My Blog
By Jeffrey J. Kraig, DDS, SC
July 18, 2021
Category: Oral Health
Tags: tooth decay  
CraftaCustomCarePlanbyIdentifyingYourIndividualRiskforToothDecay

Although we've known for some time how tooth decay forms, it's still prevalent across the population—even more so than cancer or heart disease. Along with gum disease, it's a leading cause of tooth loss.

Fortunately, our knowledge about tooth decay has grown considerably, to the point that we now recognize a number of risk factors that make it more likely a person will develop this disease. By first identifying them in individual patients, we can take steps to address them specifically to reduce the chances of this destructive disease.

Genetics. Researchers have identified around 40 to 50 genes that can influence cavity development. The best way to assess your genetic risk is through family history—if numerous close family members contend with tooth decay, your risk may be high. If so, it's important to be extra vigilant with addressing other areas over which you have more control.

Saliva. Cavities are directly caused by oral acid, a byproduct of bacteria, that can erode tooth enamel over prolonged contact. This is minimized, though, through a normal saliva flow that neutralizes acid and helps remineralize enamel. But poor saliva production can slow acid neutralization. You can improve your saliva flow by drinking more water, changing medications or using saliva-boosting products.

Oral hygiene. You can reduce bacteria (and thus acid) by removing their "room and board"—dental plaque. This accumulating film of food particles harbors the bacteria that feed on it. Daily brushing and flossing, accompanied by regular dental cleanings, effectively removes dental plaque, which in turn lowers the levels of oral bacteria and acid.

Dental-friendly diet. Even if you diligently address the previous risk factors, your diet may fight against your efforts. Diets high in processed and refined foods, especially sugar, provide abundant food sources for bacteria. On the other hand, a diet primarily of whole foods rich in vitamins (especially D) and minerals like calcium and phosphorous strengthen teeth against decay.

Preventing tooth decay isn't a "one-size-fits-all" approach. By identifying your own particular risk, we can craft a care strategy that can be your best defense against this destructive dental disease.

If you would like more information on tooth decay, please contact us or schedule an appointment for a consultation.

By Jeffrey J. Kraig, DDS, SC
July 08, 2021
Category: Oral Health
Tags: oral hygiene  
ManagingOralHealthIsanImportantPriorityforHIV-AIDPatients

Forty years have passed since the first reported case of Acquired Immune Deficiency Syndrome (AIDS), and it and the human immunodeficiency virus (HIV) that causes it are still with us. About 1.2 million Americans are currently infected with HIV, with 50,000 new cases diagnosed each year.

The emergence of antiretroviral drugs, though, has made it possible for many with HIV to live normal lives. Even so, the virus can still have a profound effect on health, including the teeth and gums. Because of its effect on the immune system, HIV+ patients are at greater risk for a number of oral conditions, like a fungal infection called candidiasis ("thrush").

Another common problem is chronic dry mouth (xerostomia), caused by a lack of saliva production. Not only does this create an unpleasant mouth feel, but the absence of saliva also increases the risk for tooth decay and periodontal (gum) disease.

The latter can be a serious malady among HIV patients, particularly a severe form of gum disease known as Necrotizing Ulcerative Periodontitis (NUP). With NUP, the gums develop ulcerations and an unpleasant odor arising from dead gum tissue.

Besides plaque removal (a regular part of gum disease treatment), NUP may also require antibiotics, antibacterial mouthrinses and pain management. NUP may also be a sign that the immune system has taken a turn for the worse, which could indicate a transition to the AIDS disease. Dentists often refer patients with NUP to a primary care provider for further diagnosis and treatment.

Besides daily brushing and flossing, regular dental cleanings are a necessary part of a HIV+ patient's health maintenance. These visits are also important for monitoring dental health, which, as previously noted, could provide early signs that the infection may be entering a new disease stage.

It's also important for HIV+ patients to see their dentist at the first sign of inflamed, red or bleeding gums, mouth lesions or loose teeth. Early treatment, especially of emerging gum disease, can prevent more serious problems from developing later.

Living with HIV-AIDS isn't easy. But proper health management, including for the teeth and gums, can help make life as normal as possible.

If you would like more information on dental care and HIV-AIDS, 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 “HIV-AIDS & Oral Health.”

LikeJohnnyManzielYouMayNeedanOralSurgeonforaMajorDentalProblem

QB sensation Johnny Manziel has had a varied career in professional football. After playing two seasons for the NFL Cleveland Browns, he quarterbacked for a number of teams in the Canadian Football League. More recently, he joined the Zappers in the new Fan Controlled Football league (FCF). But then with only a few games under his belt, he was waylaid by an emergency dental situation.

It's unclear what the situation was, but it was serious enough to involve oral surgery. As a result, he was forced to miss the Zappers' final regular-season game. His experience is a reminder that some dental problems can't wait—you have to attend to them immediately or risk severe long-term consequences.

Manziel's recent dental problem also highlights a very important specialty of dentistry—oral surgery. Oral surgeons are uniquely trained and qualified to treat and correct a number of oral problems.

Tooth extraction. Although some teeth can be removed by a general dentist, some have complications like multiple roots or impaction that make regular extractions problematic. An oral surgeon may be needed to surgically remove these kinds of problem teeth.

Disease. Oral surgeons often intervene with diseases attacking areas involving the jaws or face. This includes serious infections that could become life-threatening if they're not promptly treated by surgical means.

