Dental Questions: Is coffee bad for your teeth?

Coffee: possibly the most widely consumed non-alcoholic beverage other than water. With about 400 million cups drank EACH DAY, it is difficult to deny it's importance in our daily routines. As you probably know (or experienced), the dark pigments in this drink can cause discoloration or yellowing of the dental enamel. Beyond the cosmetic concerns, can coffee consumption harm your teeth? While it is difficult to give a definitive yes or no, there are some considerations you should take when going back for your next cup of joe. 

As a reminder, anything you eat or drink other than water has the potential to demineralize enamel and start the tooth decay process. Black coffee has a pH of about 5, meaning it is acidic enough to weaken enamel and cause initial decalcification. However, coffee has no carbs or sugars and thus cannot fuel the cavity-causing bacteria. The problem arises when sugar, cream, milk or other products are added to your beverage. Even something non-sweet like skim milk has the carbs necessary to feed bacterial growth and cause new decay.

Are we suggesting you quit drinking coffee cold turkey? Of course not! Still, there are ways you can adjust your consumption to better protect your teeth. Keep in mind that its not the amount, but the duration of carbohydrate consumption that determines tooth decay. Try to limit your coffee drinking sessions to set time frames, rather than sipping on one or two cups all morning. Swishing with water after drinking can help too, and protects against further staining!

At Thousand Oaks Family Dentistry, we know that creating good dietary habits is a moving target. We are always here to help you make great choices in protecting and improving the health of your teeth. If you would like to know more about tooth decay, how to protect your teeth or any other dental topics, please give our office a call!

Dental Questions: Why are x-rays so useful?

In modern dentistry, we take x-rays fairly frequently. The average patient will receive four "periodic" radiographs annually, and an entire "full mouth" set of images every five to seven years (depending on multiple factors). Why do we need so many pictures? As it turns out, x-rays are an invaluable tool in diagnosing, documenting and monitoring changes in dental diseases. Take a look!

Dental x-rays give a dentist much more information that simply "looking in the mouth." In regards to tooth decay, radiographs can show cavities forming in areas that are impossible to visualize, such as in-between two teeth. Furthermore, they give more information on the location and depth of decay, helping inform decisions on placing fillings versus crowns, the risk of nerve irritation and what materials to use to fill the tooth. In most instances, we will not perform a filling on a tooth without an acceptable x-ray of the effected area. Radiographs are also necessary in assessing gum disease and bone loss. They can document the amount and pattern of recession, helping make decisions on dental cleanings and possible periodontal surgeries. In severe circumstances, heavy tartar hidden beneath the gum line will be visible on radiographs as well. 

This image shows the progression of cavities, as seen on dental x-rays. In the last image, the decay has reached the tooth's nerve, necessitating a root canal

X-rays are also of great use in documenting and monitoring dental problems. Particularly in working with insurance companies, radiographs help demonstrate the necessity of certain procedures. This can improve the approval process and speed up reimbursements. Additionally, x-rays can help track the changes in dental conditions over time, aiding in decisions on treatment or continued monitoring. 

This image shows the progression of gum disease, as seen on an x-ray. The small white bumps that form on the sides of the teeth are tartar below the gumline. 

Radiographs are useful in visualizing much more than gum disease and tooth decay. Procedures like root canals, extractions and implants are impossible to perform without good radiographs. To learn more about the diagnostic tools we use in dentistry, please give our office a call. 

Dental Questions: Is tooth decay related to genetics?

We often hear of people born with "soft enamel" or "weak teeth" that have left them with a lifetime of dental problems. Naturally, genetics has to play some role in tooth decay- right? How else can we explain the the stark differences in dental experience across the population? While the foundations of dental disease are hereditary, the full answer might surprise you!

For starters, genetics can play a role in cavities and tooth decay. However, these problems affect a very small group- less than 1% of the general population. Hereditary conditions like amelogenesis imperfecta, dentinogenesis imperfecta and dentin dysplasia all cause less resistance to tooth decay and increased dental needs over a lifetime. They also come with very obvious cosmetic changes, like mottled coloring, brown/ blue enamel tones or notched edges. If your teeth appear "normal," chances are you aren't affected by one of these conditions. In addition, there are some developmental issues that can lead to weaker enamel as well. Notably, incisor-molar hypoplasia appears with mottled enamel on the permanent incisors and first molars that is less resistant to tooth decay. 

