Q: My 8-year-old daughter has been complaining about sensitive teeth. She brushes and uses tooth-flossers every day, and she only drinks diet soda, so she’s not getting a bunch of sugar. What could be causing her sensitivity?
A: Acid in foods and beverages is the most likely cause. Diet soda does not contain the sugar that makes cavity-causing bacteria thrive, but it DOES have very high acidity. Your daughter’s dental enamel may be suffering due to this acid exposure. I see this very often in children because the sour drinks and candies kids love are so acidic. People don’t have to eliminate acidic foods from their diets completely; they just need to change the way they consume those foods to help their teeth. For example, often people will sip a soda or energy drink while they’re working or watching TV – soaking their teeth for a long period of time in an acid bath. Instead, when you drink soda, drink the whole glass in one setting, and then go swish your mouth with water to limit your acid exposure. The same goes for sour candy such as Warheads. Also, wait 30 minutes after acidic foods or beverages to brush your teeth: The acid has softened your dental enamel, so you don’t want to add to the damage by brushing with abrasive toothpaste right away.
Have a question or need a dentist? Call my office at 477-5800, visit our website, or stop by in person next door to Spencer Co. Physical Therapy. I and my caring, experienced staff would be happy to assist you.
Q: Doc, I have all kinds of tooth trouble! I brush, floss, and avoid sugary foods, but I STILL get cavities, and my teeth are super-sensitive. I’ve also had several fillings break down and come out within a year or two of being placed. What should I do?
A: Visit your dentist, ASAP! It sounds like acid reflux may be the culprit. Gastroesophageal reflux disease (GERD) occurs when the valve at the top of the stomach does not function properly; instead of closing off the stomach, it allows acid to back up into the throat. GERD can cause a host of problems including erosion of dental enamel. It is estimated that 25% of adults (& children) suffer from this condition. This would explain your sensitive teeth and higher incidence of cavities: Stomach acid may be eating away your smile! If you are diagnosed with GERD, your physician or dentist will likely prescribe medication and tell you to avoid acidic foods/carbonated beverages and sleep with your head elevated. A daily fluoride rinse will also help strengthen your enamel and decrease your dental woes.
Have a question or need a dentist? Call my office at 477-5800, visit our website, or stop by in person next door to Spencer Co. Physical Therapy. I and my caring, experienced staff would be happy to assist you.
Q: I play soccer and know I need to wear a mouth guard, but which sports are the most dangerous for your smile?
A: Soccer and basketball are definitely towards the top of the list, followed by baseball/softball and football. In any sport in which players could take a ball or elbow to the face, mouth guards are a must! Mouth guards work by splinting your teeth together. In a mid-play collision, a mouth guard protects your teeth by dissipating the force, keeping top and bottom teeth from hitting together and fracturing. Athletic mouth guards are an easy way to prevent painful, costly injuries; reconstructing a damaged smile is a major-league undertaking!
Have a question or need a dentist? Call my office, visit our website, or stop by in person. I and my caring, experienced staff would be happy to assist you.
Abscess. doc My tooth started aching a few weeks ago, and now a little bubble has formed on my gum. What is it? Is it serious?
A: It sounds like you have a dental abscess, a pus-filled pocket in your gum tissue. These are usually caused by decay in a nearby tooth, gum disease, or a cracked tooth. If left untreated, this infection can spread to other soft tissues, glands, and even bones – it’s definitely serious, especially if you have diabetes, heart disease, or problems with your immune system. Call a dentist today and get an appointment to have your tooth checked. To get rid of the abscess, your dentist may suggest extracting the tooth OR doing root canal therapy and placing a crown on the tooth so you are not left with a gap in your smile. The doctor will likely prescribe an antibiotic for you, as well, to make sure any remaining infection is brought under control.
