One topic we are often asked about is finger or thumb sucking and/or pacifier use — a challenge that most parents or caregivers will likely face with at least one of their children. The first and perhaps most important thing to remember is that it is totally normal for babies and young children to suck their fingers, thumb or a pacifier. It only becomes a problem when it continues as the child ages or if you unnecessarily make it a problem.

For most children, the sucking instinct starts in the womb before birth. This fact is evident, as many expectant mothers are shown their child sucking fingers or a thumb during a mid or late-term sonogram. Once the child is born, the habit may continue because it provides the child with a sense of security. Other research indicates that some babies start sucking habits as a way to make contact with, test and learn about their new world outside the womb. It is interesting to note that most children typically tend to stop finger or thumb sucking habits on their own and without much intervention between the ages of two and four. However, for others it can continue much longer. And that is the scenario that parents and caregivers need to be aware of so that they can monitor sucking habits.

Children who suck their thumbs or a pacifier after the age of two have a higher risk of developing some long term negative effects from the habit. This includes but is not limited to upper jaw development issues and “buck” teeth (upper front teeth that protrude forward out of a natural position towards the lips). For this reason, some researchers feel that children should cease thumb or finger sucking and/or pacifier use by 18 months of age. However, the Academy of Pediatric Dentistry recommends that parents and caregivers encourage children to cease this habit by age three.

If you feel your child is at risk due to his/her age and habits, please contact us today to schedule an appointment for your child. After a thorough exam, we can work with you to create a strategy for helping your child overcome finger, thumb or pacifier habits. To learn more about this topic, continue reading the Dear Doctor magazine article “Thumb Sucking in Children.”

Because our main goal is to help you maintain optimal oral health, we use the latest proven technologies, techniques, and treatments to ensure we achieve them. One tool, radiographs or x-ray pictures, has been around for a long time with an inordinate amount of scientific research backing up both its safety and value. Here's a brief summary of why.

X-rays are a form of electromagnetic radiation just like natural daylight, except that they can easily penetrate soft bodily tissues, such as skin and muscles, without causing any harm if used properly. And as you may have guessed, we use them to examine what we can't see with the naked eye. For example, they enable us to see inside tooth structure, bones, and joints of the jaws. This ability makes x-rays a critical tool that we rely upon to monitor your oral health.

How often you need x-rays really depends upon your individual health needs and often is different from family member to family member given their age and oral health. During adolescence, we may need to take x-rays more often, so we can closely monitor the development of the teeth and jaw to check for normal growth and abnormalities, which can be corrected with early diagnosis. We may also need to use x-rays to diagnose trauma if you or any family member has experienced injury or disease. This will enable us to ensure the correct treatment is given and, in fact, is working and that there are no other related concerns.

Today's ultra-sensitive technology uses extremely low dosage x-rays and ensures early diagnosis and monitoring of your oral and dental health in safety and with confidence.

Learn more about the safety of x-rays by reading the Dear Doctor magazine article “X-ray Frequency And Safety.” If you need to schedule an appointment, contact us today.

How much do you know about dental implants? Test yourself with this quiz.

1. Earliest recorded attempts at using dental implants were from
1. Medieval England
2. The ancient Mayans
3. U.S.A. in the 1950s
2. Dental implants are called endosseous. What does this mean?
1. They fuse with the bone
2. They are inside the mouth
3. They are not real teeth
3. What are most dental implants made of?
1. Aluminum
2. Titanium
3. Steel
4. What part of the tooth does an implant replace?
1. The implant is the root replacement
2. The implant is the root plus the crown
3. The implant is the crown
5. What is the success rate of dental implants?
1. 50 percent or less
2. 75 percent
3. 95 percent or more
6. What could cause an implant to fail?
1. Smoking or drug use
2. Poor bone quality and quantity at the implant site
3. Both of the above
7. What is a tooth's emergence profile?
1. The implant and crown's shape as it emerges from beneath the gum line
2. A measure of the urgency of the tooth replacement
3. A measure of the time it takes for you to be able to chew on the new implant
8. What are some of the factors that go into the aesthetics of designing the crown?
1. Choice of materials
2. Color matching
3. Both of the above

1. b. The concept of dental implants goes back to the Mayan civilization in 600 AD.
2. a. The word endosseous (from endo meaning within and osseo meaning bone) refers to the implant's ability to fuse with or integrate with the bone in which it is placed.
3. b. Most implants are made of a titanium alloy, a metallic substance that is not rejected by the body and is able to fuse with the bone.
4. a. The term “implant” refers to the root replacement, which is anchored in the gum and bone. A crown is put around the implant where it emerges from the gumline.
5. c. The majority of studies have shown long term success rates of over 95 percent.
6. c. Factors that could cause an implant to fail include general health concerns such as smoking and drug use, osteoporosis, or a compromised immune system; poor bone quality or quantity; and poor maintenance such as lack of proper brushing and flossing.
7. a. The emergence profile has a lot to do with the implant's natural appearance. It involves the way the crown, which attaches to the implant, seemingly emerges through the gum tissue like a natural tooth.
8. c. Choices such as materials, color, and position can be worked out in the design of a customized temporary crown, which acts as a template or blueprint for a final crown.

Contact us today to schedule an appointment to discuss your questions about dental implants. You can also learn more by reading the Dear Doctor magazine article “Matching Teeth & Implants.”

Anytime you are considering an implant surgery to replace missing teeth, you should take the time to gather the facts so that you have clear understanding of the procedure, your options and any potential risks. You should also feel comfortable with the dental team who is treating you. For these reasons, we created the following comprehensive list of questions so that you can obtain the answers you need to help you feel at ease prior to treatment.

• Am I a good candidate for dental implants?
• What is the success rate for dental implants?
• How long have you been placing implants and how many do you place each year?
• Can you show me some before and after photos that illustrate your work?
• What are the risks, benefits and alternatives to dental implants?
• Are dental implants ever rejected?
• How do you assess whether I have enough bone to anchor dental implants?
• Can you tell me about the surgical procedure for implant placement?
• How long will the entire process take from my first appointment until I have my implant(s) and crown(s) in place?
• Do I have to go without teeth while my implants are healing?
• What type of anesthesia will you use during my implant surgery?
• What can I expect in the hours and days following my implant surgery?
• How long will it take my implants to heal?
• How long can I expect my implants to last?
• Will there be any maintenance required with my implant(s)?
• How much will dental implant(s) cost?
• Will my insurance cover all or a portion of the cost?

To learn more, read “Dental Implants, Evaluating Your Professional Options For Care.” Or, you can contact us to discuss your questions or to schedule an appointment.

How good of a job are you doing with brushing and flossing your teeth? This is an important question, because a healthy mouth depends on regularly removing dental plaque (a whitish, sticky film of bacteria that grows near your gumline and on the surfaces of your teeth).

Daily Plaque Removal
Most people need to brush and floss at least once a day to remove plaque. Twice a day may be ideal, as plaque forms every 12 to 24 hours on your teeth, and it will also make your mouth feel fresher. Be thorough but gentle with your teeth — excessive brushing or flossing can cause damage.

The use of an antibacterial mouthrinse to help reduce the plaque you may have missed as well as to reduce bacteria that are clinging to soft tissues or membranes in your mouth, should be included in your daily hygiene routine.

Tongue Test
When you run your tongue around your mouth after a professional dental cleaning, you sense a smooth, slippery feeling. This is the way your teeth should feel after you brush your own teeth every day. The tooth surfaces should feel smooth and slick throughout your mouth and at the gum line.

Floss Test
After running floss up and down a tooth surface, notice whether there is blood on the floss or whether the floss has an odor. If the floss squeaks when you run it up and down a tooth surface, that indicates that the tooth is squeaky clean.

Check for Bleeding
Bleeding gums are a sign of inflammation, called gingivitis, in the gum tissue. Healthy gums do not bleed. If you have recently begun using more effective brushing and flossing methods, your gums may bleed at first but then stop as your gums become healthier.

Use Disclosing Solutions
Disclosing solutions are harmless dyes that can stain plaque and make it visible. Rinsing with these solutions may surprise you by revealing the plaque on your teeth you had no idea you missed.

Visit Our Office
We can check your mouth and tell you how well you are doing in your program of daily plaque removal. As a bonus, we will give you a toothbrush so that while you're here we can check your technique to make sure you are brushing correctly.

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

Thanks to technological advances, today there are more than 40 types of traditional or standard implants. A traditional dental implant actually replaces the root of a tooth, upon which a crown is built — the part you see in the mouth. There are 2 others types that are quite similar to standard implants. Mini implants are most like traditional implants except they are smaller in diameter. Micro-mini implants are an even smaller variation with an even narrower, more screw-like appearance. Micro-mini implants are also designed to be used on a temporary basis, thus can easily be removed. Together all of these types of implants provide us with a wide variety of options for permanently replacing missing teeth.

