If you've lived for many years with crooked teeth, you may think that your teeth will be this way forever. Believe it or not, one out of every five orthodontic patients is an adult and 75% of adults have some form of malocclusion. You're never too old to improve your smile, and here a few reasons why you should consider orthodontic treatment:

• Self-Esteem: An attractive smile contributes to your confidence and self-image, and this is important at any age. Research has shown that, logically, the better you feel about your looks, the better you feel about yourself. You might not realize it, but those crooked teeth can cause you to be self-conscious, thus smiling and talking less. Studies have even demonstrated that orthodontic treatments can enhance your career opportunities.
• Longevity: Though you can always expect a certain amount of wear and tear to your teeth from aging, properly aligned teeth will function better over time. If you are prone to gum disease, your problems can worsen with poorly aligned teeth. Not only is it more difficult to clean around crooked teeth, but we often see gum recession around poorly positioned or crowded teeth.
• Options: If you choose to explore orthodontic treatment, you will see that much has changed since you were a teenager. Instead of traditional metal braces, we can sometimes use clear or colorless braces that are less noticeable. Some braces can even be attached to the back of your teeth. You may also be a candidate for clear orthodontic aligners, which use a sequence of clear, removable and custom-fitted trays to gradually straighten your teeth.

If you're considering orthodontic treatment, you should schedule an appointment with our office, so that we can conduct a thorough examination, discuss your options and recommend a course of treatment. We'll also make sure that your teeth and gums are healthy, an important requirement to successfully straighten your teeth.

If you would like more information about adult orthodontics, please contact us for a consultation. You can also learn more by reading the Dear Doctor magazine article “Orthodontics for the Older Adult.”

For years the main approach to treating tooth decay (or caries) could best be described as “drill and fill” — remove the decayed tooth material and fill the resulting cavity. But a new approach has come to prominence that addresses not only the results of decay, but seeks to identify and treat the underlying conditions that caused the decay in the first place, and may continue to infect other teeth.

This approach is known as Caries Management By Risk Assessment or CAMBRA. Rather than a “One Size Fits All” approach, CAMBRA individualizes treatment and prevention options by first assessing your own individual risk for tooth decay.

We base this assessment on what might be called the Caries Balance. On one side are factors that increase your risk of tooth decay, easily remembered by the acronym BAD: Bad bacteria that produces acid; Absence of healthy, functional saliva that neutralizes the effects of acid; and Dietary habits that are heavy with sugars, acids and between meal snacking. On the other side are protective factors that reduce your risk, known as SAFE — Saliva and sealants that protect the surfaces of teeth; Antimicrobials that help rid the mouth of bad bacteria; Fluoride, which strengthens teeth against de-mineralization caused by acid; and an Effective diet.

The assessment first involves a survey of questions about your hygiene habits, dental history and lifestyle: Do you brush twice and floss once daily? Do you live in a fluoridated area or use fluoride mouth rinse? Do you smoke? Have you had frequent cavities in the past? These and other questions, along with a complete dental exam and acid level testing, can give us a more accurate understanding of your risk and how best to incorporate treatment that reduces it even further.

Using CAMBRA, you and our dental team develop a true partnership that actually transforms your dental health from simply treating existing caries, to preventing future occurrences.

If you would like more information on the CAMBRA approach to caries prevention, 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 “Tooth Decay: How to assess your risk.”

Research has shown that periodontal (gum) disease can affect the health of your whole body. Evidence suggests a relationship between severe gum disease and cardiovascular disease (“cardio” – heart; “vascular” – blood vessel), conditions that lead to heart attacks and strokes. There is also a relationship between gum disease and pregnancy; mothers with severe gum disease have a higher incidence of pre-term delivery and low birth-weight babies. To understand gum disease, you may find the following facts helpful. How many are you aware of?

