Fluoride – What does it do for my teeth?

Fluoride is a mineral found naturally in soil, rocks, air and water. Fluoride has been used in dentistry for its topical effects of strengthening enamel and making it more resistant to dental decay. Fluoride can be delivered in the dental office as a rinse, gel, foam or varnish. It is also found in toothpastes and mouthrinses.

The Canadian Dental Association recommends brushing with fluoridated toothpaste twice per day. In young children who are liable to swallow toothpaste (6 years and under) - it is recommended to avoid fluoridated toothpaste or if the child is at high caries risk to use only the size of a ‘grain of rice’ under close adult supervision. Ingesting too much fluoride can lead to fluoride toxicity, the Maximum Acceptable Concentration is 1.5mg/L.

It can also lead to a condition called Fluorosis, which can look like white or brown flecks on your teeth and can vary in severity.  There have been other associations made between high systemic fluoride intake and bone fracture, cancer and developmental issues however the research is still unclear. This is one of the reasons community water fluoridation is so controversial. The city of Toronto’s water supply is fluoridated at a level of 0.6 parts per million.

Dental Fluorosis – ‘white flaky’ appearance. 

Find further information at these links and make your own informed decision on the subject:
McDonagh Marian S, Whiting Penny F,Wilson Paul M, Sutton Alex J, Chestnutt Ivor,Cooper Jan et al. “Systematic review of water fluoridation” BMJ 2000; 321:855

Stephen Peckham and Niyi Awofeso, “Water Fluoridation: A Critical Review of the Physiological Effects of Ingested Fluoride as a Public Health Intervention,” The Scientific World Journal, vol. 2014, Article ID 293019, 10 pages, 2014. doi:10.1155/2014/293019

http://www.cda-adc.ca/_files/position_statements/fluoride.pdf

Pregnancy and Dentistry

You’re pregnant – what does this mean for your oral health and dental visits? 

During pregnancy, it is imperative to keep your mouth as clean as possible to prevent infections or dental emergencies from appearing. This means brushing at least twice day (after breakfast and just before bed) and flossing at least once a day. If you are planning on getting pregnant, a pre-emptive visit to the dentist to make sure all is healthy in your mouth and to receive oral health tips is recommended.

During pregnancy, the second trimester is the safest to receive dental treatment. It is recommended to visit the dentist at least once during this trimester for a cleaning and to make sure everything in your mouth is healthy! Dental cleanings are completely safe and actually recommended for the pregnant patient. Due to the change in hormones during pregnancy, there is an increased risk of gingivitis.

During the first trimester, it is recommended to avoid all elective procedures, the only dental procedure recommended is emergency treatment – it is safer for the baby to eliminate any source of infections. Oral radiographs, (though they pose an extremely minor risk) should be minimized as well as drug prescription. Overall, maintaining a healthy mouth is the best thing for the pregnant patient.

Modern Crowns

What’s new with crowns?

In terms of crowns or ‘caps’ for single teeth and ‘bridges’ for one or more missing teeth - new materials are being used. Traditionally metal was used for crowns and bridges due to its strength. Then the use of porcelain fused to metal crowns became the material of choice because of their esthetics and strength. The inner layer is metal with a tooth-coloured porcelain outer covering to match the other teeth in the mouth. However, porcelain fused to metal crowns can sometimes have a small gray rim of metal at their base.

The newest crowns can now be made with a ceramic base which is white in colour. Introduced in the last decade, Zirconia has mechanical properties which are the highest reported for any dental ceramic. Zirconia bases can be used with a porcelain outer layer to deliver great esthetic outcomes. Ceramic crowns can either have two layers or just one layer. In our office we have Cerec crowns. These ceramic crowns can be finished in one appointment! Usually a crown requires 1 week fabrication at a dental laboratory. With Cerec the crown is milled in the office at the same appointment! Ask us today if you are a candidate!

Since they are relatively new, only short term follow-up studies have been conducted but they show promising results. Long-term studies are needed to further assess clinical outcomes.

 

Impacted Wisdom Teeth

 Sometimes there isn't enough room for the wisdom teeth to erupt into the dental arch which leaves them either completely or partially submerged in your jaw bone. The partial submersion can cause a food trap which leads to constant irritation, pain and infection at the back of your mouth. This condition itself can be treated by diligently cleaning the area.

However, it is often very difficult for patients to keep this area clean on their own, as it is hard to reach. If care is not given, the irritation over time can cause bone loss at the back of your second molar (the one right before the wisdom tooth). This can lead to constant infection of the partially erupted tooth, called ‘pericoronitis’. This is what is happening when someone tells you his or her wisdom teeth hurt.

Braces and Wisdom Teeth?

Q: I already had braces but now I need to get my wisdom teeth out – Will my teeth shift?

A: No!

There is no evidence in studies that says wisdom tooth removal affects the alignment of straightened teeth in front of them! Also, if there is crowding in the front of your mouth, removal of the wisdom teeth will NOT fix it. Sometimes orthodontic treatment can ‘relapse’ or go back to the position of the teeth before treatment but this is usually due to not wearing a retainer!

Q: Can my dental implant get a cavity?

A: No! 

Implants are made of a different material than natural teeth, which makes them resistant to tooth decay. This doesn’t mean that you don’t have to brush and floss! Dental implants can still experience inflammation of the tissues surrounding them and even bone loss! This is called peri-implantitis. Your implants can be best maintained with diligent home care (brushing and flossing) and hygiene visits to have them professionally cleaned along with the rest of your teeth.

So many people get their wisdom teeth removed... Is it really necessary?

The quick answer is: sometimes! 

Your wisdom teeth, also known as third molars, are the most posterior teeth in the mouth and they erupt last. Some people have lots of room in their jaws and the third molars are able to grow into the arch and function well – in this case there is no need for removal. 

Unfortunately, a lot of the time this isn't the case. Usually there is not enough room in the jaws for these teeth to come in. When there is not enough room, sometimes the wisdom teeth only partially erupt. Sometimes they don’t erupt at all and remain ‘impacted’ or stuck in your jaw bones. Sometimes,  they can even grow in the wrong direction – sideways, downwards, horizontal etc.  These improper eruption patterns can cause problems.