How often should you brush your teeth? Oral hygiene 'dos and don'ts' explained by expert

Are we brushing our teeth frequently and for long enough? The British Dental Association has outlined the routine we should all get in to.

It's a habit which has been drummed into us from an early age, but the recent news flossing your teeth could be a waste of time has put the spotlight on oral hygiene.
When it comes to looking after our teeth, there are certain pieces of wisdom which we've incorporated into our routines.
But in the wake of the news about flossing, when it comes to oral hygiene, how much does your average person know about what we should be doing - and which habits do we need to ditch?
For example, how many of us know how long we SHOULD brush or teeth for and how often? And what are we doing wrong?
MirrorOnline spoke to the British Dental Association’s scientific adviser, Professor Damien Walmsley, who kindly put together this definitive list of "dos and don'ts."

How often?

"The best way to prevent tooth decay is to brush teeth twice daily with a fluoride toothpaste to remove plaque, limit the frequency, and amount of sugary food and drinks consumed in your diet, and see the dentist regularly.

 

Don'ts'

• Brush for long enough – research indicates that people only brush for 45 seconds
• Rinse the mouth after brushing – fluoride helps to prevent, control and even stop tooth decay – but rinsing the mouth out dilutes the concentration of fluoride, so SPIT, don’t rinse.
• Brush too soon after eating – as enamel on teeth is softened after eating especially with sugary foods – it’s best to wait an hour before brushing which allows the tooth to harden up more.
• Use a hard bristle toothbrush as this can damage the soft tissues in the gums.
• Don't brush too hard – the bristles should lightly sweep the tooth.

 

'Dos'

• Brush for at least two minutes, twice daily, with a fluoridated toothpaste
• Brush last thing at night and at least on one other occasion
• Use a small headed toothbrush with medium bristles.
• Put a pea-sized blob of fluoride toothpaste on your toothbrush.
• Brush along the gum line as well as the teeth themselves
• Brush all surfaces of the teeth, including the outer, inner and chewing surfaces as well as the hard-to-reach back teeth and areas around fillings, crowns or other restorations.

If you have spaces between teeth, it is best to clean these with an interdental or single-tufted brush. Where the spaces between teeth are too tight to fit such a brush, use dental floss or tape
If you are unsure about the effectiveness of brushing, use disclosing tablets after brushing to highlight any areas you may have missed.
There is good evidence that a small-headed counter oscillating electric toothbrush helps in removing dental plaque but they must be used correctly and your dentist or hygienist will advise.

Plaque

Plaque is a sticky film of bacteria that covers your teeth and gums. It develops constantly and you clean it off every day when you brush your teeth. Certain harmful oral bacteria feed on the sugars you eat to create acids that destroy the tooth enamel.
Cavities are a bacterial infection created by acids, that cause your teeth to experience a hole in them.
The more sugar you eat, the more acid you will create in your mouth, and the more acidic attacks your teeth are exposed to, the higher the risk of developing tooth decay.

By: Zahra Mulroy, Mirror
http://www.mirror.co.uk/lifestyle/health/how-often-should-you-brush-8637066

If you have questions or would like to schedule an appointment, please contact Omni Dental Group at one of our three office locations listed below:

North Austin on Hymeadow Drive: (512) 250-5012
Central Austin on Jollyville Road: (512) 346-8424
South Austin on William Cannon: (512) 445-5811

8 Tips for a Brighter Smile

Want a brighter smile? Try these tips!

1. Avoid foods that stain
Avoid foods and beverages that are filled with sugar or are too acidic. If you're not careful, consuming these kinds of foods can damage and stain your teeth. It can be helpful to drink beverages that stain through a straw as well. This helps you circumvent those smile dulling liquids altogether! Brushing your teeth immediately after eating sugary foods may also help prevent staining. Be careful though, if a food is too acidic, you will want to wait at least thirty minutes before brushing your teeth in order to prevent enamel erosion. If you cannot brush your teeth for some reason, opt for swishing water in your mouth which is naturally filled with fluoride. (Water is not a substitution for your daily dental routine).