The following list details the types of implant restorations:

• Single tooth replacements: As the name suggests, these implants are used to replace single teeth.
• Multiple tooth replacements: Implants can be used to replace multiple teeth in a variety of ways. This includes acting as bridge supports to permanently replace missing teeth.
• Combinations of fixed and removable bridgework: Dental implants can be used to support permanently fixed in teeth, bridgework or removable bridges or dentures. Their biggest advantage over dentures alone is that they stabilize the dentures and preserve the jawbone to which they attach, thus preventing the jawbone from melting away under the pressure of dentures.
• Over-dentures: These restorations are now considered the new gold standard. In this application two or more standard implants (or multiple mini-implants) are used to attach and stabilize full dentures. Over-dentures are especially useful for tooth replacement in the lower jaw, where denture stability is often problematic.
• Temporary Anchorage Devices (TADS): These special implants are a tool that orthodontists can use to obtain a stable, non-movable anchor for moving teeth more quickly and easily. They are small, easy to place and easy to remove once their job is done.
• Temporary bridgework: In this case, mini-implants are used to support temporary bridgework. They are placed between permanent implants and later removed when the permanent implants have healed and teeth are permanently placed on them. Mini-implants ensure that a person is never without teeth during the process of teeth replacement.

To learn more on this topic, read the Dear Doctor article, “Dental Implants, Your Third Set Of Teeth.” Or if you prefer, you can contact us to discuss your questions or to schedule an appointment.

We have noticed that there are two types of patients when it comes to enhancing a person's smile. One type, which we'll call the “Perfect Minded” patient, expects teeth that are completely regular in their arrangement and of maximum whiteness and brightness, often beyond the range of traditional guides for tooth color. They are looking for a perfect “Hollywood” smile. The other, the “Natural Minded” patient, is looking for a more natural look. This person expects a general sense of regularity and alignment of teeth with definite brightness, but not so much that the teeth are noticeable before and above other facial features. Which type are you?

The “Perfect Minded” Patient
While you expect maximum regularity and alignment of teeth along with maximum whiteness and brightness, the “perfect minded” patient requires a smile completely symmetrical (balanced from one side to the other). If we drew a vertical line down the center of your face (midline), it would fall directly between your front teeth and your smile would look just the same on each side of the line. You also expect your smile to be horizontally symmetric, so that it matches the curvature of your lower lip and the gum lines match from side to side.

The “Natural Minded” Patient
You are looking for a more subtle, natural look produced by including some minor irregularities in your look. Like the “Perfect Minded” individual, you still expect your teeth to be generally regular and well aligned but you also want to have some minor asymmetries (not matching) as you move farther back along your jaw to make your teeth look real. Your preference in tooth color is not a super shade of white, but for a tooth color that looks very natural for your facial skin and hair color.

There is no right or wrong here. What is important is to be sure to communicate your expectations to us before embarking on a program of smile redesign.

Contact us today to schedule an appointment to discuss your questions about Smile Design. You can also learn more by reading the Dear Doctor magazine article “Great Expectations — Perceptions in Smile Design.”

Did you know that Americans spend nearly 3 billion dollars each year on fresh breath remedies including gum, mints and mouthrinses to address their fears of halitosis (bad breath)? This simple fact clearly reveals that Americans are obsessed with having pleasant breath. Some other interesting statistics on this subject include:

• 60% of women and 50% of men say they use breath freshening products like candy, chewing gum and sprays
• 50% of middle-aged and older adults have bad breath
• 25% of the population has chronic bad breath
• 20 to 25% of adults have bad breath due to their smoking habits

However, the best way to determine what is causing your bad breath is to have a thorough dental exam followed by a professional cleaning. The first important step of this process begins when we obtain a thorough medical history. This includes asking you questions so that we can:

• Identify your chief complaint and whether or not your bad breath is noticed by others or just a concern you have
• Learn about your medical history as well as what medications (prescription and over-the-counter), supplements, and vitamins you are currently taking
• Learn about your dietary history to see if pungent foods such as garlic and onions are foods you often eat that are contributing to the problem
• Conduct a psychosocial assessment to learn if you suffer from depression, anxiety, sleep or work problems
• Identify personal habits such as smoking cigarettes, cigars or a pipe that contribute to your bad breath

To learn more about the causes and treatments for halitosis, read the Dear Doctor article, “Bad Breath — More Than Just Embarrassing.” Or you can contact us today to schedule a consultation for an examination, cleaning and treatment plan.

Nightly snoring can be a sign of a dangerous condition called sleep apnea (from “a” meaning without and “pnea” meaning breath). When someone snores the soft tissues in the back of the throat collapse onto themselves and obstruct the airway, causing the vibration known as snoring.

If the obstruction becomes serious, it is called obstructive sleep apnea, or OSA. In such cases the flow of air may be stopped for brief periods, causing the person to wake for a second or two with a loud gasp as he attempts to catch his breath. This can cause heart and blood pressure problems, related to low oxygen levels in the blood. The obstruction and mini-awakening cycle can occur as many as 50 times an hour. A person with this condition awakens tired and faces the risk of accidents at work or while driving due to fatigue.

Studies show that sleep apnea patients are much more likely to suffer from heart attack, congestive heart failure, high blood pressure, brain damage and strokes.

What can be done to treat OSA?
Snoring, apnea, and OSA occur more frequently in people who are overweight. So start with losing weight and exercising.

At our office, we can design oral appliances to wear while sleeping that will keep your airway open while you sleep. These appliances, which look like sports mouth guards, work by repositioning the lower jaw, tongue, soft palate and uvula (soft tissues in the back of the throat); stabilizing the lower jaw and tongue; and increasing the muscle tone of the tongue.

Another approach is to use a Continuous Positive Airway Pressure (CPAP) bedside machine. These machines send pressurized air through a tube connected to a mask covering the nose and sometimes the mouth. The pressurized air opens the airway so that breathing is not interrupted.

Much less frequently, jaw surgeries may be recommended to remove excess tissues in the throat. These would be done by specially trained oral surgeons or ear, nose and throat specialists.

Diagnosis and treatment of OSA is best accomplished by joint consultation with your physician and our office. Contact us today to schedule an appointment to discuss snoring and OSA. You can learn more by reading the Dear Doctor magazine articles “Sleep Disorders and Dentistry” and “Snoring and Sleep Apnea.”

For many children, thumb sucking is a great source of comfort. However, for some parents, it sets off potential red flags. See how much you really know about thumb sucking by taking our quick and easy true/false self test.

1. Thumb or finger sucking is a totally normal behavior for babies and young children that should not cause any concerns for parents or caregivers.
   True or False
2. One of the main reasons babies and young children suck their thumbs or fingers is that it provides a sense of security.
   True or False
3. Sonograms have revealed that some babies actually begin sucking their fingers or thumbs in their mother's womb, before they are even born.
   True or False
4. Recent research has shown that children using a pacifier after the age of four may cause long-term changes in the mouth.
   True or False
5. Most children who suck their fingers or thumb tend to stop this habit on their own between the ages of two and four.
   True or False
6. One of the biggest myths about thumb sucking is that it can cause buck teeth (the teeth tip outwards towards the lips).
   True or False
7. The American Academy of Pediatric Dentistry recommends that children stop using a pacifier and/or thumb or finger sucking by the age of three; however some recent studies suggest that this should stop as early as 18 months of age.
   True or False
8. Breaking a pacifier habit is often much more difficult to break than a finger or thumb sucking habit.
   True or False
9. Dipping a pacifier, finger or thumb in vinegar is a recommended way of stopping the habit.
   True or False
10. For the most challenging cases, we may suggest that your child needs a mouth appliance that a blocks sucking habits.
    True or False

Answers: 1) False. While it is a totally natural habit, parents and caregivers should monitor thumb or finger sucking. 2) True. 3) True. 4) False. It is not age 4, but rather age 2. 5) True. 6) False. This is NOT a myth but rather a fact. 7) True. 8) False. It is easier. 9) True. 10) True.

If you are having trouble getting your child to stop using a pacifier, thumb or finger sucking habit, we are an excellent resource for working with you and your child to accomplish this goal. To learn more on this topic, continue reading the Dear Doctor magazine article “Thumb Sucking in Children.” Or you can contact us today to schedule an appointment or to discuss your questions.

A good night's sleep...have you been getting them lately? While everyone knows that sleep is important, did you know that we all spend about one-third of our lives asleep? And did you know that when deprived of sleep, the negative impact is detrimental on both an individual as well as at the societal level? These important facts are just some of the reasons why there has been an increased interest in studying sleep, sleep loss and sleep disorders.

If you have issues with sleep, you might have a sleep disorder — an epidemic problem that impacts approximately 50 to 70 million people in the US alone. Obstructive Sleep Apnea (“a” – without; “pnea” – breath) (OSA) is a medical condition that occurs when your tongue collapses against the back of your throat causing a significant reduction in your intake of air or even total temporary blockage. If left untreated, OSA can lead to an irregular heartbeat, heart attacks, high blood pressure, and other forms of heart disease plus strokes and even impotence.

Please note that while your responses to the questions below do not equate to a diagnosis, sharing them with our office can be extremely beneficial in helping us properly evaluate and treat issues related to poor sleeping habits.

