Gum disease, also called periodontal disease (from the roots for “around” and “tooth”) starts with redness and inflammation, progresses to infection, and can lead to progressive loss of attachment between the fibers that connect the bone and gum tissues to your teeth, ultimately causing loss of teeth. Here are some ways to assess your risk for gum disease.

Your risk for developing periodontal disease is higher if:

1. You are over 40.
   Studies have shown that periodontal disease and tooth loss correlate with aging. The longer plaque (a film of bacteria that collects on your teeth and gums) is allowed to stay in contact with your gums, the more you are at risk for periodontal disease. This means that brushing and flossing to remove plaque is important throughout your lifetime. To make sure you are removing plaque effectively, come into our office for an evaluation of your brushing and flossing techniques.
2. You have a family history of gum disease.
   If gum disease seems to “run in your family,” you may be genetically predisposed to having this disease. Your vulnerability or resistance to gum disease is influenced by genetics. The problem with this assessment is that if your parents were never treated for gum disease or lacked proper instruction in preventative strategies and care, their susceptibility to the disease is difficult to accurately quantify.
3. You smoke or chew tobacco.
   Here's more bad news for smokers. If you smoke or chew tobacco you are at much greater risk for the development and progression of periodontal disease. Smokers' teeth tend to have more plaque and tartar while also having them form more quickly.
4. You are a woman.
   Hormonal fluctuations during a woman's lifetime tend to make her more susceptible to gum disease than men, even if she takes good care of her teeth.
5. You have ongoing health conditions such as heart disease, respiratory disease, rheumatoid arthritis, osteoporosis, high stress, or diabetes.
   Research has shown a connection between these conditions and periodontal disease. The bacteria can pass into the blood stream and move to other parts of the body. Gum disease has also been connected with premature birth and low birth weight in babies.
6. Your gums bleed when you brush or floss.
   Healthy gums do not bleed. If yours do, you may already have the beginnings of gum disease.
7. You are getting “long in the tooth.”
   If your teeth appear longer, you may have advancing gum disease. This means that infection has caused your gum tissue to recede away from your teeth.
8. Your teeth have been getting loose.
   Advancing gum disease results in greater bone loss that is needed to support and hold your teeth in place. Loose teeth are a sign that you have a serious problem with periodontal disease.

Even with indications of serious periodontal disease, it can still be stopped. Make an appointment with us today to assess your risks. You can also learn more by reading the Dear Doctor magazine article “Assessing Risk for Gum Disease.”

Of all the teeth in the mouth, the ones receiving the most discussion and controversy would have to be the wisdom teeth or third molars. And this is not just a recent phenomenon, as people have been discussing them for centuries! See how much you really know about wisdom teeth by taking our quick and easy true/false self test.

1. Third molars received their name, “wisdom teeth,” because a moderate amount of wisdom is supposedly achieved in life about the time they appear.
   True or False
2. Wisdom teeth and all of their associated problems are commonplace in the practice of dentistry.
   True or False
3. Because wisdom teeth are so unpredictable, they typically make their appearance between the ages of 17 and 25.
   True or False
4. The most common consequence of impacted wisdom teeth is gum (periodontal) disease.
   True or False
5. If wisdom teeth are not removed, they will become impacted or cause crowding. This is why so many people require orthodontic treatment (braces).
   True or False
6. While most people have four wisdom teeth, having more (supernumerary teeth) or less (hypodontia) is possible.
   True or False
7. Through dental x-rays and routine check-ups, we can predict the timing and way in which wisdom teeth become visible (erupt).
   True or False
8. An impacted wisdom tooth, by definition, is a third molar that is colliding with or jammed against another important structure, such as an adjacent tooth, the gums or other important soft tissues in the mouth, or nerves and blood vessels.
   True or False
9. The primary symptom for indicating you have an impacted wisdom tooth is pain.
   True or False
10. If wisdom teeth need to be removed, it is best to remove them at a younger age rather than waiting until periodontal disease has started.
    True or False

Answers: 1) True. 2) True. 3) True. 4) True. 5) False. While wisdom teeth can be a factor in crowding, some people have no issues with these teeth. For them, they grow into proper position and are healthy teeth. 6) True. 7) False. Unfortunately, it is not possible to predict the way wisdom teeth will erupt. 8) True. 9) False. In some scenarios, impacted wisdom may cause no pain. 10) True.

