The gingiva (gum) is the protective skin that is located around the necks of each tooth, and covers the underlying bone that holds the roots of the teeth.

The gums are the so-called first line of defense against bacteria that try to attack the underlying bone structure of the teeth.  The gums are structured to resist the forces of mastication (chewing).  Normal gum shape permits the flow of food away from in between the teeth and along the gum line, so that food is forced away from the gingiva to the tongue and is, in turn forced between the teeth to be chewed.   The gingiva has a sensory function as well.  It is innervated with pain, touch and temperature receptors, which offer protection.

Receding gums can be a result of several factors.  Typically the main causes of receding gums are 1) gum disease or gingivitis (The bacteria in plaque causes gum inflammation which results in the erosion of the gum tissue.  2)  The other main cause is over-aggressive brushing techniques.  This “wears away” the gum tissue.

Gum recession is very easy to diagnose.  If you notice a receding of the gum line, you should make an appointment with us to confirm the diagnosis and start proper treatment.  Although gum recession can be a slow progression, the end result can be quite serious and drastic.  Gum recession can lead to tooth sensitivity, exposed root surfaces and eventually as the bacteria have greater access to the underlying structures of the teeth, bone loss and tooth loss.

Your teeth are covered with enamel – the hardest substance in your body. This helps to protect the tooth from damage by bacteria, acids and erosion.  Root surfaces are not protected with hard enamel.  The cementum that covers the root surfaces of a tooth is much softer than enamel.  It is therefore more susceptible to the bacteria that cause tooth decay, and more prone to be worn away by aggressive brushing.

Sensitivity can be quite an issue for some people if the root surfaces are exposed.   There are dentinal tubules that run from the outside of the tooth to the inner nerve.   If due to gum recession, the tubules are exposed, sensitivity can be quite extreme.

Treatment

The best treatment for receding gums is to prevent and curb gum recession.  Thorough yet gentle brushing will remove plaque along the gum line without mechanically wearing away the gum tissue.  Once lost, gum tissue will not grow back!  Advanced cases of gum recession can sometimes be treated with tissue grafts, gingival flap surgery and possibly bone grafts.  If there is too much recession, grafts and other surgeries will not help and eventually the tooth may be lost.  Meticulous care of these areas will prolong the life of the tooth.  The sooner receding gums are addressed the less invasive the treatment and the better the outcome.

Join us for our next blog for more information about the causes of sensitive teeth.

KEEP THEM FOR LIFETIME! 

Do you brush your teeth right after eating or drinking something acidic?  Brushing your teeth immediately after eating or drinking something acidic can cause tooth wear.  If you eat or drink anything acidic, brushing at the ‘wrong’ time – particularly within 20 minutes after consuming acidic foods and drinks – can wear your teeth faster than normal. Give your teeth some time. Wait a ½ hour or so, then brush.  This will allow the enamel on your teeth to re-mineralize, returning to a more wear resistant form.

Do you brush your teeth too vigorously?  Often people think that brushing harder is better because it helps to remove all the plaque and debris.  Brushing too vigorously will not only damage the gum tissue over time but it can actually wear away tooth enamel.  Especially exposed root surfaces.  It is far more effective to brush gently with a soft bristle toothbrush as the bristles are more flexible and will conform to the tooth surface better to help remove plaque and debris.  Tooth brush abrasion (wearing away of tooth surface) is common problem, and can increase tooth sensitivity.

Do you grind your teeth? It is estimated that 90% of people grind their teeth.  Many are not aware that they grind.  They may not do it every night, but over time, the damage becomes evident.  Think of taking the oil out of your car and driving around the block once a night.  For years the damage will not be obvious, but eventually problems will arise.  Grinding or clenching your teeth can have similar results.  Clenching and grinding will eventually wear down teeth, destroy the supporting bone and can cause TMJ problems.  A dentist can usually identify a clenching or grinding habit by looking at your teeth.  If wear or damage is evident, you can protect your teeth from further damage by wearing a simple appliance called a night guard.

