The market for sugar alternatives has grown exponentially since saccharin was accidentally discovered in 1878. Today, saccharin has been joined by other FDA-approved zero-calorie artificial sweeteners, including aspartame (“Equal®” or “NutraSweet®”), sucralose (“Splenda®”) and rebaudioside A, derived from the stevia plant. You can also choose low-calorie alcohol sugars like erythritol or xylitol.
With rare exceptions, all these choices are widely considered safe substitutes for table sugar, high fructose corn syrup or other versions of this plentiful carbohydrate. Finding substitutes for sugar is a worthy health goal: besides its role in obesity, sugar is considered a contributing factor in cardiovascular disease and diabetes.
It's also a prime food for oral bacteria that cause dental disease. As bacteria consume sugar they produce acid as a byproduct. Acid softens and dissolves the mineral content in enamel, leading to erosion and the formation of cavities. While saliva normally neutralizes acid after we eat, constant snacking and higher quantities of sugar in our food make it difficult for it to control or neutralize acid in the oral environment.
Because most of us are hard-wired with a “sweet tooth,” it's difficult for many to cut back on sugar. Artificial sweeteners help reduce the amount of sugar in the diet with obvious benefits for general health. It can also make a big difference in your dental health by helping you prevent tooth decay.
One alcohol sugar may even go a step further. In addition to reducing the presence of sugar in the mouth, xylitol (found in chewing gums, candy and breath mints) also seems to reduce bacterial growth by interfering with their ability to ferment the sugar.
If you're considering using an artificial sweetener, get to know them first: some like aspartame aren't suitable for baked goods or cooking, while saccharine or sucralose are. People with a rare genetic condition called phenylketonuria also can't properly process aspartame in the body.
Be sure you also talk to us about artificial sweeteners' impact on oral health, especially the benefits of xylitol for dental care. Used in a wise and informed way, these sugar alternatives can improve both your oral and general health.
If you would like more information on artificial sweeteners impact on dental health, 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 “Artificial Sweeteners: Satisfying and Protecting your Sweet Tooth.”
Even though a child’s primary (“baby”) teeth eventually give way, it’s still important to treat them if they become decayed. Primary teeth serve as guides for the emerging permanent teeth — if they’re lost prematurely, the permanent tooth may come in misaligned.
If the decay, however, affects the tooth’s inner pulp, it poses complications. A similarly decayed adult tooth would be treated with a root canal in which all the pulp tissue, including nerve fibers and blood vessels, are removed before filling and sealing. Primary teeth, however, are more dependent on these nerves and blood vessels, and conventional filling materials can impede the tooth’s natural loss process. It’s better to use more conservative treatments with primary teeth depending on the degree of decay and how much of the pulp may be affected.
If the decay is near or just at the pulp, it’s possible to use an indirect pulp treatment to remove as much of the softer decay as possible while leaving harder remnants in place: this will help keep the pulp from exposure. This is then followed with an antibacterial agent and a filling to seal the tooth.
If the pulp is partially exposed but doesn’t appear infected, a technique called direct pulp capping could be used to cover or “cap” the exposed pulp with filling material, which creates a protective barrier against decay. If decay in a portion of the pulp is present, a pulpotomy can be performed to remove the infected pulp portion. It’s important with a pulpotomy to minimize the spread of further infection by appropriately dressing the wound and sealing the tooth during and after the procedure.
A pulpectomy to completely remove pulp tissue may be necessary if in the worst case scenario the pulp is completely infected. While this closely resembles a traditional root canal treatment, we must use sealant material that can be absorbed by the body. Using other sealants could inhibit the natural process when the primary tooth’s roots begin to dissolve (resorb) to allow it to eventually give way.
These all may seem like extraordinary efforts to save a tooth with such a short lifespan. But by giving primary teeth a second chance, their permanent successors will have a better chance of future good health.
If you would like more information on treating decay in primary 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 “Root Canal Treatment for Children’s Teeth.”
Is a chipped tooth big news? It is if you’re Justin Bieber. When the pop singer recently posted a picture from the dental office to his instagram account, it got over 2.6 million “likes.” The snapshot shows him reclining in the chair, making peace signs with his hands as he opens wide; meanwhile, his dentist is busy working on his smile. The caption reads: “I chipped my tooth.”
Bieber may have a few more social media followers than the average person, but his dental problem is not unique. Sports injuries, mishaps at home, playground accidents and auto collisions are among the more common causes of dental trauma.
Some dental problems need to be treated as soon as possible, while others can wait a few days. Do you know which is which? Here are some basic guidelines:
A tooth that’s knocked out needs attention right away. First, try and locate the missing tooth and gently clean it with water — but avoid holding the tooth’s roots. Next, grasp the crown of the tooth and place it back in the socket facing the correct way. If that isn’t possible, place it between the cheek and gum, in a plastic bag with the patient’s saliva or a special tooth preservative, or in a glass of cold milk. Then rush to the dental office or emergency room right away. For the best chance of saving the tooth, it should be treated within five minutes.