To learn more about wisdom teeth and in particular, impacted wisdom teeth, continue reading the Dear Doctor magazine article “Wisdom Teeth.” Or you can contact us today to schedule an appointment to discuss your questions.

If you are pleased with your smile except for that one front tooth that appears darker, then we have good news for you. Often a tooth appears darker as a result of trauma that may have occurred years ago. Your tooth may need root canal treatment or may have already had root canal treatment in the past. Regardless, you can whiten this tooth via a process called internal bleaching. And as the name suggests, the tooth can be bleached from the inside out. Here's a brief summary of how this entire process works:

1. Performing an x-ray exam: The first step is to take a radiograph (x-ray) to make sure that your root canal filling is intact adequately sealing the root canal and the surrounding bone is healthy.
2. Making an access hole: To apply the bleaching agent, a small hole will need to be made in the back of your tooth to apply the bleach. However, before doing that, the area must be thoroughly cleaned and irrigated.
3. Sealing above the root canal filling: This step is critical to prevent the bleach from leaking into the root canal space.
4. Applying the bleach: To obtain the whitening needed, it typically requires between one and four office visits for additional bleaching.
5. Applying a permanent restoration: Once your tooth has lightened to the desired color, a permanent filling will be placed over the small hole to seal your tooth's dentin. This is then covered with tooth-colored composite resin (filling material) so that the access hole is undetectable to the naked eye.

To learn more about this procedure and see amazing before and after images, continue reading the Dear Doctor article, “Whitening Traumatized Teeth.” Or, you can contact us to discuss your questions or to schedule an appointment.

Cleaning dentures is an important part of wearing them. However, did you know that recent research has revealed a link between denture hygiene and overall health? The evidence shows that oral bacteria have been implicated in chronic obstructive pulmonary (lung) disease, bacterial endocarditis (“endo” – inside; “card” – heart), generalized infections of the respiratory tract and other systemic diseases. While it is never our intent to frighten you, we feel it is important that we share some important tips on maintaining and caring for your dentures so that your oral health does not negatively impact your general health.

Our first tip focuses on fit, as denture slippage is an experience that anyone who wears dentures dreads. So if your dentures seem to slip or you have started increasing the amount of adhesive you are using to achieve the same level of denture retention that you had when first fitted, you need to make an appointment with us soon. Otherwise, an ill-fitting denture can cause discomfort, embarrassment and contribute to other oral health issues.

Next, we must focus on cleaning your dentures. It is critical that you clean your dentures daily. However, you should never use harmful or abrasive cleansers. Nor should you ever place your dentures into boiling water! The best method for cleaning is to soak them daily in a non-abrasive denture cleaner. And when you remove them, gently brush them with a soft-bristled toothbrush.

Our last tip concerns how long you wear your dentures each day. Even if your dentures are extremely comfortable — for example, you forget they are in — you should not wear them 24 hours a day. Why? Because you will develop a chronic yeast infection called, “denture stomatitis” due to stagnation that develops under dentures when the lubricating and antibacterial effects of saliva are impeded. Unfortunately, the constant pressure on the gum tissues caused by wearing dentures can accelerate jawbone loss over time. Give your mouth and tissues a rest by sleeping without your dentures in your mouth.

To learn more tips, continue reading the Dear Doctor magazine article “Top Ten Tips For Denture Care & Maintenance.” Or you can contact us today to schedule an appointment to discuss your questions.

Dental implants traditionally have a high success rate with numerous studies showing long-term success rates of over 95%. This is just one of the reasons they have been widely accepted as the best method for permanently replacing missing teeth. In fact, over-dentures, which are full dentures supported and stabilized by at least two dental implants, are now considered the standard of care by the American Dental Association (ADA) for people who have lost all of their teeth in one or both jaws. And while they have a high success rate, there are some factors that can compromise the success rates of implants.

These factors are generally divided into three categories: general health concerns, local factors, and maintenance issues.

• General health concerns: Your general health, lifestyle, and habits can play a major role in the success of dental implants. For example, smoking, diabetes, osteoporosis (porous bone) or a compromised immune (resistance) system can all negatively impact implant healing and success. And if you have a history of radiation treatment to your jawbones, you are at a higher risk for complications.
• Local factors: Some examples of local factors that can affect implant success include bone quality and quantity — having sufficient bone in the right place to accurately secure and locate the implants.
• Maintenance issues: While implants are excellent high tech replacements for missing permanent teeth, they do require routine maintenance. This includes daily cleaning and continued professional care. Otherwise, implants are just like any other technically sophisticated devices — they may be susceptible to breakdown.

