Research Confirms: Dental Sealants Really Work!

Have you heard about dental sealants? These preventive treatments have been available for many decades, and more and more children are taking advantage of them. The National Institutes of Health (NIH) estimates that around 30% of kids from 6 to 11 years of age have had sealants applied to their molars (back teeth). Sealants are designed to reduce the incidence of cavities by filling in or eliminating the pits or crevices found in all molars, where decay-causing bacteria can hide and your brush can't reach. But do they really work?

Now, the research is in, and the answer is clear — YES!

Two major studies, each of which reviewed the results of thousands of patients over several years, recently came to the same conclusion: Dental sealants are effective at reducing cavities, and their benefits can last for four years (or more) after application. In general, the studies showed that kids who didn't get sealants were twice, three times, or even more likely to get cavities, compared to kids treated with sealants.

Sealants themselves are protective coatings made of plastic resins or glass-like materials. They are applied in liquid form, and then hardened by a special light. When “painted on” to the chewing surface of a molar, sealants fill in the tiny crevices, or “pits and fissures,” that are found there. Uneven tooth surfaces form a perfect breeding ground for the bacteria that cause tooth decay; worse yet, the bristles of a tooth brush can't usually reach them. That's what makes these areas highly susceptible to tooth decay.

Applying sealants is a quick and painless procedure that doesn't require any numbing shots or drilling. Many kids start getting sealants when the first permanent molars come in, around age 5 to 7; they may have more sealant treatments when additional molars emerge, between the ages of 11 and 14.

Sealants are recommended by the American Dental Association and the American Academy of Pediatric Dentistry, and have only a modest cost per tooth. On the other hand, having a cavity filled generally costs substantially more, and may result in more trouble (and expense) down the line — so sealants can make sense economically, as well as preventively. This is especially true for those at high risk for tooth decay.

If you have questions about dental sealants, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can read more in the Dear Doctor magazine article “Sealants for Children,” and “Top 10 Oral Health Tips for Children.”

A Retainer Helps You Keep Your New Smile After Braces

Moving your teeth to a more functional and attractive alignment is a big undertaking. You can invest months — even years — and a lot of expense to correct a bad bite. But all that effort could be for nothing if your teeth return to their original positions.

The very aspect of dental physiology that makes orthodontics possible can work against you in reverse. Your teeth are not actually rigidly fixed in the bone: they're held in place by an elastic gum tissue known as the periodontal ligament. The ligament lies between the tooth and the bone and attaches to both with tiny fibers.

While this mechanism holds the teeth firmly in place, it also allows the teeth to move in response to changes in the mouth. As we age, for example, and the teeth wear, the ligament allows movement of the teeth to accommodate for the loss of tooth surface that might have been created by the wear.

When we employ braces we're changing the mouth environment by applying pressure to the teeth in a certain direction. The teeth move in response to this pressure. But when the pressure is no longer there after removing the braces or other orthodontic devices, the ligament mechanism may then respond with a kind of “muscle memory” to pull the teeth back to where they were before.

To prevent this, we need to help the teeth maintain their new position, at least until they've become firmly set. We do this with an oral appliance known as a retainer. Just as its name implies it helps the teeth “retain” their new position.

We require most patients to initially wear their retainer around the clock. After a while we can scale back to just a few hours a day, usually at nighttime. Younger patients may only need to wear a retainer for eighteen months or so. Adults, though, may need to wear one for much longer or in some cases permanently to maintain their new bite.

Although having to wear a retainer can be tedious at times, it's a crucial part of your orthodontic treatment. By wearing one you'll have a better chance of permanently keeping your new smile.

If you would like more information on caring for your teeth after braces, 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 “The Importance of Orthodontic Retainers.”

Vivica's Veneers: the Making of a Hollywood Smile

What's an actor's most important feature? According to Vivica A. Fox, whose most recent big-screen role was in Independence Day: Resurgence, it's what you see right up front.

"On screen, your smile and your eyes are the most inviting things that bring the audience in" she said. "Especially if you play the hot chick."

But like lots of people, Vivica reached a point where she felt her smile needed a little help in order to look its best. That's when she turned to a popular cosmetic dental treatment.

"I got veneers years ago," Ms. Fox told Dear Doctor magazine in a recent interview, "just because I had some gapping that probably only I noticed."

What exactly are dental veneers? Essentially, they are thin shells of lustrous porcelain that are permanently attached to the front surfaces of the teeth. Tough, lifelike and stain-resistant, they can cover up a number of defects in your smile — including stains, chips, cracks, and even minor spacing irregularities like the ones Vivica had.

Veneers have become the treatment of choice for Hollywood celebs — and lots of regular folks too — for many reasons. Unlike some treatments that can take many months, it takes just a few appointments to have veneers placed on your teeth. Because they are custom made just for you, they allow you to decide how bright you want your smile to be: anywhere from a natural pearly hue to a brilliant "Hollywood white." Best of all, they are easy to maintain, and can last for many years with only routine care.

