Posts for: October, 2012

NineThingstoExpectDuringYourAppointmentwiththeDentalHygienist

We say that we are going to have our teeth cleaned — but a lot more than simple cleaning takes place during a visit to a dental hygienist.

  1. Health History
    Your hygienist will ask you about your general health and your dental health and any recent changes in either. By doing so she will pinpoint any issues that require special precautions during your cleaning.
  2. Cancer Screening
    Next, the hygienist carefully examines the skin in and around your mouth looking for lumps, bumps, sores, tenderness or swellings and refers areas of concern to the dentist for further evaluation. The hygienist is one of the few people who get to closely assess your whole mouth, so she is trained to spot cancer and other diseases.
  3. Evaluating Your Periodontal Health
    Your hygienist will look closely at the state of your periodontal health (from peri meaning around and dont meaning tooth). This includes checking your gums and the other tissues surrounding your teeth for inflammation (gingivitis) or bleeding.
  4. Checking for Decay
    The hygienist will examine your teeth for decay and will note the location and condition of stains or hard mineral deposits (calculus or tartar). These deposits result from a buildup of plaque (a film of bacteria) that has not been removed by daily brushing.
  5. Scaling
    The hygienist uses hand tools or a sonic scaler to remove the calculus from your teeth.
  6. Polishing
    A mechanical polisher and an abrasive polishing compound are used to polish the surface of your teeth so that they are smooth, making them more resistant to plaque, removing stains and leaving your teeth feeling squeaky clean.
  7. Measuring
    The hygienist uses a tiny probe to measure the space between your teeth and gums. Periodontal disease begins by forming pockets between the teeth and gums, so this measuring is key to your periodontal health. Generally a space of 3mm or less indicates healthy gums, pockets of 4 to 5mm indicate periodontal disease that may be reversed with good oral care at home, and pockets that are 6mm deep or more require specialized treatment by a dentist or periodontist (a dentist who specializes in care of gums).
  8. Education
    Based on the observed conditions of your gums and teeth, the hygienist will provide information aimed at improving your home oral cleansing routines and about your risk for tooth decay and gum disease.
  9. Making Your Next Appointment
    The hygienist will make an appointment for your next cleaning — in three, four, or six months depending on the health of your gums and teeth. Keeping these appointments not only keeps your teeth looking their best, but it also assures good management of your dental health.
  10. Contact us today to schedule an appointment to discuss your questions about dental hygiene. You can also learn more by reading the Dear Doctor magazine article “Dental Hygiene Visit.”


SealantsFAQHowDoSealantsPreventDecayandProtectYourChildsTeeth

The eruption of your child's first permanent teeth is a milestone in his or her development. As parents, you want to help your child preserve and protect their new permanent teeth so that they can last a lifetime. Dental sealants are one easy, simple, and inexpensive way to protect them from decay.

How do cavities develop?

The back teeth (premolars and molars) are formed with deep grooves on their biting surfaces that we call “pits and fissures.” These crevices are too deep for toothbrush bristles to reach. Bacteria can therefore grow and thrive inside them. The acid produced by these bacteria begins to dissolve the tooth enamel, starting the decay process.

Are new teeth more vulnerable?

Yes, the enamel surface of newly erupted teeth is more permeable and less resistant to tooth decay. As the enamel matures, it becomes more resistant.

How can you prevent decay in these new teeth?

Good oral hygiene habits, nutrition (including low sugar consumption), together with fluoride, sealants, and regular dental visits strengthen the teeth and can dramatically reduce tooth decay.

How does fluoride protect these teeth?

Fluoride makes the enamel surface harder and more impermeable and, therefore, less susceptible to acid attack and decay. Fluoride adds some protection to the deep pits and fissures of the teeth but they are still at high risk because of their shape and they often need further protection.

What are sealants and how do they work?

Sealants are protective coatings placed in the tiny pits and fissures to seal them from the bacteria and acids that promote decay. They actually “seal” the pits and fissures to prevent decay and can be used in the treatment of very early decay by arresting it. Greater use of sealants could reduce the need for subsequent treatment and prolong the time until treatment may become necessary.

Contact us today to schedule an appointment or to discuss your questions about dental sealants for your children. You can learn more about them by reading the Dear Doctor magazine article “Sealants for Children.”


By Edward Joseph, D.D.S.
October 17, 2012
Category: Oral Health
RepairingChippedTeeth

Your son just crashed his skateboard and cracked a tooth, or maybe your daughter fell off the monkey bars at school and now has a chipped front tooth. For children, and some adults, repairing chipped or damaged teeth with tooth-colored restorative materials directly bonded to the teeth may be the perfect solution to restore their smiles.

What is Involved: Composite bonding is a technique that has been developed to correct chipped teeth and other minor dental imperfections. It may also be used to correct mild crookedness or gaps between teeth. The procedure requires the application of a tooth-colored composite resin material to the surfaces of teeth, which is then sculpted to the desired shape. It can be performed in a single visit for one or multiple teeth. The procedure usually takes between one and two hours, and the end result is a beautiful, natural-looking smile.

Advantages for Kids and Adults: Composite resin bonding is a good choice for kids and teens since their jaws are still growing and developing, and they may still be engaged in high-risk activities. After your child's teeth and jaws are fully developed, we can discuss options for more permanent restorations such as porcelain veneers or crowns. These require removal of more tooth structure, which could compromise the long-term health of your child's teeth if done too soon. Composite resin restorations, which bond straight to the teeth and require little to no tooth preparation or drilling are therefore a good option for fixing chipped teeth, and they're less expensive than choosing veneers.

