Family & Cosmetic Care in a Comfortable, Relaxed Environment.

Serving Las Vegas and Henderson, Nevada since 1999.

Tooth issues can occur no matter what age you are. From the littlest child to the oldest adult, having good education when tooth issues arise is paramount. Have you ever wondered what parts make up your teeth? Why they are so strong?

Anatomy Of A Tooth

The anatomy of a tooth is actually quite simple. A tooth is made up of various layers that work together to give us our beautiful smiles. Every tooth is made up of multiple parts. These parts are as follows:

-Crown. This is the part of the tooth that you see when smiling. The crown is covered in a white colored material called enamel. Enamel is the hardest substance found in the human body. Even though enamel is very strong, it can easily be broken down by the acids produced by oral bacteria and the acids found is many popular drinks like soda.

-Dentin. Dentin is the layer right beneath the enamel.  Although not as hard as enamel, it’s hardness rating is comparable to that of bone.  Another great quality of dentin is it’s flexibility.  For example, if you bite down on a very hard food, the dentin is able to flex a little bit and can keep your tooth from cracking like it might if teeth were just made of enamel.

-Pulp. This is the inner most layer of the tooth.  The pulp provides bloodflow and nutrition to the tooth. The pulp also allows for the nerves to enter the tooth. Without proper bloodflow and innervation of the nerves a tooth will die. The pulp of a tooth is removed during root canal therapy. This procedure allows your dentist to save the tooth for form and function. Once the pulp is removed from a tooth it becomes more brittle with an increased risk of breaking. This is why dentists often recommend placing a dental crown over a tooth that has received root canal therapy.

-Root. This part of the tooth is hidden under the gum tissues. This can be visible when the gums recede as can happen during periodontal disease. The root is what anchors the tooth inside the bone allowing for support during chewing of food. One other portion of the root is called cementum. The cementum is a thin layer that anchors the tooth to the bone thru the periodontal ligament.

-Periodontal Ligament (PDL). The main function of the periodontal ligament is to attach the teeth to the bone.  The peridontal ligament also sends sensory information to the brain.  For example, if you are eating some popcorn and bite down hard on a popcorn kernel, your jaw suddenly opens to alleviate the pressure.  The periodontal ligament sends that pressure signal to your brain, causing that reflex. The tooth doesn’t feel the pressure since the tooth is only capable of sending pain messages to your brain.

-Gingiva (GumTissue). The gums form a collar or sheath around the teeth that protects the underlying bone.  When you stop brushing your teeth for an extended period of time, the gingiva become red and puffy as the body begins the inflammatory process. This is the body’s way of defending against the plaque that has built up.  If you completely stop brushing, the gingiva will eventually start to lose the war against plaque and recede from around the teeth resulting in periodontal disease that can eventually loosen your teeth.

-Bone. The bone holds the whole tooth in its place.  The bone is constantly remodeling itself. This is in response to various forces it experiences in the mouth.  For example, if you have braces on, there are forces pushing on the teeth.  The bone remodels itself to help the tooth move to the position in which it is being pushed.

Different Types Of Teeth

Every tooth in the mouth has a specific function. The teeth in your mouth are as follows:

-Incisors. These are the sharp, chisel-shaped front teeth (four upper, four lower). They are used for cutting foods.

-Canines. These are sometimes called cuspids, these teeth are shaped like points and are used for tearing foods.

-Premolars. These teeth have two pointed cusps on their biting surface and are sometimes also called bicuspids. The premolars are used for crushing and tearing.

-Molars. These teeth are used for grinding, these teeth have several cusps on the biting surface.

Conclusion

An educated patient is an informed patient who can make smart decisions regarding their dental and health care. Our teeth are quite strong but they are under constant bombardment from outside forces at all times. If you are experiencing any tooth issues see your dentist immediately to put your mind and dental health at ease.

