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.”

While she was pregnant with her son Camden Jack Cutler, 25-year-old Kristin Cavallari noticed an odd occurrence in her bathroom sink: “Every time I floss, my sink looks like I murdered somebody!” the actress and reality-TV personality exclaimed. Should we be concerned that something wicked is going on with the star of Laguna Beach and The Hills?

Before you call in the authorities, ask a periodontist: He or she will tell you that there's actually no mystery here. What Cavallari noticed is, in fact, a fairly common symptom of “pregnancy gingivitis,” a condition that affects many expectant moms in the second to eighth month of pregnancy. But why does it occur at this time?

First — just the facts: You may already know that gingivitis is the medical name for an early stage of gum disease. Its symptoms may include bad breath, bleeding gums, and soreness, redness, or tenderness of the gum tissue. Fundamentally, gum disease is caused by the buildup of harmful bacteria, or plaque, on the teeth at the gum line — but it's important to remember that, while hundreds of types of bacteria live in the mouth, only a few are harmful. A change in the environment inside the mouth — like inadequate oral hygiene, to use one example — can cause the harmful types to flourish.

But in this case, the culprit isn't necessarily poor hygiene — instead, blame it on the natural hormonal changes that take place in expectant moms. As levels of some female hormones (estrogen and/or progesterone) rise during pregnancy, changes occur in the blood vessels in the gums, which cause them to be more susceptible to the effects of bacterial toxins. The bacteria produce toxic chemicals, which in turn bring on the symptoms of gingivitis — including painful and inflamed gums that may bleed heavily when flossed.

Is pregnancy gingivits a cause for concern? Perhaps — but the condition is generally quite treatable. If you've noticed symptoms like Kristen's, the first thing you should do it consult our office. We can advise you on a variety of treatments designed to relieve the inflammation in your gums and prevent the harmful bacteria from proliferating. Of course, your oral health (and your overall health) are prime concerns during pregnancy — so don't hesitate to seek medical help if it's needed!

How did things work out with Kristen? She maintained an effective oral hygiene routine, delivered a healthy baby — and recently appeared on the cover of Dear Doctor magazine, as the winner of the “Best Celebrity Smile” contest for 2012. And looking at her smile, it's no mystery why she won.

If you would like more information about pregnancy gingivitis, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Expectant Mothers” and “Kristen Cavallari.”

Treating bad breath is big business. Just check your local drug store or supermarket and you'll find a mind-numbing array of mints, gums, mouthwashes, sprays, strips and other products that promise to sweeten your breath and make you (or your mouth at least) irresistible. But most of these products only mask halitosis (from the Latin “halitus” – exhalation, and Greek “osis” – disease) and some even contain ingredients, like sugar, that contribute to tooth decay and gum disease. In most cases, for enduring, healthful results, nothing beats a trusty toothbrush, toothpaste and floss, used faithfully and correctly, along with periodic dental checks and cleanings.

Oral bacteria are the number one reason for noxious breath. More than 600 types inhabit our mouth, and some of them emit awful odors — predominantly volatile sulfur compounds characterized by a “rotten egg” smell) — as they consume remnants of food trapped in our mouth. Brushing and flossing regularly, especially after eating, can dislodge food trapped between teeth (interdental) and under the gums (subgingival), depriving microbes of a ready-made meal. It also disrupts the buildup of sticky plaque (microbial “biofilms”) where odor-causing germs can flourish.

When cleaning your mouth, pay special attention to the back of the tongue. It is the primary location for generating halitosis because it is drier and less efficiently cleansed by saliva and normal oral activity than the front. Our office can instruct you on proper oral hygiene including the gentle use of a tongue scraper or brush.

Sometimes more involved periodontal techniques such as scaling and root planing (deep cleaning) are called for; antibiotics may be useful in targeting the offending microbes. If tooth decay and/or periodontal (or gum) disease is contributing to halitosis appropriate treatment is necessary.

Remember that foul breath is just a symptom of some underlying condition. If diligent oral care at home doesn't do the trick, our office can help you get to the root of the problem and determine the appropriate therapy.

If you would like more information about halitosis and ways to prevent or treat it, 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 “Bad Breath.”

