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Stress and Our Teeth

Isn’t it wonderful that no one ever has a stressful moment in their day?  Life is continually relaxed and everything is a luxury.  If this doesn’t sound like your life, you aren’t alone.  Stress at home, stress on the job, students taking finals, you name it, there are unfortunately a lot of “stresses” in life.  Often times people are too wrapped up handling the busyness and stresses of their lives to listen to their body and the indications that problems are about to occur.  

One of the biggest surprises I have had over the years in dealing with patients is how much stress can affect oral health.  If I see changes in a patient’s mouth who is typically very healthy, I routinely ask if they have been under more stress than normal.  The vast majority of the time, the answer is yes.  Certain times of the year seem to be more stressful than others and when it peaks, changes in the oral complex can arise.  Dentists routinely see oral symptoms of stress exacerbated by increased cases of oral facial pain, broken teeth, jaw pain, herpes outbreaks (cold sores), increased swelling and bleeding of the gums and temporomandibular disorders (TMD).  Left untreated, toothaches and headaches can interfere with vital functions such as eating, talking and swallowing.

It is estimated that one out of every four Americans suffers from oral facial pain.  In my experience, a lot of that pain is stress related.  When people are under stress, they have a tendency to clench and grind their teeth excessively.  The chemistry of their body can change and oral problems often arise.  Left untreated, any or all of the symptoms I mentioned above can occur.  These symptoms may also be your mouth’s warning signs for more serious health risks.

Not only can stress cause concerns in the mouth, it can also progress to larger health problems in the long run.  We know that stress and stress-related disorders including mental illnesses such as depression are contributing factors—either directly or indirectly—to problems such as heart disease, cancer, respiratory disease and accidental injuries.

After a thorough examination, diagnosis of the oral problems and screening for a stress-related disorder, dentists can often help patients by referring them to a medical specialist.  The ‘team treatment’ between dentist and medical specialist ensures both oral and overall problems are being treated and that any medications prescribed do not interfere with each other and inhibit recovery.  I have found that it is difficult for people to identify how much stress they are experiencing and to what degree it is affecting their body until they get sick.  Don’t wait until it is too late and problems are advanced.  There are numerous treatment regimens that can help and each is tailored to your specific needs.  Regular intervals for dental check-ups are a first-line of defense for detecting stress-related disorders early. 

Life can sometimes be rough, but our reaction to stress can significantly affect our long-term health.  Relax, take a deep breath and look at the big picture – life is full of wonder and excitement for each of us to enjoy.

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Stem Cells for Future Health

Baby and wisdom teeth, along with jawbone and periodontal ligament, are non-controversial sources of stem cells that could be “banked” for future health needs, according to a National Institutes of Health researcher.

Harvested from the pulp layer (an area where there are nerves and blood vessels) inside the teeth, jawbone and periodontal ligament, these stem cells may one day correct periodontal (gum) defects and cleft palate.  The stem cells have the potential to save injured teeth and grow jawbone. Regenerating an entire tooth is on the horizon, and years from now stem cells from teeth and jawbone might be used to correct cleft palate, one of the most common birth defects, sparing children multiple surgeries.

I know I’m making you kick out some cobwebs from your old science classes, but as long as a cell has a nucleus, anything is possible.  In time, individuals may be able to bank their own stem cells from baby and wisdom teeth, similar to the way umbilical cord blood is stored. At present, commercial facilities to store stem cells from teeth are not available.

According to Dr. Robey, who conducted the study, the viability of stem cells derived from baby teeth is determined by when the tooth comes out. The longer a loose tooth is left in the mouth to fall out on its own, the less viable it is as a source of stem cells.  As research in the field progresses, hopes are that stem cells from baby and wisdom teeth may one day even restore nerve cells damaged by diseases such as Parkinson’s Disease, one of the most common neurological disorders affecting the elderly.