To place traditional veneers, it's necessary to prepare the tooth by removing a small amount (a millimeter or two) of its enamel surface. This keeps it from feeling too big — but it also means the treatment can't be reversed, so once you get veneers, you'll always have them. In certain situations, "no-prep" or minimal-prep veneers, which require little or no removal of tooth enamel, may be an option for some people.

Veneers aren't the only way to create a better smile: Teeth whitening, crowns or orthodontic work may also be an alternative. But for many, veneers are the preferred option. What does Vivica think of hers?

"I love my veneers!" she declared, noting that they have held up well for over a decade.

For more information about veneers, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation.

Follow These Common Sense Steps When Your Child has a Toothache

A child's toothache is no fun for either the child or the parent. But if you're faced with this situation, don't panic — unless they have a fever or you notice facial swelling, it's unlikely an emergency.

 Instead, take the following steps:

Find out where it hurts and for how long. Tooth pain can stem from a lot of causes, including decay or a localized area of infection called an abscess. See if your child can tell you if it's coming from one particular tooth or from a general area. Although children can't always judge how long they've hurt, try to get a general idea so you'll know if you need to call us sooner rather than later.

Look for problem signs in the mouth. As you look where they say it hurts, see if you can see brown spots or cavities on any teeth — this would indicate tooth decay. Look also at the gums or inner areas of the mouth for sores or swelling. Unless they've had an injury, this could indicate an abscess.

Try to dislodge any food shards between teeth. It's also possible the pain is coming from a piece of hard food like a popcorn kernel wedged between their teeth. Help them gently floss between the teeth to see if you can dislodge any.

Try to ease the pain. Although you may not need to see us immediately, your child's mouth still aches. You can help relieve it temporarily with a child's dose of ibuprofen or acetaminophen. You can also apply an ice pack to the outside cheek for swelling, but don't apply the ice directly to the skin, which can burn it. And don't rub aspirin or other pain relievers on the gums — they're acidic and can irritate soft tissue.

See us for a full examination. It's wise to have any tooth pain checked — the question is often how soon. You should see us the same day or first thing in the morning if the pain has persisted for more than a day or night, pain relievers haven't eased the pain or they have fever or facial swelling. If the pain is short-lived you can usually wait until the next day — but do get it checked out.

If you would like more information on treating your child's toothache, 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 “A Child's Toothache.”

Clear Aligners Make it Easier for Teenagers to have Their Teeth Straightened

Braces can change a person's life — not just their appearance but their dental health as well. To be honest, though, wearing braces are, well, kind of a drag — especially for teenagers.

Braces can be restrictive and confining; you'll also have to give up certain favorite foods for a while. But more than any of that, they're just plain unattractive. Even being able to choose colors for the brackets and elastic bands can't fully ease a teenager's embarrassment when they smile.

There is, however, an alternative to braces: clear aligners. And they could make orthodontic treatment during this difficult phase of their life much easier to handle.

Clear aligners are a set of clear plastic trays that can be taken in and out of the mouth. Each of the custom-designed trays is slightly smaller from the previous one in the series. After wearing the first tray for a couple of weeks (at least 20 to 22 hours a day), the patient switches to the next tray in the series. They repeat this process until they've worn all the trays. The gradual change from tray to tray moves the teeth to the desired position.

Clear aligners have some distinct advantages over braces, especially for younger patients. They can be removed for cleaning or for a rare special event. They don't limit movement as much as braces. And, they're nearly invisible — other people may not even notice them. And newer aligners are now designed with tiny “power ridges” that increase their movement capabilities. This has made them more useful for teenagers with complicated bite problems and other issues.

There are cases, though, where braces may be the better choice: where you need more control over tooth movement or the patient needs jaw surgery to achieve proper tooth alignment. And their removability could be an issue if the patient won't leave them in their mouth for the necessary time each day.

To find out if clear aligners might be a viable option for your teenager, visit us for a complete orthodontic examination. We can then discuss your best option — clear aligners or braces — to achieve the most desirable outcome for your teenager.

If you would like more information on treating bite problems in teenagers with clear aligners, 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 “Clear Aligners for teens.”

4 Reasons you may want Your Dentist to Whiten Your Teeth

With the advent of home whitening kits, you no longer have to go to the dentist to have your teeth whitened. DIY kits are relatively safe and effective, if you follow the directions carefully.

So, you might be thinking: why have a dentist whiten my teeth? Actually, there are good reasons why you might. Here are 4 of them.

We'll make sure your teeth are healthy first. Your teeth may need some attention first, such as treatment for dental disease, before we undertake whitening. We'll also determine why your teeth are stained, which could impact how they're whitened (more about that in a moment).

Our application could take less time and last longer. Bleaching agents in home kits make up less than 10% of volume, much weaker than the applications we use. While it often takes several applications at home to achieve the desired brightness, you may only need one or two sessions with us. Our stronger solution may also extend the “fade time” — when the whitening begins to diminish — than what you may encounter with home whitening.

