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Although teeth are strong enough to tear through food, they are also fragile. An accident such as a fall may loosen teeth or knock a tooth out entirely. When a child loses a baby tooth in this manner, no permanent damage is usually done. However, adults who loosen permanent teeth may need to visit our Rochester, NY office.

The Anatomy of a Loose Tooth

The hard external layer of teeth covers a more vulnerable interior. The center of a tooth consists of the pulp, which contains blood vessels and nerves. The entire tooth extends below the surface of the gums into the jaw. Special tissue called cementum and the periodontal ligament hold teeth in place, preventing them from moving.

When a fall or blow to the face loosens a tooth, the tissues anchoring a tooth to the jaw may be damaged. This results in a loosened tooth that wiggles in place. There may be inflammation or bleeding of the gums, which signals dental damage.

Dental Treatments for a Loose Tooth

The range of dental treatments for loose teeth varies by the severity of the problem. If your teeth are just slightly loose following a fall, it may be fine to wait a few days. Teeth often retighten on their own. Simply avoid chewing with that tooth and enjoy softer foods for a few days.

If a tooth is very loose or nearly falling out, call Drs. Miller and Fontana immediately. Immediate placement of the tooth back into the socket is needed to ensure its survival. In general, a tooth must return to its socket within two hours or it may be lost.

In some cases, Drs. Miller and Fontana may recommend splinting, in which teeth are joined together to strengthen them and reduce strain on an individual tooth. Tightening or straightening the tooth can restore your ability to chew regularly without stressing the loosened tooth.

Regardless of the extent of the problem, it is essential to keep the tooth clean to prevent decay. Brush carefully with a soft-bristled brush, and use mouthwash regularly to kill bacteria.

From the time you were small, you’ve been warned about the dangers of plaque. Why? Because:

• It’s an unappealing film that sticks to your teeth
• It causes cavities
• It causes gum disease

And really, do we need to know much more than this to motivate us to brush? But if you’re in a curious mood, you might be wondering just how this soft, fuzzy film accomplishes all that damage. Let’s take a closer look at the sticky problem of plaque.

How does plaque form?

We live with hundreds of species of oral bacteria, most of which are harmless, and some of which are actually beneficial. But when our oral ecosystem gets out of balance, problems can occur. For example, without regular and thorough brushing and flossing, we start to build up plaque.

Plaque starts forming within hours of your last brushing. And even though plaque fits the very definition of “seems to appear overnight,” this biofilm is actually a complex microbial community with several different stages of development.

• It starts with saliva.

Saliva is vital to our oral health, because it keeps us hydrated, washes away food particles, neutralizes acids in the mouth, and provides minerals which keep our enamel strong. Saliva also contains proteins, which help form a healthy, protective film on the tooth surface. This film is called a pellicle.

• Bacteria attach to the pellicle.

There are species of oral bacteria that are able to attach themselves to the pellicle film within hours of its formation. As they become more firmly attached, they begin to grow and divide to form colonies, and are known as the early colonizers of the plaque biofilm.

• A complex biofilm forms.

If you’ve skipped brushing for a few days (please don’t!), you’ll notice a fuzzy, sometimes discolored film on your enamel—that’s a thriving plaque community, and it only takes a matter of days to go from invisible to unpleasant.

If you’re not removing plaque regularly, it can harden further and become tartar. And once you have tartar buildup, you’ll need the care of a dental professional to remove it.

• What happens if we ignore plaque and tartar?

We get cavities and gum disease.

How does plaque cause cavities?

• The bacteria in plaque, like all organisms, need nutrients.

Our normal oral environment and the food in our everyday diets provide the nutrients plaque needs. And, as we mentioned above, certain types of oral bacteria convert these nutrients into acids. Foods such as carbohydrates, starches, and sugars are most easily converted into acids, which is why we recommend that you enjoy them in moderation.

• The biofilm promotes acid production.

Within the plaque film, anaerobic bacteria (bacteria which don’t use oxygen) convert sugars and starches into acids. As the plaque film becomes denser, it blocks acid-neutralizing saliva and oxygen from reaching these bacteria close to the tooth’s surface, creating an ideal environment for the bacteria to produce their acid waste products.

