Refreshing Drinks and Tooth Decay

As summer draws to an end, we are caught at an in-between time of refreshing iced teas and back-to-school coffees. No matter what the season, it's easy to get stuck in a habit of sipping on something sweet and flavorful. Unfortunately, this is the exact pattern that leads to increased risk of tooth decay and cavities. 

While many think of dental decay as a childhood disease, it can most certainly affect teenagers and adults. The problem almost always extends from dietary choices. Every time we eat or drink anything other than water, our mouths become acidic for a 30 minute period. During this time, enamel is softened and more susceptible to bacterial attack. If you sip on sugary drinks all day, your mouth practically lives in this weakened state. This is why soft drinks are particularly detrimental to oral health. Commonly known as "Mountain Dew Mouth" these sweet and acidic beverages leave a telltale pattern of decay and staining in patients' mouths. 

If you're interested in cutting back on the dental damage done by your drink choices, there are a number of things you can do. First and foremost, try to avoid any drinks that contain sugar (sucrose, fructose, glucose, etc.). Even it it's naturally sweetened or organic, sugared beverages are never a good idea. Furthermore, you can cut back on the contact between your teeth and the beverage using a straw. This also works great for keeping heavily pigmented drinks away from freshly whitened teeth. Finally, rinsing with water after finishing your other beverage can help clear away any residual sugars before they cause damage. 

As you can see, small alterations to your diet can have a serious impact on your dental health. By keeping sugary foods and drinks to a minimum, you can spare yourself from extra dental work. If you would like to know more about how to adjust your diet for optimum dental health, please give our office a call!

Dental Questions: Should I be using mouthwash?

With the wide variety of mouthwashes and rinses available today, choosing a product for yourself can be quite the challenge. Between Listerine, Biotene, ACT rinse and others, there is certainly a multitude of options. However, which product should you be using? Should you be using any mouth rinses? Read on to find out how to choose the best product for your oral health. 

Many patients will start using a mouthwash as a response to bad breath. In reality, the best a mouthwash can do is mask bad breath with its flavoring. Even the strongest tasting and most astringent rinses can only help as a temporary measure. Your best bet in preventing bad breath is upping your home hygiene. Specifically, flossing and tongue brushing can have a noticeable and lasting impact on the way your breath smells.

Listerine is the most widely recognized and used mouth rinse on the market. Many patients seek the burning sensation under the idea that "if it hurts- it's working." In reality, Listerine and other alcohol based mouthwashes are designed to target periodontal disease. These rinses rely on alcohol to eliminate bacteria in the gums and pockets around the teeth. Patients with healthy gum tissue will likely not see any marked benefit from using these products. On the contrary, alcohol rinses tend to be slightly acidic which can contribute to enamel demineralization and the tooth decay process. 

For those that are interested in using a mouthwash, almost everyone can benefit from ACT Fluoride Rinse. While it lacks the burn of alcohol based mouthwashes, ACT rinse contains a therapeutic concentration of fluoride. Since Fluoride works by being in contact with dental enamel, using it in a rinse to bathe your teeth is an excellent application. For the best use, rinse with ACT after brushing, spit, and do not rinse with water. Allowing the product to have maximum contact with the teeth is key to its cavity fighting powers!

For patients with chronically dry mouths (a condition called xerostomia), products such as Biotene are an excellent choice. One of the main ingredients in Biotene is xylitol, a natural sugar substitute. In this application, xylitol helps stimulate salivation and protects against cavity causing bacteria. Because our natural saliva is protective against tooth decay, patients with dry mouths are at an extremely high risk for developing new cavities. Overall, Biotene can have a significant impact on the comfort and dental health of those patients with xerostomia. 

It is important to remember that patients with excellent oral health may not need to use a mouthwash. For many, brushing twice a day with fluoride toothpaste and flossing is sufficient to maintain tooth and gum health. If you would like more advice on rinses or any other part of oral hygiene, feel free to give our office a call!

Examining the Anti-Flossing News

If you've been on the internet in the last month, chances are you've seen the AP article titled "Medical Benefits of Dental Floss Unproven." In this article, the author postulates that as the Department of Agriculture and Health and Human Services dropped flossing from its dietary recommendations, it comes to light that there is little to no scientific evidence that flossing is beneficial to oral health.

