What is Dental Fluorosis and What Treatment Options Do I Have?

Many people think dental fluorosis is a disease, but it’s not; it’s a condition that affects the appearance of your tooth’s enamel, not the function or health of the teeth. These changes may vary from tiny, white, barely noticeable spots to very noticeable staining, discoloration, and brown markings. The spots and stains left by fluorosis are permanent and may darken over time.

Dental fluorosis occurs in children who are hypersensitive to, or exposed to fluoride between 20 and 30 months of age. Only children ages eight years and younger can develop dental fluorosis. Why? That is the period when permanent teeth are still developing under the gums. For kids, fluorosis can cause significant embarrassment and anxiety about the appearance of their teeth. No matter how much they might brush and floss, the fluorosis stains do not go away.

Many well-known sources of fluoride may contribute to overexposure, including:

• Fluoridated mouth rinse, which young children may swallow
• Bottled water which is not tested for fluoride content
• Inappropriate use of fluoride supplements
• Exposure to water that is naturally or unnaturally fluoridated to levels well above the recommended levels

One way to reduce the risk for enamel fluorosis is to teach your children not to swallow topical fluoride products, such as toothpaste that contains fluoride. In fact, kids should use no more than a pea-sized amount of fluoride toothpaste when brushing, and children under the age of two shouldn't use fluoride toothpaste at all.

http://www.southcenterdental.com/blog/page/2/ 

If you already have fluorosis there are a number of treatment options such as crowns, veneers, or composites but the least invasive procedure uses a product called MI Paste. Results vary depending on the individual and severity of the condition but in some cases individuals have seen dramatic results with this method. 

Here are the treatment results from one of our own dental assistants who tried this procedure: 

Before

After 4 Treatments

Painless Parker's Dental Circus

Before local anesthesia could manage the pain, one early 20th century dentist distracted his patients with showgirls and brass bands.

Born in Canada in 1871 Edgar Randolph Parker was perhaps the most eccentric dentist in American history. Parker attended Philadelphia Dental College and two years later graduated with a DDS degree. After graduation Parker set up shop in his hometown of New Brunswick, but there were other dentists nearby and he only had one patient in the first 90 days, this was no way to run a business. While the dental college had taught dignity in dealing with this profession, Edgar soon learned that dignity did not pay the bills. He needed a gimmick. He decided to call himself “Painless Parker.” Other dentists accused him of false advertising and he was told he could no longer call himself “Painless Parker.”  He answered to this issue by legally changing his name from “Edgar” to “Painless.” Believe it or not, this is one of the least controversial things he did.   

Having no luck in his hometown, he decided to become the “P.T. Barnum of dentistry” and moved to the United States. He even hired one of  Barnum’s ex-managers to help him take his practice on the road. He created a traveling medicine show called the Parker Dental Circus.

The first thing he did was to buy a horse and wagon and install a dental chair in the bed of this “travelling office.” Patients would not have to go to him, he would bring his practice to them. Next as a true entertainer, he hired showgirls who would sing and dance to the sounds of a band blasting away. In the middle of this entourage was Painless Parker dressed in his trademark spotless white coat, sporting his grey beaver top hat. Needless to say, this would draw a crowd. The band and showgirls distracted the patient, the noise would silence any painful noise coming from the patient, and of course it promoted his business.  

 Parker promised that he would painlessly extract a rotten tooth for 50 cents. And if the extraction wasn’t painless, he would give the customer $5.00, the equivalent of roughly $115 today. Parker used an aqueous cocaine solution which called “Hydrocaine” or a cup of whiskey to keep the patient as comfortable as possible.

To help advertise his booming business of tooth pulling, a bucket full of teeth he had personally pulled sat by his feet as he lectured to the crowds on the importance of dental hygiene. At one point he claimed to have pulled 357 teeth in one day, which he strung on a necklace.

Naturally like most showman-practitioners his shameless advertising was looked down upon in the medical community. The American Dental Association described him as “a menace to the dignity of the profession.” But despite all his theatrics, Parker was an active supporter of preventative care before it was widely promoted, as well as local anesthesia. He believed in bringing oral education and affordable services to all walks of life.

Sources:

http://www.britannica.com/blogs/2010/07/painless-parker%E2%80%99s-dental-circus/

http://www.atlasobscura.com/articles/curious-fact-of-the-week-painless-parker

http://en.wikipedia.org/wiki/Painless_Parker

TAKE MY WHAT?!?

