Dental Questions: Can I eat with my Invisalign trays on?

One of the most unexpected (but often appreciated) side effects of Invisalign treatment is weight loss. Because the trays have to be worn 22+ hours a day and can only be used on clean teeth, many patients forgo snacks and extra sugary drinks in the name of convenience. But, if you really need that afternoon pastry pick-me-up, do you actually have to take your trays out, then eat, then brush before putting them back in? The answer is yes, absolutely!

Anytime we eat or drink anything other than water, the pH balance in the mouth turns acidic. Usually, this is slowly buffered back to normal by the compounds in our saliva. However, Invisalign trays can trap food and liquids around the teeth and keep the protective saliva out. This effectively allows the teeth to soak in acid, leading to decay and decalcification spots. You don't want to finish your Invisalign treatment only to find out you need fillings! Furthermore, extreme temperatures and unexpected forces can deform the thin plastic trays. Clear aligners are designed with extreme precision, and even the smallest changes can negate their orthodontic abilities. 

Invisalign is a great treatment option for many patients, but it is not without it's limitations. If you cannot leave the trays in for nearly 24 hours every day, you may need to consider other options. To learn more about Invisalign trays, braces or other cosmetic dental procedures, please give our office a call!

Dental Questions: Can all teeth be saved with crowns?

Its easy to think of crowns as a save-all for cavities, cracked teeth and other dental disasters. Unfortunately, this is not the case. There are many situations where a crown will simply not improve the condition or longevity of a damaged tooth. The main benefit of crowns is that they restore strength to broken down teeth by creating a full coverage "cap" around the remaining structure. However, this means the tooth needs to have good gum and bone support along with some (minimal) amount of remaining tooth to hold on to. 

Firstly, a crown will do nothing to benefit a tooth with severe bone loss or gum disease. Splinting a tooth with periodontal disease to a healthy tooth may seem like a great way to stabilize roots and create a more sturdy anchor. However, research shows this is not the case and splinting teeth can actually create plaque traps that accelerate bone loss. In most instances, placing a crown on a tooth with poor bone support is ill advised and can further hinder its longevity in your mouth. 

In terms of restoring severe tooth decay or fractured teeth, crowns still have certain limitations. There needs to be a minimal amount of dental enamel and dentin above the gum line for the crown to be cemented upon. Procedures like root canals/posts, crown lengthening and orthodontics allow dentists to create more structure for the crown. However, there is a limit to how much can be done for a specific tooth. Generally speaking, teeth that are broken off at or below the gum line are usually impossible to save with a crown. If saving them is an option, it is almost always more economical and predictable to remove the tooth and replace it with an implant. 

Overall, crowns are an excellent way to recreate the bulk or body of a damaged tooth. Still, it is important to acknowledge their limitations. In some circumstances, removing the tooth in question and replacing it with a bridge or implant is the more favorable option. If you would like to know more about crowns, implants, bridges or other tooth replacement procedures, please give our office a call!

Nail biting and teeth

You've probably heard you mom say it a hundred (or more) times: biting you nails is bad for your teeth! Still, slightly less than half of all adults report some regular nail biting. Beyond the disease potential from putting your hands in your mouth, nail biting poses specific risks to the teeth. Read on to learn why this common habit is detrimental to your oral health and how to prevent it!

Nail biting requires you to use your teeth in ways that they were never designed. Using the front teeth to mash through the thick keratin on the nails wears away at the thin enamel on the ends of the incisors. These teeth were designed for tearing and cutting, not puncturing hard objects. Chipped enamel, irregular wear patterns and even tooth movement can all occur with prolonged nail biting. Some studies also report an increased frequency of TMJ pain in nail biters. The constant pressure on the jaw joints and muscles can be enough to cause soreness or even trigger headaches. 

At the core, nail biting is usually tied to stress or emotional strain. Mindfulness, stress reduction techniques and meditation can help cut out nail biting at the source. Keeping nails short and trimmed can also limit access for the teeth and thus prevent chewing as well. Some patients also use nail polish as a bad taste-deterrent, with certain brands of polish containing flavor additives specifically to stop nail biting. Finally, strong tasting/smelling ointments such as tea tree oil have been used for years to remind us to keep our fingers out of our mouths. 

All in all, you should never use your teeth for anything other than eating and chewing. Nail biting, opening packages or holding objects with your teeth can all result in cosmetic or structural damage. If you would like to know more about how to manage nail biting, repairing chipped enamel or educating children on protecting their teeth, please give our office a call!

Dental Questions: Flossing around implants

Dental implants are a new and exiting technology that has changed the way dentistry is practiced. The ability to add single teeth (or spans of teeth) back to the mouth in a non-removable fashion is a miracle for many patients. However, implants must be maintained with the same hygiene routines as natural teeth, if not more rigorously. Flossing is a particularly important step, as it directly targets the leading cause of implant failure. 

