Health Talk With Dr. Gross

Tooth Size – The Long and the Short of it

 

Tooth Size The long and the short of it

Does it ever seem that your tooth size is longer or shorter than it was when you were younger? In this article, we explore the various reasons and causes of the changes in our tooth size.

Do our teeth get longer as we age?

There is an expression that I don’t hear that often anymore. The idiom is “long in the tooth.” This phrase is usually referring to someone getting older. It is based on the thought that teeth grow longer as we age.

Well, this is true when we are children and teens. As teeth start to come in or erupt, as we term it in dentistry, they appear to be growing.

They are not growing. In fact, when teeth are developing in the gums as children, they are adult size. As we get into our teen years, the teeth grow into the mouth. It appears that they are growing bigger, but in reality, they are just uncovering themselves from the gum tissue from which they were buried.

Less gum tissue = longer teeth

Teeth, for the most part, do not grow or move anymore once we reach our late teens. However, with time, gum tissues may shrink away from the tooth.
Sometimes, we become very hard brushers and wear away our gum tissue. Gum tissue is fragile right around the tooth and can be easily brushed away. Now we see more enamel than we saw previously.

Other times, due to gum disease, a shrinkage of gum tissue may occur. This reduction happens as bacteria destroy the underlying bone and there is nothing to support the gum tissue.

In any of these cases, we see more tooth enamel. Making it appear that our teeth are longer than before. This condition occurs because more tooth is exposed above the gum line than what we may have observed in previous years.

Okay, I get it. As we get older, and our gums shrink, our teeth “appear” to get longer than they were in our youth. That’s what the idiom, “long in the tooth” means.

Why Are My Teeth So Short?

But wait! As we age, many of us see our teeth shorten. This phenomenon isn’t supposed to happen, is it? Well if the gum does not shrink away from the tooth, then the pseudo-growing phenomenon will not occur. That explains lack of getting bigger, but where does the shortness come from?
Are the teeth shorter or do they just appear that way?
Does it fool us as the tooth growing act fools us?

Our teeth DO shrink!

In reality, the teeth get shorter. It is not an optical illusion. The more we chew, the more our teeth wear.

Teeth are the hardest tissue in the body. They are denser than bone. It needs to be this hard as it is the first tissue encountered during the eating process. It needs to be very dense as it tears and grinds at food.

Ah, there is the answer to your question. We use our teeth to grind.

With modern dental care and a better understanding of what causes disease, we can keep our teeth for many years longer than previous generations. Because of this, we grind more food for more years. Over time, our teeth slowly wear away. If we are missing teeth, then the remaining ones work harder, grind more and end up wearing away more. This is how we get short teeth.

This condition is even more noticeable in the front of our mouths. Let me explain why this is so. The patient who asked me that question had their upper front teeth meet their lower front teeth. The teeth touched each other tip to tip. In dentistry, we call it “edge to edge.” Every time they chewed their food, not only did their back teeth grind, but their front teeth were grinding too.

Sounds great. After all, more teeth grinding is more efficient -right?  Wrong!

The problem stems from the fact that the front teeth are narrow-edged. They are designed to tear, not to crush. When we use them to grind, they wear away very quickly. Grinding with our incisors creates short teeth and a loss of healthy cosmetics.

We identified the problems. Any solutions?

How do we fix this issue? I will give you some answers in our next column. Until then, if things are starting to change in your mouth and just don’t look right, please give me a call and ask me a question. I will do my best to help you. You can reach me at 440.951.7856

 

Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

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Nutrition and the Durability of Your Teeth

 

Woman with salad and fork in her mouth

As a dentist, my primary concern for my patients is for the general health and durability of your teeth. Since they get used on a daily basis masticating, the obvious question of their ability to withstand wear, pressure, or damage comes to mind.

How long should my teeth last?

That’s a great question. Those of you who are regular readers probably know the answer to that.
So let me put that aside for right now and ask you a question.

“How Long Will You Last”?

Not to be morbid, but of course, it is a legitimate question.
In the Global Burden of Disease 2015 Study, dietary factors were the biggest cause of mortality in the U.S. That’s right! In the richest and most prosperous country, the way we eat was the most significant cause of death!
In fact, according to a 2013 report from the Union of Concerned Scientists, an organization that has been around since 1969, increasing our consumption of fruits and vegetables could save more than 100,000 lives and $17 billion in health care costs each year from heart disease alone!

The foods that age us

Foods that age us are typically acidic. We in the United States can call these fun foods. They are fun and appealing because we have made them the main foods in our diet. Sugary foods and refined grains, processed foods, and red meat. All of these foods are showing up in association with many diseases.

The ‘Epidemic of Plenty’

Our biggest epidemic…the epidemic of plenty has resulted in too many people being too obese. In fact, the medical community has classified obesity as an ailment in and of itself.

Following along the same lines, heart disease and diabetes with their associated problems have changed happy and productive lives to a treadmill of doctor and hospital visits. Daily pills are the norm, not the exception.

