Preventing Early Childhood Cavities

When do you think is the earliest age that tooth decay can start? Would you be surprised to learn that the answer is… just two months!

In spite of our best efforts, throughout the world tooth decay remains the most common chronic disease of childhood. And the unfortunate truth is, it’s largely preventable. Tooth decay is caused by harmful bacteria living in the mouth. These bacteria produce acids as a byproduct of feeding on the sugar we consume. The acids attack the hard enamel surfaces of the teeth, eventually making the small holes we know as cavities.

For thousands of years, these bacteria have been thriving in the carbohydrate-rich environment of our mouths. Kids aren’t born with these germs — often, however, they are passed directly from caregiver to child. But there are things you can do to keep from passing the bacteria to your children. For example, don’t share toothbrushes; don’t put items in baby’s mouth after you have licked them or put them in yours; and, if you have untreated dental disease, try to avoid kissing the baby’s lips. (And for goodness sake, don’t pre-chew a baby’s food, no matter what any celebrity may suggest.)

One effective way to control tooth decay is by reducing the amount of sugar in the diet. Sodas and candy aren’t the only culprits — fruit juices are also high in sugar. And remember, it’s not just what your child eats or drinks that matters, but when they consume it. Given time, saliva will neutralize and wash away the acids that bacteria produce. But if kids are constantly taking in sugar, the saliva can’t keep up. So give those little teeth a break — limit sugar to mealtimes, and avoid sweet treats at other times of day.

What other steps can you take to stop tooth decay before it starts? It helps to identify kids who may be more susceptible to dental disease. Given the same diet with the same oral hygiene practices, some children are much more likely than others to develop tooth decay. If these high-risk kids receive preventive treatments — such as fluoride varnishes, help with diet modification, and other measures — early tooth decay can be successfully prevented, and even reversed in some cases.

If you’re concerned that dental treatment may be too scary for little ones, you should know that we put a great deal of effort into making office visits as stress-free as possible. We have plenty of tricks to keep youngsters happy — and distracted — while we take care of business. You can help too… by maintaining a positive outlook and setting a good example.

If you would like more information about cavity prevention for children, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine article “Taking the Stress Out of Dentistry for Kids.”

Chipped Teeth Harmoniously Made Good as New!

“Break a leg” is a well-known theatrical expression for wishing good luck to an actor about to go on stage. Singers should have one of their own…“Chip a tooth”! Apparently collisions between microphones and pearly whites are an occupational hazard for crooners. Taylor Swift became one of the latest casualties during a concert in Pittsburgh while belting out her hit “I Knew You Were Trouble.” The consummate professional, she didn’t miss a beat and kept on singing despite seeing a tooth chip hit the floor.

After all, while chipping a tooth is an inconvenience, it’s not a permanent smile wrecker. Modern dentistry offers several options for restoring a damaged tooth to its original symmetry and luster, or even better!

Bonding
Dental cosmetic bonding is the quickest and lowest-cost option to repair a chip. This involves application of a composite filling material that is colored and shaped to match the original tooth. Bonding material can be used to replace the lost portion of tooth or to seamlessly reattach the lost portion if it has been preserved and is otherwise undamaged. Little to no removal of existing tooth surface is needed.

Veneers
A veneer can be used for slightly larger areas or discolored teeth. This is a thin, custom-made shell placed on the front of the tooth to give it a new “face.” Some removal of existing tooth surface may be necessary to fit a veneer so it is flush with the surfaces of surrounding intact teeth.

Crowns
When a relatively large portion of the tooth is missing, a crown is often the better choice. It fully encases the visible portion of the remaining tooth above the gum line and is shaped and sized to match the original. It can be made of tooth-colored porcelain fused to metal crowns or all-ceramic (optimal for highly visible areas). A small amount of the existing tooth surface will be removed to allow the crown to fit over it.

If you would like more information about repairing a chipped tooth, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Artistic Repair of Front Teeth With Composite Resin.”

Taking the Stress Out of Childhood Dental Visits

Dentists have been saying for years that it helps to see children as early as possible — ideally, around the time they reach one year old. Just recently, an evidence-based study was released that backs this up: It shows that starting dental visits prior to age one actually reduces the cost of oral health care, and helps ensure that kids have pleasant dental experiences in the future.

Why do young children need to go to the dentist if they only have one or two teeth (and they’re baby teeth, to boot)? For one thing, those early dental visits get a child used to the new sights and sounds of the office: the big chair, the shiny equipment, and the friendly staff who will be taking care of them. And even at this tender age, it’s not too soon to check for signs of decay, make sure gums are healthy, and show everyone the best techniques for keeping up good oral hygiene in a growing mouth.

Still, it’s natural for a child to be a little nervous before an office visit. (Even grown-ups have been known to show some anxiety at the dental office from time to time.) To ease their way through, there are several techniques you can borrow from behavioral psychology to help make the experience as stress-free as possible.

First… just relax. Remember that kids quickly pick up on non-verbal cues that tell them something’s wrong — so try and stay positive, and keep smiling. You should prepare the little ones for what’s coming — but not too much information, please! We go to great efforts to make children feel safe and comfortable in our care, and we can tell them all they need to know in age-appropriate terms. In fact, most of your child’s first dental visit may consist of a show-and-tell about what we do and what tools we use.