The stem cells from jawbone and teeth share a common origin with nerve tissue.  With the proper cues, researchers may be able to encourage them to form nerve-like tissue which may restore cells that make dopamine.  Dopamine is a brain chemical that nerve cells need to properly function.  To extract the stem cells from teeth, researchers can remove the periodontal ligament, drill into the tooth to remove the crown and then extract the pulp which is placed in an enzyme solution to release the stem cells. From jawbone, cells can be isolated by collecting marrow following a tooth extraction, for example, or by biopsy.

 

Dr. Robey outlined three approaches presently being investigated by different laboratories to implant stem cells from teeth in humans:

Place the stem cells into a mold of a tooth crown made of an enamel-like substance along with “scaffold” material. Loop blood vessels through this “construct” and implant it elsewhere in the body until it matures. Then, extract it and implant it in the mouth. For instance, researchers have already been able to use bone marrow to grow the jaw bone of a man in his shoulder blade until it was mature, then they extracted it and attached it to his jaw.
Harvest a wisdom tooth, release the stem cells from the dental pulp then implant the cells directly into a severely injured tooth. For example, if teeth are seriously injured in a car accident, usually root canals are needed and the teeth die. Instead, using stem cells, the goal is to regenerate the pulp inside the teeth. “It would be like bringing the teeth back to life, sparing them root canals.
Lastly, if no tooth is present (whether by accident, severe dental disease, or a genetic condition such as cleft palate) researchers can take stem cells from unerupted wisdom teeth, organize them into appropriate three-dimensional structures, and give them the proper “cues” before putting them back into the socket where the tooth would be, like planting a seed in a garden and waiting for a plant—in this case a tooth—to grow.
It may be years before research in the field reaches the point where it would be practical for people to start banking their teeth for stem cells.  But, when you think about it, the teeth children put under their pillows may end up being worth much more than the tooth fairy’s going rate! Plus, if you still have your wisdom teeth, it’s nice to know you’re walking around with your own source of stem cells.”

 

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Spit Tobacco

Last week I talked about the increased potential of tooth loss in people who utilize cigarettes.  This week I would like to look at some more tobacco products, namely, the “spit tobaccos.”  These include a variety of leaf, plug and snuff (dip) products.

Unfortunately, the southern region of the United States takes “top honors” on the usage of spit tobacco products.  According to a national study of chewing tobacco use in the United States, for all those that use tobacco, 57 percent are from the South, compared to 27 percent in the Midwest, 13 percent in the West and 3.5 percent in the Northeast.  Continued use of chewing tobacco puts patients at risk for precancerous oral lesions (oral leukoplakia) that can lead to oral cancer, increased cavities, gum disease, delayed wound healing, cardiovascular disease and nicotine addiction.

Research also has revealed an increase between middle school students and high school students using tobacco products.  Four percent of grammar school boys use chewing tobacco.  This percentage leaps to 20 percent for high school boys; half of which already have pre-cancerous white patches in their mouths.

Many young boys begin to use spit tobacco products when they become involved in sports, particularly baseball, thinking it will improve their performance.  Starter tobacco products geared towards teens usually have artificial flavors, such as cherry, and sugars added to mask the bitter taste of tobacco, and buffered so little nicotine is absorbed into the blood stream.  Once they are addicted, they move up to products that release more nicotine to get their ‘fix’ and dispense with candy flavored products to seek that real tobacco flavor.  Typically, kids develop a tolerance to spit tobacco products faster than cigarettes, which increases their use. 

Consider some of the following “Chewing tobacco statistics”:

Among high school seniors who have ever used smokeless tobacco, almost three-fourths began by the ninth grade.  Tobacco users who dip or chew 8 to 10 times a day may be receiving the nicotine equivalent of 30 to 40 cigarettes a day.
Spit tobacco causes leukoplakia, a disease of the mouth characterized by white patches and oral lesions on the cheeks, gums, and/or tongue.  Leukoplakia, which can lead to oral cancer, occurs in over half of all users in the first six months of beginning regular use.  Studies have found that 70 to 78 percent of spit tobacco users have oral lesions.
The risk of developing oral cancer for long-term spit tobacco users is approximately six times greater than for non-users.
Children who use spit tobacco products are 4 to 6 times more likely to develop oral cancer than non-users.
Chewing tobacco users have more root cavities.  The tobacco eats away at gums, exposing tooth roots which are sensitive to temperature and bacteria, and creates a prime environment for cavity-causing bacteria to flourish.
Double dippers are those who mix snuff and chewing tobacco.  They are more likely to develop precancerous lesions than those who use only one type of spit tobacco.
Tobacco products are addictive and a hard habit to break, but I would encourage those who utilize the products to consider quitting.  Your health may depend on it!

