Preventing Oral Health Problems

You can prevent gingivitis by keeping your teeth clean, especially near your gumline.
Brush your teeth at least twice a day and after meals when possible, and floss daily.

Other tips include:

• If you suffer from morning sickness, repeatedly rinse your mouth with water and brush your teeth as often as possible to neutralize the acid caused by vomiting
• If brushing your teeth causes morning sickness, rinse your mouth with water, brush without toothpaste and follow with anti-plaque fluoride mouthwash
• Eat a well-balanced diet with plenty of vitamin C and B12; both are important to oral health
• See your dentist for help in controlling plaque and preventing gingivitis

When to See Your Dentist

If you're pregnant or planning to become pregnant, see your dentist right away to schedule cleanings and discuss your oral health. Routine cleanings can generally be performed throughout your pregnancy, but the best time for any dental treatment is during the second trimester. Follow these guidelines for other procedures:

Dental emergencies can be treated during any trimester, but your obstetrician should be consulted during emergencies that require anesthesia or when medication is prescribed.

Most health care professionals feel its bestto avoid routine x-rays during pregnancy, though x-rays needed for an emergency treatment can be done safely after shielding your abdomen with a lead apron.

Appointments during the third trimester should be kept as brief as possible, laying back in the dental chair can be very uncomfortable. This may lead to dizziness or a loss of consciousness and may cause unnecessary stress on the baby.

Elective procedures should be postponed until after the baby's birth.

Pregnancy Gingivitis

Pregnancy gingivitis, in which the gums become red, swollen, tender and prone to bleeding, affects most pregnant women to some degree. Following fluctuations in hormone levels, it usually starts around the second month of pregnancy and decreasesduring the ninth month. If you already have gingivitis, it will most likely get worse during pregnancy. Left untreated, gingivitis can lead to periodontal disease, a more serious form of gum disease. Pregnant women are also at risk for developing pregnancy tumors, which are inflammatory, benign growths that develop on the gums as part of an exaggerated response to the irritants that cause periodontal disease. Usually, the tumors will go away on their own, but if they become uncomfortable or interfere with chewing or oral hygiene, they may need to be surgically removed.

About Periodontal Disease

Periodontal disease is a broad term used to describe various diseases that affect the gums, bone and surrounding structures of the teeth. Gum disease starts with plaque, the sticky film of food, saliva and germs that often settles at the gum line. If not cleaned away, the plaque hardens and becomes tartar. Tartar needs to be removed from your teeth by your dentist or dental hygienist.

Periodontitis is the more severe stage of gum disease; pockets form between your teeth and gums, filling with germs and infection. Sometimes surgery is needed to stop this process and save your teeth. If left untreated, you could lose your teeth.

Early warning signs of periodontal (gum) disease are:

• Red or swollen gums
• Bleeding gums
• Painful or tender gums
• Itchy sensation of the gums
• Loose or shifting teeth
• Tooth sensitivity
• Constant bad breath or taste
• Pus between teeth and when gums are pressed
• Gums pulling away from teeth

About Good Oral Care

Now for the good news: with good oral care, you can fight periodontal disease.

• Brush your teeth twice a day* (see below)
• Floss your teeth at least daily
• Watch for early signs of periodontal (gum) disease
• See your dentist at least twice a year
• Consult with your dentist to determine how many times a year you should have your teeth cleaned by your dental hygienist

* Use a toothbrush with a rounded end and soft bristles to avoid hurting your mouth. Use gentle back-andforth strokes to brush your teeth, gums and tongue. Get a new toothbrush every four months.

Other oral health issues associated with diabetes are:

• Tooth decay
• Fungal infections
• Mouth infections
• Dry mouth
• Poor healing

Again, good oral care is critical to fight tooth decay and infections. Visit your dentist or doctor if you have a mouth infection.Drinking more fluids, using sugar-free gum and sugar-free candy or over-the-counter saliva substitutes may help if you have dry mouth. Tell your dentist that you have diabetes, as he/she might prescribe antibiotics after certain procedures.

Risk Factors for Periodontal Disease

• Poor dental hygiene
• Poorly contoured fillings or crowns
• Poor nutrition
• Chewing tobacco
• High levels of stress
• Diabetes
• Down's Syndrome
• AIDS
• Taking certain medications: steroids, oral contraceptives and blood pressure medications
• Genetics: children of parents with periodontitis are 12 times more likely to have the bacteria that can lead to periodontal disease

Warning Signs and Symptoms of Periodontal Disease

The existence of bone destruction under the gums cannot be visually detected. This makes it especially important to visit your dentist regularly.
Some early warning signs include:

• Bleeding gums
• Red, tender, puffy or swollen gums
• Pain or tenderness in the gums
• Itchy sensation
• Teeth that are loose or shifting
• Tooth sensitivity
• Constant bad breath or taste
• Changes in your bite
• Changes in the fit of your oral appliance (i.e. partial denture)
• Gums that are pulling away from the teeth (i.e. recession)

If left untreated, periodontal disease can lead to tooth loss. Research indicates that periodontal diseases may contribute to diabetes, respiratory diseases, heart attack, stroke, or be associated with premature childbirth.

