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Dr.A's DENTAL DIET



Thursday, September 20, 2007

What Can You Tell Me About Ultrasonic Scalers For Cleaning Teeth?

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The answers given by Dr.A are intended as non-professional advice, for entertainment only if you will. Please do consult with your dentist of record or your physician before making any decision regarding your dental or medical health.



Q. My dental hygienist used something called an ultrasonic water jet while cleaning my teeth. Is this something I could use at home? I don't think they've ever used that technology on me before. She said it's a technology that's been around since the seventies. What is the history of this technology?

Dr.A Ultrasonic scalers were first proposed for cleaning calculus off teeth in 1955, and later became an acceptable alternative to hand cleaning instruments in 1960. They became widely used in the 70's and 80's for removing plaque (sticky food debris) and calculus (hard mineralized debris) supra-gingivally (above the gums).

They work by way of vibrational energy as the tiny tip oscillates (vibrates) rapidly helping to break apart the tough mineralized calculus. The tip also sprays a jet of water which aids in flushing away debris and helps in keeping the tooth cool. This is especially important since extreme heat applied to a single tooth could cause damage to the nerve.

Ultrasonic scalers are especially useful for patients with severe buildup of calculus on their teeth. However, there are many debates about whether ultrasonic scalers can completely replace hand instruments. Many argue that hand instruments are better at removing smaller pieces of calculus under the gums and can leave the tooth surface much smoother than ultrasonics can. Currently, many dental offices use both. The hygienist usually uses the ultrasonic first, then follows with a more detailed cleaning with hand instruments.

Care must be taken if certain areas of teeth have incomplete formation of enamel, as the vibrational energy of the ultrasonic scalers could cause damage to the underlying dentin layer.

Ultrasonic scalers can be operated by certified dental hygiensits and dentists only. So as you can imagine, there aren't any home versions of the systems, at least that I am aware of.




The answers given by Dr.A are intended as non-professional advice, for entertainment only if you will. Please do consult with your dentist of record or your physician before making any decision regarding your dental or medical health.




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What Causes My Incomplete Formation of Enamel?

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The answers given by Dr.A are intended as non-professional advice, for entertainment only if you will. Please do consult with your dentist of record or your physician before making any decision regarding your dental or medical health.



Q. For some reason I've never had a complete coating of enamel on the backs of my teeth. Is this common? What, beyond genetics, causes this incomplete formation of enamel?

Dr.A Incomplete formation of enamel (the outermost, hardest layer of your tooth) can have many causes. The most common causes are usually trauma, or serious infections and disease conditions during the development of the teeth in children. This can cause either the development of softer enamel, or hard enamel that is low in quantity. Any incomplete formation of enamel can be termed Enamel Dysplasia.

Amelgenesis Imperfecta is a genetic condition caused by the malfunctioning of one or more of the protiens found in enamel such as ameloblastin or enamlin. Patients with this condition tend to have smaller, malformed, pitted teeth, with shades of yellow or green. The teeth tend to be sensitive, and commonly exhibit cavities.

What is interesting about your condition is that the lack of enamel is focused on the backs of your teeth. This is a key feature of conditions where patients tend to vomit on a regular basis; bullemia is one example. As the acidic contents of the stomach pass through the oral cavity the backs of the teeth tend to be directly involved. The high acidity breaks down the enamel layer over time. This leaves the teeth with exposed dentin on the back and edges, and hence, more sensitive to pain and staining.

I say "interesting" because you say that you have always lacked complete enamel on the backs of your teeth. I am not aware of a genetic condition where enamel formation is hindered to only that area, on multiple teeth! It is possible to have a single point of enamel hypomaturation on a single tooth, usually characterized by a white chalky spot and caused by trauma to that tooth during development. But to say that the same surfaces on all your teeth exhibit this condition since you were a child is unheard of, by myself at least, unless you have been vomiting on a regular basis since you were a child!

You should definitely discuss this observation with your dentist of record. She or he might recommend flouride treatment, and should try to investigate the cause of your enamel malformation.




The answers given by Dr.A are intended as non-professional advice, for entertainment only if you will. Please do consult with your dentist of record or your physician before making any decision regarding your dental or medical health.




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Dr.A's Dental Diet: 5 Simple Rules for Healthy Teeth, Body & Mind

by Dr.A
dradental.com




DR.A's DENTAL DIET

Introduction


Most people forget that teeth are body parts too! So it is not surprising to learn that recently many studies have shown a link between oral disease and other maladies, including heart disease, systemic bacterial infections, and even certain types of cancer.

