“I Got Gaps, You Got Gaps”

Q: Can you tell me what My options are for closing a gap between my front teeth?

A: There are a few options to fill in a gap between teeth. In Dentistry the term for a gap is a diastema. It is very common to have a gap between the two front teeth- think Lauren Bacall. Many people find this an attractive quality in a smile, but if the gap is large, or the teeth start to shift, some people opt to have the space closed.

 

In my office, the first thing I do is a “mock up” of how the patient would look with the space closed. I do this with my tooth colored filling material right in the patients mouth. It gives them a good idea of the final result. Then we can discuss what the options are. Basically there are two options. The first is direct bonding which uses matching tooth colored resin sculpted to the two teeth to create two wider teeth, thus filling the space. I have to say that this is the option that I do most of the time. It is relatively inexpensive, looks great, last a long time and it is easy, needing no numbing.

 

Sometimes though, the size of the restoration would be too large to support a simple bonding, so a lab created porcelain restoration is needed. To close very large spaces or to create more length a crown or veneer is necessary. Although these are much more costly than bonding, they are beautiful and very long lasting. Crowns are also indicated if the teeth already have large fillings because they will strengthen the teeth.

 

Another option to close spaces is orthodontics. Using traditional braces or a new product like Invisalign you can close spaces by moving the teeth back. This would eliminate the need for any bonding. This would be a very conservative and low maintenance way to close spaces. It might be the best option if there were a lot of spaces to close.

 

In childhood there is a muscle that attaches between the top front teeth. In some people this attachment is large enough to keep the front teeth separated. If you see this situation with your child you can talk to your dentist and see if she thinks it will lead to any future orthodontic issues. Sometimes that muscle (the frenum) needs to be “clipped” so that the front teeth will move together and there will be enough room for all the adult teeth to erupt normally.

 

As you can see, there are options to close spaces between teeth. It is best to make an appointment with your dentist for a consultation to see what the best option is for your smile.

 

Deborah Petronio, D.D.S.

Aurora Dental Care

92 Grey St.

East Aurora, NY 14052

716-652-0190

 

www.auroradentalcare.com

Q: Is Invisalign a Good Option For Busy Professionals?

A: “Invisalign has become a very popular option for professionals who want straighter teeth without having all the wires and brackets that go along with traditional braces”, says Dr. Deborah Petronio. Dr. Petronio is the owner of Aurora Dental Care, which offers Invisalign for adults and teens in the Western New York area.

Although Invisalign is popular with children, teens and adults as well, the treatment is especially gaining traction among the professional crowd. “People like Invisalign because you can remove the aligners if you have a big meeting, an important presentation, or a big date,” says Dr. Petronio. Obviously, this is not an option for people who choose to go with regular metal braces instead.

Like traditional braces, Invisalign is a way of moving teeth for patients who want straighter smiles. The main difference, however is that Invisalign does not rely on brackets or wires to get the job done. The Invisalign system uses a series of clear, comfortable aligners that are custom modeled to fit your teeth, which gradually reposition your teeth into a smile you’ll be proud of. The virtually invisible aligners allow you to smile both during treatment and after. In fact, no one will know you are wearing it unless you tell.

Another reason professionals favor Invisalign is because they don’t need to take as much time off of work to come in for follow-up appointments as they would with regular braces. “The frequency with which a patient needs to come into the office with Invisalign all depends on the case, but most patients only need to see us once every 6 weeks”, says Dr. Petronio.

The addition of new technology is another great reason that people are happy with Invisalign. A device called Acceledent is now available that shortens the treatment time by half! It uses vibrations to help move the teeth, and the results are amazing.

Invisalign has become popular because many professionals appreciate not having to go through treatment as long as they would with regular braces. At Dr. Petronio’s practice, patients average 3-15 months of treatment time. Regular braces, by contrast, require an average treatment of 24 months. For this reason, professionals who don’t have the time to spend going to frequent appointments, or the desire to look younger than they already are in business settings, are increasingly choosing Invisalign to straighten their smiles.

NO PAIN? NO PROBLEM?

Unfortunately, in 2016 some people still have the idea that “if it does not hurt, there is not a problem.”  This is especially true in dentistry.  Many believe it is normal to floss and have bleeding gums, even once in awhile.   This “pink in the sink”, as a popular tooth paste brand calls bleeding gums, is an infection and infection is not healthy.  Bleeding gums is not usually associated with pain but is an indicator of problems that affect ones’ overall health.

