Baby bottle tooth decay will destroy the teeth of an infant or young child, especially the front teeth. It is an infection that will interfere with eating, speaking, appearance, and facial development.

Cause: Frequent and long-term exposure of a child's teeth to liquids containing sugars such as milk, formula, and fruit juice. The pooling liquid around the infant's teeth feeds the dental plaque that produces acid that dissolves the calcium out of the teeth. During sleep, the flow of saliva has slowed down, so there is little flushing or neutralizing, which makes the problem worse.

Prevention: Never allow the child to fall asleep with a bottle containing a sweetened liquid.

After each feeding, wipe the child's teeth and gums with a damp washcloth or small soft toothbrush to remove plaque. If the child refuses to fall asleep without a bottle, simply fill it with water and nothing else. Start visits to the dentist between six and twelve months of age.

If you have any questions about Baby Bottle Tooth Decay, please call our office.

Traumatic Injury to the Teeth
Traumatic Injury may include teeth that are knocked out (avulsed), forced out of position (extruded), or broken (fractured).

Avulsed Tooth: Attempt to find the tooth. Rinse, but do not scrub the tooth. Let the victim carry it in their mouth, between the cheek and gum. (It can also be carried in milk.) Call your dentist for an emergency appointment. Chances of success with reimplantation are greater the sooner they are done, so hasten to the dentist.

Extruded Tooth: Try to gently reposition the tooth. See a dentist as soon as possible for splinting.

Fractured Tooth: For a minor fracture there is no urgency. A chipped tooth may need polishing or restoration. A moderate fracture with broken enamel or exposed dentin that is sensitive to the air can be treated at the patient's earliest convenience. A severe fracture with trauma that has exposed the pulp of the tooth requires prompt attention to control pain and infection. The tooth may be restorable if there is enough intact root to build on. It may have to be extracted. Call our office immediately for an emergency appointment.

Problem: Patients too fearful to go to the dentist.
Solution: Dentistry has changed.

The American Dental Association studies indicate that about 50% of the population in the United States don't see a dentist on a regular basis. Fear is one of the most common reasons we hear for this lack of care. Patients often tell us of bad experiences going to the dentist as a child.

Many patients don't realized how much dentistry has changed. First of all, the anesthetics are much improved, they act quicker, last longer, and do a much better job of eliminating all feeling in the tooth. We use a topical anesthetic to numb the area before the shot, and with smaller and thinner needles, the shots are virtually painless.

Drill-less techniques work in many cases.

Dental techniques have also improved greatly. While it is still necessary to sometimes use the "drill", it is so much improved that the drilling time is greatly reduced.

Fear of pain in the dentist's care is out of date. We'll show you why!

BURNING MOUTH:
Burning mouth usually occurs in individuals over 50, but can affect others as well. There are several reasons why it occurs.

Denture problems: a new denture, or one that doesn't fit well, can irritate your entire mouth.

Reduced salivary gland function: this will cause the mouth to become dry, inviting oral discomfort, difficulty eating or swallowing, loss of taste, and a burning mouth. Salivary gland dysfunction sometimes comes with age. But there are saliva substitutes and rinses to protect your oral tissues, and soothe burning sensations.

Medications: these often dry the mouth (side effects)

Vitamin deficiency: there is some evidence linking burning mouth syndrome to Vitamin B deficiency.

Candida infections: this is a common oral fungus, usually apparent to the eye but sometimes undetectable. A topical anti-fungal agent can be prescribed.

Problem: Cancer treatment - related complications in the mouth
Solution: A complete dental evaluation prior to beginning anti-cancer therapy.

Each year about 400,000 people with cancer develop treatment-related complications in the mouth ranging from lesions to chronic dry mouth to bone disintegration. If serious, these complications can be life threatening. While many are unavoidable, some can be prevented or minimized.

It is recommended that whenever possible, a pre-therapy dental evaluation with a full set of mouth x-rays be performed. Any decay, gum disease and abscesses should be treated, if time permits, prior to chemotherapy and/or radiation therapy.

