WHAT'S NEW AT 181 CHURCH STREET
This spring many of again attended Ontario's biggest convention at the Toronto Metro Convention centre with more topics than we could possibly cover. Here are the lecture topics we attended and shared with each other afterwards:
Dr Birnie- Bumps and lumps -a review of lesions in the mouth that should not be there and how to identify them.
Dr Belvedere- Nutrition and supplements by Dr. Low Dog. Everyone should take a multi vitamin and everyone should take Omega3's. You can go to Dr Low Dog's web site to glean some of her wisdom. http://www.drlowdog.com/
Dr Campbell- Root canal and what's new in instrumentation. Dr. Brad loves to do root canal therapy!
Dr. Sevels- Pediatric dentistry- a fabulous 3 hour lecture on treating little ones, dealing with behavior and prevention strategies. After this lecture I did pass on some info to a new mom's group in my daughter-in-law's neighborhood- the most useful being how to brush a one-year-olds' teeth by laying him/her on their back and brushing upside down from behind the head. It works! I will post some Questions and Answers from that session. Scroll down.
Rashne, Susan and Diane also attended, went to lectures, demonstrations and collected many samples that they will pass onto you, our patients.
Yours Truly,
Ingrid
Q and A FROM MOM's GROUP
Q. When should I start cleaning/brushing my child's teeth?
A. Teeth are susceptible to decay as soon as they erupt into the mouth, so brushing should start as soon as teeth erupt. Cleaning a baby’s gums with a wet cloth on your finger is a good idea and gets a child used to having their mouth cleaned.
Q.How often should I be cleaning/brushing my child's teeth?
A. Again, theoretically, after every meal, and especially before bedtime. If you cannot brush after every meal, rinse with water, eat roughage (carrots, cucumbers, other vegetables) as they act as tooth cleansers.
Q. Do I need to use a brush or is a wet cloth good enough?
A. A wet cloth is good for babies. Also a finger cot (a little rubber finger cover) works well.
Q. What can I do to help teething pain?
A. A cold cloth, something rubbery to chew on, baby tylenol if there is a fever ( check with MD) Chamomile is soothing. Once the tooth is visible at the gum surface and the eruption sac surrounding the tooth has burst and the child is comfortable.
Q.What if my child's teeth are taking long to come in - does that mean there's a problem?
A. No problem. Teeth can erupt as early as one month and as late as one year. Eruption timing has a hereditary factor.
Q.Does the sugar content in fruits cause cavities? Why is it better to eat the fruit than to drink the juice?
A. Fruit sugar takes longer to break down so is the lesser of evils. Refined sugars in juice and refined sugary food break down within 20 minutes and cause acid attacks on tooth enamel. The North American indigenous population had no cavities until the Europeans arrived.
Q. What part does heredity play in my child’s teeth?
A. Time of eruption, size of teeth, size of jaw, shape of teeth, alignment are all inherited. The ability to get cavities is NOT. Cavities are entirely PREVENTABLE by staying away from sugary and refined foods and by brushing.
Q. Are electric toothbrushes better?
A. Any SOFT TOOTHBRUSH is good as long as the bristles get to the GUMLINE to clean off plaque. Electric toothbrushes have songs and buttons and gimmicks that are attractive to young children so they may be more inclined to use them more often.
Q. Is breast milk LESS cavity causing than formula?
A. Yes, because the SUGAR CONTENT is LESS than in formula
Q. When should I take my child to the dentist?
A. Take your child TO YOUR CHECK UP before your child has all their teeth (age 2 years). That way your dentist can have a quick “ look see” and answer any questions, and your child can get used to the dental office and smells and sounds. Theoretically a tooth can decay AS SOON AS IT ERUPTS into the mouth.
Q. What are the most cavity causing foods?
A. Any SUGARY FOODS, POP, JUICE AND RAISINS. Raisins are high in iron but they stick on the biting surface of molars and are extremely cariogenic (cavity causing). CHEESE IS AN EXCELLENT SNACK as it actually acts to disable bacteria in the mouth that cause cavities.
New Antibiotic
Regime
For decades the American Heart Association (AHA) recommended that
patients with certain heart conditions take antibiotics shortly before
dental treatment in order to prevent infective endocarditis (IE).
In April of 2007 the AHA recommends that most of these patients no
longer need short term antibiotics as a preventive measure before
their dental treatment.
Scientists found no compelling evidence that taking antibiotics prior
to a dental procedure prevents IE. Their hearts are often exposed
to bacteria from the mouth, which can enter their blood stream during
basic daily activity such as brushing and flossing. Following is a
list of patients who no longer need to take antibiotics before a dental
appointment. They include people with:
* mitral valve prolapse
* rheumatic heat disease
* bicuspid valve disease
* calcified aortic stenosis
* congenital heart defects such as septal defects.