2. Use dental cleaners
Between brushing, use dental cleaners to minimize the food build-up between your teeth. These brushes are disposable and very handy if you find yourself away from home without a toothbrush. You can also use them to clean the areas between teeth and brace wires if you have braces. They're sold at most grocery stores and can even be found online. 



3. Try toothpaste for sensitive teeth
If your teeth are especially sensitive, try using a toothpaste created specifically for people with sensitive teeth. If you're wondering whether or not you have sensitive teeth, here's a simple way to tell: Do your teeth feel uncomfortable when they are exposed to extreme hot and cold temperatures? If so, be sure to ask your dentist for help and additional information. 

4. Regular dental checkups
This one might seem obvious, but it is so important! Be sure to visit your dentist regularly to have your teeth inspected and cleaned. Without regular dental checkups, you run the risk of facing disease and other problems in the future. Routine dental visits help prevent the advancement of such diseases and are always a good idea. 

5. Avoid chewing on hard foods
Ice cubes pose a particular threat to the safety of teeth. Never chew on ice. You could crack or chip your teeth! Be cautious when eating popcorn, nuts or any other tough to chew food. If you believe that your teeth are chipped or cracked, see a dentist immediately to prevent pain or even bacteria growth in the cracked tooth. 



6. Brush your teeth properly
Brush your teeth from the gum line moving towards the center of your mouth. This will help get rid of food bits that hide under your gums. Scrubbing side to side is always good, but don't forget to brush with an up and down motion as well. If your gums or mouth bleed while brushing, be sure to meet with a dentist or periodontist. Bleeding gums are often a sign of gum disease, which is a major issue when left untreated. 


7. Swirl that Mouthwash
One common misunderstanding regarding oral health is that brushing is all you need for a healthy mouth. Mouthwash is often neglected in daily dental practice, but it's an essential step towards your brighter smile. Mouth wash cleans, disinfects, and reaches places your toothbrush simply cannot. Rinse twice per day when you brush those pearly whites.




8. Drink your Milk! 
In addition to providing a good source of calcium, dairy has shown to help your teeth fight cavities. If you're lactose intolerant or simply dislike dairy products, don't worry! Dark leafy greens like kale or collards, broccoli, tofu, and even almonds are all excellent natural sources of calcium.



If you have any questions regarding the health of your teeth or simply want to see a doctor, call one of our three convenient locations to set up an appointment. We are here to provide excellent service in a friendly environment.  

North location on Hymeadow Drive: (512) 250-5012
Central location on Jollyville Road: (512) 346-8424
South location on William Cannon Drive: (512) 445-5811

X-Rays and the Dentist

If you've been to the dentist recently, then you have most likely had an X-ray done. While they aren't taken during every visit, they are very helpful for establishing a patient's oral health as well as predicting which areas need to be focused on. Today we are going to give a brief overview of what exactly they are and why they are necessary. 

1.  What are X-rays? 

In 1895, Wilhelm Conrad Roentgen was working in his lab conducting research when he accidentally discovered X-rays. Since then, science and technology have evolved to use X-rays in a beneficial manner. During an exam, a patient is exposed to short bursts of radiation. This allows the doctor to view teeth in a more thorough manner than an examination. Some people are nervous about getting X-rays, however, it is important to note that the doses of radiation are too minute to cause adverse effects. In fact, during a dental X-ray, patients are only exposed to the same amount of radiation as a short airplane flight. 

2. Do I have to get X-rays?

Whether you need to look for fractures in bone or simply to check in on teeth, X-rays are the best way to do it. Dentists rely on this technology because it allows them to perceive problems before the naked eye is able see them. Some examples include, but are not limited to: periodontal disease, bone infections, hard to see tooth decay, and even some tumors. X-rays are an important part of preventative care and are nothing to be afraid of.

3. What if I'm pregnant?
This is always a great question to ask! It is best to consult your physician before exposing yourself to small quantities of radiation. Informing your dentist of this is an absolute necessity, but there is no need to forgo X-rays altogether. With pregnant patients, a thyroid collar and a leaded apron are used to prevent radiation exposure.

