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Posts for category: Oral Health

By Jay Freedman, DDS & Associates, PC
February 19, 2019
Category: Oral Health
Tags: tooth decay  
GettingtheFullPictureofYourDecayRiskLeadstoBetterPreventionStrategies

Preventing tooth decay is mostly about the basics: daily brushing and flossing followed by regular dental cleanings and checkups. But there’s also a bigger picture: your own personal risk profile for decay based on factors you can modify directly — and those you can’t.

The first type of factor usually involves habits and behavior that either work with your mouth’s natural defenses to fight decay or against it. Besides regular hygiene, your diet is probably the most important of these you can modify for better dental health.

A diet rich in fresh vegetables, protein and dairy products boosts strong, healthy teeth resistant to decay. Conversely, bacteria thrive on the sugar in many snack foods, while sodas, sports or energy drinks elevate acid levels that soften and erode the minerals in your teeth’s enamel.

Lifestyle habits like tobacco use or excessive alcohol consumption also increase your decay risk. Not only do they promote plaque buildup (the thin film of bacteria and food particles that feeds the decay process), but tobacco especially can impede the body’s natural prevention and healing properties.

Conscientious hygiene practices, a dental-friendly diet and modified lifestyle habits all can help you prevent decay. But diligence may not be enough — there are other possible factors you can’t control or may find difficult to change. For example, you may have a genetic propensity toward certain bacteria that cause decay. You may have a condition like gastric reflux that increases the mouth’s acid level. You may also be taking medications that reduce saliva flow, the mouth’s natural acid neutralizer.

But if we know which of these indirect risk factors affect you, we can compensate with extra measures. If enamel strength is a problem we can topically apply fluoride; we can also reduce chronic bacterial levels with prescription rinses. If you have restricted saliva flow, we can attempt to modify your prescriptions through your doctor or prescribe aids that increase saliva.

The key is to investigate your complete risk factor profile through a thorough dental examination. Once we know everything about your mouth, life and health that increases your decay risk, we can put in place a balanced strategy of prevention and treatment just for you. Doing so will greatly increase your chances for keeping your teeth decay-free and healthy.

If you would like more information on preventing and treating 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 “Tooth Decay: How to Assess Your Risk.”

By Jay Freedman, DDS & Associates, PC
February 09, 2019
Category: Oral Health
Tags: oral hygiene  
TestYoureBrushingandFlossingSuccesswithaPlaqueDisclosingAgent

Brushing and flossing your teeth provides a lot of benefits, including a brighter smile and fresher breath. But the primary benefit—and ultimate goal—is removing dental plaque. This biofilm of bacteria and food remnants on tooth and gum surfaces is the number one cause for dental disease.

Brushing and flossing can effectively keep plaque under control. Unfortunately, plaque can be a stubborn foe, hiding in areas easily missed if you're not thorough enough.

So how do you know you're doing a good job brushing and flossing? One quick way is to use your tongue or dental floss to feel for any grittiness, a possible sign of remaining plaque. Ultimately, your dentist or hygienist can give you the best evaluation of your hygiene efforts during your three or six-month checkup.

But there's another way to find out more definitively how well you're removing plaque in between dental visits: a plaque disclosing agent. These over-the-counter products contain a dye solution that stains plaque so it stands out from clean tooth surfaces.

A disclosing agent, which can come in the form of tablets, swabs or a liquid, is easy to use. After brushing and flossing, you apply the agent according to the product's directions. The dye reacts with plaque to stain it a distinct color. You may also find products with two-tone dyes that stain older and newer plaque different colors to better gauge your overall effectiveness.

You then examine your teeth in the bathroom mirror, looking especially for patterns of missed plaque. For example, if you see dyed plaque running along the gum line, you'll know you need to concentrate your hygiene there.

After observing what you can do to improve your future efforts, you can then brush and floss your teeth to remove as much of the dyed plaque as you can. The staining from the dye is temporary and any remaining will fade over a few hours.

Using a disclosing agent regularly could help you improve your overall hygiene technique and reduce your risk of disease. Ask your dentist for recommendations on products.

If you would like more information on improving your oral hygiene, 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 “Plaque Disclosing Agents.”

By Jay Freedman, DDS & Associates, PC
December 21, 2018
Category: Oral Health
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.”

