Posts for: March, 2014

By Arnold Cutler, D.D.S.
March 24, 2014
Category: Oral Health
FluorideisaProvenWeaponintheFightAgainstToothDecay

In the early 1900s, a Colorado dentist noticed many of his patients had unusual brown staining on their teeth — and little to no tooth decay. What he unknowingly observed was the power of a chemical substance in his patients' drinking water — fluoride. While commonplace today, fluoride sparked a revolution — and some controversy — in dental care during the 20th Century.

After decades of research and testing, most dentists now agree that fluoride reduces decay by interfering with the disease process. The optimum pH level for the mouth is neutral; however, this environment constantly changes as we eat, especially if we ingest foods or beverages high in acidity. A high acid level softens tooth enamel (a process called de-mineralization) and can lead to erosion if not neutralized. In addition, a thin layer of bacteria-rich plaque called biofilm that adheres to tooth surfaces is also acidic and is the cause of tooth decay, possibly more so in teeth made more susceptible from enamel erosion.

When fluoride is in “the right place” (present on the tooth surface and in our saliva, the body's natural acid neutralizer), it helps inhibit de-mineralization and aids in the re-hardening of the enamel (re-mineralization).

Although fluoride needs to come into direct contact with tooth enamel for optimum effectiveness, ingesting it can also prove beneficial. The fluoride we ingest eventually becomes deposited in bone. As bone grows and changes it releases this reserved fluoride back into the bloodstream where it eventually becomes part of saliva; the saliva brings it into contact with tooth surfaces.

The two most prominent ways we encounter fluoride are through fluoridated drinking water and in toothpaste. There continues to be concerns about what constitutes safe levels of fluoride in drinking water and over possible side effects like teeth staining and changes in bone structure. However, extensive studies have conclusively shown that even minimal levels of water fluoridation and the use of fluoride toothpaste have reduced tooth decay.

As the Colorado dentist discovered over a hundred years ago, fluoride is truly remarkable as a cavity fighter. Whether you have access to fluoridated water or not, we encourage you to use fluoride toothpaste to strengthen your teeth against decay.

If you would like more information on fluoride, 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 “Fluoride & Fluoridation in Dentistry.”


By Arnold Cutler, D.D.S.
March 21, 2014
Category: Oral Health
Top5SymptomsofGumDisease

Do you have gum disease? According to the U.S. Centers for Disease Control, about half of the adults in America have a mild, moderate or severe form of this disease. But if you’re 65 or older, your chance of having it goes up to 70 percent! Periodontal (gum) disease is sometimes called a “silent malady” because major symptoms may not appear until it has reached an advanced stage. How can you recognize the early warning signs? Here are some clues to look for:

  1. Redness and irritation of gums. Having red, swollen or sore gums can be a sign of gum disease; however, it could also result from brushing your teeth too vigorously, or using a brush with hard bristles. That’s why we recommend using a soft-bristled brush and a gentle cleaning stroke. If you’re doing this but you still have irritated gums, it could be an early signal of gum disease.
  2. Bleeding when you brush. Despite what you may think, this is never a normal occurrence. If your gums regularly bleed after brushing, it’s usually an indication that gum disease is present. You should come in for an examination as soon as possible.
  3. Bad breath or a bad taste in your mouth. Bad breath or unpleasant tastes could be caused by what you ate last night — or they could result from gum disease. If the odor or taste is persistent — that is, if it doesn’t seem to go away over time — it could indicate a problem with your gums.
  4. Gum recession. When you have gum recession, the healthy, pink tissue surrounding the teeth begins to pull back, or recede. This exposes more of the tooth’s structure — even its roots — and makes teeth look longer. While gum recession is a common condition that is primarily caused by periodontal disease, many people don’t realize they have it because it occurs so gradually. They also may not realize that by the time it is noticed, some underlying bone tissue has already been lost. Gum recession is a condition you shouldn’t ignore: If left untreated, it can result in the destruction of more gum and bone tissue, and even tooth loss.
  5. Tooth Sensitivity or pain when chewing. Many things can cause tooth pain or sensitivity: an old filling, tooth decay, even a cracked tooth or a root canal problem. Gum disease can also cause this unpleasant sensation. Receding gums may expose the tooth’s roots, which aren’t as well protected from the mouth’s harsh environment as the chewing surfaces; this may cause a sensation of pain when chewing or brushing. If this sensation persists, it’s time for an examination to find out what’s causing it.

