The jury’s still out on the count, but up to 700 types of bacteria call your mouth their home. About 20 billion of these organisms linger on teeth, in your saliva, and on the lining of your mouth at any given time. In dramatic fashion, they’re able to double their population every 5 hours. That helps explain why your teeth feel like they’ve grown a shag carpet in the morning. Saliva washes bacteria away when you’re awake, but your saliva output drops at night. Without the buffering and cleansing of this protective liquid, the micro-organisms flourish.

Not all of the bacteria in your mouth stir up problems. The majority of them play a role in a balanced ecosystem and coexist with viruses, fungi, and protozoa. But like any community, a few bad characters create the majority of the issues afflicting patients. Many people are surprised to learn that both cavities and gum disease are actually an infection, spurred on by a few strains of harmful bacteria.

It Starts With Sugar

Like any living organism, bacteria need energy to survive. Fermentable carbohydrates deliver their favorite fuel, and various forms of sugar provide the ideal power source to metabolize into energy. These bacteria then flood the surfaces of the teeth and gums with a toxic mix of acidic waste.

If you’ve ever seen acid poured on concrete, you have an idea of what the bacterial waste does to your teeth. The hard outer layer of enamel erodes away over time as a steady supply of acid attacks the heavily mineralized surface. A cavity starts to open in the tooth, and a lot of damage often occurs before anyone knows what’s happening.

Other types of bacteria prefer settling deeper under the gums. Their waste damages the gum lining and causes a rush of inflammation from the immune system. Bleeding gums are like an open door that invites bacteria deeper into the body. The whole toxic, inflammatory mix can cause the bone to dissolve around teeth and aggravate general health problems. 

Why Doesn’t Everyone Get Cavities?

It’s not unusual to find families with various levels of tooth decay despite similar diets and oral hygiene habits. Different people have different bacterial populations, and not everyone has been infected with the same organisms. Furthermore, some people produce critical antibodies that destroy these disease-causing bacteria. On the oral battlefield, the organisms don’t get much of a chance to thrive when the right immune system factors attack them. 

Regardless of the bacterial mix, anyone can develop a plan to control the destructive organisms responsible for cavities and gum disease. While basic habits like toothbrushing and flossing form the cornerstone to disrupting bacterial plaque, many other strategies fit individual situations. Adding prescription rinses, xylitol products, water irrigators, protective varnishes, fluoride trays, and other innovative methods can make a dramatic difference in a person’s dental story. 

Helping You Fight The Good Fight

At Azalea City Dental, we’re focused on developing a preventive approach that’s as unique as you are. By partnering with our dental hygiene team, you’ll gain an advantage that helps you overcome bacteria, genetics, and past history. 

With the right approach, you can send harmful bacteria on their way and enjoy a lifetime of good dental health!

Enjoying a cold drink usually involves a little ice. Sometimes larger pieces are hard to resist as teeth crunch them into smaller fragments. The sound of ice crystals shattering reverberates across a room unlike any other chewing activity; up to 250 pounds of force may be needed to break ice cubes with your teeth! Some people who chew ice may suffer from an iron deficiency and inflammation of the tongue. But ice-chewing often becomes a habit that simply needs to be broken.

This unique chewing habit carries a higher risk of damage to your teeth than chewing many other types of hard foods. Your teeth are made of mineralized layers that protect the soft inner nerve and blood supply found at the center of each one. Enamel, the hardest substance in your body, provides a unique armor as the outer layer. Intricate crystal rods comprise this remarkable covering, although it’s relatively brittle without the support of the layer underneath it.  

If you compress firmly on an ice cube, an extreme temperature change occurs in the crystallized enamel. As the temperature suddenly drops, the crystal expands slightly. The temporary tension releases as the temperature rises again, a process amplified by the jaw force crushing the ice. Microfractures often form in teeth after thousands of normal chewing cycles. Ice accelerates the process.

Heed The Warning

Sometimes a cracked tooth gives you warning signs. But in other cases, the first clue is when a large chunk of tooth breaks off. Many of these teeth have large silver fillings in them and may appear dark from the amalgam staining that occurs over time. A broken tooth may be sensitive to cold and hot or have sharp edges that annoy the tongue, although they rarely ache. Don’t be fooled: a broken tooth needs attention to prevent further problems from developing down the road.

In other cases, a tooth sends you warning signals that it’s cracked and in danger of getting worse. If your tooth twinges with a cold drink but feels fine to chew on, it’s probably not damaged. If you’ve tried a sensitivity toothpaste for a couple of weeks without any change, you still might want to find out the cause. But if you bite down on certain foods and experience a sharp, sudden pain in the same area, you’d better schedule to see us. Usually, this means the crack is expanding slightly under pressure and will likely worsen over time.

What Do I Do?

