Perhaps you haven’t thought of it quite this way, but saliva is one of the true wonders of the human body. This unassuming fluid performs a variety of tasks to aid digestion and help protect your mouth from disease. And you hardly notice it — except when it’s not there.
That’s the case for millions of people in America who have a chronic condition called xerostomia or “dry mouth.” This happens when the salivary glands don’t secrete enough saliva, normally two to four pints daily.
Of course, we can experience mouth dryness when we first wake up (saliva flow ebbs while we sleep), feel stressed, use tobacco, or consume alcohol and certain foods like onions or spices. It becomes a problem, though, when periods of low saliva become chronic. Without its preventive capabilities, you’ll be at much higher risk for dental diseases like tooth decay or periodontal (gum) disease.
Chronic dry mouth can occur for various reasons: systemic diseases like cancer or autoimmune deficiencies can cause it, as well as radiation or chemotherapy treatments. One of the most common causes, though, is medication, both over-the-counter and prescription. The surgeon general identifies over 500 known drugs that may inhibit saliva production, including some antihistamines, diuretics and antidepressants. It’s often why older people who take more medications than younger people suffer more as a population from dry mouth.
Because of its long-term health effects, it’s important to try to boost saliva flow. If your mouth is consistently dry, try to drink more fluids during the day. If you suspect your medication, see if your physician can prescribe a different drug. It also helps to drink a little water before and after taking oral medication.
We may also recommend medication or other substances that stimulate saliva or temporarily substitute for it. Xylitol, a natural alcohol sugar that also inhibits bacterial growth, can help relieve dryness. You’ll often find it in gums or mints.
Chronic dry mouth is more than a minor irritation — it can lead to more serious conditions. In addition to these tips, be sure to also keep up your regular dental visits and maintain a daily schedule of oral hygiene to prevent dental disease.
If you would like more information on overcoming 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.”
What's an actor's most important feature? According to Vivica A. Fox, whose most recent big-screen role was in Independence Day: Resurgence, it's what you see right up front.
"On screen, your smile and your eyes are the most inviting things that bring the audience in" she said. "Especially if you play the hot chick."
But like lots of people, Vivica reached a point where she felt her smile needed a little help in order to look its best. That's when she turned to a popular cosmetic dental treatment.
"I got veneers years ago," Ms. Fox told Dear Doctor magazine in a recent interview, "just because I had some gapping that probably only I noticed."
What exactly are dental veneers? Essentially, they are thin shells of lustrous porcelain that are permanently attached to the front surfaces of the teeth. Tough, lifelike and stain-resistant, they can cover up a number of defects in your smile — including stains, chips, cracks, and even minor spacing irregularities like the ones Vivica had.
Veneers have become the treatment of choice for Hollywood celebs — and lots of regular folks too — for many reasons. Unlike some treatments that can take many months, it takes just a few appointments to have veneers placed on your teeth. Because they are custom made just for you, they allow you to decide how bright you want your smile to be: anywhere from a natural pearly hue to a brilliant "Hollywood white." Best of all, they are easy to maintain, and can last for many years with only routine care.
To place traditional veneers, it's necessary to prepare the tooth by removing a small amount (a millimeter or two) of its enamel surface. This keeps it from feeling too big — but it also means the treatment can't be reversed, so once you get veneers, you'll always have them. In certain situations, "no-prep" or minimal-prep veneers, which require little or no removal of tooth enamel, may be an option for some people.
Veneers aren't the only way to create a better smile: Teeth whitening, crowns or orthodontic work may also be an alternative. But for many, veneers are the preferred option. What does Vivica think of hers?
"I love my veneers!" she declared, noting that they have held up well for over a decade.
Confused about which toothpaste to buy? You’re not alone — we’re all regularly confronted with multiple choices when we shop.
But you can simplify your decision-making process by first remembering that toothpaste has one main objective: helping to break down and remove dental plaque when you brush. Plaque is a thin film of bacteria and food particles that if you don’t remove through brushing and flossing could trigger tooth decay or periodontal (gum) disease.
Toothpastes contain abrasives and detergents to help make this possible. Abrasives like hydrated silica are gritty substances that work with the mechanical brushing action to loosen plaque. Detergents (usually sodium lauryl sulfate) help loosen and break down particles on your teeth that won’t otherwise dissolve with water alone. The combination of these ingredients and daily brushing action enables you to remove a substantial portion of plaque from your teeth every day.
These ingredients (along with others to retain moisture and bind everything together) are the foundation of any toothpaste. There are other additives, however, that you may also want to consider. The most important is fluoride, a naturally-occurring chemical proven to strengthen enamel against tooth decay. If you’re interested in a brighter smile, you can also look for bleaching agents that may help whiten some enamel staining. And, of course, there are various flavors to suit your taste.
You’ll also want to pay attention to ingredients if you have special concerns. If you have sensitive teeth, your dentist may recommend particular brands that help reduce discomfort. You’ll also want to be on the lookout for ingredients that you may be allergic to like the aforementioned sodium lauryl sulfate or flavors like cinnamon. Be sure to read the ingredients label if you have known issues with certain substances.
And while you’re reading the packaging look for one more thing — the American Dental Association Seal of Approval. This seal means any manufacturer claims for lower occurrences of cavities or other effects by that toothpaste have been independently verified.
It can be overwhelming amid all the product messaging to decide which toothpaste is right for you. But by knowing these basic facts about toothpaste, you can feel more confident choosing the right one to help keep your teeth and gums clean and healthy.
If you would like more information on oral hygiene products, 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 “Toothpaste: What’s in it?”
Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.
“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…
For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.
When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.
A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.
But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.
Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!
If you have questions about repairing chipped teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”
Many people learn they have periodontal (gum) disease after noticing gum swelling, soreness or bleeding. But what you can see or feel may be only the tip of the iceberg — the damage may extend much deeper.
Gum disease is caused mainly by dental plaque, a thin film of bacteria and food particles built up on teeth due to ineffective brushing and flossing. Infection of the visible gums is only the beginning — left untreated, it can advance well below the gum line and even infect supporting bone.
One critical concern in this regard is the areas where the roots of a tooth separate from each other, known as furcations. Here an infection known as a furcation invasion can cause the bone to weaken and dissolve.
This usually occurs in stages (or classes) we can detect through manual probing and/or with x-rays. In the earliest stage, Class I, we might only notice a slight pocket in the gums with no significant bone loss. In Class II, though, the pocket between the roots has become a horizontal opening of two or more millimeters, indicating definite bone loss with increased pocket depth getting “under” the crown of the tooth. Class III, the last and most serious stage, describes an opening we can probe under the crown all the way to the other side of the tooth; the bone loss now extends “through and through” the furcation.
The basic goal of gum disease treatment is to remove plaque and calculus (tartar) from all tooth and gum surfaces. But removing plaque below the gum line, especially “into” the furcations, can be challenging. We will need instruments called scalers to clean root surfaces, assisted sometimes by ultrasonic equipment to vibrate plaque loose. With furcations we may also need to employ surgery to aid gum or bone tissue regeneration or to make the area easier to access for future cleaning.
Of course, the best way to protect against furcation invasions is to prevent gum disease in the first place. Be sure to brush and floss daily and visit us for thorough dental cleanings and checkups at least every six months.
And don’t delay contacting us if you see any signs of teeth or gum problems. The sooner we can identify gum disease, the more likely we’ll be able to prevent it from doing serious damage to your gums, bone and teeth.
If you would like more information on treating gum 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 “What are Furcations?”
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