There is no way around it: smoking and drinking have a detrimental effect on your dental health, in addition to the rest of your body’s health. There could be arguments about the benefits of a glass of red wine or the medical use of marijuana, but as your health provider, my message is to encourage a clean , healthy drug-free way of living! When you smoke tobacco or drink alcohol, the harmful substances introduced to your body have adverse effects on your organs, and are both addictive and linked to cancers. As far as to your dental health, they can lead to tooth staining and discoloration, tooth decay, gum inflammation and disease, bone loss even tooth loss, as well as an increased risk of developing oral cancer.
Smoking and drinking directly passes foreign material through the oral cavity, generating adverse effects on your oral cavity. Alcohol is a desiccant (drying things up); heavy drinking dramatically decreases moisture needed to maintain a healthy oral cavity. A dry mouth increases one’s likelihood of developing tooth decay, gum disease, bad breath, fungal infection, burning sensations or soreness of the mouth. Alcohol’s acidic nature can also erode the enamel coating on a drinker’s teeth, leading to an increased chance of sensitivity and decay. Long-term contact with alcohol in the oral cavity has also been found to be possibly carcinogenic. Frequent drinking will dramatically increase the ability of cancer-causing substances present in alcoholic beverages to penetrate the lining of your mouth, such as Acetaldehyde – which forms in a person’s mouth after using alcoholic mouthwash (suspected to be carcinogenic).
Smoking is equally detrimental to your oral health. Bad breath (halitosis), sinusitis and tooth discoloration will be the first signs of oral stress of a smoker, as nicotine and tar present in cigarette smoke stains the teeth. Smoking can also result in gum disease, leading to bone loss and tooth loss from decreases in blood flow and oxygen level, and increased plaque and tartar build-up. Smoking also raises the temperature of your mouth to 140-160º F, causing constant irritation and inflammation. An increased risk of developing oral cancer is also a consequence which should not to be over looked – there are 4000 different chemicals in tobacco smoke and 50 are known carcinogens. Nearly 90% of all oral cancer patients are smokers!
Smoke exposure has deteriorated this oral cavity.
In all, smoking and drinking equally wreak havoc on your teeth, gums and oral environment. Avoid smoking and drinking at all costs, and keep your oral hygiene in tip-top condition by brushing , flossing , fluoridation, proper nutrition, and increasing the intake of supplements of vitamin Bs and C. Antioxidants are essential as well.
Do you have a gummy smile? Do your teeth appear too small, or there is too much gum showing? Aesthetic crown lengthening is a procedure which could improve your smile if you selectively decide to change the proportion of your teeth and gum.
Before Lengthening:
After Lengthening:
Your teeth are secured to your jaw via root structures that extend from the teeth into jaw bone. This bone is protected by the gums, which extends down over the top of the tooth root structure. Excess gum tissue poses no health risk, but can be unsightly and make your teeth look tiny or not as harmony with your face. Aesthetic crown lengthening remedies this condition by trimming away excess gum (and in some cases bone), reducing the amount of display of gum and lengthening the visible crown of the tooth. Gingival (gum) contouring (like a gingival plasty or soft tissue crown lengthening) refers to trimming of the gum tissue only. Most crown lengthenings refer to the recontouring of both the gum and supporting bone (osseous crown lengthening), when there is more length of the tooth is desired.
Traditionally, crown lengthening is performed with scalpel and mechanical rotary tool which trim and flap open the gum also trim away some bone tissue. This mechanical force results unfavorable inflammatory response of the periodontal tissues and taking up to 8 weeks to heal. The tissue must fully heal before restorations can take place. This procedure is often daunting to many patients!
Thankfully, new technology in the laser dentistry field has made aesthetic crown lengthening much easier and less invasive. By using a small fiber optic tip, laser energy can be manipulated to trim or ablate away tissues , disturbing the surrounding environment much less than traditional mechanical rotary instruments. The less invasive procedure means less pain, quicker healing and less trauma. The body does not react violently to laser treatment as it does blunt mechanical treatment!and often time the restorative work can be initiate quickly or even at the same visit. In some cases, crown lengthening alone can get you desirable bigger smile,but often time , the restorative work like bonding, veneers or crowns are called for the needed improvement or protection on dental structure.
