Tooth decay is not trivial. It's a worldwide epidemic, one of the most common of all diseases — second only to the common cold. It affects more than one fourth of U.S. children of ages 2 to 5 and half of those 12 to 15. Among adults, tooth decay affects more than ninety percent of those over age 40.

Prevention of cavities starts with a healthy diet and effective brushing and flossing, but it is much more complex than that. Three strategies for reducing dental caries (tooth decay) include:

Protect with Fluoride and Sealants
This works best when fluoride is applied to the crystalline coating of your child's teeth just after they push through the gums (erupt). The fluoride becomes incorporated into the tooth's surface and acts as a barrier to decay. Studies have shown that low doses of fluoride are safe and effective.

Dental sealants are used as a companion to fluoride because they seal tiny pits and fissures in the tooth's structure, creating an even stronger barrier.

Modify Oral Bacteria
Every mouth contains bacteria, no matter how well you clean your teeth. Not all bacteria cause tooth decay. The problem bacteria are those that produce acid as a byproduct of their life processes. We can identify acid-producing bacteria in your mouth, you can reduce their concentrations using antibacterial mouthrinses such as chlorhexidine, and pH neutralizing agents (substances that reduce the amount of acid).

Reduce Sugars in Your Diet
Bacteria in your mouth ferment sugars and other carbohydrates, producing acids that eat into the mineralized outside structure of your teeth, the enamel. So eating fewer sugars — particularly added sugars such as those in juices, sodas, candy and other sweets — will help prevent decay. Your total sugar intake should be less than fifty grams, or about ten teaspoons, per day. If you begin to read labels showing sugar content of common foods, you may be surprised at the amount you consume without knowing it.

If you must snack between meals, non-sugary snacks like raw vegetables and fresh fruits create a better environment for your teeth.

Xylitol, an “alcohol sugar” used in some chewing gums and dental products, has been shown to reduce decay-producing bacteria.

Try these easy strategies to keep your teeth healthy and functional throughout your lifetime.

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.”

On the day when braces come off, most people feel that their orthodontic treatment is over. When they are then asked to wear retainers, they may wonder what this additional requirement will accomplish. Wasn't the work of moving their teeth to desired positions already completed? To understand the answer to this question, you need to understand how orthodontics works.

How does orthodontic treatment remodel your smile?

Although they give the appearance of being stable and unmoving, teeth and their surrounding structures (gums, jawbones, and ligaments) are living tissues and are actually in a constant state of change.

Teeth are rooted in bone and are attached by a fibrous tissue called the periodontal ligament (from peri meaning around and odont meaning tooth). One side of the ligament attaches to the cementum (part of the tooth's root) and the other side is attached to the bone, with the tooth suspended in between.

These tissues are constantly remodeling themselves, but pressure from the lips and cheeks on one side and from the tongue on the other create a balance that keeps the teeth suspended in the same location. When mild forces are placed on the teeth, such as the forces from the wires used in orthodontic treatment, the tissues slowly adapt and rebuild, resulting in a new position for the teeth.

What are retainers?

Orthodontic retainers are devices usually made of a clear plastic section that is fitted to the roof of the mouth, with thin wires that fit over the teeth.

What is the purpose of retainers?

The remodeling process keeps going after the orthodontic treatment stops, so time is needed for the teeth to reach a new balanced state. The retainer stabilizes them in their new position so that bone and ligament can reform around the teeth and hold them there. This works well for adolescents, whose jaws are in a state of growth, but adults may need outside assistance to stabilize their teeth for a longer time. They may be asked to wear retainers indefinitely to make sure their teeth do not move from their new positions.

What happens if you don't wear your retainers?

If you don't wear your retainers, your teeth are likely to return to the positions they had prior to your orthodontic treatment. This can happen fairly rapidly, underscoring the importance of wearing retainers as instructed.

What are the different types of retainers?

Most retainers are removable devices as described above. For people who require long-term use of retainers, thin retainer wires can be bonded to the inside surfaces of their front teeth. Such wires are usually left in place for several years, relieving them of the need to remove and replace their retainers.

Contact us today to schedule an appointment to discuss your questions about orthodontics and retainers. You can also learn more by reading the Dear Doctor magazine article “Why Orthodontic Retainers?”

It can start with a simple twinge or be as severe as excruciating pain. From time to time, we have patients asking questions about tooth sensitivity — what causes it? What can be done about it? For these reasons, we have put together the following list of frequently asked questions (FAQs) so that you can develop a healthy understanding about this painful and often avoidable condition.

What is tooth sensitivity?

The first layer of protection of the teeth is enamel. Enamel is a dense crystalline structure, the hardest substance produced by animals. It is an inert substance that has no nerve supply and thus it protects the teeth from temperature and pressure changes. When it is compromised, worn thin, or exposed due to gum recession, it leaves the dentin exposed and vulnerable. Unlike enamel, dentin is living and has delicate nerve fibers within it.

What triggers tooth sensitivity?

Once dentin is exposed, it can become sensitive. It typically occurs when the dentin comes in contact with heat, cold, or the “double whammy” combination of both cold and sweets. Even the bristles of a soft toothbrush can irritate exposed dentin causing sensitivity and pain.

