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Posts for category: Oral Health

ThinkTwiceBeforeYouUndergoBotoxTreatmentforChronicJawPain

There's still much about the underlying nature of chronic jaw joint dysfunction we have yet to unravel. Treating these conditions known as temporomandibular joint disorders (TMDs) may therefore require some experimentation to find what works for each individual patient.

Most TMD therapies are relatively conservative: eating softer foods, taking anti-inflammatory pain relievers or undergoing physical therapy. There have been some surgical techniques tried to relieve jaw pain and dysfunction, but these have so far had mixed results.

Recently, the use of the drug Botox has been promoted for relieving jaw pain, albeit temporarily. Botox contains tiny amounts of botulinum toxin type A, a poisonous substance derived from the bacterium Clostridium botulinum, which can cause muscle paralysis. It's mainly used to cosmetically smooth out small wrinkles around facial features.

Because of these properties, some physicians have proposed Botox for TMD treatment to paralyze the muscles around the jaw to reduce pain and discomfort. While the treatment sounds intriguing, there are a number of reasons to be wary of it if you have TMD.

To begin with, the claims for Botox's success in relieving jaw pain have been mainly anecdotal. On the other hand, findings from randomized, double-blind trials have yet to show any solid evidence that Botox can produce these pain-relieving effects.

But even if it lived up to the claims of TMD pain relief, the effect would eventually fade in a few weeks or months, requiring the patient to repeat the injections. It's possible with multiple Botox injections that the body will develop antibodies to fight the botulinum toxin, causing the treatment to be less effective with subsequent injections.

Of even greater concern are the potential side effects of Botox TMD treatment, ranging from headaches and soreness at the injection site to more serious muscle atrophy and possible facial deformity from repeated injections. There's also evidence for decreased bone density in the jaw, which could have far-reaching consequences for someone with TMD.

The best approach still seems to lie in the more conservative therapies that treat TMD similar to other joint disorders. Finding the right combination of therapies that most benefit you will help you better manage your symptoms.

If you would like more information on treatments for TMD, 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 “Botox Treatment for TMJ Pain.”

WhatWeCanLearnFromThoseWithChronicJawPainandDiscomfort

Temporomandibular joint disorder (TMD) is an umbrella term for a number of chronic jaw problems. These conditions cause recurring pain for 10 to 30 million Americans, especially women of childbearing age.

But even after decades of treatment and research, a full understanding of TMD's underlying causes eludes us. That doesn't mean, however, that we haven't made progress—we have indeed amassed a good deal of knowledge and experience with TMD and how best to treat it.

A recent survey of over a thousand TMD patients helps highlight the current state of affairs about what we know regarding these disorders, and where the future may lie in treatment advances. Here are a few important findings gleaned from that survey.

Possible causes. When asked what they thought triggered their TMD episodes, the top answers from respondents were trauma, stress and teeth clenching habits. This fits in with the consensus among experts, who also include genetic disposition and environmental factors. Most believe that although we haven't pinpointed exact causes, we are over the target.

Links to other disorders. Two-thirds of survey respondents also reported suffering from three or more other pain-related conditions, including fibromyalgia, rheumatoid arthritis and chronic headaches. These responses seem to point to possible links between TMD and other pain-related disorders. If this is so, it could spur developments in better diagnostic methods and treatment.

The case against surgery. Surgical procedures have been used in recent years to treat TMD. But in the survey, of those who have undergone surgery only one-third reported any significant relief. In fact, 46% considered themselves worse off. Most providers still recommend a physical joint therapy approach first for TMD: moist heat or ice, massage and exercises and medications to control muscle spasms and pain.

These findings underscore one other important factor—there is no “one size fits all” approach to TMD management. As an individual patient, a custom-developed action plan of therapy, medication, and lifestyle and diet practices is the best way currently to reduce the effects of TMD on your life.

If you would like more information on TMD management and treatment, 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 “Chronic Jaw Pain and Associated Conditions.”

YouDontNeedtoPassaFootballLikePatrickMahomestoRemoveaLooseBabyTooth

Kids get pretty inventive pulling a loose primary (baby) tooth. After all, there's a profit motive involved (aka the Tooth Fairy). But a young Kansas City Chiefs fan may have topped his peers with his method, revealed in a recent Twitter video that went viral.

Inspired by all-star KC quarterback Patrick Mahomes (and sporting his #15 jersey), 7-year-old Jensen Palmer tied his loose tooth to a football with a line of string. Then, announcing “This is how an MVP gets their tooth out,” the next-gen QB sent the ball flying, with the tooth tailing close behind.

It appears young Palmer was no worse for wear with his tooth removal technique. But if you're thinking there might be a less risky, and less dramatic, way to remove a loose tooth, you're right. The first thing you should know, though: Primary teeth come out when they're good and ready, and that's important. Primary teeth play an important role in a child's current dental and speech function and their future dental development. For the latter, they serve as placeholders for permanent teeth developing within the gums. If one is lost prematurely, the corresponding permanent tooth might erupt out of position and cause bite problems.

In normal development, though, a primary tooth coming out coincides closely with the linked permanent tooth coming in. When it's time, the primary tooth lets you know by becoming quite loose in the socket.

If you think one of your children's primary teeth is ready, clean your hands first with soap and water. Then using a clean tissue, you should be able to easily wiggle the tooth with little tension. Grasp the tooth with the tissue and give it a little horizontal twist to pop it out. If that doesn't work, wait a day or two before trying again. If it does come out, be sure you have some clean gauze handy in case of bleeding from the empty socket.

Normally, nature takes its course from this point. But be on the lookout for abnormal signs like fragments of the tooth left behind in the socket (not to be mistaken for the top of the permanent tooth coming in). You should also look for redness, swelling or complaints of pain the following day—signs of possible infection. If you see anything like this, make a prompt appointment so we can take a look. Losing a primary tooth is a signpost pointing the way from childhood to adulthood (not to mention a windfall for kids under their pillows). You can help make it a smooth transition—no forward pass required.

If you would like more information about caring for primary teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Importance of Baby Teeth” and “Losing a Baby Tooth.”

TreatingToothSensitivityDependsonItsCause

A scoop of ice cream is one of life's little pleasures. But for one in three Americans, it could be something altogether different—an excruciating pain when cold ice cream meets teeth. This short but painful experience that can happen when dental nerves encounter hot or cold temperatures is called tooth sensitivity.

A look at tooth anatomy will help explain why. Teeth are mainly composed of outer enamel, a layer of nerves and blood vessels within the tooth called the pulp, and dentin, a porous layer in between. The pulp nerves pick up temperature and pressure sensations from outside the teeth through a network of tiny passageways (tubules) in the dentin. Enamel muffles these sensations before traveling the tubules, which prevents overstimulation of the nerves.

This careful balance can be disrupted, however, if the enamel becomes eroded by acid from foods or beverages, or as a byproduct of bacteria. This exposes the underlying dentin to the full brunt of outward sensations, which can then impact the nerves and cause them to overreact.

This hyper-sensitivity can also occur around the tooth roots, but for a different reason. Because the gums primarily protect this area rather than enamel, the roots can become hyper-sensitive if they lose gum coverage, a condition known as gum recession caused mainly by gum disease or over-aggressive hygiene.

Besides using dental products that block nerve sensation, reducing sensitivity largely depends on addressing the underlying cause. If gum disease, the focus is on removing plaque, a bacterial film on dental surfaces that causes and sustains the disease. Stopping an infection allows the gums to heal and hopefully regain their original teeth coverage. More advanced cases, though, may require grafting surgery to foster gum regeneration.

If the cause is enamel erosion or other results of decay or trauma, we can utilize a number of treatments depending on the extent of tooth damage including cavity filling, root canal therapy or crowning. As a last resort, we may need to remove a tooth that's beyond reasonable repair.

If you've begun to experience sensitive teeth, it's important that you see us as soon as possible. The earlier we can diagnose the cause, the less invasive we can be with treatments to ease or even stop this most unpleasant experience.

If you would like more information on tooth sensitivity, 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 “Treatment of Tooth Sensitivity.”

Regular check-ups with your dentist can maintain your oral health and catch potential concerns, including oral cancer. Prevention and early treatment is key in managing this condition. Dr. Chad Slocum and Dr. Sara Lundgaard serve the Millcreek, WA, area at Penny Creek Family & Implant Dentistry, offering routine oral cancer screenings.

What are some warning signs of oral cancer?

  • Difficulty swallowing
  • Inflamed, red patches in the mouth
  • White sores or lesions
  • Dramatic weight loss
  • Loose teeth or tooth loss
  • Heaviness at the back of the throat
  • Bleeding that comes and goes
  • Changes in the voice
  • Chronic hoarseness
  • Having a hard time moving the structures of the mouth, like the tongue, jaw and cheeks
  • Swelling

Since the mouth heals quickly, lesions or sores in the mouth should generally not take more than two weeks to heal. If your mouth has a growth, bump, or lump that will not go away, contact your dentist as soon as possible.

How can I examine myself at home before my appointment?

  • Lift your tongue and check for any discolorations or changes in the texture of your tongue.
  • Examine your lips and cheeks for any lumps
  • Push two fingers down on the underside of the tongue. At the same time, push two other fingers up underneath the chin. Check to see if there are any bumps or changes in your chin.
  • Check the palate of your mouth with your fingers to ensure it is smooth and lesion-free.
  • Gently massage your neck to make sure your lymph nodes are not swollen

Have you been looking for signs but you are unsure about the result of your home test? No need to panic. Contact Dr. Lundgaard and Dr. Slocum at Penny Creek Family & Implant Dentistry in Millcreek, WA, at (425) 337-7300 to schedule a consultation.

4TipsforHelpingaSeniorAdultKeepTheirOralHealth

By the time a person passes the half-century mark, they've done quite a bit of living: their share of ups and downs, successes and failures, and joys and sorrows. But while aging can take its toll on their physical and cognitive health, older adults still have much to offer from their life experience. It often falls to other family members to keep them in the best health possible—including their oral health.

Helping an older adult maintain healthy teeth and gums is crucial to their overall well-being. So in recognition of Older Americans Month in May, here are 4 tips for helping an older family member keep a healthy mouth.

Support their daily hygiene. Age-related physical and cognitive impairment can make the simple tasks of brushing and flossing much more difficult. You can help by providing an older family member with tools that make it easier for them to clean their teeth, like larger handled toothbrushes or water flossers. In some cases, you may have to perform their hygiene tasks for them, but it's worth the effort to reduce their risk of dental disease.

Watch for "dry mouth." If an older person complains of their mouth being constantly dry, take it seriously. Chronic dry mouth is a sign of not enough saliva, which could make them more prone to dental disease. The likely culprits, especially for older adults, are prescription medications, so speak with their doctor about alternatives. You can also encourage them to use saliva boosters or to drink more water.

Ask for oral cancer screens. Ninety percent of oral cancer occurs in people over the age of 40, with the risk increasing with age. Be sure, then, to ask for an oral cancer screen during their dental visits, presuming it's not already being done. Screenings usually involve visual and tactile examinations of the inside of the mouth and the sides of the neck, looking for unusual lesions, swelling or discolorations. The sooner oral cancer is found, the better the chances of a successful treatment outcome.

Have dental work checked. An older person may have acquired various forms of dental work like bridges, implants or removable dentures. Because these play an important role in their oral health, you should have their dental work checked routinely. This is particularly true for dentures, which can lose their fit and comfort over time. Dental work in need of repair makes dental function more difficult and can increase their risk of disease.

Given the depth of responsibility in caring for an older adult, it's easy to let some things slip by the wayside. Their oral health shouldn't be one of them—giving it the priority it deserves will pay dividends in their health overall.

If you would like more information about oral care for an older adult, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Aging & Dental Health” and “Dry Mouth.”

EatingtheRightKindofCarbsCanHelpYouAvoidGumDisease

There are great health benefits to eating better, including for your teeth and gums. But to determine your ideal diet, you'll have to come to terms with carbohydrates, the sugars, fiber and starches found in plants or dairy products that convert to glucose after digestion.

Carbohydrates (also known as carbs) are important because the glucose created from them supplies energy and regulates metabolism in the body's cells. But they can also create elevated spikes of glucose in the bloodstream that can cause chronic inflammation. Besides conditions like diabetes or heart disease, chronic inflammation also increases your risk of periodontal (gum) disease, a bacterial infection arising from dental plaque.

Many concerned about this effect choose either to severely restrict carbs in their diet or cut them out altogether. But these hardline approaches deprive you of the benefits of carbs in maintaining good health. There's a better way—and it starts with understanding that not all carbs are the same. And, one difference in particular can help you properly manage them in your diet.

Here's the key: Different carbs convert to glucose at different digestive rates of speed measured on a scale known as the glycemic index. Carbs that digest faster (and are more apt to cause glucose spikes in the bloodstream) are known as high glycemic. Those which are slower are known as low glycemic.

Your basic strategy then to avoid blood glucose spikes is to eat more low glycemic foods and less high glycemic. Foods low on the glycemic index contain complex, unrefined carbohydrates like most vegetables, greens, legumes, nuts or whole grains. High glycemic foods tend to be processed or refined with added sugar like pastries, white rice, or mashed potatoes.

Low glycemic foods also tend to have higher amounts of minerals and nutrients necessary for healthy mouths and bodies. And fresh vegetables in particular often contain high amounts of fiber, which slows down the digestion of the accompanying carbohydrates.

Eating mainly low glycemic foods can provide you the right kinds of carbs needed to keep your body healthy while avoiding glucose spikes that lead to inflammation. You're also much less likely to experience gum disease and maintain a healthy mouth.

If you would like more information on nutrition and dental health, 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 “Carbohydrates Linked to Gum Disease.”

DontEatMotorizedCornontheCobandOtherDentalSafetyTips

We're all tempted occasionally to use our teeth in ways that might risk damage. Hopefully, though, you've never considered anything close to what singer, songwriter and now social media persona Jason Derulo recently tried in a TikTok video—attempting to eat corn on the cob spinning on a power drill. The end result seemed to be a couple of broken front teeth, although many of his followers suspected an elaborate prank.

Prank or not, subjecting your teeth to “motorized corn”—or a host of other less extreme actions or habits—is not a good thing, especially if you have veneers, crowns or other dental work. Although teeth can withstand a lot, they're not invincible.

Here, then, are four things you should do to help ensure your teeth stay healthy, functional and intact.

Clean your teeth daily. Strong teeth are healthy teeth, so you want to do all you can to prevent tooth decay or gum disease. Besides semi-annual dental cleanings, the most important thing you can do is to brush and floss your teeth daily. These hygiene tasks help remove dental plaque, a thin biofilm that is the biggest culprit in dental disease that could weaken teeth and make them more susceptible to injury.

Avoid biting on hard objects. Teeth's primary purpose is to break down food for digestion, not to break open nuts or perform similar tasks. You should also avoid habitual chewing on hard objects like pencils, nails or ice to relieve stress. And, you may need to be careful eating apples or other foods with hard surfaces if you have veneers or composite bonding on your teeth.

Wear a sports mouthguard. If you or a family member are regularly involved with sports like basketball, baseball/softball or football (even informally), you can protect your teeth from facial blows by wearing an athletic mouthguard. Although you can obtain a retail variety in most stores selling sporting goods, a custom-made guard by a dentist offers the best protection and comfort.

Visit your dentist regularly. As mentioned before, semi-annual dental cleanings help remove hidden plaque and tartar and further minimize your risk of disease. Regular dental visits also give us a chance to examine your mouth for any signs of decay or gum disease, and to check on your dental health overall. Optimizing your dental health plays a key part in preventing dental damage.

You should expect an unpleasant outcome involving your teeth with power tools. But a lot less could still damage them: To fully protect your dental health, be sure you practice daily oral care, avoid tooth contact with hard objects and wear a mouthguard for high-risk physical activities.

If you would like more information on caring for your cosmetic dental work, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Porcelain Veneers” and “An Introduction to Sports Injuries & Dentistry.”

ANewDentalPainManagementApproachReducestheNeedforNarcotics

Narcotics have long played an important role in easing severe pain caused by disease, trauma or treatment. Healthcare professionals, including dentists, continue to prescribe them as a matter of course.

But narcotics are also addictive and can be dangerous if abused. Although addictions often arise from using illegal drugs like heroin, they can begin with prescriptive narcotics like morphine or oxycodone that were initially used by patients for legitimate reasons.

As a result, many healthcare providers are looking for alternatives to narcotics and new protocols for pain management. This has led to an emerging approach among dentists to use non-addictive non-steroidal anti-inflammatory drugs (NSAIDs) as their first choice for pain management, reserving narcotics for more acute situations.

Routinely used by the public to reduce mild to moderate pain, NSAIDs like acetaminophen, ibuprofen or aspirin have also been found to be effective for managing pain after many dental procedures or minor surgeries. NSAIDs also have fewer side effects than narcotics, and most can be obtained without a prescription.

Dentists have also found that alternating ibuprofen and acetaminophen can greatly increase the pain relief effect. As such, they can be used for many more after-care situations for which narcotics would have been previously prescribed. Using combined usage, dentists can further limit the use of narcotics to only the most severe pain situations.

Research from the early 2010s backs up this new approach. A study published in the Journal of the American Dental Association (JADA) concluded that patients receiving this combined ibuprofen/acetaminophen usage fared better than those only receiving either one individually. The method could also match the relief power of narcotics in after care for a wide range of procedures.

The NSAID approach is growing in popularity, but it hasn't yet displaced the first-line use of narcotics by dental professionals. The hesitancy to adopt the newer approach is fueled as much by patients, who worry it won't be as adequate as narcotics to manage their pain after dental work, as with dentists.

But as more patients experience effective results after dental work with NSAIDs alone, the new approach should gain even more momentum. And in the end, it promises to be a safer way to manage pain.

If you would like more information on dental pain management, 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 “Are Opioids (Narcotics) the Best Way to Manage Dental Pain?

AcidRefluxCouldBeDamagingYourTeeth

Your tooth enamel is often under assault from oral acid produced by bacteria and certain foods. Unless neutralized, acid can erode your enamel, and lead to destructive tooth decay.

But there's another type of acid that may be even more destructive—the acid produced in your stomach. Although important for food digestion, stomach acid outside of its normal environment can be destructive. That includes your teeth, if stomach acid finds its way into your mouth. And that can happen if you have gastroesophageal reflux disease (GERD).

GERD, a chronic condition affecting 1 in 5 adults, is caused by the weakening of the lower esophageal sphincter, a ring of muscle at the intersection of the esophagus and the stomach that prevents stomach acid from traveling back into the digestive tract and damaging the esophageal liner.

It's also possible for stomach acid to travel as far up as the mouth. With a pH of 2.0 or less, stomach acid can lower the mouth's normal pH level of 7.0 well below the 5.5 pH threshold for enamel softening and erosion. This can cause your teeth, primarily the inside surfaces of the upper teeth, to become thin, pitted or yellowed. Your teeth's sensitivity may also increase.

If you have GERD, you can take precautions to avoid tooth damage and the extensive dental work that may follow.

  • Boost acid buffering by rinsing with water (or a cup of water mixed with a ½ teaspoon of baking soda) or chewing on an antacid tablet.
  • Wait about an hour to brush your teeth following a reflux episode so that your saliva has time to neutralize acid and re-mineralize enamel.
  • If you have chronic dry mouth, stimulate saliva production by drinking more water, chewing xylitol gum or using a saliva supplement.

You can also seek to minimize GERD by avoiding tobacco and limiting your consumption of alcohol, caffeine or spicy and acidic foods. Your doctor may also prescribe medication to control your GERD symptoms.

Preventing tooth decay or gum disease from the normal occurrences of oral acid is a daily hygiene battle. Don't let GERD-related acid add to the burden.

If you would like more information on protecting your teeth from acid reflux, 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 “GERD and Oral Health.”

AreYouatRiskforToothDecayAnswerTheseQuestionsToFindOut

Tooth decay is a destructive disease that could rob you of your teeth. But it doesn't appear out of nowhere—a number of factors can make it more likely you'll get cavities.

But the good news is you can be proactive about many of these factors and greatly reduce your risk of tooth decay. Here are a few questions to ask yourself to point you in the right direction for preventing this destructive disease.

Do you brush and floss every day? A daily habit of brushing and flossing removes buildup of dental plaque, a bacterial film on teeth that's the top cause for tooth decay and periodontal (gum) disease. Hit or miss hygiene, though, can greatly increase your risk for developing a cavity.

Do you use fluoride? This naturally occurring chemical has been proven to strengthen tooth enamel against decay. Many locations add fluoride to drinking water—if your area doesn't or you want to boost your fluoride intake, use toothpastes, mouthrinses or other hygiene products containing fluoride.

Do you smoke? The nicotine in tobacco constricts blood vessels in the mouth so that they provide less nutrients and antibodies to the teeth and gums. Your mouth can't fight off infection as well as it could, increasing your risk of dental diseases like tooth decay.

Do you have dry mouth? This isn't the occasional bout of “cotton mouth,” but a chronic condition in which the mouth doesn't produce enough saliva. Saliva neutralizes mouth acid, so less of it increases your risk for decay. Chronic dry mouth can be caused by medications or other underlying conditions.

Do you snack a lot between meals? Sugary snacks, sodas or energy drinks can increase oral bacteria and acidity that foster tooth decay. If you're snacking frequently between meals, your saliva's acid neutralizing efforts may be overwhelmed. Coordinate snacking with mealtimes to boost acid buffering.

You can address many of these questions simply by adopting a daily habit of brushing and flossing, regular dental cleanings and checkups, and eating a healthy, “tooth-friendly” diet. By reducing the risk factors for decay, you can avoid cavities and preserve your teeth.

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 “Tooth Decay: How to Assess Your Risk.”

FlossinganImplant-SupportedBridgecanPreventaDamagingGumInfection

In recent years, dental implants have helped traditional bridgework take a giant leap forward. A few strategically placed implants can provide the highest support and stability we can currently achieve for this well-known dental restoration.

Implants derive this stability from the bone in which they're imbedded. Once surgically installed, the bone around a metal implant begins to grow and adhere to its titanium surface. Over time, this creates a strong anchor that firmly holds the implant in place.

But the implants' stability can be threatened if the gums around them become diseased. Gum disease, a bacterial infection caused mainly by dental plaque, can advance silently below the gum surface until it ultimately infects the bone. This can cause significant bone loss around an implant, which can weaken it to the point of failure.

To avoid this scenario, it's important to prevent gum disease by flossing daily to remove accumulated dental plaque between the implant-supported bridge and the gums, particularly around the implants. This kind of flossing around bridgework is more difficult than flossing between teeth, but it can be done with the help of a device called a floss threader.

A floss threader is a small plastic hand tool with a loop on one end and a stiffened edge on the other (similar to a sewing needle). You begin by threading about 18" of dental floss through the loop, and then work the other end of the threader between the bridge and gums to the other side.

With the floss threaded between the bridge and gums, you can now remove it from the threader, grasp each end, and floss around the sides of each implant you can reach. You'll then need to repeat the process by removing the floss, rethreading it in the threader and inserting it into the next section between implants, continuing to floss until you've accessed each side of each implant.

You can also use pre-packaged floss thread sections with a stiffened end to facilitate threading. But whichever product you use, it's important to perform this task each day to prevent a gum infection that could rob you of your implant-supported bridge.

If you would like more information on oral hygiene practices with dental work, 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 “Oral Hygiene for Fixed Bridgework.”

EatingtheRightFoodsCanBoostYourEffortstoPreventDentalDisease

You're more apt to lose teeth because of periodontal (gum) disease and tooth decay than any other cause. But neither of these bacterial diseases have to happen: You can prevent them through daily brushing and flossing and twice-a-year dental cleanings.

But that's not all: You can also boost your dental care practices by eating foods that strengthen and protect teeth. On the other hand, a poor diet could reduce the effectiveness of your oral hygiene practices in preventing tooth decay or gum disease.

A diet that might lead to the latter is often high in refined sugar (sucrose), often added to processed foods and snacks to improve taste. But sucrose is also a top food source for oral bacteria, increasing their numbers when it's readily available. A higher bacterial population greatly increases your risk for tooth decay or gum disease.

On the other hand, certain foods benefit your overall dental health. Fresh fruits and vegetables, for example, are filled with nutrients and minerals like vitamin D or calcium that strengthen teeth against disease. And although they can also contain natural sugars, these don't pose the same problems as added sucrose due to the plant fiber you consume with them.

Dairy foods can also help you maintain healthy teeth and gums. Milk and cheese contain minerals like calcium and phosphorus, and a protein called casein, all of which strengthen teeth against decay. The enzymes in cheese stimulate saliva, which in turn neutralizes mouth acid and prevent it from harming enamel.

Some foods are also natural sources of fluoride, a mineral that strengthens tooth enamel. One example is black tea, which also, along with green tea, contains antioxidants that protect against cancer.

The best strategy for “tooth-friendly” nutrition is to pursue a diet that's high in fiber-rich natural foods and low in sugar-added processed foods. In practice, you'll want most of your diet to consist of fresh fruits and vegetables and low-fat dairy food, while minimizing foods with added sugar.

Following this kind of diet will certainly benefit your overall health. But it will also make it easier for you to prevent dental disease and keep your teeth and gums healthy.

If you would like more information on how nutrition can boost your dental health, 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.”

AsAntetokounmpoKnowsEvenanNBAStarCanBeSidelinedbyaToothache

The NBA's reigning MVP Giannis Antetokounmpo may seem unstoppable, but he proved no match for a troubled tooth. Antetokounmpo, the self-proclaimed “Greek Freak,” missed one of the final three 2020 regular season games for a dental issue that resulted in last-minute oral surgery. According to a Milwaukee Bucks spokesperson, the star underwent “a root-canal like procedure.”

Root canal therapy, often simply called “a root canal,” may be needed when there is an infection inside the tooth. When dental pulp becomes inflamed or infected, excruciating pain can result. Pulp is the soft tissue that fills the inside of the tooth. It is made up of nerves, blood vessels and connective tissue. During root canal treatment, the pulp is removed, the space inside the tooth is disinfected, it is filled with a special material, and then the hole is sealed up.

A root canal is nothing to fear. It relieves pain by getting rid of infection and is so effective that over 15 million of them are performed in the U.S. each year. This routine procedure generally requires only local anesthetic, and your mouth should be back to normal within a day or two after treatment. Antetokounmpo can attest to that, as he returned to play the next day.

However, delaying root canal treatment when you need it can have serious consequences. If left untreated, an infection inside the tooth continues to spread, and it may move into the gums and jaw and cause other problems in the body. So, how do you know if you may need a root canal? Here are some signs:

Lingering sensitivity to hot or cold temperatures. One sign of nerve damage inside your tooth is pain that is still there 30 seconds after eating or drinking something hot or cold.

Intense pain when biting down. You may feel pain deep within your tooth, or in your jaw, face or other teeth. The pain may be hard to pinpoint—and even if it improves at times, it usually comes back.

A chipped, cracked or discolored tooth. A chip or crack can allow bacteria to enter the tooth, and the tooth may darken if the tissue inside is damaged.

A pimple on the gum. A bump or pimple on the gum that doesn't go away or keeps coming back may signify that a nearby tooth is infected.

Tender, swollen gums. Swollen gums may indicate an infection inside the tooth or the need for periodontal treatment.

And sometimes there is no pain, but an infection may be discovered during a dental exam.

Tooth pain should never be ignored, so don't put off a dental visit when you have a toothache. In fact, if a bad toothache goes away, it could mean that the nerves inside the tooth have died, but the infection may still be raging. Also, be sure to keep up with your regular dental checkups. We may spot a small problem that can be addressed before it becomes a bigger problem that would require more extensive treatment.

Remember, for dental issues both large and small, we're on your team! If you would like more information about tooth pain, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Tooth Pain? Don't Wait!” and “Root Canal Treatment: What You Need to Know.”

YourDentistCouldHelpYouOvercomeSleepApnea

A full night's sleep isn't a luxury—we all need it for a healthy mind and body. But 50-70 million people in the U.S. aren't getting enough sleep because of a chronic sleep disorder like obstructive sleep apnea (OSA).

OSA happens when a sleeper's airway becomes blocked (most commonly by the tongue), cutting off oxygen to the brain. The body rouses from sleep to overcome the blockage. This awakening could last only a few seconds, after which the person immediately goes back to sleep. But it can occur hundreds of times a night and interrupt deeper sleep needed for a good night's rest.

Sleep disorders like OSA are a significant medical problem that could contribute to serious health issues like high blood pressure or cardiovascular disease. If you're experiencing fatigue, irritability or your family's complaints of you snoring, you should see a physician for diagnosis and treatment options.

You should also consider another health professional who could be helpful in dealing with OSA—and may even be able to provide a treatment option: your dentist. Here's how.

A dentist could discover your OSA. Because of twice-a-year dental visits, dentists often see patients more frequently than other healthcare providers. A properly trained dentist could pick up on signs and symptoms of sleep disorder, including patients falling asleep and even snoring while in the dentist's chair.

Dentists are familiar with the mouth. Few healthcare providers focus on the oral cavity like dentists. Besides the teeth and gums, dentists also have extensive knowledge of the tonsils, uvula and tongue that often play a role in sleep disorders. As such, a dentist may notice abnormalities during routine exams that might contribute to airway obstruction during sleep.

Dentists provide a treatment option. Many OSA patients use a CPAP mask to maintain an open airway during sleep. But CPAP therapy can be uncomfortable for some. For mild to moderate cases of OSA, dentists can create an oral appliance based on the patient's mouth dimensions that prevents the tongue from sinking back into the throat.

If you believe you may have OSA or a similar sleep disorder, by all means speak with your doctor. But also mention it to your dentist—your dental provider might hold the key to a better night's sleep.

If you would like more information on how we could help with your sleep apnea symptoms, 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 “Sleep Disorders & Dentistry.”

LocalAnesthesiaMakesforaMorePleasantandPain-FreeDentalExperience

You know you should see the dentist about that nagging tooth or gum problem, but you keep putting it off. Truth be told, you're a little nervous that your treatment visit might be unpleasant.

In one sense, your concern isn't unreasonable: The teeth and gums abound in nerves that are more than effective in signaling pain. Even minor dental procedures can trigger discomfort. In another sense, though, there's no need to worry, thanks to pain-numbing techniques using local anesthesia.

The term “local” is used because the applied anesthetic only affects the area and surrounding tissues needing treatment. The anesthetic drugs temporarily block nerve electrical impulses from transmitting pain signals to the brain. Unlike general anesthesia, which requires placing a patient in an unconscious state, a patient can be awake, yet feel no sensation around the anesthetized tissue.

Dentists typically use a two-step method to prevent patients from feeling any pain during a procedure. First, they apply a topical local anesthetic to the surface of the gums. Once these top layers have been numbed, they numb the underlying tissues by injecting the anesthetic with a needle. The goal of a topical application is to ensure the patient doesn't feel the prick of the needle used for deep tissue anesthesia.

Dentists follow strict protocols using anesthesia that have been developed over several decades. As a result, local anesthesia has revolutionized dental care and greatly reduced patient discomfort safely and effectively. Its effectiveness has in fact led to a common complaint that the numbness may linger long afterwards. But that also has been addressed with better combinations of anesthetic drugs to reduce the duration of the numbing effect.

And not only does local anesthesia make for a more relaxing and pleasant experience, it also benefits the dental provider. Dentists tend to work more efficiently when they know their patients aren't in discomfort, which can result in better treatment outcomes.

If you've been putting off a trip to the dentist because you think it might be painful or uncomfortable, put those concerns to rest. With the help of local anesthesia, dental treatment can be relaxing and pain-free.

If you would like more information on having a pain-free experience at the dentist, 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 “Local Anesthesia for Pain-Free Dentistry.”

KeepYourChildsFluorideIntakeataSafebutEffectiveLevel

Fluoride is an important part of your child's dental development. But if children take in too much of this important mineral, they could experience enamel fluorosis, a condition in which teeth become discolored with dark streaking or mottling.

That's why it's important to keep fluoride levels within safe bounds, especially for children under the age of 9. To do that, here's a look at the most common sources for fluoride your child may take in and how you can moderate them.

Toothpaste. Fluoridated toothpaste is an effective way for your child to receive the benefits of fluoride. But to make sure they're not getting too much, apply only a smear of toothpaste to the brush for infants. When they get a little older you can increase that to a pea-sized amount on the end of the brush. You should also train your child not to swallow toothpaste.

Drinking water. Most water systems add tiny amounts of fluoride to drinking water. To find out how much your water provider adds visit “My Water's Fluoride” online. If it's more than the government's recommendation of 0.70 parts of fluoride per million parts of water, you may want ask your dentist if you should limit your child's consumption of fluoridated drinking water.

Infant formula. Many parents choose bottle-feeding their baby with infant formula rather than breastfeed. If you use the powdered form and mix it with tap water that's fluoridated, your baby could be ingesting more of the mineral. If breastfeeding isn't an option, try using the premixed formula, which normally contains lower levels of fluoride. If you use powdered formula, mix it with bottled water labeled “de-ionized,” “purified,” “demineralized” or “distilled.”

It might seem like the better strategy for preventing fluorosis is to avoid fluoride altogether. But that can increase the risk of tooth decay, a far more destructive outcome for your child's teeth than the appearance problems caused by fluorosis. The better way is to consult with your dentist on keeping your child's intake within recognized limits to safely receive fluoride's benefits of stronger, healthier teeth.

If you would like more information on fluoride and your baby's dental health, 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 “Tooth Development and Infant Formula.”

All-on-4 implants are a revolutionary tooth replacement option. This method relies on a minimal number of dental implants to securely hold dentures in place. Rather than the usual six to eight implants needed to hold a full denture, All-on-4 requires just four strategically placed implants. All-on-4 is available at Penny Creek Family & Implant Dentistry in Mill Creek, where Dr. Chad Slocum or Dr. Sara Lundgaard can determine if you are a candidate for this cutting edge tooth replacement method.

All-on-4 Tooth Replacement

Implant dentistry has made it possible to securely and permanently replace lost teeth. Small metal posts called dental implants are used to anchor prosthetic teeth, such as crowns or dentures, in place. One of the reasons dental implants are so secure is that they are inserted directly into bone tissue. Over the course of a few months, the metal implants and bone tissue naturally fuse together.

Six to eight dental implants are usually needed to secure a denture. However, All-on-4 technology has made it possible to hold a denture in place with just four implants. Each dental implant is placed in the bone at an angle. The result is more contact between the implant and bone tissue, which makes for a stronger hold.

To be a candidate for All-on-4 implants, patients must have good oral health, including healthy gums, and adequate bone tissue to support the dental implants. The skilled dentists at our office in Mill Creek can determine if All-on-4 is an option for you.

The Benefits

There are several benefits associated with needing fewer dental implants to secure dentures in place. Since only four implants are required, fewer surgical incisions are made, which means less discomfort for patients. Placing fewer dental implants is also more cost-effective so you’ll save money.

Another benefit of All-on-4 implants is that they help preserve bone tissue. An unfortunate side effect of tooth loss is bone loss and conventional dentures can contribute to the problem. Traditional dentures tend to place pressure on the jawbone as they are constantly pressing down into the gums. This pressure can cause bone tissue to gradually disappear. When dentures are secured in place with dental implants, there is no additional pressure on the gums or jawbone. Additionally, the fusion of metal implants and bone helps retain bone tissue.

All-on-4 implants are an exciting and revolutionary solution to tooth loss. You can securely restore your smile, as well as regular tooth functioning, with just a few dental implants.

Schedule a consultation with Penny Creek Family & Implant Dentistry in Mill Creek at (425) 337-7300.

AMildNSAIDMayBeAllYouNeedToManageDiscomfortAfterDentalWork

Undergoing dental work is for the most part a pain-free affair. But once you're home and the anesthetic begins to wear off, you may have some discomfort.

Fortunately, most post-procedure pain can be managed with non-steroidal anti-inflammatory drugs or NSAIDs. And while stronger versions of these pain relievers can be prescribed, you may only need one sold over-the-counter.

NSAIDs like ibuprofen or acetaminophen work by inhibiting the release of prostaglandins, substances that stimulate inflammation in traumatized or injured tissues. It differs in this way from the two other primary pain medications: Steroids act like natural hormones that alleviate physical stress in the tissues; and narcotics like morphine or codeine suppress the brain's reaction to nerve firings.

While these stronger types are effective for stopping pain, they can have several serious side effects. Narcotics in particular can be addictive. Although they may be necessary in serious cases of acute pain, most dentists turn to non-addictive NSAIDs first, which are usually effective with the kind of discomfort associated with dental work and with fewer side effects.

That's not to say, however, that NSAIDs are risk-free—they must be taken properly or you could suffer serious health consequences. For one, NSAIDs have a blood-thinning effect that's even more pronounced when taken consistently over a period of weeks. This can lead to bleeding that is difficult to stop and erosion of the stomach lining leading to ulcers. Prolonged use can also damage the kidneys.

As a rule of thumb, adults shouldn't take more than 2400 milligrams of ibuprofen or other NSAIDs in a day, unless otherwise directed by their doctor. For most, a 400-milligram oral dose taken with food (to minimize stomach upset) is usually sufficient to relieve pain for around five hours.

You'll usually avoid unwanted health effects by keeping within your dentist's recommended doses and taking an NSAID for only a few days. Taking an NSAID properly can help keep your discomfort to a minimum after dental work without the need for stronger drugs.

If you would like more information on managing dental pain, 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 “Treating Pain With Ibuprofen.”

AddressingRiskFactorsTakingtheFightAgainstToothDecaytoaNewLevel

Tooth decay is more prevalent than diseases like cancer, heart disease or influenza. It doesn't have to be—brushing with fluoride toothpaste, flossing, less dietary sugar and regular dental cleanings can lower the risk of this harmful disease.

Hygiene, diet and dental care work because they interrupt the disease process at various points. Daily hygiene and regular dental cleanings remove dental plaque where oral bacteria flourish. Reducing sugar eliminates one of bacteria's feeding sources. With less bacteria, there's less oral acid to erode enamel.

But as good as these methods work, we can now take the fight against tooth decay a step further. We can formulate a prevention strategy tailored to an individual patient that addresses risk factors for decay unique to them.

Poor saliva flow. One of the more important functions of this bodily fluid is to neutralize mouth acid produced by bacteria and released from food during eating. Saliva helps restore the mouth's ideal pH balance needed for optimum oral health. But if you have poor saliva flow, often because of medications, your mouth could be more acidic and thus more prone to decay.

Biofilm imbalance. The inside of your mouth is coated with an ultrathin biofilm made up of proteins, biochemicals and microorganisms. Normally, both beneficial and harmful bacteria reside together with the “good” bacteria having the edge. If the mouth becomes more acidic long-term, however, even the beneficial bacteria adapt and become more like their harmful counterparts.

Genetic factors. Researchers estimate that 40 to 50 hereditary genes can impact cavity development. Some of these genes could impact tooth formation or saliva gland anatomy, while others drive behaviors like a higher craving for sugar. A family history of tooth decay, especially when regular hygiene habits or diet don't seem to be a factor, could be an indicator that genes are influencing a person's dental health.

To determine if these or other factors could be driving a patient's higher risk for tooth decay, many dentists are now gathering more information about medications, family history or lifestyle habits. Using that information, they can introduce other measures for each patient that will lower their risk for tooth decay even more.

If you would like more information on reducing your risk of 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 “What Everyone Should Know About Tooth Decay.”

4WaysYouCanBetterManageDentalCareforaChildwithDownSyndrome

Madeline Stuart, acclaimed fashion model; Chris Burke, successful actor; Collette Divitto, founder of Collettey's Cookies. Each of them is accomplished in their own right—and each has Down syndrome. In October, Down Syndrome Awareness Month recognizes the achievements of people with Down syndrome overcoming incredible challenges. One such challenge, keeping their dental health on track, is something they and their families face every day.

Down syndrome, also known as trisomy 21, is a genetic disorder that happens when the body's cells contain an extra copy of chromosome number 21. This can cause a wide range of physical, intellectual and developmental impairments that, among other things, can contribute to dental disease and other oral health concerns.

But oral problems can be minimized, especially during childhood. Here are four ways to better manage dental care for a child with Down syndrome.

Begin dental visits early. Down syndrome patients can have physical challenges that could result in delayed tooth eruption, undersized teeth or smaller jaws that contribute to poor bite development and greater risk of tooth decay and periodontal (gum) disease. To stay ahead of any developing issues, you should begin regular visits to the dentist no later than the child's first birthday.

Be aware of dental anxiety. Some children with Down syndrome experience significant anxiety about the clinical aspects of their care. We strive to provide a comfortable, caring environment for all patients, including those with special needs. A variety of relaxation techniques as well as sedation options may help to reduce anxiety.

Coordinate medical and dental care. Medical problems can affect dental care. Be sure, then, to keep us informed about your child's health issues. For example, heart defects are more common among those with Down syndrome, and dental patients with heart conditions may need to be treated with antibiotics before certain dental procedures to minimize the chances of infection.

Make daily hygiene easier. Daily brushing and flossing are important for everyone's dental health, but they can be difficult for someone with Down syndrome. In some cases, you may have to assist or even perform these tasks for your child. You can make oral hygiene easier by choosing toothbrushes that fit your child's level of physical ability or using special flossing devices.

The physical disabilities of those with Down syndrome fall along a wide spectrum, with some individuals needing more help than others. Tailoring their dental care to their specific needs and capabilities can help keep your child's teeth and gums healthy for the long term.

If you would like more information about providing dental care for children with disabilities, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Managing Tooth Decay in Children With Chronic Diseases” and “Dentistry & Oral Health for Children.”

UseAppropriateHygieneProductsforMaximumSmileProtection

After years of research, we're confident in saying that brushing and flossing daily are essential for maintaining a healthy mouth. A mere five minutes a day performing these tasks will significantly lower your risk of dental disease.

We're also sure about the essentials you'll need to perform these tasks: a soft-bristled toothbrush using fluoride toothpaste, and a roll (or picks) of dental floss. The only deviation might be a water flosser appliance instead of flossing thread.

Unfortunately, some folks deviate even more from the norm for both of these tasks. One of the strangest is a social media trend substituting regular toothpaste with substances containing activated charcoal. The proponents of brushing with charcoal claim it will help whiten teeth and kill harmful microorganisms. People brushing with a black, tarry substance also seem to make for good “gross-out” videos.

There's no substantial evidence to support these claims. Perhaps proponents of charcoal's whitening ability are assuming it can remove stains based on its natural abrasiveness. It could, however, remove more than that: Used over time, charcoal could wear down the protective enamel coating on your teeth. If that happens, your teeth will be more yellow and at much greater risk for tooth decay.

When it comes to flossing (or more precisely, removing food material from between teeth), people can be highly inventive, substituting what might be at hand for dental floss. In a recent survey, a thousand adults were asked if they had ever used household items to clean between their teeth and what kind. Eighty percent said they had, using among other things twigs, nails (the finger or toe variety) and screwdrivers.

Such items aren't meant for dental use and can harm tooth surfaces and gum tissues. Those around you, especially at the dinner table, might also find their use off-putting. Instead, use items approved by the American Dental Association like floss, floss picks or toothpicks. Some of these items are small enough to carry with you for the occasional social “emergency.”

Brushing and flossing can absolutely make a difference keeping your teeth and gums healthy. But the real benefit comes when you perform these tasks correctly—and use the right products for the job.

If you would like more information on best oral hygiene practices, please contact us or schedule an appointment for a consultation.

AcidRefluxCouldLeadtoToothDamage

Your tooth enamel’s main nemesis is oral acid: normally produced by bacteria, foods or beverages, acid can dissolve enamel’s mineral content and cause erosion and decay. But acid might be a bigger problem for you if you also have gastroesophageal reflux disease or GERD.

GERD is a digestive condition in which stomach acid backs up into the digestive tract. Normally, a ring of muscle at the end of the esophagus prevents stomach acid from coming up into it. But if it weakens, this powerful acid can splash up into the esophagus and irritate its more delicate lining and result in a burning sensation known as heartburn or acid indigestion.

The problem for teeth, though, is that GERD could cause stomach acid to potentially come up into the mouth. Because of its high acidic pH (2.0 or less), stomach acid can cause major erosion in tooth enamel, leaving them pitted, yellow and sensitive. If not caught and treated early, some of your teeth could be damaged to the point that they have a questionable prognosis.

There are some things you can do to minimize GERD’s effect on your dental health. First and foremost, see a doctor about managing your symptoms, which might include medication. Be sure you also inform your dentist that you have GERD and what medications you’re taking.

One way to lessen the effect of higher acid in the mouth is to stimulate saliva production, which helps neutralize acid. You can do this by drinking plenty of water, taking a saliva booster or chewing xylitol-sweetened gum. You can also rinse with plain water or water mixed with baking soda (1/2 teaspoon to a cup of water), or chew an antacid tablet to help balance your mouth’s pH level.