• Do you weigh 15 pounds or more than the normal weight range for your height, sex and age?
• If you are male, is your neck measurement 17 inches or more? Or if you are female, is it 16 inches or more?
• Do sleep partners routinely tell you that you are a loud snorer and/or that during your sleep you choke, gasp for air or briefly stop breathing?
• Do you often wake up still feeling tired after 8 or more hours of sleep?
• Do you often find yourself falling asleep at work or home during periods when you should be awake?
• Do you suffer from irritability, depression, loss of memory, poor judgment and/or concentration?

The first and most important step in treating sleep apnea is to obtain a proper diagnosis. Contact us today to schedule an appointment to discuss your questions about sleep apnea. We can assist in the diagnosis and treatment of sleeping disorder along with a physician trained in this area. And rest assured that we have many treatment options we can use to help you get a great night's sleep. To learn more about sleep apnea, continue reading the Dear Doctor magazine article “If You Snore, You Must Read More!”

In times of stress, people have many ways to comfort themselves. For adults, it can be habits such as eating, drinking, or smoking. For children, it is often sucking their thumb, fingers, or a pacifier. Babies have been observed in scans to suck on their fingers and thumbs even before they are born. It makes them feel secure.

When is thumb sucking a problem?
Sucking on fingers or thumbs can be a problem when it is done too vigorously and too long. A young child's jaws are soft and can change their shape to make room for the thumb if the child sucks too hard and too often. If thumb, finger or pacifier habits continue too long, the upper front teeth may tip toward the lip or not come into the correct position in the mouth.

How do you know if your child falls into the group that will suffer from the results of too much thumb sucking? It's best to visit our office so we can check on how the child's teeth and jaws are developing.

What can be done about thumb and finger sucking?
Most children naturally stop sucking their thumbs, fingers, or pacifiers between the age of two and four. The pacifier habit is easier to break than the thumb or finger sucking habit, probably because it is always easier to find their fingers or thumbs. It is a good idea to try to transfer your child's habit to a pacifier at an early age. The next steps are to cut down pacifier usage and gradually stop by 18 months.

If your child is still engaging in these habits at age three, we can recommend strategies for cutting back and stopping. Remember that positive reinforcement, in which a child is rewarded for the desired behavior, always works better than punishment for the behavior you don't like.

Also remember that finger and thumb sucking is normal. Help your child to feel safe, secure, and comfortable as the behavior will probably disappear by itself. If you are worried about your child's sucking a pacifier, thumb or fingers, please visit us to put your mind at rest.

Contact us today to schedule an appointment to discuss your questions about children's thumb sucking. For more information, read “Thumb Sucking in Children” in Dear Doctor magazine.

Can chewing gum prevent cavities? Yes! It can if the gum is sweetened with xylitol.

What is xylitol?
Xylitol is a type of “sugar alcohol,” similar to sorbitol and mannitol, sugar replacements that are used in many low calorie foods. Xylitol occurs naturally in many fruits and vegetables and is obtained from the bark of birch trees, coconut shells and cottonseed hulls. It looks and tastes like sugar and is a diabetic-safe, low-calorie carbohydrate.

How does xylitol stop cavity formation?
Decay starts when certain bacteria break down sucrose (regular table sugar) and produce acids that dissolve the minerals in the enamel, the outer protective layer of your teeth. When the decay-causing bacteria try to consume xylitol, they are unable to break it down, and instead they begin to starve.

A normal mouth contains a large population of bacteria, and it is better for your teeth to have more “good” bacteria of the kind that do not cause cavities. Xylitol also stops your saliva from becoming acidic, so your mouth becomes a better environment for the “good” bacteria.

Chewing xylitol gum also increases your flow of saliva. Saliva contains calcium and fluoride and helps give these minerals back to your teeth (re-mineralization), undoing some of the effects of the cavity-causing bacteria. This makes chewing xylitol gum a particularly good solution for people who suffer from dry mouth.

How much xylitol do you need to prevent cavities?
We recommend that you chew or suck on two pieces of xylitol gum or two pieces of xylitol candy for five minutes following meals or snacks, four times daily — if you are at moderate to extreme risk for cavities. The target dose of xylitol is 6 to 10 grams (one or two teaspoons) spread throughout the day. Prolonged gum chewing is not advised, so most xylitol-sweetened products contain flavor that only lasts a short time to discourage excessive chewing. The only side effect of too much xylitol ingestion is that it may have a mild laxative effect.

I don't like chewing gum. Is there another way to get xylitol?
People who don't like to chew gum have the option of using xylitol in mints, candies, mouthwash, toothpaste, or mouth sprays. For these individuals, a minimum dose is 5 to 6 grams (one teaspoon) three times per day.

So now you can add xylitol to the list of ways to fight cavities: daily brushing and flossing, and regular professional cleanings — and chewing xylitol gum.

Contact us today to schedule an appointment to discuss your questions about xylitol and other methods of preventing tooth decay. You can also learn more by reading the Dear Doctor magazine article “Xylitol in Chewing Gum.”

Your car comes with a maintenance manual that tells you when to get an oil change, rotate the tires, and perform other necessary tasks. By following the manual's directions you can keep your car running in good condition for many years. Too bad a manual doesn't come with your teeth and gums!

Such a manual would concentrate on a few basic tasks we call oral hygiene and teeth cleanings. Both tasks are mainly dedicated to removing dental plaque or biofilm from the surfaces of your teeth and the surrounding gums. Plaque is now referred to as a biofilm, a film composed of bacteria, that naturally forms in your mouth. Studies have shown that dental plaque causes periodontal disease (gum disease) and dental caries (tooth decay).

Tips for Daily Removal of Dental Plaque
The way you hold your toothbrush is crucial to your ability to remove plaque effectively. We recommend that you hold it in your fingertips as you would a pen or pencil. Use small motions and pressure. Brushing too hard can damage gum tissues. Use a soft bristled brush, hold it at about a 45 degree angle to the gum line and then use a gentle scrubbing motion. Studies have shown some electric toothbrushes to be more efficient at plaque removal than hand-held brushes; but in general how you use the brush is more important than what kind of brush it is.

To remove plaque deposits from the hard-to-reach areas between your teeth, floss at least once a day. Wrap the floss around each tooth surface and gently move it up and down for a few strokes, cleaning the sides of your teeth where they face each other.

You can use an antibacterial mouthrinse to get help reduce the bacterial plaque or biofilm that you missed in brushing and flossing.

The best way to make sure you are brushing correctly is to have a dental professional demonstrate for you. We would be happy to demonstrate the correct techniques in your own mouth so that you can see how it feels, and you can copy the methods we use.

Professional Maintenance Schedule
Your car needs to go into the shop from time to time for professional maintenance. Your teeth also need a regular schedule of maintenance from a professional dentist or hygienist. Over time, plaque that you do not manage to clean off your teeth accumulates and forms hard deposits called calculus or tartar. If left on your teeth these deposits cause inflammation of your gum tissues and can lead to infection, abscesses, and even tooth loss. During a professional cleaning a technique called scaling removes these substances. For more advanced forms of gum disease, root planing is used to remove deposits of calculus below the gum line.

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

Often perceived as a cancer that only affects older adults who have a history of heavy tobacco and alcohol use, oral cancer is now on the rise among younger adults as well. New research has found a link between oral cancers, and the Human Papilloma Virus (HPV), a disease that is primarily spread through oral sex.

Importance of Screening: If you're concerned about oral cancer, rest assured that our office routinely carries out a cancer screening exam on every patient. We have several ways to painlessly detect abnormal tissues in their earliest stages. In addition, please contact our office if you experience any of the following signs or symptoms:

• White and/or red patches in the mouth or on the lips
• A bleeding or ulcerated sore in the mouth
• A sore anywhere in your mouth that doesn't heal
• Persistent difficulty swallowing, chewing, speaking, or moving your jaw or tongue

Although all of these symptoms can also be signs of less serious problems, be sure to alert our office if you notice any of the above changes.

Prevention: you can take a proactive role in preventing oral cancer by:

• Conducting an oral self-exam at least once a month. Use a bright light and a mirror, look and feel your lips and front of your gums, the roof of your mouth, and the lining of your cheeks.
• Scheduling regular exams in our office. The American Cancer Society recommends oral cancer screening exams every three years for people over age 20 and annually for those over age 40.
• Refraining from smoking or using any tobacco products and drinking alcohol only in moderation.
• Eating a well balanced diet.
• Practicing safe sex.

Contact us today to schedule an appointment to discuss any questions you may have regarding oral cancer. Read more about this topic in the Dear Doctor magazine article “Risk Factors for Oral Cancer.”

Unfortunately, going to the dentist may still be a fear and anxiety provoking experience for some people even with modern dental techniques — an interesting phenomenon given the fact that no one is born with fear. It is either a learned response based on personal experience or one that is literally imagined based upon hearing of another's treatment. However, regardless of how it develops, a person's perception is their reality. The good news is that we are here to both listen and to offer our patients the benefits of oral sedation (sedation dentistry) that allows relaxation of mind and body. Thus you can focus on feeling peaceful rather than anxious.

