Archive for November, 2009

Dentures: How to prevent getting dentures, taking care of them and their current trends.

There are so many topics in dentistry that I can write about in this column since research is exposing more advanced techniques, materials and objectives in the field.  This month I wanted the Shelby Township, Macomb, Sterling Heights and Clinton Township readership to become aware of the state of edentulous (without teeth) patient and the struggles they go through.  It is also important to know that the percentage of  people who have lost their teeth is increasing even though research is advancing.  The problem with tooth loss is that the skeletal bone actually shrinks over time where the teeth have been extracted.  Since dentures rest on the gums people who have dentures only can bite down 15-20% as hard as they could when they had teeth.  This means that they have a limited assortment of soft foods they can comfortably eat which tends to not be as nutritious as harder foods such as fresh fruits and vegetables. 

Demographics:

According to an Academy of General Dentistry article there are around 35 million Americans who have either 1 or 2 jaws of missing teeth and this number is expected to increase to 38 million by 2020.  26% of the US population between the ages of 65-74 do not have teeth.  According to David Felton DDS, the demographic most at risk for dentures are lower education, smokers, females and a population who does not take daily vitamins or supplements. 

Tooth Loss

Once thought that dentures were a normal age related event we now know it has a lot to do with genetics, nutrition, and oral hygiene.  Those who are prone to tooth loss at an early age from cavities and periodontal disease are at a much higher risk for complete tooth loss and eventual dentures.  Once a tooth is removed, the adjacent teeth move into the space creating gaps where food gets lodged, creating more problems and more tooth loss.  This is why it is best to save teeth with root canal treatment if a tooth is infected rather than have it extracted.  Having fillings done at an early enough stage prevents root canals or extractions.

Periodontal disease is the leading cause of tooth loss in adults.  This bacterial induced disease is not painful and has little symptoms so it must be diagnosed and treated by a dentist before it is too late.  If your gums bleed when brushing or flossing, if you have bad breath, if your teeth are loose, if there is swelling around the gums or you have tarter buildup then you more than likely have periodontal disease.  Ignoring your problem won’t make it go away, in fact the sooner you are treated the better the outcome. 

Denture Care

For those who have had their teeth already removed and have dentures there is hope for you.  First of all, dentures have to be replaced or relined every 5-8 years.  Because the bone that supports the denture continually shrinks it is very important that you maintain the best fit possible.  When dentures are too loose they irritate the soft tissues and bone underlying the denture.  With less biting pressure the diet only permits for softer foods to be eaten.  Another factor not addressed much is the potential for an embarrassment moment when laughing with a denture and having it drop or even pop out of your mouth. With a good fit dentures provide confidence to be yourself and to smile and laugh without concern.

Assuming the dentures are made properly and fit relatively well, mini implants can be placed in one visit to provide a snap fit so the dentures are stabilized.  These implant supported dentures continue to rest on the ridge, but since they hold tightly to the gums without adhesive, they don’t move.  You can bite, chew and laugh without worrying that the denture will jump or fall out of place. 

Here are some pointers on how to take care of your dentures:

1. Don’t use tooth paste to clean them-This can scratch the surface and potentially promote staining and tarter build up.
2. Make sure you remove them when sleeping.  When removing the dentures at night the soft tissues to get access to body’s healing saliva of the mouth.  When leaving in place thrush can develop.  This reddish yeast infection can also be seen on the corners of the mouth. 
3. Soak your denture at night in Efferdent, Polident or other soaks.
4. See your dentist every year for a denture fit analysis.  The exam we do also provides for a cancer screening in addition to an analysis on your denture’s fit.
5. Clean your dentures with a brush and a denture cleaning paste such as Denture Cream every day. 
6. Use a wash cloth to rub and stimulate the roof of the mouth, tongue and lower ridge.  This prevents the build up of bacteria and yeast in the mouth.  It is also prudent to rinse the mouth with a mouthwash such as Listerine or Crest Pro Health.
7. If you don’t currently have a dentist you can contact our office at (586)247-3500 for a Free Denture Consultation.  I will give you an honest opinion of your status.  If you have dental insurance you should give us a call as soon as possible to take advantage of this benefit before year end.

I want to wish you and your family a Joyous Christmas and remember the reason for the season is the birth of Christ the King.  He came to this earth because He cares so much for you and me that He gave His life for us on the Cross.  May 2010 be Joy filled as we all go through these tough times together.  We will prevail.

If you have questions please call the office at (586)247-3500, email me at DrAntolak@TheGentleDentist.com, write at 15055 22 Mile #2, Shelby Twp. MI 48315 or fax (586)247-1211.  The more questions I receive the more I know what you are interested in as a topic.    Thank You, Robert V. Antolak DDS

We at The Gentle Dentist provide Cosmetic, Implant and General dentistry.  Our motto is “Relax while we take care of your smile”.  For more information please visit our web site at www.TheGentleDentist.com

There are so many people who have severe anxiety that they continue to prolong their dental visits because they remember a bad experience they have had in the past.   These bad experiences have made them feel hopeless, insecure and like chickens.  Usually this self criticism is damaging to both their health and psyche.  This is an endless loop of knowing what they should do but continue to procrastinate and live in their fear.  Dentistry can be a very scary place for those who have had bad experiences.  These experiences are imprinted in the patient and even the thought makes them nervous of the dentist.