And don’t forget to look out for your enamel. Be sure you’re practicing daily brushing and flossing and using fluoride hygiene products to strengthen it. Your dentist can also apply topical solutions or prescribe special rinses with higher concentrations of fluoride.

GERD can be an unpleasant experience that escalates into major problems. Don’t let it compromise your dental health.

If you would like more information on managing oral health with acid reflux disease, please contact us or schedule an appointment for a consultation.

NHLIronManKeithYandleSuffersDentalTraumaonIce

Professional Hockey player Keith Yandle is the current NHL “iron man”—that is, he has earned the distinction of playing in the most consecutive games. On November 23, Yandle was in the first period of his 820th consecutive game when a flying puck knocked out or broke nine of his front teeth. He returned third period to play the rest of the game, reinforcing hockey players’ reputation for toughness. Since talking was uncomfortable, he texted sportswriter George Richards the following day: “Skating around with exposed roots in your mouth is not the best.”

We agree with Yandle wholeheartedly. What we don’t agree with is waiting even one day to seek treatment after serious dental trauma. It was only on the following day that Yandle went to the dentist. And after not missing a game in over 10 years, Yandle wasn’t going to let a hiccup like losing, breaking or cracking nearly a third of his teeth interfere with his iron man streak. He was back on the ice later that day to play his 821st game.

As dentists, we don’t award points for toughing it out. If anything, we give points for saving teeth—and that means getting to the dentist as soon as possible after suffering dental trauma and following these tips:

  • If a tooth is knocked loose or pushed deeper into the socket, don’t force the tooth back into position.
  • If you crack a tooth, rinse your mouth but don’t wiggle the tooth or bite down on it.
  • If you chip or break a tooth, save the tooth fragment and store it in milk or saliva. You can keep it against the inside of your cheek (not recommend for small children who are at greater risk of swallowing the tooth).
  • If the entire tooth comes out, pick up the tooth without touching the root end. Gently rinse it off and store it in milk or saliva. You can try to push the tooth back into the socket yourself, but many people feel uneasy about doing this. The important thing is to not let the tooth dry out and to contact us immediately. Go to the hospital if you cannot get to the dental office.

Although keeping natural teeth for life is our goal, sometimes the unexpected happens. If a tooth cannot be saved after injury or if a damaged tooth must be extracted, there are excellent tooth replacement options available. With today’s advanced dental implant technology, it is possible to have replacement teeth that are indistinguishable from your natural teeth—in terms of both look and function.

And always wear a mouthguard when playing contact sports! A custom mouthguard absorbs some of the forces of impact to help protect you against severe dental injury.

If you would like more information about how to protect against or treat dental trauma or about replacing teeth with dental implants, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Dental Implants: A Tooth-Replacement Method That Rarely Fails” and “The Field-Side Guide to Dental Injuries.”

4DentalHealthAreasThatDeserveAttentionBeforeGettingBacktoSchool

The final quarter of the 2019-2020 academic year was like no other in modern history. Because of COVID-19, U.S. schools and colleges lay dormant as millions of students carried on their studies via distance learning. Whether the upcoming school year will be online or in-person, the end of summer is still a great time to make sure your family's dental health is on track.

Normally, dental care is one of several items that families focus on right before school begins anew. But even if school won't be resuming in the traditional sense, you can still put the spotlight on your family's teeth and gums.

Here are 4 dental care areas that deserve your attention before the new school year begins.

Re-energize daily hygiene. The break in routine caused by sheltering in place may have had a stilting effect on regular habits like brushing and flossing. If so, now's the time to kick-start your family's daily hygiene. Brushing and flossing remove disease-causing plaque and are essential to long-term prevention of tooth decay and gum disease.

Schedule a dental cleaning. Regular professional cleanings, generally every six months, are necessary to remove hard-to-reach plaque and tartar. Scheduling may have been difficult this past spring, but as life starts to get back to normal, be sure to return to regular dental visits as soon as possible. During appointments, we can spot small issues that if left undetected could cause bigger problems later on.

Reassess your family's diet. If the last few months have impacted your normal food choices, you may want to take a closer look at your family's diet and what effect it may have on dental health. Processed foods with added sugar contribute to the risk of dental disease. But a diet rich in fresh fruits, vegetables and low-fat dairy contains abundant nutrients for strengthening teeth and gums.

Seek special evaluations as needed. It's a good idea to have your child undergo an orthodontic evaluation around age 6: If they have a poor bite developing, early intervention could prevent or minimize it. And you should have your teenagers' wisdom teeth monitored regularly in case they're impacted or causing other dental problems—they may require removal in early adulthood or before.

Hopefully, this unusual interruption in education will soon become a distant memory. But even with the school routine being upended as it has, you can still take advantage of the end of summer to give your family's dental health a boost.

If you would like more information about back-to-school dental care, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Top 10 Oral Health Tips for Children.”

HowtoProtectDentalHealthintheLaterYearsofLife

As we get older, we become more susceptible to chronic health conditions like diabetes, heart disease or arthritis. We can also begin to see more problems with our teeth and gums.

Whether it's ourselves or an older loved one, oral health deserves a heightened focus as we age on prevention and prompt treatment. Here's what you can do to protect you or a family member's teeth and gums during the aging process.

Make accommodations for oral hygiene. Keeping your mouth clean of disease-causing plaque is important at any age. But it may become harder for someone getting older: Manual dexterity can falter due to conditions like arthritis or Parkinson's Disease. Older adults with decreased physical ability may benefit from larger gripped toothbrushes or those modified with a bicycle handle. Electric power brushes are another option, as are water irrigators that can do as effective a job of flossing as threaded floss.

Watch out for “dry mouth.” Older adults often develop chronic dry mouth due to saliva-reducing medications they might be taking. It's not just an unpleasant feeling: Inadequate saliva deprives the mouth of acid neutralization. As a result, someone with chronic dry mouth has a higher risk for tooth decay. You can reduce dry mouth by talking with your doctor about prescriptions for you or a family member, drinking more water or using saliva boosting products.

Maintain regular dental visits. Regular trips to the dentist are especially important for older adults. Besides professional cleanings, dentists also check for problems that increase with aging, such as oral cancer. An older adult wearing dentures or other oral appliances also needs to have them checked periodically for any adverse changes to fit or wear.

Monitor self-care. As long as they're able, older adults should be encouraged to care daily for their own teeth. But they should also be monitored in these areas, especially if they begin to show signs of decreased mental or physical abilities. So, evaluate how they're doing with brushing and flossing, and look for signs of tooth decay or gum disease.

Aging brings its own set of challenges for maintaining optimum dental health. But taking proactive steps and acting quickly when problems arise will help meet those challenges as they come.

If you would like more information on dental care for older adults, 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 “Aging & Dental Health.”

The purpose of preventive oral care is to keep your teeth and gums healthy throughout your life. Dr. Chad Slocum and Dr. Sara Lundgaard are dentists at Penny Creek Family & Implant Dentistry in Mill Creek, WA. He can give you tips on how you and your family can practice healthy oral hygiene.

Preventive Dentistry Explained

Preventive dental care begins at home. It means developing good oral hygiene habits that begin in early childhood and continue throughout the rest of your life. Such as:

  • Brushing your teeth twice each day for two minutes each time
  • Using a quality soft-bristled toothbrush with an angled head
  • Flossing daily after brushing, with string floss or a water flosser
  • Using mouthwash to freshen breath and kill remaining bacteria

An important part of preventive dental care happens at your dentist’s office. You should make a dental visit every six months. Preventive dentistry services include:

  • Examination of your teeth and gums
  • Routine x-rays
  • Scaling and polishing your teeth
  • Checking your jawbone for problems

The Benefits of Preventive Dentistry

Not only does preventive dentistry lover your risk for developing serious dental problems such as gum disease, but it also helps promote good oral hygiene habits.

If you live in Mill Creek, call (425) 337-7300 talk to Dr. Slocum about preventive care and all your family dentistry needs. He will be happy to schedule appointments for you and your family.

ThatOddLacyMouthSoreisNoCauseforAlarm

Looking in the mirror, you probably focus on your teeth and gums—i.e., your smile. Your dentist, though, will take the time to look deeper into your mouth, searching for anything out of the ordinary. That could be a type of mouth sore known as lichen planus.

Lichen planus are lesions that can appear on skin or mucus membranes, including inside the mouth. The name comes from their resemblance to lichens, a fungus found on trees or rocks (although the sore itself isn't fungi). As such, they often have a lacy pattern of lines emanating from purplish bumps.

Again, the first indication you have such a condition may come from your dentist. Sometimes, though, you may notice greater sensitivity to spicy or acidic foods and, if the gums are affected, irritation when you eat or brush.

If you find out you have lichen planus, don't be alarmed—it usually doesn't pose harm to your health and it's not contagious. Its appearance, though, could be mimicked by more harmful medical conditions, so your dentist will want to confirm the lesion observed is truly lichen planus.

It's routine, then, for your dentist to excise a small sample of the sore's tissue and send it to a pathology lab for biopsy. Although results will more than likely confirm lichen planus or some other benign lesion, it's better to err on the side of caution and ensure you're not dealing with something more serious.

If you are diagnosed with lichen planus, you may need to take steps to manage symptoms. In most people, the sore will go away on its own, although there's no guarantee it won't reappear sometime later. In the event it lingers, your dentist may prescribe a topical steroid to help ease any discomfort.

You can also minimize a future outbreak by practicing effective daily oral hygiene to reduce the bacterial populations that may contribute to the condition. And when you're symptomatic, try avoiding spicy or acidic foods like citrus, peppers or caffeinated beverages.

Lichen planus is more bothersome than harmful. Taking the above steps can help you avoid it or deal with it more effectively when it occurs.

If you would like more information on lichen planus, 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 “Lichen Planus: Mouth Lesions That are Usually benign.”

BruinsZdenoCharaBreaksHisJawDuring2019StanleyCup

Boston Bruins defenseman Zdeno Chara had a rough Stanley Cup final against the St. Louis Blues this past June. Not only did the Bruins ultimately lose the championship, but Chara took a deflected puck shot to the face in Game Four that broke his jaw.

With the NHL season now over, the 42-year-old Bruins captain continues to mend from his injury that required extensive treatment. His experience highlights how jaw fractures and related dental damage are an unfortunate hazard in hockey—not only for pros like Chara, but also for an estimated half million U.S. amateurs, many in youth leagues.

Ice hockey isn't the only sport with this injury potential: Basketball, football (now gearing up with summer training) and even baseball players are also at risk. That's why appropriate protective gear like helmets and face shields are key to preventing injury.

For any contact sport, that protection should also include a mouthguard to absorb hard contact forces that could damage the mouth, teeth and gums. The best guards (and the most comfortable fit) are custom-made by a dentist based on impressions made of the individual's mouth.

But even with adequate protection, an injury can still happen. Here's what you should do if your child has an injury to their jaw, mouth or teeth.

Recognize signs of a broken jaw. A broken jaw can result in severe pain, swelling, difficulty speaking, numbness in the chin or lower lip or the teeth not seeming to fit together properly. You may also notice bleeding in the mouth, as well as bruising under the tongue or a cut in the ear canal resulting from jawbone movement during the fracture. Get immediate medical attention if you notice any of these signs.

Take quick action for a knocked-out tooth. A tooth knocked completely out of its socket is a severe dental injury. But you may be able to ultimately save the tooth by promptly taking the following steps: (1) find the tooth and pick it up without touching the root end, (2) rinse it off, (3) place it back in its socket with firm pressure, and (4) see a dentist as soon as possible.

Seek dental care. Besides the injuries already mentioned, you should also see a dentist for any moderate to severe trauma to the mouth, teeth and gums. Leading the list: any injury that results in tooth chipping, looseness or movement out of alignment.

Even a top athlete like Zdeno Chara isn't immune to injury. Take steps then to protect your amateur athlete from a dental or facial injury.

If you would like more information about dealing with sports-related dental injuries, please contact us or schedule an appointment for a consultation. To learn more, read the Dear Doctor magazine articles “Athletic Mouthguards” and “The Field-Side Guide to Dental Injuries.”

KnowWhattoExpectDuringYourChildsBabyTeethPhase

At no other time in a person’s life will their teeth and mouth change as rapidly as it will between infancy and adolescence. In this short span an entire set of teeth will emerge and then gradually disappear as a second permanent set takes its place.

While the process may seem chaotic, there is a natural order to it. Knowing what to expect will help ease any undue concerns you may have about your child's experience.

The first primary teeth begin to appear (erupt) in sequence depending on their type. The first are usually the lower central incisors in the very front that erupt around 6-10 months, followed then by the rest of the incisors, first molars and canines (the “eye” teeth). The last to erupt are the primary second molars in the very back of the mouth just before age 3. A similar sequence occurs when they’re lost — the central incisors loosen and fall out around 6-7 years; the second molars are the last to go at 10-12 years.

A little “chaos” is normal — but only a little. Because of the tremendous changes in the mouth, primary teeth may appear to be going in every direction with noticeable spaces between front teeth. While this is usually not a great concern, it’s still possible future malocclusions (bad bites) may be developing. To monitor this effectively you should begin regular checkups around the child’s first birthday — our trained professional eye can determine if an issue has arisen that should be treated.

Protecting primary teeth from tooth decay is another high priority. There’s a temptation to discount the damage decay may do to these teeth because “they’re going to be lost anyway.” But besides their functional role, primary teeth also help guide the developing permanent teeth to erupt in the right position. Losing a primary tooth prematurely might then cause the permanent one to come in misaligned. Preventing tooth decay with daily oral hygiene and regular office visits and cleanings (with possible sealant protection) is a priority. And should decay occur, it’s equally important to preserve the tooth for as long as possible for the sake of the succeeding tooth.

Your child’s rapid dental development is part of their journey into adulthood. Keeping a watchful eye on the process and practicing good dental care will ensure this part of the journey is uneventful.

If you would like more information on the process of dental development in children, 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 “Dentistry & Oral Health for Children.”

MonitoringYourChildsThumbSuckingCouldHelpAvoidFutureBiteProblems

Although distressing to many parents, infants and toddlers sucking their thumb is a common if not universal habit. Most children phase out of it by around age 4, usually with no ill effects. But thumb-sucking continuing into late childhood could prove problematic for a child’s bite.

Thumb sucking is related to how young children swallow. All babies are born with what is called an infantile swallowing pattern, in which they thrust their tongues forward while swallowing to ensure their lips seal around a breast or bottle nipple when they nurse. Thumb-sucking mimics this action, which most experts believe serves as a source of comfort when they’re not nursing.

Around 3 or 4, their swallowing transitions to a permanent adult swallowing pattern: the tip of the tongue now positions itself against the back of the top front teeth (you can notice it yourself when you swallow). This is also when thumb sucking normally fades.

If a child, however, has problems transitioning to an adult pattern, they may continue to thrust their tongue forward and/or prolong their thumb-sucking habit. Either can put undue pressure on the front teeth causing them to move and develop too far forward. This can create what’s known as an open bite: a slight gap still remains between the upper and lower teeth when the jaws are shut rather than the normal overlapping of the upper teeth over the lower.

While we can orthodontically treat an open bite, we can minimize the extent of any treatments if we detect the problem early and intervene with therapies to correct an abnormal swallowing pattern or prolonged thumb sucking. For the former we can assist a child in performing certain exercises that help retrain oral and facial muscles to encourage a proper swallowing pattern. This may also help diminish thumb sucking, but we may in addition need to use positive reinforcement techniques to further discourage the habit.

To stay ahead of possible problems with thumb sucking or the swallowing pattern you should begin regularly taking them to the dentist around their first birthday. It’s also a good idea to have an orthodontic evaluation around age 6 for any emerging bite problems. Taking these positive steps could help you avoid undue concern over this common habit.

If you would like more information on managing your child’s thumb-sucking habit, 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 “How Thumb Sucking Affects the Bite.”

NewStudiesShowSealantsCouldHelpYourChildAvoidToothDecay

Your child could hit a speed bump on their road to dental maturity—tooth decay. In fact, children are susceptible to an aggressive form of decay known as Early Childhood Caries (ECC) that can lead to tooth loss and possible bite issues for other teeth.

But dentists have a few weapons in their arsenal for helping children avoid tooth decay. One of these used for many years now is the application of sealants to the biting surfaces of both primary and permanent teeth. Now, two major research studies have produced evidence that sealant applications help reduce children's tooth decay.

Applying sealant is a quick and painless procedure that doesn't require drilling or anesthesia. A dentist brushes the sealant in liquid form to the nooks and crannies of a tooth's biting surfaces, which tend to accumulate decay-causing bacterial plaque. They then use a curing light to harden the sealant.

The studies previously mentioned that involved thousands of patients over a number of years, found that pediatric patients without dental sealants were more than three times likely to get cavities compared to those who had sealants applied to their teeth. The studies also found the beneficial effect of a sealant could last four years or more after its application.

The American Dental Association and the American Academy of Pediatric Dentistry recommend sealants for children, especially those at high risk for decay. It's common practice now for children to first get sealants when their first permanent molars erupt (teeth that are highly susceptible to decay), usually between the ages of 5 and 7, and then later as additional molars come in.

There is a modest cost for sealant applications, but far less than the potential costs for decay treatment and later bite issues. Having your child undergo sealant treatment is a worthwhile investment: It could prevent decay and tooth loss in the near-term, and also help your child avoid more extensive dental problems in the future.

If you would like more information on sealants and other preventive measures for children's teeth, please contact us or schedule an appointment for a consultation.

WhatYouCanDoAboutBadBreathUnlessYoureaFamousActressPrankingYourCo-Star

Hollywood superstar Jennifer Lawrence is a highly paid actress, Oscar winner, successful producer and…merry prankster. She's the latter, at least with co-star Liam Hemsworth: It seems Lawrence deliberately ate tuna fish, garlic or other malodorous foods right before their kissing scenes while filming The Hunger Games.

It was all in good fun, of course—and her punked co-star seemed to take it in good humor. In most situations, though, our mouth breath isn't something we take lightly. It can definitely be an unpleasant experience being on the receiving end of halitosis (bad breath). And when we're worried about our own breath, it can cause us to be timid and self-conscious around others.

So, here's what you can do if you're concerned about bad breath (unless you're trying to prank your co-star!).

Brush and floss daily. Bad breath often stems from leftover food particles that form a film on teeth called dental plaque. Add in bacteria, which thrive in plaque, and you have the makings for smelly breath. Thorough brushing and flossing can clear away plaque and the potential breath smell. You should also clean your dentures daily if you wear them to avoid similar breath issues.

Scrape your tongue. Some people can build up a bacterial coating on the back surface of the tongue. This coating may then emit volatile sulfur compounds (VSCs) that give breath that distinct rotten egg smell. You can remove this coating by brushing the tongue surface with your toothbrush or using a tongue scraper (we can show you how).

See your dentist. Some cases of chronic bad breath could be related to oral problems like tooth decay, gum disease or broken dental work. Treating these could help curb your bad breath, as can removing the third molars (wisdom teeth) that are prone to trapped food debris. It's also possible for bad breath to be a symptom of a systemic condition like diabetes that may require medical treatment.

Quit smoking. Tobacco can leave your breath smelly all on its own. But a smoking habit could also dry your mouth, creating the optimum conditions for bacteria to multiply. Besides increasing your disease risk, this can also contribute to chronic bad breath. Better breath is just one of the many benefits of quitting the habit.

We didn't mention mouthrinses, mints or other popular ways to freshen breath. While these can help out in a pinch, they may cover up the real causes of halitosis. Following the above suggestions, especially dental visits to uncover and treat dental problems, could solve your breath problem for good.

If you would like more information about ways to treat bad breath, please contact us or schedule an appointment. To learn more, read the Dear Doctor magazine article “Bad Breath: More Than Just Embarrassing.”

Developing A Good Oral Care Routine

Having healthy teeth requires a lifetime of care. While going to the dentist is very important, most people only visit their dentist two times a year. This is why it becomes imperative to develop a good at-home oral care routine. Dr. Chad Slocum and Dr. Sara Lundgaard from Penny Creek Family & Implant Dentistry in Mill Creek, WA, are determined to teach their patients the importance of in-home oral care, as well as setting them up with good oral care habits. Read on to learn more about some common oral care routines

Common Oral Care Habits To Follow

Here are some common practices you should consider to implement within your oral care routine.

  • Always brush before going to bed
  • Clean your tongue as often as you brush
  • Do not forget to floss
  • Use fluoride toothpaste
  • Use antiseptic mouthwash
  • Eat a balanced and nutritious diet

These are just some of the steps you should follow. For more information on why these practices can help or for further protecting your teeth, call your dentist in Mill Creek, WA.

Habits To Avoid

A very important aspect of keeping healthy teeth is by avoiding tooth decay and gum disease. There are some behaviors that can be unhealthy for your teeth and avoidance of those behaviors can be beneficial. Some of the behaviors to avoid include:

  • Using tobacco products and smoking
  • Accessive alcohol drinking
  • Drinking or eating food with excessive sugar
  • Drinking highly acidic beverages, such as soft drinks

With the combination of avoiding these poor habits as well as following a good oral care routine, you can keep your teeth healthy.

Learn More About Good Oral Care Routines From A Professional

While most were instructed to perform many of these steps from the start, it is important that these routines are performed correctly. It is always best to consult your dentist on the best oral care routine for you and your specific needs. If you live in or around Mill Creek, WA, consider visiting our office, Penny Creek Family & Implant Dentistry, where our family-friendly and professional staff can help you find the answers you need. Call our office in Mill Creek at (425) 337-7300

DontUseBenzocaineProductstoEaseYourBabysTeethingPain

Although teething is a natural part of your baby's dental development, it can be quite uncomfortable for them—and upsetting to you. During teething, children can experience symptoms like pain, drooling or irritability.

Teething is the two or three-year process of intermittent episodes of the primary ("baby") teeth moving through the gums. These episodes are like storms that build up and then subside after a few days. Your aim as a parent is to help your baby get through the "stormiest" times with as little discomfort as possible. To that end you may have considered using over-the-counter products that temporarily numb irritated gums.

Some of those numbing products, however, contain a pain reliever called benzocaine. In recent years, this and similar ingredients have been found to increase the level of a protein called methemoglobin in the bloodstream. Too much methemoglobin can result in less oxygen delivered to body tissues, a condition known as methemoglobinemia.

This oxygen decrease can cause shortness of breath, fatigue or dizziness. In its severest form it could lead to seizures, coma or even death. Children and infants are at high risk for benzocaine-induced methemoglobinemia, which is why the U.S. Food and Drug Administration has banned marketing for benzocaine products as pain relievers for teething infants and children.

Fortunately, there are alternatives for helping your child weather teething episodes. A clean, chilled (not frozen) teething ring or pacifier, or a cold, wet washcloth can help numb gum pain. You can also massage their gums with a clean finger to help counteract the pressure exerted by an emerging tooth. Be sure, though, that you're not allowing anything in your child's mouth like lead-based paint that could be toxic. And under no circumstances should you use substances containing alcohol.

For severe pain, consult your physician about using a pain reliever like acetaminophen or ibuprofen, and the proper dosage for your child. With these tips you can help your child safely pass through a teething episode.

If you would like more information on helping your child cope with teething discomfort, please contact us or schedule an appointment for a consultation.

TheGraduationSeasonisthePerfectTimetoReviewDentalHealth

The month of May blossoms annually with commencement ceremonies honoring students graduating from high schools, colleges and universities. For each graduate, the occasion represents a major milestone along their road to adulthood. It's also an appropriate time to assess their dental development.

Although our teeth and gums continue to change as we age, the greatest change occurs during the first two decades of life. In that time, humans gain one set of teeth, lose it, and then gain another in relatively rapid succession. The new permanent teeth continue to mature, as do the jaws, up through the time many are graduating from college.

Of course, you don't have to be in the process of receiving a diploma to “graduate” from adolescent to adult. If you are in that season, here are a few things regarding your dental health that may deserve your attention.

Wisdom teeth. According to folklore, the back third molars are called wisdom teeth because they usually erupt during the transition from a “learning” child to a “wise” adult. Folklore aside, though, wisdom teeth are often a source for dental problems: The last to come in (typically between ages 17 and 25), wisdom teeth often erupt out of alignment in an already crowded jaw, or are impacted and remain hidden below the gums. To avoid the cascade of problems these issues can cause, it may be necessary to remove the teeth.

Permanent restorations. Though not as often as in adults, children and teens can lose teeth to disease, injury or deliberate removal. Because the jaw is still in development, dental implants are not generally advisable. Instead, patients under twenty often have temporary restorations like partial dentures or bonded bridges. As the jaws reach full maturity in a young adult's early 20s, it's often a good time to consider a permanent implant restoration.

Smile makeovers. An upcoming graduation is also a great reason to consider cosmetic smile upgrades. When it comes to improving a smile, the sky's the limit—from professional teeth whitening for dull teeth to porcelain veneers or crowns to mask dental imperfections. It's also not too late to consider orthodontics: Braces or the increasingly popular clear aligners can straighten almost anyone's teeth at any age, as long as the person is in reasonably good health.

This may also be a good time to update your own personal care. Regular dental visits, along with daily brushing and flossing, are the foundation stones for keeping your teeth and gums healthy throughout your life. So, as you “commence” with this new chapter in your life, make a dental appointment now to “commence” with a renewed commitment to your dental health.

If you would like more information about adult dental care, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Wisdom Teeth” and “Teenagers & Dental Implants.”

FacialNervePainCanbeControlled

Every year 150,000 people, mostly women over age 50, find out they have a painful condition called trigeminal neuralgia. For many it begins as an occasional twinge along the face that steadily worsens until the simple act of chewing or speaking, or even a light touch, sets off excruciating pain.

The source of the pain is the pair of trigeminal nerves that course along each side of the face. Each nerve has three separate branches that provide sensation to the upper, middle and lower areas of the face and jaw.

The problem arises when areas of the myelin sheath, a fatty, insulating covering on nerves, becomes damaged, often because of an artery or vein pressing against it. As a result, the nerve can become hypersensitive to stimuli and transmit pain at even the slightest trigger. It may also fail to stop transmitting even after the stimulation that caused it is over.

Although the condition may not always be curable, there are various ways to effectively manage it. The most conservative way is with medications that block the nerve from transmitting pain signals to the brain, coupled with drugs that help stabilize the nerve and decrease abnormal firing.

If medication isn't enough to relieve symptoms, there may be some benefit from more invasive treatments. One technique is to insert a thin needle into the nerve to selectively damage nerve fibers to prevent them from firing. Another microsurgical procedure attempts to relocate the nerve away from a blood vessel that may be compressing it.

The latter procedure has some higher risks such as facial numbness or decreased hearing, and is often better suited for younger patients. Older patients may benefit more from the needle insertion procedure previously mentioned or a directed beam of high-dose radiation to alter the nerve.

To learn the best options for you, you should first undergo a neurological exam to verify you have trigeminal neuralgia and to rule out other causes. From there, you and your doctor can decide the best course of treatment for your age and individual condition.

Trigeminal neuralgia can be an unpleasant experience. But there are tried and true ways to minimize its effect on your life.

If you would like more information on trigeminal neuralgia, 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 “Trigeminal Neuralgia.”

TooMuchSugarCanWreckMoreThanYourTeeth

You've heard it. Your parents heard it—maybe even your grandparents too. Dentists have been alerting people for more than half a century that high sugar consumption contributes to tooth decay.

That message hasn't changed because the facts behind it are the same in the 2020s as they were in the 1950s: The bacteria that cause tooth decay feast on sugar and other leftover carbohydrates in the mouth. This causes them to multiply and increase their production of acid, which softens and erodes tooth enamel.

What has changed though, especially over the last couple of decades, is a growing understanding of how sugar consumption may affect the rest of the body. Just like the evidence of sugar's relationship to tooth decay, current scientific studies are now showing there are strong links between sugar and diseases like diabetes, heart disease and liver disease.

What's startling about what researchers are finding is that cases of these diseases are growing, Especially in younger people. This is a parallel trend to our skyrocketing increases in per capita sugar consumption: the average American now eats the equivalent of 19.5 teaspoons of added sugar every day. Health experts generally agree we should consume no more than 6 teaspoons a day, and children 4.

This is vastly more than we consumed a generation ago. One reason is because processed food manufacturers have increased sugar in their products, hiding under technical, unfamiliar names in ingredient lists. But it's still sugar, and an estimated 74% of processed foods contain some form of it.

But the real surge in sugar has come from our increasing consumption of sodas, as well as energy and sports beverages. These beverages are high in sugar—you can meet your daily allowance with just one 12-oz can of soda. These beverages are now the leading source of sugar in our diets, and, according to experts, a highly dangerous way to consume it.

In effect, dentists of old were on to something: too much sugar is bad for your teeth. It now turns out that it may be bad for your overall health too. Strictly limiting it in your family's diet could help lower your risk of tooth decay and dangerous diseases like diabetes.

If you would like more information on sugar and your health, please contact us or schedule an appointment for a consultation.

How botox from your dentists in Mill Creek, Washington can help you look your best.

Did you know your dentist can help you look younger? It’s true, thanks to the skills of your dentist and Botox. Dr. Chad Slocum and Dr. Sara Lundgaard at Penny Creek Family & Implant Dentistry in Mill Creek, Washington offer a wide range of cosmetic dentistry services, including Botox treatment.

Botox is an injectable medication at the forefront of anti-aging services. It works by temporarily freezing the nerves and muscles at the injection site. After Botox, skin appears smoother, and the appearance of lines and wrinkles is dramatically reduced.

Lines and wrinkles form as you get older because your skin loses moisture and elasticity over time. When you laugh, smile, or show other emotions, your skin doesn’t snap back the way it did when you were younger. Instead, the lines of emotion grow deeper and more permanent over time.

Botox can smooth out the lines and wrinkles, so you and your skin appear much younger. Consider Botox treatment to help reduce the appearance of:

  • Crow’s feet, the lines appearing at the corners of your eyes
  • Furrows, the lines running across your forehead
  • Glabella, the lines between your eyebrows
  • Smile and laugh lines running from your nose to your mouth

The number of injections you need will depend on the area being treated. Results typically last between 4 and 6 months, and maintenance treatments are recommended.

Consider Botox treatment from your dentist. Botox can be an important part of an anti-aging routine to keep you looking your best. To find out more about how Botox from your dentist can help you, call Dr. Chad Slocum and Dr. Sara Lundgaard of Penny Creek Family & Implant Dentistry in Mill Creek, Washington at (425) 337-7300. Call today.

ThisFebruaryShowaLittleLovetoBothYourHeartandYourGums

It’s February and time for a little heart love. And not just the Valentine’s Day kind: February is also American Heart Month, when healthcare providers promote cardiovascular health. That includes dentists, because cardiovascular health goes hand in hand with dental health.

It just so happens that February is Gum Disease Awareness Month too. If that’s a coincidence, it’s an appropriate one: Although different in nature and health impact, heart disease and gum disease are linked by a common thread: chronic inflammation.

Inflammation (or tissue swelling) in and of itself is beneficial and often necessary. When cells in the body are injured or become diseased, the immune system isolates them from healthier cells through inflammation for the protection of the latter. Once the body heals, inflammation normally subsides.

But conditions surrounding both heart disease and gum disease often prevent a decrease in inflammation. With heart disease, for example, fatty deposits called plaque accumulate within blood vessels, impeding blood flow and triggering inflammation.

A different kind of plaque plays a pivotal role with gum disease. Dental plaque is a thin biofilm that builds up on tooth surfaces. It’s home to bacteria that can infect the gums, which in turn elicits an inflammatory response within those affected tissues. Unless treated, the infection will continue to grow worse, as will the inflammation.

The bad news is that these two sources of chronic inflammation are unlikely to stay isolated. Some recent studies indicate that cardiovascular inflammation worsens gum inflammation, and vice-versa, in patients with both conditions.

The good news, though, is that treating and managing inflammation related to either condition appears to benefit the other. Patients with cardiovascular disease can often reduce their inflammation with medical treatment and medications, exercise and a heart-friendly diet.

You can also ease gum disease inflammation by undergoing dental plaque removal treatment at the first signs of an infection. And, the sooner the better: Make a dental appointment as soon as possible if you notice swollen, reddened or bleeding gums.

You can lower your gum disease risk by brushing and flossing daily to remove accumulated plaque, and visiting us at least twice a year for more thorough dental cleanings and checkups. If you’ve already experienced gum disease, you may need more frequent visits depending on your gum health.

So this February, while you’re showing your special someone how much you care, show a little love to both your heart and your gums. Your health—general and oral—will appreciate it.

If you would like more information about gum health, please contact us or schedule a consultation.

3ThingsYouCanDotoProtectYourToothEnamel

Your teeth face a hostile environment populated by disease-causing bacteria. But your teeth also have some “armor” against these microscopic foes: enamel. This hard outer tooth layer forms a barrier between harmful bacteria and the tooth’s more vulnerable layers of dentin and the inner pulp.

But although it’s tough stuff, enamel can erode when it comes into contact with high concentrations of mouth acid. Losing substantial amounts of enamel could leave your teeth exposed to disease.

So, here are 3 things you can do to help protect your enamel so it can keep on protecting you.

Careful on the brushing. Brushing removes dental plaque, a thin bacterial film on teeth most responsible for dental disease. But be careful not to brush too often, too hard and too quickly after eating. Brushing more than twice a day can cause gum recession and enamel wear; likewise, brushing too aggressively. You should also wait at least 30 minutes after eating to brush to give your saliva sufficient time to neutralize any acid. You could lose tiny bits of softened enamel brushing too soon.

Cut back on acidic foods and beverages. Spicy foods, sodas and, yes, sports and energy drinks all contain high amounts of acid that can increase your mouth’s acidity. It’s a good idea, then, to reduce acidic foods and beverages in your diet. Instead, eat less spicy foods and drink primarily water or milk. Also, look for foods and beverages with calcium, which helps increase your enamel’s ability to remineralize after acid contact.

Don’t eat right before bedtime. There are a lot of reasons not to eat just before you hit the hay—and one of them is for protecting your tooth enamel. Saliva normally neutralizes acid within a half hour to an hour after eating. While you’re sleeping, though, saliva production decreases significantly. This in turn slows its neutralizing effect, giving acid more contact time with enamel. So, end your eating a few hours before you turn in to avoid too much acid remaining on your teeth.

If you would like more information on protecting your teeth and gums from dental disease, please contact us or schedule an appointment for a consultation.

CustomMouthguardsArentJustforNFLSuperstars

If while watching a Seattle Seahawks game you thought you saw wide receiver D. K. Metcalf sucking on a “binky,” your eyes weren’t deceiving you. Well, sort of not—he’s actually been known to wear a mouth and lip guard shaped like a child’s pacifier.

Metcalf isn’t the only pro football player customizing this essential piece of safety equipment. Broncos running back Ronnie Hillman has been seen sporting “vampire fangs.” And Odell Beckham Jr., wide receiver with the Cleveland Browns, has a series of interchangeable guards with various designs and colors.

You may say, “That’s the NFL, so of course players have the money and fame to dress up their mouthguards with a little flair.” But custom mouthguards aren’t out of reach for the average athlete—in fact, it’s actually a sound idea. Not so much for expressing personality, but for the comfort and protective advantages that a custom mouthguard may have over retail varieties.

Usually made of high-resistant plastic, an athletic mouthguard absorbs blows to the face and mouth during hard contacts in sports like football, basketball and hockey. Mandated by many organized sports associations, mouthguards can prevent dental and facial injuries like chipped or knocked out teeth, gum abrasions or jaw fractures. There’s even some evidence they reduce the risk of concussion.

Many amateur players use what is known as a “boil and bite” mouthguard, available in retail sporting goods stores. They’re softened first, usually in hot water, and then placed in the mouth and clenched between the jaws to obtain a somewhat individualized fit.

Although they do provide some level of protection, a boil and bite mouthguard can’t match the accuracy of a custom mouthguard produced by a dentist based on impressions and measurements of an individual player’s mouth. As a result, custom mouthguards can be made thinner than many boil and bite guards, increasing their comfort while being worn. More importantly, their accurate fit enhances their protective capabilities.

As you might imagine, custom mouthguards are more expensive than their retail counterparts, and with younger athletes whose mouth structures are still growing, it may be necessary to upgrade a custom guard after a few seasons. Still, the cost of a custom mouthguard may be well worth the superior protection it provides for your own little star athlete. And although it may not necessarily look like a binky or vampire fangs, a custom mouthguard could make their playing experience safer and more comfortable.

If you would like more information about custom athletic mouthguards, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Athletic Mouthguards.”

FollowtheFast-FoodLeadCutBackSodasinYourChildsDiet

You can find some version of the ever popular kids’ meal at most major fast-food restaurants. It’s a neat little package: child’s size portions of burgers, chicken nuggets or sides—and often a small toy or treat to boot—all tucked into its own colorful cardboard container.

The drive-thru menu board at your favorite fast-food joint gives you plenty of choices to fill out your child’s meal. But you may notice something missing on many major chains’ kids’ menus—the mention of soft drinks as a beverage choice. You can still get one for your child’s meal, but the visual cue is no more on the menu board.

None of the “Big Three”—Burger King, McDonald’s or Wendy’s—post soft drinks as a menu item for their kid’s meals. It’s the result of an effort by health advocates promoting less soda consumption by children, the leading source of calories in the average child’s diet. With its high sugar content, it’s believed to be a major factor in the steep rise in child obesity over the last few years.

Sodas and similar beverages are also prime suspects in the prevalence of tooth decay among children. Besides sugar, these beverages are also high in acid, which can erode tooth enamel. These two ingredients combined in soda can drastically increase your child’s risk of tooth decay if they have a regular soda habit.

You can minimize this threat to their dental health by reducing their soda consumption. It’s important not to create a habit of automatically including sodas with every meal, especially when dining out. Instead, choose other beverages: Water by far is the best choice, followed by regular milk. Chocolate milk and juice are high in sugar, but they’re still a healthier choice than sodas due to their nutrient content.

Keeping sodas to a minimum could help benefit your child later in life by reducing their risk for heart disease, diabetes and other major health problems. It will also help them avoid tooth decay and the problems that that could cause for their current and future dental health.

If you would like more information on these and other effective practices for protecting your child against tooth decay, please contact us or schedule an appointment for a consultation.

YouMayNeedSomethingOtherThanOintmenttoClearupThisFacialRash

During your latest dental cleaning and checkup, your dentist notices a skin rash around your mouth. You sigh—it’s been going on for some time. And every ointment you’ve tried doesn’t help.

You may have peri-oral dermatitis, a type of skin rash dentists sometime notice during dental treatment. It doesn’t occur often—usually in only 1% of the population—but when it does, it can be resistant to common over-the-counter ointments.

That’s because peri-oral dermatitis is somewhat different from other facial rashes. Often mistaken as acne, the rash can appear as small red bumps, blisters or pus-filled pimples most often around the mouth (but not on the lips), nostrils or even the eyes. Sometimes the rash can sting, itch or burn.

People with peri-oral dermatitis often try medicated ointments to treat it. Many of these contain steroids that work well on other skin conditions; however, they can have an opposite effect on peri-oral dermatitis.

Because the steroids cause a constriction in the tiny blood vessels of the skin, the rash may first appear to be fading. This is short-lived, though, as the rash soon returns with a vengeance. Prolonged steroid applications can also thin the affected skin, making it more susceptible to infection and resistant to healing.

Peri-oral dermatitis requires a different treatment approach. The first step is to stop using any kind of steroidal cream, as well as moisturizers, ointments and both prescription and non-prescription medications. Instead, you should only use a mild soap to wash your face.

You may find the rash looking worse for a few days but be patient and continue to avoid ointments or creams. Your healthcare provider may also prescribe oral antibiotics, usually of the tetracycline family. It may take several weeks of antibiotic treatment until the skin noticeably clears up.

For most people, this approach puts their rash into permanent remission. Some, though, may see a reoccurrence, in which case it’s usually best to repeat treatment. With a little patience and care, though, you’ll finally see this persistent rash fade away.

If you would like more information on peri-oral dermatitis, please contact us or schedule an appointment for a consultation.

HeresHowtoCutThroughAlltheChoicestoFindYourRightToothbrush

Henry Ford famously said a customer could have any color they wanted on their Model T “as long as it was black.” Those days are over—today’s cars and trucks come with a slew of options, and not just their paint color.

There’s something else with a wide array of possible options: your choice of toothbrush. Your local store’s dental care aisle has dozens of toothbrushes in a myriad of sizes, shapes and features. And many promise better hygiene outcomes because of their unique design.

It’s enough to make your head spin. But you can narrow your search for the right toothbrush— just look for these basic qualities.

Bristle texture. At this all-important juncture between brush and teeth, softer-textured bristles are better. That might sound counter-intuitive, but soft bristles are just as capable at removing bacterial plaque, that sticky tooth film most responsible for dental disease, as stiffer bristles. Stiffer bristles, on the other hand, can damage gums and cause recession. Also, look too for rounded bristles (gentler on the gums), and multi-leveled or angled ones for better access around teeth.

Size and shape. Toothbrushes come in different sizes because, well, so do mouths. Look, then, for a brush and bristle head that can comfortably reach all the teeth in your mouth. If you have problems with manual dexterity, choose a brush with larger grip handles. A brush that’s comfortable to use and easy to handle can make your brushing more effective.

ADA Seal of Acceptance. The American Dental Association tests hygiene products like toothbrushes. If they pass the association’s standards, the manufacturer includes the ADA Seal of Approval on their packaging. Not all submit their brushes for this evaluation, so the seal’s absence doesn’t necessarily mean a brush is of low quality. The seal, though, does tell you the product passes muster with dental professionals.

It often takes a little trial and error to find the right brush, but since you should change yours out every six months, it’s a small price to experiment. And, no matter how great the brush, it’s only as good at removing plaque as the hand that holds it. So, be sure you learn proper brushing techniques—that and the right brush will keep your teeth and gums healthy.

If you would like more information on choosing the right toothbrush, 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 “Sizing Up Toothbrushes.”

MakeYourBabyasComfortableasPossibleDuringTeething

Your sweet, good-natured baby has seemingly gone from zero to grumpy overnight. The reason is simple: They’re teething.

Teething is a natural process in which a baby’s first teeth (primary teeth) begin to break through the gums, usually between six and nine months of age. This process continues intermittently until all twenty of the primary teeth erupt, sometime around age 3.

This uncomfortable and sometimes painful experience can cause gum swelling, biting and gnawing, chin rash and drooling. Your child may become irritable not only from this physical discomfort but also from disrupted sleep patterns and decreased appetite that often accompanies teething.

While you may have an unhappy baby while they’re teething, there’s usually no cause for concern. This is a natural process all children encounter, and the best thing you can do is make them as comfortable as possible. An exception would be accompanying diarrhea, fever or lingering crankiness—these could be symptoms of a more serious condition. If you begin to notice these, consult your doctor as soon as possible.

During teething there are a number of things you can do to reduce irritation. For one, allow your child to chew on clean, chilled (not frozen) teething rings, or a cold wet washcloth. The cold will help numb their irritated gum tissues. Massaging their gums with a clean finger can also help counteract the pressure caused by the incoming tooth.

If your doctor advises, you can also give your child over-the-counter pain relievers like acetaminophen or ibuprofen in an age-appropriate dosage. But be sure you give these medications orally and not rub them on the gums—some ingredients in them could burn the tissues. You should also not apply rubbing alcohol to the gums for the same reason. And avoid products with the numbing agent Benzocaine® in children less than two years of age unless your doctor advises otherwise.

Teething isn’t always a pleasant time for your baby or you, but it’s necessary—and temporary. In no time at all this discomfort will pass, and in its place will be their first set of teeth.

If you would like more information on teething, 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 “Teething Troubles: How to Help Keep Your Baby Comfortable.”

CertainOsteoporosisDrugsCouldPoseaFutureRisktoYourDentalHealth

Osteoporosis is a major health condition affecting millions of people, mostly women over 50. The disease weakens bone strength to the point that a minor fall or even coughing can result in broken bones. And, in an effort to treat it, some patients might find themselves at higher risk of complications during invasive dental procedures.

Over the years a number of drugs have been used to slow the disease’s progression and help the bone resist fracturing. Two of the most common kinds are bisphosphonates (Fosamax™) and RANKL inhibitors (Prolia™). They work by eliminating certain bone cells called osteoclasts, which normally break down and eliminate older bone cells to make way for newer cells created by osteoblasts.

By reducing the osteoclast cells, older bone cells live longer, which can reduce the weakening of the bone short-term. But these older cells, which normally wouldn’t survive as long, tend to become brittle and fragile after a few years of taking these drugs.

This may even cause the bone itself to begin dying, a relatively rare condition called osteonecrosis. Besides the femur in the leg, the bone most susceptible to osteonecrosis is the jawbone. This could create complications during oral procedures like jaw surgery or tooth extractions.

For this reason, doctors recommend reevaluating the need for these types of medications after 3-5 years. Dentists further recommend, in conjunction with the physician treating osteoporosis, that a patient take a “drug holiday” from either of these two medications for several months before and after any planned oral surgery or invasive dental procedure.

