Dental Questions: Why do my teeth shred floss?

Shredding or tearing floss is a common (and annoying) obstacle to keeping your teeth clean. Having to constantly switch to a new piece or use a frayed length of floss gets old fast. What could be causing your flossing woes? Take a look!

Between every two adjacent teeth exists a contact where they touch each other at their widest points. This space should be smooth and flowing, without any ridges or sharp corners. If you are shredding floss, there must be some sort of edge in this area that is disrupting the floss fibers. Many times, this is the result of a filling placed between two teeth that needs to be smoothed out. Small pieces of excess filling material, called flash can become dislodged and create an edge that tears at the floss fibers. The solution to this problem is to have a dentist smooth out or (in more drastic situations) replace the filling, creating a more anatomically correct shape. 

Floss can also shred due to food, tartar, or other debris lodged in between teeth. Tartar, in particular, is rough and irregular, creating a surface that easily tears at floss fibers. The solution to this problem is to have a dentist clean the affected teeth, and return for normal dental hygiene appointments. When combined with regular cleanings, good flossing technique will remove stuck food and prevent the formation of harmful tartar in the future. 

Flossing every day is one of the easiest and most beneficial additions to your home hygiene routine. Even if your teeth shred floss, we urge you to continue to use it daily to help maintain the health of your gums and bones. If you would like to know more about flossing, brushing, oral health 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. 

Smoking, E-Cigarettes and Oral Health

You've heard it a thousand times before- smoking tobacco products is detrimental to your overall health. Between increased cancer risk and diminished lung capacity, using cigarettes, cigars and other products stands as one of the most preventable causes of death nation wide. We would like to take a moment to inform you on the ways that smoking can harm your teeth and the oral cavity. We present this information not to scare or shame our patients who smoke, but rather as a means of informing and starting a conversation on quitting. 

In any smoked tobacco product, there are hundreds of different chemicals that pass through your mouth and into your lungs. Almost all of these compounds are damaging to the human body in some capacity. The two most notable are nicotine and tar. Nicotine is the chemical that causes addiction in smoking. It triggers the dopamine pathways in your brain to program you to enjoy the sensation of tobacco use. This is what experts refer to as the "physical addiction" of smoking. Nicotine alone does not cause cancer, but it can cause deadly poisonings in high doses.

Tar is the collection of burned compounds that comes out of smoked tobacco. It is very volatile, with the power to create the genetic changes that lead to cancer. In the mouth, smoking is a leading risk factor for oral cancers. Think about it- all that tar has to travel past the lips, teeth cheeks and gums before it even hits the lungs. Furthermore, smoking is shown to increase the risk of periodontal disease, tooth loss and soft tissue irritation. In general, bathing the oral tissues in smoke inhibits their ability to heal properly. Thus, small problems like gingivitis and ulcers tend to become more destructive and take longer to resolve. 

What about e-cigarettes? Also known as "vaping" or "vaporizers," e-cigarettes are marketed as a healthier alternative to cigarettes. Unfortunately, recent research shows that e-cigarettes create more smokers than they eliminate. Furthermore, it is important to understand that the world of e-cigarettes is largely unregulated. Vaporizers, vape pens and so called "e-juice" (the liquid you put inside vaporizer) are not well monitored for quality and safety. Caustic chemicals in juice, nicotine overdoses and too-hot heating elements are all reported problems with e-cigarettes. 

In short, putting anything other than fresh air in your mouth and lungs is a bad idea. This includes cigarettes, e-cigarettes, marijuana, hookah, smog and anything else packed with volatile chemicals. If you are a current smoker and are thinking about quitting, a good starting point is calling 1-800-NO-BUTTS or visiting tobaccofreeca.gov. At Thousand Oaks Family Dentistry, our sole focus is improving and maintaining your oral health. If you would like help quitting smoking or simply need a list of reasons and resources, please let us know at your next appointment. 

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!

Dental Questions: Do I REALLY need to floss every day?

Do you actually need to floss every day? Yes! Flossing is one of the most beneficial habits you can add to your daily routine. It is associated with lower rates of gum disease, fewer cavities and lower lifetime dental costs. However, you can only reap these benefits if you floss every single day! Sporadic or intermittent flossing still allows for bacterial growth, tooth decay and eventual dental disease. 

When you use floss, you are targeting the spaces in between the teeth, at/below the gum line. The primary goal is to remove any plaque or food that has accumulated in these areas throughout the day. Plaque is a primary concern, as it plays a major role in the gum disease process. Left undisturbed (unflossed), it only takes about 24 hours for plaque to mineralize to tartar. Tartar cannot be removed, dissolved or displaced with anything other than a professional dental cleaning. Eventually, Tartar will lead to gingivitis (inflammation of the gums) and periodontitis (irreversible bone loss around the teeth). Stuck food between the teeth can also lead to tooth decay. Sugary and carb heavy food will lodge itself between the teeth, sit up against tooth enamel, and eventually develop cavities.  

