What’s With All The Plastic?

AriannaM

Arianna Marsden, RDH

Keeping Your Teeth For a Lifetime

KarenK

Karen Kelley RDH

Keeping Your Teeth For a Lifetime

Our dental practice has more over 50 year olds than under 50.  As aging adults, we need to be aware of certain things that can keep us from retaining our teeth our entire lives.

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Judith Ann Jones, DDS, a spokesman on elder care for the American Dental Association and director of The Center for Clinical Research at the Boston University Goldman School of Dental Medicine spoke about 5 things that are especially important to the over 50 crowd.

Tooth Decay:  Contrary to what many people believe, adults keep getting cavities!  I’m always surprised when people are stunned to learn they have a cavity as an adult.  Areas of the teeth that have never had a cavity can decay, but  areas  where we see more problems are where an old filling is leaking and at the base of an older crown.  The best prevention is brushing well each day along the gumline.  An electric toothbrush is very helpful in accomplishing this as well as the use of fluoride.  An over the counter fluoride rinse nightly is great and in our office we have special prescription strength fluoride that is wonderful for cavity prevention as well as help with sensitivity.
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Dry Mouth:  Keeping Your Teeth For a Lifetime We see so many people with this problem.  “Saliva protects our teeth.  The calcium and phosphate present in saliva prevent demineralization of your teeth”, Jones says.  Many drugs cause dry mouth as well as some diseases and as we get older, we are on more medications thus we see this commonly in older adults.  This is a difficult one to deal with for those affected.  The best thing is to drink lots of water, use saliva substitute and try xylitol products.  Also, if you smoke, stop, it just makes your mouth drier.

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Gum Disease:  If your gums are swollen, red, or bleed easily, you have gum disease.  If left untreated, gum disease (gingivitis) will become more serious and will cause deterioration of the bone that holds the teeth, we call this periodontitis.   If this condition continues without treatment, it can cause the loss of the teeth.  The best way to prevent gum disease is to clean your teeth well each day with brushing, flossing, and use of interdental cleaners like soft picks or go betweens. And of course, seeing your friendly dental hygienist as often as recommended.  We can remove the mineralized bacteria from your teeth that you can’t remove with brushing.

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Tooth Crowding:  “As you age, your teeth shift”, according to Lee W. Graber, D.D.S., M.S, Ph.D., Past President of the American Association of Orthodontists. And “that can be problematic, not because you’ll look different, but because it can make your teeth more difficult to clean, leading to more decay.  It’s also of concern because misaligned teeth can lead to teeth erosion and damage to the supporting tissue and bone”, Graber says.   “Add to that the tendency of older adults to have periodontal disease, and you could end up losing your teeth even faster.”   If your teeth have really shifted, and you find you are having a difficult time keeping your teeth clean and food keeps getting caught in certain areas, ask our doctors about orthodontics.  We offer Invisalign to our patients and we’ve had patients in their later years choose to straighten their teeth.  I just finished with my invisalign treatment.  I had braces when I was a teenager but my teeth had shifted and I was experiencing these problems I just mentioned.  I decided to do Invisalign.  It’s easy to do and my teeth are so much straighter.   They are now in the correct alignment and my teeth and gums will be healthier.   If you choose not to do orthodontics, more frequently exams and cleanings may be necessary.

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Oral Cancer:  According to The Oral Cancer Foundation, more than 43,000 Americans will be diagnosed with oral cancers this year, and more than 8,000 will die from it.  “Oral cancer incidence definitely increases as you get older”, Jones says, and “is very often linked to smoking and heavy alcohol use.”   Jones also said, “Only about half of people who develop oral cancer survive the disease.”   If discovered early, there is an 80 percent chance of surviving for five years.  When we do your periodic exams when you come in for your cleaning, you will be checked for oral cancer.  We also offer Velscope, Identafi, or Oral ID technologies to help in finding oral cancer earlier.

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Keep brushing, flossing and smiling!  We want to help you keep your teeth healthy your entire lives!

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Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Sources:

http://www.huffingtonpost.com/2014/09/28/common-dental-problems-_n_5844434.html

https://aga.grandparents.com/

Electronic Cigarettes

Sharma RDH

Sharma Mulqueen, RDH

Electronic Cigarettes

E-cigarettes are electronic nicotine-delivery systems (ENDS) that consist of a cartridge containing nicotine and propylene glycol, an atomizer, and a battery (Figure 1). When a user inhales, a pressure-sensitive circuit is activated, which heats the atomizer and vaporizes the liquid as it is brought through the mouthpiece. The vapor consists of a fine mist that does not contain smoke or carbon monoxide and disperses more quickly than traditional cigarette smoke. The act of using ENDS is often called “vaping” and users are termed “vapers.”

