Don’t Want Implants? Hopeless Teeth Can be Saved

A combination of traditional techniques and latest technology can save teeth previously diagnosed as hopeless. This innovative approach can often save seemingly loose, hopeless front teeth and prevent tooth loss.

If a patient presents with teeth that have hardly any bone left due to periodontitis (gum disease), this new approach would offer the stabilization of the loose teeth with the traditional method of splinting. The latter calls for bonding (gluing) wiring on the back (lingual) side of the teeth and making them, in effect, one unit. This splinting process is like tying loose boards together to make them stronger.

Once the teeth are not loose, but stable, they can be deep cleaned without having to do surgery, as it traditionally indicated. However, with the use of endoscopy dentists and hygienists can now remove tartar sticking to the roots of the teeth under the gums without surgery. Endoscopy calls for the use of a miniaturized cameras that is inserted under the gum to broadcast magnified images of the tartar on the roots. Using special ultrasonic instruments, the tartar is removed thoroughly. Thus, the roots become infection-free.

With the teeth stabilized and source of infection removed, it has been found that gums will likely heal and be free of infection long term if the patient follows strict standard maintenance and special home care instructions. In many cases, even bone will grow back.

In some cases, the bite has changed because of drifting of the teeth. Gapes open between front teeth. Some teeth may look longer. The good news is often the teeth can be brought together in the first visit and then splinted together. The original smile can be restored in one visit, in many cases. Sometimes spot adjustment of the longer teeth may need to be done to provide a more normal bite and a normal smile line.

Most patients must return for follow-up care every three months indefinitely. And they must follow strict home care instructions in between visits. So, if you want to explore conservative alternatives to extractions, followed by implants or bridgework, contact your dentist and discuss your options thoroughly.

If you would like more information about splinting, call Dr. Chao in Alhambra, CA at (626) 308-9104

Dr. Chao proudly serves Alhambra and all surrounding areas.


A Lasting Impression: A Great Smile

It is accepted that a great smile is a great social asset and you are remembered for the great smile you have. So it is not surprising that a survey of adults found the following results:

* 92% agree that an attractive smile is an important social asset.

* 88% say that they always remember someone with an especially attractive smile.

* 85% find that an unattractive smile is less appealing to the opposite sex.

* 74% agree that an unattractive smile will negatively impact career success.

* Only 50% of respondents are satisfied with their smiles.

Some of the most common complaints people have with their smiles are those that they have had since childhood, such as discolored, gapped or crooked teeth. Other problems may be those that developed in adulthood, such as cracked or worn down teeth. Then there are teeth, which have had fillings that have discolored the front teeth, or crowns that no longer match the color of the natural teeth, which turned a darker color.

Whitening your teeth would generally be the first consideration. Very often when your teeth are whiter, minor discrepancies such as slight crowding of your front teeth will almost disappear. Your dentist may advise that all that you need may be the use of a home-bleaching product available over the counter. Failing that, you may ask your dentist to make home-bleaching trays that use a higher concentration of bleaching gel. Over a period of weeks you should see dramatic improvement. For those who want a whiter and even more dramatic result, in-office bleaching procedures that will whiten your teeth within one hour are available.

For gapped front teeth, bonding is generally the initial consideration. Cosmetic bonding calls for the dentist to incrementally build up spaces between the teeth with various shades of composite materials and then “paint” surfaces with additional composites of different hues, chroma and translucency to match the adjacent teeth. Techniques employing “optical illusion” in shaping the composites give the teeth the appearance of normal-sized teeth, without the gaps. This can be done without reducing the teeth. With some precautions and proper care cosmetic bonding can last many years without chipping or breakage.

In the case where the patient desires veneers, because of the strength and durability of enhanced porcelain, this procedure calls for reducing a slight amount of tooth structure to accommodate the thin layer of porcelain that will cover the surface of the teeth. The shell of thin porcelain is bonded over the tooth. Veneers do not change color or shine over time, and allow the dentist to do a complete makeover of the smile. Stunning results are achieved with this technique.

For crooked teeth, orthodontics is always a good alternative. Where bands and braces are impractical, veneering can bring changes in a matter of weeks. Transparent plastic “retainers” to move teeth also may be an alternative in some cases.

Where teeth are worn down, previously filled or capped, veneers or porcelain crowns may be a good solution. However, in the case where teeth have been worn down due to involuntary nighttime clenching or grinding, a bite guard should be worn so that new crowns or veneers would not be worn down again.