We can be more precise achieving the right shade. There are different shades of teeth whiteness — what looks good for someone else might not look good for you. We have the training and expertise to achieve a color that's right for you. What's more, we also have techniques and equipment like UV lighting that enables us to color match more precisely than you can with a home kit.

Your DIY kit can't alter some forms of staining. Home kits bleach only the outermost layers of tooth enamel. That won't help, though, if your discoloration originates inside the tooth. This intrinsic staining requires procedures only a dentist can perform to bleach the tooth from the inside out.

Even if you'd still like to use a home kit we'll be happy to advise you on purchasing and application. It's also a good idea to have us check the staining first to see if a home kit will work at all. In the end, we share the same desire as you do: that your teeth are as healthy as they can be and bright as you want them to be.

If you would like more information on tooth whitening options, 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 “Tooth Whitening Safety Tips.”

Dental Implants Could be Your Best Option to Replace Lost Teeth

An estimated 35 million people in the United States are missing all of their teeth on at least one jaw. Your situation may not be as serious — perhaps you've only lost one tooth. But even one missing tooth could eventually impact the health of underlying bone or other teeth — and it can certainly mar an otherwise attractive smile.

Depending on other health factors, you could be an ideal candidate for a dental implant to replace that missing tooth. Since their introduction in the 1980s, implants have rapidly become the popular choice for tooth replacement. They've gained this popularity for several reasons: they're a life-like replacement that also functions like a tooth; they're adaptable to a variety of situations; and they enjoy a 95%-plus success rate.

The key to their success lies in their unique construction: they replace the tooth root, not just the crown. They accomplish this through a metal titanium post imbedded directly into the bone. The titanium attracts bone cells, which eventually grow and adhere to the post to anchor the implant securely in the jaw. This growth also deters bone loss that occurs after tooth loss and continues after acquiring other forms of removable restorations like full or partial dentures.

If implants have one drawback, though, it's their cost, especially if you have multiple lost teeth. The good news if you're missing several teeth is that each tooth does not need an implant due to their inherent strength. As few as two implants could replace three to four missing teeth or play a role as supports for other restorations like removable dentures. Some of the implants' other benefits will also carry over, including enhanced bone health.

To determine if dental implants are a good choice for your missing teeth, you'll need to undergo an evaluation of your individual dental condition (including bone health). From there we can advise you on whether implants could change your dental health and your smile.

If you would like more information on dental implants, 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 “Dental Implants 101.”

Any Time, Any Place: Cam Newton's Guide to Flossing

When is the best time to floss your teeth: Morning? Bedtime? How about: whenever and wherever the moment feels right?

For Cam Newton, award-winning NFL quarterback for the Carolina Panthers, the answer is clearly the latter. During the third quarter of the 2016 season-opener between his team and the Denver Broncos, TV cameras focused on Newton as he sat on the bench. The 2015 MVP was clearly seen stretching a string of dental floss between his index fingers and taking care of some dental hygiene business… and thereby creating a minor storm on the internet.

Inappropriate? We don't think so. As dentists, we're always happy when someone comes along to remind people how important it is to floss. And when that person has a million-dollar smile like Cam Newton's — so much the better.

Of course, there has been a lot of discussion lately about flossing. News outlets have gleefully reported that there's a lack of hard evidence at present to show that flossing is effective. But we would like to point out that, as the saying goes, “Absence of evidence is not evidence of absence.” There are a number of reasons why health care organizations like the American Dental Association (ADA) still firmly recommend daily flossing. Here are a few:

• It's well established that when plaque is allowed to build up on teeth, tooth decay and gum disease are bound to follow.
• A tooth brush does a good job of cleaning most tooth surfaces, but it can't reach into spaces between teeth.
• Cleaning between teeth (interdental cleaning) has been shown to remove plaque and food debris from these hard-to-reach spaces.
• Dental floss isn't the only method for interdental cleaning… but it is recognized by dentists as the best way, and is an excellent method for doing this at home — or anywhere else!

Whether you use dental floss or another type of interdental cleaner is up to you. But the ADA stands by its recommendations for maintaining good oral health: Brush twice a day for two minutes with fluoride toothpaste; visit your dentist regularly for professional cleanings and checkups; and clean between teeth once a day with an interdental cleaner like floss. It doesn't matter if you do it in your own home, or on the sidelines of an NFL game… as long as you do it!

If you would like more information about flossing and oral hygiene, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation.

Lasers are Making an Impact in Treating Gum Disease

Periodontal (gum) disease is potentially devastating to your teeth, gums and bone. To fight it we have to remove the substance that causes and sustains the disease from all oral surfaces — a thin layer of bacteria and food particles known as plaque.

To accomplish this task, we use a variety of hand instruments called scalers to mechanically remove plaque and calculus (hardened plaque deposits), as well as ultrasonic equipment to vibrate plaque loose and flush it away with water. If we detect plaque deposits well below the gum line and around the tooth roots, we may need to use other techniques like root planing or surgery to access these deeper areas.