A cracked tooth can usually be saved even when a piece breaks off. But if you’re experiencing bite pain and wait too long, the tooth may split and need to be removed. Teeth that ache for an extended period of time after chewing or hurt out-of-the-blue may have deeper cracks. Many of them can still be salvaged. 

Your teeth handle a lot of use and abuse. But chewing ice leads to extra stress and possible problems that you just don’t need. Crunching on ice or hard candies may also damage porcelain restorations or other types of fillings. Many of these materials mimic tooth structure and can break if they’re misused. 

If you’re experiencing any of the alarm bells mentioned above, we’ll help you sort out the reasons and the most conservative options for care. A couple of simple tests at Azalea City Dental helps confirm a crack and the best ways to limit the damage. So next time you’re tempted to break an ice cube in half with your teeth, let it melt...your teeth will thank you for it!

Some topics are a little hard to broach, especially if we feel ashamed or embarrassed. Bad breath can be that way. It leaves us ignoring a social issue that’s easily eliminated with the right approach.  Or we might try masking our breath with tricks that encourage more problems to develop.  Understanding the causes of mouth odors marks the first step to finding an effective solution.

What Makes That Smell?

In the world around us, wind moves across the landscape and picks up invisible odor molecules generated from the dynamic environment it passes through.  Whether it’s the sweetness of lavender or the stench of rotting vegetation, these microscopic particles reach our noses, bind to receptors, and send a message.  

As we breathe, the rush of air moves across the lining of our airway and mouth.  Just like a breeze outside, breath picks up odors and sends a message to those in its path. Your diet can contribute by adding odors from compounds absorbed into your bloodstream. Think garlic breath, a smell which often excretes through your pores, too!

In some cases, bad breath results from medical conditions like diabetes, chronic bronchitis, liver disease, or respiratory tract infections.  Certain medications may also contribute to the problem by altering saliva production and causing a dry mouth.  If you suspect any of these possibilities, be sure to talk to your medical doctor.

The Real Culprit

Studies show that about 80% of bad breath cases result directly from the mouth and the bacteria thriving there. Millions of oral bacteria produce sulfur gases and other compounds that smell unpleasant. Since it’s challenging to detect your own breath, try sniffing floss after you’ve used it to get an idea of lurking odors. 

Cavities, gum disease, unclean dentures, or tonsil problems may all contribute to this nagging relationship inhibitor. Stay on schedule with your preventive dental visits to be sure any disease activity is eliminated.  Untreated gum disease is also the number one cause of tooth loss in adults. Together we can stop bad breath and help you keep your smile healthy. 

Sometimes you’re practicing excellent oral hygiene but still feel frustrated by unpleasant mouth odors. If you’ve eliminated the other possibilities, it’s time to take a better look at your tongue.  The top of the tongue is covered in a forest of papillae, projections that support taste buds and provide a textured surface to aid tactile sensation. But the velvety surface traps dead cells, food debris, and bacteria.  Sulfur gases produced by bacteria contribute to the odiferous mix, and a coating forms across the tongue.  When this coating thickens, your taste may also be altered as the odor intensifies.

An Odor Killer

Even though you remember to brush and floss, don’t forget the benefits of cleaning your tongue at least once a day. Scrubbing with a brush helps a little, but a tongue cleaner is a unique device that you draw gently across the surface of the tongue.  Like a gentle rake, it removes the debris embedded in the papillae.  Finishing with an anti-bacterial mouthwash may help freshen your breath. Be aware that many rinses contain alcohol and could dry out your mouth and exacerbate the issue.  A fluoride rinse is often the best choice, while other patients benefit from mouthwashes formulated specifically for difficult bad breath cases.  Rather than briefly masking odors, these mild rinses neutralize sulfur gases. We can discuss the options and customize a choice for you.

Be careful with other masking techniques such as sugared mints or candies. Excess sugar exposure can quietly create an environment where cavities thrive and cause bigger problems. If you like using mints, look for those sweetened with xylitol.  Xylitol tastes great and works to destroy cavity-causing bacteria.

If you keep regular visits with your hygienist, you’ll always have a partner for excellent oral health.  Finding the right strategies and tools will keep your teeth and gums healthy....and your breath fresh as the summer breeze!

Cancer afflicts more than 1.6 million people every year, along with loved ones who share the journey.  Fortunately, successful treatment modalities continue to emerge and more people than ever are winning the battle.  But often the powerful medications used to target cancer cells also deliver challenging side effects.  And while radiation techniques have become more precise in recent years, patients sometimes find themselves dealing with residual damage from their treatment.

Chemotherapy medications destroy cancer cells, but the fragile tissues of the mouth may also suffer from the exposure. Even though a particular cancer may be far from the head and neck region, a patient may find their treatment affecting the mouth.  Chemotherapy agents can result in ulcers developing in the mucosal lining of the oral cavity and throat.  If you’ve ever had a mouth or cold sore, you know just how miserable these raw areas become.