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Soft Drinks, Teens and Cavities

I’ve got to admit that I’m worried about the destruction I see in the mouths of our kids these days.  Fast food, “nutrition” bars, quick snacks and soft drinks are wreaking havoc on their teeth and overall health.  I know that our kids are constantly on the go and it’s a lot easier to “get something quick” to help teens stay alert and on schedule with all of the school, extracurricular activities and part-time jobs they have.  Unfortunately, today’s fast-paced lifestyle threatens to leave a generation with permanent damage to oral and overall health. 

Premature loss of tooth enamel and weakening of overall tooth structure are two devastating oral effects of teens’ poor diet that can not be reversed later in life.  Adolescence is the time of peak bone growth, a time when more nutrient-packed calories are essential to fuel growing bodies and strengthen teeth and bones, however adolescence is the same time when soda and sugary, high-carbohydrate foods are rapidly displacing healthy foods such as milk, fruits and vegetables.  The easy access of sugary beverages and foods from home to school and everywhere in between has compromised the health of teens’ teeth, and helped fuel the national obesity epidemic.

Drinking carbonated beverages seems to be one of the most significant causes of increased cavities and obesity for today’s teens.  Fifteen percent of American adolescents ages 6-19 are overweight.  This number is expected to increase.  Why?  Ten percent of overweight preschool age children ages 2-5 are becoming addicted to caffeine and sugar which makes it harder for them to stop unhealthy habits such as drinking soda throughout the day.

The phosphoric, citric, tartaric and/or carbonic acid in soda is linked to breaking down the tooth enamel.  The acids are also tied to the destruction of the bond around dental sealants and restorations further compromising teens’ teeth which can lead to more extensive dental treatment in order to prevent total tooth loss.  Phosphoric acid in most regular and diet cola drinks limit calcium absorption and has a direct influence on bone density.  By age 16, girls have accumulated 90 to 97 percent of their bone mass making adequate calcium intake vital.  However, national statistics show only 19 percent of girls ages 9-19 are getting the recommended dietary allowance (RDA) of 1,300 milligrams of calcium a day.  New research confirms a direct link between soft drink consumption and bone fractures in teenage girls.

Soft drink purchases by teens in schools increased 1,100 percent over the past 20 years, while dairy purchases have decreased by 30 percent.  Although federal regulations prohibit the sale of soft drinks to students during lunch hours in most schools, soft drink machines often line hallways, which means the “goods” are accessible to students all day long.

In 1977, 12- to 19-year-olds drank 16 ounces of soda a day.  In 1996, this same group consumed an average of 28 ounces a day.  Soda consumption has increased from 22.2 gallons of cola per person per year in 1970 to 56 gallons in 1999.  The average male in the 12- to 19-year age group drinks the equivalent of 868 cans a year!

Most people don’t realize it, but a typical 12-once can of regular soda contains approximately 10 teaspoons of sugar.  You read it right – 10 teaspoons!  Just put ten teaspoons of sugar in your next glass of tea and see what it tastes like.  I don’t think you will be impressed.

I know it is tough to eat properly in today’s fast paced society, but for our kids sake (and your own!) try to eat healthy and cut down on the soda and high fat/sugar foods.

 

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Snoring Prevention

Don’t Lose Sleep Because You (or someone else!) Snore

 

Answer these questions…

  •  Do you snore loudly each night?
  • Is snoring affecting your relationships?
  • Have I been told I “stop breathing”, then suddenly gasp for air while sleeping?
  • Do you frequently feel fatigued, exhausted or tired during the day?
  • Do I often doze off or fall asleep at inappropriate times?

 

If you answered yes to these questions, read on!