If you have osteoporosis, you may also want to consider alternatives to bisphosphonates and RANKL inhibitors. New drugs like raloxifene (which may also decrease the risk of breast cancer) and teriparatide work differently than the two more common drugs and may avoid their side effects. Taking supplements of Vitamin D and calcium may also improve bone health. If your physician still recommends bisphosphonates, you might discuss newer versions of the drugs that pose less risk of osteonecrosis.

Managing osteoporosis is often a balancing act between alleviating symptoms of the disease and protecting other aspects of your health. Finding that balance may help you avoid future problems, especially to your dental health.

If you would like more information on osteoporosis and dental care, 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 “Osteoporosis Drugs & Dental Treatment.”

DoaLittleExtraFoodPreptoEaseTMDDiscomfort

Because it requires jaw movement, eating can be difficult and painful if you have a temporomandibular joint disorder (TMD). During flareups you may switch to foods that are easier to eat but may be less nutritious than those you're giving up.

But there are ways to keep healthier foods in your diet while minimizing TMD discomfort. In many cases, it's a matter of preparing your food differently. Here are a variety of food groups known for their nutritional value and what you can do to prepare them for easier eating with TMD.

Fruits and Vegetables. You should peel any fruits or vegetables with hard or chewy skin like apples, peaches or cucumbers. Try chopping or pureeing fruits and vegetables you can eat raw to reduce their size and make them easier to chew. Vegetables like carrots, potatoes, broccoli or cauliflower can be cooked, then chopped or mashed.

Legumes and nuts. Pod-based vegetables like beans or peas provide a number of nutritional elements, as do nuts with their healthy fats. Your motto with these foods should be "Not too large and not too hard." Be sure then to cook, mash or puree legumes that are larger than a pea. With nuts, try nut butters for a softer serving than eating them out of the shell.

Protein and Dairy. Any meats like poultry or beef should be cut into bite-sized pieces; you can also moisten them with broths, gravies or sauces for easier chewing, or braise or stew them in liquid to tenderize them. You can also consume most milk, yogurt or cheese products you can tolerate. If you can't, try alternatives like meal replacement or whey protein beverages.

Grains. Prepare grains by cooking them until they're softened. Hot cereals like oatmeal offer a lot of nutrition and they're relatively easy to eat. Toast your bread and cut the slice into smaller pieces to minimize jaw movement.

One last tip: take your time while eating. A slower rate not only helps you enjoy your food more, it reduces the amount of work your jaws perform while eating. Less jaw work can help further ease the discomfort of TMD.

If you would like more information on how to relieve TMD pain and dysfunction, 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 “What to Eat When TMJ Pain Flares Up.”

DontPanicOverYourChildsTeethGrindingbutDoKeepanEyeonIt

First the bad news: Those nightly hair-raising sounds are indeed coming from your child’s bedroom—from your child. It’s the result of them grinding their teeth while they sleep.

But here’s the good news: the only likely harm is a lack of sleep members of your household might experience because of it. Teeth grinding is so prevalent among pre-teen children that many healthcare professionals consider it normal. But that doesn’t mean it can’t become a problem, so it’s worth monitoring.

Teeth grinding is part of a family of dental habits known as bruxism. It involves any involuntary movement of the teeth and jaws outside of their intended functions not associated with chewing, speaking or swallowing. Our main concern with any bruxism is the possibility for generating stronger biting forces than normal that could damage teeth and gums and contribute to jaw joint problems.

Teeth grinding can occur in adulthood, with stress seeming to be the major trigger for it. With children, though, it’s believed to be mainly caused by an immaturity of the child’s neuromuscular process that controls chewing. As this matures, most children will tend to outgrow the habit none the worse for wear.

But there are pediatric cases in which the generated biting forces are strong enough to cause damage. Teeth grinding is also prevalent in children who snore or breathe through their mouths, which could be a sign of a serious health condition called obstructive sleep apnea. And certain medications used to treat depression and attention deficit disorder (ADHD) may also contribute to teeth grinding.

Most of the time we can simply let the habit run its course. If, however, the child begins to experience abnormal tooth wear, headaches, jaw pain or other issues believed caused by teeth grinding, we may need to intervene. This could include a plastic night guard the child wears during sleep that prevents the teeth from making solid contact during grinding episodes. And children with signs of airway obstruction should be evaluated by an ear, nose and throat specialist.

It can be irritating or even distressing. But your child’s teeth grinding doesn’t mean you should be alarmed—only that you should keep your eye on it.

If you would like more information on teeth grinding and similar habits, 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 “When Children Grind Their Teeth.”

PopStarDemiLovatoPopsOutJayGlazersTooth

Singer and actor Demi Lovato has a new claim to fame: formidable martial artist. When she is not in the recording studio, on stage or in front of the camera, Lovato can often be found keeping in shape at Jay Glazer's Hollywood (California) gym. Glazer, who is best known as a sports journalist, also runs conditioning programs for professional athletes and celebrities based on mixed martial arts. On March 6, Glazer got more than he bargained for when 5'3" Lovato stepped into the ring and knocked out his front tooth.

Glazer reportedly used super glue to put his tooth back together. Not a good idea! While it may not be convenient to drop everything and get to the dental office, it takes an expert to safely treat a damaged tooth. If you glue a broken tooth, you risk having to undergo major work to correct your temporary fix—it's no easy task to "unglue" a tooth, and the chemicals in the glue may damage living tooth tissue as well as the surrounding gum and bone.

Would you know what to do in a dental emergency? Here are some guidelines:

  • If you chip a tooth, save the missing piece if possible. We may be able to reattach it.
  • If your tooth is cracked, rinse your mouth with warm water, but don't wiggle the tooth around or bite down on it. If it's bleeding, hold clean gauze to the area and call our office.
  • If your tooth is knocked loose or is pushed deeper into the socket, don't force the tooth back into position on your own. Immediate attention is very important.
  • If your tooth is knocked out, there's a chance it can be reattached. Pick up the tooth while being careful not to touch the root. Then rinse it off and have either someone place into its socket, or place it against the inside of your cheek or in a glass of milk. Please call the office immediately or go to a hospital.

What's the best thing to do in an emergency? Call us right away, and DON'T super glue your tooth! You can prevent worse problems by letting a professional handle any dental issues. And if you've been living with a chipped, broken or missing tooth, call us to schedule an appointment for a consultation—there are several perfectly safe ways to restore your smile. Meanwhile, if you practice martial arts to keep in shape, think twice before getting into the ring with Demi Lovato!

To learn more, read the Dear Doctor articles “Trauma & Nerve Damage to Teeth” and “Saving New Permanent Teeth After Injury.”

YourDentistMightHoldtheKeytoSolvingYourSleepApneaProblem

When you awake in the morning do you still feel exhausted? Are you irritable during the day, unable to think or focus clearly? Is your loud snoring bothering your bed partner?

If you answered affirmatively to any of these questions, you may have sleep apnea. This happens when an obstruction (usually the tongue) blocks the airway during sleep, preventing you from breathing. Your brain notices the drop in oxygen and wakes you to re-open the airway. The arousal lasts only a few seconds, and you may not even notice. But because it can happen many times a night, these waking episodes can rob you of the deep sleep your body needs.

Sleep apnea is more serious than simply waking up grumpy. Over time, it could contribute to dangerous health conditions like high blood pressure or heart disease. If you’re noticing any of these signs, it’s important then that you undergo a complete examination by a physician or dentist trained in sleep-related issues.

Fortunately, there are ways to reduce sleep apnea. One of the most common is continuous airway pressure (CPAP): This method uses a small pump that pushes pressurized air through a face mask worn while the patient sleeps. The forced air keeps the airway open and reduces apnea episodes.

While it’s an effective method, it can be uncomfortable and cumbersome to use—some people can’t tolerate wearing the mask while they sleep. But if your sleep apnea symptoms are mild to moderate, your dentist may be able to provide an alternative therapy with a specially designed oral appliance.

Similar to a mouthguard or retainer, a sleep apnea appliance worn during sleep holds the lower jaw forward, which helps move the tongue away from the airway. It’s much less cumbersome (and noisy) than a CPAP machine. And your dentist can custom design and fabricate your appliance for a comfortable fit.

Not all cases of sleep apnea can benefit from such an appliance, or even from CPAP therapy. Extreme cases could require surgery to remove tissues blocking the airway. But most sleep apnea patients don’t require this invasive intervention. Getting checked by a qualified medical professional could open the door to a more convenient and effective way to a better night’s sleep.

If you would like more information on dental solutions for sleep apnea, please contact us or schedule an appointment for a consultation.

HowBigBangTheoryActressMayimBialikGetsHerKidstoFloss

How many actresses have portrayed a neuroscientist on a wildly successful TV comedy while actually holding an advanced degree in neuroscience? As far as we know, exactly one: Mayim Bialik, who plays the lovably geeky Amy Farrah Fowler on CBS' The Big Bang Theory… and earned her PhD from UCLA.

Acknowledging her nerdy side, Bialik recently told Dear Doctor magazine, “I'm different, and I can't not be different.” Yet when it comes to her family's oral health, she wants the same things we all want: good checkups and great-looking smiles. “We're big on teeth and oral care,” she said. “Flossing is really a pleasure in our house.”

How does she get her two young sons to do it?

Bialik uses convenient pre-loaded floss holders that come complete with floss and a handle. “I just keep them in a little glass right next to the toothbrushes so they're open, no one has to reach, they're just right there,” she said. “It's really become such a routine, I don't even have to ask them anymore.”

As many parents have discovered, establishing healthy routines is one of the best things you can do to maintain your family's oral health. Here are some other oral hygiene tips you can try at home:

Brush to the music — Plenty of pop songs are about two minutes long… and that's the length of time you should brush your teeth. If brushing in silence gets boring, add a soundtrack. When the music's over — you're done!

Flossing can be fun — If standard dental floss doesn't appeal, there are many different styles of floss holders, from functional ones to cartoon characters… even some with a martial-arts theme! Find the one that your kids like best, and encourage them to use it.

The eyes don't lie — To show your kids how well (or not) they are cleaning their teeth, try using an over-the-counter disclosing solution. This harmless product will temporarily stain any plaque or debris that got left behind after brushing, so they can immediately see where they missed, and how to improve their hygiene technique — which will lead to better health.

Have regular dental exams & cleanings — When kids see you're enthusiastic about going to the dental office, it helps them feel the same way… and afterward, you can point out how great it feels to have a clean, sparkling smile.

For more information about oral hygiene, please contact our office or schedule a consultation. You can read the interview with Mayim Bialik in the latest issue of Dear Doctor magazine.

YourReoccurringSinusInfectionsMayActuallyBeCausedbyToothDecay

If you suffer frequent sinus infections, you might want to talk with your dentist about it. It could be your chronic sinus problems stem from a deeply decayed or infected tooth.

Sinuses are hollow, air-filled spaces in the front of the skull associated with nasal passages. The largest, the maxillary sinuses, are located just behind the cheekbones and above and to the rear of the upper jaw on either side of the face. These sinuses can become painfully congested when infected.

One possible cause for an infection in the maxillary sinus can occur in certain people whose upper back teeth (the molars and premolars) have roots that are close to or even protrude into the sinus. This is normally a minor anatomical feature, unless such a tooth becomes infected.

An infection in teeth with advancing decay or whose nerve tissue has died will eventually reach the root tip through tiny passageways called root canals. If the roots are close to or penetrating the maxillary sinus, the infection could move into the sinus. This is known as Maxillary Sinusitis of Endodontic Origin (MSEO).

A case of MSEO could potentially go on for years with occasional flare-ups of sinus congestion or post-nasal drip. Because of the nature of the infection within the sinus, the affected tooth itself may not show the normal signs of infection like sensitivity or pain. Doctors may attempt to treat the sinus infection with antibiotics, but because the actual source of the infection is within the tooth, this therapy is often ineffective.

If your doctor or dentist suspects MSEO, they may refer you to an endodontist, a specialist in root canals and interior tooth problems. With their advanced diagnostic capabilities, endodontists may have a better chance of accurately diagnosing and locating the source of a tooth-related infection.

As with any non-vital tooth, the likely treatment will be root canal therapy in which the infected tissue within the tooth is removed and the empty spaces filled to prevent future infection. For MSEO, the treatment not only preserves the tooth but may also relieve the infection within the sinus.

If you would like more information on the possible dental causes to sinus problems, please contact us or schedule an appointment for a consultation.

EvenAll-NaturalFruitJuiceCouldIncreasetheRiskofToothDecay

All-natural fruit juice with no additives: now what could be wrong with that? Nothing—unless your child is over-indulging. Too much of even natural fruit juice could increase their risk of tooth decay.

To understand why, we first need to look at the real culprit in tooth decay: mouth acid produced by oral bacteria as a byproduct of their digestion of sugar. Acid at high levels softens and erodes tooth enamel, which causes tooth decay. Acid levels can rise as populations of bacteria increase often fueled by sugar, one of bacteria's primary food sources.

And not just the added sugar found in soft drinks, snacks or candies—even fructose, the natural sugar found in fruit, can feed bacteria. To lower the risk of tooth decay, dentists recommend limiting the daily amount of sugar a child consumes, including natural fruit juices without added sugar.

That doesn't mean you should nix natural fruit juices altogether—they remain a good source of vitamins, minerals and other nutrients. But you'll need to keep your child's juice consumption within moderation.

As a guide, the American Academy of Pediatrics (AAP) has issued consumption recommendations for children regarding all-natural fruit juice. The academy recommends the following daily juice amounts by age:

  1. 7-18: 8 ounces (1 cup) or less;
  2. 4-6: 6 ounces or less;
  3. 1-3: 4 ounces or less;
  4. Under 1: No juice at all.

You can further reduce your child's decay risk by limiting their juice intake to mealtimes, a good practice with any sweetened beverage. Sipping through the day on juice or other sweetened beverages can cause some sugar to stay in the mouth over long periods. This can interfere with the natural ability of saliva to neutralize any acid buildup.

If you're wondering what children could drink instead of juice, low-fat or non-fat milk is an acceptable choice. But the most tooth-friendly liquid to drink is plain water. Drinking nature's hydrator is not only better for their overall health, by reducing the risk of tooth decay, it's also better for their teeth.

If you would like more information on how sugar can affect your child's dental health, 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 “Squeeze Out the Juice.”

YouMayNeedtoPostponeanUpcomingDentalVisitifYouHaveShingles

Chicken pox is a common viral infection that usually occurs during childhood. Although the disease symptoms only last a short time, the virus that caused it may remain, lying dormant for years within the body's nervous system. Decades later it may reappear with a vengeance in a form known as herpes zoster, what most people know as shingles.

A shingles outbreak can be quite painful and uncomfortable—and it's also not a condition to take lightly. Occurring mainly in people over fifty, it often begins with an itching or burning sensation in the skin. This is often followed by a red rash breaking out in a belt-like pattern over various parts of the body, which may later develop into crusty sores. Symptoms may vary from person to person, but people commonly experience severe pain, fever and fatigue.

Besides the general discomfort it creates, shingles can also pose major health problems for certain people. Individuals with other health issues like pregnancy, cancer or a compromised immune system may experience serious complications related to a shingles outbreak.

In its early stages, shingles is contagious, spreading through direct contact with shingles sores or lesions or through breathing in the secretions from an infected person. This characteristic of shingles could affect your dental care: because the virus could potentially pass to staff and other patients, dentists usually postpone cleanings or other dental treatments for patients with shingles, particularly if they have a facial rash.

If you're diagnosed with shingles, most physicians recommend you begin antiviral treatment as soon as possible. You should also let your dentist know if you have shingles, which may put off any scheduled treatments until your doctor determines you're no longer contagious.

There's one other thing you can do, especially if you're over 60: obtain a shingles vaccine, available from most physicians or clinics. The vaccine has proven effective in preventing the disease, and could help you avoid this most unpleasant health experience.

If you would like more information on shingles and its effect on dental care, please contact us or schedule an appointment for a consultation.

HealthySmilesforAlfonsoRibeiroandFamily

If there's anything that makes Alfonso Ribeiro happier than his long-running gig as host of America's Funniest Home Videos, it's the time he gets to spend with his family: his wife Angela, their two young sons, and Alfonso's teenaged daughter. As the proud dad told Dear Doctor–Dentistry & Oral Health magazine, "The best part of being a father is the smiles and the warmth you get from your children."

Because Alfonso and Angela want to make sure those little smiles stay healthy, they are careful to keep on top of their kids' oral health at home—and with regular checkups at the dental office. If you, too, want to help your children get on the road to good oral health, here are five tips:

  • Start off Right—Even before teeth emerge, gently wipe baby's gums with a clean, moist washcloth. When the first teeth appear, brush them with a tiny dab of fluoride on a soft-bristled toothbrush. Schedule an age-one dental visit for a complete evaluation, and to help your child get accustomed to the dental office.
  • Teach Them Well—When they're first learning how to take care of their teeth, most kids need a lot of help. Be patient as you demonstrate the proper way to brush and floss…over and over again. When they're ready, let them try it themselves—but keep an eye on their progress, and offer help when it's needed.
  • Watch What They Eat & Drink—Consuming foods high in sugar or starch may give kids momentary satisfaction…but these substances also feed the harmful bacteria that cause tooth decay. The same goes for sodas, juices and acidic drinks—the major sources of sugar in many children's diets. If you allow sugary snacks, limit them to around mealtimes—that gives the mouth a chance to recover its natural balance.
  • Keep Up the Good Work—That means brushing twice a day and flossing at least once a day, every single day. If motivation is an issue, encourage your kids by letting them pick out a special brush, toothpaste or floss. You can also give stickers, or use a chart to show progress and provide a reward after a certain period of time. And don't forget to give them a good example to follow!
  • Get Regular Dental Checkups—This applies to both kids and adults, but it's especially important during the years when they are rapidly growing! Timely treatment with sealants, topical fluoride applications or fillings can often help keep a small problem from turning into a major headache.

Bringing your kids to the dental office early—and regularly—is the best way to set them up for a lifetime of good checkups…even if they're a little nervous at first. Speaking of his youngest child, Alfonso Ribeiro said "I think the first time he was really frightened, but then the dentist made him feel better—and so since then, going back, it's actually a nice experience." Our goal is to provide this experience for every patient.

If you have questions about your child's dental hygiene routine, call the office or schedule a consultation. You can learn more in the Dear Doctor magazine article “How to Help Your Child Develop the Best Habits for Oral Health.”

IfYoureOlderbeontheLookoutforRootCavities

Tooth decay is a destructive oral disease, which along with periodontal (gum) disease is most responsible for tooth loss. And as you age, your disease risk goes up.

One form of decay older people often experience is root cavities. Unlike those occurring in the visible crown, root cavities often occur below the gum line and are especially destructive to tooth structure.

That's because, unlike the crown protected by ultra-hard enamel, the roots are covered by a thin, mineralized material called cementum. Although cementum offers some protection, it can't compare with the decay-resistant capacity of enamel.

The roots also depend on gum coverage for protection. But unfortunately, the gums can shrink back or recede, usually due to gum disease or over-aggressive brushing, and expose some of the root surface. With only the cementum to protect them, the roots can become highly susceptible to decay. If a cavity forms here, it can rapidly advance into the tooth's interior, the pulp, weakening the tooth and increasing its risk of loss.

To stop the decay, we must treat root cavities much like we do with crown cavities: by removing any decayed structure and then filling the cavity. But root cavities are often more difficult to access depending on how far below the gum line they extend. We may need to perform minor gum surgery to expose the cavity to treat it.

But as with any form of tooth decay, the best strategy is to prevent root cavities in the first place. Your first line of defense is a daily hygiene habit of brushing and flossing to remove dental plaque, the main cause for tooth decay. You should also visit your dentist at least twice a year (or more, if recommended) for more thorough cleanings and checkups. Your dentist can also recommend or prescribe preventive rinses, or apply fluoride to at-risk tooth surfaces to strengthen them.

You should also be on the lookout for any signs of gum disease. If you see swollen, reddened or bleeding gums, see your dentist as soon as possible. Stopping possible gum recession will further reduce your risk of root cavities.

If you would like more information on the prevention and treatment of 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 “Root Cavities: Tooth Decay Near the Gum Line Affects Many Older Adults.”

PrimaryTeethareCriticaltoFutureDentalHealthandWorthPreserving

Ask any kid and they'll tell you just how valuable "baby" teeth really are—out of the mouth, of course, and under their pillow awaiting a transaction with the Tooth Fairy. But there's more to them than their value on the Fairy Exchange Market—they play a critical role in future dental health.

Primary teeth provide the same kind of dental function as their future replacements. Children weaned from nursing can now eat solid food. They provide contact points for the tongue as a child learns to speak. And they play a role socially, as children with a "toothsome" smile begin to look more like what they will become when they're fully mature.

But primary teeth also serve as guides for the permanent teeth that will follow. As a future tooth develops below the gum line, the primary tooth preserves the space in which it will erupt. Otherwise, the space can be taken over by other teeth. This crowds out the intended tooth, which may erupt out of position or remain impacted below the gum line.

In either case, the situation could create a poor bite (malocclusion) that can be quite costly to correct. But if we can preserve a primary tooth on the verge of premature loss, we may be able to reduce the impact of a developing malocclusion or even prevent it.

We can help primary teeth last for their intended lifespan by preventing tooth decay with daily oral hygiene or clinically-applied sealants and topical fluoride. If they do become infected, it may be worth the effort to preserve them using procedures similar to a root canal treatment.

If a tooth can't be preserved, then we can try to reserve the empty space for the future tooth. One way is a space maintainer, which is a stiff wire loop attached to metal band bonded around an adjacent tooth. This keeps other teeth from drifting into the space until the permanent tooth is ready to erupt, at which time we can remove the appliance.

Your child may be anxious to get another tooth to put under their pillow. But helping that primary tooth go the distance will be more than worth it for their future dental health.

If you would like more information on the care and treatment of baby teeth, 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 “Importance of Baby Teeth.”

3ThingsYoucandotoSlowToothWear

Unlike our primitive ancestors, our teeth have it relatively easy. Human diets today are much more refined than their counterparts from thousands of years ago. Ancient teeth recovered from those bygone eras bear that out, showing much more wear on average than modern teeth.

Even so, our modern teeth still wear as we age—sometimes at an accelerated rate. But while you can't eliminate wearing entirely, you can take steps to minimize it and preserve your teeth in your later years. Here are 3 things you can do to slow your teeth's wearing process.

Prevent dental disease. Healthy teeth endure quite well even while being subjected to daily biting forces produced when we eat. But teeth weakened by tooth decay are more susceptible to wear. To avoid this, you should practice daily brushing and flossing to remove disease-causing dental plaque. And see your dentist at least twice a year for more thorough dental cleanings and checkups.

Straighten your bite. A poor bite, where the top and bottom teeth don't fit together properly, isn't just an appearance problem—it could also cause accelerated tooth wear. Having your bite orthodontically corrected not only gives you a new smile, it can also reduce abnormal biting forces that are contributing to wear. And don't let age stop you: except in cases of bone deterioration or other severe dental problems, older adults whose gums are healthy can undergo orthodontics and achieve healthy results.

Seek help for bruxism. The term bruxism refers to any involuntary habit of grinding teeth, which can produce abnormally high biting forces. Over time this can increase tooth wear or weaken teeth to the point of fracture or other severe damage. While bruxism is uncommon in adults, it's still a habit that needs to be addressed if it occurs. The usual culprit is high stress, which can be better managed through therapy or biofeedback. Your dentist can also fashion you a custom guard to wear that will prevent upper and lower teeth from wearing against each other.

If you would like more information on minimizing teeth wear, 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 “How and Why Teeth Wear.”

3ThingsYouCandotoHelpPromoteYourChildsDentalDevelopment

Tooth decay and developing bite problems could be major obstacles to your child's normal growth and development. Without good, preventive dental care at home and from the dentist, these obstacles could impact their health now and well into adulthood.

Here are 3 things you should do to help your child stay ahead of harmful dental problems.

Start daily hygiene early. To protect your child from tooth decay, you should begin cleaning their teeth and gums early, even before teeth appear. For your first hygiene efforts use a clean wet cloth to wipe their gums after feeding to reduce bacterial growth in the mouth. After teeth begin to erupt start brushing them with a fluoride toothpaste—a slight smear for infants and up to a pea-sized amount when they get older.

Keep sugar to a minimum. The bacteria that causes tooth decay thrive on sugar. To minimize bacterial growth, keep your child's sugar intake to a minimum by providing dental-friendly snacks and foods. Also, try to limit any sugar they eat to mealtimes rather than with snacking through the day. And avoid sending them to bed with a bottle filled with a sugary liquid (including formula and breastmilk).

Begin dental visits around age one. Dentists and pediatricians recommend regular dental visits for children starting around their first birthday. This increases the chances of detecting disease or bite problems early before too much damage occurs. Your dentist can also provide preventive measures like sealants or topical fluoride to reduce the risks of tooth decay. And early visits lessen the chance of your child developing dental visit anxiety, a phobia that could continue into adulthood.

If you would like more information on protecting your child's dental health, please contact us or schedule an appointment for a consultation.

DentalInjuryIsJustaTemporarySetbackforBasketballStarKevinLove

The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.

In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?

The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.

Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.

So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”

Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.

If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”

ManageYourGERDSymptomstoPreventEnamelErosion

Most dental problems arise from tooth decay and periodontal (gum) disease. But they aren't the only source of danger to your teeth—gastroesophageal reflux disease (GERD) could be just as damaging to your tooth enamel as dental disease.

GERD usually occurs when a ring of muscles at the top of the stomach weaken, allowing stomach acid to enter the esophagus. This resulting acid reflux can make life unpleasant and pose potential health dangers—over time it can damage the lining of the esophagus and cause ulcers and pre-cancerous cells. It can also erode tooth enamel if acid enters the mouth and raises its level of acidity.

This can be a problem because acid can soften and dissolve the mineral content of tooth enamel. This is the primary cause of tooth decay as acid produced by oral bacteria attack enamel. The more bacteria present, often thriving in dental plaque, the higher the potential levels of acid that can damage enamel. Stomach acid, which is strong enough to break down food, can cause similar harm to enamel if it causes higher than normal acidity in the mouth.

There are some things you can do to protect your teeth if you have GERD, namely manage your GERD symptoms with lifestyle changes and medication. You may need to avoid alcohol, caffeine or heavily acidic or spicy foods, all known to aggravate GERD symptoms. Quitting smoking and avoiding late night meals might also ease indigestion. And your doctor may recommend over-the-counter or prescription drugs to help control your acid reflux.

You can also boost your teeth's enamel health by practicing daily brushing and flossing—but not right after a reflux episode. The enamel could be softened, so brushing can potentially remove tiny particles of mineral content. Instead, rinse with water mixed with or without a little baking soda to help neutralize acid and wait about an hour—this will give saliva, the mouth's natural acid neutralizer, time to restore the mouth's normal pH level.

And be sure you're using a fluoride toothpaste. Fluoride strengthens enamel—in fact, your dentist may recommend topical fluoride applications to boost the effect.

These and other tips can help minimize the effects of GERD on your dental health. With an ounce of prevention, you can keep it from permanently damaging your teeth.

If you would like more information on managing your dental health with GERD, 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 “GERD and Oral Health.”

InstillinYourChildtheDailyHabitofBrushingandFlossing

There are a lot of things we do without much conscious thought — habits we've developed over time. Some habits help streamline our lives for the good; others, though, hold us back or even harm us. A lot of these habits, both good and bad, form during our childhood years.

That's why it's important for you to guide your children into forming good habits. The goal is that when they're adults they'll “own” these habits, and their life will be healthier and happier because of them.

One particular area of habit-forming focus is dental care. It's essential your children develop good habits caring for their teeth and gums. The most important is a daily routine of brushing and flossing.

Brushing and flossing has one primary aim: to remove bacterial plaque, a thin film of food particles that builds up on tooth surfaces. Bacteria in plaque are the main cause for two potentially devastating diseases, tooth decay and periodontal (gum) disease. Allowing plaque to build up over just a few days can trigger an infection that inflames the gums or softens enamel leading to tooth decay. Left untreated these diseases can ultimately cause tooth and bone loss.

A daily habit of brushing and flossing, along with semi-annual professional cleanings, can drastically reduce a person's risk for these diseases. It's best to instill these habits and their importance as soon as your child's teeth begin to erupt in the mouth.

In the beginning, you'll be performing the habit for them: for children two and younger use a slight smear of toothpaste on the brush. As they get older, you can increase it to pea size. Eventually you'll want to help them learn to brush on their own. In this case, modeling the behavior — both of you brushing your teeth together — will have the biggest impact and help them see how important the habit really is.

Before you know it, brushing and flossing will become second nature, a habit they'll begin doing on their own without being told. Once instilled, it'll be a habit they'll practice long after they leave your care — and one they'll hopefully pass on to their own children.

If you would like more information on proper dental care for your child, 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 “How to Help Your Child Develop the Best Habits for Oral Health.”

4ThingstoAvoidifYouWanttoSupportYourChildsDentalDevelopment

Your child's oral development generates considerable changes during their "growing up" years. There are a number of things you can do to help support their development—but also things you shouldn't.

Here are 4 things not to do if you want your child to develop healthy teeth and gums.

Neglect daily oral hygiene. To set the best long-term course for optimum oral health, begin cleaning the inside of your child's mouth even before they have teeth. Simply use a clean wet washcloth to wipe their gums after feeding to reduce bacterial growth. Once you begin seeing teeth, start brushing them every day with just a smear of toothpaste; at about age 2 you can increase that to a pea-sized amount. And don't forget to teach them when they're ready to brush and floss on their own!

Allow unlimited sugar consumption. Besides the effect it has on overall health, sugar is also a prime food source for disease-causing oral bacteria. You can reduce the sugar available for bacterial growth by avoiding sugary snacks and limiting sweet foods to meal times. Less sugar means less bacterial growth—and a lower risk of tooth decay for your child.

Put them to bed with a sugary liquid-filled bottle.  Although a bedtime bottle may help calm your baby to sleep, it could also increase their risk of tooth decay. Allowing them to sip on sugar-filled liquids like juice, milk, formula or even breast milk encourages bacterial growth. Bacteria in turn produce acid, which can dissolve the minerals in enamel and open the door to tooth decay. Sipping through the night also deprives saliva of adequate time to neutralize acid.

Wait on dental visits until they're older. Dental and pediatric associations all recommend first taking your child to the dentist sooner rather than later—by their first birthday. Starting dental visits early will help you stay ahead of any developing tooth decay or other oral problems. And just as important, your child will have an easier time "warming up" to the dental office environment at a younger age than if you wait. Dental visit anxiety, on the other hand, could continue into adulthood and interfere with regular dental care.

If you would like more information on the best dental care practices for your child, 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 “Top 10 Oral Health Tips for Children.”

NationalChildrensDentalHealthMonthHighlightsImportanceofBabyTeeth

We all know that a child's baby teeth don't last forever. So if those little teeth develop problems, like severe decay, chips or cracks, it doesn't much matter—right? Wrong! National Children's Dental Health Month, observed in February, is the perfect occasion to remember why baby teeth need the same meticulous care as adult teeth:

  • Baby teeth perform the exact same jobs adult teeth do, only in little mouths. Without healthy teeth, a child can't eat comfortably, speak properly or smile with confidence. Given that the last baby tooth doesn't fall out until around age 12, children need to rely on these "temporary" teeth for a long time!
  • While there often are no symptoms of early tooth decay, badly decayed baby teeth can become painful—and the problem may get worse quickly. Untreated tooth decay can lead to suffering and expense that could have been avoided with relatively simply dental treatment.
  • Baby teeth help guide adult teeth into the right position. Each baby tooth helps hold the right amount of space open for the next tooth that will grow in. When a baby tooth is lost before the permanent replacement is ready to grow in, orthodontic problems can result.

As you can see, good dental health has a big impact on a child's quality of life and health—in both the present and the future. That's why it's important to treat childhood dental disease and injuries promptly and properly. Regular dental exams are the best way to keep on top of your child's dental health. If a cavity is discovered at a routine exam, prompt treatment can keep the decay from spreading to the root canals.

If your child plays sports, ask us about a custom-made mouthguard. This small device can protect your child's teeth from serious injury.  And if a baby tooth does get knocked out, let us know. It may be best to fit your child with a very small dental device called a space maintainer, which will hold that empty space open until the permanent tooth beneath it grows in.

If you would like more information about children's dental health, please contact us or schedule an appointment a consultation. You can also learn more by reading the Dear Doctor magazine article “Importance of Baby Teeth.”

ChronicDryMouthCouldIncreaseYourRiskforDentalDisease

When your mouth is dry, you know it: that sticky, uncomfortable feeling when you first wake up or when you're thirsty. Fortunately, it usually goes away after you eat or drink. But what if your mouth felt like that all the time? Then, it's no longer an irritation—chronic dry mouth could also increase your risk of dental disease.

Chronic dry mouth occurs because of inadequate saliva flow. Saliva plays an important role in preventing dental disease because it neutralizes acid, which can cause the mineral content in tooth enamel to break down and lead to tooth decay. The mouth becomes more acidic right after eating, but saliva can restore its normal pH levels in about an hour—as well as some of the enamel's lost mineral content. Without saliva, your tooth enamel is at greater risk from acid.

While a number of things can potentially interfere with normal saliva production, medication is the most common. More than 500 prescription drugs, including many antihistamines, diuretics or antidepressants, can cause dry mouth. Cancer radiation or chemotherapy treatment and certain metabolic conditions like diabetes or Parkinson's disease can also increase symptoms.

If you are experiencing unusual dry mouth symptoms, see your dentist first for a full examination. Your dentist can measure your saliva flow, check your prescriptions and medical history, and examine your salivary glands for abnormalities. With this more accurate picture of your condition, they can help direct you to the most effective remedies and treatments for the cause.

If medication is the problem, you can talk to your doctor about alternative prescriptions that have a lesser effect on saliva flow. You can also drink more water before and after taking oral medication and throughout the day to help lubricate your mouth. Chewing gums or mints with xylitol, a natural alcohol sugar, can also help: xylitol helps reduce the mouth's bacterial levels, as well as stimulate saliva flow.

Easing your dry mouth symptoms can make your life more pleasant. More importantly, it can reduce your risk of future dental problems caused by a lack of saliva.

If you would like more information on dealing with chronic dry mouth, 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 “Dry Mouth: Learn about the Causes and treatment of this Common Problem.”

KnowtheFactstoReduceYourChildsTeethingDiscomfort

The arrival of your child’s first set of teeth is a natural and expected process. But that doesn’t mean this period of development, commonly known as teething, is an easy time: your baby will endure a fair amount of discomfort, and you, perhaps, a bit of anxiety.

Knowing the facts about teething can help you reduce your child’s discomfort — as well as your own concern — to a minimum. Here are a few things you need to know.

Teething duration varies from child to child. Most children’s teeth begin to erupt (appear in the mouth) between six and nine months of age — however, some children may begin at three months and some as late as a year. The full eruption sequence is usually complete by age 3.

Symptoms and their intensity may also vary. As teeth gradually break through the gum line, your baby will exhibit some or all normal teething symptoms like gum swelling, drooling and chin rash (from increased saliva flow), biting or gnawing, ear rubbing, or irritability. You may also notice behavior changes like decreased appetite or disrupted sleep. These symptoms may be a minimal bother during some teething episodes, while at other times the pain and discomfort may seem intense. Symptoms tend to increase about four days before a tooth emerges through the gums and about three days afterward.

Diarrhea, rashes or fever aren’t normal. These symptoms indicate some other sickness or condition, which can easily be masked during a teething episode. If your child exhibits any of these symptoms you should call us for an exam to rule out a more serious issue.

Keep things cool to reduce discomfort. There are a few things you can do to reduce your child’s discomfort during a teething episode. Let your child chew on chilled (but not frozen) soft items like teething rings, wet washcloths or pacifiers to reduce swelling and pain. Gum massage with your clean finger may help counteract the pressure from the erupting tooth. And, if your doctor advises it, pain relievers in the proper dosage may also help alleviate discomfort. On the other hand, don’t use rubbing alcohol to soothe painful gums, or products with the numbing agent Benzocaine in children younger than two unless advised by a healthcare professional.

If you would like more information on dealing with teething issues, 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 “Teething Troubles.”

TopicalFluorideisaSafeWaytoProtectYourChildsTeethfromDecay

We've known for decades that fluoride strengthens tooth enamel and lowers the risk for decay. And while adding it to toothpaste and drinking water are the more common ways for getting it into the body, an increasingly popular way—especially for children—is to apply fluoride directly to the teeth.

But is topical fluoride really worth the effort and expense? And, are there any side effects to treating teeth this way?

As to the first question, researchers have performed numerous studies measuring fluoride's effectiveness for preventing tooth decay. The Cochrane Oral Health Research Group recently reviewed studies on topical fluoride applications involving nearly 10,000 children and adolescents between the ages of 2 and 15. The combined average for all the studies showed a 28% reduction in decayed teeth for patients who received topical fluoride compared to those who didn't.

This was especially true for children at high risk for decay: directly applying fluoride gels, foams or varnishes to teeth reduces that risk substantially. But there are also side effects to this application. Fluoride in general has only one known safety concern, a condition known as fluorosis. Too much fluoride over time can cause heavy discoloration of the teeth. This does not affect the health of the teeth, but it can look unattractive and require cosmetic treatment to reduce its effect.

There's little to no risk for fluorosis with the controlled treatments offered by dentists; the fluoride solution remains on the teeth no more than a few minutes. But there is a possible side effect during treatment due to the relatively high dose of fluoride used. If the patient accidentally swallows some of the solution, the concentration of fluoride can cause stomach upset, vomiting or headaches.

Dentists minimize the chances for this by usually using the more difficult to swallow varnish form of topical fluoride on younger patients, and using trays or other barrier devices to isolate the fluoride solution from the rest of the mouth. Under professional supervision, it's rare for an accidental ingestion to occur.

The risks for these side effects are quite low, and the benefits of topical fluoride for reducing the chances for decay can more than outweigh them. Fluoride applications are one of many ways we can protect your child's current and future dental health.

If you would like more information on decay prevention techniques like topical fluoride, 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 “Fluoride Gels Reduce Decay.”

AdvancedEquipmentandSafePracticesEnsureX-RaySafetyforChildren

When it comes to our children’s safety, there isn’t much nowadays that isn’t under scrutiny. Whether food, clothing, toys and more, we ask the same question: can it be harmful to children?

That also includes tried and true healthcare practices. One in particular, the routine x-ray, has been an integral part of dental care for nearly a century. As a means for detecting tooth decay much earlier than by sight, it has without a doubt helped save billions of teeth.

But is it safe for children? The reason to ask is because x-rays are an invisible form of electromagnetic radiation that can penetrate human tissue. As with other forms of radiation, elevated or frequent exposure to x-rays could damage tissue and increase the future risk of cancer.

But while there is potential for harm, dentists take great care to never expose patients, especially children, to that level or frequency of radiation. They incorporate a number of safeguards based on a principle followed by all healthcare professionals in regard to x-rays called ALARA, an acronym for “as low as reasonably achievable.” This means dentists and physicians use as low an exposure of x-ray energy as is needed to achieve a reasonable beneficial outcome. In dentistry, that’s identifying and treating tooth decay.

X-ray equipment advances are a good example of ALARA in action. Digital imaging, which has largely replaced film, requires less x-ray radiation for the same results than its older counterpart. Camera equipment has also become more efficient, with modern units containing lower settings for children to ensure the proper amount of exposure.

Dentists are also careful how often they take x-ray images with their patients, only doing so when absolutely necessary. As a result, dental patients by and large experience lower dosages of x-ray radiation in a year than they receive from natural radiation background sources found every day in the environment.

Dentists are committed to using x-ray technology in as safe and beneficial a way as possible. Still, if you have concerns please feel free to discuss it further with your dental provider. Both of you have the same goal—that your children have both healthy mouths and healthy bodies for the rest of their lives.

If you would like more information on x-ray safety for children, 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 “X-Ray Safety for Children.”

TakePositiveActionwithYourChildsThumb-SuckingHabit

As a parent you’re concerned with a number of issues involving your child’s health, not the least of which involves their teeth. One of the most common is thumb-sucking.

While later thumb-sucking is a cause for concern, it’s quite normal and not viewed as harmful in infant’s and very young children. This universal habit is rooted in an infant swallowing pattern: all babies tend to push the tongue forward against the back of the teeth when they swallow, which allows them to form a seal while breast or bottle feeding. Infants and young children take comfort or experience a sense of security from sucking their thumb, which simulates infant feeding.

Soon after their primary teeth begin to erupt, the swallowing pattern changes and they begin to rest the tongue on the roof of the mouth just behind the front teeth when swallowing. For most children thumb sucking begins to fade as their swallowing pattern changes.

Some children, though, continue the habit longer even as their permanent teeth are beginning to come in. As they suck their thumb the tongue constantly rests between the front teeth, which over time may interfere with how they develop. This can cause an “open bite” in which the upper and lower teeth don’t meet properly, a problem that usually requires orthodontic treatment to correct it.

For this reason, dentists typically recommend encouraging children to stop thumb-sucking by age 3 (18-24 months to stop using a pacifier). The best approach is positive reinforcement — giving appropriate rewards over time for appropriate behavior: for example, praising them as a “big” boy or girl when they have gone a certain length of time without sucking their thumb or a pacifier. You should also use training or “Sippy” cups to help them transition from a bottle to a regular cup, which will further diminish the infant swallowing pattern and need for thumb-sucking.

Habits like thumb-sucking in young children should be kept in perspective: the habit really isn’t a problem unless it goes on too long. Gentle persuasion, along with other techniques we can help you with, is the best way to help your child eventually stop.

If you would like more information on thumb sucking, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Thumb Sucking in Children” and “How Thumb Sucking Affects the Bite.”

HeresWhattoDoifYourChildhasaToothache

What should you do if your child complains about a toothache? Before calling our office, try first to learn what you can about the toothache.

You should first ask them where exactly the pain is coming from — one particular tooth or a generalized, dull ache. Also try to find out, as best they can tell you, when they first noticed the pain. Try then to look at the tooth or area where they indicate the pain is coming from: since tooth decay is a prime cause for tooth pain, you should look for any obvious signs of it like brown spots or cavities. You should also look at the gums around the teeth for any redness or swelling, a sign of an abscess or periodontal (gum) disease.

If you notice any of these signs, the pain persists for more than a day, or it has kept the child awake during the night, you should have us examine them as soon as possible. If you notice facial swelling or they’re running a fever, please call and we will see them immediately. If it’s definitely tooth decay, it won’t go away on its own. The longer we wait to treat it, the worse its effects in the mouth.

In the meantime, you should also try to alleviate the pain as best you can. If when looking in the mouth you noticed food debris (like a piece of hard candy) wedged between the teeth, try to gently remove it with dental floss. Give them ibuprofen or acetaminophen in an appropriate dosage for their age to relieve pain, or apply an ice pack on and off for about 5 minutes at a time to the outside of their jaw.

If any of these remedies stops the pain within an hour, you can wait until the next day to call for an appointment. If the pain persists, though, then an abscess could be developing — you should call that day to see us.

Regardless of when the pain stops, or whether you see any abnormal signs, it’s still important your child see us for an accurate diagnosis. Their toothache maybe trying to tell you something’s wrong — and the earlier a problem is found and treated, the better the outcome.

If you would like more information on dental problems in young children, 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 “A Child’s Toothache.”

StayAheadofPlaqueBuildupwithEffectiveBrushingandFlossing

The vast majority of teeth and gum problems stem from two dental diseases: dental caries (tooth decay) and periodontal (gum) disease. But although these dental diseases are all too common in our society, there’s a good chance you can prevent them from harming your own dental health.

That’s because we know the primary cause for both of them—dental plaque, a thin film of bacteria and food particles that can build up on tooth surfaces usually as a result of poor oral hygiene. Remove this plaque build-up daily and you dramatically decrease your risk for disease.

The primary way to do this is with a daily habit of brushing and flossing. While regular dental cleanings remove plaque and tartar (calcified plaque) from hard to reach places, it’s your regular practice that removes the bulk of daily buildup. Interrupting plaque buildup helps keep disease-causing bacteria at bay.

That also means performing these two hygiene tasks thoroughly. For example, you should brush all tooth surfaces, especially in the rear and along the entire gum line (a complete brushing should take at least 2 minutes). And by the way, “thorough” doesn’t mean “aggressive”—a gentle circular motion is all you need. If you scrub too hard, you run the risk over time of damaging your gums.

And while many people discount flossing as a hard and unpleasant task, it’s still necessary: at least half of the plaque in your mouth accumulates between the teeth where brushing can’t reach effectively. If you find flossing too difficult, you can take advantage of tools to make the task easier. A floss threader will make it easier to get floss through your teeth; you could also use an oral irrigator, a device that emits a pressurized spray of water to loosen and flush away some plaque.