1. Periodontal disease — Any disease that affects the areas around the teeth. The word comes from the Latin “peri” meaning around and Greek “odont” meaning tooth. Periodontal disease, or gum disease as it is commonly called, is really a group of diseases with the same outcome: destruction of the periodontal tissues, loss of supporting bone and ultimately the loss of your teeth.
2. Dental plaque (Biofilms) — A bacterial film that forms on teeth at the gum line, and the reason we brush and floss. Its daily removal is necessary to keep your teeth and gums healthy. A biofilm is a biological film comprised of colonies of living organisms that are generally specific to a particular eco-system. Plaque is one type of biofilm.
3. Gingivitis (“gingiva” – gum; “itis” – inflammation) — A response of the gum tissues to plaque biofilm that is left undisturbed (due to ineffective, or inadequate oral hygiene). It is the first stage of periodontal disease.
4. Pocket formation — Just like a pocket on your clothing, pocket formation is the result of separation of the gum tissues from their normally healthy tight attachment to a tooth. Pocketing allows the introduction of bacteria, which perpetuate gum disease.
5. Abscess — A collection of pus that forms within diseased periodontal tissues. It is experienced as pain, swelling, and discharge of pus from the gum tissues and is an advanced sign of periodontal disease.

Important Tip — Bleeding Gums when brushing teeth or flossing is not normal. It is a warning sign of early gum disease that you should bring to the attention of our office.

Contact us today to schedule an appointment to discuss your questions about periodontal disease. You can also learn more by reading the Dear Doctor magazine article “Understanding Gum (Periodontal) Disease.”

The old saying, “If it ain't broke, don't fix it,” doesn't really apply when discussing your wisdom teeth. It's great if they are not bothering you, but don't wait for problems to develop before you take action. This may seem counter-intuitive, but you should know that the best time to have your wisdom teeth removed is when they are not causing problems.

Why do wisdom teeth cause problems?

Wisdom teeth are so-called because they appear at ages 17 to 25, the age of supposedly attaining wisdom. They are also known as third molars and are farthest back in your jaws. For some people they come through the gum-line only partially, or they may not erupt into the mouth at all. Unerupted they have the potential to cause problems associated with the neighboring teeth and surrounding gums.

You may have heard of “impacted” wisdom teeth. This means that they are impacted or forced against neighboring structures, teeth or bone that prevent them from coming into the mouth in correct biting position. Since they are your last teeth to come in, space for them may be severely limited. They may push into the teeth that are already in place, becoming stuck as they try to erupt. When wisdom teeth are trapped like this below the gum line and are pushing against neighboring teeth, these molars can cause problems such as infections, cysts, or gum disease.

My wisdom teeth seem OK, so why remove them?

The dilemma is that if you wait until you feel pain connected with your wisdom teeth, their neighboring teeth may already be in trouble.

Another reason to remove these back teeth before they cause problems is that it's a good idea to have your surgery while you are young. Younger, healthy patients with no infections at the site have the best chance of having their wisdom teeth extracted without complications, with an easier recovery and uneventful healing.

Of course, each situation is different. Make an appointment with us for an examination and a consultation to discuss the risks and benefits of removing your wisdom teeth. For more information read the article “Removing Wisdom Teeth” in Dear Doctor magazine.

Are you unhappy with the appearance of your smile? Do you get anxious about smiling in social settings? Have you ever wished you had teeth like your favorite celebrity? If you have answered yes to any of these questions it might be time to discuss a smile makeover with us!

During our initial meeting we will ask you exactly what look you are hoping to achieve. Open communication will help ensure ultimate success and satisfaction — you need to tell us what you want and we need to tell you what is actually possible. Then we can plan a solution that is both aesthetically pleasing and functional.

We will also decide which cosmetic materials and techniques to use; this can range from composite resins (tooth-colored fillings), porcelain veneers (thin layers of dental ceramic that are bonded to your tooth enamel) or porcelain crowns (which replace the entire external form of a tooth).

Essentially, most people seem to want one of two looks — a “perfect” Hollywood smile or a more “natural” look. For those who want a “perfect” smile, we will focus on achieving symmetry so that your smile appears perfectly balanced. We will also focus on achieving uniform and maximum tooth brightness and whiteness.

For those who want a more “natural” smile, we can enhance your smile by gently improving brightness while maintaining a more normal symmetry to each tooth shape and size. This can produce a more elegant, youthful smile, not just a Hollywood white smile. We can also maintain slight color, shape and shade variations throughout your mouth.

The best tool for testing our vision is with the use of a tool we call a “provisional restoration.” During this phase of the process we will actually create your new smile using temporary materials, allowing you to “test drive” your new look before committing to permanent materials. This way we can make sure you get exactly what you want. Once you give us the green light, these restorations will be replaced with your permanent new teeth.

Call our office today so we can get started! For more information on the importance of communication between dentist and patient during a smile makeover, read the Dear Doctor magazine article “Great Expectations: Is What You Get What You Want?”