My Blog

Posts for: August, 2011

By Steven R. Gluck, D.D.S.
August 28, 2011
Category: Oral Health
Tags: oral health   tooth decay   chewing gum   xylitol  
  1. Xylitol is a kind of sugar.
    True or False
  2. Xylitol is made from
    1. Bark of birch trees
    2. Coconut shells
    3. Cottonseed hulls
    4. All of the above
  3. Xylitol is a natural “sugar alcohol” similar to other so-called sugar alcohols such as mannitol and sorbitol.
    True or False
  4. Xylitol is broken down by decay-causing bacteria to produce acid.
    True or False
  5. Decay-causing bacteria are transmitted from a parent to a child through oral contact such as a simple lip-to-lip goodnight kiss.
    True or False
  6. Researchers have found no difference in prevention of tooth decay in gum made from xylitol compared to gums containing sorbitol/xylitol and sucrose.
    True or False
  7. Other xylitol products such as mints, candy and cookies also seem to decrease the incidence of tooth decay.
    True or False
  8. Xylitol products increase salivary flow and allow saliva to neutralize acids in your mouth.
    True or False
  9. The only side effect of too much xylitol ingestion is a possible mild laxative effect.
    True or False
  10. The target dose of xylitol is one to two teaspoons spread throughout the day.
    True or False
Answers:
  1. True. Xylitol is a kind of sugar that does not contribute to tooth decay.
  2. All of the above. It is also found naturally in some fruits and vegetables.
  3. True. The others, mannitol and sorbitol, are used as sugarless sweeteners.
  4. False. Unlike sucrose (table sugar), xylitol is NOT broken down by bacteria to produce acid. Xylitol also stops saliva from becoming acidic so your mouth becomes an unfriendly environment to acid-producing bacteria.
  5. True. However, xylitol inhibits growth and attachment of the bacteria to your teeth, so it also inhibits transmission to your children.
  6. False. Systematic use of xylitol chewing gum significantly reduces the relative risk of caries (tooth decay) when compared to chewing gums containing sorbitol/xylitol and sucrose. Xylitol gum also appears to halt the development of tiny cavities when compared to other types of chewing gum.
  7. True. Use of these products seems to stop the progression of active decay.
  8. True. Xylitol and your saliva combine to re-mineralize (harden) your teeth after an acid attack.
  9. True.
  10. True. This means two pieces of xylitol gum or two pieces of xylitol candy or mints should be consumed for five minutes four times a day after eating meals or snacks.

Contact us today to schedule an appointment to discuss your questions about xylitol and other methods of preventing tooth decay. You can also learn more by reading the Dear Doctor magazine article “Xylitol in Chewing Gum.”


By Steven R. Gluck, D.D.S.
August 21, 2011
Category: Dental Procedures

How much do you know about dental implants? Test yourself with this quiz.

  1. Earliest recorded attempts at using dental implants were from
    1. Medieval England
    2. The ancient Mayans
    3. U.S.A. in the 1950s
  2. Dental implants are called endosseous. What does this mean?
    1. They fuse with the bone
    2. They are inside the mouth
    3. They are not real teeth
  3. What are most dental implants made of?
    1. Aluminum
    2. Titanium
    3. Steel
  4. What part of the tooth does an implant replace?
    1. The implant is the root replacement
    2. The implant is the root plus the crown
    3. The implant is the crown
  5. What is the success rate of dental implants?
    1. 50 percent or less
    2. 75 percent
    3. 95 percent or more
  6. What could cause an implant to fail?
    1. Smoking or drug use
    2. Poor bone quality and quantity at the implant site
    3. Both of the above
  7. What is a tooth's emergence profile?
    1. The implant and crown's shape as it emerges from beneath the gum line
    2. A measure of the urgency of the tooth replacement
    3. A measure of the time it takes for you to be able to chew on the new implant
  8. What are some of the factors that go into the aesthetics of designing the crown?
    1. Choice of materials
    2. Color matching
    3. Both of the above
Answers:
  1. b. The concept of dental implants goes back to the Mayan civilization in 600 AD.
  2. a. The word endosseous (from endo meaning within and osseo meaning bone) refers to the implant's ability to fuse with or integrate with the bone in which it is placed.
  3. b. Most implants are made of a titanium alloy, a metallic substance that is not rejected by the body and is able to fuse with the bone.
  4. a. The term “implant” refers to the root replacement, which is anchored in the gum and bone. A crown is put around the implant where it emerges from the gumline.
  5. c. The majority of studies have shown long term success rates of over 95 percent.
  6. c. Factors that could cause an implant to fail include general health concerns such as smoking and drug use, osteoporosis, or a compromised immune system; poor bone quality or quantity; and poor maintenance such as lack of proper brushing and flossing.
  7. a. The emergence profile has a lot to do with the implant's natural appearance. It involves the way the crown, which attaches to the implant, seemingly emerges through the gum tissue like a natural tooth.
  8. c. Choices such as materials, color, and position can be worked out in the design of a customized temporary crown, which acts as a template or blueprint for a final crown.

