As if the preteen years didn’t give kids and their parents enough to think about, new oral health concerns loom on the horizon. Along with major changes to the body, brain and emotions, additional risk factors for tooth decay and gum disease appear during adolescence — the period of development starting around age 10 and extending through the teen years that marks the transition from childhood to adulthood.
Even with declining rates of tooth decay across the nation, the cavity rate remains high during adolescence. According to the American Academy of Pediatrics, 1 in every 5 adolescents has untreated tooth decay. What’s more, the onset of puberty — usually beginning around age 10-11 in girls and 11-12 in boys — brings changes in hormone levels that can affect gum health.
We all have millions of microorganisms in our mouth, representing hundreds of different species of mostly helpful, but some harmful, bacteria. Research has shown that total oral bacteria increases between ages 11 and 14, and new types of bacteria are introduced, including some that are not friendly to teeth and gums. Some unfamiliar microbes trigger an exaggerated inflammatory response to dental plaque, so gum bleeding and sensitivity are experienced by many children in this age group. In fact, “puberty gingivitis,” which peaks around age 11-13, is the most common type of gum disease found during childhood.
A combination of hormones, lifestyle changes and poor oral hygiene habits raises the risk of oral health problems among adolescents. A more independent social life may be accompanied by a change in eating habits and easier access to snacks and beverages that are sugary, acidic (like sports drinks and soda) or full of refined carbohydrates — none of which are tooth-healthy choices. And as children move toward greater independence, parents are less likely to micromanage their children’s personal care, including their oral hygiene routines. Good oral hygiene can keep dental plaque at bay, lowering the chance of having gingivitis and cavities. But let’s face it: Adolescents have a lot to think about, and keeping up with their oral health may not be top of mind.
To help your preteen stay on top of their oral health, keep healthy snacks at home for your children and their friends and make sure you are well stocked with supplies such as new toothbrushes, floss and toothpaste. In addition, most preteens (and teens) can benefit from gentle reminders about oral hygiene routines.
For optimal oral health through all stages of life, make sure your preteen keeps up with professional teeth cleanings and exams, and talk with us about whether fluoride treatments or sealants may be appropriate for your child.
For more on your child’s oral health, read “How to Help Your Child Develop the Best Habits for Oral Health” and “Dentistry & Oral Health For Children” in Dear Doctor magazine.
It’s National Gum Care Month. Let’s a moment to talk about why it’s so important to take care of your gums.
Gum disease affects almost half of adults over age 30 and approximately 70 percent of adults over age 65. The first stage of gum disease is called gingivitis, an inflammation of the gums. With gingivitis, gums can be red and puffy, and bleed easily when brushing or flossing. If gingivitis is not treated, it can progress to periodontitis, where the structures supporting the teeth, including the bone, begin to break down and be lost. Advanced stages of gum disease can lead to tooth loss and general health problems.
The good news is that gum disease is treatable — and early gum disease is even reversible. So what can you do to take care of your gums?
- Be diligent about your oral hygiene routine at home: Your first line of defense is your oral hygiene routine at home. Brush your teeth gently morning and night, using a soft toothbrush and fluoride toothpaste. Brushing too vigorously can harm your gums and cause them to recede. It is also important to floss every day to dislodge plaque that can build up between the teeth and around the gum line.
- Come in for professional dental cleanings and exams: Schedule regular professional cleanings to remove the plaque that is hard to reach. If plaque is not removed, it can harden to form tartar (or “calculus”). Only professional cleanings with special dental tools can remove tartar. When plaque and tartar form below the gum line, your bone that supports the teeth may be at risk. We can examine your mouth above and below the gum line to detect and monitor any signs of gum disease and recommend appropriate treatments.
We are always happy to talk with you about how to maintain the health of your gums. Remember that early gum disease is very treatable, so take care of your gums, and they’ll take care of you!
You can learn more about gum health in the Dear Doctor magazine article “Daily Oral Hygiene.”
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.”