If you, or someone you love snores, a good night’s sleep has probably been elusive!  Sleep disorders don’t just affect marriages and family relationships, they harm the quality of a good night’s rest and can cause some serious health risks.  Snoring is most often caused by loose or weak tissue at the back of the mouth which collapses into the airway during sleep.  The tissue flutters or vibrates as air is forced through the constricted airway.  Additionally, anatomic abnormalities such as nasal septal deviation, nasal polyps, enlarged tonsils, small or mal-positioned jaws, enlarged tongues, etc. can add to the concern.  Snoring occurs more often in cases of obesity, mouth breathing, alcohol consumption and the use of sedative medications.

Although snoring itself is physically harmless, it could be a “fire alarm” for a potentially life-threatening medical condition known as obstructive sleep apnea.  In sleep apnea, the tongue is sucked completely against the back of the throat.  Once the airway is blocked, breathing stops.  When this happens, the harder the sleeper tries to breathe, the tighter the airway seal becomes.  It’s like trying to drink through a straw that’s stuck in a lump of ice cream.  The harder you suck, the flatter the straw becomes.

This airway obstruction lasts until the brain’s oxygen level falls low enough to partially awaken the sleeper.  The tongue then returns to a more normal position and – with a loud gasp or snore – the airway seal is broken.  Because of sleep interruptions and lowered oxygen levels, the sleep apnea victim frequently feels chronically fatigued and often is more accident prone.  Other physical disorders linked to snoring and sleep apnea include chronic fatigue, daytime sleepiness, mood disturbance, decreased libido, morning headaches, mouth or throat disorders, systemic and pulmonary hypertension, cardiac arrythmias and even heart failure resulting in sudden death.

Several alternatives are available for the treatment of snoring.  As with any condition, diagnosis is the key to determining treatment, because nothing will work 100% of the time.  Behavioral measures such as losing weight, eliminating evening use of alcohol and sedatives at night and avoiding sleeping in the supine position may be the only treatment needed for mild to moderate sleep disorders.  A nasal air mask called a CPAP (Continuous Positive Airway Pressure) is a very effective noninvasive treatment.  Pressurized air is continuously forced through a sealed nasal mask that the patient wears while sleeping.  Although effective, many discontinue use because of intolerance of the mask and hose while also being connected to a machine.  Surgical management may include nasal surgery, adenotonsillectomy, jaw advancement or removal of the uvula and portions of the soft palate.

Oral or dental appliances are an excellent alternative for a number of patients who snore.  Although different “brands” exist, most appliances fit in the mouth (similar to a retainer or mouthpiece) and position the lower jaw slightly forward.  This keeps the loose or weak tissue and tongue clear of the pharyngeal airway, promoting the free passage of air.  It is based on the same principle as tilting the head back to free the airway when giving mouth-to-mouth resuscitation.  This simple, non-invasive method has proven successful for numerous patients.  Ask your dentist for an evaluation if you, or someone you loves, has a concern with snoring.  A good night’s sleep is calling your name!  

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Snoring – Rate Yourself! Part 2

Last week I talked about the rating scales I utilize in my office to help determine if a patient may have a concern with sleep disordered breathing.  I provided the Epworth Sleepiness Scale for you to complete.  Today, I will give you the other two rating scales that we have patient’s complete after an examination for their concerns with snoring/sleep apnea.

 

Thornton Snoring Scale

Snoring has a significant effect on the quality of life for many people.  Snoring can affect the person snoring and those around him/her, both physically and emotionally.  Use the following scale to choose the most appropriate number for each situation.

 

0 = Never

1 = Infrequently (1 night per week)

2 = Frequently (2-3 nights per week)

3 = Most of the time (4 or more nights per week)

 

1.      My snoring affects my relationship with my sleep partner                            _____

2.      My snoring causes my sleep partner to be irritable and/or tired                   _____

3.      My snoring requires my sleep partner and I to sleep in separate rooms       _____

4.      I am fatigued, exhausted, tired and feel a lack of energy                             _____

5.      I have a morning headache                                                                        _____

6.      I lose concentration, forget things or get sleepy at inappropriate times         _____

7.      My sleep does not seem to be restorative or restful                                    _____

8.      I feel depressed or “down”                                                                        _____

9.      My snoring is loud                                                                                     _____

10.  My snoring affects people when I am sleeping away from home                 _____

TOTAL SCORE                   _____

 

A total score of 8 and greater may indicate that your snoring may be significantly affecting your quality of life, and the lives of those around you.

