A number of factors can lead to dental caries (tooth decay). To find out if you are at high risk, ask yourself these questions.

Is plaque visible in my mouth?
Dental plaque is a whitish film of bacteria that collects on your teeth. If it is clearly visible, it means that there is a lot of it. Among the bacteria in the plaque are those that produce tooth decay, particularly in an acidic environment. (A normal mouth is neutral, measured on the pH scale, midway between the extreme acidic and basic ends of the scale.)

Do I have a dry mouth?
Saliva protects your teeth against decay by neutralizing an acidic environment and adding minerals back to the outer surface of enamel of your teeth, so reduced saliva is a high risk for caries. Many medications can cause dry mouth as a side effect.

Do I eat a lot of snacks, particularly unhealthy ones?
Frequently eating sugars, refined carbohydrates, and acidic foods promotes the growth of decay-producing bacteria. The more frequently you eat, the longer your teeth are bathed in sugars and acids. Acidic foods not only promote bacterial growth, they also directly cause erosion of the tooth's hard surface by softening and dissolving the minerals in the enamel.

Do I wear retainers, orthodontic appliances, bite guards or night guards?
These appliances are recommended for various conditions, but they tend to restrict the flow of saliva over your teeth, cutting down on the benefits of saliva mentioned above.

Do my teeth have deep pits and fissures?
The shape of your teeth is determined by your heredity. If your teeth grew in with deep grooves (fissures) and pits in them, you are at higher risk for bacterial growth and resulting decay.

Do I have conditions that expose my teeth to acids?
If you have bulimia (a psychological condition in which individuals induce vomiting), or GERD (Gastro-Esophageal Reflux Disease), your teeth may be frequently exposed to stomach acids that can cause severe erosion to your teeth.

Do I already have cavities?
Visible cavities can range from those only visible with laser technology or x-ray examination to those a dentist can see with a naked eye. If you already have small cavities, you are at high risk for developing more.

Do I have white spots on my teeth?
White spots are often the first sign of decay in a tooth's enamel. At this point, the condition is often reversible with fluorides.

Have I had a cavity within the last three years?
Recent cavities point to a high risk of more cavities in the future, unless conditions in your mouth have significantly changed.

If you have any of these indications of high risk, contact us today and ask us for suggestions for changing the conditions in your mouth. You can also learn more by reading the Dear Doctor magazine article “Tooth Decay.”

Both diabetes and gum (periodontal) disease are chronic inflammatory diseases that have negative consequences for millions of people worldwide. But before we continue, let's define these two diseases:

Periodontal disease is a condition in which biofilms of dental bacterial plaque stick to teeth near the gum lines causing the gum tissues to become inflamed and infected. If not treated properly and in an early stage, it can cause severe damage to the bone that supports the teeth, resulting in tooth loss. It occurs in the absence of good oral hygiene which includes ineffective daily brushing and flossing and neglecting to see your dentist.

Diabetes is a chronic condition in which blood glucose (sugar) levels become excessive. Glucose is the body's main source of sugar for energy. The hormone insulin, among other mechanisms, normally controls glucose. Prolonged elevated blood sugar levels are harmful and ultimately can even be life threatening if left untreated. With type 1 diabetes, insulin injections (shots) are required to maintain the proper blood sugar levels because the body no longer produces its own blood sugar. Type 2 diabetes is generally less severe and can usually be treated with a combination of diet and medication.

And while both of these diseases share the same common enemy, you, there is scientific evidence revealing links between the two. Diabetes increases the risk factor for developing periodontitis, and conversely, periodontal disease makes it more difficult for diabetics to control blood glucose levels.

Want To Learn More?

Learn more about these two diseases and their relationship by reading, “Diabetes & Periodontal Disease.” Or if you have diabetes but haven't had a dental exam and cleaning in a long time, contact us today to schedule a consultation. You can also use this consultation to discuss any questions or concerns you have about your oral health and its relationship to your diabetes.

More than 2,000 years ago, an ancient Greek physician, Hippocrates, often called the father of Western medicine, devised a mouth rinse of herbs and wine to sweeten bad breath. This problem has been around a long time, and it is still a major problem for many people. According to some studies it is one of the three main reasons people seek dental treatment.