• Acids attack enamel.

The sticky nature of plaque keeps these acids in contact with tooth enamel, where, over time, acids dissolve minerals in enamel, weakening the mineral structure of the tooth.

How does plaque cause gum disease?

• Bacteria cause inflammation and gingivitis.

The bacteria in plaque irritate the delicate tissue of the gums, which causes an inflammation response which can leave your gums swollen, red, bleeding, or tender. This early form of gum disease is gingivitis. Fortunately, good dental care and careful brushing and flossing can usually prevent and even eliminate gingivitis.

• Plaque and tartar can lead to periodontitis.

When plaque and tartar build up around and below the gumline, the gums pull away from the teeth, leaving pockets where bacteria collect, leading to infection as well as inflammation. Infections and constant inflammation not only harm gum tissue, they can destroy the bone supporting the teeth. This serious gum condition is periodontitis, and should be treated immediately to avoid further infection and even tooth loss.

How do we fight plaque?

From the time you were small, you’ve learned how to fight plaque:

• Brush at least twice a day for two minutes, and be sure to brush all of your tooth surfaces and around the gumline.
• Floss to remove plaque from between the teeth and near the gumline.
• Visit our Rochester, NY office for a thorough professional cleaning.

Be proactive. If you have any questions, talk to Drs. Miller and Fontana about the best way to keep plaque at bay. We can show you the most effective ways to brush and floss, recommend anti-plaque toothpastes and rinses, even suggest plaque-revealing tablets if you’re missing some trouble spots.

We’ve only brushed up on some plaque basics, because there is a lot more to discover about this complex biofilm. Happily, even with all there is to learn about plaque’s growth and development, it’s reassuring to know that getting rid of it is quite simple—with just a soft-bristled brush, some dental floss, and a few minutes of your time each day, you’re on the way to a healthy, happy, plaque-free smile.

Painful nails and cuticles, ruined manicures, reluctance to shake hands—there are so many good reasons to overcome the nail biting habit. But did you know that biting your nails is also bad for your dental health? Let’s look at a few more reasons to give our nails a break.

• Bacteria Bonanza

It’s a vicious—and unhealthy—circle. Nail biting leads to injuries to the nails, cuticles, and skin surrounding the nails. These broken, jagged nails can now cause injury to delicate gum tissue. And to make things worse, fingernails harbor a lot of germs and bacteria, leading to the risk of illness and oral infections.  At the same time, bacteria from our mouths can get into the area around the injured nail, potentially leading to painful infections in the fingers.

• Bruxism

Studies have indicated that nail biters have a greater risk of bruxism. Bruxism, better known as tooth grinding, can lead to a number of serious problems over time. Grinding and even clenching teeth on a regular basis can cause chronic headaches, worn enamel, fractured teeth, broken dental restorations, receding and inflamed gums, and loose teeth.

• Breakage & Bad Bites

Your nails suffer obvious breakage, clearly, but your teeth are also at risk. The constant pressure of nail biting can lead to cracking, chipping, and erosion in the front teeth. Further, the pressure put on your teeth can even move them out of alignment, leading to bite problems. As you can imagine, nail biting has an even greater impact if you are wearing braces, because those teeth are already under pressure.

Why do we bite? Nail biting, or onychophagia, is a habit often started in childhood. Some people quit on their own as they reach adulthood, but for others, it can be a lifelong and painful habit. The explanations for nail biting are many: some researchers regard the habit as a form of compulsive behavior, others believe it to be a grooming impulse gone haywire, still others think it’s a way that we respond to anxiety or other stresses.

Whatever the cause, if you want to break the habit, you have options. There are over the counter polishes that use an unpleasant taste to deter biting. Learning to recognize triggers such as stress or boredom can help you choose a different response, such as snapping a rubber band around your wrist or gripping a stress ball. Drs. Miller and Fontana can recommend some techniques for modifying this behavior. And finally, we can offer you suggestions for quitting, or even customize a mouthguard at our Rochester, NY office to discourage nail biting and prevent the problems that come with bruxism.