To learn more about dental implants, read “Dental Implants, Your Third Set Of Teeth.” Or if you prefer, you can contact us to discuss your questions or to schedule an appointment.

Until recently anyone who needed to repair cavities in his or her teeth ended up with a mouth full of “silver” fillings. Dental amalgam, which has a silver appearance, was the tooth restoration material of choice. Amalgam, a combination of metals including silver, mercury, and other metals, is still used — but today there are other options that mimic the original teeth they are restoring.

You may have read about some people's concerns about the mercury used in dental amalgam. According to the American Dental Association (ADA), scientific studies have found no ill effects arising from using dental amalgam in fillings for adults or children: “While questions have arisen about the safety of dental amalgam relating to its mercury content, the major US and international scientific and health bodies, including the National Institutes of Health, the US Public Health Service, the Centers for Disease Control and Prevention, the Food and Drug Administration and the World Health Organization, among others have been satisfied that dental amalgam is a safe, reliable and effective restorative material.” Dental amalgam is still used for molars (back teeth) that must withstand heavy pressure from chewing.

For teeth that are more visible, materials that look and perform more like the original teeth — and are thus more pleasing in appearance — are now available. Dentistry is now taking a “biomimetic approach” (from words meaning “life mimicking”). The new materials — composite resins and porcelains — look like teeth because in many ways their structure imitates the biologic structure of teeth.

Composite resins are made of a plastic material (methacrylate) combined with fillers made of silica, a form of glass. They are able to bond to natural tooth structure and resemble the dentin, the inner layer of the tooth, which has a porous structure similar to bone.

Dental porcelains are a form of ceramic. They are non-metallic materials formed by the action of heat, like the ceramics used in porcelain cups and bowls. They come in a powder form that is mixed with water, shaped, and then placed in an oven until they reach the proper hardness. The end product is translucent and very hard, resembling the densely packed crystals of calcium that make up a tooth's normal outer layer, the enamel.

The old amalgam fillings required removal of tooth material to prepare a site in which they could be placed. Composite resins and porcelains can be used to treat teeth that have small or large amounts of damage to their natural substance because the materials bond directly to the remaining dentin and enamel. Thus they end up stabilizing and strengthening the restored tooth, as well as providing a natural-looking appearance.

Contact us today to schedule an appointment to discuss your questions about tooth colored fillings. You can also learn more by reading the Dear Doctor magazine article “The Natural Beauty of Tooth Colored Fillings.”

Tooth pain occurs when a trauma or infection triggers a reaction from the nerves inside a tooth's pulp chamber. The severity of the pain and its duration can vary depending on the underlying cause, which can include anything from a loose filling to an abscess. Ignoring symptoms not only results in unnecessary physical and emotional pain, but can also lead to more expensive dental treatment as problems become more complex. Make an appointment with our office today if you are experiencing any of the following symptoms:

• Sharp pain when biting down on food — This type of pain could be indicative of a cracked tooth, loose filling, or tooth decay that is affecting one or more of your teeth. We can remove decay and replace a loose filling, but if your tooth is cracked, we will have to determine the location and depth of the crack before formulating a treatment plan. In some cases, root canal treatment or even extraction may be necessary.
• Pain that lingers after eating hot or cold foods or liquids — Mild and short-term sensitivity (lasting only seconds or a minute) to hot and cold foods resulting from gum recession can often be soothed by using a fluoride toothpaste made for sensitive teeth. However, an inflamed tooth pulp or one that is dying due to severe decay could cause sensitivity that lingers for a long time after exposure. In this case, root canal treatment may be necessary to remove dying pulp tissue in order to save the tooth.
• Constant severe pain and pressure, swelling of the gums, and sensitivity to touch — Infections and/or abscesses can spread from the tooth pulp into the surrounding periodontal tissues and bone causing this type of pain. Root canal treatment will most likely be required.
• Dull ache and pressure on one or both sides of the face in the upper teeth region — The sinuses and upper back teeth share the same nerves, so, oftentimes, referred pain from sinus congestion or infection can feel like a toothache. A thorough examination can determine whether or not the pain is dentally related.

