By Carol Haddad, DMD
November 29, 2020
Category: Oral Health
Tags: oral health   smoking  
HeresWhySmokingCanBeHazardoustoYourDentalHealth

During his exploration of the Americas, Christopher Columbus encountered a native in a canoe loaded with water, food and a strange bunching of leaves. This marked the first European encounter with tobacco, a discovery that still haunts us to the present day. Today, millions smoke tobacco—and many suffer serious health problems as a result, including dental diseases like tooth decay and gum disease.

The American Cancer Society is sponsoring its 44th annual Great American Smokeout this November 19 when health providers across the country encourage smokers to kick the tobacco habit. Dentists will certainly be among them: Studies show that smokers are five times more likely to lose teeth than non-smokers due to a higher incidence of dental disease. Here's why.

Increased plaque and tartar. The main cause for tooth decay and gum disease is dental plaque, a thin, bacterial film that builds up on teeth. Brushing and flossing, along with regular dental cleanings, can keep plaque and its hardened form tartar from accumulating. But substances in tobacco restrict the flow of saliva needed to curb bacterial growth. This in turn can increase plaque accumulation and the risk for disease.

Hidden symptoms. Your gums often “tell” you when you have early gum disease by becoming swollen and red, and bleeding easily. But if you smoke, you might not get that early warning—the nicotine in tobacco interferes with your body's inflammatory response, so your gums, although infected, may look normal. By the time you find out, the infection may have already spread, increasing your chances of tooth loss.

Slow healing. Nicotine can also constrict the mouth's blood vessels, slowing the delivery of nutrients and infection-fighting antibodies to your teeth and gums. As a result, your body may have a harder time fighting tooth decay or gum disease, and diseased tissues can take longer to heal. Slower healing can also complicate the process of getting dental implants.

Increased oral cancer risk. Although it's not as prevalent as other cancers, oral cancer is still among the deadliest with a dismal 50% survival rate after five years. Smokers are six times more likely than non-smokers to develop oral cancer. But by quitting smoking and other forms of tobacco, you could reduce your oral cancer risk to that of a non-user in just a few years.

Kicking the smoking habit often takes a monumental effort, but it's worth it. Quitting not only improves your overall well-being, it could help you gain healthier teeth and gums. To learn how, see us for an up-to-date dental exam—we can show you how getting Columbus's most notorious discovery out of your life could do wonders for your smile and dental health.

If you would like more information about the effects of tobacco on your oral health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Smoking and Gum Disease” and “Strategies to Stop Smoking.”

AgeDoesntHavetoStopYouFromStraighteningYourSmile

Cowboys wear Stetsons; ballerinas wear tutus; and teenagers wear…braces.

At least that's the popular conception. In actuality, one in five orthodontic patients is an adult, a number that continues to grow. Even adults over fifty are straightening their teeth and improving their smiles.

But it's still a big step and many adults are wary to take it because they think it's too late. Not necessarily: If you're an older adult toying with the idea of straightening your teeth, toy no more. Here's the lowdown on late in life orthodontics.

It's not just about the smile. While wanting a more attractive smile may have started you thinking about orthodontics, it's not the primary reason for considering it. Straightening your teeth can improve your health. Because misaligned teeth are more difficult to keep clean of disease-causing plaque, realigning them properly can improve your hygiene and lower your risk of dental disease. You'll also gain new chewing efficiency and comfort, which can improve your overall health and nutrition.

Health, not age, is the determining factor. Even if you're well advanced in years you can have your teeth straightened—as long as you're healthy. If your teeth, gums and supporting bone aren't in the best of shape, the stresses associated with tooth movement might be further damaging. Some systemic conditions may also interfere, so a full assessment of your overall health will be needed before treatment.

Only you and your dentist need to know. A lot of adults are embarrassed by the prospect of wearing braces. But you might be a candidate for an alternative to braces called clear aligners. These clear plastic trays are worn in a series to gradually move the teeth to their desired positions. You can remove the trays for eating or hygiene, as well as for rare special occasions. But best of all, they're nearly invisible to others.

If you're serious about straightening your teeth, take the next step by undergoing a complete dental exam. If the results of the exam show you're a good candidate for orthodontics, we can discuss your options for transforming your crooked teeth into a more attractive smile, regardless of your age.

If you would like more information on adult orthodontics, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Orthodontics for the Older Adult.”

TargetedToothRemovalCouldAidTreatmentforCertainBiteProblems

Before we begin correcting a malocclusion (poor dental bite), we need to ask a few questions: How extensive is the malocclusion? How far must we move the teeth to correct it? How might the patient's jaw size impact treatment?

Answering these and other questions help us develop an effective treatment plan. And depending on the answers, we might need to look at other procedures before we install braces—like removing one or more of the teeth.

This isn't a subject to approach lightly: All teeth play an important role in dental function and smile appearance, and ordinarily we want to preserve teeth, not remove them. Sometimes, however, it may be a necessary action to achieve our goal of an improved dental bite.

