Dental Education Library

Oral Changes with Age
Is tooth loss inevitable in your later years? How much should adults be concerned about cavities? Here you will find helpful answers to some frequently asked questions about oral health that you may have as you get older.

National Survey Reveals Baby Boomers Miss Links between Oral and Overall Health
Baby boomers looking for the warning signs of adult-onset diseases may overlook key symptoms in their mouths that should signal alarms about their overall health.
According to a survey commissioned by the Academy of General Dentistry, 63% of baby boomers (ages 45-64) with an oral symptom considered a key indicator of a more serious health condition were unaware of the symptom`s link. Boomers` failure to recognize that oral health holds valuable clues could negatively impact their overall health.

Frequently Asked Questions: Dental Fillings
Are dental amalgams safe? Is it possible to have an allergic reaction to amalgam? Is it true that dental amalgams have been banned in other countries? Is there a filling material that matches the tooth color? If my tooth doesn’t hurt and my filling is still in place, why would the filling need to be replaced?

Read this interesting and informative discussion from the American Dental Association.

FDA Consumer Update: Dental Amalgams
The Centers for Disease Control and Prevention offer some scientific background on mercury (contained within silver-colored fillings) and whether they believe the substance presents any health hazards.

Analysis Reveals a Significant Drop In Children’s Tooth Decay
Children have significantly less tooth decay in their primary (baby) and permanent teeth today than in the early 1970s, according to the Journal of the American Dental Association (JADA). The analysis reveals that among children between the ages of six and 18, the percentage of decayed permanent teeth decreased by 57.2% over 20 years.

In addition, children between the ages of two and 10 experienced a drop of nearly 40% in diseased or decayed primary teeth.

Alternative Materials
Advances in modern dental materials and techniques increasingly offer new ways to create more pleasing, natural-looking smiles. Researchers are continuing their often decades-long work developing esthetic materials, such as ceramic and plastic compounds, that mimic the appearance of natural teeth. As a result, dentists and patients today have several choices when selecting materials used to repair missing, worn, damaged, or decayed teeth.

The advent of these new materials has yet to eliminate the usefulness of more traditional dental restoratives, which include gold, base metal alloys, and dental amalgam. The strength and durability of traditional dental materials continue to make them useful for situations where restored teeth must withstand extreme forces that result from chewing, such as in the back of the mouth.

Alternatives to amalgam, such as cast gold restorations, porcelain, and composite resins, are more expensive. Gold and porcelain restorations take longer to make and can require two appointments. Composite resins, or white fillings, are esthetically appealing but require a longer time to place.

Here’s a look at some of the more common alternatives to silver amalgam:

• Composite fillings are a mixture of acrylic resin and finely ground glasslike particles that produce a tooth-colored restoration. Composite fillings provide good durability and resistance to fracture in small-to-mid-size restorations that need to withstand moderate chewing pressure. Less tooth structure is removed when the dentist prepares the tooth, which may result in a smaller filling than an amalgam.
  Composites can also be bonded, or adhesively held, in a cavity, often allowing the dentist to make a more conservative repair to the tooth. Composite fillings are less wear-resistant than silver amalgams in teeth with high chewing loads. It also takes longer to place a composite filling.
• Glass Ionomers are tooth-colored materials made of a mixture of acrylic acids and fine glass powders that are used to fill cavities, particularly those on the root surfaces of teeth. Glass ionomers can release a small amount of fluoride, which helps patients who are at high risk for decay. Glass ionomers are primarily used as small fillings in areas that do not need to withstand heavy chewing pressure. Because they have a low resistance to fracture, glass ionomers are mostly used in small, non-load-bearing fillings (those between the teeth) or on the roots of teeth.
• Resin Ionomers are also made from glass fillers with acrylic acids and resin. They are also used for non-load-bearing fillings (between the teeth) and have low to moderate resistance to fracture. Ionomers experience high wear when placed on chewing surfaces. Both glass and resin ionomers mimic natural tooth color but lack the natural translucency of enamel. Both types are well tolerated by patients, with only rare occurrences of allergic reactions.
• Porcelain (ceramic) dental materials include porcelain, ceramic or glass-like fillings, and crowns. They are used as inlays, onlays, crowns, and aesthetic veneers. A veneer is a very thin shell of porcelain that can replace or cover part of the tooth’s enamel. All-porcelain (ceramic) restorations are desirable because their color and translucency mimic natural tooth enamel.
  All-porcelain restorations require a minimum of two visits and possibly more. The restorations are prone to fracture when placed under tension or on impact. Their strength depends on an adequate thickness of porcelain and their ability to be bonded to the underlying tooth. They are highly resistant to wear, but the porcelain can quickly wear opposing teeth if the porcelain surface becomes rough.

