What and how you eat and drink has a significant impact on the health of your teeth and gums. Therefore, an effective oral hygiene regime must take your diet into account.

Acid is your teeth's enemy; it can erode their protective enamel coating (a process called demineralization). Certain foods and beverages (such as citrus drinks and coffee) contain it, and it's produced by bacteria in your mouth that feed on dietary sugar and release acid as a byproduct (a process called fermentation). Your allies are foods and beverages that neutralize acids, provide minerals and vitamins to repair tooth enamel, and stimulate saliva.

Sugar & Decay
Sugars, the leading promoter of dental decay, exist in many forms in our diet. Some occur naturally, while others — referred to as “free sugars” — are added by the manufacturer, cook or consumer. The latter are most often linked with decay. Soft drinks are the primary source of dietary free-sugars in the U.S.

Sugars in fruit, vegetables, milk and unprocessed, starch-rich foods such as rice, potatoes and whole grains, do not appear to be harmful to teeth. Note, however, that dried fruits contain a highly concentrated sugar level and can stick to tooth surfaces. The sugar substitutes xylitol and sorbitol appear not to promote decay. In fact, there's evidence that chewing xylitol-sweetened gum three to five times daily for at least five minutes (after meals) stimulates saliva flow, which helps protect against decay.

Acids & Erosion
In addition to eroding tooth enamel, acidic foods and beverages create an environment where it's easier for decay-promoting bacteria to flourish. Saliva can reduce acidity but it must have time to work, at least 30–60 minutes. That's why behaviors that maintain acid levels, such as sipping coffee throughout the day, can be harmful.

Saliva-Promoting Saviors
Saliva is a front-line defense against erosion and decay. It helps remove food particles and contains minerals that help neutralize acid and promote remineralization of the tooth surface. Foods that stimulate saliva and/or contribute essential minerals include:

• Cheese — stimulates saliva and is rich in calcium, contributing to the re-calcification of teeth and protecting against the loss of calcium,
• Cow's milk — contains decay-counteracting calcium, phosphorous and casein,
• Plant foods — are fibrous and require chewing, which mechanically stimulates saliva,
• Water — keeps you hydrated, which is important for saliva production and preventing dry mouth (a condition that promotes acid-producing bacteria), and helps wash away food particles; fluorinated water bestows the protective properties of fluoride (a compound that makes tooth enamel more resistant to acid erosion and promotes re-calcification).

As you can see, brushing and flossing effectively is just part of the oral hygiene equation.

If you would like more information about nutrition and oral hygiene, 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 “Nutrition & Oral Health.”

Oral cancer is a serious health problem, responsible for the death of about one person every hour, every day in the United States. It was once thought that folks over 40 were chiefly at risk for the disease. If present trends continue, however, younger people may soon form the majority of oral cancer patients. So, no matter who you are, it makes sense to recognize the risk factors, and find out what you can do to reduce your chances of getting the disease.

As in many other diseases, genetic factors play a role in determining whether an individual will develop oral cancer. At present, there's nothing we can do about these inborn traits. But there are several choices we can make that will lessen our risk of oral cancer. Most of these risky behaviors are associated with other types of cancer as well.

Moderate to heavy drinkers, and users of tobacco products of all types, are as much as 9 times more likely to develop the disease than non-users. Chronic exposure to the sun has long been associated with the development of cancers of the lip. And, because the sexually-transmitted Human Papilloma Virus (HPV) can lead to oral cancer, unsafe sexual behavior is a factor that's fast becoming a primary cause of the disease.

So if you need another reason to quit smoking, stop drinking excessively, wear sunscreen and practice safe sex — consider this your warning. But there's still more you can do to reduce your risk for oral cancer, and improve your general health as well.

Eating a plant-based, whole food diet doesn't just reduce your risk of getting oral cancer — it also makes you less likely to develop many other cancers, and various chronic conditions like heart disease. The exact mechanisms by which this happens aren't completely understood, but its effects have been documented in numerous studies.

Avoiding certain chemicals, like the nitrites often found in preserved foods, can reduce cancer risk. And the antioxidants you get by eating a balanced diet rich in fruits and vegetables can help protect your body from cancer-causing substances.

Finally, don't ignore regular cancer screenings. The early signs of oral cancer are difficult for many people to distinguish from common mouth sores — but we are trained to identify possible problem areas, and can schedule further tests if needed. You can get an oral cancer screening (a fast and painless procedure) at your regular dental checkup. And you always get your checkups on time — don't you?

If you have concerns about oral cancer, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Oral Cancer” and “Diet and Prevention of Oral Cancer.”

Smiling feels great and makes others feel good as well. But if you are self-conscious about exposing teeth that are showing imperfections or excessive wear, you may not be smiling as broadly as you should be. Fortunately, there are ways to correct the esthetic issues that might be holding you back. One involves covering the natural tooth partly or completely with a natural-looking but flawless “facade.”

Perhaps you've heard about dental veneers and crowns? Both can achieve similar, eye-pleasing results by changing the shape and color of your teeth and even helping to compensate for uneven spacing or alignment. And both are custom-designed for your teeth. So what's the difference and which is right for you?