An important consideration prior to having any cosmetic dentistry is to understand both the pros and the cons of each particular dental procedure. And while porcelain laminate veneers are among the most aesthetic means of creating a beautiful, more pleasing smile, they are permanent and non-reversible and should be maintained properly.

On average, you can expect porcelain veneers to last anywhere between 7 and 20+ years. However, much of that depends whether or not you care for them properly in addition to the quality of the dental porcelain, the craftsmanship, and placement of them. How long your veneers last can also depend to some extent upon how you age. This is because the gum tissues attached to the living tooth that your veneers are cemented to may shrink or pull away from the tooth exposing its root surface. If this occurs, you should see your dentist for an evaluation, as it may require veneer replacement. Or, the issue might be resolved through some minor periodontal (gum) plastic surgery.

Porcelain veneers are a low maintenance solution for solving a multitude of cosmetic dental challenges, but they do require that you protect them during sports or vigorous activity. You should also wear an oral appliance or mouthguard (nightguard) to protect them from grinding or any other involuntary damage during sleep.

To learn more about porcelain veneers, continue reading the Dear Doctor article, “Porcelain Veneers.” If you are ready to see what cosmetic dentistry can do for you, contact us to schedule a consultation.

For many brides and grooms, planning for their wedding is something they start weeks, months or even years in advance. Obviously for most couples, these plans include finding the perfect location, dress, reception area, florist and caterer. However, a growing number of couples (and parents of the bride and groom) are also looking to cosmetic dentistry prior to the wedding. A smile makeover to correct an issue and boost self-confidence makes sure that your wedding pictures are truly memorable.

If this sounds like you, take the first step towards the smile you have always wanted. To create your ideal smile, we will first meet with you to hear your concerns, goals, expectations and wedding day timeline. Feel free to bring in photos or magazine images of smiles that illustrate exactly what you want, do not want, as well as images of smiles that you consider beautiful. We will give you a thorough examination, review photos you bring with you and ensure that everyone understands and agrees with your smile makeover treatment decisions. You will also be informed about what you should expect immediately prior, during, and following your treatment.

We pride ourselves on using the latest technologies and techniques to restore natural-looking smiles. Our smile makeovers have a two-fold design plan in that we artistically create the cosmetic look you want while ensuring you obtain optimal functionality and oral health. After all, we all on the same team for helping you achieve the look you want for your wedding and maintaining your smile for years to come.

Want to learn more?

Contact us today to discuss your smile makeover questions or to schedule an appointment. You can also learn more when you continue reading the Dear Doctor article, “Wedding Day Smiles.”

Junk food and between-meal sweets are a habit for many of us, even though we know it is bad for our bodies and our teeth. As adults, we are responsible for our own choices. As parents, we are also responsible for our children's choices, and for teaching them to choose wisely.

Celebrity Chef Cat Cora offers the following six suggestions for leading children to a healthy lifestyle. Cora is a star of Iron Chef America and author of Cat Cora's Classics with a Twist: Fresh Takes on Favorite Dishes, in which she reveals healthier versions of classic recipes. In her remakes she shows how to cook with a lot of flavor while reducing fat and sugar. Cora has four young sons, so her methods are not just theories — they have been practiced in real life.

1. Remember who's the boss.

“My kids have never had fast food,” Cora said in a recent interview with Dear Doctor magazine. “The parents have a choice to do that or not,” she said. “The kids are not going to the grocery store to shop; the kids are not driving themselves through fast food chains.”

2. Make your rules clear and stick to them.

“Right now my 7-year-old tries to be picky, but it's really about us being consistent as parents,” Cat said. For example, in her household pizza is served only at the weekly pizza and movie night. The kids get a healthier version of what they want, so they don't feel deprived. The evening includes air-popped popcorn without butter — and no soda, which is bad for teeth because of its sugar and other chemical ingredients.

3. Offer your children a variety of foods and tastes.

Cora made sure her children tried different foods and spices from infancy, so they are open to trying new things. It's easier to get all the nutrition you need if you eat a wide variety of foods.

4. Learn to make tasty substitutions for sugar.

When her children were babies, Cora stopped relying on bottles and sippy cups as soon as possible, reducing her children's likelihood of developing tooth decay due to sugary residues remaining in their mouths. Now that they are older, she uses tasty substitutes for sugar such as fruit purees and the natural sugar substitute Stevia.