I have found in my 23 years of practice being a dentist is to break the cycle by breaking the silence.  What I usually see is having an email sent to me describing their bad experiences and then I will follow up with a call to discuss their concerns personally.  Many have said how this simple step has made a huge difference in their anxiety. 

Recently I had a patient who fit this description and after a few emails I called her up and talked to her.   This made it possible for her to make an appointment.  She is going to just stop into the office impromptu to meet our team and see that we are real people.  With our light cheerful environment which lacks the typical dental office smell, charts and sounds it makes trips to the dentist much more tolerable.  My hope if this describes you go to our welcome page at our office’s website http://www.thegentledentist.com/about_dr_antolak.htm to see why we at TheGentleDentist.com and your home for dentistry in the Macomb, Shelby, Clinton Township, Sterling Heights and Washington Township area.  You can also call us at 586.247.3500

Ask The Gentle Dentist             Teeth Whitening-Your questions answered

            by Robert V. Antolak DDS

In our Shelby Township dental practice one of the most requested cosmetic procedures is teeth whitening.  I would like to clarify what whitening (bleaching) is and what it is not so that you the consumer can make an informed decision when it comes to getting a brighter smile.          

Bleaching has been around in dentistry for the past 25 years or so.  It was first discovered accidentally when an oral wound cleanser was discovered to have an effect on whitening the teeth.  The active ingredients in both the wound cleaners and in bleaching agents are either carbamide peroxide or hydrogen peroxide.  These agents have the ability of creating “scrubbing bubbles”, a phenomenon observed when pouring hydrogen peroxide over a bleeding wound.  The bubbles kill off germs by breaking down the peroxide into oxygen, water and free radicals.  Free radicals are small molecules that are very active in breaking down the structure of larger molecules.

Teeth become darker over time because large stain molecules are present within the structure of enamel.  Over time these molecules will become larger and larger.  Light reflects off of these molecules creating a dark appearance, so when bleaching agents penetrate the enamel they break the large stain molecules down into much smaller molecules which reflects a lighter image. 

There are a few factors that make teeth whitening more effective:

1) Concentration and availability of active peroxide agents. The stronger the chemical the more active ingredient is available to oxidize to create more “scrubbing bubbles”.

2) Time to break down the larger stain molecule.  The best techniques are those using the plastic bleaching trays custom made at the dental office.  Usually wearing them at night allows for the best results.

3) Custom tray construction.  This is important because it is critical that the bleaching material stays in contact with only the enamel of the teeth as long as possible and not covering the gum tissue or even the root of the teeth.  If it is haphazardly made and are not precisely trimmed it will cause great tissue irritation, burning the tissue and causing tooth sensitivity.  The tray should actually create a seal at the gum line so when gas pressure is emitted from the chemical process it can actually penetrate into the tooth. 

            There are many techniques used in whitening teeth including in office whitening strips, paint on agents, toothpaste and even floss.  This is a huge industry so when there is money to be made many gimmicks and strategies are out there. 

            In my opinion the night whitening with precise custom trays work the best.  I have the Zoom light to do “in office” bleaching but rarely use it.  The reason why is that the factor of time is not present long enough to make this a long term solution.  You always have to follow up the Zoom whitening with nightly bleaching to make this a long term technique.  I have many patients who will complain that they had the Zoom done with no long term results to show for it because they were not informed that they had to whiten their teeth at night to gain the lasting effect.  I also recommend nightly use of bleaching trays because at night the saliva flow is greatly reduced when you sleep. Saliva contains enzymes that break down the peroxides so the reduced saliva helps keep the material in the tray where it is most effectively needed. 

            The whitening strips do work, but they can’t fit into the nooks and crannies if the teeth are at all crooked.  They also only cover the front 6 teeth so when one gives a big smile the back teeth are darker, which doesn’t look so good.

Deep Bleaching results:  Before and After

Tooth sensitivity is also a factor when it comes to teeth whitening.  There are acidic preservatives added to some of the products used by dentists that make the bleaching material more stable and to prevent breakdown before use.  The problem is that these agents can make the teeth more sensitive while not being active enough to break down when needed on the teeth.  Rather than adding these acidic agents to the bleach, the Kor deep bleaching solution uses refrigeration to keep it active and preserved until needed.  Hema, a common dental desensitizer is used before the bleaching process to reduce any sensitivity.  All of these details are needed as well as a precise fitting tray to give you the deepest bleaching result possible. 

There are many ways to whiten your teeth.  What is important is the fact that your dentist can provide you the best outcome.  Remember that only enamel can be whitened; tooth colored fillings, crowns and veneers can not be bleached out.  Active decay must be taken care of before bleaching is done to reduce any possibility of root canals.  The most important thing is that your dentist evaluates your situation to give you the professional guidance needed for the most predictable results.   

If you have questions about this topic or any other topic you can email me, Dr. Antolak at DrAntolak@Thegentledentist.comor fax your question to Ask the Dentist c/o Robert Antolak DDS.  The number is (586)247-1211.  Or address is 15055 22 Mile, suite #2, Shelby Twp. MI 48315.   

            Just stop in during our office hours and let me know that you read our Ask the dentist article and get a free prize.  Our office phone number is (586)247-3500.

May you and your family have a blessed Thanksgiving this year.  During these tough economic times take time to see what God has blessed you with: Family, Friends and Freedom.  What else could be better?