Missing Teeth – What’s the Big Deal?

teethTeeth can be lost through a variety of reasons.  Decay, periodontal disease (bone loss), trauma, infection, and congenital abnormalities may all result in tooth loss.

Society values a nice smile, and  misjudges those without teeth, hence people often hesitate to smile or speak in social settings if their front teeth are missing.  Therefore, most people tend to replace missing front teeth.

But the same value is not put on missing posterior teeth.  Because posterior teeth are not visible, they are often de-valued.   But any missing tooth can have a big impact on a person’s appearance and their health.

posterior teeth drifting useFor starters, when a tooth is missing, the adjacent teeth naturally begin to “drift” toward the gap, moving from their optimal position in order to fill the space. Teeth on the top will often “over-erupt” if the tooth below is missing.  While a tooth that drifts is not a painful process, it can  affect both the appearance of the mouth, and the bite (how your top and bottom teeth fit together).  A misaligned bite can cause problems with chewing and biting and can be the source of significant pain.

face changesAnother problem lies with the deterioration of bone that occurs at the site of the missing tooth.  Your tooth’s root stimulates the bone.  Without this stimulation, your jaw bone can deteriorate and cause facial disfigurement.  As the bone wastes away, the distortion of the face and a hollow appearance around the mouth can occur.  The result of tooth and bone loss can add decades to a person’s appearance.  Losing a tooth can result in a 25% decrease in bone width in just the first year. And this bone loss becomes worse and more apparent as the years go by.

Teeth are an important structure to help pronounce sounds.  When you lose teeth, your speech can become more difficult, and it can be harder for people to understand what you are saying.

Each tooth in your mouth shares the overall workload of chewing and biting.  When this happens, it can lead to premature tooth wear and breakage of the remaining teeth, or even the development of TMJ disorder

There are several options to replace missing teeth.  Join us on our next blog to see the options and the pros and cons of each option.

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Phone a Friend

Remember the game show – Who Wants To Be a Millionaire. 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 guarentees and often the best choice of treatment is based on the individual and several other factors.

I was reminded of this game when my sister called me from Texas. She was in the dental chair – and just wasn’t sure what to do. She was going to have a crown (cap) fabricated for one of her molar teeth, due to a very large old amalgam filling that was breaking down. When the dentist was preparing the tooth – it turns out there was very little tooth structure left. He presented her options. 1) Have the crown completed – no guarentees how long it would last due how little tooth structure was left. 2) Have the tooth extracted and a bridge made to fill in the gap. 3) Have the tooth extracted and an implant & crown placed. She wanted a second opinion. She trusts her dentist, but just was unsure what to do. The longest lasting and highest sucess possibility was the implant and crown, but it was also the most expensive. It was reassuring for her to “phone a friend” and ask what did I think.

Here’s the thing. No one has a crystal ball. She could go forward with the crown, knowing it is not ideal due to such little tooth structure left. It could last for months, it could last for years and years. Everyone is different. She could have the tooth out, and have a bridge made, OR… have the tooth out and a dental implant placed — that option could last her years and years and likely would. But there are no guarentees – it is dentistry.

So…. you may not have the option of “phoning a friend” who knows dentistry, but you do have your dental team. 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 guarantee how long something will last, he or she can give you an honest opinion. Some procedures have higher success rates than others.

2) Have them 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 procedurescales 3
  •  cost – something might be more expensive to start, but if it last you 5 – 10x as long, it is worth it in the long run. However at this point in your life, even if you want the best treatment, maybe you just can’t afford it.  If cost is a factor, let the office know, we will try to work with you to come up with a solution such as alternative financing.
  • 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. For instance, 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

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 caring individuals who care more about offering the best treatment possible for each person than they do money. 

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 – but maybe they had it 40 years ago, or maybe they weren’t frozen properly.  A root canal is not normally a painful experience now a days.  If your friend tells you something negative about a procedure – ask your dentist about it.

POLL the audience! Your dental team is a great asset. Ask them questions too. Chances are, many of them will have experienced the procedure your are considering, or know someone who did.

moneyDECISION TIME — Think wisely. IF there is a procedure that definitely has a higher success rate, and if you can afford it (even if you have to make a few sacrifices), invest in your teeth and go for it. If you really can’t afford it, consider the option you can afford or see if you can obtain financing for the procedure.