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The nicotine cartridges used in ENDS come in a variety of flavors, including vanilla, cherry, java, piña colada, and menthol.  As the demand rises there are some ENDS stores opening with over 1000 flavors.  They are also offered in a myriad of nicotine strengths. When e-cigarettes are inhaled, light-emitting diodes are illuminated. Originally, these lights were red, but now they are often blue or another color to differentiate them from traditional cigarettes.

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There is a lot of stir about the introduction of e-cigarettes and unknown health issues that they may cause. For the mouth, e-cigarettes seem to have some positives and negatives. It is a better option than regular tobacco cigarettes, but worse than not smoking altogether. Here are a few of the effects of e-cigarettes on the mouth.

Unfortunately, research on e-cigarettes is still very minimal. Because they are a new product, research that can space several decades is still unavailable. However, there are several chemicals and clues that help determine what e-cigarettes can do to the teeth.

Just like any cigarette, the main purpose of an e-cigarette is to inhale nicotine. Studies have shown that nicotine can slow down the production of saliva in the mouth. The more nicotine you intake, the less saliva the body is able to produce. Saliva is a main deterrent to harmful bacteria and food particles in the mouth. Low saliva levels can cause quicker tooth decay, sore gums, and eventually a loosening of the teeth. One positive of smoking e-cigarettes verses normal cigarettes is that you can control the amount of nicotine the e-cigarette will release into the body. This will slow down the eventual effect of lowered saliva levels, at least.

Another effect of nicotine in an e-cigarette or a tobacco cigarette is it acts as a vasoconstrictor, which prohibits blood flow to the mouth. This results in a fewer number of white blood cells capable of fending off infections and bacteria that harm your gums. Fewer red blood cells are also sent to your mouth tissues, which lead to faster deterioration of the tissue and your teeth.

Another concern for e-cigarettes is that they contain diethylene glycol, a highly toxic substance. However, at the current point in research, scientists have not determined how much of the substance is needed to be considered harmful to the body, especially seeing e-cigarettes use a very low amount.

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Dental hygienists should continue to support tobacco cessation through evidence-based methods, such as counseling and medications. The American Dental Hygienists’ Association’s (ADHA) “Ask, Advise, Refer” program is a national tobacco intervention initiative designed to promote cessation by dental hygienists. Available at askadviserefer.org, this program follows the most successful steps to aid patients in quitting smoking, including: an in-depth presentation on the effects of tobacco and nicotine; step-by-step guide on questioning smokers; tips on advising them of why quitting is recommended; specific referrals to local quit lines; and options for Web-based cessation programs. Also, a variety of in-office handouts and reference sheets is available for immediate download or by request from the ADHA website for clinicians.

The “Ask, Advise, Refer” program recommends offering some type of smoking cessation medication in addition to a behavioral program. One option is a traditional nicotine replacement therapy, or pharmacotherapy. FDA-approved traditional nicotine replacement therapy products include gum, lozenges, transdermal patches, nasal sprays, and oral inhalers. There are several success stories of individuals sucking on hard candy day after day.  Unfortunately this may cause cavities, but if this can stop someone from using tobacco products then it is a success.  Bupropion SR and varenicline are medications used to aid in cessation.

E-cigarettes have not been evaluated by the United States Food and Drug Administration (FDA), and the levels of nicotine or other chemicals they contain are unknown. The FDA is concerned that e-cigarettes are sold to young people and do not contain “health warnings comparable to FDAapproved nicotine replacement products or conventional cigarettes.” The administration is developing a strategy to regulate this emerging class of products.

Conclusion

In response to the decreasing number of adult cigarette smokers, the tobacco industry is trying to attract young people with “healthier” tobacco products in hopes of expanding the market. None of these products is free of carcinogens, and most still contain enough nicotine to pose an addiction risk. All of them increase users’ risk of oral cancer.

The challenge for dental professionals is to identify users of these products as they may lack the typical signs of tobacco use, such as tobacco stains and odor, and the appearance of tissue changes in unusual areas, such as under the upper lip. Clinicians can play a critical role in educating patients about the nicotine content and potential harmful effects of these new tobacco products. Not only can dental professionals provide cessation support or referral for counseling, but they can also help prevent nicotine addiction in the first place.

Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Sources:

Polosa R, Caponnetto P, Morjaria JB, Papale G, Campagna D, Russo C. Effect of an electronic nicotine delivery device (e-cigarette) on smoking reduction and cessation: a prospective 6-moth pilot study. BMC Public Health. 2013;

American Lung Association Smoking Cessation: The Economic Benefits. Available at: lung.org/stop-smoking/tobacco-control-advocacy/reports-resources/cessation-economic-benefits/states/united-states.html. Accessed April 21, 2014

US Food and Drug Administration. FDA and Public Health Experts Warn About Electronic Cigarettes. Available at: www.fda.gov/NewsEvents/ Newsroom/PressAnnouncements/ucm173222.htm. Accessed September 1, 2013

Centers for Disease Control and Prevention. 2013 Smoking and Tobacco Use. Available at: www.cdc.gov/tobacco/data_statistics/fact_sheets/economics/econ_facts/index.htm. Accessed September 1, 2013

http://www.askadviserefer.org/

What is Xylitol?

LindsayW

Lindsay Whitlock, RDH

“Xylitol is a natural sweetener derived from the fibrous parts of plants.”

What Are The Dental Benefits of Xylitol?

Splenda (Sucralose) is a commonly used artificial sweetener that one would use to sweeten their iced tea. Once you drink your sweet tea, your teeth are splashed with the sugary beverage, and the Splenda begins to break down in your mouth. Bacteria already thriving in your mouth are immediately drawn to the sugars on your teeth. During this process, the bacteria, for lack of better words, “poop” out acid onto your teeth, and begin the cavity process.

Xylitol does not break down in the mouth like typical sugars (Splenda). Because acid-producing bacteria cannot digest Xylitol, the growth of bacteria is greatly reduced in your mouth, up to 90%. After taking xylitol, the bacteria are unable to stick to the surfaces of your teeth, and thus results in decreased plaque.

Your saliva in your mouth is naturally trying to keep your mouth at a neutral pH, as one is ingesting sugars. If sugar is only consumed a couple times per day, the saliva can protect your mouth and teeth on its own. But for most, sugar is so often consumed that your natural defenses (saliva) are not enough, in the battle of cavity prevention. Xylitol can also increase a neutral pH saliva flow, which could decrease your risk of cavities.

Other Benefits of Xylitol?

  • Xylitol serves as an effective sugar substitute for diabetics and non-diabetics
  • Delicious sweet taste… with no unpleasant aftertaste
  • Provides one third fewer calories than sugar
  • May be useful as a sugar alternative for people with diabetes (on the advice of their healthcare providers)
  • It’s 100% natural. Xylitol is not an artificial substance, but a normal part of everyday metabolism. Xylitol is widely distributed throughout nature in small amounts
  • It’s safe
  • It’s convenient to use
  • Xylitol can be conveniently delivered to your teeth via chewing gum, tablets, or even candy. You don’t need to change your normal routine to make room for Xylitol

How Much, and How Often Should I use Xylitol?

Strive For 5:

  1. Use Xylitol toothpaste, mouthwash, and nasal spray upon waking up
  2. After breakfast use Xylitol gum, mints, or candy
  3. After lunch use Xylitol gum, mints, or candy
  4. After dinner use Xylitol gum, mints, or candy
  5. Use Xylitol toothpaste, mouthwash, and nasal spray upon going to bed

For a complete this of Xylitol containing products, follow this link: http://xylitol.org/xylitol-products

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Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Sources: 

http://www.Xylitol.org

Black Line Stain

AriannaM

Arianna Ritchey, RDH

BLACK LINE STAIN

During the regular prophylaxis cleaning for a recent patient, she inquired as to the black stain on her teeth.  She had excellent brushing and  flossing habits, saw us every six months for her professional cleanings, and has only one filling on her permanent teeth.  This patient does not participate in any behaviours that normally result in staining; she does not drink coffee, tea, wine, and she does not use any tobacco products.  She was also concerned, because this same type of stain is also present on her infant’s teeth, who is strictly breastfed.  So, where was this stain coming from?!

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It was explained to this patient that the stain she was experiencing was most likely a type of stain called “Black Line Stain,” or sometimes simply “Black Stain”.  Black Line Stain is more common in women than men, and can occur in patients with excellent oral hygiene.  It appears as a thin black line, which is firmly attached to the tooth surface, and most commonly near the gumline of the facial and lingual surfaces of a tooth.  This type of stain is associated with a low incidence of cavities in children and adults, and is caused by a type of Gram-positive bacteria that produces a certain colour, or chroma, which makes it identifiable. It is possible that this patient’s child has the same type of Gram-positive chromogenic bacteria on his teeth, creating the same type of Black Line Stain.  This is especially likely if the child has good oral hygiene and a low incidence of cavities.