If you or someone you know experiences mouth pain during chemotherapy, options for comfort care exist.  While a product like Oragel can be applied to mouth sores, it’s often ineffective if multiple areas break down.  We may be able to prescribe a mouth rinse formulated to soothe and coat painful lesions.  Designed as a swish and spit formula, a simple prescription could help make life a little easier during treatment.

Comfort and Protection

Radiation therapy doesn’t typically alter the mouth.  But if it’s targeted around the head and neck region, the negative effects can be dramatic.  The saliva glands constantly pump out fluid that coats the mouth, protects the teeth, and aids in digestion.  Radiation that includes these vital glands can leave permanent scarring that reduces or eliminates saliva output for years to come. While there’s no easy solution to radiation-induced salivary output, cancer patients deserve every option to improve their quality of life. 

Dry mouth, known as xerostomia, leaves the mouth parched and uncomfortable. In addition, saliva plays a protective role against tooth decay. We help patients struggling with xerostomia find ways to increase their comfort while decreasing their risk of major dental problems.  Specialty rinses, toothpastes, Xyli-melt lozenges, and other strategies can make a significant difference for cancer patients affected by xerostomia.

Some chemotherapy drugs create a small but serious risk of jawbone damage, known as osteonecrosis (ONJ).  This condition is most likely to develop if a tooth requires removal, a dental infection develops, or gum disease is present.  The best way to guard against this potential side effect is to have a dental evaluation prior to starting any chemotherapy treatment. Discussing oral health with an oncologist and dentist prior to treatment can help eliminate unnecessary complications.

Standing With You

Facing cancer involves many challenges, but our team is here to help you manage your oral health before, during, and after your therapy.  Healthy teeth will add to the richness of the years beyond your treatment, so together we can develop short and long-term strategies for optimal wellness. Please feel free to discuss any concerns or questions you may have, and encourage your loved ones to maintain their oral health through their cancer care.

The human tongue is often referred to as the most powerful muscle in the body.  But your tongue is actually comprised of eight muscles working together as a multi-use tool.  Washington Irving once said, “The tongue is the only instrument that gets sharper with use.”  Both wars and romances have begun with words rolling off the tongue, and a healthy one helps us taste food, swallow, and talk.

Changes sometimes occur on the surface of the tongue that may leave you wondering what’s going on.  While discomfort characterizes some tongue conditions, many changes could go unnoticed without a quick inspection. When you visit Azalea City Dental for care, we monitor the surfaces of your mouth for any alterations, including on and around your tongue. We can help you determine which ones reflect concerns requiring further evaluation or monitoring.

A healthy tongue is pink and covered with papillae:  small nodules with taste buds on top. The average person has about 10,000 of these projections, and they’re replaced every two weeks.  Many changes alter the papillae, although few are serious.  Let’s explore a few color shifts that you might notice on your tongue:

White Tongue

• Leukoplakia:  Cells of the tongue sometimes overgrow and produce a white film or patch, especially in areas of irritation. Tobacco is a well-known irritant along with ill-fitting dentures. Leukoplakia isn’t dangerous, but it can lead to cancer in some cases. This should be evaluated.
• Thrush:  Oral thrush, or candidiasis, is a yeast infection that can lead to excessive, thick white patches.  Babies and elderly patients sometimes get thrush, a condition that may thrive under dentures also. Diabetics, immune-compromised patients, or people using antibiotics may develop candidiasis. We can help if you’re dealing with thrush.
• Lichen Planus: This condition has an unclear cause, but it’s marked by raised white lines interlaced on your tongue. Sometimes eliminating certain foods or improving your oral home care will bring things back to normal.

Red Tongue

• Vitamin Deficiencies: The tongue may take on a generalized reddish appearance if you lack B-12 or folic acid.
• Scarlet Fever:  If you come down with a high fever and a red tongue, you need to see your doctor right away.  If you have Scarlet Fever, antibiotics are required.
• Geographic Tongue: If you notice red dots with meandering borders resembling a map, you may have this condition.  While it's benign, certain ointments can be prescribed if it results in any discomfort.

Black Hairy Tongue

• Remember the papillae mentioned earlier?  Sometimes they overgrow and become a haven for bacteria and stain.  Chemotherapy, diabetic, or antibiotic patients may also deal with black hairy tongue. While it doesn’t look pleasant and can contribute to bad breath, it rarely indicates a serious problem.  Usually better oral hygiene and tongue cleaning will take care of it, and our team can help you find a personalized strategy to deal with it.

