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Dental Health
Alert™ Library
Michael A Wong, DDS
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Dr.
Michael A Wong
San Mateo Center For Cosmetic Dentistry
256 North San Mateo Drive,
Suite 8
San Mateo, CA
94401
Email:
drwong@wowsmile.com
Phone: (650) 342-9016
Fax: (650) 342-9087
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Problems:
Dry
Mouth In Seniors Poorly
Fitting Dentures Halitosis
(Bad Breath)
Crisis
Treatment
Diet and Dental Health
Cracked,
worn, discolored or broken teeth
Gum Disease
Patient
Concern about AIDS
Discolored Teeth - Bleaching
Lost Teeth
Impact Total Health
Easy
to see Dental Problems
Poor self-image, resulting in low self-esteem |
Stained, broken, worn, or crooked teeth
Dental
disease during pregnancy
Dental decay
"cavities"
TMD
Cracked, Worn, Broken, Discolored, Unsightly Silver-Mercury Fillings
XEROSTOMIA (Dry
Mouth)
Oral Health
for Seniors
Accidental Tooth Loss By Injury
Decayed (Baby)
erupting teeth (bottle caries)
Missing Teeth
Bad Breath (halitosis) Black
and unsightly silver fillings
Stained, broken,
worn, crooked, malformed teeth |
Problem:
Dry Mouth In Seniors
Solution:
Topical fluoride rinses
More seniors today have retained their own teeth,
avoiding the trauma of removable dentures.
Many are on medications creating dryness of the mouth as a side effect.
Without the natural benefit of saliva to decrease bacterial action, we see
an increase of cavities on the root surfaces of these patients.
Anyone on a medication
causing a dry mouth should be encouraged to see their dentist for regular dental
cleanings and topical fluoride rinses.
For more information
regarding dental problems of the elderly, please call our office.
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HALITOSIS
(Bad Breath)
Lots of
patients share concern about bad breath.
As a social embarrassment, it's surely near the top of the list. Since mouthwashes won't eliminate the
problem, let's look at some possible reasons for the condition.
Certain foods, such as onions,
garlic, and spices will cause temporary bad breath. Some medical and systemic problems, such as sinusitis, can also
contribute.
But most
causes are local in nature. Bacteria,
plain and simple, are the culprit.
Bacteria do their work in the mouth, lungs, sinuses, and stomach. In the oral cavity, bacteria cause gum
disease.
This
infection is so prevalent today, it's the first dental problem we suspect when
it comes to halitosis. With a thorough
hygiene program, there is a chance to control gum problems and this
particularly awkward side effect.
Less-than-pristine dentures or
bridgework are also a source of odor.
Decay can be another culprit along with "dry mouth" syndrome
(a lot of older people are prone to reduced saliva flow).
For more information regarding bad breath, please
call our office.
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Problem:
Poorly
Fitting Dentures
Solution:
Patients should have their dentures checked at least once a year.
Many denture wearers breathe a sigh of relief when
they get their first pair of dentures, because they think their dental problems
are over. What they soon realize,
however, is that they have just traded some old problems for new ones.
Even the best dentures can't compete with
natural teeth in ability to chew food efficiently and comfortably. As the years go by, the supporting ridges
that remain after teeth have been removed gradually change and get
smaller.
For most patients, the dentures need to be
"relined" or "refitted" every 2-4 years so that the denture
will conform to the changing ridge. A
large change in weight can also alter the shape of the mouth, causing changes
in the fit.
If you have questions about your dentures, please
call our office.
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Problem:
Crisis
treatment
Solution:
Education: Don’t Rely on Pain
Many people don’t see a dentist on a regular basis. They go only when
they feel they have a problem. We call this "crisis treatment" as
opposed to "preventive treatment". While these patients may feel
they are saving money, it usually ends up costing much more in both dollars
and time. The reason for this is that most dental problems don’t have any
symptoms until they reach the advanced stages.
An example is tooth decay. We hear all the time, "Nothing hurts…I
don’t have any problems". But tooth decay doesn’t hurt! Until, that
is, it gets close to the nerve of the tooth. Then a root canal and crown are
usually necessary, instead of the small filling, which could have been
placed several years ago when the cavity was small. We can usually detect a
cavity 3-4 years before it may develop any symptoms. It is not uncommon to
see a patient with a tremendous cavity and they have never felt a thing!
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Diet
and Dental Health
Diets low in certain nutrients reduce resistance to oral and dental
infections, that is, periodontal disease (gum disease) and decay. A healthy
immune system is essential to controlling periodontal disease.