5. Include the children in meal planning.

Kids are more likely to eat a meal they are involved in planning and cooking. For example, ask them which vegetable they would like to have (not whether they want to have a vegetable).

6. Model healthy behavior for your kids.

Parents are the best role models. This is true not only for food choices, but also for exercise and maintaining a healthy lifestyle.

Contact us today to schedule an appointment to discuss your questions about oral health. You can also learn more by reading the Dear Doctor magazine article “Cat Cora.”

Let's talk about oral cancer. Yes, it's a scary subject — but the truth is, the more you know about it, the better able you are to protect yourself.

1. Who is more likely to get oral cancer? Because of your genetic disposition — heredity — men are twice as likely to develop oral cancer as women. African-Americans have a higher incidence than Caucasians. The disease is also related to aging, although in recent years many young people have been diagnosed with this disease.
2. Are some habits related to development of oral cancer? Risk factors include use of tobacco in any form, both smoking and chewing, chronic exposure to sun, and consumption of alcohol. Moderate to heavy drinkers have a three to nine times greater risk than non-drinkers. Tobacco smokers are at five to nine times greater risk than non-users, and users of snuff or chewing tobacco are at four times greater risk than non-users.
3. Where do most oral cancers occur? The most common areas are in the mouth itself, the lips, the tongue, and the pharynx (back of the mouth and throat).
4. What are the statistics for survival after treatment for oral cancer? Conquering cancer depends most on early detection. Since most cases of oral cancer are discovered at a late stage, survival is poor, with less than 60% surviving five years after treatment. When oral cancers are detected early, the survival rate is more than 80%.
5. What are some of the symptoms of oral cancer? Most oral cancers are “squamous” (small scale-shaped) cell carcinomas in the lining of the mouth. Signs of these cancers can be seen as white or red patches in the early pre-cancerous stage. These develop into an ulcer that does not heal.
6. When should you seek medical help? If you notice color changes (white or red patches) or sores or ulcers anywhere in your mouth that do not heal within two or three weeks, go to your dentist for a checkup right away. Sometimes the sores resemble cold sores. A definitive diagnosis requires a tissue biopsy, in which a small piece of tissue is removed under anesthesia and taken to a lab for microscopic examination.
7. What about regular routine examinations? An oral cancer examination should be part of your visit to our office. We will inspect your face, neck, lips and mouth for signs of cancer, feel the floor of the mouth and sides of the neck for any lumps, examine your tongue and the back of your throat. The American Cancer Society recommends a cancer related check-up annually for all individuals aged 40 and older and every three years for those between 20 and 29.

Contact us today to schedule an appointment to discuss your questions about oral cancer. You can also learn more by reading the Dear Doctor magazine article “Oral Cancer.”

You probably know that tooth decay results when the bacteria in your mouth release acids after consuming sugars. After you eat sugars, particularly the type of sugar known as sucrose, increased acid in your mouth begins to dissolve the enamel and dentin in your teeth, and you end up with cavities.

What are the Types of Sugars?
Modern diets include several types of sugars. Most of these are fermented by oral bacteria, producing acids that are harmful to teeth.

• Sucrose (commonly known as sugar)
• Glucose (released from starch consumption)
• Lactose (milk sugar) — Less acid is produced from this type of sugar
• Fructose (found naturally in fruit and also added to many processed foods)
• Maltose

Recommended intake of “free sugars” is no more than 10 teaspoons per day. Note that a can of soda contains over 6 teaspoons! Soft drinks are the largest source of sugar consumption in the U.S. In 2003, for example, Americans drank an average of 52 gallons of soft drinks. Average per capita consumption of all sugars in the U.S. was 141.5 pounds (64.3 kg) one of the highest levels in the world.

Sugar substitute xylitol (which is chemically similar to sugar but does not cause decay) can be part of a preventive program to reduce or control tooth decay. Chewing gum sweetened with xylitol stimulates saliva flow and helps protect against decay.

Sugars Released from Starches
Starches are foods like rice, potatoes, or bread. When you eat refined starches, such as white bread and rice, enzymes in your saliva release glucose. However, these foods have a lower potential to produce decay than foods with added sugars. When sugars are added to starchy foods, as in baked products and breakfast cereals, the potential for decay increases.

