Category Archives: dental care

My Back Was Causing Me Sleepless Nights

I was feeling tired all the time, and that affected every area of my life. I was not sleeping well, but I knew that it was not my mattress causing me my restless nights as others had suggested. I have slept on the couch, in the spare guest room, and even on the floor once, but I could not get a good night’s sleep. When I went to my doctor, his only recommendation was to see a chiropractor in San Rafael. I knew that he was not passing the buck, because he has always provided my family and me the best care possible.

He gave me the information for the chiropractor that he has used in the past, and I knew that was the best recommendation I was ever going to get. i contacted the number he gave me and was able to set up an appointment for the following day. I was so happy that they could get me in that quickly because frankly, I was just exhausted.

Do Ergonomic Toothbrushes Clean Teeth Better?

The practice of brushing your teeth hasn’t changed much since 1938, the year that the modern toothbrush was introduced. But the toothbrush itself has evolved quite a bit. Stroll through the oral health aisle at your local drugstore and you may be surprised by the number of toothbrush styles available and the claims made by manufacturers about the effectiveness of their toothbrushes.

The key, toothbrush manufacturers say, is ergonomics — the science of improving the ease and efficiency with which people use products. So-called ergonomic toothbrushes sport specially designed handles or brush heads to help get teeth cleaner.

Whether manual or electric, these ergonomic toothbrush designs are marketed with the promise that their shape can help you perfect the proper brushing angle and feel more comfortable during the brushing process. Some are even said to brush teeth and massage gums simultaneously — and last much longer than run-of-the-mill toothbrushes.

Do these promises hold up? According to dentist Catrise Austin, DDS, of VIP Smiles in New York City, the handles of ergonomic toothbrushes are often lighter and include grips to help people hold their brushes more easily. The heads serve different functions, too — the bristles on some models form a convex shape to help clean the lower front teeth. “They’re designed to make brushing easier, especially in the most difficult-to-clean areas of the mouth, like the lower front teeth or the upper back molars,” Dr. Austin explains.

Ergonomic vs. Regular Brushes

Despite the comfort factor, using an ergonomic toothbrush is not a guarantee of good oral health. Most adults won’t see major benefits from them as compared to ordinary toothbrushes. “If you know how to use a normal, regular toothbrush, the advantages won’t be extremely significant,” Austin says.

People who may benefit from an ergonomic toothbrush include children who have not yet developed the manual dexterity needed to brush properly and adults who have physical limitations, such as people who have had strokes or those with Parkinson’s disease. “They could also help people who are just not effective brushers, so they can get to areas they can’t easily reach,” says Austin.

What Really Keeps Teeth Clean

Often, Austin says, brushing practices can have more impact on oral health than the type of toothbrush a person uses. She recommends brushing three times a day, preferably after meals. “That will help keep plaque levels down and avoid cavity formation,” she says. You should also floss once a day. If brushing your teeth isn’t an option at certain times of the day, like after lunch, it’s also acceptable to chew sugar-free gum or rinse with a mouthwash as a temporary measure.

Austin also recommends brushing for at least two full minutes to be sure that you’ve thoroughly cleaned all of your teeth, but be careful — overly vigorous scrubbing can actually wear away enamel and cause tooth and gum sensitivity. To help counteract this, Austin suggests choosing a toothbrush with soft bristles rather than medium or hard ones.

No matter what type of toothbrush you use, it’s also important to replace it regularly — about every three to four months, but sooner if the bristles become worn. If you’re worried about keeping your toothbrush clean between uses may want to check into using a toothbrush sanitizer, which works by exposing the brush to ultraviolet light.

Dental Health and Overall Health

The condition of your mouth is closely tied to your overall health. Find out how oral health is linked to diabetes, heart disease, cancer, and more.

Taking care of your teeth isn’t just about having a nice smile and pleasant breath. Recent research has found a number of links between oral health and overall health. While in many cases, the nature of this link still isn’t clear — researchers have yet to conclude whether the connections are causal or correlative — what is certain is that the condition of your mouth is closely tied to your overall physical health.

Oral Health and Diabetes

Doctors have known for years that type 2 diabetics have an increased incidence of periodontitis, or gum disease. In July 2008 the connection was further highlighted: Researchers at Columbia University’s Mailman School of Public Health followed 9,296 nondiabetic participants, measuring their level of periodontic bacteria over the course of 20 years.

“We found that people who had higher levels of periodontal disease had a twofold risk of developing type 2 diabetes over that time period compared to people with low levels or no gum disease,” explains Ryan Demmer, PhD, associate researcher at the department of epidemiology at the Mailman School and the lead author.

