Monthly Archives: February 2017

Dental Care Safe for Pregnant Women

Dental cleanings and X-rays are safe for pregnant women, a U.S. obstetrician/gynecologist group says.

The group also advised ob-gyns to perform routine dental health assessments at women’s first prenatal visit and to encourage their patients to see a dentist during pregnancy.

“These new recommendations address the questions and concerns that many ob-gyns, dentists and our patients have about whether it is safe to have dental work during pregnancy,” Dr. Diana Cheng, vice chairwoman of the American College of Obstetricians and Gynecologists’ Committee on Health Care for Underserved Women, said in a college news release.

Dental health problems are associated with other diseases, including heart disease, diabetes and respiratory infections.

“We want ob-gyns to routinely counsel all of their patients, including pregnant women, about the importance of oral health to their overall health,” Cheng said.

The college noted that 35 percent of all women say they haven’t seen a dentist in the past year and about 40 percent of pregnant women in the United States have cavities or gum disease. Physical changes caused by pregnancy can cause changes in teeth and gums. Dental problems during pregnancy are most common among black women, smokers and women on public assistance.

“We can all reassure our patients that routine teeth cleanings, dental X-rays and local anesthesia are safe during pregnancy,” Cheng said. “Pregnancy is not a reason to delay root canals or filling cavities if they are needed because putting off treatment may lead to further complications.”

Among the potential benefits of good dental health during pregnancy is that it may decrease the transmission of cavity-causing bacteria from mother to baby, which can help reduce the child’s future risk of cavities.

Dental Plaque Can Make Cancer Risk

Poor oral hygiene may be associated with increased risk of cancer and premature death, researchers found.

Among healthy adults in Sweden plaque build-up increased the relative risk of premature death 79 percent, Birgitta Söder, PhD, of the Karolinska Institutet in Huddinge, Sweden, and colleagues reported in BMJ Open.

The finding, the authors wrote, suggests that increased plaque and associated toxins and enzymes, may be released from the built-up biofilm and enter the bloodstream through the gingival crevice, thus increasing the risk of malignancies.

In 1985 Söder and colleagues initiated a longitudinal study of 1,390 randomly selected, healthy Swedish adults ages 30 to 40, who had no signs of periodontitis at baseline. The participants were followed with periodic checkups including smoking habits and oral health through 2009.

Dental plaque measures were taken at baseline and in 1996, 1998, 2000, 2001, and 2009.

Over the 24-year study period, 58 patients died, including 35 deaths due to malignancies.

Individuals still alive at the end of follow-up had a significantly lower dental plaque index than those who died.

After multiple logistic regression analysis, Söder and colleagues found age, male gender, as well as the amount of dental plaque were principal independent predictors of mortality at follow-up. Age and male gender almost doubled the risk of dying prematurely.

They added that there were statistically significant differences between dead and living patients “regarding the amount of dental plaque, gingival inflammation, and dental calculus, indicating a significantly poorer dental status in the subjects who died when compared with survivors.”

Söder and co-authors said their hypothesis will require additional studies to determine whether any causal relationship can be derived from the association between poor oral hygiene and cancer mortality.

6 Simple Ways to Make Your Smile Sparkle

If you’re looking for an easy way to look younger without breaking your piggy bank, a recent study conducted at the Max Planck Institute in Berlin suggests that all you have to do is smile. Researchers found that strangers are more likely to underestimate a person’s age if she is smiling, and it doesn’t get much easier than that! However, according to the American Academy of Cosmetic Dentistry (AACD), a smile soured by damaged or yellow teeth has the exact opposite effect and tends to make you appear even older than your years. Fortunately, there are many ways — both low- and high-tech — to achieve a beautiful, white smile. From eating crunchy fruits and veggies to selecting certain shades of lipstick and bronzer, here’s what leading cosmetic dentists recommend to make your smile sparkle — and look younger while you’re at it!

1. Focus on Flossing

What is the No. 1 way to a bright, white smile? “It sounds boring, but plain-old basic oral hygiene is where one starts,” says Thomas Connelly, DDS, New York City-based cosmetic dentist and weekly contributor to the Huffington Post. Dr. Connelly recommends brushing your teeth after every meal — and even packing a toothbrush for an “after lunch” work brush. “Flossing every day will also go a long way in making your smile look good.” Because even the best toothbrushes and mouthwash can’t reach every crevice between your teeth, proper flossing is a sure way to prevent bacteria and plaque buildup in your mouth that, if uncontrolled, make it easier for foods, drinks and tobacco to accumulate and stain your teeth.