Source: Mouth Healthy by the American Dental Association

If you have questions concerning X-rays and the health of your teeth, feel free to call one of our three offices to schedule a consult. We are here to address any of your concerns and to provide you with a stress-free dental experience.

North location on Hymeadow Drive: (512) 250-5012  
Central location on Jollyville Road: (512) 346-8424  
South location on William Cannon Drive: (512) 445-5811

Replacing Unesthetic Restorations

There are 2 types of life spans:
Everything has a life expectancy, even dental filling materials. Dental materials appear to have two different types of life spans - a functional life span and an esthetic life span. The better the original dental restorative material and the skills of the operator, the longer the restoration will last. Lab-processed materials will generally last longer than direct placement materials.

What is the functional life span?
The functional life span is defined as the length of time a material will last before it fails to function properly. This failure will either (a) weaken the tooth or (b) permit decay or gum disease to begin. For example, when a piece of the filling breaks off (or often in the case of an amalgam [silver metal] filling, it causes a piece of the tooth to break off), the tooth requires a new restoration.

How is the esthetic life span different from the functional life span?
An esthetic life span is somewhat different. In the case of bonded and tooth-colored restorations, it means that the material, while possibly still able to function, has begun to degrade. A filling may have matched the tooth beautifully when placed, but over time, the change in color of the filling material, as well as actually tooth color changes, cause an obvious mismatch between tooth and filling material. Since the restorative material does not have the same properties as tooth enamel, it will wear a little differently. The shape will change over time, too. Luckily, it is a very slow process.

With lab-processed restorations, crowns and bridges, the crown may still be working well, but age and changes in your mouth make it and the surrounding soft tissues look less acceptable that it was when first placed. Again, this happens slowly, over many years.

What other esthetic problems can be fixed? 
Other esthetic problems that can be corrected include notches in fillings or under crowns caused by improper brushing (or decay), recession of the gum tissue that exposes  darker root surfaces around crowns or fillings, porcelain crowns (caps) that no longer match the adjacent teeth, and metal margins of crowns that are visible due to gum recession (and this is quite common).

Why should you consider getting new dental restorations?
When you can see these types of changes, you can be sure that others who look at you when you are speaking or smiling will see them too. If you place a high value on your personal appearance, this is the time to consider having the restorations replaced with newer materials. Newer dental restorative materials look better, last longer, are more color-stable, and more wear-resistant than older-generation bonded materials. You can expect them to look good for many years.

What fillings look the best?
In our opinion, silver metal fillings never look "good." Even at this best, polished and shined, they do not represent a picture of health. As the metal ages, it corrodes, pits, and darkens. Its constant expansion and contraction due to hot and cold foods we eat weakens the tooth. The darkening of a filling can cause a darkening of the tooth itself. After time, the tooth will become permanently dark gray. The wider your smile is (and the more teeth you show when talking and smiling), the more of a problem this can be. The most esthetic filling are tooth-colored.

What happens if I choose to keep my old fillings?
Broken, stained, worn, and visible fillings detract from your appearance. When you look at a tooth (from about 2 feet away) that has been restored, you should not see the filling. While these types of problems are, of course, non life-threatening, consider attending to them before they get worse - and difficult and expensive to correct.

In our office, we place a high value on the appearance of your teeth and how you feel about your smile. We want you to look your best. We use the best materials and techniques available in dentistry today to ensure a healthy smile. We will be happy to evaluate your particular condition and discuss options with you.

If you have any questions about replacing unesthetic restorations, please feel free to call our office to discuss restoration options at 512-250-5012.

Remineralization Device Could Soon Come to Market

A new device being developed by dental researchers at King's College London could soon bring to market an electronic tool that would encourage teeth to remineralize. 

Demineralization and remineralization have a crucial impact on the hardness and strength of tooth enamel.

What is demineralization?
Poor hygiene, bad brushing techniques, as well an inappropriate diet can lead to tooth decay due to changed acid levels in the oral cavity. Demineralization occurs at a low pH (acidic) when the oral environment is UNDERsaturated with mineral ions. Acids demineralize the tooth structure by dissolving calcium, phosphorus, etc. The enamel is dissolved by these organic acids (lactic and acetic acids) that are produced by the cellular action of plaque bacteria in the presence of dietary carbohydrates. This enamel erosion leads to dental cavities. 