While research has shown that 75% of all people surveyed have at least a little fear about going to the dentist, 10-15% have a great deal of fear. In fact, some of these people experience so much fear that they will cancel dental appointments or never schedule in the first place. If the latter describes your feelings, we encourage you to ask us about sedation or comfortable dentistry so that you can receive the oral healthcare you need and deserve to maintain optimal dental health.

And this good news gets even better when you understand that oral sedation does not even involve injections (shots)! We typically administer oral sedation in one of two methods: by giving you a pill to swallow whole or by giving you a tablet to place under your tongue (sub-lingually) where it dissolves. Once the prescription medication takes effect, you will remain awake and aware of your surroundings; however, the medication will help you transition from feeling nervous to a more comfortable state of being. Most of our patients describe their experience as “comfortable” or “relaxation” dentistry due to how they feel during their treatment. Simply put, the anti-anxiety (anxiolytic) medication almost literally dissolves away your fears.

Want to learn more?

Contact us today to discuss your questions or to schedule an appointment. You can also learn more by reading the article “Overcoming Dental Fear & Anxiety.”

One of the most common treatments we are asked about is a root canal and the unfortunate bad reputation associated with it. The truth is that the procedure actually relieves the pain associated with the problem and not visa versa. And here's why.

A root canal or endodontic treatment (“endo” – inside; “dont” – tooth) is a necessary procedure in which diseased pulp tissue — and the nerve, which responds by causing the pain — is removed. This is followed by cleaning and sealing the root canals. This usually results from pulp inflammation and infection as a result of a severe decay or in a heavily filled tooth. Root canal treatment is typically performed by general dentists who have taken specialized training or by endodontists, dentists who specialize in the diagnosis and treatment of root canal problems. We perform them here in our practice to save a tooth, literally, from further damage and/or loss.

Here is a quick overview of the procedure. We will begin by making a small opening in the chewing surface of your tooth so that we can access the tooth's root canal. We use small instruments to remove the dead and dying tissues of the pulp. The root canals are cleaned and disinfected. The canals are then sealed with a biocompatible filling material. Lastly, we will seal the access hole with a filling material. You will then need to get a permanent restoration or crown to protect the tooth fully.

If you feel that you have the symptoms of a root canal problem and may need a root canal treatment, contact us to schedule an appointment. And to learn more about the signs, symptoms, and what to expect after root canal treatment, read the article “Common Concerns About Root Canal Treatment.”

While some people associate the need for root canal treatment with an injury or trauma to a tooth (which is a valid cause), it can also most commonly be caused by tooth decay that is left untreated. This is the reason why we have put together this brief guide to explain the three common stages of tooth decay that lead up to the need for a root canal.

Stage 1: During this stage, decay begins to form in the tiny grooves on the biting surface of a tooth or where the teeth contact each other. The result is loss of the surface enamel of the tooth.

Stage 2: Left untreated, the disease progresses through the enamel and into the dentin, which forms the body of the tooth. Once in the dentin, it progresses more rapidly until it reaches the pulp — the living tissue within the root canals of the tooth. The decay infects the pulp tissues, which contain the nerves of the teeth, causing pain. The end result of inflammation and infection of the pulp is that it dies.

Stage 3: As the nerve dies an infection results, which causes pain and swelling. For some people who do not regularly visit our office, this may be the first physical sign that they have a problem. But all is not lost, a successful root canal treatment, whereby the infected pulpal tissue is removed and the root canals are cleaned and sealed will not only relieve the pain, but save your tooth. So the good news is that once a tooth has had the appropriate endodontic treatment (“endo” – inside; “dont” – tooth) followed by a proper restoration, the tooth can last as long as your other teeth. The key is to take proper care of your teeth, have routine cleanings, and visit our office as soon as you feel you have a problem with a tooth.

If you are having pain or symptoms from a tooth or teeth, check it out with us — you may or may not need a root canal treatment. Contact our office to schedule an appointment and find out. Don't wait until it's too late. And to learn more about the signs, symptoms, and treatments for a root canal, read the article “I'd Rather Have A Root Canal....”

We pride ourselves on educating our patients regarding oral health and dental treatment. This is why we are providing you with these frequently asked questions (FAQs) regarding root canals. Our belief is that by being informed about this important dental treatment, you will be more comfortable should you ever require a root canal.

Exactly what is root canal treatment?

A root canal treatment is an endodontic procedure (“endo” – inside: “dont” – tooth) in which the living pulp tissues are housed, including the nerves. When a severely decayed or damaged tooth begins to hurt, it is because the pulpal tissues are inflamed or infected, and the response of the nerves is varying degrees of pain — letting you know something is wrong. If the pulp is dead or dying it must be removed and the root canal of the tooth is filled and sealed to stop infection and to save the tooth.

Who typically performs them?

Endodontics is a specialty within dentistry that specifically deals with the diagnosis and treatment of diseases and disorders of root canal issues affecting a tooth's root or nerve. While endodontists are dentists who specialize in root canal treatment, general dentists may also perform root canal treatment and are usually the dentists you will consult with when you first have tooth pain and who will refer you to an endodontist if necessary.

What are the symptoms of a root canal infection?

Root canal symptoms and the character of the pain may vary depending on the cause. For example, symptoms may be:

• Sharp, acute pain that is difficult to pinpoint
• Intense pain that occurs when biting down on the tooth or food
• Lingering pain after eating either hot or cold foods
• Dull ache and pressure
• Tenderness accompanied by swelling in the nearby gums

Does root canal treatment hurt?

A common misconception is that a root canal treatment is painful when, in actuality, it is quite the opposite. The pain associated with a root canal occurs prior to treatment and is relieved by it — not visa versa.

If you have tooth pain, you may or may not need a root canal treatment. Contact us today (before your symptoms get worse) and schedule an appointment to find out what's causing the problem. And to learn more about the signs, symptoms, and treatments for a root canal, read the article “Common Concerns About Root Canal Treatment.”

Nearly every parent and caregiver has experienced that almost instantaneous sick feeling when they see that their child has been injured, especially when it is an injury to the mouth and teeth. For some, it is just a bloody lip; however, if the accident chipped a tooth, then you may have a completely different situation on your hands. If the nerve of the tooth has not been damaged, you needn't worry too much — a composite (plastic) tooth-colored restoration that is actually bonded to the tooth is an ideal material for repairing most broken or chipped teeth. See us as soon as possible to assess the extent of injury, so that proper and appropriate action can be taken.

An additional reason why bonding with composite resin may be the ideal choice for repairing a child's chipped tooth is that it can be custom created in virtually any shade so that it perfectly matches the damaged tooth and the surrounding teeth. It is also far less expensive than a crown, an important factor to consider when repairing a primary (baby) tooth that will eventually fall out to make room for a permanent tooth. If the injury is to a permanent tooth, a composite resin still may be ideal to use as a restoration until your child or teenager has stopped growing or playing contact sports. This is because your teenager may be too young for a more permanent restoration such as a crown or porcelain veneer.

An important, proactive step you can take to be prepared for the next time your child has a dental injury is to download Dear Doctor's Field-side Pocket Guide for Dental Injuries. This handy, quick reference guide is a must have for athletes, parents, caregivers, teachers, coaches or anyone who is often in an environment where a mouth injury is likely to occur. Knowing what to do and how quickly you must respond can make the critical difference between saving and losing a tooth.

Given the fact that baby-boomers are now reaching the age of retirement, understanding senior healthcare is becoming a top priority to many people. Discover your level of expertise in the area of oral health by taking the following true/false test.

True or False Self Assessment

1. All people eventually lose their teeth as they age.
2. Yellow teeth are a sign of gum disease.
3. If you have dentures, you no longer need regular dental check-ups.
4. Periodontal (gum) disease is a big problem that affects 3 out of 4 adults.
5. Electric toothbrushes can be a great option for seniors with arthritis or other debilitating conditions.

Answers

1. False: Your teeth are meant to last your lifetime.
2. False: Yellow teeth typically denote stained teeth from diet, medication, smoking, or growing older. And while they may not appear attractive, older, yellow teeth can in fact be healthy and free of gum disease. However, if your yellow teeth bother you, ask us if teeth whitening could be right for freshening up your smile while making you appear younger.
3. False: For those individuals who wear complete upper and lower dentures, you will always need routine dental exams, typically once a year so that you can be screened for cancer, as well as other oral conditions (i.e. candadiasis), to ensure the you obtain and maintain optimal oral health.
4. True: 75% of all adults over the age of 35 will experience some form of periodontal disease, a condition in which the gums become inflamed and infected. If left untreated, gum disease causes the bone that supports the teeth to deteriorate until the teeth are loosened and/or eventually lost (either they fall out on their own or must be removed). On a positive note, you can prevent gum disease by having good oral hygiene that includes flossing daily and brushing at least twice a day with a proper technique and fluoride toothpaste.
5. True: Under normal conditions, what matters most is not so much the type of toothbrush used (manual, electric or battery powered toothbrush), but rather how you use it. However, if you are unable to use a manual toothbrush effectively for proper brushing, then a power toothbrush may be able to facilitate proper cleaning more easily.

Want To Learn More?