Your tongue often reflects messages about your general health and deserves a regular inspection.  While cancerous changes are rare, it’s important that discolored or irregular areas are checked.  If you notice any of these changes, be sure to schedule an exam with us. By seeing us for your regular preventive visits, we’ll help monitor your teeth, gums, tongue, and mouth lining for optimal health!

Even if you don’t suffer from headaches, you’ve probably experienced “brain freeze” after a scoop of your favorite ice cream.  While experts don’t really know why it happens, it’s believed that the cold against your warm palate causes blood vessels to constrict and relax suddenly. This vessel spasm results in a burst of pain, leaving you empathetic to the 28 million Americans that suffer from migraines. Add another 20 million who deal with chronic headaches of other origins and you understand why doctors hear about this ailment often. In fact, physicians report headaches as the number one medical complaint and frequently order a variety of tests in search of a cause.

Headaches rarely indicate the presence of a serious disease. But if you’re dealing with frequent or severe headaches, you should consult with your physician.  While a definite diagnosis may be identified, some patients find themselves frustrated with an unclear answer. And treatment should target more than symptoms: The steady use of pain medication creates side effects that may include kidney damage or dependency.

The Missing Link

Your dentist may be able to shed a little light on chronic head pain. Millions of Americans struggle with temporomandibular joint (TMJ) headaches without realizing it.  This complex joint allows the lower jaw to fit and function against the skull in front of the ears, and one or both joints may become inflamed.  Unfortunately, TMJ headaches are frequently overlooked by physicians because symptoms often mimic other types of headaches.  The pain may feel like it’s in the sinuses, over the top of the head, or up through the temples.  But pain doesn’t always show up at the source.  It often radiates to nearby sites and confuses the search for an origin.

A recent study at the University of Buffalo examined nearly 600 patients with TMJ pain symptoms. Researchers demonstrated that in 82% of subjects, physical pressure over the TMJ area produced pain that presented as a classic muscle tension headache. Although TMJ symptoms were present in all participants, 152 were diagnosed with tension headaches only. 

That means 25% of the patients hadn’t received a complete diagnosis.

The lead researcher noted that “TMJ is very treatable, but if a jaw disorder is ignored, then treatment for a headache may not address all of the factors contributing to the headache.”  Many providers evaluating headache patients don’t understand the relationship of these joints to chronic pain conditions.  It’s simply vital that every headache sufferer receives an evaluation of this region.

While migraine headaches are linked to a vascular cause, TMJ disorders can aggravate the Trigeminal nerve and trigger their onset. This major nerve links many structures in the head and neck. While not a guarantee, migraine headaches may be reduced with proper management of these associated problems.

Consider This

Review the following questions to see if your headaches may be linked to a TMJ disorder.  Keep your answers to discuss with Dr. Bellerjeau, Dr. Lovell, Dr. MacRae or Dr. Kern:

• Do you wake up with headaches?
• Does your jaw ever feel stiff, locked, or sore in the morning?
• Do you have more than two headaches each week?
• Do you have pain in your jaw when you eat?
• Do you take painkillers four or more times each week for headaches?
• Does your jaw pop, click, or lock when you open?
• Have you noticed any changes in the way your teeth bite together?
• Have you noticed wear or chipping on any of your teeth?
• Do you catch yourself clenching your teeth during the day?
• Do you feel tenderness when you push on the sides of your face?
• Do you feel pain in front of your ears when you chew or open wide?

If you answered YES to three or more of these questions, there’s a significant chance that you’re suffering from TMJ headaches. But management of this affliction frequently involves conservative measures offering dramatic relief from pain. Dr. Bellerjeau, Dr. Lovell, Dr. MacRae and Dr. Kern's experience with TMJ headache disorders includes focusing on the cause of the problem, not just the symptoms.  We’re here to help you or your loved ones discover optimal health and pain-free living!

You feel it coming on:  A spot in your mouth starts to burn or tingle, and you know what’s about to happen. By tomorrow you’ll have a nagging sore cratered into the lining of your cheek. Aphthous ulcers afflict 20% of the population, recurring intermittently and often without a distinct pattern. After a week or two, the pain disappears and your mouth feels whole again.

Aphthous ulcers are sometimes confused with cold sores, but they’re only related by their discomfort and proximity to each other.  Cold sores occur on the lips and surrounding skin as a result of the Herpes Simplex Virus.  Aphthous ulcers don’t have such a clear cause.  These lesions show up on movable tissue surfaces inside the mouth and may be difficult to pin to a single instigator.  We understand that the body’s immune system sends inflammatory cells into an area and destroys its own tissue, but what triggers the assault?

Where Do They Come From?