Another thing to keep in mind is that parents are the major role models for their children, both in and out of the home. Kids naturally follow along — in both good and bad ways. If parents take good care of their own teeth, it helps kids develop good oral hygiene habits too. That includes brushing and flossing regularly, limiting sugary snacks between meals, and avoiding non-nutritious drinks — not only sodas, but also so-called “sports” and “energy” drinks, which can be extremely high in sugar and caffeine.

Of course, regular visits to the dentist should also be a part of every adult’s oral hygiene program. If your child sees you relaxing in the chair, it’s much easier for them to do it too. And that’s good for everybody’s health.

If you would like more information about children’s dental visits, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine article “Taking the Stress Out of Dentistry for Kids.”

TLC for Your Toothbrush

Your toothbrush serves the invaluable purpose of minimizing bacterial buildup (plaque) that can irritate gums and lead to periodontal disease, infection of the bone and tissues supporting your teeth. Brushing also helps dislodge food particles that certain oral bacteria would otherwise feed on, producing acids in the process that can eat through protective tooth enamel and the vulnerable dentin below. Given its importance to your oral health, you can maximize your toothbrush’s effectiveness by using and storing it properly, and replacing it (or the brush head if you have a powered model) regularly.

Using and Storing Your Brush
All that’s needed to dislodge plaque from oral surfaces is a relaxed grip and a gentle jiggling motion. Too much pressure can wear away tooth enamel, cause gum tissue to recede, and shorten the life of your brush head.

When you’re done using your brush:

1. Thoroughly rinse it to remove any remaining tooth paste, food particles, etc.
2. If you’re super-vigilant, you also can disinfect your brush by soaking it in mouthwash, brush-sanitizing rinse, or a half water/half hydrogen peroxide solution, or dipping it in boiling water for 5 to 10 seconds.
3. Air dry in an upright position and do not routinely cover your toothbrush or store it in a closed container. A dark, moist environment is more conducive to the growth of microorganisms.

Replacing and Recycling Your Toothbrush
Even with the best of care, toothbrush bristles become frayed and worn and their cleaning effectiveness diminishes after 3 or 4 months, according to the American Dental Association, though it could be sooner depending on factors unique to each patient. Besides checking the bristles regularly, a good way of keeping track is to write the date you start using your toothbrush in permanent pen on a big-enough spot on the handle (or doing it on masking tape applied to the base of a power brush).

Once your brush has passed its useful life for oral hygiene, you can still get plenty of mileage out of it. You’ll find plenty of ideas on the internet for cleaning grout between tiles and grime-filled spots around taps and toilet lid hinges; removing mud from boot treads; scrubbing off corrosion from around car battery terminals and more!

If you would like more information about oral hygiene, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Toothbrush Lifespan” and “Manual vs Powered Toothbrushes.”

Treating Thumb Sucking Now Could Reduce Orthodontic Treatment Later

One of the most common parental concerns is the habit of many children, even late into childhood, to suck their thumbs or fingers. Many parents have asked us, “Could this affect their teeth?”

The answer, unfortunately, is yes — thumb sucking can contribute to a malocclusion (bad bite) that could eventually require orthodontic treatment. Before making any assumptions, however, we need to understand the bigger picture.

To begin with, infants have a different swallowing mechanism than adults and older children. When you as an adult swallow, you'll notice the tip of your tongue positions itself just above the back of the top front teeth. An infant, however, will thrust their tongue between their upper and lower jaw as they swallow (also known as an infantile swallowing pattern or primary tongue thrust). The infant normally begins changing to an adult swallowing pattern when their primary (baby) teeth begin to erupt.

However, if a child's swallowing transition is slower than normal and the tongue rests between the jaws for a longer duration, it can inhibit the full eruption of teeth, believed to be the main cause of an open bite (a gap between the upper and lower teeth when the jaws are shut). The thumb during sucking resting between the teeth can have the same effect.

Thumb sucking may not necessarily lead to a malocclusion — for example, an abnormally developing jawbone could be the culprit. If prolonged thumb sucking does become a concern, however, there are steps we can take to reduce the impact of the habit. We can install a thin metal “tongue crib” behind the upper and lower incisors that will not only discourage thumb sucking, but also help retrain the tongue not to rest between the upper and lower teeth. There are also exercise routines known as orofacial myofunctional therapy (OMT) that can retrain specific muscles in the mouth to encourage more normal chewing and swallowing patterns.

These steps may not prevent future orthodontic treatment, but they could reduce its extent. The key is regular dental checkups and consultation to ensure your child's teeth and bite are developing normally.

If you would like more information on the effects of chronic thumb sucking on the mouth, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “How Thumb Sucking Affects the Bite.”

Giuliana and Bill Rancic Talk Tooth Decay

For some kids, having a cavity or two is just part of growing up. Not for Giuliana Rancic. When she was a child, the TV personality didn't have a single cavity — and she still doesn't. But for her husband Bill, co-star of the Style Network reality show Giuliana and Bill, it was a different story. A cavity-prone kid, he was never certain what a visit to the dentist might hold in store. “I can still remember the anticipation,” he recently told Dear Doctor magazine. “I always hoped I would get out of the checkups without a cavity!”

Why do some people get more cavities than others? There are a number of factors at work, but to understand it better, let's look at how tooth decay occurs.

How Cavities Form
Cavities — also called dental caries — are small pits or holes in the teeth that are caused by tooth decay. Tooth decay itself is a chronic disease that can flare up when plaque isn't kept under control. A thin, bacteria-laden film, plaque sticks to tooth surfaces both above and below the gum line, and can build up in the absence of effective oral hygiene.

