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.”

Of major importance in all wedding day plans is to ensure that you have your special day captured on film. And it is that fact that influences most brides and grooms to take a long and hard look in the mirror to observe their smiles. Not only do wedding dates motivate many brides and grooms to address concerns regarding their smile, it also serves as the perfect time for their parents to pursue their smile makeover dreams so that they too feel good about themselves in your wedding photos.

A proper smile makeover should have a two-fold design plan that ensures you obtain optimal functionality and oral health while creating the cosmetic look you want. Starting with the basics, a thorough dental cleaning is the least expensive way to remove stains and freshen both your smile and breath. We will also use this consultation to learn about your concerns, goals, expectations, and wedding day timeline to create the action plan for future treatments in reaching your smile makeover goals. You may also want to discuss whitening your teeth during your appointment, as whitening teeth is an effective way to brighten your smile a few shades in as few as 1 to 2 appointments plus whitening while at home.

If your smile makeover is a bit more challenging, relax. There are a wide variety of tools and techniques available that include bonding, veneers, crowns, bridges, and dental implants for restoring your smile. Or we may work closely with a specialist such as an orthodontist to straighten your teeth or a periodontist for periodontal plastic surgery that can alter your gum tissues and their relationship with your teeth. The most important tip to remember is to schedule your first dental appointment soon after you become engaged so that you have plenty of time prior to the big day to attain your picture perfect wedding day smile.

Want to learn more?

Contact us today to discuss your smile makeover questions or to schedule an appointment. You can also learn more by reading the Dear Doctor article, “Planning Your Wedding Day Smile.”

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.

In our office, many of our patients are always asking us if over-the-counter (OTC) mouthwashes or mouthrinses are truly effective tools for curing bad breath. Unfortunately, nearly all of them merely mask any odorous smells temporarily — regardless of how refreshing they taste. There are mouthrinses available that are effective for treating gingivitis and tooth decay, but you must visit our office to obtain a proper diagnosis and a prescription for them. Reality is that a mouthrinse alone can't cure bad breath; however, there are products available that can make a positive impact on your dental health. The key is to match the right mouthrinse to your specific dental need.

• OTC mouthrinses that contain about 0.05% sodium fluoride are an effective tool that when combined with good oral hygiene can significantly reduce the development of tooth decay.
• OTC mouthrinses that contain alcohol, triclosan, sanguinaria extract, zinc and/or essential oils such as menthol can somewhat help reduce the bacteria in plaque, which in turn can reduce gum inflammation (gingivitis) and bad breath when used in combination with proper brushing and daily flossing.
• Prescription mouthrinses containing chlorhexidine may be more effective in helping to control both gingivitis and tooth decay in certain circumstances. This is because chlorhexidine inhibits the formation of dental plaque by preventing bacteria from sticking to your teeth.

While bad breath may seem unbearable, it is often treatable. The key is to determine and then address what is causing your bad breath. A simple trip to our office for a proper exam, assessment and thorough cleaning along with improved oral hygiene may just do the trick. Contact us today to schedule a consultation for an examination and treatment plan.

Learn More

To learn more about mouthrinses, read the Dear Doctor article, “Mouthrinses.”

A generation ago, hearing the term, “smile makeover,” would most likely have resulted in questions and puzzled looks. However, through the power of both the media and celebrities, today it has become a common household term with over 70% of all inquiries coming from people in the 31 to 50 year old age group, according to the American Academy of Cosmetic Dentistry (AACD). While some people seek cosmetic dentistry purely to boost their self-esteem, others pursue it to improve first impressions during business and social interactions, as many studies have revealed that first impressions are the ones that typically last the longest.

The AACD study also revealed other interesting statistics that support why a smile makeover is a wise choice that can yield a life-changing return on your investment — you!

• 99.7% of Americans believe a smile is an important social asset.
• 74% feel an unattractive smile can hurt chances for career success.
• 50% of all people polled were unsatisfied with their smile.

Another important study recently conducted by Beall Research & Training, Inc., an independent marketing research firm, used before and after photos of smile makeovers for polling purposes. The research found that people who have had a smile makeover are viewed by others as more attractive, intelligent, happy, successful in their career, friendly, interesting, kind, wealthy, and appealing to the opposite sex. This evidence clearly proves just how important a first impression can be as well as what it can silently communicate about you.

Want to learn more?

Contact us today to discuss your smile makeover questions or to schedule a consultation. We look forward to meeting with you to learn about your specific concerns and to show you what we can do for you. You can also learn more by reading the Dear Doctor article, “The Impact Of A Smile Makeover.”