12 Things Your Dentist Knows About You Just By Looking In Your Mouth

While cavities and plaque build-up may be what's on your mind before a teeth cleaning, your dentist is looking for a whole lot more. "The mouth is the window to the body," says David Silverstrom, DDS, of The Silverstone Group in Livingston, NJ. "Often, diseases like cancer, anemia and diabetes will first be identified by the dentist in a regular examination, and this saves lives." And it's not just diseases- dentist can discover everything from your bad habits to your favorite beverages simply by asking you to say, "Ahh!"


1. You flossed right before your appointment—and that's the only time.
Sorry, but you can't fool your dentist into thinking you floss daily by doing so the night before or morning of your visit. "The gums of people who only floss right before a visit are bleeding or look damaged," says Timothy Stirneman, DDS, of All Smiles Dental in Algonquin, IL, "whereas, healthy gums are nice and tight and pink," he says. Kenneth Wong, DDS, of Santa Monica adds, "When patients floss right before coming for a cleaning, I can see the slices where the floss cut at the gum because they were overzealous."
2. You're pregnant.
"Nearly 40% of women will develop gingivitis during their pregnancy," says Glen Stephenson, DMD, of Prevention Dental in Boise, ID. "This is caused by increased progesterone, which facilitates the growth of bacteria, causing gingivitis. Some women will develop a deep red lump on their gums called a pregnancy tumor or pyogenic granuloma." (This type of tumor is completely benign and will go away after the pregnancy is over.) Stirneman adds that most women are typically pretty far along before their gums start bleeding, so it's not as though a dentist will magically "discover" that a patient is pregnant.

3. You bite your nails.
Without looking at your hands, a dentist may be able to detect this habit. "Signs include chips and cracking of the teeth, plus wear and tear on the teeth from the constant stress on them," says Keith Arbeitman, DDS, of Arbeitman & Shein in New York City. "This can cause your teeth to become uneven and lead to jaw pain and discomfort." Kyle Stanley, DDS, of Helm, Nejad, Stanley in Beverly Hills adds, "Patients that bite their nails using their front teeth usually have leveled off, flat front teeth. The nails themselves are not what cause the damage, but rather the contact that occurs between the top and bottom teeth," he says.
4. You used to suck your thumb.
"Most children that suck their thumbs or a finger have no long-term effects from the habit," says Stephenson. "However, those who did so past the age of seven or eight may show significant changes to their bite or the position of their teeth. Much of that can be corrected through orthodontic treatment, but some telltale signs can remain." Alice Lee, DDS, of Montefiore Medical Center in Bronx, NY, adds, "We can sometimes see protruding front teeth, and this can impact how kids' jaws are coming together and growing and can also impact their speech."
5. Your bad breath may mean something.
"General bad breath can be categorized as halitosis," says Arbeitman. But dentists are also trained to identify "fruity" smells and "fishy" smells, which can mean numerous things. " 'Fruity' breath could indicate uncontrolled diabetes or a dietary fast that has gone too far, while 'fishy' breath could be a sign of kidney or liver failure," he explains. If the smell is "very foul," says Arbeitman, it could be anything from gastroesophageal reflux (GERD) to an underlying lung abscess and bronchitis to a tonsil stone. Timothy Chase, DMD, of SmilesNY in New York City, adds, "The first thing the dentist should do is rule out the odor coming from the teeth and gums. After that, he should recommend that the patient see an ENT to rule out sinus issues, and a GI doc to rule out reflux issues."
6. You may have an eating disorder.
"Many patients are surprised that their dentist is the first one to ask about eating disorders," says Chase, "but bulimia exhibits a very distinct pattern of tooth wear that your dentist can easily identify." Stephenson notes that, "This erosion happens almost exclusively on the tongue-side of the front teeth and can contribute to increased cavities." But Silverstrom is quick to point out that acid erosion on the back of a patient's teeth does not always indicate an eating disorder. He says other possibilities include acid reflux and the use of antidepressants or mood-elevating drugs, both of which reduce the amount of saliva in the mouth, thereby upping the odds of acid damage.
7. You have a sinus infection.
"Often patients will call saying that they need a root canal," explains Ira Handschuh, DDS, of The Dental Design Center in NY, "when in fact it's actually a sinus infection and not a tooth problem at all." The reason, he explains, is because the roots of the top teeth are positioned in the same area as the floor of the sinuses. And both sinus infections and toothaches can show symptoms of pressure. "A simple home test is to have a patient bend over to touch their toes. If the pressure or pain increases just by doing this, the pain is most likely not tooth-related and he should see his ENT or primary care physician before coming to the dentist," he advises.