Along with dental visits at least twice a year, daily brushing and flossing is the best way to reduce your risk of both tooth decay and gum disease. Avoiding these two diseases will help ensure your smile is attractive and healthy throughout your life.

If you would like more information on preventing dental disease, 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 “Daily Oral Hygiene: Easy Habits for Maintaining Oral Health.”

NewAdvancesCouldRevolutionizeDecayTreatment

The basics for treating tooth decay have changed little since the father of modern dentistry Dr. G.V. Black developed them in the early 20th Century. Even though technical advances have streamlined treatment, our objectives are the same: remove any decayed material, prepare the cavity and then fill it.

This approach has endured because it works—dentists practicing it have preserved billions of teeth. But it has had one principle drawback: we often lose healthy tooth structure while removing decay. Although we preserve the tooth, its overall structure may be weaker.

But thanks to recent diagnostic and treatment advances we’re now preserving more of the tooth structure during treatment than ever before. On the diagnostic front enhanced x-ray technology and new magnification techniques are helping us find decay earlier when there’s less damaged material to remove and less risk to healthy structure.

Treating cavities has likewise improved with the increased use of air abrasion, an alternative to drilling. Emitting a concentrated stream of fine abrasive particles, air abrasion is mostly limited to treating small cavities. Even so, dentists using it say they’re removing less healthy tooth structure than with drilling.

While these current advances have already had a noticeable impact on decay treatment, there’s more to come. One in particular could dwarf every other advance with its impact: a tooth repairing itself through dentin regeneration.

This futuristic idea stems from a discovery by researchers at King’s College, London experimenting with Tideglusib, a medication for treating Alzheimer’s disease. The researchers placed tiny sponges soaked with the drug into holes drilled into mouse teeth. After a few weeks the holes had filled with dentin, produced by the teeth themselves.

Dentin regeneration isn’t new, but methods to date haven’t been able to produce enough dentin to repair a typical cavity. Tideglusib has proven more promising, and it’s already being used in clinical trials. If its development continues to progress, patients’ teeth may one day repair their own cavities without a filling.

Dr. Black’s enduring concepts continue to define tooth decay treatment. But developments now and on the horizon are transforming how we treat this disease in ways the father of modern dentistry couldn’t imagine.

If you would like more information on dental treatments for tooth decay, please contact us or schedule an appointment for a consultation.

KeepUpGoodDentalHabitsinCollegetoProtectYourTeethandGums

Starting college is one of life’s biggest transition moments, the first time many young people can truly say they’re on their own. Their freshman year can be both exhilarating and frightening.

The reason for this seeming dichotomy is that both exciting opportunities and harmful pitfalls abound in college life. One such pitfall that’s often overlooked involves dental health: it’s all too easy to neglect good habits and adopt bad ones. But while it may not seem as harmful as other dangers, inattention to your dental health could create consequences that plague you long after graduation.

But being diligent about dental care can help you avoid serious problems now and in the future. At the top of the list: brush and floss your teeth daily and continue seeing a dentist at least twice a year. Hopefully, your parents or guardians have trained you in these vital habits—and they’re definitely habits you should continue for the rest of your life.

Close in importance to good oral hygiene is a healthy diet. Besides eating primarily “natural” food—fresh fruits and vegetables and less-processed foods—you should also set limits on your sugar consumption. This carbohydrate is a primary food for disease-causing bacteria, so limiting as much as possible the sugar you eat to just meal times will lower your risk for tooth decay.

Another area in which you should tread wisely is alcohol consumption. Besides the obvious consequences of alcohol abuse, immoderate drinking can also cause dental problems. Alcohol (and smoking) tends to dry out the mouth, which can increase the levels of oral bacteria and in turn increase your risk of both tooth decay and periodontal (gum) disease.

Finally, avoid getting piercings involving the lips, mouth or tongue even if it’s the thing to do. Piercing hardware can chip teeth and contribute to the shrinking back of the gums (recession). And be sure you practice safe sex: unprotected sexual activity could expose you to viral infections that cause oral problems including cancer.

Your college years should be an exciting and memorable experience. By practicing these and other common sense dental habits, you’ll be sure to remember these years fondly.

If you would like more information on dental care during college, 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 “10 Health Tips for College Students.”

FanofSuperheroFilmBlackPantherBreaksSteelWirewithHerMouth

Some moviegoers have been known to crunch popcorn, bite their fingers or grab their neighbor’s hands during the intense scenes of a thriller. But for one fan, the on-screen action in the new superhero film Black Panther led to a different reaction.

Sophia Robb, an 18-year-old Californian, had to make an emergency visit to the orthodontic office because she snapped the steel wire on her retainer while watching a battle scene featuring her Hollywood crush, Michael B. Jordan. Her jaw-clenching mishap went viral and even prompted an unexpected reply from the actor himself!

Meanwhile, Sophia got her retainer fixed pronto—which was exactly the right thing to do. The retention phase is a very important part of orthodontic treatment: If you don’t wear a retainer, the beautiful new smile you’re enjoying could become crooked again. That’s because if the teeth are not held in their new positions, they will naturally begin to drift back into their former locations—and you may have to start treatment all over again…

While it’s much more common to lose a removable retainer than to damage one, it is possible for even sturdy retainers to wear out or break. This includes traditional plastic-and-wire types (also called Hawley retainers), clear plastic retainers that are molded to fit your teeth (sometimes called Essix retainers), and bonded retainers: the kind that consists of a wire that’s permanently attached to the back side of your teeth. So whichever kind you use, do what Sophia did if you feel that anything is amiss—have it looked at right away!

When Black Panther co-star Michael B. Jordan heard about the retainer mishap, he sent a message to the teen: “Since I feel partly responsible for breaking your retainers let me know if I can replace them.” His young fan was grateful for the offer—but even more thrilled to have a celebrity twitter follower.

If you have questions about orthodontic retainers, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Importance of Orthodontic Retainers” and “Bonded Retainers.”

InstillGoodDentalHabitsinYourChildasEarlyasPossible

Philosopher Will Durant wrote, "…We are what we repeatedly do. Excellence, then, is not an act but a habit." While that observation could aptly apply to a great deal of life, it's certainly true of dental health. Strong, healthy teeth and gums are largely the result of good oral habits started in early childhood.

Here are some important dental care habits you'll want to instill in your child, as well as yourself.

Practice and teach daily oral hygiene. Keeping your child's mouth clean helps prevent future dental disease. It should begin before teeth appear by wiping your baby's gums with a clean, wet cloth after every feeding to keep decay-causing bacteria from growing. Once teeth appear, switch to brushing with just a smear of toothpaste until age 2, when you can increase to a pea-sized amount. As your child matures, be sure to teach them to brush and floss for themselves, especially by modeling the behavior for them.

Begin dental visits early. Besides daily hygiene, regular professional dental care is one of the best habits for keeping healthy teeth and gums. Plan to begin your child's dental visits by age 1 when some of their teeth may have already come in. And by beginning early, it's more likely your child will view dental visits as a routine part of life, a habit they'll more likely continue into adulthood.

Keep your oral bacteria to yourself. Many strains of bacteria, especially harmful ones, don't occur spontaneously in a child's mouth. They come from the outside environment, most often from their parents or caregivers. To avoid transmitting disease-causing bacteria from you to your baby don't share eating utensils, don't lick a pacifier to clean it, and avoid kissing infants (whose immune systems are immature) on the mouth.

Encourage your teenager to avoid bad habits. Hopefully when your children reach adolescence, they've already developed good oral habits. But there are some bad habits you should also help your teen avoid. While piercings are a popular expression among this age group, teens should avoid tongue and lip bolts and other piercings that could damage teeth. A tobacco habit can also have negative consequences for dental health including increased decay or gum disease risk and cancer.

If you would like more information on dental care for children, 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 “Dentistry & Oral Health for Children.”

WhatYouCanDotoSupportYourChildsDentalDevelopment

Your child’s teeth and gum development is truly a wonder. In just a little more than two decades they’ll gain and lose one set of teeth, while the subsequent permanent set will grow in coordination with other facial and oral structures. All of these structures will finally reach maturity sometime in early adulthood.

Sometimes, though, obstacles can arise: disease, trauma or even genetics can derail normal development and endanger future health. So although nature does most of the heavy lifting, there are things you should do to keep your child’s dental development on track.

For instance, begin oral hygiene practices before their first teeth come in. By wiping their gums after feeding with a clean damp cloth, you can help reduce the numbers of disease-causing bacteria in the mouth. Once teeth appear switch to brushing.

There are also habits to avoid. Don’t kiss your baby directly on the lips—you may transfer to them your own mouth bacteria, which their young immune system can’t yet adequately handle. Also, avoid putting them to bed with a sleep-time bottle filled with sugary fluids (including milk or formula) because the constant contact between the sugar and their teeth could increase their risk for tooth decay, the number one dental disease in young children.

Of course, not all prevention efforts depend on you alone—we’re your partner in helping to keep your child’s dental development progressing normally. We can provide preventive treatments like sealants or topical fluoride to reduce the risk of tooth decay, while continually monitoring for signs of the disease that may require treatment. We also look for signs of emerging bite problems that may require intervention before their effects worsen.

This is all part of regular dental visits, usually at six-month intervals, which are best begun around your child’s first birthday. Not only does this enable us to stay ahead of dental problems, it also helps your child become more comfortable with dental visits and increase the likelihood they’ll continue the habit in adulthood.

As we said, nature is responsible for most of this amazing development without any help from us. But we can assist development and hopefully prevent issues that could diminish their dental health in years to come.

If you would like more information on supporting your child’s dental development, please contact us or schedule an appointment for a consultation.

TakeStepstoSaveanIncomingToothsPlacetoAvoidaPoorBite

At your child's latest dental visit, you found out one of their primary (“baby”) teeth has become decayed and in danger of loss. Of course, you may think, it's only a primary tooth — it's going to come out sooner or later.

But a primary tooth lost “sooner” rather than “later” can create long-term negative consequences for your child's dental health. For the sake of the future permanent tooth, the best treatment strategy could be to put forth the effort and expense to save it.

Besides its role in eating and chewing, a primary tooth's most important function is as a “trailblazer” for the permanent tooth developing below it. A primary tooth doesn't normally loosen and let go until the new permanent tooth is ready to erupt. Until then they hold the new tooth's space in the jaw.

But if the primary tooth is lost prematurely, nearby teeth can drift into and crowd the space so that the permanent tooth comes in out of position. This can result in a malocclusion, or poor bite.

Depending on the state of your child's jaw development, it may be advisable to attempt saving the tooth through a filling or, in the case of deep decay, a modified root canal treatment. If the tooth can't be saved, then placing an orthodontic appliance known as a space maintainer might be necessary. Cemented to a tooth next to the empty space, this appliance has a looped band of metal that butts against the tooth on the other side of the gap, and prevents both teeth from drifting into the space.

Intervening for a decayed primary tooth can seem a waste of time and money since it has a limited lifespan to begin with. But for the health of its companion permanent tooth, as well as possibly avoiding orthodontic treatment, it could be well worth it for your child's long-term dental health.

If you would like more information on dental care for your child, 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 “Importance of Baby Teeth.”

EffectiveOralHygieneisKeytoDiseasePreventionWhileWearingBraces

While braces are a tried and true method for achieving a more attractive smile, they may also give rise to problems with dental disease. This is because their hardware — the brackets and bands that serve as tracks for the tensioning wires — make it more difficult to access the tooth and gum surfaces to clean away plaque. This thin film of food remnant may then become a haven for bacteria that cause gum disease or tooth decay.

One of the more common conditions to occur while wearing braces is gingivitis. This is an initial inflammation of the gum tissues caused by bacterial plaque that hasn’t been removed by brushing or flossing. As the inflammation grows unchecked, the infection could advance deeper into the tissues to become a more serious form of gum disease that threatens the survival of affected teeth.

Difficult as it may be for those wearing braces, the best way to avoid gingivitis is through more thorough oral hygiene practices. Fortunately, there are many hygiene products that can help you get around many of the access difficulties posed by braces. Smaller toothbrushes known as interproximal brushes and floss threaders, small aids that thread dental floss under braces wires, can access the spaces between teeth more readily than conventional brushes or floss. Water flossers (which use water under pressure to remove plaque between teeth) and motorized toothbrushes can further increase efficiency. We can also reduce bacterial growth in the mouth if need be with prescription-strength antibacterial mouthrinses.

If, however, gingivitis or gum overgrowth (another common occurrence during orthodontic treatment) continues to be a problem, we may need to take other actions including surgery. In extreme cases, the braces may need to be removed to adequately treat the gums and allow them time to heal before proceeding with orthodontics.

Extra care with daily hygiene and regular dental checkups and cleanings in addition to your orthodontic visits will help keep gum problems at bay while you’re wearing braces. Taking this extra care will stop or minimize the effect of disease as you continue on to the ultimate goal of your orthodontic treatment — a more beautiful smile.

If you would like more information on dental care during orthodontic treatment, please contact us or schedule an appointment for a consultation.

ActressEmmaStoneRevealsHowThumbSuckingAffectedHerTeeth

It's no secret that many of Hollywood's brightest stars didn't start out with perfectly aligned, pearly-white teeth. And these days, plenty of celebs are willing to share their stories, showing how dentists help those megawatt smiles shine. In a recent interview with W magazine, Emma Stone, the stunning 28-year-old star of critically-acclaimed films like La La Land and Birdman, explained how orthodontic appliances helped her overcome problems caused by a harmful habit: persistent thumb sucking in childhood.

“I sucked my thumb until I was 11 years old,” she admitted, mischievously adding “It's still so soothing to do it.” Although it may have been comforting, the habit spelled trouble for her bite. “The roof of my mouth is so high-pitched that I had this huge overbite,” she said. “I got this gate when I was in second grade… I had braces, and then they put a gate.”

While her technical terminology isn't quite accurate, Stone is referring to a type of appliance worn in the mouth which dentists call a “tongue crib” or “thumb/finger appliance.” The purpose of these devices is to stop children from engaging in “parafunctional habits” — that is, behaviors like thumb sucking or tongue thrusting, which are unrelated to the normal function of the mouth and can cause serious bite problems. (Other parafunctional habits include nail biting, pencil chewing and teeth grinding.)

When kids develop the habit of regularly pushing the tongue against the front teeth (tongue thrusting) or sucking on an object placed inside the mouth (thumb sucking), the behavior can cause the front teeth to be pushed out of alignment. When the top teeth move forward, the condition is commonly referred to as an overbite. In some cases a more serious situation called an “open bite” may develop, which can be difficult to correct. Here, the top and bottom front teeth do not meet or overlap when the mouth is closed; instead, a vertical gap is left in between.

Orthodontic appliances are often recommended to stop harmful oral habits from causing further misalignment. Most appliances are designed with a block (or gate) that prevents the tongue or finger from pushing on the teeth; this is what the actress mentioned. Normally, when the appliance is worn for a period of months it can be expected to modify the child's behavior. Once the habit has been broken, other appliances like traditional braces or clear aligners can be used to bring the teeth into better alignment.

But in Stone's case, things didn't go so smoothly. “I'd take the gate down and suck my thumb underneath the mouth appliance,” she admitted, “because I was totally ignoring the rule to not suck your thumb while you're trying to straighten out your teeth.” That rule-breaking ended up costing the aspiring star lots of time: she spent a total of 7 years wearing braces.

Fortunately, things worked out for the best for Emma Stone: She now has a brilliant smile and a stellar career — plus a shiny new Golden Globe award! Does your child have a thumb sucking problem or another harmful oral habit? For more information about how to correct it, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine article “How Thumb Sucking Affects the Bite.”

BaseballTobaccoandOralCancer

Spring means different things to different people—but to baseball fans, it means just one thing: the start of another thrilling season. All 30 Major League Baseball teams begin play this month, delighting fans from Toronto to Texas and everywhere in between.

The boys of spring carry on an age-old tradition—yet baseball is also changing with the times. Cigarette smoking has been banned at most ballparks for years; smokeless tobacco is next. About half of the MLB venues now prohibit tobacco of any kind, including “snuff” and “dip.” What’s more, a recent contract agreement bars new Major League players from using smokeless tobacco anywhere.

Why all the fuss? Because tobacco isn’t safe to use in any form. People who use smokeless tobacco get just as much highly addictive nicotine as cigarette smokers. Plus, they get a mouthful of chemicals that are known to cause cancer. This puts them at higher risk for oral cancer, cancer of the esophagus, pancreatic cancer and other diseases.

A number of renowned ballplayers like Babe Ruth, Curt Flood and Bill Tuttle died of oral cancer. The death of Hall of Famer Tony Gwinn in 2014 focused attention on tobacco use in baseball, and helped lead to the ban. Gwynn was convinced that his addiction to smokeless tobacco led to his getting oral cancer.

Yet tobacco isn’t the only cause of oral cancer. In fact, the disease is becoming more common in young people who do not smoke. That’s one more reason why it’s so important for people of all ages to keep to a regular schedule of routine dental exams. These visits offer a great opportunity to detect oral cancer in its earliest, most treatable stages.

So as you watch your favorite team, take a tip from the professional athletes’ playbook. If you don’t use tobacco, don’t start. If you do, now is a good time to quit. For help and support, call an expert at 1-800-QUIT-NOW or visit smokefree.gov.

If you have any questions about oral cancer, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Diet and Prevention of Oral Cancer.”

SteelyDanFoundersDeathHighlightsImportanceofEarlyCancerDetection

Fans of the legendary rock band Steely Dan received some sad news a few months ago: Co-founder Walter Becker died unexpectedly at the age of 67. The cause of his death was an aggressive form of esophageal cancer. This disease, which is related to oral cancer, may not get as much attention as some others. Yet Becker's name is the latest addition to the list of well-known people whose lives it has cut short—including actor Humphrey Bogart, writer Christopher Hitchens, and TV personality Richard Dawson.

As its name implies, esophageal cancer affects the esophagus: the long, hollow tube that joins the throat to the stomach. Solid and liquid foods taken into the mouth pass through this tube on their way through the digestive system. Worldwide, it is the sixth most common cause of cancer deaths.

Like oral cancer, esophageal cancer generally does not produce obvious symptoms in its early stages. As a result, by the time these diseases are discovered, both types of cancer are most often in their later stages, and often prove difficult to treat successfully. Another similarity is that dentists can play an important role in oral and esophageal cancer detection.

Many people see dentists more often than any other health care professionals—at recommended twice-yearly checkups, for example. During routine examinations, we check the mouth, tongue, neck and throat for possible signs of oral cancer. These may include lumps, swellings, discolorations, and other abnormalities—which, fortunately, are most often harmless. Other symptoms, including persistent coughing or hoarseness, difficulty swallowing, and unexplained weight loss, are common to both oral and esophageal cancer. Chest pain, worsening heartburn or indigestion and gastroesophageal reflux disease (GERD) can also alert us to the possibility of esophageal cancer.

Cancer may be a scary subject—but early detection and treatment can offer many people the best possible outcome. If you have questions about oral or esophageal cancer, call our office or schedule a consultation. You can learn more in the Dear Doctor magazine article “Oral Cancer.”

FebruaryFocusesonChildrensDentalHealth

The month of February gets its name from the ancient spring cleansing ritual called “Februa.” So perhaps it’s appropriate that February is now celebrated as National Children’s Dental Health Month. Having a healthy mouth starts with good oral hygiene—a practice that’s important for everyone, but especially for kids, because the healthy habits they develop in childhood can keep their teeth and gums in good condition for life. How can you help your kids achieve the best oral health? We’re glad you asked. Here are five tips:

Brush and floss daily
Sure, you knew that already. But did you know that for effective cleaning, your kids should brush for two full minutes, twice a day? And despite reports you may have heard, the American Dental Association maintains that using an interdental cleaner (like floss) is essential part of good oral hygiene: It’s the best way to clean decay-causing bacteria from tooth surfaces that your brush just can’t reach.

Limit snacking to around mealtimes
If you allow kids to have sugary snacks, limit them to around mealtimes. That way, the teeth aren’t constantly bathed in substances that can feed harmful bacteria. It also gives the healthful saliva a chance to neutralize acids that can attack the tooth’s protective enamel coating.

Avoid soda and other sugary, acidic drinks
That includes so-called “sports” and “energy” drinks, which often contain extremely high levels of sugar. These beverages, along with diet sodas and some fruit juices, may also be highly acidic, and can damage teeth. What’s the best drink for your kids’ health? Plain old refreshing water!

Pay attention to baby teeth
Sure, in a few years, those teeth will be gone. But in the mean time, they have an important job to do: They not only contribute to proper speech, eating and appearance, but also hold a space for the permanent teeth that will follow them. If they are lost too early, problems with permanent teeth may follow.

Get regular checkups
Routine office visits are the best way to monitor your child’s dental health and development, prevent disease, and solve minor problems before they get bigger.  Plus, we can address any questions you may have about oral hygiene and a range of other topics. So if we haven’t seen your child lately, maybe February is a good time for a visit.

If you have questions about your child’s oral health, please contact our office or schedule a consultation. You can learn more in the Dear Doctor magazine articles “How to Help Your Child Develop the Best Habits for Oral Health” and “Importance of Baby Teeth.”

CrackedMouthCornerscanbeIrritating-HeresHowtoTreatThem

As dentists, we often see other mouth problems besides those with teeth and gums. One of the most common is cracking around the corners of the mouth. Although usually not serious, it can be irritating and uncomfortable.

Medically known as angular cheilitis (literally “an inflammation of the angles of the lip”), it’s also called perleche, derived from the French lecher, “to lick.” The latter moniker aptly describes the tendency of sufferers to compulsively lick the sores to relieve irritation, which actually can make things worse.

Perleche has a number of possible causes, mostly from in or around the mouth (although systemic diseases or medications can cause it on rare occasions). It’s often found among younger people who drool during sleep or older people with deep wrinkles along the sides of the mouth that increase the chances of dryness and cracking. Long-term wind or cold exposure, ill-fitting dentures or a lack of back teeth (which help support facial structure) may also contribute to the condition.

Patients with perleche can also develop yeast infections from a strain called candida albicans. The infection can spread through the whole mouth, significantly increasing the chances of physical discomfort.

Treating perleche often involves topical ointments with inflammation-reducing steroids and zinc oxide, which has antifungal properties, to provide an environmental barrier during the healing process. If a yeast infection occurs, we may treat it with oral or topical antifungal medication like Nystatin for the whole mouth and chlorhexidine rinses, which has antibacterial properties.

It also helps to adopt a few preventive measures that can minimize the occurrence of perleche. If you wear dentures, for example, cleaning them often (including, if necessary, with chlorhexidine) and leaving them out at night reduces bacterial and fungal growth. We can also see if your dentures are fitting properly. Replacing missing teeth provides better facial support and could minimize wrinkling around the mouth. And, of course, keeping up daily brushing and flossing helps ensure a healthy and disease-free mouth.

If you’re experiencing cracked mouth corners, let us know at your next appointment. With our help and of other medical professionals we may be able to give you relief from this irritating condition.

If you would like more information on gaining relief from angular cheilitis, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Cracked Corners of the Mouth.”

WhyitsWorththeEfforttoSaveaProblemBabyTooth

There are usually two moments when primary (“baby”) teeth generate excitement in your family: when you first notice them in your child’s mouth, and when they come out (and are headed for a rendezvous with the “tooth fairy”!).

Between these two moments, you might not give them much thought. But you should—although primary teeth don’t last long, they play a pivotal role in the replacing permanent teeth’s long-term health.

This is because a primary tooth is a kind of guide for the permanent one under development in the gums. It serves first as a “space saver,” preventing nearby teeth from drifting into where the permanent tooth would properly erupt; and, it provides a pathway for the permanent tooth to travel during eruption. If it’s lost prematurely (from injury or, more likely, disease) the permanent tooth may erupt out of position because the other teeth have crowded the space.

That’s why we try to make every reasonable effort to save a problem primary tooth. If decay, for example, has advanced deep within the tooth pulp, we may perform a modified root canal treatment to remove the diseased tissue and seal the remaining pulp from further infection. In some circumstances we may cap the tooth with a stainless steel crown (or possibly a white crown alternative) to protect the remaining structure of the tooth.

Of course, even the best efforts can fall short. If the tooth must be removed, we would then consider preserving the empty space with a space maintainer. This orthodontic device usually takes the form of a metal band that’s cemented to a tooth on one side of the empty space with a stiff wire loop soldered to it that crosses the space to rest against the tooth on the other side. The wire loop prevents other teeth from crowding in, effectively “maintaining” the space for the permanent tooth.

Regular dental visits, plus your child’s daily brushing and flossing, are also crucial in preventing primary teeth from an “early departure.” Keeping them for their full lifespan will help prevent problems that could impact your child’s dental health future.

If you would like more information on the right care approach for primary teeth, 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 “Importance of Baby Teeth.”

WeathertheStormofTeethingwithTheseComfortTips

Teething is a normal part of your baby’s dental development. That doesn’t make it less stressful, though, for you or your baby.

This natural process occurs as your child’s primary teeth sequentially erupt through the gums over a period of two or three years. The first are usually the two lower front teeth followed by the two upper front ones, beginning (give or take a couple of months) between six and nine months. By the age of three, most children have all twenty of their primary teeth.

The disruption to the gum tissues can cause a number of unpleasant side effects including gum swelling, facial rash, drooling, disrupted sleep patterns and decreased appetite. As a result a child can become irritable, bite and gnaw to relieve gum discomfort or rub their ears. Every child’s experience is different as well as their degree of pain and discomfort.

As a tooth is about to erupt, you may notice symptoms increasing a few days before and after. The symptoms will then subside until the next tooth begins to erupt. In a way, teething is much like a storm—you mostly have to ride it out. However, that doesn’t mean you can’t lessen your child’s discomfort during the teething episode.

For one thing, cold, soft items like teething rings, pacifiers or even a clean, wet washcloth your child can gnaw on will help relieve gum pressure. Chilling the item can have a pain-numbing effect—but avoid freezing temperatures, which can burn the tissues. You can also massage the gums with a clean finger to relieve pain. But don’t rub alcohol on their gums and only use numbing agents (like Benzocaine) for children older than two, and only with the advice and supervision of your healthcare provider. The use of acetaminophen or ibuprofen might also be used under the advice of your doctor.

If you notice your child has diarrhea, extensive rashes or fever, contact your physician immediately—these aren’t normal teething symptoms and may indicate something more serious. And be sure to consult with us if you have any other questions or concerns.

Teething can be a difficult time for your baby and family. But with these tips and a little “TLC” you can keep their discomfort to a minimum.

If you would like more information on caring for your baby’s developing teeth, 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 “Teething Troubles: How to Help Your Baby be Comfortable.”

You can smooth away wrinkles in just a matter of minutes.botox

Do you want to refresh your appearance and reduce premature signs of aging? If you said yes, then our Mill Creek, WA, dentists, Dr. Chad Slocum and Dr. Sara Lundgaard, are here to tell you about a fast, effective and nearly painless way to kiss facial lines goodbye.

What is Botox?

Botox is a simple solution for reducing the appearance of certain lines and wrinkles of the face. Botox employs a series of thin needles that contain a purified form of the neurotoxin botulinum toxin. When this medical-grade toxin is injected into certain muscle groups of the face it temporarily paralyzes them and prevents them from contracting. As a result, these lines and wrinkles are greatly reduced.

Is Botox right for me?

There is a reason Botox is the most popular non-surgical wrinkle treatment in Mill Creek. If people are looking to get younger, fresher-looking skin without the need for invasive cosmetic surgery then Botox may provide the little refresher you’ve been looking for. While results won’t last forever they can give you the results you want without committing to long-term changes.

Furthermore, Botox may be a great option for someone who is looking to treat crow’s feet, marionette lines (lines around the mouth) and lines around the nose, forehead, and chin. Any lines that appear when smiling, frowning or laughing are wrinkles that can be treated with Botox.

How is Botox administered?

You’ll come into our office where we will prepare the botulinum toxin powder with saline to dilute it before injecting it into the areas of the face you wish to treat. These needles are very thin and are administered with nothing more than a slight pinch or burning sensation when first injected. Of course, if you are a bit nervous about getting Botox you can talk to our Mill Creek general dentists about numbing the area with a topical cream.

When will I notice results?

Results don’t tend to take effect for up to 72 hours after your treatment, so you won’t see results immediately. Once Botox results appear they can last up to six months, after which the lines and wrinkles will slowly begin to reappear. Of course, these wrinkles will come back less severe than before Botox; however, you can also choose to get additional Botox treatment at this time to maintain your results for longer.

Penny Creek Family & Cosmetic Dentistry in Mill Creek, WA, is here to provide you with the cosmetic care you need. Whether you want to find out if your child could benefit from braces or you are interested in Botox, call our office today.

PediatricDentistsSpecializeinDentalCareforChildrenandTeens

To get your child on the right track for lifelong dental health we recommend you begin their dental visits around their first birthday. You can certainly visit your family dentist, especially if you and your family feel comfortable with them. But you also might want to consider a pediatric dentist for your child's dental needs.

What's the difference between a family dentist and a pediatric dentist? Both offer the same kind of prevention and treatment services like cleanings, fluoride applications or fillings. But like their counterparts in medicine — the family practice physician and pediatrician — the family dentist sees patients of all ages; the pediatric dentist specializes in care for children and teens only.

In this regard, pediatric dentists undergo additional training to address dental issues specifically involving children. Furthermore, their practices are geared toward children, from toys and child-sized chairs in the waiting room to “kid-friendly” exam rooms decorated to appeal to children.

While your family dentist could certainly do the same, pediatric dentists are also skilled in reducing the anxiety level that's natural for children visiting the dental office. This can be especially helpful if you have a special needs child with behavioral or developmental disorders like autism or ADHD. A pediatric dentist's soothing manner and the calm, happy environment of the office can go a long way in minimizing any related anxiety issues.

Your child may have other needs related to their oral health that could benefit from a pediatric dentist. Some children have a very aggressive form of dental caries disease (tooth decay) called early childhood caries (ECC).  If not treated promptly, many of their teeth can become severely decayed and prematurely lost, leading to possible bite problems later in life. Pediatric dentists are well-suited to treat ECC and to recognize other developmental issues.

Again, there's certainly nothing wrong with taking your child to your family dentist, especially if a long-term relationship is important to you (your child will eventually “age out” with a pediatric dentist and no longer see them). It's best to weigh this and other factors such as your child's emotional, physical and dental needs before making a decision.

If you would like more information on pediatric dentistry, please contact us or schedule an appointment for a consultation.

DiabetesandOralHealth

November is National Diabetes Month—a good time to look at the connection between diabetes and oral health. While it’s important for everyone to take care of their teeth and gums, it may be especially important for people with diabetes.

People whose diabetes is not well controlled have a higher risk of infections in the mouth, especially gum disease, also called periodontal disease. Advanced periodontal disease is the number one cause of tooth loss among adults. Not only does diabetes put you at risk of oral health problems, it goes both ways. Periodontal disease can lead to higher blood sugar levels in people with diabetes and may increase the risk of complications such as heart and kidney problems.

But here’s some good news: People who take good care of their teeth and gums may have better blood sugar levels and, conversely, better blood sugar levels generally result in better gum health. Many people successfully avoid complications of diabetes by taking good care of themselves, including their teeth and gums. Here are some things you can do to help control your diabetes:

  • Eat right, exercise and watch your weight for better blood sugar control.
  • Keep up with your oral hygiene routine at home.
  • Schedule regular dental visits and cleanings.

Better oral health combined with better blood sugar control will reduce your risk of complications from diabetes. Your dental care team can help you maintain the best oral health for better diabetes control.

If you have questions about diabetes and oral health, please contact our office or schedule a consultation. To learn more, read the Dear Doctor magazine article “Diabetes & Periodontal Disease.”

BadBreathinChildren

Even the sweetest children don’t always have sweet-smelling breath. If your child has persistent bad breath, it may be for one of the following reasons:

POOR ORAL HYGIENE HABITS. Bad breath often results from bacteria on the teeth and tongue that is not effectively removed during brushing and flossing.

  • Tip: To encourage thorough cleaning as children are developing their oral hygiene habits, try handheld flossers that are colorful and easy to use, sing or play music to make brushing time fun, or try an electric toothbrush with a timer or a tooth-brushing app that keeps kids brushing for a full two minutes.

PLAQUE BUILDUP, TOOTH DECAY AND GUM DISEASE: Plaque, a sticky bacterial biofilm, can build up on tooth surfaces, between the teeth and under the gum line and can lead to tooth decay and gum disease. These conditions may result in bad breath.

  • Tip: Stay on top of your child’s oral hygiene at home, and keep up with regular dental visits for professional cleanings and checkups.

POST-NASAL DRIP: This common cause of foul-smelling breath in children results when excessive mucus is produced and drips down the back of the throat.

  • Tip: Schedule an appointment with your child’s pediatrician to determine and treat the cause.

MOUTH BREATHING. Breathing through the mouth instead of the nose can cause a dry mouth. This can lead to increased oral bacteria, which can cause bad breath. If children breathe through the mouth all the time, not just because of a temporary cold or allergies, your child is at greater risk for tooth decay and gum disease.

  • Tip: If your child is a chronic mouth breather, schedule a dental visit so we can check for any adverse effects on dental health. Note that over time, habitual mouth breathing may lead to poor alignment of the teeth. An ear, nose and throat (ENT) specialist can treat problems with tonsils, adenoids and sinuses — common causes of mouth breathing.

FOREIGN OBJECT IN THE NOSE. It wouldn’t be the first time a child has stuck a pea or other small object up their nose â?? or their sibling’s nose — only to find that it won’t come back out. A foreign body in the nasal passage can cause infection and lead to bad breath.

  • Tip: Don’t try to remove the object at home, as part of it may remain in the nasal passage. A medical professional will have the right equipment to dislodge the object more comfortably.

MEDICATION. Children who take antibiotics for a long time may develop a fungal infection (thrush) in the mouth. Other medications can cause bad breath due to the way they break down in the body.

  • Tip: Call your pharmacist if you have a question about medications and bad breath.

MEDICAL CONDITION. Infections of the throat, sinus or tonsils can cause bad breath, as can more serious health conditions.

  • Tip: If your child’s breath is unpleasant for an extended period of time, get it checked out by a health professional.

If you are concerned about your child’s breath, schedule a visit. We are happy to remind your child of proper brushing techniques and check for other problems that need to be addressed.

For more on young children’s oral health, read “How to Help Your Child Develop the Best Habits for Oral Health” and “Why See a Pediatric Dentist?

NewSalivaTestmayHelpIdentifyOralCancerEarlier

A half million people are diagnosed every year with oral cancer. While other cancers are more prevalent, oral cancer is among the most dangerous with only a fifty percent five-year survival rate.

A major reason for this low rate is because this fast growing cancer is difficult to detect early — diagnosis comes far too often after the disease has already well advanced. In an effort to detect cancer earlier many dentists visually screen for oral abnormalities during checkups, especially patients over fifty, tobacco or heavy alcohol users, patients with a family history of cancer or a medical history of exposure to the sexually transmitted human papilloma virus, HPV-16.

If they detect an abnormality, the dentist often refers the patient to an oral surgeon or other specialist for a possible biopsy. In this procedure the surgeon removes a sample of the abnormal tissue, which is then examined microscopically for cancer cells. A biopsy remains the most effective way to diagnose oral cancer.

Because of the disease's aggressive nature, many dentists lean to the side of caution when referring patients for biopsy. As a result 90% of oral biopsies reveal no cancer. Reducing the number of biopsy referrals is highly desirable, especially for the patient undergoing the procedure. Tissue samples tend to be large to ensure complete detection of any cancer cells. Depending on the size and location of the sample, there may be a risk for loss of function or disfigurement.

A new screening tool using a sample of a patient's saliva could help reduce the number of biopsy referrals. Besides DNA, saliva also contains dormant genes called biomarkers that activate in response to the presence of a specific disease. This particular saliva test identifies those biomarkers for oral cancer if they're present.

A sample with a low score of biomarkers indicates no cancer present (with a statistical confidence of 99%). A medium or high score indicates cancer may be present, but only a biopsy can determine for sure. Using this test, dentists might be able to reduce the number of biopsy referrals and instead be able to employ watchful waiting in certain cases. Because of its simplicity and non-invasiveness, saliva screening could help identify oral cancer earlier.

If you would like more information on early detection and treatment for oral cancer, please contact us or schedule an appointment for a consultation.

FAQsAboutPediatricDentistry

Even though baby teeth are not meant to last forever, they serve some very important functions for the time they are around. Healthy baby teeth allow your child to bite and chew food, articulate sounds correctly during speech, and, of course, to smile! They also help guide the permanent teeth, which will one day replace them, into proper alignment. So it’s important to take good care of them while they’re here. Let’s answer some frequently asked questions about pediatric dentistry.

Can I get my teeth cleaned while I’m pregnant?
Yes — and you should! Both the American Dental Association and the American Congress of Obstetricians and Gynecologists recommend that women keep up with their regular schedule of dental cleanings and exams during pregnancy. Not doing so can allow disease-causing oral bacterial to flourish, which can be a health risk for both the expectant mother and her fetus.

Do infants need their teeth brushed?
Yes, it’s important to start a daily oral hygiene routine as soon as the first baby tooth appears — usually sometime between six and nine months of age. Use a very soft-bristled child-sized toothbrush and just a smear of fluoride toothpaste (the size of a grain of rice). When your child turns 3, increase the amount of fluoride toothpaste to the size of a pea.

When should I take my child in for her first dental appointment?
The answer to this one may surprise you: All children should see a dentist by the age of 1. Early dental visits get children accustomed to having their mouths examined and their teeth cleaned. Establishing this healthy habit early will go a long way toward promoting a lifetime of good oral health.

Should I worry that my child sucks his thumb?
That depends on how old he is. Thumb sucking is a normal, comforting habit for babies and toddlers. Most outgrow it by the time they are 4. But kids who don’t are at increased risk for orthodontic issues later on. If your child seems unable to break the habit, let us know; we can give you more detailed recommendations at your next appointment.

What can I do to prevent my children from getting cavities?
Make sure your children have an effective daily oral hygiene routine that includes brushing with fluoride toothpaste twice a day and flossing at least once per day. If they are too young to do a good job by themselves, help them complete these important tasks. Keep their sugar consumption as low as possible; pay particular attention to beverages — soda, sports drinks and even 100 % natural fruit juices can all promote tooth decay. We can offer individualized advice on fighting cavities, and even provide fluoride treatments and dental sealants for extra protection against cavities. So don’t forget to bring your child in to the dental office for regular exams and cleanings!

If you would like more information about caring for your child’s teeth, please contact us or schedule an appointment for a consultation.

YouDonthavetoSufferfromIrritatingCankerSores

We've all had them — tiny sores that pop up seemingly out of nowhere under the tongue or the inside of the cheek. They're named aphthous ulcers, but are more commonly known as canker sores. For some people, they can be a recurring irritation.

Round with a yellow-gray center surrounded by reddened skin, aphthous ulcers seem to coincide with periods of anxiety or stress, or as a result of some minor trauma. Many people will feel a tingling or painful sensation a few hours or days before the ulcers appear. Once they appear they usually persist for a week to ten days before finally drying and healing. In the meantime they can be painful, especially while eating or drinking.

One form known as recurrent aphthous stomatitis (RAS) affects about a quarter of the population with outbreaks of multiple ulcers that occur regularly. RAS ulcers are usually one centimeter or more in size — the larger the sore the more painful they tend to be.

There are ways to ease the discomfort of an ulcer outbreak and help hasten their healing. A number of over-the-counter products can be used in minor cases to numb the area temporarily and cover it to facilitate healing. We can also apply steroids or inject other medications for more severe cases. You may also find curbing your eating of certain foods like tomato sauce, citrus or spicy dishes can help.

For the most part aphthous ulcers aren't dangerous. In some situations, though, you should seek dental or medical evaluation: a sore that doesn't heal within two weeks; increases in severity, frequency or duration of ulcers; or when you don't seem to ever be without an ulcer in your mouth. We may need to perform tests, including tissue biopsy, to make sure there aren't any underlying systemic conditions causing the ulcers.

More than likely, though, you'll only need relief from the aggravation caused by aphthous ulcers. Among the many remedies, there's one right for you.

If you would like more information on aphthous ulcers or other mouth sores, 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 “Mouth Sores.”

Fillings are designed to be tough, but they must be replaced eventually. Our Mill Creek, WA, dentists, Dr. Chad Slocum and Dr. Sara fillingsLundgaard, share a few signs that may indicate that it's time for a new filling.

The filling is cracked

Wear and tear can eventually cause fillings to crack. Although it usually takes years of wear to crack a filling, the problem can occur sooner if you grind your teeth. Any opening in a tooth, even one as narrow as crack, can allow bacteria to enter the tooth and cause decay. In some cases, you may actually see a crack in a filling, but in others, you might not know you have one until you have X-rays during a dental visit.

Your tooth hurts

If you have a crack in your tooth, you may develop a cavity under the filling. It's important to schedule a visit with our Mill Creek office if you develop pain in a tooth that has been filled.

You feel pain when you drink cold beverages

Sensitivity to cold temperatures can occur as a result of leaky fillings. The problem happens when fillings don't adhere tightly to the sides of your teeth.

Your old filling has changed color

Tooth-colored composite resin fillings can eventually become darker or may look slightly yellow. Replacing the filling restores your tooth's appearance.

Your filling has fallen out

There's no doubt that you need a new filling if you've lost all or part of your filling. If this happens, call us as soon as possible during regular office hours. You might experience a little pain when the tooth is exposed to the air or hot or cold temperatures. If this happens, applying a little dental cement, available in drug stores, can help reduce the sensitivity.

Your filling is old

Depending on the type of material used, fillings usually last between seven to 15 years. If your filling is old and showing some signs of wear, it's best to replace it before it cracks.

Replacing problem fillings promptly can help you avoid tooth decay. If you're concerned about a filling, call our Mill Creek, WA, dentists, Dr. Slocum and Dr. Lundgaard, at (425) 337-7300 to schedule an appointment.

DrTravisStorkDontIgnoreBleedingGums

Are bleeding gums something you should be concerned about? Dear Doctor magazine recently posed that question to Dr. Travis Stork, an emergency room physician and host of the syndicated TV show The Doctors. He answered with two questions of his own: “If you started bleeding from your eyeball, would you seek medical attention?” Needless to say, most everyone would. “So,” he asked, “why is it that when we bleed all the time when we floss that we think it’s no big deal?” As it turns out, that’s an excellent question — and one that’s often misunderstood.

First of all, let’s clarify what we mean by “bleeding all the time.” As many as 90 percent of people occasionally experience bleeding gums when they clean their teeth — particularly if they don’t do it often, or are just starting a flossing routine. But if your gums bleed regularly when you brush or floss, it almost certainly means there’s a problem. Many think bleeding gums is a sign they are brushing too hard; this is possible, but unlikely. It’s much more probable that irritated and bleeding gums are a sign of periodontal (gum) disease.

How common is this malady? According to the U.S. Centers for Disease Control, nearly half of all  Americans over age 30 have mild, moderate or severe gum disease — and that number increases to 70.1 percent for those over 65! Periodontal disease can occur when a bacteria-rich biofilm in the mouth (also called plaque) is allowed to build up on tooth and gum surfaces. Plaque causes the gums to become inflamed, as the immune system responds to the bacteria. Eventually, this can cause gum tissue to pull away from the teeth, forming bacteria-filled “pockets” under the gum surface. If left untreated, it can lead to more serious infection, and even tooth loss.

What should you do if your gums bleed regularly when brushing or flossing? The first step is to come in for a thorough examination. In combination with a regular oral exam (and possibly x-rays or other diagnostic tests), a simple (and painless) instrument called a periodontal probe can be used to determine how far any periodontal disease may have progressed. Armed with this information, we can determine the most effective way to fight the battle against gum disease.

Above all, don’t wait too long to come in for an exam! As Dr. Stork notes, bleeding gums are “a sign that things aren’t quite right.”  If you would like more information about bleeding gums, please contact us or schedule an appointment. You can read more in the Dear Doctor magazine article “Bleeding Gums.” You can read the entire interview with Dr. Travis Stork in Dear Doctor magazine.

EncourageYourChildtoStopThumbSuckingbyAge4

There's something universal about thumb sucking: nearly all babies do it, and nearly all parents worry about it. While most such worries are unfounded, you should be concerned if your child sucks their thumb past age of 4 — late thumb sucking could skew bite development.

Young children suck their thumb because of the way they swallow. Babies move their tongues forward into the space between the two jaws, allowing them to form a seal around a nipple as they breast or bottle feed. Around age 4, this “infantile swallowing pattern” changes to an adult pattern where the tip of the tongue contacts the front roof of the mouth just behind the front teeth. At the same time their future bite is beginning to take shape.

