My Blog
By Steven R. Gluck, D.D.S.
April 28, 2012
Category: Oral Health
WhyDoesMyDentalHygienistAskSoManyQuestions

You just came in to have your teeth cleaned, but our hygienist is asking you about your general state of health and what medications you are taking. Meanwhile you are wondering why she doesn't just get on with the cleaning.

Dental hygienists are health care professionals who are trained and licensed to preserve your general as well as your oral health. That's why our hygienist begins your visit by asking you about your health history. Some health problems or medications may require special precautions during a dental cleaning. A hygienist also needs to know about your dietary history and other general health questions.

Our hygienist will examine the skin in and around your mouth for sores, lumps, and other areas that could be signs of oral cancer or other problems. She is trained to spot this disease and others.

Dental hygiene is individualized to your own situation. There is not a “one size fits all” solution. During your cleaning, our hygienist will also evaluate the health of your gums and teeth, checking for tooth decay and for inflammation (gingivitis) and bleeding. She will measure the space between your teeth and the surrounding gums, looking for pockets that form when the gums detach from the teeth. Such pockets indicate periodontal disease and can lead to serious problems.

After your health assessment and examination, the actual cleaning will begin. Your dental hygienist will remove deposits of plaque and calculus by using a technique called scaling. Plaque is a biofilm, a film of bacteria that builds up on your teeth. The reason you brush and floss every day is to remove this film from the surfaces of your teeth and gums and from between your teeth. Plaque that is not removed hardens into a mineralized substance called tartar or calculus, and this is what the hygienist removes by scaling.

The next step is a polish to remove surface stains from your teeth and to give your teeth the slick feeling that you identify as clean.

Finally, our hygienist will discuss your state of oral health with you and make suggestions for improvement. Most hygiene appointments take about 45 minutes to an hour. As you can see, during this appointment a lot must be done to preserve your oral health.

If you are in need of a dental cleaning, contact our office today to schedule an appointment. You can learn more about your visit to the hygienist by reading the Dear Doctor magazine article “Dental Hygiene Visit.”

IfYourChildChippedAToothWhatShouldYouDo

Nearly every parent and caregiver has experienced that almost instantaneous sick feeling when they see that their child has been injured, especially when it is an injury to the mouth and teeth. For some, it is just a bloody lip; however, if the accident chipped a tooth, then you may have a completely different situation on your hands. If the nerve of the tooth has not been damaged, you needn't worry too much — a composite (plastic) tooth-colored restoration that is actually bonded to the tooth is an ideal material for repairing most broken or chipped teeth. See us as soon as possible to assess the extent of injury, so that proper and appropriate action can be taken.

An additional reason why bonding with composite resin may be the ideal choice for repairing a child's chipped tooth is that it can be custom created in virtually any shade so that it perfectly matches the damaged tooth and the surrounding teeth. It is also far less expensive than a crown, an important factor to consider when repairing a primary (baby) tooth that will eventually fall out to make room for a permanent tooth. If the injury is to a permanent tooth, a composite resin still may be ideal to use as a restoration until your child or teenager has stopped growing or playing contact sports. This is because your teenager may be too young for a more permanent restoration such as a crown or porcelain veneer.

An important, proactive step you can take to be prepared for the next time your child has a dental injury is to download Dear Doctor's Field-side Pocket Guide for Dental Injuries. This handy, quick reference guide is a must have for athletes, parents, caregivers, teachers, coaches or anyone who is often in an environment where a mouth injury is likely to occur. Knowing what to do and how quickly you must respond can make the critical difference between saving and losing a tooth.

By Steven R. Gluck, D.D.S.
April 12, 2012
Category: Oral Health
Tags: oral health  
TestYourDentalVocabulary

When dentists talk to patients, they often use specialized vocabulary referring to various dental conditions. Do you understand what they mean when they use these words — or are you wondering what they are talking about?

Here's your chance to test your knowledge of ten words that have a particular meaning in the context of dentistry. If you already know them, congratulations! If you don't, here's your chance to learn what these words mean in the dental world.

Enamel
In dentistry, enamel is the hard outer coating of your teeth. It is the hardest substance produced by living animals. It is a non-living, mineralized, and composed of a crystalline form of calcium and phosphate.

Dentin
The dentin is the layer of a tooth that is just beneath the enamel. It is living tissue similar to bone tissue.

Pulp
When dentists speak of pulp, we mean the tissues in the central chamber of a tooth (the root canal) that nourish the dentin layer and contain the nerves of the tooth.

Bruxism
Many people exert excess pressure on their teeth by clenching or grinding them. This is called bruxism, a habit that can be very damaging to teeth.

Occlusion
By this we mean how the upper and lower teeth are aligned, and how they fit together. This can also be referred to as your bite.

Dental caries
This term refers to tooth decay. Dental caries and periodontal disease (see below) are two of the most common diseases known to man. Today, these diseases are not only treatable, but they are also largely preventable.

Periodontal disease
A term for gum disease, this term comes from “peri,” meaning around and “odont,” meaning tooth. It is used to describe a process of inflammation and infection leading to the progressive loss of attachment between the fibers that connect the bone and gum tissues to the teeth. This can lead to loss of teeth and of the bone itself.

