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By Howard D. Klein, DMD
June 23, 2020
Category: Oral Health
Tags: tooth decay  
4FoodsThatMayHelpYouPreventToothDecay

What you eat (and how often you eat it) is a major factor in the ongoing battle to prevent tooth decay. High levels of sugar or similar carbohydrates in your diet could encourage the growth of bacteria that cause tooth decay. Constantly sipping on acidic beverages like sodas or sports drinks can lead to enamel erosion.

You may be well aware of the kinds of foods that contribute to tooth decay. But did you know some foods can actually protect us from this damaging disease? Here are 4 kinds of foods believed to inhibit tooth decay.

Cheese. This food formed from milk is rich in calcium and has a stimulating effect on saliva. By eating a little cheese after a sugary snack, the increase in saliva can help neutralize the acid produced by the bacteria feeding on the sugar; the added calcium will also strengthen tooth enamel.

Fibrous plant foods. Beans, peanuts and leafy vegetables are rich in fiber and many require vigorous chewing. This in turn stimulates saliva flow, which as previously noted helps to neutralize high levels of acid.

Black and green teas. Beverages brewed from these plants are rich in polyphenols and flavonoids, providing an antioxidant effect on cells. Black tea also contains fluoride, which helps strengthen tooth enamel.

Chocolate. There’s some evidence that cocoa (from which chocolate is derived) may have some properties that inhibit tooth decay. But there is a catch — this evidence is based on unrefined cocoa, without the addition of any sugar. The high levels of sugar in processed chocolate negate this effect. Sorry chocolate lovers!

Of course, any of these and similar foods (like cow’s milk) should be considered complements to a comprehensive prevention approach that includes daily oral hygiene, limits on sugar and acidic food consumption and regular dental cleanings and checkups.

If you would like more information on preventing tooth decay, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Nutrition & Oral Health.”

By Howard D. Klein, DMD
June 13, 2020
Category: Dental Procedures
Tags: dental implant  
YourGumsandBoneNeedtoBeHealthyBeforeGettingImplants

If you've been dealing with a tooth that needs to be removed—or it's already missing—you may be looking to replace it with a dental implant. And it's a great choice: No other restoration can provide the appearance and function of a real tooth like an implant.

You and your smile are ready for it. The question is, though, are your gums and underlying bone ready? These dental structures play a critical role in an implant's stability and eventual appearance. A problem with them may make placing an implant difficult if not impossible.

An implant requires around 2.0 millimeters of bone thickness surrounding the implant surface for adequate support and to minimize the chances of gum recession. But tooth loss often leads to bone loss that can drop its thickness below this threshold. This can make placing an implant problematic.

Fortunately, though, we may be able to address the lack of sufficient bone through bone grafting. By placing grafting material within the empty socket, we create a scaffold for new bone cells to grow upon. Over time this subsequent growth may be enough to maintain an adequate thickness of bone for an implant to be placed.

The gums may also pose a problem if they've shrunk back or receded from their normal positions, as often happens because of gum disease (which may also have precipitated the tooth loss). Again, grafting procedures can help ensure there's adequate gum coverage for the implant. And healthier gums may also help protect the underlying bone from loss.

There are several techniques for placing gum tissue grafts, depending on how much recession has taken place. One procedure in particular is often used in conjunction with implant placement. A small layer of synthetic collagen material or gum tissue referred to as pa dermal apron is included with the implant when its placed. Settling into the bone socket, this apron helps thicken the gum tissues, as well as preserve the underlying bone.

During your preliminary exams, we'll assess your bone and gum health to determine if we should take any steps like these to improve them. It may add some time to the implant process, but the end result will be well worth it.

If you would like more information on dental implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Immediate Dental Implants.”

YouCanHaveaStraighterSmile-JustLiketheQueenofEngland

The monarchs of the world experience the same health issues as their subjects—but they often tend to be hush-hush about it. Recently, though, the normally reticent Queen Elizabeth II let some young dental patients in on a lesser known fact about Her Majesty's teeth.

While touring a new dental hospital, the queen told some children being fitted for braces that she too “had wires” once upon a time. She also said, “I think it's worth it in the end.”

The queen isn't the only member of the House of Windsor to need help with a poor bite. Both Princes William and Harry have worn braces, as have other members of the royal family. A propensity for overbites, underbites and other malocclusions (poor bites) can indeed pass down through families, whether of noble or common lineage.

Fortunately, there are many ways to correct congenital malocclusions, depending on their type and severity. Here are 3 of them.

Braces and clear aligners. Braces are the tried and true way to straighten misaligned teeth, while the clear aligner method—removable plastic mouth trays—is the relative “new kid on the block.” Braces are indeed effective for a wide range of malocclusions, but their wires and brackets make it difficult to brush and floss, and they're not particularly attractive. Clear aligners solve both of these issues, though they may not handle more complex malocclusions as well as braces.