In reality, the inherited component of tooth decay comes from bacterial genetics. In many instances, the cavity experience of a child's mother will predict the next generation's rate of decay. As the typical primary caregiver, close contact between mother and child leads to bacterial inoculation during a developmental period that defines the child's future oral bacteria. This is one of the reasons we stress not sharing utensils or cleaning pacifiers with spit. While all children will eventually become inoculated, delaying the start time can lower the tooth decay experience. Additionally, learned habits can play a large shaping role in tooth decay. Attitudes towards snaking, brushing/flossing, sugary foods and dental treatment become learned at a young age and can be hard to correct.  

The important message here is that very few patients actually have "soft enamel," and improving dental health is an attainable goal. Controlling sugar intake, daily brushing/ flossing and frequent hydration with fluoridated water are easy and scientifically proven to lower the risk of developing cavities. If you would like to know more about tooth decay, fillings, cavities or other dental concerns, please give our office a call!

Crowns for Baby Teeth

February is the official National Children's Dental Health Month, as recognized by the ADA. Thousand Oaks Family Dentistry will be rolling out weekly topics relating to pediatric dentistry all month long. Make sure to check back regularly to catch all the great information. 

In some ways, baby teeth aren't that different from their permanent counterparts. When a cavity gets big enough and weakens the overall tooth structure, a crown is often the recommended treatment. However, there are some fundamental differences between the crowns placed on the primary and adult teeth. Read on to catch the full story!

For starters, baby tooth crowns are not made by a dental lab. They usually come from a set of prefabricated stainless steel or polycarbonate crowns that can be adjusted and cut to fit the prepared tooth. For young children, a precise fit between tooth and crown isn't as important as getting something to cover/protect the tooth and minimizing time in the dental chair. In areas where cosmetics may be a concern, "strip" crowns can be used. Here, a clear shell is placed over the tooth and filled with tooth colored filling material. After the material is set, the shell is "stripped" away, leaving behind a natural appearing restoration. 

Many times, a crown on a baby tooth is provided in conjunction with a procedure called a pulpotomy. This is done when a cavity reaches the nerve of a tooth and causes irreversible inflammation. The dentist will remove the inflamed nerve tissue and place a medicated filling before cementing the crown. Many times it is difficult to judge wether a tooth will need a filling, crown and/or pulpotomy before beginning treatment. Don't be surprised if the plan has to change on the fly. 

We typically refer our young patients to pediatric dentists to have crowns placed. The training and expertise of these specialists make the appointments easier and less traumatic for little ones. If you would like to know more about baby tooth crowns, fillings for kids, or any other oral health topics, please give our office a call!

What causes tooth decay? - A Halloween refresher

With Halloween around the corner, we would like to take a moment to remind kids of all ages about the tooth decay process. While those sugary treats might make you happy now, they can cause a lot of problems if you aren't careful. Like many things in life, moderation is key to keeping your teeth protected from bacteria and cavities. 

The biggest point in understanding cavities is that duration, not amount, of sugar consumed is the main factor in the tooth decay process. Every time we eat or drink anything other than water, our mouth drops into an acidic state for the next hour. With this in mind, someone who snacks on candy all day will spend 24 hours bathing their teeth in acid and fueling bacteria with carbohydrates. If that same person ate the same amount of candy after a single meal, there would be a much less drastic effect on the teeth. 

Furthermore, it is important to remember that all carbohydrates can contribute to enamel demineralization and decay. Even foods that aren't necessarily sweet like goldfish crackers and pretzels are harmful to the teeth. Additionally, naturally sweetened or organic foods like fruits cause decay all the same as processed sugars. In fact, raisins are one of the most tooth-harmful snacks, due to their high sugar content, dryness and ability to stick to dental enamel. 

What can you do to prevent tooth decay? For starters, limit snacking and candy consumption to set times or pair them with scheduled meals. Do not let yourself graze on sweet food all day or take multiple hours to finish food. Additionally, rinsing your mouth out with water after eating sweets is an easy way to clear the carbohydrates from your teeth and limit their contact. Finally, brushing twice a day with fluoride toothpaste and flossing daily is the gold standard in preventing dental diseases. If you have other questions about tooth decay, candy or tooth healthy snacks, please give our office a call!