In dissecting this article, it is important to understand why dentists recommend flossing. The primary goal of flossing is to physically remove bacterial film (plaque) from the pockets between the gums and the teeth. As a secondary action, floss can dislodge food that gets stuck between teeth and help prevent decay. Floss cannot remove hard bacterial film (calculus/tartar) nor can it clean deep periodontal pockets. That being said, regular flossing will help prevent the development of these conditions to begin with. 

It becomes clear that the author of this story does not have a solid understanding of periodontal disease, oral health or scientific studies. One of the main points of the article is that there aren't any quality scientific papers that show the benefits of flossing. This fact more-so highlights the high costs and extreme difficulty in performing a study of this nature. Much of scientific research pivots on having reliable metrics and a large enough sample to get valuable data. Since flossing is so universally accepted in the dental community, securing the millions of dollars necessary to perform this study would be nearly impossible. 

Furthermore, the author argues that any evidence on flossing points to its benefits in reducing bleeding gums, removing plaque and stopping gingivitis. He seems to view these attributes in a vacuum, when in reality they are all part of the periodontal disease process. Plaque, when left undisturbed, eventually hardens into tartar. This then causes an inflammation of the gum tissue known as gingivitis. Gingivitis is responsible for the bloody, puffy and sensitive gums that many patients experience. With time, the inflammation spreads to the bone surrounding the teeth and causes it to recede creating deep pockets. At this point, the disease is called periodontitis. While it is true that floss will not reach the bottoms of these deep pockets, any reduction in bacterial load is beneficial and crucial to the treatment of periodontal disease.

The author is quick to note that "early gingivitis is a long way from severe periodontal disease" and that "severe periodontal disease may take five to 20 years to develop." What he fails to mention that slight or moderate periodontitis can develop much quicker (we usually see the first signs around age 30) and that the technical "severe" periodontal disease is a debilitating condition marked by loose teeth, chronic bad breath, pain and tooth loss. This is the exact same disease that started out as gingivitis. Why wouldn't you do everything in your power to mitigate this problem from the start? 

If you would like more reasons to keep flossing, just read any statements made by the ADA, the California Dental Association or the American Academy of Periodontology. The dental community shows unanimous support for the regular, daily use of dental floss. Furthermore, evidence shows that controlling periodontal disease is associated with less heart disease, better glucose control in diabetics and better outcomes in at-risk pregnancies. Flossing is an important part of your oral health home care! If you need any more information on the benefits of flossing or instructions on how to floss, feel free to contact our office!

Dental Questions: What's the difference between sealants and fillings?

A recent study released by the Journal of the American Dental Association identified dental sealants as one of the most effective means of reducing cavities in children. Sealants were found to be more effective than fluoride varnish at preventing decay and are associated with a 70%-80% reduction in cavities in the pits and grooves of teeth. 

A dental sealant is administered by cleaning the tooth surface, fillings the grooves with a resin material and adjusting any high points that interfere with biting/chewing. This may sound similar to the way that a traditional dental filing is performed because it is essentially the same procedure. The main differences come from the goals of the treatments and the amount of modification to the tooth. 

A dental filling is provided to remove active decay from a tooth's enamel and dentin. They usually extend 3-5 millimeters into the tooth and are used as a reparative treatment. By taking out the damaged areas, we can halt bacteria's progression into the tooth. In contrast, a sealant is performed on an undecayed tooth as a preventative measure. Typically, no tooth structure is removed. The end goal is to "seal out" food and bacteria from the deep grooves in our teeth. These tiny nooks create a perfect spot to catch food, harbor bacteria and avoid cleaning (most times the grooves are too thin to be reached by a toothbrush bristle!). 

In total, there are many similarities between traditional fillings and sealants. However, placing a sealant takes less time, requires less tooth structure to be removed and is an overall less traumatic experience for young patients. If you would like to know if you or a family member would benefit from sealants, please call our office to schedule an appointment!

