The NobleDentist Blog

NobleDentist recently added several new oral health articles to assist you.

Simply click on any of the links below to peruse that article.

1. Oral Cancer – How to Protect Yourself


2. Oral Care for Cancer Patients


3. Oral Health and Piercing


4. Periodontal Disease and Prevention


5. Periodontal Disease – Treatment for Prevention


6. Pregnancy and Oral Health


7. Sensitive Teeth – Causes and Treatment


8. Smoking and Oral Health


9. Toothbrush – Care, Cleaning, and Replacement

To learn how to save hundreds and even thousands of dollars at the dentist, click on NobleDentist.

This is an article by Norman Swan published recently by The ABC - Health Matters.

Gum disease known as periodontitis – that’s when the dentist tells you your teeth are fine but your gums need to come out – is no laughing matter. It can be associated with bad breath and loosening of the teeth.

Some people also believe that the chronic inflammation in periodontitis damages other parts of the body and causes preterm labor. But the evidence for this in humans is controversial.

A recent trial in 800 women suggests going after periodontitis doesn’t prevent early labour. Since you can have gum disease without knowing it, the women had the spaces between their teeth and gums probed and then randomly allocated to aggressive de-scaling of their roots and teeth and monthly tooth polishing or just dental check ups.

There was no reduction in preterm delivery although there was just a hint that late miscarriages and stillbirths prior to 32 weeks might have been lessened.

Every pregnant woman should have healthy teeth because it makes a difference to the baby’s dental health but not it seems, to whether he or she will be premature.

This is an article by Poornima Jayaraman that recently appeared in The Southern (Illinois, USA).

When was the last time you saw a model with a gummy smile or crooked, yellow teeth?

With the mass media constantly bombarding us with images of beautiful, successful people, with brilliant smiles, there is a subliminal pressure of sorts to put your best face forward; since it just might open the magical doors of opportunity, help you leave a positive impression on your colleagues and peers and give you that all-important edge.

There’s no doubt about it, beauty is definitely at a premium today.

The role of cosmetic dentistry and orthodontics

Since a smile can convey happiness, warmth, approachability and confidence; general dentists, orthodontists, cosmetic and esthetic dentists are literally in the limelight today as they admittedly have a lot to offer by way of smile design.

No longer are they just someone you go to see for a painful root canal or gum surgery, but they are also skilled, creative artists – the harbingers of hope, who can possibly change your life, by giving you the ultimate smile.

“The smile line refers to the amount of tooth structure that shows during a normal smile and an exaggerated smile,” explains Dr. Kyle R. Childers, DMD, MS, orthodontist at Childers’ Orthodontics in Benton, Herrin and Harrisburg. “An ‘ideal smile’ is when the upper lip just touches the point where the tooth meets the gum line. What you don’t want to see is half an inch of gum tissue.”

Dr. Christopher Hughes, DMD, Hughes Dental Arts Center in Herrin, agrees. “The gum tissue around the teeth is an important aspect of smile presentation. Since the teeth are framed by the lips; the lip position, fullness and color of the lips can also influence aesthetic appeal.”

Focusing heavily on cosmetic dentistry and reconstructive dentistry, including implants, Hughes says beautiful smiles have several common ingredients like symmetry and proportion.

But as we age, our teeth get discolored, worn out and chipped, or suffer from further decay. Sometimes we could have been in an accident and lost a tooth or chipped it. Cosmetic dentistry comes to our rescue here, by addressing all these problems, and helping to rejuvenate and rebuild our smile.

“Even an 80-year-old may come in wanting some cosmetic dentistry!” says Hughes. “And when we are done with it, they are proud as peacocks because they are so happy with the results!”

An orthodontist, like Childers, on the other hand can help redesign your smile by repositioning crooked, crowded, irregular or overlapping teeth, using braces, retainers and other devices. Orthodontics can also help with other factors that hinder a nice smile, including spaces between your teeth, protruding teeth, misaligned jaws, tooth development and jaw growth problems.

“While children in general tend to have more problems with crooked, crowded teeth, it’s simply because they haven’t lived long enough to develop stained, worn teeth as yet,” says Hughes. “In that case they visit an orthodontist and get help with their smiles.”

