Grads, Egads!

As I celebrate the end of Number One Son's high school career and his embark on matriculation at Michigan State, I am reminded of the many transitions from teen to adult.

As a dentist, the transitions from the teen years to the adult years make for some marked changes in treatment for this age group. There are issues related to growth and development to consider for these grads, such as "wisdom teeth," decay, and periodontal disease.

First, let's consider the erroneously named "wisdom teeth," dubbed by Dr. Obvious in a gray matter synaptic fury as the "18 Year Molars." Why? Because as you may have guessed, they arrive at 18 years of age. But to be truthful, "wisdom teeth" may make their presence known as early as 14 years of age and often cause numerous problems throughout life. If the "wisdom teeth" are to be removed (and most are), early extraction is more desirable than waiting out the inevitable. The teeth continue to develop, getting bigger and bigger with time and making their extraction more difficult. The summer after senior year is the prime time to remove these pesky teeth. At this age, teens are still usually covered by their parent's insurance and may still respond to parental guidance for care. Once they leave for college or jobs, many will neglect their dental health and/or may not have the means to pay for necessary treatment. Without parental influence to set up, pay for, and keep appointments, dental care takes a back seat.

Another issue that arises in early adulthood is decay. Many teens that have never had a problem with decay previously develop cavities for the first time once they head off to college. The availability of unlimited free soda in dorms and at jobs, energy drinks for all night study sessions, and a lack of attention to personal care can be to blame. Parents who have never supplied sugary drinks at home might see their children indulging a bit at college (and you hope that's all they indulge in!) and paying less attention to their personal hygiene.


Younger children are pretty much exempt from periodontal (gum) disease except in rare conditions. Once teens reach adulthood that can change a bit and we begin to take measures of periodontal condition. We record the "pocket" numbers around each tooth to establish a baseline for future years. If numbers change for the worse, more extensive patient education and treatment is initiated. Quite often a lack of attention to personal hygiene, stress, and a poor diet is the cause. This age group tends to burn the candle at both ends (really?) and is under a fair amount of stress which results in some health decline which is first visible in the mouth.

Just as most grads slowly transition to college and jobs, the changes in teen dental care are steady, predictable, and for the most part uneventful. With a little attention to hygiene and a minimum amount of professional intervention, these changes can be made with ease. Relax.

New Tools in the Fight Against Oral Cancer

Recently some new devices have come to dentists' aid in the recognition and diagnosis of oral cancers. Oral cancers do not always look scary and obvious. Check out the following pictures of various oral cancers.

They may not look scary but the facts regarding oral cancers are very scary;
- 34,000 Americans will be diagnosed with oral cancer this year.
- Of these 34,000 newly diagnosed people, 48% will be dead within five years.
- Oral cancer, unlike many other cancers, has not shown a decrease in mortality in the last 30 years.
- 25% of oral cancers occur in people with no known risk factors.
- Oral cancer occurrence is rising in young people, women, and non-smokers - those people traditionally thought of as being protected from oral cancers. This is often caused by HPV, the human papilloma virus, the same virus that causes 95% of cervical cancer.
- Oral cancer is as common as leukemia and it claims more lives than melanoma and cervical cancers.

 Several methods are available for detecting and screening for oral cancers. One method used is a "brush biopsy." These have been around for several years. It consists of a little brush that your dentist will use to scrape off some of the mucosal cells. The brush gets sent to an outside laboratory for analysis.

Another method is the Velscope. The Velscope is an early oral cancer detection device that uses a light to visualize abnormal cells. Oral cancers can be seen by the naked eye only when they are quite advanced. This is why the mortality rate of oral cancers is so high. The Velscope is an inexpensive screening tool that can be utilized to see these cellular changes early on.

The Vizlite is another device that uses light to visualize cellular changes. These methods also can detect a change in the cells below the surface of the tissue.

In the event of a positive test, all these methods would be followed up with a biopsy for definitive diagnosis.

The main purpose of these methods is to catch a cancer early on. As with any cancer, early detection is the key. All of these tests are simple, non-invasive, and inexpensive. If you have any concerns or have risk factors in your lifestyle, don't wait! Check it out. Your life could depend on it.

Now I know...

I always wondered why people had these, now I know.....
http://dentvid.com/?p=87 (watch video)

Implant Retained Dentures

People who wear complete dentures tend to lose the bone that supports the denture over years of time. The bone, especially that of the lower jaw, constantly deteriorates without natural teeth in place. This loss of bone makes it difficult for those with dentures to achieve a good fit and maintain it.


Denture wearers learn to keep their teeth in place by positioning their lip, tongue, and cheek muscles for optimal retention. Many people master these techniques for holding their teeth in place quite well, while others have issues with facial posturing and facial tension which can be undesirable.


If dentures move excessively when eating, speaking, coughing, etc., implants can be effectively used to improve denture retention.

Dental implants are most commonly used to replace missing teeth. But another excellent use of implants is in the stabilization of dentures. A couple of implants in the bone can create a button or snap to which the denture can lock. With a denture locked in place and the fear of it shifting is removed, a person can have increased confidence, better nutrition and improved facial esthetics.