The proper way to floss. After going under the tooth contacts, make sure you thread the floss down the gums and around the teeth in an up-and-down motion. 

Tonight, when you're getting ready to go to bed, do a quick experiment. First, brush your teeth thoroughly for two minutes with a fluoride toothpaste. Afterwards, floss between every tooth. Take note of all the gunk you get out even after brushing- it may surprise you! If you would like to know more about brushing, flossing or generally keeping your teeth clean, please give our office a call.

Dental Questions: Why do I have to wait for my implant crown?

If you have had an implant placed at our office or one of our specialists' offices, chances are you had to wait three to four months for the implant to heal before having a crown placed on it. Conversely, you may know someone who had an implant placed and left the same day with a (temporary) Crown. Why did you have to wait all that time for your crown? The reality is that there are hundreds of approaches to implant placement, and our office uses the most predictable and conservative method possible. 

Dental implants gain their rigidity in the mouth from two primary sources: the physical retention of the implant screw in bone and the growth of new bone around the implant. The screw force that develops immediately as the implant is placed is formally known as primary stability. This type of retention locks the implant and allows the new bone to form around the it, creating a phenomenon known as osseointegration or secondary stability. Osseointegration creates the definitive force that stabilizes the implant crown for daily use. 

Some techniques will rely on primary stability to support a crown on the implant immediately. In these methods, the screw force of the implant is absorbing all the forces of biting or chewing. Any movement or looseness would prevent new bone growth and could lead to implant failure. At Thousand Oaks Family Dentistry, we know a dental implant is a big investment into your future comfort and quality of life. We prefer to use the most predictable implant techniques and wait for secondary stability to develop. Waiting three to four months for your implant to fully heal is a small price to pay for better chances at success!

We know that choosing a treatment to replace a missing tooth can be overwhelming. At our office, we pride ourselves in offering patients all their treatment options, along with a thorough evaluation to help you pick the right choice. If you have any questions about dental implants, bridges or other tooth replacement methods, please give us a call!

Jaw pain and TMJ Disorders

The temporomanibular joints are a set of sophisticated hinges that allow us to open and close our jaws. They are constantly used throughout our waking hours to chew, swallow and express ourselves. Therefore, it is no surprise that pain and injury to these structures is not uncommon. Read on to learn more about what causes jaw joint pain and how to treat it!

The temporomandibular joints (“TMJs”) are a two hinging joints that allow the mandible to move against the Temporal bone of the skull. They have a complex movement, where the joint's head initially rotates in its socket and eventually slides forward to complete the movement. There are a number of muscles and ligaments that stabilize the TMJ, along with a cartilage disc that cushions and smoothens its action.

Most TMJ pain comes from acute injury to one of the attached joints or ligaments. Excessive gum chewing, staying open for a dental procedure and night time tooth grinding are all common culprits. Just like any other sprain, the best therapy is to allow the joint time to heal. Rest, ice packs, warm compresses and anti-inflammatory medicines like Ibuprofen are all great ways to get your jaw joints feeling great again.

Long-standing jaw pain, pain combined with a change in the joint’s range-of-motion  and pain after extreme trauma (like a car accident or physical violence) are signs of a more serious problem. The jaw joints or the cushioning disc can become dislocated, creating painful and limited motions. Fractures of the mandible can manifest as TMJ pain as well. Pain with new grinding or popping sounds can also be a sign of arthritic damage or traumatic disc displacement. In these cases, evaluation by an oral surgeon or oral-facial pain expert is the best course of action. This is also a good time to note that jaw popping without pain is usually not an emergent concern.

A final note on TMJ pain is that there are other medical conditions that can manifest themselves as jaw problems. Toothaches, ear infections and even sore throats can feel like jaw pain. Your best bet is to visit your general dentist for an initial evaluation and referral. To learn more about the jaw joints, TMJ disorders and other types of dental pain, please give our office a call!

What affects the cost of dental fillings?

If you've ever looked at an invoice after dental treatment, you may have noticed that the cost of dental fillings varies from tooth to tooth. In general, the billing prices of fillings are affected by three factors: the material, the location of the tooth in the mouth and the number of surfaces to be filled. Read on to learn how and why the different rates are calculated!