“However braces won’t help a 70-year-old lady with stained, worn teeth,” suggests Hughes. “Her teeth are probably straight, but they just don’t look good.” In that case a cosmetic dentist sets about determining how best to help her out.

Thus while both cosmetic dentistry and orthodontics take an interest in improving smiles, how they go about it is different.

Bleaching

Bleaching procedures have experienced a phenomenal growth in the past few years. Scores of people buy over-the-counter teeth whiteners and visit their dentists regularly to avail of the latest in bleaching technology, to attain the pearly whites they have always dreamt of.

Indeed the most conservative and least expensive option to dramatically improve you smile, it is an extremely common procedure today.

Veneering

Made of porcelain, a veneer recreates the appearance of a new tooth. Also known as laminating, it’s like a slip cover that fits over the front surfaces of the teeth and has both functional and aesthetic appeal.

“Cosmetics wise I seem to be doing a lot of whitening and veneering these days,” says Dr. Kwonil Park, DDS, cosmetic and general dentist, Dental Group of Carbondale. “If the stain is inside the teeth, bleaching won’t get it all. In that case, veneering and capping helps.”

A conservative, minimally invasive procedure, Park says all it involves is polishing the tooth surface, where he’s putting the porcelain in.

One important aspect of smile design is the relationship between the ends of the tooth to the lip, says Hughes. From our teenage years to our 20’s, our teeth usually don’t display much wear. But as we grow older, the teeth start to wear out, just like the bottom of our shoe sole.

While the amount of wear depends on our diet, usage, genetics and personal habits, the teeth are slowly not displayed as much in our smile as we age. “For example, say your tooth was about 10 mm long when you were 18, by the time you reach 45 years of age, it may be down to about 9 mm in length,” says Hughes. “With porcelain veneers, we can rebuild how the teeth should look and give a person back their original smile.”

“You can also cross over and put veneers on teeth that have minor tooth crowding,” says Hughes. “It all really depends on the individual case.”

Gummy Smiles

Since the teeth and the gums are part of the portrait framed by the lips, diseased, discolored or too much of gum tissue on display, can take away from the aesthetic appeal of the smile.

A gummy smile, which is also known as the gingival smile line or high smile line commonly provokes strong concern from clinicians. When a person has a gummy smile, the anterior (front) teeth look like baby teeth, since the gum covers up a lot of the tooth, says Park.

“If the problem is caused by excessive gum covering the teeth, a procedure called crown lengthening can be done, where we fully expose the entire crown” says Childers.

The gum area is then reshaped in a procedure called a gingivectomy, using a conventional scalpel, radiosurgery or lasers.

Conventional Scalpel: For more radical removals of gum tissue, the conventional scalpel method works great, even if it can be a bit on the bloody side, which makes visualization challenging for the dentist.

Radiosurgery: Using an electric current, the doctor cauterizes minute pieces of loose, diseased gum tissue and gets rid of pockets between the teeth and gums in order to achieve a sculpted gum.

“I have a radiosurgery unit and I can tell you this: the procedure is very effective with minimal bleeding,” says Hughes. “Visualize a sculptor gently and skillfully sculpting a sphere out of a piece of chalk. A gingivectomy is essentially an artistic kind of light application for sculpting gum tissue and I love it because it feels so creative.”

Lasers: Used in various ways in general dentistry for the past five to 10 years, “The laser started being widely used in orthodontics only about three years ago,” says Childers, who has over 16 years of practice under his belt.

The only one offering a laser gingivectomy in the Southern Illinois region, at present, Childers says the laser is great because it only works on gum tissue and doesn’t damage the teeth.

After painting a topical anesthetic on the gum tissue and measuring the amount that needs removal, Childers uses a diode laser to vaporize the unwanted gum tissue in small increments of about half a millimeter at a time.

“It’s less invasive, has hardly any bleeding and has no pain associated with it at all,” says Childers.

While some people just get a laser gingivectomy done, Childers says he’s used it in combination with other treatments with great success amongst his patients. For example, he adjusted the smile line of a young girl over a period of time.

The patient went through two phases of orthodontic treatment at first: slowing down the downward growth of her top jaw using headgear designed to restrict growth for one whole year, waiting two years for her permanent teeth to emerge and then using braces to push up her front teeth for a year.