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This non-metallic type of stain is absorbed onto the tooth surface deposits, such as tartar, plaque, or even the acquired pellicle.  The acquired pellicle is a thin film made up of proteins in our saliva, that forms almost instantly after a tooth is cleaned.  Because this type of bacteria is able to attach to the acquired pellicle,  this condition is not related to oral cleanliness or the presence of periodontal disease.

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To prevent this stain from building up as quickly, patients can use a toothbrush to effectively clean the teeth twice a day, while using a toothpaste that helps to prevent staining.  Powered toothbrushes can often clean the teeth most effectively without causing trauma to the gums.  Once the stain has settled onto the teeth,  the most effective way to remove this Black Line Stain is by a professional cleaning with a dental hygienist.  The hygienist may professionally remove the stain with an ultrasonic scaler, coronal polishing using an abrasive prophy paste, or by using an air-jet polisher with an abrasive powder.

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The only real downside to removing the Black Line Stain from the teeth, is that repeated stain removal using an abrasive paste or powder removes micro-millimeters of enamel from the tooth surface.  The top layer of the teeth which is partially removed during polishing, is the most fluoride-rich part of the tooth, so if frequent polishing is utilized to remove Black Line Stain, it is advisable to have a professional fluoride treatment administered after the polishing to replenish the depleted fluoride from the teeth.  Fluoride is available in a few different forms, the most effective of which are a fluoride varnish or a fluoride foam.

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There are some other types of dark stain that are caused by other sources, including dietary components, beverages, tobacco, mouthrinses and other medicaments. These types of stain have a different source than Black Line Stain, but are removed in a very similar fashion.  If you have any questions or further concerns about staining on your teeth, feel free to ask your dental hygienist!

 

 

Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Sources:

http://jairjp.com/JANUARY%202013/02%20SRUTHY%20PRATHAP.pdf

http://www.sammyboy.com/showthread.php?154192-Black-stain-in-teeth-by-chromogenic-bacteria

http://medical-dictionary.thefreedictionary.com/black+line+dental+stain

http://www.carolinasdentist.com/wp-content/uploads/2013/06/toothpaste.jpg

http://www.youngdental.com/wp-content/uploads/2013/09/dlishezpak4.jpg

http://www.sanclementeperiodontist.com/portals/165/images/fluoride.jpeg

 

Mouth Breathing

JW9(sm)

Julie West BS RDH

Parents take heed; if your child breathes through his mouth instead of his nose, he can have more problems than bad breath!

     Mouth-breathing contributes to: sleep disorders, changes in posture, jaw deformity, lowered immune function, gum disease, and tooth decay.

Mouth-breathing causes the jaws to grow in an altered fashion, resulting in long faces, tooth crowding, and an altered head posture. The lower jaw remains too far behind in its growth, producing a small chin, an abnormal bite, and a distorted profile.

Sleep disorders can be caused by the lower jaw and tongue being positioned too far back, constricting the upper airway.  Enlarged tonsils and adenoids due to chronic allergies may also constrict the airway to such an extent that normal nasal breathing becomes impossible.

Nasal breathing produces a hormone that regulates normal blood circulation. It also filters, warms and moisturizes the air. The lack of oxygen in mouth breathers, who usually snore at night and struggle for air, weakens the immune system, disrupts deep sleep cycles, and interferes with growth hormone production.  Children may be fatigued and less attentive in school due to this disruption in sleep.

Saliva helps to naturally cleanse the tissues of the mouth.  Salivary flow is disrupted by mouth-breathing, leaving a dry environment that irritates tissues and leaves them susceptible to infection such as tooth decay, gingivitis, and periodontal disease, as well as contributing to bad breath.

If you notice that your child breathes through his mouth, you can get help before these problems arise.

     Typical treatment options include myofunctional therapy to help retrain your child to breathe through their nose and the use of orthodontic appliances to help move the lower jaw forward.   The earlier mouth-breathing is addressed, the better the outcomes of treatment will be.

Below is a picture of a patient before and after treatment for mouth-breathing.

http://mcgannfacialdesign.com/before-after/

http://www.asha.org/public/speech/disorders/OMD.htm