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Posts for: August, 2014

FixingAdultTeethIsNoMissionImpossible-JustAskTomCruise

It's no surprise that plenty of teenagers go in for an orthodontic evaluation and come out wearing braces. But sometimes, an observant orthodontist may notice that an adult's smile could use a little bit of improvement, too. Even an adult like — Tom Cruise?

That's exactly what happened to the star of Top Gun, Rain Man and the Mission Impossible franchise. Cruise, then 39, was taking one of his children for orthodontic work when it was pointed out that the leading man's teeth were also out of alignment. So he opted for braces too.

“Yes, Tom Cruise has braces,” said his publicist when the star appeared, sporting his new orthodontic appliances. “To him, it's no big deal.” Cruise chose to get the relatively inconspicuous ceramic type, with only a thin wire visible in front of his teeth. He wore them for about a year and a half, having them temporarily removed when it was time to make a movie.

Ceramic braces are a popular choice among adult orthodontic patients, many of whom find that less noticeable orthodontic appliances fit in better with their personal or professional lifestyle. Clear aligners also provide a virtually invisible option. We can help you decide which appliance would best meet your needs. But the first step is a thorough evaluation of your periodontal health.

Is it Risky Business to get braces as an older adult? Not usually — but if you do show signs of periodontal disease, which is more prevalent in adults than teens, it's important to bring it under control before beginning your orthodontic treatment. There are also a few medical conditions, such as heart-valve disease, severe uncontrolled diabetes, and leukemia, which might preclude treatment.

For most people, however, orthodontics offers a great way to improve your appearance and boost your self-confidence — even if you're not a movie star. It is estimated that three-quarters of adults have some form of orthodontic problem; and studies have shown that orthodontic treatment can enhance an adult's career opportunities and social life.

So, if you're looking for a better smile at any age, don't hesitate to contact us or schedule an appointment to discuss your treatment options. You can learn more in the Dear Doctor magazine article “Orthodontics For The Older Adult.”


By John G. Fisher, DMD
August 20, 2014
Category: Oral Health
Tags: geographic tongue  
WhatintheWorldisGeographicTongue

Picture this: You’re feeling some mild irritation in your mouth, which seems to be coming from the area near your tongue. You go to the mirror, open wide… and notice a series of red patches on the tongue’s surface, which are surrounded by whitish borders. Should you drop what you’re doing and rush to get medical help right away?

Sure, a visit to the dentist might be a good idea to rule out more serious problems — but first, sit down and relax for a moment. Chances are what you’re experiencing is an essentially harmless condition called “benign migratory glossitis,” which is also known by its common name — geographic tongue. While it may look unusual, geographic tongue isn’t a serious condition: It’s not cancerous or contagious, and it doesn’t generally lead to more severe health problems. However, it can make your tongue feel a bit more sensitive, and may occasionally lead to mild sensations of burning, stinging or numbness.

The appearance of reddish patches on the tongue results from the temporary loss of structures called papillae: tiny bumps which normally cover the tongue’s surface. These patches may appear or disappear over the course of days — or even hours — and sometimes appear to change their shape or location.

What causes geographic tongue? Several factors seem to be responsible for setting off the problem, but as of yet the actual cause of the disease is unknown. Among these triggers are emotional stress and psychological upsets, hormonal disturbances, and deficiencies in zinc or vitamin B. The condition, which affects between one and three percent of the population, is seen more frequently in non-smokers, in women, and in those with a family history of the problem. It is also associated with people who suffer from psoriasis, a common skin condition, and those who have a fissured (deeply grooved) tongue.

Unfortunately, there is no “cure” for geographic tongue — but the good news is that treatment is usually unnecessary. If you’re experiencing this condition, it may help if you avoid foods with high levels of acidity (like tomatoes and citrus fruits), as well as hot and spicy foods. Alcohol and other astringent substances (like some mouthwashes) may also aggravate it.

While geographic tongue isn’t a serious condition, it can cause worry and discomfort. That’s why it’s a good idea for you to come into the office and have it checked, just to make sure. A thorough examination can put your mind at ease, and rule out other conditions that may be more of a concern. We may be also able to help you manage this condition by prescribing anesthetic mouth rinses, antihistamines, or other treatments.

If you would like more information about geographic tongue, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Geographic Tongue.”


By John G. Fisher, DMD
August 15, 2014
Category: Oral Health
MinimizingX-RayExposureRisksinChildrentoMaximizeBenefits

X-ray diagnostics have revolutionized our ability to detect early or hidden cavities, paving the way for better dental care. But x-ray exposure also increases health risks and requires careful usage, especially with children.

A form of invisible radiation, x-rays penetrate and pass through organic tissue at varying rates depending on the density of the tissue. Denser tissues such as teeth or bone allow less x-rays to pass through, resulting in a lighter image on exposed film; less dense tissues allow more, resulting in a darker image. This differentiation enables us to identify cavities between the teeth — which appear as dark areas on the lighter tooth image — more readily than sight observation or clinical examination at times.

But excessive exposure of living tissue to x-ray radiation can increase the risk of certain kinds of cancer. Children in particular are more sensitive than adults to radiation exposure because of their size and stage of development. Children also have more of their lifespan in which radiation exposure can manifest as cancer.

Because of these risks, we follow an operational principle known as ALARA, an acronym for “As Low As Reasonably Achievable.” In other words, we limit both the amount and frequency of x-ray exposure to just what we need to obtain the information necessary for effective dental care. It’s common, for example, for us to use bitewing radiographs, so named for the tab that attaches the exposable film to a stem the patient bites down on while being x-rayed. Because we only take between two and four per session, we greatly limit the patient’s exposure to x-rays.