Bleeding gums is called gingivitis, and gingivitis is the earliest form of gum disease.  It occurs daily when plaque (a sticky film of bacteria and other substances) accumulates on the teeth near the gums. If gingivitis is present, you are missing a lot of plaque while completing your daily routine of oral hygiene. 

High levels of plaque may also lead to cavities (an infection in your tooth). Most cavities are pain free until they get down to the nerves and blood vessels in the tooth’s pulp chamber.  By this time the tooth may die.  This may cause great pain, discomfort, and much more costly treatment. 

Recently scientists have discovered significant links between oral health and your overall health.  For example, chronic bleeding gums raise your body’s C - reactive proteins.  These high C-reactive proteins are a precursor for cardiovascular disease.  Other health problems associated with poor oral health are stroke, uncontrolled diabetes, osteoporosis, respiratory disease, Alzheimer’s disease, premature child birth, and many more that are being researched.

If you see a dentist on a regular three to six month basis, you will receive routine screenings for blood pressure, cancer, and periodontal disease, as well as cleaning and checking your teeth.  Your screening helps you stay healthy and keep your teeth for a lifetime.  If you have any questions please contact me at info@auroradentalcare.com or visit our website at www.auroradentalcare.com.

Question: My mom gives me such a hard time about biting my fingernails; she says it’s going to ruin my teeth. My teeth look fine, so what’s the big deal?

Answer: Nail biting, also known as onychophagia, is one of the most common habits among children, teens and young adults.  Nail biting is generally triggered by stress, excitement, boredom, inactivity or can even be a learned behavior from family members. 

According to the Academy of General Dentistry about 30% of children between ages 10 - 18 and about 15% of adults bite or chew their nails.   Nail biting occurs most during puberty.  Boys bite their nails more often than girls after the age of 10 and most people stop biting their nails by age 30.

Fingernails are almost twice as dirty as fingers.  They harbor bacteria and germs even after average hand washing.  Nail biting can transfer pinworms or bacteria buried under the surface of the nail to your mouth.  .

Braces and nail biting don’t mix either. Traditional orthodontic treatment (wires & brackets) is already putting pressure on teeth, nail biting adds unnecessary additional pressure, stressing your teeth and weakening roots.  Not to mention the wires and brackets can become bent or broken.

Perhaps the worst effect of nail biting on teeth is that it can cause teeth to chip, break and wear unnecessarily.  Nails are tough and hard, so when you bite down on them you are causing excess stress to your teeth. Over time this weakens teeth and eventually results in chipping or breaking.  Front teeth are designed for cutting – not chewing and are not strong enough to be in constant use. Nail biting causes nearly constant chewing, wearing teeth down faster than those of a non-nail biter.  This constant stress and pressure contributes to malocclusion of the anterior teeth. 

Nail biting also can cause injury to the gums.  A bitten nail tearing into gum tissue can cause further weakening of the teeth as well as disease. When bitten-off nails are swallowed, stomach problems can develop.

What you can do about it:

  1. Using a bitter tasting polish on your nails may discourage biting.  There are a number of brands available. Ask your dentist to recommend one that her/his patients have had success with.

  2. Keeping nails trimmed, filed and attractive can encourage against biting and chewing.

  3. A special mouth guard may help patients to break the habit.  Some people find it more of a hassle to take the guard out to bite their nails.  Your dentist can make one for you that custom fits over your teeth and is barely noticeable.

  4. If you are considering orthodontic treatment you may want to look into Invisalign.  The clear aligners (besides being nearly undetectable) would make it very difficult to bite your nails while giving you a more beautiful smile. 

  5. A diet rich in foods with calcium and magnesium can help nails repair and grow well.

     

    According to the Academy of General Dentistry (AGD) nail biting can result in significant additional dental bills over a lifetime.  Now that you know how harmful and costly nail biting can be, it’s time to take action to break your nail biting habit. 

     

    Dr. Deborah Petronio is the owner of Aurora Dental Care.  If you have any further questions or concerns regarding this or any dental subject, please contact her at 716-652.0190 or info@auroradentalcare.com

Get a Grip!

Question: I lost some weight recently and now my denture is loose. What should I do?

Answer: Some people think that after they get full dentures, their days of visiting the dentist are over. On one hand, of course, they are correct. The days of fillings, root canals and teeth cleanings are done. Usually the first few years of having a denture are worry free. On the other hand, there are some good reasons to keep up a yearly visit to your dentist.