While more research is needed before doctors can conclude that gum disease actually leads to diabetes, there are already a few theories about why this might be the case: One proposes that when infections in your mouth get bad enough, they can lead to low-grade inflammation throughout your body, which in turn wreaks havoc on your sugar-processing abilities. “There are all kinds of inflammatory molecules,” says Dr. Demmer, “and it’s believed that maybe some attach to insulin receptors and prevent the body’s cells from using the insulin to get glucose into the cell.”

Oral Health and Heart Disease

As with diabetes, the connection between poor oral health and cardiovascular conditions has been recognized — the two are often found together — but it still hasn’t been determined conclusively whether or not there is a direct causal relationship between them. (One reason is that there are a number of other potential risk factors — such as smoking and old age — that can lead both to gum disease and heart disease.)

However, in a 2005 study funded by the NIH, 1,056 randomly selected participants with no prior heart attacks or strokes were evaluated for levels of periodontal bacteria: After removing the effects of the other risk factors of age, gender, and smoking, it was found that there was an independent relationship between gum disease and heart disease, says Moise Desvarieux, MD, PhD, associate professor of epidemiology at the Mailman School and lead author of the study.

One theory about why this may occur, says Dr. Desvarieux, is that small amounts of bacteria enter your bloodstream while you’re chewing. “Bad” bacteria from an infected mouth may lodge itself inside blood vessels, ultimately causing dangerous blockages. Strengthening his theory is the fact that when scientists have looked at atherosclerotic blood vessels, they have sometimes found fragments of periodontal bacteria. Meanwhile, a study published in the New England Journal of Medicine in 2007 established that aggressive treatment of gum disease reduces the incidence of atherosclerosis within six months.

Pregnancy Complications and Gum Disease

For many pregnant women, gum infections stem from the fluctuating hormone levels that come with pregnancy, says Marsha Rubin, DDS, practicing diplomat of special-care dentistry at New York-Presbyterian/Weill Cornell, who sees many pregnant patients in her practice. Others neglect their oral care during pregnancy, since they have much on their minds, she adds. But that’s a mistake: Scientists believe that gum disease or inflammation in the mouth possibly triggers an increase in a chemical compound called prostaglandin, which induces early labor.

While this theory has not yet been confirmed, a 2001 study found that pregnant women who develop gum disease between weeks 21 and 24 are four to seven times more likely to give birth before week 37. There is evidence that poor gum health in the extreme can lead to low birth weight as well. A number of studies — including a 2007 study of 3,567 Turkish women and a 2007 study of 1,305 Brazilian women — found a relationship between periodontal disease, preterm birth, and low birth weight.

Pneumonia and Gum Disease

There has been a link established between poor oral health and pneumonia, though much of the research focuses on high-risk populations. A 2008 study of elderly participants found that the number who developed pneumonia was 3.9 times higher in patients with periodontal infection than in those free from it. “The lungs are very close to the mouth,” says Rubin. “Even in a healthy mouth there is lots of bacteria, but bacteria in a not-healthy mouth can get aspirated into the lungs, causing pneumonia or aggravating COPD, chronic obstructive pulmonary disorder.” Several intervention studies cited by the CDC show that an improvement in oral health can lead to a reduction in respiratory infection.

Pancreatic Cancer and Gum Disease

A study published in 2007 in the Journal of the National Cancer Institute surveyed 51,529 American men about their health every two years between 1986 and 2002. Of the 216 participants who developed pancreatic cancer, 67 of them also had periodontal disease. Independent of the participants’ smoking status, the study found that having a history of periodontal disease was associated with an increased risk of pancreatic cancer.

This, according to the study, could be because of systemic inflammation or increased levels of carcinogenic compounds produced in the infected mouth. Interestingly, another viable theory about why gum disease may cause type 2 diabetes points to damage to the pancreas as well. “With the pancreatic cancer study, we thought it was very interesting that you have this localized infection that has an impact on a systemic organ that is very intimately tied to the pathophysiology of diabetes,” says Dr. Desvarieux. Reasons for why this might be are as yet unknown.

Tips to Prepare Your Smile for a Special Event

There are many times in your life when you want your smile to be at its absolute best — and maybe you even want it to work a little harder for you. According to a recent psychology study at the Max Planck Institute in Germany, smiling can increase positive behaviors, instill confidence, and even make you appear more youthful and attractive, according to a recent Berlin-based study at the Max Planck Institute. So whether you’re going on a first date, scheduling a job interview, planning your wedding, or attending a graduation or reunion, it’s time to start thinking about how you can make the most of your smile.