If you are experiencing tooth pain, call our office immediately so that we can begin to provide you with some relief. To read about other symptoms of tooth pain and possible treatment options, read the Dear Doctor magazine article “Tooth Pain? Don't Wait!”

Oral cancer is on the rise in the United States, yet few people are familiar with the disease and its risk factors. The National Institute of Dental and Craniofacial Research (NIDCR) estimates that 35,000 Americans are diagnosed with the disease each year. The good news is that prevention and early detection can greatly reduce your risk of developing oral cancer.

Risk Factors for Oral Cancer Include:

• Tobacco: Smoking and using chewing tobacco have been shown to increase the risk of developing oral cancer.
• HPV virus: The Human Papilloma Virus (HPV) is the same virus linked to cervical cancer and genital warts. According to the Oral Cancer Foundation (OCF), many young people and women are being diagnosed with oral cancer as a result of exposure to the HPV virus.
• Age: Although it occurs more frequently in people over the age of 40, the incidence is increasing in younger people.
• Alcohol Consumption: Oral cancer is six times more common in those who drink alcohol excessively.
• Diet: People who consume lots of red and processed meat and fried foods are at greater risk.

Symptoms: Alert our office if you notice a change in your mouth such as a sore that doesn't heal or bleeds easily; a lump, thickening, crust or erosion; pain or tenderness; or a change in the way your teeth are positioned. Our office can administer an easy, painless test that detects abnormal cells.

Other symptoms may include unexplained bleeding or numbness in the mouth, difficulty chewing, swallowing or speaking, hoarseness, chronic sore throat or changes in your voice.

Importance of Dental Screenings: In its early stages, oral cancer can often go unnoticed, but visiting our office regularly can ensure that any cancerous cells are detected and treated early. Our office will check your tongue and the area under your tongue, as well as your lips and palate and the back of your mouth.

Contact us today to schedule an appointment to discuss any questions that you may have regarding oral cancer. Read more about this topic in the Dear Doctor magazine article “Oral Cancer: This Article May Save Your Life.”

Nearly everyone who has ever played a sport, or had a child participate in one, has had that panic-filled moment when they witness an injury. And when you consider that there are more than 22,000 dental injuries each year in children younger than 18 years of age, you see there is fact to backup this concern. This is just one reason why we strongly encourage all of our patients who are involved in activities such as football, soccer, hockey, wrestling, lacrosse, skateboarding, field hockey and more to wear one of our custom-fitted professional mouthguards. It is especially true for basketball and baseball, which are responsible for the largest number of dental injuries.

The following are some key issues to help you understand the importance and advantages mouthguards offer.

Is there a way to determine who is at the highest risk for sports injuries?

Yes there are several. Age, gender, dental anatomy, and the type of sports being played are the four categories used to measure the risks for dental injuries. Young male teens still top the list of most likely to be injured; however, the gap is closing with more females getting involved in sports. Learn which sports or exercise activities made the American Dental Association’s list of recommendations for using a custom mouthguard, when you continue reading “Athletic Mouthguards.”

What's the difference between a “boil and bite” mouthguard and a professionally made mouthguard?

We are often asked this very important question. While some over-the-counter (OTC) mouthguards provide what is advertised as a “custom-fit” to your teeth, it is nowhere near the fit — and thus protection — you receive from our mouthguards that are crafted from precise molds of your teeth. Additionally, because all aspects of our mouthguards are tailored to each specific mouth, they provide much more protection and comfort. This important fact can enhance performance as the athlete can literally breathe easier while wearing one of our mouthguards.

What can I do if I witness a dental injury?

The first important fact to know is that you do not have to be a dental or healthcare professional to assist. However, before jumping in to help out, consult Dear Doctor's Field-Side Guide to Dental Injuries. This pocket-sized, quick-reference guide details what you should do at the scene of a dental injury based on the type of injury. But best of all, it is available to you free of charge from Dear Doctor.

Want to know more?

Contact us today to discuss your questions or to schedule an appointment.