Sealants
Research has shown that almost everybody has a 95% chance of eventually experiencing cavities in the pits and grooves of their teeth.

Sealants were developed in the 1950s and became commercially available in the early 1970s. The American Dental Association Council on Dental Therapeutics accepted the first sealant in 1972. Sealants work by filling in the crevasses on the chewing surfaces of the teeth. This shuts out food particles that could get caught in the teeth, causing cavities.

The application is fast and comfortable, and it can protect teeth for many years. Research has shown that sealants stop cavities when placed on top of a slightly decayed tooth by sealing off the supply of nutrients to the bacteria that causes a cavity.

Sealants act as a barrier, preventing bacteria and food from accumulating in tooth grooves and pits. Sealants are best suited for permanent first molars, which erupt around age 6, and second molars, which erupt around age 12.

Sealants work best when applied after the tooth has fully emerged. Because of this, children derive the greatest benefit from sealants because of the newness of their teeth. Research has shown that more than 65% of all cavities occur in the narrow pits and grooves of a child’s newly erupted teeth because of trapped food particles and bacteria.

Application
Sealant application involves cleaning the tooth’s surface and rinsing the surface to remove all traces of the cleaning agent. An etching solution or gel is applied to the tooth’s enamel surface, including the pits and grooves. After 15 seconds, the solution is thoroughly rinsed away with water. After the site is dried, the sealant material is applied and allowed to harden by using a special curing light.

Sealants normally last about five years. They should always be examined at the child’s regular checkup. Sealants are extremely effective in preventing decay on the chewing surfaces of the back teeth.

Insurance coverage for sealant procedures is increasing but is still minimal. Many dentists expect this trend to change as insurers become more convinced that sealants can help reduce future dental expenses and protect the teeth from more aggressive forms of treatment.

For decades, fluoride has been held in high regard by the dental community as an important mineral that strengthens tooth enamel, which thereby helps to prevent the decay of tooth structures.

Water fluoridation is endorsed by nearly every major health and safety-related organization in the world. Communities make it a common practice to “fluoridate” their drinking supplies so that the general population can benefit from this inexpensive and effective preventative treatment.

According to the American Dental Association, more than 144 million U.S. residents in more than 10,000 communities drink fluoridated water, most from public water supplies with sodium fluoride added artificially.

Bottled Water, Home Water Treatment Systems, and Fluoride Exposure
Can the consistent use of bottled water result in individuals missing the benefits of optimally fluoridated water? Can home water treatment systems (e.g., water filters) affect optimally fluoridated water supplies? The answer is yes to both.

Read how you can avoid some of the pitfalls preventing you from getting the maximum value of fluoride in this article from the American Dental Association.

ADA Statement on FDA Toothpaste Warning Labels
The American Dental Association’s Council on Scientific Affairs believes that one part of the warning now required on fluoride toothpaste by the Food and Drug Administration (FDA) could unnecessarily frighten parents and children and that the label greatly overstates any demonstrated or potential danger posed by fluoride toothpaste.

The label language, “If you accidentally swallow more than used for brushing, seek professional help or contact a poison control center immediately,” is now required on all fluoride toothpaste. But the ADA, in a letter sent to the FDA last year, pointed out that a child could not absorb enough fluoride from toothpaste to cause a serious problem and that the excellent safety record of fluoride toothpaste argues against any unnecessary regulation.