So my goal with Dr.A's Dental Diet is not to introduce a ground shaking new overly-hyped diet plan, but to instill common sense when you are planning your next meal. Your teeth, body and mind are intertwined. Taking care of your teeth helps in keeping your body in healthy shape and your mind sharp.

While I will be updating my site with various tips and commentary, here are 5 simple rules that you must follow to adhere to my diet plan:


1. Balance
Whether it is carbs, protiens, fats, exercise, sleeping, or even drinking alcohol, balancing them all during the day is key.

2. Prevent
Brush, floss, rinse, visit your dentist, keep up with your cleaning visits. This is important in preventing cavities and oral problems. And if you do have a simple small cavity, so what? fill it and move on. Don't dwell on it, and be too scared to do anything about it, or let the finances get in the way. Remember, a small cavity will keep growing, so will the dental bill.

There are many different types of dental oral rinses, not just the ones that burn! I will show you how to maximize the benefits of your morning rinses, and also point out those soothing moisturizing rinses before bedtime. Don't forget water! Rinse while you eat or right after a meal with water to dislodge food debris, or right after drinking coffee or tea to help reduce teeth staining.

3. Exercise
Sports, work, hobbies, even shopping, yes shopping, what ever gets you out of the house and your comfy chair and makes you walk, run, and sweat. Muscle mass improves your metabolism and blood flow, and in turn helps burn fat. Improved blood flow also helps keep your gums healthy.

4. Relax
Make time for your self. Whether it is sleeping, reading, talking on the phone with a friend, playing video games, or visiting my website, make time for quiet relaxing activities to give your body and mind the opportunity to recharge for another hectic day.

5. Cheat
Yes, you heard that right, you are allowed to cheat on this diet plan! I can show you how to sneak in a couple of deserts and sweat snacks a day and still keep those pounds off, and maintain a healthy white smile. It is better to cheat in front of my diet plan, than to cheat behind it's back!


So stay tuned, and check back often to read my latest tips and commentary on how best to take care of your teeth, your body, and mind.




Dr.A's Dental Diet
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Why is Milk Good for My Teeth When it is High in Sugar?

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The answers given by Dr.A are intended as non-professional advice, for entertainment only if you will. Please do consult with your dentist of record or your physician before making any decision regarding your dental or medical health.



Q. Why is milk good for my teeth when it is high in sugar?

A. Milk is in fact good for your teeth, especially for children. The reason is that milk contains calcium which is needed for building stronger enamel (the outer layer of your tooth), and is low in acidity. In some studies it has been found that cheese and milk can not only protect your enamel from degradation caused by high acidic foods, but can also reverse that damage.

However, it is true, milk is high in simple sugars. A single serving of milk usually contains anywhere from 9 to 14 grams of sugar. That is why whenever it comes to your health, moderation is key. Drink too much milk and the high sugar can cause damage, especially if your oral hygiene habits are poor.

That is why I would rather see adults drink a little less milk, and instead, eat more cheese. Cheese, again in moderation (it does have a moderate amount of fat after all!), is one of the best foods for your oral health. It is High in calcium and Vitamin D, and low in acidity. During chewing, cheese can also be beneficial as food debris remaining on your teeth sticks to it pretty well.



The answers given by Dr.A are intended as non-professional advice, for entertainment only if you will. Please do consult with your dentist of record or your physician before making any decision regarding your dental or medical health.




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Dr.A's Dental Diet

by Dr.A
dradental.com



Dr.A's Dental Diet is the idea of maintaining a beautiful smile through nutritional food habits that are also beneficial for the optimal health of your body and mind. The Dental Diet will be a regular feature of the Dental Journal.

Dr.A's Dental Diet will feature tips and commentary on how to best keep your mind, your body, and your teeth (they're part of your body too!), in optimal health.



1. Introducton: 5 Simple Rules

2. Cranberry Juice and Your Teeth

3. Tips to Lower Tooth Staining by Common Drinks






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What's Longer Lasting Silver or White Fillings?

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The answers given by Dr.A are intended as non-professional advice, for entertainment only if you will. Please do consult with your dentist of record or your physician before making any decision regarding your dental or medical health.



Q. What's longer lasting silver or white fillings?

A. I don't see many patients asking for amalgam (or silver fillings as most patients call them) fillings these days. The last time I restorted a tooth with amalgam was in dental school!

Amalgam has seen its fair share of contraversy in the media, as some studies have shown some long lasting health effects on patients, while many others have shown no relevant issues.

Many studies have shown that amalgam fillings, especially when used in posterior teeth (your back teeth; molars and premolars), have a lower rate of failure than composites (white fillings). Most of these studies investigated the frequency of failure over a few years on teeth requiring large multi-surface fillings. Each tooth has 4 surfaces; Lingual (tongue side), Facial or Buccal (cheek side), Mesial (side facing the front of your mouth), Distal (side facing the back of your mouth).