It is always good to be prepared before you have any dental or medical procedure. Make sure that you are informed and know what to expect to make you as comfortable as possible. We recommend that you have a list of questions with you to ask us during your consultation. If we inform you that you need a crown, consider asking any or all of the following questions:

• Am I a good candidate for a crown?
• Can you do a computer-generated mock-up of my new smile with crowns? (This question is only applicable if the crown is for a front or visible tooth.)
• Is there a way that I can “test-drive” my new smile and crown(s) before making them permanent?
• How long will the entire process take from my first appointment through completion?
• What are the risks, benefits and alternatives associated with the type of crown(s) you are recommending?
• Is there any discomfort associated with crown procedures?
• Will I need or receive any type of sedation when you prepare (drill) the tooth or teeth for a crown?
• Is what you are recommending commonly done?
• Can you show me some before and after photos of cases that you have done?
• How much will my crown(s) cost?
• Will my insurance cover all or a portion of the cost?
• How long can I expect my crown(s) to last?
• Will there be any maintenance required with my crown(s)?

To learn more about crowns, read the Dear Doctor article, “Porcelain Crowns & Veneers.” Or you can contact us today to discuss your situation and schedule a consultation.

Snoring and Obstructive Sleep Apnea (OSA) is a condition that occurs when the upper airway (back of your throat) collapses or is blocked, causing significant airflow disruption. A person with OSA continues snoring at a regular rate but is interrupted by long silent periods during which there is no breathing for atleast 10 seconds or more. Believe it or not, this issue affects millions of people worldwide. It can leave you feeling tired, depressed, irritable, as well as cause memory loss and poor concentration. And if you have OSA that is left undiagnosed and untreated you could fall victim to heart attacks, strokes, irregular heartbeat, high blood pressure, heart disease and even impotence. For these reasons, we feel it is important that you understand the real-world consequences that can occur if you ignore your OSA.

Reality is that most people are unaware that their dentist can be an excellent resource in helping to diagnose and treat OSA. However the first and most important step is to receive a proper, thorough examination and diagnosis with an appropriately trained physician and dentist. If after completing this process you are diagnosed with OSA, we will discuss treatment options. Some of these may include:

• Suggesting that you exercise and lose weight if you are overweight.
• Sleeping with a Continuous Positive Airway Pressure (CPAP) machine that provides pressurized air into your airways through a mask that covers both your nose and mouth while sleeping.
• Sleeping with a professionally made oral appliance or mouthguard that can reposition your lower jaw, tongue, soft palate and uvula (the dangling tissue in the top, back portion of your mouth) into a better position during sleep to relieve blockage.

If you are ready to discuss you questions and concerns about your snoring, or the snoring habits of another family member, contact us today to schedule a consultation. You can also learn more about the signs, symptoms, and treatment options when you read “Snoring & Sleep Apnea.”

A dental crown is a tooth-shaped “cap” or cover that we place over a tooth that is badly damaged from trauma or decay to restore its shape, strength, size and functionality. We also use them for cosmetic reasons to improve a tooth's appearance with natural, life-like results. Crowns are generally handcrafted by dental laboratory technicians using high-quality dental porcelains (ceramic materials) that are made to fit on precise replicas (molds) of the prepared teeth. In our office, we generally make temporary crowns to protect the teeth to keep them comfortable and functional while the permanent crown(s) is being made. And once a crown is placed (cemented into position), it fully encases the entire visible portion of the tooth that lies at and above the gum line.

When Are They Necessary?

There are many reasons a crown may be needed. Some of these include:

• To repair a tooth that is worn down, broken or badly damaged by decay or injury.
• To restore a tooth so severely damaged by decay that the tooth's structure is no longer intact enough to place a filling or where a filling can't restore the tooth to its former strength.
• To protect a tooth that has minor cracks or fractures from further damage.
• To create a bridge to replace a missing tooth, in which the teeth on either side, known as abutments, must be “crowned” to attach to the “pontic” (from the French word, “pont” that means bridge).
• To create the visible part of the tooth that sits atop a dental implant.
• To improve the appearance of a tooth providing a more appealing shape and color.

To learn more on this topic, read the Dear Doctor article, “Porcelain Crowns & Veneers.” You can also contact us to discuss your questions or to schedule a consultation.

Considering that over 90 million Americans suffer from chronic bad breath and everyone else has dealt with some form of it at one time or another, we want to address some common causes and cures so you are prepared if it happens to you.

What are the most common causes of bad breath?

Halitosis or bad breath most often occurs when you have poor oral hygiene and/or routinely consume odorous foods and drinks. In fact, 90% percent of mouth odors come from the food you eat or bacteria that’s already there, according to the American Dental Association. Other causes for halitosis include:

• Excessive bacterial growth in the mouth and especially on the tongue
• Known and characteristically odor producing foods and drinks such as onions, garlic, coffee, tobacco and alcohol products
• Diabetes and diseases of the liver and kidneys
• A poorly hydrated body (and mouth) from not drinking enough water everyday

What should I do if I feel (or people tell me) I have chronic bad breath?