If you are among the 50% who are not satisfied with your smile, see your dentist for the solution that will work best for you. And if you are among the fortunate 50%, who are satisfied with your smile, see your dentist regularly so that you can maintain that great smile for a lifetime.


Bleachorexia: Excessive Teeth Whitening

Excessive, unsupervised teeth whitening, dubbed “Bleachorexia,” may lead to receding gums and oversensivity, according to a news segment on Good Morning America.

This TV program cited Dr. Laurence Rifkin who treated five-time World Boxing Council champion Mia St. John for “bleachorexia.” St. John “constantly” bleached her teeth to the point her dentist warned her that her teeth might turn to “mush.” A good thing can become a bad thing, if overdone, said Dr. Rifkin. For that reason some dentists have coined a new term, “Bleachorexia,” to describe excessive, or obsessive preoccupation with teeth whitening.

Also interviewed on this show was Dr. Jen Ashton who quoted the position of the American Dental Association (ADA) with regard to teeth whitening. Dr. Ashton stated that teeth whitening should only be done after consultation and examination with your dentist. Especially if you already have crowns, fillings or veneers on your teeth, you should be treated under the supervision of your dentist. The ADA warned that there is not enough evidence to support long-term, unsupervised and/or repeated use of bleaching products.

When consulting with your dentist, it would be important to have the front teeth examined to determine whether there are fillings, crowns or veneers and their relative condition. Should “leaky fillings” be replaced first to prevent bleaching agents from leaking through to the nerve? Would dark fillings be bleached as white as the teeth? Would these darker fillings be even more obvious when the teeth become whiter? Crowns and fillings do not whiten. Would there be a contrast problem? Are the gums in good shape? If not, can inflamed gums be irritated and can they become painful if exposed to bleaching agents? These are the many questions to ask your dentist before you allow bleaching agents to be applied to your teeth.

The following is the ADA statement on teeth whitening:

“The ADA recommends that if you choose to use a bleaching product, you should only do so after consultation with a dentist. This is especially important for patients with many fillings, crowns, and extremely dark stains. A thorough oral examination, performed by a licensed dentist, is essential to determine if bleaching is an appropriate course of treatment. The dentist and patient together can determine the most appropriate treatment. The dentist may then advise the patient and supervise the use of bleaching agents within the context of a comprehensive, appropriately sequenced treatment plan … Patients should be cautioned that not enough information is available to support unsupervised long-term and/or repeated use of bleaching products.”

Nothing can be gained by bypassing your dentist and hygienist when you consider improving your teeth and your dental health by means not recommended by the ADA.


Fizzy Drinks Destroy Teeth; Every Sip is an Attack

Fizzy drinks make fuzzy teeth! Keeping teeth healthy for a lifetime means preventing tooth decay and erosion. Tooth erosion is a newer phenomenon and one that is preventable, according to the Indiana Dental Association which provided the following information:

Erosion is the chemical loss of enamel due to acid. Acid is found primarily in soft drinks, sports drinks, juices and acidic foods. Acid reflux, vomiting and other illnesses that produce stomach acid in the mouth can also erode tooth enamel.

Enamel is the protective outer layer of teeth. Throughout the day, your enamel undergoes a continuous dissolving and repairing cycle. Milk, fluoride, water and fluoridated toothpastes can repair and build back the minerals essential to healthy teeth. Low pH beverages such as soft drinks, sports drinks, fruit juices and wine dissolve enamel. Sour candies can also erode enamel.

When acid continuously attacks teeth, they cannot repair themselves and will gradually begin to turn fuzzy and dissolve. Dentists consider every sip of a low pH drink an acid attack. Even one bottle of soda or a single sports drink, if sipped over hours, can do extensive, irreversible damage to tooth enamel.

Decay is literally a soft spot in the enamel which penetrates the dentin, or a hole in the tooth. Decay is caused when the mouth’s bacteria react to sugar. The chemical interaction between bacteria and sugar produces acid. The acid-producing bacteria eat the enamel until a hole is made in the tooth, also known as a cavity. Preventing cavities involves brushing, flossing and keeping sugar to a minimum.

Acid attacks do the most damage when you are very thirsty or have a dry mouth. Saliva, your mouth’s natural defense shield, covers your teeth and provides some protection against acid attacks. When you’re dehydrated, you lack saliva and your teeth are more vulnerable to acid attacks.