Aging better is possiblegood food-good health-good life

We can’t stop aging, but we can control to an extent the quality of life as we age. We can see this addressed in many societies around the world who age much differently than we do.

Dr. Michael Gregor, a leading physician who emphasizes nutrition as the best medicine, echoes this sentiment.
He discusses and recommends plants and fruit to stave off many diseases.
Many plants have an antiplatelet effect on our system. Platelets cause the blood to become sticky and clot. Clots in our arteries cause heart attacks and strokes.
One of the reasons that many of my patients take a baby aspirin daily is to counteract this clotting effect. The aspirin reduces the platelet activity and makes the blood thinner.
Isn’t it amazing that plants will do this also, without any possible stomach issues as are those associated with aspirin?
Strawberries and other berries will lower activated platelets.
These activated platelets are loaded with inflammatory chemicals. So just by eating more fruits and vegetables we can potentially reduce or limit many debilitating disorders the ‘epidemic of plenty’ causes.

Your teeth should last a lifetime.

A plant-based diet can make sure of it.carrot-kale-walnuts-tomatoes-berries

Now we know the answer to our initial question. Your teeth should last your entire life. The reason is obvious. If we want to live a long and vital life, we need to have a diet that is plant-centric.

We need to be filling the majority of our plates with whole grains, vegetables, legumes, nuts, and berries. However, to consume these, we need strong, durable and healthy teeth.

First of all, a plant-based diet eliminates most foods that attack our teeth via their associated stickiness. Sticky foods attract a load of bacteria and the acid that they produce. That’s a fast track to dental cavities. It’s no secret that tooth decay is the number one thing that will compromise the durability of your teeth.
Non-inflammatory foods allow our bodies to have greater resistance to disease in general. Including such plant-based foods into your diet translates into healthy gums and strong supporting bone.

Proper tooth maintenance is required

Grinding and chewing these fiber-filled foods efficiently & correctly requires healthy teeth and gums. Therefore, if you break a tooth, you need to have it fixed. In the event a tooth is lost, you need to replace it. Our mouth can be a very efficient device if we take care of it correctly. Unfortunately, many people take care of other machines in their lives better than their mouths. Not only is this disastrous for our oral health, but it is also detrimental to our general health. Proper nutrition can ensure you enjoy both for many healthy years to come.

If it has been a while since you had your teeth checked and evaluated to ascertain their level of health, don’t
hesitate to call me. You can reach me at 440.951.7856.
Megan will answer the phone and point you in the right direction.

Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western
Reserve School of Dental Medicine

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Dental Anesthesia: Its Not Just Shots Anymore!

 dentist with dental anesthesia needle

I Hate Shots. I Wish That You Would Have Something Else!

Many years ago, just the opposite was stated. Dental anesthesia simply didn’t exist! There was really nothing to numb or deaden a tooth so it could be treated. The first local anesthetic used was actually cocaine. It worked but of course, it was addictive and toxic. It wasn’t until the beginning of the last century that our famous Novocaine came on the scene. In fact, it was so popular that many people today use the word to mean a local anesthetic.

Pain-free dentistry is now a reality!

We really don’t use Novocaine anymore in dentistry as it has been replaced by better anesthetics with fewer side issues. These newer products give better numbing, which we call “anesthesia” and work quicker. It would be an understatement to say that local anesthetic has revolutionized dental care. We can now perform a variety of procedures, whether simple or sophisticated with the patient being totally pain-free.

Before local anesthetic, the only treatment available was the removal of a troublesome tooth and of course was not a pleasant experience for any one. The ability to numb a tooth has led to more people keeping teeth for their entire lives, rather than being toothless in their twenties. So that’s great! We can do a dental procedure in a pain-free environment using a local anesthetic. The problem with this from the patient perspective is how we have to administer it. Of course, I am referring to the dreaded shot.

What is dental anesthetics?

Let’s talk a little about this. The method of action of a local anesthetic is to bathe the nerves that transmit sensation from the tooth to the brain in this numbing liquid. When the nerves come in contact with the solution they shut down and no longer do their job of sending a pain signal. This closed for lunch sign is effective until the anesthetic leaves the area of the nerve and sensation comes back to the tooth.

Different locations of the mouth have different requirements for giving the anesthetic. For the upper teeth, it is given one way. For the lower teeth, it is given another way. The upper jaw is much more porous than the lower jaw. Therefore, simply placing the anesthetic under the gum next to an upper tooth will cause the tooth to numb. The lower jaw is much denser and if you put anesthetic next to a tooth it will not penetrate the jaw and reach the nerves of the tooth. To numb a lower tooth, you have to find the nerve that supplies the entire side of the mouth and numb that. That is why we numb the back of the mouth when we work on lower teeth even though we may be working more towards the front of the mouth.

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Did you know? There is now a nasal spray dental anesthetic!

