Smart Mouth Summer 2017

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mart mouth

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Texas Dental Association Patient Publication

Summer 2017

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Pg. 7

Cavities 101 Pg. 3

Dental Phobia

Why there’s no need to worry Pg. 5

Do your kids

Grind their teeth?

Pg. 9

Your dentist is a TDA Member.

What does that mean for you?

Pg. 2

Periodicals supplement to the Texas Dental Journal, August 2017

W hat’s Smart Mouth™, a publication of the Texas Dental Association (TDA), is produced for the purpose of providing oral health information to the public. Member dentists can access electronic versions of Smart Mouth™ on tda.org.

The material contained herein is for educational purposes and is not intended for diagnostic or treatment decisions.

Please contact your dentist for oral health concerns and questions. Visit tda.org for more oral health information and resources. For comments and suggestions about Smart Mouth™, please contact the Texas Dental Association, attn Managing Editor Billy Callis, 1946 S IH 35 Ste 400, Austin, TX 78704; Phone 512-443-3675; Email bcallis@tda.org. ©2017 Texas Dental Association Daniel L. Jones, DDS, PhD Editor Lee Ann Johnson Director of Member Services & Administration Billy Callis Managing Editor

inside

contents Your Dentist is a TDA Member............................2 What does that mean for you?

Cavities 101.................................................................. 3-4 Everything you wanted to know about cavities-but were afraid to ask

Dental Phobia..............................................................5-6 What to do about it--and why there’s no need to worry

The Price of Procrastination...........................7-8 It’s tempting to put off your next dental visit. But does it pay to wait?

Teeth Grinding in Children..........................9-10 Could it be related to something more serious?

The persons shown in photographs in this publication are stock photography models (Models) and are not actual patients of, nor are they affiliated with, the Texas Dental Association and indirect parent companies, subsidiaries, or subsidiaries of its parent companies ("Affiliates"). Texas Dental Association has obtained the rights to use the photographs via license agreements with certain third party stock photography companies, and Texas Dental Association's use of the photographs is in compliance with the terms of those license agreements.

The photographs showing the Models are used in this publication for illustrative purposes only. The Models do not personally endorse Texas Dental Association, or any products, services, causes, or endeavors associated with, or provided by, Texas Dental Association or any of Texas Dental Association's Affiliates. The context in which the photographs are used in this publication is not intended to reflect personally on any of the Models shown in the photographs. Texas Dental Association, its respective officers, directors, employees, agents, and/or independent contractors assume no liability for any consequence relating directly or indirectly to the use of the photographs showing the Models in this publication.

Look for the next issue of Smart Mouth, available only in your TDA member dentist’s office!

Your dentist is a TDA member.

What does that mean The Texas Dental Association (TDA) is the professional organization for dentists in the state. TDA is aďŹƒliated with the American Dental Association (ADA). Dentists who join TDA are members of the ADA, and also their local group, called a component society. TDA has been helping dentists serve their patients since 1871.

Are all dentists TDA members?

Dentists’ membership in TDA is voluntary. A majority of dentists in Texas are members, but not all.

Why choose a TDA member dentist?

TDA members are required to abide by the ADA Principles of Ethics.

That means they follow 5 general ideas: self-governance, do no harm, do good, fairness, and truthfulness. For more about the Principles of Ethics, and what that means, visit SmartMouthTexas.org.

TDA members are informed and up-to-date.

TDA member dentists have access to a wealth of research and continuing education available to them, helping them maintain and further their clinical knowledge.

TDA members are connected.

Dentists who belong to TDA also belong to the American Dental Association and their local society. That means they are accountable to a community of their peers. And if they need to refer a patient to another dentist, they have access to a network of trusted, known colleagues.

Visit us online at: SmartMouthTexas.org

Professional. Dedicated. Trusted.

CAVITIES

101

By Dr Jennifer Bone TDA Member Dentist, Kerrville, Texas

Cavities.

You hear about them when you’re a kid.

You know they’re bad, and you just hope that when you go for your dental check-up, you don’t have any.

cavities may form. Of course, there’s a little more to it than that. As the bacteria consume sugars, they produce acids.

If the acids hang around long enough, they can dissolve tooth structure.

Beyond a primal sense of dread and vague idea about what they are, you may not know much more about cavities.

Knowledge is power, though, and maybe, just maybe, the more you understand about cavities, the better you’ll be able to avoid them.

Wait a second—my dentist says I have a cavity, but I don’t see a hole in my tooth, and nothing even hurts.

What’s going on?

By the time you see an actual hole in your tooth, the damage can be significant. Cavities keep a low profile when they are just starting out. Most of the time, you won’t feel any discomfort associated with a small cavity. In fact, if the weakened tooth structure has not progressed too far into the tooth, there’s a chance that the cavity may be reversed. That’s why periodic exams by your dentist, including the use of x-rays and other diagnostic tools, are so important. The information gained

So what is a cavity? In its most generic sense, a cavity is a hole. In its most generic dental sense, it’s a hole in your tooth. You can also think of a cavity as a weakened area in a tooth.