Even patients who have no pain or dental disorders need a thorough cleaning. The goal should be to have the patient's mouth in optimal health prior to beginning anti-cancer therapy.

If you have questions regarding cancer treatment and your dental health, please call our office.

Problem: Crisis treatment
Solution: Education: Don't Rely on Pain

Many people don't see a dentist on a regular basis. They go only when they feel they have a problem. We call this "crisis treatment" as opposed to "preventive treatment". While these patients may feel they are saving money, it usually ends up costing much more in both dollars and time. The reason for this is that most dental problems don't have any symptoms until they reach the advanced stages.

An example is tooth decay. We hear all the time, "Nothing hurts...I don't have any problems". But tooth decay doesn't hurt! Until, that is, it gets close to the nerve of the tooth. Then a root canal and crown are usually necessary, instead of the small filling, which could have been placed several years ago when the cavity was small. We can usually detect a cavity 3-4 years before it may develop any symptoms. It is not uncommon to see a patient with a tremendous cavity and they have never felt a thing!

Problem: Too much Filling, too little tooth
Solution: A Crown for a Tooth

Teeth are often restored with fillings of silver or composite plastics. These materials can often accomplish the aim of replacing the part of the tooth that has been lost in a strong and good-looking manner. However, there comes a point where the damage to the tooth has removed too much structure to hold a filling. The restoration must be done by a technique that will attach to the remaining tooth, stand up under heavier use and meet more elaborate cosmetic requirements.

The Crown is the dental restoration that can strengthen and restore the entire top of a tooth. The crown can also be part of the attachment of a fixed bridge for the replacement of teeth. The tooth is strengthened because it is covered from the outside with a casting of metal or ceramic that will wrap up and splint the tooth.

The chewing of the tooth can be improved because it can be reshaped to match more efficiently with the opposing teeth. A crown can improve cosmetics by the use of modern ceramic processes that produce translucency and color that is more natural than has ever been possible.

Diet and Dental Health
Diets low in certain nutrients reduce resistance to oral and dental infections, that is, periodontal disease (gum disease) and decay. A healthy immune system is essential to controlling periodontal disease.

Counseling in the Four Basic Food groups will improve dental health and general health. The consumption of sugar, especially in sticky forms or in a baby bottle while sleeping, contributes to the rapid development of dental decay.

The trace nutrient fluoride, may not be adequately supplied by bottle or municipal water supplies. Supplementation with oral tablets and topical application will reduce the incidence of dental decay by more than 60%.

Together, a balanced diet, daily use of fluoride, effective brushing, and sensible eating habits can reduce the risk of, or even prevent, infectious dental disease.

Please don't hesitate to call our office if you need more information on diet or fluoride supplementation and its relationship to dental health.

Problem: Discolored teeth
Solution: Bleaching

We all lead with our smile. Your smile brightens up each person you meet. Are you happy with your smile?

One question I ask my patients is: "What would you do to your mouth if you had a magic wand?" Nine out of ten tell me they would like whiter or brighter teeth.

Is there a solution?

The answer is yes. Many times the process is relatively simple. Bleaching teeth, through treatment in the office and/or by home bleaching techniques, has worked wonders for many patients.

So, if you could use help in brightening your smile, please don't hesitate to call our office. I am always dedicated to achieving a healthy smile.

Problem: Discolored Teeth
Solution: Adhesive Dentistry

For over 100 years, dentistry has restored teeth primarily with a material made of mercury and silver. It has done its job well, although we have had to live with its weaknesses. Those weaknesses consist of cracking teeth due to expansion of the material, and restorations turning black as the silver in the material corrodes.

Now, we have many ways to provide tooth-colored restorations. We can use adhesives to bond tooth parts that look and act like teeth. We can provide a bright, healthy and strong smile with these exciting new techniques in adhesion dentistry.

Please don't hesitate to call me personally if you have any patients who you believe would benefit from these advancements. Together, we can bring a smile back to your face.

