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Q: Do you have any general safety tips for protecting teeth?

A: In addition to brushing, flossing and making regular trips to the dentist for exams and cleaning, you can take numerous common-sense steps to help preserve the integrity of your smile. For instance, though the law requires it already, we’ll remind you to always wear a seat belt when driving or riding in a car. A short stop, whether you’re in front or back, can crack your mouth against whatever’s in front of you. When running or walking, be mindful of your surroundings and your terrain. A crack in the pavement, a raised piece of sidewalk, can send you tumbling and put your teeth in jeopardy.

If athletics is your thing, decide whether a mouth guard is appropriate. And elect to be safe rather than sorry. Elbows flying in a pick-up game of basketball can wreak havoc with a smile.

Don’t drink hot chocolate while eating ice cream. This is by way of saying avoid dramatic temperature changes in your mouth. They can make enamel contract and expand and lead to hairline cracks that will ultimately cause problems. If you can’t brush right after a meal, rinse your mouth with water or chew some sugarless gum. Talk with your dentist about other common-sense steps you can take to protect your teeth 

Q: What’s the best way to avoid oral cancer?

A: The first step in avoiding oral cancer is to eliminate from your lifestyle well-known risk factors like tobacco and alcohol. Regarding tobacco, it’s not just smoking that’s a problem. Chewing tobacco is just as dangerous to your oral health. The risk of cancer is greater in a person who both smokes and drinks than in a person who does just one or the other. And regular visits to your dentist are also important. As with any form of cancer, early detection is vital to successful treatment. Stay alert for signs of a cancerous or pre-cancerous development. Those would include:

•   A sore that just won’t heal or bleeds easily.

•   Difficulty chewing, speaking, swallowing or moving the tongue or jaw.

•   A lump or any thickening in the cheek or tongue.

•   Any color change in the tissue of your mouth, and specifically, a white or red patch anywhere in the mouth. 

Give yourself a periodic self-examination. If you notice any of these signs, contact your dentist immediately for a professional assessment. Talk with your dentist about other ways to minimize your risk of oral cancer.

Q: What is involved in capping a tooth’s pulp?

A: The pulp is, literally, the tooth’s nerve center. Inside the enamel and dentin, the pulp holds the nerves, blood vessels and connective tissue. If decay pierces the enamel and dentin and threatens the pulp, it will not only be very painful, it can also kill the nerve, often making root canal therapy necessary to save the tooth.

But your dentist may choose to try to save the nerve with a pulp cap. Direct capping is used when removal of decay actually exposes the pulp. The dentist puts a protective layer of calcium hydroxide over the pulp, then perhaps a sedative layer of material over that, and then a filling. If the procedure is successful, the nerve will pull away from the calcium hydroxide, leaving space for new dentin. A similar procedure, called indirect pulp capping, is used if the decay has not gone all the way through the dentin to the pulp. A cap can give the dentin time to regenerate. In either case, when the dentist can determine, after weeks or months, if the procedure was successful, he’ll apply a permanent filling.

Practice good oral hygiene at home and visit your dentist regularly so you’ll never need to find out first hand what pulp capping is really like. 

 

Q: What’s the difference between oral cysts and tumors?

A: A tumor is a growth; a cyst is a hollow sac or pouch that holds fluid, a semi-fluid or a solid substance. A tumor can be benign, meaning non-cancerous, or malignant, meaning cancerous. Cysts are generally benign, though on rare occasions they can become cancerous. A cyst can develop as a result of, among other things, a blocked duct, infection or trauma. Cysts are generally painless, though speaking or eating may irritate them.

With few exceptions, the causes of tumors are not known. One type of non-malignant tumor in the mouth is called oral tori. This growth of bone is fairly common and follows hereditary patterns. Also, it’s not uncommon for a woman in the first trimester of pregnancy to develop benign growths between the teeth that are known as “pregnancy tumors.” Reddish masses, they appear and grow quickly. They may last through the pregnancy and may or may not disappear shortly after the birth.

