ASK Dr.A

Dr.A's DENTAL DIET



Wednesday, September 3, 2008

Why Do My Teeth Have Thin Enamel, and What Can I Do About It?

Ask Dr.A
dradental.com



The answers given by Dr.A are intended as non-professional advice, for entertainment only if you will. Please do consult with your dentist of record or your physician before making any decision regarding your dental or medical health.




Dear Dr. A,

I am 24 years old and I have thin enamel on all my teeth. My entire life I have never had any problems with my teeth or had any work done, except for having my wisdom teeth removed.

I have always had a good diet, and as a child my parents hardly ever gave me sugar, and I was barely ever allowed to have fruit juice. Today my diet is still good, although I am pretty sure that my current diet has increased the acidity in my mouth.

I have seen some of the treatments online promising to eliminate sensitivity and so forth, however, none promise to build enamel and solve my problem, as such. My dentist has told me that I have about 10 years until this becomes a serious problem and suggests at that time that I will need to have crowns placed on all my teeth.

Do have any suggestions? or any advice? any response would be greatly appreciated.

Kind Regards




Dr.A - Of course, it would be difficult to diagnose your problem without having a full examination of your teeth and surrounding tissues done in person. Having said that, I will try my best to address your concerns.

For your dentist to suggest that all your teeth may need to be crowned soon is extreme. I am not suggesting that it is not warranted, rather, only in extreme cases do dentists suggest such a treatment plan, especially for someone of your age. It would be interesting to understand exactly why your dentist came to this conclusion.

Did your dentist diagnose you with any form of Amelogenesis Imperfecta? This is a range of conditions that affect the development of enamel in varying ways. However, these conditions usually present themselves with obvious clinical symptoms, ie. mishapen teeth, and correlated with high rate of dental caries. In your case however, and according to you, you have never had any dental work in terms of restorations done on your teeth!

So personally, and based the information so far, I do not believe you suffer from Amelogenesis Imperfecta.

Thin enamel could also be the result of trauma or injury during the early development of teeth. This usually affects only one or a few teeth, and not the entire dentition.

Another cause of weak enamel is bulemia. The high acidic nature of stomach contents being purged causes havoc on the strength of your enamel. Bulemia however is usually seen more often in young teenage females.

What I would suggest is to visit your dentist again, and try to find out if you have Amelogenesis Imperfecta, or if the dentist feels you have had any trauma to the teeth during development. I would also suggest that before you do any expensive and extensive restorative work visit a second, or even a third dentist, just to get more opinions.

In the mean time, you should try ACT Restore rinse, and brush with Flouridex, which is a prescription toothpase with a high amount of flouride. Flouride may help in restoring some of the strength lost in your enamel. I would not use Flouridex for more than a couple of weeks, as the longterm effects of high flouride could be bad for your health. As for the ACT rinse, I would make it a daily habit to rinse with ACT just once, for as long as you need. Of course, consult the manufacturer's directions for more detailed or contrary information.

I am not sure where you live, but ACT and Flouridex are US trademarks, they may or may not be available outside the U.S. Ask your dentist what alternatives are available where you reside.

Read more Ask Dr.A




The answers given by Dr.A are intended as non-professional advice, for entertainment only if you will. Please do consult with your dentist of record or your physician before making any decision regarding your dental or medical health.







______________



Thursday, July 17, 2008

Tips to Reduce Tooth Staining by Common Drinks

Dr.A's Dental Diet
DrADental.com



One of the fastest growing areas of dentistry these days has to be tooth whitening products; including strips, rinses, toothpastes, bleaching trays, whitening lasers such as ZOOM, and many more. But what I personally do not like about whitening products is that it provides you with a quick fix. This makes you less likely to worry about what you are eating or drinking, and how that affects your teeth.

Whitening products are usually bleach based. Bleach is a pretty potent chemical, and how it works on teeth might surprise a lot of you. The idea is that the acid pokes microscopic holes in the enamel, the outer protective surface of your teeth, so that the whitening penetrates to the deeper layers of your teeth.