Firstly, a yearly visit gives us the opportunity to do an oral exam. In our office, this means checking your head and neck for any signs of something abnormal such as oral cancer, sores, swollen glands and other things which would necessitate a further examination. For the oral cancer screening we use state of the art technology to detect precancerous lesions that cannot be seen yet with the naked eye. Early detection can result in increased success rate during treatment. Not having teeth does not decrease your risk of oral cancer, so this is an important test to have each year.

We also professionally clean your denture and evaluate the fit. Even though the teeth are gone, the bone in your mouth changes shape over time. As you stated, loosing weight can also affect the fit of your denture. A nicely fitting denture makes eating more comfortable and can eliminate the need for denture adhesives. Some times your existing denture can be relined, and sometimes a new one is needed. You can discuss and decide these things with your dentist at your appointment.

Another thing you may be interested is dental implants. These devices can be used to either secure a denture or even eliminate it altogether. Implants are very secure, very reliable and can be done in a cost effective manner. Your dentist can give you more information on this wonderful option.

There are some good reasons to visit your dentist even if you don’t have teeth. Having a professional do a thorough examination of your mouth once a year can prevent problems and address oral health issues early in order to keep you healthy.

 

Deborah Petronio D.D.S.

Aurora Dental Care

652-0190

Tooth Sensitivity is a Pain!

Many patients come to see me with complaints of tooth sensitivity. It can range from annoying to mind numbingly painful. My job as a dentist is to figure out the cause and then to fix it. Sometimes sensitivity has a very obvious cause like a broken tooth or a cavity. Sometimes though, it is more difficult to diagnose the reason.

When a person has gum disease bacteria will destroy the bone supporting the teeth. Eventually the gums will recede and the roots of the teeth are partially exposed. Since there is no enamel covering the roots they can be very sensitive to hot, cold and touch. Another case where teeth are sensitive up near the gum line happens when someone clenches or grinds their teeth. The very thinnest part of the enamel up by the gums breaks off and then vigorous tooth brushing can wear away the root to form a notch. Sometimes these areas can be hypersensitive. If not kept clean they can also be a place where a  cavity can form. In extreme cases they can weaken the tooth so much as to risk the tooth breaking off!

Grinding your teeth is another common cause of sensitivity. Years of grinding can expose the inner, more sensitive layer of tooth called the dentin. Some people experience cold, hot, or chewing sensitivity. Hard food such as chips or seeds can give quite a “zing” when chewing where there is exposed dentin.

Fortunately there are treatments for tooth sensitivity. Sometimes, if decay is present the treatment may consist of a filling, or even a root canal or crown. If the sensitivity is from grinding and clenching we may recommend a nightguard to prevent further damage. If no decay or structural damage is present I like to take a stepwise approach. I recommend toothpaste for sensitive teeth first. If the sensitivity is mild, sometimes this is all a patient needs to do. From there we may place a desensitizing medicine in the office, recommend a fluoride treatment, or even a filling to stop the sensitivity. It is best to have a conversation with your dentist to figure out what treatment is best for you.

Tooth sensitivity is quite literally a pain, but it is comforting to know that your dentist can give you relief!

Question: Can you stop a cavity?

Answer: A cavity in a tooth can be stopped! For this to happen certain factors must take place though. Firstly, the patient must commit to maintaining their daily home care routine. This includes thoroughly cleaning all surfaces of the teeth. We recommend brushing with a fluoride containing toothpaste for two minutes each time twice a day. Flossing once a day is also recommended. If you can brush and floss right before going to bed, that is the best time since saliva flow decreases at night, therefore creating an ideal environment for cavities to form or grow if there is plaque or food left on the teeth all night. The important thing is to clean ALL surfaces of ALL teeth daily

Secondly, we recommend a low sugar diet. Food containing sugar or carbohydrates provides food for cavity causing bacteria. Limiting sugar to mealtimes and limiting snacking on sugary foods and drinks can help control cavities. Some people don’t realize that foods like bread or pretzels break down to sugar when we eat them. It’s not just candy that leads to cavities.

Lastly, you must have adequate saliva to help wash away food particles from your teeth. Saliva flow can be affected by many common medications, radiation therapy, auto immune diseases, or inadequate fluid intake. Your dentist and primary care doctor can help with managing your saliva flow. People with reduced saliva flow can benefit from everything I mentioned above, and also more frequent dental visits, topical fluoride treatments, prescription strength toothpaste, and even medication. Everyone can make sure they drink lots of water every day.