Less refined starches such as whole grains require more chewing and stimulate secretion of saliva, which protects from harmful acids.

The Case for Fruit
Fresh fruit has not been shown to produce cavities, so it makes sense to eat them instead of sugary desserts and snacks. Dried fruit is more of a problem because the drying process releases free sugars.

Contact us today to schedule an appointment to discuss your questions about diet and oral health. You can also learn more by reading the Dear Doctor magazine article “Nutrition & Oral Health.”

Until recently anyone who needed to repair cavities in his or her teeth ended up with a mouth full of “silver” fillings. Dental amalgam, which has a silver appearance, was the tooth restoration material of choice. Amalgam, a combination of metals including silver, mercury, and other metals, is still used — but today there are other options that mimic the original teeth they are restoring.

You may have read about some people's concerns about the mercury used in dental amalgam. According to the American Dental Association (ADA), scientific studies have found no ill effects arising from using dental amalgam in fillings for adults or children: “While questions have arisen about the safety of dental amalgam relating to its mercury content, the major US and international scientific and health bodies, including the National Institutes of Health, the US Public Health Service, the Centers for Disease Control and Prevention, the Food and Drug Administration and the World Health Organization, among others have been satisfied that dental amalgam is a safe, reliable and effective restorative material.” Dental amalgam is still used for molars (back teeth) that must withstand heavy pressure from chewing.

For teeth that are more visible, materials that look and perform more like the original teeth — and are thus more pleasing in appearance — are now available. Dentistry is now taking a “biomimetic approach” (from words meaning “life mimicking”). The new materials — composite resins and porcelains — look like teeth because in many ways their structure imitates the biologic structure of teeth.

Composite resins are made of a plastic material (methacrylate) combined with fillers made of silica, a form of glass. They are able to bond to natural tooth structure and resemble the dentin, the inner layer of the tooth, which has a porous structure similar to bone.

Dental porcelains are a form of ceramic. They are non-metallic materials formed by the action of heat, like the ceramics used in porcelain cups and bowls. They come in a powder form that is mixed with water, shaped, and then placed in an oven until they reach the proper hardness. The end product is translucent and very hard, resembling the densely packed crystals of calcium that make up a tooth's normal outer layer, the enamel.

The old amalgam fillings required removal of tooth material to prepare a site in which they could be placed. Composite resins and porcelains can be used to treat teeth that have small or large amounts of damage to their natural substance because the materials bond directly to the remaining dentin and enamel. Thus they end up stabilizing and strengthening the restored tooth, as well as providing a natural-looking appearance.

Contact us today to schedule an appointment to discuss your questions about tooth colored fillings. You can also learn more by reading the Dear Doctor magazine article “The Natural Beauty of Tooth Colored Fillings.”

We've all heard of morning sickness, but did you know that it's also not unusual for pregnant women to experience oral discomfort? This is what Entertainment Tonight co-host Nancy O'Dell discovered when she was expecting her daughter, Ashby. In an exclusive interview with Dear Doctor magazine, Nancy described how her gums became extra-sensitive during pregnancy, leading her dentist to diagnose her with “pregnancy gingivitis” (“gingival” – gum tissue; “itis” – inflammation).

“While my dental health has always been relatively normal, pregnancy did cause me some concern about my teeth and gums,” Nancy said. “With my dentist's advice and treatment, the few problems I had were minimized,” she said.

It's especially important to maintain good oral hygiene during pregnancy with routine brushing and flossing, and regular professional cleanings. This will reduce the accumulation of the dental bacterial plaque that leads to gum disease. Both mother and child are particularly vulnerable to these bacteria during this sensitive time. Scientific studies have established a link between preterm delivery and the presence of periodontal (gum) disease in pregnant women. Also, the elevated hormone levels of pregnancy cause the tiny blood vessels of the gum tissues to become dilated (widened) and therefore more susceptible to the effects of plaque bacteria and their toxins. Gingivitis is especially common during the second to eighth months of pregnancy.

