Humans naturally react with pleasure to a beautiful smile. Starting with our mother's joy at seeing our first smile, we have learned throughout our lives that a smile is an invitation to a positive interaction. But are some smiles more beautiful than others? What is it that makes a smile beautiful?

As with art and music, people's perceptions of beauty differ with their backgrounds and culture. Most people respond well to an appearance of healthy teeth and gums. Some feel that teeth must be very white and bright, while others look for even alignment and proportionally sized teeth. With today's dentistry, all of these factors can be changed and enhanced.

Let's look at the components of a smile, starting with the teeth. Evenly sized, white teeth are generally considered to be the basis of an attractive smile. Chipped or discolored front teeth can be repaired by bonding tooth-colored composite resin restorations. Thin porcelain veneers can be applied to teeth that are too small, misshapen or discolored. Tooth colored fillings can be used to repair damaged or decayed back teeth, or porcelain crowns may be used to replace the top part of a tooth that has been seriously damaged. If teeth are missing because of trauma or loss due to decay, today they can be replaced by dental implants, topped with crowns that are colored and shaped exactly like the natural teeth.

Of course, if your teeth emerge from inflamed, infected gums, your smile needs improvement. Healthy teeth and gums result from good dental hygiene habits and regular professional dental cleanings and checkups. Teeth can be whitened and brightened both through home methods and in the dental office. Ask us about the options available for tooth whitening.

Another factor that goes into a smile is the relation of the upper to the lower jaw, or the bite. A poor bite is called a malocclusion. Orthodontic treatment, with the use of traditional braces or clear aligners, can move the teeth into a better bite position so that they look and function better.

Repairing parts of your smile that make you feel self conscious will help your smile in more ways than one. If you feel good about yourself, you look better. We get the process started, and you do the rest.

Contact us today to schedule an appointment to discuss your questions about cosmetic dentistry. You can also learn more by reading the Dear Doctor magazine article “Cosmetic Dentistry: A time for change.”

We know from research extending back to the 1930s that very small amounts of fluoride in drinking water can significantly reduce dental caries (cavities) with no negative health effects. Fluoridated water is currently available to 70% of all Americans. However, we have also learned that excess fluoride from combined sources can result in staining of teeth called “fluorosis.”

What is the optimum fluoride concentration for healthy teeth?
A fluoride concentration of about 0.7-1.20 milligrams per liter (mg/L), or .7 to 1.2 ppm (parts per million), in the water supply seems to be optimum for dental health without causing negative effects. This concentration is about the same as a grain of salt in a gallon of water. An amount of 1 ppm was originally considered the safe standard, but since today Americans have access to more sources of fluoride than they did when water fluoridation was first introduced, the recommended amount has been reduced to .7 mg/L or .7 ppm.

The crucial amount to measure is the quantity of fluoride that is swallowed. Generally, the optimal level of fluoride per day from all sources is thought to be about .06 milligrams per kilogram of body weight, or about a sixth of the weight of a grain of salt for every two pounds of body weight.

It is probably not possible to calculate the precise amount of fluoride each person ingests per day, because the amount depends on more than just the amount of tapwater you drink. Bottled waters, soft drinks and juices also contain fluoride. Breast milk and cow's milk are very low in fluoride, but infant formulas may contain higher levels. Foods found to have high fluoride content include teas, dry infant cereals and processed chicken, fish and seafood products. Toothpaste can contribute to a child's total fluoride intake if the child swallows it.

What are the effects of too much fluoride?
Dental fluorosis produces a “mottling” of the outer coating of the tooth, the enamel. Mottling may show as staining ranging from small white striations to stained pitting and severe browning of the enamel surface.

The first six to eight years of life is the most risky time for development of dental fluorosis. Parents need to monitor their children to make sure they use small amounts of fluoride toothpaste (an amount the size of a pea on the brush is recommended). Watch for white spots on the enamel (hard outside coating) of your child's teeth. White spots from fluorosis mean it is time to pay attention to how much fluoride your child is getting from various sources, and to cut back on the total. You want fluoride's protection against cavities for your child's teeth, without the unsightliness of dental fluorosis from too much fluoride.

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

It can start with a simple twinge or be as severe as excruciating pain. From time to time, we have patients asking questions about tooth sensitivity — what causes it? What can be done about it? For these reasons, we have put together the following list of frequently asked questions (FAQs) so that you can develop a healthy understanding about this painful and often avoidable condition.

What is tooth sensitivity?

The first layer of protection of the teeth is enamel. Enamel is a dense crystalline structure, the hardest substance produced by animals. It is an inert substance that has no nerve supply and thus it protects the teeth from temperature and pressure changes. When it is compromised, worn thin, or exposed due to gum recession, it leaves the dentin exposed and vulnerable. Unlike enamel, dentin is living and has delicate nerve fibers within it.

What triggers tooth sensitivity?