2. Boost Your Calcium and Vitamin C Intake

Since a healthy mouth and white smile are so closely correlated, maintaining strong teeth is another way to keep your smile looking bright. Eating a balanced diet filled with certain teeth-fortifying nutrients will help fend off oral health problems that can detract from a pretty smile, such as tooth decay, erosion, and periodontal disease. Calcium is needed to grow and develop both baby and adult teeth and even strengthens your jawbone. If you’re looking for some of the best foods to maintain a strong, healthy bite, go for calcium-rich low-fat and fat-free milk, cheeses, cruciferous vegetables (green leafy vegetables like cabbage, bok choy, broccoli, and cauliflower), and calcium-fortified juices, breakfast cereals, breads, or soy products.

Vitamin C is another nutrient that helps maintain strong teeth by working as an antioxidant to repair tissue and prevent disease-causing bacteria from penetrating the gums, so those cruciferous veggies — particularly broccoli — will do double duty, since they’re rich in both calcium and vitamin C.

In addition, any crunchy fruits and veggies, like apples and carrots, are good for your teeth, since chewing them increases levels of saliva, which can help protect the teeth from plaque-causing bacteria by breaking down food caught between teeth. Similarly, drinking plenty of water also helps rid your mouth of such bacteria (especially after meals) while also helping to prevent stains and protect your teeth from the harmful effects of acidic foods and beverages, according to the AACD. Chewing sugarless gum is another simple way to trigger saliva — a natural way to fight acid and keep your teeth looking bright.

3. Forget Food and Drink Foes

Conversely, there are also foods that can put your white smile in jeopardy. Avoid sodas — even diet! — and sugary foods, especially hard, sticky, or gummy candies. Acidic foods, like citrus, may appear healthy but aren’t particularly good for your chompers: they can weaken tooth enamel and create an environment for cavity-causing bacteria to thrive. This can ultimately cause tooth decay and discoloration that appears as bright white spots on the teeth.

And foods and beverages that stain teeth are — obviously — huge threats to your white smile as well. “Red wine, coffee, and tea tend to cause the most staining,” according to dental experts Donna Zak, DDS, of Zak and Frankel Dental Associates, and Gregg Lituchy, DDS, of Lowenberg & Lituchy, both based in New York City. Connelly adds that refraining from tobacco use is a huge step in the right direction as well, since it’s a major tooth-staining culprit.

4. Try Professional Bleaching

Teeth whitening by a skilled dentist is a faster and more effective way to get a white smile than over-the-counter products. Professional chairside bleaching treatments like Zoom! or BriteSmile use a much higher concentration of whitening ingredients than OTC whiteners and incorporate laser technology that is thought to penetrate teeth and facilitate a deeper whitening effect — and usually only take about one hour. “This works very well, but most patients still need to follow up with at-home custom bleaching trays or white strips to get the teeth to the desired shade,” says Dr. Zak. Zak also recommends another method called KöR Whitening Deep Bleaching System, which combines chairside bleaching with home application for better results. Prices for in-office treatments vary, but can easily set you back $500-1,000.

5. Choose a DIY Whitener

If you don’t want to shell out for a pro treatment, some OTC methods can help to brighten your smile. Zak says that Aquafresh trays work well, and Dr. Lituchy recommends Crest Whitestrips. Lituchy adds that whitening strips combined with whitening toothpaste are a good “one-two punch” toward achieving a white smile: “The whitening toothpaste removes the external surface stains, whereas whitening strips penetrate the deeper tooth layers to actually bleach the teeth.” Connelly typically recommends the GO SMiLE brand of toothpastes and whiteners.

6. Fake It With Makeup

If you’re looking for an even faster solution than an over-the-counter whitening kit can offer, try a new makeup routine to get a whiter smile on the go. “One way to make teeth ‘appear’ brighter instantly is by wearing shades of lipstick that have a blue undertone, as well as makeup, such as bronzer, to darken the skin tone so there is a greater contrast to the teeth,” says Lituchy.

Fluoride in Your Water: The Great Debate

You’ve heard about fluoride from your dentist — there are fluoridated toothpastes, mouth rinses, even supplements. But do you know what fluoride is?