If a tooth is loosened or displaced (pushed sideways, deeper into or out of its socket), it’s best to seek dental treatment within 6 hours. A complete examination will be needed to find out exactly what’s wrong and how best to treat it. Loosened or displaced teeth may be splinted to give them stability while they heal. In some situations, a root canal may be necessary to save the tooth.
Broken or fractured (cracked) teeth should receive treatment within 12 hours. If the injury extends into the tooth’s inner pulp tissue, root canal treatment will be needed. Depending on the severity of the injury, the tooth may need a crown (cap) to restore its function and appearance. If pieces of the tooth have been recovered, bring them with you to the office.
Chipped teeth are among the most common dental injuries, and can generally be restored successfully. Minor chips or rough edges can be polished off with a dental instrument. Teeth with slightly larger chips can often be restored via cosmetic bonding with tooth-colored resins. When more of the tooth structure is missing, the best solution may be porcelain veneers or crowns. These procedures can generally be accomplished at a scheduled office visit. However, if the tooth is painful, sensitive to heat or cold or producing other symptoms, don’t wait for an appointment — seek help right away.
Justin Bieber earned lots of “likes” by sharing a picture from the dental office. But maybe the take-home from his post is this: If you have a dental injury, be sure to get treatment when it’s needed. The ability to restore a damaged smile is one of the best things about modern dentistry.
If you have questions about dental injury, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Repairing Chipped Teeth” and “Porcelain Crowns & Veneers.”
For over a century now, health providers have depended on blood and urine samples to diagnose many forms of disease. Very soon, though, we may routinely use a different bodily fluid that's easier and cheaper to collect: saliva.
Secreted by six hundred or more glands in the mouth, saliva performs a number of important functions for digestion and overall oral health. Saliva lubricates the mouth to make food easier to swallow. Its enzymes begin the digestion process breaking down food even before we swallow. It also helps wash out food particles that could build up as plaque on the teeth and harbor disease-causing bacteria.
In terms of dental health, its greatest role is as a neutralizer of food acid. It's natural after we eat for the acid levels in the mouth to rise above normal. If acid remains in contact with enamel for an extended period of time it can soften the enamel's minerals and make it easier for them to erode. Within thirty minutes to an hour after eating, saliva neutralizes acid and restores the mouth's normal pH level. Saliva also contains calcium and phosphate materials, which helps restore some of the minerals the enamel may have lost from the acid contact.
But we're discovering saliva can do even more: we can now use it as an indicator for certain conditions in the body. Like blood or urine, saliva contains molecules that can serve as biological markers for different types of disease. By employing devices calibrated to detect these markers, we can use saliva to uncover cancer, diabetes or other systemic conditions.
As these particular devices are manufactured and become more available, the use of saliva for disease diagnosis will rise. In the future, you may not need a trip to the bathroom or wince at a needle stick — a swab of your saliva will do!
If you would like more information on saliva's role in your health, 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 “Saliva: How it is Used to Diagnose Disease.”
Like other healthcare providers, your dentist keeps records of your ongoing care. These include not only their written notes but also x-ray imaging, frequency of visits and cleanings, and any medical information that could affect your care. What’s more, they have a legal obligation to maintain these records.
Your dental records help guide decisions about your care. In that regard, you should consider something else—you may need to change providers: your dentist retires or you move; your dentist isn’t in your new insurance network; or, unfortunately, you have an “irreconcilable” difference with your provider.
If that happens, it’s very important your dental records find their way to your new provider. Here are 3 reasons why.
Your individual dental history. Each person’s dental situation and needs are unique. Your past records help clue in your new dentist about your past history and current needs, which will help guide how they treat you.
Time and money. Your dental records contain x-rays or other diagnostic information about your oral condition, including preparations for any upcoming dental work. If you change dentists before completing that treatment, your new dentist may have to start over with new diagnostic tests if they don’t have this previous data. It could cost you more money and make you wait longer for a needed procedure.
Coordinating dental care with your general health. Your mouth isn’t isolated from the rest of your body, and some dental treatment measures could affect other health conditions (and vice-versa). If your new dentist knows other health issues you may have from your previous records, it can help ensure you’re getting dental treatment appropriate to your overall health.
For the most streamlined transition between providers, it’s important your dental records follow you. You’re entitled to having those records transferred, and, if you’re uncomfortable asking yourself, your new provider can obtain them for you. Just be sure to ask.
If you would like more information on your rights regarding your dental care records, 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 “Why Your Dental Records Should Follow You.”
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