Recent advances in high-speed film and digital equipment have also significantly reduced x-ray exposure levels. The average child today is exposed to just 2-4 microsieverts during an x-ray session — much less than the 10 microsieverts of background radiation we all are exposed to in the natural environment every day.

Regardless of the relative safety of modern radiography, we do understand your concerns for your child’s health. We’re more than happy to discuss these risks and how they can be minimized while achieving maximum benefits for optimum dental health. Our aim is to provide your child with the highest care possible at the lowest risk to their health.

If you would like more information on the use of x-rays in dentistry, 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 “X-Ray Safety for Children.”


By John G. Fisher, DMD
August 04, 2014
Category: Oral Health
Tags: tooth decay   cavity  
AreCavitiesContagious

Think of a contagious disease and you may picture one of the great outbreaks of the past: the terrible flu epidemic of 1918, the ever-present threat of polio in the early 20th Century, and the ancient (and still widespread) danger of cholera in overcrowded urban areas. Or you may think of the common cold, a familiar contagious malady that’s still very much with us. Yet there’s one contagious disease you may not think of, but probably should: tooth decay.

Many people don’t realize that tooth decay is contagious. But the fact is, decay bacteria can be passed between people like a bad cold — and it happens all the time.

Sugar usually gets the blame for tooth decay; a recent survey found that 81 percent of Americans say it’s responsible for cavities. But sugar alone isn’t the culprit. Cavities are actually caused by certain types of bacteria that cling to the teeth in the absence of proper oral hygiene. These bacteria process sugar from the foods we eat, and then secrete acidic byproducts that erode the hard enamel of the teeth. This causes the formation of the tiny holes we call cavities.

Children aren’t born with S. Mutans. But studies show that most of them “catch” it from their caregivers — often, their parents. By the time they are two years old, over 80 percent of kids will have detectable levels of the bacteria. Whether or not they pick up harmful microorganisms — and how much they have — depends on the infectiousness of the strain, and on the caregiver’s attention to oral hygiene.

How can you prevent the spread of decay-causing bacteria? Essentially, by limiting its transfer from your mouth to your baby’s mouth. So don’t “clean” a baby’s pacifier by putting it in your mouth, and don’t share utensils — for example, by tasting baby’s food with his or her spoon. While it’s ever so tempting, avoid kissing baby’s lips, especially if there is a chance of transferring saliva. And don’t even think of “pre-chewing” baby’s food — no matter what some self-appointed health gurus may say.

There’s still another way to limit the spread of decay-causing microorganisms: Make sure your own practice of oral hygiene is top-notch! Oral bacteria can spread not only from parents to babies, but also between adults. Maintaining good oral health means brushing and flossing every day, and getting regular check-ups: It’s important for you, and for everyone you care about.

If you have questions about tooth decay prevention or oral hygiene care, please contact us or schedule an appointment for a consultation. You can read more in the Dear Doctor magazine articles “Tooth Decay” and “How to Help Your Child Develop the Best Habits for Oral Health.”


GrandpaKnowsBestHowKristiYamaguchiManagesHerKidsOralHealth

When Olympic figure skater Kristi Yamaguchi wanted to help her kids develop good oral health habits, the gold-medal-winner made good use of a family connection: Her father Jim Yamaguchi is a practicing dentist in the San Francisco Bay area who treats her entire brood. As she said in a recent interview, when she suspects the kids may be spending a little less effort on oral hygiene than they should, she playfully admonishes them: “You've got to brush your teeth better than that. Papa-san is going to know!”

Not all kids are lucky enough to have a grandpa who's a dentist — but every child can learn how to help take care of his or her oral health with age-appropriate techniques, plus plenty of parental guidance and encouragement. What's the best way to help your kids develop good oral hygiene routines? We're glad you asked!

Through babyhood and the toddler years, parents have the main responsibility for keeping kids' teeth clean. But as they begin to put away pacifiers and cease sucking thumbs — around ages 2 to 4 — children can also begin to help with their own oral hygiene routine. By then, kids will probably be used to the feel of gentle brushing, and may be eager to try it themselves.

A soft-bristled brush with a pea-sized dab of toothpaste is all they need to get started… along with a good dose of parental patience. Show them how to wiggle the brush back and forth from the gum line, and all around the upper and lower teeth, both in front and in back. At first, they will probably need plenty of help. But after the age of 6 or so, as their manual dexterity increases, so will their ability to get the job done.

You'll still have to check their work periodically — but you can also teach them how to do it on their own: Have your child run his or her tongue over the tooth surfaces. If they feel smooth and silky, they're probably clean too. If not… try, try again. This test is a good guideline to brushing effectiveness — but if you want to know for sure, use a temporary dye called a disclosing tablet (available at many drugstores) to reveal unseen buildups of plaque bacteria.

What else can you do to give your children the best chance at keeping a healthy mouth and sparkly teeth? Set a positive example! Make sure you (and your kids) eat a healthy diet, get moderate exercise, limit between-meal treats — and visit the dentist regularly. The encouragement you'll get after having a good dental checkup will make you feel like a gold medalist — even if the praise isn't coming from grandpa.

If you would like more information on how to help your child develop good oral health habits, 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 “Dentistry & Oral Health For Children” and “How to Help Your Child Develop the Best Habits for Oral Health.”