Do you take any type of medication regularly? There are many types of medications that can cause dry mouth. Saliva is important because it not only helps to dilute acids in the mouth (due to it’s alkalinity), but it helps to wash away food and debris providing a cleansing effect.   When your mouth lacks moisture, your teeth quickly become more vulnerable to enamel erosion, cavities and gum problems.   Ask your doctor or pharmacist if any of the medications you take can dry up your protective saliva.  See our posts regarding the benefits of saliva: http://sunningdaledentalblog.com/2012/07/17/6-ways-saliva-protects-your-teeth/  and the effects of dry mouth: http://sunningdaledentalblog.com/2011/06/06/dry-mouth/

Do you experience frequent bouts of heartburn or gastroesophageal reflux (GERD), or vomit frequently? Your digestive system churns with acids. When the acids find their way back up into your mouth via burping, reflux or vomiting, your tooth enamel may be damaged. People with heartburn, GERD, and eating disorders like bulimia or anorexia should take steps to protect their teeth.  Ask us how.

Do you swim in chlorinated pools often?  The pH balance of chlorinated water can sometimes be too low (acidic), putting swimmers at risk for rapidly deteriorating enamel. The lower the pH level of a liquid, the more acidic and harmful it is to your teeth.  According to  an article by The Academy of General Dentistry, swimmers who are in the water for six hours or more per week run the risk of yellow or brown stains forming on their teeth.  If you are at risk please ask us how to protect your teeth.  For more information click on the link:  http://www.speareducation.com/spear-review/2012/08/chlorine-why-teeth-are-shaking-in-their-boots/

Sipping on beverages throughout the day.   The sugar from a single sip can sit on your teeth for 20 minutes, and the accumulation of sugar can lead to rampant decay.  Acidic drinks will also make teeth more vulnerable to decay.  Sipping on any beverages (anything other than water) throughout the day maintains a constant attack on your teeth. http://sunningdaledentalblog.com/2012/02/01/what-are-the-worst-drinks-for-your-teeth/,  http://sunningdaledentalblog.com/2011/06/01/the-7-worst-food-and-drinks-for-your-teeth/

Sucking often on cough drops or other candies.  Just because cough drops are sold in the medicine aisle doesn’t mean they’re healthy. Most are loaded with sugar. So after soothing your throat with a lozenge, be sure to rinse with water. Whether the sugar comes from a cough drop or a hard candy, it reacts with the sticky plaque that coats your teeth. Then bacteria in the plaque convert the sugar into an acid that eats away at tooth enamel.  Gummy candy and fruit roll ups, etc also stick to the teeth keeping the sugar in contact with the teeth for hours.  Parents often think they are giving their children healthy snacks when in reality, they are not. 

Chewing ice and crunching on hard candy.  You would think that because ice is just frozen water, it is good for your teeth.  However chewing on ice, and crunching ice (and hard candy), can fracture your teeth and irritate the soft tissue in your mouth.

Using your teeth to open anything! Don’t use your teeth to open a bottle, a package, a barrett, a bobby pin, or anything else. It can lead to chipped or fractured teeth. 

Smoking as well as chewing tobacco. You knew this one had to be on the list! Smoking as well as popping a wad of tobacco into your mouth can not only yellow your teeth, but more importantly lead to oral cancer. Why would you even want to risk it? 

Piercing your tongue.  Studs or rings in the mouth can chip teeth and damage the gums. More importantly, the piercing creates a wound in the mouth, which is a highly-bacterial environment and could increase the risk of infection.

Nervous Habits.  Anytime you bite down on a hard, non-food object, you risk damaging your teeth. Individuals that have such nervous habits as chewing on pencils, biting their nails, or tapping a pen against their teeth, risk inadvertently cracking or chipping a tooth. Just like with ice cubes, you’re better off chewing on a piece of sugar free gum instead.

Playing sports without a sports guard.   Whether you play football, hockey, or any other contact sport, don’t get in the game without a mouth guard. Without it, your teeth could get chipped or even knocked out.  It is just not worth the risk!

Skipping Dental Checkups.  Dentists often recommend dental check ups and cleanings every six months, but most patients fail to comply. This allows plaque to form tartar (calculus), which attracts more plaque on its surface, carrying the plaque deeper within the gums.  This can destroy the tooth’s supporting structures (the bone).  Cavities if caught early are much easier to fix, and less tooth structure is lost.  “The sooner you find issues, the easier and less expensive they will be to address,”

10. Drink Bottled Water.  Most bottled water has little or no fluoride and most home filtration systems filter much of it out. Stick with fluoridated tap water since it’s “the most cost-effective way to prevent cavities and fight tooth decay,”  If your water isn’t fluoridated, you may require some type of fluoride supplement.