Many believe that periodontal disease is a disease that is solely based on genetics. My grandparents had dentures, my parents had dentures, so will I. The truth is, that genetics plays a role, but is not a sentence for dentures. There are risks and limitations in the progression of periodontal disease… Can each patient limit the risks of developing full blown progressive periodontal disease?….The answer is a resounding…YES! It takes a good oral hygiene regimen, knowledge of the current state of your condition, and frequent professional cleaning to keep our mouths in a healthy, disease-free state.

Risk Factors Of Periodontal Disease

Patient Caused Risk Factors

-Poor Oral Hygiene – This is an obvious one that each individual can control. Brushing, flossing, rinsing, and seeking regular dental care are essential steps to remain periodontal disease free and avoid progression beyond gingivitis.

-Age - Research has shown that older people have the highest rates of periodontal disease. The research shows that over 70% of Americans 65 and older have periodontitis.

-Smoking Or Tobacco UseTobacco use is linked with many serious illnesses such as cancer, lung disease and heart disease, as well as numerous other health problems. Tobacco users also are at increased risk for periodontal disease. Studies have shown that tobacco use may be one of the most significant risk factors in the development and progression of periodontal disease.

-Poor nutrition- Eating an unhealthy diet will not supply you with the essential vitamins and minerals necessary for tissue healing and repair.

-Anatomy - The local anatomic risk factors for periodontal disease include:,

1. Furcation anatomy. These are the spaces between roots of molars.  In many instances, the entrance of  such furcations are restricted enough to limit access for proper hygiene maintenance. Risk factors for periodontal disease are classified according to their involvement in tooth furcations. A Grade I CEP presents with minimal projection of enamel toward the entrance of the furaction. A Grade II CEP approximates the entrance of the furcation, and the tip of a Grade Ill CEP is well within the furcation.

2. Common anatomic deformities. These interfere with a patient’s ability to effectively remove plaque biofilm which are one of the risk factors for periodontal disease. An example are Cervical enamel projections (CEP). CEPs are tooth developmental deformities of the CEJ found on molars.

4. Palato-gingival grooves (PGG). POGs are tooth developmental deformities of maxillary central and lateral incisors. They begin in lingual pits and extend vertically onto root surfaces. PGGs could, on rare occasions, extend to the root apex. PGGs are commonly associated risk factors for periodontal disease with increased gingival inflammation, plaque accumulation, and probing depth.

5. Open contacts, loss of interdental papilla, and food impaction. Open contacts between teeth may allow for easy food impaction. Food impaction is defined as the forceful wedging of food between teeth. Loss of the pointed papilla between teeth leaves another area for food impaction.

-Medications - Some drugs, such as oral contraceptives, anti-depressants, and certain heart medicines, can have an affect on your oral health, causing dry mouth, inflammation and gum tissue overgrowth. It is important to tell your dentist the medications you might be on so they can tailor a treatment schedule for your needs.

-Other Disease - These include cardiovascular disease, diabetes, and rheumatoid arthritis.  These diseases can interfere with the inflammatory process, causing healing problems, and may worsen the condition of the gums.

-Poor Nutrition – A diet without all the essential nutrients for our bodies to function can compromise our immune systems, decrease healing ability, and make tissue weaker and easier to breakdown. This will make it harder to fight off infection. Since, periodontal disease essentially begins as an infection, this lack of nutrition can make the periodontal disease develop and progress faster than it normally would. Studies have also linked obesity with an increased risk of periodontal disease.

Dentist Caused Risk Factors

-Overhanging dental restorations – A poorly completed dental restoration typically has dental material overhanging the tooth. This creates an issue keeping the area clean and also creates an area for food and bacteria to build up. These overhangs can be irritating to the tissues and retain plaque and food more easily.

-Violation of the “biologic width” –  is the height between the deepest point of the gum pocket and the bone. This distance is important to consider when fabricating any dental restorations, because they must respect the natural architecture of the gingival attachment if harmful consequences are to be avoided. These consequences include bone and tissue recession.