When people know they have a denture that will not fall out or shift during function, the facial muscles relax, leading to an improved facial appearance. Implant retained dentures may also create fewer sore spots because the denture is additionally supported by bone, not just soft tissue.

Implants can be retrofitted into an existing denture or planned with the initial placement of a denture. If you are one of the many people for whom dentures can literally be a pain, an implant retained denture may be the answer.

Dentists warn cavities are contagious | savannahnow.com

Dentists warn cavities are contagious savannahnow.com

Whoops! Denture Blunder!

The Bite Runner

The bite or what dentists call “occlusion” refers to the way your teeth come together when you close your jaw. Ideally we want the bite to be balanced, meaning that all the back teeth touch at the same time when biting and swallowing. When touching the biting edges of your top and bottom teeth together, the back teeth should separate. When the teeth do not meet in this manner and interferences with jaw movement result, dental problems like clenching and grinding, excessive tooth wear, and temporomandibular joint (TMJ) issues can arise.

A bad bite can contribute to clenching (usually during the day, holding upper and lower teeth together forcefully) and grinding (usually while sleeping, sliding clenched teeth side to side). Most people who exhibit this behavior are completely unaware that they are doing it and if they are aware, often do not realize that this is abnormal. The daily “clenchers” with bad bites also tend to grind their teeth at night, blissfully unaware that they are causing compounding the damage to their teeth, gums, and TMJ.


The teeth of those people with bad bites tend to demonstrate some common characteristics. Typical problems visible are heavy wear facets where the teeth contact improperly, cracked or fractured teeth, cracked or fractured restorations, notching of the root surfaces (abfractions), and worn down teeth. Teeth naturally wear down with age and use, but with excessive stress teeth wear at an exaggerated rate. The teeth will exhibit “wear beyond their years.”

Gum (periodontal) problems are also exacerbated by a bad bite. Unusual forces or stresses can strain the socket like bone surrounding the teeth. With constant stress the bone breaks down and is lost. When the bone goes, the gums go with it. Over a period of time there is nothing left to support the teeth and they become loose and painful.


Bite problems can cause many TMJ issues. The main symptoms are clicking, locking open or closed, pain in the TMJ and muscles surrounding, muscle tension, and migraine or tension headaches. All these problems occur when the joint is excessively stressed which makes the muscles work harder. The muscles spasm and constrict nerves and blood supply to the sides of the head resulting in headaches.

So how do we fix a bad bite? The solution is determined by the cause of the bite problem. If the bad bite is a result of improper tooth position, braces can be an effective treatment. If the bad bite is a consequence of missing teeth, bridges, partials, dentures, and implants can be used to restore the bite. If the bite problem causes clenching and/or grinding, a bite guard would be an effective treatment to reduce damage to the teeth and TMJ.

LORD OF THE FLOSS

Flossing is an annoying little habit that is so easy to do but so hard to do regularly. Most people would not think of going without brushing twice daily but those same people typically do not floss at all. Ever. Your mother was right. You should floss your teeth every day! Picture this - if you think about the shape of a tooth as a box – you can see that brushing only touches three sides of the box, the top and two of the sides. Flossing is the only way to clean the sides of the box that touch other boxes. Flossing is the only way to clean in between your teeth. Period. You can brush perfectly and use mouthwash and special toothpaste, it doesn’t matter. You will still have plaque and bacteria between your teeth. And between the teeth is where all the problems begin.


Without flossing the gums get red and inflamed, the condition dental personnel call gingivitis. This low grade inflammation causes levels of CRP (C-reactive protein) to increase in the bloodstream. CRP is a marker for inflammation in the body. High levels of this protein are associated with increased risks of premature birth, heart disease, strokes, and most recently, Alzheimer’s disease. The higher the CRP levels, the higher the risk. Of course, gingivitis isn’t the only cause of increased CRP levels. Smoking, high blood pressure, diabetes, and infections all contribute to raising CRP levels. Flossing is just one easy way for anyone to decrease the level of inflammation in the body.

Although the above is scary, most children and teens aren’t concerned with their CRP levels. But this does not mean that flossing isn’t important for them. The bacteria between the teeth can also cause cavities. Although decay is found most commonly on the pits and fissures on the biting surfaces of the back teeth, the second most common place for decay is in between the teeth, where the teeth contact each other. This decay doesn’t hurt and isn’t visible to the eye in the initial stages. It can only be seen on xrays. Without flossing, the contact points between the teeth are never cleaned. Add a little sugar to that bacteria sitting in the tooth and you have the recipe for decay.

When flossing, the floss shouldn’t “snap” between the teeth. Most people just snap the floss between and think the job is done. There is a little more to flossing properly. Wrap floss around your fingers and while moving the floss up, down, back, and forth wipe the side of each tooth in the contact. Angle the floss so it wraps around the tooth in a “C” shape and go below the gumline. Don’t forget to wrap the “C” around the other tooth too to make sure you floss both teeth that are touching. If you have the floss positioned properly, this will not hurt. Wind the floss so a fresh piece of floss can be used for each contact. Floss behind the last tooth too, this is an area that is difficult to reach with brushing. Once you get the hang of it, flossing is easy to do, even without looking in a mirror. Flossing should be a part of your regular hygiene, just like brushing.