Gum disease (gingivitis) and tooth decay are primarily caused by dental plaque. Dental plaque is a whitish, sticky film that accumulates daily along the gumline and on the surfaces of your teeth. Composed of bacteria, it is controllable through good oral hygiene habits — most importantly, effective brushing.

Controlling plaque and preventing gingivitis and tooth decay will make it more likely that you keep your teeth through your lifetime and will also improve your general health. Scientific studies have linked gum disease and diseases of the heart and circulatory system.

“I know how to brush my teeth. I've been doing it since I was a toddler,” you may be saying. But you may not be performing this daily ritual in the most effective way.

Let's take another look at tooth brushing. First, your grip: Hold the brush in your fingertips with a light pressure. Position the brush so the bristles are at a 45 degree angle to your gumline, and then brush with a gentle scrubbing motion. Don’t scrub too hard, or you may damage your sensitive gum tissue.

Some electric brushes can remove plaque more quickly than a regular hand-held brush, but if you brush well any kind of brush works. A brush will last several months. Get a new one when the bristles become worn or splayed out.

Use a toothpaste that contains fluoride. When used consistently, fluoride toothpastes make your teeth more resistant to decay. Spit out the toothpaste after brushing, but don't rinse or you will wash the fluoride away.

After brushing, complete your cleaning job by using floss to clean between your teeth where the brush does not reach. Wrap it in a “C” shape around each tooth and move it vertically up and down, removing plaque from the tooth surfaces where your teeth meet. You can also use an antibacterial mouth rinse.

Thoroughly clean your teeth at least once a day, brushing and flossing. A plaque film takes 12 to 24 hours to form itself again.

To be certain you are brushing correctly, ask our office or one of our hygienists to demonstrate brushing techniques for you in your own mouth. You can also assess the quality of your brushing technique by checking with your tongue after brushing to make sure your tooth surfaces feel smooth and slick. Your gums should not bleed after brushing. Bleeding is a sign of infection. If you have a habit of consistent brushing but your gums continue to bleed, it's time for a visit to our office.

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.”

Why is it important to replace missing teeth with restorations such as dental implants? You might be surprised to find that the damage caused by missing teeth is much greater than the simple gaps left in your smile.

As the years go by, teeth lost early in adulthood cause structural changes in a person's face. By age 45 changes in facial structure are already visible in the form of sunken cheeks. By 60, cheeks and lips lose their support, resulting in an aging look. This process continues and if the teeth are not replaced, much of the structural support of the person's face is lost.

These changes are caused by loss of bone. Although it may seem static, bone is actually living tissue that needs constant stimulation to maintain its form and density. With normal stimulation it is in a constant state of resorption (breaking down) and deposition (building up). Teeth provide the needed stimulation for the bone that surrounds them (called alveolar bone) as they meet each other during biting, chewing, and speech. When the stimulation continues, the bone continues to rebuild itself. Without this stimulation, the bone resorbs, does not build up again, and loses substance.

Without stimulation, alveolar bone loses width, height, and volume. Since your teeth and their surrounding bone support your chin, cheeks, and lips, this has a powerful effect on your appearance. It may also affect your ability to chew and to speak.

As alveolar bone diminishes, the next layer of bone also begins to resorb. This is the bone of the jaw itself. The lower part of the face begins to collapse, and the cheeks become hollow. This effect is especially noticeable for people with no teeth (edentulous).

Usually the first tooth to be lost, due to infection and decay, is a molar (back tooth). In the past, a missing single back tooth was frequently replaced by a fixed partial denture (FPD). A crown is provided for each of the two teeth on the sides of the gap, called abutment teeth, to support a false tooth in the middle. However, if they are not well cared for, the abutment teeth may be the next to succumb to decay.

Today the treatment of choice is an implant. A dental implant is a tooth-root replacement made of titanium, which fuses with the bone — making it very stable. Above the gums it is covered by a crown that looks like a natural tooth. The benefit of the implant is that it continues to provide stimulation to the alveolar bone, preventing bone loss.

Implants are also a good choice in the case of multiple missing teeth. They can be used to support bridges or false teeth (dentures). The results are an improved, younger appearance and better functionality.

Contact us today to schedule an appointment to discuss your questions about missing teeth. You can also learn more by reading the Dear Doctor magazine article “The Hidden Consequences of Losing Teeth.”

Grinding, clenching, and gritting your teeth are common reactions to stress — but their results can be quite complex. Here are some questions and answers that will fill you in on what you may not know about this widespread problem.

My dentist said I was bruxing. What does that mean?
Bruxing means that your teeth are grinding upon each other. Many people carry out this habit subconsciously and are not even aware that they are doing it.

Is bruxing or gritting harmful?
Such habits are called “parafunctional” (from para, meaning outside, and function, meaning purpose). This is because these stress habits exert much larger biting forces — as much as ten times more — than in normal biting and chewing activities. This excess pressure can cause damage to jaw joints and muscles, resulting in muscle spasm and pain; and to the teeth, resulting in wear, fractures or looseness. They can also cause headaches, earaches, and even neck and backaches because of the pressures on various structures in the face and mouth.