Counseling in the Four Basic Food groups will improve dental health and
general health. The consumption of sugar, especially in sticky forms or in a
baby bottle while sleeping, contributes to the rapid development of dental
decay.
The trace nutrient fluoride, may not be adequately supplied by bottle or
municipal water supplies. Supplementation with oral tablets and topical
application will reduce the incidence of dental decay by more than 60%.
Together, a balanced diet, daily use of fluoride, effective brushing, and
sensible eating habits can reduce the risk of, or even prevent, infectious
dental disease.
Please don’t hesitate to call our office if you need more information
on diet or fluoride supplementation and its relationship to dental health.
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Problem:
Cracked,
worn, discolored or broken teeth
Solution:
Tooth-colored "resin" fillings
Recent advances in dental porcelains have produced a remarkable product.
All porcelain crowns, are positively outstanding for their natural
appearance and long-lasting strength and durability. No longer do patients
have to suffer with the unsightly dark blue lines around the margins of
crowns or the opaqueness of the porcelain that tells everyone as soon as you
smile that you've been "capped".
These crowns are so "life-like" they are virtually
indistinguishable from natural teeth. These attractive restorations usually
can be placed in two visits and a local anesthetic is all that is needed for
comfort. All porcelain crowns will not only look nicer but they are
stronger, last longer and are kinder to the opposing teeth than other caps
or crowns.
Please call for a free cosmetic consultation. Please ask any questions you
may have about the benefits of all porcelain restorations during your
consultation.
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Problem:
Gum Disease
Solution:
Detecting Early Symptoms
The American Dental Association says that over 75-80% of all adults have
or will have some form of gum disease
Gum disease, or more correctly called "periodontal disease", is
a bacterial infection in the gums and supporting structures of the teeth. It
can be divided into several categories.
The first stage is called "gingivitis" and is characterized
by gum tissue that is red, puffy, and bleeds easily when touched with a
toothbrush, floss or dental instrument.
The second, third, and fourth stages are initial, moderate, and
advanced "periodontal disease", respectively. These stages are
different from gingivitis because the infection has destroyed the bone
supporting the teeth, causing eventual tooth loss. The treatment is more
involved at these stages, usually consisting of a special cleaning with
anesthesia and sometimes gum surgery.
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Problem:
Patient concern about AIDS
Solution:
Modern Patient Protection
A recent survey of dental patients showed that patient protection was
#1 on their list of concerns about dental care. Some patients have even
quit going to the dentist because of their fears.
Fortunately, trips to the dentist have never been safer. The case
in Florida where the patient was apparently infected with the AIDS virus
by her dentist is the only such case out of tens of millions of dental
treatments performed since the introduction of the virus. The Center for
Disease Control still does not know the method of infection.
However, even one case is too many. We have responded by adopting
"universal (or standard) precautions". These involve sterilizing
all instruments in dry-heat ovens or steam autoclaves to kill any
bacteria. Disposable items are used whenever possible. The chance of
contracting an infection in the dental chair is extremely remote, but the
chance of losing one’s teeth because of lack of proper dental care is
extremely likely.
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Problem:
Discolored teeth
Solution:
Bleaching
We all lead with our smile. Your smile brightens up each person you meet.
Are you happy with your smile?
One question I ask my patients is: "What would you do to your
mouth if you had a magic wand?" Nine out of ten tell me they would
like whiter or brighter teeth.
Is there a solution?
The answer is yes. Many times the process is relatively simple. Bleaching
teeth, through treatment in the office and/or by home bleaching techniques,
has worked wonders for many patients.
So, if you could use help in brightening your smile, please don't
hesitate to call our office. I am always dedicated to achieving a healthy
smile.
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Problem:
Lost Teeth Impact Total Health
The loss of natural teeth is far-reaching and cannot be resolved by
dentures. (Is blindness resolved by inserting glass eyes?)
Solution:
Keep Teeth
In the past, the loss of teeth was dismissed as a natural part of the
aging process, and dentures were considered a normal sign of old age. While
such ignorance is rapidly becoming a thing of the past, there is still not a
general awareness of the seriousness of edentulism. Multiple tooth loss is
most commonly caused by periodontal disease, i.e.. gum and bone
disease. Periodontal disease has a high statistical correlation with chronic
debilitating disease, such as diabetes, cardiovascular disease and
arthritis. So it is not very surprising that studies now show a shortened
life expectancy by as much as 10 years for persons who have lost their
natural teeth, when compared to those who have kept their teeth.
