My Blog

By Drs. Heller & Meersand
September 18, 2019
Category: Oral Health
Tags: gum disease   smoking  
SmokingCouldIncreaseYourGumDiseaseRisk

Although periodontal (gum) disease starts with the gums, the teeth may ultimately suffer. An infection can damage the gum attachment and supporting bone to the point that an affected tooth could be lost.

The main cause for gum disease is dental plaque, a bacterial biofilm that accumulates on teeth due to ineffective oral hygiene. But there can be other contributing factors that make you more susceptible to an infection. Smoking tobacco is one of the most harmful as more than half of smokers develop gum disease at some point in their life. If you’re a heavy smoker, you have double the risk of gum disease than a non-smoker.

There are several reasons why smoking increases the risk of gum disease. For one, smoking reduces the body’s production of antibodies. This diminishes the body’s ability to fight oral infections and aid healing. As a smoker, your body can’t respond adequately enough to the rapid spread of a gum infection.

Another reason for the increased risk with smoking are the chemicals in tobacco that damage the connectivity of gum tissues to teeth that keep them anchored in place. The heavier the smoking habit, the worse this particular damage is to the gums. This can accelerate the disease and make it more likely you’ll lose affected teeth.

Smoking can also interfere with getting a prompt diagnosis of gum disease because the nicotine in tobacco reduces the blood supply to the gums. Usually a person with an infection may first notice their gums are reddened or swollen, and bleed easily. Smoking, however, can give a false impression of health because it prevents the infected gum tissues from becoming swollen and are less likely to bleed. As a result, you may learn you have the disease much later rather than sooner, allowing the infection to inflict more damage.

There are ways to reduce your disease risk if you smoke. The top way: Kick the smoking habit. With time, the effects of smoking on your mouth and body will diminish, and you’ll be better able to fight infection.

You should also practice daily brushing and flossing to keep plaque at bay, followed by regular dental cleanings to remove hard to reach plaque and calculus (tartar) deposits. You should also see your dentist at the first sign of trouble with your gums.

If you would like more information on the prevention and treatment of gum disease, 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 “Smoking and Gum Disease.”

By Drs. Heller & Meersand
September 08, 2019
Category: Dental Procedures
Tags: dental implant  
YourQuestforaDentalImplantMightBeInterruptedbyBoneLoss

Years ago, disease or trauma robbed you of one of your teeth. At the time you might have opted for an affordable solution, like a partial denture. But now you'd like to restore that missing tooth with a dental implant, the most life-like tooth replacement available.

That's a great decision. But there may be a hiccup along the way to your new implant: the state of the underlying jawbone. Implants need a certain amount of bone for proper placement. If not enough is present, that may cause an interruption in your plans—and that could be a real possibility if your tooth has been missing for some time.

That's because, like other living tissues, bone has a growth cycle: Old bone cells die and dissolve, while new cells form to take their place. In the jaw, the force produced by teeth during chewing helps to keep this growth process in the bone functioning at a healthy pace.

When a tooth goes missing, though, so does this chewing stimulation. A lack of stimulation can slow the growth rate for that part of the bone and its volume can diminish over time. It's possible for a quarter of the bone volume to be lost within the first year after losing a tooth.

If you've experienced that level of bone loss, we may not be able to place an implant—yet. You might still have a few options. For one, we could attempt to regenerate some of the bone through grafting. Bone material grafted into the affected area can serve as a scaffold for new bone cells to form and adhere. Over time, this could result in a sufficient amount of regenerated bone to support a dental implant.

Another possibility might be to install a smaller diameter implant like those used to support removable dentures. Because they're smaller they require less bone than standard-sized implants. They're not for every situation, though, and are best suited for situations where aesthetics isn't a priority.

To know what your options are regarding an implant-based restoration, you'll need to undergo a thorough evaluation of your oral health, including supporting bone. Depending on your situation, you may still be able to renew your smile with this premier tooth replacement option.

If you would like more information on dental implants, 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 “Dental Implants After Previous Tooth Loss.”

By Drs. Heller & Meersand
August 29, 2019
Category: Oral Health
ExpertAdviceVivicaAFoxonKissingandOralhealth

Is having good oral hygiene important to kissing? Who's better to answer that question than Vivica A. Fox? Among her other achievements, the versatile actress won the “Best Kiss” honor at the MTV Movie Awards, for a memorable scene with Will Smith in the 1996 blockbuster Independence Day. When Dear Doctor magazine asked her, Ms. Fox said that proper oral hygiene was indeed essential. Actually, she said:

"Ooooh, yes, yes, yes, Honey, 'cause Baby, if you kiss somebody with a dragon mouth, my God, it's the worst experience ever as an actor to try to act like you enjoy it!"

And even if you're not on stage, it's no fun to kiss someone whose oral hygiene isn't what it should be. So what's the best way to step up your game? Here's how Vivica does it:

“I visit my dentist every three months and get my teeth cleaned, I floss, I brush, I just spent two hundred bucks on an electronic toothbrush — I'm into dental hygiene for sure.”

