My Blog

Posts for: January, 2014

By John G. Fisher, DMD
January 30, 2014
Category: Oral Health
Tags: oral health   nutrition  
DietDosandDontsforOralHealth

What and how you eat and drink has a significant impact on the health of your teeth and gums. Therefore, an effective oral hygiene regime must take your diet into account.

Acid is your teeth's enemy; it can erode their protective enamel coating (a process called demineralization). Certain foods and beverages (such as citrus drinks and coffee) contain it, and it's produced by bacteria in your mouth that feed on dietary sugar and release acid as a byproduct (a process called fermentation). Your allies are foods and beverages that neutralize acids, provide minerals and vitamins to repair tooth enamel, and stimulate saliva.

Sugar & Decay
Sugars, the leading promoter of dental decay, exist in many forms in our diet. Some occur naturally, while others — referred to as “free sugars” — are added by the manufacturer, cook or consumer. The latter are most often linked with decay. Soft drinks are the primary source of dietary free-sugars in the U.S.

Sugars in fruit, vegetables, milk and unprocessed, starch-rich foods such as rice, potatoes and whole grains, do not appear to be harmful to teeth. Note, however, that dried fruits contain a highly concentrated sugar level and can stick to tooth surfaces. The sugar substitutes xylitol and sorbitol appear not to promote decay. In fact, there's evidence that chewing xylitol-sweetened gum three to five times daily for at least five minutes (after meals) stimulates saliva flow, which helps protect against decay.

Acids & Erosion
In addition to eroding tooth enamel, acidic foods and beverages create an environment where it's easier for decay-promoting bacteria to flourish. Saliva can reduce acidity but it must have time to work, at least 30–60 minutes. That's why behaviors that maintain acid levels, such as sipping coffee throughout the day, can be harmful.

Saliva-Promoting Saviors
Saliva is a front-line defense against erosion and decay. It helps remove food particles and contains minerals that help neutralize acid and promote remineralization of the tooth surface. Foods that stimulate saliva and/or contribute essential minerals include:

  • Cheese — stimulates saliva and is rich in calcium, contributing to the re-calcification of teeth and protecting against the loss of calcium,
  • Cow's milk — contains decay-counteracting calcium, phosphorous and casein,
  • Plant foods — are fibrous and require chewing, which mechanically stimulates saliva,
  • Water — keeps you hydrated, which is important for saliva production and preventing dry mouth (a condition that promotes acid-producing bacteria), and helps wash away food particles; fluorinated water bestows the protective properties of fluoride (a compound that makes tooth enamel more resistant to acid erosion and promotes re-calcification).

As you can see, brushing and flossing effectively is just part of the oral hygiene equation.

If you would like more information about nutrition and oral hygiene, 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 “Nutrition & Oral Health.”


By John G. Fisher, DMD
January 22, 2014
Category: Oral Health
Tags: oral health  
DentalMetalsPoseaLowRiskofAllergyAmongMostPeople

In modern times, metals have played an important role in tooth preservation and restoration. From the dental amalgam used for a century and a half to fill cavities to the titanium alloy of dental implants, your dental care would not be as comprehensive as it is today without them. But could these metals, so important in providing oral health, cause an allergic reaction in some people?

An allergy is an exaggerated response of the body’s immune system to any substance (living or non-living) it identifies as a threat. The response could be as minor as a rash or as life-threatening as a systemic shut-down of the body’s internal organs. An allergy can develop with anything, including metals, at any time.

A low percentage of the population has an allergy to one or more metals: some surveys indicate 17% of women and 3% of men are allergic to nickel, while even fewer are allergic to cobalt and chromium. Dermatitis patients seem to have a higher reaction rate, some allergic even to metals in jewelry or clothing that contact the skin.

Dental amalgam, an alloy made of various metals including mercury, has been used effectively since the mid-19th Century to fill cavities; even with today’s tooth-colored resin materials, amalgam is still used for many back teeth fillings. Over its history there have been only rare reports of allergic reactions, mainly localized rashes or moderate inflammation.

The most recent metal to come under scrutiny is titanium used in dental implants. Not only is it highly biocompatible with the human body, but titanium’s bone-loving (osteophilic) quality encourages bone growth around the implant’s titanium post inserted into the jawbone, strengthening it over time. But does titanium pose an allergic threat for some people? One study reviewed the cases of 1,500 implant patients for any evidence of a titanium allergy. The study found a very low occurrence (0.6%) of reactions.

The conclusion, then, is that the use of metals, especially for dental implants, carries only a minimal risk for allergic reactions and none are life-threatening. The vast majority of dental patients can benefit from the use of these metals to improve their oral health without adverse reaction.

If you would like more information on metal allergies with dental materials, 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 “Metal Allergies to Dental Implants.”


By John G. Fisher, DMD
January 14, 2014
Category: Oral Health
Tags: oral health  
HealthRisksofOralPiercings

If you have to ask why anybody would voluntarily endure the pain of receiving a tongue piercing — then maybe you're just too old to understand. But seriously: no matter where you stand on the aesthetics of the issue, you shouldn't ignore the real health risks that go along with the installation of oral piercings.

According to the Journal of the American Dental Association, the most common sites for intraoral piercing are the tongue and the lip. In the case of the so-called “tongue bolt,” several significant short-term and long-term risks have been identified; most also apply to other types of oral piercings as well.

The tongue is primarily composed of muscle tissue, along with a rich supply of associated blood vessels and nerves. This explains why accidentally biting your tongue can be so painful — and bloody. Installing a tongue bolt involves piercing a small hole through the tongue, and attaching the ornament through the hole.

In rare instances — such as the case of a teenager who experienced severe pain and the sensation of electrical shocks — nerve irritation and damage may occur soon after a tongue bolt is installed. (Fortunately, her symptoms cleared up shortly after the bolt was removed.) More often, the symptoms are less severe, but the health issues are chronic.

Tongue bolts are known to cause problems with the teeth, including increased sensitivity and pain. Teeth are also prone to chipping due to contact with the ornament. These are among the reasons why you are likely to need more frequent dental checkups if you have an oral piercing.

Additionally, periodontal (gum) problems can develop in individuals with oral piercings. These frequently appear as gum recession, inflammation and infection. Eventually, bone loss may occur as well.

The good news: removing an oral piercing is generally easy, and the area is quick to heal. If it doesn't seal up by itself, the hole left behind can be closed with only minor surgery. And removing the piercing immediately reduces your health risk — thus instantly improving your overall oral health.

Thinking of getting — or removing — an oral piercing? Talk to us. No matter what you decide to do, you owe it to your health to become informed about the issues surrounding these body ornaments.

If you would like more information about oral piercings, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “How Oral Piercings Affect Your Oral Health,” and “Body Piercings and Teeth.”