Excess bacterial plaque can occasionally lead to another pregnancy-related condition in the second trimester: an overgrowth of gum tissue called a “pregnancy tumor.” In this case, “tumor” means nothing more than a swelling or growth. Pregnancy tumors, usually found between the teeth, are completely benign but they do bleed easily and are characterized by a red, raw-looking mulberry-like surface. They can be surgically removed if they do not resolve themselves after the baby is born.

If you are experiencing any pregnancy-related oral health issues, please contact us today to schedule an appointment for a consultation. If you would like to read Dear Doctor's entire interview with Nancy O'Dell, please see “Nancy O'Dell.” Dear Doctor also has more on “Pregnancy and Oral Health: Everything You Always Wanted To Know But Never Knew To Ask.”

CAMBRA — Caries Management By Risk Assessment

Worried about tooth decay? Dental Decay is one of the most common and infectious diseases known to man, but it is also very preventable. Today, it is even possible to determine your risk for getting tooth decay. There are disease indicators and risk indicators that can be assessed and used to determine your chances of getting tooth decay. And more importantly, they can be used to prevent and reverse early decay.

Essentially, the difference between healthy teeth and tooth decay is a matter of balance and keeping the balance tipped toward health. That means controlling the factors that tip it toward health and away from disease. Here's a little about how it works:

Disease indicators, as the name implies, are indicators of disease. For example, the presence of white spots on the enamel of your teeth, early signs of decay, which can be detected by your dentist, your past experience of cavities, and whether you currently have tooth decay.

Today, with a “simple saliva sample,” we can test the bacteria in your mouth to determine your decay risk with a simple meter reading.

There are also certain risk factors for tooth decay that you can change by modifying what you do. The ways in which you can help yourself include:

• Reduce the amount of bacterial plaque (biofilm) build-up on your teeth. If plaque is actually visible on your teeth with the naked eye, it means there is a large amount that needs to be removed professionally. High levels of bacteria leave teeth more susceptible to attack from acid-producing bacteria that cause decay.
• Stop snacking on foods containing sugar between meals. Reducing the number of times your teeth are exposed to sugary snacks, and those that contain high amounts of refined carbohydrates, will help lower your risk of tooth decay. Stop feeding the bacteria sugar, which is turned into acid.
• Use fluoride toothpaste. This toothpaste will help strengthen your teeth, making them more resistant to acid attack. Deep grooves in the biting surfaces of your teeth, which we call pits and fissures, increase the likelihood of tooth decay making it impossible to reach with just a toothbrush. However, sealing these areas with “sealants” will prevent these areas from decaying.
• Always ask your doctors about the potential side effects of all medications. Certain drugs reduce the production of saliva and lead to dry mouth, which is one of the main contributors to tooth decay. Saliva has important buffering properties, neutralizing acids in the mouth, helping to reduce risk of decay.
• If you have an eating disorder, get professional help. People suffering from both bulimia and anorexia frequently vomit after meals, which creates a highly acidic condition in the mouth. Getting control over these conditions can help you also gain control over your risk for tooth decay.

We can further help assess your risk for tooth decay by using low dosage x-rays, microscopes, innovative laser technology, and other modern means. Call our office today to schedule a screening. To learn more about the diagnosis and prognosis of tooth decay, read the exclusive Dear Doctor magazine article “Tooth Decay: How To Assess Your Risk.”

Witnessing or being involved in a sports-related dental injury can be a scary event not only for the player, but also for onlookers even if the injuries turn out to be minor. However, knowing what to do — and more importantly — how quickly to react can make a radical difference to the outcome. This is just one reason why we want to share the following easy-to-remember guidelines for what, how and when you need to respond to various types of dental injuries.

• Immediate — within 5 minutes of the injury: If a permanent tooth is totally knocked out (avulsed), it requires immediate treatment by cleaning and re-implanting the tooth back into its original position to have any hope of saving the tooth long-term. Knocked out baby (primary) teeth are not reimplanted for fear of damage to underlying permanent teeth.
• Urgent — within 6 hours of the injury: If a permanent or primary tooth is still in the mouth but has been moved from its original position, it is considered an acute injury and should be treated within 6 hours.
• Less urgent — within 12 hours of the injury: If a permanent or primary tooth is broken or chipped but has not shifted from its original position, the injury is classified as less urgent. You still need to see a dentist for an exam; however, you generally can wait up to 12 hours before possible irreversible damage occurs.

