If you’re pregnant, you may find yourself pondering decisions you didn’t have to think about before. Should you have that glass of wine… or skip it, because of the alcohol; go for the sushi… or avoid uncooked foods; take the pain reliever… or live with the headache. And if you have a toothache — or even if you’re overdue for a checkup and a cleaning — you may also be wondering whether having dental treatment (especially treatment that might involve local anesthetics) is safe for you and your developing baby.
Fortunately, a study that recently appeared in the Journal of the American Dental Association (JADA) should let expectant moms breathe a little easier. The research concludes that it’s safe for pregnant women to undergo dental treatment, including procedures that use local anesthetics.
And that’s good news indeed, because while maintaining good oral health during pregnancy is critical for the developing baby, many expectant moms experience problems during this period.Â Some common issues include a higher risk of tooth decay due to increased carbohydrate consumption, and sore or bleeding gums from a condition called pregnancy gingivitis.
According to the study’s lead author, Aharon Hagai, D.M.D., "[Pregnancy] is a crucial period of time in a woman’s life, and maintaining oral health is directly related to good overall health." Yet, as Dr. Hagai notes, pregnant women sometimes avoid the dentist even if they have a problem. So his team set out to determine whether having dental treatment with anesthesia affected the outcome of pregnancies. They compared a total of 1,004 women, some of whom had dental treatment with local anesthesia, and some who did not.
The research showed there was no significant difference between the two groups. This applied in terms of both major medical problems (such as cleft palate, heart defects or cerebral palsy) and other issues, including low birth weight and preterm delivery. Dr. Hagai summed it up this way: "We aimed to determine if there was a significant risk associated with dental treatment with anesthesia and pregnancy outcomes. We did not find any."
So if you’re pregnant, there’s one less thing to worry about. Go ahead and schedule your routine dental check up — and remember that it is particularly important to have cleanings during pregnancy. Â If you experience changes in your oral health, don’t hesitate to come in for an office visit and cleaning; that way, you can make sure your hormonal changes are not playing havoc with your gums. There is an old saying in some cultures that for every child a woman has, she loses a tooth. Don’t let that happen to you.
If you have questions about oral health and pregnancy, please call our office to schedule a consultation. You can read more in the Dear Doctor magazine article “Expectant Mothers: Dental facts you need to know” and “Pregnancy and Oral Health.”
It takes a lot of skill, experience, talent and artistry to create tooth restorations that look so natural that no one can tell them apart from the originals. To do so requires understanding of the normal anatomy of a tooth as well as of the interactions of light and color.
The color that we perceive when looking at a tooth results from the combined appearance of the tooth’s center core (dentin layer) and its covering enamel. Going from the outside in, the enamel is made of tightly packed crystals of calcium, which cause it to be one of the hardest substances naturally produced by animals. The crystals are also responsible for a tooth’s brilliance and translucence. The dentin is more like bone, a porous living tissue composed of microscopic tubes, interspersed with more calcium crystals. In the very center of the tooth is a central chamber containing the pulp and nerves.
Each of these layers has its own physical and optical properties. Since the enamel is translucent and the dentin is more opaque, most of the tooth’s color comes from the dentin and is transmitted through the enamel layer. Factors that affect this transmission include the thickness and age of the enamel as well as external tooth whitening.
If the enamel is more translucent, more of the color of the dentin shows through. If it is more opaque, the enamel absorbs and reflects light so that less color is visible and the enamel looks brighter.
Color means the whole spectrum in the rainbow. The spectrum is made up of the three primary colors — red, blue, and green. When all are combined, they create white light.
Hue refers to the brightest forms of the colors. The color we perceive depends on the dominant wavelength of light that is reflected by an object.
Value refers to a color’s lightness or darkness. A brighter color has a higher value.
Chroma is the amount of identifiable hue in a color. An achromatic color (without hue) appears gray.
Saturation is a measure of a color’s intensity.
This terminology of color is used not only by dentists and dental technicians, but also by a wide range of artists. It implies expertise and understanding of how colors work, how they vary and change and affect one another.
Contact us today to schedule an appointment or to discuss your questions about bonding to repair chipped teeth. You can also learn more by reading the Dear Doctor article, “Artistic Repair of Front Teeth with Composite Resin.”
