of ultrasonic vibration to crush and remove hard, calcified deposits of calculus. They also create shockwaves that disrupt bacterial cells. Use of these tools includes washing and flushing the pockets and any exposed root surfaces with water.
Pros: They are as effective as manual instruments for calculus removal in shallow gum pockets and significantly more effective in pockets greater than 4mm. They are very effective in removing calculus from root surfaces and from within periodontal pockets. Their small tips can penetrate deeper into periodontal pockets than manual instruments and are more comfortable to experience, and they are more effective for cleaning difficult nooks and crannies. Coolant sprays flush the area and remove bacteria and their by-products. They require less time than manual instruments.
Cons: A contaminated mist may form so that the hygienist needs to wear protective equipment. The vibration of the ultrasonic instruments may make it difficult to feel if the root surface is completely smooth and free of calculus. Power scalers affect some heart pacemakers.
Conventional Hand-held Scalers
How they work: These depend on the skill and knowledge of the hygienist to manipulate them and scrape away calculus (tartar) from teeth and within pockets.
Pros: They are equally effective for plaque and calculus removal from shallow gum pockets. They do not interfere with electronic equipment like heart pacemakers. They can be used more easily on teeth in which there are areas of demineralization (areas where minerals have been removed from the tooth's enamel, making it more vulnerable to decay). They are easier on the tooth's surface and are thus better for use with porcelain or composite restoration, or sensitive teeth.
Cons: They take longer to complete a cleaning. Sometimes they cause more discomfort than ultrasonic scalers.
In most cases the choice of scalers is not really an either/or situation. Most experts say that the best results come through using both types of instruments. As a result, cleanings can be done with effective and efficient outcomes and greater patient comfort.
Contact us today to schedule an appointment to discuss your questions about dental cleanings. You can also learn more by reading the Dear Doctor magazine article, “Dental Cleanings Using Ultrasonic Scalers.”