Well, we might add that you don't need to spend tons of money on a toothbrush — after all, it's not the brush that keeps your mouth healthy, but the hand that holds it. And not everyone needs to come in as often every three months. But her tips are generally right on.

For proper at-home oral care, nothing beats brushing twice a day for two minutes each time, and flossing once a day. Brushing removes the sticky, bacteria-laden plaque that clings to your teeth and causes tooth decay and gum disease — not to mention malodorous breath. Don't forget to brush your tongue as well — it can also harbor those bad-breath bacteria.

While brushing is effective, it can't reach the tiny spaces in between teeth and under gums where plaque bacteria can hide. But floss can: That's what makes it so important to getting your mouth really clean.

Finally, regular professional checkups and cleanings are an essential part of good oral hygiene. Why? Because even the most dutiful brushing and flossing can't remove the hardened coating called tartar that eventually forms on tooth surfaces. Only a trained health care provider with the right dental tools can! And when you come in for a routine office visit, you'll also get a thorough checkup that can detect tooth decay, gum disease, and other threats to your oral health.

Bad breath isn't just a turn-off for kissing — It can indicate a possible problem in your mouth. So listen to what award-winning kisser Vivica Fox says: Paying attention to your oral hygiene can really pay off! For more information, contact us or schedule an appointment for a consultation. You can read the entire interview with Vivica A. Fox in Dear Doctor's latest issue.

EnsuretheBestOutcomewiththeRightCareforaTeensMissingTooth

While it's possible for a teenager to lose a tooth from decay, it's more common they'll lose one from an accidental knockout. If that happens to your teenager, there are some things you should know to achieve a good outcome.

Our top concern is to preserve the underlying bone following tooth loss. Like other tissues, bone has a life cycle: older cells dissolve and are absorbed by the body (resorption), then replaced by new cells. The biting pressure generated when we chew helps stimulate this growth. But bone around a missing tooth lacks this stimulation and may not keep up with resorption at a healthy rate.

This can cause a person to lose some of the bone around an empty tooth socket. To counteract this, we may place a bone graft at the site. Made of bone minerals, usually from a donor, the graft serves as a scaffold for new bone growth. By preventing significant bone loss we can better ensure success with a future restoration.

Because of its lifelikeness, functionality and durability, dental implants are considered the best of the restoration options that can be considered to replace a missing tooth. But placing an implant during the teen years is problematic because the jaws are still growing. If we place an implant prematurely it will appear to be out of alignment when the jaw fully matures. Better to wait until the jaw finishes development in early adulthood.

In the meantime, there are a couple of temporary options that work well for teens: a removable partial denture (RFP) or a fixed modified bridge. The latter is similar to bridges made for adults, but uses tabs of dental material that bond a prosthetic (false) tooth to the adjacent natural teeth to hold it in place. This alleviates the need to permanently alter the adjacent natural teeth and buy time so that the implant can be placed after growth and development has finished.

And no need to worry about postponing orthodontic treatment in the event of a tooth loss. In most cases we can go ahead with treatment, and may even be able to incorporate a prosthetic tooth into the braces or clear aligners.

It's always unfortunate to lose a tooth, especially from a sudden accident. The good news, though, is that with proper care and attention we can restore your teenager's smile.

If you would like more information on how to treat lost teeth in teenagers, 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 “Dental Implants for Teenagers.”

GuideYourOlderChildrenorTeensthroughThese3OralHealthAreas

Helping your infant or toddler develop good dental habits is one of the best head starts you can give them toward optimum oral health. But even after they’ve matured enough to handle hygiene tasks without you, they still need your guidance.

This is especially true in the “tween” and teen years. Although they’re beginning to flex their independence muscles, they’re still vulnerable at this age to peer pressure urging them to try things that, among other outcomes, could hurt their oral health.

Here are 3 areas where your input and guidance could save your older children and teens from oral health problems.

Sports activities. As children mature, they may also become involved with various physical activities, including contact sports. Years of diligent hygiene and dental care can be undone with one traumatic blow to the mouth. You can help avoid this by urging your child to wear a mouth guard during sports activity. While there are some good choices on the retail market, the most effective mouth guards are custom-created by a dentist to precisely fit your child’s mouth.

Oral piercings. While expressions of solidarity among young people are popular and often harmless, some like oral piercings and their hardware could potentially damage teeth and gums. You should especially discourage your child from obtaining tongue bolts or other types of lip or mouth hardware, which can cause tooth wear or fracture. Instead, encourage them to take up safer forms of self-expression.

Bad habits and addictions. A young person “spreading their wings” may be tempted to dabble in habit-forming or addictive activities. In addition to their effect on the rest of the body, tobacco, alcohol and drugs can have severe long-term consequences for oral health. Unsafe sexual practices could lead to the contraction of the human papilloma virus, which has been linked to oral cancer in young adults. Be sure your teen understands the dangers of these habits to both their oral and general health—and don’t hesitate to seek professional help when a habit becomes an addiction.

If you would like more information on helping your child develop great oral habits, 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 “How to Help Your Child Develop the Best Habits for Oral Health.”





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