In addition to longevity, quality-of-life differences are just as
significant. The functional efficiency of dentures has been measured to be
only 20% of that of natural teeth. Can there be any doubt that nutritional
deficiencies will be much more prevalent in those without their natural
teeth? Loss of teeth often causes a feeling of loss of wholeness and a sense
of deterioration and aging. Given these factors, preservation of the natural
teeth is integral to whole-person wellness.
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Problem:
Some dental problems are easy to see!
Solutions:
See the dentist!
One of the easiest problems to spot is a build-up of plaque. Plaque is
the soft, sticky layer of bacteria, which is constantly forming on the
teeth. Usually it is invisible to the naked eye, but when a person is not
brushing adequately, it can build up to where it appears to be a thick
whitish coating on the teeth at the gum line. If not removed, it can lead to
gum disease.
Another potential problem, which is easy to spot, is missing teeth. Many
patients assume that if they are still able to eat, they are O.K. But very
often, losing just one tooth can lead to the loss of support, and teeth
begin to drift into the empty space, causing a change in the bite. It also
forces the remaining teeth to carry an additional load, sometimes past their
ability to adapt. In most cases, when even one tooth is lost, the remaining
teeth suffer and are more likely to be lost as well.
We specialize in the treatment of problems such as these. Call our office
for the care you need.
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Problem:
Poor self-image, resulting in low
self-esteem.
Solution:
A Proud Smile Helps
The appearance of the teeth has a dramatic effect on both the person's
attractiveness to others and on their own self-image and self-esteem.
Studies have shown that a person's appearance will have a strong effect on
their social and career success, by influencing how others perceive them.
While the appearance of the teeth is one of the most important
contributors to facial beauty, it is also probably the most often neglected
when improvements to appearance are sought. A person with low self-esteem
connected to their facial appearance, can often be greatly helped by
cosmetic dental procedures.
Dental make-overs have become more common, less invasive, and more
effective in correcting deformities and cosmetic dental problems. The effect
of these procedures can be nothing short of dramatic both in terms of
appearance and also in terms of correcting, at least partially, personality
deficiencies caused by poor self-image. Ugly teeth are no longer a matter of
fate; they are now becoming a matter of choice.
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Problem:
Stained, broken, worn, or crooked teeth
Solutions:
Porcelain Veneers
Porcelain veneers are often used for the same reasons as bonding (to
lighten stains, close gaps and even alter crooked or malformed teeth). They
are considerable more durable and stain resistant than bonding.
The veneer is actually a thin piece of porcelain similar in size to a
fingernail. Once it is "bonded" onto the tooth it becomes extremely strong.
It also blends in with the remaining tooth structure so that it is
unnoticeable to the naked-eye. Once in place, it looks, feels, and functions
just like a regular tooth.
Porcelain veneers can be utilized to change the shape and color of a
single tooth or if necessary, revamp an entire smile. Porcelain veneers can
also be used to correct teeth that have been worn from clenching and
grinding.
Please call for a free cosmetic consultation. You may ask any questions
you have about the benefits of porcelain veneers.
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Problem:
Dental disease during pregnancy
Solution:
A dental evaluation and preventive dental
care
Many mothers have experienced gum disease, dental pain and/or tooth
extraction during or shortly after their pregnancy. This is often seen as
being a "normal" side effect of being pregnant. However, dental disease,
which is an infection of the teeth and/or gums, is not "normal" for any
patient.
There are three basic events that happen during pregnancy which make the
patient more susceptible to dental disease. First, hormonal changes may make
the gums more susceptible to gum disease. Second, pregnant women tend to eat
smaller, more frequent meals, exposing their teeth and gums to sugars and
acids more often. Third, cravings for "junk foods" and inadequate oral
hygiene pose an increased threat to the teeth and gums.
Pregnant women should be advised to schedule a dental evaluation and
receive preventive dental care. Personalized oral hygiene instruction should
also be given to fight disease and promote overall good health for the
mother and her baby.
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Problem:
Dental decay "cavities"
Solution:
Prevention through the use of sealants
Fluoride has been a great benefit to patients of all ages n helping
prevent dental decay. Regular brushing and flossing lowers the chance of
developing "cavities." However, the most decay-prone areas of teeth are the
grooves and depressions on the chewing surfaces of the back teeth, which
require further preventive care.
To prevent decay, a plastic-like coating called a sealant should be
painted on the chewing surfaces of all the back teeth. Studies have shown
that sealants can reduce tooth decay by as much as 90% to 100%. The American
Dental Association recommends sealants be placed as soon as the first adult
back teeth come in at age 6 or 7. Sealants should continue to be used as
each adult back tooth comes into the mouth. All back teeth that need to be
sealed are present by age 13. Sealant application is simple, fast, and
painless.
