Answers to Expectant Mothers' Frequent Questions

Pregnancy is an exciting time in a woman’s life — but it can also generate a lot of questions about both the mother’s and the baby’s health. The realm of dental care is no exception.

Here are a few of the questions we frequently hear from expectant mothers, along with our answers.

Does the baby’s tooth calcium come from my teeth?
This question is frequently asked by mothers who may have had dental issues and are worried they’ll pass on these problems to their baby. Simply put, no — a baby developing in the womb derives minerals like calcium for their teeth and bones from the mother’s diet, not her teeth. What an expectant mother can do is be sure to eat a healthy, balanced diet rich in nutrients and minerals like calcium.

Am I at heightened risk for dental disease during pregnancy?
Pregnancy does cause significant increases in your body’s hormones, particularly estrogen. This can cause changes in the gum tissue’s blood vessels that may make you more susceptible to periodontal (gum) disease (commonly called “pregnancy gingivitis”). It’s also possible later in pregnancy to develop non-cancerous overgrowths of gum tissues called “pregnancy tumors.” The heightened risk for gum disease during pregnancy calls for increased vigilance in monitoring gum health.

What should I do to take care of my teeth?
It’s important to brush your teeth thoroughly twice a day with ADA-approved fluoridated toothpaste to remove plaque, a thin layer of bacteria and food remnants that adhere to teeth. You should also floss daily and consider using an anti-plaque/anti-gingivitis mouthrinse. And, of course, you should see us for regular office cleanings and checkups, or if you notice swollen, tender or bleeding gums, or other abnormalities.

Should I take prenatal fluoride supplements?
This sounds appealing as a way to give your baby a head start on strong tooth development. Studies on its effectiveness, however, remain slim and somewhat inconclusive — we simply don’t have enough data to make a recommendation. What does have a solid research record is the application of fluoride to teeth in young children just after they appear in the mouth — studies involving over a thousand teeth have shown 99% cavity-free results using topical fluoride applications with sealants.

If you would like more information on dental care during pregnancy, 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 “Expectant Mothers.”

Proper Cleaning Techniques can Help you Control Chronic Bad Breath

We all experience the occasional bout of bad breath from dry mouth or after eating certain foods. Chronic halitosis, on the other hand, could have an underlying health cause like periodontal (gum) disease, sinus infections or even systemic illnesses like diabetes. Anyone with persistent halitosis should undergo a thorough examination to determine the root cause.

If such an examination rules out a more serious cause, it’s then possible the particular population of bacteria that inhabit your mouth (out of a possible 600 or more strains) and your body’s response makes you more susceptible to halitosis. After feeding on food remnants, dead skin cells or post-nasal drip, certain types of bacteria excrete volatile sulfur compounds (VSCs) that give off an odor similar to “rotten eggs.”

In this case, we want to reduce the bacterial population through plaque removal, which in turn reduces the levels of VSCs. Our approach then is effective oral hygiene and perhaps a few cleanings — the basics every person should practice for good oral health — along with a few extra measures specific to chronic halitosis.

This calls for brushing and flossing your teeth daily. This will remove much of the plaque, the main breeding and feeding ground for bacteria, that has accumulated over the preceding twenty-four hours. In some cases, we may also recommend the use of an interproximal brush that is more adept in removing plaque clinging to areas between the teeth.

You may also need to pay special attention in cleaning another oral structure contributing to your bad breath — your tongue. The back of the tongue in particular is a “hideout” for bacteria: relatively dry and poorly cleansed because of its convoluted microscopic structure, bacteria often thrive undisturbed under a continually-forming tongue coating. Simply brushing the tongue may not be enough — you may also need to use a tongue scraper, a dental device that removes this coating. (For more information, see the Dear Doctor article, “Tongue Scraping.”)

Last but not least, visit our office for cleanings and checkups at least twice a year. Professional cleanings remove bacterial plaque and calculus (hardened plaque deposits) you’re unable to reach and remove with daily hygiene measures. Following this and the other steps described above will go a long way toward eliminating your bad breath, as well as enhancing your total oral health.

If you would like more information on treating chronic bad breath, 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 “Bad Breath: More Than Just Embarrassing.”

Porcelain Veneers Could Change Your Appearance for the Better

We now have an amazing repertoire in dentistry to restore the look and function of damaged or missing teeth. From tooth-colored crowns to life-like dental implants, we can turn an embarrassing smile into one you’re confident to show the world.

But what if your teeth are visually unappealing but structurally sound? Perhaps they’re slightly irregular or discolored — do you still need the “heavy artillery” in our arsenal of restoration options?