When a cavity starts, bacteria will demineralize an area of tooth enamel. At this point, if the patient adheres to the suggestions above, there is still a chance that the cavity will remineralize. If caught early enough it is possible for the tooth to return to perfect condition. More often though, even if remineralized, the area will be a weak spot. As soon as poor oral hygiene or poor diet return, that remineralized area will be the first place to be attacked.

Scientists and researchers are working in these areas to develop better strategies to combat tooth decay and remineralize teeth. Unfortunately no amount of science can overcome poor hygiene habits and a high sugar diet!

Question: I read a lot of things about dental care on Facebook. How come my dentist doesn’t talk to me about things like oil pulling, whitening with charcoal, and the dangers of fluoride?

Answer: Social media like Facebook, Twitter and Pinterest have fundamentally changed the way we receive our information. We have embraced the instant age where just about any subject is at the tip of our fingers on our phones, I-pads and laptops. I personally love Facebook and spend too much time being friends with people I have never met in person. I also receive the posts about dental care, so I know what you are talking about. Some of these types of “healthcare” posts are very informative and thought provoking. Others, I think are posted more for shock value.

For example, you can always try the method of whitening your teeth with charcoal. It is inexpensive, and probably works as well as whitening toothpastes. But why? Does oil pulling work? Sure, if you look at the literature, oil pulling works as well as brushing for 2 minutes twice a day and flossing. So if you really hate the normal routine, do oil pulling, which means swishing with coconut oil for twenty (yes it has to be twenty) minutes every day for the rest of your life. If you have that kind of dedication, why not just brush and floss? You will save about 15 minutes a day!

As far as fluoride goes, I have written extensively about this in previous articles. The facts are these. The research showing the horrors of fluoride are faulty. They used data from places where the natural concentration is thousands of times higher than what we have added to our public water supply. Of course, too much of anything can be bad. In recommended doses fluoride has been one of the biggest health benefits of our time. It makes teeth stronger and helps them resist the decay process. It has lowered the amount of tooth decay by 25% for all populations. That is great since tooth decay has historically been one of the biggest health problems for children.

So, enjoy all those cute cat videos on Facebook. Talk to your dentist about dentistry and oral health. If you have any questions, visit our Facebook page!

Obamacare

By now everyone has heard of “Obamacare”. Changes to health insurance plans have left some people in confusion. Some who previously could not afford health insurance find themselves able to afford good quality coverage for the first time. Others have seen their premiums skyrocket in relation to their coverage. No matter what your opinion of our healthcare system is, it is important to try to understand your coverage.

For dentists there has been a major shift. Every child under the age of 18 is mandated to have a dental plan. These are often embedded into the family’s health insurance policy. Unfortunately those plans vary widely, from very little coverage, to Medicaid, to regular fee for service dental plans. Young adults are able to stay on their parent’s plans until age 26.

For seniors there are also some changes. Depending on your Medicare part B coverage, you may be eligible for an included plan that provides basic preventative dental care at no cost. Ask if your dentist is participating with this plan. If you would like to, you can also purchase a stand alone dental rider that covers dental work like fillings and crowns.

Changes will continue to abound, and these will inevitable lead to confusion, but maybe some unexpected benefits! Remember that your doctor and dentist are adapting to changes also, so if you have questions about your coverage be sure to ask!

I finally did it!

One of the things I remember vividly from my childhood is every once in a while, my Mom would need a crown. She would bite on a popcorn kernel or some other hard thing and break her tooth. She would go see the dentist and he would do a crown or “cap” on her tooth. This was a big deal for her and entailed several appointments.

As a general dentist, this is something I now see just about every day. It is very common for a tooth which has had a large filling, especially an old filling, to break. Many times a crown is the best option to be able to save the tooth. Patients generally do not like this procedure because it is both expensive and time consuming.

Now I have something that can help with at least one of those complaints!  My new equipment can take a digital scan of the tooth, then mill an all ceramic crown which can be cemented at the same appointment.  This eliminates the return trip to fit and cement the crown. Patients ask me all the time if there is an easier way to do a crown. Well, this is the answer.

Technology has come a long way in the last few years. Remember when we used to listen to cassette tapes and think we were cool? Dentistry has come a long way too. I have never been the kind of person to jump on the bandwagon and try a new procedure before is it tried and true.  On the same hand, I don’t want to be a straggler to adopt a great technology the benefits my patients and has great results.