So what's the problem? Over time, these microscopic holes also make it easier for fluids to penetrate the enamel surface as well! This not only induces stronger sensitivity to cold or hot drinks, but also makes it more likely that you will stain!

The more you stain, the more likely you will use whitening products, the more likely you will stain, and so on...

I am not downplaying bleaching producs, but I would like to offer preventative tips so that you are less likely to stain, and less likely to overuse whitening products.


Coffee
It is interesting to note how whitening prodcuts in the U.S. became more popular as Starbucks expanded! I guess dentists owe Starbucks a whole lot. Joking aside, coffee is one of the biggest causes of tooth staining.

So what can you do? I have three words, Milk, milk, milk. A latte is a shot of espresso with the rest of the cup made of milk. This greatly lowers the staining power of the espresso. And lactose intolerance is not an excuse anymore. There are many milk alternativers, including soy milk. What if you don't like milk? Than you should have a bottle of water on hand and rinse (read on).


Tea
There are many alternatives to black tea, which is very potent in staining teeth. Even green tea can have a strong staining effect. What you should drink are herbal teas. White tea is also a great alternative. White tea is made from amateur green tea leaves.


Wine
We all know the staining power of red wine, especially on couches and cocktail dresses! So if you enjoy your wine on a daily basis, then try to stick to white wine as much as possible. Do you still favour red wine? Then, rinse (Read on).


Fruit Juice
Surprised! Some fruit juices can stain your teeth, such as cranberries, blackberries, and carrots. Stick to lighter juices, such as apples, pineapples, and melons.


Soda
Stick to soda with a lighter shade, such as gingerale, Sprite, and try to keep away from darker sodas such as Pepsi, Coke, and Root Beer. But, regardless of the staining effect, sodas are carbonated, which can over time cause the breakdown of enamel.


Lemonade
Lemonade is high in acidity, and usually high in sugars. This combination is very potent. So please, no lemonade!


Water
Relax, water does not stain, but it does deserve its own section here because it can be the greatest tool in your arsenal against tooth stains. Whenever I am drinking coffee, tea, or wine I always have a bottle or glass of water on hand. It has now become a habit of mine to rinse my mouth with water after a few sips of whatever I'm drinking. This minimizes the staining effect of these drinks since it lowers the amount of time they are coating my teeth.






Dr.A's Dental Diet
__________________



Monday, November 5, 2007

How Can I Reverse Teeth Erosion from Bulemia and Drug Use?

Ask Dr.A
dradental.com



The answers given by Dr.A are intended as non-professional advice, for entertainment only if you will. Please do consult with your dentist of record or your physician before making any decision regarding your dental or medical health.




Hello Dr.A, I had a problem with meth and bulimia. I recently just got help and I needed advice on what to do about my teeth erosion.

My enamel on my teeth; some parts are clear on my teeth on the bottom and I see some of the enamel had come off making my teeth sensitive. I know I can't do much about the chips on my teeth but I was wondering what I could to help repair my enamel and teeth to rebuild them somehow.

I've been using ACT and Crest Pro but I'm not sure if that's enough. Please tell me what I could do, thanks so much for your help!




Dr.A - First off, let me commend you on the confidence and self-respect you must have shown in battling both bulemia and drug abuse. You have already proven your dedication to your health and life.

The erosion of enamel surfaces on teeth can vary depending on the cause. While bulemia and certain drug abuse can result in severe enamel breakdown, over-consumption of acidic foods such as lemons can also result in such breakdown to some extent.

Bulemia usually results in enamel breakdown due to the acidic contents of the stomach as they coat the teeth. Drug abuse can also result in weakend enamel, in addition to skin and hair, because of deleterious nutritional habits and especially grinding, which can leave teeth chipped and broken.

In your case, it is difficult for me to imagine just how badly eroded your enamel is since I have never met you and examined you in person. If your findings are moderate, that is, the sensitivity and chipping of your teeth are not extremely painful and obvious, then I would continue to use ACT flouride rinse, and brush with ProNamel toothpaste by Sensodyne (which I personaly use at home), and evaluate following 2-4 weeks of use.

