My Blog

By Scott R. Smith, DDS, PC
November 29, 2020
Category: Oral Health
Tags: fluoride  
NewRecommendationsMakeWaterFluoridationSaferThanEver

For over half a century now, community water systems have been adding fluoride to drinking water to help reduce the risk of tooth decay. Numerous long-term studies have demonstrated the soundness of this practice, prompting the U.S. Centers for Disease Control to call water fluoridation one of the ten most effective public health measures of the 20th Century.

In the 1960s, after years of study into the teeth-strengthening effects of fluoride, the U.S. Public Health Service recommended that drinking water utilities add fluoride at a rate of between 0.7 and 1.20 milligrams per liter (mg/L) or parts per million (ppm) of water. This recommendation held fast until 2015 when the service changed the recommendation to no more than 0.7 mg/L.

Why the change to guidelines that had been in place for over fifty years? The revision was in response to an increasing occurrence of dental fluorosis. This condition happens when the teeth absorb more fluoride than necessary, leading to discoloration of the surface enamel, creating effects like small white spots or brownish “mottling.”

Dental fluorosis is the only known health condition caused by fluoride. As such, it doesn't damage the tooth itself, and is mainly a cosmetic problem. But it can still be avoided if fluoride intake is kept at moderate levels.

The original recommendation was sound science when first introduced. Since then, though, the prevalence of fluoride in everyday life has grown, with the chemical commonly found in dental care products like toothpastes or mouthrinses, as well as many processed foods and beverages and even infant formula. Our society's overall intake of fluoride has been growing as a result.

The new recommendation came after several years of research to verify water fluoridation levels of 0.7 mg/L would still be effective in the fight against tooth decay while lowering the risk of dental fluorosis. With this adjustment, this important and safe measure for keeping your family's teeth protected against disease is safer than ever.

If you would like more information on how fluoride can help your family fight tooth decay, please contact us or schedule an appointment for a consultation.

By Scott R. Smith, DDS, PC
November 19, 2020
Category: Oral Health
Tags: oral health   smoking  
HeresWhySmokingCanBeHazardoustoYourDentalHealth

During his exploration of the Americas, Christopher Columbus encountered a native in a canoe loaded with water, food and a strange bunching of leaves. This marked the first European encounter with tobacco, a discovery that still haunts us to the present day. Today, millions smoke tobacco—and many suffer serious health problems as a result, including dental diseases like tooth decay and gum disease.

The American Cancer Society is sponsoring its 44th annual Great American Smokeout this November 19 when health providers across the country encourage smokers to kick the tobacco habit. Dentists will certainly be among them: Studies show that smokers are five times more likely to lose teeth than non-smokers due to a higher incidence of dental disease. Here's why.

Increased plaque and tartar. The main cause for tooth decay and gum disease is dental plaque, a thin, bacterial film that builds up on teeth. Brushing and flossing, along with regular dental cleanings, can keep plaque and its hardened form tartar from accumulating. But substances in tobacco restrict the flow of saliva needed to curb bacterial growth. This in turn can increase plaque accumulation and the risk for disease.

Hidden symptoms. Your gums often “tell” you when you have early gum disease by becoming swollen and red, and bleeding easily. But if you smoke, you might not get that early warning—the nicotine in tobacco interferes with your body's inflammatory response, so your gums, although infected, may look normal. By the time you find out, the infection may have already spread, increasing your chances of tooth loss.

Slow healing. Nicotine can also constrict the mouth's blood vessels, slowing the delivery of nutrients and infection-fighting antibodies to your teeth and gums. As a result, your body may have a harder time fighting tooth decay or gum disease, and diseased tissues can take longer to heal. Slower healing can also complicate the process of getting dental implants.

Increased oral cancer risk. Although it's not as prevalent as other cancers, oral cancer is still among the deadliest with a dismal 50% survival rate after five years. Smokers are six times more likely than non-smokers to develop oral cancer. But by quitting smoking and other forms of tobacco, you could reduce your oral cancer risk to that of a non-user in just a few years.

Kicking the smoking habit often takes a monumental effort, but it's worth it. Quitting not only improves your overall well-being, it could help you gain healthier teeth and gums. To learn how, see us for an up-to-date dental exam—we can show you how getting Columbus's most notorious discovery out of your life could do wonders for your smile and dental health.

If you would like more information about the effects of tobacco on your oral health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Smoking and Gum Disease” and “Strategies to Stop Smoking.”