What can be done to minimize tooth sensitivity?

One of the simplest ways to minimize or prevent sensitivity is by teaching proper brushing techniques so that teeth are cleaned without causing either sensitivity or damage. Brushing too hard is a frequent culprit. Being overzealous can literally cause gum recession, leave dentin, and wear it away leaving it grooved. Another step to minimize sensitivity is to use a toothpaste containing fluoride. Fluoride increases the strength of tooth surfaces and thus makes teeth more resistant to attack by acids and sweets. If severe, we may need to apply a barrier to cover the sensitive areas. These barriers may range from concentrated fluoride varnishes to replacing lost tooth structure with filling materials.

Want to learn more?

To learn more about this topic, read the article “Sensitive Teeth.” Or if you are suffering from this condition, please contact our office to schedule an appointment. During your appointment, we will conduct a thorough examination to ascertain what is causing your sensitivity as well as what we can do to treat and/or prevent future issues.

A number of factors can lead to dental caries (tooth decay). To find out if you are at high risk, ask yourself these questions.

Is plaque visible in my mouth?
Dental plaque is a whitish film of bacteria that collects on your teeth. If it is clearly visible, it means that there is a lot of it. Among the bacteria in the plaque are those that produce tooth decay, particularly in an acidic environment. (A normal mouth is neutral, measured on the pH scale, midway between the extreme acidic and basic ends of the scale.)

Do I have a dry mouth?
Saliva protects your teeth against decay by neutralizing an acidic environment and adding minerals back to the outer surface of enamel of your teeth, so reduced saliva is a high risk for caries. Many medications can cause dry mouth as a side effect.

Do I eat a lot of snacks, particularly unhealthy ones?
Frequently eating sugars, refined carbohydrates, and acidic foods promotes the growth of decay-producing bacteria. The more frequently you eat, the longer your teeth are bathed in sugars and acids. Acidic foods not only promote bacterial growth, they also directly cause erosion of the tooth's hard surface by softening and dissolving the minerals in the enamel.

Do I wear retainers, orthodontic appliances, bite guards or night guards?
These appliances are recommended for various conditions, but they tend to restrict the flow of saliva over your teeth, cutting down on the benefits of saliva mentioned above.

Do my teeth have deep pits and fissures?
The shape of your teeth is determined by your heredity. If your teeth grew in with deep grooves (fissures) and pits in them, you are at higher risk for bacterial growth and resulting decay.

Do I have conditions that expose my teeth to acids?
If you have bulimia (a psychological condition in which individuals induce vomiting), or GERD (Gastro-Esophageal Reflux Disease), your teeth may be frequently exposed to stomach acids that can cause severe erosion to your teeth.

Do I already have cavities?
Visible cavities can range from those only visible with laser technology or x-ray examination to those a dentist can see with a naked eye. If you already have small cavities, you are at high risk for developing more.

Do I have white spots on my teeth?
White spots are often the first sign of decay in a tooth's enamel. At this point, the condition is often reversible with fluorides.

Have I had a cavity within the last three years?
Recent cavities point to a high risk of more cavities in the future, unless conditions in your mouth have significantly changed.

If you have any of these indications of high risk, contact us today and ask us for suggestions for changing the conditions in your mouth. You can also learn more by reading the Dear Doctor magazine article “Tooth Decay.”

Here's an interesting tidbit of information on Wheel of Fortune host Vanna White: like many people, she grinds her teeth at night. In a detailed interview with Dear Doctor magazine, Vanna explained how she had to replace a filling in a back tooth several times because of her grinding habit. Eventually, she had her dentist make her a nightguard to protect her famous smile.

“I really try to sleep with it every night,” Vanna told the magazine. “I try to keep it on my nightstand so when I go to bed, I remember to put it in. Or I will put it by my toothbrush so I can put it in after brushing my teeth at night.”

The habit of teeth grinding or clenching is often associated with stress and/or sleep deprivation. It is referred to as “parafunctional” (“para” – outside, “function” – normal), meaning it can generate biting forces well outside the normal range — perhaps 10 times normal. This excessive force can affect many areas of the oral system. Teeth may become worn, chipped or loose; jaw joints or muscles can go into spasm; and some grinders (or “bruxers” as they are also called) may even experience discomfort of the head, ears, neck or back. Many times, a person with a grinding habit does not become aware of it until it is pointed out by a sleep partner or dental professional.

Like Vanna White's dentist, we often recommend a nightguard to those with nocturnal bruxing habits. It is made of a very thin, wear-resistant plastic that fits over the biting surfaces of the upper teeth only. The lower teeth are then free to glide or skate over the guard, which prevents them from biting into the upper teeth. Some people wear their guards during the day if they tend to clench their teeth when under stress.

If you are concerned about teeth grinding or interested in learning more about nightguards, please contact us today to schedule an appointment for a consultation. If you would like to read Dear Doctor's entire interview with Vanna White, please see “Vanna White.” Dear Doctor also has more on “Stress & Tooth Habits.”