“The final piece of the puzzle was the laser,” says Childers.

Getting the Tom Cruise smile!

Since there are very few of us out there that don’t want a good smile or value the way we look, modern dentistry comes to our rescue with several tools and techniques designed to restore teeth to their natural, gleaming beauty.

“Many people come to me and say ‘I want to look like Tom Cruise!’” says Park, an ex-New Yorker, who has more than five years of experience in cosmetic dentistry. “What they don’t realize is that his teeth are messed up! His center line is off, mid line is off. They just see how white his teeth are and want to emulate him.”

With increased life spans and better quality of life, Kwonil says many of his patients have a positive outlook. They say, “I may be 60, but my life starts again. Now give me the whitest teeth you can!”

“People are more savvy today,” declares Childers who has many patients coming into his office having already researched procedures they want done on the internet. “They know what they want and will ask for it. Of course it’s up to us to determine if it’s the treatment they actually need!”

The Big Picture

With the boom in cosmetic surgery, anti-aging products, weight loss procedures and body-beautiful therapies, is it any wonder that improving and redesigning your very smile is taking top priority on many people’s lists?

“Everyone is so focused on having pearly whites, that they forget the bigger picture,” says Rhonda DeMattei, RDH, Ph.D., assistant professor of dental hygiene, Southern Illinois University, Carbondale. “The focus needs to be on oral health, hygiene and general wellness. What’s the point if you have a nice smile, but still have gum disease?”

DeMattei admits that people possibly feel better about themselves, with an increase in self esteem, when they finally have a smile they are proud of. But she fears our society over-emphasizes the importance of a perfect smile and sacrifices the emphasis on dental health.

“It all goes back to our social expectations,” says DeMattei. “With big businesses setting the standards, you always see models with the perfect smile, if you open any magazine or switch on the TV.” The model then becomes the icon for beauty that everyone wants to emulate on a sub-conscious level.

DeMattei warns that there is a fine line between what’s necessary and what the media and dental companies are pushing as perfect. “But on the other hand, thank goodness there are dentists who can give the patient whatever they want, be it veneers, bleaching, straightening teeth or just redesigning the way you smile,” says DeMattei.

NobleDentist recently added several new dental care articles to assist you.

Simply click on any of the links below to peruse that article.

1. Eating Habits that Can Harm Teeth


2. Endodontic Treatment – Root Canal Treatment


3. Fillings – When Do They Need Replacing?


4. Fluoride – Nature’s Cavity Fighter


5. Gum Disease – Periodontal Disease – Gingivitis – Periodontitis


6. Healthy Mouth, Healthy Body


7. Oral Health and Diabetes


8. Oral Health and Medications


9. Oral Health and Methamphetamine Use


10. Mouthguards – Keeping Your Teeth Safe

To learn how to save hundreds and even thousands of dollars at the dentist, click on NobleDentist.

This is an article published recently by the Academy of General Dentistry.

(This is an American article – spelling and statistics are specific to America.)

More than 32 million adults are at risk of dry mouth, or xerostomia, caused mainly by prescription and over-the-counter drug products. Dry mouth can lead to extensive decay, serious oral infections and make it difficult to swallow and speak. More than 80 percent of patients complain about dry mouth and dry mouth symptoms per week, according to a recent online member poll conducted by the Academy of General Dentistry (AGD).

To help the public better understand dry mouth as well as find the most effective treatment, the AGD developed a new print public service announcement (PSA) intended to raise awareness about the causes and consequences of dry mouth. The AGD also developed a special section on its Web site, www.agd.org, which provides free tools the public can use to learn more about this very serious issue.

“Our profession and our members continue to see an increase of cases of this condition due to a rise in medication consumption by the public,” says AGD President Bruce DeGinder, DS, MAGD. “We want to educate the public that more than 400 prescriptions and over-the-counter drugs are known to cause dry mouth and that their general dentist can help provide solutions to this problem.”

Dry mouth is caused by a decrease in the amount of saliva in the mouth when the salivary glands do not work properly. The salivary glands help keep the mouth moist, which helps prevent decay and other oral health problems.