Demineralized surfaces are porous and adherent, thus becoming favorable to bacteria growth that causes dental cavities and decay. In other words, enamel demineralization equals the beginning of cavity formation. Often, as a result of smoothness reduction, the tooth surface may suffer from superficial pigmentation, which can be visually unpleasant and impossible to remove with the toothbrush. 

Demineralized teeth are very sensitive to diverse stimuli: sensitive to hot and cold foods and drinks, as well as sensitive to the touch; brushing can be uncomfortable, even painful, and the patient can be tempted to skip brushing or cut it short, which is usually fatal for his or her teeth. When demineralized hypersensitive teeth are not properly cleaned, severe dental cavities affect the entire dental structure. Treatment becomes difficult. Patients need to understand that this condition appears as a result of an infection that can easily get out of control if hygiene is neglected.

What is remineralization?
Remineralization allows the loss of calcium, phosphate, and fluoride ions to be replaced. 

How do dentists fix cavities now?

With 2.3 billion affected annually, dental caries is one of the most common preventable diseases globally. Tooth decay normally develops in several stages, starting as a microscopic defect where minerals leach out of tooth. Dentists normally treat established caries in a tooth by drilling to remove the decay and filling the tooth with a material such as amalgam or composite resin. 

What can this tool do?
Reminova Ltd, a company that emerged from King's College London Dental Innovation and Translation Centre, takes a different approach - one that rebuilds the tooth and heals it without the need for drills, needles, or amalgam. By accelerating the natural process by which calcium and phosphate minerals re-enter the tooth to repair a defect, the device boosts the tooth's natural repair process.

How would the tool work?

Electric currents already used to check pulp/nerve of a tooth

The two-step method developed by Reminova first prepares the damaged part of the enamel outer layer of the tooth and then uses a tiny electric current to "push" minerals into the tooth to repair the damaged site. The defect is remineralized in a painless process that requires no drills, no injections, and no filling materials. Electric currents are already used by dentists to check the pulp or nerve of a tooth; the new device uses a far smaller current than that currently used on patients and cannot be felt by the patient. The technique, known as Electrically Accelerated and Enhanced Remineralization (EAER), could be brought to market within 3 years.

What is the company?
Reminova Ltd will be based in Perth, Scotland, to benefit from the strong life sciences and dentistry base. It will commercialize the work of Professor Nigel Pitts and Dr. Chris Longbottom, based in the Dental Institute at King's College London. With a combined 80 years' experience in dentistry, they have previously brought dental devices to market to detect tooth decay. The company, formed in collaboration with Innova Partnerships, is currently seeking private investment to develop their remineralization device. 

Who are the designers?
Kit Malthouse, chair of MedCity and London's deputy mayor for business and enterprise, commented, "It's brilliant to see the really creative research taking place at King's making its way out of the lab so quickly and being turned into a new device that has the potential to make a real difference to the dental health and patient experience of people with tooth decay."

Sources:
https://wwww.dentalaegis.com/news.php?id=15411
http://www.dentfix.ro/en/2011/10/demineralization/ 
http://www.dentistryiq.com/articles/wdj/print/volume-4/issue-9/focus-on-orthodontics/demineralization-and-remineralization-the-battle-to-keep-teeth-strong-and-healthy.html

Drinking Coffee Accelerates Orthodontic Tooth Movement

What is orthodontic tooth movement?
A unique process where a solid object (tooth) is made to move through a solid medium (bone). Orthodontic tooth movement occurs due to the pressure that is transmitted to the clinical crown of the tooth, down to the root, and ultimately to the periodontal ligament (the tissue that attaches the tooth to the bone) and alveolar bone surrounding the root.

On the surface of the tooth in the direction where the tooth is being moved, the periodontal membrane is squeezed, resulting in compression of the periodontal fibers within the membrane. The bone surface contacting the periodontal membrane begins to resorb due to the activation of cells called osteoclasts.

