Monday, September 28, 2009

Tongue Studs & Lip Rings

Oral piercings are becoming more and more popular with young adults and teenagers. They're a fashion statement and they're very distinctive! Are you thinking of getting one? It's important to consider the risks and benefits. The benefits are they look cool and unique!

Now, familiarize yourself with the risks (and how to avoid potential problems):

First, for the person who's going to be doing the piercing: How do they clean their instruments? Are they autoclaved, and cleaned with a disinfectant (glutaraldehyde)? Are they wearing masks and gloves? Are sterile needles used? What is there plan in case of an emergency during the procedure?

Second, know the complications and possible adverse effects of the piercing procedure: Pain (duhh!), swelling (tongue swelling may require anti-inflammatory agents to control, to prevent your airway from being blocked), prolonged bleeding (if a blood vessel is cut), nerve damage, high risk of infection (mouths are filled with germs!) and a risk of endocarditis in people with certain heart problems.

Third, keep in mind that the stud or ring itself can produce adverse effects and possible trauma: An increase in saliva, difficulty in pronouncing words, aspiration (breathing the stud/ring into your lungs if it comes loose), chipping teeth and gingival recession (where the gums pull away from your teeth). According to a review of the research literature, 'Jewelry-related complications mainly consisted of tooth fractures and wear (14%-41%) and gingival recessions (19%-68%).' Also, the stud or ring itself will become a haven for bacterial plaque, so keep it clean (remove and wash it with soap whenever you brush and floss your teeth!).

Check out these links if you’d like more information about tongue and lip piercings, and their possible side-effects:

Oral Piercings
Oral Piercing and Health
Tongue Piercing - Case Report and Review of Current Practice

Thursday, September 24, 2009

Sports Drinks and Teeth

When I was in grade-school, every student knew in their mind that they could instantly be turned from a mediocre kid in gym class, to a professional athlete, simply by consuming a sports drink like Gatorade, PowerAde, or the carbonated drink All-Sport. They were delicious, thirst-quenching, gave us energy, and the pros drank them so they must be amazing!

Today, the number of these sports-drinks on the market are astounding! Gatorade itself has several different beverage products (Gatorade G, No Excuses, Shine On, Be Tough, Bring It, Focus, G2). There are also 'sports waters' including Gatorade's Propel Fitness Water!

Why am I bringing these up? Because the one thing they have in common is they contain sugar (sucrose and glucose-fructose). While you or your kids are fighting off your thirst with these drinks, the sugar is soaking into the teeth (figuratively speaking). Because you're exercising, there's decreased salivary flow in your mouth, meaning the sugar isn't naturally washed off your teeth as well (or as quickly) as it would if you were at rest. This allows the bacteria and germs to take over and start the early processes of tooth decay (metabolizing the sugar and producing acids on the tooth surface). What's worse, is these beverages (like most soft-drinks) are acidic, which promotes an even more suitable environment for the germs to thrive!

Now, I enjoy these beverages, and I think many athletes would agree that they help to keep their energy levels high during sporting events. What I am suggesting to you, the parent or athlete, is to take measures to prevent the progression of tooth decay processes.

One suggestion is to have a separate bottle of water that you can use during a sports event to rinse with after consuming the sports drink. Glug-glug (sports drink), glug-glug or rinse-rinse (water). This will help flush excess sugar off your teeth. Another suggestion is to rinse out your mouth after the sporting event with a antiseptic mouthwash (rinsing for at least 30 seconds). This will help remove the excess sugar, and kill many of the germs on the tooth surfaces. Of course, before bed at night, go through your regular routine of brushing your teeth gently for two minutes, followed by flossing all of your teeth.

Check out these two research articles (one, and two) discussing how exposure to soft-drinks (such as sports drinks and colas) roughens up the surface enamel of teeth. Yikes!

Wednesday, September 23, 2009

Help! My Kid's Tooth Got Knocked Out!

What happens if your child's adult tooth gets knocked out in an injury? This situation is no fun for anyone. Your poor son or daughter is going to be upset and in pain, and if you haven't read this article in time, you might not know what to do.

Thankfully, the answer is straightforward: Get that tooth back in your child's mouth NOW!

If you're able to place your child's tooth back into the tooth socket within 5 minutes of the injury, there's a much higher chance that the tooth will heal itself back in place. By 30 minutes of the tooth being out, there's no ability for the tooth to recover. If you can help it, do NOT touch the root of the tooth, as you can damage the ligament cells that act to hold the tooth in place. If the tooth has landed in dirt or sand, pick it up by the crown and gently rinse it of loose debris before putting it back in the socket.