For example, it might be necessary for correcting a malocclusion caused by severe teeth crowding. This occurs when one or both of the jaws hasn't grown to a sufficient size to accommodate all of the teeth erupting on it. As a result, some of the teeth could come in out of their proper alignment.

If caught early before puberty, we may be able to use other techniques to alleviate crowding, like a device called a palatal expander that influences an upper jaw to widen as it grows. If successful, it could provide later teeth more room to erupt in their proper positions.

But even if additional jaw growth occurs, it may not be enough to avoid a malocclusion or treatment with braces. Alleviating further crowding by removing teeth in little noticed areas could help with subsequent orthodontics.

Removing teeth may also be the answer for other problems like an impacted tooth, in which the tooth has not fully erupted and remains submerged in the gums. It's sometimes possible to use a technique to “pull” the tooth down where it should be; but again, that will still require jaw space that may not be available. The more effective course might be to remove the impacted tooth.

Whether or not tooth extraction will be needed can depend on a thorough orthodontic evaluation and full consideration of all the available options. Even though the ideal situation is to correct a bite with all teeth present and accounted for, it may be for the better good to sacrifice some.

If you would like more information on orthodontic techniques, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Removing Teeth for Orthodontic Treatment.”

By Carol Haddad, DMD
October 30, 2020
Category: Dental Procedures
Tags: wisdom teeth  
WisdomTeethBearCloseMonitoringforFutureDentalHealth

One of the major signs that a young person's dental development is nearing completion is the eruption of the last four permanent teeth: the third molars, located rear-most on either side of both the upper and lower jaws. But the advent of these molars, also called wisdom teeth, isn't always a cause for celebration: They can give rise to serious dental problems.

Wisdom teeth often arrive on an already crowded jaw, making them subject to erupting out of position or becoming impacted, totally or partially submerged in the gums. This can cause harm not only to themselves, but also to other teeth: They can impinge on and damage the roots of their neighbors; impede brushing and flossing and increase the risk of disease; and skew the alignment of other teeth to create poor bites that affect dental health and function.

Wisdom teeth are considered so prone to these problems (an estimated 70% between ages 20 and 30 have at least one impacted molar) that it's been a common practice to remove them before they show signs of disease or poor bite development. As a result, third molar extractions are the most common surgical procedure performed by oral surgeons.

But the dental profession is now reevaluating this practice of early removal. On the whole, it's difficult to predict if the eruption of wisdom teeth in a particular person will actually lead to problems. It may be premature, then, to remove wisdom teeth before there's sufficient evidence of its necessity.

As a result, many dentists now follow a more nuanced approach to wisdom teeth management. An impacted wisdom tooth that's diseased or contributing to disease is an obvious candidate for removal. But if the eruption is proceeding without signs of impaction, disease or poor bite development, many providers recommend not removing them early. Instead, their development is allowed to continue, although monitored closely.

If signs of problems do begin to emerge, then removal may again be an option. Until then, a more long-term watchful approach toward wisdom teeth may be the best strategy for helping a young person achieve optimal dental health.

If you would like more information on managing wisdom teeth treatment, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Wisdom Teeth: Coming of Age May Come With a Dilemma.”

DirectVeneersOfferaQuickandAffordableAlternativetoTraditionalVeneers

Orthodontics, veneers and other cosmetic dental techniques can turn a less than perfect smile into a beautiful one—but not always very quickly. For example, porcelain veneers can take weeks from planning to installation, including the meticulous work of an outside dental lab to produce veneers that look natural as well as beautiful.

But you may be able to take advantage of another approach, one that often takes no more than a couple of dental visits. Called direct veneers, it's actually a process of bonding and sculpting life-like composite materials to teeth that are heavily stained, chipped or that contain tiny crevices called “craze lines.”

Unlike the similarly-named traditional method, direct veneers don't involve the creation of layered porcelain veneers fashioned by a dental lab. But this newer process is similar to the older one in that some of the enamel must be removed from the teeth in question to provide a suitable surface for the composite material to adhere. This alteration will be permanent, requiring a restorative covering on the treated teeth from then on.

Right before this preparation, though, a dentist typically makes an impression of the patient's mouth. This will be the basis for creating the procedural plan for the dental work, particularly a “trial smile” from similar composite material that can be applied to the patient's teeth before actual restoration work begins. This temporary application gives both patient and dentist an opportunity to visualize the final look, and make needed adjustments in color and shaping.

Once the work plan is finalized, the patient then returns for the actual restoration procedure. The dentist begins by applying and bonding the composite material to the prepared teeth. Then, using a drill and manual instruments, the dentist shapes and smooths the material into a tooth-like appearance that blends with other teeth. The procedure can take a few hours, but it can usually be completed during a single visit.

Although direct veneers may not last as long as porcelain veneers, the process is less costly and requires less time to complete. Direct veneers could be an economical solution for achieving a more attractive smile.

If you would like more information on direct veneers, please contact us or schedule an appointment for a consultation. You can also learn more about this topic with a firsthand patient account by reading the Dear Doctor magazine article “A New Smile With Direct Veneers.”





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