Problem: Gum Disease
Solution: Detecting Early Symptoms

The American Dental Association says that over 75-80% of all adults have or will have some form of gum disease

Gum disease, or more correctly called "periodontal disease", is a bacterial infection in the gums and supporting structures of the teeth. It can be divided into several categories.

The first stage is called "gingivitis" and is characterized by gum tissue that is red, puffy, and bleeds easily when touched with a toothbrush, floss or dental instrument.

The second, third, and fourth stages are initial, moderate, and advanced "periodontal disease", respectively. These stages are different from gingivitis because the infection has destroyed the bone supporting the teeth, causing eventual tooth loss. The treatment is more involved at these stages, usually consisting of a special cleaning with anesthesia and sometimes gum surgery.

Problem: Infections in joint replacements can be instigated by severe tooth and gum infection.
Solution: Thorough dental examination for presence of tooth and gum infection prior to joint replacement.

Periodontal disease is a commonly occurring oral infection of the adult population (80% of adults are affected) destroying the bony support of the teeth. This infection slowly progresses over the lifetime of the patient and is often manifested in the advanced stage in the senior population. Because of the lack of any discomfort to the patient until total loss of bony support to the teeth, many adults are unaware that they have this infection. However, the bacteria from this bone destroying disease, especially in the more advanced cases, has been attributed to possible infection of joint replacements.

Candidates for joint replacements who have not been seen by a dentist in over a year should be considered for a thorough dental evaluation of their teeth and gums before surgery. Depending on the severity of the infection, treatment of gum infections and tooth abscesses may take from two weeks to two months before the patient reaches adequate health before surgery.

If you have any questions about infection in joint replacements, please call our office.

Problem: Lost Teeth Impact Total Health
The loss of natural teeth is far-reaching and cannot be resolved by dentures. (Is blindness resolved by inserting glass eyes?)
Solution: Keep Teeth

In the past, the loss of teeth was dismissed as a natural part of the aging process, and dentures were considered a normal sign of old age. While such ignorance is rapidly becoming a thing of the past, there is still not a general awareness of the seriousness of edentulism. Multiple tooth loss is most commonly caused by periodontal disease, i.e.. gum and bone disease. Periodontal disease has a high statistical correlation with chronic debilitating disease, such as diabetes, cardiovascular disease and arthritis. So it is not very surprising that studies now show a shortened life expectancy by as much as 10 years for persons who have lost their natural teeth, when compared to those who have kept their teeth.

In addition to longevity, quality-of-life differences are just as significant. The functional efficiency of dentures has been measured to be only 20% of that of natural teeth. Can there be any doubt that nutritional deficiencies will be much more prevalent in those without their natural teeth? Loss of teeth often causes a feeling of loss of wholeness and a sense of deterioration and aging. Given these factors, preservation of the natural teeth is integral to whole-person wellness.

Problem: Some dental problems are easy to see!
Solutions: See the dentist!

One of the easiest problems to spot is a build-up of plaque. Plaque is the soft, sticky layer of bacteria, which is constantly forming on the teeth. Usually it is invisible to the naked eye, but when a person is not brushing adequately, it can build up to where it appears to be a thick whitish coating on the teeth at the gum line. If not removed, it can lead to gum disease.

Another potential problem, which is easy to spot, is missing teeth. Many patients assume that if they are still able to eat, they are O.K. But very often, losing just one tooth can lead to the loss of support, and teeth begin to drift into the empty space, causing a change in the bite. It also forces the remaining teeth to carry an additional load, sometimes past their ability to adapt. In most cases, when even one tooth is lost, the remaining teeth suffer and are more likely to be lost as well.

We specialize in the treatment of problems such as these. Call our office for the care you need.

Problem: Poor self-image, resulting in low self-esteem.
Solution: A Proud Smile Helps

The appearance of the teeth has a dramatic effect on both the person's attractiveness to others and on their own self-image and self-esteem. Studies have shown that a person's appearance will have a strong effect on their social and career success, by influencing how others perceive them.

