By Dr. David L. Carlson
May 10, 2019
Category: Oral Health
Tags: oral hygiene  
HeresHowtoCarefor3CommonDentalRestorations

Today's dental restorations are truly amazing. Not only are they life-like and functional, they can endure for many years a hostile environment of bacteria, acid and heavy biting forces.

Even so, you'll still need to take care of your restorations to help them last. Here's how to extend the life of 3 common forms of dental work.

Fillings. We use fillings, both metal amalgam and tooth-colored materials, to repair holes or cavities in teeth caused by tooth decay. Although strong, dental fillings can break if you subject them to abnormally high biting force (like chewing ice). There's also a chance that if a slight separation occurs between the filling and tooth, bacteria can take up residence and reignite the decay process. To prevent this, practice a daily regimen of oral hygiene to clean away bacterial plaque—and reduce sugar in your diet, a prime food source for bacteria.

Veneers. Usually made of thin porcelain, veneers are bonded to the front of teeth to mask chips, stains, gaps or other blemishes. But although they're strong, veneers aren't immune to damage. Habits like biting nails, the aforementioned ice chewing or unconsciously grinding your teeth could cause a chipped veneer. And if periodontal (gum) disease causes your gums to recede, the exposed part of the tooth may look noticeably darker than the veneer. To protect your veneers and their appearance, avoid habits like ice chewing, and seek treatment for teeth grinding and dental disease.

Bridgework. Bridges are used to replace one or more missing teeth. Traditional bridges use the natural teeth on either side of the gap to support the bridge; for a single missing tooth, implants are a preferable option because they don't require permanently altering the neighboring teeth to support it. With either option, though, you should brush and floss around the restoration to reduce the risk of dental disease. Infections like gum disease or tooth decay could eventually weaken the bridge's supporting teeth or gum disease can damage an implant's gum and bone support.

With any dental restoration, be sure to practice daily oral hygiene, eat a nutritious, low-sugar diet, and see your dentist regularly for cleanings and checkups. Taking care of your dental work will help it take care of you for a long time to come.

If you would like more information on maintaining your dental restorations, please contact us or schedule an appointment for a consultation.

By Dr. David L. Carlson
April 30, 2019
Category: Oral Health
JamieFoxxChipsaTooth-ThisTimebyAccident

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.”

By Dr. David L. Carlson
April 20, 2019
Category: Oral Health
Tags: oral health   dentistry  
MonitoringBloodPressureisAlsoImportantDuringDentalCare

You may think your blood pressure is only important to your general health — but it can also affect your dental care. That’s why it’s increasingly common for dental providers to include blood pressure monitoring for patients during routine visits.

High blood pressure is a risk factor for several major health conditions including heart attack, stroke and diabetes, and is one of the most common diagnoses in the United States. Even so, many people don’t know their blood pressure is abnormally high. It may be discovered during an annual health visit, or not at all. Since many people visit their dentist twice a year for cleanings, taking a blood pressure reading during these visits increases the chance of detecting a high pressure.

In one study published in the Journal of the American Dental Association, the researchers looked at dental patients who had not seen a doctor in the previous twelve months and who underwent blood pressure screening during a regular dental visit. Seventeen percent of those studied learned they were at increased risk for cardiovascular disease.

High blood pressure can also have a direct effect on how we treat your teeth and gums. For example, we may have to adapt and become more diligent about preventing dental disease if you’re taking a blood pressure drug that could trigger reduced saliva flow (dry mouth), a factor in tooth decay. Certain local anesthetics may also contain substances like epinephrine that constrict blood vessels, which can increase blood pressure. To avoid this if you’re hypertensive, we may need to adjust the dosage of anesthetic drugs to lessen this effect.

Monitoring blood pressure in the dental office is a good example of how all healthcare services can interact with each other. At the very least, a blood pressure check at your next cleaning could alert you to a potentially dangerous condition you didn’t even know you had.