There isn’t always a lot of lead time when it comes to preparing for a first date or interview, so in this case, the biggest bang for your buck is bleaching, and you have two options. You can schedule an appointment with your dentist for professional, in-office teeth whitening, or get an over-the-counter whitening product and do it yourself.

Teeth Whitening in a Pinch

If you can get a last-minute appointment with your dentist, the professional bleaching that she provides will be a quicker (and more impressive) fix than what you’ll achieve with drugstore whitening kits — though it will be considerably more expensive. An in-office whitening session may set you back anywhere from $500-1,000, while an over-the-counter treatment costs between $20-100. But if you have the time and the budget, getting your teeth whitened by a professional is both faster and more effective than doing it yourself, according to Donna Zak, DDS, of Zak and Frankel Dental Associates in New York City.

The concentration of whitening ingredients used in the dental-office product is much higher (about 15 to 35 percent hydrogen peroxide) than the amount in the products you can buy at your local drugstore (about 3 to 10 percent hydrogen peroxide). During your office treatment, your dentist will apply a whitening gel to your teeth and may activate the bleaching process with a laser technology that is thought to penetrate teeth and create a deeper whitening effect (known as power bleaching). Typically this process only takes one hour and can yield drastic results.

But if you can’t score an appointment with your dentist — or your budget simply won’t allow it — “go ahead and get an over-the-counter product and bleach your teeth a week or a few days before,” says Dr. Zak. She recommends Crest Whitestrips or Aquafresh White Trays. “Whitening toothpastes can also help,” says Gregg Lituchy, DDS, of Lowenberg & Lituchy in New York City.

“But they really only remove the external stains on the tooth surface, whereas whitening strips penetrate the deeper tooth layers to actually bleach the teeth.” When used together, Dr. Lituchy suggests that teeth whitening strips with whitening toothpaste is a good combo for making teeth appear whiter.

In a real pinch, the easiest way to achieve a whiter smile is to try a new makeup routine. Both Zak and Lituchy agree that wearing a shade of lipstick with a blue undertone is a good trick to make your smile look instantly brighter. Darkening your skin tone with a bronzer, says Lituchy, will also help create a greater contrast to the teeth and make them appear whiter. Additionally, he suggests avoiding any food or drinks that are likely to darken the teeth before the big event, so avoid coffee, black tea, red wine, and dark-colored berries — and don’t smoke! Tobacco is one of the worst teeth-staining offenders.

A Serious Smile Makeover

Million-dollar smiles are no longer just for the rich and famous — and they’re not as costly as they used to be either. More and more everyday people are getting their teeth professionally bleached, straightened, and even replaced with long, straight rows of porcelain veneers. And if you’re getting ready for a longer-term event like wedding, graduation, or reunion, you can take advantage of these more time-intensive procedures.

With extra time to prepare for a special event, patients have the opportunity to visit the dentist for multiple teeth whitening treatments and can achieve more impressive results than from just a one-time session. Echoing Zak’s assessment, Brian Kantor, DDS, of Lowenberg & Lituchy, says that patients can maintain and boost the bleaching process by getting custom-made bleaching trays to take home with them. Your dentist will take dental impressions to produce the trays that will fit comfortably and help the bleach sit against the teeth better than a generic OTC product. Because they are custom fit for your mouth, they also prevent the whitening agent from irritating the gums. “The in-office whitening combined with the prolonged use of the take-home trays will give the best possible results from bleaching,” Dr. Kantor says. These custom trays may also be available for patients who opt out of the in-office procedure and only wish to whiten at home with a professionally-dispensed product.

But color may not be the only obstacle in your way of a great, white smile. As you age, the wear-and-tear on your teeth is reflected in your smile. Before your big event, you may want enhance your smile — and your overall oral health — with a complete smile renovation. Replace old fillings, fix an improper bite, straighten crooked teeth that have shifted over the years, and repair any cracks or chips.

“If you are looking to do dentistry on your teeth to change them, such as crowns or veneers, I would start at least six months before the big day,” says Zak. In addition to factoring in your dentist’s availability and the dental lab’s schedule, the exact amount of time depends on how many veneers would be needed. For example, replacing only the upper front teeth with veneers could take about a month. However, if the work is more extensive and includes the back teeth, then Zak says it could take between six months and a year. Veneers are a great choice for a smile makeover for those deemed candidates by their dentist and who have the time and budget (porcelain veneers can cost $1,000 to $2,500 per tooth). “Not only can they straighten the teeth,” says Kantor, “they can also improve the color and shape of the teeth.”

