At some point in every person's life, they will experience bleeding gums or gingivitis, a mild inflammation of the gingiva (gums), which is the first stage of periodontal (gum) disease. For example, when was the last time you were brushing or flossing your teeth and noticed that your gums were bleeding or that when you spit and rinsed there was some blood? When this occurs, it is a sign that you have gum disease, as healthy gum tissues do not bleed. And no, it is highly unlikely that your bleeding is from brushing too hard. You would have to use extreme force to make healthy gum tissues bleed. However, this is exactly how most people discount or ignore this warning sign.

If this sounds like you or another member of your family, here's what you can expect when you see us for treatment. Depending on the severity of your periodontal disease, all of these treatment options may not be necessary.

Behavior change: We will collect a thorough medical history to obtain facts about your oral hygiene, eating and other personal habits such as alcohol and tobacco use to determine their impact on your periodontal disease. Proper brushing and flossing techniques are necessary for everyone, whether you have early or late stage gum disease; however, you must commit to a good daily oral health routine if you want to achieve success and thus keep you mouth and teeth healthy.

Calculus (tartar) removal: Cleaning is not just your responsibility. We'll clean and polish your teeth to remove calculus (tartar), the calcified deposits of bacterial products that become glued to the teeth and roots that you can’t remove. In fact, routine visits to see us for a thorough cleaning will help ensure that all the unhealthy calculus (tartar) is removed from your teeth.

Evaluation: Usually after three or four weeks, we will want to see you to evaluate your progress and to see the response of your gingival tissues to the treatment thus far. And depending on the severity of your gum disease, we may need another follow-up exam to decide the best maintenance and monitoring regimen necessary to keep your mouth healthy.

Occlusal or Bite Therapy: This treatment, if necessary, usually occurs once your gum tissues have been stabilized and the inflammation and infection have been controlled. It is during this phase that we will address loose teeth or teeth that have shifted or drifted in position.

Surgical Therapy: For more severe cases of gum disease, you may need periodontal plastic surgery to repair and regenerate gum and bone tissue and their attachment to the teeth. It may also be necessary to replace missing teeth with dental implants.

If you are ready to talk to us about the current state of your mouth (or the mouth of another member of your family), contact us today to schedule an appointment. The first step towards achieving optimal oral health could start with this simple call. Or, you can learn more by reading, “Understanding Gum Disease.”

Can chewing gum prevent cavities? Yes! It can if the gum is sweetened with xylitol.

What is xylitol?
Xylitol is a type of “sugar alcohol,” similar to sorbitol and mannitol, sugar replacements that are used in many low calorie foods. Xylitol occurs naturally in many fruits and vegetables and is obtained from the bark of birch trees, coconut shells and cottonseed hulls. It looks and tastes like sugar and is a diabetic-safe, low-calorie carbohydrate.

How does xylitol stop cavity formation?
Decay starts when certain bacteria break down sucrose (regular table sugar) and produce acids that dissolve the minerals in the enamel, the outer protective layer of your teeth. When the decay-causing bacteria try to consume xylitol, they are unable to break it down, and instead they begin to starve.

A normal mouth contains a large population of bacteria, and it is better for your teeth to have more “good” bacteria of the kind that do not cause cavities. Xylitol also stops your saliva from becoming acidic, so your mouth becomes a better environment for the “good” bacteria.

Chewing xylitol gum also increases your flow of saliva. Saliva contains calcium and fluoride and helps give these minerals back to your teeth (re-mineralization), undoing some of the effects of the cavity-causing bacteria. This makes chewing xylitol gum a particularly good solution for people who suffer from dry mouth.

How much xylitol do you need to prevent cavities?
We recommend that you chew or suck on two pieces of xylitol gum or two pieces of xylitol candy for five minutes following meals or snacks, four times daily — if you are at moderate to extreme risk for cavities. The target dose of xylitol is 6 to 10 grams (one or two teaspoons) spread throughout the day. Prolonged gum chewing is not advised, so most xylitol-sweetened products contain flavor that only lasts a short time to discourage excessive chewing. The only side effect of too much xylitol ingestion is that it may have a mild laxative effect.

I don't like chewing gum. Is there another way to get xylitol?
People who don't like to chew gum have the option of using xylitol in mints, candies, mouthwash, toothpaste, or mouth sprays. For these individuals, a minimum dose is 5 to 6 grams (one teaspoon) three times per day.

So now you can add xylitol to the list of ways to fight cavities: daily brushing and flossing, and regular professional cleanings — and chewing xylitol gum.

Contact us today to schedule an appointment to discuss your questions about xylitol and other methods of preventing tooth decay. You can also learn more by reading the Dear Doctor magazine article “Xylitol in Chewing Gum.”

Your teeth were designed to last you a lifetime, so you should do everything you can to protect them. This includes guarding them against dental erosion. However, many people may not know for sure what dental erosion is, much less how or why they need to guard against it.

