Dental implants have soared in popularity thanks to their life-likeness, functionality and durability. But these prized qualities have also created an ironic downside—people are much more likely to replace a tooth with an implant rather than go through the time and effort to preserve it.
We say downside because even though an implant is as close to a real tooth as we can now achieve in dentistry, it still can't rival the real thing. It's usually in your long-term health interest to save a tooth if reasonably possible. And, there are effective ways to do so.
Most dental problems arise from two common oral diseases. One is tooth decay, caused by contact with acid produced by bacteria living in dental plaque. We can often minimize the damage by treating the early cavities decay can create. But if we don't treat it in time, the decay can advance into the tooth's pulp chamber, putting the tooth in danger of loss.
We can intervene, though, using root canal therapy, in which we drill into the tooth to access its interior. We clean out the decayed tooth structure, remove the diseased pulp tissue and fill the empty chamber and root canals to seal the tooth and later crown it to further protect it from re-infection.
Periodontal (gum) disease also begins with bacteria, but in this case the infection is in the gum tissues. Over time the ensuing inflammation locks into battle with the plaque-fueled infection. This stalemate ultimately weakens gum attachment, the roots and supporting bone that can also increases risk for tooth loss.
We can stop a gum infection through a variety of techniques, all following a similar principle—completely removing any accumulated plaque and tartar from the teeth and gums. This stops the infection and starts the process of gum and bone healing.
You should be under no illusions that either of these approaches will be easy. Advanced tooth decay can be complex and often require the skills of an endodontist (a specialist in root canals). Likewise, gum disease may require surgical intervention. But even with these difficulties, it's usually worth it to your dental health to consider saving your tooth first before you replace it with an implant.
If you would like more information on how best to treat a problem tooth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Save a Tooth or Get an Implant?”
Although cancer treatment has advanced steadily in recent decades, the most used therapies continue to be radiation and chemotherapy to eradicate cancerous cells. And while they often work, both can cause "collateral damage" in healthy tissues near the targeted cells.
This can create a number of indirect consequences for a patient's health, including in the mouth. The salivary glands, for example, can be damaged by radiation treatments aimed at the head or neck. The effect on these glands can interrupt the normal flow of saliva and cause xerostomia or "dry mouth."
Lack of adequate saliva causes more than an unpleasant, sticky mouth feeling. One of saliva's main functions is to neutralize acid that builds up naturally after eating. Without it, high acid levels can cause enamel and root surface erosion and lead to tooth decay.
Cancer treatment can also contribute to gastro-esophageal reflux disease (GERD). This disease causes stomach acid to bypass the natural tissue barriers of the esophagus and enter the mouth. As with dry mouth, the increased acid level from GERD can be just as devastating to enamel—and the damage will be permanent.
To minimize these effects on your dental health, it's important to take proactive steps before, during and after cancer treatment. If at all possible, have any needed dental work performed before you begin radiation or chemotherapy—it's better to start it with teeth and gums as healthy as possible.
During treatment, try to continue regular dental visits to monitor your oral health and receive any needed preventive or therapeutic treatments. Depending on your condition and the advice of your dentist, you may need to increase your visit frequency during this time. Your dentist can help with boosting your saliva production and strengthening your tooth enamel. But you should also practice daily brushing and flossing, drink plenty of water and seek treatment for any resulting GERD symptoms.
Even with the best efforts, though, your teeth and gums may still incur damage while treating your cancer. Fortunately, there are a wide array of materials and procedures that can effectively restore them to health. So, once your treatments are completed consult with a dentist on your options for improving the health and appearance of your teeth and gums.
Sometimes, looking at old pictures can really bring memories back to life. Just ask Stefani Germanotta—the pop diva better known as Lady Gaga. In one scene from the recent documentary Five Foot Two, as family members sort through headshots from her teen years, her father proclaims: "Here, this proves she had braces!"
"If I had kept that gap, then I would have even more problems with Madonna," Lady Gaga replies, referencing an ongoing feud between the two musical celebrities.
The photos of Gaga's teenage smile reveal that the singer of hits like "Born This Way" once had a noticeable gap (which dentists call a diastema) between her front teeth. This condition is common in children, but often becomes less conspicuous with age. It isn't necessarily a problem: Lots of well-known people have extra space in their smiles, including ex-football player and TV host Michael Strahan, actress Anna Paquin…and fellow pop superstar Madonna. It hasn't hurt any of their careers.
Yet others would prefer a smile without the gap. Fortunately, diastema in children is generally not difficult to fix. One of the easiest ways to do so is with traditional braces or clear aligners. These orthodontic appliances, usually worn for a period of months, can actually move the teeth into positions that look more pleasing in the smile and function better in the bite. For many people, orthodontic treatment is a part of their emergence from adolescence into adulthood.