One of the keys to a healthy mouth is daily oral hygiene. These tasks have one objective: remove plaque, a thin film of bacteria and leftover food particles, from tooth surfaces. Plaque fosters bacterial growth that can cause diseases like tooth decay or periodontal (gum) disease.
Brushing does an effective job removing plaque from the broad surfaces of teeth. But because plaque can also grow between teeth where your brush can’t reach, you also need to floss.
Unfortunately, flossing is a lot of people’s least favorite hygiene task. It can be time-consuming and requires a little more dexterity than brushing. As a result, it’s common for people to brush but not floss — and potentially miss plaque that could trigger dental disease.
There is an easier alternative to traditional string flossing: an oral irrigator. These countertop appliances deliver a stream of pulsating water at high pressure through a handheld device that looks similar to a power toothbrush. The user directs the water stream through the nozzle tip (which comes in various sizes) between the teeth. The water vibrates plaque loose and then rinses it away.
Besides people with limited dexterity, water flossers are also ideal for individuals wearing braces or other orthodontic hardware. Because of the metal hardware on and around teeth, flossing can be an arduous task. An oral irrigator makes it easier to floss and reduce plaque buildup, a perennial problem for orthodontic patients. In fact, one study of orthodontic patients found that using an irrigator with a tip especially designed for braces removed five times as much plaque as patients using only a manual toothbrush.
Of course, anyone can use an oral irrigator as an alternative to traditional flossing. Your dentist and staff can advise you on what to look for in equipment and provide instruction on how to use it. If traditional flossing isn’t your thing, consider an oral irrigator to get rid of plaque and keep your teeth and gums healthy and attractive.
If you would like more information on oral irrigation to remove daily plaque, 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 “Cleaning between Your Teeth: How Water Flossing can help.”
In her decades-long career, renowned actress Kathy Bates has won Golden Globes, Emmys, and many other honors. Bates began acting in her twenties, but didn't achieve national recognition until she won the best actress Oscar for Misery — when she was 42 years old! “I was told early on that because of my physique and my look, I'd probably blossom more in my middle age,” she recently told Dear Doctor magazine. “[That] has certainly been true.” So if there's one lesson we can take from her success, it might be that persistence pays off.
When it comes to her smile, Kathy also recognizes the value of persistence. Now 67, the veteran actress had orthodontic treatment in her 50's to straighten her teeth. Yet she is still conscientious about wearing her retainer. “I wear a retainer every night,” she said. “I got lazy about it once, and then it was very difficult to put the retainer back in. So I was aware that the teeth really do move.”
Indeed they do. In fact, the ability to move teeth is what makes orthodontic treatment work. By applying consistent and gentle forces, the teeth can be shifted into better positions in the smile. That's called the active stage of orthodontic treatment. Once that stage is over, another begins: the retention stage. The purpose of retention is to keep that straightened smile looking as good as it did when the braces came off. And that's where the retainer comes in.
There are several different kinds of retainers, but all have the same purpose: To hold the teeth in their new positions and keep them from shifting back to where they were. We sometimes say teeth have a “memory” — not literally, but in the sense that if left alone, teeth tend to migrate back to their former locations. And if you've worn orthodontic appliances, like braces or aligners, that means right back where you started before treatment.
By holding the teeth in place, retainers help stabilize them in their new positions. They allow new bone and ligaments to re-form and mature around them, and give the gums time to remodel themselves. This process can take months to years to be complete. But you may not need to wear a retainer all the time: Often, removable retainers are worn 24 hours a day at first; later they are worn only at night. We will let you know what's best in your individual situation.
So take a tip from Kathy Bates, star of the hit TV series American Horror Story, and wear your retainer as instructed. That's the best way to keep your straight new smile from changing back to the way it was — and to keep a bad dream from coming true.
If you would like more information about orthodontic retainers, please contact us or schedule an appointment for a consultation. You can learn more about this topic in the Dear Doctor magazine articles “Why Orthodontic Retainers?” and “The Importance of Orthodontic Retainers.” The interview with Kathy Bates appears in the latest issue of Dear Doctor.
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