Please call our office with any questions you may have about the benefits
using a sealant in preventing dental decay.
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TMD:
Temporomandibular joint dysfunction (TMD) is a misalignment within the
intricate network of muscles, bones, and joints connecting the skull and
lower jaw. When the jaw is awry, the joints and muscles tend to compensate
by moving into a new position, and the jawbone grates on other bones and
soft tissues. The pain can be extreme and debilitating.
Diagnosis can be difficult. TMD disorders may mimic the symptoms of other
ailments-such as tumors, sinus infections and, on the surface, defy
detection.
Dentists have been working with TMD therapies for some years now. Once we
identify the problem and the cause, treatment is often straightforward.
Among possible remedies are muscle relaxants, minor reshaping of teeth, or
mouth splints. Physical therapy, even simple massage, has been effective in
pain control. Surgery is rare.
The longer the diagnosis is postponed, the greater the joint and tissue
damage - and the greater the pain.
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Problem:
Cracked, worn, broken, discolored,
unsightly silver-mercury fillings
Solutions:
Tooth-colored "resin" fillings
For over 100 years, dentists have been using silver-mercury amalgam
fillings to restore decayed or broken teeth. The only other alternative was
gold and that was always too expensive for most folks. Now there is a new
and economical way to restore teeth using tooth-colored resin fillings. The
resin is made up of glass particles in a plastic matrix. The doctor bonds
the putty-like material to the tooth with a high-intensity light. This
hardens the material and allows it to be shaped and polished for immediate
use.
Once completed, the tooth has a natural appearance and is actually
stronger than before due to the strength of the adhesive agent used to bond
the resin to the tooth. Resin restorations not only look better, but they
are stronger and last longer than the old silver-amalgam fillings. Resin
restorations can range from $150 to $350 per tooth.
Please call with any questions you may have about the benefits of resin
restorations.
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Problem:
XEROSTOMIA (Dry Mouth)
Solution:
Dental Treatment or Consultation
Dry mouth problem is common. The lack of adequate saliva is more than
bothersome for three out of every ten Americans. When the natural flow of
saliva is reduced, you can experience trouble swallowing, pain throughout
oral tissues and, nearly always, a short-cut to dental caries and gum
disease. The tongue sticks, food doesn't have much taste, and digestion
suffers.
Xerostomia, or dry mouth syndrome, can come with aging, or often as a
side effect of many medications. Half of cancer patients undergoing
chemotherapy experience an extreme form of xerostomia, with critical effects
on their dental health. There is relief in the form of dry mouth toothpaste,
special saliva-producing chewing gum, or saliva substitute solutions.
For more information regarding Xerostomia and methods of treatment,
please call our office.
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Oral Health for Seniors
The good habits of effective daily brushing, diet, and use of fluoride will
help the aging person adapt to changing conditions. Reduced salivary flow
and addition of medications will affect oral health dramatically.
Changes of the teeth and gums: Teeth will darken because of
long-term exposure to plaque and changes in the dentin within the tooth. The
gums may recede and uncover the roots. Exposed roots will be darker than the
enamel part of the tooth and are prone to decay. Fillings can decay and
darken, too, as they weaken over time.
"Dry Mouth" may develop: Saliva is useful to lubricate, wash away
plaque, and neutralize the acid produced by plaque. Flow of saliva can be
reduced by a medical disorder or be a side effect of antihistamine,
decongestants, pain killers or diuretics. The build-up of plaque will
accelerate tooth decay. There will also be more gum infection which will
cause a loss of bone support for the teeth. Poorly-fitting or poorly-cleaned
dentures, illness, and some medications increase the severity of the
problem.
For more information regarding dental problems of the elderly, please
call our office.
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Problem:
Accidental Tooth Loss by Injury
Solutions:
Knowing the Proper First Aid
- If the tooth is loose
, even extremely so, but is still attached in
any way, leave it in place; do not remove it.
- If it is out of its socket
completely and unattached, but still in
the victim’s mouth, it is best to have the person hold it there, if
possible, until a dentist can attempt re-implantation.
- If it is out of the mouth
, do not let it dry out. Handle it as
little as possible.
Do not attempt to disinfect the tooth, or scrub it, or remove any tissue
attached to it.