When gingival contouring or crown lengthening is performed – but left with a compromised biological width (2 to 3mm is necessary for safe formation of a protective zone from the gum border to the bone) - gum tissue will stay inflammed and grow back after several months. It is important to have an experienced dental professional for proper diagnosis before getting your gum trimmed. Find a dental professional who been properly trained using lasers for a more comfortable surgical experience (www. Laserdentistry.org). The design of the smile and the shaping of the gum line both need an aesthetic touch (apart from solid surgical technique), so it is equally important for the dental professional have aesthetic background to assure the best aesthetic result (www. aacd.com).
Laser Gum treatment is an exciting treatment modality for treating and managing gum disease. Laser dentistry has been around for two decades, it is very useful in many applications on soft or hard tissues: the focused energy allows for precision treatment while minimizing pain and recovery time. Although only 6 to 7% of dental practices utilize laser technology so far, you may benefit greatly from laser dentistry.
Periodontal disease in particular is a fantastic candidate for laser treatment. The nature of periodontitis (gum disease) involves bacterial growth which affects the supporting structures of the teeth, destroying attachment tissues which create deep periodontal pockets that are not easily cleanable (causing the gum disease to progress). Gum tissue responds very well to laser energy, which removes diseased linings in the periodontal pocket and also kills the bacteria. The laser-tissue interaction is thermal, controlled energy from the selected tip of the laser fiber will evaporate the inflamed unhealthy lining tissue ; its rising temperature will also kill any pathogen present in the tissue. The clean and less traumatic site becomes more efficient and comfortable for your healing. Other benefits of laser treatment include biostimulation (photo-biomodulation) on the cellular level , which energizes damaged cells through light receptors , allowing tissue to heal promptly!
The laser gum treatment is usually administered in conjunction with traditional scaling and root planning (SRP) services, performed with ultrasonic or hand instruments that remove toxic calculus from the root surface. Unlike more traditional methods which use a scaler to scrape away diseased tissue, the laser approach treats the diseased tissues with electromagnetic energy to ablate diseased tissues non-evasively, followed by irrigation with antiseptic solution (chlorhexidine) to flush away and clean the periodontal pockets. For more severe cases, localized placement of certain antibiotic agents (like Arestin minocycline hydrochloride) inside the treated periodontal pocket can assure a complication-free healing process without systemic effects. Low level laser therapy can also be applied to decrease post-operative discomfort and promote healing through photo-biomodulation.
Laser gum treatment has provided tremendous patient benefits as I have witnessed since it has been incorporated into my practice since 1997, but this treatment modality has raised some eyebrows in the periodontal community. It is difficult to establish a parameter with energy and expect to have consistent result on different subjects; there are too many variables from the color, texture, composition and condition of the tissues, whether the origin of the cause has been managed and how the different laser energy is handled by various operators. There are studies which have proven different results, and over-promising commercials also exist which have discouraged development of laser gum treatment.
When properly conducted, laser gum treatment provides a cleaner and more comfortable site for healing. The predictability of tissue regeneration, however, is too complicated for a blog discussion! I do recommend you go to a reliable, non-biased source like The Academy of Laser Dentistry to learn more about the benefits of laser treatment or referrals of certified laser dentists.
It really sounded like wishful thinking, but it’s true that sometimes tooth discomfort does go away on its own.
Tooth sensitivity is a problem that many, many people suffer from caused by a multitude of reasons – but does it merit a visit to your dentist? Yes, it is in your best interest to receive a proper diagnosis. This will allow you to make an educated plan of action to have a trouble-free healthy mouth.
In some situations, the toothache or sensitivity comes and goes and is most likely a reversible inflammatory response of the tooth. Once the irritant is removed, the symptoms subside. The transient inflammation of the pulpal tissue (within the tooth) or the gum could reverse on its own because our body is capable of repairing and regenerating itself at a molecular and cellular level. As long as irritating and / or destructive factors are controlled (such as thermal, bacterial, mechanical and chemical forces) and your body is in healthy shape, your body should do its job and heal properly. At the inflammatory stage, diagnosis will rely on a clinical exam (visual and instrumental exploration, and a tooth vitality test), as well as your oral history and x-rays.
