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PreservingthePulpisPriorityOnewithaNewlyEruptedPermanentTooth

The change from primary teeth to permanent is an announcement to the world that a boy or girl is "growing up." "Growing up," though, is still not "grown"—the new teeth are still in a period of development that can affect how we treat them if they're injured or diseased.

While a new tooth erupts with all its anatomical layers, the middle dentin is somewhat thinner than it will be after it matures. The pulp, the tooth's innermost layer, produces new dentin and gradually increases the dentin layer during this early development period. While the pulp continues to produce dentin over a tooth's lifetime, most of it occurs in these early years.

To prevent or stop any infection, we would normally perform a root canal treatment in which we remove the pulp tissue and fill the empty pulp chamber and root canals. This poses no real issue in an older tooth with mature dentin. Removing the pulp from an immature tooth, though, could interrupt dentin development and interfere with the tooth's root growth. Besides a higher risk of discoloration, the tooth could become more brittle and prone to fracture.

That's why we place a high priority on preserving a younger tooth's pulp. Rather than a root canal treatment, we may treat it instead with one of a number of modified techniques that interact less with the pulp. Which of these we use will depend on the extent of the pulp's involvement with the injury or disease.

If it's unexposed, we may use a procedure called indirect pulp therapy, where we remove most of the tooth's damaged dentin but leave some of the harder portion intact next to the pulp to avoid exposure. If, though, some but not all of the pulp is damaged, we may perform a pulpotomy: here we remove the damaged pulp tissue while leaving the healthier portion intact. We may then apply a stimulant substance to encourage more dentin production to seal the exposure.

These and other techniques can help repair an injured young tooth while preserving most or all of its vital pulp. Although we can't always use them, when we can they could give the tooth its best chance for a full life.

If you would like more information on caring for your child's teeth, 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 “Saving New Permanent Teeth after Injury.”

By Randall Furman DDS
November 28, 2018
Category: Oral Health
Tags: oral health   GERD  
TheConnectionBetweenGERDandOralHealth

Not coincidentally, GERD Awareness Week overlaps with the Thanksgiving holiday. Many people get acid indigestion from time to time, especially during this month of major feasting, but if you suffer from more than occasional acid reflux, you may be among the 20 percent of U.S. adults with gastroesophageal reflux disease, or GERD. For many individuals, painful heartburn often accompanies acid reflux; however, for others there are few or no symptoms. In the latter situation, dentists may be the first to suspect GERD based on what we see during a regular dental exam.

With GERD, acid washes up from the stomach into the esophagus or throat, and even into the mouth. If the condition is not treated, the repeated contact with acid can lead to ulcers and cause pre-cancerous cell changes along the esophagus lining. In addition, the acids can eat away at tooth enamel and harm the soft tissues of the mouth, which may result in severely eroded teeth and chronic gum disease. Unfortunately for those who have relatively minor symptoms, GERD may go undetected until serious damage has been done. For this reason, diagnosis and treatment of GERD is very important.

You can play a big role in managing your GERD symptoms. Besides taking any over-the-counter or prescription medication your doctor recommends, you can help control acid reflux by eating smaller meals, avoiding foods and beverages that trigger heartburn, refraining from eating within three hours of bedtime, and resisting the urge to recline right after eating. Also, quitting smoking and taking off extra weight can help greatly.

Further, it is important to take steps to protect your teeth if you suffer from GERD. Here are some tips:

  • Neutralize acid by chewing on an antacid tablet or rinsing your mouth with half a teaspoon of baking soda mixed into a cup of water.
  • Don't brush your teeth immediately after an episode of acid reflux, as this could damage the weakened tooth enamel. Instead, rinse your mouth with water to dilute the acid and wait an hour before you brush to allow your saliva to rebuild the minerals on the surface of your teeth.
  • Schedule regular dental visits to monitor the health of your teeth and gums. Depending on your specific situation, we may recommend a particular treatment to help strengthen your teeth.

Our goal is to help you preserve your teeth for life, so be sure to tell us if you have been diagnosed with GERD or any other medical condition. If you have questions, contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “GERD and Oral Health” and “Tooth Decay: How to Assess Your Risk.”

By Randall Furman DDS
December 05, 2017
Category: Oral Health
Tags: oral health  
HolidayTipsforHealthierTeeth

As the old song says, “’Tis the season to be jolly.” And for many of us, the year-end holidays offer a perfect opportunity to break out of our daily routine and get together with co-workers, friends and family.¬†Whether it’s a casual gathering at home or a night on the town, one thing is for sure: There’s likely to be plenty of food and drinks at hand to keep the good times rolling.

We’re not going to say that you should never indulge in a sugar cookie or a tumbler of eggnog. But everyone knows that too much of a good thing can be bad for your health. So here are some simple tips to help keep your oral health in good shape while you’re enjoying the holiday season.

Choose Healthier Snacks — good-tasting munchies don’t have to be bad for you. Plant-based hors d’oeuvres like hummus with raw vegetables can be just as delicious and satisfying as chips and dip—and a lot healthier, with plenty of vitamins and fiber, and little or no sugar. Cheese, yogurt and other dairy products, eaten in moderation, can actually be beneficial for your oral health: they can stimulate the flow of saliva and restore minerals to the teeth. If you choose to eat sweet snacks, limit them to around mealtimes. That way, your mouth gets a break from sugar and acid in between meals.