Mouth sores may show up one at a time or in groups spread across multiple areas.  Many patients feel frustrated by their inability to control these painful ulcers, but understanding possible causes may help you take steps to eliminate or reduce outbreaks.  Here are a few triggers to consider:

• Stress. If we started a list of all the maladies stress creates in our bodies, we’d need to buy a ream of paper to finish it.  Aphthous ulcers often erupt when we’re experiencing a high level of stress.
• Hormone Changes. Some women experience outbreaks before their period, while others are ulcer-free until after menopause.
• Vitamin and Mineral Deficiencies.  Low levels of iron, vitamin B12, calcium, selenium, or folic acid are just a few nutrients linked to aphthous ulcers.
• Genetics. A lot of health conditions run in the genes, and mouth ulcers seem to be one to add to the list.
• Toothpaste.  Most toothpastes contain a foaming agent called sodium lauryl sulfate (SLS). This ingredient is linked to mouth ulcers in some patients.  Sensitivity to mint flavoring may also lead to a similar problem.
• Systemic Diseases. Crohn’s Disease, Coeliac Disease, Reactive Arthritis, and Behcet’s Disease are a few conditions that might also include mouth sores.
• Medications.  Some people find that non-steroidal anti-inflammatory drugs, like ibuprofen, lead to mouth sores.  Beta-blockers, used to treat high blood pressure and certain heart conditions, along with chemotherapy agents, are also culprits.
• Foods.  When a sore shows up, consider certain foods in your diet in the previous 24 hours. Chocolate, coffee, spicy foods, peanuts, almonds, strawberries, cheese, and wheat flour are known initiators.

Most episodes of aphthous ulcers clear up and move on within a couple of weeks.  If you have a sore that doesn’t resolve within a month, it’s time to see the team at Azalea City Dental. In these cases, a closer analysis of the area should be done. 

While identifying a cause may lead to a lifestyle adjustment that eliminates sores, many patients end up enduring the discomfort until they heal.  Here are a few tips to minimize the disruption:

• Be Gentle. Stay away from spicy or acidic foods during an outbreak.  Use a soft toothbrush and consider an SLS-free toothpaste for awhile.
• Numb It.  Grab a tube of a numbing or coating agent like Oragel, Kanka, or zilactin-B. Carry it in your pocket and apply as needed to cut the pain.
• Rinse.  You might try mixing ¼ cup hydrogen peroxide, ¼ cup water, 1 tsp baking soda, and 1 tsp salt to create a rinse that disinfects and neutralizes sore spots. This mix is particularly useful if you’re suffering from multiple ulcers.  Rincinol PRN is a commercial rinse available at many retailers that draws strong reviews from users.
• Try Tea.  Some patients get relief by applying a damp tea bag to a mouth sore for a few minutes at a time.  You may also find that sipping licorice tea helps.
• Bump B-12.  A well-designed research project showed that patients taking 1000 mg of sublingual B-12 experienced a significant reduction in mouth ulcers and pain levels. Regardless of initial B12 blood levels, 74% of patients were ulcer-free after six months compared to 32% in the control group.  Definitely worth considering!
• Chat With Us.  If you’re dealing with mouth ulcers, talk to us the next time you’re in our office. We may be able to personalize our recommendations and offer other management suggestions.

At Azalea City Dental, we want to help you find answers to every question you have about your dental health.  Aphthous ulcers frustrate many people, but sometimes just one tip contributes to reducing your pain.  We look forward to discussing all your concerns at your next visit!

Kids reach many milestones as they grow, including frequent visits from the tooth fairy. A series of developmental steps cause baby teeth to fall out and adult teeth to replace them. But sometimes adults lose permanent teeth from disease or trauma. Modern dentistry presents options for every unfortunate scenario, restoring full function and appearance. We enjoy techniques and materials today for tooth replacement not available in previous generations. Yet dental scientists continue their reach for new horizons and innovative possibilities.

Tufts School of Dental Medicine researchers are harvesting stem cells that grow new teeth and jaw bone. These “universal cells,” taken from inside healthy adult teeth, differentiate into tooth buds. But this intricate process of cellular differentiation only takes place under conditions that replicate an embryonic jaw. Growth hormones and nutrients must stimulate development at exactly the right times. As a result, new teeth won’t grow in a petri dish. They need a precise framework, one which the Tufts researchers continue to design.

Progress Continues

The Tuft’s team recently constructed a cellular matrix that allows successful implantation of a tooth bud into a pig’s jaw. Under their design, early adult-stage teeth develop within five months. But the transfer from pigs to humans requires significant advancements yet to come. Researchers project that humans won’t profit from these developments for another ten years. The exciting progress hints at options once believed to be impossible.

In the meantime, dental implants offer the closest alternative to growing new teeth. Titanium pieces placed into the jawbone mimic tooth roots that support life-like porcelain crowns. And research has brought major benefits to implant technology as well. Specialized coatings and modified designs help produce outstanding integration success, while 3D imaging technology allows precise planning of every case.