 The last scale that I utilize is one that is filled out by a person’s sleep partner.

 

Sleep Observer Scale 

Most of the following questions relate to the behavior you have observed in this patient while he/she is asleep.  Use the following scale to choose the most appropriate number for each situation. 

 

0 = Never

1 = Infrequently (1 night per week)

2 = Frequently (2-3 nights per week)

3 = Most of the time (4 or more nights per week)

Loud, obtrusive or irritating snoring                                          ________
Choking or gasping for air                                                       ________
Pauses in breathing                                                                  ________
Twitching/kicking of arms or legs                                             ________
Snoring requiring separate bedrooms                                       ________
Falling asleep at inappropriate times (driving, in meetings, etc.)  ________

 

A score of 5 or greater indicates symptoms that are affecting the health, safety or quality of life of the person observed.

If you think you, or someone you know has a concern with snoring/sleep apnea, contact your dentist for an evaluation to see what treatment may be appropriate.

 

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Snoring – Rate Yourself! Part 1

A month or so ago I wrote an article about the treatment of snoring and sleep apnea.  Since then I have had several patients ask “How do I know if my snoring is a concern or not?”  Sleep studies are an ideal way to tell for sure, but when patients enter our practice asking about snoring and/or sleep apnea, we examine them and provide a series of survey questions to answer which can indicate the possibility of sleep disordered breathing.  I’m sure many of the readers have the same question so I thought I would share some of those survey questions with you in today’s article.  This is one way for you to get an idea of the possibility as to whether you have a concern or not.  I utilize three different “rating scales” in my office.  The Epworth Sleepiness Scale provides an indication of sleep disordered breathing, the Thornton Snoring Scale indicates whether snoring may be affecting your quality of life and the lives of those around you and the Sleep Observer Scale (completed by a sleep partner) is indicative of symptoms that may be affecting your health and/or safety.  Score yourself below and see what you find out.

 

Epworth Sleepiness Scale

In contrast to just feeling tired, how likely are you to doze off or fall asleep in the following situations?  Use the following scale to choose the most appropriate number for each situation.

0 = Would never dose

1 = Slight chance of dosing

2 = Moderate chance of dosing

3 = High chance of dosing

 

Situation                                                                       Chance of Dosing

1.      Sitting and Reading                                                 __________

2.      Watching Television                                                __________

3.      Sitting inactive in a public place (i.e. theater)            __________

4.      As a car passenger for an hour without a break       __________

5.      Lying down to rest in the afternoon                         __________

6.      Sitting and talking to someone                                 __________

7.      Sitting quietly after lunch without alcohol                  __________

8.      In a car, while stopping for a few minutes in traffic   __________

TOTAL SCORE                       __________

 

A total score of 6 or greater indicates the possibility of sleep disordered breathing.

Hopefully you are well rested and came up with a low score.  Next week I will share the other two rating scales for you to evaluate as well.  Have a great week and here’s to a good night’s sleep!

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Smoking and Tooth Loss

How Many Teeth Are In That Cigarette Pack?


I know from watching my patients that it can be very difficult to stop using any type of a tobacco. If you are someone who is considering stopping the smoking habit, I thought I might give you a little extra incentive to give it a try.  A one-pack-a-day smoking habit can cost you the loss of at least two teeth every 10 years.  Smokers are about 2 times more likely to lose their teeth than non-smokers, according to the results of two separate 30-year studies that investigated the relationship between smoking and tooth loss among males and females at Tufts University in Boston.

