My Blog
By Steven M. Erlandson, DDS
February 09, 2019
Category: Oral Health
Tags: topical fluoride  
TopicalFluorideisaSafeWaytoProtectYourChildsTeethfromDecay

We've known for decades that fluoride strengthens tooth enamel and lowers the risk for decay. And while adding it to toothpaste and drinking water are the more common ways for getting it into the body, an increasingly popular way—especially for children—is to apply fluoride directly to the teeth.

But is topical fluoride really worth the effort and expense? And, are there any side effects to treating teeth this way?

As to the first question, researchers have performed numerous studies measuring fluoride's effectiveness for preventing tooth decay. The Cochrane Oral Health Research Group recently reviewed studies on topical fluoride applications involving nearly 10,000 children and adolescents between the ages of 2 and 15. The combined average for all the studies showed a 28% reduction in decayed teeth for patients who received topical fluoride compared to those who didn't.

This was especially true for children at high risk for decay: directly applying fluoride gels, foams or varnishes to teeth reduces that risk substantially. But there are also side effects to this application. Fluoride in general has only one known safety concern, a condition known as fluorosis. Too much fluoride over time can cause heavy discoloration of the teeth. This does not affect the health of the teeth, but it can look unattractive and require cosmetic treatment to reduce its effect.

There's little to no risk for fluorosis with the controlled treatments offered by dentists; the fluoride solution remains on the teeth no more than a few minutes. But there is a possible side effect during treatment due to the relatively high dose of fluoride used. If the patient accidentally swallows some of the solution, the concentration of fluoride can cause stomach upset, vomiting or headaches.

Dentists minimize the chances for this by usually using the more difficult to swallow varnish form of topical fluoride on younger patients, and using trays or other barrier devices to isolate the fluoride solution from the rest of the mouth. Under professional supervision, it's rare for an accidental ingestion to occur.

The risks for these side effects are quite low, and the benefits of topical fluoride for reducing the chances for decay can more than outweigh them. Fluoride applications are one of many ways we can protect your child's current and future dental health.

If you would like more information on decay prevention techniques like topical fluoride, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Fluoride Gels Reduce Decay.”

YoumayNeedOrthodonticTreatmentBeforeObtainingImplants

You have a lot of options for replacing missing teeth, from state-of-the-art dental implants to affordable, but effective partial dentures. But if the teeth in question have been missing for a while, you may first have to undergo orthodontic treatment. Here's why.

While they may feel rigid and firm in the jawbone, teeth are actually held in place by periodontal (gum) ligaments. These elastic tissues lie between the teeth and the bone and attach to both with tiny filaments. This mechanism allows the teeth to incrementally move over time in response to biting pressures or other environmental factors.

When a tooth goes missing the teeth on either side of the space naturally move or "drift" into it to help close the gap. This natural occurrence can reduce the space for a restoration if it has gone on for some time. To make room for a new prosthetic (false) tooth, we may have to move the drifted teeth back to where they belong.

If you're thinking metal braces, that is an option—but not the only one. Clear aligners are another way to move teeth if the bite problem (malocclusion) isn't too severe. Aligners are a series of custom-made, clear, plastic trays worn over the teeth. The patient wears each tray, slightly smaller than the previous one in the series, for about two weeks before changing to the next one. The reduction in size gradually moves teeth to their intended target position.

Many adults prefer clear aligners because they're nearly invisible and don't stand out like metal braces. They're removable, so you can take them out for cleaning or for special occasions. And, we can also attach a prosthetic tooth to the tray that temporarily covers the missing tooth space.

Whichever orthodontic treatment you choose, once completed we can then proceed with restoration to permanently replace your missing teeth. While it can be a long process, the end result is a beautiful smile that could last for years to come.

If you would like more information on your dental restoration options, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Straightening a Smile before Replacing Lost Teeth.”

By Steven M. Erlandson, DDS
January 20, 2019
Category: Oral Health
BeyonceMakesFlossingaFamilyAffair

As is the case with most celebs today, Beyonce is no stranger to sharing on social media… but she really got our attention with a video she recently posted on instagram. The clip shows the superstar songstress — along with her adorable three-year old daughter Blue Ivy — flossing their teeth! In the background, a vocalist (sounding remarkably like her husband Jay-Z) repeats the phrase “flossin’…flossin’…” as mom and daughter appear to take care of their dental hygiene in time with the beat: https://instagram.com/p/073CF1vw07/?taken-by=beyonce

We’re happy that this clip highlights the importance of helping kids get an early start on good oral hygiene. And, according to authorities like the American Dental Association and the American Academy of Pediatric Dentistry, age 3 is about the right time for kids to begin getting involved in the care of their own teeth.

Of course, parents should start paying attention to their kids’ oral hygiene long before age three. In fact, as soon as baby’s tiny teeth make their first appearance, the teeth and gums can be cleaned with a soft brush or cloth and a smear of fluoride toothpaste, about the size of a grain of rice. Around age 3, kids will develop the ability to spit out toothpaste. That’s when you can increase the amount of toothpaste a little, and start explaining to them how you clean all around the teeth on the top and bottom of the mouth. Depending on your child’s dexterity, age 3 might be a good time to let them have a try at brushing by themselves.