In a normal bite the front teeth slightly overlap the bottom and leave no gap between the jaws when closed.  But if thumb sucking continues well into school age, the constant pushing of the tongue through the opening in the jaws could alter the front teeth's position as they erupt. As a result they may not fully erupt or erupt too far forward. This could create an open bite, with a gap between the upper and lower teeth when the jaws are closed.

Of course, the best way to avoid this outcome is to encourage your child to stop thumb sucking before they turn four. If, however, they're already developing a poor bite (malocclusion), all is not lost — it can be treated.

It's important, though, not to wait: if you suspect a problem you should see an orthodontist for a full evaluation and accurate diagnosis. There are even some measures that could discourage thumb sucking and lessen the need for braces later. These include a tongue crib, a metal appliance placed behind the upper and lower incisors, or exercises to train the tongue and facial muscles to adopt an adult swallowing pattern. Often, a reward system for not sucking their thumbs helps achieve success as well.

Thumb-sucking shouldn't be a concern if you help your child stop before age 4 and keep an eye on their bite development. Doing those things will help ensure they'll have both healthy and straight teeth.

If you would like more information on thumb sucking, 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 “How Thumb Sucking Affects the Bite.”

GameSetMatchMilosRaonicSaysAMouthguardHelpsHimWin

When you’re among the top players in your field, you need every advantage to help you stay competitive: Not just the best equipment, but anything else that relieves pain and stress, and allows you to play better. For top-seeded Canadian tennis player Milos Raonic, that extra help came in a somewhat unexpected form: a custom made mouthguard that he wears on the court and off. “[It helps] to not grind my teeth while I play,” said the 25-year-old up-and-coming ace. “It just causes stress and headaches sometimes.”

Mouthguards are often worn by athletes engaged in sports that carry the risk of dental injury — such as basketball, football, hockey, and some two dozen others; wearing one is a great way to keep your teeth from being seriously injured. But Raonic’s mouthguard isn’t primarily for safety; it’s actually designed to help him solve the problem of teeth grinding, or bruxism. This habitual behavior causes him to unconsciously tense up his jaw, potentially leading to problems with muscles and teeth.

Bruxism is a common issue that’s often caused or aggravated by stress. You don’t have to be a world-class athlete to suffer from this condition: Everyday anxieties can have the same effect. The behavior is often worsened when you consume stimulating substances, such as alcohol, tobacco, caffeine, and other drugs.

While bruxism affects thousands of people, some don’t even suspect they have it. That’s because it may occur at any time — even while you’re asleep! The powerful jaw muscles that clench and grind teeth together can wear down tooth enamel, and damage both natural teeth and dental work. They can even cause loose teeth! What’s more, a clenching and grinding habit can result in pain, headaches and muscle soreness… which can really put you off your game.

There are several ways to relieve the problem of bruxism. Stress reduction is one approach that works in some cases. When it’s not enough, a custom made occlusal guard (also called a night guard or mouthguard) provided by our office can make a big difference. “When I don’t sleep with it for a night,” Raonic said “I can feel my jaw muscles just tense up the next day. I don’t sense myself grinding but I can sort of feel that difference the next day.”

 An occlusal guard is made from an exact model of your own mouth. It helps to keep your teeth in better alignment and prevent them from coming into contact, so they can’t damage each other. It also protects your jaw joints from being stressed by excessive force. Plus, it’s secure and comfortable to wear. “I wear it all the time other than when I’m eating, so I got used to it pretty quickly,” said Raonic.

Teeth grinding can be a big problem — whether you put on your game face on the court… or at home. If you would like more information about bruxism, contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Stress & Tooth Habits” and “When Children Grind Their Teeth.”

ThumbSuckingOneofManyFactorstoConsiderWhenTreatingaPoorBite

It’s true — thumb sucking beyond age 4 can cause bite problems for permanent teeth. But prolonged thumb sucking is just one of a number of possible contributing factors for a bad bite (malocclusion). A dentist must identify all the factors involved when a bad bite is present — their involvement is essential for a successful treatment outcome.

A fairly benign habit for infants and toddlers, thumb sucking is related to an “infantile swallowing pattern” young children use by thrusting their tongues forward between the upper and lower teeth when they swallow. Around age 4, though, they usually transition to an adult swallowing pattern in which the tongue rests on the roof of the mouth just behind the front teeth. Thumb sucking stops for most children around the same time.

Thumb sucking beyond this age, though, can put increased pressure on incoming permanent teeth pushing them forward. This could lead to an “open bite” in which the upper and lower teeth don’t meet when the jaws are closed. The tongue may also continue to thrust forward when swallowing to seal the resulting gap, which further reinforces the open bite.

Before treating the bite with braces, we must first address the thumb sucking and improper tongue placement when swallowing — if either isn’t corrected the teeth could gradually revert to their previous positions after the braces come off. Besides behavioral incentives, we can also employ a thin metal appliance called a “tongue crib” placed behind the upper and lower incisors. A tongue crib discourages thumb sucking and makes it more difficult for the tongue to rest within the open bite gap when swallowing, which helps retrain it to a more normal position.

An open bite can also occur if the jaws develop with too much vertical growth. Like thumb sucking and improper tongue placement, abnormal jaw growth could ultimately cause orthodontic treatment to fail. In this case, though, surgery may be necessary to correct the jaw structure.

With all these possible variables, our first step needs to be a thorough orthodontic exam that identifies all the cause factors for your child’s specific malocclusion. Knowing if and how thumb sucking may have contributed to the poor bite will help us design a treatment strategy that’s successful.

If you would like more information on the causes of poor tooth position, 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 “How Thumb Sucking Affects the Bite.”

FifthHarmonysCamilaCabelloChipsaToothbutConcertStillWorthIt

Everyone loves a concert where there's plenty of audience participation… until it starts to get out of hand. Recently, the platinum-selling band Fifth Harmony was playing to a packed house in Atlanta when things went awry for vocalist Camila Cabello. Fans were batting around a big plastic ball, and one unfortunate swing sent the ball hurtling toward the stage — and directly into Cabello's face. Pushing the microphone into her mouth, it left the “Worth It” singer with a chipped front tooth.

Ouch! Cabello finished the show nevertheless, and didn't seem too upset. “Atlanta… u wild… love u,” she tweeted later that night. “Gotta get it fixed now tho lol.” Fortunately, dentistry offers a number of ways to make that chipped tooth look as good as new.

A small chip at the edge of the tooth can sometimes be polished with dental instruments to remove the sharp edges. If it's a little bigger, a procedure called dental bonding may be recommended. Here, the missing part is filled in with a mixture of plastic resin and glass fillers, which are then cured (hardened) with a special light. The tooth-colored bonding material provides a tough, lifelike restoration that's hard to tell apart from your natural teeth. While bonding can be performed in just one office visit, the material can stain over time and may eventually need to be replaced.

Porcelain veneers are a more long-lasting solution. These wafer-thin coverings go over the entire front surface of the tooth, and can resolve a number of defects — including chips, discoloration, and even minor size or spacing irregularities. You can get a single veneer or have your whole smile redone, in shades ranging from a pearly luster to an ultra-bright white; that's why veneers are a favorite of Hollywood stars. Getting veneers is a procedure that takes several office visits, but the beautiful results can last for many years.

If a chip or crack extends into the inner part of a tooth, you'll probably need a crown (or cap) to restore the tooth's function and appearance. As long as the roots are healthy, the entire part of the tooth above the gum line can be replaced with a natural-looking restoration. You may also need a root canal to remove the damaged pulp material and prevent infection if the fracture went too far. While small chips or cracks aren't usually an emergency (unless accompanied by pain), damage to the tooth's pulp requires prompt attention.

If you have questions about smile restoration, please contact us and schedule an appointment. You can read more in the Dear Doctor magazine articles “Porcelain Veneers: Strength & Beauty As Never Before” and “Porcelain Crowns & Veneers.”

BeAlerttotheUnintendedConsequencesofCancerTreatmenttoOralHealth

Thanks to treatments like chemotherapy and radiation, your chances of surviving cancer are greater than ever. These treatments, however, often produce unwelcome side effects. Treating throat or oral cancer, for example, could damage your mouth's salivary glands or bone.

Saliva is essential to oral health, providing antibodies to curb the growth of disease-causing bacteria and neutralizing acid, which can erode enamel. But salivary glands damaged during cancer treatment may not be able to produce enough saliva. The resulting “dry mouth” creates an environment conducive to bacterial growth and elevated acid levels.

You can help reduce the effects of dry mouth during your treatment (and after, if the damage is permanent) by drinking more water or by using substances that stimulate saliva. Cutting back on acidic foods and beverages will also help lower your mouth's acidity. And be sure to keep up daily oral hygiene and regular dental visits.

The more ominous threat to oral health during cancer treatment, though, is osteoradionecrosis. This occurs when radiation targets specific areas of bone. The bone can lose blood supply and living cellular tissue, which inhibit its ability to heal or replenish itself. If this occurs in the jawbone of teeth that may be lost, the bone tissue could be adversely affected during healing.

Depending on your treatment needs, your risk for osteoradionecrosis might be unavoidable if teeth are to be lost. It's important we discuss that risk because it could impact future dental treatment. In the worst case, before cancer treatment, we may not be able to save affected teeth and your restorative options might be limited.

If your risk of osteoradionecrosis is minimal, though, we may be able to restore any resulting damaged or missing teeth with a wide range of options like dental implants or crowns before or after your cancer treatment.

As with other aspects of health, taking care of your teeth and gums while undergoing cancer treatment can be challenging; some problems may be unavoidable. But with a proper dental treatment plan during and after chemotherapy and radiation, we can minimize those problems and help to eventually restore your smile.

If you would like more information on smile restoration after cancer, please contact us or schedule an appointment for a consultation.

LifeIsSometimesaGrindforBrookeShields

Ever since childhood, when her career as a model and actress took off, Brooke Shields has enjoyed worldwide recognition — through advertisements for designer jeans, appearances on The Muppet Show, and starring roles in big-screen films. But not long ago, that familiar face was spotted in an unusual place: wearing a nasal anesthesia mask at the dentist's office. In fact, Shields posted the photo to her own Instagram account, with the caption “More dental surgery! I grind my teeth!” And judging by the number of comments the post received, she's far from alone.

In fact, researchers estimate that around one in ten adults have dental issues that stem from teeth grinding, which is also called bruxism. (Many children also grind their teeth, but it rarely causes serious problems, and is often outgrown.) About half of the people who are teeth grinders report problems like persistent headaches, jaw tenderness and sore teeth. Bruxism may also result in excessive tooth wear, and may damage dental work like crowns and bridges; in severe cases, loosened or fractured teeth have been reported.

Researchers have been studying teeth grinding for many years; their findings seem to indicate that it has no single cause. However, there are a number of factors that play a significant role in this condition. One is the anatomy of the jaw itself, and the effect of worn or misaligned teeth on the bite. Another factor relates to changes in brain activity that occur during the sleep cycle. In fact, nocturnal (nighttime) bruxism is now classified as a sleep-related movement disorder. Still other factors, such as the use of tobacco, alcohol and drugs, and a high level of stress or anxiety, can make an individual more likely to experience bruxism.

What can be done for people whose teeth grinding is causing problems? Since this condition may have many causes, a number of different treatments are available. Successful management of bruxism often begins by striving to eliminate the factors that may cause problems — for example, making lifestyle changes to improve your health, creating a soothing nighttime environment, and trying stress-reduction techniques; these may include anything from warm baths and soft music at bedtime, to meditation and mindfulness exercises.

Several dental treatments are also available, including a custom-made occlusal guard (night guard) that can keep your teeth from being damaged by grinding. In some cases, a bite adjustment may also be recommended: In this procedure, a small amount of enamel is removed from a tooth to change the way it contacts the opposite tooth, thereby lessening the biting force on it. More invasive techniques (such as surgery) are rarely needed.

A little tooth grinding once in a while can be a normal response to stress; in fact, becoming aware of the condition is often the first step to controlling it. But if you begin to notice issues that could stem from bruxism — or if the loud grinding sounds cause problems for your sleeping partner — it may be time to contact us or schedule an appointment. You can read more about bruxism in the Dear Doctor magazine article “Stress and Tooth Habits.”

InTodaysNFLOralHygieneTakesCenterStage

Everyone knows that in the game of football, quarterbacks are looked up to as team leaders. That's why we're so pleased to see some NFL QB's setting great examples of… wait for it… excellent oral hygiene.

First, at the 2016 season opener against the Broncos, Cam Newton of the Carolina Panthers was spotted on the bench; in his hands was a strand of dental floss. In between plays, the 2105 MVP was observed giving his hard-to-reach tooth surfaces a good cleaning with the floss.

Later, Buffalo Bills QB Tyrod Taylor was seen on the sideline of a game against the 49ers — with a bottle of mouthwash. Taylor took a swig, swished it around his mouth for a minute, and spit it out. Was he trying to make his breath fresher in the huddle when he called out plays?

Maybe… but in fact, a good mouthrinse can be much more than a short-lived breath freshener.

Cosmetic rinses can leave your breath with a minty taste or pleasant smell — but the sensation is only temporary. And while there's nothing wrong with having good-smelling breath, using a cosmetic mouthwash doesn't improve your oral hygiene — in fact, it can actually mask odors that may indicate a problem, such as tooth decay or gum disease.

Using a therapeutic mouthrinse, however, can actually enhance your oral health. Many commonly available therapeutic rinses contain anti-cariogenic (cavity-fighting) ingredients, such as fluoride; these can help prevent tooth decay and cavity formation by strengthening tooth enamel. Others contain antibacterial ingredients; these can help control the harmful oral bacteria found in plaque — the sticky film that can build up on your teeth in between cleanings. Some antibacterial mouthrinses are available over-the-counter, while others are prescription-only. When used along with brushing and flossing, they can reduce gum disease (gingivitis) and promote good oral health.

So why did Taylor rinse? His coach Rex Ryan later explained that he was cleaning out his mouth after a hard hit, which may have caused some bleeding. Ryan also noted, “He [Taylor] does have the best smelling breath in the league for any quarterback.” The coach didn't explain how he knows that — but never mind. The takeaway is that a cosmetic rinse may be OK for a quick fix — but when it comes to good oral hygiene, using a therapeutic mouthrinse as a part of your daily routine (along with flossing and brushing) can really step up your game.

If you would like more information about mouthrinses and oral hygiene, contact us or schedule a consultation.

ExpertAdviceVivicaAFoxonKissingandOralhealth

Is having good oral hygiene important to kissing? Who's better to answer that question than Vivica A. Fox? Among her other achievements, the versatile actress won the “Best Kiss” honor at the MTV Movie Awards, for a memorable scene with Will Smith in the 1996 blockbuster Independence Day. When Dear Doctor magazine asked her, Ms. Fox said that proper oral hygiene was indeed essential. Actually, she said:

"Ooooh, yes, yes, yes, Honey, 'cause Baby, if you kiss somebody with a dragon mouth, my God, it's the worst experience ever as an actor to try to act like you enjoy it!"

And even if you're not on stage, it's no fun to kiss someone whose oral hygiene isn't what it should be. So what's the best way to step up your game? Here's how Vivica does it:

“I visit my dentist every three months and get my teeth cleaned, I floss, I brush, I just spent two hundred bucks on an electronic toothbrush — I'm into dental hygiene for sure.”

Well, we might add that you don't need to spend tons of money on a toothbrush — after all, it's not the brush that keeps your mouth healthy, but the hand that holds it. And not everyone needs to come in as often every three months. But her tips are generally right on.

For proper at-home oral care, nothing beats brushing twice a day for two minutes each time, and flossing once a day. Brushing removes the sticky, bacteria-laden plaque that clings to your teeth and causes tooth decay and gum disease — not to mention malodorous breath. Don't forget to brush your tongue as well — it can also harbor those bad-breath bacteria.

While brushing is effective, it can't reach the tiny spaces in between teeth and under gums where plaque bacteria can hide. But floss can: That's what makes it so important to getting your mouth really clean.

Finally, regular professional checkups and cleanings are an essential part of good oral hygiene. Why? Because even the most dutiful brushing and flossing can't remove the hardened coating called tartar that eventually forms on tooth surfaces. Only a trained health care provider with the right dental tools can! And when you come in for a routine office visit, you'll also get a thorough checkup that can detect tooth decay, gum disease, and other threats to your oral health.

Bad breath isn't just a turn-off for kissing — It can indicate a possible problem in your mouth. So listen to what award-winning kisser Vivica Fox says: Paying attention to your oral hygiene can really pay off! For more information, contact us or schedule an appointment for a consultation. You can read the entire interview with Vivica A. Fox in Dear Doctor's latest issue.

KeepaLookoutforTheseSoftTissueConditionsintheMouth

There's more to your dental visit than preventing or treating teeth or gum problems. We're also on the lookout for a number of potential soft tissue problems that could occur in or around your mouth.

Here are 4 examples of such problems we can detect and help you manage.

Lumps. Whenever you accidentally bite the inside of your mouth, the wound you create forms a protective layer of hard collagen. Unfortunately, the “callous” can rise higher than the surrounding cheek surface and easily get in the way of your teeth again. With successive bites and more scar tissue you'll soon notice a prominent lump. Although not a health danger, it becomes annoying with each successive bite. We can surgically remove the lump and flatten out the mouth surface.

Canker sores. Known as aphthous ulcers, these round sores with a yellow-gray center and a red “halo” can break out on the inside cheeks, tongue or back of the throat. Unless they don't heal within a couple of weeks or seem to be increasing in frequency, they're nothing to worry about. They can, however, cause a burning or stinging sensation. We can reduce this discomfort and speed healing with over-the-counter ointments or prescription options like topical or injected steroids.

Cracked mouth corners. Also known as perleche (from the French lecher, meaning “to lick”), your mouth corners can become dry and irritated and you may begin licking them to soothe the discomfort. Accumulated saliva can trigger a yeast infection, which can spread to other parts of your mouth. We can usually prevent this by prescribing antifungal ointments, and a steroid ointment to control inflammation.

Mouth rash. Peri-oral dermatitis is a red, scaly rash that appears around the outside of the mouth. Because it's often mistaken for acne or other conditions, it's often treated with topical steroids. This actually suppresses the skin's normal healing effects and can actually make the rash worse. The best way to treat it is to stop using any kind of ointment or cream and use only mild soap to wash the area. We can also prescribe antibiotics to help speed the healing process.

If you would like more information on these and other soft tissue problems, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Common Lumps and Bumps in the Mouth,” “Mouth Sores,” and “Cracked Corners of the Mouth.”

NoahGallowaysDentallyDangerousDancing

For anyone else, having a tooth accidentally knocked out while practicing a dance routine would be a very big deal. But not for Dancing With The Stars contestant Noah Galloway. Galloway, an Iraq War veteran and a double amputee, took a kick to the face from his partner during a recent practice session, which knocked out a front tooth. As his horrified partner looked on, Galloway picked the missing tooth up from the floor, rinsed out his mouth, and quickly assessed his injury. “No big deal,” he told a cameraman capturing the scene.

Of course, not everyone would have the training — or the presence of mind — to do what Galloway did in that situation. But if you’re facing a serious dental trauma, such as a knocked out tooth, minutes count. Would you know what to do under those circumstances? Here’s a basic guide.

If a permanent tooth is completely knocked out of its socket, you need to act quickly. Once the injured person is stable, recover the tooth and gently clean it with water — but avoid grasping it by its roots! Next, if possible, place the tooth back in its socket in the jaw, making sure it is facing the correct way. Hold it in place with a damp cloth or gauze, and rush to the dental office, or to the emergency room if it’s after hours or if there appear to be other injuries.

If it isn’t possible to put the tooth back, you can place it between the cheek and gum, or in a plastic bag with the patient’s saliva, or in the special tooth-preserving liquid found in some first-aid kits. Either way, the sooner medical attention is received, the better the chances that the tooth can be saved.

When a tooth is loosened or displaced but not knocked out, you should receive dental attention within six hours of the accident. In the meantime, you can rinse the mouth with water and take over-the-counter anti-inflammatory medication (such as ibuprofen) to ease pain. A cold pack temporarily applied to the outside of the face can also help relieve discomfort.

When teeth are broken or chipped, you have up to 12 hours to get dental treatment. Follow the guidelines above for pain relief, but don’t forget to come in to the office even if the pain isn’t severe. Of course, if you experience bleeding that can’t be controlled after five minutes, dizziness, loss of consciousness or intense pain, seek emergency medical help right away.

And as for Noah Galloway:  In an interview a few days later, he showed off his new smile, with the temporary bridge his dentist provided… and he even continued to dance with the same partner!

If you would like more information about dental trauma, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Trauma & Nerve Damage to Teeth” and “The Field-Side Guide to Dental Injuries.”

CustomOralAppliancesCouldHelpStopSleepApnea

For millions of Americans, sleep apnea is a serious health condition. Not only can it impair your day-to-day living, you might be more susceptible to high blood pressure, heart disease or stroke.

Sleep apnea occurs when you stop breathing for short periods while asleep. When blood oxygen drops too low, your body automatically wakes you to take a breath. This can disrupt your sleep several times a night. Chronic symptoms like drowsiness, irritability or headaches during the day, or indications you're a loud snorer, are all possible signs of sleep apnea.

Fortunately, we can treat sleep apnea. One way is continuous airway pressure therapy (CPAP), a pump device that supplies pressurized air through a mask to keep the airway open during sleep. Although CPAP is effective, some people find it uncomfortable to use.

There's a more comfortable option for sleep apnea caused by mouth structures like the tongue or tonsils obstructing the airway. It involves a custom-fitted oral appliance worn while you sleep that moves these structures out of the way.

Such appliances come in two basic types. One type fits over the upper and lower teeth and uses tiny metal hinges to move the lower jaw and tongue forward away from the airway. The other fits around and presses the tongue down like a tongue depressor to move it forward.

Before starting treatment, we need to first find out if you actually have sleep apnea and what's causing it (some cases may be more acute and require advanced treatments like jaw surgery). We'll need to perform medical and oral exams and take a history, and we'll likely refer you to a sleep medicine specialist for further testing.

If you have obstructive sleep apnea, a custom-fitted appliance could be a good solution. We'll create and adjust it according to your particular mouth and jaw contours for maximum comfort. Besides the appliance, you might also lose excess weight, adjust your sleep position, seek treatment for allergies, and quit smoking. All these could help reduce sleep apnea.

In any event, your first step is to find out if you have sleep apnea. From there we'll help you find the right treatment to improve your overall health and well being.

If you would like more information on treatments for sleep apnea, 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 “Sleep Disorders & Dentistry.”

4ThingstoGiveYourChildaHeadStartonGoodOralHealth

From the time they're born, you do everything you can to help your children develop a healthy body. That should include their teeth and gums. It's not over-dramatizing to say that what you do now may set the pattern for a healthy mouth for the rest of their life.

Here, then, are 4 things you should be doing for your children's oral health before they begin school.

Train them to brush and floss. Good hygiene habits have one primary purpose — remove dental plaque, a thin film of bacteria and food particles that builds up on tooth surfaces. Plaque is the number one cause of tooth decay and periodontal (gum) disease, so focus on brushing and later flossing as soon as their first teeth appear in the mouth, gradually training them to perform the tasks themselves. You can also teach them to test their efforts with a rub of the tongue — if it feels smooth and “squeaky,” their teeth are clean!

Keep your own oral bacteria to yourself. Children aren't born with decay-producing bacteria — it's passed on to them through physical contact from parents and caregivers. To limit their exposure to these “bad” bacteria, avoid kissing infants on the lips, don't share eating utensils and don't lick a pacifier to clean it off.

Eat healthy — and watch those sweets. Building up healthy teeth with strong enamel is as important to decay prevention as daily hygiene. Be sure they're getting the nutrients they need through a healthy diet of fresh fruits and vegetables, protein and dairy (and set a good example by eating nutritiously too). Sugar is a prime food source for bacteria that cause tooth decay, so avoid sugary snacks if possible and limit consumption to mealtimes.

Wean them off pacifiers and thumb sucking. It's quite normal for children to suck pacifiers and their thumbs as infants and young toddlers. It becomes a problem for bite development, though, if these habits continue into later childhood. As a rule of thumb, begin encouraging your children to stop sucking pacifiers or their thumbs by age 3.

If you would like more information on promoting your child's dental health, 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 “Help your Child Develop the Best Habits for Oral Health.”

Brushing and flossing your teeth daily can help prevent cavities. However, despite good oral hygiene, tooth decay can still occur. There cavityare several signs of a potential cavity. If you are experiencing any of them, it is important that you have your teeth professionally examined by a dentist immediately. The Mill Creek, WA dentists at Penny Creek Family & Cosmetic Dentistry can help.

Signs of a Cavity

Not only do cavities cause discomfort, but they can also lead to more serious oral health problems. When cavities go untreated, infections and tooth loss can occur. There are several signs that you might have a cavity, including:

  • Tooth Sensitivity
  • Tooth Pain
  • Chronic Bad Breath
  • Dark Spots on Teeth
  • Holes in Teeth
  • Pus

Experiencing pain or sensitivity in your teeth can mean that a cavity has developed. Many people’s teeth are sensitive to hot or cold foods and beverages and that doesn’t always mean they have cavities. If you have tried brushing with a toothpaste for sensitive teeth and are still experiencing discomfort, then you might have a cavity. Additionally, if your teeth feel especially sensitive when eating extremely sweet or sugary foods, that is an indication of potential tooth decay and/or a cavity.

As mentioned, other signs of a cavity include persistent bad breath and the formation of dark spots or holes in the teeth. These are all indications of poor oral health. Finally, the most serious sign of a cavity is the presence of pus. When pus is present, an abscess has developed and should be treated immediately. If this has happened to you, seek professional dental assistance right away.

Cavity Prevention

There are several steps you can take to prevent cavities. One of the best things you can do to maintain good oral health is get professional dental cleanings from your Mill Creek area dentists at least twice a year. Other cavity prevention measures include:

  • Brushing your teeth with a fluoride toothpaste at least twice a day.
  • Flossing your teeth every night before bed.
  • Rinsing with a fluoridated mouth rinse daily.
  • Limiting the amount of sugary foods and beverages in your diet.
  • Having dental sealants professionally applied to your teeth.

Untreated cavities can lead to more serious problems with your oral health. Taking good care of your teeth and mouth is important to preventing cavities, and that includes regular dental visits. Call Penny Creek Family & Cosmetic Dentistry at (425) 337-7300 to schedule a professional cleaning and cavity check with Dr. Chad Slocum or Dr. Sara Lundgaard, your Mill Creek, WA dentists.

HowtoKeepToothWearingtoaMinimumasyouAge

One of the unfortunate aspects of aging is tooth wear. Depending on your diet, years of biting and chewing can cause enamel along the biting surfaces to erode. Your body also can't replace enamel — so when it comes to teeth it's not a question of if, but how much your teeth will wear during your lifetime.

To make matters worse, certain conditions cause tooth wear to accelerate. Teeth softened by acids or tooth decay, for example, erode faster than healthier teeth. So will grinding habits: often fueled by stress, these include chewing on hard items like nails, pencils or bobby pins.

You may also grind your teeth, usually while you sleep. Normal biting and chewing produces pressure of about 13 to 23 pounds per square inch: grinding your teeth at night can well exceed this, even up into the hundreds of pounds.

There are some things we can do to alleviate these issues. For clenching and grinding habits, one primary step is to address stress through counseling or biofeedback therapy. For nighttime teeth grinding we can create a bite guard to wear while you sleep that will prevent your teeth from generating abnormal forces.

Finally, it's important that you take care of your teeth through daily oral hygiene, regular office cleanings and checkups, and a nutritious diet for maintaining strong bones and teeth. Keeping your teeth free from diseases that could compromise your enamel as well as other aspects of your mouth will help them stay as strong as possible.

If you would like more information on slowing the rate of tooth wear as you age, 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 “How and Why Teeth Wear.”

PatientswithHIVMustPayCloseAttentiontoTheirOralHealth

Acquired Immune Deficiency Syndrome (AIDS) jolted our collective consciousness in the 1980s. The deadly disease caused by the human immunodeficiency virus (HIV) had no known cure and, at the time, no effective treatment.

HIV is a retrovirus, a virus with a genetic makeup and reproduction system differing from other kinds. After taking up permanent residency in the body, HIV begins “hijacking” the replication process of cells in the body's immune system and replacing it with a copy of its own. This destroys the cells' ability to protect the body from hostile organisms. As the virus affects more and more cells, the patient's condition ultimately develops into AIDS.

An estimated 35 million people worldwide (1.2 million in the U.S.) are currently infected with the virus. Thanks to new antiretroviral drugs, though, HIV can be kept from accelerating into AIDS. While their condition remains serious, many HIV positive patients can now live long and relatively normal lives. Even so, having the virus requires them to pay close attention to their health, including their mouth.

Even while stalled from becoming AIDS, HIV can still cause oral problems for 30 to 80% of patients. The fungal infection candidiasis (also known as thrush) is the most common of these problems, which appears as lesions, cracking skin or creamy white patches on the tongue or palate that easily bleed. Patients also have higher risks for dry mouth, oral cancer and periodontal (gum) disease.

HIV positive patients must practice diligent daily oral care and see their dentist for checkups regularly. Prevention, early diagnosis and treatment can keep gum disease and other damaging conditions under control. Monitoring oral health is also important because certain mouth conditions could be an early sign the infection is entering a new advanced stage in the body that requires additional attention.

Keeping vigilant in all aspects of health is a way of life for someone with HIV. Such vigilance, though, can help them maintain a healthy mouth and even prolong their life.

If you would like more information on how to manage oral care with HIV, please contact us or schedule an appointment for a consultation.

EvenCelebritiesLikeJenniferLawrenceArentImmuneFromBadBreath

Exchanging passionate kisses with big-screen star Jennifer Lawrence might sound like a dream come true. But according to Liam Hemsworth, her Hunger Games co-star, it could also be a nightmare… because J.Law’s breath wasn’t always fresh. “Anytime I had to kiss Jennifer was pretty uncomfortable,” Hemsworth said on The Tonight Show.

Lawrence said the problem resulted from her inadvertently consuming tuna or garlic before the lip-locking scenes; fortunately, the two stars were able to share a laugh about it later. But for many people, bad breath is no joke. It can lead to embarrassment and social difficulties — and it occasionally signifies a more serious problem. So what causes bad breath, and what can you do about it?

In 9 out of 10 cases, bad breath originates in the mouth. (In rare situations, it results from a medical issue in another part of the body, such as liver disease or a lung infection.) The foul odors associated with bad breath can be temporarily masked with mouthwash or breath mints — but in order to really control it, we need to find out exactly what’s causing the problem, and address its source.

As Lawrence and Hemsworth found out, some foods and beverages can indeed cause a malodorous mouth. Onions, garlic, alcohol and coffee are deservedly blamed for this. Tobacco products are also big contributors to bad breath — which is one more reason to quit. But fasting isn’t the answer either: stop eating for long enough and another set of foul-smelling substances will be released. Your best bet is to stay well hydrated and snack on crisp, fresh foods like celery, apples or parsley.

And speaking of hydration (or the lack of it): Mouth dryness and reduced salivary flow during the nighttime hours is what causes “morning breath.” Certain health issues and some medications can also cause “dry mouth,” or xerostomia. Drinking plenty of water can encourage the production of healthy saliva — but if that’s not enough, tell us about it: We may recommend switching medications (if possible), chewing xylitol gum or using a saliva substitute.

Finally, maintaining excellent oral hygiene is a great way to avoid bad breath. The goal of oral hygiene is to control the harmful bacteria that live in your mouth. These microorganisms can cause gum disease, tooth decay, and bad breath — so keeping them in check is good for your overall oral health. Remember to brush twice and floss once daily, stay away from sugary foods and beverages, and visit the dental office regularly for checkups and professional cleanings.

So did J.Law apologize for the malodorous makeout session? Not exactly. “[For] Bradley Cooper, Christian Bale, yeah, I’ll brush my teeth,” she laughed.

Hemsworth jokingly agreed: “If I was kissing Christian Bale I probably would have brushed my teeth too. With you, it’s like, ‘Eh. Whatever.’”

If you would like more information about bad breath and oral hygiene, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine article “Bad Breath: More than Just Embarrassing.”

The importance of a good dental hygiene routine

The dental hygiene routine you practice every day is the most important step toward maintaining your good oral health. When you have oral hygienegood oral habits, you are ensuring the health of your smile and helping your overall health. In fact, according to the Mayo Clinic, an unhealthy mouth has been linked to:

  • Diabetes
  • Heart disease
  • Stroke
  • Alzheimer’s disease
  • Diabetes

Your family dentists at Penny Creek Family & Cosmetic Dentistry in Mill Creek, Washington want you to know all about how to take great care of your teeth and gums. They want you to know why good oral habits mean good oral health.

The goal of your oral hygiene program should be to thoroughly remove plaque from your teeth as often as you can. Your plaque contains millions of harmful bacteria which produce toxins that can destroy the hard and soft tissue of your mouth.

Your family dentists at Penny Creek Family & Cosmetic Dentistry want you to remember to add these simple tasks to your daily dental hygiene routine to ensure plaque removal:

  • Brush after each meal and before you go to sleep with a soft toothbrush and fluoride toothpaste; you can also use sonic or electric toothbrushes to effectively clean your teeth.
  • Floss at least once per day; using a piece of floss is best because you can wrap around tooth surfaces, ensuring you clean thoroughly in between your teeth, however, you can use tools like floss threaders or picks if they help you.
  • Fluoride rinses can also be used but be sure to not rinse or eat afterward; fluoride works best if it is allowed to remain on your teeth as long as possible.

Don’t forget to visit your family dentists at Penny Creek Family & Cosmetic Dentistry regularly. It’s best to visit every six months for a professional cleaning, and at least yearly for an exam and x-rays.

You can prevent many dental problems if you practice good oral habits; however, there are some dental issues which only your dentist can diagnose. That’s why it’s important to combine good oral habits with professional dental care. It’s time to partner with your dentists at Penny Creek Family & Cosmetic Dentistry in Mill Creek, Washington. Ensure your good oral health by calling today!

ActorDavidRamseyDiscussesBabyBottleToothDecay

Cavities can happen even before a baby has his first piece of candy. This was the difficult lesson actor David Ramsey of the TV shows Arrow and Dexter learned when his son DJ’s teeth were first emerging.

“His first teeth came in weak,” Ramsey recalled in a recent interview. “They had brown spots on them and they were brittle.” Those brown spots, he said, quickly turned into cavi­ties. How did this happen?

Ramsey said DJ’s dentist suspected it had to do with the child’s feedings — not what he was being fed but how. DJ was often nursed to sleep, “so there were pools of breast milk that he could go to sleep with in his mouth,” Ramsey explained.

While breastfeeding offers an infant many health benefits, problems can occur when the natural sugars in breast milk are left in contact with teeth for long periods.  Sugar feeds decay-causing oral bacteria, and these bacteria in turn release tooth-eroding acids. The softer teeth of a young child are particularly vulnerable to these acids; the end result can be tooth decay.

This condition, technically known as “early child caries,” is referred to in laymen’s terms as “baby bottle tooth decay.” However, it can result from nighttime feedings by bottle or breast. The best way to prevent this problem is to avoid nursing babies to sleep at night once they reach the teething stage; a bottle-fed baby should not be allowed to fall asleep with anything but water in their bottle or “sippy cup.”

Here are some other basics of infant dental care that every parent should know:

  • Wipe your baby’s newly emerging teeth with a clean, moist washcloth after feedings.
  • Brush teeth that have completely grown in with a soft-bristled, child-size toothbrush and a smear of fluoride toothpaste no bigger than a grain of rice.
  • Start regular dental checkups by the first birthday.

Fortunately, Ramsey reports that his son is doing very well after an extended period of professional dental treatments and parental vigilance.

“It took a number of months, but his teeth are much, much better,” he said. “Right now we’re still helping him and we’re still really on top of the teeth situation.”

If you would like more information on dental care for babies and toddlers, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “The Age One Dental Visit” and “Dentistry & Oral Health for Children.”

ActorDavidRamseySaysDontForgettoFloss

Can you have healthy teeth and still have gum disease? Absolutely! And if you don’t believe us, just ask actor David Ramsey. The cast member of TV hits such as Dexter and Arrow said in a recent interview that up to the present day, he has never had a single cavity. Yet at a routine dental visit during his college years, Ramsey’s dentist pointed out how easily his gums bled during the exam. This was an early sign of periodontal (gum) disease, the dentist told him.

“I learned that just because you don’t have cavities, doesn’t mean you don’t have periodontal disease,” Ramsey said.

Apparently, Ramsey had always been very conscientious about brushing his teeth but he never flossed them.

“This isn’t just some strange phenomenon that exists just in my house — a lot of people who brush don’t really floss,” he noted.

Unfortunately, that’s true — and we’d certainly like to change it. So why is flossing so important?

Oral diseases such as tooth decay and periodontal disease often start when dental plaque, a bacteria-laden film that collects on teeth, is allowed to build up. These sticky deposits can harden into a substance called tartar or calculus, which is irritating to the gums and must be removed during a professional teeth cleaning.

Brushing teeth is one way to remove soft plaque, but it is not effective at reaching bacteria or food debris between teeth. That’s where flossing comes in. Floss can fit into spaces that your toothbrush never reaches. In fact, if you don’t floss, you’re leaving about a third to half of your tooth surfaces unclean — and, as David Ramsey found out, that’s a path to periodontal disease.

Since then, however, Ramsey has become a meticulous flosser, and he proudly notes that the long-ago dental appointment “was the last we heard of any type of gum disease.”

Let that be the same for you! Just remember to brush and floss, eat a good diet low in sugar, and come in to the dental office for regular professional cleanings.

If you would like more information on flossing or periodontal disease, please contact us today to schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Understanding Gum (Periodontal) Disease.”

3WaystoReducetheBacteriainYourMouththatCauseToothDecay

Tooth decay doesn’t suddenly appear out of the blue. Cavities and other damage are the result of a long process that begins with bacteria living in a thin biofilm on tooth surfaces known as plaque. These bacteria thrive on sugars from leftover food in your mouth and then produce acid as a waste product. Chronic high levels of acid cause your enamel, the protective layer of your teeth, to soften and erode.

While there are treatment options at each stage of decay — including crowning or even tooth replacement — the best approach is to try to prevent plaque buildup that supports disease-causing bacteria. Here are 3 of the best ways you can do that.

Brush and floss daily. It usually takes 12-24 hours for enough plaque buildup to support bacteria. By brushing and flossing at least once a day, you can remove most of this buildup, with twice a year dental cleanings to remove hard to reach plaque you may have missed. Be sure to use fluoride toothpaste to help strengthen enamel against high acid. And wait a half hour to an hour after eating before brushing to give saliva time to reduce the acid level in your mouth.

Cut back on sweets. You’re not the only one who loves sugary snack foods — so do oral bacteria. The more sugar and other carbohydrates they feast on, the more they produce acid. The best approach is to cut out sugar-rich snacks altogether and instead snack on fresh fruits, raw vegetables or dairy products. Limit sweet treats to meal times.

Use decay-fighting supplements. Your mouth and hygiene efforts may need a little assistance, especially if you have low saliva flow. You can boost this with an artificial saliva supplement as well as with products containing xylitol, an alcohol-based sugar. Xylitol also has an added benefit in the fight against decay because it inhibits bacterial growth. And be sure to talk with us first before taking any dental supplement.

If you would like more information on dental hygiene and care, 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 “Cost-Saving Treatment Alternatives.”

How long has it been since you had a dental checkup? If you're still trying to remember, it may be time to schedule an appointment with family dentistthe dentists at Penny Creek Family & Cosmetic Dentistry in Mill Creek, WA. Having a family dentist is an important part of maintaining the overall health of yourself and your family. Here's how regular visits to your Mill Creek family dentist can help keep you smiling:

Sparing you cost, time and discomfort

By establishing yourself at your Mill Creek family dentist's office, dental problems can be identified and treated quickly. Patients who visit their family dentist twice a year are much more likely to have fewer costly dental procedures. This is because problems are treated before they become complicated and expensive to fix. Those who wait until they have an emergency to seek dental treatment often experience more pain and expense because their dental health has not been properly maintained.

One-stop shop

Instead of taking your toddler to one dentist, driving your teenager to another, and making your own appointments with someone else, a family dentist offers all of these specialties under one roof. Family dentists, like Dr. Chad Slocum and Dr. Sara Lundgaard in Mill Creek, have the training and experience necessary to treat patients in all stages of life. They will treat baby teeth as they grow in, monitor the transition to permanent teeth, and work with you to keep your adult smile healthy and bright. In many cases, two or more family members can be treated on the same day.

Still can't remember the last time you were in the dental chair? Don't waste any more time - give us a call at Penny Creek Family & Cosmetic Dentistry in Mill Creek, WA to schedule an evaluation for yourself or a family member. We'd be happy to help you take charge of your dental health.

KeepaCloseEyeonYourChildsFluorideIntake

Fluoride has been proven to strengthen tooth enamel against decay. That’s why it’s not only added to toothpaste and other dental products, but also to drinking water — in nearly three-quarters of U.S. water systems.

While research has eased most serious health questions about fluoride, there remains one moderate concern. Too much fluoride over time, especially in infants and young children, could lead to “enamel fluorosis,” an excess of fluoride in the tooth structure that can cause spotting or streaking in the enamel. While often barely noticeable, some cases of fluorosis can produce dark staining and a pitted appearance. Although not a symptom of disease, fluorosis can create a long-term cosmetic concern for the person.

To minimize its occurrence, children under the age of 9 shouldn’t regularly ingest fluoride above of the recommended level of 0.70 ppm (parts per million). In practical terms, you as a parent should monitor two primary sources of fluoride intake: toothpaste and drinking water.

Young children tend to swallow toothpaste rather than spit it out after brushing, which could result in too much fluoride ingestion if the amount is too great. The American Academy of Pediatric Dentistry therefore recommends a small “smear” of toothpaste for children under two, and a pea-sized amount for children up to age six. Brushing should also be limited to no more than two times a day.

Your child or infant could also take in too much fluoride through fluoridated drinking water, especially if you’re using it to mix infant formula. You should first find out the fluoride levels in your local water system by contacting the utility or the health department. If your system is part of the U.S. Centers for Disease Control and Prevention’s (CDC) “My Water’s Fluoride” program, you may be able to access that information on line at http://apps.nccd.cdc.gov/MWF/Index.asp.

If the risk for developing fluorosis in your area is high, you can minimize your infant’s intake with a few recommendations: breastfeed rather than use formula; use “ready-to-feed” formula that doesn’t need mixing and contains lower fluoride levels; and use bottled water specifically labeled “de-ionized,” “purified,” “de-mineralized,” or “distilled.”

Fluoride can be a wonderful adjunct to dental care in reducing risk for tooth decay. Keeping an eye on how much fluoride your child takes in can also minimize the chance of future appearance problems.

If you would like more information on the possible effects of fluoride on young children, 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 “Tooth Development and Infant Formula.”

SofiaVergaraObsessedWithOralHygiene

A woman as gorgeous and funny as Sofia Vergara surely planned to be a model and actress from the get-go, right? Wrong! Sofia’s first career choice actually was to be… a dentist! That’s right, the sexy star of TV’s Modern Family actually was only two semesters shy of finishing a dental degree in her native Columbia when she traded dental school for the small screen. Still, dental health remains a top priority for the actress and her son, Manolo.

“I’m obsessed,” she recently told People magazine. “My son thinks I’m crazy because I make him do a cleaning every three months. I try to bribe the dentist to make him to do it sooner!”

That’s what we call a healthy obsession (teeth-cleaning, not bribery). And while coming in for a professional cleaning every three months may not be necessary for everyone, some people — especially those who are particularly susceptible to gum disease — may benefit from professional cleanings on a three-month schedule. In fact, there is no one-size-fits-all approach to having professional teeth cleanings — but everyone needs this beneficial procedure on a regular basis.

Even if you are meticulous about your daily oral hygiene routine at home, there are plenty of reasons for regular checkups. They include:

  • Dental exam. Oral health problems such as tooth decay and gum disease are much easier — and less expensive — to treat in the earliest stages. You may not have symptoms of either disease early on, but we can spot the warning signs and take appropriate preventive or restorative measures.
  • Oral cancer screening. Oral cancer is not just a concern of the middle aged and elderly — young adults can be affected as well (even those who do not smoke). The survival rate for this deadly disease goes up tremendously if it is detected quickly, and an oral cancer screening is part of every routine dental visit.
  • Professional teeth cleaning. Calcified (hardened) dental plaque (tartar or calculus) can build up near the gum line over time — even if you brush and floss every day. These deposits can irritate your gums and create favorable conditions for tooth decay. You can’t remove tartar by flossing or brushing, but we can clear it away — and leave you with a bright, fresh-feeling smile!

So take a tip from Sofia Vergara, and don’t skimp on professional cleanings and checkups. If you want to know how often you should come in for routine dental checkups, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor articles “Dental Hygiene Visit” and “Dental Cleanings Using Ultrasonic Scalers.”

