If You Snack and Sip All Day, You Risk Decay!

Do you sip on sugar sweetened drinks throughout your day?  Do you snack on foods with added sugar throughout your day?  If this is you, beware!  These habits can lead to tooth decay.

 Refined sugar is added to many foods and drinks.  The worst liquid offenders are soda, sports drinks, sweet ice tea, and fruit juice.  The problem is when you sip on these types of drinks throughout your day, your teeth are constantly bathed in refined sugar.  Over time, the sugar in these drinks reacts with the plaque bacteria that is always present in your mouth.  The by-product of this reaction is an acid that is strong enough to eat through your tooth enamel.  Within 20 minutes after you eat or drink something with refined sugar, the acid production process has begun.  Soda also contains phosphoric acid.  If you frequently drink soda (even diet soda), the phosphoric acid can cause erosion to your tooth enamel; this makes your tooth enamel weaker and increases your chances of developing tooth decay. 

One can of regular Coke has over 9 teaspoons of sugar. A 12-oz. can of Mountain Dew contains 11 teaspoons of sugar. A person who drinks two cans per day consumes more than 1.5 pounds of sugar per week from Mountain Dew alone. www.floridahealth.gov/chdcollier/Documents/.../sipalldaypresentation.pdf

Eating foods high in refined sugar can also lead to tooth decay.  If you eat sugary foods during the day, you can help minimize the harmful effects of the sugar on your teeth by rinsing your mouth with water, or brushing your teeth after you eat the sweet treat. 

It is important for your dental health to avoid drinking beverages throughout your day that are high in refined sugar and acidic and avoid eating frequent sugary snacks. The best defense against sugar and acids is thorough brushing and just as important....cleaning between your teeth.  Often, tooth decay begins in between teeth where your toothbrush cannot reach.  If you don't regularly floss, the acid produced by the combination of bacteria and sugar sticks between your teeth and causes cavities to form.

Fluoride is also very beneficial in combating the effects of acid on your teeth.  Fluoride actually promotes re-mineralization of your tooth enamel making it more resistant to the destructive acid produced by sugar or consumed in soda.  Fluoride is in most toothpaste, you can even buy mouth rinse with fluoride, or your dentist can prescribe a prescription strength fluoride toothpaste.   

Mouth of a diet soda abuser

                                                                (photo courtesy of The Academy of Dentistry)

Australian Dental Association

Salivary Testing to Treat Gum Disease

       Have you been told that you have areas in your mouth with "deep pockets"?  Have you had a "deep cleaning" but despite your efforts at good oral hygiene your gums still bleed regularly?  Now there is an easy way to find out exactly which bacteria are causing your gum problems.  A company called Oral DNA Labs offers salivary testing that can identify which bacteria are triggering your periodontal (gum) disease.
     Periodontal (gum) disease is a fairly common condition.  It begins as gingivitis which is gum inflammation due to a build up of plaque on the teeth.  Dental plaque is bacteria, food particles and mucus.  Over time this plaque, if not removed, can harden on the teeth, thus becoming tartar.  The bacteria in the plaque and tartar cause the gums to be inflamed and the bleed easily.  The inflammation can spread to the ligaments and bone that hold the teeth in place.  Once this occurs, the condition is called periodontitis.  Untreated periodontitis can lead to tooth loss.
     Oral DNA Labs offers a saliva test that can identify exactly which bacteria are triggering the periodontal disease.  The test is very simple to do and can be done in our office in just a few minutes.  The patient just swishes a special saline solution in their mouth for 30 seconds then expectorates into a special vial which gets securely sealed and sent directly to Oral DNA Labs for analysis.  We then receive a detailed report identifying the types of destructive bacteria that were present in the sample along with recommended treatment protocols.
     Watch this short video from the TV show The Doctors that discusses Oral DNA testing
http://www.thedoctorstv.com/videolib/init/7581
You can also learn more by visiting the Oral DNA Labs websitehttp://www.oraldna.com/

New Oral Probiotic

          The term "Probiotic" is very common in many products available today.  Probiotics are microorganisms that may have health benefits when consumed.  They can be added to food, like yogurt, or taken alone in a capsule form.  At Clearwater Dental Associates we are excited to offer a new Oral Probiotic called EvoraPro.  EvoraPro oral probiotic works by outnumbering the undesirable bacteria in the mouth.  When the bad bacteria are outnumbered, the beneficial bacteria can flourish and re-establish a correct bacterial balance which leads to healthier teeth and gums.
      Researcher, Dr. Jeffrey D. Hillman collected bacteria samples from people with healthy teeth.
He isolated three particular bacteria that were found in every "healthy mouth" sample.  The bacteria he grouped together worked to outnumber destructive bacteria strains found in the mouth.
     The bacteria Dr. Hillman grouped together are called ProBiora3 and are found in EvoraPro. This is the only probiotic with original bacterial strains cultivated from people with healthy mouths. There are no food products that contain these bacteria strains.  By crowding out the destructive bacteria with beneficial bacteria, the plaque bacteria grow much much slower above and below the gums. Each EvoraPro tablet contains the ProBiora3 healthy bacteria strains. The patient dissolves one EvoraPro mint in the mouth per day.

How does EvoraPro fit into patients’ oral
care routine?

EvoraPro is best started when a patient has just completed a
professional prophylaxis.

• A professional prophylaxis removes both beneficial and undesirable bacteria
• Allowed to dissolve on the tongue after the patient’s oral hygiene routine, EvoraPro begins to repopulate the mouth with a healthy balance of essential probiotic bacteria
• Because EvoraPro only contains bacteria naturally found in the oral cavity, it is ideal for most patients

The healthy bacteria in EvoraPro also help eliminate the bacteria that can cause bad breath. The good bacteria found in EvoraPro also produce a low dose of hydrogen peroxide which can whiten and brighten your teeth as well.

Our New Product Line, PerioSciences

     We have a new product line called PerioSciences.  These products utilize combinations of specific antioxidants that work with the natural antioxidants in saliva.  We all have naturally occurring antioxidants in our saliva.  These antioxidants work on a molecular level to fight off inflammatory stressors that can eventually cause tissue destruction and cell death if an imbalance occurs. Our salivary antioxidant levels decrease as we age and are compromised in the presence of inflammation caused by certain stressors like bacteria, systemic conditions, medications, nicotine, dental surgery, certain materials used in dental procedures and ulcers.
     Antioxidants are large, complex molecules that are produces by the body and they are found naturally in certain foods or plants.  Antioxidants work by bonding with free radicals (unstable molecules with an unpaired electron).  When one of these unstable free radical molecules finds another molecule, it may "steal" an electron to complete the pair.  Now the second molecule has an unpaired electron, and is now then a new free radical.  This process of one molecule stealing an electron is called oxidation.  Antioxidants work to stop or retard the process of oxidation.
     Antioxidants are part of the body's innate defense mechanism and many occur naturally in your saliva.  The antioxidants in saliva are critical for fighting free radicals and oxidative stress in the mouth.  Unfortunately however, the natural levels of antioxidants in saliva may not be enough to combat the high levels of free radicals caused by oral infection, systemic inflammation or toxic substances. 
     A very common source of chronic inflammation is periodontal (gum) disease.  The natural antioxidants found in saliva are abnormally low in people with periodontal disease.  The theory behind using antioxidants in the mouth is that they will combat the free radicals and reduce the inflammation caused by gum disease.
Using the PerioSciences products can help replenish your supply of salivary antioxidants to help minimize your mouth's negative reaction to inflammation and amplify wound healing. It will also keep the good bacteria at healthy levels.
     At Clearwater Dental Associates, we have the PerioSciences products that help to treat dry mouth and sensitivity.  There are hundreds of prescription medications that cause a reduction in saliva, giving the patient a constant dry mouth.  The antioxidants in the PerioSciences help to combat the bacteria that sticks to the teeth because of the dry mouth.  This can help to reduce tooth decay which can occur as a result of dry mouth.  The antioxidant properties  can also help to stimulate salivary flow.
    If you would like more information on these products, or if you think you would be a good candidate for using them, contact our office.  We also have an "online store" link on our homepage for ordering PerioSciences.

Diabetes and Your Oral Health

November is Diabetes Awareness month so this blog post is about diabetes and your oral health.  Diabetes affects over 25 million Americans.  This disease can cause problems with your eyes, nerves, kidneys, heart and other parts of your body.  Diabetes can also affect your teeth and gums.  Oral health problems related to diabetes are gum disease, thrush and slower healing after oral surgery.

Gum (periodontal) disease is when the tissues that hold your teeth in place become infected.  If the infection progresses to the severe state, the bone is destroyed and the infected teeth have to be removed. In young adults,  if someone has diabetes, they are about twice as likely to have active gum disease.  In older adults who have diabetes, active gum disease and infection is very common.  Diabetics with poor sugar control are more likely to lose teeth due to gum disease than diabetics who have their sugar under control.  Some studies suggest that treating active gum disease may help improve blood sugar control, thus improving the overall health of the diabetic patient. 

The dentists and hygienists at Clearwater Dental Associates routinely  check for signs of active gum disease and we recommend dental treatment to treat the infected areas so the overall health of our diabetic patients can improve.

Another oral health problem related to diabetes is thrush.  Thrush is a fungal infection that occurs more often in people with diabetes.  In the mouth, thrush looks like white and red patches that may be sore or look like small ulcers.  Thrush may make your tongue feel like it is burning thus making chewing and swallowing uncomfortable.  Fortunately, there are medicines that can cure thrush within a relatively short period of time. 

If you are diabetic it may take your body longer to heal after having any type of oral surgery.  This would include having a tooth pulled.  It is important to discuss your diabetes with your dentist before doing any type of oral surgery. 

Patients with diabetes should be very pro-active with their dental care.  They should have regular dental cleanings and exams which would include evaluation of their periodontal (gum) health.  If you are diabetic and you have been told that you have active areas of gum disease or infection it is very important to treat these areas and get them to healthier, non infection state.

What is a Crown and Why Do I Need a Crown?

A crown, or "cap" as it is commonly referred, is a cover that your dentist puts over a tooth.  The purpose of a crown is to make a tooth stronger by repairing it or to improve the way the tooth looks. A crown should look exactly like a natural tooth, it should be the same size and shape as your natural tooth.
A tooth may need a crown if:

• a tooth has a cavity that is too large for a filling
•  you need to cover a dental implant
•  you have a tooth that is cracked, worn down or weakened
•  a tooth has had a root canal
• you want to cover a discolored or badly shaped tooth thus improving your smile

Crowns are made from several different types of materials. Crowns can be made from metal alloys, ceramics, porcelain, composite resin or some combination of these materials.  Your dentist will make your crown so it fits comfortably in your mouth and looks like a natural tooth.  When determining the type of material to use to make your crown, you dentist will consider the location of the tooth, the position of the gum tissue and how much of the tooth shows when you smile.  You as the patient may also have a personal preference as to how you want your crown to look.

Once your dentist has determined that your tooth needs a crown, it usually takes two appointments to complete the treatment. At the first visit your dentist will prepare the tooth by removing a thin outer layer of the tooth.  This is done so when the new crown is cemented on your remaining tooth, it will fit and not be bigger than the natural tooth. After the tooth is prepared, an impression (exact mold) of the tooth is made to provide an exact model that a lab technician will use to  make your crown.  After the impression is taken, a temporary crown will be made and cemented on your tooth using a temporary cement.  You will wear this temporary crown for a week or two until the lab technician is finished making the permanent crown.  It is important to keep the temporary crown in your mouth, without it your teeth can shift then the new crown won't fit properly.  When the permanent crown is completed, the dentist will take off the temporary crown and try in your new permanent crown.  Sometimes it is necessary to make some minor adjustments to be sure that the bite is exactly correct. When you bite together the tooth with the new crown should feel comfortable and no different that your other teeth. After any adjustments have been made, then your dentist will cement the new crown on the tooth using a permanent cement.

It is important to remember that under the crown is your natural tooth and it is still possible to get a cavity on the natural tooth that is under a crown.   It is important to brush twice a day and floss daily to remove the plaque bacteria to keep the tooth under the crown and the gum tissue around the crown healthy.  As always, be sure to see your dentist regularly for professional cleanings and exams.

Why Doesn't My Insurance Pay for This?

     Dental insurance is a benefit offered by many employers.  It actually works more like a valuable "coupon" that can reduce the cost of your dental treatment.  It is important to remember that dental benefit plans do not cover all of the cost of dental treatment.  Hopefully this post will help to clarify how dental benefit plans work.
      It is important to remember that dental benefits offered by a plan should not be confused with dental treatment that is needed.  Dental benefit plans are a contract between your employer and an insurance company.  The dental treatment you need is determined by your dentist.  Your dental coverage is not based on what you need or what your dentist recommends.  Your dental coverage is based on how much your employer pays into the dental benefit plan. 
     At Clearwater Dental Associates, our main goal is to help you take good care of your teeth and provide excellent dental care for you and your family regardless of the stipulations of a dental benefit plan.  As a courtesy to our patients, we file dental claims with the insurance company.  We ask that the portion NOT covered by insurance be paid at the time of treatment. 
     Dental benefit plans use the term UCR (Usual, Customary & Reasonable) when they refer to the maximum charge for treatment that they allow.  The insurance company will make it seem that their UCR is the standard rate that most dentists charge for their procedures, but this is incorrect. 

• UCR charges usually do not reflect what dentists usually charge
• Insurance companies can set whatever UCR fees they want, they are not required to match actual fees charged by dentists in the area where you live
• An insurance company does not update their UCR amounts to keep with rising costs.  Often, they keep their UCR amounts the same for many years.
• Insurance companies are not required to say how they set their UCR rates. 

If your dental treatment costs more than what your insurance company has set for their UCR, it does not mean that your dentist has overcharged you. It means that your insurance company has not updated their UCR amounts, or the data the insurance company is using to set their UCR rates is not reflective of the state you live in.
    
     Another confusing issue with dental benefit plans are the terms PPO, DHMO, and Preferred Providers.  PPO and DHMO refer types of dental benefit plans companies offer.  A PPO type of plan gives patients the option of going to an "in-network" or "preferred" provider or they can go to an "out of network" provider.  An "in network or preferred provider"  means that the dentist has signed a contract with an insurance company and the fees charged are pre-determined and cannot be changed.  The benefit of a PPO type of plan is that if someone does not want to change dentists, they can go to an "out of network" provider and still use their dental benefits.  The out of pocket amount owed may be more, but that can be determined before dental treatment is rendered.
     DHMO dental plans do not give the patient the flexibility of going to an "out of network" dentist.  The dental benefits can only be used at an office with a dentist who is an "in network" DHMO provider.  If a patient goes to a dentist who is NOT a DHMO provider, the insurance will not pay anything.
     All dental benefit plans come with an annual maximum.  This is the largest dollar amount that the plan will pay out during a year.  The annual maximum is decided in the contract between your employer and the insurance company.  Annual maximums are not always updated to keep up with the costs of dental care.  In the 1980's the average annual maximum was about $1000 per year, and today the average annual maximum is only about $1500 per year.

At Clearwater Dental Associates, we have dentists who are contracted with some insurance companies, thus they are "in-network".  We have dentists who are contracted with Argus, Assurant, Cigna, Delta Dental Premiere, DeCare, Metlife, Prinicpal,  and United Concordia. 

Although you may be tempted to make decisions about your dental care based on what your insurance will pay, just remember that your dental needs are determined by your dentist and the least expensive option is not always the best.