For over half a century now, community water systems have been adding fluoride to drinking water to help reduce the risk of tooth decay. Numerous long-term studies have demonstrated the soundness of this practice, prompting the U.S. Centers for Disease Control to call water fluoridation one of the ten most effective public health measures of the 20th Century.
In the 1960s, after years of study into the teeth-strengthening effects of fluoride, the U.S. Public Health Service recommended that drinking water utilities add fluoride at a rate of between 0.7 and 1.20 milligrams per liter (mg/L) or parts per million (ppm) of water. This recommendation held fast until 2015 when the service changed the recommendation to no more than 0.7 mg/L.
Why the change to guidelines that had been in place for over fifty years? The revision was in response to an increasing occurrence of dental fluorosis. This condition happens when the teeth absorb more fluoride than necessary, leading to discoloration of the surface enamel, creating effects like small white spots or brownish “mottling.”
Dental fluorosis is the only known health condition caused by fluoride. As such, it doesn't damage the tooth itself, and is mainly a cosmetic problem. But it can still be avoided if fluoride intake is kept at moderate levels.
The original recommendation was sound science when first introduced. Since then, though, the prevalence of fluoride in everyday life has grown, with the chemical commonly found in dental care products like toothpastes or mouthrinses, as well as many processed foods and beverages and even infant formula. Our society's overall intake of fluoride has been growing as a result.
The new recommendation came after several years of research to verify water fluoridation levels of 0.7 mg/L would still be effective in the fight against tooth decay while lowering the risk of dental fluorosis. With this adjustment, this important and safe measure for keeping your family's teeth protected against disease is safer than ever.
Fluoride is an important part of your child's dental development. But if children take in too much of this important mineral, they could experience enamel fluorosis, a condition in which teeth become discolored with dark streaking or mottling.
That's why it's important to keep fluoride levels within safe bounds, especially for children under the age of 9. To do that, here's a look at the most common sources for fluoride your child may take in and how you can moderate them.
Toothpaste. Fluoridated toothpaste is an effective way for your child to receive the benefits of fluoride. But to make sure they're not getting too much, apply only a smear of toothpaste to the brush for infants. When they get a little older you can increase that to a pea-sized amount on the end of the brush. You should also train your child not to swallow toothpaste.
Drinking water. Most water systems add tiny amounts of fluoride to drinking water. To find out how much your water provider adds visit “My Water's Fluoride” online. If it's more than the government's recommendation of 0.70 parts of fluoride per million parts of water, you may want ask your dentist if you should limit your child's consumption of fluoridated drinking water.
Infant formula. Many parents choose bottle-feeding their baby with infant formula rather than breastfeed. If you use the powdered form and mix it with tap water that's fluoridated, your baby could be ingesting more of the mineral. If breastfeeding isn't an option, try using the premixed formula, which normally contains lower levels of fluoride. If you use powdered formula, mix it with bottled water labeled “de-ionized,” “purified,” “demineralized” or “distilled.”
It might seem like the better strategy for preventing fluorosis is to avoid fluoride altogether. But that can increase the risk of tooth decay, a far more destructive outcome for your child's teeth than the appearance problems caused by fluorosis. The better way is to consult with your dentist on keeping your child's intake within recognized limits to safely receive fluoride's benefits of stronger, healthier teeth.
If you would like more information on fluoride and your baby's dental health, 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 “Tooth Development and Infant Formula.”
If you're an adult, your teeth shouldn't wiggle—not even a little bit. If you have a loose tooth, you need to see your dentist as soon as possible to avoid losing it permanently.
Loose teeth usually happen because of one of two kinds of bite-related trauma. One is known as primary occlusal, which usually happens when the periodontal (gum) structures that help secure teeth encounter higher than normal biting forces. This is usually due to a clenching or grinding habit.
The other and more common kind is secondary occlusal: This happens when the periodontal structures and supporting bone are in a weakened state, usually because of gum disease. In this condition, even normal biting forces can cause damage to a tooth's gum attachment and result in looseness.
To stop a loose tooth from becoming a lost tooth, we'll need to take these immediate steps.
Treat any underlying disease. If a gum infection is the culprit, our first priority is to stop it from doing any more damage. The main treatment for gum disease is to remove dental plaque, a thin film of bacteria and food particles that's the usual cause for the infection. Depending on how much the infection has advanced, this could take several sessions to bring it under control.
Reduce abnormal biting forces. If teeth are loose from abnormally high bite forces, there are a few things we can do. One is to selectively reshape the biting surfaces of teeth so that they receive less force while biting. Another approach is to minimize the effect of teeth grinding with an occlusal guard worn in the mouth: Its slick plastic surface prevents teeth from making solid contact while biting.
Splint loose teeth to secure them. We can secure loose teeth by splinting them to more stable teeth with metal strips or other means. Splinting is often done in conjunction with the aforementioned treatments, and is usually temporary until the tooth regains its periodontal attachments. Sometimes, though, it may be necessary to permanently splint a weakened tooth.
A loose tooth isn't necessarily destined to be lost. But we'll have to act quickly—if you have a loose tooth see us as soon as possible to determine how best to save it.
If you would like more information on saving loose teeth, 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 “Treatment for Loose Teeth.”
The NBA's reigning MVP Giannis Antetokounmpo may seem unstoppable, but he proved no match for a troubled tooth. Antetokounmpo, the self-proclaimed “Greek Freak,” missed one of the final three 2020 regular season games for a dental issue that resulted in last-minute oral surgery. According to a Milwaukee Bucks spokesperson, the star underwent “a root-canal like procedure.”
Root canal therapy, often simply called “a root canal,” may be needed when there is an infection inside the tooth. When dental pulp becomes inflamed or infected, excruciating pain can result. Pulp is the soft tissue that fills the inside of the tooth. It is made up of nerves, blood vessels and connective tissue. During root canal treatment, the pulp is removed, the space inside the tooth is disinfected, it is filled with a special material, and then the hole is sealed up.
A root canal is nothing to fear. It relieves pain by getting rid of infection and is so effective that over 15 million of them are performed in the U.S. each year. This routine procedure generally requires only local anesthetic, and your mouth should be back to normal within a day or two after treatment. Antetokounmpo can attest to that, as he returned to play the next day.
However, delaying root canal treatment when you need it can have serious consequences. If left untreated, an infection inside the tooth continues to spread, and it may move into the gums and jaw and cause other problems in the body. So, how do you know if you may need a root canal? Here are some signs:
Lingering sensitivity to hot or cold temperatures. One sign of nerve damage inside your tooth is pain that is still there 30 seconds after eating or drinking something hot or cold.
Intense pain when biting down. You may feel pain deep within your tooth, or in your jaw, face or other teeth. The pain may be hard to pinpoint—and even if it improves at times, it usually comes back.
A chipped, cracked or discolored tooth. A chip or crack can allow bacteria to enter the tooth, and the tooth may darken if the tissue inside is damaged.
A pimple on the gum. A bump or pimple on the gum that doesn't go away or keeps coming back may signify that a nearby tooth is infected.
Tender, swollen gums. Swollen gums may indicate an infection inside the tooth or the need for periodontal treatment.
And sometimes there is no pain, but an infection may be discovered during a dental exam.
Tooth pain should never be ignored, so don't put off a dental visit when you have a toothache. In fact, if a bad toothache goes away, it could mean that the nerves inside the tooth have died, but the infection may still be raging. Also, be sure to keep up with your regular dental checkups. We may spot a small problem that can be addressed before it becomes a bigger problem that would require more extensive treatment.
Remember, for dental issues both large and small, we're on your team! If you would like more information about tooth pain, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Tooth Pain? Don't Wait!” and “Root Canal Treatment: What You Need to Know.”
What a difference a hundred years can make—especially the last one hundred. In the early 20th Century, trains were the prime mode of cross-country transportation, electrical power was not universally available, and only the well-to-do could afford automobiles and telephones. We live in a far different world, transformed by digital media, air travel and instantaneous global communication.
Dental care has also made exponential leaps. Dentists in the early 21st Century have more effective and powerful treatments for disease, as well as life-like and durable restorations for missing teeth and less-than-perfect smiles. As far as dentistry goes, you couldn't live in a better time.
But if you thought the last century was amazing for dental care, you won't believe what may soon be coming your way this century. Here are a few of the incredible possibilities poised to become reality in the near future.
Regenerating teeth. As of now, the permanent teeth you have is all you're going to have—but that may soon change. Researchers are closing in on the ability to grow new dentin—and if that becomes practical, other parts of teeth may be next. Utilizing a person's stem cells, the building blocks of specialized human tissue, may yield the greatest prize of all, a completely regenerated tooth.
Targeting bacteria. Tooth decay and other dental diseases are most often caused by bacteria—but not every strain. The true culprits are a select few like Streptococcus mutans, which causes tooth decay. Based on growing knowledge of the human genome, we may one day be able to develop therapies that block transmission of specific bacteria from caregivers to infants, or inhibit these bacteria's ability to produce acid that erodes tooth enamel.
Employing “nano” tools. Nanotechnology tools and devices are no bigger than 100 nanometers (a nanometer is a one billionth of a meter), and perform tasks on the cellular level. Many researchers believe we may soon develop a device of this size that can seek out and destroy tiny clusters of cancer cells within the human body before they spread. This could be a game-changer for treating deadly oral cancer.
The current state of dental care would have amazed our great-grandparents. But we may soon be just as amazed at what 21st Century brings us.
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