I wanted to share Karen’s lovely smile – so I snapped the attached photo. Her teeth are perfectly aligned and are the right size and shape.  The proportions are appropriate.  Her gums and the underlying attachment apparatus are healthy.  She has a broad arch and a wide smile.  She shows the right amount of gum tissue.  (The left lip lifts slightly higher – but thats ok with me.)  She comes into the office regularly for exams and preventive care and for me to admire her lovely smile.  Her tooth color has darkened somewhat with age – this is natural as she doesn’t smoke or drink red wine.  We have discussed tooth whitening – in office whitening or with at-home bleaching trays.  Then her very lovely smile will really dazzle!

I love this cartoon of a woman brushing her teeth with a cup of hot tea (New York Times, April 29, 2013).  The question is:  ”why don’t we use hot water to brush our teeth?”  I have to confess that I have never asked myself this question, nor has anyone ever asked it of me.  But someone did think to ask it of the Times‘ C. Claiborne Ray.  He, in turn, contacted the American Dental Association.

Their spokesperson, searching for an answer, offered that hot water might soften toothbrush bristles, rendering them less effective. But where is the study that shows this?  The spokesperson also suggested that hot water that sits in a hot water tank may harbor harmful chemicals.  But in the end he contradicted himself in recommending that hot water be used to rinse the brush after brushing.  The bottom line: brush and floss carefully – regardless of the water temperature – and visit the dentist regularly!

A study published in the March issue of the Journal of the American Dental Association (JADA) by researchers at the University of Buffalo compares postmenopausal women who have smoked to postmenopausal women who never smoked.  They concluded that smokers are at a much higher risk of losing their teeth.  Women have better oral health care and visit the dentist more regularly then men, yet women have more tooth loss than men of the same age.  Heavy smokers (26 pack-years of smoking, meaning the equivalent of having smoked a pack a day for 26 years) were twice as likely to have lost teeth due to periodontal disease, than those who have never smoked.

The study suggests that cigarette smoke may exacerbate gum disease or that the chemicals found in smoke may favor plaque forming bacteria.  Nicotine also reduces bone density.

Anecdotal evidence in my office supports the connection between smoking and tooth loss.  When I sit down with a patient to review their medical and dental history, I always ask about their smoking history.  When they arrive “long of tooth,” with loose teeth and missing teeth, I usually find that smoking is part of their history.

What do you do if you or your child has a fall and a tooth is knocked out (we call this an avulsed tooth)? This is truly an emergency.  You need to know that the tooth has the best chance of survival if action is immediate.  Put the tooth in liquid – preferably milk – and get to the dentist immediately.  Milk is compatible with teeth and has essential nutrients and growth factors.

But I have recently read that soy milk is also an excellent medium for the avulsed tooth.  Soy milk is rich in protein, amino acids, vitamins and minerals that are essential for cell nutrition.

Always looking to keep up with new developments in dentistry, I took two continuing education courses this week.

Wednesday night was a lecture on how periodontal therapy can enhance orthodontic results.  That gummy smile in which too much gum tissue is exposed when the patient smiles can be eliminated with periodontal treatment.  An impacted tooth can be coaxed into position with proper periodontal access.

On Friday I took an all-day course on “All on Four,” in which implants are placed and teeth affixed the same day, thus eliminating a removable denture when all of a patient’s teeth need to be extracted.  This is an amazing service for people who qualify for this treatment.

Recently a woman came into my office with an upper bridge that was failing.  Her teeth could not be salvaged.  But she did not want her husband to know that she was going to lose her teeth.  So we scheduled her for teeth-in-a-day: her teeth were removed, implants placed and a provisional fixed bridge placed.  She looks great and her husband never found out that instead of her own, failing teeth, she now has implants!

Old Dentures

New Dentures

Bernice’s old dentures were uncomfortable and unattractive and she could only eat soft, mushy foods.  In just four visits (three weeks total), with the help of our wonderful custom denture laboratory, we created new dentures for her.  She looks fabulous, eats everything (even steak and apples), and she is so comfortable, she says she often forgets that she is wearing dentures.  What more can you ask for?

Severely Decayed Teeth

An Immediate Denture for Denise

Denise’s teeth were severely decayed, and we determined that they could not be saved.  We elected to remove her remaining teeth and replace them with an immediate denture.  This is a two visit procedure.  We take custom impressions. The immediate dentures are then fabricated by our fabulous denture laboratory. The teeth can then be extracted, and the immediate denture is inserted the same day – thus “immediate.”  The patient is NEVER without teeth. This takes careful planning!

The healing process then takes several months because the bone and soft tissues remodel where the teeth were extracted.  As the healing progresses, we reline the immediate denture so it fits the altered tissue.  We will see you for a reline as often as needed – sometimes once or twice, sometimes more.  Once the tissues are relatively stable, we will take custom impressions of the altered tissue and fabricate a new denture that will look great, function superbly and be very comfortable.  How good is that?

Decayed teeth in need of veneers and crowns

New Veneers and Crowns

Before and after photos of Mike’s old and new smile.  During his first visit two weeks ago I removed the decay in Mike’s front teeth and placed temporary crowns. During his second visit today, I bonded in place these sparkling new crowns and veneers.  He is one happy patient!

As many people are now aware, a Tulsa, Oklahoma dentist is being investigated for neglecting to follow appropriate infection control methods and for improper management practices.  Patients of that practice are being tested for HIV.

Please be assured that the safety of the patients in our practice is of paramount concern to us.  We follow the most stringent infection control procedures.  I only delegate procedures to licensed and qualified staff.  All staff scrub their hands before every patient.  We use appropriate protective garb: gloves, eyewear, masks, gowns.  We use new gloves and masks for each patient.  All surfaces in the examining room are cleaned and decontaminated after each patient visit.  Dental instruments that are not disposable are cleaned and sterilized in between patients.  We use an up-to-date autoclave which utilizes steam under pressure.  Disposable sharps, including needles and burs, are placed in special containers for monitored disposal.

Please visit the American Dental Association website: http://www.mouthhealthy.org for more information on infection control, as well as other dental topics of interest.  We are also happy to answer any questions you may have and you are invited to take a tour of our very clean office.

This is a photo that I took in my office today of a fractured tooth.  The tooth had an old, worn out amalgam filling that needed to be replaced with a crown. A crown would have held the tooth together. But as the patient did not have a crown placed, the tooth now needs to be extracted and an implant placed. The moral: don’t delay; visit the dentist and save your teeth before it is too late!