On the surface of the root from which the tooth moves, the periodontal membrane becomes stretched. This activates cells called osteoblasts. These cells regenerate new alveolar bone in the area where the tooth was once located. That is why teeth may be slightly loose during orthodontic treatment. Once the movement has stopped, the ligaments are no longer stretched or squeezed and the bone regenerates and fills in around the periodontal ligament, causing the tooth to be more secure in the bone.

The following article shows that daily coffee consumption enhances orthodontic tooth movement, and consequently can shorten the duration in which patients have to wear braces.

The Study
Caffeine has been shown to affect bone metabolism through regulation of osteoclast, osteoblast, and calcium balance. This study investigated the effects of drinking coffee on orthodontic tooth movement (OTM). Drinking coffee, as a daily habit of many people, can be an effective accelerator of tooth movement with little side effects. Caffeine can break the calcium balance in bone tissue and directly inhibit the development of osteoblasts, leading to temporary decreased bone mineral density and consequently inducing faster orthodontic tooth movement.

Why is it important?
Developing new methods to enhance orthodontic tooth movement and shorten the duration of treatment has always been desired. However, to date, no therapies have been widely used in clinics. Much effect has been made to explore therapies to shorten the orthodontic treatment period with limited success. Daily coffee consumption may be a promising approach to enhance orthodontic tooth movement for its reversible effect on bone mineral density and calcium balance.

The setup
30 male Wistar rats were randomly divided into two groups:

1. regular OTM = rO
2. coffee + OTM = cO

At 5 weeks of age, the cO rats began receiving daily intragastric administration of coffee according to body weight.

At 13 weeks of age, the left maxillary first molar of the both groups was moved mesially with a nickel-titanium coil spring

After 3 weeks, the OTM amount was measured. 

How was it measured?
The alveolar bone mineral density (BMD) was analyzed with micro-computed tomography (uCT).
Immunohistochemical staining was done for TRAP and RANKL expression in the periodontium. The periodontal ligament (PDL) tissue model was established through 3D culturing human PDL cells in poly lactic-co-glycolic acid (PLGA) scaffolds.

What did they find?
Compared with rO, the cO rats had significantly larger tooth movement. Meanwhile, the cO had significantly lower alveolar BMD, indicated decreased bone mineralization. Moreover, in the compression periodontium, the cO had significantly more TRAP+ osteoclasts and higher RANKL expression, indicating increased osteoclastogenesis. 

Summary
This study found that drinking coffee accelerates OTM, probably through the effects of caffeine on osteoclastogenesis enhancement via RANKL elevation. This research was supported by the National Nature Science Foundation of China.

Click here to read the study.

Click on this link to read another study about how carbonated soft drinks DECREASES the rate of orthodontic tooth movement. "The role of soft drinks in decreasing tooth movement might be related to its effects on bone metabolism."

Scaling and Root Planing

What is scaling?
Scaling is a periodontal dental procedure in which plaque and calculus are removed from the tooth both above (supragingival) and below (subgingival) the gum (gingiva). 

What is root planing?
Root planing is a procedure in which diseased or altered portions of the root surface, the cementum, and dentin are removed and the resulting new surface is made smooth and clean. The more altered and damaged the root surface has been from calculus (tartar) accumulation, the more the need for root planing.

Why is it necessary?
The purpose of scaling and root planing is to remove all debris from the teeth. Any item that can cause inflammation of the gum tissue must be eliminated. The root surface must be made as smooth as possible. Irregularities in the root surface can contribute to gum inflammation. Irregularities are sites for bacteria and plaque buildup. The bacteria and the toxins they produce in the plaque are held against the tooth by the calculus. In this way, plaque and calculus on the teeth have been positively linked to gum disease.

What is the procedure like?
Depending on the severity of your particular periodontal problem, scaling and root planing may be the definitive treatment and no further procedures will be required. In many cases scaling and root planing are only a necessary part of the overall therapy. It is a demanding procedure. It requires much more time than the familiar adult prophylaxis (cleaning). It is usually done in multiple appointments, treating a quarter, half mouth, or your full mouth at each appointment. In this office we find that most patients are most comfortable if the area to be treated during the root planing procedure is anesthetized with a local anesthetic.