The CAD-CAM technology is great for making all ceramic and resin restorations. We can even mill a “filling” out of a block of resin and cement it on to your tooth. Unfortunately there are still some things it won’t do. Any crown or bridge with metal in it still is made using casting. And of course, our dental lab technician is still a very valuable part of the team to make sure that you have the best type ofdental work for your situation.

Maybe your dentist already has this equipment. There are 24 dentisst in the Buffalo area that use the CEREC like I just got. Ask if it is right for you!

Deborah Petronio, D.D.S.

www.auroradentalcare.com

"Use it or lose it": Dental Insurance

Around this time of each year we send a note to our patients with dental insurance. This very important note has a very important message….”Use it or lose it”! We are referring to dental insurance benefits. Most dental insurance plans start over on the first of every calendar year. So if you have need treatment at the dentist and you have remaining insurance benefits, now is a great time to make an appointment to get things done.

Let me explain a little bit about dental insurance. Be glad if you have it!  If your employer gives it to you as part of a benefits package, it is part of your pay. It’s something that most people don’t have. I call it a discount program for the dentist. It may not pay for everything, but it sure helps. Different plans cover dental care in different amounts. Within the same insurance company you can find plans that cover a little or a lot. Some only cover preventative care like cleanings and x-rays. Premium plans may cover 80-90% of dental work up to a certain yearly maximum.

If you are unsure of your coverage you can talk to your employer or Human resources department. If you have a dentist, the staff at the office should also be able to help. In my office, Kim is the insurance expert. She can get you reliable information on what your insurance will cover and what your out of pocket expenses will be so you can plan for your dental care.

Patients often ask me if they should purchase a dental insurance policy. My answer is always the same. You need to crunch the numbers. For an individual, often you are paying as much for the insurance policy than you would ever be able to get back from it. For a family though, it may make sense to have a family policy. Remember that new insurance laws make it mandatory that each child be covered for dental care as an extension of health insurance. Your health insurance provider should be able to help you with this.

Question: Why does the dentist want me to go there every six months to get my teeth cleaned? I don’t think that’s necessary.

Answer: Historically dentists have recommended a cleaning appointment usually with a dental hygienist every six months. This is usually accompanied by an examination with the dentist. X rays are taken every year on average to detect cavities between the teeth and to check bone levels.

That being said, there is no reason why an individual’s plan for keeping their teeth healthy can’t be customized to meet their specific needs. In my practice I have a plan for each patient. Some follow the above regimen and it seems to work very well to keep their teeth healthy. Other people need more or less. When you have periodontal disease you need to keep it under control so those patients may come every three months for a maintenance appointment with the hygienist. This seems to be the right amount of time between visits to keep the disease process under control. I have other patients that only come once a year to get their teeth cleaned and have x-rays every couple of years, but these patients have beautiful teeth, no cavities or periodontal issues.

If you want to make sure you have a plan that works for you, talk to your dentist. Maybe there is a reason you need to be seen every six months and once it is explained it will make sense to you. I am a firm believer it being your own health advocate and being able to make informed decisions.

If you want to see the dentist less, here are some tips! First, have a meticulous oral hygiene regimen. We recommend brushing at least twice a day and flossing at least once a day. Using an antiseptic mouth rinse like Listerine is also helpful. Do you do that everyday?

Secondly, watch your diet. Snacking on sugary drinks and foods without brushing afterwards is a great way to get cavities. Good snacks for your teeth are cheese (which contains an enzyme that helps control decay), water, or veggies.

Lastly, nip small problems in the bud before they become big problems. Don’t put off regular checkups, because that is the way we can detect problems like cavities when they are small and easy to treat. Putting things off just makes problems bigger, more expensive to fix and involve more time and discomfort.

Have an honest conversation with your dentist and dental hygienist about what they see and how best to keep your teeth in good shape so you can keep smiling.

Deborah Petronio D.D.S.

Aurora Dental Care

652-0190

Question: My six year old’s new front teeth are coming in twisted. Should I take her to an orthodontist?

