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Posts for: May, 2014

By Bruce P. Mercado, DDS, PC
May 27, 2014
Category: Oral Health
FluorideisaProvenWeaponintheFightAgainstToothDecay

In the early 1900s, a Colorado dentist noticed many of his patients had unusual brown staining on their teeth — and little to no tooth decay. What he unknowingly observed was the power of a chemical substance in his patients' drinking water — fluoride. While commonplace today, fluoride sparked a revolution — and some controversy — in dental care during the 20th Century.

After decades of research and testing, most dentists now agree that fluoride reduces decay by interfering with the disease process. The optimum pH level for the mouth is neutral; however, this environment constantly changes as we eat, especially if we ingest foods or beverages high in acidity. A high acid level softens tooth enamel (a process called de-mineralization) and can lead to erosion if not neutralized. In addition, a thin layer of bacteria-rich plaque called biofilm that adheres to tooth surfaces is also acidic and is the cause of tooth decay, possibly more so in teeth made more susceptible from enamel erosion.

When fluoride is in “the right place” (present on the tooth surface and in our saliva, the body's natural acid neutralizer), it helps inhibit de-mineralization and aids in the re-hardening of the enamel (re-mineralization).

Although fluoride needs to come into direct contact with tooth enamel for optimum effectiveness, ingesting it can also prove beneficial. The fluoride we ingest eventually becomes deposited in bone. As bone grows and changes it releases this reserved fluoride back into the bloodstream where it eventually becomes part of saliva; the saliva brings it into contact with tooth surfaces.

The two most prominent ways we encounter fluoride are through fluoridated drinking water and in toothpaste. There continues to be concerns about what constitutes safe levels of fluoride in drinking water and over possible side effects like teeth staining and changes in bone structure. However, extensive studies have conclusively shown that even minimal levels of water fluoridation and the use of fluoride toothpaste have reduced tooth decay.

As the Colorado dentist discovered over a hundred years ago, fluoride is truly remarkable as a cavity fighter. Whether you have access to fluoridated water or not, we encourage you to use fluoride toothpaste to strengthen your teeth against decay.

If you would like more information on fluoride, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Fluoride & Fluoridation in Dentistry.”


DidYouKnowMajorLeagueBaseballPlayersHaveNewRestrictionsonChewingTobacco

Chewing tobacco is a known cause of oral cancer, yet many a Major League Baseball player has been seen walking onto the field with a round tin visibly poking out of his back pocket. That was before this year. Recognizing the influence big-leaguers have on their young fans, MLB players agreed to a new contract that limits their use of chewing tobacco and their ability to carry it around their fans. The 2012 season is the first to be played under the new rules, which were championed by Baseball Commissioner Bud Selig.

One player who used smokeless tobacco heavily is Baseball Hall of Famer Tony Gwynn. The former Padres slugger earlier this year endured 14 hours of surgery to remove a cancerous growth from the inside of his right cheek and graft a nerve from his shoulder to replace a facial nerve damaged by the tumor. This was Gwynn's second cancer surgery in less than two years.

When it comes to oral cancer, the importance of early detection can't be stressed enough. Unfortunately, this form of cancer is not usually detected until a late stage so the overall survival rate is poor, with only 58% surviving five years after treatment. Yet when oral cancer is detected while a lesion is small, survival rate exceeds 80%. That's why an oral cancer screening is always part of your dental check-up or regular cleaning appointment at this office.

During this screening we will examine your face, neck, lips, mouth, tongue and the back of your throat for any suspicious lesions (sores or ulcers) or lumps. Of course, if you notice any unusual lesions, or color changes (white or red patches), anywhere in your mouth that do not heal within two-three weeks, please come in to see us as soon as possible. And if you need help kicking a tobacco habit, we can advise you on how to get it.

If you would like more information about oral cancer, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Oral Cancer.”


By Bruce P. Mercado, DDS, PC
May 02, 2014
Category: Uncategorized
Tags: tooth wear  
KeepanEyeonAbnormalToothWear

Tooth wear, especially on biting surfaces, is a normal part of aging — we all lose some of our tooth enamel as we grow older. Even primary (“baby”) teeth may show some wear before they’re lost. But there’s also excessive, premature tooth wear caused by disease or abnormal biting habits. This type of wear is cause for concern and action before it leads to tooth loss.

Normal tooth wear occurs because of what teeth naturally do — bite and chew. When teeth come together as we eat they generate a modest amount of force: between 13 and 23 pounds. Our teeth also make brief contacts hundreds to thousands times a day. Again, this produces force, though not to the extent we see with biting and chewing: somewhere between 0.75 and 7.5 pounds. These glancing contacts are actually good for dental health because they provide needed stimulation to the teeth and jaws that help the body maintain healthy bone and tooth attachments.

But parafunctional (outside the normal function) habits like teeth grinding or foreign object chewing can greatly increase the generated force, up to 230 pounds. These may result in noticeable symptoms like fractures or loose teeth, but not always — the damage may not be noticeable until much later in the form of excessive tooth wear.

These parafunctional habits aren’t the only cause for excessive tooth wear; tooth decay can weaken the tooth structure, making it more susceptible to wear. And, some restorative materials used for fillings may also affect the rate of wear.

Because excessive tooth wear may or may not present with immediate symptoms, it’s important to maintain regular dental checkups to monitor the condition of your teeth. Our training and experience helps us identify signs of excessive tooth wear and, depending on the extent of damage, work with you on a treatment plan. You should also keep us informed about oral habits, especially teeth grinding, thumb sucking or foreign object chewing (toys, nails, pencils, etc.).

Your teeth will wear as you grow older. By keeping a close eye on your teeth, we’ll help you keep that wear at a normal rate.

If you would like more information on preventing excessive tooth wear, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “When Children Grind Their Teeth.”