Palatal expanders. When the upper jaw develops too narrowly, a malocclusion may result from teeth crowding into too small a space. But before the upper jaw bones fuse together in late childhood, orthodontists can fit a device called a palatal expander inside the upper teeth, which exerts gentle outward pressure on the teeth. This encourages more bone growth in the center to widen the jaw and help prevent a difficult malocclusion from forming.

Specialized braces for impacted teeth. An impacted tooth, which remains partially or completely hidden in the gums, can impede dental health, function and appearance. But we may be able to coax some impacted teeth like the front canines into full eruption. This requires a special orthodontic technique in which a bracket is surgically attached to the impacted tooth's crown. A chain connected to the bracket is then looped over other orthodontic hardware to gradually pull the tooth down where it should be.

Although some techniques like palatal expanders are best undertaken in early dental development, people of any age and reasonably good health can have a problem bite corrected with other methods. If you are among those who benefit from orthodontics, you'll have something in common with the Sovereign of the British Isles: a healthy, attractive and straighter smile.

If you would like more information about orthodontic treatment options, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “The Magic of Orthodontics.”

By Howard D. Klein, DMD
May 24, 2020
Category: Dental Procedures
Tags: tooth pain  
WhyandHowtoSaveaDiseasedTooth

Let's say you have a diseased tooth you think might be on its last leg. It might be possible to save it, perhaps with a significant investment of time and money. On the other hand, you could have it replaced with a life-like dental implant.

That seems like a no-brainer, especially since implants are as close as we have to natural teeth. But you might want to take a second look at salvaging your tooth—as wonderful as implants are, they can't beat the real thing.

Our teeth, gums and jaws form an intricate oral system: Each part supports the others for optimum function and health. Rescuing a troubled tooth could be the best way to preserve that function, and replacing it, even with a dental implant, a less satisfying option.

How we save it will depend on what's threatening it, like advanced tooth decay. Caused by bacterial acid that creates a cavity in enamel and underlying dentin, decay can quickly spread into the tooth's pulp and root canals, and eventually threaten the supporting bone.

We may be able to stop decay and save the tooth with a root canal treatment. During this procedure, we remove diseased tissue from the pulp and root canals through a drilled access hole, and then fill the empty spaces. We then seal the access and later crown the tooth to protect it against future infection.

A second common threat is periodontal (gum) disease. Bacteria in dental plaque infect the outer gums and, like tooth decay, the infection quickly spreads deeper into the root and bone. The disease weakens gum attachments to affected teeth, hastening their demise.

To treat gum disease, we manually remove built-up plaque and tartar (hardened plaque). This deprives the infecting bacteria of their primary food source and “starves” the infection. Depending on the disease's advancement, this might take several cleaning sessions and possible gum surgery to access deep pockets of infection around the root.

Because both of these treatment modalities can be quite in-depth, we'll need to assess the survivability of the tooth. The tooth could be too far gone and not worth the effort and expense to save it. If there is a reasonable chance, though, a rescue attempt for your troubled tooth might be the right option.

If you would like more information on whether to save or replace a tooth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Save a Tooth or Get an Implant?

VeneersanAffordableLowImpactWaytoAchieveaMoreAttractiveSmile

There are a lot of ways to improve the appearance of your teeth. Some methods can be quite involved like crowns or bridgework, which require extensive alteration of teeth to accommodate them.

Other methods, though, can achieve stunning results with less tooth reduction or alteration to your teeth. Porcelain veneers are one such alternative that literally puts a new face on your teeth. A dental veneer is a thin layer of restorative material (usually porcelain) that is bonded to the outside of a tooth to cover blemishes. They’re an excellent choice for dealing with otherwise healthy teeth with mild to moderate chipping, wearing, staining or slight misalignment.

Veneers can be fashioned to match the shape and texture of the prepared tooth, as well as coloring that blends with neighboring teeth. They’re created by skilled dental lab technicians who use porcelain powder mixed with water to create layers of pliable porcelain laminated together to achieve the appropriate thickness and shape. The veneer is then oven-fired to produce a strong, durable product.

Their use in various dental situations does require some tooth preparation, though normally not as much as other restorative measures — usually no more than 0.5 mm of surface enamel. Removing this small amount will ensure the veneer doesn’t look too thick and bulky once bonded to the tooth.

There are some situations, though, where veneers aren’t the best choice: because they’re mainly a cosmetic solution, they can’t remedy problems like poor tooth position and bite or large discrepancies in root position. And teeth that are heavily decayed may require more extensive dental work to repair and preserve them.

In the right situation, though, veneers can make a huge difference to your smile and last for years, as long as you practice effective oral hygiene and don’t subject them to abnormal biting force (no cracking hard shell nuts with them — they can shatter). In skilled hands, veneers can transform your teeth from embarrassing to dazzling.

If you would like more information on porcelain veneers, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Smile Design Enhanced with Porcelain Veneers.”





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