-Open contacts and food impaction - If a dentist places a new dental restoration and does not create the proper tight contact between adjacent teeth, that area becomes a food and plaque trap. It will necessitate improved dental hygiene in that area to keep it clean. More often than not, food and debris will accumulate creating a localized area of periodontal disease.

-Occlusal trauma – If a new restoration is not properly set in alignment with the other teeth, a patient can create damage to the tooth as well as the surrounding tissue just from the act of chewing. The bite should always be checked and adjusted after dental work to prevent trauma to an individual tooth.

Periodontal Disease Conclusion

Luckily, with the exception of the anatomy we are born with, all of these periodontal disease risk factors can be overcome. The first step is to practice good oral hygiene by brushing, flossing, and using an antibacterial mouthrinse. The second step is to choose a well qualified dentist and keep a regular schedule to help give you the best fighting chance at preventing,  treating and stabilizing periodontal disease.

Flossing is often overlooked as part our oral hygiene regimen. Although it is often overlooked, it is essential to maintaining healthy teeth and gums. Brushing alone cannot remove food debris and bacteria in and around our teeth. Flossing is able to reach areas in between teeth and in the back areas of the mouth. Flossing really is a simple act, but many often overlook it and ignore the habit of flossing. For those of us who do floss, improper technique can also cause problems.

Common Flossing Mistakes

1. Skipping The Back Teeth – When we floss it is essential to not only concentrate on the front teeth. It is equally important to get in the back of the mouth, between and around molars, and keep those areas clean. This removes food and plaque bacteria in areas from which a toothbrush can not reach. You need to keep your teeth as clean as possible to avoid the onset of periodontal disease and tooth decay.

2. Not Rotating The Floss At Each Area – The purpose of flossing is to remove bacteria, food debris, and bacteria from between the teeth. If you do not rotate the floss at each tooth you are just replacing the removed bacteria and debris back into the mouth.

3. Flossing Too Aggressively – Some of our teeth have tighter spaces than others and this could cause a more aggressive approach to flossing. It is better to gently work the floss up and down between your teeth, following the natural curve of the tooth, so as not to snap the floss down and cut your gums. You should floss using a mirror to watch what you are doing, it is easier to see if you are missing anything. You should NEVER , “shoeshine” your teeth. Side to side aggressive motion, over time, causes notches into the roots of the teeth.

4. Not Flossing Because Your Gums Bleed – At times our gums can bleed if we are not maintaining proper oral hygiene. This is the earliest sign of periodontal disease, called “Gingivitis”. This stage of periodontal disease can be reversed. If you see some blood, continue gentle flossing, and rinsing with warm salt water. As the bacteria and irritants are removed the inflammation will subside and so will the bleeding. It might take 1-2 weeks for that to happen.

5. Keep Track Of Where You Are Flossing – It can be very easy to miss a tooth or two while flossing. Create a good routine to keep on track and not get distracted.

6. Not Flossing At All! – This is the biggest mistake! Many have been lucky enough not to have decay or serious problems, and have never flossed. This may have “worked” for you in your youth, but it will put you at risk for periodontal disease as you get older. People who have never had a cavity, and do not have good oral hygiene habits are at much higher risk for gum disease. Those pearly whites may stay beautiful until they day they all start to fall out!

Conclusion

Don’t wait for problems to begin. Floss regularly and correctly, and you are setting yourself up for good success in maintaining your oral health. Remember, to floss gently, properly, and often. As many dentists say,” You don’t have to floss all of your teeth, just the ones you want to keep!”.

Tooth brushing has been a part of our lives since we can remember. It has become an activity that, for most, seems to be second nature. Brushing your teeth, as with any habit, can become tedious. You may forget the proper way and get sloppy, or may never have learned proper tooth brushing techniques to begin with. Improper tooth brushing technique can lead to many problems, including root and enamel wear, gum recession, cavities, and gum disease .