In one study, 495 healthy men had their teeth examined every three years.  The men were divided into three groups: those who never used tobacco products, those who continuously smoked, and those who smoked at the beginning of the study, but later quit.  Smokers lost an average of 2.9 teeth after 10 years of smoking one pack a day, while non-smokers lost an average of 1.3 teeth after 10 years.  In men who quit, the tooth loss was 2.4 teeth after 10 years of smoking one pack a day and this decreased to 1.7 lost teeth after they quit.

The good news is that the risk of tooth loss decreases after you quit smoking, but the bad news is that the risk of tooth loss was still higher among the quitters than among those who never smoked.

Another study at Tufts University looked at 583 healthy postmenopausal women, aged 41 to 76, and the result also showed that female smokers were twice as likely to lose one or more teeth than nonsmokers every 10 years, and that the risk of losing teeth decreases among women who quit smoking.

The bottom line is that smoking leads to periodontal disease which leads to tooth loss.  One theory is that tobacco may restrict the blood flow to the gum tissues, which would restrict the necessary nutrients to the bone and periodontal support of the teeth.  Another theory is that smoking causes a chain of events in the mouth that eventually leads to tooth loss.  The chain starts with plaque build-up on teeth, which is linked to tartar build-up (an even harder substance on the teeth), which can cause gingivitis.  From there, you step up to periodontal disease, and the final destination is tooth loss.

The chain can be broken by brushing and flossing regularly and by stopping the use of tobacco.

 

What’s in a puff?


If you start smoking at age 18 and smoke one pack a day, how many teeth will you lose by the time you are 35 years old?

Answer: Between 4 and 5 teeth – Ouch!

 

With excellent home care and regular dental visits, the vast majority of dental disease is preventable and/or repairable.  Smoking automatically makes it more difficult.  If you are thinking of quitting – go ahead and give it a try.  Your teeth will appreciate it.

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Smile – Is Yours Important?

I’m a dentist, so I know you think I am biased when I say the first thing I notice about a person is their smile, but apparently it’s important to more people than those involved with my profession.  I recently read an article based on a study done for the American Academy of Cosmetic Dentistry (AACD) that evaluated whether or not a beautiful smile will make you more attractive. According to research conducted by Beall Research & Training of Chicago, a new smile will make you appear more intelligent, interesting, successful and wealthy to others as well. Dr. Anne Beall, a social psychologist and market research professional carried out the independent study on behalf of the AACD. Pictures of eight individuals were shown to 528 Americans, a statistically valid cross section of the population. The respondents were asked to quickly judge the eight people as to how attractive, intelligent, happy, successful in their career, friendly, interesting, kind, wealthy, popular with the opposite sex, and sensitive to other people they were.

Two sets of photos were created, with each set showing four individuals before undergoing cosmetic dentistry, and four after treatment. Half the respondents viewed set A, the other half set B. The eight subjects viewed by respondents were evenly divided by gender. Two had mild improvements through cosmetic dentistry, two had moderate improvements, and four had major improvements to their smiles, to give a wide range for respondents to view. None, however, had visibly rotten teeth, missing teeth or catastrophically bad dental health in the before shots. Respondents were not told they were looking at dentistry, but were asked to make snap judgments rating each person for the ten characteristics, on a scale of one to ten, with “one” being “not at all,” and “ten” being “extremely.”

The results indicated that an attractive smile does have broad ranging benefits:

Characteristic Average

“Before” rating

“After” rating

Increase

Attractive

4.6

5.9

1.3

Intelligent

5.9

6.5

.6

Happy

6.2

6.8

.4

Successful in their career

5.8

6.7

.9

Friendly

6.3

6.8

.5

Interesting

5.4

6.1

.7

Kind

6.0

6.4

.4

Wealthy

4.9

5.9

1.0

Popular with the opposite sex

5.0

6.2

1.2

Sensitive to other people

5.6

6.1

.5




In an independent study conducted on behalf of the AACD in 2004, it was discovered that virtually all Americans (99.7%) believe a smile is an important social asset. The same study showed that 96% of adults believe an attractive smile makes a person more appealing to members of the opposite sex and that 74% of adults feels an unattractive smile can hurt a person’s chances for career success.
When asked, “What is the first thing you notice in a person’s smile?”The most common responses were: Straightness, Whiteness & Color of Teeth, Cleanliness of Teeth, Sincerity of Smile, Any Missing Teeth, and the Sparkle of the Smile.
And when asked, “What types of things do you consider make a smile unattractive?” The most common responses were: Discolored, Yellow, or Stained Teeth, Missing Teeth, Crooked Teeth, Decaying Teeth & Cavities, Gaps & Spaces in Teeth and Dirty Teeth.