INSTRUMENT STERILIZATION

With all the media attention on dental office instrument sterilization the past several days, Sunningdale Dental wants to reassure our current and future patients that our sterilization techniques are of the highest standard. Our office is designed with an open concept so that the sterilization center is visually open for all patients to walk by and see that it is immaculate. Our instruments are kept in cassettes and each cassette goes through a Hydrim after the instruments are used.

A hydrim is an automated washing system, that cleans instruments before we sterilize them.  The advantages of automated washing systems over traditional manual cleaning are recognized by the Center for Disease Control and independent research and testing organizations. If it’s not clean, it can’t be sterilized.

Once the cassettes and instruments are washed, they are wrapped in autoclavable single use paper, sealed with special tape (that turns a different colour once it has been sterilized), and then loaded into the sterilizer.  Before the sterilizer is unloaded, it is carefully checked to ensure that the sterilization cycle was complete.  Once sterilized the cassettes are kept wrapped and in a special cupboard until we are ready to use them.

We preform spore testing on all our sterilizers once a day to ensure they are functioning properly. We maintain a log book of all spore testing samples completed.   We have written infection control protocols that are reviewed yearly and strictly adhered to.

Rest assured that Sunningdale Dental is a bit obsessive about keeping our equipment and instruments as clean and sterile as possible!

If contestants were unsure of the answer, they had 3 life lines – poll the audience, phone a friend and 50/50.   Sometimes choices in dentistry can be confusing. There are no guarantees and often the best choice of treatment is based on the individual and factors beyond anyone’s control.

Here’s the problem. No one has a crystal ball. There are too many factors influencing dentistry to make it an exact science.

IF you have a family member or friend who is in “dentistry” you may be able to ask them for an informed opinion regarding treatment recommendations.  But if you do not have the option of “phoning a friend” who knows dentistry, keep in mind that you do have your dental team and we are on your side.

Our office mission statement is “Providing excellence in dental care to you and your family while treating you like one of ours!”.

If you are unsure of something….. here are some steps to help you decide what is right for you.

1) Ask lots of questions – no question is a “dumb” question. Make sure you understand each option thoroughly. What are the pros, the cons and the cost. While the dentist cannot tell you how long something will last, some procedures definitely have higher success rates than others.

2) Have the dentist, hygienist or assistant show you pictures or diagrams to explain each procedure.

3) Make sure you consider all the factors when making your decision.
-    pros and cons of each procedure
-    cost – something might be more expensive to start, but if it lasts 5 – 10x as long, it may be worth it in the long run. However you may be at a stage in life that although you want the best treatment possible, you just can’t afford it. If cost is a factor let us know, perhaps alternative financing might be an option.
-  are you worried a procedure might hurt, or are there other factors influencing your decision (such as time to complete the procedure, how it will look etc.).  Discuss these things with us.  For example, many people are afraid it will hurt to have a dental implant placed, but in reality, there is usually very little pain associated with placing an implant – it is a very gentle procedure with little downtime after. Don’t be afraid to ask us.

4) Make sure you trust your dentist and dental team. You must be confident that they have your best interests at heart. Most dentists are honest individuals
who care about you and what is best for you.

Asking friends. On a side note, if you are going to ask a friend their opinion, make sure they know dentistry. Often friends will tell you “oh I had a root canal and it was awful”. Well that may have been true – maybe they had it 40 years ago, or maybe they weren’t frozen properly among other things. Often friends do not give accurate current information, or their view may be skewed by other factors. If you hear something like that from a friend – ASK your dentist. Will this hurt?

Remember – we are here to help you, and partner with you in your health care.

“If someone is too tired to smile,  give them one of your smiles, because no one needs a smile as much as those you have none to give”   Author unknown”

Forcing yourself to smile can boost your mood.  Psychologists have found that even if you are in a bad mood, smiling can instantly lift your spirits!

Like yawning, smiling is contagious. Scientists in Sweden say people had difficulty frowning when they looked at other people who were smiling!