Contact us today to schedule an appointment to discuss your questions about dental implants. You can also learn more by reading the Dear Doctor magazine article “Matching Teeth & Implants.”


By Steven R. Gluck, D.D.S.
August 14, 2011
Category: Oral Health
Tags: oral hygiene   root planing  

What does it mean when your dental hygienist recommends root planing? To put it simply, root planing is a method of cleaning the roots of your teeth in order to avoid periodontal (“peri” – around, “odont” – tooth) disease.

Periodontal disease happens when dental plaque, a biofilm of bacteria, is not regularly removed and begins to build up on teeth near the gum line. The bacteria cause inflammation, and this in turn causes the gum tissue to detach from the teeth. The widening spaces between the gum tissue and the teeth, called pockets, are environments in which bacteria can continue to collect and cause further inflammation and infection. Ultimately, this can lead to infection, bone loss, and loss of teeth.

Root planing is a technique designed to avoid such dire results. The bacteria, along with products they manufacture as part of their metabolism, can become ingrained in the surfaces of the tooth's root (the part of the tooth that is below the enamel). These bacterial products will form hard deposits called tartar or calculus.

Deep Cleaning Your Teeth
Of course, the best idea is to brush and floss away the plaque before the bacteria begin to build up on your teeth. If this is not done and pockets begin to form, the bacteria and toxic products are more difficult to remove in order to deep clean your teeth.

The first step is scaling. My hygienist or I will remove superficial collections of calculus. If material still remains within deep pockets, root planing is the next step. It involves actually planing the surface of the root, smoothing the surface free of calculus, bacteria, and toxins that have ingrained into the root surfaces.

Root planing is most often done under local anesthesia so that you remain comfortable while the cleaning procedures are done. The initial cleaning may be done by an ultrasonic instrument that vibrates particles off the root surfaces and flushes the pockets with water. Small hand instruments called curettes are used to finish the process. Antibacterial medication may then be used to help clear away infection from the pockets. Sometimes you may experience some tooth sensitivity to hot and cold after the root planing. If needed, this can be treated by applying fluoride to the root surfaces.

Depending on the extent of your gum disease, it may not be possible to remove all the deposits at one appointment, and it may be necessary to have multiple appointments over a few weeks to remove the remaining deposits. Often after three to four weeks the inflamed tissues have healed, leaving you with healthy gums once again.

Contact us today to schedule an appointment to discuss your questions about dental hygiene and root planing. You can also learn more by reading the Dear Doctor magazine article “Root Planing.”


By Steven R. Gluck, D.D.S.
August 07, 2011
Category: Oral Health
Tags: oral health   fluoride  

The CDC (Centers for Disease Control and Prevention) calls fluoridation of drinking water one of the ten most important public health measures of the 20th century, along with such measures as vaccination and motor-vehicle safety.

A fluoride concentration of about one milligram per liter (1 mg/L), or 1 part per million (1ppm), in the water supply is associated with substantially fewer cavities. This concentration of fluoride (equivalent to a grain of salt in a gallon of water) has been found to have no negative health effects.

The connection between fluoride and oral health was confirmed in the first half of the 20th century, and by 1955 the first clinically proven fluoride toothpaste was launched. Fluoride-containing toothpastes are common today, along with other fluoride-containing products.

Protective Effects of Fluoride
Ongoing studies have shown that fluoride has both a systemic (through the body) effect and a local effect at the tooth surfaces. Tooth decay takes place as part of a kind of active war between de-mineralization and re-mineralization, in which acids produced by bacteria in plaque (a biofilm in your mouth) soften and dissolve the minerals (de-mineralization) in the tooth's surface. At the same time, the saliva bathing the tooth acts to re-harden the tooth's surface by adding minerals back (re-mineralization). If fluoride is present in the biofilm and in the saliva, it protects against de-mineralization.

The fluoride you drink in your water is deposited in your bones. Bone is an active living substance that is constantly broken down and rebuilt as a normal body process. As this happens the fluoride is released into the blood, from which it can enter the saliva and act on the tooth surface. The fluoride in toothpastes and products like rinses is delivered directly to the tooth surface. Fluorides can also be eaten in foods with high fluoride content such as teas, dry infant cereals and processed chicken, fish and seafood products.

Problems with Over-use
Eating or swallowing too much fluoride can contribute to a discoloration of teeth called dental fluorosis, which varies in appearance from small white striations to stained pitting and severe brown mottling of the enamel. To avoid this effect, monitor children's tooth brushing to make sure they use only a small amount of fluoride toothpaste and do not swallow it.

Adding fluoride to water has been controversial because some people believe that it may cause other harmful effects. However, most health experts believe that fluoridated water carries no significant health risks and significantly contributes to public health by preventing tooth decay.

Contact us today to schedule an appointment to discuss your questions about fluoride. You can also learn more by reading the Dear Doctor magazine article “Fluoride & Fluoridation in Dentistry.”