If you feel you missed too many of the above questions, read the Dear Doctor article, “Oral Hygiene Behavior.” Or, contact us today to discuss your questions or to schedule a consultation. ]]>Mon, 28 Mar 2011 08:41:12 -0500http://www.dttollefsondds.com/blog/post/what-our-office-can-do-about-your-snoring-or-sleep-apnea.html

Snoring and Obstructive Sleep Apnea (OSA) is a condition that occurs when the upper airway (back of your throat) collapses or is blocked, causing significant airflow disruption. A person with OSA continues snoring at a regular rate but is interrupted by long silent periods during which there is no breathing for atleast 10 seconds or more. Believe it or not, this issue affects millions of people worldwide. It can leave you feeling tired, depressed, irritable, as well as cause memory loss and poor concentration. And if you have OSA that is left undiagnosed and untreated you could fall victim to heart attacks, strokes, irregular heartbeat, high blood pressure, heart disease and even impotence. For these reasons, we feel it is important that you understand the real-world consequences that can occur if you ignore your OSA.

Reality is that most people are unaware that their dentist can be an excellent resource in helping to diagnose and treat OSA. However the first and most important step is to receive a proper, thorough examination and diagnosis with an appropriately trained physician and dentist. If after completing this process you are diagnosed with OSA, we will discuss treatment options. Some of these may include:

• Suggesting that you exercise and lose weight if you are overweight.
• Sleeping with a Continuous Positive Airway Pressure (CPAP) machine that provides pressurized air into your airways through a mask that covers both your nose and mouth while sleeping.
• Sleeping with a professionally made oral appliance or mouthguard that can reposition your lower jaw, tongue, soft palate and uvula (the dangling tissue in the top, back portion of your mouth) into a better position during sleep to relieve blockage.

If you are ready to discuss you questions and concerns about your snoring, or the snoring habits of another family member, contact us today to schedule a consultation. You can also learn more about the signs, symptoms, and treatment options when you read “Snoring & Sleep Apnea.”

Root canal, or endodontic (“endo” – inside; “dont” – tooth) treatment, is often wrongly perceived as a highly unpleasant experience and one that causes tremendous pain. However, the truth is that the procedure actually relieves the pain being caused by an infected and inflamed tooth pulp (inside of the tooth). Advances in dentistry have made treatment virtually pain free and it can be completed relatively quickly, usually in a single visit. Left untreated, infection can spread into the bone immediately around the tooth's root, so prompt attention is the best course of action.

If the term “root canal” still sends shivers down your spine, don't despair. Here is some information that should help put your mind at ease.

• Root canal treatment is necessary when deep decay or trauma has caused the inside (pulp) of the tooth to become inflamed or infected. Symptoms of infection can include sharp pain when biting down, lingering pain after consuming very hot or cold foods, a dull ache and feeling of pressure near the infected tooth, and tender gum tissue surrounding the infected tooth.
• After a local anesthetic is administered to numb the infected tooth and its surrounding area, we will make a small opening on the chewing surface of the tooth. This will allow us to remove dead and dying tissue from the pulp and to then clean and disinfect the root canals. Using small instruments, we will shape the canals and seal them with biocompatible filling materials.
• You may feel slight tenderness at the treated site for a few days, but this is quite manageable and can be relieved with over-the-counter (OTC) non-steroidal, anti-inflammatory pain relievers such as aspirin or ibuprofen. You should refrain from chewing on the treated tooth until your follow-up appointment. A crown or other restoration may be needed to protect the tooth and restore it to full function.

If you think you might be a candidate for a root canal treatment, schedule an appointment as soon as possible. If you would like to learn more about the process of root canal treatment, please read the Dear Doctor magazine article “Common Concerns About Root Canal Treatment.”

If you have ever had halitosis (bad breath), you know it can cause you to feel self-conscious and embarrassed. And while the odor is typically a primary concern, determining what is causing it is a task we can assist you with resolving. This is especially true when you experience bad breath outside of those times when you've just consumed pungent foods and drinks such as coffee, garlic or raw onions. For example, it is quite a different scenario to have family members, friends, co-workers or even total strangers consistently complaining or using body language to denote your bad breath. If the later best describes your situation — and be honest with yourself — then you need a thorough dental exam to discover the ultimate cause (or causes) of your halitosis. This is especially important because so many people are unaware that there can be numerous oral and/or general health concerns triggering their bad breath.

Most unpleasant mouth odors arise from the more than 600 types of bacteria found in the average mouth, with several dozens of these bacteria being the primary culprits for producing foul odors. And while food particles left between teeth can be key contributors to bad breath, the tongue or more specifically, the back of the tongue, is the most common location. Dry mouth is another cause for bad breath, as evident by the dreaded morning breath we all experience from mouth breathing as we sleep. Bad breath is also caused by certain medical conditions such as liver disease, lung infections, diabetes, kidney infections or failure and cancer.

The good news is that we can work with you to develop an effective treatment for your bad breath. And if necessary, we can work with your physician on a total treatment plan should your condition be due to health conditions outside your mouth. However, if your bad breath originates in your mouth, we may recommend any or all of the following to return your mouth to optimal oral health:

• Oral hygiene instruction to learn the proper ways to brush, floss, scrape your tongue and use mouthwashes
• Denture hygiene instruction for proper cleaning and maintenance of both full and partial dentures and bridgework
• Periodontal (gum) therapy that includes professionally cleaning your teeth (scaling), smoothing your teeth's root surfaces (root planning) and possible antibiotic therapy
• Removal of tooth decay where large, open cavities (caries) are present
• Repair of broken fillings
• Removal of wisdom teeth (third molars) with gum flaps
• Treatment of yeast infections (candidasis)

To learn more about the causes and treatments for halitosis, read the Dear Doctor article, “Bad Breath — More Than Just Embarrassing.”

Ready To Take The Next Step?

If you want to address your own concerns with bad breath, contact us today to schedule a consultation for an examination and treatment plan. You will find yourself smiling and laughing more once you are confident you have a clean, healthy mouth.

In a recent online poll conducted by Dear Doctor, the premier oral healthcare resource for consumers, 77% of those polled planned on visiting their dentist prior to their wedding. For some, this includes a thorough cleaning to remove stains and freshen both their smile and breath. However, a growing number of brides, grooms, and parents of the couple are seeking cosmetic dentistry or more specifically, a smile makeover, to transform their smile for their special day as well as their future.

If this describes your situation, take the first step towards the smile you have always wanted. To create your ideal smile, we will first meet with you to get to know you better and hear your concerns, goals, expectations and wedding day timeline. Bringing in photos or magazine images of smiles that you consider beautiful will help to ensure that we understand what you find attractive, as beauty can vary greatly from individual to individual. During this initial consultation, you will also learn about your smile makeover treatment options and what you could expect immediately prior, during and following each option.

Some subtle improvements we may consider are teeth whitening and bonding. Both of these options can take place in just a few office visits and produce very attractive results. Porcelain veneers and crowns can provide you with longer-term results that can last from 10 to 20 years. However, because they typically require 1 to 4 months advance notice, it is important to see us as soon as possible to ensure you have enough time before your special day. Another procedure that can play a dramatic role in your smile makeover is periodontal plastic surgery to improve and alter your gum tissues and their relationship to your teeth. For example, the appearance of “short” teeth can be corrected by lengthening them during a surgical procedure that has minor discomfort yet results in a life-long change.

Want to learn more?

Contact us today to discuss your smile makeover questions or to schedule an appointment. You can also learn more by reading the Dear Doctor article, “Planning Your Wedding Day Smile.”

Before determining if a bridge or an implant will work best for you, here is some useful background information. There are two main parts to a tooth; the crown or part that you see above the gum line and the root portion that is below the gum line and encased in bone — the part that is replaced by a dental implant.

A dental implant is inserted into the jawbone during a surgical procedure. The implant is actually a titanium screw-like device that is placed in contact with the bone. During a 3 to 6 month healing period, it subsequently fuses to the bone. A crown made from dental porcelain, gold or a combination of both is then attached to the implant to mimic a healthy, normal tooth.

There are two critical reasons why implants are the preferred method for permanently replacing an adult tooth. The first is that they are less susceptible to gum disease and they are not subject to tooth decay. The second is that because they attach to the jawbone and not to the adjacent teeth. And while an implant may cost a little more initially, when compared to the longevity and replacement cost of bridgework over a lifetime, they may cost less.

By contrast, a fixed bridge is also a non-removable restoration or prosthesis (replacement part) that is held in place by attaching it to your natural adjacent teeth. The treatment gets its name from the French word for bridge, “pont,” as the tooth being replaced is called a pontic. Before placing a bridge, the teeth on either side of the missing tooth must be prepared by removing layers of tooth enamel. Three new teeth are then crafted as a single unit from dental porcelain and/or precious metals with crowns on either side of the pontic. The pontic is held in place when the crowns are placed. Bridgework is at risk for gum disease and tooth decay and requires careful maintenance.

As with most dental procedures you have options and choices. Luckily, when it comes to determining whether a bridge or an implant will work best for you, you can rely upon our expertise. However, by having a clear understanding of these two options you are now better prepared for working with us should you require this treatment option. To learn more read the article, “Implants Vs. Bridgework.” Or, contact us to discuss your questions or to schedule an appointment.