Dental or tooth erosion is the irreversible loss of tooth enamel from chemical attack by acids. Eating or sucking acidic foods such as lemons is a good example. But most people are shocked to discover that it can also be caused by their favorite sodas (carbonated beverages), natural fruit juices, energy and sports drinks — especially with excessive consumption. It takes the saliva, nature's protection, at least 30 to 60 minutes to neutralize the effects of acid, so only one acidic drink an hour causes your teeth to be continually bathed in acid. And this is an important fact to know, because if your mouth is acidic all the time, this will promote tooth decay.

Will brushing help out with prevention?

When it comes to dental erosion, brushing immediately after acid consumption can actually make it worse by accelerating the erosion process. This is because the acids in these drinks (and some foods) actually dissolves tooth enamel and softens the tooth surface. These newly softened surfaces can literally be brushed away if you brush before your saliva has a chance to try to reverse the process. If done often, you could even brush away your enamel! For this reason, you should wait at least 30 to 60 minutes before you brush your teeth after consuming any of these products.

So what can you do to prevent dental erosion?

One important step that you (and your family) can do to help prevent dental erosion is to limit the amount of these beverages you drink. Instead, try drinking calcium-rich milk or water and saving your favorite acidic beverage for a special treat that you consume preferably with a meal. Try reducing the number of these drinks you consume over a period of time. If you must drink an acidic beverage avoid swishing it in the mouth and use a straw to reduce the contact between the acid and your teeth.

Just remember that once your dental enamel has eroded, it is gone forever. So you should follow these simple tips now to protect your smile and future.

When involved in high impact sports or vigorous activities, it is important to protect your mouth and teeth. This statement is backed by the fact that there are over 600,000 sports-related dental injuries treated in emergency rooms across the US each year according to the US Centers for Disease Control (CDC).

In addition to absorbing and distributing the forces that impact the mouth, teeth, face and jaws an athlete receives while participating in sports such as baseball, football, basketball, hockey (ice and field), skateboarding and wrestling, the American Dental Association (ADA), also recommends the use of custom mouthguards for other activities such as acrobatics, bicycling, handball, racquetball, skiing, and even weightlifting.

These facts make two things clear: (1) it is vital that you obtain a professionally made mouthguard that you wear during these types of activities and (2) that you also understand how this mouthguard protects you. Below are just a few ways.

1. Lacerations. A custom-fit, professionally made mouthguard covers the sharp surfaces of the teeth to protect the soft tissues of the cheeks, lips, gums and tongue from lacerations that can occur from a blow or sudden jolt.
2. Mouth Impact. Just as a mouthguard protects against soft tissue lacerations, it can also help prevent injuries to the jaws and teeth. This includes but is not limited to chipped teeth, fractured teeth, broken teeth and teeth that are partially or fully knocked out of their natural position.
3. TMJ (jaw joint) Trauma. Wearing a properly fitted mouthguard can reduce the potential for jaw displacement and joint fractures by cushioning the jaws against damage from an impact.
4. Direct Jaw Impact. Anytime a person receives a direct impact to his/her jaw, having a mouthguard in place may help prevent more serious injuries to teeth and jaws. This is especially important for anyone diagnosed with TMJ.
5. Jaw Fracture. A custom-fit, professionally made mouthguard both absorbs and distributes impact forces so that jaws are protected. And it is this reduction in force that can help prevent the jaws from fractures.
6. Under Chin Impact. Receiving a blow under the chin can obviously damage teeth; however, it can also cause damage to the jaws as well as inflame or cause TMJ issues.

You can learn more about mouthguards by continuing to read the Dear Doctor magazine article “Athletic Mouthguards.” Or you can contact us today to schedule an appointment.

Tongue and other piercings are a current fad or trend, but can often lead to unforeseen problems.

Piercing the tongue and installing a metal ornament called a tongue bolt commonly leads to chipped teeth, sensitivity, and pain. More frequently, it can cause problems with the gums, such as recession, inflammation, infection, bone loss, and even nerve damage.

In one case reported by the American Medical Association, a teenager suffered 20 to 30 daily electrical shocks in many areas of her face after having her tongue pierced and installing a tongue bolt. A neurologist found that the bolt irritated the nerves to her tongue, causing the symptoms. After the bolt was removed, the shocks and symptoms ceased and her tongue healed.

Having the bolts placed may be painful. The tongue is rich in nerves and blood vessels and a lot of bleeding can occur, which can be difficult to stop. Think about how painful it is when you bite your tongue or lip accidentally. And tongue and lip bolts are not generally placed by health professionals or under sterile conditions.

If you are considering getting an oral piercing, make an appointment with us to discuss all the possible ramifications before you make the decision to go ahead. If you already have an oral piercing, be sure to come in for frequent checkups.

Contact us today to schedule an appointment to discuss your questions about oral piercings. You can also learn more by reading the Dear Doctor magazine article on “Body Piercings and Teeth: The dangers of tongue and lip piercing.”