My Blog

Posts for: October, 2013

By Drake Tollefson DDS
October 30, 2013
Category: Oral Health
GumDiseaseandYouATrue-FalseTest

Periodontal disease is the leading cause of tooth loss in adults. A recent survey by the Centers for Disease Control and Prevention showed that nearly half of Americans older than 30 had some signs of periodontal disease. That's more than 64 million people.

How much do you know about this potentially serious disease? Take our quiz and find out.

True or False: Gum Disease is caused by bacteria in the mouth

TRUE. Of the hundreds of types of bacteria that occur naturally in the mouth, only a small percentage are harmful. But when oral hygiene (brushing and flossing) is lacking, these can build up in a dental plaque, or biofilm. This often causes inflammation of the gums, the first step in the progression of gum disease.

True or False: Gum disease is more prevalent among younger people

FALSE. Gum disease is most often a chronic disease, meaning that it progresses over time. Statistics show that as we age, our chances of developing gum disease increase, as does the disease's severity. In fact, according to the study mentioned above, about 70% of adults 65 and over have mild, moderate or severe periodontitis, or gum disease.

True or False: Bleeding of the gums shows that you're brushing too hard

FALSE. You might be brushing too hard — but any bleeding of the gum tissue is abnormal. Gum sensitivity, redness and bleeding are typically the early warning signs of gum disease. Another is bad breath, which may be caused by the same harmful bacteria. If you notice these symptoms, it's time for a checkup.

True or False: Smokers are more likely to develop gum disease

TRUE. Not only are smokers more likely to develop gum disease, but in its later stages they typically show more rapid bone loss. Smoking also prevents the warning signs of gum disease - bleeding and swelling of the gum tissues - from becoming apparent. Other risk factors for developing the disease include diabetes and pregnancy (due to hormonal changes). Genetics is also thought to play a role in who gets the disease — so if you have a family history of gum disease, you should be extra vigilant.

True or False: The effects of gum disease are limited to the mouth

FALSE. Numerous studies suggest that there is a relationship between periodontal health and overall health. Severe gum disease, a chronic inflammatory disease, is thought to increase the risk of cardiovascular diseases like heart attack and stroke. It may also lead to complications in pregnancy, and problems of blood-sugar control in diabetics.

So if you have any risk factors for gum disease, or if you notice possible symptoms, don't ignore it: let us have a look. We can quickly evaluate your condition and recommend the appropriate treatments if necessary. With proper management, and your help in prevention, we can control gum disease.

If you have concerns about gum disease, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Understanding Gum (Periodontal) Disease” and “Warning Signs of Periodontal (Gum) Disease.”


By Drake Tollefson DDS
October 22, 2013
Category: Dental Procedures
Tags: veneers   prepless veneers  
No-PrepVeneersmaybeanOptionforSomePatients

Although traditional porcelain laminate veneers are much less invasive than other cosmetic dental applications, they still often require the removal of some of the surface tooth enamel, a process known as tooth reduction. Now, an alternative veneer treatment known as “no-prep” veneers eliminates this initial step of tooth reduction for some patients.

Although most reductions take very little of the tooth enamel, they do permanently alter the tooth. No-prep veneers are growing in popularity because the tooth is not permanently altered, allowing for two benefits: if desired, the veneer application can be reversed and the tooth returned to its original state; and there's more flexibility for patients to “test-drive” their new look with prototype veneers worn while the permanent veneers are manufactured, with changes made easily during this tryout period.

Dentists have long regarded at least a minimum of tooth reduction as absolutely necessary for the proper adhesion of veneers, and to avoid a bulky or over-contoured smile. And, while advances in no-prep veneers have largely addressed these concerns, it is true this option isn't for every patient considering a veneer application.

For example, patients with large or forward-positioned teeth are not good candidates for no-prep veneers. Patients who choose a veneer treatment over orthodontic treatment for certain conditions will likely need some tooth preparation to achieve an acceptable aesthetic result. For patients generally, no-prep veneers have a limited application range on the bottom jaw due to space limitations.

Simply put, traditional veneers are a more versatile option for most patients. On the other hand, no-prep veneers can be a good choice for patients with genetically small or misshapen teeth, teeth reduced by erosion or grinding, or those with narrow or diminished smiles.

If you're considering this option, our first step is to conduct a complete examination of your teeth and mouth. We'll carefully evaluate every aspect of your mouth structure and overall dental condition. If you fit the criteria, you may be able to avoid tooth reduction and still gain the smile you desire.

If you would like more information on no-prep veneers, 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 “Porcelain Veneers Without the Drill.”


By Drake Tollefson DDS
October 14, 2013
Category: Oral Health
Tags: sensitive teeth  
TreatingPainfulToothSensitivityBeginsWithFindingitsSource

If you wince while eating certain foods and beverages, you're not alone — one in three Americans suffer from the pain of tooth sensitivity. Fortunately, there are ways to treat it and reduce the pain.

Dentinal hypersensitivity occurs when dentin loses its protective cover. Dentin, a living tissue within a tooth, is composed of tiny tubules that act as conduits for transmitting sensations from the surface of the tooth to the nerves in the inner pulp. These tubules are protected by cementum, a hard, outer layer that covers the tooth root. But when the root becomes exposed, the cementum is easily stripped from the root. The tubules become more sensitive to sensations of temperature or pressure.