Contact us to schedule an appointment for a proper diagnosis and plan of action for returning your mouth to optimal health.

What are some tips I can do to prevent occasional bad breath?

In most cases, bad breath is totally preventable when you follow the tips below:

• Brush your teeth in the morning and at bedtime using a fluoride toothpaste and a proper (and gentle) brushing technique.
• Floss your teeth at least once a day.
• Clean your tongue after brushing your teeth with either a scraping tool you can purchase at a drug or discount store or by gently brushing it with your toothbrush.
• Keep your mouth moist by drinking plenty of water during the day.
• Be prepared by having some mouth cleaning tools (floss, a toothbrush, toothpaste or some sugar free gum) handy to freshen your mouth after consuming bad smelling foods, drinks or using tobacco or alcohol.
• Eat fresh fruits and vegetables to increase saliva production in your mouth and help remove food particles that can lodge between teeth.
• Maintain regular dental check-ups.

Want to learn more?

Contact us today to discuss your questions or to schedule an appointment. You can also learn more about halitosis by reading the Dear Doctor article, “Bad Breath — More than Just Embarrassing.”

Research has revealed that over 12 million Americans suffer from Obstructive Sleep Apnea (OSA), a condition that occurs when the upper airway (tissues at the back of the mouth and throat) collapse causing significant airflow disruption or even no airflow whatsoever for 10 seconds or more. It can leave you feeling tired, depressed, irritable, as well as cause memory loss and poor concentration. But, did you know that we can help treat your sleep apnea?

The primary method dentists who are trained in sleep medicine use to treat OSA is through the use of an oral appliance. Similar in look to an orthodontic retainer or sports mouthguard, oral appliances are designed to maintain an opened, unobstructed, upper airway during sleep. And while there are many different oral appliances available in the marketplace, less than 20 have been approved through the FDA (Food and Drug Administration) for treating sleep apnea. The key to success is to avoid those over-the-counter (OTC), generic mouthguards and instead use a professionally made and custom-fitted oral appliance, made from a precise models of your teeth and mouth. They are best at keeping your airway open and preventing the muscles and soft tissues from sagging down when relaxed during sleep. Other advantages of custom-fit oral appliances are that they can reposition your lower jaw, tongue, soft palate and uvula (the tissue in the back of the throat that dangles like a punching bag); stabilize your lower jaw and tongue; and increase the muscle tone of your tongue.

But Is Treatment Really That Important?

Absolutely! If undiagnosed and/or left untreated, sleep apnea can be life threatening. It can cause heart attacks, strokes, impotence, irregular heartbeat, high blood pressure, and heart disease — many of which can kill you.

Want To Learn More?

To learn more about sleep apnea, read the Dear Doctor article, “Snoring & Sleep Apnea.” Or if you are ready for a thorough examination and to discuss your snoring, contact us today to schedule an appointment.

If you asked a room full of parents about their opinions on thumb sucking and pacifiers, the odds are good that you would get a wide variety of opinions. The truth is that this habit is a perfectly normal behavior in babies and young children; however, it is something that parents and caregivers should monitor. This is why we want to share a few basic myths and facts to set the record straight.

So how early does thumb sucking start?
It is interesting to note that thumb sucking for some babies actually starts before birth. This fact is proven quite often when expectant mothers “see” their unborn child sucking fingers or a thumb during a routine mid to later term sonogram. Sucking for babies is absolutely normal; it provides them with a sense of security. It is also a way they test, make contact and learn about their world.

At what age should a parent be concerned if their child still sucks a pacifier, finger or a thumb?
Recent studies have shown that if a sucking habit continues after the age of two, there may be some long-term changes in the mouth that have can have a negative impact on jaw development and/or with the upper front teeth. (It can cause these upper front teeth to become “bucked” or protrude forward towards the lips.) The American Academy of Pediatric Dentistry recommends that parents and caregivers encourage children to cease this habit by about age three.

Do children ever stop this habit on their own?
Absolutely! If left alone, many children will naturally stop sucking their fingers or thumb between the ages of two and four. The main points to remember are that sucking habits are totally natural and should stop on their own. You should not make it a problem unnecessarily. If, however, your child is getting older and still seems dependant upon this habit, feel free to contact us today to schedule an appointment for your child or to discuss your specific questions about pacifiers and finger or thumb sucking. You can also learn more about this topic by continuing to read the Dear Doctor magazine article “Thumb Sucking in Children.”