Enamel Fluorosis
According to the American Academy of Pediatric Dentistry, a child may face enamel fluorosis if they receive too much fluoride during tooth development. Too much fluoride can result in defects in tooth enamel.

CDC Website Provides Information on Community Water Fluoridation
People seeking information on whether their water system is fluoridated can now find out by visiting a new Web site at the Centers for Disease Control and Prevention (CDC). The new feature, “My Water’s Fluoride,” allows consumers in participating states to check out basic information about their water system, including the number of people served and the target fluoridation level.

Optimal levels recommended by the U.S. Public Health Service and CDC for drinking water range from 0.7 parts per million (ppm) for warmer climates to 1.2 ppm for cooler climates, accounting for the tendency to drink more water in warmer climates.

Participating states include Arizona, Colorado, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Maine, Massachusetts, Michigan, Minnesota, Nebraska, New Hampshire, Nevada, North Dakota, Oklahoma, Pennsylvania, and Wisconsin.

The First Line of Defense against Oral Health Problems
In general dentistry, the dentist is the primary care provider for patients of all ages and is responsible for the prevention, diagnosis, and treatment of a wide variety of conditions, disorders, and diseases affecting the teeth, gums, and maxillofacial (jaw and face) parts of the body. Even though general dentists primarily provide preventative care and minor restorative therapy, they can often perform various other dental procedures, including minor cosmetic treatments.

The American Dental Association (ADA) recommends that patients visit their general dentist at least once every six months to ensure proper oral health and functionality. Regular oral health check-ups and maintenance help prevent serious dental problems that may require more extensive and costly treatments.

General dentists are highly educated and trained in multiple facets of dentistry, providing various services for you and your family.

• Crowns and bridges
• Dentures
• Dental implants
• Gum disease (Periodontal) Treatment
• Orthodontics
• Root canal therapy
• Teeth cleanings
• Bonding
• Dental fillings

General dentists who do not perform a certain treatment will provide you with a specialist referral.

Standards and Best Practice
With the increased media attention on infection outbreaks such as AIDS and multi-drug resistant strains of viruses, it’s no wonder people have heightened concerns about infection control during a medical procedure.

Gloves, gowns, and masks must be worn in all dentist offices today—a far cry from just a few decades ago when fewer than one-third of all dentists even wore such personal protective equipment or PPE. After each patient visits, disposable PPE, such as gloves, drapes, needles, and scalpel blades-are thrown away, hands are washed, and a new pair of gloves is used for the next patient.

All hand instruments used on patients are washed, disinfected, and sterilized with chemicals or steam after each use.

One of the most effective methods for preventing disease transmission—washing one’s hands—is practiced in our office. It is routine to wash hands at the beginning of the day, before and after glove use, and after touching surfaces that may have become contaminated.

Water Quality and Biofilms
Concerns about the quality of water used in a dentist’s office are unfounded, provided the dentist follows the infection control guidelines of the Centers for Disease Control and the American Dental Association.

Some health “experts” in recent years have called into question the risks associated with so-called “biofilms,” which are thin layers of microscopic germs that collect on virtually any surface. Essentially, these bacteria and fungi occur everywhere, including faucets in your home; your body is no less accustomed to exposure than in any other situation.

No scientific evidence has linked biofilms with disease. You are susceptible to germs everywhere if you have a compromised or weakened immune system. Consequently, let our office know if you have such a condition so we can take additional precautions.

Does mercury in the silver fillings in your mouth pose any long-term health risks? Despite everything we’ve been told since childhood, does fluoride cause more harm than good? What does the latest research reveal about tobacco use on your overall oral health?

This section is dedicated to the latest information about these and other oral health topics, pulled from authoritative sources such as the American Dental Association.

Click here for the latest news from the American Dental Association.

Recently, naturally occurring latex has been linked to allergic reactions in people who use such products as latex gloves. The proteins in the latex, which can also become airborne, can cause problems in vulnerable people, such as breathing problems and contact dermatitis. Some allergic reactions, including anaphylactic shock, have been more severe.

