If you have to ask why anybody would voluntarily endure the pain of receiving a tongue piercing — then maybe you're just too old to understand. But seriously: no matter where you stand on the aesthetics of the issue, you shouldn't ignore the real health risks that go along with the installation of oral piercings.

According to the Journal of the American Dental Association, the most common sites for intraoral piercing are the tongue and the lip. In the case of the so-called “tongue bolt,” several significant short-term and long-term risks have been identified; most also apply to other types of oral piercings as well.

The tongue is primarily composed of muscle tissue, along with a rich supply of associated blood vessels and nerves. This explains why accidentally biting your tongue can be so painful — and bloody. Installing a tongue bolt involves piercing a small hole through the tongue, and attaching the ornament through the hole.

In rare instances — such as the case of a teenager who experienced severe pain and the sensation of electrical shocks — nerve irritation and damage may occur soon after a tongue bolt is installed. (Fortunately, her symptoms cleared up shortly after the bolt was removed.) More often, the symptoms are less severe, but the health issues are chronic.

Tongue bolts are known to cause problems with the teeth, including increased sensitivity and pain. Teeth are also prone to chipping due to contact with the ornament. These are among the reasons why you are likely to need more frequent dental checkups if you have an oral piercing.

Additionally, periodontal (gum) problems can develop in individuals with oral piercings. These frequently appear as gum recession, inflammation and infection. Eventually, bone loss may occur as well.

The good news: removing an oral piercing is generally easy, and the area is quick to heal. If it doesn't seal up by itself, the hole left behind can be closed with only minor surgery. And removing the piercing immediately reduces your health risk — thus instantly improving your overall oral health.

Thinking of getting — or removing — an oral piercing? Talk to us. No matter what you decide to do, you owe it to your health to become informed about the issues surrounding these body ornaments.

If you would like more information about oral piercings, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “How Oral Piercings Affect Your Oral Health,” and “Body Piercings and Teeth.”

Everyone knows Vanna White as the elegant co-host of the popular game show Wheel of Fortune. But here's one thing you may not know: White is listed in the Guinness Book of World Records as television's most frequent clapper, with an average of 720 claps per show — that's over 28,000 per season! And here's something else: the star with the megawatt smile wore braces as a kid, and she's not too shy to talk about it.

“I only had to wear them for a year and it was a good experience for me,” she told an interviewer for Dear Doctor magazine. But when it was time for her son to get them, White noticed something different. “We used to have those silver bands that went all the way around each tooth, and they don't have that anymore. It is fascinating to see how far they have come.”

We're glad she noticed! In fact, orthodontic appliances have advanced a good deal in the past decade or so. Instead of using metal bands, brackets holding the wire part of braces are now typically attached directly to the teeth with a dental adhesive. For an even less obtrusive look, ask about using colorless brackets instead of metal ones — that way, the only part that's clearly visible is the thin wire itself. And in some situations, braces can be placed on the lingual (tongue) side of the teeth, making them all but invisible.

Another type of nearly invisible appliance is the clear orthodontic aligner. The aligner system consists of a series of precision-made transparent “trays” that fit over the teeth. Each tray is worn for a few weeks, and each moves your teeth by a small amount; together, they can help correct mild to moderate orthodontic problems. And the best part — they're really hard to notice! That makes them perfect for both adults concerned about a “professional” look, and image-conscious teens.

So if you're a TV star — or if you'd just like to have a brighter and better smile — it's never too late to get started! If you would like more information about orthodontics, please contact us for a consultation. You can learn more in the Dear Doctor magazine articles “The Magic of Orthodontics” and “Clear Orthodontic Aligners.”

You've taken good care of your teeth all your life, with brushing, flossing and regular visits to the dentist. But chances are that someday (or maybe even now) you may be told that you need a restoration on one or more of your teeth. Oftentimes, that means a crown.

But what exactly is a crown, and why is it used? We're glad you asked!

In the course of time, natural teeth may need to be restored for a variety of reasons. As we age, our teeth may eventually become chipped or discolored. They can become weak and prone to cracking, or actually break due to tooth decay or trauma. Treating tooth decay may require a filling so large that there isn't much tooth surface left. Or, getting a dental implant (which replaces the roots of the tooth) means that you will need a replacement for the visible part of the tooth as well.

A crown (sometimes called a cap) is a common type of dental restoration. It's a way of replacing the tooth structure, in part or in full. A crown can cover the whole visible portion of the tooth, right down to the gum line. Since it's custom-made just for you, it is designed to fit in and function just like the rest of your teeth. And because it's composed of an extremely hard substance (gold, porcelain, ceramic, or some combination of these materials) it's made to last for a long time.

If a dental examination shows that you need a crown, here's how the process works: First, any decay is removed from the affected tooth, and it is prepared for restoration. Then, a 3-D replica of the tooth (and adjacent teeth) is made. This model is used to create a crown that matches your natural teeth. If you're getting a tooth-colored crown, the exact shade of the adjacent teeth will be duplicated as closely as possible.

After the crown has been fabricated, the tooth is made ready to receive the restoration. The crown is adjusted to mesh perfectly with the prepared tooth, and to function with the whole bite. Then, it is cemented or bonded into place. When it's all done, it can be hard to tell that you had any dental work done at all.