Preventive antibiotics prior to treatment are still advised for patients
with:
* artificial heart valves
* a history of infective endocarditis
* serious congenital heart conditions
* repaired heart defects
* cardiac transplants
* hip and knee replacements
If you are not sure which category you are in, please check with your
physician.
Pregnancy and Oral Health
Hormone changes, altered diet, nausea and vomiting can cause changes
to oral tissues of pregnant women.
The most common oral manifestation during pregnancy is irritated,
bleeding gums caused in part by increased estrogen and progesterone
levels.
The best way to minimize irritated gums
is to massage the gums with a soft brush to eliminate ALL plaque and
to increase the blood flow.
Altered diet with the increase of carbohydrates can increase the risk
of cavities. Tooth enamel does NOT loose calcium during pregnancy
. Again, impeccable oral hygiene will prevent cavities and bleeding
puffy gums.
Microwaving Dentures Kills Bacteria
A recently published study demonstrated that microwave irradiation
effectively sterilized acrylic dentures. The technique avoided the
problems associated with washing off sterilizing solutions and soaks.
The study cautioned microwave sterilization of partial dentures with
metal components as the metal causes sparks.
Enclosing the removable partial in plastic autoclave bags in a dry
state avoided this problem.
From: International Journal of Prosthodontics 19:288-293,2006
Spring 2006 - What's New
It’s that time of year. We’re
looking forward to spring and summer and if last summer is any indication
it’ll probably be a hot one. Some of us in this office are on
diets. Between us we have lost 60 pounds. Elliminate white flour,
white sugar and salt. Eat lots of fruit and vegetables. Here are some
thoughts on nutrition, as it applies to healthy eating for you and
your children’s teeth.
Did you know that a large bag of movie theatre popcorn (20 cups) contains
1300 calories and 50 grams of fat which includes trans bad- for-your-heart
fat. That about equals your daily caloric intake in one bag.
However if you air pop it yourself with no oils or butter the numbers
change.
Portion control is paramount to any weight loss program. If you eat
one cup of air popped popcorn the calorie containment is 30 calories.
Pop corn contains lots of fibre and is an excellent snack to send
to school.
How about those nice bags of licorice twizzlers that people buy at
the movies? Three little sticks equal 50 calories. If you eat the
whole bag during the movie - 1000 calories. Gummy bears have the least
calories as they contain mostly gelatin with flavour and color added
with very little sugar -a good candy but it does stick to the teeth
and brushing afterwards is a good idea.
Our snacks - asparagus spears wrapped in lettuce leaves covered in
hummus, rye crackers, fruit and vegetables.
Water - we drank 2-3 liters or 6 small bottles per day to hydrate
and cleanse. Some bottled water contains flouride. The recommended
dose for children who’s teeth are developing is .3ppm. So if
your child drinks bottled water, read the labels and buy the kind
with flouride. Flouridated water is a huge factor in cavity prevention.
Did you know that drinking pop is a leading cause of obesity? One
can of pop contains 8 teaspoons of sugar, has no nutritional value
and is one of the major causes of dental decay.
Watch the sugar content of vitamins. Read labels. If a child chews
or sucks on sugar coated vitamins, he or she is coating their teeth
with decay causing sugar.
The foods that cause obesity and ill health are usually also the foods
that cause cavities.
So read labels, cut back on processed foods and sugars, go back to
primal eating habits by eating nuts, berries, fruits and vegetables
and your body and teeth will benefit.
Root Cavities
Shakespeare used the expression, “Long in the Tooth” to
mean that a person was aged. Shakespeare was clever at expressing
deeper meaning. A dentist might explain that a person whose teeth
appeared longer would not only be older but would likely have periodontal
disease. For instance, if you have periodontal disease you would have
bone loss and recession of the gums. Your teeth would appear longer.
With the longer tooth and recession of the gums, the roots of your
teeth would be exposed. Since the roots of teeth consist of dentin
which is softer than enamel, the roots are much more prone to decay.
Root caries is difficult to restore when large. An extraction would
be the treatment of choice. But if caught early, when the cavity is
small, the dentist can often restore the area.
Elderly people who are on medications should check their medications
for sugar content. Lozenges that people suck on at bedtime also cause
decay.
Many medications cause dry mouth. Saliva neutralizes acid and washes
away bacteria. Decrease in saliva flow causes dentin to be prone to
decay.
A decrease in saliva also causes decay causing plaque to be sticky.
Fluoride rinses are a good idea for people with exposed roots. Meticulous
brushing and flossing also are a necessity for prevention of decay.