Recare
The scaling and root planing may have to be repeated in the future. It is customary to place the patient on a 3- to 4-month hygiene recare schedule. Scientific evidence clearly shows that for individuals who have demonstrated a predisposition to periodontal disease, an interval of 6 months is too long. We will determine the appropriate interval for you. As your situation changes, there may be changes in the length of these intervals as well.

What happens after treatment?
Other than the teeth being somewhat sensitive after the scaling and root planing procedure, there is little postoperative discomfort. The sensitivity will diminish with time. If you have been diagnosed as having severe periodontal infection, the sensitivity may remain for quite some time and further procedures may be needed to eliminate sensitivity. Although many procedures in dentistry can be considered elective, we consider scaling and root planing to be a necessity for your dental health.

Post-procedure Tips:

• If therapeutic prophylaxis has been completed because your gingival (gum) tissue showed signs of infection and inflammation, and if you had significant calculus (tartar) buildup:

• You may notice that your teeth feel different where the calculus was removed. The soft tissues may be sensitive or sore for approximately one day as they begin to heal. You may find that taking an over-the-counter pain reliever (aspirin, ibuprofen, etc.) will help during this 24-hour period. You may also rinse your mouth every few hours with warm salt water. Make sure that you brush and floss your teeth during this time period as you have been instructed. be gentle, because the brushed areas may be sore, but be thorough! You do not want to have the periodontal infection begin again.
• If scaling and root planing, or other more involved periodontal procedures has been completed:

• You can expected your gingival (gum) tissues to be quite sore. This is normal when the gum tissues have been infected and inflamed for some time. The more severely they have been affected, the more discomfort you can expect. This soreness should go away very quickly. You may rinse with warm salt water every few hours until the soreness is gone.
• If scaling and root planing has been completed:

• You may also notice that the teeth have become sensitive to temperature changes after the scaling and root planing. This sensation frequently occurs when the surfaces of the roots of your teeth have been cleaned. Removal of the debris covering the roots and attached to the roots leaves the roots open to temperature stimulus. If the problem persists, please let us know.
• When you examine your gums closely in a mirror, you will also observe that the color, texture, and position of your periodontal tissues will undergo a change as the healing takes place. The swollen, reddened gum tissue will shrink, become more firm, and return to a healthy pink color. Watch for these welcome signs of improvement and be encouraged by the healing process.
• Please do not forget to brush, floss, and use other periodontal cleaning aids as you have been taught. It is important that you begin establishing proper oral self-care habits immediately. If you find that the recently treated areas are sensitive to the brushing and flossing, be gentle - but be thorough! With proper technique you cannot damage the teeth or gingival tissues.
• Brush after ever meal with a fluoride-containing toothpaste. Rinse with a fluoride-containing mouthrinse once each day.

Preventing Recurrence
Once scaling and root planing has been completed, it is most important for you to practice the brushing and flossing techniques in which you will be instructed. If we have recommended any additional periodontal aids, you must use them, too. Your cooperation is vital if the procedures are to be successful. To remain disease-free, you will need to remain constant in your oral self-care regimen.

If you have any questions about scaling and root planing, please feel free schedule a comprehensive dental exam with our office at 512-250-5012.

Instruments of a Dental Office

When you go to your dentist, do you ever wonder what those tools going into your mouth are used for? They can be pointy, sharp, loud and very scary looking! We are here to put your fears to rest! These tools are simple and were made to make your dental visit pain-free.

The prophy cup polishes teeth after cleaning 

 An explorer detects breaks in enamel

A perio probe measures sulcus depth

 The high speed handpiece prepares teeth for fillings, etc

The slow speed handpiece removes soft decay

The sonic scaler cleans teeth quickly and easily

The Micro Air-Abrasion handpiece prepares teeth for fillings

 The high velocity suction removes water quickly

 The slow speed suction keeps the mouth dry

 The curing light is used to harden white fillings

The air/water syringe squirts air and/or water

Takes diagnostic x-rays of your teeth 

Click here to HEAR what sound each instrument makes!

These tools help make modern dentistry possible! You can come for your dental appointment without worry of pain!