Many medications, prescription and over-the-counter, may decrease saliva flow and they can contribute to symptoms associated with dry mouth. The most common troublemakers are anti-hypertensives, anti-depressants, painkillers, tranquilizers, diuretics, and antihistamines. Dry mouth can cause extensive tooth decay, even in people who have had a healthy mouth for years, and it contributes to many other oral health problems. Dry mouth may be a sign of a serious health condition or may occur when a person is upset or experiences stress.

“The PSA educates the public that their general dentist can help identify medications that may be responsible for causing dry mouth,” says Cindy G. Bauer, DDS, MAGD, chair of the AGD’s Council on Public Information. “They may recommend home remedies such as sucking on ice chips, sucking on sugar-free hard candy or chewing gum and rinsing with a mixture of baking soda and water.”

A new University of Kentucky study indicates that pregnant women can safely visit the dentist during the second and third trimesters of pregnancy. The study, published on 2 November 2006 in The New England Journal of Medicine (NEJM), was designed to evaluate the effectiveness of treating periodontal disease to reduce the risk of pre-term birth.

The study, “Treatment of Periodontal Disease and the Risk of Preterm Birth,” is the largest clinical trial to date to evaluate whether treating periodontal disease during pregnancy reduces a woman’s risk of early delivery. While the study did not prove that oral treatment impacted the risk of pre-term birth, it did provide evidence that receiving dental care during the second or third trimester of pregnancy is safe.

UK researchers Dr. John Novak, professor and associate director of the College of Dentistry’s Center for Oral Health Research, and Dr. James Ferguson, professor and chair, UK College of Medicine Department of Obstetrics and Gynecology, teamed with other researchers to study the connection between maternal periodontal disease and increased risk of preterm birth and low birth weight.

In the United States, more than one-half million – or about one in eight – babies are born prematurely, which is defined as a birth that occurs before 37 weeks of pregnancy. Extremely preterm babies can be so small and underdeveloped that they must remain hospitalized for months, and, if they survive, spend years battling chronic health problems.

“Kentucky has some of the highest levels of preterm birth and periodontal disease in the nation and we hoped that this study would impact both conditions,” said Novak.

“Periodontal disease and preterm delivery share many common risk factors with an increased incidence in certain races and ethnic groups, in individuals with lower socio-economic status, in individuals that smoke, and in individuals that receive minimal professional care.”

This was the first National Institutes of Health (NIH) funded, multi-center, prospective, fully randomized study to explore this topic. Until now, little research had been conducted, although dentists generally provide limited dental care to women only during the second trimester when the fetus has reached a more stable developmental stage and before treatment becomes too physically cumbersome for the mother.

“We were thrilled that this study was published in what is arguably the most respected medical journal in the world and think it was terrific that pregnant women from the Commonwealth of Kentucky were able to participate in this very important NIH sponsored clinical investigation,” Ferguson said. “These facts reflect very favorably on the quality of the clinical research that is being conducted at the University of Kentucky. Moreover, these research findings provide important and practical answers to physicians and dentists across the nation as they care daily for pregnant women in their practices.”

Novak and Ferguson contend that there is a relationship between periodontal disease and obstetrical complication, although the answer is still not yet known.

“Dr. Novak and I have already initiated continued collaborative research into modifying oral, behavioral and obstetrical risk factors as part of a new March of Dimes initiative to reduce preterm birth in Kentucky,” Ferguson said. “We believe that we will ultimately be able to impact the growing problem of preterm birth in Kentucky and provide for a healthy future for all of our children.”

This is an article by Gary Grasso that appeared recently in the Pasadena Star-News.

Robert Paige hates going to the dentist. So, he doesn’t go.
“I had a bad experience in high school,” said Paige, a 34-year-old auto service technician.

“I broke some of my teeth playing sports and had to have two root canals, which were done without anesthesia.”

Paige has a relatively common phobia: the fear of visiting the dentist, or “dentophobia.” Paige’s dental health and possibly even his physical health have been affected because of his phobia.

According to the American Dental Association, about 30 to 40 million Americans have some degree of “dentophobia”.

Many people, like Paige, blame traumatic experiences when they were children for their dental phobias.

But dental work can be put off only so long, and adults are faced with extensive work to repair problems that have been neglected over the years.