The human body is a marvel of complication, sophistication, and crossovers when it comes to its various parts. Because of this, we now can actually numb many upper teeth without a shot. Yes, that is not a typo! We DO NOT need a shot for a number of upper teeth. Just last year the FDA approved a product called Kovanaze for use in dentistry for upper teeth. The product is a nasal spray that is given prior to performing dental work. It can numb the upper front teeth without the side effect of numbing the lips and cheeks. It is not for all teeth, but one of the most sensitive injections is in the front of the mouth. With this nasal spray anesthetic, those days are history.

Topical dental anesthetic for pain-free cleanings

Many people are sensitive to having their teeth cleaned. Because of this, they skip their very important dental cleanings and checkups and only come when it is too late. I use another product which can be squirted around a tooth without the use of a needle to numb the area. This can make your cleaning totally pain free.

Unlike the nasal spray, I can use this any place in the mouth. It doesn’t make a difference if it is an upper tooth with its porous jaw or a lower tooth with a dense jaw. This product simply works without having to use a shot. This product is called Oraqix (pronounced Ora-Kicks) and I have used it for a number of years to make routine procedures more comfortable and easier. When you are at ease, our work goes faster and is done much better. It is a win-win for all involved.

Today, Dental Anesthesia does not have to mean shots

So although needles have not left medicine, and dentistry, in particular, there are a number of innovations that work towards my goal in interacting with my patients. That goal is providing the best care with the most comfort. Needle free anesthesia is an example of that approach and desire. If these or other dental topics are intriguing and you want to learn more about new techniques and products, please call me. I can be reached at 440.951.7856 and look forward to hearing from you.

One of the best ways to learn about the latest in dental care is to register and attend my next educational seminar which is open to the public. It will take place on Thursday, August 24, 2017. It will be at my office on Lakeshore Boulevard at 6:00 PM. Call our office to register.

 

Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

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Cracked or Chipped Tooth Restoration Concerns

 

Cracked tooth restoration patient grimacing

When one’s tooth is in need of repair it’s interesting to see how as doctor & patient, we each have different concerns when faced with a cracked/chipped tooth restoration procedure.

I’m Leaving Town Next Week. What Can You Do For My Broken Front Tooth?

This was asked to me by a patient that I have been privileged to serve for 38 years. Yes, we know each other very well and I am proud to say that she has all of her teeth. This is the result of she and I working together to maintain her oral health.

Her particular dilemma last week was that she was going away for a few weeks and her front tooth had fractured. She thought that time was the biggest issue in this case. “How will you get this done in time?” I had some other concerns. Let’s talk about her anxiety and later on my thoughts and worries on the matter.

Dental treatment and Tooth Restoration repair times

At times, certain types of dental treatment can take a long time to accomplish. If I can fix something in the office, then I am usually done in one visit.
Problems of time develop when I need to collaborate with one of my dental treatment partners. Most notably, this is the dental laboratory One of the biggest things that slow us down can be laboratory time to make a dental replacement. Tooth restoration could involve crafting a crown, a denture or a variety of other dental devices that are custom made for your mouth. They could require a multitude of visits, impressions, phone calls and emails to the lab. This just slows everything down.

However, new digital technology can speed up a number of procedures and make long waits not relevant to many cases. They are not for everyone and every situation but when we can use them, they are fantastic.
This was actually the case with my patient. We were able to use a special type of metal-free material and in just a few days get our final beautiful result.

A temporary and permanent solution

In the office, I tended to her needs and immediately began to fix her broken front tooth. With new in-office materials, I was able to obtain an acceptable temporary result before she left.
The final, long lasting and highly aesthetic result needed my dental laboratory’s involvement. We chose a type of very cosmetic crown which can be made in a day.
It turns out, that time, which she thought was a major issue, was really not a concern at all. Her new front tooth came back from the lab in plenty of time for her to catch her flight.

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What I as a cosmetic dentist worries about when repairing a front tooth

I began this column with the comment that I had other concerns besides the time factor. My biggest worry was due to the fact that we were dealing with one of her smile teeth. Let me rephrase that. We were dealing with her very front teeth.

Matching a front tooth to its ‘twin’

One of the hardest things to do in dentistry from a cosmetic standpoint is matching a front tooth to its paired tooth. What do I mean by a “paired tooth”? Let’s draw an imaginary line right through the center of our nose in a vertical direction. Half of our teeth are on the right side of this line and half of the teeth are on the right side of this line. We call this line, the “midline”. All of our front teeth have a pair or a twin. One of these teeth is on the left side of the midline and one is on the right side of the midline. These two sides meet smack dab in the center. Our large front teeth, which we call central incisors are right next to each other.

When we need to fix one of them, the slightest difference between them in color or shape will be very noticeable. This is because this tooth’s partner or twin is right next to it. We spend a lot of time brushing our front teeth and see this pair of teeth the most. Matching them can be a real challenge. Sometimes, we are forced to treat both teeth in an effort to create a stunning result.

Both our concerns resolved to our mutual satisfaction

When I finally tried in her new front tooth, she said that I had a twinkle in my eye and a smile on my face. She knew that I had successfully dealt with my concern. I had created a natural look that both she and I were proud of.

The longer that I practice and see new innovations in the field, the happier I am for my patients. Dentistry can offer so many solutions to problems of the past.