While the appearance of the teeth is one of the most important contributors to facial beauty, it is also probably the most often neglected when improvements to appearance are sought. A person with low self-esteem connected to their facial appearance, can often be greatly helped by cosmetic dental procedures.

Dental make-overs have become more common, less invasive, and more effective in correcting deformities and cosmetic dental problems. The effect of these procedures can be nothing short of dramatic both in terms of appearance and also in terms of correcting, at least partially, personality deficiencies caused by poor self-image. Ugly teeth are no longer a matter of fate; they are now becoming a matter of choice.

Problem: Stained, broken, worn, or crooked teeth
Solutions: Bonding, Porcelain Veneers

Bonding is typically painless and can yield dramatic results in a single office visit. Essentially, bonding hides any natural flaws through the placement of a thin plastic coating on the front surface of the teeth. After treating the tooth surface, a puttylike bonding material is applied that is then sculpted, shaped and colored to suit the patient's needs. A high-intensity light causes the plastic to harden after which the new surface is smoothed and polished. Bonding can lighten stains, close gaps and even alter crooked or malformed teeth. It can be utilized to change the shape or color of a single tooth or if necessary to revamp the entire smile.

Porcelain veneers are often used for the same reasons as bonding. They are considerably more durable and stain resistant than bonding. The veneer is actually a thin piece of porcelain similar in size to a fingernail. Once it is "bonded" onto the tooth it becomes extremely strong. It also blends in with the remaining tooth structure so that it is unnoticeable to the naked-eye. Once in place, it looks, feels, and functions just like a regular tooth. Porcelain veneers can be utilized to change the shape and color of a single tooth or if necessary, revamp an entire smile. Porcelain veneers can also be used to correct teeth that have been worn from clenching and grinding.

Please call our office for a free cosmetic consultation.

Problem: Dental disease during pregnancy
Solution: A dental evaluation and preventive dental care

Many mothers have experienced gum disease, dental pain and/or tooth extraction during or shortly after their pregnancy. This is often seen as being a "normal" side effect of being pregnant. However, dental disease, which is an infection of the teeth and/or gums, is not "normal" for any patient.

There are three basic events that happen during pregnancy which make the patient more susceptible to dental disease. First, hormonal changes may make the gums more susceptible to gum disease. Second, pregnant women tend to eat smaller, more frequent meals, exposing their teeth and gums to sugars and acids more often. Third, cravings for "junk foods" and inadequate oral hygiene pose an increased threat to the teeth and gums.

Pregnant women should be advised to schedule a dental evaluation and receive preventive dental care. Personalized oral hygiene instruction should also be given to fight disease and promote overall good health for the mother and her baby.

Problem: Dental decay "cavities"
Solution: Prevention through the use of sealants

Fluoride has been a great benefit to patients of all ages n helping prevent dental decay. Regular brushing and flossing lowers the chance of developing "cavities." However, the most decay-prone areas of teeth are the grooves and depressions on the chewing surfaces of the back teeth, which require further preventive care.

To prevent decay, a plastic-like coating called a sealant should be painted on the chewing surfaces of all the back teeth. Studies have shown that sealants can reduce tooth decay by as much as 90% to 100%. The American Dental Association recommends sealants be placed as soon as the first adult back teeth come in at age 6 or 7. Sealants should continue to be used as each adult back tooth comes into the mouth. All back teeth that need to be sealed are present by age 13. Sealant application is simple, fast, and painless.

Please call our office with any questions you may have about the benefits using a sealant in preventing dental decay.

TMD:
Temporomandibular joint dysfunction (TMD) is a misalignment within the intricate network of muscles, bones, and joints connecting the skull and lower jaw. When the jaw is awry, the joints and muscles tend to compensate by moving into a new position, and the jawbone grates on other bones and soft tissues. The pain can be extreme and debilitating.

Diagnosis can be difficult. TMD disorders may mimic the symptoms of other ailments-such as tumors, sinus infections and, on the surface, defy detection.