Want To Learn More?

There are several ways you can learn more about sports-related dental injuries.

• Read the Dear Doctor article, “The Field-Side Guide To Dental Injuries.”
• Download and print the FREE quick reference guide
• Or if you have a traumatized, damaged, chipped or missing tooth from a sports or any other type of injury, contact us to discuss your situation or to schedule an appointment.
]]>2013-01-05 15:03:48http://www.gregoryrobinsdds.com/blog/post/what-are-baby-teeth-and-why-do-they-come-out.html

Many youngsters look forward to finding a surprise under their pillow after a visit from the “tooth fairy.” This fable may comfort children who wonder why their first teeth come out. Parents need to know that losing baby teeth, also called primary or deciduous teeth, is completely normal, but at the right time and the right “space.”

A child's first set of teeth must be lost to create room for the adult or permanent teeth that have been forming beneath them. The buds of the permanent teeth grow within a child's jawbone just under the baby teeth. The tops, or crowns, grow first, followed by the roots. Then as the roots develop, the permanent teeth push the baby teeth above them up through the gum tissues. As this happens, the roots of the baby teeth are resorbed, or melted away.

With their roots gone, eventually the baby teeth become so loose that they can be easily removed or fall out on their own, making room for the adult teeth to appear. Sometimes, when a baby tooth is so loose, it can be wiggled out. It leaves a little bleeding gum tissue that heals easily. This is also normal.

Besides making sure the tooth fairy comes, parents need to be sure that their children are evaluated to determine whether baby teeth are being lost in the right sequence so they will act as guides for the adult teeth. If teeth are lost prematurely because of decay or trauma, it is important that space is maintained for the adult teeth when they come in.

Contact us today to schedule an appointment or to discuss whether your child's baby teeth are being lost in the right sequence and the adult teeth are coming in correctly. To read more about losing baby teeth, see the article “Losing a Baby Tooth: Understanding an important process in your child's development.”

]]>2012-12-29 03:18:12http://www.gregoryrobinsdds.com/blog/post/child-star-nolan-gould-talks-about-tooth-extractions-orthodontic-treatment.html

Nolan Gould of the hit TV show Modern Family has an uncommon gift for comedy, but he also has a very common orthodontic problem: too many teeth for the size of his mouth, which often results in “crowding.”

“My teeth used to be pretty messed up,” Nolan recently told Dear Doctor magazine in an exclusive interview. “I had two extra teeth when I was born. They hadn't come out (erupted) yet. And all the other teeth that were already there were starting to point backwards because it was getting so crowded in my mouth. They had to remove those two (extra) teeth,” he said.

Although being born with extra teeth is somewhat unusual, needing to have teeth extracted for orthodontic reasons is not. In fact, orthodontic treatment often involves removing teeth to relieve crowding. It makes sense when you think about it: When there are too many teeth for the size of the dental arches (upper and/or lower jaws) or the teeth are larger in size than the dental arch can accommodate, there may not be enough space to align them properly. The necessary space can be created by removing teeth.

The teeth most frequently extracted for orthodontic reasons are the first bicuspid teeth. These are the ones right between the cuspid, or eyeteeth (under the eyes) and the molars (biggest back teeth). Once there is enough space, the orthodontist can choose from a variety of orthodontic appliances to align the teeth, depending on the specific needs of the individual.

In Nolan's case, it was the extra two teeth he was born with that were removed. Afterwards, the young actor's orthodontist was able to shift Nolan's remaining teeth into proper alignment using orthodontic appliances called Crozats. Made of metal wires, Crozats go around the back teeth and behind the front teeth, making them virtually invisible.

“You can remove them, which is really good for acting, especially because you can't see them,” Nolan explained. “I can wear them 24/7 and nobody will ever notice.”

Nolan's orthodontic appliances may not be noticeable, but his fabulous smile certainly is!

If you would like to learn more about improving tooth alignment with orthodontics, please contact us today to schedule an appointment for a consultation. If you would like to read Dear Doctor's entire interview with Nolan Gould, please see “Nolan Gould.” Dear Doctor also has more on “Tooth Removal for Orthodontic Reasons.”