If you have a cosmetic or tooth restoration concern, don’t hesitate to educate yourself. Call your dentist or call me, and let’s talk about your issues. I can be reached at 440.951.7856 and look forward to speaking to you.

One last thought.
I will be conducting another educational seminar which is open to the public on Thursday, August 24, 2017. Watch this column for more information, click here to register online or call us to register over the phone.

 

Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

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Am I a Good Candidate for Mini-Implants?

Older couple smiling - mini dental Implants

Mini-Implants – A Magic Bullet?

There was a folk song that was popular many years ago that was entitled “If I Had A Hammer”. The lyrics began with “If I had a hammer, I’d hammer in the morning, I’d hammer in the evening, All over this land….” I thought of this song as I saw an ad in the paper for the use of mini-implants. The ad seemed to imply that instead of using conventional (whatever that may mean) implants, anyone can use mini-implants and get all the same results. The commercial said that these mini-implants were easier to place, took less time, involved faster healing, and were half the cost. It would seem anyone is a good candidate for mini-implants.

Sounds great right? Unfortunately, mini-implants are not the magic bullet some make them out to be. Let’s take a few minutes to learn together about this subject and why not just anyone is a good candidate for mini-implants.

What are Mini-Implants?

Mini-Implants are pretty self-descriptive. They are miniature versions of their big brother – traditional dental implants.

We all like small. We like items to be petite. Our phones have become miniature computers. There is even a brand of car that is becoming more popular call the Mini Cooper. In an era of super-sizing, being smaller and more compact is still a very positive attribute to have.

So it sounds like smaller, miniature implants are the new and improved implant. We have moved forward to this compact era. I can use a mini-implant wherever I previously used a conventional implant. Just like the song says: I would hammer in the morning…….” I would use my hammer everywhere and all the time.

Size – The Biggest Advantage and Disadvantage of Mini-Implants

The ad went on to say that healing is faster and the teeth can go in faster and the results are immediate. We all want this. Right? As with many things in life, if something was really true then everyone would be doing that thing. We need to talk about this.
The biggest advantage to mini-implants is their size. The biggest disadvantage to mini-implants is their size! That’s right, the best thing about them is actually the worst thing about them.

Implants serve as a foundation for teeth in the mouth

Many years ago a wise oral surgeon told me that he always over-engineered his implant cases. He used the biggest and most implants wherever he possibly could. The reason was very simple. Implants serve as a foundation for teeth in the mouth.

When we build a house, for example, do you ever hear that the contractor uses mini-supports? Where we need to use studs every sixteen inches, do we put them every three feet? Of course not. We need to construct a structure that is solid and will endure the weight and other forces that may be put on it.

So I will ask you: Why do we think that we can skimp on support for teeth? We chew meat….we chew bread…we chew nuts. These and many other foods put many heavy forces on our teeth. We need support. We have at least twenty-eight teeth. Why do we need so many? Let us develop a few big teeth on some small roots and that’s it. These mini roots would make it easier to brush and floss. Our dental cleanings would go faster as there are fewer and smaller roots to develop tartar to clean.

The answer is obvious. It wouldn’t work. From a structural standpoint, it is faulty. We need enough teeth and large enough roots to handle all the forces of chewing. People with a full compliment of teeth and a healthy supporting gums and bone can exert the greatest biting forces. These forces are needed to properly eat our food and allow us to be nutritionally fit.

Where the greater force is exerted, the greater the support needed

Where we have the greatest forces, we need the biggest implants to support these tremendous forces. Back teeth is NOT an area where we use mini-implants. The biting and chewing forces of our large molars will overload a miniature implant. You can’t put a top-heavy crown on a little tiny implant and expect the support to last. This will overload the situation and cause the implant to fail. I have written extensively on how detrimental to natural teeth excessive biting and grinding can be.  In the case of an undersized implant, even normal biting is too much!

Where mini-implants are best used

So, after all, is said and done, where would I use a mini-implant? Who is a good candidate for mini-implants?
I have used them for years, but the need to pick and choose the right candidate for mini-implants is important. I would not “use my hammer to hammer all over the land”.

Mini-Implants are best used to support a denture that already has a reduced biting force. It should bite against another denture, not against natural teeth. This will produce excessive forces for the mini-implant. Because they are smaller in diameter, one needs more of them to support a denture. Where I could use 2 normal size implants, with mini-implants, I need at least double that.

You still need to evaluate the patient and the remaining bone to place these properly. I have seen too many inexperienced dentists place mini-implants in the wrong area or missed the bone because they used shortcuts in their techniques. When I teach my students, I emphasize proper preparation before ever beginning any treatment.

So yes, mini-implants are a valuable adjunct to all the other tools and techniques that I have. Proper preparation and planning are crucial as with all things in life. If you ever wondered if you are a good candidate for mini-implants or any other type of implant, please call me at 440.951.7856. I will be more than happy to talk to you and advise you to the best of my ability. I look forward to hearing from you.

Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

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Oral Hygiene & The Risk Of Stroke

Proper oral hygiene and diet can prevent stroke

Oral Hygiene and the risk of stroke. On the surface, these two concepts do not seem interrelated. In reality, along with a proper diet, your oral hygiene can be very instrumental in preventing a stroke.

I Had A Stroke in My Eye Last Weekend!

That was the statement that I heard from a patient when asking about anything new in his medicines or medical conditions. I needed an education on this topic so I asked the patient to explain what that was.
The reality of the term is really no different than any other type of stroke. According to the American Academy of Ophthalmology, an eye stroke’s most common symptom is sudden, painless vision loss. Depending on the location, it could result in total loss of vision for the entire affected eye or as in my patient’s case, it affected only part of his eye.

The Academy goes on to say that men in their sixth decade of life are the most likely to experience this. Patients with diabetes, high cholesterol, heart disease, and narrowing of the carotid artery will increase the likelihood of this happening.
So what does this have to do with teeth? I will explain that soon.

The Last Word on Saturated Fats & Your Health

In a recent article published just last week, Dr. Joel Kahn, a professor of cardiology, discussed the findings of June 15, 2017, by a Presidential Advisory from the American Heart Association. It made clear and recommended that limiting those foods high in saturated fat and included this in a large paper.

The following is part of a news release from the American Heart Association:
“Saturated fats are found in meat, full-fat dairy products and tropical oils such as coconut, palm, and others. Other types of fats include polyunsaturated fats, found in corn, soybean, peanut and other oils, and monounsaturated fats, found in olive, canola, safflower, avocado and other oils.”
They went on to discuss these types of fats. Here are some highlights of their statements:

1. Randomized controlled trials that lowered intake of dietary saturated fat and replaced it with polyunsaturated vegetable oil reduced cardiovascular disease by approximately 30 percent –similar to that achieved by cholesterol-lowering drugs, known as statins.

2. Prospective observational studies in many populations showed that lower intake of saturated fat coupled with higher intake of polyunsaturated and monounsaturated fat is associated with lower rates of cardiovascular disease.

3. Replacement of saturated fat with mostly refined carbohydrate and sugars is not associated with lower rates of cardiovascular disease(heart disease).

Dr. Kahn went on to say that this ended decades of misinformation that tried to state that this is not necessarily true. Over a century of solid scientific research has pointed to eating more fruits, vegetables and whole grains, while eliminating meat and dairy, will improve the chances of having a better quality of life for decades.

Get through your 60’s without a major health issue, & you’re in good shape

I have always said that if you can get through your 60’s without a major health issue, you were in good shape. It is this decade that years of bad habits and diets show up.

These bad habits build up plaques in the arteries. When these plaques break off and get lodged somewhere they stop the blood flow to that part of the body. In my patient’s case, it was his eye. If it gets stuck in your head, you could die or be permanently impaired due to loss of brain function. In the heart, you will get a heart attack.  By eating saturated fats, these are some of the consequences associated with all of this.

A Plant-Based Diet, Oral Hygiene and The Risk Of Stroke

The game plan is obvious. Reduce the intake of these fats and replace this diet with one loaded with fruits and vegetables.

How does one enjoy all these varieties of food? It all starts with my good friends…the back molars. We need to keep our back teeth in great shape in order to ingest and digest these foods properly. Consequently, apples, walnuts, carrots etc are impossible to eat unless we can mash and smash these foods as the first step of digestion. Frequent checkups followed by being receptive to advice will keep our teeth for decades.

“It’s just a back tooth and I don’t really care” is the wrong approach. Wherever possible do everything to save your back teeth. In the event that is not a possibility for whatever reason, then replace them with something strong and stable.

The bottom line is this. Oral hygiene & the risk of stroke are related to one another. You need to incorporate good oral hygiene along with a plant-based heavy diet to reduce your risk for stroke and other related ailments. It’s not just your teeth that benefit. Your whole body does!

If you want to talk to me more about any of this information, please call me at 440.951.7856. I look forward to hearing from you.

Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

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Take Control of Your Dental Destiny – Good Oral Health is up to You

Good Oral health is up to you! Floss!

Do you find that you are always having issues maintaining your teeth properly? Have you resigned yourself to always having tooth decay? Do you dread visiting the dentist because of it? “I can’t help it! Soft teeth run in my family”
While some factors in keeping your mouth healthy are not entirely left to your discretion, the fact remains, good oral health IS up to you.

“Your teeth look fantastic!”

That’s what I said to a patient last Friday morning as I finished her 6-month checkup and cleaning. This patient was seen all too often for decay, root canals, and crowns. It felt like every few months, she was calling with broken teeth and pain. What was her response to my comment? She showed me a great smile and said: “I started to floss”.

Nutrition isn’t the only consideration for a healthy snack

There’s actually a lot more to the story than that. She is actually a raisin lover. Every morning, it was Raisin Bran. Snacks all day long were raisins.
Now don’t get me wrong. Raisins, or dried fruit in general, are great snacks to eat. Raisins are a snack rich in B vitamins, iron and potassium. Low in sodium, and high fiber is some of its other positive attributes. Besides nutrients, raisins are also a good source of carbohydrates for energy. Plus they are not loaded with all types of chemicals that we find in processed foods.