The Benefits of Sugar Free Gum

Are you a frequent gum-chewer? Men's Health Magazine recently published an article discussing how chewing sugar free gum can save you thousands of dollars in dental expenses. Find out why adding gum to your daily routine can help fight cavity causing bacteria!

Every time we eat or drink anything made with sugars or carbohydrates, our mouths turn acidic for a thirty minute period. This is caused by bacteria in our mouths processing sugars into their associated acids. Over time, the acid buildup weakens dental enamel and begins to form cavities in our teeth. These cavities tend to develop in areas that trap food, as bacteria have more fuel to turn into acid. This is one of the reasons why decay in common in between teeth and in the pits/grooves of posterior teeth. 

The Men's Health article correctly identifies that sugar free gum lacks the necessary ingredients to fuel bacterial acid production. In addition to this, gum helps loosen food that gets packed into our teeth after meals. Finally, chewing gum stimulates saliva flow which is a crucial factor in preventing tooth decay. Our saliva has incredible natural remineralizing properties and can have a tremendous effect on the progression of cavities.  

One topic the article does not address is the type of sweetener to look for in sugar free gum. Most brands use typical sugar substitutes like sorbitol and aspartame. However, chewing gum made with xylitol will add even more protective factors into your daily routine. Xylitol is a natural sugar alcohol that inhibits ability of bacteria to grow and stick to our teeth. While xylitol gum can be purchased at many stores, health food markets typically carry the best variety. You can also order it online from companies like Dr. John's Candies (our office's favorite!).

It is currently believed that Xylitol's maximum dental benefit comes from using it three to five times a day. However, it is not a substitute for flossing or brushing with a fluoride toothpaste. If you would like to know more about the protective factors of xylitol gum, how it is best used and what it does for our teeth, please give our office a call!

Link to Men's Health Article: www.menshealth.com/health/habit-save-money-dentist

Dentistry and Children's Teeth

If you ever took a fall or had a cavity as a child, you're probably thankful that we get two sets of teeth. Our primary dentition can certainly seem like a second chance to recover from youthful mishaps. You may be wondering why, if adult teeth will eventually take their place, do we perform restorative dental procedures on kids teeth? Crowns, fillings and even braces may seem excessive when you could simply "extract and wait" for the adult teeth to come in. On the contrary, primary teeth serve a number of important roles in establishing a healthy adult dentitition. 

One of the most basic goals of primary teeth is to hold space for the permanent teeth. They create markers for where the adult teeth need to erupt and keep adjacent teeth from crowding into the open spaces. Once you lose a primary tooth, the teeth on either side can start to drift into its space, blocking the adult tooth from eruption. Many times, children who lose a primary tooth prematurely will receive a space maintainer- a cemented retainer that keeps two teeth from coming closer together.

Primary teeth also play an important role in the development of the jawbones. This is the guiding principle behind interceptive orthodontics, where braces and orthodontic appliances are placed on baby teeth. By ensuring these teeth are in ideal locations, an orthodontist can guide the development of the jaws and palate while lessening the need for future adjustment. 

Beyond the developmental importance of primary teeth, they are critical in psychological and social factors as well. Missing multiple anterior teeth can be embarrassing or humiliating, particularly when children are not at the appropriate age of tooth loss. Moreover, the posterior teeth are important in chewing and processing food. Without the ability to chew, we miss out on important nutrients in our diet. Molars allow us to break down food, increase surface area and ultimately facilitate healthy digestion. 

In short, the primary teeth are an incredibly important part of childhood development. With this in mind, dentists do all they can to maintain these teeth through their healthy lifespans. If you want to know more about childhood dentition, the importance of brushing and flossing or dental development, please give our office a call!

Dental Questions: What is a flipper?

With the rise of dental implants, many patients are electing to have teeth extracted rather than spending time and money on a losing battle. Since implants can take months to heal before a crown is placed, there is now a question on what to do with the missing spaces in the meantime. While you can elect to leave these areas open in the interim, this is not an option when the implant is placed in the smile zone. For these situations, you may be made a flipper- or temporary denture. 