Once you have properly diagnosed your source of pain, a solution can be found. If the exam shows your tooth already has irreversible pulpitis or infection, a root canal will likely be advised. If the toothache is from decay or damaged, insufficient tooth structure, the tooth should be cleaned and restored. If the sensitivity is from gum recession and root exposure, fluoride desensitization, gum grafts or the wearing of a night guard (if bruxismor TMJ is a contributing factor) may be recommended. If you are going through orthodontic treatment (braces) or are in a transitional stage of dental treatment, ask your dental professional to check if something can be improved to make you feel better. If you have a poor diet or drink soda or alcohol, acidic erosion is likely stripping your tooth structure away, exposing dentin and causing sensitivity. Poor oral hygiene and plaque retention is also likely a factor (your mouth is like an acid bath to your teeth in this situation).
Perhaps the most important factor in preventing (and treating) sensitivity is controlling your oral environment and the destructive forces that lie within. If you suffer from night grinding, wear a night guard. If dentin and root exposure has already occurred, wearing a night guard and using desensitizing fluoride toothpaste will promote forming of secondary dentin which will block out the dentinal tubules (which conducts sensitivity) and work as a barrier to protect the tooth. Sensitivity can caused by caries decay – a cavity. Of course, cavities need to be treated by a dental professional, but if you are able to find the source of your discomfort before a cavity develops, you will be on the fast track to good health. A proper diet and oral hygiene will also vastly improve your oral health and reduce risk of decay – brush and floss twice a day, and after meals!
Learn your body inside and out, and reflect. Take time each day to notice how you feel, and if your health has shifted for the better or worse. If you feel you have a weakness in your mouth, think about what the cause is, diagnose the problem, and find a solution. Ask questions and learn from your dental professional , contol of your dental health is in your hand!
“No more drill?” was an exciting news headliner in May of 1997, implying that with Er:YAG dental lasers, drills were no longer necessary for treating cavities! A decade later, we can re-evaluate or validate the pros and cons of cavity treatment with dental lasers.
In recent years, lasers have been utilized for providing precise, less-painful, clean and miraculous medical and dental procedures. In dentistry, various treatments on soft tissues (like aesthetic gum contouring, gum treatment for gingivitis and periodontal disease, apthous ulcers, frenectomies, biopsies and more) are precisely performed and heal faster with less discomfort than traditional treatments. Surgeries can be done in a very clean and fairly bloodless field. Lasers have also been used to aid in faster and more efficient tooth whitening procedures. Later exploration into how lasers can be utilized in the dental field have revealed hard tissue applications, including tooth and bone.
How does laser energy work with our body? The laser-tissue interaction can be looked at by identifying the laser’s characteristics. The laser wavelength (which has a very specific peak absorption curve) is attracted to certain tissues or elements. Our body, as a recipient site receiving the laser energy, is composed of different structures and elements. The best and most efficient results occur when the perfect match is found between the laser’s energy and the target tissue.
Since erbium energy (Er:YAG) is attracted to water and hydroxylapatite (tooth and bone elements), and decayed tooth structures are full of moisture, the laser energy reacts to your decayed tooth structure much quicker than your healthy tooth structure. This means the decayed tooth structure can be ablated away efficiently. The process happens precisely at the target tissue (the cavity), energy does not travel beyond this site – this means the tooth will not react to the process, resulting in less irritation than a traditional dental drill (which carries mechanical vibration and heat, causing irritation to the teeth)!
In comparison, when it comes to restorative dentistry, rotary instruments (like a traditional drill) are still easier, faster and more predictable in creating specific tooth shapes to receive dental restorations, and rotary instruments have been improved, combining elements of both air and electricity, giving better torque energy, less vibration and less noise.
When discussing the removal of decayed tooth structure , the erbium laser is still a wonderful tool to create a sterile, clean site. Obtaining a laser solely for removing tooth decay, however, is not feasible.So there is few dentists offer such service. Erbium lasers are very useful for bone and soft tissue procedures (water component), dental implant recovery surgeries, and aesthetic crown lengthening (eliminating a gummy smile).Hopefully when you need such services can receive the benefits what laser dentistry can offer.