- If it is recovered from the ground or other soiled area, rinse
it off in lukewarm water. Preserve it in milk until a dentist is
available. If milk is not available, lukewarm water will suffice. not
available, lukewarm water will suffice.
- Time out of the socket is critical in the long-term success of
re-implantation. After 30 minutes, the success potential begins to
decline. However, re-implantation is still possible after several hours,
so the attempt can still be made even if the tooth has been out for a long
period.
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Problem:
Decayed (Baby) erupting teeth (bottle
caries)Solution:
Educate parents on cause of bottle caries
Children who have erupted teeth or are past the age to be weaned are
highly susceptible to rotted front teeth when being put to bed with a bottle
containing milk, juice or other sugar-containing liquids. There is decreased
salivary flow during sleep and clearance of the liquid from the teeth is
slowed. The liquid pools around the upper front teeth and creates an
excellent environment to promote the growth of decay-causing bacteria.
Removing the bottle before the first tooth appears and wiping the child’s
gums and teeth with a soft cloth before being put to bed can help prevent
decay.
Signs and appearance of teeth displaying bottle caries:
- Brown teeth with fragmented edges
- Upper front teeth that break easily
At 18 months of age, parents should be encouraged to ask their dentist to
examine their child and recommend home care.
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Problem:
Missing Teeth
Solution:
Implants
"Well, you know Doc, it's just a back tooth. No one will see it so I'll
just get rid of it. It's not going to make a difference."
The plain truth is that it will make a difference. The loss of just a
single tooth can set a course that can destroy an entire mouth. "Well, if
that's true, tell me more. I sure don't want to lose the front ones that I
smile with."
Teeth will drift and tip into a space that is created by missing teeth.
Just like two gears of a car that are not properly aligned, pretty soon
you've got a whole lot of problems.
"Well, I don't like that. What can I do?" If it sounds like I've
heard this conversation a few times, you're right. If I'm going to keep a
patient happy, I need to provide options at this point.
One of the options would be an implant. This is the replacement of a
tooth with a false root that is surgically placed. It is then
followed by the careful construction of a crown to replace the missing
tooth, to prevent teeth from shifting and thereby causing further tooth
loss.
If you have any questions about missing teeth and possible implant
treatment, please call our office.
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Problem:
Bad breath (halitosis)
Solution:
Dental evaluation and treatment of
probable tooth decay and periodontitis
While bad breath might be a symptom of some other disorder, it most
likely stems from dental decay and periodontitis.
Periodontitis is a disease affecting gums and bone that support the
teeth, and it results from inadequate tooth brushing and flossing. In this
disease, the irritated gums pull away from the teeth and form pockets
between the teeth and the gums. These pockets fill with bacteria and pus
which give off a foul odor.
Patients with bad breath should be referred for a complete dental
evaluation. If gum disease and/or dental decay is diagnosed, it can be
treated readily. The patient will no longer have an infection in his or her
mouth, and he or she will no longer have the embarrassment of bad breath.
If you have questions regarding halitosis, please call our office.
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Problem:
Black
and unsightly silver fillings
Solution:
"Invisible" composite
fillings
Many people have had silver fillings placed into their teeth because
they had "cavities". These silver fillings are called amalgams.
Amalgam fills the space where the decay in the tooth has been removed.
However over times, the amalgam corrodes and leaks which blackens the
silver, and many times the tooth. This is easily seen as soon as a patient
opens his or her mouth and is usually a source of embarrassment for the
patient.
Composite fillings are made of a porcelain-like material that actually
bonds to the tooth for a tight seal. They are strong and stain-resistant,
and they are color-matched to the natural tooth, making them
"invisible". Composite fillings also lack the sensitivity that
is often associated with silver amalgam fillings. They are especially
suited for smaller cavities and for patients who may be allergic to metal
fillings.
Please don’t hesitate to call our office with any questions you may
have about the benefits of replacing silver amalgam fillings with
invisible composite fillings.
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Problem:
Stained, broken, worn, crooked, malformed teeth
Solutions:
Bonding
Bonding is typically painless and can yield dramatic results in a
single office visit. Essentially, bonding hides any natural flaws through
the placement of a thin plastic coating on the front surface of the teeth.
After treating the tooth surface, a puttylike bonding material is applied
that is then sculpted, shaped and colored to suit the patient’s needs. A
high-intensity light causes the plastic to harden after which the new
surface is smoothed and polished.
Bonding can lighten stains, close gaps and even alter crooked or
malformed teeth. It can be utilized to change the shape or color of a
single tooth or if necessary to revamp the entire smile.
Please call our office for a free cosmetic consultation.
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