KeepaCloseEyeonYourDentalHealthWhileUndergoingCancerTreatment

As a cancer patient, you know how important radiation and chemotherapy are to overcoming the disease. But these treatments often come at a price to other aspects of your health, including your teeth and gums if the treatment target includes the head or neck regions.

Radiation and chemotherapy are effective because they target and destroy cancer cells. Unfortunately, they may also kill non-cancerous, healthy cells; in the mouth, for example, they can damage the cells in the salivary glands and disrupt their ability to produce adequate saliva flow, leading to xerostomia (dry mouth).

This could seriously affect your teeth’s protective enamel shell. As we eat or drink, our mouth’s pH level can become too acidic. Acid is your enamel’s primary enemy because it causes the minerals in the enamel to soften and dissolve (de-mineralization). Saliva neutralizes acid and replaces much of the enamel’s minerals.

Without adequate saliva flow, the enamel will tend to erode over time. You can further aggravate the situation if you routinely consume acidic foods and drinks, like sipping energy drinks or soda during the day. Once the enamel is gone it can’t be replaced naturally, and the teeth will be in serious danger of tooth decay and eventual loss of function and appearance.

To avoid these consequences you should take steps during cancer treatment to reduce your risk for xerostomia or other unhealthy mouth conditions: limit your consumption of acidic foods and beverages; use mouth rinses to counteract acidity and inhibit bacterial growth; and promote saliva flow through medication.

It may be, though, that enamel erosion and subsequent tooth damage is unavoidable. In this case, you may need to consider restorative options with artificial crowns or other cosmetic enhancements — not only to improve your appearance but also to protect your natural teeth from further damage.

Before considering the latter, you should undergo a complete dental examination to assess your condition and make sure you have adequate bone and gum support, and any dental disease under control. From here, we can go about restoring the attractive smile that may have faded during your battle with cancer.

If you would like more information on oral care during and after cancer treatment, please contact us or schedule an appointment for a consultation.

NoGleeinToothGrinding

Sure, it’s big news when celebs tweet selfies from the dental office… if you’re still living in the 20th century. But in Hollywood today, it’s harder to say who hasn’t posted snaps of themselves in the dentist’s chair than who has. Yet the pictures recently uploaded to Twitter by Mark Salling, the actor and singer who regularly appears as Noah “Puck” Puckerman on the popular TV series Glee, made us sit up and take notice.

“Getting my chipped tooth fixed. Also, apparently, I’m a big grinder,” read the caption. The photo showed a set of upper front teeth with visible chips on the biting surface. What’s so special about this seemingly mundane tweet? It’s a great way of bringing attention to a relatively common, but often overlooked problem: teeth clenching and grinding, also called bruxism.

Although bruxism is a habit that affects scores of people, many don’t even realize they have it. That’s because the condition may only become active at night. When the teeth are unconsciously ground together, the forces they produce can wear down the enamel, cause chipping or damage to teeth or dental work (such as veneers or fillings), or even loosen a tooth! While it’s common in children under 11 years old, in adults it can be a cause for concern.

Sometimes, mouth pain, soreness and visible damage alert individuals to their grinding habits; other times, a dental professional will notice the evidence of bruxism during an exam or cleaning: tooth sensitivity and telltale wear and tear on the chewing surfaces. Either way, it’s time to act.

Bruxism is most often caused by stress, which can negatively impact the body in many ways. It may also result from bite problems, the overuse of stimulating substances (caffeine, alcohol, tobacco, and illegal drugs), and as a side effect of certain medications. Sometimes, simply becoming aware of the habit can help a person get it under control. Common methods of stress reduction include exercise, meditation, a warm bath or a quiet period before bedtime; these can be tried while we monitor the situation to see if the problem is going away.

If stress reduction alone doesn’t do the trick, several other methods can be effective. When bruxism is caused by a minor bite problem, we can sometimes do a minor “bite adjustment” in the office. This involves removing a tiny bit of enamel from an individual tooth that is out of position, bringing it in line with the others. If it’s a more serious malocclusion, orthodontic appliances or other procedures may be recommended.

When grinding is severe enough to damage teeth or dental work, we may also recommend a custom-made night guard (occlusal guard), which you put in your mouth at bedtime. Comfortable and secure, this appliance prevents your teeth from being damaged by contacting each other, and protects your jaw joints from stresses due to excessive grinding forces.

Whether or not you have to smile for a living, teeth grinding can be a big problem. If you would like more information about this condition, call our office to schedule a consultation for a consultation.

KeepingFluoridetoJusttheRightAmountProtectsYourFamilysSmiles

Since the 1950s fluoride has played an important role in the fight against tooth decay as an additive to hygiene products and many public water supplies. But although a proven cavity fighter, some have questioned its safety over the years.

To date, though, the only substantiated health risk from fluoride use is a condition known as enamel fluorosis, which occurs when too much fluoride is ingested during early tooth development as the mineral embeds in the tooth structure. Fluorosis can cause changes in the enamel’s appearance, ranging from barely noticeable white streaking to darker visible staining and a pitted texture.

Fluorosis is primarily a cosmetic problem and not a serious health issue. The staining on otherwise sound teeth, however, is permanent and more severe cases may require extensive bleaching treatment to improve appearance. The best strategy is to prevent fluorosis by monitoring and limiting your child’s fluoride intake, until about age 9.

Tooth decay is a more serious condition than fluorosis so we’re not advocating you eliminate fluoride but that you keep your family’s intake within safe levels. The first step is to determine just how much that intake is now, particularly if you drink fluoridated water. If you have public water, you may be able to find its fluoridation level online at apps.nccd.cdc.gov or call the utility directly.

You should also be careful about the amount of toothpaste your child uses to brush their teeth. Children under two need only a trace (a “smear”) on the brush, and children between the ages of 2 and 6 a pea-sized amount. And, they should brush no more than twice a day.

Another possible concern is infant formula, especially mixable powder. While the formula itself doesn’t contain fluoride, water mixed with it may. If you live in an area with increased fluorosis risk, consider breast-feeding (breast milk has little fluoride), using ready-to-feed formula, or mixing powdered formula with bottled water labeled “de-ionized,” “purified,” “demineralized” or “distilled.”

We’ll be glad to help assess your family’s current fluoride intake and advise you on making adjustments to bring it into normal ranges. Taking in the right amount of fluoride assures you and your children receive the most benefit and protection from it, while avoiding future smile problems.

If you would like more information on managing your family’s fluoride intake, please contact us today to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Tooth Development and Infant Formula.”

ReplacingaKnocked-OutToothQuicklyIncreasesitsSurvivalChances

Mouth injuries in children and teens are more common than you might think: about one out of three boys and one out of four girls will have experienced an injury before they graduate from high school. Besides contact sports, other types of accidents like car crashes or falls are high on the cause list.

Although most dental injuries aren’t considered true emergencies, there are a few where prompt action may mean the difference between ultimately saving or losing a tooth. One such situation is a knocked out tooth.

In the event of a knocked out (or avulsed) tooth, your primary goal is to place the tooth back into the empty socket as quickly as possible. Teeth that have been out of the mouth for less than five minutes have the best chance of reattachment and survival. The first step is to quickly locate the missing tooth.

Once you’ve found it, use only cold, clean water run or poured over the tooth to carefully clean off dirt or debris (no soaps or cleansers). You should also avoid touching the tooth root or scrubbing any part of it. After cleaning it of debris, gently place the tooth back in its socket, then immediately contact us or visit an emergency room. While you’re en route to our office the patient should carefully hold the tooth in place. If the tooth can’t be immediately placed into the socket (the patient is unconscious, for example), then you should place the tooth in a clean container and keep it moist with cold milk, a sterile saline solution or even the patient’s saliva.

Taking these steps increases the chances of a successful re-implantation, although the injury may ultimately affect the tooth’s lifespan. Replanted teeth can suffer from root resorption (where the root tissue dissolves) or a process known as ankylosis in which the tooth fuses directly to the jawbone with no healthy periodontal ligament in between. Either of these conditions can lead to tooth loss.

Still, it’s worthwhile to try to save the tooth, even if for a few more years. Those extra years can help you prepare for a future restoration.

If you would like more information on responding to dental injuries, 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 “Accidental Tooth Loss.”

LamarOdomReboundsFromDentalAnxiety

Professional basketball player Lamar Odom is sometimes known as “the candyman” because of his notorious fondness for sweets. But when his sweet tooth finally caught up with him — in the form of a mouthful of decayed teeth — the six-foot-ten-inch, 230-pound hoops star admitted that he had been avoiding treatment… because he was afraid of going to the dentist!

It took two Kardashians (Khloe and Kim) and a painful toothache to finally persuade Odom to sit in the chair. Once he did, it was found that he needed a root canal, a wisdom tooth extraction, and several fillings. Yet the fretful forward sailed through the whole set of procedures in a single visit, and walked out with a big smile afterward. How did his dentists make that happen?

Put it down to the “magic” of sedation dentistry. With anxiety-relieving medications that can be delivered orally (in pill form or by gas) or intravenously (into the bloodstream), the techniques of sedation dentistry can help even the most fearful patients get the dental care they need. That’s good news for about 50 percent of the population, who admit they’re at least somewhat afraid of the dentist — and even better for the 15 percent who avoid dental care completely due to their fear.

Dentists have a number of ways to ease apprehensive patients through a dental visit. An oral anti-anxiety drug can be given in pill form about an hour beforehand. Nitrous oxide (sometimes called “laughing gas”), which is administered by a mask placed over the mouth or nose, may also be used to relieve anxiety. The calming effects of these medications help make any nervousness melt away — and in many circumstances, mild sedation is all that’s needed to ease the fear.

For lengthier or more complex procedures, intravenous (IV) sedation may be recommended. Unlike deeper (unconscious) sedation, IV sedation doesn’t cause “sleep.” Instead, it puts you in a comfortable semi-awake state, where you can still breathe on your own and respond to stimuli… but without feeling any anxiety. And when the procedure is over, you probably won’t have any memory of it at all.

IV sedation can be administered by dentists who are specially trained and equipped with the proper safety equipment. While sedation is being provided, you will be monitored at all times by a dedicated staff member; when it’s over, you will rest for a while as the medication quickly wears off. Then (as is the case with oral sedation), you’ll need another person to give you a ride home.

Does sedation dentistry really work? Lamar Odom thinks so. “I feel so much better,” he said when his 7-hour procedure was over. “I feel like I accomplished something.”

If you would like more information about sedation dentistry, please contact us or schedule an appointment. You can learn more by reading the Dear Doctor magazine article “Oral Sedation Dentistry.”

BeyonceMakesFlossingaFamilyAffair

As is the case with most celebs today, Beyonce is no stranger to sharing on social media… but she really got our attention with a video she recently posted on instagram. The clip shows the superstar songstress — along with her adorable three-year old daughter Blue Ivy — flossing their teeth! In the background, a vocalist (sounding remarkably like her husband Jay-Z) repeats the phrase “flossin’…flossin’…” as mom and daughter appear to take care of their dental hygiene in time with the beat: https://instagram.com/p/073CF1vw07/?taken-by=beyonce

We’re happy that this clip highlights the importance of helping kids get an early start on good oral hygiene. And, according to authorities like the American Dental Association and the American Academy of Pediatric Dentistry, age 3 is about the right time for kids to begin getting involved in the care of their own teeth.

Of course, parents should start paying attention to their kids’ oral hygiene long before age three. In fact, as soon as baby’s tiny teeth make their first appearance, the teeth and gums can be cleaned with a soft brush or cloth and a smear of fluoride toothpaste, about the size of a grain of rice. Around age 3, kids will develop the ability to spit out toothpaste. That’s when you can increase the amount of toothpaste a little, and start explaining to them how you clean all around the teeth on the top and bottom of the mouth. Depending on your child’s dexterity, age 3 might be a good time to let them have a try at brushing by themselves.

Ready to help your kids take the first steps to a lifetime of good dental checkups? Place a pea-sized dab of fluoride toothpaste on a soft-bristled brush, and gently guide them as they clean in front, in back, on all surfaces of each tooth. At first, it’s a good idea to take turns brushing. That way, you can be sure they’re learning the right techniques and keeping their teeth plaque-free, while making the experience challenging and fun.

Most kids will need parental supervision and help with brushing until around age 6. As they develop better hand-eye coordination and the ability to follow through with the cleaning regimen, they can be left on their own more. But even the best may need some “brushing up” on their tooth-cleaning techniques from time to time.

What about flossing? While it’s an essential part of good oral hygiene, it does take a little more dexterity to do it properly. Flossing the gaps between teeth should be started when the teeth begin growing close to one another. Depending on how a child’s teeth are spaced, perhaps only the back ones will need to be flossed at first. Even after they learn to brush, kids may still need help flossing — but a floss holder (like the one Beyonce is using in the clip) can make the job a lot easier.

If you would like more information about maintaining your children’s oral hygiene, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Top 10 Oral Health Tips For Children” and “How to Help Your Child Develop the Best Habits for Oral Health.”

TheTypeofToothPainYouHaveCouldbeTellingYouWhatsWrong

As with the rest of the body, tooth pain is an indication that something’s wrong. While the exact cause requires a dental exam, the location, quality and duration of the pain could narrow the possibilities. With that in mind, here are 3 types of tooth pain and what it might be telling you.

Sensitivity. Pain or discomfort when you eat or drink cold foods or bite down could mean you have a small area of decay in the tooth, a loose filling or an exposed root surface from gum recession. Dental work to repair a decayed tooth or filling could alleviate the pain; in the case of gum recession, you may need to reduce overaggressive brushing or seek treatment for periodontal (gum) disease, the two main causes of the condition.

Dull or lingering pain. A dull ache in the rear sinus area could indicate a problem with a back tooth — they share the same nerve pathways as the sinuses, so you may be feeling referred pain. In the case of lingering pain after eating or drinking something hot or cold, there may be decay within the inner pulp chamber of the tooth that’s damaging or even killing the nerve tissue. If so, a root canal treatment might be in order.

Sharp pain. That sudden, excruciating pain when you bite down could mean you’re experiencing advanced decay, a loose filling or possibly a cracked tooth. If the pain seems to radiate from the gums — and they’re swollen and sensitive — you may have developed an abscess brought on by periodontal (gum) disease. In all these cases, appropriate dental treatment like decay removal and filling, root canal treatment or plaque removal may be necessary, depending on the cause and extent of the problem.

Regardless of what kind of pain you’re feeling, you should see us as soon as possible — in many situations waiting will only make the problem worse. The sooner we discover the cause, the sooner we can begin the right treatment to solve the issue and alleviate your pain.

If you would like more information on the causes and treatment of tooth pain, 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 “Tooth Pain? Don’t Wait!

NancyODellonMakingOralHygieneFunforKids

When Entertainment Tonight host Nancy O’Dell set out to teach her young daughter Ashby how to brush her teeth, she knew the surest path to success would be to make it fun for the toddler.

“The best thing with kids is you have to make everything a game,” Nancy recently said in an interview with Dear Doctor TV. She bought Ashby a timer in the shape of a tooth that ticks for two minutes — the recommended amount of time that should be spent on brushing — and the little girl loved it. “She thought that was super fun, that she would turn the timer on and she would brush her teeth for that long,” Nancy said.

Ashby was also treated to a shopping trip for oral-hygiene supplies with Mom. “She got to go with me and choose the toothpaste that she wanted,” Nancy recalled. “They had some SpongeBob toothpaste that she really liked, so we made it into a fun activity.”

Seems like this savvy mom is on to something! Just because good oral hygiene is a must for your child’s health and dental development, that doesn’t mean it has to feel like a chore. Equally important to making oral-hygiene instruction fun is that it start as early as possible. It’s best to begin cleaning your child’s teeth as soon as they start to appear in infancy. Use a small, soft-bristled, child-sized brush or a clean, damp washcloth and just a thin smear of fluoride toothpaste, about the size of a grain of rice.

Once your child is old enough to hold the toothbrush and understand what the goal is, you can let him or her have a turn at brushing; but make sure you also take your turn, so that every tooth gets brushed — front, back and all chewing surfaces. After your child turns 3 and is capable of spitting out the toothpaste, you can increase the toothpaste amount to the size of a pea. Kids can usually take over the task of brushing by themselves around age 6, but may still need help with flossing.

Another great way to teach your children the best oral-hygiene practices is to model them yourself. If you brush and floss every day, and have regular cleanings and exams at the dental office, your child will come to understand what a normal, healthy and important routine this is. Ashby will certainly get this message from her mom.

“I’m very adamant about seeing the dentist regularly,” Nancy O’Dell said in her Dear Doctor interview. “I make sure that I go when I’m supposed to go.”

It’s no wonder that Nancy has such a beautiful, healthy-looking smile. And from the looks of things, her daughter is on track to have one, too. We would like to see every child get off to an equally good start!

If you have questions about your child’s oral health, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Taking the Stress Out of Dentistry for Kids” and “Top 10 Oral Health Tips for Children.”

GiancarloStantonGetsMajor-LeagueMouthProtection

For major-league slugger Giancarlo Stanton, 2014 was a record-breaking year. After the baseball season ended, he signed a 13-year, $325 million contract with the Miami Marlins — the biggest deal in sports history. But earlier that same year, Stanton suffered one of the worst accidents in baseball: He was hit in the face by an 88-mph fastball, sustaining multiple fractures, lacerations, and extensive dental damage.

After the accident, Stanton didn’t play for the remainder of the season. But now he’s back in Spring Training… and he’s got a not-so-secret weapon to help protect him against another injury: A custom-made face guard designed to absorb impacts and keep him from suffering further trauma.

As sports fans, we’re glad that Stanton was able to overcome his injury and get back in the game. As dentists, we’d like to remind you that you don’t have to be a major-league player to feel the harmful effects of a sports injury — and you don’t have to look far to find a way to protect yourself. In fact, you can get a custom-made mouthguard right here at the dental office.

Mouthguards have a long tradition in sports like football, boxing, and hockey. But did you know that far more Americans are injured every year playing “non-collision” sports like basketball, baseball — and even bicycling? And it doesn’t take a major-league fastball to cause a dental injury: The highest incidence of sports-related dental injuries occurs in 15-to-18-year-old males. In fact, about one-third of all dental injuries among children stem from various types of sports activities. These injuries may result in countless hours being lost from school and work, and cost significant sums for treatment and restoration.

Mouthguards have a proven track record in reducing dental and facial injuries: They are capable of absorbing the energy of a blow to the mouth, and dissipating it in a way that prevents damage to facial structures and teeth. But not all mouthguards are created equal: Custom-fabricated mouthguards, which are produced from an exact model of your mouth made right here in the dental office, offer by far the best protection. They fit better and safeguard the teeth more fully than any off-the-shelf or “boil-and-bite” type can. Plus, they’re more comfortable to wear. And let’s face it: No mouth guard can protect your teeth if you don’t wear it.

What’s more, some recent studies indicate that custom-made mouthguards may offer significant protection against concussion. An increasing awareness of the dangers that concussion may pose to athletes is one more reason why we recommend custom-made mouthguards to active people and their families.

To get his face guard, Giancarlo Stanton reportedly went to a specialist sporting-goods manufacturer in Illinois, and paid around $1,000. But you can get a custom-made mouthguard for yourself or your loved ones right at our office for a fraction of that price. And the peace of mind it can give you is… priceless.

If you have questions about custom-made mouthguards, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “An Introduction to Sports Injuries & Dentistry” and “Athletic Mouthguards.”

ActressBlytheDannerIsaLeaderintheFightAgainstOralCancer

After her husband, producer Bruce Paltrow, succumbed to oral cancer in 2002, actress Blythe Danner made it her mission to help save other families from the heartache she and her children (Jake and Gwyneth Paltrow) suffered with his loss. Now active with the Oral Cancer Foundation, Blythe uses her fame to bring awareness to the disease, which she says she and her family knew very little about before Bruce received his diagnosis.

In an interview with People magazine, Blythe said she believes her husband's cancer could have been detected earlier if the family had been alert to the symptoms.

“For months I had noticed Bruce's voice was hoarse,” she said. “I started asking him to see a doctor. But he kept saying, ‘No, no, no, I'm fine.’ ”

When a lump became visible in his neck, he did go to the doctor and found he had a tumor in his throat. The cancer eventually spread to his lymph nodes. Compounding Blythe's sadness is the feeling that she might have been able to do something to prevent her husband's death.

“I feel tremendously guilty,” she told the magazine, noting that she wishes she had simply insisted her husband get himself checked out. “Education and early detection are so important,” she said of her campaign to raise awareness. “That's why I'm doing this.”

Though Bruce Paltrow was a smoker, it's important to note that young, non-smokers comprise the fastest-growing segment of the population being diagnosed with the disease. That's because a sexually transmitted virus known as HPV16 is now a major cause of oral cancer.

Oral cancer screenings are yet another good reason to make regular semi-annual visits to the dentist. We have the training to notice oral abnormalities, and to monitor and/or biopsy any suspicious lesions. At your oral cancer screening, we will feel your neck for lumps and inspect your lips and all inside surfaces of the mouth, including the back of your throat.

Of course, if you or a loved one experience persistent hoarseness, white or red patches or other changes in your mouth or tongue that don't go away in a few weeks, please don't hesitate to come in and see us.

If you have any concerns about oral cancer, please contact us or schedule an appointment for a consultation. You can learn more about the disease in the Dear Doctor magazine article “Oral Cancer.”

DailyHygieneTasksPerformedProperlyHelpEnsureGoodOralHealth

Daily personal care is essential for optimal oral health. Brushing and flossing in particular keep bacteria and acid, the main causes of dental disease, at manageable levels. But to gain the most benefit from your personal care, you need to perform these tasks effectively with the proper techniques and equipment.

For most people brushing begins with a soft-bristled, multi-tufted toothbrush with fluoride toothpaste that helps strengthen enamel. You should hold the brush at a slight angle and brush with a gentle motion to remove plaque, the main cause of gum disease and tooth decay — if you’re too aggressive by brushing too hard or too long, you could damage the gums. You should brush no more than twice a day for two minutes, and at least thirty minutes to an hour after eating to allow saliva time to neutralize any remaining acid and help restore minerals to enamel.

Although some people find flossing difficult to perform, it remains an important component of daily care. Flossing once a day removes plaque from between teeth where a brush can’t reach. If you need help with your technique using string floss, we’ll be glad to provide instruction at your next visit. If you have bridges, braces or other dental restorations or appliances that make string flossing difficult, you might consider other options like floss threaders or a water flosser.

There are also dietary and lifestyle choices you can make to enhance your daily care: limit sugary or acidic foods to mealtime and avoid between meal snacks to reduce bacteria and acid in the mouth; drink water to keep your mouth moist, which will inhibit plaque buildup; and stop tobacco use, excessive alcohol consumption and chewing habits like clenching or biting on hard objects. Above all, be sure to visit us at least twice a year for cleanings and checkups, or when you notice abnormalities like bleeding gums, pain or sores.

Keeping your teeth and gums healthy can be done, but it requires a daily care commitment. Performing these hygiene habits in an effective manner will help preserve your teeth for a lifetime.

If you would like more information on effective oral care, please contact us or schedule an appointment for a consultation.

FixingthatGapinyourTeeth

We all know Madonna, Seal, David Letterman, Anna Paquin and Michael Strahan (of the talk show Kelly and Michael). What do all of these celebrities have in common? Each has a “signature gap” between their front teeth. Given that they have been in the public eye for quite some time, it's not likely that these famous faces will choose to change their well-known smile. In fact, Michael Strahan has publically stated that he will never close his gap.

However, it is not uncommon for people to desire to fix a small gap in their teeth, particularly in advance of important events, such as weddings. Often times, fixing this small gap requires relatively simple orthodontic movements or tooth straightening. Since the teeth don't have to be moved very far, we can usually use simple appliances to correct the issue within a few months.

In order for us to determine your course of treatment, you'll need to make an appointment with our office for a thorough examination. When we examine you, we'll be looking for a number of items that will affect our treatment recommendation:

  • Is there enough room to close the space without creating other bite problems?
  • Are the roots of the teeth in reasonably good position to allow for minor tooth movement to close the space? X-rays will be required to make a proper assessment.
  • Is there an involuntary tongue habit that has pushed the teeth forward and created the gap? If so, this could be difficult to fix quickly.
  • Are the surrounding gum tissues and bone healthy?

Based on our assessment and your individual needs, we may recommend one of the following options:

  • Clear retainers, a computer-generated series of clear retainers customized for your bite to move the teeth
  • Removable orthodontic retainers to which we will attach small springs or elastics to facilitate the minor tooth movement
  • Traditional fixed orthodontic appliances (most commonly known as braces), small metal or clear brackets bonded to your teeth through which tiny wires are used to move the teeth

Regardless of the method we choose, once your teeth have moved into the new position, it is important for you to remember that they must be kept in this position until the bone stabilizes around the teeth. We may therefore advise you to wear a retainer for a few months to a few years, depending on your situation.

If you would like more information about orthodontic treatments, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Minor Tooth Movement.”

UseSweetenerSubstitutesWiselytoReduceSugarinYourDiet

Although a variety of foods provide energy-producing carbohydrates, sugar is among the most popular. It’s believed we universally crave sugar because of the quick energy boost after eating it, or that it also causes a release in our brains of serotonin endorphins, chemicals which relax us and make us feel good.

But there is a downside to refined sugars like table sugar or high-fructose corn syrup: too much in our diets contributes to conditions like cardiovascular disease, diabetes, and dental disease. On the latter, sugar is a primary food source for oral bacteria; the more sugar available in the mouth the higher the levels of bacteria that lead to tooth decay and gum disease.

Moderating your intake of refined sugars and other carbohydrates can be hard to do, given that many processed foods contain various forms of refined sugar. A diet rich in fresh fruits and vegetables helps control sugar intake as well as contribute to overall health. Many people also turn to a variety of sugar substitutes: one study found roughly 85% of Americans use some form of it in place of sugar. They’re also being added to many processed foods: unless you’re checking ingredients labels, you may be consuming them unknowingly.

Sugar substitutes are generally either artificial, manufactured products like saccharin or aspartame or extractions from natural substances like stevia or sorbitol. The good news concerning your teeth and gums is that all the major sugar substitutes don’t encourage bacterial growth. Still, while they’re generally safe for consumption, each has varying properties and may have side-effects for certain people. For example, people with phenylketonuria, a rare genetic condition, can’t process aspartame properly and should avoid it.

One alcohol-based sweetener in particular is of interest in oral care. A number of studies indicate xylitol may actually inhibit bacterial growth and thus reduce the risk of tooth decay. You can find xylitol in a variety of gum and mint products.

When considering what sugar substitutes to use, be sure you’re up to date on their potential health effects for certain individuals, as well as check the ingredients labels of processed foods for added sweeteners. As your dentist, we’ll also be glad to advise you on strategies to reduce sugar in your diet and promote better dental health.

If you would like more information on your best options for sweeteners, 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 “Artificial Sweeteners.”

GivingaKnockedOutToothaSecondChance

It can happen in an instant — your child takes a hard hit to the mouth while playing football, basketball or some other contact sport. Suddenly, he or she faces the severest of dental injuries: a knocked out tooth.

There's both good and bad news about this situation. First, the good news: the knocked out tooth can be reinserted into its socket and take root again. The bad news, though, is that the tooth has only the slimmest of chances for long-term survival — and those chances diminish drastically if the reinsertion doesn't take place within the first five minutes of the injury.

Outside of the five-minute window, it's almost inevitable that the tooth root won't reattach properly with the tiny fibers of the periodontal ligament, the sling-like tissue that normally holds the tooth in place to the jawbone. Instead, the root may fuse directly with the bone rather than via the ligament, forming what is called ankylosis. This will ultimately cause the root to melt away, a process known as resorption, and result in loss of the tooth.

Of course, the resorption process will vary with each individual — for some, tooth loss may occur in just a few years, while for others the process could linger for decades. The best estimate would be four to seven years, but only if the tooth receives a root canal treatment to remove any dead tissue from the tooth pulp and seal it from possible infection. Over time the tooth may darken significantly and require whitening treatment. Because the tooth may be fused directly to the jawbone it can't grow normally as its neighbor teeth will and thus may appear uneven in the smile line. From a cosmetic point of view, it may be best at that time to remove the tooth and replace it with an implant or other cosmetic solution.

In many ways the longevity of the tooth post-injury really depends on time — the time it takes to reinsert the knocked out tooth into its socket. The quicker you take action, the better the chances the tooth will survive.

If you would like more information on treating a knocked out 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 “Knocked Out Tooth: How Long Will a Tooth Last After Replantation?

YourDentistcanHelpGuideyouintheBestTreatmentOptionforSleepApnea

Do you still feel tired or unfocused even after a full night’s sleep? Do others complain about your snoring? It’s possible these are signs that you may have sleep apnea.

Sleep apnea is a condition in which you stop breathing while you sleep. Your brain will awaken you to breathe, although you may not consciously realize it since the waking period can be less than a second. But it does disrupt your sleep rhythm, especially during the all-important deep sleep period called Rapid Eye Movement (REM). These disruptions don’t allow your body to receive the full benefit of sleep, hence your lack of energy and focus during the day.

One of the most common causes for sleep apnea is the collapse of soft tissues near the throat as they relax during sleep that restrict the airway. Snoring is an indication this may be occurring: air vibrates rapidly (and loudly) as it passes through this restriction when you breathe in.

As your dentist, we’re well-trained in the anatomy and function of the entire oral structure, and qualified to offer solutions for sleep apnea. If you’ve been diagnosed with sleep apnea (after a complete examination, including an observation session at a sleep laboratory), we can then help you decide on a treatment approach. The following are three such options, depending on the severity of your sleep apnea.

Oral Appliance Therapy. An oral appliance you wear while you sleep is a first line treatment for mild or moderate sleep apnea. The appliance, which we custom design for you, helps hold the lower jaw in a forward position: this moves the tongue and other soft structures away from the back of the throat, thereby opening the airway.

Continuous Positive Airway Pressure (CPAP). Intended for more moderate to severe forms of sleep apnea, a CPAP machine produces continuous air pressure to the throat through a mask you wear during sleep. This forces the tongue forward and the airway open.

Surgical Intervention. These procedures remove excess tissue that may be obstructing the airway. Due to its invasiveness and permanent alteration of the throat area, surgery is reserved for patients who haven’t responded to other therapies in a satisfactory manner.

Whether mild or severe, it’s possible to effectively treat sleep apnea. If successful, not only will you benefit from better sleep and greater alertness, you’ll also improve your long-term health.

If you would like more information on treating sleep apnea, 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 “Sleep Disorders & Dentistry.”

TheTigerandMikeTysonsTeeth

Mike Tyson's gap-toothed smile is part of athlete-turned-celebrity's signature look. During his two-decade career as a professional boxer, the former heavyweight champion has been known for both giving — and occasionally receiving — knockout punches. But the story of how he lost one set of front teeth is a bit more unusual.

In a recent interview with the Las Vegas Review Journal, Tyson's wife Kiki stated that one of the champ's major dental dilemmas didn't come from blows inside the ring. In fact, she said, Tyson lost the teeth after being head-butted by his pet tiger, Kenya.

It's too bad Tyson wasn't wearing a mouthguard before he decided to play with kitty.

Fight fans know that boxers always put in a mouthguard before they enter the ring. But the pugilistic pursuit is just one among the two-dozen-odd sports for which the American Dental Association recommends the use of custom mouthguards. Others include baseball, skateboarding, surfing and bicycling. (Maybe horsing around with tigers should be added to the list!)

Why is it so important for participants in athletic activities to use this piece of protective gear? According to the U.S. Centers for Disease Control, sports-related dental injuries account for over 600,000 emergency-room visits each year. Many of these injuries require further dental treatment; some may lead to tooth loss and require costly replacement. Not wearing a mouthguard makes an athlete 60 times more likely to sustain harm to the teeth, according to the American Dental Association. So there's really no contest.

You can find basic, off-the-shelf mouthguards in limited sizes at many sporting goods stores. But for a reasonable cost, we can provide you with a properly fitted dental appliance that's custom-made just for you. Starting with a precise model of your teeth, individual mouthguards are crafted from impact-resistant materials which are designed to be strong, comfortable, resilient — and effective.

Research shows that custom-made mouthguards offer superior quality and protection. So if you or your loved ones like to get out on the playing field, don't neglect this important piece of sporting equipment. And watch out for the cat.

If you have questions about mouthguards, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine article “Athletic Mouthguards.”

KeepToothDecayAway

Did you know that tooth decay (dental caries) is the second most frequently occurring disease — surpassed only by the common cold? It can start as soon as toddlers sprout their first teeth and by middle age, more than 90% of adults are affected by the problem! Fortunately, you can significantly lower your risk for decay. The key is to nurture health-promoting (protective) factors in your mouth while discouraging those that are disease causing (pathologic).

The top two traditional steps can't be stressed enough:

Good Oral Hygiene. Diligent brushing and flossing, along with routine professional cleanings, help limit a buildup of bacterial plaque (biofilm). This whitish film is attractive to decay-producing bacteria (among the many types of bacteria — including beneficial ones — that normally live in the mouth). These microbes like to snack on sugars and carbohydrates (perhaps part of that bagel you had for breakfast or the midafternoon candy bar), and in the process they produce acid. A healthy oral environment has a neutral pH — a perfect balance between acids and bases. But in a more acidic environment, minerals in the protective enamel of your teeth start to dissolve, exposing the dentin and root surfaces underneath that are even more vulnerable.

Sensible Diet. Keep decay-producing bacteria in check by limiting your intake of sugars and carbohydrates; the bacteria need these nutrients to grow and reproduce. Choose products containing natural sugars, such as those in fruits and vegetables, over those containing added sugars, such as sodas and candy. Be aware that Xylitol, an “alcohol sugar” used in some chewing gums and dental products, can actually help reduce pathogenic bacteria. And don't forget that frequent consumption of acidic foods and beverages, such as sipping coffee during the day, can create an acidic environment in your mouth that can contribute to decay by eroding tooth enamel and weakening its defenses.

Individual Risk Factors

You also may have individual risk factors as well that our office can help you identify and address. For example, the shape of everyone's teeth varies and some of us have more valleys, tiny grooves and pits than others. These likely places for bacteria to congregate can be the most difficult to reach with a toothbrush, but invisible sealants can be applied to prevent bacteria from reaching those areas.

If you would like more information about tooth decay and prevention, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Tooth Decay” and “Tooth Decay — How To Assess Your Risk.”

TheTaleoftheToothworm

Ever wonder just exactly what causes cavities? Once upon a time, “Toothworms” — miniscule, yet relentless pests — were thought to be responsible for this widespread malady. This belief persisted from ancient times through the 17th Century; William Shakespeare even made reference to the baneful beasts in his play Much Ado about Nothing. (“What, sigh for a toothache? [It] is but a humor or a worm.”) Today, however, we know why no one ever observed an honest-to-goodness toothworm: it’s because they’re much too tiny to see with the naked eye.

Actually, it isn’t worms, but much smaller organisms that cause tooth decay. These harmful plaque bacteria (along with many helpful microorganisms) live in the mouth, and build up on surfaces of the teeth when they aren’t cleaned properly. They feed on sugar in the diet, and release substances that erode tooth enamel, which causes small holes called cavities. Cavities, in turn, are what’s responsible for most toothaches.

While we may scoff at old legends, one fact remains: Even today, according to the National Institutes of Health, tooth decay is the number one chronic disease of both children and adults; and it’s almost entirely preventable. We can’t blame it on toothworms — but what can we do about it?

Glad you asked! The best way to avoid decay is through prevention. That means brushing your teeth twice a day with a fluoride toothpaste, and flossing them every day. It also means eating a balanced diet and avoiding acidic and sugary foods — like soda, some juices, and sweet, sticky snacks. If you do consume these types of foods, limit them to mealtimes; that gives your saliva enough time in between to neutralize the acids naturally. And, of course, make an appointment see us twice a year for a complete check-up and professional cleaning.

If you do begin to notice the symptoms of tooth decay (toothache, for example) it’s important to come in to the dental office right away, so we can treat the problem before it gets worse. Prompt action can often help save a tooth that might otherwise be lost. Besides filling the cavity, we may be also able to recommend ways to help prevent the disease from affecting other teeth. And if you need a more extensive procedure to relieve the problem — such as a root canal — we can make sure you get the appropriate treatment.

We’ve come a long way since the “toothworm” days — but we can still do a lot more to make tooth decay a thing of the past.

If you would like more information about tooth decay and cavity prevention, please contact us or schedule an appointment. You can learn more in the Dear Doctor magazine article “Tooth Decay — The World’s Oldest & Most Widespread Disease” and “Tooth Decay — How To Assess Your Risk.”

At around the age of 17-25, our third set of molars comes in, which are also called “wisdom teeth.” Although all of your other teeth came in smoothly as a child, these are usually not quite as simple. Extracting, or taking out one or more wisdom teeth is a fairly common procedure that is performed on about 5 million patients every year. Mill Creek residents are assured a stress-free experience at Penny Creek Family and Implant Dentistry. Wisdom Teeth Extractions
 

Listed below are some usual reasons why wisdom teeth are removed:

  • The jaw in your mouth is too small to and cannot make room for all of your teeth. This can lead to crowding and can cause your wisdom teeth to become impacted and unable to emerge from the gums. This can be harmful to the adjacent bone or teeth.
  • The wisdom teeth are coming in crooked and can damage other teeth and structures of the jaw. This can cause bite problems.
  • If the wisdom tooth does not fully break through the gums, it can increase the chance of a bacterial infection.
  • A cyst can develop around a wisdom tooth that has not erupted and can cause infection.

Wisdom Teeth: What You Need to Know About Having One or More Removed

Taking out one or more wisdom teeth is typically an in-office procedure. Most procedures involve a local anesthetic to numb the area. If multiple teeth are removed, conscious sedation will most likely be administered as well. Our dentist will discuss the best options with you before the procedure.
 
After you are numb or properly sedated, the gum tissue at the extraction site may need to be opened if the wisdom teeth is impacted. The tooth will then be gently removed. The site will then most likely be stitched to help with healing.
 

What to Expect After the Procedure

Most patients can expect a few days of recovery after the teeth have been removed. It is important to rest when possible and take any pain medication that our dentist has prescribed you. A number of patients will experience bleeding where the teeth were removed. Biting on gauze pads and resting your head on pillows that are elevated can control it. Swelling of the cheeks is also common, and can be controlled by holding an ice pack on the outside of the cheek for a few minutes at a time.
 
Having your wisdom teeth removed can be a bit frightening and nerve wracking. If you need your third molars extracted, meet with our dentist at Penny Creek Family and Implant Dentistry. We will do the best that we can to make your experience as easy-going as possible.
Emergency Dentist Mill Creek WAAn unbearable toothache is enough to keep you up all night, while a knocked out tooth will need professional dental care right away in order to preserve the tooth. From minor injuries to serious emergencies, when dental problems arise, it’s important to understand how to care for your injuries until you can get to your dentist for treatment.
 
Just as a broken bone or a sore throat requires medical attention from a doctor, an injury to the teeth or mouth needs to be examined and treated by your dentist as well. Don’t put off dental injuries until it’s too late. When an injury occurs, the sooner you treat it the better.
 

How to Stop Agonizing Tooth Pain

 
Often times, a toothache is a warning sign of some other underlying dental problem, such as an infected tooth. When severe, a toothache can keep you from enjoying normal activities and even keep you up through the night. You will want to make an appointment with Dr. Chad Slocum and Dr. Sara Lundgaard, our Mill Creek area emergency dentists, right away to get to the bottom of the pain, especially if it lasts for more than a few days. A dentist can detect any problems and administer the appropriate treatment to ease the pain and prevent any additional damage.
 
You can also help ease your tooth pain before you can get to your dentist by:
 
  • Applying a cold compress to the side of your cheek
  • Elevating your head to reduce the pressure on the affected tooth
  • Rinsing with a mixture of salt and water to remove and food particles or debris that may be irritating your toothache.
  • Avoiding foods that intensify the pain, such as foods with extreme temperature or foods that are hard to chew
 

Preserving a Knocked Out Tooth

 
If your tooth is knocked out, try to stay calm. You will need to act quickly in order to save the tooth and have it successfully re-implanted by your dentist. First, gently rinse the tooth with water, being very careful not to remove any of the attached tissue. Carefully try to place the tooth back into the socket, as this is one of the best ways to preserve the tooth before you can get to your dentist.
 
If this isn’t possible, gently place the tooth into a small cup of milk and take it with you to the dentist immediately. Generally, getting to the dentist within one hour of having it knocked out will be its best chance of recovery. If successful re-insertion of the tooth isn’t possible, don’t worry. Advances in modern dentistry have made it possible for dentists to offer advanced restoration procedures, such as dental implants.
 

Preventing Injuries

 
It’s not surprising that the majority of dental injuries occur during sports related activities. All it takes is an elbow to the face during a soccer game to knock out a tooth or cut your lip. What is surprising is that many athletes fail to wear the appropriate mouth protectors during these vigorous events.  A mouth guard is the best way to protect the mouth and teeth. This simple appliance can go a long way to prevent serious dental problems- an investment that’s well worth it.
 
You can also avoid unnecessary dental emergencies and pain by practicing good oral hygiene and visiting Dr. Chad Slocum and Dr. Sara Lundgaard, your emergency dentists in Mill Creek, for regular checkups. This is one of the easiest and best ways to ensure your teeth and gums are healthy, and Dr. Slocum and Dr. Lundgaard can detect problems in their earliest stages to make recommendations for treatments and prevention.
ProteinInformationinSalivaCouldLeadtoBetterDiagnosticTests

You've probably never thought of the saliva swishing around in your mouth as amazing. The fact is, though, life would be a lot harder without it. Digestion would be quite unpleasant without its enzymes breaking down food during chewing; the soft tissues of our mouth would suffer more environmental abuse without its protective wash; and without its ability to neutralize acid, our tooth enamel would erode.

What's also amazing is what saliva can reveal about our health. As researchers discover more about this phenomenon, it's leading to better and less invasive ways to diagnose disease.

Similar to blood, saliva is composed of proteins containing RNA and DNA molecules which together hold the genetic instructions the human body needs to reproduce cells. We can therefore test saliva for health conditions as we do with blood, but with less invasive collection techniques and far less hazard to healthcare workers from blood-borne diseases. For example, doctors now have a saliva test that can detect the presence of HIV viruses that cause Acquired Immune Deficiency Syndrome (AIDS). Another saliva test will soon be available that can test for hepatitis.

Unfortunately, only a few such tests now exist. Researchers must first identify and then catalog saliva's biomarkers, protein molecules that correspond to specific health conditions — a daunting task since most are marked not by one but hundreds of proteins. Then it's a matter of developing diagnostic devices that can detect these biomarkers.

Although that too is a huge task, existing technology like mass spectrometry (already used to help detect early stages of oral cancer) could be a promising starting point. This process measures the portion of the light spectrum emitted by a molecule, a feature that could help identify a saliva protein by its emitted light signature.

Thanks to the work of these researchers, many of them in the dental profession, information about our bodies contained in saliva may soon be accessible. That accessibility may lead to earlier diagnoses and more successful treatment outcomes.

If you would like more information on saliva and your oral health, 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 “Secrets of Saliva.”

DiagnosingyourJawPain

If you were recently in an accident or received a hard hit while playing sports and you have been feeling jaw pain ever since, you may be suffering from a serious injury. It is important that you make an appointment with us immediately, so that we can conduct a proper examination, make a diagnosis and prescribe a suitable treatment. Even if the pain is lessening, you should still make an appointment.

Without seeing you, we have no way of definitively diagnosing the cause of your pain. However, here are a few possibilities:

  1. You displaced a tooth or teeth.
  2. You indirectly traumatized or injured the jaw joint (TMJ — temporomandibular joint). This trauma will cause swelling in the joint space, and the ball of the jaw joint will not fully seat into the joint space. If this is the issue, it is likely that your back teeth on the affected side will not be able to touch. Over time, the swelling should subside, allowing the teeth to fit together normally.
  3. You may have a minor fracture of your lower jaw. The most common is a “sub-condylar” fracture (just below the head of the joint), which will persist in symptoms that are more severe than simply bruising and swelling.
  4. You may have dislocated the joint, which means the condyle or joint head has been moved out of the joint space.

All of the above injuries can also cause muscle spasms, meaning that the inflammation from the injury results in the muscles on both sides of the jaw locking it in position to stop further movement and damage.

The most critical step is for you to make an appointment with our office, so we can conduct a physical examination, using x-rays to reveal the extent of your injury. We'll also be able to see whether the injury is to the soft tissue or bone.

Treatment may involve a variety of things, including anti-inflammatory and muscle relaxant medications. If your teeth have been damaged, we'll recommend a way to fix this issue. If you have dislocated your jaw, we may be able to place it back through gentle manipulation. If you have fractured your jaw, we'll need to reposition the broken parts and splint them to keep them still, so that they can heal.