 While gum disease is persistent and aggressive, these traditional techniques have proven quite effective in controlling the infection and restoring health to diseased gums. Yet like other aspects of medicine and dentistry, technological advances have created a new option for gum disease treatment: the Nd:YAG laser.

The Nd:YAG laser is named for the crystal it uses to produce a narrow and intense beam of light on a specific frequency. In recent years it's become an important surgical tool because it can distinguish between diseased and healthy tissue, destroying the former while not affecting the latter. It's being used now on a limited basis for treating gum disease, especially for removing infected tissue in deep pockets that can form below the gum line, and for removing plaque and calculus from root surfaces.

 Because of its precision, early evidence of effectiveness is encouraging: minimal tissue damage and swelling, less bleeding and reduced patient discomfort after treatment. The heat from the laser has also been shown to kill bacteria and essentially sterilize the area.

Still, the findings aren't conclusive enough as to whether lasers are superior in most circumstances to traditional scaling methods. For the time being, we'll continue to use the tried and true methods for removing plaque and calculus. But as laser technology advances, the time may come when this new approach to gum disease treatment will become a more prominent and beneficial option for patients.

If you would like more information on your treatment options for gum 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 “Lasers Versus Traditional Cleanings for Treating Gum Disease.”

Your Options for Restoring a Chipped Tooth

A tooth that's been chipped doesn't mean it's no longer healthy. The same, unfortunately, can't be said about the attractiveness of your smile, especially if it's one of your front teeth. A chipped tooth can be quite noticeable and make you self-conscious.

The good news is a chipped tooth can be restored cosmetically to look just as normal and attractive as your other teeth. Depending on the application there are two different materials we commonly use: porcelains, a type of oven-fired ceramic most often found in veneers or crowns; or composite resins, a mixture of glass and plastic substances we apply in liquid form that hardens in built-up layers on the tooth's surface to ultimately resemble normal tooth shape and color.

So, which of these two materials is the best option for your tooth? That depends on the extent and location of the tooth damage. Composite resins are most often used for mild to moderate chipping or breaks in the enamel (and somewhat for the underlying dentin) or decayed areas in the front teeth. Porcelain veneers or crowns are better for more extensive damage or discoloration.

Both materials have their advantages and disadvantages. Composite resins can be applied in one office visit, but they require a skillful technique and an artistic eye to achieve a life-like appearance; although their strength has improved over the years, they're also limited in their durability and longevity compared to porcelain. Porcelain, on the other hand, is quite durable and has an excellent tooth-like appearance; they do, however, require removal of more tooth material than a composite resin to accommodate the new veneer or crown, along with more than one visit and the services of a dental lab to create the restoration.

The best way to find out which option is best for you is to visit us for a thorough dental examination. From there we can review with you our findings, our recommendations and the costs associated with each option. But whichever material we use, porcelain or composite resins, you can look forward to a new smile you'll be proud to display.

If you would like more information on cosmetic treatments for 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 article “Artistic Repair of Front Teeth with Composite Resin.”

Kathy Bates Plays It Smart With Professional Teeth Whitening

Academy Award-winning actress Kathy Bates knows how important it is to present your best face to the world — and one of the most important features of that face is a beaming smile. But there came a point when she noticed something was a little off. “I've always had good teeth, but it seemed to me as I was getting older that they weren't looking as good,” Kathy explained in a recent interview with Dear Doctor magazine.

That's when she decided it was time to take action. Kathy had orthodontic treatment when she was in her fifties, and she keeps her smile bright with tooth whitening treatments. She uses a kit provided by her dentist with a safe, effective whitening solution.

Of course, a bright, healthy smile looks great anywhere — whether you're on the red carpet or “off the grid.” And you don't have to be a Hollywood star to have professional whitening treatments. In fact, teeth whitening is one of the most popular and affordable cosmetic treatments modern dentistry offers.

The basic options for professional teeth whitening include in-office bleaching or take-home kits. Both types of dentist-supervised treatments offer a safe and effective means of getting a brighter smile; the main difference is how long they take to produce results. A single one-hour treatment in the office can make your teeth up to ten shades lighter — a big difference! To get that same lightening with at-home trays, it would take several days. On the plus side, the take-home kit is less expensive, and can achieve the same results in a bit more time.

It's important to note that not all teeth can be whitened with these treatments. Some teeth have intrinsic (internal) stains that aren't affected by external agents like bleaches. Also, teeth that have been restored (with bonding or veneers, for example) generally won't change color. And you can't necessarily whiten your teeth to any degree: Every tooth has a maximum whiteness, and adding more bleach won't lighten it beyond that level. Most people, however, find that teeth whitening treatments produce noticeable and pleasing results.

What about those off-the-shelf kits or in-the-mall kiosks? They might work… or they might not. But one thing's for sure: Without a dentist's supervision, you're on your own. That's the main reason why you should go with a pro if you're considering teeth whitening. We not only ensure that your treatment is safe — we can also give you a realistic idea of what results to expect, and we will make sure that other dental problems aren't keeping you from having a great-looking smile.

How often does Kathy Bates see her dentist for a checkup and cleaning? “I go about every four months,” she noted. “I'm pretty careful about it.” And if you've seen her smile, you can tell that it pays off. If you would like more information about teeth whitening, 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 “Important Teeth Whitening Questions Answered” and “Teeth Whitening.”

The AGD Mastership Award Recognizes Your Dentist's Commitment to High-Quality Care

No one ever said it was easy to become a dentist. After earning an undergraduate degree in science, prospective dentists must successfully complete four years in the rigorous environment of an accredited dental school. After that, every dentist must pass a state-administered exam before being licensed to practice in that state.  At that point, you might think the dental educational process is over. But it isn't.

State regulations generally require dentists to complete a certain number of continuing-education credits every year, in order to maintain their licenses. It's a way of ensuring that dentists stay current with the latest innovations in their field, and provide their patients with good-quality care. But some dedicated practitioners take it even further.

Dentists who join the Academy of General Dentistry (AGD) — a professional organization founded in 1952, which currently has about 37,000 members — must live up to a stricter standard. AGD members are committed to taking at least 75 hours of continuing education courses every three years. According to surveys, however, most members average more than 40 hours every year: That's a full work-week dedicated to education.

When a dentist has been a member of the AGD for three years, completed 500 hours of continuing education, and passed a comprehensive examination, he or she can become a Fellow of the Academy of General Dentistry. This honorary designation is a way of recognizing a dentist's commitment to providing excellence in patient care. To date, about 11,000 members of the AGD have become Fellows.

There's one more step in the pyramid: Mastership. To attain this designation, after becoming a Fellow, a dentist must complete an additional 600 hours of continuing education, including 400 hours of "hands-on" training. Needless to say, this denotes an extremely high level of dedication. A dentist who receives this honor has devoted a significant amount of time to his or her profession, and is up to date on the most current standards of care. About 1,000 AGD members have achieved Mastership thus far.

We're pleased to let our patients know that Dr. Cindy Sumarauw was recently recognized as a Master by the Academy of General Dentistry. The Mastership Award symbolizes Dr. Sumarauw's commitment to remain at the forefront of dental science.  And it's one more way of showing her dedication to providing excellent dental care for her patients. If you have questions or concerns about your dental health, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation.

Dental Porcelain is a Great Option for Creating a Natural Appearance

The mark of a great dental restoration is that you can’t see it. It’s there in plain sight, but others observing your new and improved smile can’t tell the difference between the restoration and your natural teeth. Everything looks, well, natural.

That’s the great advantage of dental porcelain. A dental technician with technical skill and artistic flair can form this inorganic, ceramic material into a life-like replica of your tooth, with a shape and color that blends in with the rest of your teeth. And because of its strength properties, porcelain restorations can hold up to the normal chewing and biting forces in your mouth, as long as you use prudence when biting down on hard substances.

Porcelain is also highly adaptable to different kinds of restorations. For natural teeth still viable but no longer attractive, porcelain can be the main ingredient in two very popular and effective restorations, the veneer and the crown. Although the porcelain material is the same for both, their construction and application are quite different.

Veneers are very thin laminated layers of dental porcelain custom-colored and shaped for bonding to the outer visible portion of a tooth. They’re a great solution for relatively decay-free teeth that have minor to moderate defects like chipping, slight misalignment or heavy staining. They often require some permanent removal of tooth enamel to ensure their appearance isn’t too bulky, but causes minimal impact to the tooth.

Crowns, on the other hand, are complete tooth replicas that are bonded in place over an existing tooth like a cap. They’re a good choice for teeth in which the root and inner layers are still viable, but the tooth has been significantly damaged by decay or trauma. They’re also useful as a protective cover for teeth that have undergone root canal treatment. But unlike the minimal impact of veneers, crowns require significant tooth alterations to accommodate them.

In either case, though, the end result is much the same: both crowns and veneers can be fashioned to precisely mimic the shape, color and texture of natural teeth. In skillful hands, these porcelain restorations can transform your smile for the better and no one but you and your dentist will ever need to know.

If you would like more information on porcelain restorations, 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 & Veneers.”

Crowns can now be made In-Office with the CEREC System

The traditional way to restore a tooth with an artificial crown takes several weeks and multiple office visits: from tooth preparation and impression molding to crown production by a dental laboratory, followed by adjustments and cementing. There’s an alternative that reduces this process to a fraction of the time, and all from right inside our office.

Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM) using CEREC is a digital system that enables dentists to create dental restorations with laboratory-grade materials in minutes rather than weeks. As it continues to innovate, you’ll see more and more dentists investing in the new technology for their patients.

A crown restoration with CAD/CAM begins like any other with decay removal and preparation of the tooth. It diverges, though, from the traditional in how an impression of your teeth and gums is obtained: instead of rubber-like molding materials to create a physical impression, we lightly dust the mouth interior with a reflective powder. Using a scanning wand, the reflective powder allows us to capture multiple, detailed images of your mouth that the CAD/CAM computer transforms into an accurate three-dimensional model.

We use the model to first assess if the tooth has been effectively prepared for a restoration. If so, the design feature of the system will provide us with thousands of tooth forms to choose from to match with your natural teeth. You’ll be able to view the proposed size and shape of the new crown via computer simulation before signing off on the design.

Next is the actual manufacture of the crown that takes place right in the dentist’s office. A pre-formed block of ceramic material is inserted in the milling equipment where, following the pre-determined computer design, the milling heads carve the ceramic block. After milling, we fine-tune the crown surface and apply stains or glazes fired to create a life-like color and texture that matches your natural teeth. We can then adjust the crown in your mouth and permanently affix it to the tooth.

While much of the CAD/CAM system is automated, ultimate success still depends on the dentist’s expertise and artistry. CAD/CAM enhances those skills with greater precision and in much less time than traditional crowns. It’s certainly a growing option for many people to restore the form and function of decayed teeth.

If you would like more information on computer-aided dental restorations, 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 “Creating In-Office Dental Restorations with Computers.”

Focus on Prime Dental Health Risk Areas to Map Out Your Care Plan

Dental care is more than brushing and flossing every day, visiting the dentist at least twice a year and occasionally having a problem treated. To get the most out of your care, we need to consider the “big picture” of risk management: identifying where your oral health is most at risk and tailoring your treatment approach accordingly.

With that in mind, here are the 4 main risk areas we should address for your long-term dental health.

Support structures. Healthy gums and bone support healthy teeth. The loss of these support structures from dental disease puts your teeth at higher risk of loss. The focus then is keeping the gums and bone healthy through dedicated oral hygiene, regular checkups and office cleanings, lifestyle changes (like refraining from tobacco use), nutrition and early, proactive disease treatment.

Tooth health. Your teeth also need to be healthy and sound. When compromised by decay, erosion or injury, your risk for losing them increases. To manage that risk, we need to identify, treat or minimize the root causes of unhealthy teeth like disease-causing bacteria, high acid levels in the mouth or restricted saliva flow. It’s also important to repair damaged teeth as soon as possible through fillings, crowns or root canal treatments to give teeth a better chance of survival — and to know when a tooth is beyond salvage and should be replaced with an appropriate restoration.

Mouth function. Your teeth, muscles and jaw joints work like an intricate mechanism to help you eat, speak and even smile. When they don’t function properly, though, it can lead to significant dental problems. Tooth grinding habits, poor bites (malocclusions) or temporomandibular (jaw) joint issues can cause pain, compromised function, and even excessive tooth wear that may compromise dental health and affect appearance. It’s necessary to treat these underlying functional problems through conservative TMD treatments, night guards or lifestyle changes before attempting dental restoration or the damage will continue.

Smile appearance. Although subjective, how you feel about your smile is extremely important, and can have a profound effect on your self-image and relationships. Blemished, misaligned, or missing teeth pose a personal and social risk and deserve attention. While you should have realistic expectations about both your overall mouth condition and your financial ability, there are many options for improving your teeth’s appearance and ultimately your smile.

If you would like more information on comprehensive dental care, 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 “Successful Dental Treatment.”

Pain Relievers like Ibuprofen are Effective and Safe - if Used Properly

Managing pain is an important part of dental care — alleviating pain caused by disease or trauma and reducing discomfort during and after treatments. In many of these instances we can do this effectively with mild, over-the-counter drugs like ibuprofen or aspirin.

These Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are safer and have fewer side effects than stronger prescription pain drugs, and have proven effective after extensive studies. Nevertheless, they can cause problems if not taken properly.

NSAIDs work by blocking prostaglandins, substances released by diseased or damaged tissues that have become inflamed (swollen). Inhibiting prostaglandins reduces inflammation that in turn eases pain. This differs from steroids that reduce inflammation by suppressing the immune system or narcotics like morphine or codeine that act on the brain to reduce pain.

Both steroids and narcotics are strong, prescription medications used only for severe pain, and can be addictive if abused. While NSAIDs aren’t as habit-forming and have milder side effects, they can cause significant health problems if overused. The most common is their tendency to act as a blood thinner, which decreases the blood’s ability to clot.

This can lead to serious complications: over-extended use of aspirin, for example, can damage stomach lining and give rise to ulcers or dangerous bleeding; ibuprofen can damage the kidneys. An estimated 100,000 Americans are hospitalized each year due to ulcers or gastrointestinal bleeding linked to chronic NSAID use for pain relief. They’re not recommended for patients who are pregnant, have preexisting stomach problems or heart disease.

In short, NSAIDs are best used for only brief periods to alleviate short-term discomfort. Unless otherwise directed by a physician, a single dose of 400-600 milligrams is safe and normally sufficient for about five hours of mild to moderate pain relief; daily dosages shouldn’t exceed 2400 milligrams.

NSAIDs remain the best approach for alleviating most dental pain and discomfort. Taken properly, they can help you cope with pain until you’re back on your feet again.

If you would like more information on managing pain associated with dental care, 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 “Treating Pain with Ibuprofen.”

4 Tips for Extending the Life of Your Oral Appliance

There are many different removable appliances — from dentures to retainers — that help people enjoy better mouth function and a more attractive smile. But like many things we use, they can wear out. Because they’re also spending a lot of time in the mouth they can become an attractive home for disease-causing bacteria.

You can extend your appliance’s life through regular cleaning and maintenance. Here are 4 tips to help you do it properly.

Use detergent — not toothpaste or bleach — for cleaning. Your appliance may look like teeth or gums, but it isn’t made of living tissue and shouldn’t be cleaned the same way. The abrasives in toothpaste can cause microscopic scratches in appliance materials that could harbor bacteria. Bleach is also a no-no — while it kills bacteria it also breaks down the composition of many appliance plastics. Ordinary household soaps like dish detergent work just fine.

Use warm — not hot or boiling — water. Boiling water also kills bacteria, but it and even hot tap water can soften many dental plastics and distort your appliance’s precise fit. Warm soapy water is sufficient for keeping your appliance clean. Be sure also to use a separate brush from your regular toothbrush, ideally one designed to clean appliances.

Consider using an ultrasonic cleaner. No matter how thorough you are, you won’t be able to fully access tiny crevices in your appliance with a brush. If you have a permanent appliance like a denture or retainer, consider purchasing an ultrasonic cleaner, a device that emits high frequency sound vibrations to loosen plaque in those hard to reach places.

Protect your appliance while it’s out of your mouth. Place a towel in the sink while you’re cleaning your appliance — an accidental drop onto a soft towel is less likely to damage it than on a hard porcelain or metal basin. Unless otherwise directed, it’s also best to remove your appliance while you sleep to help cut down on bacterial growth. But don’t leave it lying anywhere — pets or even young children may find it a fascinating “toy.” Be sure to store it in its case or in cleaning solution in a high place.

If you would like more information on taking care of an oral appliance, 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 “10 Tips for Cleaning Your Oral Appliance.”

3 Reasons Why Orthodontics is Worth the Effort - at Any Age

Think braces and you may conjure up the image of a teenager undergoing what is for many adolescents a rite of passage. But while correcting poor bites (malocclusions) is usually optimal between pre-adolescence and early adulthood, it’s just as viable an option for older adults.

Still, many people in their later years with malocclusions think orthodontics isn’t worth the bother — it’s simply too late for them or they don’t want the "embarrassment" of wearing metal braces at their age. But even if you’re older, it’s worth reconsidering treating that bad bite. Here are 3 reasons why.

Misaligned teeth can affect your oral health. If your teeth are out of position, then they will be much harder to keep clean, and may wear down at a higher rate than normally aligned teeth. You may also find chewing your food becomes easier with a straighter bite, which can improve your overall nutrition.

A More Aesthetic Option to Metal Braces. One of the biggest concerns for many older adults is the thought of wearing metal braces for an extended time. Clear aligners are a more attractive alternative. They are a series of computer-generated incremental clear plastic trays: each tray is worn for about two weeks moving teeth a small distance before changing to the next tray in the sequence until the end of treatment. Not only are they much less noticeable than metal braces, they can be removed for easier oral hygiene, or even for a rare special occasion.

Age Really isn’t a Factor. Not everyone is a good candidate for orthodontics. A person’s level of bone volume is a major consideration: if they have significant bone loss successful tooth movement may not be possible. Systemic conditions like diabetes, severe heart-valve disease or leukemia, or drugs for arthritis or osteoporosis can also make treatment difficult if not out of the question. But, if you’re in reasonably good health with adequate bone support, there’s no reason you can’t undergo orthodontics — at any age.

If you would like more information on orthodontic treatment at any age, 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 “Orthodontics for the Older Adult.”

Preserving Baby Teeth Crucial to Future Dental Health

It’s easy to view your child’s primary (“baby”) teeth as less important than the permanent teeth replacing them. They’re temporary — the last of them will give way around ages 10 to 13 — so why go to extraordinary lengths to save them if they’re decayed?

Although relatively short in life, primary teeth are indeed important. They, of course, provide young children a means to speak and eat. But they’re also pivotal to your child’s mouth and facial development. A primary tooth lost early can lead to adverse effects in the permanent teeth and bite later.

A primary tooth holds open the space in the jaw for the permanent tooth as it develops below the gums. When it’s ready to come in, the roots of the primary tooth dissolves (resorbs), allowing it to be lost. If they are lost too early, though, it can disrupt this spacing, especially for a back tooth. If this happens, adjacent teeth can move or “drift” naturally into the open space, greatly increasing the chances of a bad bite (malocclusion). The permanent tooth may then come in the wrong position or perhaps not at all, setting up the need for costly future orthodontic treatment.