How do cavities form? The bacteria in your mouth feed on the sugars in the food you eat and

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through early diagnosis can help catch cavities in their infancy. If treatment is needed, it’s typically easier, more predictable, more comfortable and it costs less to fix a small cavity than a large one.

But I don’t eat candy and cookies all day long—how did this happen?

Candy, cookies, and sweetened drinks are all obvious sugar sources.

Did you know that any carbohydrate in your diet can be a food source for the bacteria that are involved in the cavity-making process? Have you considered that bacteria in your mouth can be just as happy to feed on your “left-over” crackers, chips, bread, alcoholic beverages, juices, rice, fruits and even vegetables?

Additionally, acids in the foods and drinks you consume (like sodas, sports drinks, lemons and limes) contribute to the problem by weakening tooth structure all on their own—no bacteria needed.

Well, my parents and grandparents had lots of cavities and ended up with dentures, so I’ll end up the same way and so will my kids.

Maybe, but maybe not. It’s true that some people are more susceptible to cavities. Your genetic make-up is one part of the equation, but your overall health, the medicines you take, the quality of your saliva, the quality of your diet and oral care habits all factor into your tendencies to get cavities. Your family may be more likely to experience cavities, but that doesn’t doom you to a life with dentures. Smart food choices and thoughtful brushing and flossing habits will help keep cavities at bay. Seeing your dentist for regular check-ups is also critical for early detection of problems and for providing advice about how to be more effective with your home care.

It may be an uphill battle for you, but don’t be discouraged—dental success is definitely worth the effort in the long run!

Dr Jennifer Bone is a graduate of the University of Texas School of Dentistry at San Antonio, where she also completed an Advanced Education in General Dentistry residency. She and her husband are co-owners of Hill Country Dental Associates, a group dental practice in Kerrville, Texas.

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DENTAL phobia?

No NEED to Worry.

By Dr Sarah Percy TDA Member Dentist, San Antonio, Texas

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oes the thought of sitting in the dental chair keep you up at night? Or even worse, keep you from seeing your dentist regularly? For many people, avoiding the dentist is a major consequence of dental anxiety.

Believe it or not, missing your regular dental visits will actually lead to needing more dental work…which means even more visits to the dentist!

So, how do we manage your anxiety?

There are several ways to reduce your anxiety in the dental office. Even something as simple as distraction like watching TV, listening to music, resting with your eyes closed or wearing dark sunglasses during your appointment can help. For those needing something more, there are 4 different routes of dental sedation.

Nitrous oxide or “laughing gas” This method is most common with children but works great on adults with mild anxiety.

Nitrous oxide is an odorless gas that you inhale and will help to take the edge off. A great thing about nitrous oxide is that once you leave the dental office, its effects have already worn off so you are able to drive yourself home.

Oral sedation If you’ve tried nitrous oxide but want to be more relaxed, oral sedation is a great option. All you do is take a pill! The medication may be prescribed for you to take before arriving at your appointment or can be given to you when you get to the dental office. The effects of oral sedation can last a few hours so it is best to have someone drive you home from your appointment.

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IV sedation This route will provide the greatest sedation possible in the dental office and is best for those with the most severe anxiety. Just as if you were giving blood, an intravenous line is placed in your arm for easy administration of the medications. Using an IV allows precise doses to be given that are specific to each patient. While you will not be unconscious, many people are relaxed enough to sleep through the procedure. You will still be able to breathe on your own and may not remember much of the procedure. In many cases, you can get all your dental work done in one visit. For IV sedation, you cannot eat for a few hours before your appointment and you must have someone drive home afterwards.

General anesthesia When all other routes of sedation have been unsuccessful or are not good options for you, the last stop is general anesthesia. This form of sedation is often done in a special clinic or hospital, usually with an anesthesiologist. Like when having surgery in the hospital, you will be completely unconscious with a machine to help you breathe.

Your dentist will review your overall health and the medications you take to ensure you are a good candidate for sedation. He or she will also determine which route of sedation will work best for you.

Because each of these routes require special permits, not all dentists are equipped to provide each level of sedation. Contact your TDA member dentist to discuss the ways they can help relieve your dental anxiety.

Dr Percy practices general dentistry in San Antonio, TX. After earning her dental degree from Texas A&M University Baylor College of Dentistry, she completed a residency in advanced general dentistry at the UT Health Science Center in San Antonio.

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By Dr Kurt Loveless TDA Member Dentist, Lubbock, Texas

I

have been a dentist in west Texas for over 30 years, and after being in practice for that amount of time, there is a recurring theme I seem to run across on a pretty regular basis.

I am going to preface this by saying that I think, to a certain extent, it is a part of human nature to want to delay our dental treatment. There are a lot of reasons for that. There are a lot of reasons that people fear treatment, or are worried about the cost and how to pay for it. So I get asked this question on a pretty routine basis: “Doctor, can this wait?”