8. You have a vitamin deficiency. "A deficiency of vitamins and minerals can cause many oral conditions, like burning tongue syndrome, tissue sloughing off, increased infections, delayed healing, bone infections, and easy-to-bleed gums," explains John P. Dougherty, DDS, MAGD, of Artistic Dental at the Biltmore in Phoenix, AZ. Stephenson adds, "Surprisingly, iron deficiencies show up in many ways in your mouth. It can give some patients severe sores in the corners of their mouth while others have changes in their tongues. Some may experience a painful burning sensation, or all the small papillae fall off their tongue leaving it glossy and smooth. Getting more iron will solve these problems.
9. You have diabetes. "Many times, imbalances in sugar will show a rapid change in the health of your gums, including increased swelling, bleeding, and sensitivity," says Handschuh. "In conjunction, the consistency of saliva may change, and there may be increased decay. These may all be signs of sugar levels that are out of control, so dentists can alert patients to see their doctor to check for diabetes."

10. You have a drinking problem. "Alcoholic patients are cavity-prone because alcohol tends to dry the mouth out," says David Tarica, DMD, of 34th Street Dental in New York City. "A dry mouth will lead to cavities, because saliva neutralizes the damage-causing acid in our mouths. In addition, alcoholics have 'chipmunk red cheeks,' and the smell alone is usually a giveaway."
11. You have oral cancer. "The first signs of oral cancer can be seen from the following: unexplained bleeding in the mouth, white, red, or speckled patches in the mouth, a change in the way your teeth fit together, swellings, thickenings, lumps or bumps or eroded areas on the lips, gums, or other areas inside the mouth," explains Michael Apa, DDS, of Rosenthal Apa Group in New York City. "An oral surgeon should be consulted for a biopsy of any suspicious tissue."
12. You love Gatorade. You may know why you chipped your tooth, but Hugh Flax, DDS, of Flax Dental in Atlanta says that even though the cause may be apparent, "there could be underlying factors that weakened the tooth and made it susceptible to being chipped in the first place." He explains that teeth can be softened by sodas and other sugary beverages over time, which may make a tooth more susceptible to chipping. Energy drinks, which tend to be even more acidic than soft drinks, may cause even more damage to tooth enamel, he says.


By: Elizabeth Jenkins, Prevention
http://www.prevention.com/health/what-your-dentist-knows-about-your-health

 

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

10 Things You Should Know Before Going to the Dentist

Fortunately for parents and kids, there are ways to make the dentist appointment less stressful for everyone. Here are 10 things to know before visiting the dentist:

1. Find a dentist that suits you and your family. Seek recommendations or look online for reviews. Call ahead to ask if you can interview or speak with the dentist about any reservations you may have regarding your dentist appointment. If you are taking a child to the dentist, consider using a pediatric dentist.

2. Gather your dental records, x-rays, insurance information, and any other pertinent papers to bring with you to your appointment. If this is a child’s first appointment, consider letting them hand their records to the dentist themselves.

3. Know your water. Find out if your drinking water contains fluoride. If not, your doctor may suggest that you and your child use a fluoride mouth rinse in addition to regular brushing and flossing.

4. Write down any questions you may have, so you do not forget to leave without the answers you need. When taking children to their dentist appointment, encourage them to ask any questions they may have too.

5. Talk with your children about what they can expect to happen during their visit. Describe how their teeth will be cleaned and the dentist will check for cavities. Explaining the procedure beforehand may help to ease any nervousness and help them to feel more confident during their appointment.

6. Talk with your dentist. If your child is nervous about the visit, let your dentist and hygienist know. Some children may be nervous, while others may have difficulty sitting still, or even sensitivities to lights and sounds. Talk with the dental office beforehand to make sure they can accommodate your needs.