Acquired Immune Deficiency Syndrome (AIDS) jolted our collective consciousness in the 1980s. The deadly disease caused by the human immunodeficiency virus (HIV) had no known cure and, at the time, no effective treatment.
HIV is a retrovirus, a virus with a genetic makeup and reproduction system differing from other kinds. After taking up permanent residency in the body, HIV begins “hijacking” the replication process of cells in the body's immune system and replacing it with a copy of its own. This destroys the cells' ability to protect the body from hostile organisms. As the virus affects more and more cells, the patient's condition ultimately develops into AIDS.
An estimated 35 million people worldwide (1.2 million in the U.S.) are currently infected with the virus. Thanks to new antiretroviral drugs, though, HIV can be kept from accelerating into AIDS. While their condition remains serious, many HIV positive patients can now live long and relatively normal lives. Even so, having the virus requires them to pay close attention to their health, including their mouth.
Even while stalled from becoming AIDS, HIV can still cause oral problems for 30 to 80% of patients. The fungal infection candidiasis (also known as thrush) is the most common of these problems, which appears as lesions, cracking skin or creamy white patches on the tongue or palate that easily bleed. Patients also have higher risks for dry mouth, oral cancer and periodontal (gum) disease.
HIV positive patients must practice diligent daily oral care and see their dentist for checkups regularly. Prevention, early diagnosis and treatment can keep gum disease and other damaging conditions under control. Monitoring oral health is also important because certain mouth conditions could be an early sign the infection is entering a new advanced stage in the body that requires additional attention.
Keeping vigilant in all aspects of health is a way of life for someone with HIV. Such vigilance, though, can help them maintain a healthy mouth and even prolong their life.
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.”
Watching your kids dress up in cute, spooky costumes and go out trick-or-treating can be a real thrill. But thinking about the dental damage caused by eating all those sweets might just give you the chills. So is it best to act like a witch and take away all the candy from those adorable little ghosts and goblins?
Relax! According to experts like the American Dental Association, it’s OK to let kids enjoy some sweet treats on special occasions like Halloween—especially if they have been taking good care of their oral hygiene all year long, by brushing twice each day and flossing once every day. But to help keep cavities away from those young smiles, there are some things parents (and everyone else) should understand.
Cavities—small holes in the tooth’s outer surface that result from the decay process—get started when bacteria in the mouth feed on sugar and produce acids. The acids eat away at the hard enamel coating of teeth. If left untreated, decay will eventually reach the soft inner core of the tooth, causing even more serious damage.
There are several ways to stop the process of tooth decay. One is to take away the sugar that decay bacteria feed on. Because this ingredient is common in so many foods, it’s hard to completely eliminate sugar from the diet. Instead, it may be more practical to limit the consumption of sweets. For example, if kids are only allowed to eat sugary treats around mealtimes, it gives the mouth plenty of “downtime,” in which healthful saliva can neutralize the bacterial acids. It also helps to avoid sweets that stick to teeth (like taffy or gummy bears) and those that stay in the mouth for a long time (like hard candy).
Another way to help stop tooth decay is by maintaining top-notch oral hygiene. Decay bacteria thrive in the sticky film called plaque that clings stubbornly to the surfaces of teeth. Plaque can be removed by—you guessed it—effective brushing and flossing techniques. While it’s a good start, brushing alone won’t remove plaque from the spaces between teeth and under the gums: That’s why flossing is an essential part of the daily oral hygiene routine. Helping your kids develop good oral hygiene habits is among the best things you can do to fight cavities.
And speaking of habits, there are a few others that can help—or hurt—your oral health. For example, drinking plenty of water keeps the body hydrated and benefits oral health; but regularly drinking soda and other sweetened or acidic beverages greatly increases the risk of tooth decay. And seeing your dentist on a regular basis for professional cleanings and routine checkups is one of the most beneficial habits of all. Working together, we can help keep tooth decay from turning into a scary situation for kids—and adults too.
If you have questions about cavity prevention or oral hygiene, please contact our office or schedule a consultation. You can learn more in the Dear Doctor magazine articles “How to Help Your Child Develop the Best Habits for Oral Health” and “Tooth Decay—How to Assess Your Risk.”
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