Dentists have been working with TMD therapies for some years now. Once we identify the problem and the cause, treatment is often straightforward. Among possible remedies are muscle relaxants, minor reshaping of teeth, or mouth splints. Physical therapy, even simple massage, has been effective in pain control. Surgery is rare.

The longer the diagnosis is postponed, the greater the joint and tissue damage - and the greater the pain.

Problem: Cracked, worn, broken, discolored, unsightly silver-mercury fillings
Solutions: Tooth-colored "resin" fillings

For over 100 years, dentists have been using silver-mercury amalgam fillings to restore decayed or broken teeth. The only other alternative was gold and that was always too expensive for most folks. Now there is a new and economical way to restore teeth using tooth-colored resin fillings. The resin is made up of glass particles in a plastic matrix. The doctor bonds the putty-like material to the tooth with a high-intensity light. This hardens the material and allows it to be shaped and polished for immediate use.

Once completed, the tooth has a natural appearance and is actually stronger than before due to the strength of the adhesive agent used to bond the resin to the tooth. Resin restorations not only look better, but they are stronger and last longer than the old silver-amalgam fillings. Resin restorations can range from $150 to $350 per tooth.

Please call with any questions you may have about the benefits of resin restorations.

Problem: XEROSTOMIA (Dry Mouth)

Solution: Dental Treatment or Consultation

Dry mouth problem is common. The lack of adequate saliva is more than bothersome for three out of every ten Americans. When the natural flow of saliva is reduced, you can experience trouble swallowing, pain throughout oral tissues and, nearly always, a short-cut to dental caries and gum disease. The tongue sticks, food doesn't have much taste, and digestion suffers.

Xerostomia, or dry mouth syndrome, can come with aging, or often as a side effect of many medications. Half of cancer patients undergoing chemotherapy experience an extreme form of xerostomia, with critical effects on their dental health. There is relief in the form of dry mouth toothpaste, special saliva-producing chewing gum, or saliva substitute solutions.

For more information regarding Xerostomia and methods of treatment, please call our office.

Oral Health for Seniors
The good habits of effective daily brushing, diet, and use of fluoride will help the aging person adapt to changing conditions. Reduced salivary flow and addition of medications will affect oral health dramatically.

Changes of the teeth and gums: Teeth will darken because of long-term exposure to plaque and changes in the dentin within the tooth. The gums may recede and uncover the roots. Exposed roots will be darker than the enamel part of the tooth and are prone to decay. Fillings can decay and darken, too, as they weaken over time.

"Dry Mouth" may develop: Saliva is useful to lubricate, wash away plaque, and neutralize the acid produced by plaque. Flow of saliva can be reduced by a medical disorder or be a side effect of antihistamine, decongestants, pain killers or diuretics. The build-up of plaque will accelerate tooth decay. There will also be more gum infection which will cause a loss of bone support for the teeth. Poorly-fitting or poorly-cleaned dentures, illness, and some medications increase the severity of the problem.

For more information regarding dental problems of the elderly, please call our office.

Sleep Apnea
Sleep apnea is a potentially dangerous disorder with fairly benign symptoms such as loud snoring at night, and morning headaches or daytime bouts of sleepiness. The cause? Intermittent periods throughout sleep when you actually stop breathing.

Breathing cessation, or apnea, lasts from seconds to nearly a minute. When breathing resumes, the brain senses lack of oxygen and wakes you up. The snoring is loud, sometimes explosive. In the morning, the build-up of carbon dioxide in the blood causes headaches. And the lack of deep, relaxing sleep can leave one drowsy and usually grouchy, during the day.

During sleep apnea , the upper air passages in the mouth and throat are obstructed (no one is sure why). One form of treatment that has proven successful is wearing an acrylic appliance during sleep to keep air passages open. It’s comfortable and easy to use.

For more information regarding sleep apnea please call our office.

