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A Spot of Trouble?

March 15th, 2023

Your smile is in the spotlight every day, helping you greet the world with confidence! But when you’re self-conscious about discolored spots on your teeth, it’s time to get some professional advice to deal with these troublesome tints.

Discolored patches, both dark and light, can develop for a number of different reasons. Some markings are cosmetic only, and some spots require treatment. Some can be removed with a professional cleaning, and some might require more serious restoration. Let’s have a look at some of the common causes of enamel discoloration.

  • Cavities

Decayed enamel can appear as a brown spot on the tooth. A dark edge around a filling might mean decay underneath.

Regular checkups at our East Lyme, CT office will help catch small cavities before they become big ones. If you need a filling, the filling color can be matched to your tooth color for an undetectable restoration.

  • Demineralization

Bacteria in plaque produce acids, which attack our teeth. These acids erode minerals such as calcium and phosphorus from enamel, leaving a weak spot that is vulnerable to decay. This process is called “demineralization,” and often leaves a whiter spot on a tooth where minerals have leached away. Common reasons for demineralization are neglecting dental hygiene, failure to clean around braces, and a diet filled with sugary and acidic foods.

Fluoride and enamel-strengthening toothpastes, a healthy saliva flow, and a balanced diet help our teeth “remineralize,” bathing teeth in minerals that can help replace those that have been lost. But if you have lingering white spots due to demineralization, Dr. James Robson can provide some options, including whitening, microabrasion, and veneers.

  • Fluorosis

Fluorosis is a cosmetic condition caused by exposure to too much fluoride while the permanent teeth are still forming (generally, during the years before a child’s eighth birthday). Small white spots and patches are a common result of mild fluorosis. In more serious cases, teeth can be pitted and stained with brown, gray, or black spots.

Preventing fluorosis begins in early childhood. Talk to Dr. James Robson about fluoride levels in local tap water if you have any concerns. Use only the recommended amount of toothpaste (the size of a grain of rice for children three and under; the size of a pea for children three to six), and show your child how to spit out toothpaste and rinse after brushing. Keep fluoride toothpastes and other fluoride products out of the reach of young children. Don’t give children fluoride supplements or fluoride rinses without discussing it with Dr. James Robson.

If your own teeth have been affected by fluorosis, talk to us. Again, this is a cosmetic condition affecting otherwise healthy teeth. Whitening treatments can be helpful in mild cases, microabrasion has been effective for mild to moderate cases, and, for severe cases, cosmetic restorations such as bonding and veneers are an option.

  • Tartar

Are you seeing an accumulation of dark brown spots and stains on your teeth, especially between the teeth and at the gum line? This might mean that you have tartar buildup. When you brush plaque away every day, your enamel stays smooth and clear. But when plaque builds up over time, it hardens and becomes tartar.

How hard is tartar? So hard that it can only be removed with a professional cleaning. Eliminate this source of spots and staining with twice daily brushing and daily flossing, and make sure regular professional cleanings are on your calendar.

  • Other Causes

Medications taken while teeth were developing (notably, antibiotics in the tetracycline family) can cause discoloration. Medical conditions such as celiac disease and enamel hypoplasia can affect both tooth color and enamel formation.

Cosmetic treatment and restorations can help with discoloration caused by medications, and restorations such as bonding, veneers, and crowns can restore tooth appearance and function when medical conditions cause imperfections in enamel color and structure.

If you’re unhappy with the overall whiteness of your smile, a professional whitening might be just what you’re looking for. If specific patches, streaks, and spots of a different color are dimming your bright smile, it’s time for an exam. Dr. James Robson will be able to tell you the reason for any discolored enamel as well as present you with all your treatment options. Put the spotlight back where it belongs—on your healthy, confidant smile!

Antibiotic Prophylaxis or Premedication

March 15th, 2023

In years past, it was often recommended that dental patients who had a history of heart problems or other conditions, such as joint implants, be given antibiotics before any dental work. This pre-treatment is called prophylaxis, based on the Greek words for “protecting beforehand.” Why would Dr. James Robson suggest this protection? It has to do with possible effects of oral bacteria on the rest of the body.

Our bodies are home to bacteria which are common in our mouths, but which can be dangerous elsewhere. If these oral bacteria get into the bloodstream, they can collect around the heart valve, the heart lining, or blood vessels. A rare, but often extremely serious, infection called infective endocarditis can result.