Answer: Beginning around age five or six every child begins to get their adult set of teeth. Usually we see the “six year molars” appear behind the last baby teeth. Shortly afterward the two middle front bottom teeth will get loose and come out, allowing for the new incisors to make their way into the mouth. This is usually a great time to have an evaluation of your child’s bite. Your general dentist will check this at your regularly scheduled hygiene appointment. This is a good time to start talking about options for any treatment that may be recommended. Some general dentists and pediatric dentists have training in orthodontics in addition to their primary discipline. These dentists may do some orthodontics in their practice and feel comfortable treating your child. Most dentists will refer to an orthodontist. Orthodontists are specialists that have 2-3 more years of training beyond dental school in orthodontics and limit their practice to orthodontics only. An orthodontist not only does braces, but also monitors growth and development. An early consultation with an orthodontist may seem unnecessary to some parents since the child doesn’t have all their adult teeth, but actually monitoring is important. During a consultation to an orthodontist, she/he may gather information and records to determine whether your child might need some early form if intervention. It has become more frequent that the child may need some form of an appliance to expand the arches to allow all the teeth to come in. In years past, many people had to have teeth removed during the process of orthodontics. This is no longer the case, and many other benefits can be obtained by early intervention.

 The American Orthodontic Society recommends that a child be seen for an orthodontic consult and the first sign of an orthodontic problem, or by age 7 at the latest. As I said, this first contact is usually with your child’s dentist. The dentist will decide if a consult with an orthodontist is necessary. In my practice I actually do treat some children with appliance therapy and orthodontics. In the majority of cases I refer to an orthodontist though, and encourage patients to seek several opinions if they have questions about their child’s recommended treatment.

Dr. Deborah Petronio can be reached by calling Aurora Dental Care at 652-0190 or visiting www.auroradentalcare.com

Question: What is the best snack to give my kids after school that is good for their teeth?

Answer: Kids come home from school ravenous. They want something to fill their bellies to tide them over until supper. As parents, we want don’t want them to just munch on chips or candy and soda. Fortunately there are lots of healthy snack ideas out there. As a dentist I am always interested in ideas that don’t contain a lot of sugar. I learned that cheese is one of the best snacks. Don’t get the processed kind because it doesn’t have any of the benefits of real cheese. Cheese contains no sugar and also has an enzyme that inhibits tooth decay. That makes it a great snack when your child isn’t going to be able to brush afterwards. Here are some other snack ideas:

  1. Smoothies are sure to please. Use frozen or fresh fruit to sweeten them
  2. Yogurt is tasty. Buy unsweetened yogurt and add fruit and maybe a touch of honey.
  3. Homemade sweet potato chips. Slice or make wedges. Spray lightly with oil and sprinkle lightly with salt. Bake until crisp. You could also make a dipping sauce.
  4. Home made snack mix. Mix unsweetened banana chips, nuts, popcorn and whatever else you like and put it in bags so it is ready to go.
  5. Fruit can be cut up ahead of time and then its ready for snacks. Another fruit idea for young kids is fruit racers. Cut two grapes in half and use toothpicks to attach them as wheels on the bottom of an apple wedge.

These are a few ideas, but you can get lots more by looking on the internet. You could do a search or you could use an app like Pinterest.

I hope this inspires you to think about snack that not only taste good, but are good for you children’s health and their teeth!

Question: My front teeth are worn and chipping! I hate how it looks and I don’t know how this happened. What can I do?

Answer: It sounds like you have been grinding your teeth for some time. The medical word for this is bruxism. It is very common for people to grind their teeth. Reasons include anxiety, poorly aligned or missing teeth, and sleep disorders such as sleep apnea.

As a dentist, I see signs of bruxism every day in my patients. As you said, tooth wear and breaking is one of the common side effects of grinding. This happens over the years, but when something breaks that is usually a sign that the bruxism may be serious. If teeth are severely worn or broken a conversation with your dentist is necessary. Express your concern and see what options are available to restore your teeth. These options include bonding tooth colored filling material, lab created restorations like crowns, or even extracting a tooth and replacing it with an implant.

Along with tooth wear and breaking, another side effect of bruxism is loosening teeth, especially if there is periodontal disease present. When you lose bone that supports the teeth in your jaw due to periodontal disease, grinding just exacerbates the problem. I have always used the analogy of loosening a fence post from the ground by knocking it around. It eventually loosens the soil around the post so that it lifts right out. The same thing happens to a tooth when you combine bone loss and grinding your teeth.

People who grind their teeth may also complain of frequent headaches and facial pain. When you grind, you are engaging the muscles that close your jaw. When these are squeezed for long periods of time they can cause pain and have even been attributed to migraines. People who have Temporomandibular Joint(TMJ) problems will have those problems worsened by grinding.