Braces and aligners, along with other specialized orthodontic appliances, can also remedy many bite problems besides diastema. They can correct misaligned teeth and spacing irregularities, fix overbites and underbites, and take care of numerous other types of malocclusions (bite problems).
The American Association of Orthodontists recommends that kids get screened for orthodontic problems at age 7. Even if an issue is found, most won't get treatment at this age—but in some instances, it's possible that early intervention can save a great deal of time, money and effort later. For example, while the jaw is still developing, its growth can be guided with special appliances that can make future orthodontic treatment go quicker and easier.
Yet orthodontics isn't just for children—adults can wear braces too! As long as teeth and gums are healthy, there's no upper age limit on orthodontic treatment. Instead of traditional silver braces, many adults choose tooth-colored braces or clear aligners to complement their more professional appearance.
So if your child is at the age where screening is recommended—or if you're unhappy with your own smile—ask us whether orthodontics could help. But if you get into a rivalry with Madonna…you're on your own.
If you have questions about orthodontic treatment, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Magic of Orthodontics” and “Orthodontics For The Older Adult.”
There are a number of lifestyle changes you can make if you want to reduce your risk of oral cancer, with quitting a tobacco habit at the top of the list. You should also moderate your alcohol consumption and practice safe sex to prevent the spread of the human papilloma virus (HPV 16) linked to oral cancer.
And there's one other area that might be ripe for change—your diet. The foods we consume can work both ways in regard to cancer: some, especially processed products with certain chemicals, increase your cancer risk; more natural foods, on the other hand, can help your body fight cancer formation.
Although how cancer forms and grows isn't fully understood, we do know some of the mechanisms involved. One major factor in cancer growth is damage to DNA, the molecule that contains all the instructions for normal cell growth. Certain chemicals called carcinogens cause much of this DNA damage.
One example of these dangerous chemicals are nitrosamines, found in substances used to preserve meats like bacon or ham. Nitrosamines also occur in beer during the brewing process, some fish and fish products, processed cheese and foods pickled with nitrite salt. It's believed long-term consumption of foods with these chemicals can increase the risk of cancer.
On the other hand, there are foods with substances called antioxidants that help our bodies resist cancer. Antioxidants protect cells from unstable molecules called free radicals that can also damage DNA. You'll find antioxidants in abundance in fresh fruits and vegetables, especially those high in fiber. Vitamins like C and E found in many natural foods also have antioxidant properties.
So, to help keep your risk of cancer and other diseases low, make sure your diet includes mostly fresh fruits and vegetables, along with plant-based fats found in nuts or olive oil. At the same time minimize your consumption of processed foods with preservatives and other chemicals, along with animal and saturated fats.
A change in eating not only reduces your cancer risk, it can also improve your overall health and well-being. You'll also find a healthy diet can be dental-friendly—it can help keep your teeth and gums disease-free and healthy.
If you would like more information on dental-friendly nutrition practices, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Diet and Prevention of Oral Cancer.”
Fluoride is a critical weapon in the war against tooth decay. But this natural chemical proven to strengthen tooth enamel has also aroused suspicion over the years that it might cause health problems.
These suspicions have led to rigorous testing of fluoride's safety. And the verdict from decades of research? We've found only one verifiable side effect, a condition called enamel fluorosis. Caused by too much fluoride present in the body, enamel fluorosis produces white streaks and patches on teeth, and can develop into darker staining and pitting in extreme cases. But other than having an unattractive appearance, the teeth remain sound and healthy.
Fortunately, you can reduce the risk of fluorosis by limiting fluoride exposure to within recommended limits. Fluoride can show up in processed foods and other substances, but the two sources you should focus on most are oral hygiene products and fluoridated drinking water.
Dentists highly recommend using toothpaste with fluoride to fight tooth decay. But be careful how much your family uses, especially younger members. An infant only needs a slight smear of toothpaste on their brush for effective hygiene. At around age 2, you can increase the amount to about the size of a vegetable pea.
As to drinking water, most utilities add fluoride to their supply. If yours does, you can find out how much they add by calling them or visiting cdc.gov ("My Water's Fluoride"), where you can also learn more about recommended levels of fluoridation. If you think it's excessive, you can switch to water labeled "de-ionized," "purified," "demineralized," or "distilled," which contain little to no added fluoride.
Even if your fluoridated water is within recommended levels, you may wish to take extra precautions for infants nursing with formula. If possible, use "ready-to-feed" formula, which usually contains very low amounts of fluoride if any. If you're using the powdered form, use only water with the aforementioned labeling for mixing.
Before making any drastic changes that might affect your family's fluoride intake, consult with your dentist first. And be sure you're keeping up regular dental visits—your dentist may be able to detect any early signs of fluorosis before it becomes a bigger problem.
If you would like more information on maintaining the proper fluoride balance with your family, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Tooth Development and Infant Formula.”
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