Here are some antique dental tools that, thankfully, no longer are used!

Douglas Lever: a combination of elevator and forceps

Clockwork Drill: the first drill that could rotate continuously to remove damage from a tooth

Civil War era set of dental forceps: the drill in the center telescoped to work on the root of the tooth being extracted. Can you believe that during this time, the dental anesthetic still had not been popularized?! Ouch!

If you have any questions about what instruments Omni Dental uses or how we use it, please feel free to check out our website or give us a call at 512-250-5012

Check out this article for a more in-depth look at antique dental tools: http://gajitz.com/the-whole-tooth-5-truly-terrifying-antique-dental-tools/

Dentin Decay

Detect decay by inspecting the color and hardness
Usually, dental decay is fairly easy to detect. When a cavity is just beginning, it is typically identified by a brown or white color or a change in the translucency of the enamel of the tooth. The dentist or dental hygienist uses a special dental instrument called an explorer to feel the suspect area and check its hardness. If the area is hard, in other words, if no break in the enamel layer is detected, we feel there is not a cavity present. If, however, the surface feels soft and the explorer "sticks" in the suspect site, we feel a cavity is present.

Fluoride makes our enamel stronger, but dentin decay is harder to detect Because of the widespread use and availability of fluoride in our drinking water, foods, and oral care products, we are seeing a different decay pattern. The appearance is different from the typical pattern of decay and more difficult to detect. As the outer surface of the enamel absorbs fluoride (from toothpaste, for example), the enamel becomes very resistant to demineralization and eventual decay. If there is a small break in the integrity of the enamel, a pit or groove where decay-causing bacteria can live, the bacteria can dissolve the enamel in such a way that the hole in the enamel cannot be detected. Once the decay-causing bacteria reach the underlying dentin, the acids eat away at that substance and quickly make a large cavity - but one that still cannot be easily seen or detected. In this way the enamel becomes undermined. A dentist looking at such a small cavity would think it very easy to restore. However, once the decayed portion of the enamel is removed and the dentin becomes visible, the true extent of the damage becomes obvious. The small cavity becomes a big cavity.

One of the major problems with decay that appears to occur only in the dentin is in the detection. If a radiograph is taken a part of the periodic examination process, we may be able to see dentin decay if it is moderate to extensive. Decay seen on radiographs is typically two to seven times greater in the tooth. Modern high-speed radiographic film and reduced x-ray exposure makes it more difficult to detect early decay on radiographs.

You can prevent decay by using fluoride
The conscientious application of a source of topical fluoride, through either an over-the-counter dentifrice or a prescription fluoride product, and thorough plaque removal are essential. Bonded sealants are also an effective protection against dentin decay. We strongly advice these procedures. Periodic examinations at intervals recommended by the dentist catch decay at the earliest possible time. This is the only way to keep small problems from developing into larger problems.

Click here to check out our blog post on foods that cause decay. 
Click here for our post on how to prevent decay.

If you have any questions about dentin decay, please feel free to ask us. 

Smile (Lip) Line

What is the lip line?
How many teeth you show when you smile or speak and how much of each tooth (length) is displayed when you smile broadly, or (at the opposite end of the spectrum) when your lips are at rest, are functions of where your upper lip attaches to your face and how old you are.

3 classifications

There are 3 classifications of "lip line" that dentists use - low, medium, and high. 

A low lip line is one in which very little of your teeth are visible when you talk or smile. Someone with a low lip line will show, at the most, a millimeter or two of the edge of the biting edge of the tooth. 

A medium lip line will allow most of the tooth, up to and including a millimeter or two of the gum tissue, to be visible. 

A person with a high lip line will show all the top front teeth and a significant amount of gum tissue when speaking or smiling.

High Lip Line

Changing your lip line
Dentists (and plastic surgeons) have not been very successful in surgically changing the low, medium, or high lip line. There are some dental "tricks" that can be used in limited situations to reduce the amount of gum display evident with a high smile line. Most of the corrective procedures to improve the esthetics of the situation require significant investments of both time and money. Periodontal (gum) surgery, alone or in conjunction with porcelain veneers or ceramic crowns, is more likely. In extreme cases the only option may be to surgically reposition the entire maxilla (with or without orthodontics). Conversely, the appearance of showing no teeth when talking or smiling is regarded as one associated with advanced aging.