Of course, everyone has bacteria in their mouth, both “good” and “bad” (pathogenic) types. But when the bad guys outnumber the good, trouble can start. When you consume sweets, plaque bacteria process the sugars and release acid as a byproduct. The acid eats into tooth surfaces, causing decay — and cavities that need filling. Left untreated, decay can work its way into the tooth's pulp, resulting in infection and pain. Eventually, treatment might involve a root canal — or, in the worst case, extraction.

What can you do if you seem to be prone to cavities? One effective way to fight tooth decay is by maintaining good oral hygiene. Brush at least twice daily, for at least two minutes each time. Use a soft-bristled brush and a dab of fluoride toothpaste to clean all around your teeth. Most importantly, floss above and below the gum line, every day. And just as important, don't forget to have regular dental checkups every six months.

A Healthy Balance
Another cavity-fighting strategy is eating a balanced diet. Avoid soda, sugary “energy” drinks and sweet treats — but if you choose to consume sugar, have it with meals instead of between meals. This will give your saliva, which has natural cavity-fighting properties, a chance to work.

“It's all about maintaining a healthy balance,” Giuliana told Dear Doctor. And Bill agrees: “I love nuts and fruit for a healthy snack,” he said, adding that he's meticulous about brushing and flossing. And when the couple smiles, you can see how those healthy habits pay off.

If you would like more information on preventing tooth decay, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can learn more about this topic in the Dear Doctor magazine articles “Tooth Decay” and “Tooth Decay – How To Assess Your Risk.”

Kristi Yamaguchi's Braces Helped Give Her a Winning Smile

If Kristi Yamaguchi's kids inherit her figure skating ability, they might just be headed for the Olympics — after all, their mom won the gold medal for figure skating in the 1992 games. When it comes to teeth, however, she wouldn't mind if they inherited her spouse's instead. “My husband [fellow Olympian turned pro hockey player Bret Hedican] never had braces,” she recently told an interviewer. “I'm hoping they get his teeth.”

When you look at the elegant skating star's pearly smile, you'd never suspect she had dental problems. In fact, Kristi had four permanent teeth extracted to relieve the crowding in her mouth. She also wore braces to correct irregularities in both upper and lower teeth. Could orthodontics work the same “magic” for your kids — or yourself?

It just might. The first step toward finding out is having an orthodontic evaluation. For kids, the right time for an initial evaluation is no later than age 7. By then, the first molars are usually present and your child's bite pattern is establishing. Even though treatment may not begin for several more years, it's helpful to know what problems may arise in your child's individual situation — and to start treating them at just the right time.

Orthodontics has progressed a great deal in the two decades since Yamaguchi's braces came off. Today, small devices called palatal expanders are often used to create more space in the mouth, as an alternative to tooth extraction. There are also many new options for orthodontic appliances, in addition to standard metal braces. These include unobtrusive tooth-colored braces and lingual braces, which are applied to the tongue side of the teeth and can't be seen. In some cases, clear plastic aligners can be used instead of braces, for a look that's almost invisible.

Adolescence is often the preferred time to do orthodontic treatment. By then, the permanent teeth have mostly come in, but there's still some growing left to do. But age isn't a factor that should stop you from getting the smile you've always wanted. About one in five orthodontic patients today is an adult — and those less-visible appliances can fit in well with the more “professional” image of an older person.

Orthodontics can't help make someone an Olympic athlete — only lots of talent and practice can do that. But it can make a big difference in a person's appearance. “Once my braces came off, it was like — Wow! That looks so much nicer,” Yamaguchi recollected. And today, the mother of two, author, and philanthropist sports the same appealing smile she had on the podium at the Albertville Olympic Games.

If you would like more information on how orthodontics could help you get the smile you've dreamed about, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Early Orthodontic Evaluation” and “The Magic of Orthodontics.”

Tips for Maintaining and Caring for Your Dentures

Cleaning dentures is an important part of wearing them. However, did you know that recent research has revealed a link between denture hygiene and overall health? The evidence shows that oral bacteria have been implicated in chronic obstructive pulmonary (lung) disease, bacterial endocarditis (“endo” – inside; “card” – heart), generalized infections of the respiratory tract and other systemic diseases. While it is never our intent to frighten you, we feel it is important that we share some important tips on maintaining and caring for your dentures so that your oral health does not negatively impact your general health.

Our first tip focuses on fit, as denture slippage is an experience that anyone who wears dentures dreads. So if your dentures seem to slip or you have started increasing the amount of adhesive you are using to achieve the same level of denture retention that you had when first fitted, you need to make an appointment with us soon. Otherwise, an ill-fitting denture can cause discomfort, embarrassment and contribute to other oral health issues.

Next, we must focus on cleaning your dentures. It is critical that you clean your dentures daily. However, you should never use harmful or abrasive cleansers. Nor should you ever place your dentures into boiling water! The best method for cleaning is to soak them daily in a non-abrasive denture cleaner. And when you remove them, gently brush them with a soft-bristled toothbrush.

Our last tip concerns how long you wear your dentures each day. Even if your dentures are extremely comfortable — for example, you forget they are in — you should not wear them 24 hours a day. Why? Because you will develop a chronic yeast infection called, “denture stomatitis” due to stagnation that develops under dentures when the lubricating and antibacterial effects of saliva are impeded. Unfortunately, the constant pressure on the gum tissues caused by wearing dentures can accelerate jawbone loss over time. Give your mouth and tissues a rest by sleeping without your dentures in your mouth.

To learn more tips, continue reading the Dear Doctor magazine article “Top Ten Tips For Denture Care & Maintenance.” Or please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation.

Whitening is a Safe and Effective Way to get That "Hollywood Smile"

The “Hollywood Smile” — dazzlingly white — is associated in our society with youth, health and vitality. Achieving that smile through either professional or home whitening applications has become very popular.

Teeth become discolored or dull for a number of reasons. It can be something intrinsic with the teeth — changes in enamel or dental structure during development, inherited disorders, heavy exposure to fluoride or tetracycline, or changes in mineral structure or wear due to aging. It can also be extrinsic, resulting from environmental or lifestyle causes. Eating foods with tannins (red wine, coffee or tea) or carotene pigments found in plant foods like oranges or carrots, or using tobacco may all cause staining.

Most modern applications involve an oxidizing chemical (usually hydrogen peroxide) that bleaches the teeth. Professional applications in a dentist's office use high concentrations of hydrogen peroxide (usually 35 to 45%) applied directly to the teeth with control measures to protect the lips and gums. This type of application can lighten the color of teeth up to ten shades.

There are a number of home options too: whitening strips, “Paint on” or “Brush on” whitening, and even whitening gum. We can also provide you with a “Take home” kit that resembles the professional application but is generally less expensive. Although all these home applications are generally safe and effective, they typically take longer for results (several repeated days as opposed to about one hour for an office application), and not always to the same level of lightness as the professional.

Just about anyone can be a candidate for a whitening application. However, if you have thinner than normal dentin and more porous enamel, or suffer from gum recession or enamel loss, then whitening may increase tooth sensitivity. And, whitening is not a permanent solution: the brightness will fade over time, usually within a year. You can slow the fading by avoiding foods and habits that contribute to staining. It's also possible to touch up the initial whitening once or twice a year to extend the life of your new, bright smile.

If you would like more information on teeth whitening, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Teeth Whitening.”

Achieving a Transformed Smile With Porcelain Veneers or Crowns

Today's cosmetic dentist can bring amazing transformations to their patient's smiles. That's because we now have a versatile array of materials and processes that precisely replicate the appearance of natural teeth.

Two of the most useful are porcelain veneers and crowns. Although different in structure and function, veneers and crowns both utilize a material known as dental porcelain, a ceramic material that can be shaped to resemble an individual patient's natural tooth shape, with the same color, hue saturation and translucence as the original or surrounding teeth.

As the name implies, veneers are a thin layer of dental porcelain that adheres to the outer surface of a tooth, essentially as a replacement for enamel. They solve a number of esthetic issues patients have with their teeth, especially those in front: poor color, shape and contours; broken teeth; poor tooth position; and staining that can't be removed with conventional bleaching. They most often require minimal tooth preparation, as only 1 mm or less of tooth enamel needs to be removed. Occasionally, no tooth reduction is required.

However, they are not a good solution where there is not an adequate amount of tooth structure to work with. In this case, a crown may be the best choice. A crown (or cap) covers the remaining tooth structure completely, reinforcing the remaining tooth structure 360°. This is an excellent choice for patients who have lost a large amount of tooth structure due to decay, trauma or grinding habits that have eroded the enamel.

To determine if you are a true candidate for either of these applications you should undergo a smile analysis in our office. During this process it's even possible to create a diagnostic mock-up — a “trial smile,” if you will — with temporary tooth-colored materials applied to your teeth and then photographed for your review.

The smile analysis helps us recommend the best solution for you and in turn will help you make an informed choice on the right application for you. Although either option may not be feasible in all situations, they may just be the right choice to change your smile for the better.

If you would like more information on how porcelain veneers and crowns can help transform your smile, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Porcelain Crowns and Veneers.”

Prevention is the Key in the Fight Against Periodontal Disease

Billions of bacteria live in each of our mouths, sharing a common environment with teeth and soft tissues. Most of the time, they coexist in symbiotic balance. But sometimes that balance becomes disrupted, leading to a destructive condition known as periodontal disease.

From the Latin peri (“around”) and the Greek odont (“tooth”), periodontal refers to the tissues that are around the teeth. When they become diseased, it's a serious matter; and not just because of potential tooth loss — there is evidence that periodontal disease has links to cardiovascular disease and, for pregnant women, low birth weights in pre-term babies.

There are a number of factors that can increase your risk of developing periodontal disease, like smoking, poor nutrition, and your systemic health. The biggest factor, however, is increased bacterial plaque due to poor oral hygiene practices.

Periodontal disease is progressive. As unhealthy bacteria levels increase, the bacteria eventually cause bone loss, the gums separate from the teeth and create what is referred to as periodontal pockets. As the pockets deepen around the teeth, plaque and tartar become extremely difficult to remove, even if you resume a proper hygiene routine. At this stage, treating the disease will require a different approach. And if left untreated, the teeth will most likely continue to lose bone and eventually be lost.

Through a dental exam, we can determine the presence and extent of the disease and recommend a treatment strategy. Besides lifestyle changes and better hygiene habits, this strategy might also include treatment with antibiotics, a thorough mechanical cleaning to remove tartar and plaque, surgical techniques to remove infected tissue, or occlusal bite therapy.

Above all, prevention is the key. Through proper dental hygiene and regular dental exams and cleanings, stopping periodontal disease from beginning in the first place is your best defense.

If you would like more information on the treatment of periodontal disease, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Understanding Gum Disease.”

Wearing an Orthodontic Retainer Preserves Your Well-Earned Smile

Orthodontic treatment (commonly known as braces) can be a lengthy process to re-align your teeth to a more functional and aesthetic position. Once the orthodontic devices are removed, however, the treatment isn't finished. Wearing a retainer is the final step to ensuring that the re-alignment doesn't eventually fail. It's designed to do just what its name implies — to “retain” the teeth's new position and prevent a relapse to the old.

This can happen because of the way teeth fit into the jaw bone. The teeth are joined to the bone by the periodontal ligament, which works somewhat like a hammock: the ligament's fibers act like threads that fit into the tooth on one side and into the bone on the other, and hold the teeth in place.

As living tissue, the ligament's cell structure is dynamic and can adapt to the gentle pressure applied by an orthodontic device. However, once this pressure subsides after the device is removed “muscle memory” can cause the ligament to resist the new position and pull the teeth back to their original setting. The retainer helps hold the teeth in the new position while the bone and ligament continue to mature and stabilize around the teeth.

There are two basic types of retainers; the one recommended for you will depend on your age and the extent of your orthodontic treatment. One type is a removable device that is typically worn around the clock initially, but may eventually only need to be worn at night or for even a lesser interval of time. The other type is attached permanently behind the teeth and can only be removed by an orthodontist. Permanent retainers have the benefit of not being as visible as the removable type, and there's no bother with putting them in and taking them out.

You may consider wearing a retainer a nuisance especially after months of orthodontic treatment. But consider it the last lap in a long race — only by finishing can you achieve that winning smile.

If you would like more information on the use of a retainer, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “The Importance of Orthodontic Retainers” and “Why Orthodontic Retainers?”

Answering Common Questions on TMJ Disorders

You have probably heard a lot of people talk about TMJ disorders, but do you know what it all means? How do you know if you are suffering from a TMJ disorder?

Below are answers to some common questions about TMJ disorders.

What is a TMJ disorder?
First, we should explain that TMJ actually refers to the Temporomandibular Joint, which is the formal name for your jaw joint(s). TMD stands for Temporomandibular Disorders, which is the correct name for the muscle and/or joint symptoms that commonly arise when there is TMJ pain and dysfunction. You may have heard people refer to the actual disorder as TMJ, but this name is incorrect.

When I experience TMJ pain, what exactly is happening?
Let's first understand all of the parts that play a role in your pain. The temporomandibular joints connect your mandible (lower jaw) to your skull on both the left and right sides, which makes the lower jaw the only bone in the body with completely symmetrical joints at both ends. There is a ball-and-socket relationship between your jaw and your skull on both sides, but the unique part is the presence of a cushioning disk between the two surfaces in each joint. Each TMJ has a disk between the ball (condyle) and socket (fossa), and this sometimes ends up being an especially important area when trouble arises.

So, how do I know if I have TMD?
You can never be absolutely sure, but here are some symptoms you should be sure to share with us during your examination:

• Clicking. You may experience a clicking sound in the jaw, usually due to a shift in the position of the disk inside the joint. However, if you do not have pain or limited jaw function, this symptom may be insignificant.
• Muscle Pain. The next symptom is jaw muscle pain, usually in the cheeks or temples. If the muscle is sore or stiff in the morning, this pain is usually related to clenching or grinding in your sleep. However, there are more complex muscle pains that can spread to your head and neck.
• TMJ Pain. This third symptom refers to pain actually inside one or both of your jaw joints, technically described as arthritis of the TMJ.

If diagnosed, what can I expect from treatment?
We will first need to assess the damage to your TMJ, and from there we will recommend a course of treatment to relieve your pain. Treatment may range from hot or cold compresses and anti-inflammatory medications to physical therapy or a bite guard. We may also advise you to do jaw exercises at home. In general, we will do our best to treat your issue without orthodontic treatment or surgery.

If you would like more information about TMD, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Seeking Relief from TMD.”

Reduce Your Risk of Oral Cancer With a Healthy Whole Food Diet

While genetics certainly plays a role in a person's susceptibility to various forms of cancer (including oral cancer), there are lifestyle factors that also play a role.

In the case of developing oral cancer, there are a number of prominent lifestyle changes you can make to help reduce your risk: protect yourself from too much sun exposure; avoid the use of any type of tobacco (smoke and smokeless); limit your intake of alcoholic beverages to a moderate level; abstain from risky sexual behavior; and eat a diet rich in fresh fruit and vegetables, as well as other whole foods.

That last lifestyle change not only reduces your level of negative exposure from the environment, it may also provide a positive effect as well. For example, normal cellular function produces unstable molecules known as “free radicals” that can damage the DNA structure within the cell; this could be a precursor to the development of cancer. There are natural substances, however, that can help protect cells against the damage caused by free radicals. These are known as “antioxidants” and they are abundant in many plant-based foods. You, of course, may know them by other names: vitamins, carotenoids (found in red and orange fruits and vegetables) or fiber, to name a few.

A well-balanced diet can provide these and other kinds of cancer-fighting nutrients. And, it's important that you eat the source of these nutrients — fresh plant-based foods. Studies have shown that dietary supplements can't match the effectiveness of actually eating fruit and vegetables.

Besides lowering your cancer risk, a plant-based, whole food diet will also result in better oral health. Diets heavy in processed foods with high amounts of sugar or other bacteria-friendly substances inhibit good oral health.

If you would like more information on the role of diet in reducing your risk to cancer, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Diet and Prevention of Oral Cancer.”

Sealants and Protecting your Child from Cavities

As a parent, hearing that your child has a cavity is almost worse than hearing that you have a cavity. You wonder if the cavity is your fault — did you fail to teach your child proper oral hygiene? Should you have spent more time teaching him how to brush? Well, luckily, there are several ways, in addition to diligent oral hygiene, to protect your children's teeth from decay.

When your children are young, the newly erupted enamel of their teeth is more permeable and therefore more susceptible to tooth decay. As the enamel matures, it becomes stronger and more resistant to decay. Until this point, it is very important to protect the surfaces of your child's newly erupting teeth.

One way to protect the enamel is with fluoride, which makes the surface of enamel harder and less vulnerable to acid attack and decay. However, because of the deep pits and fissures in the teeth, they are still at high risk for decay and may need further protection. In these cases, we might recommend sealants, protective coatings placed in the pits and fissures of teeth to prevent decay. In doing so, these invisible coatings actually “seal” them from attack. The procedure is usually completely painless, and only occasionally, a very small amount of tooth enamel is removed. Though some children feel a quick tinge of cold during the procedure, this mild feeling is not enough to demand the use of numbing injections.

Generally, we will use sealants when we examine your child and find that decay is starting or likely to start in a tooth. However, in cases where children have a high risk of cavities, we may seal all permanent molar teeth and many baby molar teeth soon after eruption.

If you would like more information about sealants, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Sealants for Children.”

A Solution for your Chipped Tooth

Whether it's a chipped tooth or a cut in your mouth, there is nothing pleasant about experiencing a dental injury. The good news is that advances in modern dentistry ensure that we'll be able to fix the issue with minimal discomfort and maximum results. If you've suffered a chipped tooth as a result of an unfortunate accident, composite resin bonding may be the ideal solution to your problem. The procedure is simple and painless and, most importantly, you'll surely be pleased with the results.

Here's how it works. The bonding is actually a tooth-colored material that is a combination of plastic and glass. The composites come in a wide range of colors that allow us to create a bonding that is nearly identical to your natural tooth. Once we have the composite material, we will bond it to the tooth by slightly roughening the tooth so that the resin fills in small cuts in the tooth surface. We'll utilize a special light to activate the resin, helping it bond and set. Finally, we'll polish and buff your tooth for a smooth, natural finish.

The procedure will involve very little preparation (drilling) of the tooth structure. In addition, since placing composite resin does not require us to outsource to a laboratory, we can usually complete this procedure in just one short visit.

Composite resin bonding is an excellent solution for small chips to your tooth, but the more tooth structure that is lost, the less effective they become. While the material is durable, it is not as strong as the tooth structure it replaces. There are therefore, some disadvantages. A large amount of resin may not stand up to biting force over time, and the composite can also stain as it ages. When you come to our office for an appointment, we will evaluate whether porcelain restoration might be more suitable for a long-term material solution.

If you would like more information about bonding, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Repairing Chipped Teeth.”

Questions about Cosmetic Dentistry

Once you've decided to make over your smile, you're embarking on an exciting journey to restore your smile and your confidence. As experts in cosmetic dentistry, you should consider us partners on this journey, here to help not only fulfill your vision, but also answer any questions while making you feel at ease throughout the process.

Today there are many options for making over your smile, and when we meet for an initial consultation, we'll discuss many of them with you. Until then, you might have some questions about cosmetic dentistry.

What is a cosmetic dentist?
We are restorative dentists who are experts in the art of smile design. We have put a great deal of emphasis on studying the concepts of smile design and the innovative materials used for a smile makeover. We have made it our life's work to remain up-to-date on the latest innovations in dentistry.

What is the difference between cosmetic and restorative dentistry?
There is some overlap between cosmetic and restorative dentistry. However, a cosmetic dentist goes beyond restoring your teeth to their proper function — our goal is to achieve the most optimal esthetic result and satisfy the vision that you have for your smile.

What can I expect at the initial consultation?
Before you come in for the initial consultation, ask yourself some important questions:

• Do you dislike the color of your teeth?
• Do you have chips or cracks that need to be fixed?
• Do you have crooked teeth or spaces between teeth that you would like eliminated?

The goal of this first appointment will be to determine exactly what you want out of your smile makeover. We suggest that you bring in photos to show us what you would like your future smile to look like. We will also conduct a thorough examination to determine if your cosmetic issues are the result of any underlying health issues. During this examination, we'll be doing a Smile Analysis, studying all of the elements of your smile, from teeth to gums and jaws. From there, we'll walk through treatment options, including pricing and timelines, and develop a plan of action.

If you would like more information about cosmetic dentistry and the procedures we may recommend for your smile makeover, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Cosmetic Dentistry.”

Technology for Teens with Clear Aligners

Braces have traditionally been seen as a “rite of passage” for teenagers, and while most teenagers learned to “em-brace” their orthodontics, in some situations, braces were less appealing. For example, like many people, you may have old prom and homecoming photos featuring beautiful dresses, tuxedos and a mouth full of metal braces.

Luckily, thanks to modern technology, your teen has more options than ever before, including clear aligners. Clear aligners use a system of clear, removable trays to gradually straighten teeth. Each individual aligner is slightly different than the previous one and made of a virtually invisible plastic that completely covers the teeth. When worn for 22 hours per day for a two-week period before moving on to the next aligner, teeth can be moved into the desired position. This movement can take anywhere from 6 to 24 months, and aligners can be taken out for eating, drinking and other short periods of time.

Technology is really at its finest when it comes to Invisalign clear aligners. They are computer-generated, based on photographs, models of your teen's teeth and x-rays. The models are sent to a laboratory where a computer creates a 3D image, and we manipulate each tooth on the screen into a new position until they are all properly aligned. Special software then simulates the movement of your teen's teeth and essentially creates the course of treatment. Finally, we create plastic aligners for each step of the movement.

Technology is also responsible for making clear aligners a better option for teenagers over the past few years. Originally, teens were not seen as good candidates for clear aligners because their second molars have not fully grown into position and also because it was assumed, since the aligners are removable, teenagers might not be as diligent about wearing the aligners as adults. Technology is responsible for a solution for both of these issues. Eruption tabs serve as space-holders for teeth that haven't grown in, and clear aligners for teens have compliance indicators built-in that fade with time as each aligner is worn.

When you bring your teenager into our office for an initial consultation, we'll evaluate whether clear aligners will be an appropriate solution for his orthodontic needs.

If you would like more information about clear aligners, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Clear Aligners for Teenagers.”

Braces Have Come a Long Way, Says Vanna White

Everyone knows Vanna White as the elegant co-host of the popular game show Wheel of Fortune. But here's one thing you may not know: White is listed in the Guinness Book of World Records as television's most frequent clapper, with an average of 720 claps per show — that's over 28,000 per season! And here's something else: the star with the megawatt smile wore braces as a kid, and she's not too shy to talk about it.

“I only had to wear them for a year and it was a good experience for me,” she told an interviewer for Dear Doctor magazine. But when it was time for her son to get them, White noticed something different. “We used to have those silver bands that went all the way around each tooth, and they don't have that anymore. It is fascinating to see how far they have come.”

We're glad she noticed! In fact, orthodontic appliances have advanced a good deal in the past decade or so. Instead of using metal bands, brackets holding the wire part of braces are now typically attached directly to the teeth with a dental adhesive. For an even less obtrusive look, ask about using colorless brackets instead of metal ones — that way, the only part that's clearly visible is the thin wire itself. And in some situations, braces can be placed on the lingual (tongue) side of the teeth, making them all but invisible.

Another type of nearly invisible appliance is the Invisalign clear orthodontic aligner. The aligner system consists of a series of precision-made transparent “trays” that fit over the teeth. Each tray is worn for a few weeks, and each moves your teeth by a small amount; together, they can help correct mild to moderate orthodontic problems. And the best part — they're really hard to notice! That makes them perfect for both adults concerned about a “professional” look, and image-conscious teens.

So if you're a TV star — or if you'd just like to have a brighter and better smile — it's never too late to get started! If you would like more information about orthodontics, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “The Magic of Orthodontics” and “Clear Orthodontic Aligners.”

Battling Bruxism and Saving Your Teeth

Do you clench your jaw or grind your teeth? Bite your nails? Chew on pencils or toothpicks? Or, heaven forbid, unscrew hard-to-open bottle caps using your precious pearly whites?

Over time, habits such as these — referred to in dentistry as “parafunctional” (para – outside; functional – normal) or beyond the range of what nature intended — can inflict excessive wear and tear on your teeth. Besides the impact damaged teeth can have on your smile, so called “tooth to tooth” and “tooth to foreign object” behaviors can cause physical problems, such as jaw joint and muscle pain, headaches, earaches, and even neck and back pain.

Use of Excessive Force

Parafunctional behaviors exert an abnormal amount of force on your teeth — up to 10 times the amount used for biting and chewing. Tooth grinding or “bruxism” (from the Greek word brykein – “gnash the teeth”) is particularly detrimental and is commonly seen in individuals who are experiencing a stressful time in their life. Some medications can also trigger it. Since bruxism often occurs while people sleep, it's possible to be unaware of it unless a partner comments (it can be noisy!) or a dental professional points out the tell-tale signs of wear.

To counter the adverse effects of nocturnal tooth grinding our office can create a customized night or occlusal (bite) guard. Typically fashioned from a hard, clear “processed acrylic” (wear-resistant plastic), this type of guard is amazingly inconspicuous. It is made to fit over the biting surfaces of the upper teeth only and is thinner than a dime. When it is worn, the lower teeth easily glide over the upper teeth rather than chomping into and gnashing with them, which minimizes the likelihood of erosion, chipping and uneven or excessive wear of the biting surface of the teeth. The guard is so unobtrusive, that some people even wear it as they go about their daily activities.

Remember: In addition to proper dental hygiene, you can help keep your teeth healthy by using them wisely!

If you would like more information about parafunctional habits like bruxism and ways to protect your teeth, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Stress & Tooth Habits” and “How And Why Teeth Wear.”

Are You at Risk for Oral Cancer?

Oral cancer accounts for approximately 3% of cancers in men and 2% in women. That may not sound like a lot, but the disease often isn't detected until it has progressed to its later stages when it's harder to treat and the outlook for survival is significantly diminished.

The main areas where oral carcinomas (cancers) occur are:

• the tongue (most common location, particularly the sides and underneath)
• the lip (especially the lower one),
• the oral cavity (the mouth), and
• the pharynx (back of mouth and throat).

Risk Factors You Can't Control

Even if you can't change these risks, awareness helps raise your vigilance in order to catch potential problems early when treatment options and positive outcomes are greatest.

• Heredity
• Aging — More than 90% of all oral cancers occur in individuals over 40. However, the incidence among younger people has been on the uptick recently, perhaps related to lifestyle behaviors.
• Race — African Americans have a higher incidence of oral cancer than Caucasians.

Risk Factors You Can Address

• Smoking and chewing tobacco — Smokers are at five to nine times greater risk and snuff and tobacco chewers at about four times greater risk
• Alcohol — Moderate to heavy drinkers are at three to nine times greater risk; the higher the alcohol content, the greater the risk
• Diet — A high intake of fruits/vegetables, which are high in antioxidants, has been found to have a protective effect against a variety of cancers, including oral.
• Chronic sun exposure — Often connected with lip cancers.
• Viral infections — Namely the human papilloma virus “HPV 16,” which has been linked to sexual transmission (oral sex) and cervical cancer in women.

As part of your routine oral hygiene, you should be closely monitoring any non-healing changes in your mouth (e.g., ulcers or sores, white or red patches on the tongue). And rest assured that as part of your regular check-ups, our office performs a comprehensive visual screening for signs of oral cancer.

If you would like more information about oral cancer prevention and detection, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Oral Cancer” and “Diet and Prevention of Oral Cancer.”

February is National Children's Dental Health Month

All during February, we are taking part in the celebration of National Children's Dental Health Month. This annual observance is sponsored by the American Dental Association (ADA) to raise awareness of how important it is to develop good oral hygiene habits at an early age. Good dental health will promote your children's overall health and even their performance at school. According to the U.S. Surgeon General, an estimated 51 million school hours are lost per year due to dental-related illness.

To get every child off to the best possible start, we recommend that the first dental visit take place around the time of your child's first birthday. This will establish a “dental home” for your little one and allow caring professionals to respond to any issues that come up early on. Regular, semi-annual visits should follow to maintain healthy baby teeth, which in turn will have a positive affect on the permanent teeth that will replace them.

If your children are of school age, they will probably enjoy some of the games, puzzles and coloring sheets the ADA has created to help instill healthy habits. You can access the whole collection at http://www.ada.org/5578.aspx#sheets.

If you have any questions about oral health for children, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for your child. You can read more about the importance of the “Age One Dental Visit in Dear Doctor magazine.

Treating Chipped Teeth: A Common Sports Injury Among Kids

One went over the handlebars of his mountain bike. Another got an elbow going for a lay-up. For a third, it was that tricky maneuver on her new snowboard...

These are just a few of the ways that kids' teeth can be injured. (No doubt, parents can think of plenty more.) The good news is that modern dentistry offers more options than ever for treating the injury and restoring the appearance and function of the teeth.

Teeth that are fractured or dislodged are a serious condition that requires immediate, comprehensive treatment. The majority of dental injuries, however, are less severe: most often, they involve chipped teeth. If chips occur in the upper front teeth — as some 80% of dental injuries do — even small flaws can have a big affect on the appearance. And, especially in the teenage years, appearance can mean everything.

In many cases, small chips in the teeth can be repaired effectively using a procedure called “bonding.” In this treatment, we use a tooth-colored material made by mixing a plastic matrix and a glass-like filler, which provides adequate strength and aesthetic qualities similar to the natural teeth. In fact, this composite material can be matched to an individual's tooth color so accurately that it's hard to notice any difference.

Composite resins can be successfully bonded to most healthy teeth — and they offer some advantages over other restoration methods, particularly for children and teenagers. The bonding procedure avoids making tiny “undercuts” in the natural substance of the tooth, while metal fillings need to “lock in” to the tooth's structure. This means that bondings generally require less tooth preparation, which usually makes bonding a quick and relatively easy method of restoration.

It's true that, over time, some bonded restorations may not stand up to the tremendous biting forces of the jaw as well as porcelain restorations — but in young people whose permanent teeth have large pulp (nerve) chambers, the removal of too much tooth structure could compromise the long-term health of the tooth. Later on, we can look at performing a different type of restoration.

If you have questions about cosmetic bonding or sports-related dental injuries, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Repairing Chipped Teeth” and “An Introduction to Sports Injuries & Dentistry.”

Smile Makeovers — Planning For Your Wedding

Of major importance in all wedding day plans is to ensure that you have your special day captured on film. And it is that fact that influences most brides and grooms to take a long and hard look in the mirror to observe their smiles. Not only do wedding dates motivate many brides and grooms to address concerns regarding their smile, it also serves as the perfect time for their parents to pursue their smile makeover dreams so that they too feel good about themselves in your wedding photos.

A proper smile makeover should have a two-fold design plan that ensures you obtain optimal functionality and oral health while creating the cosmetic look you want. Starting with the basics, a thorough dental cleaning is the least expensive way to remove stains and freshen both your smile and breath. We will also use this consultation to learn about your concerns, goals, expectations, and wedding day timeline to create the action plan for future treatments in reaching your smile makeover goals. You may also want to discuss whitening your teeth during your appointment, as whitening teeth is an effective way to brighten your smile a few shades in as few as 1 to 2 appointments plus whitening while at home.

If your smile makeover is a bit more challenging, relax. There are a wide variety of tools and techniques available that include bonding, porcelain veneers, crowns, bridges, and dental implants for restoring your smile. Or we may work closely with a specialist such as an orthodontist to straighten your teeth or a periodontist for periodontal plastic surgery that can alter your gum tissues and their relationship with your teeth. The most important tip to remember is to schedule your first dental appointment soon after you become engaged so that you have plenty of time prior to the big day to attain your picture perfect wedding day smile.

Want to learn more?

Contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment to discuss your smile makeover questions. You can also learn more by reading the Dear Doctor article, “Planning Your Wedding Day Smile.”