Oral cancer strikes some 35,000 Americans every year. If you notice any sort of change in your mouth, see your dentist as soon as possible. To find out more about cysts and tumors, talk with your dentist. 

 

Q: Is it safe for children to use toothpaste that has fluoride in it?

A: It’s not only safe, it’s highly recommended. A landmark 2003 study that reviewed five decades’ worth of clinical trials involving children and adolescents found that brushing with fluoridated toothpaste resulted in 24 percent fewer cavities compared with regular use of non-fluoridated toothpaste. The study found that brushing once a day with a fluoride toothpaste had benefits, and that brushing twice a day conferred greater protection.

Fluorine, the element from which fluoride is derived, is proven effective in fighting tooth decay because it strengthens enamel. And it’s not just recommended for children: fluoride is credited with having reduced tooth decay across all age groups in the United States by 50 to 60 percent since the practice of adding fluoride to public water supplies in the years after World War II. Because it is so effective, the use of fluoridated toothpaste also holds down the cost of dental treatment. When you buy toothpaste, look for the American Dental Association Seal of Acceptance on the product. Talk with your dentist about the benefits of fluoride toothpaste. 

 

Q: What is a root canal?

A:  A root canal is a procedure used to repair and save a tooth that has severely decayed and/or has become infected to the point that the pulp, the nerve-carrying interior portion of the tooth, has to be removed.

The pulp extends from the crown of the tooth to the tip of the root in the jaw. If it becomes infected, it can lead to abscesses, infections at the root of the tooth. In a root canal, the dentist—or an endodontist, a general dentist who has gone on for further training to  specialize in root canals—will open the crown of the tooth and remove the diseased pulp. The dentist may put medication into the pulp chamber and the canals of the root. The dentist may leave the tooth open for a few days if it needs to drain, or may put a temporary filling on the tooth. After a time, the dentist will remove the temporary filling and clean out the inside of the tooth. When your dentist is sure the infection is gone, he or she will fill the tooth and put on a new artificial crown.

Root canal therapy will require more than one visit to the dentist. Talk with your dentist about the root canal procedure and, more importantly, about what you can do to avoid ever needing one.

 

Q: What should I do if I get a toothache?

A: A toothache can be an excruciating experience. Its relentless throbbing can make it impossible for a person to concentrate on anything else. The pain can wake you, or keep you awake, at night, and make you reluctant to eat for fear of aggravating the situation. Temporary measures—ice, clove oil, aspirin—may ease the pain. But if you have a toothache, you most likely have an infection that needs the attention of a dentist.

Putting off treatment with the use of home remedies is only going to exacerbate the situation. If the cause of the toothache is decay that has caused infection, the tooth is going to need immediate treatment from the dentist. The treatment could be a filling, an extraction or some other procedure, like a root canal. The sooner you visit the dentist, the sooner you get relief. Also, the longer you put off visiting the dentist, the more likely that a dental problem, like gum disease, can develop and have an adverse effect on your overall health. Talk with your dentist about ways to avoid toothache and keep your mouth fresh and clean. 

 

Q: Is dental health really an issue with kids?

A: Tooth decay is the number one health issue with children, even more prevalent than asthma. Dental problems cause kids to miss school and can lead to problems with eating, sleeping and developing properly. Thus, it’s important to get regular dental care for children.

The American Dental Association recommends a visit to the dentist within six months of the eruption of a baby’s first tooth, but no later than the child’s first birthday. Waiting until a child is in pain is not the way to determine the time for a first dental visit. By that time, several teeth could be involved. Not only will the dentist examine your child’s teeth, he     or she can guide you on the proper use of sippy cups and bottles and give you some good nutrition advice for your child.

One way to promote good oral care with your children is to set a good example. If they see you brushing and flossing at home, the more likely they are to adopt good habits. One tip from some experts is to help your children brush their teeth until they can write in cursive. Until that time, their small motor skills may not be adequate to accomplish a thorough brushing. Talk with a dentist for more information on how to preserve your child’s dental health.

