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: 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!

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!

Organic Toothpaste

If you shop at a natural market like Whole Foods or Sprouts, you have probably seen the organic toothpastes available in the cosmetics aisle. Companies like Toms of Maine and Jason all sell numerous types and flavors of toothpaste with varying promises. No matter what the packaging claims about being anti-cavity or enamel strengthening, all toothpastes have to have fluoride to protect against oral disease.

The protective factor of brushing your teeth comes from the mechanical action of scrubbing the enamel and the remineralizing effect of fluoride. Fluoride works by increasing the rate of enamel mineralization and interfering with bacteria's ability to colonize your teeth. Years of research and clinical trials have shown that using fluoride is safe, effective and significantly lowers your risk of developing cavities.  If you aren't using fluoride toothpaste, you are missing out these great benefits. Other ingredients, such as baking soda or triclosan may add to the protective factors but are not effective enough on their own to fight cavities. 

If you are interested in switching to an organic or specialty toothpaste, simply check the packaging for added fluoride (all active ingredients have to be disclosed by law). Specifically, Toms of Maine sells a version of their organic toothpaste with fluoride. If you have any more questions about fluoride, toothpaste, or oral hygiene, please give our office a call! 

What About Mouthwash?

Mouthwash can be a great tool in achieving overall oral health. However, it is important to acknowledge why you are using it and pick a product that meets your goals. Many patients gravitate towards alcohol based products like Listerine Ultraclean and Scope. These brands are designed to fight against plaque and gingivitis with their antimicrobial properties. They are excellent choices for individuals with periodontal disease and inflamed gum tissue. However, these mouthwashes tend to be acidic and abrasive to tooth enamel.

We feel that the majority of our patients would be better suited with a fluoride rinse type of mouthwash like Act Rinse. These products are designed to strengthen enamel and interfere with decay-causing bacteria. While they may not have the satisfying "burn" of an alcohol mouthwash, they are definitely doing their job!

Using mouthwash for fresh breath? You might want to try a different tactic. Once the flavoring wears off, mouthwashes aren't particularly protective against bad breath. Your best bet is to target the smells at the source. Flossing and tongue brushing have been shown to be particularly helpful in approving mouth odors. If you have any other mouthwash related questions, be sure to give our office a call!

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! 

Dental Questions: Can Sensodyne Pronamel Rebuild Enamel?

Unfortunately, there are no products that can “rebuild” dental enamel in the traditional sense. Our teeth do not have biological mechanisms that will allow them to create more enamel or to integrate new enamel. Any product that advertises otherwise will not be able to live up to its claims.

The enamel in our teeth is essentially a crystal made from calcium, phosphate and other minerals. When we consume acidic foods and drinks, the low pH causes the crystal to demineralize and become softer. This process can be further intensified by the cavity causing bacteria in our mouth. With time, this demineralization and constant acid exposure leads to permanent loss of enamel structure.

What Sensodyne Pronamel can do is remineralize the softened enamel. It contains a therapeutic dose of fluoride, which is extremely beneficial in restoring mineral content, slowing decay and protecting against future acid exposures. It is important to note that any mainstream toothpaste will have therapeutic levels of fluoride and will provide similar results. The most important factor is that you are using a fluoride toothpaste twice a day for two minutes, along with daily flossing.

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!