Dental caries (tooth decay) is similar to the pesky bumblebee that invades your lovely summer barbecue. You can find temporary solace from this intruder by eliminating that very first bee that you see, but if you are situated in an area that is close to the bee's nest, it won't be long before the next bee buzzes along. This is similar to tooth decay. Having one cavity-laden tooth drilled and filled is really just a temporary fix. The underlying conditions that led to tooth decay in the first place need to be addressed in order for your risk of future infection to decrease.

Researcher Dr. John Featherstone created the concept of the Caries Balance in 2002, in which he explained that tooth decay and overall dental health are dependent upon a proper balance of disease-causing and health-promoting factors. Discovering what the fundamental problem really is (and getting as far away from that hornet's nest as possible) can help both determine and curb your risk for future tooth decay.

Here's the issue in a nutshell: Susceptible teeth, in the presence of acid producing bacteria when fed by sugar from your diet, basically, will create all the conditions necessary to cause tooth decay.

To determine your risk for tooth decay, see how many times you answer “Yes” to the following questions:

1. Do you brush your teeth twice a day to reduce bacterial plaque sticking to the teeth?
2. Do you use fluoride toothpaste to strengthen the teeth against acid attack?
3. Do you use a fluoride mouthrinse?
4. Do you floss daily?

Every affirmative answer decreases your risk of getting cavities, but even doing all of this may not be enough!

Now, how many times can you answer “Yes” to these questions?:

1. Do you smoke? Smoking causes mouth dryness, and creates a host of other health problems.
2. Do you snack frequently between meals? One sugary snack and your mouth is acidic for the next hour. One snack per hour and your mouth is acidic all day.
3. Do you frequently have acid reflux or heartburn? Reflux creates extreme acidity in the mouth and directly erodes tooth enamel.
4. Do you drink soda, sports drinks, or acidic beverages frequently? These beverages are very acidic.
5. Is your mouth frequently dry? Do you take any medications that cause mouth dryness? Saliva is nature's own defense against acidity and helps neutralize acid in the mouth.
6. Have you had frequent cavities in the past and/or have you had any crowns or fillings in the past three months? The best indicator of future disease is past disease!

Every affirmative answer increases your risk of getting cavities!

Now that you are a little more knowledgeable about your personal risk for tooth decay, make an appointment with us to discuss the preventative measures that can give you some control over the future condition of your teeth. Ignoring the risks and then ending up with a mouth full of rotting teeth when you knew better could really sting a little!

To learn even more about the delicate balance between the disease causing and protective factors related to tooth decay, read the Dear Doctor magazine article “Tooth Decay: How To Assess Your Risk.”

Gum recession is a common problem affecting millions of Americans to some degree. If you have it, you will notice that the pink gum tissue surrounding one or more of your teeth has shrunk or receded and left the tooth-root surfaces exposed. How does this happen? And does it require treatment? The answers to both of these questions will vary from person to person. The good news is that treatment is available for those who need it.

The way you care for your teeth can be a major factor in gum recession. If you do not effectively remove plaque (bacterial biofilm) from your teeth daily, you may develop gum inflammation, gum disease and/or recession. Conversely, if you brush or floss too hard or for too long, you can also damage your gums. Please remember that it doesn't take a lot of pressure to remove biofilm; you just need to make sure you get to each tooth, right down to the gum line.

Other causes of gum recession include: mal-positioned and/or prominent teeth that are not fully encased in supporting bone; muscle attachments (frenums) pulling at the gum line; habits such as holding foreign objects (nails, pins) between the teeth that press on the gum tissues; and badly fitting oral appliances such as dentures, braces – even tongue bolts and lip piercings.

Besides not looking too great, gum recession can lead to anything from minor tooth sensitivity to tooth loss in the most severe cases. If you are experiencing any discomfort from a loss of gum (also called “gingival”) tissue, we'd certainly like to know about it. We would be happy to examine your condition and make recommendations.

There are surgical procedures that are very effective in treating these problems. Procedures such as gingival grafting or periodontal plastic surgery (“peri” – around; “odont” – tooth), often involve taking a small piece of healthy gingival tissue from the roof of your mouth and grafting it to the area where it is needed. Ultrafine sutures hold the graft in place until it “takes.” Laboratory-processed donor tissue can also be used. In either case, the procedure has a terrific success rate.