Fruit Juice and Baby Teeth

In a recent article, the American Association of Pediatrics has announced that children under the age of 1 year should not be given fruit juice. They propose that juice "offers no nutritional benefits early in life" and that the process of making juice strips fruit of its natural fibers while concentrating sugars. From a dental perspective, fruit juice proposes many threats to developing teeth and can contribute to rampant decay. 

One of the biggest problems with childhood juice consumption is the misconception that fruit juice is "healthy." Whether natural, organic, unfiltered or cold pressed, all commercially available juices are high in dietary sugar. In fact, most rival the sugar content of colas and other soft drinks. This, combined with juice's typically acidic content, makes it a perfect fuel for tooth decay. Liquids are excellent at bathing the teeth, while the sugar content feeds bacteria and acidity weakens enamel. This perfect storm leaves many children with a tell-tale pattern of cavities sometimes known as "Mountain Dew Mouth." 

Small servings of juice once a day (particularly when served with a meal) are generally acceptable from a dental perspective. Multiple servings, putting children to sleep with bottles full of juice and sipping on juice all day (regardless of actual quantity consumed) put a child's dental health at jeopardy. Remember, tooth decay relates to the duration of time consuming a sugary beverage rather than the actual amount of sugar consumed. If you would like to know more about tooth decay, preventing cavities in baby teeth or pediatric dentistry, please give our office a call!

Dental Questions: Can eating fruit harm your teeth?

Fruits and vegetables are often hailed as the healthiest parts of a balanced diet. They bring vitamins, minerals and antioxidants to almost every dish, while avoiding harmful fats and oils. However, since many fruits are acidic and high in sugars, they can be potentially harmful to your teeth.

As with all foods, the quantity and quality of the fruit you eat doesn't matter as much as the duration in which it is consumed. The bacteria in your mouth don't care if it's organic and natural or processed and preserved. To them, sugar is sugar. As such, the best way you can modify the bacteria's response is to limit the time that your teeth are exposed to carbohydrates.

Every time we eat or drink our mouths turn to an acidic state for 30 minutes. During this period, dental enamel becomes softened and prone to decay. In this sense, someone who eats every 30 minutes spends nearly the entire day damaging their teeth. This is why snacking on apple slices all day is more harmful than eating a single candy bar immediately after a meal (in a strictly dental sense).  

Another factor you can control is the consistency of the foods you eat. Sticky and dry fruits like raisins can be much more harmful than something crisp and moist like pear or apple. This is particularly true in children, who don't have a natural tendency to pick food out of their teeth. 

In total, fruit makes an excellent healthy snack, but must be enjoyed in moderation. Realize that it still contains acids and sugars that fuel the tooth decay process. As with any sweet food, we recommend keeping snacking on fruits to a minimum and sticking to eating only at mealtime. If you must snack, make sure that you are cleaning your teeth of any residual food and rinsing with water when you're finished. If you have any more questions on diets, tooth decay and cavity prevention, please give our office a call!

Hidden Sugars

While we typically think of tooth decay as a childhood disease, it can affect anyone at any age. In fact, while cavities are slowly declining in young children, 92% of adults over the age of 20 have some form of decay. This is largely attributed to "hidden sugars" in our daily diets. 

Nearly everyone tries to eat healthy and stay away from sweets and sugary drinks. However, it is important to understand that sugars can "hide" in the foods we eat every day. These hidden sugars are particularly detrimental when used as snacks or consumed over a long period of time. Duration, not quantity, is the most important factor in the decay process. A prime example of hidden sugars would be cheese crackers like Goldfish or Cheez-its. While they may have a low sugar content by recipe, our saliva can break down the carbohydrates into smaller glucose and fructose molecules. Combine this with the the crackers' sticky nature and you have a perfect storm for tooth decay!

Other sugars we consume aren't quite as discreet, but still manage to sneak in without us noticing. This is particularly true in an office environment where coworkers are constantly bringing in donuts, birthday cakes and sweet treats. While we may not plan or think of these foods as part of our diet, they still can have a serious effect on our teeth. 