Smiling relieves stress.  Your body releases endorphins when you smile (even if the smile is forced) and the endorphins can produce a change in mood, thereby releasing stress and boosting your immune system.

Smiles can use between 5 and 53 muscles.  Keep in mind that it is easier to smile than to frown – it actually takes on average 43 muscles to frown and only 17 muscles to smile.

Smiles are a universal sign of happiness. Handshakes, hugs, and bows all can mean different things in different cultures, but smiling is known around the world as a sign of happiness and acceptance.

Babies are born with the ability to smile.  Scientists believe that all babies are born with the ability to smile – it is not something they just copy from watching us – as even blind babies smile.  Newborns tend to have more preference for a person with a smile than a person that is not smiling!

Babies actually start smiling in the womb.  New 3-D ultrasound imaging has captured vivid pictures in which developing babies are smiling in the womb.  Right after birth, babies  start smiling in their sleep, and at about 4 weeks of age they smile on purpose.   Newborns tend to have more preference for a person with a smile than a person that is not smiling!

There are 19 different types of smiles.  A researcher in San Francisco identified 19 types of smiles and 2 categories of smiles.  Polite “social” smiles which engage few fewer muscles and “sincere felt” smiles which use more muscles.

Smiles are the most easily recognizable facial expression – people can recognize smiles from up to 300 feet away!

People with big grins live longer.  In a study published in the States, people who smile live an average of 7 years longer than people who don’t smile at all.  Perhaps this is because smiles reveal positive feelings and positive feelings are linked to well-being.

When someone smiles out of genuine delight, a facial muscle contracts and crinkles the skin around the eyes.  So you may be able to spot a fake smile if this muscle doesn’t budge.

Kids smile more than 400 hundred times a day!  Women smile an average of 62 times a day and men – just 8 times a day.

Smiling sends out the message to people that you are approachable.  This directly correlates with doing well in business, love and friendships.

Many animals have the ability to smile – for example chimpanzees and dogs can both be seen with smiles.

It is estimated that 80% of adults in this country have periodontal disease. This is when irreversible bone loss occurs resulting from the virulent bacteria that collect between the teeth. Research has shown that periodontal disease is a risk factor for serious conditions such as heart and lung disease, diabetes, and premature and low birth weight babies. Since periodontal disease is painless, many people are unaware they have this condition. The good news is that it’s never too late to start doing something about it.

Regular tooth brushing cannot reach all the areas of our mouth. Brushing is only able to clean about 60% of the mouth, whereas flossing is able to get to the other 40% if done properly.

Flossing is able to remove plaque, bacteria, and food debris between teeth.  Flossing has many benefits.  A cleaner feeling mouth, it helps to prevent bad breath, and it helps to prevent cavities and bone loss.

If flossing is so good for your oral and overall health, why don’t more people do it?  Statistics show that approximately 33% of people floss daily.   Flossing is a hard habit to develop and maintain.  Some people who have dexterity problems or large hands, find it difficult to floss.  Other people just can’t get into the habit.   There are alternatives though – and while they may not be as good as old fashioned flossing, they will make an improvement to your oral health.

1.  End tufted brush

This is a brush that has bristles similar to a toothbrush but the size of the brush head is much smaller.  It is great for brushing gently along the gum line, and between teeth.

To use an end-tufted brush place the brush along the gum line where the gum edge meets the tooth.  Slowly move the brush along the gum line applying light pressure.  Trace along the wavy gum line moving from tooth to tooth, adding a circular motion between the teeth.

2.  Interdental Brushes

Interdental brushes are also known as an interproximal brush.  These brushes are recommended for interproximal areas (areas between the teeth) where the gum is missing, shortened or has root concavities. This brush can also be used to clean around orthodontic appliances, space maintainers, small spaces in between teeth, under bridges if there is a space, and when spaces are large enough to easily receive the device.

To use an interdental brush, moisten the brush tip and insert it at an angle following the contour of the gingiva.      Move the brush back and forth from the cheek side in towards the tongue side and back. Brushes come in different sizes according to the size of the space in between the teeth. The brush tip should be slightly larger than the space which it is going to fill and clean. Do not jam an interdental brush in an area where there is not enough space as this could damage the tissue.