Floss wands and threaders work better for people who may have trouble
manipulating floss with their fingers.
Visiting your dentist every 3 or 4 months for check ups is also a
good idea.
Stress and Dentistry
Stress is often expressed by clenching
and grinding the teeth. Clenching and grinding can cause tooth fractures,
sensitive teeth and weakening of the supporting bone for the teeth.
Patients often describe stress symptoms as follows,
* Tension and headaches
* Short temper
* Restlessness at night, tired jaw muscles in the morning
*Stomach ulcers and indigestion
Although treatment of dental symptoms with a bite appliance will protect
your teeth, your stress may still persist. Intervention of stress
reduction is helpful.
Some of the common causes of stress?
* Work conflicts with other people
* Conflicts at home with your spouse
* Unresolved family issues
* Financial troubles
* Conflicts in parenting skills
* Taking on too many responsibilities
* Family illness, caretaking and death
* Add your own.................................
If you experience stress symptoms, then work with your dentist to
protect your teeth from harmful grinding and clenching. If symptoms
of stress persist, then seek assistance from a licensed therapist
for a stress reduction program.
Antibiotic Prophylaxis
Antibiotic prophylaxis means we prescribe
penicillin- or if you have allergies, another antibiotic- to kill
bacteria that gets into your blood stream when we clean your teeth
. Everyone has common bacteria that live in the mouth. Any manipulation
of the oral tissues pushes this bacteria into the blood stream. This
is especially true when we clean your teeth.
In most healthy people the body simply fights this bacteria. But people
who have heart murmurs, prosthetic heart valves, joint replacements,
common mouth bacteria can cause infections . Like a brook with rocks
that cause turbulence, the blood stream with irregularities such as
faulty heart valves or prosthetic valves are like the rocks where
bacteria will get lodged and cause infection.
Any one with joint replacements or prosthetic heart valves should
have impeccable oral hygiene as simple brushing can cause gums to
bleed and bacteria to enter the blood stream. Four percent of infections
originate in the dental office. The rest are due to home manipulation.
Good oral hygiene is a must to prevent infection of the heart valves
or prosthetic joints.
Premedication is a must before a dental appointment. Please inform
us. We are tedious in our queries about “any changes to your
medical history?” but we have good reason.
What Causes Cavities?
Parents often say,
“But my child brushes! How come he/she still has cavities?”
or, I hear one child complain about a brother and sister,
“He never brushes and doesn’t have cavities. How come I
have cavities? I brush!”
Here are some day to day, hour to hour habits and factors that determine
how prone a child is to cavities.
SALIVA FLOW
Saliva washes away and neutralizes cavity causing acid from sugar
breakdown. Saliva flow increases at mealtimes. Our saliva has different
consistencies. Thick ropey saliva sticks to teeth. If you eat sugary
snacks especially between meals, someone with thick saliva is more
prone to cavities because sticky saliva keeps the sugar next to the
teeth. Instead of the saliva washing away the sugar filled plaque,
the plaque will stick to teeth and cause decay. People with this type
of saliva need to brush after every meal, every snack and every cup
of tea that contains sugar.
ALIGNMENT OF TEETH
Crooked teeth have more nooks and crannies for plaque to hide. Natural
cleansing or brushing removes sugar plaque much more easily if teeth
are picket fence straight.
TIMING OF SNACKS
Some schools have abolished lunch hour and have ‘nutrition breaks’
instead. If a child has 3 or 4 nutrition breaks in a day and has sweets
at these breaks, he/she is more likely to get cavities than if there
is one lunch hour with one meal. Each time natural or processed sugar
is broken down by bacteria in the mouth, the result is an acid attack
on the teeth that can last twenty minutes. Continual sipping of a
drink like juice or tea with sugar causes an ongoing acid attack on
tooth enamel and results in cavities.
Eat sweets at meal times when saliva flow is greatest or eat sweets
once during the day and brush immediately afterwards.
I encourage cheese snacks for school lunches. Cheese actually prevents
cavities by neutralizing the acid in your mouth.
BOTTLED WATER
More and more people drink bottled water instead of fluoridated tap
water. The single biggest reason that children have harder enamel
is because fluoride was added to the water in the1950’s.
Fluoride makes enamel harder and less prone to decay.
Fluoride that is ingested as permanent teeth are still developing
incorporates itself into the tooth structure BEFORE the tooth erupts.
Once a tooth has erupted into the mouth, the enamel structure has
already formed.
Today as more and more children drink bottled water, they miss out
on the protection of fluoride. Fluor-a-Day vitamins like One- a-Day
vitamins may be a solution for children who only drink bottled water
with no fluoride. Read your bottled water label carefully.
For
A Light Touch