Since the 1950s fluoride has played an important role in the fight against tooth decay as an additive to hygiene products and many public water supplies. But although a proven cavity fighter, some have questioned its safety over the years.
To date, though, the only substantiated health risk from fluoride use is a condition known as enamel fluorosis, which occurs when too much fluoride is ingested during early tooth development as the mineral embeds in the tooth structure. Fluorosis can cause changes in the enamel’s appearance, ranging from barely noticeable white streaking to darker visible staining and a pitted texture.
Fluorosis is primarily a cosmetic problem and not a serious health issue. The staining on otherwise sound teeth, however, is permanent and more severe cases may require extensive bleaching treatment to improve appearance. The best strategy is to prevent fluorosis by monitoring and limiting your child’s fluoride intake, until about age 9.
Tooth decay is a more serious condition than fluorosis so we’re not advocating you eliminate fluoride but that you keep your family’s intake within safe levels. The first step is to determine just how much that intake is now, particularly if you drink fluoridated water. If you have public water, you may be able to find its fluoridation level online at apps.nccd.cdc.gov or call the utility directly.
You should also be careful about the amount of toothpaste your child uses to brush their teeth. Children under two need only a trace (a “smear”) on the brush, and children between the ages of 2 and 6 a pea-sized amount. And, they should brush no more than twice a day.
Another possible concern is infant formula, especially mixable powder. While the formula itself doesn’t contain fluoride, water mixed with it may. If you live in an area with increased fluorosis risk, consider breast-feeding (breast milk has little fluoride), using ready-to-feed formula, or mixing powdered formula with bottled water labeled “de-ionized,” “purified,” “demineralized” or “distilled.”
We’ll be glad to help assess your family’s current fluoride intake and advise you on making adjustments to bring it into normal ranges. Taking in the right amount of fluoride assures you and your children receive the most benefit and protection from it, while avoiding future smile problems.
If you would like more information on managing your family’s fluoride intake, please contact us today to 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.”
If you regularly participate in sports or other physical activity, you’re at a higher risk for dental injuries. While chipped teeth are the most common result of these injuries, a few may result in more serious trauma — dislodged, cracked or knocked out teeth. In these cases, the core of the tooth — the pulp — and the root may have been damaged. Saving the tooth may require endodontic treatment and possibly the expertise of a specialist in the field, an endodontist.
Endodontics, from the Greek words for “within” and “tooth,” is a specialty of dentistry that treats disease or damage affecting the inner parts of a tooth, particularly the pulp chamber, the root canals, and the root. While all dentists are trained in endodontic procedures, an endodontist has advanced training, experience and specialized equipment to address complex cases.
The type of endodontic treatment needed for an injured tooth will depend on the extent of damage. A mature, permanent tooth with pulp damage, for example, may require a root canal treatment. In this procedure the pulp chamber and root canals are thoroughly cleaned out, and then are filled with a special filling to prevent any future infection. Later the tooth should be crowned to permanently seal it. Although a general dentist may perform a root canal, more complex cases, such as a tooth with an extensive root canal network, may need to be performed by an endodontist using microscopic equipment.
A tooth that has undergone severe trauma, especially a knocked out tooth, will need extensive follow-up care by a general dentist and possibly an endodontist to improve its chances of long-term survival. Because of the severity, the tooth may lose viability and the body ultimately may begin to reject it. For this reason, the tooth should be monitored on a regular basis and may need further treatment from time to time, even up to five years after the injury.
One final word: if you participate in sports or exercise activity, you can significantly reduce your risk of dental injury with a mouthguard. There are various types, but the best protection is one custom designed to fit the specific contours of your mouth. We’ll be glad to advise you further on how to protect your teeth from injury.
If you would like more information on dental injury prevention and treatment, 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 “Trauma & Nerve Damage to Teeth.”
The electronic cigarette (e-cig), the much-acclaimed smoking alternative, has recently been linked to hundreds of lung-related illnesses and deaths among otherwise healthy young adults. But dentists were actually among the first to sound alarm bells on the potential harm of “vaping,” particularly to dental health.
If you're vaping as a substitute for smoking, you may be trading one set of oral health risks for another. Many dentists believe vaping may be no safer for your mouth than traditional tobacco.
An e-cig is a small, handheld device that holds a mixture of water, flavoring and chemicals. The device heats the liquid until it becomes a gaseous aerosol the user inhales into their lungs. Proponents say it's a safer and cleaner alternative to smoking. But, like cigarettes, vaping mixtures can contain nicotine. This chemical constricts blood vessels, decreasing nutrients and infection-fighting agents to the gums and increasing the risk of gum disease.
And although vaping flavorings are FDA-approved as a food additive, there's some evidence as an aerosol they irritate the mouth's inner membranes and cause mouth dryness similar to smoking. Vaping liquids also contain propylene glycol for moisture preservation, which some studies have shown increases a buildup of plaque, the bacterial film most responsible for dental disease.
All of these different effects from vaping can create a perfect storm in the mouth for disease. So, rather than switch to vaping, consider quitting the tobacco habit altogether. It's a solid thing to do for your teeth and gums, not to mention the rest of the body.