   

  Taking a blood pressure reading is one of the first things our clinical staff does when a patient comes in for a dental visit. This may seem insignificant but there can be serious consequences if certain dental procedures are done on a patient with high blood pressure. Consequences may include excessive bleeding and increased risk of heart attack or stroke. 

    Normal blood pressure readings for healthy individuals 20 years and older should be 120/80 mmHg. If blood pressure readings are consistently higher than 120/80 it means that individual is most likely suffering from hypertension. According to Heart.org, the website of the American Heart Association, "Untreated high blood pressure damages and scars your arteries." High blood pressure increases the risk of blood clots, organ damage, heart attacks and strokes. High blood pressure also results in increased plaque build-up and weakening of blood vessels. 

    Since most people see their dentist on a more consistent basis than their general physician, dentists can provide valuable information to patients by checking their blood pressure regularly and informing them when the measurements are suggestive of Hypertension. If blood pressure readings are higher than normal, the dentist will likely refer the patient to a physician for further testing before any dental work is done. Even if an individual is taking medication for hypertension, blood pressure should still be monitored. A blood pressure screening at the dentist's office is just too good an opportunity to pass up. It takes only a few minutes and the information is potentially life-saving. 

The History of Dental Floss

 

 

 

During Ancient Times

Over the years, anthropologists have found evidence that ancient people used various implements such as pointed sticks for interdental cleaning.

 

 The Beginning

But according to most sources, credit for the invention of dental floss as we know it goes to a New Orleans dentist, who in 1815 began advising his patients to use a thin silk thread to clean between their teeth.

 

 The Evolution Of Dental Floss (1882-1896)

The idea caught on, and in 1882 a company called the Codman and Shurtleft Company, based in Randolph, Massachusetts, began marketing an unwaxed silk dental floss. This was followed in 1896 by the first dental floss from Johnson & Johnson. The New Jersey-based J&J took out a patent for dental floss in 1898 that was made from the same silk material used by doctors for silk stitches.

 

 The Evolution of Dental Floss (1940-1950)

During the 1940s, nylon replaced silk as the material for dental floss-its consistent texture and resistance to shredding were an improvement over the silk versions. The use of nylon also allowed for the development of waxed floss in the 1940s, and for the development of dental tape in the 1950s.

 

 Today

Since then, the variety of types of dental floss has expanded to include newer materials such as Gore-Tex, and different textures such as spongy floss and soft floss. And today's floss has other features to make flossing easier. For example, floss with stiffened ends to help with flossing around braces or other dental appliances. 

 

 

 

Source: http://www.oralb.com/topics/history-of-dental-floss.aspx 

 

The Twilight Zone

      Choosing a toothbrush sounds like an easy task but taking a stroll down the toothbrush isle can sometimes be overwhelming! They each promise something different, fresh breath, deep cleaning, or tooth whitening. So how do you know what toothbrush is best for you? Well, here are a few easy guidelines to follow when choosing the proper toothbrush:

1)Electric vs. manual
      a. Studies show there is no significant difference between electric and manual toohbrushes in their ability to remove plaque and prevent gum disease. Choose the one you are most likely to use.

2)Bristle flexibility
     a. Choose a brush with soft bristles. Stiff bristles can cause gum recession and sensitivity.
 
3)Size
     a. The size of the toothbrush head is important too. Bigger is not always better. Smaller heads can get into difficult to reach areas more easily than large heads can. Pick a brush that compliments the size of your mouth.

4)Handle
      a. Look for a toothbrush that has a handle that fits comfortably in your hand and is easy to maneuver. (electric toothbrush handles can sometimes be easier to use for individuals with limited dexterity)

5)Safety
      a. Make sure to choose a brush with the American Dental Association (ADA) seal of approval on the package.

Diabetes & Oral Health

November is American Diabetes Month ®. In addition to complications such as heart disease, stroke, and kidney disease, the 26 million Americans living with diabetes also have to deal with the unexpected risk of gum disease.          

Individuals with diabetes are at an increased risk for Periodontitis (serious gum disease) because in general they are more susceptible to bacterial infections, and have a decreased ability to fight off bacteria that invade the gums.

 Periodontitis may have the potential to affect blood glucose control and contribute to the progression of diabetes.