Gum disease is a widespread problem — but it’s also very treatable. If you would like more information, call our office to arrange a consultation. You can learn more in the Dear Doctor magazine articles “Warning Signs of Periodontal (Gum) Disease” and “Understanding Gum (Periodontal) Disease.”


By Arnold Cutler, D.D.S.
March 12, 2014
Category: Oral Health
GumInflammationCouldHaveanEffectonYourHeartHealth

Your body’s organ systems are interlinked — what happens in one system may affect another. An example of this is the interrelationship between periodontal (gum) disease and cardiovascular disease (CVD).

Medicine has discovered a common link between these two different conditions — inflammation. A result of the body’s defense mechanisms, chronic inflammation is damaging to both your mouth and your heart. Inflammation can destroy the gum’s soft tissue and underlying bone and lead to tooth loss. In the cardiovascular system, inflammation can begin and accelerate the buildup of plaque within arterial blood vessels (atherosclerosis). This inhibits the flow of oxygenated blood to both the heart and brain, which sets the stage for a heart attack or stroke.

Gum disease begins with poor oral hygiene. When brushing and flossing aren’t performed on a regular basis, or not performed adequately, it allows a thin layer of bacterial plaque called biofilm to build up on the teeth. The bacteria cause infection in the soft tissues of the gum that triggers the chronic inflammation. Because it’s often unaccompanied by other signs of infection like fever, a patient may not even be aware of it. There’s evidence now that inflammation caused by moderate to severe gum disease can contribute to a similar response in blood vessels.

We can treat the gum disease and reduce or eliminate the inflammation. This first requires the removal of all plaque and calculus (harder deposits) on the teeth, down to the root level. It may require surgery to access these areas and to help regenerate some of the lost tissue and bone that support the teeth. It’s also important to institute proper oral hygiene — effective daily brushing and flossing, semi-annual office cleanings and checkups.

In a similar way, you should address signs of inflammation in your cardiovascular system, including blood pressure management and the control of LDL (bad) cholesterol. Because both gum disease and CVD share many of the same risk factors, you can positively impact both your oral and general health by eating more nutritional foods, engaging in regular exercise and quitting tobacco products.

Treating any symptom of inflammation is important to improving your total health. By bringing gum disease and its accompanying inflammation under control, you may in turn help your heart and blood vessels.

If you would like more information on the relationship between heart and gum diseases, 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 “The Link Between Heart & Gum Diseases.”


By Arnold Cutler, D.D.S.
March 04, 2014
Category: Oral Health
ReducingtheRisksandEffectsofDentalSportsInjuries

Sports are an important element in human society — besides providing enjoyment they also build discipline, teamwork and character.

But sports activities, especially for children and teenagers, also carry the risk of physical injury — and your teeth and mouth aren’t immune. About 22,000 mouth injuries occur annually in individuals under the age of 18. As the degree of contact within the sport rises, so does the risk of dental injuries.

To reduce this risk, it’s important to adopt a comprehensive approach to dental injuries, beginning with protection. For any sport that involves a ball, stick, puck or physical contact with another player, athletes should incorporate two pieces of equipment to fully protect against mouth injury: headgear and a mouthguard. Both help to evenly distribute the forces generated during an impact and thus reduce the chance or severity of injury.

The design of headgear will depend on other factors involving a particular sport. Mouthguards are more singular in their purpose, and so what works in one sport should work in another. While there are a number of types like stock or “boil and bite,” the highest level of protection is a custom-fitted mouthguard created by a dentist to specifically fit the individual’s bite. Although more costly than other options, it can better reduce the chances of an even more costly mouth injury.

Because we can only reduce the risk of injury but never eliminate it, protection is only part of the approach. Individuals, parents and sports officials should have plans in place for treating dental injuries should they occur. Depending on the level of trauma, individuals should have access to a dentist as soon as possible. It’s also important to know what to do when specific injuries occur, whether they require an immediate, urgent or less urgent response. The Dear Doctor magazine article, “The Field Guide to Dental Injuries” is an excellent primer on dental injury treatment.

Sports can have a positive effect on physical, emotional and social development. Adopting a well-rounded approach to dental injury prevention and treatment will help keep the focus on those benefits.

If you would like more information on protection and treatment from sports-related dental injuries, 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 “An Introduction to Sports Injuries & Dentistry.”




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