Most people associate bacteria with disease and ill health. But the real story about the trillions of microscopic organisms now living in and on your body is a bit more complicated. With recent advances in genetic code research scientists are learning that many of these microorganisms you’re hosting are actually beneficial for you — including your teeth and gums.
Beginning at birth and throughout your lifetime you are continually developing a distinct microbiome — actual communities of bacteria and other microorganisms that inhabit your body. As your microbiome develops it helps train your immune system to distinguish between “good” bacteria that help with digestion and other bodily processes and “bad” bacteria that cause disease.Â And it continually adapts to changes in what we eat, the pets we acquire or the drugs we take.
But lifestyle choices like diet can also have a detrimental effect, causing harmful bacteria to become dominant. This seems to be the case with Streptococcus mutans, the bacterial strain most associated with tooth decay. Scientists have analyzed biofilm (plaque deposits on teeth) from the pre-industrial era before 1900 and compared it with modern biofilm samples. They’ve found Streptococcus mutans levels to be much higher in modern biofilm, which they directly attribute to the modern Western diet.
As we gain a better understanding of these findings and of the role of bacteria in our lives, it could change many health recommendations not only about diet but about medications too. In the fight against disease, for example, we’ve used antibiotics to eradicate infection-causing microorganisms, but with a broad destructive ability that can also kill many beneficial strains of bacteria. It’s hoped as our knowledge grows we’ll be able to create newer drugs that more narrowly target harmful microorganisms while not affecting beneficial ones.
There’s a new appreciation emerging for bacteria’s role in our lives. As a result efforts to rebalance a person’s microbiome when they become sick may eventually become a critical element in healthcare treatment strategies. The benefits of this strategy for health, including for our teeth and gums, could be quite impressive.
If you would like more information on the role of bacteria in oral 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 “New Research Shows Bacteria Essential to Health.”
Magician Michael Grandinetti mystifies and astonishes audiences with his sleight of hand and mastery of illusion. But when he initially steps onto the stage, it’s his smile that grabs the attention. “The first thing… that an audience notices is your smile; it’s what really connects you as a person to them,” Michael told an interviewer.
He attributes his audience-pleasing smile to several years of orthodontic treatment as a teenager to straighten misaligned teeth, plus a lifetime of good oral care. “I’m so thankful that I did it,” he said about wearing orthodontic braces. “It was so beneficial. And… looking at the path I’ve chosen, it was life-changing.”
Orthodontics — the dental subspecialty focused on treating malocclusions (literally “bad bites”) — can indeed make life-changing improvements. Properly positioned teeth are integral to the aesthetics of any smile, and a smile that’s pleasing to look at boosts confidence and self-esteem and makes a terrific first impression. Studies have even linked having an attractive smile with greater professional success.
There can also be functional benefits such as improved biting/chewing and speech, and reduced strain on jaw muscles and joints. Additionally, well-aligned teeth are easier to clean and less likely to trap food particles that can lead to decay.
The Science Behind the Magic
There are more options than ever for correcting bites, but all capitalize on the fact that teeth are suspended in individual jawbone sockets by elastic periodontal ligaments that enable them to move. Orthodontic appliances (commonly called braces or clear aligners) place light, controlled forces on teeth in a calculated fashion to move them into their new desired alignment.
The “gold standard” in orthodontic treatment remains the orthodontic band for posterior (back) teeth and the bonded bracket for front teeth. Thin, flexible wires threaded through the brackets create the light forces needed for repositioning. Traditionally the brackets have been made of metal, but for those concerned about the aesthetics, they can also be made out of a clear material. Lingual braces, which are bonded to the back of teeth instead of the front, are another less visible option. The most discrete appliance is the removable clear aligner, which consists of a progression of custom-made clear trays that reposition teeth incrementally.
How’s that for a disappearing act?!
If you would like more information about orthodontic treatment please contact us or schedule an appointment for a consultation. You can also learn more about the subject by reading the Dear Doctor magazine article “The Magic of Orthodontics.”
For years preparing teeth for fillings or other restorations has required the use of a drill. Although quite effective in removing decayed structure and preparing the tooth for bonding, it usually requires a local anesthetic. That and the noise it generates can be unsettling for many patients.
In recent years, a different type of technique known as “air abrasion” has increased in popularity among dentists. Known also as “particle abrasion,” the technique uses a stream of fine particles to remove decayed tooth structure and is less invasive than the traditional drill. Although the technology has been around since the mid-20th Century, recent developments in suction pumps that remove much of the dust created have made it more practical. It also works well with new natural-looking bonding materials used for tooth structure replacement.
The fine particles — usually an abrasive substance like aluminum oxide — are rapidly discharged through a hand-held instrument using pressurized air aimed at affected tooth areas. Decayed teeth structure is softer than healthier tissue, which allows air abrasion to precisely remove decay while not damaging the other.
Besides removing decay or abrading the tooth for bonding, air abrasion can also be used to minimize stained areas on surface enamel and to clean blood, saliva or temporary cements from tooth surfaces during dental procedures. It’s also useful for smoothing out small defects in enamel or aiding in sealant applications.
It does, however, have a few limitations. It’s not as efficient as the traditional drill with larger cavities or for re-treating sites with metal (amalgam) fillings. Because of the fine texture of the abrasive particles, affected teeth need to be isolated within the mouth using a rubber dam or a silicone sheet. High-volume suction must be continually applied to capture the fine particles before the patient swallows them or it fills the procedure room with a fine cloud of material.
Still, while air abrasion technology is relatively new, it has clear advantages over the traditional drill in many procedures. As advances in the technology continue, air abrasion promises to offer a more comfortable and less invasive experience in dental treatment.
Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.
“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…
For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.
When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.
A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.
But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.
Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!
If you have questions about repairing chipped teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”
Although anxiety about dental procedures might seem like something you should be able to control, for many people, it's actually a result of overactive receptors in the brain that control reactions to stimuli. Dr. Michael Owens of Vibrant Smiles Dental in Waldorf, MD, is a dentist who understands the science behind dental anxiety and wants his patients to feel at ease when faced with dental procedures. That's why he offers a variety of anxiolytics, which temporarily counteract the brain's inherent responses and allow you to feel relaxed and comfortable.
For patients who feel a mild to moderate sense of anxiety about procedures at their dentist's office, Dr. Owens suggests using nitrous oxide, an inhaled gas, to calm their nerves. A lightweight and loose-fitting mask is placed over the nose before the procedure and the gas is delivered by regular breathing. The nickname "laughing gas" comes from the silly or euphoric feeling that some people experience, but our trained staff will maintain an appropriate level of nitrous oxide to make sure that you are comfortable without feeling dizzy or restless. The effects of nitrous wear off almost as soon as the mask is removed; you'll be able to drive home and resume normal activity afterward.
There are many different oral medications available to help you stay calm and relaxed during a dental procedure. These medications, when taken at a therapeutic level and monitored by professionals, are very safe and effective. What you need will depend on your level of anxiety, the length of your procedure and what medications you're currently taking. That's why it's important to disclose your medical history with your Waldorf dentist; determining what kind of anti-anxiety medication works best for you is an invaluable way to maintain your dental health. Most of these medications will require a ride home after a procedure, as their effects can last for several hours.
To schedule an appointment at Vibrant Smiles Dental in Waldorf, MD, contact us today! We look forward to helping you maintain your dental health comfortably!
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