If you would like more information about jaw pain, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Jaw Pain.”

TRUEORFALSETheGreatToothpasteTest

You use toothpaste every day — don't you? But how much do you really know about what's inside the tube: namely, the white, sticky stuff that keeps your teeth clean and your breath fresh? Take this True/False quiz and find out!

True of false: Powdered charcoal, brick dust and crushed bones were once ingredients in toothpaste. TRUE

Many years ago, these gritty abrasive materials were used to make toothpaste. Today, abrasives are still used — but they're much gentler. Compounds like hydrated silica or alumina, calcium carbonate, and dicalcium phosphate have proven effective at cleaning and polishing tooth surfaces without damaging the enamel.

True of false: Fluoride was first introduced into toothpaste in 1955. FALSE

Arguably toothpaste's most important ingredient, fluoride was used as early as 1914. But its mass-marketing debut came with the Crest brand in the mid-1950s. Today, no toothpaste without fluoride can receive the American Dental Association's Seal of Approval. That's because it has been shown to strengthen tooth enamel and help prevent tooth decay.

True of false: Detergent is a common ingredient of toothpaste. TRUE

But it isn't the same kind you do laundry with. Detergents — also called surfactants, because they act on the surfaces of liquids — help to loosen and break down deposits on your teeth, which can then be rinsed away. Like other health and beauty products, many toothpastes use a gentle detergent, derived from coconut or palm kernel oil, called sodium lauryl sulfate.

True of false: Whitening toothpastes work, to some degree, on all stains. FALSE

Whether the whitening agents in toothpaste will work for you depends on why your teeth don't look white in the first place. The abrasives and enzymes in these toothpastes can help remove “extrinsic” stains: those on the surface of your teeth. But for “intrinsic” stains — that is, internal discoloration — they probably won't help. In that case, you may need to get professional bleaching treatments.

True of false: Toothpastes made for sensitive teeth have substances that block pain transmission. TRUE

Potassium nitrate and strontium chloride can block the sensation of pain that may occur when dentin — the material that makes up most of the inside of teeth, and is normally covered by enamel — becomes exposed. Fluoride, too, helps reduce sensitivity. But the benefits of reduced tooth sensitivity may take a few weeks to really be felt.

If you have questions about toothpastes or oral hygiene, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine article “Toothpaste — What's In It?

KeepYourGumsinthePink

Being “in the pink” is a good thing; it means you're healthy. Being “in the red” is not so good; it means your health is questionable (financially, anyway). Though they weren't coined for dentistry per se, these colorful expressions are helpful reminders when it comes to taking care of your gums: Pink is their natural, healthy color; that's what you want to see every time you look in the mirror. Red is generally a warning that something's amiss.

If your gums, or “gingiva,” appear slightly swollen and reddened at the margins and/or they bleed when lightly prodded by brushing or flossing, it's likely that you have gingivitis. This is an immune response to the buildup of bacterial plaque (biofilm) at your gum line. It is also an early red flag for periodontal disease (peri – around, odont – tooth), a degenerative process that affects not only the gums, but the periodontal ligament that attaches each tooth in its bony socket, and the underlying supporting bone.

Attentive home dental hygiene practices prevent most plaque buildup from occurring. Brushing correctly at the gum line is a good start. But even a deftly handled brush can't reach everywhere, so it's important to use dental floss or specially designed mini-brushes to get in between teeth and other hard-to-reach areas. Our office can instruct you on optimal home care techniques. We also encourage you to visit at regular intervals for professional cleanings so you are assured of addressing anything home care might miss.

In the absence of good oral hygiene, dental plaque can build and become increasingly difficult to remove as it calcifies, becoming tartar. It becomes a breeding ground for disease-causing microbes that normally wouldn't have the chance to gain a foothold. When caught early, gingivitis can be treated before any harm is done. Sometimes a thorough professional cleaning is sufficient. If the problem is ignored, however, the disease will most certainly progress to destruction of the surrounding, supporting tissues — the periodontal ligament and the underlying bone. If this happens, tooth loss could eventually result.

That said, there can be other causes for bleeding gums. These include:

  • Brushing too rigorously or using a toothbrush with bristles that are too firm
  • Side effect of a medication
  • In women, elevated hormone levels (e.g., birth control pills or pregnancy)
  • A systemic (bodily) disease

Whatever the reason, red is not normal when it comes to your gums. The sooner you discover the underlying reason(s) for inflammation or bleeding and take appropriate action, you and your smile will be back in the pink and you'll have no reason to be blue!

If you would like more information about preventing or treating bleeding gums, 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 “Bleeding Gums.”

ProtectYourChildAthleteFromInjuryWithaCustom-FittedMouthguard

Youth sports can be a positive life experience for your child or teenager. But there's also a risk of injury in many sporting activities, including to the teeth and mouth. An injury to the mouth, especially for a child or young adolescent whose teeth are still developing, can have a significant negative impact on their oral health.

When it comes to teeth or mouth injuries, the best preventive measure is for your child to wear an athletic mouthguard, especially for contact sports like football, hockey or soccer. But be warned: not all mouthguards are alike — and neither is their level of protection.

Mouthguards can be classified into three types. The first is known as “stock,” which is the least expensive and offers the least level of protection. They usually are available only in limited sizes (small, medium, large, etc.) and cannot be custom-fitted for the individual. This significantly lowers their protective ability, and thus we do not recommend these to our patients.

The next type is referred to as “boil and bite.” These mouthguards are made of a material called thermoplastic, which becomes pliable when heated. When first purchased, the guard is placed in boiling water until soft; the individual can then place them in the mouth and bite down or press the guard into the teeth until it hardens and forms to their palates. Although this type offers a better fit and more protection than stock mouthguards, it isn't the highest level of protection available.

That distinction goes to the last type — a custom mouthguard made by a dentist. Although the most expensive of the three, it offers the best fit and the highest level of protection. A well-made custom mouthguard is tear-resistant, fits comfortably, is easy to clean and doesn't restrict speaking and breathing. We recommend this guard as your best alternative for protecting your child athlete from tooth and mouth damage.

If you would like more information on the use of athletic mouthguards for young athletes, contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Mouthguards.”

WhatToDoAboutAChildsToothache

It's 3:00 PM, your child has just come back from the school playground — and she's complaining of a toothache that's making her miserable. She can't seem to say if there was a particular injury or a blow, but the more she talks about it, the worse it gets. You're the parent... what are you going to do now?

If you've ever been through this type of situation, you know that a calm demeanor and a little TLC can go a long way. But how do you know whether you're facing a dental emergency, or a routine booboo? Here are a few general rules that may help.

First, relax: Without a fever and facial swelling, a child's toothache isn't usually an emergency. But any tooth pain that keeps a child up at night or lasts into the next day should be evaluated by a dentist. Even if it's nothing but a small cavity (the most common cause of toothache) you don't want to let it go untreated. That could allow it to turn from a small discomfort into a major problem — like a painful abscess.

There are some things you can do at home to try and get a handle on what's causing the pain. Encourage the child to show you exactly where the pain is located, and to tell you when and how it started. Then, examine the area closely. Look for obvious brown spots, or even tiny cavities (holes) on biting surfaces or between teeth, which might indicate decay. Also check the gums surrounding the tooth, to see if there are sores or swelling.

You may find evidence of a traumatic injury, like a cut or bruise — or, if only swelling is apparent, it may mean an abscess has formed. If nothing looks amiss, try gently flossing on either side of the hurting tooth. This may dislodge a particle of food that's causing pain and pressure.

If the pain persists, you can try giving an appropriate dose of ibuprofen or acetaminophen, or applying an ice pack on the outside of the jaw — one minute on and one minute off. But even if you can make the immediate pain go away, don't neglect the situation that caused it. Unless you're absolutely sure you know why the toothache occurred, you should bring the child in for an examination. It will put your mind at rest — and maybe prevent a bigger problem down the road.

If you have questions about toothaches in children, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine article “A Child's Toothache.”

WhyYourTeethMayHurt

Don't ignore tooth pain hoping it goes away. No matter how mild or fleeting it may be, it's a sign that something's wrong. Healthy teeth shouldn't cause discomfort because the parts containing the nerves — the interior pulp and the dentin around it — are shielded by dental enamel and gums.

Here are some common reasons that teeth ache:

  1. Gum Recession. Over time, gums can recede. Improper or excessive brushing can affect them, especially if you are genetically predisposed by having thin gums. When gums retreat, dentin can, or eventually will, be exposed. Besides its susceptibility to sensation, dentin is also more vulnerable to erosion and decay than enamel.
  2. Tooth Erosion/Decay. When acid-producing oral bacteria get the upper hand, they can eat through the tooth's protective enamel to the dentin. You may start feeling sensitivity as the decay gets deeper and closer to the pulp (nerves). Only removal of the decay and filling the cavity can stop the process.
  3. Old/Loose/Lost Filling. Fillings seal off areas of past decay. If they don't fit right or are dislodged altogether, air or food particles can slip inside and irritate exposed nerve endings. A crevice to hide in makes it prime real estate again for bacteria, too.
  4. Cracked Tooth. Teeth grinding and jaw clenching can have a similar impact on teeth that a miner's pick has on rock. At first thin lines in your enamel can develop, then cracks develop that may expose the dentin, and finally the tooth might fracture, exposing the pulp. The earlier this process is caught, the better.
  5. Pulp Tissue Infection/Inflammation. This can be caused by deep decay or trauma and suggests your tooth may be in its death throes. Sometimes the pulp infection travels into the surrounding periodontal (peri – around; odont – tooth) tissues and causes an abscess to develop. This absolutely requires immediate attention.
  6. Residual Sensitivity from Dental Work. Removal of decay before placing a filling can cause tooth sensitivity. It can take 1-4 weeks or so to improve.
  7. Sinus Pain. Congestion can cause “referred” pain in the upper teeth. When the congestion subsides, the pain should, too.

As you can see, it's risky to discount tooth pain and “wait ‘til it goes away.” Our office can help you determine the origin of your pain and the best course of action to resolve it. When in doubt, it's always better to err on the side of caution!

If you would like more information about tooth pain and ways to prevent or treat it, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Tooth Pain? Don't Wait!” and “Sensitive Teeth.”

BadBreathmdashMoreThanJustEmbarrassing

Most people agree that bad breath is more than embarrassing. It affects personal, social and business relationships. Although Americans spend roughly $3 billion annually on gum, mints and mouth rinses that promise relief, they are nothing more than temporary cover ups. Discovering the underlying cause of the problem is the only way to effectively eliminate the halitosis (“halitus” – breath; “osis” – disorder) long term. If you have bad breath, we can help.

While it's true that there are a few systemic (general body) medical conditions that can cause bad breath, including lung infections, liver disease, diabetes and cancer, the majority of causes originate in the mouth. We can conduct a simple oral examination to help diagnose the underlying cause of your bad breath. We will check your mouth thoroughly for signs of any dental problems that can produce an odor, including decayed or abscessed teeth, diseased gums, a coated tongue or infected tonsils. Typically, halitosis occurs when bacteria collect on the surface and back of the tongue where it is drier. Bacteria thrive in this environment, resulting in a “rotten egg” odor that so many of us are all too familiar with. This odor actually emanates from volatile sulfur compounds (VSFs), but will go away with proper treatment.

Once the exact cause is pinpointed, your halitosis can be treated in several ways. For example, we can show you how to brush and floss properly to more effectively remove bacteria responsible for tooth decay and gum disease — don't be embarrassed, nobody really knows until they're shown by a professional. We can also show you how to use a tongue scraper or brush to carefully clean the surface of your tongue. Treatment of tooth decay, the repair of defective or broken fillings, extraction of wisdom teeth (third molars) and periodontal (gum) therapy such as scaling and root planing (deep cleaning) will all help treat infection and consequently bad breath.

You don't have to be embarrassed by bad breath any longer! The sooner you call our office to schedule an examination, the sooner you will be able to breathe a lot more freely. For more information about the causes of bad breath, read the Dear Doctor magazine article “Bad Breath: More Than Just Embarrassing.”

BadBreathmdashSufferNoMore

While most people can expect to have a temporary case of bad breath after eating spiced foods like garlic, smoking, drinking coffee or wine, odor that persists and becomes chronic is not something to take lightly. We can help diagnose the underlying cause of your bad breath, making both you and the people around you much happier!

Chronic bad breath, also known as “halitosis,” affects about 25% of Americans to some extent. Treating the condition effectively requires a thorough oral examination to uncover the source of the odor. Although some forms of bad breath can be caused by medical conditions like diabetes, lung infections, even kidney failure and cancer, between 85% and 90% of cases originate in the mouth. There are more than 600 types of bacteria found in the average mouth and, given the right (or, should we say, wrong) oral environment, dozens of these bacteria can produce foul odors including a “rotten egg” smell from the production of volatile sulfur compounds (VSCs).

Some of the oral causes of bad breath include:

  • Naturally occurring bacteria found on the back of the tongue that thrive on food deposits, dead skin cells and post nasal drip (Yuck!);
  • Dry mouth, after sleeping, especially when an individual breathes through his or her mouth;
  • Unclean dentures;
  • Decaying or abscessed teeth;
  • Diseased gums; and
  • Infected tonsils.

Once the exact origin of the odor has been determined, we can tell you what form of treatment you'll need to successfully banish the bad breath for good. If your problem is merely the result of poor oral hygiene you can play a large role in turning your situation around. In any case, treatments for mouth-related halitosis can include:

  • A careful, at-home plaque control routine using dental floss and a special toothbrush designed to clean between teeth — nobody really knows how to properly clean without professional instruction;
  • In-office and at-home tongue cleaning using a tongue scraper or brush;
  • Instruction on how to properly clean your dentures;
  • To treat underlying gum disease, periodontal therapy in the form of a deep cleaning, also known as scaling or root planing; and
  • Extraction of wisdom teeth that exhibit debris-trapping gum tissue traps.

So if you are ready to toss your breath mints away and pursue a more permanent solution to rectify your mouth odor, call our office today to schedule an appointment. For more information about the causes of bad breath, read the Dear Doctor magazine article “Bad Breath: More Than Just Embarrassing.”

MythorFactTestYourKnowledgeaboutPregnancyandOralHealth

Already read every “What to Expect” book twice over? Think you know something about how pregnancy affects your teeth and gums — and vice versa? OK, ace — test your knowledge by taking the quiz below. No peeking at the answers!

Myth or fact: The calcium in baby's teeth comes from mom's teeth.

MYTH. Calcium is needed to build baby's teeth and bones, but it should come primarily from the mother's diet, not her body. If an expectant mom's diet contains too little calcium, however, this essential mineral may be supplied from calcium stored in her bones. That's one reason why a proper diet — with an adequate intake of dairy products, plus dietary supplements, if recommended — is important throughout pregnancy.

Myth or fact: Developing symptoms of periodontal disease is common during pregnancy.

FACT. The levels of many hormones, including progesterone, are higher during pregnancy. When periodontal disease is present, progesterone stimulates the body to produce prostaglandins, which cause inflammation of blood vessels in the gum tissue. This can result in a disease called pregnancy gingivitis. Excess growths of gum tissue called “pregnancy tumors” may also develop. These benign growths are probably related to dental plaque.

Myth or fact: Untreated dental infections pose a risk to the fetus as well as the mother.

FACT. Studies have shown that pregnant women with severe periodontal disease are at greater risk for preterm birth and low birth weight babies, and may be susceptible to an increased rate of pre-eclampsia, a serious complication. This seems to be due to the fact that oral bacteria can trigger inflammatory responses in other parts of the body — even the placenta. That's why a dental evaluation is so important at the first sign of a potential problem.

Myth or fact: All moms should take fluoride supplements to help their babies form strong teeth.

MYTH (for now). The benefits of parental fluoride supplements are poorly studied, and at present remain controversial. Although baby's teeth begin forming in the second month, fluoride works best after the teeth have erupted in the mouth. So, at present, this practice isn't recommended by the American Academy of Pediatric Dentistry.

Myth or fact: Once your baby is born, it's OK to feed them pre-chewed food or slobber over them.

Myth (we gave that one away). First of all, it's gross. Second, while your baby isn't born with the bacteria that cause tooth decay, this behavior can transmit them from you to her, causing dental problems down the road. So don't do it. But do come in for a dental evaluation as soon as you know you're expecting. And have a safe and healthy pregnancy!

If you would like more information about pregnancy and oral health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Pregnancy and Oral Health,” and “Expectant Mothers.”

MaintainingOralHealthWhenYoureExpecting

Every pregnant woman knows that her body will go through a series of profound changes as it's making a new life. Along with the alterations in overall size and changes in eating and sleeping patterns, pregnancy also affects the teeth and gums. Here are some answers to common questions women may have about oral health during pregnancy.

1) What's the most important thing I can do for my baby's oral health?

Maintain your own dental and general health! Eat a healthy and balanced diet — it provides the nutrients, vitamins and minerals needed for proper development of your baby's teeth and bones. While food cravings and aversions are common, try to at least limit your intake of sugary snacks to mealtimes. Don't neglect the good habits of brushing, flossing, and seeing your dentist regularly. This will help minimize the possibility of tooth decay or gum disease.

2) Does pregnancy make me more susceptible to gum disease?

Yes. “Pregnancy gingivitis” (“gingival” – gum tissue; “it is” – inflammation of) may develop from the second to the eighth month. This is mostly due to elevated hormone levels. In the presence of gum disease, pregnancy hormones may stimulate the production of prostaglandins, which cause inflammation of gum tissues. Occasionally, benign growths called “pregnancy tumors” may also appear on the gums during the second trimester. If they don't resolve themselves, these may be surgically removed after the baby is born.

3) With all my other concerns right now, why is the health of my teeth and gums so important?

Several studies have shown a link between periodontal (gum) disease, pre-term delivery and low birth weight — conditions which put some newborns at greater risk for health complications. There's also a correlation between more severe periodontal disease and an increased rate of pre-eclampsia, a potentially serious condition. But treating periodontal disease decreases the level of inflammation-causing prostaglandins. That's one reason why you should come into our office for an evaluation as soon as you know you're expecting.

4) Is it safe to get dental treatments while I'm pregnant?

Dental examinations and routine treatment during pregnancy is generally safe for both mom and baby. If you need non-urgent dental care, it may be most comfortable in the first five months of pregnancy. Situations requiring urgent care are managed as they arise, to treat pain and infection and to reduce stress to the developing fetus. Under the watchful eye of your dentist, it's possible to have anesthesia, X-rays and dental medications (if needed) without undue risk. So don't let worries about dental treatments keep you from coming in for a check-up!

If you would like more information about pregnancy and oral health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Pregnancy and Oral Health,” and “Expectant Mothers.”

LearnAboutLivingtheLifeYouLovewithDesignerNateBerkus

Design expert and television celebrity Nate Berkus has definite ideas about how to live. In a recent interview, he explained his ideas on design. He also talked about health, and how he keeps his teeth and mouth healthy.

From an initial design makeover that he did eight years ago on the Oprah Winfrey Show, Berkus has gone on to do 127 such makeovers. He was such a success that he now hosts his own daily talk show. He has also developed a line of home products for the Home Shopping Network and has his own design firm, Nate Berkus Associates. His clients include well-known restaurants and hotels as well as private homes. He has written articles for O Magazine and authored a book on the subject of transforming your home into a place you love.

“I realized many years ago that I wasn't going on Oprah to pick sofa colors and paint chips. I was there to lift people up through the way they live,” he says. His secret to design success is to “go with what you love.” He says, “Don't worry about mixing metals, eras or styles. If you love each item, you'll find a way to make it work.”

His common sense practical attitude continues when it comes to dental health. Berkus is blessed with a healthy mouth and teeth. He doesn't feel anxious when visiting the dentist because he usually has a good report. He has not needed orthodontics or cosmetic dentistry. He thanks his childhood dentist for giving him fluoride treatments and sealants, and for teaching him healthy dental hygiene habits.

Berkus brushes his teeth twice or even three times a day, with a manual or electric toothbrush — depending on whether he is at home or traveling. He also follows his dentist's advice about flossing: “Floss the ones you want to keep!” He says that he tried tooth whitening once, but he felt that the whiteness was “too white.” Now he simply works to maintain his natural tooth color and smile.

Contact us today to schedule an appointment to discuss your questions about maintaining healthy teeth. You can also learn more by reading the Dear Doctor magazine article “Nate Berkus, Helping Others Love the Way They Live.”

TheDangersofTongueampLipPiercingtoDentalHealth

Tongue and lip piercing is a growing popular trend for some young people and adults; however, did you know that they could wreak havoc on oral health? In fact, some people soon discover that before they can even enjoy their new piercing they are faced with issues ranging from bleeding and infection to nerve damage. Tongues and lips are highly vascular — that means they have lots of blood vessels that can bleed easily and are not always easy to stop once they start bleeding. Many tongue and lip bolts can initiate problems such as tooth sensitivity, gum disease and recession, chipped teeth and more. In addition, not all tattoo parlors and tattooists are properly licensed to do piercings. Therefore, sterile techniques are not always guaranteed if they do not come under the scrutiny government agencies. Unfortunately, these potential concerns are rarely discussed prior to receiving a piercing.

So what can be done if you already have a tongue or lip piercing?

If you already have piercings, it is critical that they are closely monitored by your health professionals to make sure they are not doing damage. It is also important that you have routine dental exams to ensure that you do not have any silent problems causing issues that you haven't noticed. However, your best option is to consider removing these oral piercings. The good news is that most often the hole in your tongue or lip may heal itself; otherwise, a minor corrective surgery may be required.

A note of warning: Before you contemplate a piercing, get as much information as you can about them and the person who will do them. This includes asking about their risks, benefits and better alternatives. And then think twice to make sure they will not become permanent and negative reminders of temporary emotions!

FoolproofFlossing

Dental professionals agree that effective removal of plaque, the film of bacteria (also called a biofilm) that gathers on everyone's teeth, is the key to good dental health. Daily brushing and flossing are the usual recommendation for plaque removal. It is important to ask us about effective brushing and flossing. At your next appointment, ask us for a demonstration.

Effective brushing removes plaque from the easily accessed surfaces of the teeth. To remove plaque from between the teeth, you must floss.

Some people find it awkward to hold the floss with their fingers as they move it around their teeth. One technique for flossing, suggested by a dentist in Dear Doctor magazine, may make it easier than more traditional methods, although it does take a little practice.

Preparation
This method requires tearing off a 10 to 12 inch length of floss and tying it to form a circle big enough for your fingers, but not your thumbs, to fit within it. The circle should be knotted with a double knot.

To Clean Teeth and Gums
Keep the floss taut at all times, with about and inch or less between your thumb and index fingers for your upper teeth, or index fingers only for your lower teeth. Curve the floss around each tooth and gently move it up and down until you hear a squeaky clean sound. Extend the downward movement of the floss to just below the surface of the gum, without being too harsh and causing injury. As you move from tooth to tooth, move around the floss circle so that each tooth gets a clean section of floss.

Upper Teeth
Place all your fingers in the ring, with the floss over your left thumb and right index finger to floss your upper left teeth, and over your right thumb and left index finger to do the other side.

Lower Teeth
Use both index fingers to floss all your lower teeth.

You may only need to floss once a day before or after brushing to keep your gums health and ward off periodontal (gum) disease. Your dentist will guide you as to how often you may need to floss your teeth. Try this technique and see how it works for you.

Contact us today to schedule an appointment to discuss your questions about flossing techniques. You can also learn more by reading the Dear Doctor magazine article “Flossing — A Different Approach.”

TVsNateBerkusDiscussesDentalSealantsFluorideTreatmentsandFlossing

Nate Berkus, author, interior designer and host of his own television program, The Nate Berkus Show, is a consummate professional who has always focused on “helping others love the way they live,” as he puts it. Berkus is known as one of America's most beloved go-to-guys for inspiration on the latest design trends. And then there is his captivating smile.

In an exclusive interview with Dear Doctor magazine, Berkus discusses his trademark smile. Unlike most people in Hollywood, his smile is totally natural — he never wore braces or had any cosmetic work. However, Berkus does give credit to his childhood dentist for the preventative healthcare he received as a young boy. Berkus states, “I'm grateful for having been given fluoride treatments and sealants as a child. Healthy habits should start at a young age.”

As for his oral hygiene routine today, Berkus says he brushes his teeth at least two times a day, and sometimes three times a day. Berkus is also an avid “flosser” and follows the important flossing advice he learned from his dentist: “Floss the ones you want to keep.”

In addition to his design expertise, Berkus is right on the mark with his opinions on oral hygiene. In fact, he inspired our office to put together the following list of facts and oral health tips:

  • The first step in improving your oral health is to learn good oral hygiene behavior. Simply put, to maintain optimal oral health, you must brush and floss properly so that you thoroughly remove the dental plaque.
  • The second step is a thorough evaluation system. We are a key part of this step. During your next office visit, we can conduct a thorough examination, review your brushing and flossing techniques, examine the health of your tongue and discuss any questions you have. We can also clean your teeth and ensure that you leave our offices confident with your new oral hygiene routine. And if you don't have an appointment, contact us today to schedule one.

To learn more about improving your oral hygiene, you can continue reading the Dear Doctor magazine article “Oral Hygiene Behavior - Dental Health For Life.” And to read the entire interview with Nate Berkus, please see the article “Nate Berkus.”

WaysYouCanMinimizeToothSensitivity

If you have ever suffered from tooth sensitivity, you know all too well how real the pain can be — anything from a slight twinge to pain that can be downright excruciating. Sensitivity may be experienced several times throughout the day or just every once in a while. However, as we say, a little knowledge can go a long way. And we can provide you with the know-how and steps to help minimize your tooth sensitivity.

One of the first steps we will take is to review your brushing habits, as an improper brushing technique can not only cause tooth sensitivity, but it also can make the sensitivity worse once it is present. We will teach you how to remove dental plaque safely without damaging your delicate gum tissues, which can cause gum recession leaving the dentin exposed. Another step we may take is to provide you with a special toothpaste containing fluoride or one specifically targeted to sensitive teeth. The fluoride increases the strength of tooth surfaces and thus makes teeth more resistant to acid attack and sensitive to sweets. Or if the sensitivity is severe and/or constant, we may need to apply a barrier to cover the sensitive areas. These barriers may range from concentrated fluoride varnishes to bonded filling materials to cover the sensitive areas. If the pain is severe and constant, it may be possible that the pulpal tissue containing the nerves in your tooth are inflamed and you may need a root canal treatment to relieve your pain and save the tooth.

If you are experiencing tooth sensitivity or have questions about this condition, please contact us to schedule an appointment. Or you can learn more about this topic by reading the article “Sensitive Teeth.”

OralHealthTipsforSpecialNeedsChildren

If you are the parent or caregiver of a special needs child or a child with a chronic disease, you face additional challenges when it comes to life's everyday routines. This includes establishing and maintaining good oral health so that your child is not at risk for other healthcare issues due to poor oral hygiene. For these reasons, our office has put together real-world advice that will make a difference in the life of your child.

The visit to our office that can make the biggest difference is your child's first one. However, be sure to contact us in advance of your child's appointment to let us know the details of your child's special needs or chronic disease state. This will give us the opportunity to contact your child's primary care physician or one of his/her specialists before starting treatment to obtain any medical information or special instructions. It will also enable us to be prepared so that we can pay special attention to these needs, as well as to make any necessary modifications to our office and/or equipment. Our primary focus is to work with you and your child's healthcare team towards the same goal. We all want your office visit to go smoothly and comfortably so that your child's first dental experience is a positive one.

Depending on the age of your child and his/her special needs, we most likely will start a gentle process of training and education. For example we will teach your child how to brush properly. It is important that you sit in and participate in this educational process so that you can reinforce this training at home. And little things count; before working with your child at home, you should set the stage so that it will be a comfortable setting with adequate light, fresh water for rinsing, and a mirror. You also need to have all of your supplies handy, such as a toothbrush, toothpaste, floss and rubber gloves (if needed).

To learn more tips, continue reading the Dear Doctor magazine article “How To Care for the Oral Health of Children with Disabilities and Special Needs.” Or, you can contact us today to schedule an appointment or to discuss your questions about your child's special oral healthcare needs.

TooMuchPressureHowtoWardOffSinusPain

If you engage in frequent air travel, you have probably experienced pain in your ears and sinuses related to pressure changes. The pain is caused by “barotraumas” (from baro meaning pressure — also the root of the word “barometer” — and trauma meaning injury) and is also called a “squeeze.” Divers also sometimes experience this discomfort or pain.

The cause of barotraumas is air pressure (or water pressure, in the case of divers) on the outside of your body that is not equal to the pressure inside your body. Normally when pressure outside your body changes, your organs such as your blood, bones, and muscles transmit the changes equally from outside to inside. Some structures in your body, such as your middle ear spaces and your sinus cavities (spaces in the facial bones of the skull), don't transmit the pressure as well because they are filled with air and have rigid walls. The maxillary (upper jaw) sinuses are pyramid-shaped spaces in the bone located below your eyes, on either side of your nose.

You have probably tried to stop such pain in your ears by yawning, chewing, or moving your jaw back and forth. These maneuvers, called “clearing,” allow air to move from the back of your throat into your ear canals so that the pressure can equalize. Similarly, your sinuses have small openings near their lower borders, so that you can clear pressure changes within them. If you have a head cold or flu and the membranes lining your sinuses are swollen and inflamed, they may close off the openings and make it difficult to clear these spaces. This can sometimes lead to intense pain.

Because the lower walls of these sinuses are adjacent to your upper back teeth, these teeth share the same nerves as the maxillary sinuses. This sharing sometimes causes pain felt in your back teeth to be perceived as pain in the sinuses, or vice versa. Pain felt a distance from its actual stimulus because of shared nerves is called “referred pain.”

Be sure to make an appointment with us if you experience pain in any of your teeth. Any defect in a filling or tooth can allow air to enter the tooth. It could be referred pain from your sinuses, or the result of pressure changes on trapped air within a filling or a tooth. Such pain, called barodontalgia (from baro meaning pressure, don't meaning tooth, and algia meaning pain) is an early sign of injury in a tooth.

Contact us today to schedule an appointment to discuss your questions about tooth and sinus pain. You can also learn more by reading the Dear Doctor magazine article “Pressure Changes Can Cause Tooth & Sinus Pain.”

JerryRicesAdviceonProtectingYourChildrensTeeth

According to NFL football legend Jerry Rice, “Football can be brutal—injuries, including those to the face and mouth, are a common risk for any player.” And if anyone should know, it would be Jerry.

During an interview with Dear Doctor magazine, the retired NFL pro discussed his good fortune to have had just a few minor dental injuries during his pro playing days. He credits this success to the trainers and protective equipment professional football teams have to keep the players off the injured list. However, this was not the case during his earlier years in football. “There wasn't a lot of focus on protecting your teeth in high school,” he said. “You had to buy your own mouthguard.” He continued, “Things changed, though, when I went to college.”

Unfortunately, not much has changed since Jerry's high school days for young athletes. This is why we feel it is so important that parents and caregivers understand the risks and take proactive steps towards protecting the teeth, gums, bone and soft tissues of their children with a mouthguard. This is especially true for anyone — adults included — participating in high-contact sports such as basketball, baseball, hockey (field and ice), football, soccer, wrestling, martial arts, boxing and activities such as skateboarding, in-line skating and skydiving.

But all mouthguards are not the same. The best mouthguard, based upon evidence-based research, is one that is custom-designed and made by a dental professional, with the athlete's individual needs taken into account.

We make our custom mouthguards from precise and exact molds of your teeth, and we use resilient and tear-resistant materials. Once completed, it should be comfortable yet fit snugly so that you are able to talk and breathe easily with it in place. It should also be odorless, tasteless, not bulky and have excellent retention, fit and sufficient thickness in critical areas.

And while mouthguards may seem indestructible, they do require proper care. You should clean it before and after each use with a toothbrush and toothpaste, transport and store the mouthguard in a sturdy container that has vents, make sure not to leave it in the sun or in hot water and rinse it with cold, soapy water or mouthwash after each use. And last but not least, you should periodically check it for wear and tear so that you will know when replacement is needed.

To learn more about mouthguards, continue reading the Dear Doctor magazine article “Athletic Mouthguards.” Or you can contact us today to schedule an appointment so that we can conduct a thorough examination and make molds of your teeth for your custom mouthguard. And if you want to read the entire feature article on Jerry Rice continue reading “Jerry Rice — An Unbelievable Rise To NFL Stardom.”

UnconsciousHabitsCanWearDownTeeth

If your teeth have a worn appearance, it's possible you have a habit you're not even aware of: clenching or grinding your teeth. Also called “bruxism,” this destructive action causes your top and bottom teeth to come together or scrape past each other with a force that's many times what is normal for biting and chewing.

So what's normal? This can be expressed in terms of pounds. An adult usually exerts a force of 13-23 pounds to bite or chew food. But we have the potential to generate as much as 230 pounds of force, or 10 times what's normal. A “parafunctional” force of this magnitude applied repeatedly is bound to stress your teeth and other areas of your oral system. Besides wearing away the enamel of your teeth — and maybe even some of the softer dentin layer underneath — you may experience muscle spasms or pain in your jaw joints. Serious cases of wear can lead to “bite collapse” in which your face actually changes shape as your cheeks and lips lose support. This can make you look prematurely aged.

What can be done? To prevent further wear, we can fabricate for you a thin, plastic mouthguard that will protect your teeth at night or during times of intense stress. We can also recommend ways to temporarily relieve the discomfort that your grinding/clenching habits can cause. Heat and/or anti-inflammatory medication, for example, can be helpful.

If your tooth wear is minor (raggedness along the biting edge of a tooth or teeth) you may not need any restorative work. However, if tooth wear has already caused changes to your teeth and bite that you find aesthetically or functionally unacceptable, we can restore lost tooth structure in a variety of ways. Veneers and crowns are two examples.

If you have any questions about tooth wear or grinding habits, please contact us today to schedule an appointment for a consultation. You can learn more about this topic by reading the Dear Doctor magazine article “How And Why Teeth Wear.”

ThreeWaystoPreventToothDecay

Tooth decay is not trivial. It's a worldwide epidemic, one of the most common of all diseases — second only to the common cold. It affects more than one fourth of U.S. children of ages 2 to 5 and half of those 12 to 15. Among adults, tooth decay affects more than ninety percent of those over age 40.

Prevention of cavities starts with a healthy diet and effective brushing and flossing, but it is much more complex than that. Three strategies for reducing dental caries (tooth decay) include:

Protect with Fluoride and Sealants
This works best when fluoride is applied to the crystalline coating of your child's teeth just after they push through the gums (erupt). The fluoride becomes incorporated into the tooth's surface and acts as a barrier to decay. Studies have shown that low doses of fluoride are safe and effective.

Dental sealants are used as a companion to fluoride because they seal tiny pits and fissures in the tooth's structure, creating an even stronger barrier.

Modify Oral Bacteria
Every mouth contains bacteria, no matter how well you clean your teeth. Not all bacteria cause tooth decay. The problem bacteria are those that produce acid as a byproduct of their life processes. We can identify acid-producing bacteria in your mouth, you can reduce their concentrations using antibacterial mouthrinses such as chlorhexidine, and pH neutralizing agents (substances that reduce the amount of acid).

Reduce Sugars in Your Diet
Bacteria in your mouth ferment sugars and other carbohydrates, producing acids that eat into the mineralized outside structure of your teeth, the enamel. So eating fewer sugars — particularly added sugars such as those in juices, sodas, candy and other sweets — will help prevent decay. Your total sugar intake should be less than fifty grams, or about ten teaspoons, per day. If you begin to read labels showing sugar content of common foods, you may be surprised at the amount you consume without knowing it.

If you must snack between meals, non-sugary snacks like raw vegetables and fresh fruits create a better environment for your teeth.

Xylitol, an “alcohol sugar” used in some chewing gums and dental products, has been shown to reduce decay-producing bacteria.

Try these easy strategies to keep your teeth healthy and functional throughout your lifetime.

Contact us today to schedule an appointment to discuss your questions about tooth decay. You can learn more by reading the Dear Doctor magazine article “Tooth Decay.”

NancyODellSpeaksOutOnHerExperiencesWithPregnancyGingivitis

When it comes to sensitive gums during pregnancy, Nancy O'Dell, the former co-anchor of Access Hollywood and new co-anchor of Entertainment Tonight, can speak from her own experience. In an interview with Dear Doctor magazine, she described the gum sensitivity she developed when pregnant with her daughter, Ashby. She said her dentist diagnosed her with pregnancy gingivitis, a condition that occurs during pregnancy and is the result of hormonal changes that increases blood flow to the gums. And based on her own experiences, Nancy shares this advice with mothers-to-be: use a softer bristled toothbrush, a gentle flossing and brushing technique and mild salt water rinses.

Before we continue we must share one important fact: our goal here is not to scare mothers-to-be, but rather to educate them on some of the common, real-world conditions that can occur during pregnancy. This is why we urge all mothers-to-be to contact us to schedule an appointment for a thorough examination as soon as they know they are pregnant to determine if any special dental care is necessary.

Periodontal (gum) disease can impact anyone; however, during pregnancy the tiny blood vessels of the gum tissues can become dilated (widened) in response to the elevated hormone levels of which progesterone is one example. This, in turn, causes the gum tissues to become more susceptible to the effects of plaque bacteria and their toxins. The warning signs of periodontal disease and pregnancy gingivitis include: swelling, redness, bleeding and sensitivity of the gum tissues. It is quite common during the second to eighth months of pregnancy.

Early gum disease, if left untreated, can progress to destructive periodontitis, which causes inflammation and infection of the supporting structures of the teeth. This can result in the eventual loss of teeth — again, if left untreated. Furthermore, there have been a variety of studies that show a positive link between preterm delivery and the presence of gum disease. There has also been a link between an increased rate of pre-eclampsia (high blood pressure during pregnancy) and periodontal disease. Researchers feel this suggests that periodontal disease may cause stress to the blood vessels of the mother, placenta and fetus.

To learn more about this topic, continue reading the Dear Doctor magazine article “Pregnancy and Oral Health.” And if you want to read the entire feature article on Nancy O'Dell, continue reading “Nancy O'Dell.”

GumDiseaseCanIncreaseYourRiskofHeartDisease

You've probably heard that old song about the leg bone being connected to the knee bone; it's easy to see how the human skeleton links together. But the concept of anatomical parts being interconnected actually goes further than you might think. Problems in almost any part of the body can have profound effects in other areas. Your gums offer a perfect example.

Believe it or not, medical research has established a connection between gum disease and cardiovascular disease (CVD). They appear to be linked by inflammation, a protective response to infection. Inflammation can be characterized by a redness and swelling of the body's tissues that you can see. Or its effects can be less obvious.

Gum disease is an infection caused by bacteria, which build up in the mouth in the absence of regular or effective brushing and flossing. When left undisturbed, the bacterial biofilms (dental plaque) change over time so that a small set of highly pathogenic (“patho” – disease; “genic” – causing) organisms emerge that cause periodontitis (“peri” – around; “odont” – tooth; “itis” – inflammation).

Periodontitis can cause not just a localized inflammation of the gum tissue, but also a systemic (whole-body) inflammation. And this chronic, low-grade inflammation throughout the body appears to increase the risk of heart disease considerably. The good news is that there is a lot we can do about gum disease. And when we reduce the inflammation it causes, we can also reduce the risks for CVD and the heart attacks and strokes that can result.

The first step is a thorough, professional periodontal cleaning to remove the bacterial biofilm attached to the roots of the teeth. Sometimes a short course of antibiotics is prescribed to further fight the infection. Advanced periodontitis may require surgery so that we can reach all of the contaminated root surfaces for removal of the bacterial biofilm.

We will also review with you how you can prevent the growth of harmful bacteria through an effective daily oral hygiene routine. This is crucial to maintaining your oral health, which in turn affects your general health and overall well-being.

Contact us today to schedule an appointment to discuss your questions about the relationship between gum disease and heart disease. You can also learn more by reading the Dear Doctor magazine article, “The Link Between Heart & Gum Diseases.”

DontLetToothPainLingermdashTheCostMayJustBeTooHigh

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!

WhatFlorenceHendersonLearnedFromHerImpactedTeeth

Life lessons are learned in the most surprising places. This is no different for celebrities. Take, for example, Florence Henderson, an actress, singer, philanthropist, author and star of the hit television series, The Brady Bunch. As she told Dear Doctor magazine, her experience with having four impacted wisdom teeth removed — at the same time — “...only made me more aware of how important dental care is.” She continued, “This is why I have always gone every six months for a check up.”

Another important lesson we want to share is the fact that even if your impacted third molars (wisdom teeth) are not bothering you or causing any pain, you may still need to have them removed.

Why? Having a tooth submerged below the gum, pressing on the roots of other teeth is problematic; the tooth should be removed so that you can avoid major dental problems before they occur. For example, it is not uncommon for us to find an impacted third molar pressing against the roots of the adjacent second molar. Furthermore, because the enamel crown of this impacted tooth is trapped below the gum, we sometimes find an infection, gum disease or even cyst formation occurring.

Often, the best time to remove a wisdom tooth is when it is not causing any problems. This is because a painful wisdom tooth or pain in the area of the wisdom tooth may be a sign that significant damage has occurred or is occurring. It is also better to remove wisdom teeth when you are young, as young healthy people with no prior infections at the site provide the best opportunity for us to remove the tooth with no complications.

To learn more about impacted wisdom teeth, continue reading the Dear Doctor magazine article “Removing Wisdom Teeth.” Or if you suspect or already know that you have an impacted wisdom tooth, contact us today to schedule an appointment so that we can conduct a thorough examination that includes x-rays. During this private consultation, we will also address any questions you have as well as your treatment options. And if you want to read the entire article on Florence Henderson, continue reading “Florence Henderson.”

FollowinVannaWhitesFootstepsandReplaceThatMissingBackTooth

As the co-host of one of America's most beloved television game shows, Wheel of Fortune, Vanna White is recognized for her beautiful gowns and her dazzling smile. However, during an exclusive interview with Dear Doctor magazine, she shared her experiences with cosmetic dentistry. “I had a bridge put in probably 30 years ago where I had a tooth pulled and there was a space,” Vanna said.

Prior to having a permanent tooth pulled, most people are concerned with what can be done to replace it. It's important to follow through and do exactly that. This is especially true with back teeth. Just because you can't see them, it doesn't mean you won't face problems if they are not replaced.

For example, did you know that missing posterior (back) teeth can lead to a wide array or problems with the remaining teeth, muscles, ligaments, joints and jaw bones? This includes:

  • A decrease in chewing efficiency that in turn can impact your diet, nutrition and overall health
  • Excessive erosion or wear of remaining teeth
  • Tipping, migration, rotation and even loss of adjacent remaining teeth
  • Painful jaw problems such as Temporomandibular Dysfunction (TMD)

One treatment option is to follow in Vanna's footsteps and consider a fixed bridge. This is an excellent option when dental implants won't work. And through our artistry, we can easily blend them in color and appearance with your surrounding teeth.

When implants are possible, they represent the best option. They are easily maintained and are a durable, long-lasting solution that can increase bite support.

To learn more about this topic, continue reading the Dear Doctor magazine article “Replacing Back Teeth.” Or if you are already missing a permanent tooth, you can contact us today to schedule an appointment so that we can conduct a thorough examination. We will also address any questions you have as well as your treatment options. And if you want to read the entire feature article on Vanna White, continue reading “Vanna White.”

YourDentistMayBeAbleToHelpYouStopSnoring

Dentistry has ventured into the new area of sleep medicine by helping snorers — and their exasperated sleeping partners — with custom-made anti-snoring devices. These oral appliances, which resemble orthodontic retainers or sports mouthguards, keep the snorer's airway clear and the bedroom quiet. To see how they work, you have to understand the mechanics of snoring.

Snoring occurs when the upper airway (back of the throat) becomes blocked by the tongue or other soft-tissue structures, such as large tonsils or a long soft palate. The vibrating of these obstacles creates the sound we call snoring.

Snoring is often worse when sleeping on one's back because that position encourages the lower jaw to fall back and the tongue to close off the airway. This is where Oral Appliance Therapy comes in. These custom-fitted devices are designed to keep the upper airway open during sleep by pulling the lower jaw forward, which in turn brings the tongue away from the throat. Dentists, and our office in particular, are the only source for Oral Appliance Therapy.

People who snore should have a thorough examination to rule out Obstructive Sleep Apnea (OSA), a potentially dangerous condition in which airflow can be cut off completely for 10 or more seconds (“a” – without; “pnea” – breath), reducing blood-oxygen levels. Chronic, loud snoring is a common finding with OSA.

Please remember that sleep is an integral part of health and well-being. In fact, we spend about a third of our lives doing it. If you are snoring or have any sleep-related breathing disorders that are waking you or your bed partner, be sure to tell our office. There are plenty of examples of the havoc wreaked by sleep-deprived individuals. Remember the Exxon Valdez?

If you have any questions about Oral Appliance Therapy, please contact us or schedule an appointment for a consultation.