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.”

No one participates in sports or recreational activities with the goal of oral or facial injury. However, the facts reveal two things: sports injuries are the number one cause, impacting thousands of adults and children annually and many of them can be prevented or at least minimized with education and the use of a properly fitted professional mouthguard.

In addition to the obvious negative of the physical injury to the mouth and face, oral-facial injuries can also be both emotional and psychological. And while these injuries can occur due to a multitude of reasons, a recent study found that approximately 25% occur while playing sports. The following poignant facts should raise your awareness of dental injuries.

Did you know…?

• On average, 22,000 dental injuries occur annually in children under the age of 18.
• Outdoor activities and products are associated with the largest number of dental injuries to baby (primary) teeth in children aged 7 to 12 with 50% of these incidents related to bicycle accidents.
• Outdoor activities and products are also associated with the largest number of dental injuries to permanent teeth in adolescents aged 13 to 17.
• Of all sports, baseball and basketball consistently produce the largest number of dental injuries each year.
• Over 80% of all dental injuries involve the upper front teeth.
• Age, gender, condition and position of the teeth, as well as the type of sport being played are all key risk factors associated with the likelihood of experiencing a sports injury.
• Studies show that teenage boys involved in contact sports, collision sports, and high-velocity non-contact sports are at the highest risks for dental injuries.
• Young girls are starting to participate in many of these same sports, and thus their risks for injuries are climbing.
• Home furniture is the main culprit in over 50% of the dental injuries in children under the age of 7.

We encourage you to take a moment to assess your own as well as your family's risk of dental injury and to think about how you can treat and prevent them. To learn more, read the Dear Doctor article, “An Introduction To Sports Injuries & Dentistry.” Or, feel free to contact us to discuss your questions or to schedule a consultation.

When it comes to restoring both the beauty and functionality of a smile, two of the most commonly used techniques are porcelain crowns and veneers. Why? They consistently deliver beautiful, natural-looking results that are permanent and require very little maintenance. And while they have many things in common, they also have just as many differences.

The Similarities

Here are some facts that apply to both porcelain veneers and crowns:

• Both enable changes to a tooth's color and shape.
• Dental laboratory technicians use precise molds made by our office to hand-craft porcelain veneers and crowns.
• Both are made using high-quality dental porcelain.
• Neither respond to tooth whitening products — the color of the veneer or crown remains the same color as the day it was placed.
• Neither procedure is reversible once completed.

The Differences

Here are some of their differences:

• Crowns are used to replace a larger amount of tooth structure while veneers are thin shells that are placed over the front surface of teeth.
• Veneers require much less tooth preparation (reduction by drilling) than crowns.
• Crowns allow for greater change of tooth shape, while veneers allow for more minor changes.
• Crowns are generally used to restore teeth that have lost tooth structure from decay or trauma.
• Veneers are generally used where teeth are structurally healthy and intact, but color and shape change are required.
• Veneers are used mostly for teeth that are visible when smiling, while crowns can be used to restore virtually any tooth.

Want To Learn More?

To learn more, read the Dear Doctor article, “Porcelain Crowns & Veneers.” Or, you can contact us to discuss your questions or to schedule a consultation.

We are often asked about restorative and cosmetic dentistry procedures and the role they play in a smile makeover. We are also faced with people wondering whether or not they can benefit from treatment. For this reason, we developed the following self-assessment to help you determine whether or not cosmetic dentistry is right for you.

• Do you avoid smiling in public or for photos?
• Are you self-conscious about spaces and gaps between your teeth?
• Do your teeth make you look older than you feel?
• Have you ever held back or restrained a smile?
• Do you feel that your teeth are stained or yellow?
• Do you hold your hand in front of your mouth when talking, laughing or smiling?
• Do your teeth look old and worn down, making you look and feel older?
• Do your teeth appear short because of a “gummy” smile?
• Are your teeth crooked, chipped or crowded?
• Do you wish you had someone else's smile?

If you answered, “yes” to one or more of the above questions, then you could benefit from a smile makeover. However, that is the easiest part of the process. The next step is the one that probably matters the most — scheduling a consultation with us. During this appointment you can discuss the specifics that bother you about your smile using your responses from our self-assessment test. You can also learn about the many treatment options available for providing you with the smile of your dreams.

Ready To Take The Next Step?

Contact us today to discuss your smile makeover questions or to schedule a consultation. Or, learn more now when you continue reading the Dear Doctor article, “The Impact Of A Smile Makeover.”

Parenthood comes with no manual — if it did it would surely include many essential tips to make your job easier while improving your children's lives. One important fact that surprises many people, is the age you should take your children to the dentist for their first dental appointment, age one. The reason that the age one dental visit is so important is that it establishes the foundation of oral healthcare for the rest of their lives. Unfortunately, some parents wrongly assume that because primary teeth “fall out anyway,” they do not need to worry about them. Nothing could be further from the truth!

One problem children may face is Early Childhood Caries (ECC) tooth decay. This is a type of tooth decay that occurs from sucking on a bottle filled with sugary liquids such as formula, juices and fruity drinks for extended periods of time and from a sleep-time bottle. ECC can affect all the primary (baby) teeth in infants soon after they come into the mouth.

Bringing your children into our office for their age one dental visit enables us to establish a friendly, trusting relationship with the whole family while we assess your children's oral health. During this consultation we will identify if the teeth and jaws are developing correctly, whether habits such as sucking on baby bottles are causing tooth decay or if there are other underlying issues that may indicate future problems. And this ounce of prevention often enables us to stop an anticipated problem before it even starts.

Canker sores are characterized by one or more painful sores on the tongue, soft palate, insides of the cheeks or lips and the gums. These inflamed, tender sores are typically round, white, or gray in color, with a red surrounding border

Causes

While their exact cause is unknown, common triggers of a canker sore may include:

• Stress
• Immune deficiencies
• Infection
• Aggressive tooth brushing
• Oral tissue injury
• Allergic reaction
• Spicy or acidic foods
• Abrasive foods or dental appliances

If one does develop, rinse with salt water daily and apply an over-the-counter oral numbing agent to alleviate the pain. Doing so will speed up the healing process and make eating, drinking and brushing more bearable.

When to Seek Medical Attention

Monitor your canker sores as they develop to detect unusual changes. Canker sores will generally heal on their own and don't require treatment. If your sores are abnormally large, last longer than a few weeks or are so painful you can't eat or drink, you should make an appointment with our Terrace Park and Lovelan, OH offices. Recurring canker sores and intolerable pain is not normal and should be examined by a dentist.

Chronic acts of grinding can result in a fracturing, loosening or loss of the teeth. Severe cases can also lead to jaw disorders, like temporomandibular joint (TMJ) disorder and frequent headaches.

Common warning signs and symptoms of chronic teeth grinding may include:

• Worn down, flattened or chipped teeth
• Frequent earaches, facial pain or jaw pain
• Unexplained headaches, particularly in the morning
• Increased tooth sensitivity
• Indentions on tongue
• Worn tooth enamel, exposing deep layers of the tooth
• Chewed tissue on inside of cheek
• Enlarged or tightened jaw muscles due to severe contractions
• Grinding or clenching that is loud enough to awaken others in your household

There isn't one cause of bruxism, but many times teeth grinding is related with reasons such as stress or a natural response due to the misalignment of teeth. In children, many times bruxism is a result of the growth and development of the jaws and teeth.

Treatment for bruxism will vary, depending on the severity and cause. Sometimes simple behavior modification or relaxation techniques may be enough to reduce teeth clenching. If bruxism is caused by dental problems, Distinctive Smiles can work with you to correct the malocclusion. Other possible solutions include dental appliances which can also protect the teeth from the impact of grinding.

Unfortunately, you may not even realize that you have bruxism until it causes significant damage to your teeth. If you suspect you may be grinding your teeth, visit Distinctive Smiles for an evaluation. During regular visits to our Loveland or Terrace Parks offices, the teeth are examined for evidence of grinding, such as jaw tenderness and abnormalities in your teeth. Distinctive Smiles can help you identify your cause of grinding and determine the best treatment to help you stop.

Easy Ways to Avoid Dental Injuries

• Avoid chewing ice or hard candy which can crack teeth
• Avoid ripping objects with teeth, such as sealed packages and tape
• Avoid the risk of injury to teeth, gums, lips and tongue by wearing a mouthguard when participating in sports and high-impact activities
• Visit Distinctive Smiles for regular check ups and cleanings

Whether you're at home, in the car or at work, when a dental emergency strikes, you'll want to be prepared. Until you can get into our Loveland and Terrace Park dental offices, following these basic steps can help relieve the pain, save your tooth and prevent additional damage. Before acting on any dental emergency, you should always contact Distinctive Smiles first to ensure safe and appropriate care.