By Scott R. Smith, DDS, PC
November 08, 2020
Category: Dental Procedures
Tags: dental implant  
AToothinaDayImplantCouldGiveYouaPerfectSmileFromDayOne

Getting a new implant tooth in only one day sounds too good to be true. But it's true—up to a point. Whether or not you can undergo an immediate crown replacement (attaching a crown to an implant right after surgery) will depend mostly on the underlying bone.

Traditionally, an implant crown isn't attached until several weeks after surgery to allow bone cells to grow and adhere to an implant's titanium surface (osseointegration). The gums are sutured back in place to protect the metal implant until it develops a durable hold within the bone. But this also leaves you with a noticeable missing tooth gap during the integration period.

A “tooth in a day” procedure gives you a full smile right after implant surgery. There is one catch, though—this first crown will be temporary and it won't be able to receive biting pressure.

Until the bone and implant fully integrate, attaching a full-sized permanent crown can damage the implant. To avoid this, the initial crown is slightly shorter than the future permanent crown. This prevents it from contacting solidly with teeth on the other jaw while biting or chewing, which can generate enough force to potentially damage the implant.

If you undergo an immediate-load crown on your implant, you'll have to return later for the full-length permanent crown. In the meantime, though, you'll avoid the embarrassment of a missing tooth in your smile.

With that said, the target bone must be healthy and intact for you to undergo a “tooth in a day” procedure. That isn't always the case with missing teeth—over time, bone volume can gradually diminish. The subsequent loss can complicate implant placement, which must be exact to achieve the most natural outcome. If extensive bone loss exists, you may need grafting to build up enough bone to adequately support an implant.

Even if an implant can be placed, the bone may still be too weak to allow for immediate crown placement. In that case, the traditional procedure may be the best course to allow the bone and implant to fully bond.

To determine if you're a candidate for a “tooth in a day” implant procedure, you'll first need to have a thorough dental exam that includes an assessment of bone health. If it's sound, you may be able to have a full smile right after implant surgery.

If you would like more information on dental implant restorations, 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 “Same-Day Tooth Replacement With Dental Implants.”

By Scott R. Smith, DDS, PC
October 29, 2020
Category: Oral Health
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.”

By Scott R. Smith, DDS, PC
October 19, 2020
Category: Oral Health
Tags: oral hygiene  
ProtectYourselfFromGumDiseasefortheHealthofYourMouthANDYourBody

October is National Dental Hygiene Month, when we call attention to the importance of keeping those pearly whites clean. Brushing and flossing, along with regular dental cleanings, protect your teeth and gums from dental disease. It might also lessen the risk or severity of heart disease, arthritis—or even dementia or Alzheimer's disease.

Sound far-fetched? A number of years ago, researchers noticed that people with periodontal (gum) disease were also more prone to systemic conditions like chronic heart and lung diseases, diabetes or rheumatoid arthritis. The common thread: inflammation, the body's response to infection or trauma.

Inflammation in and of itself is a necessary part of the healing process. But if it becomes chronic, as it often does with a gum infection and these other systemic diseases, this defensive response meant to aid healing can instead damage tissues.

We've also learned that inflammation arising from gum disease may worsen inflammation associated with other systemic conditions. It can work the other way as well: If you have an inflammatory disease, your risk for gum disease goes up and any gum infection can be more acute.

What we've learned recently, though, might be even more concerning: Results from a recent study are showing some evidence of a link between gum disease and dementia and decline in cognitive ability. The study, published in the journal Neurology this past July, followed approximately 8,000 Americans for twenty years. Participants came from a variety of locations and demographic subsets, and were on average in their early sixties with no signs of dementia at the beginning of the study.

Of the participants who completed the study, about 19% had developed dementia. Of these participants, those with severe gum disease and tooth loss were slightly more likely to have dementia than subjects with healthy teeth and gums.

At the very least, these studies raise more questions about the connections between oral and general health, calling for further exploration. One thing's for sure, though—healthy teeth and gums play an important role in the overall quality of life and health. The time and effort required for the following are well worth it to maintain a healthy mouth.

  1. Brush and floss your teeth every day without fail;
  2. Visit your dentist at least twice a year for professional cleanings;
  3. Eat a “tooth-friendly” diet low in sugar and rich in vitamins and minerals (especially calcium);
  4. See your dentist as soon as possible if you notice swollen, reddened or bleeding gums.

We all want to stay fit and active throughout our senior years. Taking care of your teeth and gums—especially with daily oral hygiene—is a key part of the formula for a long and happy life.

If you would like more information about the importance of dental hygiene to overall health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “10 Tips for Daily Oral Care at Home.”





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