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Different Types of Teeth

There are 4 different kinds of permanent teeth.  Why are some teeth thin, while others are thick with a biting surface that has peaks and grooves?  The answer is the teeth look different from one another because they are designed to do different things!

incichiThe Incisors are the teeth in the very front. They’re the sharpest teeth. Incisors are shaped like tiny chisels with flat ends that are sharp.  They are built to cut food (like sharp scissors), and they are also shaped to shovel the food inward.

cus tooThe Cuspid or Canine teeth are the pointed teeth located beside the incisors.  People have a total of four canine teeth, two on top and two on the bottom. They are also called the “eye” teeth.  Unless they have been worn down by chewing and grinding, they are quite pointed.  They have only one root, but it is the longest root of any of your teeth – which gives them added stability because they are meant for grasping and tearing food.

crunchPremolar or bicuspid teeth are located just behind your canine teeth. There are 8 bicuspid teeth in total – 4 on the top, 4 on the bottom. They have a completely different shape than both the incisors and canines. Bicuspid teeth have a flatter chewing surface with ridges, – all of which makes them perfect for crushing and grinding food.

mill mill 2The Molars are the last teeth towards the back of your mouth. You have eight of these (not including your wisdom teeth which are also molars).  There are normally four molars on the top arch and four on the bottom arch.  The word molar means “millstone,” which makes sense as these teeth work similar to a millstone, grinding food. go tooThey are wider and stronger than premolars, and they have more ridges. Molars work closely with your tongue to help you swallow food. The tongue sweeps chewed food to the back of your mouth, where the molars grind it until it is mashed up and ready to be swallowed.

Eating fruitThe next time you eat, pay attention to which teeth do which jobs. Having an apple? Incisors do a good job of biting into it. What about a carrot? Most people use their canines or premolars to bite a piece off, then use their molars to get the job done.  Think about how hard it would be to completely chew a carrot with your front teeth!  How about a slice of pizza or a piece of toast? Your canines will help you tear at the food, and then your premolars and molars will help you grind up and swallow the pizza or toast.

If you are missing some teeth, it will often “over stress” other teeth as they end up doing jobs they weren’t meant to do, and chewing is not evenly distributed.  Join us for our next blog “Missing Teeth – Not Just a Cosmetic Issue!”

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Managing all those Sweet Halloween Treats

halloween trick or treat 2Halloween is an exciting time for children. They get to dress up in their favorite costume and trick or treat for lots of loot.  However, it is not such an exciting time for parents! Now that Halloween has come and gone, parents may be left wondering how to manage all the sugary treats that were collected….

If you are worried that the treats your kids will be eating will damage their teeth, here is a list of Halloween candy tips to help minimize the effects of all that candy on teeth.If you are worried that the treats your kids will be eating will damage their teeth, here is a list of Halloween candy tips to help minimize the effects of all that candy on teeth.

Sort and Eliminate: After trick-or-treating, sit down with your kids and sort through the candy together. Most parents know that they should check for any candy that may have been tampered with, but they should also look at the type of candy their child received.  Sort the candy into piles – hard candy, soft sticky candy, and less harmful candy.

  • Hard Candy — there are 2 ways to eat hard candy – both are a danger to teeth.  Sucking on hard candies provides a long exposure to the sugars that nourish cavity-causing bacteria.  Crunching on hard candy can break a tooth, damage orthodontic brackets and wires, and damage sealants.Stock Photo
  • Soft and Sticky Candy – such as gummy bears, taffy, sticky caramels, fruit snacks etc., stick between teeth, in the grooves of the biting surfaces of teeth and around orthodontic brackets and wires, and provide bacteria with a nice long-term meal.
  • Safer Candies – candies that are soft and non-sticky – things like chocolates, M&M’s, and peanut butter treats are the least harmful to teeth.

Consider a “Buy Back” for offending candy.  If the candy your child received sets off an alarm in your mind, consider offering a trade for such candy. Set a limit of 1 to 5 cents per piece of candy, and “buy back” the offending candy.

Halloween-CandySet Limits:  Once you have sorted their candy, and narrowed it down, set rules for when and how much candy can be consumed. Schedule “candy time” once a day, preferably with snacks or meals, not in between. It is always best to eat sweets with other foods. The presence of the additional food increases the saliva production in the mouth. This increase in saliva helps to break down the sugar quickly, which in turn decreases the amount of acid produced in the mouth.  Do not allow them to “snack” on the candy throughout the whole day because it provides a constant sugar  attack on the teeth.

brushing teethBrush and floss:  After consuming Halloween candy – have your child brush and floss their teeth.  You can also have them rinse with a mouthwash designed for kids that contains fluoride, which will help to prevent cavities.