A Cavity Disappearing Act

Another intriguing frontier in dental research involves dental fillings that stimulate teeth to repair their own damage. Decayed parts of teeth usually are drilled out and restored with various materials. But researchers at Nottingham and Harvard University recently earned recognition from the Royal Society of Chemistry for their innovative approach.

These teams created a filling material that stimulates stem cells to grow dentin, the firm inner layer of every tooth.  They’ve also demonstrated the ability to regenerate the internal nerve and blood vessel center of teeth, the pulp. This part of the tooth usually undergoes root canal treatment when it's infected. Widespread regenerative procedures are a few years off. But these materials could revolutionize the treatment of some common dental problems.

Stay Tuned!

Research keeps moving dentistry into fascinating new frontiers with solutions once considered impossible. Dental stem cells open doors to future procedures that will someday be commonplace. But you don’t have to wait for life-changing dentistry: Implants and biocompatible restorative materials now offer modern options for full function and beauty. The Azalea City Dental team constantly monitors our profession for developments that enhance your experience. We look forward to discussing the fascinating world of biomedical research in dentistry with you at future visits!

Do you ever wake up and feel like you’ve been sucking on a cotton ball? Or that you just crossed the Sahara Desert without taking enough water?  Everyone deals with a dry mouth occasionally.  At night, your saliva glands reduce their output and little moisture flows into your mouth.  Plus, mouth-breathing often dries you out a bit more.  But as you wake up, saliva glands start pumping the first of 50 ounces of daily fluid supporting the first step of digestion. Soon everything feels back to normal

But what if you’re amongst the 10% of the population that deals with persistent dry mouth, known as xerostomia?  No matter what you do, your mouth feels parched most of the time. Good saliva flow is easy to take for granted, until you no longer have it.  And for millions of people, the loss of mouth moisture is a serious quality-of-life issue. 

Saliva is 99.5% water, but it also contains a host of components that support your health. Key enzymes, suspended in a mucous matrix that lubricates the mouth, comprise the first step in digestion. And other enzymes that destroy bacteria join the complex environment supported by healthy salivary flow.  Electrolytes, along with specialized compounds like opiorphin, a pain-killing substance, help support a system that’s easy to take for granted when it works right. Furthermore, saliva helps buffer against acidity, a state that leaves teeth dangerously susceptible to rapid tooth decay.

Why Does This Happen?

Numerous causes lurk behind the scenes to hinder the reliable production of saliva. A few of the most common culprits to consider include:

• Medications:  Xerostomia is a frustrating side effect of nearly 500 medications! And frequently patients taking multiple prescriptions compound the problem even further. For many patients, this is a catch-22:  The medicine is necessary, but the side effects create other problems.
• Disease and Medical Conditions:  Dry mouth accompanies a range of conditions including Sjogren’s Syndrome, Alzheimer's, diabetes, cystic fibrosis, rheumatoid arthritis, Parkinson’s disease, and others.
• Cancer Treatment: Radiation to the head and neck area can damage salivary glands leading to a permanent reduction in production.  Some types of chemotherapy may alter moisture levels also.
• Nerve Damage:  Surgery or an injury to specific nerves may cause dry mouth.

If any of these possibilities could be behind your dry mouth problems, definitive solutions may be difficult to find.  However, there are a few tips that will help you reduce both the discomfort and risk associated with xerostomia.  Consider the following:

• Medication Changes:  It’s rarely a good idea to drop your prescribed medications to eliminate dry mouth problems.  And you certainly wouldn’t want to make changes without consulting your physician. But there may be useful alternatives to explore.  Be sure to talk it over with your doctor.
• New Medications:  While you’re talking to your doctor, you might explore the possibility of using a prescription that stimulates saliva production. They’re not for everyone, but ask for more information in regards to your situation.
• Drink Water:  Dry mouth or not, most of us don’t hydrate enough. Carry water with you everywhere and sip freely...all the time.
• Limit Alcohol and Caffeine:  When you’re parched, you don’t need any extra hindrance. Avoid these dehydrating products.
• Try Biotene products, Oracoat Xylimelts, saliva substitutes, or other products:  Xylimelts, placed in your cheek like a lifesaver, dissolve slowly and add moisture to your mouth. But DON’T use other types of candies! They can promote tooth decay, while Xylimelts protect against decay.

Many other tricks will help you adapt to the challenges of xerostomia. The Azalea City Dental team will help customize solutions that increase your comfort and decrease your risk of dental problems associated with a dry mouth.

An eye-catching smile reflects warmth, trust, and friendliness unlike any other human characteristic.  Actors discover that a smile aids their careers, and mothers instinctively know their smile calms a fussy baby. This universal asset crosses every border and brightens faded photos from bygone eras.  That’s probably why teeth whitening tops the list of the most popular cosmetic services requested by patients from their dentist.  Up to 10 million people will purchase whitening products and services in the U.S. this year alone.