However, it is a sticky food. So all day long it sits and sticks in and around the teeth. This is a formula for disaster. This is especially true if we have a lot of fillings or as we age and expose more root surface.
Therefore, removal of the sticky, sugary residue is paramount to reaping all of the health benefits of this great snack while minimizing its downside.

Good oral health is like a three legged stool

Health and particularly oral health is like a “three-legged stool”. You need all three legs for the stool to stand upright. If one of the legs is faulty the stool can not stand. It will topple over. Having a healthy oral environment is dependent on three factors as well. These factors of good oral health are not in any particular order as we talk about them.

Leg 1: Your diet

First of all, we need to watch what we eat. The texture and makeup of foods can promote or deter oral disease. Certain foods are more conducive to creating an environment where bad bacteria can survive and grow. These bacteria are the prime culprits in cavities and gum disease.

These bacteria love the sticky and gooey foods that we all enjoy. As long as the food is stuck in our mouths, these bacteria have a Thanksgiving Day feast. Unfortunately, we are stuck with the bad effects of this feast.

Leg 2: Oral hygiene

Related to the first one, the second leg of our good oral health stool involves oral hygiene. In fact, it helps control the first one if sticky foods are a large part of our diet. It is comprised of those activities and tools that we use to reducing the effect of foods on our teeth. It is our actions that we employ to keep our mouth clean.

Brushing, flossing, using an oral irrigating device are some of those activities that we utilize to attain a clean mouth. Even rinsing one’s mouth with water after eating can be beneficial in certain circumstances. Yes, anything is better than nothing, which means the more you clean, the cleaner and better your oral health can be. So frequency is also an important factor.

Leg 3: Our DNA and predispositions

While the first two legs, we can control entirely. The last supporting leg of our good oral health stool is our own genetic makeup. Our personal DNA composition and how prone we are to decay or gum disease.
The reality is you may have a genetic predisposition to ‘soft teeth’ or ‘ bad gums’ which is detrimental to good oral health.

Well, that’s a bum rap! We can not control that at all. I believed that until I recently learned some new facts. I read and listen to a number of physicians. One of the latest trends in medicine is how lifestyle interacts with the cards that we are dealt with, in other words, our genetic makeup.
I recently had a conversation with a cardiologist who told me that even though someone may have genes for heart issues, one’s habits and lifestyle may prevent those “bad” genes from ever turning on. In other words, create an environment where your genetic makeup has a minimal influence on bad things happening to you.

Regarding your oral health, this translates to proper diet, brushing well and often, and seeing a professional at the recommended intervals so you can control the age old “soft teeth” or “bad gums run in my family” issues. Staying away from junk and practicing cleanliness will do wonders for our oral health. In fact, that is a prescription for good overall health in general.

Control your dental destiny

So if you are searching for a way to change your dental future and control your dental destiny, please feel free to call me and let’s talk about it. Good oral health is achievable! My wonderful staff and I will do everything that we can to move you along the way to this goal. I can be reached at 440.951.7856 and look forward to speaking to you.

 

Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

 

The Healthy Smile has two convenient locations!

34586 Lakeshore Boulevard (¼ mile west of Route 91 on Lakeshore Boulevard)
Eastlake, Ohio 44095
440.951.7856

Severance Medical Arts Building, Suite 603
5 Severance Center
Cleveland Heights, Ohio 44118
216-371-2333

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‘Misaligned’ teeth are necessary for proper tooth function and health.

'Misaligned' teeth are necessary for proper tooth function and health.

 

My Upper Front Teeth are in Front of my Bottom Teeth. Can You Fix It?

When you say “Fix”, it implies that something is broken. As such we have to determine what is broken and then proceed to fix it. I hear this statement many times or I’m asked as a question regarding the position of the upper front teeth in relation to the lower front teeth. It is usually preceded by “my bite is all messed up…look at my front teeth!” The truth of the matter is, ‘misaligned’ teeth are necessary for proper tooth function and health.

Why we have different shaped teeth

Before we determine if the bite is “all messed up”, we have to examine the shape and function of teeth. I have touched upon this in the past, but a review is good for all of us.

Have you ever wondered why teeth have different shapes? Let’s think together and try to compare teeth to other parts of the body in an effort to answer this question. The best comparison which can be made is to our fingers. Our fingers and thumbs are different in size, shape, and position. Why is this so? The answer is very simple. It is a function of different jobs for different fingers.

Each of our fingers has its own particular function and that finger is best suited for that activity. In addition to that, the different shapes of the fingers allow each one to work in group function with the other fingers. For example, our thumb is called “opposable”. That means that is be placed opposite the fingers of the same hand to grab something. Opposable thumbs that allow fingers to hold an item are a unique feature of humans and other primates.