As we commemorate the Great American Smokeout on November 21, this month is the perfect time to take action. Here are some tips to help you kick the habit.
Don't try to quit all at once. Your body has developed a physical connection with nicotine, so quitting “cold turkey” can be extremely difficult and unpleasant. Although different approaches work for different people, you may find it easier to overcome your habit by gradually reducing the number of cigarettes you smoke each day.
Enroll in a cessation program. There are a number of step-by-step programs, some involving medication, that can help you quit smoking. Talk to us or your doctor about using a cessation program to end your tobacco habit.
Seek support from others. Beating the smoking habit can be tough if you're trying to do it solo. Instead, enlist the help of family and friends to support you and keep you on track. Consider also joining a supervised support group for quitting smoking near you or online.
Smoking can harm your dental health and vaping may be just as harmful. Distancing yourself from both habits will help you maintain a healthier smile and a healthier life.
If you would like more information about the effects of vaping and tobacco use, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Vaping and Oral Health” and “Smoking and Gum Disease.”
As the host of America's Funniest Home Videos on ABC TV, Alfonso Ribeiro has witnessed plenty of unintentional physical comedy…or, as he puts it in an interview with Dear Doctor–Dentistry & Oral Health magazine, "When people do stuff and you're like, 'Dude, you just hurt yourself for no reason!'" So when he had his own dental dilemma, Alfonso was determined not to let it turn onto an "epic fail."
The television personality was in his thirties when a painful tooth infection flared up. Instead of ignoring the problem, he took care of it by visiting his dentist, who recommended a root canal procedure. "It's not like you wake up and go, 'Yay, I'm going to have my root canal today!'" he joked. "But once it's done, you couldn't be happier because the pain is gone and you're just smiling because you're no longer in pain!"
Alfonso's experience echoes that of many other people. The root canal procedure is designed to save an infected tooth that otherwise would probably be lost. The infection may start when harmful bacteria from the mouth create a small hole (called a cavity) in the tooth's surface. If left untreated, the decay bacteria continue to eat away at the tooth's structure. Eventually, they can reach the soft pulp tissue, which extends through branching spaces deep inside the tooth called root canals.
Once infection gets a foothold there, it's time for root canal treatment! In this procedure, the area is first numbed; next, a small hole is made in the tooth to give access to the pulp, which contains nerves and blood vessels. The diseased tissue is then carefully removed with tiny instruments, and the canals are disinfected to prevent bacteria from spreading. Finally, the tooth is sealed up to prevent re-infection. Following treatment, a crown (cap) is usually required to restore the tooth's full function and appearance.
Root canal treatment sometimes gets a bad rap from people who are unfamiliar with it, or have come across misinformation on the internet. The truth is, a root canal doesn't cause pain: It relieves pain! The alternatives—having the tooth pulled or leaving the infection untreated—are often much worse.
Having a tooth extracted and replaced can be costly and time consuming…yet a missing tooth that isn't replaced can cause problems for your oral health, nutrition and self-esteem. And an untreated infection doesn't just go away on its own—it continues to smolder in your body, potentially causing serious problems. So if you need a root canal, don't delay!
If you would like additional information on root canal treatment, please contact us or schedule a consultation. You can learn more by reading the Dear Doctor magazine articles “A Step-By-Step Guide to Root Canal Treatment” and “Root Canal Treatment: What You Need to Know.”
Perhaps you’ve heard the old saying: “Take care of your dentures and your dentures will take care of you.” Well, maybe it’s not that old—but it’s still a sensible notion. Maintaining your dentures by routinely cleaning them and having them checked for fit will improve their longevity.
There’s one other thing you should include on your maintenance routine—avoid wearing your dentures 24/7, especially while you sleep. This bad habit could lead to some unpleasant consequences.
For one, wearing dentures continuously can accelerate bone loss in the jaw that eventually causes your dentures to lose their comfortable fit. Bone loss is a natural consequence of tooth loss because the bone no longer receives the stimulation to grow transmitted by the teeth during chewing. Dentures can’t transmit this stimulus; what’s more, the pressure they place on the gums and underlying bony ridges could make bone loss worse. You can relieve this gum pressure at night by taking them out.
Dentures can also become a breeding ground for bacteria and fungi that cause disease, irritation and unpleasant mouth odors. Taking dentures out at night deprives these microorganisms of a prime opportunity to carry on business as usual—and it’s also a great time to clean your dentures. People who sleep with their dentures in their mouth are more likely to have gum or oral yeast infections and higher levels of proteins produced by white cells that increase inflammation. That could contribute to other diseases throughout the body.
Besides taking your dentures out at night, you should also practice other daily hygiene tasks. Remove your dentures after eating and rinse them with clean water. Brush your dentures daily with a soft-bristled brush and dish or antibacterial soap or dental cleanser (no toothpaste—it’s too abrasive for denture surfaces). Be sure you clean your gums and tongue every day too. When your dentures are out, store them in clean water or preferably an alkaline peroxide-based solution.
Removing your dentures at night and these other good habits will help extend the life and fit of your dentures. It could also help keep the rest of you healthy.
If you would like more information on denture care, 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 “Sleeping in Dentures: A Habit that Can Cause Health Problems.”
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