Temporary Treatment for Common Dental Emergencies

• Toothache: Rinse mouth with warm water to clean the affected tooth, and gently floss to remove food or debris that may be trapped between the teeth. If pain persists, visit a dentist for a thorough evaluation as it may indicate a cavity or infection.
• Broken tooth: Rinse mouth with warm water; locate the lost filling or tooth pieces; and control swelling or bleeding with an ice pack and gauze. See your dentist as soon as possible.
• Knocked out tooth: Gently place the tooth back into the socket if possible. If not, tuck it between your cheek and gum or place it in a small container of milk. Getting to your dentist within one hour of the accident with the tooth is your best bet for successfully reattaching the tooth to the supporting tissues.
• Objects caught between teeth: Rinse your mouth with warm water. If that doesn't work, gently try to remove the object with floss. Avoid using sharp instruments that could injure or cut the gums. If the object can't be dislodged, visit Distinctive Smiles for professional assistance.

Temporary dental care is just that- temporary. It's important to seek professional dental assistance as soon as possible following an injury to your teeth or gums.

Fortunately, an unforeseen dental emergency can usually be prevented with early detection and preventative care. Practice good oral hygiene-brushing and flossing daily-and visit our Loveland and Terrace Park offices for regular check ups and cleanings. As a general rule, if your teeth or mouth hurt, visit Distinctive Smiles for a careful evaluation and proper treatment.

Persistent toothaches that result in throbbing or sharp pain are common symptoms of a tooth abscess. Other symptoms include:

• Pain when chewing
• Sensitivity to hot or cold
• Swollen lymph nodes in the neck
• Feeling of overall uneasiness or illness
• Redness and inflammation of the gums
• Bad taste in mouth or foul smelling breath
• Fever

If you're experiencing any of the symptoms listed above, you'll want to visit Distinctive Smiles as soon as possible, as an abscess won't go away on its own. Delaying treatment can lead to serious health complications, including tooth loss and the spread of infection to your soft tissues or the jaw bone. An abscess that ruptures or a tooth root that dies as a result of the infection may reduce the pain significantly, but dental treatment will still be necessary as the infection remains active and can continue to spread to surrounding tissues.

Treatment for a tooth abscess may vary depending on the severity of the infection. At Distinctive Smiles our treatment plan focuses on eliminating the infection, preserving the tooth, and preventing further dental complications.

Keeping your teeth and gums healthy is the best way to prevent dental problems that may lead to an abscessed tooth, including daily brushing, flossing and a healthy diet. Additionally, regular visits to our Loveland and Terrace Park offices for cleanings and check ups are also critical for detecting dental problems early.

If you have missing teeth, dental implants are the state-of-the-art tooth replacement system. They act as substitutes for natural tooth roots, stabilizing the bone with which they fuse and become integrated with. This protects the remaining bone and prevents its further loss, the natural occurrence after the natural teeth are lost. Done correctly, implants can offer a long-term solution to the problem of missing teeth.

Key factors assuring dental implant success are having an experienced dental team consisting of:

1. A surgeon (periodontist or oral surgeon, or dentist trained in surgical techniques to place the implants)
2. A dental technician who will design the crowns (tooth portion of the implant)
3. A restorative dentist to place the crowns

The whole team is necessary to plan the process as well as carry out their individual roles. They will ensure that there is enough bone and that it is in the right place prior to treatment to allow for proper implant position, and that the implant/s are correctly placed, which is necessary to allow for natural aesthetics and proper function.

Replacing missing teeth is imperative to maintaining normal oral health and function. Dental implants will help support the entire structure of the face. If back teeth are lost, the vertical height of the lower face and mouth can begin to collapse, negatively impacting biting function and causing creasing and cracking of the lips and facial skin, resulting in a prematurely aged look.

Implants differ from bridgework in several ways, making them the most favorable option for tooth replacement in many cases. For starters, they do not affect adjacent teeth, nor do they decay like teeth, and they are less susceptible to gum disease. In the long-term, implants are a more cost-effective solution based on the fact that once they are placed, their life expectancy is longer than bridgework.

If you have missing teeth that have negatively affected your appearance, self-confidence, and ability to chew, call us today to talk about the possibility of replacing them with dental implants. To learn more about the use and capabilities of dental implants, read the Dear Doctor magazine article “Dental Implants: Evaluating Your Options For Replacing Missing Teeth.”

Studies have shown that as many as 75 out of every 100 people fear dental visits; and for 10 to 15 of them, the fear is so great that they never get treatment — leading to serious dental problems and worse. Untreated disease in your teeth and gums can negatively affect the health of your entire body.

How can you conquer your fears so you can get the treatment you need? The answer includes (a) working with us to overcome your fears and have a positive experience while undergoing dental treatment, and (b) using oral sedation or anti-anxiety medication to help you quell your fears and relax.

Overcoming Your Fears

People develop fear of the dentist when they have a bad dental experience themselves, or sometimes when they hear of a bad experience someone else has had. The more you are afraid, the more you feel the symptoms of fear, and the more you connect those symptoms with the experience. You need to stop this negative memory sequence and replace the feelings of fear and loss of control with memories of good experiences and feelings of being in control.

It helps to know that you are not alone in your fears and that you can do something positive about them. First, make an appointment to discuss your fears with us, your dental professionals. Start with small procedures that cause only mild anxiety, and give yourself adequate time to get over your fears.

Contact us today to schedule an appointment to talk about any fears you may have. You can also learn more by reading the Dear Doctor magazine articles “Overcoming Dental Fear & Anxiety” and “Oral Sedation Dentistry.”

Recent research has revealed a relationship between overall general health and proper care for your dentures. The evidence shows that oral bacteria have been implicated in bacterial endocarditis (“endo” – inside; “card” – heart), chronic obstructive pulmonary (lung) disease, generalized infections of the respiratory tract and other systemic diseases. This proves what you might not suspect — you need to pay attention to the care of your dentures to achieve optimal health. For this reason, we have put together this list of five great tips for caring for your dentures.

1. Daily cleaning at home: It is critical that you thoroughly remove the bacterial biofilm in your mouth and on your dentures. This one tip alone will help minimize the likelihood of your developing inflammation (denture stomatitis) under your dentures.
2. Don't boil your dentures: While cleaning is important, you should NEVER place your dentures into boiling water because it can damage and warp them.
3. Don't wear your dentures 24/7: To help reduce or minimize denture stomatitis, you really should not wear your dentures 24/7. It is important to thoroughly clean them each night along with your mouth (as noted above), and then leave them out while you sleep. This will also slow down the bone loss that naturally occurs from the pressure caused by wearing dentures.
4. Always store your dentures immersed in water: This tip is so important because it helps prevent your dentures from warping. And do not forget to change the water each day, as well as to clean the container in which you store them.
5. Annual professional cleaning: Even though you may do an excellent job cleaning your teeth at home, you still need to come to our offices at least once a year for an examination, fit and function check, as well as a professional cleaning. During this cleaning, we will use our ultrasonic cleaners to minimize the biofilm that accumulates over time.

To learn more tips, continue reading the Dear Doctor magazine article “Top Ten Tips For Denture Care & Maintenance.” Or you can contact us today to schedule an appointment to discuss your questions.

Dentistry has ventured into the new area of sleep medicine by helping snorers — and their exasperated sleeping partners — with custom-made anti-snoring devices. These oral appliances, which resemble orthodontic retainers or sports mouthguards, keep the snorer's airway clear and the bedroom quiet. To see how they work, you have to understand the mechanics of snoring.

Snoring occurs when the upper airway (back of the throat) becomes blocked by the tongue or other soft-tissue structures, such as large tonsils or a long soft palate. The vibrating of these obstacles creates the sound we call snoring.

Snoring is often worse when sleeping on one's back because that position encourages the lower jaw to fall back and the tongue to close off the airway. This is where Oral Appliance Therapy comes in. These custom-fitted devices are designed to keep the upper airway open during sleep by pulling the lower jaw forward, which in turn brings the tongue away from the throat. Dentists, and our office in particular, are the only source for Oral Appliance Therapy.

People who snore should have a thorough examination to rule out Obstructive Sleep Apnea (OSA), a potentially dangerous condition in which airflow can be cut off completely for 10 or more seconds (“a” – without; “pnea” – breath), reducing blood-oxygen levels. Chronic, loud snoring is a common finding with OSA.

Please remember that sleep is an integral part of health and well-being. In fact, we spend about a third of our lives doing it. If you are snoring or have any sleep-related breathing disorders that are waking you or your bed partner, be sure to tell our office. There are plenty of examples of the havoc wreaked by sleep-deprived individuals. Remember the Exxon Valdez?

If you have any questions about Oral Appliance Therapy, 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 “Sleep Disorders & Dentistry.”

As a Pro Football Hall of Famer and first runner up on the hit television show Dancing with the Stars, Jerry Rice has a face and smile that truly has star quality. However, that was not always the case. During an interview with Dear Doctor magazine, the retired NFL pro discussed his good fortune to have had just a few minor dental injuries throughout his football career. He went on to say that his cosmetic dentist repaired several of his chipped teeth with full crowns. Rice now maintains his beautiful smile with routine cleanings and occasional tooth bleaching.