3)  Interdental Sticks

These are specially designed soft wooden / plastic wedges for cleaning between teeth.  If your are using a wooden stick, the end of the stick should be moistened and softened in the mouth before use.  To use, gently insert the stick between the teeth, with the flat edge facing the gum.  Then move it in and out gently to clean the teeth and massage the gums.   The sticks should only be used where there is sufficient space to allow the free movement of the stick between the teeth. Do not force them into position.

4.  Dental Flosser Toothpicks

These products are like a soft-bristled toothpick. There are many brands out there.  Gently insert the toothpick between the teeth if there is room and move it back and forth to clean the area.

5.  Flossers

Flossers are small plastic devices that hold about a 1/2 inch of floss.  For many people they make flossing easier as they are small and fit in your mouth better than your fingers!  They are easy to use with one hand.  There are many brands and styles of flossers.  They usually come packaged in 50 – 200 flossers per package.  Invest in a good brand so the floss doesn’t shred when used between tight contacts.

6. Water Flossers or Oral Irrigators

The water flosser/oral irrigator has been shown in studies to be effective in reducing bleeding and gingivitis.  There are several brands out there.  We do not endorse any one brand.  It is important to make sure it uses a pulsating action, as the pulsating flow of water helps to clear bacteria and debris from between the teeth.  It also stimulates blood flow. A small amount of mouthwash can be added to the water for flavoring and/or to enhance compliance. Any solution used should be at room temperature for greatest comfort. Follow manufacturers directions for adding solutions. Failing to do so may shorten the life of the unit.

7.  Electric flossers

There are several types of electric flossers on the market.  We don’t endorse any specific brand, but one sample of an electric flosser is the Airfloss. It’s microburst technology applies a quick burst of pressurized air and micro-water droplets to clean deep between teeth where a toothbrush can’t reach and with less mess than oral irrigators. This gentle yet effective technology is proven to remove more plaque between teeth than brushing with a manual toothbrush alone.

As you can see, there are many alternatives to flossing.  While they may not be ideal, if you will use them properly and on a regular basis, you will see an improvement in your oral health.  Pick an alternative that is easy for you and try it – who knows – it may be one New Years Resolution you keep!

For a long time we’ve known that many risk factors (smoking, alcohol, drug use and infections) can contribute to mothers having premature, low birth weight babies.  In addition, research suggests that serious gum disease, (called periodontitis) can cause your baby to be born too early and too small.

Pregnant women who have periodontal disease may be seven times more likely to have a baby that is premature.  Premature birth can lead to some serious problems for a baby.

Pregnancy hormones can affect your gums causing swelling, inflammation or bleeding.  This is called pregnancy gingivitis. It often begins in the second or third month of pregnancy and increases in severity, so it’s a good idea to have your teeth checked and cleaned while pregnant. You should make an appointment with your dentist at least once during the nine months, and if you have gingivitis, visit the dentist once each trimester.

Prevention of gingivitis during pregnancy

• You can prevent gingivitis by keeping your teeth clean, especially near your gum line
• Brush your teeth at least twice a day for 2 minutes each time.  Brush after meals when possible.
• Floss daily
• If you suffer from morning sickness, repeatedly rinse your mouth with water to try to neutralize the acid caused by vomiting.  Do not brush immediately after vomiting because stomach acid weakens tooth enamel and brushing can cause erosion of the enamel.  Rinse with water and wait 30 min to brush.
• If brushing your teeth causes morning sickness, rinse your mouth with water, try brushing without toothpaste.
• Eat a well-balanced diet with plenty of vitamin C and B12.
• See your dentist – schedule routine exams and cleanings for help in controlling plaque, preventing gingivitis and to maintain good dental health.

Other Resources:
http://www.perio.org/consumer/women.htm#pre
http://www.marchofdimes.com/pregnancy/yourbody_teeth.html
http://www.mchoralhealth.org/PDFs/pregnancybrochure.pdf

3 out of 4 of our dentists are participating.  Dr. Julie Bargiglione didn’t think she would have much luck growing a mustache so opted out!

Check out our Facebook page to monitor Dr. Carson, Dr. MacHardy and Dr. Aiello’s progress.  Click on the facebook link to go there now. 

