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DecidingtheFateofWisdomTeethMoreNuancedThaninthePast

If you're of a certain age, there's a good chance you've had your third molars—wisdom teeth—removed. At one time, extracting these particular teeth was a common practice, even if they hadn't shown any signs or symptoms of disease or dysfunction. But now, if you have a son or daughter coming of age, your dentist may recommend leaving theirs right where they are.

So, what's changed?

Wisdom teeth have longed been viewed as problematic. As the last of the permanent teeth, they often erupt on a jaw already crowded with other teeth. This can cause them to come in out of position—or not at all, remaining partially or totally submerged (impacted) beneath the gums.

Misaligned teeth are more difficult to keep clean of bacterial plaque, which in turn raises the risk of tooth decay or gum disease. Impacted teeth can put pressure on the roots of neighboring teeth, which further increases the risk for disease or bite problems.

To avoid these common problems associated with wisdom teeth, dentists often remove them as a preemptive measure. Given their size and possible root complexity, this is no small matter: Removing them usually requires oral surgery, making wisdom teeth extraction one of the top oral surgical procedures performed each year.

Today, however, many dentists are taking a more nuanced approach to wisdom teeth. While they still recommend removal for those displaying signs of disease or other problems, they may advise leaving them in place if the teeth are healthy, not interfering with their neighbors, and not affecting bite development.

That's not necessarily a final decision, especially with younger patients. The dentist will continue to monitor the wisdom teeth for any emerging disease or problems, and may put extraction back on the table if the situation merits it.

The key is to consider each patient and their dental needs regarding wisdom teeth on an individual basis. If warranted, removing the wisdom teeth may still be warranted if will help prevent disease, keep bite development on track and optimize oral health overall.

If you would like more information on wisdom teeth, 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 “Wisdom Teeth: Coming of Age May Come With a Dilemma.”

By Dr. Griffith
November 30, 2021
Category: Oral Health
Tags: fluoride  
ALittleFluorideGoesaLongWayinProtectingYourFamilysTeeth

A popular Sixties-era hair cream touted their product with the tagline, "A little dab'll do ya!" In other words, it didn't take much to make your hair look awesome.

Something similar could be said about fluoride. Tiny amounts of this "wonder" chemical in hygiene products and drinking water are widely credited with giving people a big boost in protection against tooth decay.

A Colorado dentist is credited with first noticing fluoride's beneficial effects early in the Twentieth Century. Although many of his patients' teeth had brownish staining (more about that in a moment), he also noticed they had a low incidence of cavities. He soon traced the effect to fluoride naturally occurring in their drinking water.

Fast forward to today, and fluoride is routinely added in trace amounts to dental care products and by water utilities to the drinking water supply. It's discovery and application have been heralded as one of the top public health successes of the Twentieth Century.

Fluoride, though, seems a little too amazing for some. Over its history of use in dental care, critics of fluoride have argued the chemical contributes to severe health problems like low IQ, cancer or birth defects.

But after several decades of study, the only documented health risk posed by fluoride is a condition called fluorosis, a form of staining that gives the teeth a brown, mottled appearance (remember our Colorado residents?). It's mainly a cosmetic problem, however, and poses no substantial threat to a person's oral or general health.

And, it's easily prevented. Since it's caused by too much fluoride in prolonged contact with the teeth, fluorosis can be avoided by limiting fluoride intake to the minimum necessary to be effective. Along these lines, the U.S. Public Health Service recently reduced its recommended amounts added to drinking water 0.7 milligrams per liter (mg/L) of water. Evidence indicated fluoride's effectiveness even at these lower amounts.

You may also want to talk with your dentist about how much fluoride your family is ingesting, including from hidden sources like certain foods, infant formula or bottled water. Even if you need to reduce your family's intake of fluoride, though, a little in your life can help keep your family's teeth in good health.

If you would like more information on the benefits of fluoride in dental 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 “Fluoride & Fluoridation in Dentistry.”

KickingtheSmokingHabitBoostsYourHealthIncludingTeethandGums

Quitting smoking is hard. The love affair between your brain and nicotine chains the habit to your daily life. But it's still worth the effort to quit to save your health from disease—including those that impact your teeth and gums. And, there's no time better to launch your "kick the habit" project than the American Cancer Society's Great American Smokeout day this November 18.

As to smoking's impact on your teeth and gums: Two-thirds of America's 32 million smokers contend with gum disease. A smoker's risk for tooth decay is also higher, as well as their prospects for implant failure.

So, why is smoking hazardous to your oral health?

Primarily, nicotine constricts oral blood vessels, which in turn reduces the nutrients and antibodies reaching the teeth and gums. Your mouth thus struggles to fight bacteria that cause tooth decay or gum disease.

Inadequate blood circulation can also hide signs of gum disease like swollen, reddened or bleeding gums. Instead, a smoker's gums may look deceivingly healthy, although you may have a gum infection that could be well advanced when it's finally diagnosed.

Gum or bone grafting also depends on good blood flow, or the grafts may not fully regenerate new tissue. The situation's similar for an implant: Its titanium post needs bone to grow and adhere to its surface to acquire sufficient strength and stability. But slow wound healing due to poor circulation can interfere with this process and cause an implant to fail.

For your mouth's sake, as well as the rest of your body, quitting smoking could help you avoid these problems. But as an ingrained, addictive habit, your body needs to "unlearn" it to stop it. Here are some ideas to help make that process easier.

