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WINTER 2017-2018

mart mouth


Texas Dental Association Patient Publication

What are your options for replacing a tooth?pg 7

What should you expect when you have your WISDOM TEETH removed? pg 3

No, really: what’s the deal with fluoride? pg 9

What’s the right age for an ORTHODONTIC CHECK-UP? pg 5


Your dentist is a TDA MEMBER. What does that mean FOR YOU? pg 2

Periodicals supplement to the Texas Dental Journal, December 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, CAE Director of Member Services & Administration Billy Callis, CDE Managing Editor


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

Having your Wisdom Teeth Removed...3-4 What to expect before and after

The Right Age for an Orthodontic Checkup.........................................5-6 When to take your kids in--and why

Replacing a Tooth....................................................7-8 Your options--and the pros and cons

The Truth about Fluoride........................... 9-10 Get the real story--and separate the myth from fact

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.

The Best Age for an


By Dr Vladimir Tabakman TDA Member Dentist, Houston, Texas


ou may have noticed that children are wearing braces younger and younger nowadays. Why?

Well, according to the American Association of Orthodontics, they recommend all children have their first orthodontic screening starting at 7 years old. In the past, parents were usually told to wait until their child’s baby teeth were gone and all their permanent teeth were in. Or they would wait until their dentist told them they should see an orthodontist. Over the years, this has changed. At an early age, orthodontists can already spot problems with jaw growth and emerging adult teeth while baby teeth are still present. Even though a child’s teeth may appear straight, there could be a problem that only an orthodontist can detect. Early treatment may prevent or intercept more serious problems from developing. This early phase of orthodontic treatment will give your orthodontist the chance to correct problems and improve appearance when a child’s natural growth processes are in full swing. This may involve some sort of appliance or partial braces to guide the jaw growth or make room for adult teeth. Catching these problems early may make treatment at a later age shorter and less complicated.


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Most often, early treatment is not necessary and all the orthodontist may do is monitor the growth and development of your child’s teeth. In fact, most kids don’t even begin active orthodontic treatment until the ages of nine to 14 years old. Keep in mind that timing is everything. Early detection of problems such as premature loss of baby teeth, crowding, cross bites, or thumb sucking can result in a shorter course of treatment. If your child is older than seven years old, just remember: it’s not too late for a check-up!

Vladimir Tabakman, DDS, MS currently owns 2 full time practices in Houston, Texas: Bellaire Family Orthodontics and West Houston Orthodontics. He earned his Doctor of Dental Surgery from the University of Texas at San Antonio and his Master of Orthodontics from the University of Detroit Mercy.

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Having your

Wisdom Teeth removed what to expect before and after

By Dr Craig Armstrong TDA Member Dentist, Houston, Texas


our last set of molars, or third molars, have been referred to as “wisdom teeth” since the 17th century. These teeth generally make their appearance between the ages of 17 and 25, an age at which we are supposed to be wiser--hence the term “wisdom teeth.” Having your wisdom teeth removed can feel somewhat overwhelming if you don’t know what to expect. So let’s talk about what you can expect. CONSULTATION APPOINTMENT A consultation appointment is simply a time to sit down and discuss with your doctor before the procedure takes place. During this appointment, your doctor might: -Discuss your medical history and explain the procedure. -Go over the “do’s” and “don’ts” following the procedure. -Discuss questions and put to rest any concerns that you may have. Pro tip: Write down any questions they may have and bring them with them to the consultation appointment. It’s very easy to forget a question that you wanted to ask, so write it down. SEDATION Most doctors recommend that their patients have wisdom teeth removed while the patient is sedated. Most commonly patients are sedated using I.V. (Intravenous) Conscious Sedation, although there are other types of sedation available. This type of sedation allows for safe, efficient and comfortable removable of wisdom teeth. Your doctor will explain the different types of sedation available and help you select the best for you. You will need a responsible adult, over 18 years old, to accompany you and remain with you throughout the procedure. The doctor’s ultimate goal is to provide you with a safe and comfortable dental experience.


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POST-PROCEDURE So now that you have had all your written questions answered, your appointment is completed, and you have had your wisdom teeth removed. What can you expect? -Some bleeding or “oozing” of blood for 12 to 24 hours following the appointment -Some swelling for the first couple of days, which should go away by approximately the 5th day -Discomfort which may last for 2 to 3 days immediately after surgery. These are the norms, but everyone is a little different so there may be a little variation. AFTER-CARE/INSTRUCTIONS Following the procedure, patients are always given both a verbal and written set of instructions to take home. These instructions include: -How to manage any discomfort -How to take any medications that have been prescribed -A contact number for the doctor in case concerns or questions that arise Your doctor should contact you immediately following your procedure to check on you to make sure you are comfortable. Five to 7 days following your procedure, you should return to your doctor’s office for a follow up visit to make sure you are healing properly and to provide you with any further instructions. For most patients it takes a couple of months for the areas where the wisdom teeth were removed to completely fill in and it is as if they were never there. I have found that the best outcomes occur when the patient is well informed and all of their concerns have been addressed. So, get all the information you can, communicate with your doctor, follow the do’s and don’ts and you should have a positive wisdom tooth removal experience.

Dr Craig Armstrong maintains a general dentistry practice in Houston and has been an active member of the Texas Dental Association since graduating from the University of Texas Dental Branch in Houston in 1989.