Tooth Brushing Mistake #1

-Choosing the wrong tooth brush. Not all toothbrushes are the same. Things to consider when choosing the right type of toothbrush include size of head, size of handle, and type of bristles. The head of the toothbrush should be the right size to enable you to reach all tooth surfaces. If you are straining to open wide enough to get the brush into your mouth, having a hard time cleaning around back molars, or banging into other teeth, then the brush is probably too large for you. The handle needs to be comfortable for you to use and fit your hand properly. The bristles should be soft to extra soft. If it the bristles are any harder, you increase surface abrasion.  Abrasion slowly causes wear and damage to your teeth and gums while brushing. As for manual tooth brush vs electric tooth brush, most research shows that electric toothbrushes get the teeth far cleaner than a manual brush, and if used properly, cause less abrasion.

Tooth Brushing Mistake #2

-Not brushing enough. This includes both, time of actual tooth brushing and the times per day you brush. It is recommended that you brush a minimum of twice per day for at least two minutes each time. Many of us do not brush for the recommended amount of time,instead brushing for only 15-30 s, this can definitely lead to insufficient removal of food and plaque bacteria. Brushing after each meal is ideal, removing food particles before they begin to cause problems. Timers can help you spend the correct amount of time, or humming a tune, many electric toothbrushes have an advantage in that many have a built in timer to monitor the time you are tooth brushing. Carrying a spare toothbrush or having one in your desk at work, may help you to brush more frequently.

Tooth Brushing Mistake #3

-Brushing too aggressively. Tooth brushing too vigorously can erode tooth enamel, expose the roots of the teeth, and wear away gum tissue. Erosion causes increased sensitivity to hot, cold, and sweets. Develop the proper tooth brushing technique utilizing the right amount of force to keep your teeth clean. An aggressive tooth brushing technique is difficult to change, especially if you have been doing it this way for a long time. Electric toothbrushes are ideal for changing technique, as you hold them over each tooth, letting the brush do the work, and do not “brush” with them.

Tooth Brushing Mistake #4

-Using improper tooth brushing technique. The tooth brush should be angled at a 45 degree angle and use short strokes when brushing. This will allow you to brush safely but also give yo the ability to remove the plaque at the gum line. The strokes should be soft, going up and down, and circular or vertical. Be sure to brush the outer AND inner surfaces of your teeth along with the chewing surfaces and finally your tongue.

Tooth Brushing Mistake #5

-Not Rinsing? Cleaning your brush. Bacteria will grow on an un-rinsed, wet toothbrush. If you do not rinse, and clean your toothbrush, you will be putting plaque bacteria back in your mouth each time you brush. Rinse and dry your tooth brush after you brush to help remove any leftover toothpaste, and rid of the moist environment that bacteria love. There are many techniques to clean your brush, including UV sanitizers, soap and water, and anti bacterial rinses. Keep your mouth cleaner with a clean, dry toothbrush.

Tooth Brushing Mistake #6

-Not changing your toothbrush regularly. The recommendation from the American Dental Association is to change to a new brush every 3-4 months or sooner if the bristles appear worn.  Research shows us that, as toothbrush bristles splay, their ability to remove plaque decreases significantly. You know how often and how hard you use your brush, which will help you evaluate when it is time for a new brush. Do a visual inspection every so often to ensure the bristles still have their original flexibility. There are even some brushes now that have colored indicators on them to tell you when brushes need changing. You may need to change every 1-2 months if you are a frequent brusher.

Conclusion

Tooth brushing is a very important daily habit. The premise is simple, but the technique is critical to good oral health. It is never too late to learn proper tooth brushing technique. Don’t be shy, ask your hygienist if you are doing it correctly, he/she may have some great pointers for you. The next time you see your dentist  for a dental examination and professional cleaning, take full advantage of their knowledge, and ask questions. You may be pleasantly surprised by the outcome, healthier teeth and gums!