Have a question or need a dentist? Call 477-5800, stop by my office at 4819 Taylorsville Rd (by Spencer Family Medicine), or email me at jlesniak@drransdell.com
Whitening
Q: My daughter is ten years old and her teeth are healthy but not very white. She has started asking if she can get her teeth whitened. How old does a child need to be before they can have this done, and how much would it cost?
A: Although extra-white smiles are increasingly popular, I do not recommend whitening for patients under 18 years. Nerves in children’s teeth are larger than adult nerves, and the nerves are also less protected because natural calcification has not had much time to occur. A child’s chance of experiencing sensitivity and discomfort with whitening is therefore much higher. Until your daughter is older, I would suggest whitening toothpaste or an over-the-counter whitening rinse, no stronger products. Stronger over-the-counter products such as gel strips or whitening trays carry as much risk for sensitivity as in-office whitening, perhaps even higher because the solution has to stay on the teeth for a longer period of time at home to achieve any effect. Different brands and types of over-the-counter products can cost from $15-50 per month with varying results, while in-office “instant” whitening treatments cost from $300-700 for profound, predictable whitening. Office whitening may be the only effective choice for patients with conditions such as tetracycline staining. Children too young for whitening treatment can prevent excessive staining and cavities by avoiding dark or brightly-colored drinks such as tea, coffee, and colored sodas, by brushing and flossing regularly, and by having regular dental cleanings.
Q: I was eating a sugar cookie, and a piece of my tooth chipped off. How could that happen? The cookie was so soft!
A: Teeth that are decayed and left untreated are often susceptible to chipping, but a variety of situations can cause healthy teeth to chip, too. Normally, teeth operate like a bed of nails: No single tooth is applying extreme pressure, and if a person tries to eat something too hard, healthy nerves say, “Hey! Stop that!” However, some foods require an odd chewing motion and apply a lot of pressure to just a few teeth. Candy “jaw-breakers,” for example, are aptly named – just think of how your jaws move to crunch the oversized hard candy on one side, while the other side is empty! Occasionally, teeth can be chipped in a “tooth on tooth” collision when one jaw slips forward or backward from the other jaw when biting.
Even more dangerous than hard, crunchy foods are the unknown hard pieces that may lurk in seemingly soft foods. When eating hard foods, one can gauge how much pressure to apply to bite the food in pieces. When eating soft foods, on the other hand, we often don’t pay much attention to how hard we bite. This may be what happened in your situation. If you were goin’ to town on that soft sugar cookie and hit a hidden hard bit, such as a nut or a candy sprinkle, you may have bitten a lot harder than usual, thereby chipping your tooth.
Your dentist may offer a variety of methods to repair your chipped tooth. If the chip is minor, the broken edge of the tooth may be smoothed to keep you from cutting your tongue. Other treatments include applying a tooth-colored filling to the area or, in more extreme cases (especially if the tooth is decayed or has been filled in the past), making a crown or “cap” to protect the remaining tooth structure. A quick x-ray will determine what treatment is best.
Q: I want to have my teeth whitened, but I have some repair work such as caps/crowns and some bonded material that was placed to repair a very small chip in my tooth. Am I a good candidate for whitening?
A: When deciding if a patient has a good chance of whitening success, I look at where any older restorations are located in the mouth – because these restorations will not whiten. If some of your front teeth have crowns or fillings, and you try to whiten your teeth, you will end up with an “Indian corn” grin! If restorations are on back teeth, however, you may still choose to whiten because the darker teeth likely will not show when you speak or smile. If your dentist has diagnosed that you need a crown or large restoration, you may want to think about whitening before your treatment is done: that way, the crown can be made to match your newly whitened teeth, not your old shade. I regularly give patients a discount on our 1-hour ZOOM Whitening when done in conjunction with crown or bridge treatment – a nice surprise to congratulate patients for choosing to improve their oral health. If your current crowns are visible when you smile, and whiter teeth are very important to you, the only option is to have whitening treatment and then have your crowns replaced in a lighter shade.
Q: I was recently diagnosed with diabetes, and my doctor asked a lot of questions about my teeth and told me to be sure to go see my dentist. Why are my teeth so important?