Here are some facts you may not know about bad breath:

• Bad breath is sometimes called halitosis, which comes from the Latin halitus (exhalation) and the Greek osis (a condition or disease-causing process).
• Chronic bad breath is usually caused by certain types of oral bacteria. These particular bacteria are present in about 25% of the population.
• Bad breath has spawned a major industry in the United States. Americans spend nearly three billion dollars a year on gum, mints, and mouth rinses to sweeten their breath. About 60% of women and 50% of men say they use breath freshening products.
• Diseases in the oral cavity such as tooth decay and periodontal (gum) disease can often cause bad breath. If either of these diseases are your cause for bad breath, treatment would be necessary to eliminate this problem.
• The tongue is the most common location for bad breath. Bacteria are relatively sheltered on the back of the tongue, where they live on remnants of food, dead skin cells and post-nasal drip. These bacteria can generate volatile sulfur compounds (VSCs) that are also found in decaying animal or vegetable matter. VSCs are known by an unpleasant rotten egg smell.
• Bad breath can also be caused by dry mouth (xerostomia). This condition affects millions of people and can result from smoking, alcohol or coffee drinking, and it is sometimes a side effect of medications. Another cause may be mouth breathing.
• Halitosis can also originate in other parts of the mouth besides the tongue. These include inter-dental (between teeth) and sub-gingival (under the gums) areas.
• When people are starving (and sometimes when they are dieting to lose weight), their bodies begin burning their fats causing their breath to develop the smell of ketones — which smell like acetone, similar to nail polish remover. If people are not eating or drinking the coating on their tongue increases as well, making VSCs more prominent.

At our office, we want to fight bad breath or halitosis by making sure our patients understand how to clean their teeth, gums, the back of the tongue, and dentures.

Contact us today to schedule an appointment to discuss your questions about bad breath. You can also learn more by reading the Dear Doctor magazine article “Bad Breath: More than just embarrassing.”

If you see blood when you brush or floss your teeth, it generally indicates a problem with your oral health. You may think you are brushing too hard, but this is not usually why gums bleed. The usual culprit is dental plaque.

Plaque is the sticky, whitish film of bacteria that forms on your teeth every day. If you brush regularly, you probably remove most of it — but some may remain behind and accumulate where your teeth meet your gums, particularly between your teeth. As the bacteria build up, along with by-products of their metabolism (the chemical reactions that maintain their lives), they cause inflammation, called gingivitis, in the adjacent gums.

Bleeding gums are an early symptom of gingivitis. Continuing contact with plaque at the gum line can cause your gum tissue to separate from nearby teeth, creating pockets in which the inflammation becomes even worse. The process leads to periodontal disease (“peri” – meaning around, “odont” – tooth). The increasing infection can eat away the bone that anchors the teeth, leading to possible tooth loss. Periodontal disease is not an uncommon problem. About 90% of the population has bleeding gums at some time or another, and approximately 10% go on to develop periodontal disease.

When you lose bone around your teeth, the gums separate from the tooth and “pockets” form between your teeth and gums. The inflammation and infection may continue within the pockets even if your gums have stopped bleeding when you brush. That's why it is important to have regular dental exams — to check up on and stop periodontal disease before it has a chance to cause serious damage.

There may also be other reasons for bleeding gums that have to do with your general state of health. Women who have elevated levels of hormones caused by birth control pills or pregnancy may experience an increased response to plaque that makes their gums bleed more easily. Increased bleeding in your gums can also be caused by some diseases or as a side effect of some medications.

The most important way to prevent bleeding gums is to learn proper brushing and flossing techniques so that you effectively remove plaque from your teeth on a daily basis. If you are not sure you are using the right techniques, make an appointment and have us demonstrate at your next dental visit.

With all the best intentions, some plaque may remain. Plaque that is allowed to stay on your teeth hardens into a substance called tartar or calculus. This must be removed periodically with a professional cleaning by me or by our hygienist.

With not too much effort, you can ensure that your teeth are clean and plaque free, and your healthy gums no longer bleed.

Contact us today to schedule an appointment to discuss your questions about bleeding gums. You can also learn more by reading the Dear Doctor magazine article “Bleeding Gums.”

Gum or periodontal disease is a condition in which “biofilms” or dental bacterial plaque sticks to teeth around the gum line in the absence of good oral hygiene. If left untreated, it causes inflammation of the gums and surrounding tissues of the teeth that can result in “pocketing,” gum recession and bone loss that eventually leads to loose teeth, followed by no teeth! And for about 10 to 15% of those having gingivitis or stage 1 periodontal disease, it can get worse by progressing into chronic periodontal disease. However, the good news is that a conservative and simple treatment called root planing combined with good daily oral hygiene may return your gum tissues to health, and even eliminate the need for gum surgery.

Most of the time, root planing is performed with local anesthesia (numbing shots) in the areas requiring treatment. Anesthesia is an important part because you should always feel relaxed and comfortable during treatment. Because inflamed gum tissues may be quite sensitive, these numbing shots enable us to accomplish our goals and thoroughly remove the problematic material from your teeth's roots.

Root planing or deep cleaning is a routine dental procedure usually done in conjunction with scaling, the removal of the more superficial deposits on the tooth surfaces. Root planing involves physically planing (scraping) the root surfaces of the teeth to remove calculus, bacteria and toxins that are ingrained into their surfaces so that the attached gum tissues can heal. It is carried out with manual hand instruments, ultrasonic electronic instruments or a combination of both for your comfort and best results.

You can learn more about this procedure by reading, “Root Planing.” Or if you want to schedule an appointment to discuss your questions, contact us today.