Our SDC Magazine to stay up-to-date on oral health topics!
Maintaining good oral health care during your pregnancy is essential for the health and safety of you and your developing baby. Pregnant women may experience trouble with oral hygiene due to a number of reasons. Bleeding gums (due to hormone levels), morning sickness, and gag reflexes may cause difficulties with tooth brushing.
Because of these factors, you should be conscious of the high sugar content in some foods and ensure that good oral health habits are sustained. More research is needed, but overall many studies have concluded that there are associations between periodontitis and pre-term birth, low birthweight, and pre-eclampsia (high blood pressure which causes pregnancy complications). Fortunately, a study published in the Journal of the American Dental Association by Hagai, et al. (2015) followed 210 pregnant women who received dental local anesthesia with dental treatment. When compared to a control group of women who did not receive dental treatment during pregnancy, it was found that there was no difference in the rate of miscarriages, gestational age at delivery, or birth weight. Therefore, the results of this study and the American Dental Association support the use of preventative, diagnostic, and restorative dental treatment, as well as local anesthetics, during pregnancy.
One consideration to note is that you should time your dental appointments during the most appropriate stages in your pregnancy. Fetal organs develop during the first trimester, so it is recommended that any dental treatment should be conducted in the second trimester (weeks 14-20), when the process of making organs is fully complete, and when any nausea is usually less of an issue.
References: Pregnancy outcome after in utero exposure to local anesthetics as part of dental treatment: A prospective comparative cohort study
Systematic review https://doi-org.ezproxy.bu.edu/10.1111/cdoe.12167
It may seem better to use more “natural” remedies to whiten your teeth, but be wary of these do-it-yourself methods because they’re not always the healthiest choice. Using fruit and vinegar can wear away your enamel, the outer layer of your teeth, which demineralizes whenever the acid level in your mouth drops below a pH of 5.5. The pH level of a lemon is about 2--the same acidity as your stomach acid. The enamel that you have is the amount that you will have for life because it can never grow back, so it’s best to avoid soaking and scrubbing your teeth with acid.
Similarly, scrubbing your teeth with activated charcoal is too abrasive and will wear your enamel away. The integrity of your teeth will be compromised, susceptibility to tooth sensitivity and to cavities will be higher, and unfortunately, your teeth can end up looking more yellow. This is due to exposing the deeper, softer, and yellower tissue of your teeth after scraping the top layer of enamel away. Baking soda by nature is low-abrasive and may have antimicrobial properties, but it isn’t recommended to brush with baking soda alone because it’s also important to strengthen your enamel with fluoride (which you typically get in toothpaste). Try to look for a whitening toothpaste that has the ADA Seal of Acceptance on the packaging (there are ADA-approved toothpastes with baking soda!); this way, you know that what you’re using is not only effective in whitening but also in maintaining the strength of your teeth.
As for oil pulling or turmeric pastes, there is no reliable scientific evidence to show that these methods whiten teeth. In order to whiten your teeth safely, brush your teeth twice a day for two minutes; use a whitening toothpaste approved by the ADA; floss once a day; limit teeth-staining food and drink (e.g., coffee, red wine, tea); avoid smoking or tobacco use; and receive regular cleanings at the dental office.
Feel free to ask your dentist about any professional whitening products, which can only be done in the dental office. There are also at-home kits that are approved with the ADA Seal of Acceptance, so look for whitening products that display that seal to ensure the safety and actual whitening of your teeth if you’d like to try it yourself at home.
Stain removal and whitening by baking soda dentifrice
Fluoride is a substance that helps strengthen enamel, the outermost layer of our teeth. All water contains fluoride naturally, but oftentimes the level is below what has been found to prevent tooth decay. Because of strong scientific evidence behind the benefits and effectiveness of fluoride, cities have fluoridated their water supply to match the appropriate levels that strengthen enamel. Fluoridating public water is the most efficient method of preventing childhood dental decay, and it has been shown to prevent at least 25 percent of tooth decay for both children and adults. Adding fluoride to water is just like fortifying salt with iodine or milk with vitamin D. In fact, the CDC has stated that community water fluoridation is one of the top 10 great public health achievements of the 20th century!
Fluoride protects our teeth with both systemic and localized benefits. As teeth are developing, drinking water with fluoride helps strengthen enamel as it forms, and while we drink, fluoride coats our teeth and helps remineralize (rebuild) weakened enamel.
The levels of fluoride in our water are far, far below what would be toxic, so fluoridated water is safe. It should be noted, however, that too much ingestion of fluoride in young children can cause fluorosis, a condition that affects the appearance of teeth with faint lines or streaks. This is readily preventable by ensuring that kids younger than 3 years of age have their teeth brushed with only a smear of toothpaste; for 3- to 6-year olds, children should be brushing with a pea-sized amount of fluoridated toothpaste. Appropriate supervision is recommended so that children avoid swallowing as little toothpaste as possible.
Although enamel is the hardest tissue in our bodies, it unfortunately cannot repair itself, so it’s important for us to strengthen and retain the enamel we have! Using fluoride is a great, safe, and effective way to do so, and it’s easy to find in toothpaste and in tap water that comes right out of the sink.