Once dentin is exposed, it can become sensitive. It typically occurs when the dentin comes in contact with heat, cold, or the “double whammy” combination of both cold and sweets. Even the bristles of a soft toothbrush can irritate exposed dentin causing sensitivity and pain.

What can be done to minimize tooth sensitivity?

One of the simplest ways to minimize or prevent sensitivity is by teaching proper brushing techniques so that teeth are cleaned without causing either sensitivity or damage. Brushing too hard is a frequent culprit. Being overzealous can literally cause gum recession, leave dentin, and wear it away leaving it grooved. Another step to minimize sensitivity is to use a toothpaste containing fluoride. Fluoride increases the strength of tooth surfaces and thus makes teeth more resistant to attack by acids and sweets. If severe, we may need to apply a barrier to cover the sensitive areas. These barriers may range from concentrated fluoride varnishes to replacing lost tooth structure with filling materials.

Want to learn more?

To learn more about this topic, read the article “Sensitive Teeth.” Or if you are suffering from this condition, please contact our office to schedule an appointment. During your appointment, we will conduct a thorough examination to ascertain what is causing your sensitivity as well as what we can do to treat and/or prevent future issues.

If your teeth have a worn appearance, it's possible you have a habit you're not even aware of: clenching or grinding your teeth. Also called “bruxism,” this destructive action causes your top and bottom teeth to come together or scrape past each other with a force that's many times what is normal for biting and chewing.

So what's normal? This can be expressed in terms of pounds. An adult usually exerts a force of 13-23 pounds to bite or chew food. But we have the potential to generate as much as 230 pounds of force, or 10 times what's normal. A “parafunctional” force of this magnitude applied repeatedly is bound to stress your teeth and other areas of your oral system. Besides wearing away the enamel of your teeth — and maybe even some of the softer dentin layer underneath — you may experience muscle spasms or pain in your jaw joints. Serious cases of wear can lead to “bite collapse” in which your face actually changes shape as your cheeks and lips lose support. This can make you look prematurely aged.

What can be done? To prevent further wear, we can fabricate for you a thin, plastic mouthguard that will protect your teeth at night or during times of intense stress. We can also recommend ways to temporarily relieve the discomfort that your grinding/clenching habits can cause. Heat and/or anti-inflammatory medication, for example, can be helpful.

If your tooth wear is minor (raggedness along the biting edge of a tooth or teeth) you may not need any restorative work. However, if tooth wear has already caused changes to your teeth and bite that you find aesthetically or functionally unacceptable, we can restore lost tooth structure in a variety of ways. Veneers and crowns are two examples.

If you have any questions about tooth wear or grinding habits, please contact us today to schedule an appointment for a consultation. You can learn more about this topic by reading the Dear Doctor magazine article “How And Why Teeth Wear.”

Scientists don't know much about sleep even though it has been extensively studied. We do know that several hours of deep, restful sleep per night are essential for a healthy life.

Many people remain tired and unrefreshed, even after a full night's sleep. About a third of them are affected by sleep related breathing disorders (SRBD). Dentists can play a significant role in helping patients overcome these disorders, which range from frequent snoring to severe Obstructive Sleep Apnea (OSA). If you think you may have such a disorder, read on.

Under normal conditions, your upper airway is open, allowing air to flow from your nose, through your throat, and into your lungs. If you suffer from SRBD, you experience frequent reductions in the flow of air to your lungs during sleep. You may not be aware of it, but sometimes your breathing may even stop for brief periods. These reductions happen when your tongue and other soft tissues in the back of your throat collapse backwards and block your upper airway or windpipe. You may briefly awaken as many as 50 times per night because of these breathing lapses. These brief awakenings, called micro-arousals, keep you from reaching the deep stages of sleep your body needs.

The resulting reduced oxygen flow to your heart and to your brain can cause serious damage. You will also be tired during the day and experience a lack of energy, even if you sleep for seven or eight hours per night. This constant drowsiness puts you at greater risk for accidents.

Because dentists generally see their patients at six-month or other regular intervals, we are in a good position to screen and refer patients with suspected SRBD to physicians for diagnosis and treatment. Dentists can also treat SRBD in a number of ways.

• One of these is Oral Appliance Therapy (OAT), in which a device that looks something like an orthodontic retainer holds your lower jaw in a forward position relative to your upper jaw, preventing your tongue and soft tissue from collapsing into your airway.
• Another consists of breathing equipment called Continuous Positive Airway Pressure (CPAP). The CPAP is a mask connected to a machine that pushes air into your lungs.
• Other treatments include oral surgery or orthodontia. The goal of these techniques is to increase the volume of air passing through your upper airway by pushing your tongue forward.

Medical insurance usually covers the cost of much of these treatments.

Contact us today to schedule an appointment to discuss your questions about sleep disorders and their treatments. You can also learn more by reading the Dear Doctor magazine article “Sleep Disorders and Dentistry.”