But it doesn’t mean the fear is gone.

New Techniques

To help these patients, some dentists are bringing the techniques for IV sedation that hospitals use into the dental office.

Among them is Dr. David R. Wyndhamsmith at Pasadena Dental Care, who also is an anesthesiologist.

“I’m 50 years old and I still get sick before a dental appointment.

Afterwards, my neck and shoulders ache from so much tension while in the chair – the actual procedures are nothing compared to my mental torture. To me, it’s the idea of fingers, metal, scraping, digging, drilling in my mouth that really scares me”

The term “I.V.” refers to the use of drugs delivered intravenously. Using an IV pump that delivers non-barbiturate-based sedatives, the dentist can bring patients to a state where they don’t hear or feel anything, yet they are breathing on their own.

The IV system allows the dentist to monitor and adjust the level of drugs more precisely than by other methods. By using non-barbiturate medications, patients can be awakened more quickly and can go home from the office fully awake, without the usual grogginess and nausea of traditional IV anesthesia.

So-called “Twilight” dentistry uses pills or gas to produce grogginess, but the patient is still awake.

IV sedation dentistry benefits patients who are phobic, people with allergies to barbiturate-based sedatives, and children who can’t sit still or cooperate.

Some patients who request IV sedation are not necessarily phobic, Wyndhamsmith said.

“They want to save time,” he said. “Most, if not all cosmetic and dental problems can be addressed while the patient is asleep, there is no need to return for multiple visits, having a little done each time.”

Paige had a root canal, three crowns, three fillings and cleaning, all done while under IV sedation.

“When I learned about this option, I jumped on it, because it’s the only way I would ever get my teeth taken care of,” Paige said.

Some patients who have dental procedures done under IV sedation are gradually able to go back to having regular dental care, including patients who have procedures done under general anesthesia oral sedation or gas.

Causes of Dental Phobias

Dental phobias and anxiety stem from various sources.

These can lead to a strongly conditioned fear response.

The following are the most common origins of dental fear:

• Previously painful or negative experiences during visits to a dentist’s office. This can even include careless comments made by a dentist or hygienist during a past examination.
• A severe discomfort with feeling helpless and/or out of control in the dental situation.
• A sense of embarrassment of dental neglect and fear of ridicule or belittlement at the dental office.
• Scary anecdotes of negative dental experiences related by family and friends. n Negative, menacing portrayals of dentists in movies, TV, newspapers and magazines.
• A sense of depersonalization in the dental process, intensified by today’s necessity for the use of barrier precautions, such as masks, latex gloves and shields.
• A general fear of the unknown.

The Process

Many dental fears can be attributed to either past negative experiences or a fear of the unknown.

Most people can overcome these fears by becoming comfortable with their dentist and familiarizing themselves with the procedures and instruments that will be used in each treatment. During the first appointment, the phobic patient should discuss his or her fears with the dentist and review the treatment plan that the dentist recommends.

Patients who fear a specific part of dental treatment, for example, fear of the drill, should ask the dentist to let them have a look and listen to the drill first.

It often helps to get used to things before the treatment begins.

Phobic patients can also arrange to use a pre-arranged signal for their dentists to stop if they feel pain or discomfort during a procedure.

This helps to build trust in the dentist and provides the patient with a feeling of control.

Once the patient’s fears are brought under control, subsequent visits should be scheduled relatively close together to help the patient reinforce and maintain his or her comfort level.

Working together, the dentist and patient can develop a relationship that can encourage good dental health and habits.

NobleDentist recently added several new dental health articles to assist you.

Simply click on any of the links below to peruse that article.

1. Basic Oral Care


2. Bisphosphonate Medications and Your Oral Health


3. Bottled Water and Oral Health


4. Burning Mouth Syndrome


5. Buying Oral Care Products


6. Canker Sores and Cold Sores


7. Cracked or Broken Tooth


8. Dental Sealants – Protecting Your Teeth


9. Diet and Tooth Decay


10. Dry Mouth – Xerostomia

To learn how to save hundreds and even thousands of dollars at the dentist, click on NobleDentist.

This is an article published recently by Andrew Bridges of The Associated Press.

WASHINGTON - Government health advisers have questioned a federal report concluding that the mercury-laden amalgam dentists use to fill cavities is safe.