Not at all — dental veneers that provide amazing aesthetic results with minimal tooth preparation may be an appropriate restoration choice for you. As the name implies, veneers are a thin layer of dental material (usually porcelain) that’s permanently bonded to the outside of a tooth. Veneers can be shaped to resemble natural teeth — especially effective for changing the appearance of small or slightly misshapen teeth — and can be customized to match an individual patient’s tooth color.

Veneered teeth require very little preparation compared to other restorations; still, most veneer applications do require some permanent enamel removal so that the applied veneers appear natural. In recent years, however, changes in veneer design and materials have made it possible for some patients to receive veneers without some tooth prep.

If taken care of properly, veneers can last anywhere from seven to twenty years (in some cases, more). While their material composition and the bonding process can withstand normal biting forces, wearers need to keep in mind porcelain is a form of glass — excessive twisting or pressures from excessive grinding habits could cause them to shatter.

And because veneers are made of an inert, non-living material, they can’t adapt to any changes that may occur biologically to your teeth and gums and may need to be updated at some point in the future. The good news is that a loosened veneer can often be repaired.

If you’d like to know if you’re a good candidate for this cost-effective, minimally invasive option, visit us for an examination. Balancing all the factors, porcelain veneers just may be your answer to achieving a better smile.

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

Five Things to Know About Bleeding Gums

Did you ever brush your teeth and find that your gums were bleeding slightly? This unwelcome discovery is more common than you might think — and it might have something to tell you about your oral health. Here are five things you should know about bleeding gums.

• As much as 90% of the population occasionally experiences bleeding gums. It happens most often while brushing — and it’s often a sign of trouble, indicating that your gums are inflamed and/or you aren’t brushing or flossing optimally.
• Bleeding gums can be an early warning sign of gum disease. In its earliest stages, this malady is called gingivitis, and it’s quite common. About 10 to 15 percent of people with gingivitis go on to develop a more serious form of gum disease, called periodontitis. If left untreated, it can lead to gum recession, bone loss, and eventually tooth loss.
• A professional exam is the best way to tell if you have gum disease. Your dentist or hygienist may use a small hand-held instrument called a periodontal probe to check the spaces between your teeth and gums. When gum tissue becomes detached from the teeth, and when it bleeds while being probed, gum disease is suspected.
• Other symptoms can confirm the presence of gum disease. These include the presence of pus and the formation of deep “pockets” under the gums, where gum tissues have separated from teeth. The pockets may harbor harmful bacteria, and need to be treated before they cause more damage.
• Several factors may influence the health of your gums. How effectively you brush and floss has a major impact on the health of your gums. But other factors are important too: For instance, women who are pregnant or taking birth control pills sometimes have bleeding gums due to higher hormone levels. Diabetics and people with compromised immune systems often tend to have worse problems with periodontal disease. Certain drugs, like aspirin and Coumadin, may cause increased bleeding; smoking, by contrast, can mask the presence of gum disease by restricting blood flow.

It’s never “normal” to have bleeding gums — so if you notice this problem, be sure to have an examination as soon as you can. If you have questions about bleeding gums or periodontal disease, 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 “Assessing Risk For Gum Disease.”

Retainers Help Preserve Your New Smile After Braces

Your braces have finally been removed and you’ve unveiled your new smile to the world. You’re finished with orthodontics — right?

Not quite. If you want to “retain” your new smile you’ll need to wear a retainer appliance: depending on your age and which teeth were moved, that could be for several months or even indefinitely.

Retainers are necessary because of how teeth naturally move within the mouth. Although your teeth may seem rigidly set in bone, they’re actually held in place by an elastic tissue called the periodontal ligament. This tissue is quite dynamic in response to biting forces or even normal tooth wear. When forces are applied to a tooth, it’s the ligament that transmits pressure against the teeth to gradually move them to a more accommodating position. In response, the bone resorbs (dissolves) on the side of the tooth moving toward the new position while laying down new growth on the other side. This bone growth will help anchor the tooth in the new position.

Braces use this natural process to gradually move teeth; both the ligament and bone will reform as needed. But this reforming process takes time. Furthermore, there’s a natural balance between the teeth, the tongue and the lips and cheeks. Although the new position created by orthodontics may be more aesthetically pleasing, it may disrupt the natural balance of these surrounding muscles. The influence of habits like clenching or grinding of your teeth may also disturb the new tooth position. The natural tendency is to revert back to the original tooth position.

