By Iris L. Shields, DDS
August 13, 2019
Category: Dental Procedures
Tags: crown  
AStainlessSteelCrownCouldExtendtheLifeofaPrimaryMolar

One of the key elements in a child’s development is their first set of teeth. Although primary (“baby”) teeth last only a few years, they’re critically important for enabling a child to eat solid foods, speak and smile.

But they also provide one more important benefit—they hold the space in the jaw reserved for the permanent teeth developing just under the gums until they erupt. But if a child loses a primary tooth prematurely because of disease or injury, other teeth may drift into the vacant space and crowd it out for the intended permanent tooth. It may then come in misaligned or remain stuck within the gums (impaction).

To avoid this, we try to treat and preserve a diseased primary tooth if at all practical. For a primary molar, one of the large teeth in the back of the mouth, this might include capping it with a stainless steel crown.

Why a metal crown? Primary molars normally don’t fall out until around ages 10-12, so it may be years for a younger child before their permanent molars erupt. All during that time these particular teeth will encounter heavier biting forces than teeth in the front.

A steel crown is often the best solution for a molar given their longer lifespans and encountered biting forces. The crown’s metal construction can stand up to these forces while still protecting the tooth from re-infection from decay. And because molars are typically outside of the “smile zone” occupied by more visible front teeth, the crown’s metal appearance isn’t usually an aesthetic issue.

Crowning a molar usually takes one visit, a dentist typically performing the procedure with local anesthesia and possibly a mild sedative like nitrous oxide gas (“laughing gas”). After removing any decayed structure from the tooth, the dentist will then fit a pre-formed crown over the remaining structure, sized and shaped to match the original tooth as close as possible.

A stainless steel crown is a cost-effective way to added needed years to a primary molar that could otherwise be lost prematurely. Preserving it may help a child avoid bite problems and expensive future treatments.

If you would like more information on dental care 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 “Stainless Steel Crowns for Kids: A Safe and Effective Way to Restore Primary Molars.”

NationalFreshBreathDayRemindsUstoSeekOuttheSourceofBadBreath

Be sure to mark August 6 on your calendars—and not just because it's the day in 1661 when the Dutch sold Brazil to Portugal, or when President Johnson signed the Voting Rights Act in 1965, or when the Ramones performed for the last time in 1996. August 6 also happens to be National Fresh Breath Day! But since fresh breath is important to us every day, we like to celebrate all month long.

Celebrating fresh breath might not seem as noteworthy as these other historical moments, but if you're a frequent halitosis (bad breath) sufferer, you know it can be downright embarrassing. More importantly, it could be a sign of a deeper health problem. It turns out there are a number of reasons why you might have bad breath. Here are the most common.

You're not adequately cleaning your mouth. Certain strains of bacteria are known for emitting volatile sulfur compounds, which give rise to that "rotten egg" smell and are a major component of bad breath. Because they feed on leftover sugars and proteins from food, you can keep them and their noxious odors at bay by brushing and flossing your teeth and brushing the broad surface of the tongue, a prime breeding ground for these bacteria.

You're not producing enough saliva. This unsung bodily fluid is a key part of good oral health. Besides helping to rinse the mouth of food particles after eating, saliva also fights odor-causing bacteria. If your mouth is dry because you're not producing enough saliva, bacteria can grow and create a number of oral health problems, including bad breath. You may be able to relieve chronic dry mouth and accompanying bad breath by using saliva-boosting agents or drinking more water. You should also talk to your doctor about any medications you're taking that might interfere with saliva production.

It could be caused by disease. Tooth decay or periodontal (gum) disease naturally give rise to bad breath—but so can other diseases like diabetes, cancer or respiratory infections. As you're dealing with these other conditions, you may also need to contend with bad breath as a side effect. You can help reduce any disease-based odors by keeping up your daily oral hygiene, especially if you're undergoing treatment for a systemic condition. Obtaining treatment, particularly if you have tooth decay or gum disease, will help reduce these embarrassing foul odors.

National Fresh Breath Day may not share the same pedestal with other momentous August dates, but if it reminds you to keep your mouth clean and see your dentist regularly, fresh breath certainly deserves its own day.

If you would like more information about the causes and remedies for bad breath, please contact us or schedule an appointment for a consultation. To learn more, read the Dear Doctor magazine articles “Bad Breath: More Than Just Embarrassing” and “Dry Mouth.”

DiabetesDoesntHavetoStopYouFromGettinganImplant-ifitsUnderControl

You would love to replace a troubled tooth with a dental implant. But you have one nagging concern: you also have diabetes. Could that keep you from getting an implant?

The answer, unfortunately, is yes, it might: the effect diabetes can have on the body could affect an implant's success and longevity. The key word, though, is might—it's not inevitable you'll encounter these obstacles with your implant.

Diabetes is a group of metabolic diseases that interfere with the normal levels of blood glucose, a natural sugar that is the energy source for the body's cells. Normally, the pancreas produces a hormone called insulin as needed to regulate glucose in the bloodstream. A diabetic, though either can't produce insulin or not enough, or the body doesn't respond to the insulin that is produced.

And while the condition can often be managed through diet, exercise, medication or supplemental insulin, there can still be complications like slow wound healing. High glucose can damage blood vessels, causing them to deliver less nutrients and antibodies to various parts of the body like the eyes, fingers and toes, or the kidneys. It can also affect the gums and their ability to heal.

Another possible complication from diabetes is with the body's inflammatory response. This is triggered whenever tissues in the body are diseased or injured, sealing them off from damaging the rest of the body. The response, however, can become chronic in diabetics, which could damage otherwise healthy tissues.

Both of these complications can disrupt the process for getting an implant. Like other surgical procedures, implantation disrupts the gum tissues. They will need to heal; likewise, the implant itself must integrate fully with the bone in which it's inserted. Both healing and bone integration might be impeded by slow wound healing and chronic inflammation.

Again, it might. In reality, as a number of studies comparing implant outcomes between diabetics and non-diabetics has shown, there is little difference in the success rate, provided the diabetes is under control. Diabetics with well-managed glucose can have success rates above 95%, well within the normal range.

An implant restoration is a decision you should make with your dentist. But if you're doing a good job managing your diabetes, your chances of a successful outcome are good.

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

By Iris L. Shields, DDS
July 14, 2019
Category: Oral Health
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.

By Iris L. Shields, DDS
July 04, 2019
Category: Oral Health
Tags: tooth decay  
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.”





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