Along with reliable information on teeth whitening, some misconceptions exist.  While the best source of accurate information and quality product selection is your dentist, here are a few myths that need a quick look.

Myth 1:  Whitening Toothpastes and Rinses Will Do The Trick

On a crowded supermarket shelf, every product looks for a reason to stand out. As a result, many whitening toothpastes and rinses catch the consumer’s eye. While there’s nothing wrong with these products, they’re far too weak to produce a significant result.  Breakdown of stain doesn’t occur until after about 20 minutes of product contact with the teeth. If you rely on these products for a brighter smile, you’ll be waiting a long time to see a difference.

Myth 2: Gels Purchased Online Are The Same As Professional Gels

The quality of the gels used for whitening makes a significant difference in the outcome.  While all gels are created from a base of carbamide or hydrogen peroxide, their formulations and handling aren’t always equal. Gels are highly sensitive to temperature and deteriorate if not stored or transported properly, and expiration dates come and go quicker than with many products.  Dentists use products from highly-reputable sources with excellent quality control protocols in place.  Plus, the type and strength of gel used should be personalized for each patient for predictable results.

Myth 3:  Discolored Crowns and Fillings Whiten Just Like Teeth

Your smile should be evaluated for materials that won’t respond to whitening, including porcelain crowns and composite fillings.  If these teeth don’t show when you grin, then there’s little concern. But a porcelain crown centered in your smile won’t change color at all, often leaving a discolored tooth unchanged.  Yet whitening can be a valuable initial step to brighten your overall smile, followed by replacement of dark crowns and fillings with modern materials. Be sure to discuss the desired result with our doctors and discover which areas will lighten...or not.

Myth 4:  Once Teeth Are Whitened, It Lasts Forever

Stain accumulates on the surfaces of the teeth exposed to many different foods and drinks.  Coffee, tea, chocolate, wine and tobacco top the list of yellowing agents that deposit color onto the enamel.  While professional whitening agents break down the barrier, new deposits begin to form immediately. But the enhanced color usually holds nicely for 1-2 years and may stay indefinitely with a simple maintenance routine.  A customized strategy to keep your smile bright can be designed with the Azalea City Dental team.

Myth 5:  Whitening Gels Damage Your Teeth

Be careful with this one.  Studies confirm that whitening gels are safe when used in the proper formulations, exposure times, and methods.  Higher concentrations provide benefits in the right situations, but these formulas usually contain fluoride to protect tooth enamel. Poor fitting whitening trays sold as a one-size-fits-all design may lead to excessive tissue irritation. But custom trays ensure an ideal fit and less unnecessary exposure to the whitening ingredients.   Our doctors chose the highest-quality systems and prescribes a protocol that fits your particular situation.  This approach leads to extremely safe whitening with exceptional results.

Teeth whitening enriches your life by returning the brilliance to your smile, removing years of stain accumulation.  Feel free to discuss your options with our team to find a safe, effective method that fits you.  Before you know it, you’ll be enjoying the 24/7 benefits of a brighter smile!

If we chose our habits based on the latest headlines, we’d be caught in lurching chaos.  One day we’d be popping Vitamin D, and throwing it out the next. In the 24/7 news storm driven by social media, midnight bloggers, and major news outlets, a flood of conflicting reports fill the insatiable demand for information. Now, even the credibility of flossing can’t escape controversy.

Recently, the Associated Press reviewed 25 studies that compared the use of a toothbrush with the use of a toothbrush and floss.  The reporter concluded that the evidence for flossing is “weak, very unreliable” of “very low” quality, and carries a “moderate to large potential for bias.”  This conclusion resulted in a knee-jerk deluge of headlines declaring How an AP Reporter Took Down Flossing and asking Are Americans Wasting $448 Million a Year on Dental Floss? Guilty non-flossers gloated under banners such as Flossing Fraud Exposed and Finally, The Floss Scam Is Up. 

Before you casually dismiss a habit supporting better health while saving millions of dollars in healthcare costs since 1882, do yourself a favor: Take a step back and start with a 35,000-foot view.

Flossing and The Big Picture

Flossing is a simple, oral hygiene habit.  Costing 1.1 cents per use and demanding .13% of your day to practice, it’s questionable whether the flossing controversy even warrants so much attention. And if you need much evidence of what flossing does, do your own experiment. Wrap it around the neck of a molar, slide it out and put it right under your nose.  The visible bacterial film coupled with a foul stench might leave you pondering why anyone would bother funding a study on flossing effectiveness over a 20-year period. There must be more pressing issues to explore. When it comes to flossing, the words of one well-known brand fits: “Just Do It.”