What is the usual treatment for problems arising from these stress habits?
The first thing we want to do is relieve your pain and discomfort. Second, we want to stop future damage. Application of heat or cold is helpful, and mild anti-inflammatory and muscle relaxant drugs are prescribed for pain and muscle spasm. To prevent future occurrences, we may treat you with biofeedback or refer you to someone who can offer psychotherapy.

What is a night guard and how can it help?
A night guard is an unobtrusive thin plastic appliance that is made to fit over the biting surfaces of your upper teeth. These guards are so unobtrusive that they can even be worn during the day if your stress level is so high that you grind your teeth during the day. The guard is adjusted to leave the lower teeth free to move against the surface of the guard, but they cannot bite into the upper teeth. This prevents wear on the teeth and lets the jaw muscles relax, preventing the pain of muscle spasm.

Contact us today to schedule an appointment to discuss your questions about stress and tooth grinding. You can also learn more by reading the Dear Doctor magazine article “Stress & Tooth Habits.”

According to the Centers for Disease Control and Prevention (CDC), community water fluoridation has been a safe and healthy way to prevent tooth decay effectively for over 65 years now. In fact, the CDC has recognized water fluoridation as one of the 10 great public health achievements of the 20th century.

It all began back in the 1930's when it was discovered that fluoride had oral health benefits. However, community water fluoridation did not begin until January 25, 1945, when Grand Rapids, Michigan became the first city to add fluoride to its municipal water system. Before it was officially rolled out in other cities, Grand Rapids was compared to other cities or “controlled groups” that had not added fluoride to their water so that scientific research could assess the relationship between tooth decay and fluoride. Well, you can guess the results — it was proven that fluoride helped reduce tooth decay when added to ordinary tap water. On November 29, 1951, the National Academy of Sciences’ National Research Council (NRC) declared water fluoridation safe, effective, and beneficial based upon the results of their findings and the fact that there was a dramatic decline in tooth decay in the children of Grand Rapids.

Ever since, fluoride has continued to play a critical role as a simple, safe, effective way to provide improved oral health by helping reduce tooth decay in the United States. This reality is still being demonstrated with each new generation benefiting from better oral health than the previous generation.

As for identifying when the time is right to introduce fluoride to your children's oral health program, ask us. Most children get the right amount of fluoride to help prevent cavities if they drink water that contains fluoride. And if by chance you live in an area where your tap water is not fluoridated, brush your children's teeth with no more than a pea-sized amount of fluoride toothpaste twice a day and ask your dentist about fluoride supplements and treatment.

Learn more on this topic by reading the Dear Doctor article, “Fluoride And Fluoridation In Dentistry.”

A pregnant woman has a lot to think about while preparing to welcome a new member of her family. It's important to think about her oral health as well. She is sharing her body with the developing infant, so problems with her health — including her dental health — can affect the baby. The following facts will help you understand the relationship between oral health and pregnancy.

1. A baby's primary (baby) teeth begin to form during the sixth week of pregnancy. They begin to form their enamel (the hard outer layer of the teeth) and dentin layer (just under the enamel) at about the third or fourth month. The calcium, phosphorous, and protein that are needed for these structures must all be provided by the mother's diet.
2. A good diet for a pregnant mother, in order to provide for both her needs and those of the fetus (the developing baby), includes whole grains, fruits, vegetables — including green leafy vegetables — proteins and dairy products. A doctor may also recommend iron and/or folic acid supplements.
3. If the mother's diet does not provide enough calcium for the baby's bones and teeth, it will come from calcium stored in her bones — not from her teeth. The old idea that a mother's teeth lose calcium during pregnancy has been found to be a myth.
4. Progesterone, a normal female hormone, is elevated during pregnancy. This hormone stimulates production of prostaglandins, substances that cause inflammation in gum tissues if the bacteria that cause periodontal (gum) disease are present. The resulting swelling, redness, and sensitive gum tissues, called pregnancy gingivitis, are common during the second to eighth months of pregnancy.
5. The bacteria involved in periodontal disease can affect whole body conditions such as heart disease and strokes, diabetes, and respiratory diseases. The inflammation resulting from such bacteria can also cause premature delivery (birth before 37 weeks of pregnancy) or low birth weight in the baby.
6. Periodontal disease is also related to pre-eclampsia, or high blood pressure, during pregnancy.
7. Dental x-rays do not expose the mother to very high radiation, but in any case every precaution is taken to minimize exposure to the fetus. These include a leaded apron that shields the baby from exposure.
8. Most drugs commonly used in dentistry, including local anesthetics, can safely be given to pregnant women without affecting the fetus. However, it is important to let your dentist know you are pregnant before embarking on any treatment to make sure anything that is done will be safe for the fetus and its developing teeth.

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