I would just like to talk a little bit about what I have seen over 30 years when most patients wait to have their dental work done. First of all, unlike a lot of medical situations, most dental problems are easily detected and taken care of when you, as a patient, are unaware that you have them. This creates a little bit of a problem, because as we recommend treatment to you, say at a hygiene visit or if you have come in with a related issue, we may suggest treatment for issues that we see that you may or may not be feeling. At this stage, we can usually treat it easily and relatively inexpensively. When you start to notice symptoms such as pain or sensitivity, the problem has already become more costly and complex.

This is why maintaining regular cleanings has always played a crucial role in helping to prevent more serious dental problems. My patients who are regular visitors to our office every 3, 4, 6 months show a history of having a lot fewer dental problems in the long run. But when a patient in my office is presented with treatment that may not be causing them discomfort at that time, they often say, “well, can I wait on this?” or “Will this wait?” Well, unfortunately by the time it gets to the point that I am recommending treatment, it probably cannot wait.

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So, what happens when you do wait? Life happens! You get busy, situations come up and this dental issue that isn’t causing much discomfort gets put on the back burner. Then you bite down on something or feel a sudden twinge and all of a sudden, that little dental issue turns into a much bigger problem. I have seen it happen time and again, even twice this week in my practice. People who were waiting on insurance to renew to have crowns placed on teeth with root canals ended up cracking and losing the teeth, wasting the money for the root canal we had done several months ago and requiring much more costly treatment to replace these teeth. The price of procrastination forces us, dentists and patients, into making compromised decisions that, over a period of a lifetime, lead to more tooth loss, more dental work, and usually more painful dental work.

So, I would just like to encourage everybody: I know it’s human nature to want to wait on something but, please, don’t wait on your dental treatment, because it is just going to cost you more in the long run. I hope that this encourages you to speak with your doctor about your specific concerns if something is keeping you from completing treatment. More than likely, there is a way your doctor can work with you to overcome them in a way that fits your needs.

To your health—now, and in the future!

Dr Loveless has practiced in Lubbock for more than 30 years. When he is not in the office, he enjoys aviation.

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Teeth Grinding

By Dr James Tovar TDA Member Dentist, Helotes, Texas

I

often have parents come into my office with concerns that their child is grinding their teeth. The sound of enamel scraping on enamel can be like nails on a chalk board, especially if you hear it coming from your 7 year old while they nap.

“My child is grinding their teeth at night. Do they need a night guard? What should I do?”

Giving a child a night guard for grinding is rarely the answer and should be avoided. Just like adults, kids can also grind their teeth. And just like adults, this night-time habit can be a manifestation of more serious problems, such as obstructive sleep apnea.

“I didn’t know a child could have sleep apnea.”

Anyone can have sleep apnea, even a child. And night-time teeth grinding (also known as sleep bruxism) can be a warning sign that should not be ignored. It is well established that teeth grinding is linked to disturbances in sleep. If a child is having trouble breathing while they sleep, it could have detrimental short term and long term effects. Only a physician may diagnose obstructive sleep apnea.

“How do I know if my child has sleep apnea?”

Look for these specific signs and symptoms at home: 1.

Teeth grinding 2.

Snoring 3.

Sudden onset of bed-wetting “What if my child does all three of these?”

Consult with your dentist. A dentist not only looks for cavities but will also look at a child’s tonsils. Enlarged tonsils may restrict a child’s breathing ability. A visit to an ENT specialist is commonly warranted for possible tonsil removal. Your dentist may also recommend early orthodontics. A child with a small or narrow mouth may need a special device placed that slowly expands their mouth to improve their airway.

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Children

“Why is all of this important? My friend told me that their little boy would grind his teeth all the time but he eventually stopped when all of his adult teeth came in.”

When kids are between the ages of 5 and 11, their airway to tonsil size ratio is very small. But as they grow, so do their jaws and airway. Their tonsils will also tend to shrink. By the time all of the adult teeth are in (typically around age 12), most kids who grind their teeth will have “grown out of it.” They are finally able to sleep without having breathing disturbances.

But how long are you willing to wait for a child to “grow out of it”? A child that has problems sleeping may become hyperactive during the day, fall behind in behavioral development, and may have problems concentrating. That child may also have a reduced amount of REM sleep, which is a stage of sleep important for the brain to “consolidate” information recently learned. Improper breathing habits may also result in poor jaw and facial muscle development.

In summary, the physical action of a child grinding his or her teeth is relatively harmless. But the reasons that are causing the grinding in the first place may not be. A child with undiagnosed obstructive sleep apnea during an important developmental age may have lifelong effects. It is important to discuss these issues with your dentist. Your dentist can work with your physician on the best treatment options for sleep apnea.

Dr James Tovar is a graduate of Baylor College of Dentistry. After graduating in 2013, he moved back to his hometown of San Antonio and practices family dentistry in Helotes, a small town northwest of San Antonio.

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Your dentist is a member of the Texas Dental Association (TDA).

With more than 9,000 members, the TDA is the state’s largest dental organization, and is affiliated with the American Dental Association.

To find out more about oral health, and the TDA, visit us online at SmartMouthTexas.org.

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