STOP the continuous acid and sugar attack on your teeth by limiting the quantity of soft drinks and sports drinks and instead choose healthy drinks such as milk and water. Reduce the size of the drink and use a straw to draw the damaging liquid away from your teeth. Food consumed with acidic drinks can often help counteract acid attacks.

Most important is to brush your teeth before bed to reduce bacteria and to help harden your enamel. Wait at least one hour after drinking an acidic drink to brush your teeth to allow your saliva to begin the repair process.


What Causes Elite Athletes to Have Poor Dental Health?

Just because you exercise regularly and are in top physical shape, it doesn’t mean you will also have good dental health. In fact, elite athletes have high rates of oral disease not because of lack of brushing (they brush their teeth more frequently than most people, finds a new UCL study).
The main culprit appears to be “energy drinks.”

The findings, published in the British Dental Journal, highlight potential for improvement as most of the athletes expressed an interest in changing their oral hygiene behavior to improve their oral health.

The UCL Eastman Dental Institute research team surveyed 352 Olympic and professional athletes across 11 sports, including cycling, swimming, rugby, football, rowing, hockey, sailing and athletics, where they provided dental check-ups for male and female athletes measuring tooth decay, gum health and acid erosion.

The researchers also asked athletes what they did to keep their mouth, teeth and gums healthy.

The dental check-ups revealed substantial amounts of oral disease as reported in a 2018 paper, finding that nearly half (49.1%) had untreated tooth decay, the large majority showed early signs of gum inflammation, and almost a third (32%) reported that their oral health had a negative impact on their training and performance.

This new study found that 94% reported brushing their teeth at least twice a day, and 44% reported regularly cleaning between their teeth (flossing) — substantially higher figures than for the general population (75% for twice-daily brushing and 21% for flossing).

However, the researchers found that the athletes regularly use sports drinks (87%), energy bars (59%) and energy gels (70%), which are known to damage teeth.

Encouragingly, the surveyed athletes said they would consider adopting even better oral hygiene habits to tackle this and an intervention study has already been piloted.

Just because you are athletic, it doesn’t mean you will have good oral health. So, watch the sweet drinks. See your dentist regularly to check for decay and gum inflammation.


Is Brushing Your Teeth in the Shower Good or Bad for You?

Should you brush your teeth in the shower? Is it estimated that about 4% of Americans routinely brush their teeth in the shower according to a recent survey by the Delta Dental Plans Association, a dental-insurance provider. That’s about 13 million people.

What are the pros and cons? Some say that it saves time and water. As to saving time, it’s debatable. To save time, one would have to multi-task by scrubbing the body and brushing the teeth at the same time. But if you are loitering in the shower, it would make sense that by brushing your teeth there you are saving time.

As to saving water, according to the American Water Works Association, a nonprofit founded to improve water quality and supply, modern shower heads use 2½ to 3½ gallons a minute, versus 1 to 3 for sinks. Especially if you are turning off the water while you are brushing over the sink, it appears that you would be saving some water.

Some folks even brush their teeth in the bath. They would have to not spit out the toothpaste nor rinse out the mouth until they get out of the bath tub. What if you swallow the toothpaste? You might be ingesting the fluoride, which is a poison in high doses.

The American Dental Association (ADA) says there isn’t any harm in shower brushing, as long as it gets done twice a day and that the toothbrush doesn’t stay in there. A moist environment is more conducive to bacteria growth, and if the shower doesn’t completely dry between uses, the toothbrush can be susceptible to bacterial growth, the ADA says. This may be somewhat inconvenient for some folks. You’d have to take out the toothbrush each time to let it dry between showers. But if you can do it, the ADA would have no objection.

But the ADA does recommend flossing your teeth regularly. Wrapping your wet fingers around a floss and trying to floss your teeth without the aid of a mirror would be somewhat challenging for most people. You can use disposable plastic flossers that come in various shapes and sizes. They have small handles with a fork strung with a floss. They might be less difficult in some way.

For those folks with food traps between teeth, flossing is a must and is not optional. So, if you need to floss regularly, it would make sense for you to brush and floss over the sink, rather than brush your teeth in the shower, then floss your teeth over the sink.

If you think about it, flossing in the bath tub may not be something you’d want to do.