Did you know that recent research has shown diabetes is a risk factor for increased severity of periodontal (gum) disease and that periodontitis is a risk factor for worsening blood glucose (sugar) control in people with diabetes? Periodontitis can even increase the risk of diabetic complications for people diagnosed with diabetes. When you combine these facts with the following, you will clearly see how important it is to understand and manage these two diseases.

• Over 23 million people in the United States currently have diabetes and over 170 million worldwide.
• 14+ million Americans have a condition called pre-diabetes.
• Another estimated 6 million people in the US have diabetes but are unaware and thus not diagnosed.
• Periodontal disease is the second most common disease known to man, only surpassed by tooth decay.
• Diabetic individuals with periodontal disease have a greater risk for cardiovascular and kidney complications than those diabetics not having periodontal disease.

What You Can Do

One of the most important steps you can take if you have either of these conditions or suspect that you might have one or both is to make an appointment with your physician or with our office for a thorough examination. You should schedule an appointment with your physician for an exam and blood work so that your general health and well-being are monitored. Be certain to share your medical information and any family history of diabetes with our office, as it tends to occur in families.

Learn More

Learn the risks and how to take care of types 1 and 2 diabetes, as well as the stages of periodontal disease (with detailed full-color illustrations) when you read the Dear Doctor article, “Diabetes & Periodontal Disease.” Or if you want to schedule an appointment to discuss your questions, contact us today.

When treating Temporomandibular (jaw joint) Disorder (formerly known as Temporomandibular Joint Disorder, TMJ), we feel we have two equally important challenges facing us. First, we must start your treatment by relieving the symptoms of pain and discomfort. We typically accomplish this with heat, mild pain medications, a diet of soft foods, and some simple jaw exercises. Once we have begun to relieve your pain, our second critical objective is to identify and remedy what is causing the pain. It could be the result of an injury or trauma to the jaws and/or teeth or it could be due to a bite issue or a filling or crown that is too high and thus causing a misaligned bite. There are many other reasons, so it is first necessary to obtain a thorough medical history and conduct a comprehensive evaluation so that we can properly diagnose and treat the TMD condition and what is causing it.

Next to stress resulting in clenching and grinding habits, the four most common causes leading to TMD include:

• Underlying dental conditions that are triggering muscle pain
• Internal joint derangement (displaced or improperly positioned jaw joint)
• Osteoarthritis (degenerative joint disease)
• Synovitis — the painful inflammation of a synovial joint-lining membrane that is characterized by swelling, due to effusion (fluid collection)

If you or another family member suffer from chronic jaw pain, please let us know so that we can properly address your concerns and conduct a thorough examination. Or if you are in constant or severe pain, contact us as soon as possible to schedule an appointment. You can learn more about the signs, symptoms, and treatment options for TMD by reading “TMD — Understanding The Great Imposter.”

Recent research has revealed that there is a link between cardiovascular (“cardio” – heart; “vascular” – blood vessel) disease (CVD) and periodontal (gum) disease. The link is Inflammation. This is why it is important to learn more about this important relationship so that you can take proactive steps to improving your health and life.

What causes periodontal disease?
Simply put, irregular and ineffective brushing and flossing are the root causes of periodontal disease. Over time and when bacterial biofilms (dental plaque) are left unchecked, they lead to the emergence of a small set of highly pathogenic (“patho” – disease; “genic” – causing) organisms that are consistently associated with periodontitis (“peri” – gum; “odont” – tooth; “itis” – inflammation) or gum disease.

Is periodontal disease common or am I one of the few who have it?
It is a quite common disease, with mild to moderate forms of it impacting 30 to 50% of US adults. More severe cases affect 5 to 15%. One of the reasons these numbers are so high is because periodontal disease is a silent, painless disease that often occurs without any symptoms.

So how does my gum disease link to potential heart disease?
Inflammation is a characteristic of chronic disease. People with moderate to severe periodontitis have increased levels of systemic (general body) inflammation. If left untreated, the same bacterial strains that are commonly found in periodontal pockets surrounding diseased teeth have been found in blood vessel plaques of people with CVD.

