10 Fascinating Facts About Dental School

A typical practice model used in dental education. It helps simulate the restraints and difficulties of working on a real patient. 

Most people outside of the profession can't say they know much about dental education. Of course dentists learn about teeth and the mouth, but what about the rest of the body? How long is dental school? Is there a difference between a D.D.S. and a D.M.D. degree? We compiled a short list of lesser known facts about dental school to separate some of the truths from the rumors! Take a look: 

1. Most schools require dental students to dissect a human body from the head and neck to the torso. Some require a whole-body dissection. This includes structures such as the arms, GI tract and heart. 

2. Some schools hold courses and seminars on dental research. These are classes specifically geared towards evaluating research papers for clinical application. 

3. The average dental student doesn't get to work on an actual patient until they have completed two years of didactic education. Only then are they allowed clinical responsibility. 

4. Dental residencies can take from 1-6 years in addition to the four years of dental school. The longest (6 years) is for a joint DDS/MD degree in oral and maxillofacial surgery. That rounds up to 14 years of college education! 

The beige tooth was actually hand carved from wax. Students are required to make teeth from wax to learn about the finer points of dental anatomy. 

5. Dental students still learn how to hand form teeth from wax. Although this technique is dated, it teaches invaluable lessons on tooth anatomy.

6. There are over 60 dental schools in the United States. 

7. Some schools grant D.D.S. degrees and other grant the title of D.M.D. There is absolutely no difference in the responsibilities and privileges between degrees; they are completely equal!

8. Dental residents (post-doctoral students) can be called upon to assist in many hospital duties. Some even provide general anesthesia for surgical cases. 

9. There are nine ADA recognized dental specialties/residencies: Endodontics, Dental Public Health, Oral Pathology, Oral Radiology, Orthodontics, Oral Surgery, Pediatric Dentistry, Prosthodontics and Periodontics.

10. Dental education never stops. In order to hold a valid license, a dentist has to take continuing education courses every year. 

Video Blog on Home Hygiene

Greetings, my name is Dr. Kari Ann Hong, and I have a family dentistry practice where I see patients from all age groups.  In my practice, I help educate my patients about what they can do at home to help care for their teeth.  

The first topic of discussion is what patients eat and drink and how frequently they do so.  Our mouths all naturally harbor a certain amount of bacteria.  A specific strain called streptococcous mutans is responsible for eating the foods and beverages we ingest and creating acid.  This acid causes a breakdown in the calcium phosphate structure of our teeth, leading to tooth decay.  Certain foods will stick to the teeth longer than others and make the teeth more susceptible to decay.  Examples of cavity provoking foods and beverages are pretzels, crackers, cereals, sodas, energy drinks, and juices.  Natural foods that come from a tree or are picked from the ground will naturally wash of the teeth much quicker after we eat it.

Every time we eat or drink something other than water, our mouth will become more acidic for at least fifteen minutes after we ingest it.  So the more frequently we eat, the more acid that accumulates in our mouths.

In order to counteract the bacteria in our mouths and the foods that stick to our teeth, it is important that we brush twice a day and floss once a day.  I generally recommend an electric rechargeable toothbrush like a Sonicare or an Oral B to all of my patients.  These electric toothbrushes are great because they help remove plaque build up better that we can with a manual toothbrush.  Also, they have timers on them to encourage us to brush for a full two minutes.  I recommend that my patient split their mouth up into four quadrants, and spend 30 seconds on each quadrant.  If you choose to use a manual toothbrush, then I recommend a soft tooth brush.  A harder tooth brush can adversely abrade the gum tissue or the tooth surface with extended use.  Place the tooth brush at a 45 degree angle to the tooth surface.  Make sure to gently massage the tooth and focus on where the teeth meet the gums, because this is where the plaque likes to collect.  

I recommend flossing or using a hygiene tool to clean below the contact of the teeth at least once a day. The idea behind flossing is that you want to get the floss between the gum and the tooth, by wrapping each tooth you have just flossed between in a C-motion.  For the butler soft pic, you just need to get it below the contact area.