My recommendation is that since you should brush and floss your teeth regularly you should do both over the sink.

If you still have questions, ask your dentist.


Long in the Tooth May Mean Shorter Life

The number of teeth you keep as you get older could indicate just how long you will keep getting older. The main reason for loss of teeth in adulthood is gum disease, called periodontitis.

This disease causes bone loss, which leads to loosening and drifting of the front teeth. This leads to the phrase, “long in the tooth,” which implies old age.

Aside from periodontitis, recent research has closely related tooth loss to “stress” during a person’s life, including specific social, emotional, economic, and educational experiences as well as health issues like chronic disease, genetic conditions, nutritional intake, and lifestyle choices. According to studies cited by the Oral Health Foundation, smoking or just continued poor oral health leads to premature loss of teeth.

No matter the cause of tooth loss, people who had lost 5 or more teeth by the age of 65 years were more likely to suffer from cardiovascular disease, diabetes, and osteoporosis, all of which could severely limit life expectancy, according to the Oral Health Foundation.

Another study concludes that the number of teeth in aging humans can affect longevity and life expectancy. Also, tooth loss is a predictor of shortened longevity.

The Oral Health Foundation is encouraging people to pay close attention to their mouth and to visit their dental team regularly to check for any signs of disease that could lead to tooth loss. The organization also notes that a similar study found that people who have a full set of teeth when they are 74 years old are significantly more likely to reach the age of 100.

“It is very evident that what is going on in our mouths can really be a useful window to our overall health. It is therefore vital that we take proper care of our mouth and pay close attention to what is happening, as it could be a sign of something more serious,” according to the Oral Health Foundation.

So, if you don’t want to get “long in the tooth,” visit your dentist regularly and reduce sugar intake. And do not smoke.


No More Root Canals?

What if there is no more need for root canal treatment to be done in order save a “dead” tooth?

Researchers at the University of Nottingham and the Wyss Institute at Harvard University has developed new regenerative dental fillings that use stems cells inside our teeth to repair tissue. This potentially can make conventional root canal treatment a choice, but not the only alternative when you have an “abscessed” tooth, or a tooth which has a “dead” nerve.

This new regenerative filling contains “pluri-potent” cells which has the biologic potential of becoming whatever cells are needed to regenerate the nerves, blood vessels and other tissue in the canals of the tooth. This source of cells actually can be recruited by this innovative filling material.

During a root canal procedure, the pulp of the tooth and the nerve are removed. If the new treatment becomes available, fillings made of synthetic biomaterials would be inserted, stimulating dental stems cells to repair and regenerate dentin, which is the hard, organic substance that accounts for root and inner structure of the crown of the tooth.

Stems cells can serve many different functions in the body, including repairs, according to the U.S. Food and Drug Administration. Stems cells are currently used, for example, to help treat spinal injuries, arthritis and diabetes.

Stems cells are already being used in dentistry to regenerate bone and gums through a process called Platelet Rich Plasma (PRP). In this application of stem cell regeneration, platelets from the blood drawn from the patient is concentrated through a centrifuging process. This process causes the plasma to be infused with high amount of growth factors (stems cells). The enriched plasma is then reintroduced into the appropriate site to assist in the regeneration of bone and gum.

Thus, stems cell research is now in the throes of revolutionizing the field of endodontics, the specialty concerned with saving teeth through root canal treatment. In the new era endodontists, and perhaps general practitioners, will administer the regenerative filling material using the proper clinical protocol to regenerate the nerves of the tooth in the similar manner that dentists are now regenerating bone and gum with stems cell technology.

It is not expected that this regenerative filling material will be less costly than doing regular root canal. Therefore on the basis of cost alone, the public is advised to observe proper dental hygiene as well as dietary recommendation to avoid developing cavities that can lead to abscessed teeth.

It is, of course, important to see your dentist regular for check ups and cleaning in order to avoid expensive and possibly uncomfortable root canals.

Children Teeth

Tooth Decay Can Stunt Growth

A new study suggests that tooth decay may push back growth in children. The study appeared in the online version of Pediatrics journal and was conducted at University College London and King Fahad Armed Forces Hospital in Saudi Arabia.

The research team wanted to explore the relationship between oral health and growth after previous studies failed to show definitive evidence one way or the other. In this study, the researchers looked at the dental decay and the correlation between height and weight in Saudi Arabian children ages 6 through 8.