It is no longer recommended that every patient with a heart condition take antibiotics before dental procedures. Doctors worry about adverse effects from antibiotics or, more generally, that an overuse of antibiotics in the general population will lead to more strains of antibiotic-resistant bacteria.

There are some patients, however, who are at a higher risk of developing infective endocarditis, and who should always use preventative antibiotics. Generally, premedication is advised if you have one of these risk factors:

  • A history of infective endocarditis
  • Certain congenital heart conditions (heart conditions present since birth)
  • An artificial heart valve
  • A heart transplant

Your cardiologist will know if prophylaxis is advisable, and if you are taking any drugs which could interact with antibiotics. Always talk to your doctor about any dental procedures you are planning, particularly if they are invasive procedures such as gum surgery or extractions.

If you believe you would benefit from antibiotics before dental treatment at our East Lyme, CT office, the most important first step is to talk with your doctors. We are trained to know which pre-existing health conditions call for prophylaxis, which dental procedures require them, which antibiotics to use, and when to take them. Tell us about any health conditions you have, especially cardiac or vascular issues, and any medication allergies. Working with you and your doctor to protect your health is our first priority, and having a complete picture of your medical health will let us know if antibiotic prophylaxis is right for you.

Flossing Fact or Flossing Fiction?

March 8th, 2023

Somewhere in a bathroom drawer or medicine cabinet, we all have one—that little plastic dental floss dispenser. And whether you use your floss every day (yay!), or have completely forgotten it was in there (not so good), just how much do you know about that sturdy string? Let’s find out!

  • Flossing has been around for hundreds of years.

FACT: It’s been just over two hundred years since Dr. Levi Spear Parmly, a dentist in New Orleans, suggested his patients use waxed silk thread to clean between their teeth. This is considered the first “official” invention of dental floss, although using some form of tool to get rid of food particles between the teeth has been around since prehistoric times.

  • Brushing well is the same as flossing.

FICTION: It’s really not. While brushing does a great job of cleaning food particles, plaque, and bacteria from your enamel, there are some places those bristles can’t… quite… reach. Floss was designed to clean plaque and food from between the teeth and close to the gum line where your brush doesn’t fit.

  • There’s more than one way to clean between your teeth.

FACT: Indeed there is! Not only are there many varieties of dental floss (waxed, flavored, round, flat, thick, thin, in a dispenser, attached to miniature floss wands), but you have alternatives if using any kind of floss is difficult for you. Water-flossers direct a pulsing stream of water between and around the teeth and gum line to remove food particles and plaque. Another useful alternative is the interproximal brush, a tiny little cone-shaped brush designed to remove food and plaque from those hard-to-reach spots.

  • Flossing helps prevent gum disease.

FACT: Scientific studies haven’t provided definitive answers. But Dr. James Robson and our team strongly recommend daily flossing as one of the most important things you can do to prevent gum disease. Gingivitis, or mild gum disease, is caused by irritated, inflamed gum tissue. Gum tissue becomes irritated and inflamed as a response to the bacteria, plaque, and tartar, which stick to your teeth. Anything you can do to help remove these irritants will reduce your risk of gum disease.

  • Flossing helps prevent cavities.

FACT: We strongly recommend daily flossing to remove the food particles and plaque, which lead to cavities. Brushing removes cavity-causing plaque from the outer surfaces of your teeth. But there’s a lot of enamel between your teeth as well. Flossing removes plaque from these hidden spots, helping to prevent interproximal (“between the teeth”) cavities from forming.

  • Bleeding when you floss is normal.

FICTION: Bleeding isn’t a typical reaction to flossing. Bleeding gums could be an early sign of gum disease caused by plaque and tartar buildup. On the other hand, if you floss too hard, or go too deeply below the gum line, you can make delicate gum tissue bleed. Ask Dr. James Robson for tips on perfect flossing technique.

  • You need to floss after every meal.

FICTION: Dental professionals generally recommend brushing twice a day and flossing at least once each day. But this suggestion comes with some exceptions. If you have braces, your orthodontist might recommend flossing after eating. And certainly, for removing pesky food particles, flossing or interdental picks are a sensible choice after any meal.