Different shaped teeth serve different functions

Okay, enough about fingers. Let’s get back to the teeth. If we take what we learned about fingers and apply it back to the teeth, we have our answer. Teeth have different shapes, just like fingers have different shapes because their functions are different.

We say that we chew with our teeth. This “chewing” activity is actually a complicated process. It involves grabbing the food, tearing the food, cutting it into smaller pieces. After all of this, the food is ground or “humanly pureed” to allow us to easily swallow and digest the food.

The back teeth are broad and flat as they act like little millstones in a grinding wheel. The front teeth are first in line to encounter food and must rip, tear, and slice. Just like a pair of scissors that have the blades go past each other to cut, so too, our upper teeth are slightly ahead of our lower teeth to create a scissor-like action. This slices the food into a more manageable size. Think of eating an apple. We first “bite” with our front teeth and then move the food to the back of the mouth for the “grinding” process. The sum total of all of this mastication is called chewing.

”Misaligned’ teeth are necessary for proper tooth function and health.

So now we understand that our upper front teeth must be long and narrow and work with the lower front teeth to initiate the chewing process. This is best accomplished when our upper front teeth do not meet the lower front teeth head on, but rather are slightly forward to create the scissor movement that is needed. In addition to inefficient biting, having the upper teeth meeting the lower teeth directly causes undue wear and tear on these teeth. Edges can chip and fracture as a result. You want to have your teeth slightly ‘misaligned’ – it keeps them functioning properly! That’s right! ‘Misaligned’ teeth are necessary for proper tooth function and health.

I just saw a patient yesterday that fractured her front tooth right down to the gum. This occurred because her upper front tooth was receiving all the force of her bite. Despite having a crown on her tooth, she still fractured her tooth! Since her tooth is actually slightly off in position that created this recipe for disaster. She was referred to me to remove the root and do an implant. I will st rive to place the implant in a position that will be kinder to the final result.

In conclusion

So the next time that you look in the mirror and smile. Don’t put your upper teeth directly on top of your bottom teeth. That is not proper tooth alignment. If for some reason you see this, go to your dentist and ask for an opinion. If you don’t have a dentist that you see on a regular basis, please call and ask to speak to me at 440.951.7856. I will try my best to help you. Looking forward to conversing with you!

Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

The Healthy Smile has two convenient locations!

34586 Lakeshore Boulevard (¼ mile west of Route 91 on Lakeshore Boulevard)
Eastlake, Ohio 44095
440.951.7856

Severance Medical Arts Building, Suite 603
5 Severance Center
Cleveland Heights, Ohio 44118
216-371-2333

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There’s no Such Thing as a ‘Dental Implant Specialist’

Smiling dentist looking and pointing up to the side

Should I see a specialist for my dental implants?

Do I need a separate dental implant specialist to have my implants done?  This is a question that is asked to me periodically. The most recent occurrence of this question happened 2 weeks ago. Let me add, parenthetically, that the question is usually asked to me by a new patient. Once a patient becomes part of the practice, he or she is usually comfortable with the wide array of services that our office can provide.

Let me get back to our question and relate to you what happened. I was outlining a treatment for a new patient. The treatment included dental implants, removal of teeth, crowns, a full denture and a partial denture. We had discussed various options for a number of appointments. As always, I make the patient a partner with me in the ultimate plan. I inform and educate. Together we create a plan that works for that patient in that circumstance. After a number of discussions, he asks me the specialist question.

How specialties operate in dentistry

Before I answered him, I needed to explain how specialties operate in dentistry.
To be called a specialist, you must practice one of the dentistry’s recognized specialties. Periodontics which involves treating the gums, endodontics which treats root canals, oral surgery which involves tooth extractions and more. Lastly, orthodontics, the discipline that helps to straighten teeth is another specialty. These are all recognized specialties by the governing bodies of dentistry. Governing bodies are state boards and national societies. You can’t just take any procedure and call yourself a specialist. You will be taken to task by state dental boards. Most dental specialists limit their practice to their specialty. This is why if you see a root canal specialist for a root canal procedure, you will need to go back to the general dentist to place a filling or crown over the hole that was made to do the root canal.

Technically, there is no such thing as a ‘dental implant specialist’

So now let’s go back to our question from my patient. The answer is simply that implant dentistry is not a recognized specialty in the United States.
The American Dental Association (ADA) has not established implant dentistry as a specialty. Some professional dental organizations offer “credentials” in implant dentistry for their members, who often promote their expertise using these credentials. However, none of these credentials are recognized by the ADA.
As such, no dentist is a “dental implant specialist” per se.

Now there are specialists such as oral surgeons or periodontists that place implants, but they are not “dental implant specialists”. In fact, if either of these types of doctors places an implant you have to go to another office to finish and put a crown on the implant. This is what I hear from so many patients who don’t like bouncing from office to office. Dentists who do the entire implant case for a patient from start to finish have been referred to as an ‘Implantologist’. Going by that unofficial and casual definition, my credentials and work fit into that category.