A dental implant is essentially a titanium screw that is placed beneath the gums and into the jaw bone. A crown is either cemented or screwed on to the implant, allowing the gum tissue to heal around it and create the appearance of a natural tooth. While the bones will eventually integrate with the titanium in the screw, the gums never truly "attach" to the sides of the implant crown. The result is a deeper pocket than a natural tooth, with much more potential for food collection and inflammation. Flossing is an essential part of cleaning the sides of the implant and removing irritants and plaque from its pockets. Much like the progression of natural gum disease, unclean implants can develop gum irritation and accelerated bone loss. When used correctly, floss reaches areas that the toothbrush cannot reach and keeps inflammation to a minimum. Don't worry- the floss won't damage the implant crown or the screw underneath!

Implants are an investment that begs to be protected. Regular brushing, flossing and dental cleanings are the only way to ensure your new teeth for many years to come. If you have any more questions about cleaning implants, brushing your teeth or using dental floss, please give our office a call!

Dental Questions: Is chewing gum good for your teeth?

Chewing gum is often touted as a great way to freshen your breath and remove strong tastes. You may have even heard that it can protect teeth or the dental enamel. While there is some truth to this statement, you have to be careful of what type of gum you use. Additionally, no matter what any advertising agency says, chewing gum is no replacement for daily brushing or flossing. However, it is an easy way to add a protective factor to your daily routine. Take a look!

First and foremost, for a gum to be "good" for your teeth, it absolutely has to be sugar free. Any products flavored with fructose, sucrose or HFCS are capable of fueling bacteria and starting the tooth decay process. Sugary gum is particularly harmful, since it is kept in the mouth and not swallowed. Gums flavored with sucralose, stevia, aspartame or xylitol are much safer options. Notably, xylitol provides the secondary benefits of stimulating salivation and inhibiting bacterial growth. You can find specific xylitol flavored gums at health food stores like Sprouts and Whole Foods. 

The physical act of chewing gum also has some benefits to the teeth. Chewing activates the salivary glands, keeping your teeth moist and mineralized. Additionally, gum can dislodge food stuck in the biting surfaces. However, gum overuse is a real problem that can lead to sore jaw muscles and headaches. Like anything, use gum with moderation and listen to your body. 

Chewing sugar free gum is an easy way to add extra protection against cavities and tooth decay. If you would like to know more about preventing cavities, brushing or flossing, please give our office a call!

Dental Questions: Does every tooth need a crown after a root canal?

As a rule of thumb, if you have a root canal performed on a tooth, you should expect to have a crown placed afterwards. Crowns help restore the structure and rigidity to a tooth after it has been "hollowed out" by the root canal process. In a few instances, a dentist may not recommend placing a crown on a tooth as part of definitive treatment. However, these cases are certainly the exception, and not the rule. 

To perform a root canal, an opening has to be created to access the nerve space within the tooth. This involves removing important structural components of the dental enamel, and thus rendering the tooth much more likely to fracture. A crown remedies this problem by creating a solid cap around the tooth that braces it against biting and chewing forces. Root canal treated teeth also frequently require buildups to replace lost tooth structure and posts to resist against lateral and shearing forces. The cost and time investment of these treatments need to be considered when you choose to have a root canal performed. Without them, the tooth has an much higher chance of breaking during normal use. 

In some cases, a dentist will not recommend placing a crown on a root canal treated tooth. Depending on how the patient bites and how much natural tooth structure remains, anterior (front) teeth do not always need crowns. Because they are not primary chewing teeth, the front teeth tend to deal with much less force than the canines, premolars or molars. Additionally, teeth opposing (biting into) dentures or teeth that have nothing to chew against may not need crowns after root canal treatment. In these instances, there is not enough force generated to put the weakened tooth at risk. 

In general, expect to need a crown placed as part of completing your root canal treatment. At Thousand Oaks Family Dentistry, we do our best to inform patients of their complete treatment needs- from start to finish. If you would like to learn more about root canals, crowns, fillings or cavities, please give our office a call!

Make a healthy mouth part of your 2018 resolution!

As the new year rapidly approaches, we're sure that you have a few great resolutions picked out. In addition to eating healthier and watching less TV, we hope you choose to up your oral health for 2018. At Thousand Oaks Family Dentistry, we've compiled a list of great ways and reasons to keep those teeth clean. As always, we hope everyone has a happy and safe New Year's holiday!

-78% of Americans will have one cavity by the age of 17.

- Populations in areas with fluoridated drinking water (like Thousand Oaks/Conejo Valley) experience 15% less cavities on average when compared to non-fluoridated areas. 

- Daily use of fluoride toothpaste is associated with an ADDITIONAL 25% reduction in new cavities.

- One in six Americans will miss work this year due to tooth pain or dental problems. 

- Over a quarter of Americans report never flossing; less than a quarter report flossing every day. 

- More than half of American adults suffer from gum disease. 

- Healthier gums are associated with better heart health, fewer pregnancy risks and better diabetes control. 

- The cost of electric toothbrushes is constantly falling, while the features (pressure sensors, timers, etc.) continues to grow.

- You only get ONE set of adult teeth- the best time to take care of them is now!