Prevention of Periodontal Disease

• Good oral hygiene and visiting your dentist regularly can stop the disease's progression
• Eating a balanced diet to supply nutrients for good health
• Proper use of a toothbrush, toothpaste, dental floss and mouthwash
• Drinking at least seven glasses of water per day to increase saliva in the mouth

Treatments

An evaluation is done using a periodontal probe to measure the depth of the space between the teeth and gums and x-rays are taken to see whether the bone is damaged. Depending on the disease progression, the following treatments are used:

• More frequent cleaning interval
• Scaling is done to scrape off tartar and plaque from the tooth's crowns and roots
• Root planing is done to smooth rough surfaces of the root and allow the gums to heal
• Surgery may be needed in certain cases to properly treat the disease

Early detection is important in the treatment of periodontal disease. In addition, you keep dental costs down by preventing further destruction. If you have any questions on periodontal disease, its progression and treatment, ask your dental care provider.

Learn more about Periodontal Disease Treatments »

Reasons for Root Canals

A damaged or diseased tooth will not heal by itself. Without treatment, the infection will spread, bone around the tooth will begin to degenerate and the tooth could fall out. The only alternative is removing the tooth.

Common Factors and Symptoms

• Trauma such as a physical blow
• Irritation caused by deep decay
• Advanced gum disease
• Pain or throbbing while biting
• Sensitivity to hot and cold
• Severe decay or an injury that creates inflammation

Treatment

After examining and X-raying the tooth, it will be determined if a root canal is needed. When the decision for root canal therapy has been made, a series of appointments will be scheduled

• First appointment — the diseased pulp will be removed, leaving the canal intact. The canal will be rinsed out, and a medication will be placed inside the canal. A temporary crown will be placed on the tooth.
• Second appointment — the canal will besterilized and filled with a permanent material. It's important to follow all of your instructions to avoid complications.

Over the years, people have heard horror stories about root canals. Rest assured that your dentist will administer medication to make sure the area is numb and you won't feel pain. Today, a root canal procedure using modern technology is nearly pain-free. The tissue surrounding the tooth may be sensitive following the procedure. Over-the-counter pain medication can be used to help the discomfort.

After Care

After the root canal is completed, you may notice a slight discoloration and brittleness in the treated tooth. In most cases, your dentist will recommend that the treated tooth receive a permanent crown. If the tooth is not crowned, you may want to ask your dentist about tooth whitening. A follow-up exam can monitor tissue healing. From this point on, brush and floss as usual and see your dentist on a regular basis.

Contrary to popular belief, after a root canal your tooth is not dead. It is alive because it receives a source of blood and nerve supply from surrounding tissue. The tooth will have no feeling to hot or cold, but will be functional for biting. With proper care and regular visits to your dentist or hygienist, the tooth should last as long as your other teeth.

The Soft Drink Tooth Decay Process

When drinking soft drinks and other sugary liquids, you're exposing your teeth to something over time that even with good brushing and flossing, can break down the hard enamel that protects your teeth. Tooth decay is caused from the tiny bacteria thriving around teeth that, when exposed to sugar, produce acid. The acid causes enamel and any exposed root surfaces to soften and decay.

Risk Factors of Soft Drink Tooth Decay

• Exposure time
• Previous cavities, crowns or fillings
• Reduced salivation (i.e. with medication, radiation or dry mouth)
• Genetics
• Individual susceptibility
• Home care
• No dental care (neglect)
• Not enough fluoridation
• Crowding of the teeth
• Deep pits and grooves in teeth

Effects of Tooth Decay

The hard outer coating of the teeth gets eaten away during tooth decay and leaves tooth surfaces looking darkly stained, soft and a leathery consistency. Some teeth even get tiny holes at the gum line. When left untreated, tooth decay can lead to larger cavities, root canals, crowns and possible tooth loss.

Beyond tooth decay, excess sugar consumption can lead to obesity, diabetes, calcium-robbed bones, kidney stones, osteoporosis and overall poor health.

Prevention

• Limit the amount of soda and other sugary liquids you drink, especially when wearing braces or retainers
• Drink other alternatives to soft drinks, such as water
• Read labels for sugar, which can also be called high-fructose corn syrup, sucrose, glucose or dextrose
• Ask your dentist about prescription fluoride to strengthen tooth enamel

Soft Drinks with High Acid Content

• Pepsi
• Coke
• Orange Minute Maid Soda
• Hawaiian Fruit Punch
• Squirt
  (University of Minnesota School of Dentistry, 2000)

Soft Drinks with High Sugar Conten

• Orange Slice
• Drape Minute Maid Soda
• Orange Minute Maid Soda
• Mountain Dew
• Barq's
  (University of Minnesota School of Dentistry, 2000)

Treatment of Soft Drink Tooth Decay

Even if your teeth are treated for tooth decay, if you continue to drink an excess of soft drinks, decay will return. Decay between and around the teeth is difficult to treat; often, the end treatment is crowns and caps on the teeth. Usually, regular cleaning by your dentist, use of fluoride treatments and proper brushing and flossing can reduce tooth decay. You do not have to stop drinking sodas and other sugary liquids entirely, but gradually start to limit your daily intake. The frequency of consumption is more or equally important as the amount consumed.