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Replacing a tooth: Your Options--and the Pros and Cons

By Dr Christopher W. Proctor TDA Member Dentist, Abilene, Texas


s a restorative dentist, I do everything in my power to help my patients keep their teeth for a lifetime. Unfortunately, there are times when everything in my power just isn’t enough, and a tooth needs to be removed. At this point (even before an extraction), it’s important to discuss different ways a patient can fill the space created by a missing tooth. Here are the options I review with patients, along with the pros and cons we discuss: 1. No treatment This is always the first choice I give a patient. It's my least favorite option, but depending on the situation sometimes it is the best choice for a patient. •Pros: it’s the cheapest option, and sometimes the easiest for the patient. •Cons: it has the most potential ill side effects, like shifting teeth and bone loss in the affected area. 2. Removable partial Sometimes called an interim partial or a "flipper," these are similar to an orthodontic retainer and have an acrylic tooth attached to fill the space where a tooth is missing. This is also a temporary solution used during the healing process for a tooth that is going to be replaced by a dental implant. • Pros: the least expensive method to replace a tooth after it is lost, a great temporary fi between the stages of dental implant. •Cons: flippers take getting used to for talking and eating, and they are susceptible to breakage and can be lost.


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3. Fixed bridge When a patient is certain they want to replace a missing tooth, one of the better long-term solutions is a fixed bridge. The teeth adjacent to the open space are prepared for crowns, and a single piece covers both teeth and connects them with a replacement tooth ("pontic"). A final cement is used to fix this to the teeth, so like a crown, a bridge is not intended to be removable. •Pros: improved function and esthetics over a flipper; can be completed in 2-3 weeks; since it is cemented, the concerns of a bridge coming out or being lost are much fewer. •Cons: a more expensive option than a flipper; can be considered an aggressive option for missing teeth adjacent to otherwise healthy teeth; if any part of a bridge fails due to leakage or decay, the entire bridge needs to be replaced. 4. Dental implant These are increasingly becoming the standard of care for replacing missing teeth. Whether as an individual tooth replacement or to help retain a larger prosthesis like a denture. Implants are basically artificial roots, made of a material like titanium, that are surgically placed in the jaw bone and form a tight bond to bone (called "Osseointegration"). Once this occurs, a tooth can be fitted with a tooth form ("abutment") and then receive a crown. The length of time required to heal and the success of implant placement depends on several factors pertinent to the patient and his/her health history. •Pros: it is a fixed tooth replacement that functions and looks like a natural tooth; adjacent teeth are unaffected, and an implant restoration is not susceptible to decay. •Cons: implant treatment is done in stages with healing time between, and treatment can take several months; a flipper can be required to replace the missing tooth while the implant heals; it is the most expensive of the tooth replacement options. The treatment options in this article cover the main methods of tooth replacement. None of these treatments will exempt you from doing your part with good home care. Failure of any restoration can occur even when a patient is diligent about oral hygiene, and the best way to spot problems early is having regular recall and x-rays in a dental office. Dr Christopher Proctor practices general dentistry in Abilene, Texas at Southwest Dental Care, and earned his Doctorate of Dental Surgery from the University of Texas Health Science Center at San Antonio Dental School.

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It’s in your toothpaste. It’s in your water. And it might be on your Facebook or Twitter feed, your local news station, or your city council’s agenda. It’s fluoride, and it’s gaining a lot of publicity--even though water fluoridation has been widespread in the US since at least 1960. (1) With all the information out there, how do you know what’s true--and what’s just a myth?


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Fact: Fluoride is a naturally occurring mineral. And numerous scientific studies have shown that community water fluoridation is completely safe. (2)


The Centers for Disease Control named water fluoridation one of the 10 great public health achievements of the 20th century--along with seatbelts reducing tobacco use, food safety laws, and lowered infant mortality. (5)



s, and Scientists, dentist ir doubts doctors have the about fluoride.

The World Health Organization, American Dental Association, American Medical Association, Centers for Disease Control, US Public Health Service, and more than 125 other organizations and institutions across the world recognize the benefits of fluoridation. (3)

myth: Fluoride costs taxpayers too much.

Fact: It costs less per person to fluoridate water for a lifetime than it does to get one cavity filled. In most cities, every $1 invested in fluoridation means $38 saved in dental treatment costs. (4) That's a solid investment.

References: 1: "One in a million: the first community trial of water fluoridation." ncbi.nlm.nih.gov/pmc/articles/PMC2627472/pdf/17128347.pdf 2: "Fluoridation Safety." cdc.gov/fluoridation/safety/ 3: "ADA Fluoridation Facts Compendium." ADA.org/4378.aspx 4: "An economic evaluation of community water fluoridation." ncbi.nlm.nih.gov/pubmed/11474918 5: "Ten Great Public Health Achievements in the 20th Century." cdc.gov/about/history/tengpha.htm This article appeared in a slightly different form in the winter 2015-2016 edition of Smart Mouth.


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. 1 9 4 6 S I H 3 5 S t e 4 0 0 A u s t i n , T X 7 8 7 0 4 P : 5 1 2 - 4 4 3 - 3 6 7 5 t d a . o r g

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Smart Mouth - Winter 2017-2018  

The Texas Dental Association's magazine for patients.

Smart Mouth - Winter 2017-2018  

The Texas Dental Association's magazine for patients.