It’s never too late to quit. If nail biting has become more than a cosmetic problem, let’s work on a solution. Healthy, attractive nails are a great goal to work toward, but nothing beats a beautiful, healthy smile!

Your smile is in the spotlight every day, helping you greet the world with confidence! But when you’re self-conscious about discolored spots on your teeth, it’s time to get some professional advice to deal with these troublesome tints.

Discolored patches, both dark and light, can develop for a number of different reasons. Some markings are cosmetic only, and some spots require treatment. Some can be removed with a professional cleaning, and some might require more serious restoration. Let’s have a look at some of the common causes of enamel discoloration.

• Cavities

Decayed enamel can appear as a brown spot on the tooth. A dark edge around a filling might mean decay underneath.

Regular checkups at our Rochester, NY office will help catch small cavities before they become big ones. If you need a filling, the filling color can be matched to your tooth color for an undetectable restoration.

• Demineralization

Bacteria in plaque produce acids, which attack our teeth. These acids erode minerals such as calcium and phosphorus from enamel, leaving a weak spot that is vulnerable to decay. This process is called “demineralization,” and often leaves a whiter spot on a tooth where minerals have leached away. Common reasons for demineralization are neglecting dental hygiene, failure to clean around braces, and a diet filled with sugary and acidic foods.

Fluoride and enamel-strengthening toothpastes, a healthy saliva flow, and a balanced diet help our teeth “remineralize,” bathing teeth in minerals that can help replace those that have been lost. But if you have lingering white spots due to demineralization, Drs. Miller and Fontana can provide some options, including whitening, microabrasion, and veneers.

• Fluorosis

Fluorosis is a cosmetic condition caused by exposure to too much fluoride while the permanent teeth are still forming (generally, during the years before a child’s eighth birthday). Small white spots and patches are a common result of mild fluorosis. In more serious cases, teeth can be pitted and stained with brown, gray, or black spots.

Preventing fluorosis begins in early childhood. Talk to Drs. Miller and Fontana about fluoride levels in local tap water if you have any concerns. Use only the recommended amount of toothpaste (the size of a grain of rice for children three and under; the size of a pea for children three to six), and show your child how to spit out toothpaste and rinse after brushing. Keep fluoride toothpastes and other fluoride products out of the reach of young children. Don’t give children fluoride supplements or fluoride rinses without discussing it with Drs. Miller and Fontana.

If your own teeth have been affected by fluorosis, talk to us. Again, this is a cosmetic condition affecting otherwise healthy teeth. Whitening treatments can be helpful in mild cases, microabrasion has been effective for mild to moderate cases, and, for severe cases, cosmetic restorations such as bonding and veneers are an option.

• Tartar

Are you seeing an accumulation of dark brown spots and stains on your teeth, especially between the teeth and at the gum line? This might mean that you have tartar buildup. When you brush plaque away every day, your enamel stays smooth and clear. But when plaque builds up over time, it hardens and becomes tartar.

How hard is tartar? So hard that it can only be removed with a professional cleaning. Eliminate this source of spots and staining with twice daily brushing and daily flossing, and make sure regular professional cleanings are on your calendar.

• Other Causes

Medications taken while teeth were developing (notably, antibiotics in the tetracycline family) can cause discoloration. Medical conditions such as celiac disease and enamel hypoplasia can affect both tooth color and enamel formation.

Cosmetic treatment and restorations can help with discoloration caused by medications, and restorations such as bonding, veneers, and crowns can restore tooth appearance and function when medical conditions cause imperfections in enamel color and structure.

If you’re unhappy with the overall whiteness of your smile, a professional whitening might be just what you’re looking for. If specific patches, streaks, and spots of a different color are dimming your bright smile, it’s time for an exam. Drs. Miller and Fontana will be able to tell you the reason for any discolored enamel as well as present you with all your treatment options. Put the spotlight back where it belongs—on your healthy, confidant smile!