7. Practice full disclosure with both the dentist and the hygienist. It will be helpful to tell them about any health issues, even if you may not think it would be a concern during a regular dental appointment. Let the office know if there is a chance that you may be pregnant, if you or your child have any allergies (particularly to latex or medications), bleeding or clotting problems, or any other health issues. Women who are pregnant or nursing may need to avoid x-rays and certain dental procedures.

8. Request your favorite hygienist. If you find a hygienist who you or child respond well to, ask for that person’s name and have it added to your file. That way you can request that same hygienist for your next visit.

9. Remember to schedule your next appointment! (This is one sin that I am super guilty of committing, and then before I know it too much time has passed between appointments.) Dental exams are not merely to check for cavities. Your dentist will be looking for signs of decay, gum disease and even oral cancer, so do not skip an appointment simply because you or your child are not having any pain.

10. Keep proper dental care going all year long. According to the CDC, tooth decay affects children in the United States more than any other chronic infectious disease. Keep up with regular dental care, including brushing twice daily, flossing, and eating a healthy diet. You should also speak with your dentist about whether or not your child should be using a flouride mouth rinse. Encourage your children to take care of their teeth so they can avoid any issues in the future. The better you and your children care for your teeth between appointments, the more likely your appointments are to go smoothly.

By: Jessica Cohen, Babble
http://www.phillytrib.com/things-you-should-know-before-going-to-the-dentist/article_771dac6e-d24f-5c43-a0ae-0d28cc15eb4a.html

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

Dental Insurance Coverage

Your employer, management, or union has purchased dental insurance coverage from a selection of plans offered by an insurance company or broker. Each insurance company offers many different plans. 

What is covered?
The type of dental benefits that are covered relate to the dollar amount spent on the benefit package. Generally, the more money spent on a plan, the more services are covered. Most dental insurance covers only 50% to 80% of the cost of the treatment. Major services (crowns, bridges, etc.), which are the most expensive dental procedures, are usually only covered at a 50% rate. For example, some dental benefit packages will not cover the fees for porcelain (tooth-colored material) crowns on teeth that are not visible when you talk or smile; they will only pay for a metal crown. Under this type of plan, you must pay the full amount of the cost of the porcelain on those teeth. According to insurance companies, fillings in front teeth have both functional use and cosmetic components. They will pay for the functional part but not the full amount for the cosmetic restorations.

Who is responsible for payment?
The fees charged for dental treatment reflect the many different parts of a particular procedure or procedures. Treatment for your particular needs may or may not fall within the limits set by your particular dental plan. Many dental procedures may not even be listed in your insurance's procedure/payment schedule. If your dental procedure falls into this category, you may not receive any insurance reimbursement for that procedure. You are ultimately responsible for paying the entire fee for an accepted dental treatment, regardless of your insurance coverage.

Choosing Treatment Options
Our goal through your examination, diagnosis, and treatment phases is to provide you with the best possible oral health. We do not allow the insurance company to tell us how to treat you. We recommend to you those treatments that we believe you need and we will discuss alternative plans with you. Whether or not the recommended treatment is a covered dental benefit is between you and your employer and the insurance carrier.

Submitting the Claim
We are happy to help you receive the maximum benefits you are allowed from your dental coverage. In order for us to submit your insurance claim, we will need an insurance form with your portion completed and signed. We deal with dental insurance companies on a daily basis; therefore, we have a great deal of experience submitting these claims to insurance carriers. We take great care in submitting claims properly the first time. 

There are three things we cannot do: 
1) Alter the date of treatment; 
2) Submit a claim for more than the actual fee; 
3) Submit a claim for procedures that have not been performed. 

Because it is not at all uncommon for the insurance carriers to make a mistake, we would prefer to submit the claims ourselves, and then verify proper payment. Insurance carriers may respond to requests for payment of preauthorized treatment in as little as a week or as long as 45 days. Please be patient; we have no control over the post office or the speed with which the insurance carrier processes your claim.

Our office cannot negotiate with your insurance company for reimbursement of dental expenses. Only the purchaser of the plan (your employer) can negotiate better coverage. If you would like better or more coverage, you will need to talk with your plan purchaser about the features you want in your dental plan.