The oral health of the children was graded on the DMFT (Decayed, Missing and Filled Teeth) scale, which is a scale that determines the seriousness of decayed, missing and filled teeth.

The research team later analyzed the statistics and concluded that there was, in fact, a relationship between low height/weight and a greater number of cavities. Children with severe decay had a higher chance of being underweight and shorter when compared to their peers.

Even when confounding factors such as demographics and social values were taken into account, statistics showed there is a meaningful relationship between dental health and physical growth.

It may be that children may be eating the wrong things besides neglecting oral hygiene. It may be that with compromised teeth a child does not want to eat or eat the right kind of foods. It may be that infection, even if not acute and painful, can affect the health and growth of the child. Further studies hopefully will throw more light on this vital subject.

It certainly is a warning sign and reminder to parents to pay even more attention to their children’s dental health. We know poor dental health can impact one’s general health. Heart disease, diabetes, Alzheimer’s, rheumatoid arthritis are some examples of medical conditions associated with dental disease. Perhaps it’s not surprising the growth and development of a child is similarly compromised by dental neglect.

What is the take-home lesson for the New Year? Taking care of our children’s dental health will ensure normal growth and development.

Make sure they form the right habits and brush their teeth regularly. Educate our children as to the importance of having healthy, clean, bright teeth. Teach them to watch their sugar intake, to stay away from sodas as much as possible. Try Xylitol, a sugar free, decay-inhibiting gum. Take them to the dentist every six months. Above all, take care of our own teeth and gums and set a good example for our children. See the dentist every 6 months, at least.


10 Things Not To Put In Your Mouth

Everyone knows that certain things present high risk of harm when put into the mouth. Tobacco, raw meat, toys, gun barrels or your own foot are some well-known examples.
Other not-recommended items are:

1) A toothbrush with too much toothpaste – This may keep you from seeing what you are brushing. Studies show that people who dry brush their teeth first, then brush again with toothpaste, have less gum bleeding and tartar than those who brush only with toothpaste. The overwhelming taste of the toothpaste may also cause hastening of the teeth brushing routine.

2) Contact Lenses – Cleaning or moistening your contact lenses by putting them in your mouth is not a good idea, because bacteria in the mouth can cause conjunctivitis.

3) Pencils, pens or pipes – Chewing on these items can cause both the wearing down of the teeth and invisible cracks or fissures to form in the enamel of the teeth. Under certain circumstances, these cracks or fissures can make it more likely for your teeth to crack or chip. TNJ (jaw joint) problems can be aggravated by chewing on foreign objects.

4) Tongue studs and lip or cheek rings – Puncture of the tongue can lead to excessive bleeding or infection, such as hepatitis. It’s amazing how many people with tongue studs or lip rings tell their dentists they hate Novocain shots.

5) Hot food followed by cold – Hot coffee or drinks followed immediately by an icy drink or ice cream can lead to cracks in your teeth. Dental enamel is highly mineralized and hard, when it is exposed to extremes in temperatures, tiny cracks may form on your teeth.

6) Metal nails – Holding nails in your mouth may be convenient, but a slip or fall can cause nails to puncture the lip or mouth.

7) Small (onilateral) partial dentures – Partial dentures or removable bridges that are not attachable to both sides of the mouth are small enough to be swallowed during sleep and can cause choking.

8) Aspirin on the gum – Because aspirin is so acidic, leaving an aspirin on your gum to relieve pain can end up leaving you in more discomfort. Aspirin can denude the surface of the gum and leave it extremely raw and sore.

9) Super glue to glue back a loose crown – Gluing back a loose crown with super glue or any other commercial glue may seem like a good self-help idea. But the strong chemicals in these glues can cause terrific toothaches and result in the entire tooth being dissolved by the glue in a very short time.

10) Ice, seeds, jawbreakers, etc. – Chewing on hard items like these can fracture your teeth, especially if you already have large fillings in your teeth. Incidentally, restaurants and markets are generally fair about reimbursing you for the cost of restoring a tooth that broke from biting into a foreign object in your food. In either case, you must report it immediately to the restaurant or store manager. Then see your dentist as soon as possible. If it happened from food purchased at a market, you must show the manager the food item, the receipt, the foreign object and tooth fragments, if any. Then see your dentist for a brief report stating the cause and estimated cost for treatment.