Dentistry is continuously evolving. New technology, new techniques, new prospects – it’s exciting! Get excited about your opportunity to get better dental service, ask your dental professional “what’s new!” Get the whole team excited about what benefits we can all receive from all the new and advanced technology available to us today.
Toothpaste (or a gel dentifrice) is something most of us take for granted – it’s always there when we need it, and most of us don’t give much thought to what it’s made of. With the toothpaste market as big as it is, with many different products promising different effects, it can be a tough job to choose which pea sized potion will give you a dazzling smile, kissable breath, rid you of dental sensitivity, or fight against dental and gum disease.
Toothpaste is a cleansing agent used to clean your teeth and aid in the elimination of halitosis (bad breath). The main cleaning is done with the mechanical friction effect from brushing with your toothbrush. Toothpaste acts as a lubricant, easing the friction of the brush’s bristles on your teeth and gum. A modern toothpaste does incorporate several key elements, so in your two minute “good brushing routine with a pea size potion,” you can do quite a bit of good for your mouth. Toothpaste has abrasives to scour off bacterial films, it has fluorides to harden tooth structures against decay. It can also contain different active ingredients serving various purposes, such as triclosan (an antibacterial agent which fights against plaque-forming microbes), pyrophosphate (a tartar control agent), potassium nitrate (desensitizer), carbomide peroxide (bleaching agent) and sodium lauryl sulfates (detergent and foaming agent to carry away debris).
Some ingredients like lauryl sulfates can irritate soft tissues, or allergic reactions with certain people (often replaced with lauryl sarcosinate). There are many other inactive ingredients in toothpaste, like thickeners which serve for the right viscosity and moisture of the paste, water softener to make detergent work better, flavor and sweetener for a more pleasant brushing experience. Wow, there are too many chemicals in that little bit of paste! If you prefer a more holistic approach for your oral hygiene, you may choose all-natural products like Tooth & Gums paste (which are antibacterial but contain no artificial chemicals).
Other things about the marketing slogan “Teeth Whitening” – this simply means removing surface stains, not actually whitening the color of your teeth. Make sure your children do not consume any fluoride-containing toothpaste, only use as a topical agent. After brushing, be sure to rinse well. If you still have questions about which toothpaste is right for you, consult with your dental professional!
The toothbrush is, of course, an essential tool for keeping your teeth clean and plaque-free, but there are many types of toothbrushes available for use. The structure of your mouth is very intricate, including soft gum tissue, hard enamel, various crevices and spaces where food can hide, etc – and every person’s mouth is different, and responds differently to various types of brushes. How do you pick the right toothbrush for you?
If you get perfect dental check-up scores, do not have any type of gum sensitivity issues nor any other dental problems, you can probably keep your present hygiene routine. An over-the-counter toothbrush will normally suffice for people with normal gums and teeth if you are using it properly. If you have a history of dental and gum issues, special care is needed. You may need more than one toothbrush (different sizes and shapes of brush heads and tips) to adequately clean between your teeth and restorative material, such as a specialty brush shaped to accommodate dental restorations.
What about electric toothbrushes? There are many toothbrushes on the market, available both over-the-counter and from your dentist, which advertise a much deeper cleaning than what a manual toothbrush can provide. Keep in mind that an inexpensive battery-operated toothbrush often lacks the torque (twisting power) needed to adequately clean your teeth, remove plaque and remove biofilm; If you have children who refuse to brush their teeth, an electric toothbrush might be a fun way to encourage proper oral hygiene!