And finally, when respondents were asked, “What would you most like to improve about your smile?” The most common response was:Whiter & Brighter Teeth
Is your smile important – apparently so. The studies confirm something most of us already know, that cosmetic dentistry can provide an answer for anyone looking to improve their smile, their self-confidence, and their prospects for romantic and career success. Hope you have a great week.

 

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Sensitive Teeth

Ice cream, frozen yogurt, popsicles and lemonade are all wonderful for cool treats on the hot summer days we have been having lately.  But, just taking a spoonful of ice cream or a sip of cold lemonade can be a painful experience for people with sensitive teeth.  Sensitive teeth are one of the most common complaints among dental patients.  An estimated 45 million adults in the United States suffer at some time from a sensitive tooth.  Not only can cold be painful, a sensitive tooth can react to stimulation like hot beverages, touching your teeth, eating sweets or exposing them to cold air.  Tooth sensitivity is caused by the stimulation of cells within tiny microscopic tubes located in the second layer of tooth structure called the dentin.  Over time, if the hard enamel is worn down or the gums recede, these microscopic tubes are exposed.  They are normally sealed, but can develop small cracks or openings that allow fluid movement in the tubes.  When exposed, any stimulation can cause pain and even affect or change eating, drinking, breathing or brushing habits. 

How can I avoid sensitivity?
A variety of things can cause tooth sensitivity.  Something as simple as your toothpaste may be the culprit.  Some toothpastes contain abrasive ingredients that may be too harsh for people who have sensitive teeth.  Ingredients found in some whitening toothpastes that lighten and remove certain stains from enamel can also be the cause of discomfort.  Even though “tartar control” toothpastes are wonderful at reducing the build-up tartar, approximately 10-20% of patients who use them will develop some sort of sensitivity or tissue irritation.  Other causes include brushing with a hard-bristled brush, grinding or clenching your teeth or a high intake of acidic drinks or foods.  Next time you have a soft drink, check the label.  One of the significant ingredients in most is phosphoric acid!

 

What can I do about sensitive teeth?
First of all, avoid any of the things I mentioned above.  Any treatment beyond prevention for sensitive teeth is geared towards “clogging up the tubes”.  If they can be sealed and the nerve hasn’t been affected, sensitivity can usually be alleviated.  In many cases, tooth sensitivity can be reduced by using an over-the-counter desensitizing toothpaste that contains potassium nitrate or strontium chloride.  These ingredients help block transmission of sensation from the tooth to the nerve.  If you try one of these, be aware that it normally takes three to four weeks of daily use before you will notice a difference.  Avoid using hard-bristled toothbrushes and brushing your teeth too hard, which can wear down the tooth’s root surface and expose sensitive spots.  The way to find out if you’re brushing your teeth too hard is to take a good look at your toothbrush.  If the bristles are pointing in multiple directions, you’re brushing too hard!  If the home treatments aren’t effective, see the dentist.  He/she may prescribe fluoride; apply a desensitizing agent or a protective sealant type material.  In some cases placement of a filling may be done to stop the discomfort. 

How do I know when it’s time to see a dentist?
If a tooth is highly sensitive for more than three or four days, and reacts to hot and cold temperatures, it’s best to get a diagnostic evaluation from your dentist to determine the extent of the problem.  If your tooth is sensitive to biting as well as temperature change, it could be a cracked tooth.  Because pain symptoms can be similar, some people might think a tooth is sensitive, when instead, they actually have a cavity or abscess that’s not yet visible. 

If sensitivity is a concern, don’t ignore it, summer and ice cold lemonade are coming soon!