If you would like more information on the relationship of blood pressure and other medical issues to 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 “Monitoring Blood Pressure.”

By Dr. David L. Carlson
April 10, 2019
Category: Oral Health
Tags: tooth decay  
3WaystoReducetheBacteriainYourMouththatCauseToothDecay

Tooth decay doesn’t suddenly appear out of the blue. Cavities and other damage are the result of a long process that begins with bacteria living in a thin biofilm on tooth surfaces known as plaque. These bacteria thrive on sugars from leftover food in your mouth and then produce acid as a waste product. Chronic high levels of acid cause your enamel, the protective layer of your teeth, to soften and erode.

While there are treatment options at each stage of decay — including crowning or even tooth replacement — the best approach is to try to prevent plaque buildup that supports disease-causing bacteria. Here are 3 of the best ways you can do that.

Brush and floss daily. It usually takes 12-24 hours for enough plaque buildup to support bacteria. By brushing and flossing at least once a day, you can remove most of this buildup, with twice a year dental cleanings to remove hard to reach plaque you may have missed. Be sure to use fluoride toothpaste to help strengthen enamel against high acid. And wait a half hour to an hour after eating before brushing to give saliva time to reduce the acid level in your mouth.

Cut back on sweets. You’re not the only one who loves sugary snack foods — so do oral bacteria. The more sugar and other carbohydrates they feast on, the more they produce acid. The best approach is to cut out sugar-rich snacks altogether and instead snack on fresh fruits, raw vegetables or dairy products. Limit sweet treats to meal times.

Use decay-fighting supplements. Your mouth and hygiene efforts may need a little assistance, especially if you have low saliva flow. You can boost this with an artificial saliva supplement as well as with products containing xylitol, an alcohol-based sugar. Xylitol also has an added benefit in the fight against decay because it inhibits bacterial growth. And be sure to talk with us first before taking any dental supplement.

If you would like more information on dental hygiene and 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 “Cost-Saving Treatment Alternatives.”

By Dr. David L. Carlson
March 31, 2019
Category: Oral Health
Tags: tooth decay   nutrition   sugar  
LimitSugarinYourDietforBetterOralandGeneralHealth

Even after decades emphasizing oral hygiene and supplemental fluoride to fight dental disease, we’re now seeing an increase in tooth decay, especially among children. What’s causing this alarming trend?

Many in both the dental and medical professions link this and other health problems to a rise in the amount and consumption of sugar added to food products. A number of years ago our annual average consumption of added sugar was about 4 pounds per person; today, it’s closer to 90 pounds.

The increase in sugar consumption can be traced to the 1970s when the food industry began adding more sugar to make processed foods stripped of oils and fats taste better. Today, 77% of the approximately 600,000 food items sold in the United States contain some form of sugar (under a variety of names).

This additional sugar, however, has produced an unintended consequence: sugar triggers the release of a brain chemical called dopamine that regulates our sense of reward when we engage in a desirable behavior. The excess dopamine creates a weak addiction to sugar, which then leads to overconsumption, contributing to our current obesity epidemic and the rise in health problems like heart disease or Type 2 diabetes. This is especially alarming among children: thirty years ago Type 2 diabetes was unheard of among children — today there are over 55,000 diagnosed pediatric cases.

For both you and your family’s general and dental health, you should consider ways to reduce your sugar intake: purchase and eat most of your food from the “outer edges” of your supermarket — meats, dairy, and fresh vegetables and fruits (which do contain the sugar fructose, but are mostly fiber that slows the liver’s processing of the sugar); limit processed foods with added sugar, and learn to recognize its inclusion in products by reading ingredients labels. You should also be wary of sweetened beverages such as sodas, sports drinks, teas or juices, and try to drink more water.

The recommended daily sugar consumption is less than six teaspoons a day (about two-thirds the amount in one can of soda). By restricting this consumption, you’ll improve your general health and reduce your risk for dental disease.

If you would like more information on the general and dental health effects of sugar, please contact us or schedule an appointment for a consultation.





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