The more advanced electric toothbrushes, with proper technique, can clean your teeth more effectively than manual brushes. Manual brushing often does not do a good enough job at removing plaque than electric toothbrushes from your dentist (prescription electric toothbrushes like Rotadent, what I recommend to my patients has micro-filaments bristles with different tips). These brushes allow more advanced brushing techniques with different brush head attachments to accommodate different parts of the mouth, and have the necessary torque to properly clean your oral environment. If you have any of the following conditions, you should equip yourself with a better toothbrush for better oral health: orthodontic braces, gum problems, dental implants, dental bridges, arthritis, etc…
No matter what type of toothbrush you have, remember that it is necessary to spend two minutes brush at least twice a day, and after meals. The food caught between your teeth can start producing harmful bacteria only 5 minutes after eating (which is why you should bring a toothbrush to school or work every day)! Because every mouth is different, and certain tooth angles (and dental work) require special brushing or special brushes, consult with your dental professional. Besides brushing, flossing, tongue scraping, rinsing, and irrigation are all important steps to get your mouth’s environment as squeaky clean as it can be. It is a lot of work to keep yourself in top condition, but it will become second nature. You deserve paying your mouth so much attention – for your own health!
When you stay up way too late you might find pimples on your face and canker sores in your mouth – never fun to get! This painfully annoying little mouth sore – also known as an aphthous ulcer, can be quite bothersome to your eating and speaking actions for days. Thankfully, you can still kiss your loved ones with a canker sore, which are not contagious, different from viral cold sores (also known as a fever blister) caused by the herpes virus. Both are ulcerative sores in the mouth, but canker sores occur on the soft tissue inside the mouth. Cold sores tend to be on the outside of the mouth, around the lips.
Canker sores can arise for many reasons; the most common are stress factors, like a lack of sleep. Stress can wear down your body’s immune system, making your oral environment more susceptible to ulceration. Food allergies or sensitivities (to acidic fruits or toothpaste containing sodium lauryl sulfate for example) can trigger canker sore formation. The environment you are in can also stress your body and cause canker sores, like being in extreme heat or cold. Deficiencies in iron, folic acid, zinc or vitamin B12 will lead to a nutritional imbalance in your body, making you more susceptible to canker sores. Bacterial infection, hormonal imbalances and hereditary issues can all be causative factors. Finally, dental appliances or procedures which place pressure in specific parts of your mouth (like braces) can cause canker sores. Some physicians have theorized that canker sores are actually hereditary, but extensive research on this topic has not yet taken place.
So what do you do if you have a canker sore? Improve your lifestyle! If you are able to extend your sleep cycle to between 7 and 8.5 hours of sleep nightly, maintain a balanced diet and master “stress management” at work, school and at home, your canker sore frequency will decrease. Canker sores are your body’s way of telling you to slow down and re-evaluate! Luckily, most canker sores will heal within 14 days (albeit painfully), unless your immune system was compromised. If you have a canker sore, avoid contact with it. Any unnecessary stimulation to the site can cause you to say ouch! Avoid spicy or acidic foods as this will further irritate the site. Make sure you are eating a well balanced diet, take supplements like vitamin B and C, and reduce your acidic fruit intake.
There are topical agents which can relieve canker sore symptoms, such as Milk of Magnesia, kenalog in orabase, tetracycline, suspension or low-level-laser-therapy (LLLT). Non-alcoholic mouthwash can also reduce the frequency of canker sores. If you do suffer from severe, frequent or lingering canker sores, speak with your dental professional or your primary health care physician. Remember, the best path to a healthy, ulcer-free mouth is proper oral hygiene, a healthy lifestyle (including quality sleep) and a healthy, balanced diet – if you take care of your body, you can enjoy your quality of life even more.
Have you ever woken up feeling tired? Have you ever fallen asleep while driving? Even if you went to sleep early last night? Do you snore? Sleep apnea could be playing a role. There are countless undiagnosed and untreated cases of sleep apnea in our society (which have been linked to car accidents and machinery accidents from sufferers of sleep apnea, causing operator error).
The most common type of sleep apnea is obstructive sleep apnea. It is a disorder in which a person periodically pauses breathing during sleep (usually an average of 10 seconds). This is usually associated with a reduction in blood oxygen saturation, which can lead to drowsy and excessive sleepiness during the day. Obstructive sleep apnea can also endanger your cardiovascular system.
The airway can become obstructed at several sites. The upper airway can be obstructed by excess tissue in the airway, large tonsils, a large tongue and/or a retruded lower jaw. Usually, the airway muscles are relaxing and collapsing during sleep in this case. Nasal congestion or blockages (as a deviated septum), large turbinate and collapsed nostrils can cause your throat and tongue muscles to contract at night. Ask your partner to observe you sleep if you are in doubt, and keep a sleep diary every night, recording when you fall asleep, when you wake up, if you recall any trouble breathing during the night and how refreshed you feel when you wake. Speak with a sleep specialist to have a sleep test.