Good oral hygiene is important for everyone, but especially for folks with health concerns that can compromise their smiles. Diabetes is one such condition: it restricts blood flow to extremities, including your hands, feet, and gums, and it can also cause dry mouth. If tartar builds up and leads to gum infection (periodontal disease), the decreased blood flow to your gums makes it harder for your body to fight the infection and heal. If you also have dry mouth, your saliva is not bathing your teeth and washing away bacteria. This combination means you’re more at risk for tooth loss and decay than people who do not have diabetes.
Recent studies have shown that bacteria from your mouth can affect other parts of your body, even harming the cells that regulate insulin to control your blood sugar. To protect your total-body health, therefore, brushing and flossing daily and having twice-yearly check-ups are key!
Q: I have a big decayed area in my tooth, and I made an appointment to have the cavity filled. My dentist said I should get a crown put over the filling. Why is that?
A: If the tooth is over ¾ filling or if the filling was done to repair one of the bumps or “cusps” on the top of the tooth, a crown or onlay may be recommended (porcelain or gold structure that covers the filling and is shaped like the surrounding teeth). Because so much of the tooth is composed of filling, the remaining tooth structure may be unable to support chewing foods like raw carrots or crispy bacon. A large filling can act as a wedge and crack the thin, remaining shell of tooth if you bite down wrong. (Ever seen how a wedge works when a person uses it to chop wood?) A fracture like that can mean Root Canal City or Tooth Loss City – double the pain and cost of doing a crown in the first place.
Q: Why do different dental offices charge different amounts for patients’ visits?
A: Often, the offices are actually providing different services as part of their doctors’ “Standards of Care.” These standards are developed by each dentist based on the dentist’s experience, education, and philosophy of treatment, and they create a noticeable difference between offices.
For instance, a New Patient’s teeth-cleaning and check-up appointment at one office might include polishing the teeth with a flavored paste, instructing the patient on proper brushing and flossing, taking 4 “bitewing” x-rays to examine the back teeth for any cavities, and sending the patient home with a new toothbrush and sample toothpaste. At another office, the same New Patient’s teeth-cleaning and check-up might include using an ultrasonic device to loosen any plaque along the patient’s gumline, cleaning the teeth with a hand-held instrument, polishing and flossing the teeth, using a Diagnodent machine to test the density of the teeth for any developing cavities, taking x-rays of all teeth at this first visit to get a picture of the new patient’s total oral health, checking the patient for signs of oral cancer, and offering the patient a Fluoride rinse to strengthen and protect teeth and gums at home. (And of course giving the patients their new brushes and samples – ALL dentists know their patients need a little extra encouragement for taking care of their smiles!)
Notice the differences between these two office visits? Yet at each office, the visit is the “normal” care given to a New Patient. Prices will often reflect differences in what services the patient is actually getting. If you are going to call several offices to compare costs, therefore, make sure you ask what services are included. Otherwise, you might be comparing apples to oranges to kiwi fruit.
Q: I don’t have dental insurance, but I do have teeth… Do you have any options to make dental care affordable for me?
A: My goal as a dentist is to make the best treatment available & affordable for everyone. There are lots of people in your situation, and even when people have dental insurance, the care their teeth require often exceeds their yearly benefit allowance. Therefore, I offer several financial options. The program we use is Care Credit. They offer interest-free monthly payments up to a year or extended payments at low interest for longer than a year. Patients can apply online or by telephone, either at home or at my office. This is a great way for people to get the care they need when they need it. …So often, if a person waits on treatment so he can “save up” to do it, the conditions worsen (i.e. more expensive, painful & difficult to cure) or even become unfix able (i.e. tooth loss). Another financial arrangement: If a patient chooses to prepay for treatment instead of financing, I discount a certain percentage off of the total cost. And as always, I like to offer specials on different popular treatments such as Cleanings, Invisalign “Clear” Orthodontics, or Whitening services from time to time.