All dental procedures are categorized using the Current Dental Terminology codes, which are maintained by the American Dental Association. These codes allow standardization of information between dental offices, patients and insurance agencies. In regards to dental fillings, these codes can specify the location, surfaces and material used for the restoration. Generally, the number of surfaces to be filled has the biggest impact on final cost. A filling that requires three surfaces is typically more challenging and time consuming than a single surface restoration. This does not account for the size or depth of the cavity to be filled, but merely the number of tooth walls that are to be repaired. The type of dental fillings also affects the price. Materials that are more difficult to place (such as tooth colored "composite" fillings) are typically charged at a somewhat higher rate than others. Finally, the location in the mouth has some affect on filling prices. Fillings towards the back of the mouth tend to be larger and more difficult to place, and thus are coded at a higher rate. 

At Thousand Oaks Family Dentistry, we maintain treatment rates that are on-average with the Thousand Oaks area. However, we must urge against the pitfalls of choosing a dentist based on prices alone. You should choose an office that fits best with you and your family's specific needs. If you would like to know more about dental fillings, crowns or other dental procedures, please give our office a call!

The ADA Seal of Acceptance

When you're shopping the oral healthcare aisle at your local market, you will notice most products bear the "ADA Seal of Acceptance." This logo indicates that the American Dental Association stands behind the item's efficacy and ability to improve your overall oral health. However, it is important to understand exactly what the seal means and how you can use it to inform your product choices. 

When a product earns the ADA seal of acceptance, it means that it contains an attribute that is scientifically proven to maintain or improve oral health. For toothpastes, it might be a therapeutic dose of fluoride. For mouth guards, it might mean a minimum level of shock/impact protection. To earn this endorsement, manufacturers have to apply to the ADA. The seal is not a legal or regulatory requirement to designate an "effective" product. Therefore, items without the seal of acceptance aren't necessarily lacking these important attributes. For example, lesser known brands of toothpaste may contain an appropriate amount of fluoride, but still do not have the seal. With that being said, shopping without the seal of acceptance can place you at risk of purchasing a less effective product. Fluoride free toothpastes, charcoal whitening powders and flimsy mouth guards all lack the ADA seal, and for good reason: they probably won't do you much good!

On the opposite side, just because a product contains the seal of acceptance does not automatically indicate it is the right one for you. For example, Listerine mouth rinse bears the ADA seal of acceptance due to it's ability to aid in the treatment of periodontal disease. However, if you struggle more with tooth decay than gum disease, a fluoride rinse like ACT with fluoride (which also bears the seal) would be far more advantageous. At the end of the day, you should be reading packaging for active ingredients, what they accomplish and decide if it fits in with your oral health needs. 

We know that there are many types and varieties of products available to keep your mouth happy and healthy. If you have any questions about toothpastes, toothbrushes, floss or the seal of acceptance, please give our office a call!

Fluoride for Kids

Remember, kids only need a small portion of toothpaste. 

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. 

Historically, fluoride recommendations for children have gone through a few revisions. Every year, the public health experts at the Center for Disease Control (CDC) and American Dental Association (ADA) evaluate the latest research and recalibrate their suggestions on fluoride use. Data on the number of children with cavities, the number of cavities per child and access to fluoridated drinking water all weigh in on the latest guidelines. 

Fortunately, if you live in Los Angeles or Ventura county and get your water from a major utilities provider, your tap water is properly fluoridated. The exact amount of fluoride varies by district, but generally hovers around 0.7 milligrams per liter. This number was recently lowered due to increased access and usage of fluoride toothpastes and varnishes by the general population. As long as you are drinking, cooking or rinsing with tap water, you and your family are getting a therapeutic dose of fluoride. 

Previously, the ADA recommended against using fluoride toothpaste for children under the age of one. This was to combat the risk of fluorosis (fluoride induced discoloration of teeth) of the adult teeth during critical developmental phases. However, modern research shows that using a rice grain sized smear of paste is safe for children of all ages. Once teeth are visible in the mouth, we recommend attempting to brush twice daily. At about three years of age, you can up the amount to a pea sized portion of toothpaste. As with any medication, make sure your child isn't consuming large portions of toothpaste during brushing or otherwise. 

What's off the recommendation list for fluoride? Supplements and vitamins. As it turns out, ingesting fluoride (like with a chewable vitamin) isn't nearly as effective as having the compound physically contact the tooth. In today's dental practice we will apply fluoride as a foam or varnish at periodic cleaning appointments. Allowing the fluoride to sit on the teeth undisturbed for 30 minutes is proven to limit the development of new cavities. Plus it comes in great flavors!

Due to diets and medical conditions, some children have an even higher risk of developing new tooth decay. Products like fluoride rinses, gels and even xylitol anticavity supplements are available to keep teeth healthy and decay free. If you would like to know more about fluoride, preventative dentistry and how to protect your kids' teeth, please give our office a call!