One aspect of your decision must weigh on how your smile looks. Many patients ask me to replace their many amalgam fillings on their lower teeth because they are tired of their "silvery smile".

Another issue is fracture rate. A recent study has shown that compared to all materials used in dentistry, premolars (teeth before your molars) with large 3-surface amalgam fillings had the lowest fracture strength. While historically, research and practice have shown that large amalgam fillings do better than composites, what I do think is just as important is the strength of the tooth itself. Composites do a better job of holding your tooth together since they are acutally bonded to your tooth structure, where as amalgams are simply placed and compacted into the cavity to be held mainly by mechanical means.

While I personally have not taken data from my patients, I must say that I treat many patients who have fractured their teeth restored with large amalgam fillings.

So as you can see, there are many variables to discuss with your dentist before making a decision, but generally, amalgam fillings are less likely to need replacement when than composite resins, and fracture less, but teeth in need of large fillings have a higher chance of fracturing if restored with amaglam.

In fact, the very same study showed that percelain ceramic resorations protected the teeth against fracture the best. If your tooth needs a large restoration then you may want to discuss full coverage percelain crowns, onlays, or inlays with your dentist. You may even consider gold, as it still remains one of the best materials to be placed in your mouth.



The answers given by Dr.A are intended as non-professional advice, for entertainment only if you will. Please do consult with your dentist of record or your physician before making any decision regarding your dental or medical health.




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Why Should I Get A Filling If My Tooth Doesn't Hurt?

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The answers given by Dr.A are intended as non-professional advice, for entertainment only if you will. Please do consult with your dentist of record or your physician before making any decision regarding your dental or medical health.



Q. Why Should I Get A Filling If My Tooth Doesn't Hurt?

A. I am assuming that your dentist has found a relatively small cavity in your tooth.

If you are feeling pain due to a cavity then the infection in your tooth has already broke through the enamel (the outer hard layer of your tooth) and made its way into the softer more sensitive layer, the dentin.

The dentinal layer has a larger amount of nerve and vascular tissue than does enamel. Basically, your tooth could have a long standing cavity in your enamel layer, but you might not know about it due to the relative lack of nerve tissue.

Why would you wait until the infection has made its way into the deeper layers of your teeth before doing something about it? That is the point of visiting your dentist on a regular basis; to find problems when they are still small.

At least you're not in pain. I treat many patients who put up with a "little" toothache for months before succumbing to it. If you wait too long, and "deal" with the pain of an infection that has made its way into the dentinal layer, then the next layer is the nerve, and at that point a root canal is indicated. Save your self some pain, and money, and get those non-painful small cavities filled.



The answers given by Dr.A are intended as non-professional advice, for entertainment only if you will. Please do consult with your dentist of record or your physician before making any decision regarding your dental or medical health.




DrADental.com
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Do Anxious Dental Patients Really Need Oral Sedation?

by Hisham S. Ayoub, DMD
DrADental.com



"Did I really Have a Root Canal?" was the title of the article that ran in Tuesday's (June 19th) edition of the Wall Street Journal. It is a remark made by a dental patient who underwent a root canal treatment under oral sedation.

More and more patients these days are asking for oral sedation as a way of circumventing their anxiety during dental treatment, and dentists are happily obliging. Why? Well, some dentists charge as much as $800 for the oral sedation in addition to the treatment, and usually that is not covered by insurance companies.

I personally think that the majority of anxious dental patients out there do not need oral sedation, which is typically the insomina drug Halcion (Triazolam) used by dentists as an "off label". Halcion is made by Pfizer.

What Halcion does is place the patient in a sedated state of mind which typically includes mild amnesia, helping the patient forget most of the treatment. The patient is usually prescribed a dosage the night before, and another in the morning right before the treatment. A designated driver must be at hand at the end of the procedure as the effects can last several hours.

But Nitrous Oxide, better known as laughing gas, can be just fine in allevaiting anxiety. It can be less of a concern in terms of overdosing and side effects, and does not last as long. Patients usually need no more than 10-15 minutes following the procedure to be fully recovered. Nitrous Oxide is also covered by insurance in most cases.

People do not like dentists. I know; my own wife is, as Kramer from Seinfeld termed it, an anti-dentite. Yet, usually with a slow and comforting treatment environment she does not even need nitrous, let alone oral sedation. Now, of course, I am not sure if that would be the case if another dentist is treating her, but my point is there are methods of circumventing a patient's anxiety levels without the use of pills and oral drugs.

Most of the anxiety and fear that patients feel towards the dentist in their adult years is usually the cause of a fearful event early in their childhood, and is usually precipitated by their parents.