Asking someone to give up their favorite snacks "cold turkey" is usually impossible. Instead, we suggest keeping the duration and number of snacking sessions to a minimum. For example, instead of eating a box of raisins over the course of an afternoon, try to consume all of them in an even fifteen minute period. Also, make sure to follow any snack or meal with a rinse of water and some xylitol gum. This combination is a quick and easy way to minimize bacterial activity after an influx of sugar.

If you would like to know more about tooth decay, what causes it and how we can stop the process, please call our office. The most important component of dental care is prevention, and we want to keep our patients equipped with the latest research in hygiene and oral health. 

Case Presentation: Mountain Dew Mouth Reconstruction

Today’s case is a typical example of a condition called “Mountain Dew mouth.” It shows how rampant decay develops and what we can do to repair and intervene. Before describing what we did, it is important to note that home care and diet are key in stopping the spread of cavities. All the dentistry in the world won’t help unless we can disrupt the decay causing bacteria!

We typically see Mountain Dew mouth in younger patients who haven’t seen a dentist in a few years. Sugary drinks (such as Mountain Dew) create the perfect storm for rampant dental decay. They can contain as much as 46 grams of sugar per 12 ounce serving, more than enough to feed the bacteria in your mouth and start the decay process. The liquid is both sticky and acidic, making it efficient at evenly coating and softening all enamel surfaces. Finally, these drinks usually consumed over a long period of time. Duration, not quantity, is the important factor in the tooth decay process. The same 46 grams of sugar wouldn’t be nearly as destructive if they were consumed quickly and not allowed to bathe the teeth.

This patient came to us with dark stained decay around the necks of their front teeth. These areas take the majority of liquid exposure when we drink, and thus tend to decay first. You can also spot dark shadows around the sides of the teeth, signifying more decay beneath the enamel surface. None of the cavities on the front teeth extended to the dental pulp, meaning root canals or extractions weren’t immediately necessary. Unfortunately, some of the molars did have extensive decay and will need to be removed at a future appointment.

We proceeded to remove all decayed and compromised enamel. This process is very delicate, as we want to be thorough while leaving as much sound tooth structure as possible.  Once the decay was gone, we filled the teeth using a combination of glass ionomer and composite tooth colored materials. Glass ionomer is great for repairing rampant decay, as it both bonds to the tooth structure and releases fluoride on to the remaining enamel. In contrast, composite allows us to recreate difficult contours and best match the cosmetics of natural teeth. The entire procedure took us a single appointment, and the patient left our office with a beautifully restored smile!

Again, it is important to note that all of our restorative work will come undone unless this patient can stop the intake of sugary drinks and keep up with their daily brushing and flossing. While fillings and crowns can remove active dental decay, only proper hygiene AND healthy diet choices can stop the bacteria’s progress. If you would like to know more about dental decay, what foods cause it or how to intervene, please contact our office.

No-Drill Dentistry

One of the newest "buzz words" in the dental field is no-drill dentistry. The idea behind this treatment is that if tooth decay is caught early enough it can be remineralized and "reversed" through a number of preventative measures. While these techniques sound new and exciting, they are based on established concepts that we have been using in our office for years.

Tooth decay starts in enamel and spreads towards the inner layers of dentin and pulp. The bacteria begin by removing mineral from enamel, followed by destroying the scaffolding that holds the minerals. While decay sits entirely in enamel, it can be stopped and remineralized. This relies on the use of fluoride (found in drinking water, toothpaste, etc.) along with good oral hygiene (frequent brushing/flossing, low sugar diet, infrequent snacking). However, once the underlying scaffolding is gone, there is no "regrowing" lost enamel. Furthermore, decay that extends into dentin spreads rampantly and cannot be stopped from further progression. At this point, traditional dental work must be performed to keep the cavity from growing.

Thousand Oaks Family Dentistry uses the principals of no-drill dentistry on every one of our patients. We only treat decay via traditional methods when we absolutely have to and always try to naturally remineralize first. Our younger patients all receive fluoride foam treatment with every cleaning while our adult patients are consulted and evaluated for special rinses, pastes or other preventative measures. In short, we try everything possible before touching a tooth with a drill. If you would like to know more about no-drill dentistry, preventative dentistry or any other techniques, please give our office a call!