Posts for: November, 2013
Dental plaque (a film of bacteria that forms on your teeth) is known to be the main cause of periodontal (gum) disease. When the bacteria settle on your teeth they form a whitish film called biofilm. Those that are not removed cause formation of “pockets,” areas of separation between the teeth and their surrounding gums, in which plaque hardens into deposits known as calculus or tartar. The purpose of having your teeth cleaned regularly by a trained professional hygienist is to remove deposits of plaque and calculus. Removal of hard deposits on your teeth is called “scaling.” This can be done either by using hand-held scalers or by newer technology: ultrasonic power scalers.
Let's take a look at the strengths and weaknesses of both types of instruments.
How they work: These instruments use the energy of ultrasonic vibration to crush and remove hard, calcified deposits of calculus. They also create shockwaves that disrupt bacterial cells. Use of these tools includes washing and flushing the pockets and any exposed root surfaces with water.
Pros: They are as effective as manual instruments for calculus removal in shallow gum pockets and significantly more effective in pockets greater than 4mm. They are very effective in removing calculus from root surfaces and from within periodontal pockets. Their small tips can penetrate deeper into periodontal pockets than manual instruments and are more comfortable to experience, and they are more effective for cleaning difficult nooks and crannies. Coolant sprays flush the area and remove bacteria and their by-products. They require less time than manual instruments.
Cons: A contaminated mist may form so that the hygienist needs to wear protective equipment. The vibration of the ultrasonic instruments may make it difficult to feel if the root surface is completely smooth and free of calculus. Power scalers affect some heart pacemakers.
Conventional Hand-held Scalers
How they work: These depend on the skill and knowledge of the hygienist to manipulate them and scrape away calculus (tartar) from teeth and within pockets.
Pros: They are equally effective for plaque and calculus removal from shallow gum pockets. They do not interfere with electronic equipment like heart pacemakers. They can be used more easily on teeth in which there are areas of demineralization (areas where minerals have been removed from the tooth's enamel, making it more vulnerable to decay). They are easier on the tooth's surface and are thus better for use with porcelain or composite restoration, or sensitive teeth.
Cons: They take longer to complete a cleaning. Sometimes they cause more discomfort than ultrasonic scalers.
In most cases the choice of scalers is not really an either/or situation. Most experts say that the best results come through using both types of instruments. As a result, cleanings can be done with effective and efficient outcomes and greater patient comfort.
Contact us today to schedule an appointment to discuss your questions about dental cleanings. You can also learn more by reading the Dear Doctor magazine article, “Dental Cleanings Using Ultrasonic Scalers.”
It’s indisputable that fluoride has revolutionized dental care. Decades of research have overwhelming shown this natural, enamel-strengthening chemical has decreased tooth decay.
Too much fluoride, though, can cause enamel fluorosis, a permanent staining of tooth enamel. In its mildest form, the teeth develop faint whitish streaks; in more severe cases, the staining is noticeably darker and the teeth appear pitted. The teeth themselves aren’t damaged, but the unsightly staining could require cosmetic treatment. Children under age 9 (when permanent teeth enamel matures) are especially at risk of fluorosis due to over-fluoridation.
Because of fluoride’s prevalence in hygiene products and many drinking water supplies, it’s not always easy to know if your child is receiving too much. There are two areas, though, that bear watching.
First, you should limit the serving quantity of fluoride hygiene products, particularly toothpaste. Children tend to swallow rather than spit out toothpaste after brushing, so they ingest more fluoride. We recommend a small “smear” of toothpaste on the brush for children under two, and a pea-sized amount for children two to four.
The other concern is your drinking water. Three-quarters of America’s water systems add fluoride, usually to a recommended level of 0.70 PPM (parts per million). To know if your water supply adds fluoride and at what levels, you can contact your local water utility or health department, or check the Center for Disease Control’s website for their “My Water’s Fluoride” program (http://apps.nccd.cdc.gov/MWF/Index.asp). This site will have information if your water system participates in the program.
If your area exceeds recommended levels or is at high risk for fluorosis, we recommend reducing the use of tap water in infant formula. Besides breast-feeding (human breast milk is low in fluoride), you can use either ready-to-feed formula, or mix powdered formula with water specifically labeled “de-ionized,” “purified,” “de-mineralized,” or “distilled.”
One thing you should not do is eliminate your use of products containing fluoride — this may increase your child’s risk of tooth decay. The consequences of decay can be serious and have a life-long effect — and far outweigh the risks of fluorosis staining.