Drink Plenty of Water — Sure, there are plenty more exotic beverage choices. But for better health, alternate those fancy drinks with glasses of water. Sugary, acidic beverages like soda (or even juice) can feed decay-causing bacteria and weaken the tooth’s enamel, leading to cavities. Alcohol dries out the mouth, which can cause a number of oral health problems. But water promotes the body’s production of beneficial saliva, and keeps you healthy and hydrated. It also helps neutralize tooth-eroding acid and wash away sticky food residue that can cling to your teeth.

Don’t Neglect Your Oral Health Routine — Sure, between frantic holiday shopping and eagerly anticipated get-togethers, it may seem like there aren’t enough hours in the day. But it’s always important to maintain your regular oral health routine—and even more so at this time of year. Brushing twice a day for two minutes each time and flossing once a day are proven ways to prevent cavities and gum disease. Find a few minutes to take care of yourself and you can keep your smile looking good all year long.

The holidays are a time for friends, family, fun and celebration. We offer these suggestions with our best wishes for a safe and healthy season. If you would like more information about how to maintain good oral health—during the holidays or any time of year—please contact our office or schedule a consultation. Read more in the Dear Doctor magazine articles “Nutrition and Oral Health” and “10 Tips for Daily Oral Care at Home.”

APediatricDentistCouldbeaGreatChoiceforYourChildsDentalCare

When it's time for your child to visit the dentist (we recommend around their first birthday), you may want them to see your family dentist. But you might also want to consider another option: a pediatric dentist.

The difference between the two is much the same as between a pediatrician and a family practitioner. Both can treat juvenile patients — but a family provider sees patients of all ages while a pediatrician or pediatric dentist specializes in patients who haven't reached adulthood.

Recognized as a specialty by the American Dental Association, pediatric dentists undergo about three more years of additional post-dental school training and must be licensed in the state where they practice. They're uniquely focused on dental care during the childhood stages of jaw and facial structure development.

Pediatric dentists also gear their practices toward children in an effort to reduce anxiety. The reception area and treatment rooms are usually decorated in bright, primary colors, with toys and child-sized furniture to make their young patients feel more at ease. Dentists and staff also have training and experience interacting with children and their parents to help them relax during exams and procedures.

While a pediatric practice is a good choice for any child, it can be especially beneficial for children with special needs. The “child-friendly” environment is especially soothing for children with autism, ADHD or other behavioral/developmental disorders. And pediatric dentists are especially adept in treating children at higher risk for tooth decay, especially an aggressive form called early childhood caries (ECC).

Your family dentist, of course, can presumably provide the same quality care and have an equally welcome environment for children. And unlike a pediatric dentist who will typically stop seeing patients when they reach adulthood, care from your family dentist can continue as your child gets older.

In the end it's a personal choice, depending on the needs of your family. Just be sure your child does see a dental provider regularly during their developing years: doing so will help ensure a lifetime of healthy teeth and gums.

If you would like more information on visiting a pediatric dentist for your child's dental needs, 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 “Why See a Pediatric Dentist?

By Randall Furman DDS
February 14, 2017
Category: Oral Health
ExpertAdviceVivicaAFoxonKissingandOralhealth

Is having good oral hygiene important to kissing? Who's better to answer that question than Vivica A. Fox? Among her other achievements, the versatile actress won the “Best Kiss” honor at the MTV Movie Awards, for a memorable scene with Will Smith in the 1996 blockbuster Independence Day. When Dear Doctor magazine asked her, Ms. Fox said that proper oral hygiene was indeed essential. Actually, she said:

"Ooooh, yes, yes, yes, Honey, 'cause Baby, if you kiss somebody with a dragon mouth, my God, it's the worst experience ever as an actor to try to act like you enjoy it!"

And even if you're not on stage, it's no fun to kiss someone whose oral hygiene isn't what it should be. So what's the best way to step up your game? Here's how Vivica does it:

“I visit my dentist every three months and get my teeth cleaned, I floss, I brush, I just spent two hundred bucks on an electronic toothbrush — I'm into dental hygiene for sure.”

Well, we might add that you don't need to spend tons of money on a toothbrush — after all, it's not the brush that keeps your mouth healthy, but the hand that holds it. And not everyone needs to come in as often every three months. But her tips are generally right on.

For proper at-home oral care, nothing beats brushing twice a day for two minutes each time, and flossing once a day. Brushing removes the sticky, bacteria-laden plaque that clings to your teeth and causes tooth decay and gum disease — not to mention malodorous breath. Don't forget to brush your tongue as well — it can also harbor those bad-breath bacteria.

While brushing is effective, it can't reach the tiny spaces in between teeth and under gums where plaque bacteria can hide. But floss can: That's what makes it so important to getting your mouth really clean.

Finally, regular professional checkups and cleanings are an essential part of good oral hygiene. Why? Because even the most dutiful brushing and flossing can't remove the hardened coating called tartar that eventually forms on tooth surfaces. Only a trained health care provider with the right dental tools can! And when you come in for a routine office visit, you'll also get a thorough checkup that can detect tooth decay, gum disease, and other threats to your oral health.

Bad breath isn't just a turn-off for kissing — It can indicate a possible problem in your mouth. So listen to what award-winning kisser Vivica Fox says: Paying attention to your oral hygiene can really pay off! For more information, contact us or schedule an appointment for a consultation. You can read the entire interview with Vivica A. Fox in Dear Doctor's latest issue.