Nicotine Replacement Therapy. Under your doctor's guidance, you can take medications that deliver nicotine to the body without smoking, and gradually reduce its concentration. This approach can be costly, however, and cause unpleasant side effects.

Brand fading. With this technique, you continuously switch to cigarette brands with less nicotine. This gradually acclimates your body to lower concentrations of the chemical, and eventually wean off it entirely. Here's an online site listing nicotine strength by brand.

Don't do it alone. Quitting smoking doesn't need to be a solo act. Developing relationships with those who don't smoke or who are also quitting can make it easier. One way is to attend a smoking cessation group for support and encouragement from others who're also trying to quit.

Above all, speak with your doctor or dentist to learn more about what you can do to stop smoking. It can be difficult, but the rewards—especially for your oral health—are well worth it.

If you would like more information about smoking and oral health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Strategies to Stop Smoking.”

EmmaRobertsConfessestoHavingaMajorSweetToothWhileExpecting

Emma Roberts, star of American Horror Story (and niece of actress Julia Roberts), welcomed her first child at the end of 2020. She confessed that her love of sweets made pregnancy challenging. She couldn't get enough of cupcakes with sprinkles and a Salt & Straw ice cream flavor called The Great Candycopia. But Roberts isn't unique. Hormonal changes in pregnancy often bring heightened cravings for certain foods. Unfortunately, this can increase an expectant mother's risk for dental disease, especially if they're consuming more sugary foods.

In fact, around four in ten expectant women will develop a form of periodontal disease called pregnancy gingivitis. It begins with dental plaque, a thin film that forms on tooth surfaces filled with oral bacteria that can infect the gums. And what do these bacteria love to eat? Yep—sugar, the same thing many women crave during pregnancy.

So, if you're expecting a baby, what can you do to minimize your risk for dental disease?

Practice oral hygiene. Removing dental plaque by brushing and flossing daily is the most important thing you can do personally to prevent both tooth decay and gum disease. It's even more important given the physical and hormonal changes that occur when you're pregnant. Be sure, then, that you're diligent about brushing and flossing every day without fail.

Control your sugar intake. If you have strong cravings for sweets, cutting back may be about as easy as stopping an elephant on a rampage through the jungle. But do give your best effort to eating more dairy- and protein-rich foods rather than refined carbohydrates like pastries or candies. Not only will reducing sugar help you avoid dental disease, these other foods will help strengthen your teeth.

Maintain regular dental visits. Seeing us for regular cleanings further reduces your disease risk. We can clean your teeth of any plaque deposits you might have missed, especially hardened plaque called tartar that's nearly impossible to remove with brushing and flossing. We'll also monitor your teeth and gums for any developing disease that requires further treatment.

Undergo needed treatments. Concerned for their baby's safety, many expectant mothers are hesitant about undergoing dental procedures. But both the American Congress of Obstetricians and Gynecologists and the American Dental Association endorse necessary dental treatments during pregnancy, even if they include local anesthesia. We will make you have only a safe type of anesthesia, and we can advise you when it is prudent to postpone certain treatments, such as some elective procedures, until after the baby is born.

Emma Roberts got through a healthy pregnancy—cravings and all—and is now enjoying her new baby boy. Whether you're a celebrity like Emma Roberts or not, expecting a baby is an exciting life moment. Follow these tips to keep your teeth and gums healthy throughout your pregnancy, and be sure to let the dental team know of your pregnancy before any treatment.

If you would like more information about dental care during pregnancy, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Pregnancy and Oral Health.”

FluorideTreatmentsGiveYourChildAddedProtectionAgainstCavities

When it comes to helping your child avoid tooth decay, it's all hands on deck. Tooth decay can not only harm their current set of primary teeth, but the loss of even one tooth could lead to bite problems later on.

And, even if you're doing all the right things—daily brushing and flossing, limiting sugar consumption and regular dental visits—your child might still develop cavities. If so, it may be necessary to add a boost of prevention with topical fluoride applied by your dentist.

With its enamel-strengthening properties, fluoride plays an important role in dental disease prevention. For decades, manufacturers have added fluoride to toothpaste. And, many water utilities now add tiny amounts of fluoride to their drinking supply.

According to a number of studies, these fluoride applications are effective weapons against tooth decay. But direct applications of fluoride to tooth surfaces can provide even greater benefit to children with a higher susceptibility for decay.

Topical fluoride is usually applied by means of a gel, foam or varnish. In varnish form, it's brushed on the teeth, while dentists apply the foam solution within a tray fitted around the teeth. The gel application can be administered by either method.

Although these topical applications use a higher concentration of fluoride than you find in toothpaste, it poses no serious danger to a child's health. But because high doses of fluoride can lead to staining, topical applications are only administered periodically during childhood.

The only short-term health concern is if the child accidentally swallows some of the mixture during application. This can cause symptoms like an upset stomach, vomiting or headache. Dentists, however, take a number of precautions to prevent accidental ingestion in order to avoid these unpleasant side effects.

The benefits, though, appear to well outweigh this minor risk. In a review of several scientific studies involving nearly 10,000 children, there was an average 28% reduction in decayed, missing or filled teeth in those children that underwent topical fluoride treatments.

If you want to know more about topical fluoride treatments and whether they can help your child avoid tooth decay, talk to your dentist. This fluoride booster could help further protect them from this destructive dental disease.

If you would like more information on helping your child avoid tooth decay, 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 “Fluoride Gels Reduce Decay.”





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