There is another component to how much of your teeth show when your lips are at rest, and it has to do with gravity and time. Your face and lips are composed of soft tissue that is under a constant gravity challenge. Gravity always wins, given enough time. There skin and subskin tissues drop over the years. If, with your lips at rest, you showed about 3 mm of the biting edges of the top two front teeth when you were 20 years old, by the time you are 40, you may show only 2 mm of edge. Someone 50 years of age would show 1 mm, and at 60 years, maybe no tooth is seen when the lips are at rest. The tissues of the human face will drop about 1 mm every 10 years, beginning around age 40. As the facial tissues lose elasticity, they slowly drop. Obviously, some lucky people have better genetics and their faces will stay tighter and the tissue drop will be slower. Correcting the age-related facial tissue drop can be done with plastic surgery - the common face lift.

High, medium. and low lip lines

Genetics or Gravity? 
If you are reading this, then you have either asked questions about your smile and lip line or this issue has been addressed in the broader context of cosmetic dentistry procedures you require. After a thorough examination, we will explain what situation you have and what corrective measures are possible.

If you have any questions about your smile line, please feel free to call our office for a consultation at 512-250-5012.

Sealants and Fluoride: Benefit to Adult Patients

Dental decay can develop at any time, regardless of a person's age. A change in diet, change in lifestyle, change in oral self-care habits, the use of prescription medications, or a change in systemic health due to the normal aging process can all affect the caries (decay) susceptibility. Few people remain completely free of decay. Proper oral self-care on your part and properly spaced dental hygiene prevention appointments will go a long way to reduce the opportunity to have new decay to begin.

As you age, it is possible that some of your gum tissue will recede, exposing the root surfaces of your teeth. This gum recession can occur from improper brushing (brushing too hard with a hard toothbrush) or as a result of past periodontal problems. The more a tooth and root are exposed, the greater is the surface area you will have to keep clean. Sometimes the teeth with exposed roots are very hard to keep clean. These roots may be sensitive to temperature changes and are often times uncomfortable to brush. Decreased salivary flow (dry mouth) helps to create a breeding ground for bacteria to accumulate on the enamel and especially on the root surface. And root decay usually progresses quite quickly!

Goal of Prevention
Your goal should be to keep the dentist from drilling your teeth. Any reasonable preventive measure that is available should be seriously considered. When the dentist drills, you lose. When the dentist does not drill, you win.

                               
                                                         Dental Sealants

Please see our blog post on sealants. Although sealants are primarily designed for children, adults who have a history of active decay should consider having sealants placed on the posterior (back) teeth where indicated. We will tell you where it is possible to place the sealants. Even if you have not had a cavity for a long time, consider the application of a sealant as an inexpensive insurance policy for your teeth. Perhaps you would never get decay on the unsealed surfaces. But, just as you insure your home against destruction by fire, a sealant insures the tooth surface from decay. Preventive measures may allow you to avoid having your teeth drilled. You win! 

Topical Fluoride
For a similar reason, we advise the use of topical fluoride treatments for adults. The effectiveness of systemic and topical fluoride in preventing decay is well documented. When a cavity first starts, an application of fluoride might (depending on when it is used) reduce or eliminate the need for drilling.

Fluoride Varnish

An alternative to the fluoride treatment we can provide in our office is a daily rinse. If you can rinse with an over-the-counter mouth rinse containing fluoride every night as directed on the rinse label, you do not need the office topical fluoride treatment. If you cannot rinse daily as instructed, you will need the benefit from the strong office-applied topical fluoride treatment. Your oral health will benefit most from small increments of fluoride that are applied daily rather than one larger concentration every 6 months. However, only you know whether you will be faithful in your rinsing routine. When in doubt, let us do it here.

We stress prevention of dental disease above all else. Sealants and topical fluoride treatments are two of the more important preventive dental measures that we believe will significantly enhance your oral health.