The SMILE PLAN is a great option for those with out Dental Insurance. It covers 2 cleanings per year, most x-rays and gives substantial discounts for most all other dental procedures.
In all circumstances, I try to give patients a range of treatment & financial options so that they can find the ones that best fit their circumstances. If you are in need of dental care, I hope you will call and speak with my office managers regarding financial arrangements.
Q: Why do I need to use a Fluoride rinse? Isn’t Fluoride added to our drinking water?
A: While there may be some fluoride in our water supply, studies have shown that using a concentrated Fluoride rinse can actually help teeth “heal” any areas of beginning decalcification, the first stage of developing cavities. Several of our patients have been diagnosed with areas that need to be “drilled and filled” at their next cleaning appointment, have started using daily Fluoride, and no longer have to have restorative treatment – because Fluoride has reversed the early decay in their teeth. Additionally, maintaining a good Fluoride level in your saliva aids in plaque & tartar control and helps eliminate sensitivity. We therefore recommend it for all patients, from over-the-counter flavored rinses for children to prescription-strength Prevident for adults.
Q: My husband was just diagnosed as having gum disease. Is that contagious?
A: Surprisingly, YES.
Dental Decay is as Well!
Recent research shows the bacteria that causes gum (periodontal) disease can actually be transmitted through saliva – aka kissing, sharing utensils or cups, etc. Genetic factors and oral hygiene habits determine how susceptible a person is, and the more virulent the bacteria, the more likely family members are to contract the disease. Periodontal infections are responsible for up to 75% of all adult tooth loss, as rampant infection causes gum recession and bone loss around teeth (not to mention the links between gum disease, diabetes, and heart disease).
Fortunately, gum disease can be treated, and your husband should pursue treatment right away – for the sake of BOTH your smiles.
Q: My friend went to your office for a cleaning and check-up. She said you use 2 kinds of fluoride: foam fluoride at her appointment and a prescription rinse to use at home. Why the 2 different kinds?
A: Great question! I recommend fluoride to decrease sensitivity and inhibit the formation of plaque on your teeth in-between dental cleanings. Research has shown that both applications of fluoride have benefits for your smile. Compare using fluoride to using Whitening products: Like a ZOOM In-Office Whitening improves the color of your teeth right away, high-powered foam fluoride raises the concentration in your mouth “all at once.” This big increase could be dangerous if done everyday instead of once per 6 months. Using fluoride rinse at home, therefore, is like using whitening toothpaste: Instead of the dramatic “spike” of fluoride you get in the office, you are keeping a high level of fluoride in your saliva, maintaining the benefits every day.
To me, the most exciting ‘Fluoride Fact’ is that it can actually “heal” teeth over time by replacing minerals in areas that are starting to decalcify (the beginning of tooth decay)! Home fluoride is especially important for patients who have “dry mouth” or who are wearing metal braces, as their teeth are at higher risk of decalcification/ decay. I recommend ACT over-the-counter rinse for young children and prescription-strength Prevident rinse for adults.
Q: I see commercials on TV for the clear braces that look like mouthguards. Do those teeth straighteners work? And if they work, how?
A: Yes – the InvisAlign “aligners” do work and can be a great option for patients who might not want conventional braces. The clear trays can be both more aesthetically pleasing than metal braces and more convenient, since they can be removed to eat, brush, and floss. And the price of aligners is usually comparable to the cost of metal braces.
These smile-straightening systems are a 3-step process: First, schedule an appointment with your dental professional to discuss the changes that need to be made to your smile and whether or not InvisAlign might be best for you. Second, your dentist will take impressions of your teeth so that your clear aligning trays can be made. Finally, you will wear each set of aligners for 3 weeks – taking them out to eat, brush, and floss – while your dentist monitors your progress until your teeth are properly aligned. Then you can enjoy your healthy, beautiful smile!
Aligners are not for everyone, however – only your dentist will be able to tell whether or not they will work for you.