To create your ideal smile, make a consultation appointment with your regular dentist or consider seeking out a dentist who specializes in smile enhancement. Share your concerns about your teeth and your goals for your new smile. Since beauty is always in the eye of the beholder, photos and images from magazines can be helpful when you try to convey what you consider attractive. Your dentist will then discuss your treatment options and get you on track with a plan that fits the timeline leading up to your special event.

Dentist Gives Advice to Keep Holiday Smiles Bright

The busy holiday season may disrupt many people’s daily routines, but at this time of year it is especially important to remember to look after your teeth, an expert advises.

“Holiday get-togethers tend to lead people to consume sugary treats and drink alcoholic beverages more than usual,” Dr. George Shepley, spokesperson for the Academy of General Dentistry, said in an academy news release.

“Additionally, with their busy schedules and increased stress levels, I’ve noticed that my patients’ oral hygiene suffers. They forget the most basic of oral hygiene tasks that can counteract the effects of sugary snacks and drinks,” he pointed out.

Shepley offers suggestions on a number of ways to protect your teeth during the holiday season.

To reduce the risk of damage from drinking red and white wines, which are highly acidic and can eat away at a tooth’s enamel, refrain from swishing wine around in your mouth and drink water between glasses of wine to rinse acid from your teeth.

And, while holiday goodies such as cookies, chocolate and candy canes are tempting, the sugar in them promotes the growth of cavity-causing bacteria. If you can’t brush or floss after eating sweet treats, drink water or chew a piece of sugarless gum, which will increased saliva flow and help wash away the bacteria.

Finally, Shepley pointed out, holiday stress can cause some people to grind or clench their teeth, potentially resulting in chipped teeth, jaw pain and headaches.

“Finding ways to alleviate your anxiety can help, but it’s also important to see your dentist, who can recommend solutions like a custom night guard,” Shepley said. “Wearing one at night will prevent you from taking out the holiday stress on your teeth while you sleep.”

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.

7 Biggest Causes of Tooth Sensitivity

Does drinking an ice cold beverage cause dental discomfort? Or do you find yourself wincing when you brush or floss? You could have what’s known as tooth sensitivity.

You don’t have to put up with the pain, however. There are things you can do to lessen tooth sensitivity and improve your oral health, says Leslie Seldin, DDS, a dentist in New York City and an associate professor of dentistry at the Columbia University College of Dental Medicine.

Here’s why you could be experiencing this mouth malady — and steps you can take to find relief for sensitive teeth:

1. You brush with too much gusto. Sometimes tooth sensitivity comes from brushing with too much force or using a hard-bristled toothbrush. Over time, you can wear down the protective layers of your teeth and expose microscopic hollow tubes or canals that lead to your dental nerves. When these tubes are exposed to extreme temperatures or acidic or sticky foods, tooth sensitivity and discomfort can result. The simplest solution is to switch to a toothbrush with softer bristles and to be gentler when brushing.

2. You eat acidic foods. If the pathways to your nerves are exposed, acidic foods such as tomato sauce, lemon, grapefruit, kiwi, and pickles can cause pain. But avoiding these foods can help you avoid any tooth discomfort.

3. You’re a tooth-grinder. Even though tooth enamel is the strongest substance in your body, grinding your teeth can wear down the enamel. By doing so, you expose the dentin, or the middle layer of the tooth, which contains the hollow tubes that lead to your nerves. Talk to your dentist about finding a mouth guard that can stop you from grinding. The best guards are custom-made to fit your bite, Dr. Seldin says.

4. You use tooth-whitening toothpaste. Many manufacturers add tooth-whitening chemicals to their toothpaste formulas, and some people are more sensitive to them than others. If your toothpaste contains whitening agents, consider switching to one that doesn’t.

5. You’re a mouthwash junkie. Like whitening toothpaste, some over-the-counter mouthwashes and rinses contain alcohol and other chemicals that can make your teeth more sensitive — especially if your dentin’s exposed. Instead, try neutral fluoride rinses or simply skip the rinse and be more diligent about flossing and brushing.

6. You’ve got gum disease. Receding gums, which are increasingly common with age (especially if you haven’t kept up with your dental health), can cause tooth sensitivity. If gum disease or gingivitis is the problem, your dentist will come up with a plan to treat the underlying disease, and may also suggest a procedure to seal your teeth.

7. You have excessive plaque. The purpose of flossing and brushing is to remove plaque that forms after you eat. An excessive buildup of plaque can cause tooth enamel to wear away. Again, your teeth can become more sensitive as they lose protection provided by the enamel. The solution is to practice good daily dental care and visit your dentist for cleanings every six months — or more frequently if necessary.