In terms of what toothpastes or mouthwashes to use, I have a couple of suggestions.  Any fluoridated toothpaste will be sufficient to clean the teeth.  In patients that have a high risk of tooth decay, I will often recommend an additional  tooth paste to be brushed on with a dry toothbrush, after regular tooth brushing.  CariFree gel and MI paste are two of my favorite products for tooth remineralization.  Both products have calcium, phosphate, and fluoride that help to rebuild tooth structure.  

For mouth washes, I like over the counter ACT Fluoride rinse for those prone to tooth decay.  For those that are prone to gum disease, I recommend Listerine, which is anti-bacterial.  CariFree also makes a mouth wash that is pH neutral and has the same calcium and phosphate as the gel.

Finally, if you like to chew gum, then you can also fight your bacteria at the same time, by finiding a gum with xylitol. Xylitol is a plant derived sugar that prohibits the bacteria in our mouths from producing acid.  Studies have shown that 5-8mg of xylitol a day in a chewable form helps protect our teeth.  

If you would like more information about what you can do to prevent tooth decay and make your teeth healthier, contact us for a new patient exam, where we will go into your specific needs in detail!

Fluoride- The Facts

One of the most controversial topics in dentistry (and possibly all of healthcare) is the use of fluoride in our water supplies and dental products. What is it? Why do we use it? Could it harm my family? Today, we would like to take a moment to lift the myths and mysteries away from fluoride- a safe and effective measure for remineralizing and protecting teeth.

Fluoride (F-) is a negatively charged ion, similar to chloride ion (Cl-) in sodium chloride (Table salt). As such, it needs to be bound to a positively charged ion to exist as a solid mineral. This is why the labels on toothpastes and other dental products will list “stannous” fluoride or “sodium” fluoride as the active ingredient. The first part of the compound merely serves as a safe means of stabilizing the F- ion for delivery. Like table salt, when a compound with fluoride is dissolved into a solution, some of the ions will split into two, leaving a small portion of free floating F- ions.

The chemical mechanism by which Fluoride remineralizes and repairs is quite simple. The outer enamel layer of our teeth is essentially a crystal composed of calcium and phosphate. As acid, biofilms and bacteria break down this crystal, the calcium and phosphate become weakened and dissolve into our saliva. Fluoride works by encouraging the two compounds to reunite and incorporate back into the enamel. Similarly, If teeth are exposed to fluoride during development, the enamel tends to grow stronger and more resistant to decay. Scientific studies have also shown that fluoride inhibits bacteria’s ability to produce acid and stick to the teeth. This combination of effects makes fluoride an excellent candidate for fighting tooth decay.

Since fluoride needs to be in close proximity to the teeth to work, it’s effectiveness is dependent on exposure time and the not amount consumed. For example, swishing for 30 minutes with shot glass of fluoridated water would be more effective than gulping down a glass of fluoridated water in 30 seconds. Likewise, this is the reason toothpaste is not (and should not be) consumed for it to work ideally.

Since 2007, the water supply in Southern California has been fluoridated to a level of about 0.7 PPM (parts per million). The EPA suggests that any any fluoride level under 2.0 PPM is safe for consumption, while levels between 0.7PPM and 1.2PPM are ideal for medical effectiveness. As such, our water supply is well within safe limits. Additionally, some sources of water are naturally fluoridated without man made intervention. Here, governments and municipalities will occasionally have to de-fluoridate water before it is ideal for consumption. In addition to water supplies, many dental products and supplements contain fluoride in safe levels. Typically, any product advertising “anticavity” or “helps rebuild teeth” contains some amount of fluoride.

Although the medical benefits and potential risks of fluoride are well known and documented, some individuals feel that it is unsafe for human use. Common sources of fear are over impaired glucose metabolism, pineal gland hardening, poisoning and decreased cognitive ability. It is important to note that no reputable scientific journal supports any of these claims in regards to fluoride administered or used properly.

Many websites that quote scientific studies to prove the harms of fluoride typically cite outdated or unreliable papers, or do not understand (or relay) what the paper proves. For example, some studies have highlighted that fluoridated water can be dangerous when administered in extremely high levels. This is very true; large doses of fluoride can be quite harmful or even deadly, just like too much tylenol, alcohol or allergy medication. However, when used properly, fluoride is an extremely safe method of protecting our teeth.