Many health experts have rightly attributed the dramatic increase in allergic reactions to latex in the healthcare community to the increased use of gloves and other personal protection equipment in light of the AIDS epidemic.

Latex is pervasive in many household items—from toys and balloons to rubber bands and condoms.

Latex allergies could cause the following symptoms:

• Dry skin
• Hives
• Low blood pressure
• Nausea
• Respiratory problems
• Tingling sensations

People with high-risk factors for latex allergy include those who have undergone multiple surgical operations, have spina bifida, or are persistently exposed to latex products.

If you are vulnerable to latex or have allergies related to it, please notify our office and, by all means, seek medical attention from your family physician.

Certain kinds of medications can hurt your teeth.

Long ago, children exposed to tetracycline developed tooth problems, including discoloration, later in life. However, the medication fell out of use and is not an issue today. The best precaution is to ask your family physician if any prescribed medications can harm your teeth or other oral structures.

Dry mouth is commonly associated with certain medications, including antihistamines, diuretics, decongestants, and painkillers. People with medical conditions, such as an eating disorder or diabetes, are often plagued by dry mouth. Other causes are related to aging (including rheumatoid arthritis) and compromised immune systems. Garlic and tobacco use are other known culprits.

A dry mouth occurs when saliva production drops. Saliva is one of your body’s natural defenses against plaque because it acts to rid your mouth of cavity-causing bacteria and other harmful materials.

Some of the less alarming results of dry mouth include bad breath. But dry mouth can lead to more serious problems, including burning tongue syndrome, a painful condition caused by a lack of moisture on the tongue.

If dry mouth isn’t readily apparent, you may experience other conditions that dry mouth can cause, including an overly sensitive tongue, chronic thirst, or even difficulty speaking.

Heart Disease
Poor dental hygiene can cause many problems outside your mouth – including your heart.

Medical research has uncovered a definitive link between heart disease and certain oral infections, such as periodontal disease. Some have even suggested that gum disease may be as dangerous as or more dangerous than other factors, such as tobacco use. Chronic periodontitis, or persistent gum disease, has been linked to cardiovascular problems by medical researchers.

In short, infections and harmful bacteria in your mouth can spread through the bloodstream to your liver, which produces harmful proteins that can lead to systemic cardiac problems. That’s why it’s critical to practice good oral hygiene to keep infections at bay—this includes a daily regimen of brushing, flossing, and rinsing.

Antibiotic Prophylaxis
In some cases, patients with compromised immune systems or who fear an infection from a dental procedure may take antibiotics before visiting the dentist.

Bacteria from your mouth can enter your bloodstream during a dental procedure where tissues are cut or bleeding occurs. A healthy immune system will normally fight such bacteria before they result in an infection.

However, certain cardiovascular conditions in patients with weakened hearts could put them at risk for an infection or heart muscle inflammation (bacterial endocarditis) resulting from a dental procedure.

Patients with heart conditions (including weakened heart valves) are strongly advised to inform our office before undergoing any dental procedure. The proper antibiotic will prevent any unnecessary complications.

Oral piercings (usually on the tongue or around the lips) have quickly become popular. With this popular trend, it is important to realize that sometimes even precautions taken during the installation of the piercing jewelry are not enough to stave off harmful, long-term consequences, such as cracked or chipped teeth, swelling, problems with swallowing and taste, and scars. There is also a possibility of choking on a piece of dislodged jewelry, which makes it important to ask if the risks are warranted.

One of the most serious long-term health problems from oral piercings is damage to the soft tissues, such as the cheeks, gums, and palate, and opportunistic infections. When performed in an unsterile environment, body piercing may also put you at risk of contracting deadly infectious diseases such as HIV and hepatitis.

A tongue piercing is a common form of body piercing. However, tongue piercings have been known to cause blocked airways (from a swollen tongue). In some cases, a tongue piercing can cause uncontrolled bleeding.