Dr. William Rice DDS

Plaque is a sticky film of bacteria that covers our teeth and, when we eat something, these bacteria release acids that attack the tooth enamel.

When these attacks are repeated over time, the enamel will break down and this will eventually lead to cavities.

When plaque is not removed through daily brushing and cleaning it hardens into calculus or tartar. When tartar collects above the gum line, brushing and cleaning between the teeth becomes more difficult.

The gum tissue can become swollen or may bleed. This is called gingivitis and it is the early stage of periodontal (gum) disease.

There are several steps you can take to protect yourself against this happening:

– Brush your teeth twice a day with fluoride toothpaste
– Clean between teeth daily with floss or an interdental cleaner
– Eat a balanced diet and limit the number of snacks between meals
– Visit your dentist regularly for professional cleanings and oral exams
– Ask your dentist about sealants � these are protective coatings that can be applied to the back teeth where decay often starts.

If you take steps to remove the plaque each day, you have a greater chance of avoiding tooth and gum problems.

Your smile makes a huge difference to what people think about you and how you feel about yourself.

And there are many options available to help you improve the look and brightness of your smile, including:

In-office bleaching: During chair-side bleaching, the dentist will apply either a protective gel to your gums or a rubber shield to protect the oral soft tissues. A bleaching agent is then applied to the teeth, and a special light may be used to enhance the action of the agent.

At-home bleaching: There are several types of products available for use at home, which can either be dispensed by your dentist or purchased over-the-counter. These include peroxide bleaching solutions, which actually bleach the tooth enamel. Peroxide-containing whiteners typically come in a gel and are placed in a mouth guard.

Whitening toothpastes: All toothpastes help remove surface stain through the action of mild abrasives. “Whitening” toothpastes include special chemical or polishing agents that are more effective at removing stains. However, unlike bleaches, they don’t alter the intrinsic color of teeth.

Start by speaking to your dentist. He or she will tell you if whitening procedures would be effective for you as whiteners may not correct all types of discoloration.

The Invisalign system is a series of clear, thin, mouthguards that fit over the teeth and can gradually straighten them.

These have been called �invisible braces� as they can be an effective alternative to metal braces in some circumstances.

The big advantage of Invisalign is much improved appearance and comfort.

Invisalign mouthguards can be removed during eating and when brushing and flossing. As traditional braces may trap food and plaque, this is another major benefit of Invisalign.

While the system has advantages, it also has some drawbacks.

For example, it is more expensive – costing 25-50 percent more than metal braces.

Also the fact that you remove the mouthguards more often means that you may forget to wear them and it could take longer for you to achieve the desired results.

Invisalign is better suited to some people than others – for example, it may be particularly suitable for adults who have slight to moderate spacing or crowding of their teeth.

Your dentist will be able to tell you if you might be a suitable candiate for Invisalign.

You will get more detailed advice from an orthodontist who has been certified in the Invisalign system.

More than fifteen percent of American adults suffer from chronic facial pain.

Common symptoms can include pain in or around the ear, tenderness of the jaw, clicking or popping noises when opening the mouth or even head and neck aches.

There are two joints and several jaw muscles which make it possible to open and close the mouth. They work together when you chew, speak, and swallow.

These structures include muscles and ligaments, as well as the jaw bone, the mandible (lower jaw) with two joints, the TMJ�s.

The TM joint is one of the most complex joints in the body. Located on each side of the head, these joints work together and can make many different movements, including a combination of rotating and gliding action when chewing and speaking.

Several muscles help open and close the mouth. They control the lower jaw (mandible) as it moves forward, backward, and side-to-side.

Both TM joints are involved in these movements. Each TM joint has a disc between the ball and socket. The disc cushions the load while enabling the jaw to open widely and perform rotating and translocational movements.

Any problem that prevents this complex system of muscles, ligaments, discs and bones from working together properly may result in a painful TMJ disorder.

If you are suffering from this type of pain, your dentist can help identify its source with a thorough exam and appropriate x-rays.

Often, the problem is a sinus or toothache or it could be an early stage of periodontal disease.

But for some pain, the cause is not so easily diagnosed.

The pain could be related to the facial muscles, the jaw or temporomandibular joint, located in the front of the ear.

Treatments for this pain may include stress reducing exercises, muscle relaxants, or wearing a mouth protector to prevent teeth grinding.
They’ve been successful for many and your dentist can recommend which is best for you.

Sealants are made from plastic material applied to the back teeth to protect the enamel from plaque and acids.

The plastic bonds into the depressions and grooves (pits and fissures) of the chewing surfaces of the back teeth – premolars and molars.

Although thorough brushing and flossing can help remove food particles and plaque from smooth surfaces of teeth, the toothbrush bristles cannot reach all the way into the depressions and grooves to extract food and plaque.

The benefit of sealants is that they protect these vulnerable areas by “sealing out” plaque and food.

Your dentist can apply sealants quite easily and it takes only a few minutes to seal each tooth.

The teeth being sealed will first be cleaned. Then the chewing surfaces are roughened with an acid solution which makes it easier for the sealant to stick to the tooth.

The sealant is then ‘painted’ onto the tooth enamel, where it bonds directly to the tooth and hardens.

Sometimes a special curing light is used to help the sealant harden.