I am not saying that dentists did not have a role either. Some dentists do need to pay extra attention to the comfort needs of their patients, but more and more of the younger dentists these days are properly trained and honestly concerned about the comfort of their patients. An unhappy patient, no matter how unwarranted, is a non-returning patient.

But I do feel that parents can and should aid in the comfort of their children with their early dental needs. I remmember a mother who brought in her 4 kids to the clinic. Her eldest son, in his mid-teens, had a pretty deep cavity on one of his teeth and did need a root canal. His attitude and his eyes clearly stated the obvious; he was not looking forward to any treatment.

After he was locally anesthetized, which in itself took a lot of patient comforting, his eyes began to tear, and ask a lot of questions, a common tactic by younger patients to delay the work.

Now, his mother never explained that he usually needs nitrous oxide, nor did she warn me about his extreme anxiety, and as I turned on my dental drill, and having heard the noise, he gives out a loud yell of surprise. His mother starts yelling out loud from the patient waiting room. I walk over to her and she begans to shoot questions at me hysterically; "what's going on?", "why is he crying?", "I just came over for an exam, and you talked me into a root canal?, "I don't even know what's going on?" and on and on...

I spent the better of 20 minutes trying to calm the mother down knowing that it is now too late for her boy, he has heard everything and is now even more hysterical just like his mother. I wasn't even going to try the Nitrous on him. I promptly referred her to a local pedodontist.

Talking to her I learned that she was terrified of the dentist, and that her parents and herself, did not have great teeth and hated to go to the dentist. This is typical of anxious dental patients who sometimes do not know why they are scared, rather they know that their parents, their siblings, or friends had a horrible experience and did not want to go through the same. What worries me the most of this experience is the fear and anxiety instilled in her other three younger children who have now witnessed their older brother's, and mother's dental fear.

While some patients with extreme fear and phobia do need oral sedation, I firmly believe that with proper comfort, Nitrous Oxide, and a good warning in advance of possible anxiety should be more than adequate for most fearful adult patients.

As for the young patients whose dental experience is just beginning, parents please, do your kids' a favor and try your best not to motivate further fear in them. Your dentist is on your side in making sure your children have the very best experience possible.



This article represents Dr.Ayoub's opinion only and should not be considered as medical nor dental advice. Please seek the advice of your local dentist or visit the American Dental Association (www.ada.org) for further information.




Dr.A's Dental Journal________________

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About Dr. A's Dental Journal

111 North Pine Island Rd
suite 101
Plantation, Florida
(954) 473-6500







Dr.Hisham S. Ayoub, DMD (Dr.A) is a general dentist practicing in south florida. He grew up in Toronto, Canada, recieved his B.Sc. of Science in Human Biology from the University of Toronto, and completed his Doctorate of Medical Dentistry degree from Nova Southeastern University in Fort Lauderdale.

Dr.A has always been interested in reading and writing about the very latest in science and medicine. His love for journalism and his keen interest in the latest research motivated the publication of Dr.A's Dental Journal, which will serve as a regular journal and resource for dental patients.

Dr.A's The Dental Diet is the idea of maintaining a beautiful smile through nutritional food habits that are also beneficial for the optimal health of your body and mind. The Dental Diet will be a regular feature of the Dental Journal.


Membership:
American Academy of the History of Dentistry
Florida Dental Association
American Dental Association

Certification:
BOTOX treatment by the Esthetic Skin Institute
laser dentistry by the Academy of Laser Dentistry



Have a Dental Question? Ask Dr.A

The answers given by Dr.A are intended as non-professional advice, for entertainment only if you will. Please do consult with your dentist of record or your physician before making any decision regarding your dental or medical health.


To Ask Dr. A a question, please visit his DoctorBook profile , then click on ASK DOCTOR A QUESTION. Some of the answers will be republished on DrADental.com.


Dr.A will do his best to answer your questions in order. Please allow a few days for an answer. By emailing your question you are giving Dr.A permission to publish it on the site. No personal information, including email address, will be made public. Dr.A will email you once the answer is posted.



Ask Dr.A archives:
(latest on top)


Why Do My Teeth Have Thin Enamel, and What Can I Do About It?

How Can I Reverse Teeth Erosion from Bulemia and Drug Use?

Does It Matter Where A Dentist Graduated From?

Can Food Debris Hide a Tooth Cavity on X-rays?

What Can You Tell Me About Ultrasonic Scalers For Cleaning Teeth?

What Causes My Incomplete Formation of Enamel?

Why is milk good for my teeth if it is high in sugar?

What's longer lasting silver or white fillings?

Why should I get a filling if my tooth doesn't hurt?





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