If you have any questions about gum recession, please contact us or schedule an appointment for a consultation. To learn more about the topic of oral appliance therapy, please see the Dear Doctor magazine article “Periodontal Plastic Surgery.”

If your teeth have a worn appearance, it's possible you have a habit you're not even aware of: clenching or grinding your teeth. Also called “bruxism,” this destructive action causes your top and bottom teeth to come together or scrape past each other with a force that's many times what is normal for biting and chewing.

So what's normal? This can be expressed in terms of pounds. An adult usually exerts a force of 13-23 pounds to bite or chew food. But we have the potential to generate as much as 230 pounds of force, or 10 times what's normal. A “parafunctional” force of this magnitude applied repeatedly is bound to stress your teeth and other areas of your oral system. Besides wearing away the enamel of your teeth — and maybe even some of the softer dentin layer underneath — you may experience muscle spasms or pain in your jaw joints. Serious cases of wear can lead to “bite collapse” in which your face actually changes shape as your cheeks and lips lose support. This can make you look prematurely aged.

What can be done? To prevent further wear, we can fabricate for you a thin, plastic mouthguard that will protect your teeth at night or during times of intense stress. We can also recommend ways to temporarily relieve the discomfort that your grinding/clenching habits can cause. Heat and/or anti-inflammatory medication, for example, can be helpful.

If your tooth wear is minor (raggedness along the biting edge of a tooth or teeth) you may not need any restorative work. However, if tooth wear has already caused changes to your teeth and bite that you find aesthetically or functionally unacceptable, we can restore lost tooth structure in a variety of ways. Veneers and crowns are two examples.

If you have any questions about tooth wear or grinding habits, please contact us today to schedule an appointment for a consultation. You can learn more about this topic by reading the Dear Doctor magazine article “How And Why Teeth Wear.”

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?”

Periodontal (gum) disease, though it may be invisible to everyone but your dentist, can have a powerful effect on your entire body. Not only is it dangerous to your teeth and jaws, but it can increase your risk of heart attack and stroke, cause preterm births in pregnant women, and affect blood sugar control in diabetics.

Diabetics are our subject for today. Symptoms of diabetes include abnormally high levels of glucose (a form of sugar) in the blood, leading to frequent urination, excessive thirst, blurred vision, unexplained weight loss, and loss of energy. The disease can also cause severe complications in various parts of the body.

Normally, glucose, your body's main energy source, is kept under control by a hormone called insulin, which is made by an organ called the pancreas. In type 1 diabetes, a person's pancreas does not produce enough insulin to deal with all the glucose in his or her blood. In type 2 diabetes — a condition related to increased age, physical inactivity, overweight, and heredity — the pancreas may produce enough insulin, but the body is not able to use it effectively. This condition is called insulin resistance.

People with type 1 diabetes need insulin to survive. Type 2 may be treated with exercise, diet, medications, and insulin supplements.

Serious complications of diabetes range from kidney failure, blindness, and nerve damage to infections that do not heal, gangrene and amputation of limbs.

Diabetes and periodontal disease seem to have reciprocal effects on each other. Diabetics are more likely to have periodontal disease than non-diabetics; and those with periodontal disease are likely to face worsening blood sugar control over time.

Periodontal disease (from “peri”, meaning around and “odont”, meaning tooth), is caused by dental plaque — a film of bacteria that settles on your teeth and gums every day. It's what you remove with daily brushing and flossing. Any bacteria that remain cause inflammation, which can lead in the worst cases to loss of bone and eventual loss of teeth.

The close relationship of diabetes and periodontal disease probably results from changes in the function of immune cells responsible for healing. Inflammation is a part of normal wound healing — but chronic or prolonged inflammation can destroy the tissues it was meant to heal. This may be a major factor in the destructive complications of diabetes.

Many of these complications begin in the blood vessels. Like the eyes and the kidneys, gum tissues are rich in blood vessels. Gum tissues are also under constant attack from bacteria. If you are a diabetic, effective plaque control, along with regular professional dental cleaning, can have positive effects not only on periodontal disease, but also on control of your blood glucose level.

Contact us today to schedule an appointment to discuss your questions about periodontal disease and its connections with diabetes. You can also learn more by reading the Dear Doctor magazine article “Diabetes & Periodontal Disease.”