That’s why it’s better to save the tooth if we can, even employing a modified root canal treatment for deep decay if necessary. If, however, the primary tooth is lost prematurely due to disease or trauma, we can still attempt to preserve the space left behind. One way is to install a “space maintainer,” a metal orthodontic device that prevents adjacent teeth from moving into the space. This will still require constant monitoring and extra care to prevent the device from dislodging.

The best strategy for preserving primary teeth is, of course, prevention. By establishing daily brushing when the first teeth appear in the mouth, coupled with regular dental cleanings and checkups twice a year and a diet low in sugar-added foods, you can reduce the risk of dental disease. Further prevention with sealants or topical fluoride can also strengthen young teeth.

Keeping primary teeth healthy will help ensure they’ll continue until they’ve served their purpose. In the end they’ll set the stage for a lifetime of healthy teeth.

If you would like more information on caring for your child's primary 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 article “Importance of Baby Teeth.”

Smoking Increases Your Risk for Dental Implant Failure

There are definite links between smoking tobacco and several major health problems. While we’re all familiar with its relationship to cancer or heart disease, smoking can also adversely affect your dental health, particularly the long-term survival of dental implants.

Smoking can affect your mouth in two ways: first, the inhaled smoke can slowly “cook” gum tissue to form a thickened top layer of cells and damage salivary glands, which reduces saliva flow causing mouth dryness. Second, the nicotine in tobacco may cause the mouth’s blood vessels to constrict and inhibit blood flow, which can weaken the body’s defenses and healing ability.

Put all these outcomes together and you increase your risk of periodontal (gum) disease that can cause the loss of supporting gum tissue and bone. Bone loss especially can have an adverse effect on implant stability, which relies on adequate bone for anchorage.

Slower mouth healing caused by smoking also lowers the chances of a successful outcome to implant surgery. Over time, bone in the jaw grows and attaches to the imbedded titanium implant, which will increase the implant’s strength and durability. With a weakened healing mechanism, however, this process known as osseo-integration may fail to develop fully. As a result, the implant won’t be as strong and stable as it could be and may fail when it encounters normal biting forces.

This scenario is borne out in a number of research studies. Although dental implants have a very high success rate, about 5% fail. Twice as many of those failures occurred in smokers compared to non-smokers. Although an implant isn’t destined to fail if you’re a smoker, your risks are much higher.

You can reduce that risk by trying to quit smoking a few weeks before implant surgery, or at the very least try not smoking a week before and two weeks after the procedure, and follow good oral hygiene practices to prevent gum disease. And, be sure to see us on a regular basis for checkups and implant maintenance.

Dental implants are a highly successful tooth replacement option that can give you decades of service. Don’t allow smoking to short-circuit that success.

If you would like more information on the impact of smoking and other lifestyle issues on dental implants, 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 “Dental Implants & Smoking.”

A Little Extra Effort Can Make Brushing and Flossing with Braces Easier

Moving teeth through orthodontics is more than a “smile makeover” — it’s also an investment in yours or a family member’s future oral health. Normally aligned teeth function better and are easier to keep clean and healthy.

Ironically, though, the same appliance that helps enhance future oral health can also make it harder to keep the mouth healthy in the here and now. This is because fixed orthodontic hardware like braces can impede a patient’s ability to reach tooth surfaces while brushing or flossing to remove plaque. This thin biofilm of food remnant and bacteria can build up on tooth surfaces and cause tooth decay or periodontal (gum) disease.

It’s therefore not uncommon for people wearing braces to have two to three times the plaque on their teeth. This is especially problematic for younger patients whose newly erupted permanent teeth don’t have the resistance of older teeth to the acid that causes tooth decay.

While maintaining effective hygiene during braces is difficult, it isn’t impossible. There are a number of things that can be done to improve plaque removal. When brushing use a soft bristle, multi-tufted brush, which is more flexible for reaching around hardware. Be sure to take the time to brush above and below each braces wire all the way around, then on the inside of the teeth and the biting surfaces. If there’s difficulty reaching between teeth with regular flossing techniques, consider using a special floss holder or invest in a “water” flosser that sprays water under a pulsing pressure to remove plaque between teeth.

It’s also a good practice to eat a diet rich in fresh fruits, vegetables and dairy products and low on snacks with added sugar, a prime food source for bacteria. Use fluoride toothpastes and antibacterial mouth rinses to help strengthen enamel and reduce bacteria. Continue regular visits to the family dentist for dental cleanings to remove hard to reach plaque and calculus (hardened deposits) and monitor for disease.

It may take a little extra time and the aid of a few new tools, but your efforts will make a difference. You or your loved one will be taking care of their teeth now, while the braces take care of their health and smile tomorrow.

If you would like more information on hygiene practices during orthodontic treatment, 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 “Caring for Teeth During Orthodontic Treatment.”