My Blog
By George Mui, DDS, Ltd. Gentle Dental Care
December 12, 2021
Category: Dental Procedures
3WaystoCorrectaSmileWithMissingIncisors

In the classic holiday film, It's a Wonderful Life, George Bailey sees what life would be like if he'd never been born. In a variation on the theme, imagine your life if your teeth had never formed.

That's actually a reality for some—they're born without teeth, albeit usually only one or two. But even then, they're often more susceptible to problems with their bite, speech development and nutrition.

And if their missing teeth affects their appearance, their self-image could also take a hit. In particular, the maxillary lateral incisors on either side of the central incisors (those in the very front) can create an odd smile if missing.

Fortunately, we can correct the problem of missing lateral incisors with three possible solutions. The first is canine substitution, involving the pair of pointed teeth next in line to the missing incisors. In effect, we use orthodontic appliances like braces to move them toward the frontmost teeth and close the missing teeth gap.

It's a minimally invasive way to improve smile appearance. But because of their size and sharp edges, it's often necessary to alter the canines, perhaps even crown them. Some people may also need gum surgery to "blend" the gums with the repositioned teeth.

A second method is a fixed bridge, a series of fused crowns. Those in the middle replace the missing teeth, while those on the ends are bonded to the natural teeth on either side of the gap to support the bridge.

Bridges can function well for many years, but it does require permanently altering the supporting teeth for crowning. An alternative Maryland or bonded bridge doesn't require this alteration, but it's also less durable than a traditional bridge.

Finally, we could replace the missing teeth with dental implants, a titanium post imbedded into the jawbone with an attached life-like crown. An implant tooth can last for decades, and don't require alterations to other teeth. However, they're not suitable for younger patients who are still undergoing jaw development—a temporary restoration may thus be in order until the jaw matures.

Being born without certain teeth is something you can't do anything about. But you can change how it affects your appearance and life with one of these options for a new smile.

If you would like more information on correcting a smile with missing teeth, 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 “When Permanent Teeth Don't Grow.”

By George Mui, DDS, Ltd. Gentle Dental Care
December 07, 2021
Category: Oral Health
Tags: teeth grinding  
GetAheadofTeethGrindingtoAvoidHarmtoYourTeeth

We like to think we're more prone to stress in our modern, fast-paced world than those who lived in "simpler" times, but a finding from the recent discovery of Richard the III's remains in England suggests differently. Investigators noted the king had well-worn teeth, perhaps from grinding them out of stress.

We can't be sure this was the cause for the king's dental problems, or if teeth grinding was common in the 15th Century. But we are sure the problem exists today among adults.

Tooth grinding is the grinding, gnashing or clenching of teeth involuntarily when not engaged in regular dental functions like eating or speaking. It can occur while a person is awake, but most often while they're asleep.

The habit regularly occurs in children, but is not considered a major problem as most outgrow it by adolescence, usually with no lingering damage. Not so with adults: Because the habit generates abnormally high biting forces, teeth grinding can lead to accelerated tooth wear. It can also weaken teeth, making them more susceptible to fracture or disease.

People who grind their teeth will typically awaken with sore jaws or the complaints of family members about the loud chattering noise emitted during an episode. If you suspect a problem, you should see your dentist for a definitive diagnosis, and to learn how to reduce its occurrence and effects.

Treatments for the habit vary depending on underlying causes. They may involve lifestyle changes like quitting tobacco, limiting alcohol or altering your use of certain drugs or medications.  Because stress is often a major factor, learning better relaxation techniques through meditation, group therapy or biofeedback may also help reduce teeth grinding.

These treatments, though, can take time, so you may also need ways to minimize the effects of the habit in the meantime. One of those ways is for your dentist to create an occlusal guard that you wear while you sleep. The guard prevents the teeth from making solid contact, thus reducing the potential biting forces.

It's important, then, to see your dentist as soon as possible if you suspect you're grinding your teeth. Finding out as early as possible and then taking positive steps to stop or reduce its effect can save your teeth from a good deal of harm.

If you would like more information on teeth grinding, 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 “Teeth Grinding.”

By George Mui, DDS, Ltd. Gentle Dental Care
December 02, 2021
Category: Oral Health
Tags: oral health   nutrition  
3ThingsYouCanDotoKeepHolidaySweetsFromInterferingWithYourDentalHealth

In his iconic poem, "A Visit from St. Nicholas," Clement Moore wrote of children sleeping "while visions of sugar plums danced in their heads." Indeed, sweet treats are still interwoven into the holidays—and a prime reason why we tend to put on pounds during the season. It may also be why your next dental visit might come with some unpleasant news.

The starring actors in much of traditional holiday snacking and feasting are naturally-occurring or added sugars. Carbohydrates like refined sugar in particular can dramatically affect your dental health if you over-consume them, because they can feed the bacteria that causes both tooth decay and gum disease.

There are ways, though, to reduce their impact on your teeth and gums. You can, of course, go "cold turkey" and cut refined sugar out completely, as well as curtail other carbohydrates like refined flours and fruit. It's effective, but not much fun—and what are the holidays without fun?

More in line with "moderation in all things," there are other ways to minimize the impact of carbohydrates on your teeth and gums during the holiday season. Here are a few of them.

Limit refined sugar. While you and your family may not be up for banning sugar during the holidays, you can reduce it significantly. For instance, prepare more savory items rather than the sweeter kinds. If you must go for sweet, opt for naturally occurring sugars in fruit or dairy rather than refined table sugar or high fructose corn syrup.