If you have any questions about your dental insurance coverage, please feel free to ask us. 

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

Prophylaxis

There is nothing more important to your dental health than maintaining a clean mouth. Prevention or absence of infection optimizes our general health. A clean mouth will be disease-, infection-, and trouble-free. A clean mouth will not be predisposed to developing either decay or periodontal (gum) disease. One of our very important functions in dentistry is to teach you how to properly maintain your teeth and gums, and to regularly remove anything that you are unable to remove yourself.

The theory and practice of preventive dentistry have undergone revolutionary changes in recent years. We now know that the preventive needs of every individual differ. The adage of "see you dentist regularly; get your teeth cleaned twice a year" has changed too.

What Is Prophylaxis?
Oral prophylaxis is a simple dental procedure by which your dentist or hygienist will clean your teeth using hand instruments or ultrasonic scaler. No matter how good you are at cleaning your teeth, there is always plaque left between your teeth and at the gum line. As time advances and cleaning is neglected, the early stage soft plaque will change into hard tartar (calculus). This plaque and calculus gives rise to periodontitis and gingivitis.

How Oral Prophylaxis Is Done
1. Sit back and relax on the dental chair while your dentist evaluates your medical history
2. Dentist will examine your mouth and look for signs of periodontal pockets and gum infections
3. An ultrasonic scaler will be used to clean your teeth. The scaler is a hand-held device with a hand piece and a pointy tip. It ejects pressurized water and the tip vibrates in order to remove the plaque and calculus from the teeth surface
4. Hand instruments are used to clean tricky spots and difficult to reach areas
5. If you have any cavities or gum problems, you will be notified
6. In the end, a prophylaxis paste will be used for polishing the tooth surface. A miniature rubber cup is fitted over a hand piece and small amount of prophy paste will be applied on the cup and your teeth will be polished 

How Often Should You Schedule Cleanings?
The recare and examination interval that we have recommended for you is designed for your unique situation. And it, too, can change. The interval between regular prophylaxis (cleaning) appointments that is established for you is a function of many things.
These include:

• general health

• dexterity and hand/eye coordination

• age

• diet

• stress levels

• oral habits

• position and alignment of the teeth

• number, type, size, and location of restorations

• restorative materials used

• periodontal history

• location of bone and periodontal tissues

Simply stated, the more complex your dental situation and the more your tooth position and alignment deviate from the normal, the harder you will find it to keep your teeth clean and your gums healthy.

Recent studies have identified many of the microorganisms that cause gum disease and decay. They can be controlled with your help and with ours. These studies also show that a "cleaning" every 6 months may not be adequate for some patients. In order to prevent destructive oral disease, prophylaxis appointments in intervals of anywhere from 2 months to a year may be recommended. Periodontal (gum) disease can happen anywhere in your mouth at any time.

You don't have to let it happen to you! We are here to be your guide to good health.

If you have any questions about your oral care maintenance intervals, please feel free to call our office at 512-250-5012.

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.

Does Oil Pulling Work?

Starting the day off at the beach with your skin smelling of tropical-scented sunscreen can be one of life's greatest pleasures. Smelling coconut oil as you swish it around in your mouth before work -- well, that's another story. 

What is Oil Pulling?

Oil pulling, or placing oil in the mouth to kill harmful bacteria, seems to have caught on recently. It's a controversial practice that takes dedication and time, though fortunately not the 10 or 20 minutes of marathon swishing some sources suggest. Oil pulling, an ancient Ayurvedic folk practice, dates back 3,000 to 5,000 years to traditional Indian medical remedies. Advocates claim swishing any type of oil in your mouth every day will whiten your teeth, reduce bacteria, strengthen your gums and jaw, improve your skin, clear your sinuses, prevent ​bad breath and even protect against heart disease and Alzheimer’s disease. 

Two sessions of four minutes, as recommended by Dr. Amala Guha, assistant professor of immunology and medicine at the University of Connecticut Health Center and the founding president of The International Society for Ayurveda and Health, were sufficient for my first attempt at oil pulling. The taste itself isn't so bad on the surface, but putting chunky coconut oil in your mouth before being fully awake can trigger a gag reflex.