  • Your dentist will never know that you haven’t been flossing.

FICTION: Nope. Sure, you can miss flossing a few times and catch up before your appointment at our East Lyme, CT office. But built-up plaque between the teeth, red, swollen, or bleeding gums, and gingivitis and interproximal cavities let both you and Dr. James Robson know that you’ve been neglecting good dental habits.

  • It’s never too late to start flossing!

FACT: Flossing is a simple, quick, and inexpensive way to maintain tooth and gum health. If you haven’t had much luck flossing in the past, ask Dr. James Robson for flossing tools and techniques that will work for your specific needs. Start now, and see what a difference it will make at your next checkup!

If you had all these flossing facts at your fingertips, congratulations! But if you didn’t, no need to worry, because the real test of your knowledge is in its application. Flossing properly at least once each day will give you something far more rewarding than blog-quiz kudos—you’ll see that regular flossing rewarded with healthier teeth and gums!

Do We Outgrow Tooth Decay?

March 8th, 2023

Short answer: No. But, since an answer that short is hardly worth the time it took you to click on the link, allow us to explain further!

We tend to think of tooth decay as something we leave behind with childhood. And, while it’s true that youthful cavities are unfortunately common, older adults face unique challenges of their own which put them at risk for cavities.

Root Cavities

Gum tissue often recedes with age. And our roots, which were once completely covered and protected by gum tissue, become partially exposed to plaque, acidic foods, and the abrasive effects of heavy-handed brushing.

This is a problem. Instead of enamel, a substance called cementum covers and protects our roots. But cementum isn’t as strong as enamel, and so our roots are much more vulnerable to the cavity-causing bacteria in plaque, erosion from dietary acids, and damage caused by abrasive brushing. Root cavities also progress faster than crown cavities, which can mean a root canal procedure in your future, or, even worse, an extraction if a cavity isn’t treated promptly.

What can you do to avoid root cavities?

  • Do what you do to avoid any cavity—brush at least twice a day for two minutes, use floss to clean between the teeth and along the gumline, and use a fluoride toothpaste.
  • Fluoride treatments can be applied to the exposed root area for added protection. Ask your dentist about this option.
  • Take care of your gum health. See Dr. James Robson regularly, and, if you have serious gum disease, a visit to your periodontist might be in order.
  • Always use a soft toothbrush. Even a brush with medium bristles can be too firm for teeth and gums.

Failing Fillings

As we age, our dental restorations age as well. Over time, fillings can become loose, erode, or crack, which can lead to cavities under or around these damaged restorations. Bacteria can reach beneath a loose filling—your toothbrush can’t.

What can you do to prevent cavities in these hidden spots?

  • Keep up with your dental checkups. Part of each dental exam is checking the condition of your dental restorations.
  • Visit Robson Dentistry if you notice any sign of tooth decay, including tooth pain, sensitivity, or discoloration.
  • If you discover a loose, cracked, or lost filling, even without any discomfort, call Dr. James Robson right away. A timely replacement filling can prevent hidden decay from seriously damaging a tooth.

Dry Mouth

Dry mouth, or xerostomia, occurs when our bodies don’t produce their normal amount of saliva. Saliva, of course, is vital for healthy and comfortable eating—it helps us swallow, digest, and taste our food. And it also has dental benefits! Saliva helps neutralize the acidic foods we eat, washes away food particles and bacteria, and contains minerals like calcium and phosphorus which remineralize tooth enamel.

Many medical conditions (including diabetes and high blood pressure), medical treatments (such as chemotherapy and radiation), and medications (both prescribed and over the counter) can reduce normal saliva production.

What can you do to restore saliva production?

  • Drink fluids as recommended, especially water.
  • Chew gum. Sugarless gum encourages saliva. Sucking on sugar-free candies works as well.
  • Brush regularly with fluoride toothpaste, and ask about fluoride rinses.
  • Talk to Dr. James Robson. There are medications available that can help.

Keeping up with our dental health is important at any age. Brushing and flossing, fluoride toothpaste, regular dental exams and cleanings at our East Lyme, CT dental office—the basics of dental health don’t change over time, even if our dental challenges are a bit different as we get older. After all, do you ever outgrow an attractive, healthy smile? This answer is short and sweet: never.

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