If you would like to learn more about caring for your teeth, toothpaste, flossing or other oral health topics, please give our office a call. Our main goal is ensuring that your teeth are healthy and beautiful for 2018 and beyond!

Using an Old Retainer to Straighten Teeth

If you have had braces in the past, you were probably given a retainer at the completion of your treatment. For many, wearing a retainer daily is a task that usually falls to the wayside after a few years. When this happens, some may experience a slight movement of their teeth over time. Others will see complete orthodontic relapse to their previously crooked state. Either way, you may be tempted to reuse your old retainer to re-straighten your teeth.

The amount of post-braces movement your teeth will go through depends largely on the way your teeth mesh together and the amount of space on your dental arch. It is tough to predict what patient will experience the most movement after treatment. While using an old retainer to treat this relapse may seem like an easy fix, it is generally not a good idea. Retainers can correct some slight movement of the teeth, but lack the properties to actually adjust your smile. Causing serious damage is unlikely, but you always run the chances of irritating your gums, starting a toothache or chipping enamel. As with any appliance, NEVER force your retainer over shifted teeth.

If your teeth have moved significantly after braces, Invisalign can be a great option. A short treatment of clear aligners can properly straighten teeth and create a better smile line. If you would like to know more about orthodontics, retainers or Invisalign, please give our office a call!

Types of Implant Dentures

(Left): An Implant overdenture retained by two implants. (Right): A hybrid implant denture resting entirely on four implants. 

While we often consider dental implants as a solution to replace single missing teeth, they can also be used in conjunction with dentures to replace entire arches of teeth. Many of the aspects of denture use that patients find objectionable can be alleviated with the addition of implants. However, it is important to understand the different ways that implants are used to support dentures, and the benefits of the specific appliances. 

Most patients with “implant dentures” are using a system called implant overdentures.  Here, a fairly traditional denture rests “over” two to four implants on the top or bottom jaw. It is designed to be removable and snaps onto the implant anchors. This makes cleaning around the implants easy and convenient. When compared to regular dentures, implant overdentures have much more stability and retention on the soft tissue. This is particularly beneficial for the mandible, which does not benefit from the “suction cup” action that maxillary dentures have on the palate. It is important to note that the support for biting force with this system still relies on the gums and soft tissue. Thus, you will never be able to generate as much force as natural teeth. Additionally, some patients will still object to the removable nature and bulk of these appliances. However, they are an excellent compromise between usability, cosmetics, ease of cleaning and cost for denture wearers.

A newer system of implant dentures is the all-on-four or "hybrid" implant supported dentures. This appliance is permanently screwed or cemented on four to six implants on the top or bottom jaw. They are not designed to be removed, and thus are more difficult to clean versus implant overdentures. However, they function much more like natural teeth, as the entire arch rests solely on implants. They are much less bulky than traditional dentures and provide easier chewing and biting. Most all-on-four appliances are milled out of a single piece of zirconia. Thus, if any part of it chips or breaks, an entirely new arch of teeth needs to be created. The biggest drawback to this system is cost. Treatment for all-on-four dentures is typically two to three times the cost of implant overdentures. For this price, you are getting the best permanent replacement for natural chewing and eating.

Other factors, such as bone health, gum tissues, jaw relations and face shape will all play into your choice between implant overdentures and all-on-four implant dentures. Surprisingly, cosmetics varies from patient to patient, with some seeing more realistic results with implant overdentures. Making an informed decision relies on a thurough exam and consultation to create a comprehensive treatment plan. If you would like to know more about dentures, implants or other methods of replacing teeth, give our office a call!

Dental Questions: Can I be allergic to dental crowns or fillings?

While understanding all of your medical allergies is essential to providing safe care, reactions to common dental materials are rare. Over decades, the products we use were developed to avoid irritation and work well with the natural tissues in your body. Overall, any allergic response to a crown, filling or implant would be extremely unlikely. 

In the past, fillings and crown materials relied heavily on the use of metal. Mixtures of different metals called alloys allowed labs to create resilient structures that adapted well to the natural teeth. In the early years, many porcelain and metal crowns contained high amounts of nickel in their structure. Patients with nickel allergies sometimes developed irritation, itching and swelling around newly placed restorations. In modern dentistry, less irritating metals such as gold and palladium are now used in place of nickel. As a whole, metal plays a much smaller role in today's practice, and thus metal allergies are not a predominant concern. 

Tooth colored materials are even less likely to cause an allergic reaction. The crowns we place are typically either made of ceramic or glass and thus have almost no allergic potential. The fillings we place at our office are also non-irritating. Composite (tooth colored) materials are placed in an "uncured" state (so that they are soft/moldable) and "cured" with a light to become rigid and durable. Once the material is cured, the chemical structure is permanently altered and unable to leak or leech compounds into the body. 

Overall, the materials used at a modern dental office are extremely safe. Our patients' health and safety is of utmost importance, beyond the need to fix a single tooth. If you would like to know more about the products we use at our office or have a question about how one of your allergies or conditions might affect dental care, please give our office a call.