So what can be done to help prevent dental problems associated with diabetes?

1.      Keep blood glucose levels under control

2.      Take good care of the teeth and gums

This includes:

a.      Regular 6month checkups

b.      Flossing daily

c.       Brushing twice a day

Denture wearers:

d.      Remove and clean dentures daily

3.      Avoid smoking

4.      Make sure to inform your dentist of all current medications

Some prescription medications can cause dry mouth. To counteract this:

a.      Drink water frequently throughout the day

b.      Ask your dentist about special toothpastes and mouth rinses that are specially formulated for dry mouth

This information and much more can be found on the American Diabetes Association website @ www.diabetes.org

Why Halloween Is Really a Scary Holiday: A Dentist's Perspective By: Mark Burhenne DDS

    I see an influx of patients after Halloween, but not for the reason you'd expect. Cavities don't form overnight; it's the parents I see with broken molars from biting down on hard candy, claiming they are saving their kids from the threat in the Halloween bag.

    The problem with Halloween isn't the $1,000 per tooth it costs to rebuild these adult teeth with crowns. It's that these adults grew up with a tradition that perpetuates an unhealthy relationship with food and continue that tradition right to the door of the dentist. This dysfunctional tradition of binging and unbridled indulgence is costing us our health and sending the wrong message to kids.

    I think everyone of us as kids remembers when we first heard that everyone in the neighborhood was giving out free candy, and that all you had to do was a wear a silly costume and disguise your identity to gain access. And we all wore the costumes. And we all amassed the insane amounts of candy. Oh, but "don't take candy from strangers," we were told the rest of the year. What a crazy and confusing childhood, and all in the name of tradition.

    We spend $2 to $4 billion dollars on Halloween candy every year. I wonder what that translates to in dental costs, not to mention child obesity. Halloween is the second largest commercial holiday in America, superseding Valentine's Day with $6.9 billion dollars in commercial sales each year. And it's growing. No wonder it's a scary holiday.

    Parents, listen up: I may have a solution to this madness. I won't be buying back candy from my patients as other dentists do. I think that just confuses kids and gives the candy some artificial value (not to mention artificial coloring). And where in that dental office does that candy end up anyway? If I were a kid, I'd be thinking, "Hey, if the dentist is willing to pay for this stuff, maybe I just better keep it and eat it."

    I suggest that you invoke the spirit of the Great Pumpkin. Okay, I admit, this works only up to a certain age, but it does work. It's been tried and tested by yours truly. My three daughters to this day give the candy up to the Great Pumpkin. They certainly enjoy some of their candy the night of Halloween, but the bulk of it goes into a bag and out onto the front porch to await the arrival of the Great Pumpkin. In all his great wisdom, he brings gifts like books and software, something I'd like to teach my children are real treats.

    Linus and Sally of the Peanuts gang, who sat in the pumpkin patch waiting for the Great Pumpkin, were ridiculed by Snoopy, Lucy and the rest of the gang. They missed out on the trick-or-treating and all the candy, and in the end the Great Pumpkin didn't even come. Linus blames it on his wavering belief in the Great Pumpkin and, with chattering teeth, ends up getting dragged to bed by his sister early the next morning. Linus was a romantic, no doubt, but he had fewer cavities than all the gang except for, perhaps, Snoopy (since candy is even lower quality than dog food -- really).

     If your children eat candy, make sure it's under a controlled environment. Have drinking water available to them (to buffer the huge hit of acids that ensue within minutes of candy consumption) and a toothbrush nearby (for the mandatory tooth brushing session within 20 minutes of the candy consumption).

    Moderation is key. Having fun on Halloween does not have to mean developing lifelong bad habits or dysfunctional relationships with food. Try to break the cycle of stereotypical "candy worship" seen in children by replacing that Halloween candy with a far greater treat from the Great Pumpkin -- a book, a CD, athletic equipment or a new bike or skateboard. And brush, floss, and drink lots of water afterward to minimize the hit to your mouth. For you adults that break a molar on a Worther's Original, I can only help you later in the dental chair.

    So if for you on Halloween the treat is what's it all about, then the trick is really on you. See you next week, in my dental chair. I'm ready!


By: Mark Burhenne DDS
Dr. Burhenne is a dental health expert for CNN, CBS, and Huffington Post, which is where this story was first published.