Dental Precautions while traveling:

Q: We're planning an overseas vacation. Any tips for dental hygiene?

A: The first piece of advice is to schedule a cleaning and thorough dental exam at least a couple of weeks before leaving on your trip.  Knowing your mouth is in good shape before you leave can ease any anxiety about having to deal with a problem while you're abroad.  If you have a major procedure coming up, have it finished before you go, or schedule it for your return.  You don't want to have to deal with a dentist who doesn't know you-and whome you don't know-if you have an emergency in another country.  Have your dentist's office phone number with you if you need to contact them in an emergency.

Certainly when you're packing, dont forget your dental equipment: toothbrush, floss, toothpaste and whatever other items you may regularly use.  Remember that in these days of the TSA and heightened security, you may not be able to bring toothpaste or mouthwash on a flight in your carry-on.  And don't be tempted to rinse your mouth with tap water from the plane's rest room.  Everyone's situation, or course, is different.  If you're planning an overseas trip, talk with your dentist about what you specifically, should have with you and what you should do if an emergency arises.

How Tooth decay starts:

Q; What gets a cavity started?

A; What starts a cavity is the repetition of a process that occurs in your mouth when sugars from the food and drink you consume interact with bacteria that live in the plaque on your teeth.  That interaction produces acid, which begins a process called demineralization, the loss of calcium and phosphate from the tooth's enamel.  It usually starts in a spot not readily noticeable, like in a fissure.  Eventually, over months and months, the affected patch of enamel collapses, leaving a hole, or cavity.  Left untreated, the cavity will spread into the dentin, the softer, more sensitive part of the tooth under the enamel.  If the excruciating pain hasn't driven you to the dentist first, decay will eventually destroy the tooth.

One of the keys to preventing decay is the removal of plaque.  Plaque is the filmy substance that's on the teeth.  The more it is allowed to build up, the greater the danger of decay.  Brushing and flossing are so important because they are the most effective ways of eliminating plaque.  Keeping sugar out of your diet is another key.  Talk with your dentist about ways to cut down your risk of tooth decay.

Frequency of X-Rays:

Q: How often should a person have dental x-rays taken?

A: Every case is different. Generally, if you are a new patient, the dentist will depend on your gu=eneral health, your age and your dental condition.  For instance, if you suffer from gum disease, x-rays may be necessary to check on the condition's progression.  Bone loss will be visible on an x-ray, but not to the naked eye.  Regarding age, children may need more frequent x-ray examinations because their teeth and jaws are in a state of continuing development.

In terms of additional lifetime risk from radiation exposure, dental x-ray examinations are considered by experts to have negligible impact.  Your dentist can give you a thorough explination of the value of radiograph examinations and how they may be appropriate to your particular case.
 

Tooth Structure:

Q: How many parts does a tooth have?

A: Each tooth is a relatively complex entity.  To begin with, each has two major sections: the crown-that portion that is visible above the gum, and the root, the part that goes down into the gum and secures the tooth in a socket in the jaw.  The outside of the crown is covered with enamel, which is the hardest substance in the body.  At the heart of the tooth is the pulp, which contains blood vessels and nerves that sense heat, cold, pressure and pain.

The pulp is inside a hard substance called the dentin, which by mass accounts for most of the tooth.  Although the dentin is hard, it's considerably more flexible than enamel and gives the tooth the elasticity needed to chew hard food without cracking the tooth-not that a tooth with never crack.  The dentin gets nutrients from the pulp and can reproduce itself as long as the pulp is healthy.  As the enamel protects the crown, the root is protected by cementum, a bone-like substance.  The cementum connects with the preiodontal ligament, which connects the root of the tooth to the socket in the jaw.  Talk with your dentist about the importance of the various parts of the tooth and what you can do to keep your teeth healthy.