If the sensitivity is painful and the chipping is extreme, then visit your dentist and ask for high dose flouride treatment. That may result in some reversal of the enamel loss.

However, it is usually necessary in that case to restore your teeth with composite resins (white fillings), or porcelain veneers and crowns to achieve optimal protection from further chipping and for beautiful aesthetics. In your question you stated that you knew you "can't do much about the chips on my teeth", which couldn't be further from the truth. You absolutely can, and should, repair any chips on your teeth as any fracture, no matter how small, can extend itself further and create more fractures, analogous to chipped glass.

You must recognize that if you do decide to not only invest your money but also your time in trying to reverse the damage and restore your white smile you must first be committed to stopping any of your previous drug and bulemic habits. Otherwise, there does not exist any dental restorative material that can withstand constant acidic conditions and forceful grinding.

Do your self a favor; visit your dentist and learn how a new smile can give you confidence in your self, and how this renewed confidence can lead to a brand new you.




The answers given by Dr.A are intended as non-professional advice, for entertainment only if you will. Please do consult with your dentist of record or your physician before making any decision regarding your dental or medical health.






More Ask Dr.A
______________



Thursday, October 18, 2007

Does It Matter Where A Dentist Graduated From?

Ask Dr.A
dradental.com



The answers given by Dr.A are intended as non-professional advice, for entertainment only if you will. Please do consult with your dentist of record or your physician before making any decision regarding your dental or medical health.




I would like to find out where my dentist went to school without having to ask him outright. For physicians, their medical school is listed with the information about their license activity. For dentists, this is not true in California. I don't know what other states do.

I am one of those folks who have had both fabulous and truly awful dental work. One of the ways to increase the odds of good care is to know the dentist's background and training. Can you provide any help in this regard? I do hope so. If you can not, where do we write?




Dr.A - The dentist's year and school of graduation, and disciplinary record should be available at your state's dental association. If not made public on their site, then by all means call them. You can find your state's association by googling it.

Let me take this opportunity to discuss a dentist's abilities. If you are looking for a dentist that has recently graduated, then maybe the quality of the program at the school from which that dentist graduated from might make a difference. However, all dentists must continue to enroll in continuing education classes to keep their licenses active with their particular state association and department of health.

After a few years of continuing education and clinical experience the dentist's alma mater should not make a difference on the quality of work. What you should be looking for is how long a dentist has been working out of school, and if there are any disciplinary hearings on their professional record.



The answers given by Dr.A are intended as non-professional advice, for entertainment only if you will. Please do consult with your dentist of record or your physician before making any decision regarding your dental or medical health.






More Ask Dr.A
______________



Thursday, October 11, 2007

Can Food Debris Hide a Tooth Cavity on X-Rays?

Ask Dr.A
dradental.com



The answers given by Dr.A are intended as non-professional advice, for entertainment only if you will. Please do consult with your dentist of record or your physician before making any decision regarding your dental or medical health.



Q. I have seen 2 dentists in the past 3 months who have both assured me that my teeth are in good condition and that I have no cavities. Prior to these visits, I had last seen a dentist more than a decade ago. I feel certain that I have at least 1 cavity. My certainty stems from the following:

Last year, while eating I suddenly heard and felt a crunch in my mouth. Upon inspection I found that it was a piece of silver filling, a finding corroborated by a jagged edge on one of my left molars that could be felt with my tongue. Secondly, when sucking on the tooth, a decidedly unpleasant taste appears, despite the fact that I floss regularly.

So my question is:

Is it possible for food debris to become so compacted in a cavity that is not attended to, that the cavity cannot be detected on x-rays?




Dr.A - If your observations, mainly the broken piece of amalgam and the jagged tooth filling, are correct then I would have to assume you have a broken filling and that it needs replacing. Now, for two dentists to say otherwise, I would also have to assume that there's nothing of significance that can be detected. As you can guess, I cannot give you a solid answer as to what is really going on with your tooth with the limited information you have given me.

