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.”