Eat sweet treats with meals. Constant snacking often comes with the holiday season. And, why not—all those abundant goodies are just begging to be eaten. But noshing all the time never allows your mouth's saliva, which neutralizes the enamel-eroding acid produced by the bacteria fueled by sugar, a chance to finish its buffering. Instead, try as much as possible to limit treats to mealtimes.

Use different sweeteners. There are a number of alternative sweeteners to regular sugar, both natural and artificial. Some work better in baked goods, while others are more suitable for candies or beverages. Xylitol in particular, a sugar alcohol, actually discourages oral bacterial growth. You can also use natural sweetening agents like stevia or erythritol to help reduce refined sugar in your treats.

Even if you normally limit carbohydrates, it's understandable if their consumption rises during the holidays. That's why it's important you don't neglect daily brushing and flossing to help control bacterial plaque, the main driver for dental disease. Both effective oral hygiene and reining in the sweets will help your teeth and gums sail through the holidays into the new year.

If you would like more information about protecting your oral health during the holidays, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “The Bitter Truth About Sugar.”

By George Mui, DDS, Ltd. Gentle Dental Care
November 27, 2021
Category: Oral Health
Tags: oral hygiene  
5TipsForKeepingYourToothEnamelHealthy

You know what people say: "Protect your tooth enamel, and it will protect your teeth." Then again, maybe you've never heard anyone say that—but it's still true. Super strong enamel protects teeth from oral threats that have the potential to do them in.

Unfortunately, holding the title of "Hardest substance in the human body" doesn't make enamel indestructible. It's especially threatened by oral acid, which can soften its mineral content and lead to erosion.

That doesn't have to happen. Here are 5 things you can do to protect your enamel—and your teeth.

Don't brush too often. Brushing is essential for removing bacterial plaque, the main cause for dental disease. But more isn't always good—brushing too frequently can wear down enamel (and damage your gums, too). So, limit daily brushing to no more than twice a day.

Don't brush too soon. Oral acid normally peaks at mealtime, which can put your enamel into a softer than normal state. No worries, though, because saliva neutralizes acid within about an hour. But brushing before saliva finishes rebuffering could cause tiny bits of softened enamel to flake off—so, wait an hour after eating to brush.

Stop eating—right before turning in for the night, that is. Because saliva flow drops significantly during sleep, the decreased saliva may struggle to buffer acid from that late night snack. To avoid this situation, end your eating or snacking at least an hour before bedtime.

Increase your calcium. This essential mineral that helps us maintain strong bones and teeth can also help our enamel remineralize faster after acid contact. Be sure, then, to include calcium-rich foods and calcium-fortified beverages in your diet.

Limit acidic beverages. Many sodas, sports and energy drinks are high in acid, which can skew your mouth's normal pH. Go with low-acidic beverages like milk or water, or limit acidic drinks to mealtimes when saliva flows more freely. Also, consider using a straw while drinking acidic beverages to lessen their contact with teeth.

Remember, enamel isn't a renewable resource—once it's gone, it's gone. Take care of your enamel, then, so it will continue to take care of you!

If you would like more information on caring for your tooth enamel, 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 “6 Tips to Help Prevent the Erosion of Tooth Enamel.”

By George Mui, DDS, Ltd. Gentle Dental Care
November 22, 2021
Category: Oral Health
Tags: tooth decay  
TheresMoreWeCanDoAboutToothDecayBesidesDrillandFill

Until recently, the standard treatment for tooth decay remained essentially the same for nearly a century: Remove any decayed structure, then prepare and fill the cavity. But that singular protocol has begun to change recently.

Although "drilling and filling" saves teeth, it doesn't fully address the causes of decay. In response, dentists have broadened their approach to the disease—the focus now is on an individual patient's particular set of risk factors for decay and how to reduce those.

At the heart of this new approach is a better understanding of oral bacteria, the true cause of decay. Bacteria produce acid, which can erode tooth enamel and create a gateway into the tooth for decay to advance. We therefore want to lower those risk factors that may lead to bacterial growth and elevated acidity.

One of our major objectives in this newer approach is to reduce plaque, a thin film of food particles used by bacteria for food and habitation. Removing plaque, principally through better oral hygiene, in turn reduces decay-causing bacteria.

Plaque isn't the only mechanism for bacterial growth and acidity. Appliances like dentures or retainers accumulate bacteria if not regularly cleaned. Reduced saliva flow, often due to certain medications or smoking, limits this fluid's ability to buffer acid and acid reflux or acidic beverages like sodas, sports or energy drinks can disrupt the mouth's normal pH and increase the risk for enamel erosion.

Our aim, then, is to develop a long-term strategy based on the patient's individual set of oral disease risk factors. To determine those, we'll need to examine their medical history (including family), current health status and lifestyle habits. From there, we can create a specific plan targeting the identified risk factors for decay.

Some of the elements of such a strategy might include:

  • Daily brushing and flossing, along with regular dental cleanings;
  • Fluoride dental products or treatments to strengthen enamel;
  • Changes in diet and excess snacking, and ceasing from any tobacco use;
  • Cleaning and maintaining appliances, as well as monitoring past dental work.

Improving the mouth environment by limiting the presence of oral bacteria and acid can reduce the occurrence of tooth decay and the extent of treatment that might be needed. It's a more nuanced approach that can improve dental health.

If you would like more information on tooth decay prevention and treatment, 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 “Tooth Decay: How to Assess Your Risk.”





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