We use retainers to prevent this reversal. Nearly all orthodontic patients will initially wear them all the time, and for younger patients this may be reduced to wear only during sleep time. Total wear time usually lasts a minimum of eighteen months, until the bone and ligament have fully reformed.

For older patients, though, retainer wear may need to continue indefinitely to prevent “relapse.” In these long-term cases another option to a removable retainer is to permanently bond thin retainer wires to the inside surfaces of the front teeth. The wires can remain in place for several years and are much less noticeable than a removable retainer.

While retainers are often considered inconvenient, they’re absolutely necessary for preserving the results of orthodontic treatment. In the end they’ll help you keep the form and function of your new smile.

If you would like more information on orthodontic retainers, 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 “Why Orthodontic Retainers?”

Curt Schilling Blames Smokeless Tobacco for His Oral Cancer

For years, even as tobacco use began to decline and disappear in most settings, professional baseball seemed one of the few exceptions. Now, the tide is finally turning. Recently, the legendary right-hand pitcher Curt Schilling revealed that he had been treated for oral cancer — and said that his chewing tobacco habit was to blame. “I’ll go to my grave believing that was why I got [cancer],” Schilling told the Boston Globe.

Schilling isn’t the only former player whose oral cancer is blamed on smokeless tobacco. Tony Gwynn, Hall of Famer and beloved coach, recently passed away from oral cancer at the age of 54. His death led to players pledging to give up the habit. But many still use “dip” or “snuff,” thinking perhaps it’s not so bad after all.

In fact, nothing could be further from the truth. With nicotine as its active ingredient, chewing tobacco can be just as addictive as cigarettes. Not only is nicotine addictive, it also increases heart rate and blood pressure, constricts the arteries, and affects the body in other ways. In addition to nicotine, chewing tobacco contains about 30 other chemicals known to cause cancer.

Tobacco use of any kind is a major risk factor for oral cancer. While it isn’t as well-known as some other types of cancer, oral cancer can be just as deadly. About 43,000 people in the U.S. are diagnosed with it each year — and the 5-year survival rate is just 57%. One reason for the relatively low survival rate is that oral cancer isn’t usually detected until it has reached a later stage, when it’s much harder to treat.

What can you do to reduce your risk for oral cancer? Clearly, you should stop using tobacco products of any kind. Moderating your intake of alcohol, and eating more plant foods and less red meat can also have an impact. And don’t forget to have regular dental checkups: cancer’s warning signs can often be recognized in an oral examination — and early detection can boost survival rates to 80-90 percent.

How does Schilling feel about chewing tobacco now? “I lost my sense of smell, my taste buds for the most part. I had gum issues, they bled, all this other stuff,” he told the Globe. “I wish I could go back and never have dipped. Not once.”

If you have questions about oral cancer or cancer prevention, 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 “Chewing Tobacco” and “Diet and Prevention of Oral Cancer.”

Dental Hygienist - Your Partner in Preventing Disease and Maintaining Oral Health

Keeping up your dental hygiene with daily brushing and flossing is essential to preventing disease and maintaining good oral health. But that doesn’t mean it’s all on your shoulders — the fact is, you have a strong partner in your dental hygienist. This valuable member of our staff provides a number of different functions that add a boost to your hygiene habits.

Perhaps the most important of those functions is semi-annual teeth cleanings. While daily brushing and flossing removes most of the bacterial plaque that causes dental disease and decay, harder deposits (tartar) will still form over time, especially in places your brush or floss can’t reach. To remove it requires advanced skills and specially designed hand instruments or ultrasonic equipment. In the case of advancing gum disease, your hygienist may also assist with a procedure known as root planing to reach plaque and tartar adhering to tooth root surfaces below the gum line.

Dental hygienists are also on the lookout for abnormalities that may be a sign of disease. During teeth-cleaning sessions, your hygienist looks for gum inflammation or bleeding that may indicate the presence of periodontal gum disease, a progressive condition that, left untreated, could lead to tooth loss. We will be able to assess the extent of the disease by gently probing and measuring any detachment of the gum tissue that has formed voids known as pockets. They also look for signs of oral cancer — bumps, sores or areas of swelling or tenderness.

There’s one other function your hygienist provides to enhance your oral health — educating and training you on dental care. They can provide you helpful information on risk factors for tooth decay or other dental diseases, along with helpful ways to reduce that risk. They can also help you improve your brushing and flossing techniques by demonstrating proper form.

Cleaning, monitoring and educating — these different “hats” your hygienist wears form a beneficial part of your overall dental care. Working together, you’ll be able to keep your teeth and gums in good form and function.

If you would like more information on the benefits of a dental hygienist, 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 Hygiene Visit.”