Chew Sugar-Free Gum: Sugar-free gum works just like food to increase the saliva production in the mouth. Offer your child a piece of sugar free gum if tooth brushing is not an option after eating the candy. When selecting a sugar-free gum, look for one that contains xylitol, for the added benefit it brings for post-candy consumption.  There are also xylitol mints available if your child does not like gum.

Store Candy Out of Sight:  If children don’t see it, they will be less likely to ask for it.

Set an expiration date:  Impose a reasonable time limit to keep the Halloween candy in the house, then get rid of it!

apple 1Set an example:  Make sure you set an example for your kids with how you consume sweets during the day.  If they see you practicing healthy snacking – they are more likely to get on board with it!

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Nail Biting and Your Health

Nail Biting

Woman biting nailsYou may have been advised to avoid chewing on hard nuts, and ice cubes as it may chip your teeth.  The same warning applies to nail biting.  Dental enamel is the strongest tissue in the body.  But habitually biting on fingernails may eventually wear the enamel away, and cause other dental problems.

You may bite your nails without realizing you are doing it.  Many people bite their nails while involved in another activity, such as reading, watching television, or talking on the phone, or they bite their nails out of habit, boredom or stress. Nail biting affects people of all ages, and it can not only damage your teeth, but may affect your overall health.

Nail biting (technically called Onychophagia) is fairly common:

  • About 30 percent of children aged 7-10 bite their nails
  • About 45 percent of teenagers bite their nails
  • About 25 percent of young adults bite their nails
  • Only about five percent of older adults bite their nails

Problems with Nail Biting:

  • nail biting 8 borderFront teeth damage – Most nail biters use their front upper and lower teeth. Nails are fairly hard, and the constant pressure applied to those teeth when biting on the nails can result in worn enamel, chipped or broken teeth.  It can also contribute to the teeth becoming crooked/misaligned etc.
  • Nail biting is not good for teeth with braces either: braces already put pressure on teeth, the additional pressure from nail biting can lead to the weakening of the roots.
  • Gum tissue damage – jagged fingernails can cut gum tissue.
  • nailing biting germsIt is unsanitary.  If you have broken skin around your nails, it is basically an “open wound”.  The two “germiest” places on your body are generally your hands/fingernails and your mouth.  Even with frequent hand washing, your fingers are still dirty.  Your fingernails are almost twice as dirty as your fingers.  A study done by renowned microbiologist Dr. Anthony C Hilton concluded that 25% of men, and 15% of women have a harmful bacteria called enterobacteriaceae living under their nails.  Another expert — Dr. David Katz of Yale University — conducted an experiment with his students to test bacteria grow under the fingernails. He concluded that short painted nails have least amount of bacteria growth. Conversely, long unpainted nails had the most growth.  Due to the bacteria, not only is there concern for germs being passed from the hands to the mouth, but imagine all the germs from the mouth that can be passed along to broken skin around fingernails. Either way it can provide access for these undesirable germs to your bloodstream.
  • Gingivitis – Also known as the first stage of gum disease, gingivitis is a bacterial based condition that often gets its start from plaque build-up. But injury to gum tissue and the introduction of bacteria can also result in gum disease.
  • It can be costly: According to the Academy of General Dentistry (AGD), nail biting can result in up to $4,000 in additional dental bills over one lifetime.

What treatments are available for nail-biting?

Several treatment measures may help you stop biting your nails. Some focus on behavioral changes and some focus on physical barriers to nail-biting.

  • First – be more conscious of your nail biting – try not to bite your nails.  Ask others to tell you when you are biting your nails.
  • nail biting 9b borderKeep your nails trimmed and filed. Taking care of your nails can help reduce your nail-biting habit.
  • Have a manicure regularly or use nail polish. Men can use a clear polish. Wearing artificial nails may help you to stop biting your nails as well.
  • Paint a bitter-tasting polish or cream for around your fingernails, such as CONTROL-IT or Thum on your nails. The awful taste will remind you to stop every time you start to bite your nails.
  • Try keeping a record of nail-biting.  You will become more aware of the times when you bite your nails which may help you to stop biting your nails.
  • nail biting silly putty borderbSubstitute another activity, such as squeezing a stress ball or Silly Putty, or drawing/doodling, when you find yourself biting your nails.
  • Wear gloves, or put adhesive bandages around your nails, whenever possible to remind you not to bite your nails.
  • Snap a rubber band on the inside of your wrist when you start to bite your nails so you have a negative physical response to nail-biting.