By Jay Freedman, DDS & Associates, PC
December 01, 2018
Category: Oral Health
Tags: tooth decay  
ToothDecaycanbeLessofaProblemwithMinimallyInvasiveDentistry

“Less is more” is a truism for much of life. It’s also an important feature of an emerging approach to treating tooth decay known as minimally invasive dentistry (MID).

MID updates another revolution in dental care that occurred in the early 1900s. Treating decay took a quantum leap thanks to techniques developed by Dr. G. V. Black, considered the father of modern dentistry. Dr. Black’s approach (known as “extension for prevention”) involved not only removing decayed tooth structure, but also adjacent areas deemed vulnerable to decay, which made them easier to clean. On the downside, though, it also created larger than normal fillings.

As the practice prevailed through much of the Twentieth Century another weakness became apparent—the approach could not guarantee a treated tooth would not experience decay again. This became the real impetus toward MID—to find more comprehensive ways to treat decay with as little impact on the tooth structure as possible.

These efforts received a real boost from emerging technology. This was especially true in diagnostics with the rise of new devices like intraoral cameras and techniques like laser fluorescence that can enable dentists to detect decay much earlier. It’s now possible to catch the disease at an earlier stage before substantial damage to the tooth occurs.

MID has also led to new treatments that preserve more of the tooth structure. Traditional drilling is increasingly giving way to air abrasion, the use of a fine particle stream of aluminum oxide, glass beads or baking soda directed precisely at decayed structure and minimizing damage to healthy structure. We’re also using new filling materials like composite resin for restorations after treatment that are strong yet still life-like and attractive.

We also can’t forget the role of the twin daily hygiene practices brushing and flossing to remove bacterial plaque, the main source of dental disease. And regular dental cleanings and checkups round out the MID approach, helping to ensure that decay doesn’t get too far. The end result of this revolutionary approach: your teeth can experience less impact from treatment and remain healthier and more attractive in the long-run.

If you would like more information on minimally invasive 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 “Minimally Invasive Dentistry: When Less Care is more.”

By Jay Freedman, DDS & Associates, PC
November 21, 2018
Category: Oral Health
Tags: oral health  
TakingCareofOralHealthCrucialtoQualityofLifeforHIVPositivePatients

In the early Eighties, dentists began noticing symptoms among a few patients that indicated something far more serious. They were, in fact, among the first healthcare providers to recognize what we now know as HIV-AIDS.

Today, about 1.2 million Americans have contracted the Human Immunodeficiency Virus (HIV). It’s a retrovirus, somewhat different than other viruses: it can invade immune system cells and hijack their replication mechanism to reproduce itself. Untreated it eventually destroys these cells to give rise to the more serious, life-threatening disease Acquired Immunodeficiency Syndrome (AIDS).

Thanks to antiretroviral drugs, most HIV positive patients live somewhat normal lives and avoid the more serious Acquired Immunodeficiency Syndrome (AIDS). But while antiretroviral therapy effectively inhibits the action of the virus, it isn’t a cure — the virus is a permanent resident of the body and can still affect health, especially in the mouth.

In this regard, one of the more common conditions associated with HIV is Candidiasis, a fungal infection also known as thrush, which causes cracking of the mouth corners and lesions or white patches on the surface of the tongue or roof of the mouth. HIV patients may also experience limited saliva flow that causes dry mouth (xerostomia) with effects that range from bad breath to a higher risk of tooth decay.

The most serious effect, though, of HIV on oral health is the body’s lower resistance to fight periodontal (gum) disease. HIV patients are especially susceptible to a severe form known as Necrotizing Ulcerative Periodontitis (NUP), a sign as well of immune system deterioration and the beginning of AIDS. This painful condition causes gum ulcerations, extensive bleeding, and the rapid deterioration of gum attachment to teeth.

If you or a family member is HIV positive, you’ll need to pay close attention to oral health. Besides diligent brushing and flossing, you or they should also regularly visit the dentist. These visits not only provide diagnosis and treatment of dental problems, they’re also an important monitoring point for gauging the extent of the HIV infection.

Taking care of dental problems will also ease some of the discomfort associated with HIV. Thanks to proper oral care, you or someone you love can experience a higher quality of life.

If you would like more information on oral and dental health for patients with HIV, please contact us or schedule an appointment for a consultation.