Erosion
When you consume acidic foods or drinks, the acids in your mouth react directly with minerals in the outer enamel of your teeth, causing chemical erosion. This is not the same as tooth decay, which is caused by acids released by bacterial film that forms on your teeth (see below).

Dental implant
A dental implant is a permanent replacement for a missing tooth. It replaces the root portion of the tooth and is most often composed of a titanium alloy. The titanium root fuses with the jaw bone, making the implant very stable. A crown is attached to the implant and can be crafted to match your natural teeth.

Plaque
Dental plaque is the whitish film of bacteria (a biofilm) that collects on your teeth. Your goal in daily brushing and flossing is to remove plaque.

Contact us today to schedule an appointment to discuss any questions you may have about your teeth and gums. You can also learn more by reading Dear Doctor magazine article “How and Why Teeth Wear.”

By Steven R. Gluck, D.D.S.
April 04, 2012
Category: Oral Health
Tags: fluoride  
UnderstandingtheLatestNewsonFluoride

Guidelines regarding the concentration of fluoride in water have recently been changed by the US Government's Department of Health and Human Services (HHS) and the Environmental Protection Agency (EPA). These agencies recommended a reduction of fluoride in water supplies to 0.7mg/L, modifying the original recommendations provided in 1962 by the US Public Health Service.

What is fluoride, and why add it to water supplies?
Fluoride is a chemical form of fluorine, a naturally occurring element. For decades, scientists have carried out studies on the effects of fluoride in water, and they have proved that fluoride strengthens tooth surfaces and makes them resistant to decay. 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 Center for Disease Control (CDC) says that fluoridated water is one of the ten most effective public health measures of the 20th Century. The optimal amount of fluoride necessary to make teeth resistant to decay turns out to be between 0.7 and 1.20 milligrams per liter (mg/L). A certain amount of fluoride occurs naturally in water supplies, and communities have added fluoride to bring the amount up to the optimal recommendations.

How does fluoride you drink get into your teeth?
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.

What about fluoride from other sources?
Americans now have access to many sources of fluoride in addition to the water they drink. These include foods, beverages and toothpaste. As a result, dentists have begun to notice an increased prevalence of a condition known as Dental Fluorosis.

What is Dental Fluorosis?
Dental Fluorosis can occur when teeth, particularly in children, receive too much fluoride. This condition is a mottling or uneven staining of the tooth surface enamel. There may be small white spots or extensive brownish discolorations. The mottled enamel is still resistant to decay, but it may be unattractive in appearance.

What is the idea behind the new guidelines?
With the new guidelines, fluoride is kept at the lower end of the scale of the optimal concentration for strengthening teeth against decay. At this end, there is room to add consumption of fluoride from other sources such as foods or toothpaste. In short, it is the best of both worlds.

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

By Steven R. Gluck, D.D.S.
March 27, 2012
Category: Oral Health
DiabeticsWatchOutforaHiddenEnemyGumDisease

Periodontal (gum) disease, though it may be invisible to everyone but your dentist, can have a powerful effect on your entire body. Not only is it dangerous to your teeth and jaws, but it can increase your risk of heart attack and stroke, cause preterm births in pregnant women, and affect blood sugar control in diabetics.

Diabetics are our subject for today. Symptoms of diabetes include abnormally high levels of glucose (a form of sugar) in the blood, leading to frequent urination, excessive thirst, blurred vision, unexplained weight loss, and loss of energy. The disease can also cause severe complications in various parts of the body.

Normally, glucose, your body's main energy source, is kept under control by a hormone called insulin, which is made by an organ called the pancreas. In type 1 diabetes, a person's pancreas does not produce enough insulin to deal with all the glucose in his or her blood. In type 2 diabetes — a condition related to increased age, physical inactivity, overweight, and heredity — the pancreas may produce enough insulin, but the body is not able to use it effectively. This condition is called insulin resistance.

People with type 1 diabetes need insulin to survive. Type 2 may be treated with exercise, diet, medications, and insulin supplements.

Serious complications of diabetes range from kidney failure, blindness, and nerve damage to infections that do not heal, gangrene and amputation of limbs.

Diabetes and periodontal disease seem to have reciprocal effects on each other. Diabetics are more likely to have periodontal disease than non-diabetics; and those with periodontal disease are likely to face worsening blood sugar control over time.

Periodontal disease (from “peri”, meaning around and “odont”, meaning tooth), is caused by dental plaque — a film of bacteria that settles on your teeth and gums every day. It's what you remove with daily brushing and flossing. Any bacteria that remain cause inflammation, which can lead in the worst cases to loss of bone and eventual loss of teeth.

The close relationship of diabetes and periodontal disease probably results from changes in the function of immune cells responsible for healing. Inflammation is a part of normal wound healing — but chronic or prolonged inflammation can destroy the tissues it was meant to heal. This may be a major factor in the destructive complications of diabetes.

Many of these complications begin in the blood vessels. Like the eyes and the kidneys, gum tissues are rich in blood vessels. Gum tissues are also under constant attack from bacteria. If you are a diabetic, effective plaque control, along with regular professional dental cleaning, can have positive effects not only on periodontal disease, but also on control of your blood glucose level.

Contact us today to schedule an appointment to discuss your questions about periodontal disease and its connections with diabetes. You can also learn more by reading the Dear Doctor magazine article “Diabetes & Periodontal Disease.”





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