Problem: Accidental Tooth Loss by Injury
Solutions: Knowing the Proper First Aid

If the tooth is loose, even extremely so, but is still attached in any way, leave it in place; do not remove it.
If it is out of its socket completely and unattached, but still in the victim’s mouth, it is best to have the person hold it there, if possible, until a dentist can attempt re-implantation.
If it is out of the mouth, do not let it dry out. Handle it as little as possible.
Do not attempt to disinfect the tooth, or scrub it, or remove any tissue attached to it.

If it is recovered from the ground or other soiled area, rinse it off in lukewarm water. Preserve it in milk until a dentist is available. If milk is not available, lukewarm water will suffice. not available, lukewarm water will suffice.
Time out of the socket is critical in the long-term success of re-implantation. After 30 minutes, the success potential begins to decline. However, re-implantation is still possible after several hours, so the attempt can still be made even if the tooth has been out for a long period.

Problem: Decayed (Baby) erupting teeth (bottle caries)
Solution: Educate parents on cause of bottle caries

Children who have erupted teeth or are past the age to be weaned are highly susceptible to rotted front teeth when being put to bed with a bottle containing milk, juice or other sugar-containing liquids. There is decreased salivary flow during sleep and clearance of the liquid from the teeth is slowed. The liquid pools around the upper front teeth and creates an excellent environment to promote the growth of decay-causing bacteria. Removing the bottle before the first tooth appears and wiping the child’s gums and teeth with a soft cloth before being put to bed can help prevent decay.

Signs and appearance of teeth displaying bottle caries:

Brown teeth with fragmented edges
Upper front teeth that break easily
At 18 months of age, parents should be encouraged to ask their dentist to examine their child and recommend home care.

Problem: Missing Teeth
Solution: Implants

"Well, you know Doc, it's just a back tooth. No one will see it so I'll just get rid of it. It's not going to make a difference."

The plain truth is that it will make a difference. The loss of just a single tooth can set a course that can destroy an entire mouth. "Well, if that's true, tell me more. I sure don't want to lose the front ones that I smile with."

Teeth will drift and tip into a space that is created by missing teeth. Just like two gears of a car that are not properly aligned, pretty soon you've got a whole lot of problems.

"Well, I don't like that. What can I do?" If it sounds like I've heard this conversation a few times, you're right. If I'm going to keep a patient happy, I need to provide options at this point.

One of the options would be an implant. This is the replacement of a tooth with a false root that is surgically placed. It is then followed by the careful construction of a crown to replace the missing tooth, to prevent teeth from shifting and thereby causing further tooth loss. If you have any questions about missing teeth and possible implant treatment, please call our office.

Problem: Bad breath (halitosis)
Solution: Dental evaluation and treatment of probable tooth decay and periodontitis

While bad breath might be a symptom of some other disorder, it most likely stems from dental decay and periodontitis.

Periodontitis is a disease affecting gums and bone that support the teeth, and it results from inadequate tooth brushing and flossing. In this disease, the irritated gums pull away from the teeth and form pockets between the teeth and the gums. These pockets fill with bacteria and pus which give off a foul odor.

Patients with bad breath should be referred for a complete dental evaluation. If gum disease and/or dental decay is diagnosed, it can be treated readily. The patient will no longer have an infection in his or her mouth, and he or she will no longer have the embarrassment of bad breath.

Problem: Black and unsightly silver fillings
Solution: "Invisible" composite fillings

Many people have had silver fillings placed into their teeth because they had "cavities". These silver fillings are called amalgams. Amalgam fills the space where the decay in the tooth has been removed. However over times, the amalgam corrodes and leaks which blackens the silver, and many times the tooth. This is easily seen as soon as a patient opens his or her mouth and is usually a source of embarrassment for the patient.

Composite fillings are made of a porcelain-like material that actually bonds to the tooth for a tight seal. They are strong and stain-resistant, and they are color-matched to the natural tooth, making them "invisible". Composite fillings also lack the sensitivity that is often associated with silver amalgam fillings. They are especially suited for smaller cavities and for patients who may be allergic to metal fillings.

Please don't hesitate to call our office with any questions you may have about the benefits of replacing silver amalgam fillings with invisible composite fillings.