Receding gums are the main culprit for root exposure. This condition can result from periodontal disease, which arises mainly from poor oral hygiene. At the other end of the spectrum, over-aggressive brushing can lead to receding gums. Brushing may also contribute to another source of dentinal hypersensitivity: enamel erosion. The minerals in enamel begin to soften and erode as the acidic level of the mouth rises. Saliva neutralizes the acid and can restore a neutral balance in about thirty minutes to an hour after eating. If you brush before this process completes, you could brush away some of the softened enamel.

To properly treat tooth sensitivity, our first step is to find the cause. If it stems from improper or premature brushing, we can counsel you on proper technique. If periodontal disease is a factor, we would first treat the disease and then work with you on a proper oral hygiene regimen to reduce bacterial plaque, the main cause of the infection.

There are treatments as well to reduce nerve sensitivity and thereby ease the pain. Toothpastes and other mouth products with fluoride help reduce sensitivity, as well as products containing potassium nitrate or potassium citrate. We can also apply a varnish containing a concentrated dose of fluoride directly to tooth surfaces. Another approach is to block the tubules using bonding agents or sealants; this will reduce their capacity to receive and transmit sensations.

If you would like more information on the causes and treatment of tooth sensitivity, 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 “Treatment of Tooth Sensitivity.”


LeaveEnoughTimeforYourWedding-DaySmileMakeover

Some people are planners, and others just go with the flow. Some spend all winter in the gym, and others try and lose ten pounds right before beach season. Some have every detail of their wedding day planned out months in advance, and others... don't.

No matter which kind of person you are, you'll want to look your best for your wedding day. And that includes sporting a bright, healthy-looking smile. Depending how much time you have beforehand, there's a range of dental treatments that can help you look and feel great — not just that day, but every day. Here's a rundown of what you can do in the time remaining before your big day.

Time Left: Up to two years. If you've planned this far in advance, congratulations! You probably have time for almost any needed dental treatment — including orthodontics, which can straighten misaligned teeth and correct a bad bite. But even if you don't have quite so much time, don't despair: Clear aligners and tooth-colored or tongue-side braces, if recommended, can make orthodontic appliances nearly invisible.

Time Left: Six months to one year. Many dental treatments, like periodontal plastic surgery or tooth implants, can achieve remarkable results in this time. Periodontal surgery can give you a less “gummy” smile and greatly improve the aesthetics of your teeth. Tooth implants are modern dentistry's best option for replacing missing teeth. Natural-looking implants have a success rate of 95%, and can last a lifetime.

Time left: Three or four months. There's plenty you can do! If the roots are intact, a crown can be placed on a damaged tooth to restore its appearance and function. Or, missing teeth can be replaced via bridgework, which supports a false tooth from abutments on either side. Stained or discolored teeth can also be dramatically lightened with veneers, where a porcelain shell replaces the tooth's outermost layer of enamel. Tooth implants are still a possibility, under the right circumstances. We can evaluate your individual situation and come up with the best option to replace missing teeth.

Time left: Six weeks or so. You still have time for some basic, yet effective, treatments. Small chips or discolored fillings can be restored with tooth-colored materials that securely bond to the teeth themselves. You can also brighten your teeth by several shades using the techniques of bleaching. In-office whitening treatments are the fastest, but take-home kits, used under our supervision, offer similar results in a longer time.

Have even less time? At the very least, come in for a thorough cleaning right before the date! This will help remove many surface stains and freshen up your smile. Be sure to call in advance so that you're able to get an appointment. Then, smile for the camera!

If you would like more information about a wedding-day smile makeover, please contact us or schedule an appointment to discuss your treatment options. You can learn more in the Dear Doctor magazine article “Wedding Day Smiles.”


By Drake Tollefson DDS
October 03, 2013
Category: Oral Health
Tags: oral health  
ProteinInformationinSalivaCouldLeadtoBetterDiagnosticTests

You've probably never thought of the saliva swishing around in your mouth as amazing. The fact is, though, life would be a lot harder without it. Digestion would be quite unpleasant without its enzymes breaking down food during chewing; the soft tissues of our mouth would suffer more environmental abuse without its protective wash; and without its ability to neutralize acid, our tooth enamel would erode.

What's also amazing is what saliva can reveal about our health. As researchers discover more about this phenomenon, it's leading to better and less invasive ways to diagnose disease.

Similar to blood, saliva is composed of proteins containing RNA and DNA molecules which together hold the genetic instructions the human body needs to reproduce cells. We can therefore test saliva for health conditions as we do with blood, but with less invasive collection techniques and far less hazard to healthcare workers from blood-borne diseases. For example, doctors now have a saliva test that can detect the presence of HIV viruses that cause Acquired Immune Deficiency Syndrome (AIDS). Another saliva test will soon be available that can test for hepatitis.

Unfortunately, only a few such tests now exist. Researchers must first identify and then catalog saliva's biomarkers, protein molecules that correspond to specific health conditions — a daunting task since most are marked not by one but hundreds of proteins. Then it's a matter of developing diagnostic devices that can detect these biomarkers.

Although that too is a huge task, existing technology like mass spectrometry (already used to help detect early stages of oral cancer) could be a promising starting point. This process measures the portion of the light spectrum emitted by a molecule, a feature that could help identify a saliva protein by its emitted light signature.

Thanks to the work of these researchers, many of them in the dental profession, information about our bodies contained in saliva may soon be accessible. That accessibility may lead to earlier diagnoses and more successful treatment outcomes.

If you would like more information on saliva and your oral health, 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 “Secrets of Saliva.”