Drink liquids low in sugar and acid, and be sure to maintain good oral health by brushing, flossing and visiting your dentist. If you have questions on soft drink tooth decay, ask your dental care provider.

Tooth Development

Your child's first set of teeth are called "primary teeth". These teeth are important. They assist in a child's chewing abilities and speech development. They also act as "space-savers" in the jaw for the positioning of permanent teeth. Maintaining the health of their primary teeth may reduce the need for future orthodontic work. More importantly, a strong, beautiful smile helps your child to develop good self-esteem.

Potential Problems & Solutions

Children's teeth are often exposed to unique and inherent problems. Left uncorrected, they can become serious.

Baby Bottle Tooth Decay

Infants and young children often suffer what is known as "Baby Bottle" tooth decay. This occurs when sugary liquids found in milk, formula or fruit juices are exposed to the teeth for long periods of time. When asleep saliva decreases. This allows these sugars to pool around the teeth. The mouth's bacteria uses these sugars to create acids that damage teeth.

Your child's teeth should be checked on a regular basis for any brown spots which may mark the onset of tooth decay. Regular brushing should start with the first tooth but it is a good idea to clean your child's gums with a washcloth even before the teeth appear. To avoid baby bottle decay, do not let your child sleep with a bottle.

Thumb Sucking

In most cases thumb sucking is not harmful and most children will outgrow it by age 5. It becomes a problem when it is allowed to continue while permanent teeth are developing. The jawbone in children under the age of 8 is still soft and pliable. Thumb sucking can reshape the jaw and cause mis-alignment. Upper teeth will flare outwards while lower teeth are forced inwards.

If a child is having difficulty quitting, you may want to set up a rewards program for each time or day that they do not suck their thumb. If you are still having difficulty, your dentist can place an appliance in your child's mouth that should end the thumb sucking within days.

Other Considerations

Good dental hygiene and health in the early years will help your child develop a positive relationship with their dentist and may avoid extensive dental work in the future. To avoid any negativity associated with tooth decay, in addition to proper brushing and dental cleanings you may want to consider "Sealants".

Sealants

A Sealant is a clear, acrylic-like material that bonds with the tooth to help shield out the decay causing bacteria. They are a safe, painless and low cost way to protect your child's teeth. They are usually applied to molars since the pits and fissures of the molars are the most likely locations for cavities. Sealants should be applied when the first permanent molars (6-7 years) appear and again when the second permanent molars (11-13 years) appear. They need to be applied before the decay process begins.

In cases where they is a high risk of tooth decay, sealants may be applied to primary molars as well. Since primary teeth are "space-savers" for future permanent teeth, losing them to tooth decay may cause future orthodontic problems. Have your dentist assess whether or not sealants are warranted for your child.

Orthodontics

An Orthodontist diagnoses and treats problems associated with the positioning of the teeth. Crowded, crooked or mis-aligned teeth can cause problems with speech, tooth decay, joints, gum disease and/or may cause teeth to be chipped or lost.

It is generally recommended that children have an Orthodontic assessment by the age of 7. Since the jaw bone is still soft and pliable up until the age of 8, early assessments allow for corrections in alignment which may be much more difficult to correct later.

Your First Dental Visit

Generally, the first visit includes an overall assessment of your child's teeth and gums. Your dentist may want to take x-rays to examine facial bones and search for hidden decay. They may also recommend a cleaning and fluoride treatment.

You can consider bringing your child to see a dentist as early as 6 months of age but it is recommended that their first dental visit be no later than age 1. Preparing for these early experiences reduces the likelihood of your child becoming dental phobic.

• Choose your dentist carefully. Assure their office promotes a positive environment that makes both you and your child feel comfortable.
• Explain to your child what to expect during their initial visit. You may want to ask your dentist what procedures will be done ahead of time, so that you can prepare your child properly for each stage of their visit.
• Often the process of cleanings and exams is more frightening than the dentist. Consider having your child watch you get a cleaning or exam before it is their turn.
• Pick a time of day when your child is well rested.
• Children are intuitive. Be careful not to pass on your own fears or anxieties about dental visits to your children. Assure you are positive and prepared for the experience.
• After their initial visit, it is recommended that children visit their dentist every 6 months.

Establishing good dental habits and positive experiences early, is important for your child's long-term dental health.