Ready to help your kids take the first steps to a lifetime of good dental checkups? Place a pea-sized dab of fluoride toothpaste on a soft-bristled brush, and gently guide them as they clean in front, in back, on all surfaces of each tooth. At first, it’s a good idea to take turns brushing. That way, you can be sure they’re learning the right techniques and keeping their teeth plaque-free, while making the experience challenging and fun.

Most kids will need parental supervision and help with brushing until around age 6. As they develop better hand-eye coordination and the ability to follow through with the cleaning regimen, they can be left on their own more. But even the best may need some “brushing up” on their tooth-cleaning techniques from time to time.

What about flossing? While it’s an essential part of good oral hygiene, it does take a little more dexterity to do it properly. Flossing the gaps between teeth should be started when the teeth begin growing close to one another. Depending on how a child’s teeth are spaced, perhaps only the back ones will need to be flossed at first. Even after they learn to brush, kids may still need help flossing — but a floss holder (like the one Beyonce is using in the clip) can make the job a lot easier.

If you would like more information about maintaining your children’s oral hygiene, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Top 10 Oral Health Tips For Children” and “How to Help Your Child Develop the Best Habits for Oral Health.”

By Steven M. Erlandson, DDS
January 10, 2019
Category: Dental Procedures
Tags: dental implants  
DentalImplantsBetterthanEverthankstoOngoingTechAdvances

While many people still consider dental implants the "new kids on the block" in dental restoration, they're now in their fourth decade of use. And since their inception implant technology has continued to improve and revolutionize how we replace missing teeth.

Implants are a different "species" compared to other restoration methods. To be precise, an implant is a tooth root replacement—usually a titanium metal post imbedded directly into the jaw bone. Titanium is not only a biocompatible metal, but bone cells naturally grow on its surface to create a strong and durable hold. It's this secure hold that's most responsible for implants' high long-term success rate.

But we should also credit some of this success to the steady stream of advances over the years in implant construction and supporting technologies. For one thing, we're now more accurate and precise with implant placement thanks to advances in computer tomography (CT) and cone beam CT (CBCT) scanning.

These digital processes merge a series of images taken by a special camera to form a three-dimensional model of the jaw. We can manipulate this model on a computer monitor to view it from different vantage points. It can help us locate and avoid anatomical structures like nerves and sinuses when determining where to place a future implant. CT and CBCT are especially useful when there's a concern about adequate available bone, a necessity for stable implants.

Technology has also improved how we create surgical guides, often used during implant surgery to obtain the most accurate results. Surgical guides are custom-made devices that fit over the teeth with the drilling locations for the implants marked on them. Recent advances in 3-D printing have made these guides even more accurate so that they fit more securely in the mouth. This greater stability increases their accuracy during the drilling sequence during surgery.

These and other advances are helping ensure every implant is a success story. The end result is both a functional restoration and a beautiful smile.

If you would like more information on dental implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “How Technology Aids Dental Implant Therapy.”

By Steven M. Erlandson, DDS
December 31, 2018
Category: Uncategorized
Tags: pulp capping  
Less-InvasivePulpCappingCouldSaveYourTooth

There’s one sure thing about tooth decay: you can’t ignore it. In fact, the best outcomes result from finding it early and treating it before it enters the pulp in the center of the tooth, often a filling or similar treatment.

If it does advance to the pulp, you may need a root canal treatment to save the tooth. This is a moderately invasive procedure where we access the pulp and root canals, tiny passageways leading to the root and supporting bone. We then remove all the diseased tissue and fill the empty pulp chamber and root canals with a special filling. Later we’ll crown the tooth for added protection against future infection or fracture of the tooth.

But there’s also another less-invasive method than a root canal called pulp capping. It’s only appropriate to use, however, if the pulp has become exposed or almost exposed by decay, but hasn’t yet shown signs of disease.

Pulp capping can be either direct or indirect. We use direct pulp capping if the healthy pulp has been exposed by the disease process. We first isolate the tooth from the rest of the mouth to prevent contamination and then proceed to remove all of the tooth’s decayed dentin structure. We then apply a biocompatible material directly over the pulp to protect it from further decay and to facilitate healing. We then restore the tooth, usually with a filling, to its proper function and life-like appearance.

When the pulp is threatened by decay but not yet exposed, we may then use the indirect method. In this approach we first remove most of the decayed dentin, but leave a small amount next to the pulp to keep it covered. We then treat this remaining dentin with a material to help it heal and re-mineralize, followed by a temporary filling of the tooth. A few months later we’ll remove this filling and inspect the treated dentin. If it has regenerated sufficiently, we remove any remaining decay and permanently restore the tooth.

As we said, pulp capping is only used with patients with deep decay whose pulp tissue is healthy. But when we can use it we can avoid some of the permanent alterations that often come with a root canal treatment and still save the tooth.

If you would like more information on treatments for tooth decay, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Pulp Capping: A Procedure that May Save a Decayed Tooth.”





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