As long as the sealant remains intact, the tooth surface will be protected from decay.
They usually last several years before a reapplication is needed. Your dentist will check the condition of the sealants during your regular visits and reapply them when necessary.

Sealants are ideal for children because the risk of developing pit and fissure decay starts early in life. However, many adults can benefit from sealants as well.

Your dentist can tell you whether sealants would help your oral hygiene program.

Research has shown strong links between periodontitis (advanced form of gum disease) and other health problems such as cardiovascular disease, stroke and bacterial pneumonia.

And pregnant women with periodontitis may be at increased risk of delivering pre-term and/or having babies with low birth weight.

However, just because two conditions occur at the same time, doesn’t necessarily mean that one condition causes the other. The relationship could work the other way.

For example, there is evidence that diabetics are more likely to develop periodontitis and have more severe periodontitis than non-diabetics.

Alternatively, two conditions that occur together may be caused by something else.

In addition, people who smoke or use alcohol have a higher than average risk of developing periodontitis and other conditions, including oral cancer.

Research is looking at what happens when periodontitis is treated in individuals with these problems.

The aim is to find out whether periodontitis does have an effect on other health problems.

If one caused the other, improvement in periodontal health would also improve other health problems.

While the research is not yet conclusive, the potential link between periodontitis and systemic health problems, means that preventing periodontitis may be an important step in maintaining overall health.

In most cases, good oral health can be maintained by brushing and flossing every day and receiving regular professional dental care.

Some children suck on their thumbs and parents often wonder if it is harmful.

Sucking on something is a child’s natural reflex. It can help them feel more secure so they start to suck on their thumbs, fingers, pacifiers or other objects.

Since thumbsucking is relaxing, it may also help them sleep.

However, after the permanent teeth come in, sucking may cause problems with the proper growth of the mouth and the alignment of teeth. It can also cause changes in the roof of the mouth.

Whether or not dental problems will result depends on the intensity of the sucking.

A child who vigorously sucks their thumb is more likely to have difficulties than one who rests their thumb passively in their mouth. Young children who suck their thumbs aggressively may even cause problems with their baby teeth.

If you notice changes in your child�s primary teeth, consult your dentist.

Usually children will stop sucking their thumbs between the ages of about two and four. They should have ceased sucking by the time the permanent front teeth are ready to erupt.

If your child is continuing to suck their thumbs, here are some tips:

– Praise them for not sucking, instead of scolding them when they are
– If they are sucking because they feel insecure, focus on correcting the cause of the anxiety
– For older children, involve them in choosing the method of stopping

If necessary, your dentist can help by encouraging the child and explaining what could happen to their teeth if they do not stop sucking.

Your smile makes a huge difference to what people think about you and how you feel about yourself.

And there are many options available to help you improve the look and brightness of your smile, including:

In-office bleaching: During chair-side bleaching, the dentist will apply either a protective gel to your gums or a rubber shield to protect the oral soft tissues. A bleaching agent is then applied to the teeth, and a special light may be used to enhance the action of the agent.

At-home bleaching: There are several types of products available for use at home, which can either be dispensed by your dentist or purchased over-the-counter. These include peroxide bleaching solutions, which actually bleach the tooth enamel. Peroxide-containing whiteners typically come in a gel and are placed in a mouth guard.

Whitening toothpastes: All toothpastes help remove surface stain through the action of mild abrasives. “Whitening” toothpastes include special chemical or polishing agents that are more effective at removing stains. However, unlike bleaches, they don’t alter the intrinsic color of teeth.

Start by speaking to your dentist. He or she will tell you if whitening procedures would be effective for you as whiteners may not correct all types of discoloration.

Nowadays, thanks to advances in dental techniques and materials, patients have a much wider range of choices when they have to repair missing, worn, damaged or decayed teeth.

For example, materials such as ceramics and polymer compounds that look more like natural teeth help dentists create pleasing, natural-looking smiles.

The traditional materials such as gold, base metal alloys and dental amalgam are still widely used as they have many advantages.

The strength and durability of traditional dental materials continues to make them useful in many situations. For example, they are good when fillings are required in the back teeth because the pressure of chewing is high in that area.

The choice of the best option will depend on several factors such as the patient’s oral and general health, where and how the filling is placed and the number of visits needed to prepare and adjust the restored tooth.

The choice about which option is best depends on each individual�s needs so you should discuss the options with your dentist.

While local anesthetics are often used in dental treatment, there is sometimes a need for anti-anxiety agents – such as nitrous oxide – or sedatives to help people relax during dental visits.

Dentists may use these agents to induce “minimal or moderate sedation”.

In this case, the patient reaches a relaxed state during treatment but can respond to speech or touch.

Sedatives can be administered before, during or after dental procedures by mouth, inhalation or injection.

More complex treatments may require drugs that can induce “deep sedation”.

This reduces consciousness and causes a loss of feeling which helps to reduce both pain and anxiety.

Sometimes patients undergo “general anesthesia” where the drugs lead to a temporary loss of consciousness.

A dentist may recommend deep sedation or general anesthesia for certain procedures with children or with adults who have severe anxiety or for people who have difficulty controlling their movements.

While these techniques to control pain and anxiety are used to treat tens of millions of patients safely every year, it�s important that you let your dentist know anything that might affect your ability to benefit from them for example, tell them about any illnesses or health conditions, whether you are taking any medications and if you’ve had any problems with allergic reactions to medications.