So what do you do? A thorough dental exam is a must. Your dentist has experience to know how to handle this. Some complicated cases may be referred to a specialist, but routine handling of bruxism is usually done by a general dentist. They may recommend a nightguard if you are grinding your teeth at night. This is a plastic guard that fits over the top or bottom teeth and acts as a shield so that you end up grinding the device rather than your teeth. It works well if you only grind at night. If you find that you are clenching or grinding during the day the dentist may want to help by referring you for chiropractic care or physical therapy. Relaxation techniques and exercises may be prescribed. In acute situations, medication may be prescribed. If restorative dentistry is required, the dentist may make a nightguard afterward to protect that investment.

Everyone experiences some wear on there teeth due to normal chewing over the years. If you see that you teeth are getting short, breaking, chipping or loosening, it may be a sign that something more serious is going on. Ask your dentist about it soon!

Question: I read on the internet that Fluoride is bad for you. Is that true?

Answer: Well, to answer that question, I have to begin with saying that you are correct in questioning scientific information that you get from the internet, especially from social media sites like Facebook. These are not quality scientific sites and therefore some of the“science” is not reliable.  That being said, there has been a long standing debate about the benefits of fluoride. When you see the anti fluoride stories on the internet, they often say they have scientific studies to back up their claims of brain damage, brittle bones and even autism. These studies were done in the few places in the world where the natural fluoride levels are thousands of times higher than normal. These studies should not be used to show that fluoride in toothpaste and drinking water are dangerous because the comparisons are just not valid. Too much fluoride is toxic. The same is true of all medicines and vitamins. In its proper dosage, fluoride is safe and has many health benefits. Babies and small children should not use toothpaste with fluoride because they will tend to swallow it.  Start the fluoridated toothpaste when they can reliably spit and rinse.

Some of the benefits of fluoride include the following. Fluoride in drinking water can reduce cavities by as much as 60%. Fluoride treatments in the dental office can reduce decay by 40% when given twice a year. Using a fluoride toothpaste can reduce cavities by up to 25%. Fluoride is also used with adults to reduce sensitive teeth and as an antibacterial rinse to help control periodontal disease. Adults who have “dry mouth syndrome” due to medications or certain conditions greatly benefit from fluoride to combat cavity formation. These are tremendous benefits!

The boom in drinking bottled water has greatly reduced some people’s exposure to fluoride. Most bottled water does not have any.  Mayer Bothers water in this area is one brand of bottled water that contains fluoride.  Also well water may not contain any fluoride. If you want to know how much fluoride is naturally occurring in your water you can have it tested. Then your dentist or physician can adjust the dosage of fluoride supplements accordingly.

All in all, the use of fluoride has helped curb tooth decay. As a dentist, I rarely have to do fillings on children in my general practice. This may not be the same for all dentist in all areas, but boy, I wish I had more fluoride when I was growing up!  If you have any questions about fluoride I recommend talking to your dentist. The American Dental Association also has good information on their website.

Question: My mouth is dry all the time. What can I do about it?

Answer: Dry mouth or xerostomia is a condition shared by many people. There are many reasons for dry mouth, but one of the most common is due to some prescription medications. There are over 400 medications which list dry mouth as a side effect. Some of the symptoms include

  • a sticky, dry feeling in your mouth

  • thick or stringy saliva

  • a burning sensation

  • sore tongue, lips (especially at the corners)

  • altered sense of taste

  • bad breath

  • increased plaque and decay

    Other factors which contribute to dry mouth are stress, radiation treatment to the head and neck area for cancer treatment, diabetes, Alzheimer’s disease, AIDS, and Sjogren’s syndrome.

    Because dry mouth increases your chances of tooth decay and other problems, caring for your teeth and gums at home is vital. You should brush with a soft toothbrush twice a day, and floss every day to remove debris from between your teeth.

    Increasing fluid intake should help. Frequent sips of water or sucking on ice chips is a good way to get fluids. You may have a dentist or physician recommend over the counter saliva substitutes from the pharmacy. Prescriptions may need to be changed, or you may have a prescription for a medication that increases saliva production. Avoid tobacco, caffeine, and carbonated beverages. Sleeping with a humidifier may help.

    Regular checkups are imperative because dental decay and other problems can crop up quickly. If you have any questions please contact me at Petronio@auroradentalcare.com or visit our website at www.auroradentalcare.com