Planning and executing your implant procedure from start to finish

As a patient would you like to go from office to office to get your implant procedure completed? Starting it by one specialist and following up at another? Of course not! I find it very stimulating for me to plan and execute a case from start to finish. When I place an implant, I know what it will be used for and can control the placement to accommodate the final result. In cases where issues may arise, I can apprise the patient when it happens and then deal accordingly so the final result is not changed or if need be, altered in the least way possible. My patients always appreciate me staying on top of their treatment. You also benefit from getting the entire procedure done by one doctor – me.

Having years of experience is a huge advantage

When it comes to dental implants, having years of experience is a huge advantage, especially for my patients.
I have been placing and restoring dental implants since the early 1990’s. Besides teaching graduate students, I am now proud to say that I am associated with Northeast Ohio’s first implant company – Zuga Medical located in nearby Beachwood, Ohio. As their head trainer and instructor, I instruct licensed dentists in the discipline of placing and restoring dental implants using the Zuga Implant System. I present theory and science to these doctors. I follow this with live patient treatment while they watch the procedure.

If a picture is worth a thousand words, then these demonstrations must be worth over a million words for these doctors. This is so rewarding for me as I can share my many decades of knowledge with many of my colleagues. This allows more patients in our local area to benefit from one of the most exciting advancements in dentistry in many years.

In Conclusion

If you are contemplating dental implants and would like to find out more about this exciting aspect of dentistry, please feel free to call me at 440-951-7856 and allow me to share in creating a healthy mouth for you to enjoy for years to come. I look forward to hearing from you.

Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

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Even Tiny Spaces Between Our Teeth Can Cause Serious Damage

Man poking at food stuck between teeth

Help! I just started to get food caught between my teeth!

This is an issue that comes up many times during the week. I hear it from patients and I hear reports from our talented hygienists when they give me a report on the status of a patient. In fact, I just heard it this morning as I met a patient on the street and he complained of this also. Food impaction in the mouth is a result of spaces between our teeth. So before we talk about whether or not catching food is a concern, let’s discuss spacing in between teeth.

Our teeth work best when they are all neatly in a row.

In an ideal world, every tooth in your mouth would be lined up like little soldiers in a row. Each one next to its neighbor with no overlapping or crowding. They should touch each other in a firm way. Not too much pressure and not too little pressure. The reason that this arrangement is ideal as a self-protection mechanism. Let me explain.

The main purpose of our teeth, aside from flashing a dazzling smile, is to chew and properly break up food for digestion. The digestive process begins in the mouth with tearing, grinding and chemical breakdown via our saliva. Not all foods are cooperative and simply go down our esophagus. When the teeth are all aligned and touching each other they create a path for the food to actually slide off into our cheeks and not stay on our teeth. This helps to break down the food further as it can be brought back around and chewed a second or third time. All of this makes the food easier to swallow and reduces the work that your stomach has to do. Teeth are protecting themselves when they touch, as food does not get stuck on them. Proper alignment of your teeth is really a self-preservation tool for them.

Different types of spaces require different types of solutions.

Now, let’s return to the issues caused by spaces. In our not so perfect world, people can develop spaces between our teeth. Sometimes we lose a tooth and have a big space. Other times we have a cavity and develop a small space. Last, but not least, our teeth may drift or move a little creating a tiny space.

Okay, so what does all that mean. If we lose a tooth and have a large space, we all know that we have to fill the space and replace the tooth. If not, nasty things can happen to the teeth around the space and even in other areas of the mouth. Our second “space” example is when we develop decay in between teeth. These spaces will become painful as the cavity progresses and can really destroy a tooth. This pain will drive us to get the cavity remedied before it goes too far. Typically a filling will take care of this issue.

The most dangerous spaces are those that occur as teeth shift and drift. These tiny spaces become a place for food impaction. Food gets stuck in between these little spaces and sits against the tooth and gum for long periods of time. The food attracts bacteria. These bacteria then feed on the food and produce acid. This acid is what causes a tooth to decay. Many times this decay, or cavity as it is often referred to, will progress unbeknown to anyone. It shows up under the gum and moves into the tooth. All of sudden we have a toothache and are looking at a root canal or complete tooth removal. Not only do spaces prevent our mouth from working at optimum efficiency in the digestive department, but the spaces are a cause for a lot of dental work and pain – hence the patient complaints.

 

When it comes to spaces between our teeth, even regular brushing and flossing are not enough.

Some patients believe that they can keep these tiny spaces clean. This is very difficult to do and a challenge, even for the most meticulous of patients who brush properly and floss thoroughly as recommended. We usually can not see the food particles that are caught between our teeth as they are wedged very low on the tooth near the gum. To see this in one’s own mouth is nearly impossible. This is why a dentist is needed to close these spaces between our teeth properly. There are a variety of ways to do this and each situation is different.

So the next time you become aware of these spaces or the dentist asks you if you ever notice food packing in a certain place, your radar should go off and inquire as to how the issue can be remedied. If you notice one of these areas that were not a problem before, give me a call and I will do my best to suggest a treatment for you. Patients can reach me at 440-951-7856 and I look forward to talking to you about this or any other dental concerns you may have.

 

Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.

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