Meanwhile, consumer activists pressed for at least a partial ban on the silver dental fillings, as they expose patients to toxic mercury.

The Food and Drug Administration asked a joint panel of outside advisers to decide whether the study – a review of 34 recent research studies – reflects current knowledge about the risks associated with the fillings.

Meeting Thursday, panel members and consultants didn’t discuss a potential ban, but did say the report fell short of expectations.

“Just by looking at this paper, we are in a sense really limiting ourselves. I am not convinced we are doing justice to the topic at hand,” said Michael Aschner, a professor of pediatrics and pharmacology at Vanderbilt University and a panel consultant.

The study found “no significant new information” that would change the FDA’s earlier determination that mercury-based fillings don’t harm patients, except in rare cases where they have allergic reactions.

Mississippi dentists, reached on Thursday, said they normally use amalgam fillings containing mercury and find no cause for alarm.

“It’s a good, economical filling,” said Dr. Sherry Gwin, who has been practicing in Pearl for 20 years and is familiar with the debate. “I have never read a reputable study that found it toxic in the amounts we use.”

Gwin estimated that she had placed about 12,000 amalgam fillings in her career while also offering alternatives.

Dr. Jennifer Ray, a Biloxi dentist who has been seeing patients for five years, said she follows the American Dental Association’s guidelines, which have been repeatedly tested for safety.

“It becomes a personal choice for the patient,” she said. “I use composite and amalgam. I discuss it with patients and let them decide.”

Consumer groups opposed to the use of mercury in dentistry dispute the conclusion that amalgam does not harm patients. The groups petitioned the FDA earlier in the week for an immediate ban on the cavity-filler in pregnant women.

“Do the right, decent, honorable and God-loving thing: There needs to be an immediate embargo on mercury fillings for everyone, or at least pregnant women and children, because they are our future,” said Michael Burke, who blamed mercury fillings for the early onset of Alzheimer’s disease in his wife, Phyllis, in 2004.

The FDA review falls short because it doesn’t lay out what questions about the safety of mercury fillings remain to be answered, said panel member Dr. Larry Goldstein, a Duke University professor of medicine.

Amalgam fillings, also called silver fillings, by weight are about 50 percent mercury, joined with silver, copper and tin. Dentists have used amalgam to fill cavities since the 1800s.

Today, tens of millions of Americans receive mercury fillings each year. Amalgam use has begun to taper off, though, with many doctors switching to resin composite fillings that blend better with the natural coloring of teeth.

However, such “cosmetic” fillings can’t always be substituted for amalgam, including in cases where dentists have to place large fillings in the back teeth, Dr. Ronald Zentz, of the ADA, said in a recent interview.

Dentist Howard Bailit said he and his colleagues at the University of Connecticut studied the impact of a ban on mercury fillings and found it would increase costs, reduce the number of cavities filled and have an overall negative effect on oral health.

“Our recommendation is, do not ban the use of dental amalgams,” Bailit said.

With amalgam fillings, mercury vapor is released when patients chew and brush their teeth. Significant levels of mercury exposure can cause permanent damage to the brain and kidneys. Fetuses and children are especially sensitive to its harmful effects.

Scientists have found that mercury levels in the blood, urine and body tissues rise the more mercury fillings a person has. However, even among people with numerous fillings, exposure levels are well below those known to be harmful, the FDA report said.

Dr. Roger Porter, an industry representative on one of the two panels, called the study “very deficient” because it didn’t address how the human body absorbs, distributes, processes and eliminates mercury.

NobleDentist recently added several new oral health articles to assist you.

Simply click on any of the links below to peruse that article.

1. Brides and their Smiles


2. Dental Implants – An Option for Replacing Missing Teeth


3. Dental Sealants – Protecting Your Teeth


4. Dental Veneers – Improving Your Smile with Dental Veneers


5. Tooth Coloured Fillings – White Fillings


6. Anesthesia & Visiting a Dentist


7. Antibiotics Before Dental Treatment


8. Baby Bottles to Cups


9. Baby’s First Teeth


10. Back-to-School Dental Check-Up

To learn how to save hundreds and even thousands of dollars at the dentist, click on NobleDentist.