Fluoride is found naturally in water (rivers, lakes, streams, and oceans) and in many foods, such as grapes and tea. It’s also added to certain processed cereals and infant formulas. And this mineral has a big benefit: It protects your teeth from the plaque bacteria and sugars that hang around your mouth after you eat, preventing tooth enamel from being eaten away and cavities from forming.

In fact, evidence suggests that fluoride not only prevents decay, but also reverses it by enhancing re-mineralization, the rebuilding of tooth enamel that has begun to decay. That’s why the American Dental Association (ADA), as well as most dentists, believes that small amounts of fluoride should be added to water supplies so that everyone gets an adequate amount.

The scientific evidence is quite clear, says Howard Pollick, BDS, MPH, a professor in the department of preventive and restorative dental sciences at the School of Dentistry at the University of California in San Francisco, and a spokesman for the American Dental Association. “Fluoride prevents tooth decay,” he says.

However, others believe that adding fluoride to water supplies is unnecessary and dangerous. A recent government study found that about two in five teens have dental fluorosis — white spots and streaks on their teeth — from consuming too much fluoride.

A Short History of Fluoride

On Jan. 25, 1945, the city of Grand Rapids, Mich., was the first to add fluoride to its municipal water supply. Studies had shown that children had fewer cavities if they lived in areas where the water contained more fluoride. Today, nearly three-quarters of Americans live in communities with fluoridated water supplies.

Dr. Pollick says that many communities have less than 0.3 parts per million of fluoride in their water — less than what U.S. public health officials recommend for the prevention of tooth decay.

However, fluoride today is more widely available in toothpastes, mouthwashes, and rinses, as well as in a gel, foam, or varnish that dentists can apply to teeth, than it was in the mid-1940s when communities began fluoridating their water.

Government health officials recently acknowledged these changes in lifestyle and lowered the recommend levels for water fluoridation. In January, the U.S. Department of Health and Human Services and the U.S. Environmental Protection Agency (EPA) recommended that the fluoride level in drinking water be set at 0.7 milligrams per liter of water. Their previous recommendation had been a range of 0.7 to 1.2 milligrams.

Still, Pollick says research shows that the benefits of fluoridation outweigh the risks and that, by fluoridating the water, children from poorer families who don’t have as much access to dental health care are at least consuming fluoride. Dental fluorosis is mostly a cosmetic issue that can be dealt with, he says, and there’s no evidence that fluoridation poses a cancer risk, as some activists claim.

“We’re confident,” says Pollick, who served on the EPA panel that recommended the changes, “that water fluoridation is safe and a cost-effective way of reaching an entire community.”

The Argument Against Fluoridation

Though the American Dental Association supports fluoridation, critics believe that any amount of fluoride added to water is too much — claiming it puts people at risk for adverse health conditions, including fractures, brain damage, and cancer.

“Water fluoridation is not safe,” says Kathleen Thiessen, PhD, of the Center for Risk Analysis at SENES Oak Ridge Inc. in Tennessee. “At levels of exposure typically encountered in the United States, even with the recent lower recommended fluoride concentration, people are exposed at or above a level that is associated with a higher risk of adverse health effects.”

Bill Osmunson, DDS, MPH, a general and cosmetic dentist in Bellevue, Wash., says that dental fluorosis is more than just a “cosmetic problem,” and it can be costly to treat. “Some patients pay $20,000 to $30,000 to have it repaired, and the repair doesn’t last forever,” he says.

According to Dr. Osmunson, studies show that excess fluoride can cause fractures to teeth and bones, kidney damage, thyroid issues, heart disease, brain damage, and cancer. The amount of tooth decay that is seen doesn’t vary between communities where the water is fluoridated and those where it isn’t, Osmunson says. So, he asks, why put people at risk?

But according to the National Cancer Institute, the evidence from many studies done on fluoride exposure in both humans and animals shows no association between fluoridated water and risk for cancer. Adults who get too much fluoride have been shown to be at risk for a painful bone condition called fluorosis of bone — but this is exceedingly rare at the fluoride levels found in the United States.

ADA’s Bottom Line

According to the ADA, the new recommendation for fluoride levels should provide an effective level of fluoride that will continue to reduce the incidence of tooth decay in children and adults of all ages and incomes, while minimizing the rate of dental fluorosis.