To donate to the Sunningdale Team, click on the link below.

Movember Canada Sunningdale Team

Do you think baby teeth are temporary, and therefore not important? Think again. Baby teeth are necessary for chewing, speaking, and smiling. They also serve as placeholders for the adult teeth.

If baby teeth are infected or lost too early due to tooth decay, your child may develop poor eating habits, speech problems, crooked teeth, and damaged adult teeth. In addition, the chances that adult teeth will end up being crooked are greatly increased.

The good news is that a few simple steps can help prevent infant tooth decay. Here’s how:

• Try not to transmit bacteria to your child via saliva exchange. Rinse pacifiers and toys in clean water, and use a clean spoon for each person eating.
• Wipe the baby’s gums with a clean gauze pad or washcloth after each feeding.
• Use an appropriate toothbrush along with a toothpaste (approved by the Canadian Dental Association  http://www.cda-adc.ca/en/cda/seal_of_recognition/products/) to brush when baby’s first tooth comes in.  Continue to clean and massage the gums in areas without teeth.  (Fluoride-free toothpaste is recommended for children under the age of two.  You can use a pea-sized amount of approved fluoridated toothpaste when the child has mastered the art of ”spitting out” excess toothpaste)
• Do not place sugary drinks in baby bottles or sippy cups. Only fill these containers with water, breast milk, or formula. Do not dip pacifiers in sweet liquids (honey, etc.)
• Review  your child’s eating habits. Eliminate sugar-filled snacks and encourage a healthy, nutritious diet.
• Do not allow the child to take a liquid-filled bottle to bed. If the child insists, fill the bottle with water as opposed to milk or any other sugary alternative.
• Brush  your child’s teeth until he or she reaches the age of seven. Before this time, children are often unable to reach certain places in the mouth.
• Floss your child’s teeth once all the baby teeth have come in

Remember, when breast or bottle feeding:

• Take the bottle/breast away when the child has had enough.
• Do not put a baby or infant to bed with a bottle or allow him/her to suckle on the breast for prolonged periods during sleep.
• Introduce the baby to a feeding cup between 6 and 8 months of age.

  Soothers

Avoid dipping soothers in honey, sugar or other foods or liquids. All sugars (including natural sugars) that are not easily cleared from the mouth, can lead to tooth decay.

Medicines

If your child needs medicine, ask your doctor or pharmacist to prescribe a sugar-free form.

 

What can cause infant tooth decay?

According to a 2008 study in Pediatric Dentistry, primarily mothers, or anyone who kisses an infant with active tooth decay could pass cavities to the infant.  Only people with active tooth decay can transfer the cavities to infants.   Acid producing bacteria (streptococcus mutans) in the oral cavity cause tooth decay.  Studies show that infants are not born with the bacteria that cause cavities, but that they are infected most often by their parents or caregivers.  Once the transmission of bacteria from caregiver to baby has occurred the bacteria can multiply. The transmission of this decay causing oral bacteria from a caregiver to an infant could be caused by:

• kissing the infant
• the caregiver using their eating utensils to feed the infant
• the caregiver tasting the food or testing the temperature in their mouth prior to feeding
• ‘washing’ a soother in the caregivers’s mouth and then giving it to the infant
• the infant placing their fingers into the caregivers’s mouth and then into their own.

The most prominent cause of baby tooth decay however, is frequent exposure to sweetened liquids.  These liquids include breast milk, baby formula, juice, and sweetened water.  During the day, salivary flow is high and is more likely to wash away the sugary liquids that bacteria feed on to produce acid.  During the night salivary flow is greatly reduced.  When an infant is allowed to suck on a nursing bottle containing sugary liquids at night, the sugary liquids pool around the baby’s teeth giving the bacteria more time to convert the sugars to acid.  This acid will dissolve the enamel of the baby teeth resulting in cavities.

Baby teeth are more sensitive to getting cavities when they first erupt. It is important to keep the primary teeth healthy because they stay in the mouth for five to ten years. If teeth are infected or lost too early due to  decay, your child may develop poor eating habits, speech problems, crooked teeth, and damaged adult teeth. 

The good news is that a few simple steps can help stave off infant tooth decay.

Watch for our next blog    “Preventing Infant Tooth Decay”