"People are saying that their breath is better, their gums don’t bleed anymore and their teeth look a little whiter," says Jeffrey Dalin​, a dentist based in St. Louis. "I haven’t had the guts to do it, but I think it’s something at least worth looking into." 

What does research say?

But what's the scope (and scoop) on this mouth rinse practice? Does it work?

"It's not given proper credit," said Guha, who was trained in Ayurveda, a traditional form of medicine that relies on natural healing, in India. She explains that using liquids in the mouth for health purposes is mentioned in two ancient Indian Ayurvedic texts (one written in 800 B.C. and the other in 700 B.C.), and the practice is part of one of the oldest health systems in the world.

Oil pulling for oral hygiene is common. But before you go racing out to the store for oil, the American Dental Association cautions that because of a lack of evidence, they do not recommend oil pulling as a replacement for standard oral health care such as flossing and teeth brushing.

The texts also claim that about 30 systemic diseases, including headaches and diabetes, can be cured. Yet there is a lack of knowledge on the science and side effects behind the practice, according to Guha.

A small study published in 2009 involving sesame oil and 20 adolescent boys with plaque-induced gingivitis found that oil pulling reduced plaque and the bacterium Streptococcus mutans. This bacterium is cited as being a major cause of tooth decay and overgrowth of bacteria in mouth can also lead to gum disease.

A larger study published in 2013, also using sesame oil, found similar results, summarizing that oil pulling had a significant effect on plaque and gingivitis.

For coconut oil users, lauric acid found in the oil can be a benefit. It is known for its antimicrobial properties, such as the ability to fight off viruses, bacteria and yeasts.

Another study from 2011 says, "Oil pulling therapy has been equally effective like chlorhexidine [mouthwash] on halitosis and organisms."

How it works

Guha says there are two oil pulling techniques: kavala and gandusa.

Kavala: fill your mouth with liquid and hold it there for a couple of minutes before swirling it around the mouth and spitting it out. The process shouldn't exceed more than three or four minutes; it's repeated at least two or three times.

Gandusa: the technique of holding the liquid still in the mouth for three to five minutes. The liquid is then spit out and the process is repeated.

In Ayurveda, many different liquids can be used depending on the condition being treated and the physiology of the person. Milk, honey and hot water containing herbs are just some of the other mediums, explains Guha.

For daily oral hygiene, she recommends using coconut or sesame oil, which she says have mild abrasive powers and more healing benefits than other oils (and are less harmful).

Where to dispose the oil?

Jennifer Beckinsale, who tried oil pulling for 10 days, spit hers into a disposable cup and threw it away, but didn't like how wasteful that felt. Still, she says she would try oil pulling again. Remember, your sink is out, because the oil may harden and clog your pipes.

When to expect results?

Results can be expected in a few months with benefits such as reduced plaque, cavity prevention and stronger gums for individuals who already have a healthy mouth. For the person with plaque buildup, we recommend a teeth cleaning first for faster results.

How it doesn't work

Mark Wolff, professor and chair at the New York University College of Dentistry, expresses skepticism about oil pulling's effects on oral health. "I am not sure there is any harm, but I have never seen it have any positive effect on my patients who have been using oil pulling or in clinical research that has been published."

Limited research, mostly dating back to 2008 and 2009, suggests oil pulling – particularly with coconut oil – can stop plaque from forming. But evidence is lacking, and experts caution that you shouldn’t expect any greater benefits. "There’s absolutely no data whatsoever that shows diabetes can be treated or prevented, or that heart disease can be," says Lyla Blake-Gumbs, a physician with the Cleveland Clinic’s Center for Integrative Medicine. "It’s not a new practice – it’s been done thousands of years – but there were no real records kept​. So I can’t go to any objective, well-run clinical trials to look into the other claims." 

There is also little research available on the effectiveness of these treatments to cure other diseases.

Negative Side Effects

Guha warns that there can be negative side effects if improper technique is used, including dry mouth, excessive thirst, muscular stiffness, exhaustion and loss of sensation or taste in the mouth. Oil pulling likely won’t cause any adverse effects – so long as you don’t swallow the oil. Doing so could cause diarrhea or an upset stomach, Blake-Gumbs says. And the swooshing itself isn’t going to taste good. Oil, be it olive, sesame or coconut, is often difficult to tolerate – and some types are solid at room temperature, until they begin to melt in your mouth. "I had one patient tell me she did it with sesame oil first, and she couldn’t hold it in her mouth because it was too strong a flavor," Blake-Gumbs says. "Then she tried olive oil, and that was more agreeable to her."