If you have chipped, broken or missing teeth, or are considering a smile makeover, we want to know exactly what you want to change about your smile, as the old adage is true: Beauty is in the eyes of the beholder. This is one reason why we feel that listening is one of the most important skills we can use during your private, smile-makeover consultation. We want to use this time to ensure we see what you see as attractive and vice versa so that together we can design a realistic, achievable blueprint for your dream smile.

For this reason, we have put together some questions you should ask yourself prior to your appointment:

• What do you like and dislike about the color, size, shape and spacing of your teeth?
• Do you like how much of your teeth show when you smile and when your lips are relaxed?
• Are you happy with the amount of gum tissue that shows when you smile?
• Do you prefer a “Hollywood smile” with perfectly aligned, bright white teeth, or do you prefer a more natural looking smile with slight color, shape and shade variations?

To learn more about obtaining the smile you want, continue reading the Dear Doctor magazine article “Great Expectations — Perceptions In Smile Design.” Or you can contact us today to schedule an appointment so that we can conduct a thorough examination and discuss your cosmetic and restorative dentistry treatment goals. And if you want to read the entire feature article on Jerry Rice, continue reading “Jerry Rice — An Unbelievable Rise To NFL Stardom.”

Perhaps you've seen Nate Berkus on The Oprah Winfrey Show or watched his television program, The Nate Berkus Show. You may even have read his best-selling book, Home Rules: Transform the Place You Live Into a Place You'll Love. Regardless of where or how you discovered Berkus, you will surely have noticed his dazzling smile.

Berkus recently opened up about the facts behind his trademark smile during an interview with Dear Doctor magazine. First off, his smile is totally natural, as he never wore braces or had any cosmetic work, including porcelain veneers. However, Berkus does give credit to his childhood dentist for the preventative healthcare he received as a young boy. “I'm grateful for having been given fluoride treatments and sealants as a child,” he said. Nate also shared the important flossing advice he learned from his dentist that he still follows today: “Floss the ones you want to keep.” Berkus went on to say that he feels, “healthy habits should start at a young age.”

And we totally agree! For this reason we have put together the following list of facts and oral hygiene tips:

• Over 50% of plaque accumulation occurs in the protected areas between teeth — a place that may be difficult or even impossible to reach with a toothbrush.
• A thorough brushing may take up to two minutes at first, and it may feel awkward as you reach some places in your mouth.
• Remember, more is NOT always better! Brushing or flossing too hard can be damaging to your teeth and gums. And never saw back and forth with your floss.

To learn more about oral hygiene, including brushing and flossing techniques, you can continue reading the Dear Doctor article “Oral Hygiene Behavior - Dental Health For Life.” Or you can contact us today to schedule an appointment so that we can conduct a thorough examination, review your brushing and flossing techniques, and discuss any questions you have as well as treatment options. As needed, we will work with you to teach you the proper brushing and flossing techniques so that you feel confident before you leave our office. And to read the entire interview with Nate Berkus, please see the Dear Doctor article “Nate Berkus.”

According to NFL football legend Jerry Rice, “Football can be brutal—injuries, including those to the face and mouth, are a common risk for any player.” And if anyone should know, it would be Jerry.

During an interview with Dear Doctor magazine, the retired NFL pro discussed his good fortune to have had just a few minor dental injuries during his pro playing days. He credits this success to the trainers and protective equipment professional football teams have to keep the players off the injured list. However, this was not the case during his earlier years in football. “There wasn't a lot of focus on protecting your teeth in high school,” he said. “You had to buy your own mouthguard.” He continued, “Things changed, though, when I went to college.”

Unfortunately, not much has changed since Jerry's high school days for young athletes. This is why we feel it is so important that parents and caregivers understand the risks and take proactive steps towards protecting the teeth, gums, bone and soft tissues of their children with a mouthguard. This is especially true for anyone — adults included — participating in high-contact sports such as basketball, baseball, hockey (field and ice), football, soccer, wrestling, martial arts, boxing and activities such as skateboarding, in-line skating and skydiving.

But all mouthguards are not the same. The best mouthguard, based upon evidence-based research, is one that is custom-designed and made by a dental professional, with the athlete's individual needs taken into account.

We make our custom mouthguards from precise and exact molds of your teeth, and we use resilient and tear-resistant materials. Once completed, it should be comfortable yet fit snugly so that you are able to talk and breathe easily with it in place. It should also be odorless, tasteless, not bulky and have excellent retention, fit and sufficient thickness in critical areas.

And while mouthguards may seem indestructible, they do require proper care. You should clean it before and after each use with a toothbrush and toothpaste, transport and store the mouthguard in a sturdy container that has vents, make sure not to leave it in the sun or in hot water and rinse it with cold, soapy water or mouthwash after each use. And last but not least, you should periodically check it for wear and tear so that you will know when replacement is needed.

To learn more about mouthguards, continue reading the Dear Doctor magazine article “Athletic Mouthguards.” Or you can contact us today to schedule an appointment so that we can conduct a thorough examination and make molds of your teeth for your custom mouthguard. And if you want to read the entire feature article on Jerry Rice continue reading “Jerry Rice — An Unbelievable Rise To NFL Stardom.”

Expectant mothers expect to deal with tooth-related milestones in their child's early years, such as teething and even the eventual shedding of those baby teeth to the Tooth Fairy. But there are many facets of children's oral health that may not be as well known. For example, did you know that using sugary fluids in your baby's bottle too frequently could promote constant acid production in your child's mouth leading to early childhood decay? Did you know that parents and caregivers who have decay transmit the bacteria that cause decay to their children?

Baby or primary teeth serve as guides for permanent teeth and, therefore, their health sets the stage for the health and proper function of their permanent successors. A comprehensive examination during a child's first visit can help uncover any underlying conditions that might be indicative of future problems, like tooth decay that can start as early as the age of six months when their first teeth appear. So the “Age One Visit” is the right time for a first dental visit.

What else do you know or want to know? Take our short quiz to help your child. The answers are listed at the bottom of this article.

The Quiz

1. Mounting evidence suggests that a child's oral health is most closely tied to which relative?
1. Mother
2. Father
3. Brother
4. Sister
2. Parents should bring their children to see a pediatric dentist:
1. Once they turn two?
2. Before they start kindergarten?
3. Preferably before their first birthday?
4. When they start to lose their baby teeth?
3. Tooth decay that occurs in infants and young children is referred to as what?
1. Primary tooth decay
2. Early Childhood Caries
3. Diapers to Decay Disease
4. Pediatric Dental Caries Syndrome
4. To help diminish the likelihood that your baby/infant will develop a cavity, you should:
1. Restrict the amount of sugary fluids your child drinks to mealtimes
2. Maintain proper oral hygiene to reduce harmful bacteria
3. Use fluoride to make the teeth more resistant to acid attack
4. All of the above
5. Infants are most susceptible to tooth decay when:
1. Breast feeding
2. Drinking milk from a bottle during meal times
3. Sucking on a pacifier that has been dipped in jam
4. Sleeping on their sides

The Answers

1) a = mother 2) c = before their first birthday 3) b = early childhood caries 4) d = all of the above 5) c = sucking on a pacifier that has been dipped in jam

Your baby's first visit to the dentist will cover a lot of ground, including diagnosis, prevention, education, and treatment as we help start him or her on the path to long-lasting oral and dental health. Call our office to schedule an appointment now. You can also learn more about pediatric tooth decay by reading the Dear Doctor magazine article “Age One Dental Visit — Why It's Important For Your Baby.”

Since the dawn of man, periodontal (gum) disease has impacted humans. And while dental health has dramatically improved over the generations, the facts are still clear — millions of Americans are suffering from gum disease and probably do not even know that they have a problem. This is because periodontal disease most often starts without any symptoms or ones that most people tend to discount or ignore.

Stage 1: Gingivitis. The first stage of gum disease is inflammation of the gingiva (gums) without bone loss. While nearly all people will develop gingivitis in the absence of good oral hygiene, only 10 to 15% of them will go on to develop more advanced stages of the disease.

Stage 2: Early periodontitis. With this stage, gingivitis progresses into the deeper periodontal structures — the tissues that attach the teeth to the bone resulting in early or beginning bone loss. About 10% of the population develops full-blown periodontitis with progressive bone loss.

Stage 3: Moderate periodontitis. The third stage of gum disease results in moderate bone loss (20 to 50%) of root surfaces of the teeth due to continued destruction of the surrounding tissues and bone. Periodontal disease is “cyclical” — it goes in cycles with bursts of activity, followed by a period in which the body tries to recover. This is called chronic inflammation, or frustrated healing.

Stage 4: Advanced periodontitis. With the final stage of gum disease, there is severe bone loss (50 to 85%) from the tooth's root. This stage includes looseness of teeth, moving teeth, abscess formation with red, swollen and painful gums. The end results — eating and even smiling is difficult and uncomfortable, and you could lose all your teeth.

You can learn more about gum disease in the Dear Doctor article, “Understanding Gum Disease.”

Have We Described Your Mouth?

If any of the above stages sounds like we are talking about your mouth, contact us today to schedule a consultation, discuss your questions and receive a thorough exam. If addressed promptly and with commitment to following your treatment plan, your mouth can return to good oral health.