If you would like more information on fluoride and your infant, 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.”
Not only can orthodontic treatment transform your smile, it can also restore function to your teeth and mouth that will improve both your oral and general health. But any treatment to straighten misaligned teeth requires careful planning. Depending on the exact nature of your misalignment, there may be some additional steps we would need to perform before undertaking orthodontic treatment.
One common need is space to help relieve overcrowding. To make room for tooth movement, often a tooth may need to be removed if the crowding is excessive. The most likely candidates are the first bicuspids, teeth located between the cuspids (or eyeteeth, located in line under the eyes) and the second premolar located in front of the molar teeth. The removal of these first premolars won't have a great effect on future form or function. Under the gentle pressure exerted by the braces, neighboring teeth will move and fill in the open space. Today's orthodontist goes to great lengths to avoid removing any teeth; in severe overcrowding, though, this is an acceptable way to create needed space.
Damaged teeth in need of replacement may also be removed before orthodontics and certainly more desirable — if any tooth needed to be removed, you would always choose a damaged tooth first. The object is to first preserve the underlying bone and close the space to avoid replacing that tooth or, if not possible, maintain the correct amount of space for any future restoration.
As living tissue, bone constantly reshapes in response to its environment. If it no longer senses a tooth (or the forces exerted by a tooth when biting or chewing), the bone will slowly disappear through a process known as bone resorption. To counteract this process, we may graft material (like processed donor bone) into the socket to encourage and maintain bone growth. This creates a platform for future tooth replacements like implants or bridgework after orthodontic treatment.
After orthodontics, it may also be necessary to install some type of “placeholder” (temporary bridgework or partial denture) in the area of missing teeth. Keeping the teeth from migrating into the space will improve the chances that any permanent restoration like an implant or fixed bridgework will look natural — as if it belonged there the entire time.
A complete dental examination will indicate whether any teeth need to be removed before undergoing orthodontic treatment. If necessary, taking this strategic step will help ensure we achieve the best result — a winning smile.
If you would like more information on tooth removal and other options to enhance orthodontics, 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 Removal for Orthodontic Reasons.”
OK, so you've been getting orthodontic treatment for what seems like a long time, and finally, your braces are about to come off! Now you're home free, right?
Well, almost… but now comes the final part of your treatment: the retention phase. That means you'll need to wear a retainer. Most people find that a retainer is more comfortable than braces — but because it is often removable, there's the temptation to just leave it off. Don't do it! Here are the top five reasons why you should always wear your retainer as instructed:
1) A retainer helps to make your teeth stable in their new positions.
Your teeth aren't rigidly set in stone (or in bone) — instead, they are held in place by a hammock-like set of ligaments, and the bone that surrounds them is somewhat pliable. That's a good thing… because, otherwise, they would be even harder to move! But it means that it will take some time for the bone and ligament around the teeth to re-form and stabilize in its new position. A retainer holds them in position while that is happening.
2) If you don't wear it, your brand-new smile may not stay looking the way it should.
Did you know that your bone and gum tissue have some “memory?” Unfortunately, it's not the kind that could help you on a science quiz — but teeth can “remember” where they used to be located… and, if you leave them alone, they may try and go back there! A major goal of the retainer is to keep your new smile looking great! If you don't wear it, and your teeth shift back, you risk losing all the time (and money) you invested.
3) There are different types of retainers available; one of them might be just right for you.
At one time, all retainers were made of pink plastic and silvery wire, and were removable. That kind is still available, but now you may have a choice of different colors or patterns — you might even be able to customize yours! Another alternative that may be appropriate is a clear retainer that fits over your teeth, making it nearly invisible. In some cases, you can have a thin wire bonded to the inside of the teeth instead of a removable retainer. It doesn't show, and you don't have to worry about taking it out.
4) As time goes on, you'll probably need to wear your retainer less and less.
At first, you'll probably need to wear your retainer all the time, but after a while you may only have to wear it at night — a lot easier to manage! Think of it as a way of easing yourself out of orthodontic treatment — and into a brand-new smile. The retention stage also helps your teeth avoid damage by allowing the process to end slowly and gently.
5) Lots of celebrities wear them.
If we know who, we aren't telling — but let's just say that several young entertainers and a recently married British Prince have worn retainers, or are still wearing them. So, you're in good company!
If you would like more information about orthodontic retainers, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Why Orthodontic Retainers?” and “The Importance of Orthodontic Retainers.”