Is it possible for food to block out a cavity on the x-ray? No. When reading x-rays there are two types of structures, those that show up white (radio-opague) and those that show up black or not at all (radio-lucent). Anything hard or mineralized, such as bone, tooth enamel, etc will show up as a varying degree of white depending on how dense the structure is. Anything soft, mushy, or empy space will show up black as x-ray beams pass through unobstructed.

So as you can imagine, food debris that is compacted in a hollow cavity cannot show up on the x-ray, therefore, the cavity will still show as a black hole or hollow, and the dentist should be able to detect it.

Sorry, but it is difficult to analyze your case without seeing the x-ray and clinically observing the tooth. What you should do is visit your dentist (or both dentists) again and complain of the said symptoms; the ragged edge and foul taste. Make sure you make the appointment for that reason only so that the dentist's full attention is on that one problem.




The answers given by Dr.A are intended as non-professional advice, for entertainment only if you will. Please do consult with your dentist of record or your physician before making any decision regarding your dental or medical health.




More Ask Dr.A
______________



Monday, October 1, 2007

Cranberry Juice and Your Teeth

Dr.A's Dental Diet
dradental.com



Various studies have shown that certain components found in Cranberry Juice disrupted the adhesive properties of bacterial biofilms found in the oral cavity.

Biofilms are a way for bacteria to stick to each other and protect eacth other from harm. These bacterial congregations are sticky, and make it hard for their removal. In essence, drinking cranberry juice has been found to act as an anti-bacterial agent, breaking up these biofilms on teeth.

Having said that, don't go out and drink just any cranberry juice. Remember, many juices contain a lot of added sugar. Drink only those juices with no extra sugar. Also, take care not to drink too much. All fruit juices contain a high amount of natural sugar.

Cranberry juice can stain your teeth, so make sure you rinse with water after drinking.







Dr.A's Dental Diet
__________________



Thursday, September 20, 2007

What Can You Tell Me About Ultrasonic Scalers For Cleaning Teeth?

Ask Dr.A
dradental.com



The answers given by Dr.A are intended as non-professional advice, for entertainment only if you will. Please do consult with your dentist of record or your physician before making any decision regarding your dental or medical health.



Q. My dental hygienist used something called an ultrasonic water jet while cleaning my teeth. Is this something I could use at home? I don't think they've ever used that technology on me before. She said it's a technology that's been around since the seventies. What is the history of this technology?

Dr.A Ultrasonic scalers were first proposed for cleaning calculus off teeth in 1955, and later became an acceptable alternative to hand cleaning instruments in 1960. They became widely used in the 70's and 80's for removing plaque (sticky food debris) and calculus (hard mineralized debris) supra-gingivally (above the gums).

They work by way of vibrational energy as the tiny tip oscillates (vibrates) rapidly helping to break apart the tough mineralized calculus. The tip also sprays a jet of water which aids in flushing away debris and helps in keeping the tooth cool. This is especially important since extreme heat applied to a single tooth could cause damage to the nerve.

Ultrasonic scalers are especially useful for patients with severe buildup of calculus on their teeth. However, there are many debates about whether ultrasonic scalers can completely replace hand instruments. Many argue that hand instruments are better at removing smaller pieces of calculus under the gums and can leave the tooth surface much smoother than ultrasonics can. Currently, many dental offices use both. The hygienist usually uses the ultrasonic first, then follows with a more detailed cleaning with hand instruments.

Care must be taken if certain areas of teeth have incomplete formation of enamel, as the vibrational energy of the ultrasonic scalers could cause damage to the underlying dentin layer.

Ultrasonic scalers can be operated by certified dental hygiensits and dentists only. So as you can imagine, there aren't any home versions of the systems, at least that I am aware of.




The answers given by Dr.A are intended as non-professional advice, for entertainment only if you will. Please do consult with your dentist of record or your physician before making any decision regarding your dental or medical health.




More Ask Dr.A
______________