One distinguishing feature is the amount of tooth each covers. A veneer is a wafer-thin layer of dental porcelain that bonds to the front of your tooth. A crown, also fashioned from dental porcelain, fits over and covers the entire existing tooth, like a hood, right down to the gum. With either approach, to ensure the best, most natural fit, some of the natural tooth structure must be reduced by a minimal amount. In the case of veneers, up to 1 mm of tooth enamel — about the thinness of a fingernail — is removed. Crowns are generally thicker than veneers, so in their case the removal of at least 2 mm of tooth is needed.

Another difference between veneers and crowns is the situations in which one might be more suitable than the other to achieve the desired results. For example, a crown may be necessary when too much tooth structure has been lost to decay or other problems, or for use on back teeth that have to withstand greater impact from biting and chewing. A dental professional can make a recommendation based on your goals, the condition of the tooth or teeth in question, and other factors.

Either way, both veneers and crowns are an excellent solution for a range of esthetic concerns — from poor tooth color/staining, chips and cracks, and excessive wear at the bottom of teeth (from bruxism, a term for teeth grinding) to making small teeth look larger, closing minor gaps between teeth, and making slight corrections in alignment.

If you would like more information about veneers and crowns, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Porcelain Crowns & Veneers” and “Porcelain Veneers: Strength & Beauty As Never Before.”

Ninety percent of people have noticed bleeding from their gums when they brush or floss their teeth at some time or other. You may wonder if this is a result of brushing too hard — but that's not usually the case.

If your gums don't hurt — even if they bleed easily — you may think the bleeding is normal, nothing to worry about, or you're brushing too hard.

Bleeding from your gums is not normal!

It is an early warning sign of gum disease. In fact ten percent of those who start with bleeding gums go on to develop serious periodontal disease affecting the support for the teeth leading to tooth loss.

Then why do my gums bleed?

The way you brush your teeth is indeed a factor! Bacteria that normally reside in the mouth (in fact you need them to stay healthy) collect along the gum line in a biofilm. When the biofilm is not removed effectively on a daily basis, over time the gums become inflamed and bleed when touched. Other signs of inflamed gums — gingivitis — are redness and swelling, and even recession.

SO — the problem is not that you are brushing too hard, but that you are not brushing and/or flossing effectively. Both are important.

Three ways to stop bleeding gums before they lead to serious problems

1. It all starts with brushing your teeth correctly at the gum line. Use a soft multi-tufted toothbrush. Hold it in the gum line and wiggle it gently until the tooth surfaces feel clean to your tongue — just like when you've had a professional cleaning. It doesn't take force, be gentle.
2. It's just as important to remove biofilm from between the teeth where the toothbrush won't reach. If you are having difficulty flossing, we've got some easy demonstrations and instructional tips.
3. Remember, as we say, “It's not the brush, it's the hand that holds it.”

Contact us today to schedule an appointment or to discuss your questions about bleeding gums. Bring your toothbrush and floss with you to our office and ask us to demonstrate proper oral hygiene techniques. You can also learn more by reading the Dear Doctor magazine article “Bleeding Gums: A very important warning sign of gum disease.”

Whether they come as removable devices or wires permanently attached behind the front teeth, orthodontic retainers have a crucial job to do in your mouth. Here's the skinny on what you ought to know about them.

1) Retainers keep your new smile looking the way it should.

After having braces to move your teeth into the desired position, a retainer is needed to keep them from moving right back where they were! In time, the periodontal (“peri” – around; “odont” – tooth) structures, which are constantly renewing themselves, will adapt to their new positions, and the teeth will stabilize.

2) There are different types of retainers.

Once upon a time, retainers were made of pink plastic and bent wire, and were removable. They're still available — but a common alternative today is to have clear retainers that fit onto your teeth covering them entirely or to have thin wires bonded to the inside of the front teeth They don't show, and you don't have to worry about putting them in and taking them out. If you prefer, ask us whether this type of retainer would work for you.

3) It takes several months for your teeth to become stable in a new arrangement.

Teeth must be held in position long enough for the bone and ligament that attaches them to the jaw to re-form and mature around them. A retainer helps avoid trauma as the teeth and associated structures are adjusting to relocation, allowing the process to end slowly and gently.

4) Even when they're stable, your teeth are always in a “dynamic” state.

There is some “memory” inherent in bone and gum tissue, which tends to cause teeth to shift back to their former positions for a long period of time after treatment. But teeth aren't held in place just by bone and ligament — a balance between the forces of the lips, cheeks and tongue also helps them stay put. This balance changes over a period of time.

5) The movement of teeth is unique to each person, and is not predictable.

Contrary to what orthodontists used to believe, there is no “right” position for the teeth that assures they will stay in place permanently. In time, the position of the teeth may change due to a slow “uprighting” movement of the front teeth in the lower jaw, which causes them to crowd as they move toward the tongue. Other factors may also cause a gradual movement of the teeth. But remember to always follow our recommendations; they will help keep your smile looking its best.

If you would like more information about orthodontic retainers, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Why Orthodontic Retainers?” and “The Importance of Orthodontic Retainers.”