Disadvantages: The longevity of composite resin restorations is related to how well you maintain your teeth. Many people can go for ten or fifteen years before they need to have the bonded resins repaired or replaced. Others will tend to stain and wear after only one or two years and will need some touch-up work.

Contact us today to schedule an appointment to discuss any questions you may have regarding dental bonding. Read more about this topic in the Dear Doctor magazine article “Repairing Chipped Teeth.”


By Edward Joseph, D.D.S.
October 17, 2012
Category: Oral Health
Tags: oral health   fluoride  
HowDoesFluorideProtectYourTeeth

The CDC (Centers for Disease Control and Prevention) calls fluoridation of drinking water one of the ten most important public health measures of the 20th century, along with such measures as vaccination and motor-vehicle safety.

A fluoride concentration of about one milligram per liter (1 mg/L), or 1 part per million (1ppm), in the water supply is associated with substantially fewer cavities. This concentration of fluoride (equivalent to a grain of salt in a gallon of water) has been found to have no negative health effects.

The connection between fluoride and oral health was confirmed in the first half of the 20th century, and by 1955 the first clinically proven fluoride toothpaste was launched. Fluoride-containing toothpastes are common today, along with other fluoride-containing products.

Protective Effects of Fluoride
Ongoing studies have shown that fluoride has both a systemic (through the body) effect and a local effect at the tooth surfaces. Tooth decay takes place as part of a kind of active war between de-mineralization and re-mineralization, in which acids produced by bacteria in plaque (a biofilm in your mouth) soften and dissolve the minerals (de-mineralization) in the tooth's surface. At the same time, the saliva bathing the tooth acts to re-harden the tooth's surface by adding minerals back (re-mineralization). If fluoride is present in the biofilm and in the saliva, it protects against de-mineralization.

The fluoride you drink in your water is deposited in your bones. Bone is an active living substance that is constantly broken down and rebuilt as a normal body process. As this happens the fluoride is released into the blood, from which it can enter the saliva and act on the tooth surface. The fluoride in toothpastes and products like rinses is delivered directly to the tooth surface. Fluorides can also be eaten in foods with high fluoride content such as teas, dry infant cereals and processed chicken, fish and seafood products.

Problems with Over-use
Eating or swallowing too much fluoride can contribute to a discoloration of teeth called dental fluorosis, which varies in appearance from small white striations to stained pitting and severe brown mottling of the enamel. To avoid this effect, monitor children's tooth brushing to make sure they use only a small amount of fluoride toothpaste and do not swallow it.

Adding fluoride to water has been controversial because some people believe that it may cause other harmful effects. However, most health experts believe that fluoridated water carries no significant health risks and significantly contributes to public health by preventing tooth decay.

Contact us today to schedule an appointment to discuss your questions about fluoride. You can also learn more by reading the Dear Doctor magazine article “Fluoride & Fluoridation in Dentistry.”


By Edward Joseph, D.D.S.
October 17, 2012
Category: Oral Health
TakeOurQuizAreYouAtRiskForToothDecay

Dental caries (tooth decay) is similar to the pesky bumblebee that invades your lovely summer barbecue. You can find temporary solace from this intruder by eliminating that very first bee that you see, but if you are situated in an area that is close to the bee's nest, it won't be long before the next bee buzzes along. This is similar to tooth decay. Having one cavity-laden tooth drilled and filled is really just a temporary fix. The underlying conditions that led to tooth decay in the first place need to be addressed in order for your risk of future infection to decrease.

Researcher Dr. John Featherstone created the concept of the Caries Balance in 2002, in which he explained that tooth decay and overall dental health are dependent upon a proper balance of disease-causing and health-promoting factors. Discovering what the fundamental problem really is (and getting as far away from that hornet's nest as possible) can help both determine and curb your risk for future tooth decay.

Here's the issue in a nutshell: Susceptible teeth, in the presence of acid producing bacteria when fed by sugar from your diet, basically, will create all the conditions necessary to cause tooth decay.

To determine your risk for tooth decay, see how many times you answer “Yes” to the following questions:

  1. Do you brush your teeth twice a day to reduce bacterial plaque sticking to the teeth?
  2. Do you use fluoride toothpaste to strengthen the teeth against acid attack?
  3. Do you use a fluoride mouthrinse?
  4. Do you floss daily?

Every affirmative answer decreases your risk of getting cavities, but even doing all of this may not be enough!

Now, how many times can you answer “Yes” to these questions?:

  1. Do you smoke? Smoking causes mouth dryness, and creates a host of other health problems.
  2. Do you snack frequently between meals? One sugary snack and your mouth is acidic for the next hour. One snack per hour and your mouth is acidic all day.
  3. Do you frequently have acid reflux or heartburn? Reflux creates extreme acidity in the mouth and directly erodes tooth enamel.
  4. Do you drink soda, sports drinks, or acidic beverages frequently? These beverages are very acidic.
  5. Is your mouth frequently dry? Do you take any medications that cause mouth dryness? Saliva is nature's own defense against acidity and helps neutralize acid in the mouth.
  6. Have you had frequent cavities in the past and/or have you had any crowns or fillings in the past three months? The best indicator of future disease is past disease!

Every affirmative answer increases your risk of getting cavities!

Now that you are a little more knowledgeable about your personal risk for tooth decay, make an appointment with us to discuss the preventative measures that can give you some control over the future condition of your teeth. Ignoring the risks and then ending up with a mouth full of rotting teeth when you knew better could really sting a little!

To learn even more about the delicate balance between the disease causing and protective factors related to tooth decay, read the Dear Doctor magazine article “Tooth Decay: How To Assess Your Risk.”




Burbank, CA Dentist
Edward C. Joseph, D.D.S.
2701 West Alameda Ave, Suite #503
Burbank, CA 91505
(818) 842-7628

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