Flippers are also known as stay plates or temporary partial dentures. They are made of a hard, pink acrylic resin that supports the prosthetic teeth. They may also have a series of metal clasps that hold the frame firmly in place. Flippers differ from permanent dentures primarily in the way they rest on the teeth and gums. Partial dentures are fitted to the mouth so that the teeth serve as the primary supporting structures. If the gums have to be utilized in holding the denture, very specific areas are used, as to not cause any lasting damage. In contrast, flippers rest entirely on the gums and soft tissues. Over time, the constant pressure on gums can cause the underlying bone to resorb or irritate the periodontal tissues. With this in mind, they are inappropriate as permanent appliances. However, they can be a great interim solution in implant placement. 

Flippers are created by a dental laboratory and take about two weeks to complete. They typically blend seamlessly with the natural tissues and aren't noticeable as "denture teeth." If you would like to know more about flippers and how they can be a part of your implant treatment, please give our office a call!

Photographs at the dentist's office

If you have had a new patient exam at Thousand Oaks Family Dentistry, part of your appointment was dedicated to taking pictures of your face, smile and teeth. Depending on where you previously received care, this may have seemed like a strange proposition. However, photography is an increasingly useful tool in the modern dental practice that allows us to better serve our patients. 

In it's most simple form, photography gives us a baseline idea of how your teeth look. While x-rays allow us to see cavities, infections and bone levels, nothing short of a traditional photograph can clue us into the cosmetic history of your teeth. If, God forbid, you were in an accident that damaged your anterior teeth, these images would help us recreate your smile most accurately. Additionally, photos help us track changes over time. Acid erosion, staining and orthodontic movement are all best recorded using traditional photography.

In addition to creating a cosmetic record, photographs can help us in billing your insurance. Many times, insurance companies will not cover certain treatments unless they were used to treat tooth decay. This becomes a problem on the chewing surfaces of teeth,  where decay is usually visible to the naked eye but poorly imaged on x-rays. By the time decay on these surfaces is visible on an x-ray, the cavity usually extends almost entirely to the tooth nerve. In contrast, photographs allow us to document decay early and reduce the number of hiccups between you and your insurance provider. 

In total, photography is not a replacement for standard x-rays. However, they are a safe, quick and reliable supplement that helps us better serve our patients. If you have any more questions about dental photography, our exams or any other service offered at Thousand Oaks Family Dentistry, please give us a call. We are always here to serve any and all of your dental needs!

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. 

Recent changes to our Root Canal Policies

Our office recently changed our protocols on finishing root canal procedures done by endodontic specialists. These changes reflect the safest and most effective dental practices known today. As with all procedures carried out at Thousand Oaks Family Dentistry, we put your treatment, comfort and convenience first!

When a root canal is finished, you are essentially left with a tooth sans nerve tissue and a small opening at the top. This opening is a necessary part of the root canal procedure that allows the endodontist to reach the nerve tissue and roots. Unfortunately, it is also a major deterrent to the long term structural integrity of the tooth. In order to restore strength to the tooth, the opening needs to be sealed with a special filling material called a core and finished off with a dental crown. This core material chemically bonds to the enamel and protects against fractures and cracks. Many times, a device called a post will be added to the core to provide more rigidity when necessary. Posts extend partially down one root and create an additional structural anchor for the core to adhere to. 

Historically, the endodontists we work with would complete the root canal procedure and place a temporary filling into the opening (a "temporary core). This material does not actually bond to dental enamel and only serves to keep bacteria and food out of the inner tooth. It is very easy to remove, allowing for the quick re-access of a tooth if the first root canal was unsuccessful. Patients then had to return to our office, have the temporary filling removed and have a permanent restoration placed. Not only did this create a new opportunity for bacteria to invade the tooth, it caused our patients to spend days to weeks functioning with a severely weakened tooth. 

Currently, our endodontic specialists are placing permanent posts and cores at the time of root canal completion. This ensures the tooth is continuously sealed and structurally reinforced prior to crown placement. While immediately placing a permanent core can make re-accessing the tooth more difficult, the positives largely outweigh any negatives. Very few teeth end up needing immediate re-access, and the continued structural support of the tooth is a far more important factor in long term root canal success. 

If you would like to know more about root canals, posts, cores or any other dental procedures, please call our office. We are always happy and excited to walk you through any part of your dental treatment!