If you're thinking that it's a challenge to make an “artificial” tooth fit in with your natural teeth, you're right — but we do it all the time! Creating a superb-looking restoration is a blend of science and art. It takes a careful eye to match tooth colors and to adjust biting surfaces and spacing for a perfect fit. But when experienced dental professionals and patients work together, the results can make us both proud of the achievement.

If you would like more information about crowns, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Porcelain Crowns & Veneers” and “Gold or Porcelain Crowns.”

What and how you eat and drink has a significant impact on the health of your teeth and gums. Therefore, an effective oral hygiene regime must take your diet into account.

Acid is your teeth's enemy; it can erode their protective enamel coating (a process called demineralization). Certain foods and beverages (such as citrus drinks and coffee) contain it, and it's produced by bacteria in your mouth that feed on dietary sugar and release acid as a byproduct (a process called fermentation). Your allies are foods and beverages that neutralize acids, provide minerals and vitamins to repair tooth enamel, and stimulate saliva.

Sugar & Decay
Sugars, the leading promoter of dental decay, exist in many forms in our diet. Some occur naturally, while others — referred to as “free sugars” — are added by the manufacturer, cook or consumer. The latter are most often linked with decay. Soft drinks are the primary source of dietary free-sugars in the U.S.

Sugars in fruit, vegetables, milk and unprocessed, starch-rich foods such as rice, potatoes and whole grains, do not appear to be harmful to teeth. Note, however, that dried fruits contain a highly concentrated sugar level and can stick to tooth surfaces. The sugar substitutes xylitol and sorbitol appear not to promote decay. In fact, there's evidence that chewing xylitol-sweetened gum three to five times daily for at least five minutes (after meals) stimulates saliva flow, which helps protect against decay.

Acids & Erosion
In addition to eroding tooth enamel, acidic foods and beverages create an environment where it's easier for decay-promoting bacteria to flourish. Saliva can reduce acidity but it must have time to work, at least 30–60 minutes. That's why behaviors that maintain acid levels, such as sipping coffee throughout the day, can be harmful.

Saliva-Promoting Saviors
Saliva is a front-line defense against erosion and decay. It helps remove food particles and contains minerals that help neutralize acid and promote remineralization of the tooth surface. Foods that stimulate saliva and/or contribute essential minerals include:

• Cheese — stimulates saliva and is rich in calcium, contributing to the re-calcification of teeth and protecting against the loss of calcium,
• Cow's milk — contains decay-counteracting calcium, phosphorous and casein,
• Plant foods — are fibrous and require chewing, which mechanically stimulates saliva,
• Water — keeps you hydrated, which is important for saliva production and preventing dry mouth (a condition that promotes acid-producing bacteria), and helps wash away food particles; fluorinated water bestows the protective properties of fluoride (a compound that makes tooth enamel more resistant to acid erosion and promotes re-calcification).

As you can see, brushing and flossing effectively is just part of the oral hygiene equation.

If you would like more information about nutrition and oral hygiene, 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 “Nutrition & Oral Health.”

Do you have silver dental fillings that you wish you didn't have? Wouldn't it be nice if no one could look in your mouth and see how many cavities you had as a kid? Tooth-colored fillings may offer a solution to the problem of too much metal in your mouth. How much do you really know about non-metallic tooth-colored fillings? Take our quiz and find out.

True or false: Tooth-colored fillings are a radical new technology.

False. A variety of dental porcelains and composite resins have been successfully used in tooth restoration for many years. These materials have been designed to mimic the properties of the two major components of teeth: the hard outer enamel, and the bone-like inner dentin. Our increasing understanding of tooth structure and composition has led to better and more natural-looking filling substances.

True or false: Teeth must remain rigid under the pressure of the bite.

False. At one time, metal amalgam (silver) fillings were preferred because of their extreme hardness. But we now know that the crowns of our teeth actually flex under the forces of the bite. This discovery has spurred the development of new methods and materials to stabilize the restored tooth and reduce the incidence of premature failure.

True or false: It's usually more complicated to put in a tooth-colored filling than a metal one.

False. Regardless of which material is used, the basic process of filling a tooth is the same. The dentist prepares the tooth for treatment, removes decay, and places a filling directly into the tooth. If the filling is moderately deep, a tooth-colored filling may be set in several layers which are successively “cured” or hardened. More extensive restorations may require more than one visit, but the natural-looking results generally justify the extra time.

True or false: Regular metal fillings make the tooth structure stronger.

False. Properly securing an amalgam filling may require the tooth to be “undercut,” meaning that a greater amount of healthy tooth material must be removed. This can weaken the tooth structure, eventually leading it to chip and crack. Non-metallic fillings don't require undercutting, so more tooth structure is left intact. This more conservative treatment can result in a stronger, longer-lasting restoration.

True or false: Non-metallic (tooth-colored) fillings are safer than silver fillings.

False. While each method has advantages and disadvantages, and may not be an appropriate treatment in every situation, both methods have been deemed safe and effective by major U.S. and international science and health organizations. While there have been recent concerns about mercury in amalgam fillings, there is presently no reason to believe that it presents any cause for concern.

If you would like more information about tooth-colored fillings, 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 “The Natural Beauty of Tooth-Colored Fillings.”