If you do have tooth damage from nail biting, give our office a call.  We can discuss the options for repairing the damage.

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Breast Feeding and Early Childhood Caries

Is Your Breast Fed Baby at Risk for Early Childhood Caries?

Our recent post discussed Baby Bottle Tooth Decay (Early Childhood Caries) and how and why it occurs.  It is important for Moms who breast feed their baby to know that just because a baby is breast fed, does not mean they are immune to early childhood caries.

Mother Breastfeeding Baby In NurseryTooth decay can arise when a young child nurses from the breast, because breast milk also has sugar in it.  However, breastfeeding is associated with a low risk of developing tooth decay, compared with bottle feeding. Nevertheless, breast milk does contain sugars and some infants who breast feed for long periods throughout the day or night may develop tooth decay.

For Breast-fed Babies

  • Avoid :  feedings that last more than 30 minutes.
  • Avoid :  prolonged and unrestricted night time feeding.
  • Avoid :  frequent, on-demand (“at-will”) feedings once the first teeth erupt.
  • Avoid:   nursing your child to sleep.  If your baby is breastfed, and won’t fall asleep without being nursed, try to avoid letting him/her sleep with the nipple in his/her mouth. After he/she falls asleep, remove the nipple to prevent pooling of liquid.
  • After each feed, wipe your child’s gums with a clean, damp gauze pad or washcloth.    You should start brushing your child’s teeth as soon as the first teeth come in.  Gently brush with a child-sized toothbrush and water.

Lift the Lip” to check for signs of Early Childhood Caries  Once the primary teeth have erupted, parents can lift the baby’s upper lip and visually check both front and back of the four upper front teeth at least once a month.

baby-teething1[1]Checking a child’s teeth takes only a minute. It is helpful to have one adult hold the baby while a second adult looks at the teeth. A small dental mirror can help in viewing the back surfaces of the teeth. White spots on the surface of the upper front teeth or whitish lines at the base of the teeth along the gum line are indicators of Early Childhood Caries. If a parent notices any white spots on the teeth, a dentist visit is warranted. At this stage, Early Childhood Caries may still be reversible with prompt treatment. If left unchecked, the “white spot” lesions can rapidly develop to brown spots and general decay of the teeth.

For more information about how to prevent early childhood caries see our blog “How to Prevent Early Childhood Caries”

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How to Prevent Baby Bottle Tooth Decay

7893594_s-300x200HOW TO PREVENT EARLY CHILDHOOD CARIES 

  • If you must give the baby a bottle as a comfort at bedtime, it should contain only water.
  • If your child won’t fall asleep without the bottle and its usual beverage, gradually dilute the bottle’s contents with water over a period of two to three weeks, progressing to strictly water in the bottle.
  • Baby-Care-and-Cleaning-TipsAfter each feed, wipe your child’s gums with a clean, damp gauze pad or washcloth.    You should start brushing your child’s teeth as soon as the first teeth come in.  Gently brush with a child-sized toothbrush and water.  Rinsing the mouth is an option you can try with older children.
  • Fluoridated toothpaste can be used safely when you are sure that your child spits out all of the toothpaste after brushing. Older children can use a toothbrush with soft, nylon bristles. Use a very small amount of toothpaste (no more than the size of a pea). (You should consult the child’s dentist before considering using fluoride toothpaste).
  • Baby drinking from bottle. Image shot 2008. Exact date unknown.Avoid letting your infant walk around using a bottle of milk or juice as a pacifier or security object.  Do not allow your child to sip on a bottle filled with juice, milk, or formula for long periods of time as a pacifier
  • Start to teach your child to drink from a cup at about six months of age. Plan to stop using a bottle by 12 to 14 months at the latest.
  • pacifierAlways be sure your baby’s pacifier is clean. Don’t ever dip it in anything (such as sugar or honey). Don’t clean your baby’s pacifier by sucking on it yourself, a common but unhealthy practice, since you are passing bacteria from your mouth over to your baby!
  • Since some medications are more than 50% sugar, they can also cause cavities to form. Be sure to have your child rinse or brush after taking medications.
  • baby-teeth-6485868Inspect your baby’s teeth frequently and have them checked by your child’s doctor or a dentist.
  • Start dental visits by your child’s first birthday.

Join our next blog to learn if breast fed babies are at risk for early childhood decay!

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