If you do have sleep apnea, what does it mean? Depending on the type and severity of your sleep apnea, it could spell some very dangerous health effects, and could even be life-threatening. The main effects of sleep apnea are daytime drowsiness (sleep deprivation) and oxygen deprivation. Depriving your brain of oxygen while sleeping is particularly dangerous and can result in heart disease, high blood pressure, sexual dysfunction, and learning/memory problems. Some sufferers of sleep apnea report short term memory loss, as a result of oxygen deprivation during sleep.
Mild sleep apnea is usually treated by some behavioral changes. Losing weight and sleeping on your side is often recommended. There are several oral or dental devices that can help keep the airway open – most are for bringing your lower jaw forward, or elevating your soft palete to retrain the tongue from falling back, blocking the airway. Moderate to severe sleep apnea is usually treated with a CPAP system (continuous positive airway pressure) which straps around your head and ventilates oxygen into your respiratory system, ensuring a clear breathing pathway during sleep. There are surgical innovations, such as LAUP (laser assisted uvulo-plasty) as well as radio-frequency somnoplasties and radio-frequency volumetric reductions of the palate or tongue to help alleviate severe sleep apnea.
Behavioral modifications can also be advised from your dental professional to treat obstructive sleep apnea, after it has been diagnosed. Besides losing weight and sleeping on your side and controlling your allergies, a properly designed dental appliance can help you get healthier sleep. Your bed partner might get more peaceful sleep as well!
Fluoride treatment is effective with preventing cavities and tooth decay. As a dentist, this is what I have recommended to people who I see can benefit from fluoride treatment’s ability to remineralize and desensitize your teeth. However, I must confess there is risk involved with using fluoride due to its potentially damaging systematic effects.
Fluorine, the ionized form of fluoride is highly active to phosphate ions in your body (where calcium is found in large amounts – like the bones and teeth). In teeth, fluorine combines with the inorganic compound apatite, to form a harder, less water-soluble fluoride salt, which resists the acidic erosion of some oral environments. A pregnant mother’s fluorine intake affects the primary teeth of the fetus. Fluorine intake from fluoridated water (or a fluoride supplement) can also affect teeth in child development of up to around age 8 (making teeth harder and more resistant to decay). Unfortunately, excessive amounts of fluoride can lead to fluorosis, which causes white, brown or black stains (and even pitting) of the teeth, and/or brittle, aching bones and joints. An even darker fact regarding fluoride: many researchers believe it is carcinogenic. Japanese research has shown fluoride as being capable of transforming healthy cells into cancer cells. Additionally, the New Jersey Department of Health has found that young men exposed to fluoridated water have a much higher occurrence rate of bone cancer. Other studies performed by private corporations (Procter & Gamble in particular) have shown fluoride used to fluoridate public water sources significantly increases the chances of genetic damage in its drinkers.
So use fluoride with caution – it is beneficial for cavity prevention and treating tooth sensitivity, but it is for topical use only – do not ingest! Children especially need special care from their parents with undertaking any type of fluoride treatment, no fluoride toothpaste or fluoride should ever be swallowed. If fluoride use is recommended by your doctor or dental professional, calcium supplements (or food rich in calcium like dairy products) are recommended to ensure your bones stay strong and balance out any potential loss of calcium due to fluorine exposure.
There are alternatives for remineralizing your tooth structure, such as calcium phosphate and calcium carbonate. If you have any concerns, speak with your dental professional. Remember, the best way to prevent tooth decay is to eat sensibly and keep your mouth sparkling clean by properly brushing and flossing after every meal.
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, generating adverse effects on your oral cavity. Alcohol is a desiccant (drying things up); heavy drinking dramatically decreases moisture needed to maintain a healthy oral cavity. A dry mouth increases one’s likelihood of developing tooth decay, gum disease, bad breath, fungal infection, burning sensations or soreness of the mouth. Alcohol’s acidic nature can also erode the enamel 
After Lengthening:
