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Posts for: April, 2013

By Gregory J. Gauthier DDS, LLC
April 27, 2013
Category: Oral Health
ThumbSuckingHarmlessHabitorPotentialProblem

For many parents, the image of an infant intently absorbed in sucking a pacifier — or her own thumb — is one of the cherished memories of babyhood. But if this habit goes on for too long, it can cause problems with the child's bite. Want to know what the potential predicaments are, when you should be concerned about the behavior, and what you can do? Read on!

Thumb sucking is a natural, comforting behavior of humans (and some other primates) related to nursing. It usually goes away on its own by the time the permanent teeth are coming in. But it can be a hard habit to break — and if it becomes a persistent behavior, the consequences may include a problem called an “open bite.”

In a normal bite, the top teeth slightly overlap the bottom teeth. When the thumb (or any other object) constantly rests between the upper and lower teeth, however, the pressure it exerts may prevent the teeth from fully erupting (coming out from the gums into the mouth) and alter the shape and development of the upper and lower jawbone. This result is a gap between the upper and lower teeth.

The same problem may also be caused by prolonging the “infantile swallowing pattern,” a forward-thrusting position of the tongue which, like thumb sucking, normally begins to cease around age four. That's when it is replaced by the adult swallowing pattern, where the tongue is held behind the teeth, against the roof on the mouth. Researchers believe that most open bites result from the failure to change from the infantile to the adult swallowing pattern.

When should you be concerned about the thumb sucking habit? If the behavior continues much past toddlerhood, or if the sucking is particularly active, you may wish to have us evaluate your child's bite. The American Academy of Pediatric Dentistry recommends having the habit stop by age 3. Persistent thumb sucking can actually push the teeth forward and change the growth patterns of the jaw, creating more difficult problems.

There are several methods for controlling the behavior and correcting problems with the bite. One is an appliance called a “tongue crib.” This thin metal device is placed behind the upper and lower incisors. It discourages thumb sucking, while at the same time helping to keep the tongue from inserting itself between the upper and lower teeth. Eliminating these unhelpful habits is essential to allow the teeth to erupt into proper position and to allow for the normal development of the jawbones.

Recent research has also shown that individualized exercise routines called orofacial myofunctional therapy (OMT) can be highly effective in preventing open bite relapses. These exercises are designed to retrain muscles in the face, tongue and lips, and can help to create good chewing and swallowing patterns.

If you would like more information about thumb sucking or children's bite problems, please contact us or schedule an appointment for a consultation. You can also learn more about these issues by reading the Dear Doctor magazine article “How Thumb Sucking Affects The Bite.”


DidYouKnowMajorLeagueBaseballPlayersHaveNewRestrictionsonChewingTobacco

Chewing tobacco is a known cause of oral cancer, yet many a Major League Baseball player has been seen walking onto the field with a round tin visibly poking out of his back pocket. That was before this year. Recognizing the influence big-leaguers have on their young fans, MLB players agreed to a new contract that limits their use of chewing tobacco and their ability to carry it around their fans. The 2012 season is the first to be played under the new rules, which were championed by Baseball Commissioner Bud Selig.

One player who used smokeless tobacco heavily is Baseball Hall of Famer Tony Gwynn. The former Padres slugger earlier this year endured 14 hours of surgery to remove a cancerous growth from the inside of his right cheek and graft a nerve from his shoulder to replace a facial nerve damaged by the tumor. This was Gwynn's second cancer surgery in less than two years.

When it comes to oral cancer, the importance of early detection can't be stressed enough. Unfortunately, this form of cancer is not usually detected until a late stage so the overall survival rate is poor, with only 58% surviving five years after treatment. Yet when oral cancer is detected while a lesion is small, survival rate exceeds 80%. That's why an oral cancer screening is always part of your dental check-up or regular cleaning appointment at this office.

During this screening we will examine your face, neck, lips, mouth, tongue and the back of your throat for any suspicious lesions (sores or ulcers) or lumps. Of course, if you notice any unusual lesions, or color changes (white or red patches), anywhere in your mouth that do not heal within two-three weeks, please come in to see us as soon as possible. And if you need help kicking a tobacco habit, we can advise you on how to get it.

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


By Gregory J. Gauthier DDS, LLC
April 12, 2013
Category: Oral Health
Tags: oral health   toothpaste  
TRUEORFALSETheGreatToothpasteTest

You use toothpaste every day — don't you? But how much do you really know about what's inside the tube: namely, the white, sticky stuff that keeps your teeth clean and your breath fresh? Take this True/False quiz and find out!

True of false: Powdered charcoal, brick dust and crushed bones were once ingredients in toothpaste. TRUE

Many years ago, these gritty abrasive materials were used to make toothpaste. Today, abrasives are still used — but they're much gentler. Compounds like hydrated silica or alumina, calcium carbonate, and dicalcium phosphate have proven effective at cleaning and polishing tooth surfaces without damaging the enamel.

True of false: Fluoride was first introduced into toothpaste in 1955. FALSE

Arguably toothpaste's most important ingredient, fluoride was used as early as 1914. But its mass-marketing debut came with the Crest brand in the mid-1950s. Today, no toothpaste without fluoride can receive the American Dental Association's Seal of Approval. That's because it has been shown to strengthen tooth enamel and help prevent tooth decay.

True of false: Detergent is a common ingredient of toothpaste. TRUE

But it isn't the same kind you do laundry with. Detergents — also called surfactants, because they act on the surfaces of liquids — help to loosen and break down deposits on your teeth, which can then be rinsed away. Like other health and beauty products, many toothpastes use a gentle detergent, derived from coconut or palm kernel oil, called sodium lauryl sulfate.

True of false: Whitening toothpastes work, to some degree, on all stains. FALSE

Whether the whitening agents in toothpaste will work for you depends on why your teeth don't look white in the first place. The abrasives and enzymes in these toothpastes can help remove “extrinsic” stains: those on the surface of your teeth. But for “intrinsic” stains — that is, internal discoloration — they probably won't help. In that case, you may need to get professional bleaching treatments.

True of false: Toothpastes made for sensitive teeth have substances that block pain transmission. TRUE

Potassium nitrate and strontium chloride can block the sensation of pain that may occur when dentin — the material that makes up most of the inside of teeth, and is normally covered by enamel — becomes exposed. Fluoride, too, helps reduce sensitivity. But the benefits of reduced tooth sensitivity may take a few weeks to really be felt.

If you have questions about toothpastes or oral hygiene, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine article “Toothpaste — What's In It?


By Gregory J. Gauthier DDS, LLC
April 05, 2013
Category: Oral Health
TaketheScreamOutofIceCream

“We all scream for ice cream,” the saying goes. But what if eating ice cream — or any very cold or hot food — literally makes you want to scream because your teeth hurt so much?

What causes sensitivity in teeth?

Understanding the anatomy of a tooth helps explain what happens when a tooth becomes sensitive to heat and cold. A tooth is composed of three types of tissue: a hard outer shell of enamel, the body of the tooth composed of the dentin, and an interior tissue of the pulp.

Enamel: The enamel forms the outside of the crown, the part of the tooth you normally see. Made of densely packed crystals of calcium, it is resistant to wear. It is not living tissue, and does not contain nerves, but it is capable of transmitting temperature like hot and cold.

Dentin: Inside the tooth's crown and root is a living tissue called dentin, which is a porous structure similar to bone. It is composed of microscopic tubules containing living cells, which are encased in a hard substance made of calcium crystals.

Pulp: The living dentin transmits sensation through to the pulp, which is in the center of the tooth and contains the tooth's blood vessels and nerves.

A tooth's enamel normally protects the dentin from exposure to extremes of temperature and pressure. If you wear away the enamel and expose the dentin, it will pass sensation through to the nerves in the pulp more directly. The result can range from a twinge to an excruciating pain.

Sensitivity can be caused by:

  • Overzealous tooth brushing resulting in enamel wear and consequently dentin exposure and wear.
  • Enamel and dentin erosion by acids in the foods and beverages you eat and drink.
  • Tooth decay — the most common cause of sensitivity. Decay destroys enamel and dentin inflaming and infecting the living tissues of the pulp, which become increasingly painful.

What can you do to make your teeth less sensitive?

  • Use a soft bristle tooth brush, and brush the affected teeth gently to remove all bacterial plaque. We can advise you on safe and effective brushing techniques.
  • Use toothpaste that contains fluoride. Fluoride strengthens tooth surfaces and makes them more resistant to sensitivity and decay.
  • Ask us about professionally applied fluoride varnishes or filling materials that can cover and replace sensitive or lost tooth structure.

Of course, if the problem is caused by tooth decay, make an appointment with us to remove the decay and place a filling in the sensitive teeth.

Contact us today to schedule an appointment to discuss your questions about sensitive teeth. You can also read the Dear Doctor magazine article “Sensitive Teeth.”