To learn more about the topic of oral appliance therapy, please see the Dear Doctor magazine article “Sleep Disorders & Dentistry.”

AremouthguardsimportantJustaskFitnessExpertJillianMichaels

Protecting one's smile is important at any age. This is especially true for people who participate in contact sports or other activities where a trauma to the mouth can occur. While we all tend to believe that we are safe and that injuries “only happen to other people,” we could not be further from the truth. Take, for example, Jillian Michaels, an accomplished author, business mogul, wellness expert, trainer and star of The Biggest Loser. She learned this invaluable lesson after breaking her two front teeth as a child and having them repaired with crowns. As Jillian stated in her interview with Dear Doctor magazine, “Now, I generally wear a mouthguard if I am doing anything where my teeth have any chance of being knocked out.”

We feel obligated to educate our patients so that you can make informed decisions about your oral health. This is why we put together the following brief list of research findings.

Did you know?

  • According to the American Dental Association, an athlete is 60 times more likely to suffer harm to the teeth when not wearing a mouthguard.
  • The US Centers for Disease Control reports that sports-related dental injuries account for more than 600,000 visits to the emergency room each year.
  • People who do not have a knocked-out tooth properly reserved or replanted may face a lifetime cost of $10,000 to $20,000 per tooth, according to the National Youth Sports Foundation for Safety.
  • The Academy of General Dentistry estimates that mouthguards prevent more than 200,000 injuries each year.

If feel you and/or your children need a custom-fitted, professionally made mouthguard, contact us today to schedule an appointment. During your private consultation, we will conduct a thorough examination, listen to your concerns, and answer all of your questions as we discuss the best methods for protecting your investment — your own, or your children's, teeth.

To learn more about mouthguards, continue reading the Dear Doctor magazine article “Athletic Mouthguards, One of the most important parts of any uniform!” And to read the entire interview with Jillian Michaels, please see the article “Jillian Michaels — The Biggest Loser's health and wellness expert talks about her oral health, keeping fit and plans for the future.”

FromModeltoMogulKathyIrelandMaintainsaSparklingSmile

You may have seen Kathy Ireland on the cover of Sports Illustrated, but did you know that she is now a business mogul?

Through it all, Ireland has kept her model good looks, and that includes a bright, glowing smile. In a recent interview with Dear Doctor magazine she said that keeping her smile has required ongoing maintenance and more.

It seems that Ireland is a bit of a daredevil. She described a moment of fun with her children when she tried to stand in their wagon and “wagon surf” across her driveway. It ended badly when she crashed into her parked car and suffered a broken nose, split forehead and several broken teeth. “I learned that my love of adventure exceeds my coordination,” she commented.

Ireland was born in Glendale, California in 1963. She demonstrated her drive to succeed early in life, starting at age 4 when she and her sister sold painted rocks from their wagon. Later she had a paper route. She began modeling at 17, with the goal of earning enough to pay for college or to start a business. In her successful modeling career she graced the covers of Glamour, Cosmopolitan, Harper's Bazaar and Sports Illustrated. Her first cover for Sports Illustrated, the publication's 25th Anniversary Swimsuit Edition, was the magazine's best-selling swimsuit issue to date.

In 1993 she founded her marketing and design firm, kathy ireland Worldwide. Now a billion-dollar industry, the firm sells fashions such as wedding gowns and bridesmaid dresses, as well as a wide range of items for home and family.

She has also written a number of books teaching others how to be successful — based on her own experience — as well as three children's books.

Discussing her oral health, Ireland says that she required serious professional assistance on more than one occasion. When she was a child she knocked out a tooth and later knocked it loose again. As an adolescent she wore braces for about three years. After the driveway incident she needed numerous veneers and dental implants to replace a lost tooth and restore her smile.

Her maintenance routine includes regular flossing and brushing, and she has her teeth cleaned every six months. She keeps up on her reading about the latest in research on dental health, and encourages her three children to floss and brush their teeth, to limit eating sweets and to do what they can to avoid injuries to their mouths and teeth.

Contact us today to schedule an appointment to discuss your questions about how to maintain your own smile. You can also learn more by reading the Dear Doctor magazine article “Kathy Ireland.”

Sucking their fingers or thumbs makes young babies feel secure and is completely normal behavior. Babies have been observed to suck their fingers or thumbs even before they are born. But like many comforting habits, over-doing pacifier, thumb, or finger sucking habits may be harmful.

Stop Pacifier Use by 18 Months

Studies have shown that pacifier use after the age of two may cause long-term changes in a child's mouth. We recommend that pacifier use should stop by about 18 months. A pacifier habit is often easier to break than finger or thumb sucking.

Stop Thumb and Finger Sucking by Age Three

Most children naturally stop thumb and finger sucking between two and four years of age, but some children continue this habit much longer. This may cause their upper front teeth to tip towards their lips or to come into position improperly. It can also cause their upper jaw to develop incorrectly. The American Academy of Pediatric Dentistry recommends that children stop these habits by age three.

Use of Behavior Management to Encourage Quitting

We offer creative strategies for gentle ways to cut back and stop pacifier use, including behavior management techniques that use appropriate rewards given at predetermined intervals. Meanwhile, make periodic appointments with us to carefully watch the way your child's teeth and jaws develop.

When your child is old enough to understand the possible results of a sucking habit, just talking about what may happen to teeth as a result can often encourage him/her to quit. As a last resort, a mouth appliance that blocks sucking may be needed.

If you are worried about your child sucking a pacifier, thumb, or fingers, please visit us to put your mind at rest. For more information read “Thumb Sucking in Children” in Dear Doctor magazine. Contact us today to schedule an appointment to discuss your questions about children's thumb sucking.

Tooth sensitivity is an issue that can range from a slight twinge at times to downright excruciating pain. However, before we continue, understanding the cause of tooth sensitivity is helpful to both relieving and treating it.

Tooth enamel is inert in that it has no nerve supply and thus it protects the teeth from temperature and pressure changes — the main cause of sensitivity. Once it is compromised, worn thin, or exposed due to gum recession, it leaves the delicate nerve fibers within the dentin vulnerable to touch, acid, and temperature change. These nerve fibers most often grab your attention when they come in contact with heat, cold, or a “double whammy” combination of both cold and sweet. They also become sensitive to touch — even the bristles of a soft toothbrush can irritate exposed dentin.

As for the causes of tooth sensitivity, one common cause we see is aggressive brushing. Yes, too much brushing can be bad for you! To be more specific, excessive, improper brushing with a sawing back and forth motion can erode the gum tissues, expose, wear, and even groove the dentin. Another cause for sensitivity can be from the destructive process of tooth decay that eats through the enamel and into the dentin.

If you are experiencing tooth sensitivity or have questions about this condition, please contact us to schedule an appointment. Or you can learn more about this topic by reading the Dear Doctor magazine article “Sensitive Teeth.”

When involved in high impact sports or vigorous activities, it is important to protect your mouth and teeth. This statement is backed by the fact that there are over 600,000 sports-related dental injuries treated in emergency rooms across the US each year according to the US Centers for Disease Control (CDC).

In addition to absorbing and distributing the forces that impact the mouth, teeth, face and jaws an athlete receives while participating in sports such as baseball, football, basketball, hockey (ice and field), skateboarding and wrestling, the American Dental Association (ADA), also recommends the use of custom mouthguards for other activities such as acrobatics, bicycling, handball, racquetball, skiing, and even weightlifting.

These facts make two things clear: (1) it is vital that you obtain a professionally made mouthguard that you wear during these types of activities and (2) that you also understand how this mouthguard protects you. Below are just a few ways.

  1. Lacerations. A custom-fit, professionally made mouthguard covers the sharp surfaces of the teeth to protect the soft tissues of the cheeks, lips, gums and tongue from lacerations that can occur from a blow or sudden jolt.
  2. Mouth Impact. Just as a mouthguard protects against soft tissue lacerations, it can also help prevent injuries to the jaws and teeth. This includes but is not limited to chipped teeth, fractured teeth, broken teeth and teeth that are partially or fully knocked out of their natural position.
  3. TMJ (jaw joint) Trauma. Wearing a properly fitted mouthguard can reduce the potential for jaw displacement and joint fractures by cushioning the jaws against damage from an impact.
  4. Direct Jaw Impact. Anytime a person receives a direct impact to his/her jaw, having a mouthguard in place may help prevent more serious injuries to teeth and jaws. This is especially important for anyone diagnosed with TMJ.
  5. Jaw Fracture. A custom-fit, professionally made mouthguard both absorbs and distributes impact forces so that jaws are protected. And it is this reduction in force that can help prevent the jaws from fractures.
  6. Under Chin Impact. Receiving a blow under the chin can obviously damage teeth; however, it can also cause damage to the jaws as well as inflame or cause TMJ issues.

You can learn more about mouthguards by continuing to read the Dear Doctor magazine article “Athletic Mouthguards.” Or you can contact us today to schedule an appointment.

We have learned that an important part of oral health is education — but more importantly, making it fun to learn so that you retain (and apply) what you learn! For this reason, we have put together the following self-test so that you can quickly access your knowledge on the subject of mouthguards.

  1. The first sport to use (and require) protective mouthguards was:
    1. football
    2. boxing
    3. baseball
    4. ice hockey
  2. Research conducted by the American Dental Association (ADA) found that individuals are ___ times more likely to damage their teeth when not wearing a mouthguard while engaged in contact sports or rigorous physical exercise.
    1. 10
    2. 20
    3. 40
    4. 60
  3. As a rule of thumb, females do not require mouthguards because they are not as physically active as their male counterparts.
    1. True
    2. False
  4. The American Academy of General Dentistry (AAGD) reports that mouthguards prevent more than ______ injuries to the mouth and/or teeth each year.
    1. 200,000
    2. 300,000
    3. 400,000
    4. 500,000
  5. Which of the following sports or activities does the ADA recommend that participants wear protective mouthguards:
    1. acrobatics
    2. bicycling
    3. handball
    4. all of the above
  6. The US Centers for Disease Control (CDC) reports that more than ______ sports-related injuries end-up in the emergency room each year with injury or damage to the teeth and mouth.
    1. 275,000
    2. 425,000
    3. 600,000
    4. 735,000
  7. Over-the-counter mouthguards are just as effective as professionally made mouthguards.
    1. True
    2. False
  8. In addition to the trauma of having a tooth (or teeth) knocked out, individuals who have suffered from this type of injury may end up spending ______ per tooth over a lifetime for teeth that are not properly preserved and replanted according to the National Youth Sports Foundation for Safety.
    1. $10,000 to $20,000
    2. $15,000 to $25,000
    3. $25,000 to $35,000
    4. Less than $10,000

Answers: 1) b, 2) d, 3) b, 4) a, 5) d, 6) c, 7) b, 8) a

You can learn more about the importance of mouthguards when you continue reading the Dear Doctor magazine article “Athletic Mouthguards.” And if you have already experienced a dental injury, it may not be too late. However, we need to evaluate the damage so that we can establish a plan for restoring optimal oral health. Contact us today to learn more about protecting your mouth and teeth or to schedule an appointment.

Often perceived as a cancer that only affects older adults who have a history of heavy tobacco and alcohol use, oral cancer is now on the rise among younger adults as well. New research has found a link between oral cancers, and the Human Papilloma Virus (HPV), a disease that is primarily spread through oral sex.

Importance of Screening: If you're concerned about oral cancer, rest assured that our office routinely carries out a cancer screening exam on every patient. We have several ways to painlessly detect abnormal tissues in their earliest stages. In addition, please contact our office if you experience any of the following signs or symptoms:

  • White and/or red patches in the mouth or on the lips
  • A bleeding or ulcerated sore in the mouth
  • A sore anywhere in your mouth that doesn't heal
  • Persistent difficulty swallowing, chewing, speaking, or moving your jaw or tongue

Although all of these symptoms can also be signs of less serious problems, be sure to alert our office if you notice any of the above changes.

Prevention: you can take a proactive role in preventing oral cancer by:

  • Conducting an oral self-exam at least once a month. Use a bright light and a mirror, look and feel your lips and front of your gums, the roof of your mouth, and the lining of your cheeks.
  • Scheduling regular exams in our office. The American Cancer Society recommends oral cancer screening exams every three years for people over age 20 and annually for those over age 40.
  • Refraining from smoking or using any tobacco products and drinking alcohol only in moderation.
  • Eating a well balanced diet.
  • Practicing safe sex.

Contact us today to schedule an appointment to discuss any questions you may have regarding oral cancer. Read more about this topic in the Dear Doctor magazine article “Risk Factors for Oral Cancer.”

For many children, thumb sucking is a great source of comfort. However, for some parents, it sets off potential red flags. See how much you really know about thumb sucking by taking our quick and easy true/false self test.

  1. Thumb or finger sucking is a totally normal behavior for babies and young children that should not cause any concerns for parents or caregivers.
    True or False
  2. One of the main reasons babies and young children suck their thumbs or fingers is that it provides a sense of security.
    True or False
  3. Sonograms have revealed that some babies actually begin sucking their fingers or thumbs in their mother's womb, before they are even born.
    True or False
  4. Recent research has shown that children using a pacifier after the age of four may cause long-term changes in the mouth.
    True or False
  5. Most children who suck their fingers or thumb tend to stop this habit on their own between the ages of two and four.
    True or False
  6. One of the biggest myths about thumb sucking is that it can cause buck teeth (the teeth tip outwards towards the lips).
    True or False
  7. The American Academy of Pediatric Dentistry recommends that children stop using a pacifier and/or thumb or finger sucking by the age of three; however some recent studies suggest that this should stop as early as 18 months of age.
    True or False
  8. Breaking a pacifier habit is often much more difficult to break than a finger or thumb sucking habit.
    True or False
  9. Dipping a pacifier, finger or thumb in vinegar is a recommended way of stopping the habit.
    True or False
  10. For the most challenging cases, we may suggest that your child needs a mouth appliance that a blocks sucking habits.
    True or False

Answers: 1) False. While it is a totally natural habit, parents and caregivers should monitor thumb or finger sucking. 2) True. 3) True. 4) False. It is not age 4, but rather age 2. 5) True. 6) False. This is NOT a myth but rather a fact. 7) True. 8) False. It is easier. 9) True. 10) True.

If you are having trouble getting your child to stop using a pacifier, thumb or finger sucking habit, we are an excellent resource for working with you and your child to accomplish this goal. To learn more on this topic, continue reading the Dear Doctor magazine article “Thumb Sucking in Children.” Or you can contact us today to schedule an appointment or to discuss your questions.

Sleeping disorders impact people in different ways. For some people, they may feel they do not have a problem — except for the fact that their sleeping partner complains about their snoring. For others, they may know they have a snoring issue because they constantly wake themselves up gasping for air. This is a dangerous condition known as Obstructive Sleep Apnea OSA (“a” – without; “pnea” – breath). If any of these scenarios sound like your experience, then you may have OSA or another type of Sleep Related Breathing Disorder (SRBD). However, before jumping to conclusions, you need to obtain a thorough examination from a primary-care physician who is trained in sleep medicine in conjunction with our office. We have received training in the diagnosis and treatment of sleep disorders. But the good news is that sleep apnea is a treatable condition.

As for your question, yes, there are many things we can do to treat your snoring after the cause of your problem is properly established. One helpful approach is through the use of a specially designed oral appliance that we custom make and fit to your mouth. It is easy to use during sleep. Once in place, it will keep your lower jaw in a forward position so that your tongue is held forward to stop blocking your upper airway (i.e. the back of your throat and area causing your snoring and hindering your breathing while you sleep). Another option is to use a Continuous Positive Airway Pressure (CPAP) machine. This specialized machine requires you to sleep with a mask that covers your mouth and/or nose. While you sleep, it delivers continuous pressure to your windpipe so that your tongue is forced away from your airway.

If your snoring is keeping you or your loved ones awake, we are a good place to start. Contact us today to discuss your questions about snoring or to schedule an appointment. You can also learn more about snoring and sleep disorders when you continue reading the Dear Doctor magazine article “Sleep Disorders & Dentistry.”

Grinding, clenching, and gritting your teeth are common reactions to stress — but their results can be quite complex. Here are some questions and answers that will fill you in on what you may not know about this widespread problem.

My dentist said I was bruxing. What does that mean?
Bruxing means that your teeth are grinding upon each other. Many people carry out this habit subconsciously and are not even aware that they are doing it.

Is bruxing or gritting harmful?
Such habits are called “parafunctional” (from para, meaning outside, and function, meaning purpose). This is because these stress habits exert much larger biting forces — as much as ten times more — than in normal biting and chewing activities. This excess pressure can cause damage to jaw joints and muscles, resulting in muscle spasm and pain; and to the teeth, resulting in wear, fractures or looseness. They can also cause headaches, earaches, and even neck and backaches because of the pressures on various structures in the face and mouth.

What is the usual treatment for problems arising from these stress habits?
The first thing we want to do is relieve your pain and discomfort. Second, we want to stop future damage. Application of heat or cold is helpful, and mild anti-inflammatory and muscle relaxant drugs are prescribed for pain and muscle spasm. To prevent future occurrences, we may treat you with biofeedback or refer you to someone who can offer psychotherapy.

What is a night guard and how can it help?
A night guard is an unobtrusive thin plastic appliance that is made to fit over the biting surfaces of your upper teeth. These guards are so unobtrusive that they can even be worn during the day if your stress level is so high that you grind your teeth during the day. The guard is adjusted to leave the lower teeth free to move against the surface of the guard, but they cannot bite into the upper teeth. This prevents wear on the teeth and lets the jaw muscles relax, preventing the pain of muscle spasm.

Contact us today to schedule an appointment to discuss your questions about stress and tooth grinding. You can also learn more by reading the Dear Doctor magazine article “Stress & Tooth Habits.”

It is important to brush your teeth every day to remove plaque (that sticky white film, composed of bacteria, on your teeth near your gums), but it is possible to overdo it — particularly if you find that your teeth are becoming sensitive to hot and cold or to variations in pressure.

Brushing your teeth too hard or too many times per day can aggravate tooth sensitivity, which can range from a mild twinge to a severe pain. You can accomplish the goal of tooth brushing — plaque removal — by using a soft brush with a very gentle action. Repeated aggressive brushing with a hard brush is not required and can even be harmful to your teeth and gums.

To understand how teeth become sensitive, you need to know about the internal structure of your teeth. Teeth are covered by enamel, a hard mineralized coating that protects them from changes in temperature and pressure. If the enamel is worn away, it exposes the next lower layer of the tooth, the dentin. The dentin is a living tissue containing nerve fibers that connect to the nerves in the tooth's root.

Excessive tooth brushing can irritate your gums and cause them to shrink away from your teeth, particularly if you have thin gum tissues. The thickness or thinness of your gum tissues is something you inherit from your parents, so you can't change it. Hard brushing can begin to wear away the enamel covering of your teeth. Exposure to acids or sugars in the foods you eat and drink can continue the damage.

Acidic foods and drinks such as fruit juices dissolve some of the minerals in your teeth by a process called “demineralization.” Fortunately, your saliva can interact with the enamel and bring back minerals that are leaving the tooth's surface. This process is called “remineralization.” It is important to let your healthy saliva wash your teeth's surfaces for a while before brushing so that dissolved minerals get a chance to be returned to your enamel. It takes between twelve and twenty-four hours for plaque to form on your teeth, so you don't need to brush more than twice a day.

The best way to make sure you are brushing your teeth properly is to have us evaluate your brushing technique at your next dental appointment. We will be able to tell you whether you need to change the angle of your brush or the pressure you are applying for the most effective removal of plaque with the least wear on your teeth and gums. Tooth brushing serves an important purpose, but remember that you can actually have too much of a good thing.

Contact us today to schedule an appointment to discuss your questions about tooth brushing and oral hygiene. You can also learn more by reading the Dear Doctor magazine article “Sensitive Teeth.”

Your car comes with a maintenance manual that tells you when to get an oil change, rotate the tires, and perform other necessary tasks. By following the manual's directions you can keep your car running in good condition for many years. Too bad a manual doesn't come with your teeth and gums!

Such a manual would concentrate on a few basic tasks we call oral hygiene and teeth cleanings. Both tasks are mainly dedicated to removing dental plaque or biofilm from the surfaces of your teeth and the surrounding gums. Plaque is now referred to as a biofilm, a film composed of bacteria, that naturally forms in your mouth. Studies have shown that dental plaque causes periodontal disease (gum disease) and dental caries (tooth decay).

Tips for Daily Removal of Dental Plaque
The way you hold your toothbrush is crucial to your ability to remove plaque effectively. We recommend that you hold it in your fingertips as you would a pen or pencil. Use small motions and pressure. Brushing too hard can damage gum tissues. Use a soft bristled brush, hold it at about a 45 degree angle to the gum line and then use a gentle scrubbing motion. Studies have shown some electric toothbrushes to be more efficient at plaque removal than hand-held brushes; but in general how you use the brush is more important than what kind of brush it is.

To remove plaque deposits from the hard-to-reach areas between your teeth, floss at least once a day. Wrap the floss around each tooth surface and gently move it up and down for a few strokes, cleaning the sides of your teeth where they face each other.

You can use an antibacterial mouthrinse to get help reduce the bacterial plaque or biofilm that you missed in brushing and flossing.

The best way to make sure you are brushing correctly is to have a dental professional demonstrate for you. We would be happy to demonstrate the correct techniques in your own mouth so that you can see how it feels, and you can copy the methods we use.

Professional Maintenance Schedule
Your car needs to go into the shop from time to time for professional maintenance. Your teeth also need a regular schedule of maintenance from a professional dentist or hygienist. Over time, plaque that you do not manage to clean off your teeth accumulates and forms hard deposits called calculus or tartar. If left on your teeth these deposits cause inflammation of your gum tissues and can lead to infection, abscesses, and even tooth loss. During a professional cleaning a technique called scaling removes these substances. For more advanced forms of gum disease, root planing is used to remove deposits of calculus below the gum line.

Contact us today to schedule an appointment to discuss your questions about oral hygiene. You can also learn more by reading the Dear Doctor magazine article “Oral Hygiene Behavior.”

The much anticipated day has arrived: your child's braces have been removed. You are really happy with the way your son's or daughter's smile looks now. All the time, money, and discomfort of having teeth straightened have been well worth it.

But did you know that the teeth could relapse into their old positions if your child doesn't wear a retainer every night?

Why is wearing a retainer necessary?
It is important for both you and your child to understand the reason for wearing a retainer. It has to do with how orthodontia works in causing teeth to move to more satisfactory positions.

The reason that orthodontia (“ortho” – straight, “odont” – tooth) works is that the tissues holding teeth in place are living and keep remodeling themselves. Teeth are suspended in the jawbone by the periodontal ligament (“peri” – around, “odont” – tooth), which suspends the tooth by extending from the cementum of the tooth on one side into the bone on the other. Cementum is the thin layer of calcified tissue covering the dentin of the root. When light forces are placed on it, the periodontal ligament can reform itself and adapt to the pressures it is under.

Orthodontists know how to keep the pressures during orthodontic treatment light enough to cause movement that is slow and steady but not so strong that the tissues are damaged. If too much force is applied, the process can cause damage to the periodontal tissues and tooth roots.

When the teeth have moved to their desired positions, they will continue slowly moving. The purpose of a retainer is to stabilize the teeth in their “finished” position. They must be retained in this position long enough that the bone and ligament can completely re-form around them, a process that can take several months.

Make it clear to your child that a retainer won't have to be worn forever. Once your child understands that it is very important to wear the retainer for a few months in order to stabilize that attractive new smile, it should be easy to convince him or her to use it nightly.

Contact us today to schedule an appointment to discuss your questions about retainers. You can also learn more by reading the Dear Doctor magazine article “Why Orthodontic Retainers?

Nearly everyone has snored at some point in life. However, if your sleeping partner routinely tells you that you suffer from this problem, you really should take action to confirm or deny your suspicions. You may be like one of the 50 to 70 million people in the US alone that suffer from Obstructive Sleep Apnea (OSA), a medical condition in which the upper airway (the back of your throat) collapses during sleep thus limiting your intake of oxygen. And this condition is serious. If left untreated, OSA can lead to a stroke, impotence, an irregular heartbeat, heart attacks, high blood pressure, and other forms of heart disease.

The first and most important step you should take if you snore is to obtain a thorough examination by both your primary-care physician and our office. We have completed specialized training in sleep medicine so that we can not only diagnose but also thoroughly treat your sleep disorders.

If you are diagnosed with this problem, relax. We have many ways we can treat your condition. One of the most common methods is to provide you with oral appliance therapy. This first line of treatment involves our making a customized oral appliance (mouthpiece) that will hold your lower jaw forward. By doing this, we can move your tongue away from the back of your throat so that your airway is less likely to get blocked while you sleep. (It is this blockage that causes the infamous snoring sound.)

Another option we may consider using to treat your sleep apnea if it is moderate to advanced is a Continuous Positive Airway Pressure (CPAP) machine. These machines require you to sleep with a mask over your nose and/or mouth and produce continuous pressure in your windpipe so that your tongue is forced forward away from your airway. Not only can these machines potentially eliminate your snoring, but they can also give you the restful night's sleep that you have been missing.

The last and most permanent solution for treating certain non-responsive cases of sleep apnea is surgery. This option is typically reserved for the most advanced cases to eliminate or reduce an obstruction to the airway.

Contact us today to discuss your questions about sleep apnea or to schedule an appointment. You can also learn more about sleep apnea when you continue reading the Dear Doctor magazine article “Sleep Disorders & Dentistry.”

Nearly everyone is familiar with snoring, having either been awakened by a snoring, sleeping partner or by snoring so loudly that you wake yourself up. As if the sounds emanating from snoring weren't bad enough, snoring is no laughing matter and should never be ignored. And why? It can be a sign of other health issues.

Snoring occurs when the soft tissue structures of the upper airway (the back of your throat) collapse onto themselves, the tongue drops back and air is blocked in its movement through the mouth and nose into the lungs. These obstacles cause a vibration that produces the snoring sound. Snoring can also be caused by large tonsils, a long soft palate, a large tongue, the uvula (the tissue in the back of the throat that dangles like a punching bag), and/or fat deposits.

If snoring is more severe, it may denote a medical condition called Obstructive Sleep Apnea (OSA; or just “sleep apnea”). It occurs when the upper airway collapses causing significant airflow disruption or even no airflow whatsoever for 10 seconds or more and can leave you feeling tired, depressed, irritable, as well as cause memory loss and poor concentration. But have no fear; you are not alone, as millions of people worldwide have been diagnosed with this condition. There are also numerous treatment options that we can discuss with you — should you be diagnosed with this problem.

You can learn more about sleep apnea by reading 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 a consultation.

Periodontal or gum disease is an often silent disease that can cause significant damage to the health of your teeth and body. The reason it is so often classified as a silent disease is because it is chronic or longstanding and often without any symptoms or pain that most people associate with a disease until it may be too late.

If you think you may have gum disease, here is what to look for:

  • Bleeding gums — probably one of the most common and overlooked early warning signs that most people ignore is thinking that the bleeding is being caused by brushing their teeth too hard. The truth is that you would have to brush extremely hard to cause healthy gum tissues to bleed.
  • Bad breath — something everyone has experienced; however, it can also be a warning sign of periodontal disease. This is especially true for people who hate or refuse to floss their teeth, thereby trapping literally billions of bacteria where they love to collect in the protected areas between the teeth.
  • Redness, swelling, and/or receding gums — all signs of gum disease often accompanied by sensitivity of the gum tissues around the teeth.
  • Chronic inflammation — long-standing gum inflammation is a sign that your gum tissues are not healing properly. Periodontal disease exhibits periods with bursts of activity followed by periods where the body tries to recover.
  • Loose and/or moving teeth — that seem to be drifting into a new position, are visible signs that you are highly likely to have periodontal disease.
  • Abscess formation — late stage gum disease is characterized by painful, swollen, red pockets of pus, which denotes an acute localized periodontal infection.

If you have any of these signs, you need to make an appointment for a thorough evaluation. Otherwise, you could end up losing your teeth to the second most common disease known to man after tooth decay. To learn more about gum disease, continue reading, “Warning Signs of Periodontal (Gum) Disease.” Or, contact us today to schedule an appointment.

Anyone who has seen fitness and life coach Jillian Michaels on The Biggest Loser and Losing It with Jillian knows she has the expertise and determination to help overweight people reach new levels of fitness and health. Using her own difficult life experiences, Jillian is able to help others look below the surface to the roots of their own unhealthy lifestyles. As a child, she suffered from night terrors, then her parents divorced when she was 12. She reacted to her anger and unhappiness by comforting herself with food. By age 17 she weighed 175 pounds — too much weight for her small 5'2" frame. To get Jillian involved in physical activity, her mother signed her up for a martial arts class. It was the right choice. Jillian loved the physical and spiritual aspects of martial arts practice, and this training pointed the way to what ultimately became her career.

It's no wonder Jillian is concerned about America's obesity problem — especially in children. To counter it, she and a business partner put together a Wii game, “Jillian Michaels' Fitness Ultimatum.” “If you turn exercise into a game, it's much easier to get kids to join in,” she says.

For adults, Jillian is concerned with unhealthy body images put forward by the fashion industry and media. She says, “Educating women on the importance of a healthy diet and exercise program is essential, but getting them to realize that women are supposed to have curves is equally important.” She is working on a new book, which is designed to help people live a healthy lifestyle, realize their true potential, and find happiness in just being themselves.

Since good health also includes good oral health, here's a sampling of what Jillian discussed about healthy habits in her interview with Dear Doctor magazine.

How can parents encourage their children to have healthy habits? Jillian says it starts with parents setting a good example. Parents can persuade children to get exercise by going outside to play with them. Gardening together and serving kids home-grown vegetables is a good way to encourage healthy eating.

What is her dental care routine? Jillian brushes her teeth two or three times a day with an electric toothbrush and she flosses daily. She never leaves home without toothpaste, an electric travel toothbrush, and floss as well as some sort of lip gloss. She sees her dentist, whom she calls “amazing,” at least twice a year for cleanings.

How does she guard against damage from martial arts? Jillian broke her two front teeth as a child and had them repaired with crowns. Now she wears a mouthguard when doing vigorous exercise.

What other cosmetic dental procedures has she had? She also had braces and has had her teeth whitened.

Jillian knows that it takes hard work and commitment to health and exercise, along with good oral health habits, to look and feel your best. You can learn more about Jillian by reading the entire interview in the article “Jillian Michaels: The Biggest Loser's health and wellness expert talks about her oral health, keeping fit and plans for the future.” Contact us today to discuss your questions about tooth whitening, crowns, or mouthguards or to schedule an appointment.

Vanna White has been a household name for the last 27+ years and is best known as the first female co-host of the game show, Wheel of Fortune. She radiates a warm, friendly, down-home appeal and says when describing herself, “what you see is what you get!” While this is quite true, there is so much more to her. She has received a star on the famous Hollywood Walk Of Fame, has starred in an NBC movie and written a book. She is even featured in The Guinness Book of World Records as TV's most frequent clapper, and most recently started her own line of yarn called Vanna's Choice with half of the proceeds going to St. Jude Children's Research Hospital. And while any one of these accolades could serve as the highlight of a lifetime for most, for Vanna they fall slightly short. Her favorite job is being mother to her son, Nicholas, and daughter, Giovanna.

The following are excerpts taken from an exclusive interview in Dear Doctor magazine, the premier oral healthcare resource for patients and consumers.

What is the secret to her dazzling smile?
Vanna's oral healthcare routine is the same today as it has been since her childhood — and one everyone can follow. She brushes her teeth at least twice a day (morning and at bedtime) and flosses her teeth daily. She also has strong feelings about flossing. “I think that flossing is the most important thing. I believe that dental floss helps a lot as it keeps your gums strong and looking younger.”

What about bleaching, has she done it?
Absolutely! Vanna bleaches her teeth once or twice a year to help retain her naturally white teeth and to offset any discoloration from coffee and an occasional glass of red wine. “I have done over-the-counter and professional bleaching, but I do like the trays my dentist made because they fit perfectly.” She also states, “Anything you can do professionally is probably better because I would assume that a dentist's ingredients are stronger than over-the-counter products.”

Has she had any cosmetic dentistry?
When it comes to answering a question about cosmetic dentistry, Vanna is just as open and honest as she is about everything else — a trait for which she is known. “I had a bridge put in probably 30 years ago, where I had a tooth pulled and there was a space. And I did have a little tiny chip on one of my front teeth years ago that my dentist fixed. But that is it. Again, I feel very fortunate to have good teeth. The braces [from her childhood] straightened them out and there has been no need for any cosmetics since then.”

Does she do anything to protect her teeth?
While she admits to occasionally forgetting to use her nightguard, a protective mouthguard worn during sleep, she firmly believes in their need. “I do sleep in a nightguard because I grind my teeth. I have a filling in the back that probably has been filled five times from grinding.” She added, “Both of my children do have mouthguards that they wear for their sports.”

Want a smile like Vanna's?
Contact us today to schedule an appointment or to discuss your questions about bleaching, cosmetic dentistry or mouthguards. You can also learn more about Vanna by reading the entire interview in the Dear Doctor article, “Vanna White — The Smile Defining America's Favorite Game Show — Wheel Of Fortune.”

Some of the most important lessons parents and caregivers can give their children involve teaching and demonstrating good oral health habits. The following tips from the Centers for Disease Control and Prevention (CDC) are some ideas for helping you keep your children's teeth healthy.

  1. Start cleaning teeth early.
    As soon as a child's first tooth erupts (appears), you should clean it daily by using a clean, damp cloth. Once several teeth are in, you should switch to a small, soft-bristled toothbrush. As for using toothpaste containing fluoride, you typically should start using it to brush your child's teeth at around 2 years old. However, there are some situations in which we recommend using toothpaste earlier than age 2. It just depends on your child’s mouth and development.

  2. Use the right amount of fluoride toothpaste.
    Many people are aware that using toothpaste containing fluoride is an important tool for fighting tooth decay. But, many are shocked to discover how much should be used and what could happen if too much is used and swallowed. Because children under the age of 6 may tend to swallow all or some portion of toothpaste, you should only use (and teach them to use) a small amount—about the size of a pea. Otherwise, they could be at risk for getting white spots on their permanent teeth years later from having swallowed too much fluoride. This is also a key reason for teaching children how to rinse and spit properly after brushing their teeth.

  3. Supervise brushing.
    Because children's abilities and maturity can vary greatly from child to child, you should brush your children's teeth until they have demonstrated the ability to handle the task alone. However, even when you give them the power to self-brush, you need to monitor them closely to ensure they are doing a thorough job, using the correct amount of toothpaste, and not brushing in a way that could damage teeth or gums. Brushing for too long and too hard are bad habits that can be detrimental to teeth and gums.

  4. Talk to your child's doctor and with our office.
    Did you know that your first appointment should be at age one? The age one dental visit can be critical in establishing great communication and trust, and preventing early childhood decay. And having a positive rapport with your dentist and physician is important at any age; however, it is vital for parents and caregivers to develop great communication with their healthcare professionals on behalf of their children from the start of life. Not only does it model good habits for them to observe, but it also helps you stay abreast of the oral and general health needs.

Want to learn more?

Contact us today to discuss your questions or to schedule a consultation. You can also learn more by reading the Dear Doctor article, “Oral Hygiene Behavior.”

When it comes to sports, all athletes need to know how to assess their risk for experiencing a sports-related injury as well as how to prevent one. The first step to accomplish this is learning how sports and activities are classified, as they define risks from little-to-no chance of injury to highly susceptible for injuries. These categories include:

  • Low velocity, non-contact sports: These sports and activities have the lowest risk, as they typically include sports where the athletes perform individually at reasonable speed without physical contact. Examples include: golf, Nordic skiing, weight lifting, running and swimming.
  • High velocity, non-contact sports: These sports and activities are those where athletes move at high rates of speed but with no contact with other participants. While there is no contact, anytime you are moving at high rates of speed, accidents can happen. Examples include: bicycling, motocross, skateboarding, skiing and snowboarding.
  • Contact sports: As the title states, these sports and activities include frequent body-to-body contact or body to equipment (e.g., a ball, glove, etc.) contact. Examples include: basketball, soccer, lacrosse, baseball and softball.
  • Collision sports: With these sports and activities, strong, forceful, body-to-body or body-to-equipment contact is a primary goal of the sport. Examples include football, ice hockey, rugby, and boxing. Without the proper protective head and mouth gear, participants are highly likely to experience an oral-facial and/or head injury.

The good news is that you can dramatically reduce the odds of serious dental and oral-facial injury by ensuring that you wear a professionally made mouthguard in addition to a helmet, facemask, or other protective gear that is appropriate to the sport. This is especially true if you participate in the high velocity, contact and collision categories. These simple steps can help reduce worries for not only players, but also for parents, caregivers and coaches. For more information, read, “An Introduction To Sports Injuries & Dentistry.” You can also download a FREE, pocket-sized guide for managing dental injuries.

According to the Centers for Disease Control and Prevention (CDC), community water fluoridation has been a safe and healthy way to prevent tooth decay effectively for over 65 years now. In fact, the CDC has recognized water fluoridation as one of the 10 great public health achievements of the 20th century.

It all began back in the 1930's when it was discovered that fluoride had oral health benefits. However, community water fluoridation did not begin until January 25, 1945, when Grand Rapids, Michigan became the first city to add fluoride to its municipal water system. Before it was officially rolled out in other cities, Grand Rapids was compared to other cities or “controlled groups” that had not added fluoride to their water so that scientific research could assess the relationship between tooth decay and fluoride. Well, you can guess the results — it was proven that fluoride helped reduce tooth decay when added to ordinary tap water. On November 29, 1951, the National Academy of Sciences’ National Research Council (NRC) declared water fluoridation safe, effective, and beneficial based upon the results of their findings and the fact that there was a dramatic decline in tooth decay in the children of Grand Rapids.

Ever since, fluoride has continued to play a critical role as a simple, safe, effective way to provide improved oral health by helping reduce tooth decay in the United States. This reality is still being demonstrated with each new generation benefiting from better oral health than the previous generation.

As for identifying when the time is right to introduce fluoride to your children's oral health program, ask us. Most children get the right amount of fluoride to help prevent cavities if they drink water that contains fluoride. And if by chance you live in an area where your tap water is not fluoridated, brush your children's teeth with no more than a pea-sized amount of fluoride toothpaste twice a day and ask your dentist about fluoride supplements and treatment.

Learn more on this topic by reading the Dear Doctor article, “Fluoride And Fluoridation In Dentistry.”

If you suffer from snoring or think you may have Obstructive Sleep Apnea (OSA), did you know that your dentist could play an important role in treating your condition? For most people this is surprising; however, we can provide both education and some treatment options. And as needed, we will work with your other healthcare professionals to get an accurate diagnosis so that you can improve both your sleep and your health.

Oral Appliance Therapy: These devices may look like orthodontic retainers or sports mouthguards, but they are designed to maintain an open, unobstructed, upper airway (tissues at the back of your throat) during sleep. There are many different oral appliances available but less than 20 have been approved through the FDA (Food and Drug Administration) for treating sleep apnea. Depending on your specific condition, we may use it alone or in combination with other means of treating your OSA. Here’s how they work. They reposition the lower jaw, tongue, soft palate and uvula (the tissue in the back of the throat that dangles like a punching bag); stabilize the lower jaw and tongue; and increase the muscle tone of the tongue — unblocking the airway.

Continuous Positive Airway Pressure (CPAP): CPAP bedside machines generate pressurized air delivered through a tube connected to a mask covering the nose and sometimes mouth. Pressurized air opens the airway (windpipe) in the same manner as blowing into a balloon; when air is blown in, the balloon opens and gets wider. This treatment option is generally not used for snoring, but rather for the more serious condition, OSA.

Surgery: Specially trained oral and maxillofacial surgeons may include more complex jaw advancement surgeries. Additionally, an Ear, Nose & Throat (ENT) specialist (otolaryngologist) may consider surgery to remove excess tissues in the throat. It also may be necessary to remove the tonsils and adenoids (especially in children), the uvula, or even parts of the soft palate.

The first step towards getting a great night's sleep if you are a snorer that has never been diagnosed or treated for your condition is to obtain a thorough examination by a physician specifically trained in diagnosing and treating sleep disorders. And depending on the seriousness of your condition, he or she may strongly encourage you to participate in a sleep study. The results from this “study” can provide your dentist and other healthcare professionals with precise data about your snoring, breathing and sleeping habits. This information is key to treating OSA, if you are in fact diagnosed with this condition. Learn more when you read, “Snoring & Sleep Apnea.” Or if you are ready for a thorough examination and to discuss your snoring, contact us today to schedule an appointment.

Everyone agrees that education is an important part of personal growth. However, one area of study that often slips through the cracks centers on oral healthcare basics. And whether or not we all do it as often as we should, most people know they should brush and floss their teeth daily. But other than that, do you feel you are knowledgeable and thus have a healthy dental IQ?

We have developed a quick and easy oral health IQ test to help you self-assess your expertise. The answers are listed at the bottom of this article.

The Quiz

  1. What has been the largest, single factor influencing the decline in tooth decay over the past 40 years in America?
    1. Fluoridated water
    2. Fluoridated toothpaste
    3. Flossing
    4. Sealants
  2. Your dentists can help treat which of the following problem(s)?
    1. Halitosis (bad breath)
    2. Snoring and sleep apnea
    3. Headaches, Temporomandibular Disorder (TMD), or Temporomandibular Joint Dysfunction
    4. All of the above
  3. The most important aspect of brushing your teeth is...?
    1. The brand of toothpaste you use
    2. Your brushing technique and frequency
    3. The brand of your toothbrush
    4. Using an electric toothbrush
  4. At a minimum, how often should you have a thorough dental evaluation?
    1. Every six months
    2. Once a year
    3. Every five years
    4. Only if you are experiencing pain
  5. At a minimum, how often should you have your teeth professionally cleaned?
    1. Every six months
    2. Once a year
    3. Every five years
    4. It depends on your age and oral health

Want to learn more?

Contact us today to discuss your questions or to schedule a consultation. You can also learn more by reading the Dear Doctor article, “Oral Hygiene Behavior.”

The Answers

1) a = fluoridated water, 2) d = all of the above, 3) b = your brushing technique and frequency, 4) b = once a year, 5) d = It depends on your age and oral health

For decades, fluoride has been held in high regard by the dental community as an important mineral that strengthens tooth enamel, which thereby helps to prevent decay of tooth structures.

Water fluoridation is endorsed by nearly every major health and safety-related organization in the world. Communities make it a common practice to "fluoridate" their drinking supplies in order for the general population to benefit from this inexpensive and effective preventative treatment. According to the American Dental Association, more than 144 million U.S. residents in more than 10,000 communities drink fluoridated water, most from public water supplies with sodium fluoride added artificially.

Bottled water, home water treatment systems, and fluoride exposure

Can the consistent use of bottled water result in individuals missing the benefits of optimally fluoridated water? Can home water treatment systems (e.g., water filters) affect optimally fluoridated water supplies? The answer is yes to both. Read how you can avoid some of the pitfalls that may be preventing you from getting the maximum value of fluoride, in this article from the American Dental Association.

ADA statement on FDA toothpaste warning labels

The American Dental Association`s Council on Scientific Affairs believes that one part of the warning now required on fluoride toothpastes by the Food and Drug Administration (FDA) could unnecessarily frighten parents and children, and that the label greatly overstates any demonstrated or potential danger posed by fluoride toothpastes. The label language, "If you accidentally swallow more than used for brushing, seek professional help or contact a poison control center immediately," is now required on all fluoride toothpastes. But the ADA, in a letter sent to the FDA last year, pointed out that a child could not absorb enough fluoride from toothpaste to cause a serious problem and that the excellent safety record on fluoride toothpaste argues against any unnecessary regulation.

Enamel fluorosis

According to the American Academy of Pediatric Dentistry, a child may face a condition called enamel fluorosis if he or she receives too much fluoride during the years of tooth development. Too much fluoride can result in defects in tooth enamel.

CDC web site provides information on community water fluoridation

People seeking information on whether their water system is fluoridated, can now find out by visiting a new Web site at the Centers for Disease Control and Prevention (CDC). The new feature, "My Water`s Fluoride," allows consumers in participating states to check out basic information about their water system, including the number of people served by the system and the target fluoridation level. Optimal levels recommended by the U.S. Public Health Service and CDC for drinking water range from 0.7 parts per million (ppm) for warmer climates, to 1.2 ppm for cooler climates accounting for the tendency to drink more water in warmer climates. States that are currently participating include Arizona, Colorado, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Maine, Massachusetts, Michigan, Minnesota, Nebraska, New Hampshire, Nevada, North Dakota, Oklahoma, Pennsylvania, and Wisconsin.

For more information about fluoride in our drinking water in Mill Creek Washington, please contact Dr. Chad G. Slocum DDS or Sara M. Lundgaard DDS at Penny Creek Family & Cosmetic Dentistry.