Bite improvement. Some poor bites (malocclusions) arise from a mismatch in the sizes of the jaws.  An oral surgeon may be able to correct this through orthognathic surgery to reposition the jaw to the skull. This may compensate for the difference in jaw sizes and reduce the bite problem.

Implants. Dental implants are one of the best ways to replace teeth, either as a standalone tooth or as support for a fixed dental bridge or a removable denture.  In some cases, it may be better for an oral surgeon to place the implants into a patient's jawbone.

Reconstruction. Injuries or birth defects like a cleft lip or palate can alter the appearance and function of the face, jaws or mouth. An oral surgeon may be able to perform procedures that repair the damage and correct oral or facial deformities.

Sleep apnea. Obstructive sleep apnea is usually caused by the tongue relaxing against the back of the throat during sleep and blocking the airway. But other anatomical structures like tonsils or adenoids can do the same thing. An oral surgeon could address this situation by surgically altering obstructing tissues.

It's likely most of your dental care won't require the services of an oral surgeon. But when you do need surgical treatment, like Johnny Manziel, these dental specialists can make a big difference in your oral health.

If you would like more information about oral surgery, please contact us or schedule a consultation.

3QuickDentalProcedurestoPuttheDazzleinYourWeddingDaySmile

The traditional June wedding season hit a bump last year during the COVID-19 pandemic as many couples down-scaled or postponed their ceremonies. But with hopes that the virus is finally waning, this year the early summer tradition shows signs of reviving. If you're one of those happy couples, you're no doubt working right now to look your best—and that would include your smile.

And there's no time like the present to make sure your teeth and gums are spruced up for the big day. True, some cosmetic enhancements can take weeks or even months to complete. But some can give you a brighter, more attractive smile with just a dental visit or two.

Here are 3 procedures that could help your smile match that once-in-a-lifetime moment.

Dental cleaning. The main purpose for visiting us every six months is to remove any harmful plaque and tartar missed with daily hygiene. But an added benefit for these single-visit dental cleanings can be a brighter, fresher smile. To take advantage, schedule a dental cleaning within a week or so of your wedding.

Teeth whitening. If you want to take your smile brightness to another level, you may want to consider professional teeth-whitening. The professional bleaching solutions we use can restore shine and translucence to dull, yellowed teeth that could last for months or, with touch-ups, a few years. We can also fine-tune the level of brightness you're most comfortable displaying to your wedding guests.

Dental bonding. Do you have a chipped or disfigured tooth that puts a damper on your smile? We may be able to make that defect disappear in just one visit with dental bonding. Using a dental resin material matched to your natural tooth color, we can fill in your tooth flaw and then sculpt it to look as natural as possible. The end result is a life-like, durable finish that will have you beaming on your big day.

Like we said, if your wedding is just around the corner, these particular techniques can make a big difference for your smile. If, however, you still have a few months before your wedding, you may be able to take advantage of other therapeutic and cosmetic measures like dental veneers, crowns or even possibly orthodontics.

To learn more about your cosmetic options, see us for a full evaluation of your smile needs. We'll work with you to help you achieve the most attractive smile possible for your once-in-a-lifetime day.

If you would like more information about cosmetic dental choices, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Planning Your Wedding Day Smile.”

By Jeffrey J. Kraig, DDS, SC
June 08, 2021
Category: Oral Health
Tags: tooth decay  
MinimallyInvasiveDentistryANewApproachtoPreventingandTreatingDecay

Since the late 19th Century, dentists have used established protocols to successfully prevent and treat tooth decay. But there've been changes to this approach the last few years to improve its effectiveness, changes we now refer to as Minimally Invasive Dentistry or MID.

The older approach for treating dental caries (tooth decay) follows the protocols established by Dr. G.V. Black, considered the father of modern dentistry. Black advocated removing not only decayed structure but also some of the healthier but vulnerable portions of a tooth, to avoid further decay and make the tooth easier to clean. This resulted in larger fillings, although they've become smaller as dental techniques have advanced.

MID, on the other hand, aims to remove as little tooth structure as possible while still effectively treating and preventing future decay. To achieve that goal we begin first with a complete assessment of a patient's individual decay risk, known as Caries Management By Risk Assessment (CAMBRA).

With CAMBRA, we're looking at other factors besides individual tooth health: a patient's hygiene, lifestyle and dietary habits; the types and amount of bacteria present; and the quality of saliva flow, needed to neutralize mouth acid. With these the results we develop a customized prevention and treatment strategy.

MID also focuses on detecting dental caries as early as possible. Besides traditional x-rays, we're beginning to use other methods like dental microscopes, laser fluorescence, infrared photography or optical scanning. Early detection leads to early intervention, and with techniques that are much less invasive than the traditional approach.

The new approach also changes how we repair decayed teeth. We're increasingly using air abrasion, a technology that uses fine particles in a pressurized air stream to remove softer decayed tooth material and less healthy structure than the traditional dental drill. We're also using composite resin and other advanced materials for filings: these tooth-colored materials are stronger than previous versions and are quickly taking the place of metal amalgam, requiring less structural removal to accommodate them.

MID's core principles are early disease detection, proactive prevention and treatment with less structural removal. With this enhanced approach to effective dentistry, we're keeping your teeth healthy with minimal discomfort, lower costs and less long-term impact.

If you would like more information on the benefits of the MID approach, please contact us or schedule an appointment for a consultation.





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