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Posts for category: Oral Health

By Trish Palmeri, DDS
August 18, 2019
Category: Oral Health
Tags: tooth decay  
EvenAll-NaturalFruitJuiceCouldIncreasetheRiskofToothDecay

All-natural fruit juice with no additives: now what could be wrong with that? Nothing—unless your child is over-indulging. Too much of even natural fruit juice could increase their risk of tooth decay.

To understand why, we first need to look at the real culprit in tooth decay: mouth acid produced by oral bacteria as a byproduct of their digestion of sugar. Acid at high levels softens and erodes tooth enamel, which causes tooth decay. Acid levels can rise as populations of bacteria increase often fueled by sugar, one of bacteria's primary food sources.

And not just the added sugar found in soft drinks, snacks or candies—even fructose, the natural sugar found in fruit, can feed bacteria. To lower the risk of tooth decay, dentists recommend limiting the daily amount of sugar a child consumes, including natural fruit juices without added sugar.

That doesn't mean you should nix natural fruit juices altogether—they remain a good source of vitamins, minerals and other nutrients. But you'll need to keep your child's juice consumption within moderation.

As a guide, the American Academy of Pediatrics (AAP) has issued consumption recommendations for children regarding all-natural fruit juice. The academy recommends the following daily juice amounts by age:

  1. 7-18: 8 ounces (1 cup) or less;
  2. 4-6: 6 ounces or less;
  3. 1-3: 4 ounces or less;
  4. Under 1: No juice at all.

You can further reduce your child's decay risk by limiting their juice intake to mealtimes, a good practice with any sweetened beverage. Sipping through the day on juice or other sweetened beverages can cause some sugar to stay in the mouth over long periods. This can interfere with the natural ability of saliva to neutralize any acid buildup.

If you're wondering what children could drink instead of juice, low-fat or non-fat milk is an acceptable choice. But the most tooth-friendly liquid to drink is plain water. Drinking nature's hydrator is not only better for their overall health, by reducing the risk of tooth decay, it's also better for their teeth.

If you would like more information on how sugar can affect your child's dental health, 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 “Squeeze Out the Juice.”

By Trish Palmeri, DDS
July 29, 2019
Category: Oral Health
Tags: oral cancer  
RegularScreeningsCouldHelpWithEarlyOralCancerDetection

Your regular dental checkups should periodically include an important screening for oral cancer, especially as you grow older. Although oral cancers make up less than 3% of all other types, they’re among the most deadly with a 58% survival rate after five years.

Besides hereditary factors, oral cancer is strongly linked to tobacco use, alcohol abuse or diets low in fresh fruits and vegetables. It’s also a greater concern as we age: 90% of new cases of oral cancer occur in people over the age of 40, heightening the need for regular screenings. These screenings become all the more important because many early sores or lesions can mimic other conditions like canker sores — without early detection, the disease could already be in advanced stages when it’s diagnosed.

An oral screening for cancer involves both sight and touch. We’ll first look for any suspicious lesions and red or white patches in the soft tissues of the face, neck, lips and mouth. We’ll then feel for any abnormal lumps on the mouth floor, the sides of the neck and in gland locations. We’ll also examine all sides of the tongue including underneath, as well as the tissues lining the back of your throat.

If we notice anything that’s concerning we may then perform a biopsy by removing a small bit of the suspicious tissue and have it examined microscopically for the presence of cancer cells. We may also remove any lesions deemed pre-cancerous as an added precaution against possible cancer development.

The American Cancer Society recommends an oral cancer screening annually for people forty years or older and every three years for people between the ages of 20 and 39. Even better, we recommend all adults undergo a screening every year. This, along with ending tobacco use and other lifestyle and dietary changes, will greatly improve your chances of remaining free of oral cancer.

If you would like more information on detecting and treating oral cancer, 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 “Oral Cancer.”

By Trish Palmeri, DDS
July 19, 2019
Category: Oral Health
KeepanEyeontheJawBoneAfteraTeenagersToothLoss

Accidents happen, especially to teenagers involved with sports or similar activities. In an instant they can lose one or more teeth and permanently alter their smile.

Fortunately we can restore a teenager’s lost teeth, but often not immediately as a permanent restoration with a dental implant requires maturity of their jaw structure. Our focus then turns to the age of the patient and the condition of the underlying bone. A future dental implant, your best choice for tooth replacement, depends on bone for support, but also the age of the patient as it relates to jaw development.

There are a couple of ways an accidental tooth loss can harm supporting bone: first and foremost, the impact of the accident itself can damage the bony socket. To find out for sure we may need to perform a cone beam scan, a type of x-ray that allows us to view the area three-dimensionally. If we do find damage, we can attempt to repair the socket through bone grafting.

Bone can also suffer from the long-term absence of a tooth. Bone has a growth cycle in which older cells dissolve and new ones form to take their place. The force generated by teeth when we eat or chew helps stimulate this growth. Without stimulation, as with a missing tooth, the bone may not grow at a healthy rate. In time, it could lose some of its volume and density and not be able to support an implant.