This all sounds bad...is there any good news?
Yes! Research has revealed that if periodontal disease is treated, inflammation and infection can be reduced. This also reduces the risk for heart attacks and strokes, both of which are common results of CVD. All it may take is a thorough exam for gum disease and thorough dental cleaning. During your exam, we can also make sure you are brushing and flossing properly so that you are effectively removing bacterial biofilm. But if you have severe periodontal disease, you may need deeper cleanings and more advanced treatment to save your teeth and your heart.

To learn more on this subject, continue reading the Dear Doctor magazine article “The Link Between Heart & Gum Diseases.” You can also contact us today with any questions or to schedule an appointment.

Twenty-first Century techniques can create a replacement for a missing or damaged tooth that looks exactly like a natural tooth and actually fuses with the bone of your jaw. How does this amazing technology work? Test your knowledge on these questions.

What is a dental implant?
A dental implant is actually a replacement for the root of a tooth. In the natural tooth, the root is the part of the tooth below the gum line that is suspended in the bone by ligaments that attach the root to the bone. An implant is a root like substitute that is directly attached to the bone by a process referred to as osteointegration. An implant crown is then attached to the implant and is the visible part that we see above the gum tissues.

What is a modern dental implant made of?
Most are made of titanium. This metal is not rejected by the body and in fact fuses with the bone in which the implant is anchored, making it extremely stable.

How long do implants last?
A successful implant can last a lifetime. Factors that can affect an implant's success are smoking, certain drugs, osteoporosis, a history of radiation treatment, or a compromised immune system. We will evaluate all your conditions of dental and general health before deciding on an implant for you.

What makes the crown look like a real tooth?
The new crown looks real if it matches the shape and color of adjacent natural teeth. Its appearance also depends on what we as dentists refer to as the emergence profile (the way the crown seems to emerge from the gum tissue).

What is the function of a temporary crown?
A customized temporary crown can allow details of color, shape, and emergence profile to be worked out during this “temporary” phase of treatment. It can also test whether the tooth will function correctly for speech, biting and chewing. After these details are worked out, the temporary crown can be used as a blueprint for the permanent one.

What is the first step to getting a dental implant?
Make an appointment with us for a full assessment, diagnosis, and plan for placing the implant and crown.

Contact us today to schedule an appointment to discuss any additional questions about dental implants. You can also learn more by reading the Dear Doctor magazine article “Dental Implants, Your Third Set of Teeth.”

When it comes to cosmetic dentistry, we have numerous techniques that we can use to produce a dazzling smile while restoring or helping you maintain optimal oral health. From tooth whitening and gum contouring to bonding and veneers, see how much you really know about cosmetic dentistry by playing our matching game.

1. Whitening
2. Bonding
3. Enamel shaping
4. Orthodontics
5. Veneers
6. Crowns and bridgework
7. Implants
8. Gum contouring

1. ______ is a minor surgical procedure in which we alter the position of the gum tissue and sometimes even the underlying bone.
2. ______ is a treatment option that is not permanent and may require several applications to achieve the desired color results.
3. ______ is a restorative technique that involves applying an a tooth colored filling material (composite resin) to a tooth that is color-matched and shaped to restore a decayed or damaged tooth.
4. ______ is a treatment option for restoring heavily damaged teeth or replacing missing teeth.
5. ______ is a procedure in which small amounts of enamel, a tooth's outer layer, is removed to reshape it to improve the look of a tooth.
6. ______ is a minor cosmetic procedure in which we apply a peroxide-based material to bleach out minor stains and discoloration from teeth.
7. ______ is a procedure in which we permanently replace a missing tooth by attaching a crown (artificial tooth) to a titanium post that has been surgically placed within the jaw.
8. ______ is a treatment option in which teeth are aligned into a proper position giving a more attractive appearance. It is often used in conjunction with other cosmetic procedures.
9. ______ is a cosmetic technique where we place a custom-designed, thin shell of tooth-colored material (usually porcelain) to the front surface of a tooth.
10. ______ is the most common technique for repairing chipped, broken or decayed teeth. It may also be used to alter the shape of a small or irregular tooth.

Answers: 1) H. 2) A. 3) B. 4) F. 5) C. 6) A. 7) G. 8) D. 9) E. 10) B

To learn more about cosmetic and restorative dentistry, continue reading the Dear Doctor magazine article “Beautiful Smiles by Design.” Or you can contact us today to schedule an appointment to discuss your specific questions.