Dental professionals tracking diligent, and not-so-diligent patients, tell you what scientific research has never fully established:  Flossing helps prevent chronic, long-term dilemmas (like complete tooth loss) resulting from devastating oral diseases. The differences observed between these patient groups couldn’t be starker. Yes, properly designed longitudinal studies stretching over half a lifetime would lend credibility to flossing.  But these costly, demanding projects aren’t easy to conduct. So condemning a simple hygiene habit at the risk of losing your teeth is a decision you’ll have to make. 

"The condition we're trying to prevent, which is gum disease, is something that takes years to develop, and most of the studies only last for a few weeks or months," says Dr. Tim Lafolla, a dentist associated with the National Institutes of Health. "So the evidence that we gather from these studies is fairly indirect. We can look at bleeding gums, we can look at inflammation, but we have to extrapolate from that evidence to gum disease."

The condemnation of flossing appears to come from extrapolating data as well.  So if you’re going to weigh whether it’s worth roughly $4 annually to floss, consider the rest of the story, including the parts backed by substantial evidence.

Do You Want to Leave this Bacterial Sludge?

Dental plaque is a sticky biofilm with 70% of its dry weight coming from both beneficial and harmful bacteria.  But after three weeks adhered to the teeth, the bacterial population shifts to a distinctive mix of organisms associated with gum disease in nearly half the population.[i] While your immunity and your body’s inflammatory response influence the occurrence and rate of disease, unremoved plaque amplifies an unnecessary risk.

Furthermore, in less than two weeks, plaque begins to mineralize and harden into tartar.  This coral-like matrix provides a housing framework for more strains of harmful bacteria to embed around the teeth.  And at this stage, floss won’t dislodge the hardened bacterial colonies.

Cavities afflict over 90% of the adult population, and a quarter of people over 60 have lost all of their teeth.  As the pH of plaque drops from 7 to 5.5, the acidic wastes from bacterial sugar metabolism dissolve the mineral surfaces of teeth.  Since plaque starts to re-form within 24 hours of removal, daily disruption of the sticky film from all surfaces remains a cornerstone of cavity prevention.

Twenty-five years ago, a peer-reviewed study considered the effectiveness of plaque removal with floss or a micro-brush slid between the teeth. While the micro-brush removed more plaque, both methods significantly reduced plaque compared to brushing alone.[ii] Other scientists confirmed these findings. In fact, one University study showed brushing and flossing resulted in half the gum inflammation as brushing alone, after just two weeks[iii]. If flossing contributed this much benefit so quickly, why would the healthy state not last throughout a lifetime? But the Associated Press chose to cite only studies that don’t confirm their anti-flossing position.

So if you’re comfortable leaving plaque on 50% of your tooth surfaces, then toss the floss.  If you’re in the half of the population that deals with bone-dissolving periodontitis driven by plaque, then roll the dice.  Research shows that areas with active gum disease flourish with up to ten times the bacterial numbers than non-disease sites.[iv]  Is plaque worth leaving?

Flossing as a Catch-All Term

Since the 1800’s and the advent of flossing, many other methods for removing plaque from between the teeth developed. Who hasn’t heard of a toothpick, which pre-dates flossing? Research has even compared two different types of toothpicks, both of which demonstrated significant reductions in plaque.[v]

Most dental professionals readily acknowledge that the issue’s less about flossing and more about a consistent routine of cleaning between the teeth.  Proper flossing remains a gold standard for aiding the process.  But the best method is whichever method you’ll use, and many patients find techniques that work better for them than flossing. Oral irrigators offer a modern way of flushing away plaque in-between teeth, for example.

Dental professionals understand that cavities and gum disease result from a complex host of factors, and plaque control is just one piece of the puzzle.  But the holistic approach to optimal dental health still incorporates the disruption of dental plaque with consistent cleaning of all tooth surfaces.

The danger with headlines that reject flossing is that you’ll then reject cleaning these areas entirely. In the book The Slight Edge: Turning Simple Disciplines into Massive Success and Happiness, author Jeff Olson reminds us of a critical point: Simple disciplines in all areas of life give you a slight daily advantage that you may not even notice in the short-term. 

But over time, even a personal hygiene habit could easily be the difference between health and ailment. In this case, that could mean losing or saving your teeth.  Furthermore, with current research linking periodontitis to heart disease, stroke, arthritis, and certain types of cancer, you may be risking even more.

Toss the floss?  You decide

[i] http://www.ncbi.nlm.nih.gov/pubmed/15143484

[ii] http://www.ncbi.nlm.nih.gov/pubmed/1960236

[iii] http://www.joponline.org/doi/abs/10.1902/jop.1989.60.5.243

[iv] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3768898/

[v] http://www.ncbi.nlm.nih.gov/pubmed/19178096