There are plenty of advertisements and online bloggers boasting that they can provide quick and cheap orthodontic treatment without a single dental visit. While purchasing your own orthodontic materials or sending your own impressions from home may sound enticing and more convenient, the risk for harm is very high. It’s likely that the consequences will cost you much more than the money you would have tried to save by avoiding the dentist.
These newer companies or tutorials on YouTube will try to lure you in by saying there’s an easier way to have a more aesthetically-pleasing smile. However, fidgeting with the way your teeth fit together is not a trivial matter: teeth are organs that directly affect the quality of your speech, your ability to eat, and your confidence. Moreover, orthodontic treatment is a medical procedure, and the tissues and bone structure that hold your teeth in place require specific movements.
The ultimate problem is that these companies and bloggers simply do not have the expertise required to ensure safe and sustainable treatments: oral examinations with x-rays; appropriate treatment planning; continuous assessment of progress; and a final assessment with the means to stabilize the teeth post-treatment. All of these steps are necessary because every patient is not a one-size-fits-all case. If you choose the DIY route, no expert is there to assess your specific oral health. Proceeding to move them with undiagnosed oral health issues, let alone without a dental professional there to ensure correct and safe movements during your treatment, can yield devastating effects like permanently losing your teeth.
If you’re feeling hesitant about the cost of orthodontic treatment, know that it is possible to establish payment plans so that moving your teeth in a professional and safe manner is more accessible. Medical procedures are not where you want to cut corners. Consult a dental professional so that your teeth not only look great but are also still capable of functioning, too!
References: Burfer, D. (2017, November 10). ADA discourages DIY orthodontics through resolution. Retrieved September 29, 2018, from https://www.ada.org/en/publications/ada-news/2017-archive/november/ada-discourages-diy-orthodontics-through-resolution
You may have heard about root canals on TV, in movies, or even from a friend, and more often than not, they’re described as scary and painful dental procedures. In reality, a root canal is very similar to a long, skinny filling. Patients typically need a root canal because of an infection in the tooth’s roots, which have canals that hold the blood vessels and nerves of the tooth (the “pulp”). These pulpal infections can be caused by a variety of reasons: deep cavities, periodontal disease, a cracked tooth, and even traumatic injury to a tooth. You may experience pain, but if the pulp is necrotic (with cell and tissue death), you may not even notice that you have an infected tooth. Regardless of whether or not you can feel it, however, it’s important to treat these infections before they progress to becoming an abscess: a pocket of pus that leads to more serious infection in your jaw bone, adjacent teeth, and surrounding supporting tissues.
Root canals are a routine procedure that can be done to save your teeth. You’ll be free of infection and be able to retain the functionality of your infected tooth. First, a dentist or endodontist (root canal specialist) will carefully remove the pulp. After cleaning and disinfecting the tooth’s canals, he or she will then place a filling to seal the space and save the integrity of your tooth. The tooth’s pulp is very important during its growth and development, but once it’s fully matured, it receives nourishment from the supporting tissues. This is why your tooth will be able to function normally once the root canal procedure is complete.
Perhaps you’re wondering if you can just get your infected tooth pulled instead of undergoing a root canal. While that is an option (especially if it is unable to be saved, and you need a dental implant or bridge to restore the tooth), an extraction alone cannot be a permanent solution. Over time, a missing tooth will lead to other issues. Teeth have receptors that allow it to sense pressure when you bite down, which help teeth stay in place in their bone sockets. The tooth that normally contacts your missing tooth will supraerupt (extend out of its normal place in the bone) if it doesn’t have that opposing force anymore. Additionally, the teeth that normally sit adjacent to this missing space can also shift, affecting your bite and your smile. If your dentist says that your case can be treated with root canal, proceeding with this routine treatment is a way for you to get rid of your infection safely and to save your natural tooth--without negatively affecting the rest of your teeth.
When permanent molars (the larger teeth in the back of our mouths) develop, they form pits and fissures that are visible on the tooth’s chewing surfaces. Some of these pits and fissures fuse together, but others naturally stay unfused (or non-coalesced)--leaving openings so tiny that it’s impossible for us to clean the food and bacteria trapped in the full depths of these fissures. The bristles of our toothbrushes are too wide to fit through these areas, which is why cavities can form easily in the deepest part of these pits and fissures. Thankfully, with dental sealants, we can seal off the openings of these spaces before bacteria can decay our teeth from within. Typically, sealants are a liquid placed on top of the chewing surfaces of molars, which are then set in place by chemical or light activation.
First, the chewing surfaces will be prepared to ensure that the sealants adhere properly to the tooth. Sealant flows easily and will be placed only in the pit and fissure grooves of your molars. Once every open crevice is covered, the chemical or light activation will harden the sealants, protecting and sealing these spaces closed.
Children are typically recommended for sealants so that we can prevent bacteria and food from getting trapped inside these deep fissures in the first place. The first permanent molars typically erupt in the mouth at age 6, so it’s best to protect and seal off these spaces as early as possible. Adults may also be recommended for sealants if they have never had sealants placed before.
When it comes to preventing and stopping existing pit and fissure cavities, evidence has shown that sealants are an effective treatment when compared to children and adolescents who do not have sealants or who simply use fluoride varnish. Additionally, sealants have shown the ability to arrest non-cavitated lesions in the teeth (the initial stages of a cavity that have not yet broken through the surface of the tooth).