Installing an implant right after tooth loss could help avoid this situation. Bone has a natural affinity with the titanium post imbedded in the jaw and will naturally grow and adhere to it. But we can’t place an implant with a teenager. This is because the jaw is still developing so an implant would gradually become misaligned as the jaw grows. It’s best to install an implant later after full jaw development in early adulthood.

Today, we can place a bone graft in the empty socket right after tooth loss. The graft serves as a scaffold for bone cells to grow on and will help keep the bone volume at a healthy level until we can install an implant.

Timing is everything in restoring a teenager’s accidental tooth loss. But with coordination and care for the supporting bone, a teenager can eventually enter their adult years with their smile intact.

If you would like more information on restoring your teenager’s smile after tooth loss, 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 “Dental Implants for Teenagers.”

By Trish Palmeri, DDS
July 09, 2019
Category: Oral Health
Tags: oral hygiene  
ImproveYourDentalHealthbyMasteringYourBrushingSkills

You're not just a patient to your dentist—you're also a partner for achieving your best oral health possible. And it takes what both of you do to achieve it.

No doubt your dentist always strives to bring their "A Game" when providing you care. You should carry the same attitude into your personal oral hygiene—to truly master the skill of brushing.

Like its equally important counterpart flossing, brushing isn't mechanically complicated—you need only a minimum of dexterity to perform it. But there are nuances to brushing that could mean the difference between just adequate and super effective.

The goal of both brushing and flossing is to clean the teeth of dental plaque, a built-up film of bacteria and food particles most responsible for dental diseases like tooth decay and periodontal (gum) disease. Brushing removes plaque from the broad front and back surfaces of teeth, while flossing removes it from between teeth where a toothbrush can't reach.

While a lot of cleaning tasks require bearing down with a little "elbow grease," that's unnecessary with brushing—in fact, you may increase your risk of gum recession if you brush too vigorously or too often. All you need is to apply a gentle, circular motion along all tooth surfaces from the gum line to the top of the tooth—a thorough brushing usually takes about two minutes, once or twice a day.

Your equipment is also important. Be sure your toothbrush is soft-bristled, multi-tufted and with a head small enough to maneuver comfortably inside your mouth. Because the bristles wear and eventually lose their effectiveness, change your brush about every three months. And be sure your toothpaste contains fluoride to help strengthen your enamel.

One last tip: while it may sound counterintuitive, don't brush immediately after a meal. Eating increases the mouth's acidity, which can temporarily soften the minerals in tooth enamel. If you brush right away you might slough off tiny bits of softened enamel. Instead, wait an hour before brushing to give your saliva time to neutralize the acid and help re-mineralize your enamel.

Unlike your dentist partner, your role in caring for your teeth doesn't require years of training. But a little extra effort to improve your brushing proficiency could increase your chances for a healthy mouth.

If you would like more information on best practices for personal oral hygiene, 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 “10 Tips for Daily Oral Care at Home.”

DoThisforYourDentalHealthBeforeDuringandAfterCancerTreatment

Although cancer treatment has advanced steadily in recent decades, the most used therapies continue to be radiation and chemotherapy to eradicate cancerous cells. And while they often work, both can cause "collateral damage" in healthy tissues near the targeted cells.

This can create a number of indirect consequences for a patient's health, including in the mouth. The salivary glands, for example, can be damaged by radiation treatments aimed at the head or neck. The effect on these glands can interrupt the normal flow of saliva and cause xerostomia or "dry mouth."

Lack of adequate saliva causes more than an unpleasant, sticky mouth feeling. One of saliva's main functions is to neutralize acid that builds up naturally after eating. Without it, high acid levels can cause enamel and root surface erosion and lead to tooth decay.

Cancer treatment can also contribute to gastro-esophageal reflux disease (GERD). This disease causes stomach acid to bypass the natural tissue barriers of the esophagus and enter the mouth. As with dry mouth, the increased acid level from GERD can be just as devastating to enamel—and the damage will be permanent.

To minimize these effects on your dental health, it's important to take proactive steps before, during and after cancer treatment. If at all possible, have any needed dental work performed before you begin radiation or chemotherapy—it's better to start it with teeth and gums as healthy as possible.

During treatment, try to continue regular dental visits to monitor your oral health and receive any needed preventive or therapeutic treatments. Depending on your condition and the advice of your dentist, you may need to increase your visit frequency during this time. Your dentist can help with boosting your saliva production and strengthening your tooth enamel. But you should also practice daily brushing and flossing, drink plenty of water and seek treatment for any resulting GERD symptoms.

Even with the best efforts, though, your teeth and gums may still incur damage while treating your cancer. Fortunately, there are a wide array of materials and procedures that can effectively restore them to health. So, once your treatments are completed consult with a dentist on your options for improving the health and appearance of your teeth and gums.

If you would like more information on caring for your teeth while undergoing intensive medical treatment, please contact us or schedule an appointment for a consultation.