In reality, the main concern with fluoride use and exposure is the onset of fluorosis in young children. As the adult teeth develop, overexposure to fluoride can cause white streaks or marks to appear within the outer enamel layer. This is typically found in children who start to take fluoride supplements at a very early age or are have their teeth brushed very often with too much toothpaste. To help prevent fluorosis, we recommend that children ages three and under should only brush with a smear of fluoride toothpaste, while ages six and under should brush with a pea sized portion. Your child should always be guided or supervised during brushing, to ensure they are applying toothpaste, spitting and rinsing properly. Extra fluoride supplements and treatments should be avoided, unless recommended by a dental professional. In general, fluorosis is generally a concern only until age 8, when the adult teeth have finished developing.

At Thousand Oaks Family Dentistry, we are firm believers in the efficacy of fluoride. We offer topical fluoride treatments for all patients with active tooth decay. In addition, we recommend ACT Fluoride rinse instead of mouthwash for our adult patients who have a history of cavities.  For those with aggressive decay, we offer a range of products that combine fluoride with xylitol, calcium and phosphate to arrest further cavities before they progress. In total, our entire spectrum of preventative recommendations incorporate fluoride to some degree. If you would like to know more about fluoride, how it works or why we use it, please call our office. We want you to feel assured about all of your dental health needs and choices!

Eating Disorders and Oral Health

Anyone affected by an eating disorder can tell you about its tolls on whole body health. Whether overeating, binging eating or bulimia, these conditions have very tangible effects on the entire system. We would like to take a moment to highlight how some of these disorders affect oral health. Please understand that this information is not presented to to scare or shame anyone. Rather, we want our patients to understand what is happening to their mouths, and how to go forward and manage the diseases’ effects.

Eating disorders involving overeating can damage teeth by creating prolonged acidic events in the mouth. Every time we eat or drink, our mouth pH turns acidic for the duration of the meal and the following 30 minutes. If someone were to eat once every half hour, their mouth would spend the entire day in a state of acidity. As this acid sits on the teeth, it begins to break down the tooth enamel, causing decay. Thus, overeaters who graze throughout the day are particularly susceptible to poor oral health. In addition to problems with the amount of food, the type of food consumed presents problems as well. Binge eaters can gravitate towards sweet, sticky and carbohydrate heavy products (“comfort foods”). These foods are excellent at adhering to the teeth, causing a drop in mouth pH and fueling bacteria to colonize and produce further acid. This can lead to more decay, recession and gum disease. In total, overeating can take many of the problems associated with frequent snacking or poor diets, and amplify them.

No matter what your diet, sticky, sugary and carbohydrate heavy foods are excellent at causing tooth decay. Overeaters are particularly susceptible to these effects due to their high frequency of exposure. 

At the opposite end of the spectrum, bulimia can also be particularly damaging to the teeth. Purging can leave patterns of acid erosion across the entire mouth, causing extensive enamel degradation and gum inflammation. Stomach acid is much stronger than any pH drop induced by food consumption, and thus the effects of bulimia manifest themselves very rapidly. In comparison, each session of purging would be akin to rinsing your whole mouth with concentrated lemon juice. These effects can be further amplified if the acid isn’t rinsed off and allowed to sit on the teeth. Time is an important factor in tooth decay, and the longer the teeth are exposed to acid, the more extensive the decay will be.

A visualization of the affects of bulimia on teeth. From bulimiahelp.org

While this information may seem daunting, it is important to remember that there are ways to improve your oral health and stop the progression of decay. Fillings, crowns and root canals can halt existing cavities and pain while restoring the esthetics of your smile. For teeth in the early stages of decay, there are a number of products to help repair enamel. Rinses such as Carifree CTx3 offer remineralization through fluoride and xylitol exposure, while pastes like GC MI-Paste provide extra calcium phosphate for rebuilding enamel. Overall, the important thing to remember is there is always a solution to your current oral state.

Again, our office presents this information to help you better understand how a psychological disorder (eating) can affect your physical body (teeth). If you are affected by an eating disorder, we encourage you to seek professional help. We want all of our patients to lead healthy lives, and are happy to help you find inner wellness!