]]>2012-12-19 14:32:24http://www.gregoryrobinsdds.com/blog/post/a-new-improved-solution-for-loss-of-teeth-in-the-lower-jaw.html

What does the term “two-implant overdentures” mean?
For more than a century, complete dentures were the only care option for edentulous (toothless) people. As a solution, these left a lot to be desired, particularly for the lower jaw. Now dental technology has developed a better alternative that combines two strategically placed dental implants and a traditional lower denture that has been modified to fit over the two implants — thus the term.

What are the problems with traditional dentures?
The problem is that when you lose teeth, the bone that supported the missing teeth begins to shrink away. This is known as resorption, and it is the reason that dentures fitted too soon after teeth are lost quickly become loose. Bone loss happens most rapidly during the first year and is four times greater in the lower jaw than in the upper.

Why not just use dental adhesives to hold dentures tightly to the lower jaw?
Zinc, a major ingredient in most dental adhesives, has been associated with neurological disorders and may be unsafe. In addition, dental adhesives are expensive and the cost of frequent usage adds up.

Besides dental adhesives, are other health problems associated with dentures?
Yes, edentulism has been related to poor nutrition. Many edentulous people switch to soft foods with high fat content because they find healthier foods like vegetables and proteins difficult to chew.

What are dental implants?
Dental implants are replacements for the roots of teeth, the parts that are below the gumline and anchored in bone. They are usually covered with a crown that shows above the line of the gums.

What are the benefits of implants?
Most importantly, implants reduce the amount of bone resorption. Studies have shown about 75% less resorption in parts of the jaw with implants compared to areas without them. Since most of the bone loss occurs within the first year after tooth loss, it is important to place implants within this time period.

Is a complete set of dental implants a good solution for edentulism?
Yes, it can be a good solution, but it is not for everyone. Some patients, who have lost a great deal of bone support, need another solution for cosmetic reasons that offer more facial support like an implant overdenture. In addition, depending on their resources and insurance, some people require a less expensive solution.

Why does the two-implant overdenture work better for the lower jaw?
Based on differences in bone volume, density and other factors, we think that four to six implants are needed to retain an upper implant overdenture. Thus a two-implant overdenture is a good solution to consider for a lower jaw, but other options might be preferred for an upper jaw.

Contact us today to schedule an appointment to discuss your questions about dentures and implants. You can also learn more by reading the Dear Doctor magazine article “Implant Overdentures for the Lower Jaw.”

]]>2012-12-14 09:14:00http://www.gregoryrobinsdds.com/blog/post/bleaching-mdash-an-excellent-tool-for-whitening-stained-teeth.html

The embarrassment of having discolored and/or stained teeth can be monumental and negatively impact your love life, work career, interactions with others, on top of undermining your self-esteem. And it is this reality that urges many people to wonder what teeth whitening could do for their specific needs. However, before obtaining any “fix,” you really should get an understanding of what causes staining of your teeth. This important step will enable you to make the necessary lifestyle and behavioral changes to prevent future issues.

For example, letting us know which of the following common causes for staining teeth apply to you can be an excellent first step towards building an optimal action plan for brightening your smile.

Which of the following questions about discolored teeth apply to you?

• Staining from tobacco use?
• Staining from coffee, tea and/or wine?
• Your teeth have become progressively discolored and yellow with age?
• Staining from red (tomato-based) sauces, sodas/colas and blueberries among other things?
• Other family members have stained teeth so it seems to be genetic?
• Staining from medications such as the antibiotic tetracycline given as a child?

Your honest responses to the above, along with your medical history will enable us to formulate the appropriate therapy for brightening your smile. And for most people this includes bleaching, an inexpensive yet effective method for whitening teeth. It is most often accomplished using a gel that is between 15% and 35% carbamide peroxide, a type of hydrogen peroxide. Years of research have proven that this whitening agent does not damage tooth enamel or the nerves inside the teeth. The only side effect that some people experience is slight tooth sensitivity and irritation of the gum tissues. However, they both are usually temporary, often occuring when you first start bleaching and generally subside after a few days. You can learn more when you continue reading the Dear Doctor article, “Tooth Staining.” Or, you can contact us to discuss your questions or to schedule an appointment.

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