After you've placed the tooth back, make an 'emergency appointment' with your dentist to evaluate the situation, as they may want to temporarily bond the tooth to the adjacent teeth to promote stability during the healing process (for a couple of weeks).

This is just a 'nuts and bolts' discussion I'm presenting. If you'd like more information on the topic, please visit the website listed below that has resources for you to download to learn more about teeth injuries and what to do when they occur!

The Knocked-Out Permanent Tooth: Information for the patients/parents/caregivers

Sports Dentistry

I was fortunate enough today to hear a seminar on dental injuries from an area dentist who is a member of the Academy of Sports Dentistry. I learned many surprising facts that I wanted to pass on to you!

Did you know that 1 in 3 boys and 1 in 4 girls will sustain some kind of tooth or dental related injury before they turn 18? 90% of these injuries are chipped teeth, and 80% involve the two upper front teeth (the maxillary central incisors).

Even more surprising is the sports that cause the most injuries. You may be surprised to learn that 40% of all sports injuries are from either.... basketball or baseball! I'm sure you were thinking either hockey or football right? Well, kids playing these sports are required to wear helmets and face-masks, which provide excellent protection.

Recommendation: If your child enjoys playing sports, I advise you to have a custom mouthguard made by your dentist in order to protect your kid's teeth. Ask your dentist about mouthguards before your child starts playing on the team!

Learn more about Sports Dentistry at

Tuesday, September 22, 2009

Favorite Toothpaste

Two of my favorite and most popular brands of toothpaste today include Crest Pro-Health and Colgate Total. Both are accepted by the American Dental Association.

Crest Pro-Health includes the active ingredients stannous fluoride and sodium hexametaphosphate. The stannous fluoride protects against gingivitis, plaque, cavities and tooth sensitivity. The sodium hexametaphosphate fights stain and tartar build-up. It is advertised as the most comprehensive protection for your teeth.

The other product, Colgate Total, in addition to having the ADA approval, it is also approved by the Food and Drug Administration (in its effect to fight gingivitis). The proven effects of Colgate Total last for up to 12 hours after you brush your teeth (even after eating and drinking). Along with fluoride, this toothpaste has another active ingredients called triclosan (an antibacterial chemical). Linked with a copolymer, triclosan is able to attach to teeth, providing the 12 hour protection.

Obviously, there is a lot of scientific research going into the development of these products.
Two recent studies include this one for Colgate Total, and this one for Crest Pro-Health.

What it comes down to for each person is a matter of taste. I for one enjoy Colgate Total's taste and texture, whereas I find Crest Pro-Health to have a gritty feeling on my teeth when I brush (although the flavor is very pleasant).

I haven't discussed proper brushing technique yet, however for now just remember to brush your teeth at least twice a day (once after breakfast, and once before bed). Use a fluoride-containing toothpaste, and consider giving one of the two listed above a try!

Monday, September 21, 2009


Imagine no longer having any surprises at the dentist about cavities hiding between teeth. If there's one thing that you can be doing to improve your oral hygiene (reduce cavities, gum disease and bad breath), without having to spend a lot of money or invest a lot of time into, it's flossing your teeth.

I have patients who tell me "Doctor, my gums bleed when I brush my teeth!" and "I get sensitive feelings between my teeth!" When I ask them about their flossing habits, they often say the same thing, "Oh I only floss when I get something caught in my teeth," or "The last time I flossed? Ummm, I think you did it!"

No one seems to like to floss!

Listen closely folks... Want to keep your teeth in your mouth nice and healthy? Go out, buy yourself some floss (whether it's Oral B Satin, or Crest's Glide, or any other brand that looks appealing to you), and start flossing your teeth ONCE A DAY! Here's how:

  1. Take a strip of floss in your hands, and wind it around your middle fingers.
  2. Slide the floss between your teeth gently, and guide it between your teeth and the gums.
  3. 'Hug the tooth,' with the floss and make several up-and-down strokes. Then, move the floss to hug the tooth on the other side for several up-and-down strokes.
  4. Remove the floss, and move on to the next interproximal area (ie. the area between two teeth).
If you're new to flossing, it may be necessary to do this in the bathroom in front of a mirror. If you're relatively comfortable with flossing, I have an even better tip for you: Keep some floss near your television set, and floss at night while watching TV! You're sitting there doing nothing while watching your favorite show, so you may as well floss! This will make flossing much less of a tedious habit, and more of an enjoyable activity.

