Posts for: September, 2011
It is important to brush your teeth every day to remove plaque (that sticky white film, composed of bacteria, on your teeth near your gums), but it is possible to overdo it — particularly if you find that your teeth are becoming sensitive to hot and cold or to variations in pressure.
Brushing your teeth too hard or too many times per day can aggravate tooth sensitivity, which can range from a mild twinge to a severe pain. You can accomplish the goal of tooth brushing — plaque removal — by using a soft brush with a very gentle action. Repeated aggressive brushing with a hard brush is not required and can even be harmful to your teeth and gums.
To understand how teeth become sensitive, you need to know about the internal structure of your teeth. Teeth are covered by enamel, a hard mineralized coating that protects them from changes in temperature and pressure. If the enamel is worn away, it exposes the next lower layer of the tooth, the dentin. The dentin is a living tissue containing nerve fibers that connect to the nerves in the tooth's root.
Excessive tooth brushing can irritate your gums and cause them to shrink away from your teeth, particularly if you have thin gum tissues. The thickness or thinness of your gum tissues is something you inherit from your parents, so you can't change it. Hard brushing can begin to wear away the enamel covering of your teeth. Exposure to acids or sugars in the foods you eat and drink can continue the damage.
Acidic foods and drinks such as fruit juices dissolve some of the minerals in your teeth by a process called “demineralization.” Fortunately, your saliva can interact with the enamel and bring back minerals that are leaving the tooth's surface. This process is called “remineralization.” It is important to let your healthy saliva wash your teeth's surfaces for a while before brushing so that dissolved minerals get a chance to be returned to your enamel. It takes between twelve and twenty-four hours for plaque to form on your teeth, so you don't need to brush more than twice a day.
The best way to make sure you are brushing your teeth properly is to have us evaluate your brushing technique at your next dental appointment. We will be able to tell you whether you need to change the angle of your brush or the pressure you are applying for the most effective removal of plaque with the least wear on your teeth and gums. Tooth brushing serves an important purpose, but remember that you can actually have too much of a good thing.
The goal of restorative dentistry is to return the teeth to full form (shape) and function. For years, a key tool for achieving this goal has been through the use of metal amalgams (silver looking dental fillings). However, this technique does have some disadvantages. One is the fact that they can involve removal of healthy tooth structure to retain them. Too much “undercutting” can undermine and weaken a tooth resulting in less resistance to biting forces possibly leading to fatigue fractures and cracked tooth syndrome. Another approach is call “biomimetic” which literally means mimicking life. This approach to dentistry is made possible through the structured use of tooth-like materials such as composite resins. Scientific studies and clinical experience have validated their use as both safe and predictable.
By mimicking life, we rely upon our delicate balance of artistry, experience and expertise to provide you with properly restored teeth that function and wear normally, while appearing indistinguishable from natural teeth. Dental composite are now the most commonly used materials for tooth-colored adhesive restorations and have properties similar to a natural tooth's enamel and dentin. They consist of resin which are plastic and fillers made of silica (a form of glass). The fillers give the composites wear resistance and translucency (see through properties). However, most of the properties of enamel are also mimicked quite well by dental porcelains. Porcelains are a form of ceramic, that are formed by the action of heat. Dental porcelains come in all colors and shades so we can easily and perfectly match the color of virtually any natural tooth. As for longevity, porcelain is typically your best option because it is the closest option in mimicking a natural tooth.
To learn more on this subject, you can continue reading the Dear Doctor magazine article “The Natural Beauty of Tooth Colored Fillings.” Or contact us today to schedule an appointment to discuss your specific questions.
CAT scans or Computer Assisted Tomograph scans have been around for years. However, it is quickly becoming the new standard in dentistry. The reasons are clear both literally and figuratively, as they provide our office with millions of pictures so that we can combine them together to create 3-dimensional (3-D) images. Prior to this technology, we could only image the body in 2-dimensions with x-rays (radiographs) — a technology first developed by Roentgen.
One of the best features of CAT scans and CBCT (Cone Beam Computed Tomography) scanning is that they enable us to see and experience the body from the inside. Having this ability changes (and many times) improves upon the way we diagnose. Here's how they work in very simplistic terms. Picture your favorite multi-layered cake with each layer representing an image. A three-layer cake requires just three images. For us to build a 3-D image similar to the cake, we require millions of very thin layers (images) that we put together, one on top of another, until our results, one 3-D image. And by having so many thin layers, we are best able to diagnose. For example, in our cake analogy, it is easier to determine if the cake contains finely chopped nuts, berries or other ingredients when you cut numerous very thin slices of cake to examine versus having one large chunk of cake.
It is important to note that in our office we may not recommend using this technology in all cases, as it may not be necessary for your particular diagnosis and/or treatment. While the technology can prove invaluable, it is quite expensive and a simple 2-D x-ray may provide everything we need. However, some dental specialty areas where CAT scans are currently used include:
- Orthodontists and pediatric dentists
- Cosmetic dentists and tooth replacement specialists (prosthodontists)
- Oral surgeons
- Root canal specialists (endodontists)
- Gum specialist (periodontists)
To learn more about CAT scans and how they are used in the various specialty areas, read the Dear Doctor magazine article “CAT Scans in Dentistry.” Or you can contact us today to schedule an appointment to discuss your specific questions.
We know from research extending back to the 1930s that very small amounts of fluoride in drinking water can significantly reduce dental caries (cavities) with no negative health effects. Fluoridated water is currently available to 70% of all Americans. However, we have also learned that excess fluoride from combined sources can result in staining of teeth called “fluorosis.”
What is the optimum fluoride concentration for healthy teeth?
A fluoride concentration of about 0.7-1.20 milligrams per liter (mg/L), or .7 to 1.2 ppm (parts per million), in the water supply seems to be optimum for dental health without causing negative effects. This concentration is about the same as a grain of salt in a gallon of water. An amount of 1 ppm was originally considered the safe standard, but since today Americans have access to more sources of fluoride than they did when water fluoridation was first introduced, the recommended amount has been reduced to .7 mg/L or .7 ppm.
The crucial amount to measure is the quantity of fluoride that is swallowed. Generally, the optimal level of fluoride per day from all sources is thought to be about .06 milligrams per kilogram of body weight, or about a sixth of the weight of a grain of salt for every two pounds of body weight.
It is probably not possible to calculate the precise amount of fluoride each person ingests per day, because the amount depends on more than just the amount of tapwater you drink. Bottled waters, soft drinks and juices also contain fluoride. Breast milk and cow's milk are very low in fluoride, but infant formulas may contain higher levels. Foods found to have high fluoride content include teas, dry infant cereals and processed chicken, fish and seafood products. Toothpaste can contribute to a child's total fluoride intake if the child swallows it.
What are the effects of too much fluoride?
Dental fluorosis produces a “mottling” of the outer coating of the tooth, the enamel. Mottling may show as staining ranging from small white striations to stained pitting and severe browning of the enamel surface.
The first six to eight years of life is the most risky time for development of dental fluorosis. Parents need to monitor their children to make sure they use small amounts of fluoride toothpaste (an amount the size of a pea on the brush is recommended). Watch for white spots on the enamel (hard outside coating) of your child's teeth. White spots from fluorosis mean it is time to pay attention to how much fluoride your child is getting from various sources, and to cut back on the total. You want fluoride's protection against cavities for your child's teeth, without the unsightliness of dental fluorosis from too much fluoride.
Contact us today to schedule an appointment to discuss your questions about fluoride. You can also learn more by reading the Dear Doctor magazine articles “Fluoride & Fluoridation in Dentistry” and “New Fluoride Recommendations.”