Are You Interested?

Individuals who are interested in trying kavala or gandusa to treat health conditions need to review all credentials of Ayruvedic practitioners before starting any treatment. Guha says that there are very few trained professionals in the United States as none of the Ayurveda schools here are accredited; only schools in India provide the proper certifications.

Bottom line? 

Oil pulling is relatively simple and inexpensive – coconut oil runs around $10 ​or less​ ​​​​– and it’s not invasive. But there’s still no solid evidence that it actually works, and experts agree that if you’re concerned about your teeth, it’s best to brush at least twice a day for two minutes each time.

If you're just looking for a natural way to boost your oral health, you can oil away without supervision and get about the same benefits as commercial mouthwash.

Just don't forget to floss.

Article published on CNN.

US News article.

Crowns: An Overview

Why would I need a crown (cap)?
1. A tooth has been so badly damaged by decay or so heavily restored by fillings that it can only be saved with cast restoration
2. A tooth has been treated endodontically (root canal treatment). These teeth are almost always restored with a cast restoration because they have lost a great deal of tooth structure from fracture, decay, or the drilling process. These teeth are prone to fracture under normal and light chewing forces.
3. The tooth needs to be used as an abutment (anchor) for a bridge to replace missing teeth.
4. Grinding your teeth, an improper bite, age, fillings and tooth decay can all be contributing factors in the wearing down, cracking or breakage of your teeth. 

What are dental crowns?
Dental crowns cover the entire visible surface of your affected tooth and add strength, durability and tooth stability. Click here to learn about the difference between crowns, bridges, and implants.

What kinds of crowns are there?
Expect to pay more for porcelain crowns because they are usually more time-consuming than gold crowns. Porcelain, porcelain over metal and gold crowns average between $600 to $3100 each in total cost. The new reinforced resin or bonded all-porcelain type costs more than other types, require more skill from your dentist and the lab, and may exceed your insurance plan coverage for crowns.

• Resin and Porcelain Crowns

• The new reinforced resin or bonded all-porcelain type of crown as the nicest appearance. This crown can be made from pure ceramic or a new reinforced composite resin, and is almost indistinguishable from natural teeth. Thew new bonding technology involved provides an exceptional bond to your tooth. It is metal-free, and thus satisfies the needs of patients with metal sensitivities. When correcting your back teeth with bonding, the cosmetic dentist will perform a tooth colored onlay. This type of procedure is used to correct only those parts of the tooth that are in need. This is a metal-free procedure. 
• Advantage: Porcelain crowns or new reinforced resin are considered to be the most aesthetically pleasing, as it is so easily matched in color to the surrounding teeth
• Disadvantage: The thickness of the porcelain required for pleasing aesthetics also requires that more tooth structure needs to be removed. It is more difficult for your cosmetic dentist to get an ideal fit where your gum meets the crown. Gingival inflammation appears to be more common with porcelain crowns that gold crowns. All-porcelain crowns require a higher skill level from your dentist and lab.
• Crowns Made of Gold

• Gold crowns are appropriate when appearance is not a priority to you. The gold metal is extremely workable, making gold crowns a more precise fit than any other type. While there exists a slight possibility of chipping with porcelain crowns, gold crowns provide no such possibility.
• Advantage: The preparation of a tooth for a gold crown is the simplest and least complicated preparation as there is minimal tooth structure removal with as much as possible of the healthy tooth structure remaining untouched. While porcelain is hard by comparison, it may cause wear on opposing teeth over the years where goal is not as likely to do so. Gold is also easier to fit to the area where the tooth and crown meet for a better fit. Gold is also a healthier environment for the gum tissue.
• Disadvantage: The cosmetic aspect, unless it is being used in the back of your mouth
• Porcelain and Metal Crowns

• For a very natural appearance, porcelain fused to metal crowns are the answer. However, they have a metal substructure and require an opaque below the porcelain. This can make the translucency of natural teeth difficult to replicate. Occasionally, a darker line will be visible at the edge of the crown, near to your gum when it recedes with age. 
• Advantage: Porcelain fused-to-metal crowns have a very natural appearance
• Disadvantage: They have a metal substructure and require an opaque below the porcelain. This can make the translucency of natural teeth difficult to replicate. Occasionally a darker line will be visible at the edge of the crown, near to your gum when it recedes with age
• Types of Porcelain
• There are two types of porcelain - felspathic and pressed ceramic porcelains. The felspathic type is the original method that has been around for 20 years. Ceramist in a dental lab bakes porcelain onto tin foil and then heats it in an oven. The Ceramist is able to create tints and opaques inside the porcelain to give the natural look we seek.
• Pressed ceramic is created from a single ingot. The single ingot is milled in one piece to create the desired shape. The stains and opaques are applied only to the surface of the porcelain to give a natural look.

How do I choose a color for the dental crowns - how white should it be?
Whiten your natural teeth to either the level of whiteness you want or to the brightest they can be. Your cosmetic dentist will then have the crowns made to that color. Teeth are of course not monochromatic, so typically more than one color is used to used a very natural look. This color variation is critical in avoiding fake or artificial looking teeth. It is the internal contrast of colors that help create vitality. The internal play of light on the porcelain in the restoration helps to create this vitality. Surface texture is also very important, and helps to break up light reflections and make the crown look more natural.

There is no one standard system in the dental field to measure and determine tooth color. The most often heard about, however, is the Vita shade guide. This guide divides tooth color into four basic shade ranges:

A (reddish brown)
B (reddish yellow)
C (gray)
D (reddish gray)

In the A range, there are five level of darkness. Ranges B, C, and D, each have four levels.

Not all of your teeth are the same natural color. Usually your eye teeth tend to be darker than the others, your front teeth are typically the whitest, and molars tend to be a shade between the two. The goal for everyone is to achieve their individual optimum whiteness while still looking natural.

Most dentists will show you a shade chart for your to pick from. Keep in mind, with a good cosmetic dentist, this is merely a starting point. Other considerations when determining the color of crowns for each patient are your complexion, hair color, the color of your natural teeth and even your eye color.

What is the procedure?
- Preparing (drilling) the tooth in an appropriate fashion for the type of crown chosen
- Making impressions of the prepared tooth, opposing teeth, and the occlusal (bite) relationships
- Selecting a shade for tooth-colored crowns
- Fabricating a provisional restoration that will remain in place while the crown is being constructed
- Cementing or bonding the completed crown into position. If the work to be done is extensive, there may also be several appointments needed for preliminary seating (try-in) of the crowns or castings

What do I need to do BEFORE I get the crown?
It is important for the ultimate success of the crown(s) that you understand and can perform thorough plaque removal. You should immediately begin following the oral self-care instructions that you have been given. It will make the procedure more comfortable and efficient, and the resulting restorations will look better. Final impressions cannot be taken until the gum tissue is healthy. Crown lengthening is an oral surgery treatment that involves removing excess gum tissue around the upper teeth to make them look longer. Your cooperation is appreciated and necessary.

What do I need to do AFTER I get the crown?
As is true with your natural teeth and especially with teeth that have been restored with any dental material, you should avoid chewing on excessively hard or sticky foods after the crowns have been cemented. It is especially important not to bite down on hard foods with just one tooth. The porcelain material can fracture from the metal substructure under extreme forces. Anything you chew that could break a natural tooth could break a crown!

Be sure to brush and floss daily as instructed. We also advise using a fluoride mouthrinse as part of your daily routine. Please be sure to return for your regular examinations and prophylaxis (cleaning) appointments at the time intervals we suggest.

After observing these types of procedures for many years, we note that the gingiva (gums) can recede from the crown margins and the surrounding tooth structure may become visible. This recession usually takes place over a period of several years and may require restoration replacements or a periodontal plastic surgery procedure to correct it.

We expect that you will receive many years of service from the cast restoration.

If you have any questions about crowns and bridges, call our office and ask or set up an appointment. We have 3 convenient locations around Austin.