Also, if you're new to flossing or haven't flossed in many days, don't be alarmed if your gums bleed a bit. The reason for the bleeding is your gums are inflamed. This is called 'gingivitis.' The gums are inflamed from having bacteria/germs built up in these areas (which happens within minutes/hours of eating without properly cleaning your teeth). After flossing once a day for a few days, you should notice this bleeding goes away (as the inflammation of the gums goes away). If bleeding is profuse, or it doesn't go away after a week of careful flossing, contact your dentist.

Sunday, September 20, 2009

Baby's First Visit to the Dentist!

Having a baby in the house can be pretty hectic, exciting and all-consuming! Late night feedings, diaper changes, vaccinations.... the list goes on and on! As time flies by, many new parents want to know when they should first bring their baby to the dentist.

The rule of thumb is to bring the baby in within 6 months of the first tooth erupting in the mouth, or by age 1.

This first appointment serves a few important functions:
  1. Teaching the parent(s) the proper way to care for the baby's newly erupting teeth,
  2. Allowing the dentist to evaluate the baby's mouth to insure proper development and health
  3. Providing mom/dad an opportunity to address any questions/issues they have with baby's mouth,
  4. Makes the crucial first step in introducing a young person to the dental environment.
The dentist will often do a 'lap exam,' looking into the baby's mouth while the baby is held by mom or dad. You can be certain your baby will be comfortable at the appointment, since you'll be right there for the exam!

Another question is what type of dentist is suitable to look after your baby's dental health. There is a sub-specialty of dentistry known as pediatric dentistry, where pedodontists treat only people from birth to late teens. They have the most training, experience and education when it comes to children, however your family dentist may also be equally qualified (especially a general dentist with many years of experience). Ask your family dentist and see who they would recommend to see.

The American Academy of Pediatric Dentistry is an excellent resource to assist parents in finding a local pediatric dentist.

Chewing Gum

Why kick things off discussing something only kids like you ask? Well as it turns out, chewing gum isn't just for kids. It's marketed to adults as well, and it's incredibly popular. I often have patients tell me they chew gum all the time, and even I for one, chew at least one piece of gum everyday. I find it helps lower my stress level and I like the taste!

With all of their fancy colors, who isn't mesmerized by the gum-ball machine in the grocery store? For just a quarter, you get a huge gum-ball that even Tiger Woods might confuse for a golf ball!

The problem with these gum-balls, is they're pure sugar. Chewing them allows the sugar to remain in your mouth, where bacteria have a field-day digesting the stuff (and rotting your teeth in the process!!!).
Sugar + Bacteria + Your mouth ----> Cavities!

What are some healthy alternatives? Well, believe it or not, the American Dental Association has placed their seal of acceptance on certain chewing gums! The one common feature is they're all sugar-free (instead getting their taste from sugar substitutes):

Wrigley's Extra Sugarfree Gum
Wrigley's Orbit Sugarfree Gum
Dentyne Ice Sugarless Gum
Stride Sugarless Gum
Trident Sugarless Gum

Studies have shown that chewing sugarless gum increases salivary flow in your mouth, which reduces the amount of acids produced by germs! These acids are responsible for breaking down your teeth (causing decay). Check out the literature (here's one example article):
Sugar Substitutes, Chewing Gum and Dental Caries

It's important to remember that chewing gum (even sugar-free) is no substitute for proper brushing and flossing (which will be discussed in a future post!).

Still, if you're feeling the need to chew... you may as well chew something that promotes a healthy mouth. When your mouth is healthy, it puts a smile on your face!

Oral Health Overview

Hi Everyone,

If there's one thing I've learned as a general dentist in a hospital setting, it's that even in America (a land of abundance), many people suffer from poor oral health (cavities, and periodontal disease for starters) .

This blog is meant to give tips from my personal professional experience, so that you can improve your oral hygiene, and hopefully improve your life. It is not meant to replace the advice given by your physician, or your family dentist, and nothing I write is expressly approved by the American Dental Association. I'm simply writing from my own experience. Also, I am not sponsored by any dental product companies, so I'm free to discuss them all!

Topics may range from home dental care, oral hygiene instruction, description of common dental procedures to the review of products I commonly use and recommend.

Occasionally, I'll write about topics not related to oral health, but to general health and healthy living. Who knows, I may throw in a movie review or discuss an important issue of the day, just to keep things fresh and fun!

If anyone has suggestions for topics or improvements, please don't hesitate to send me an email: