Smile! October is National Dental Hygiene Month. While everyone knows that a great smile can brighten any room, as we age, that beautiful smile can become harder to maintain. The good news is that with healthy habits and some help from your dentist, a youthful, charming smile can be yours at any age.
Teeth Through the Years
With the exception of wisdom teeth, all of the permanent teeth have typically arrived by the age of 13, which means that we need them to last a good 70 years or so. However, through years of use, eating and drinking the wrong things, or traumas large and small, teeth may become discolored, damaged or lost. Gums can also be an area of concern when they recede too much, become the site of bacteria pockets, or even deteriorate along with the bone inside.
"Teeth get more brittle as we age, just like our bones," says Dr. Dina J. Giesler, general/cosmetic dentist and owner of Atlanta Smiles and Wellness. The goal is to slow down or stop this process as much as possible to hold onto a healthy mouth and a beautiful smile. "[A great smile] offers that radiance of youth before decades of bite stress and discoloring foods and drinks take their toll," says dentist Dr. Roberta D. Cann of Cann Dentistry.
According to the American Dental Association (ADA), about a quarter of the elderly population has had all of their natural teeth extracted. More shocking, in the United States, 41,000 people a year are diagnosed with oral cancer, and today the fastest growing population of oral cancer is in 18 to 40-year-olds. So what can you do? First, focus on prevention, and, if necessary take, advantage of the latest advances in cosmetic dentistry procedures.
Get Into the Habit
It's no surprise that the key to oral health begins with healthy habits. "Good home care is a must – that would include brushing at least twice a day and flossing daily," says general dentist Dr. Jane Puskas. "Flossing takes one minute. It's all about creating habits." Not only does flossing help minimize decay, but it also keeps the gums healthy. "It massages the tissue; it's almost like exercising. Nice tight gums are what we want. We don't want flabby gums because if they are flabby, they are going to collect more bacteria."
As the body fights infections, it releases enzymes that break down foreign objects (like bacteria), and those enzymes also break down bone, which can lead to major oral issues. Despite the benefits of flossing, the ADA states that only about half of Americans floss daily, and nearly 20 percent do not floss at all. Even regular brushing and flossing can only do so much. A visit to the dental hygienist is crucial to really get things properly cleaned. "You've got to go every six months," recommends Dr. Puskas. And if you are prone to gum disease (periodontal disease), "it is extremely important that you have cleanings three to four months apart to prevent the colonization of bacteria from forming," Dr. Giesler says. Nearly 50 percent of Americans aged 35 to 44 have gingivitis, which is inflammation of the gums. Mouthwashes can have beneficial effects, and Listerine is a good choice because it has anti-microbial properties, according to Dr. Puskas. Gum health is very important because as we age, some bone loss naturally occurs, and pockets can develop in the gums. Since these pockets often collect bacteria, periodontal surgery may be necessary to eliminate the pockets. The gums also recede naturally, but if they recede too much, patients may opt for a graft to protect the teeth from recession (this can also improve the look of your smile). Regular visits to the dentist can also detect issues before they become severe. "A natural smile is so much better than a restored smile," Dr. Puskas says. "We want our teeth to last a lifetime."
Healthy Diet, Healthy Mouth
For good oral health, consume a lot of fruits and vegetables, raw and unprocessed foods when at all possible. "A healthy diet does translate into healthy teeth," Dr. Puskas says. "What's good for your general health is good for your oral health."
The first rule is to reduce your sugar intake. "Sugar and carbohydrates lead to dental decay," Dr. Giesler says. "Sweet tea, soda and sports drinks are the worst." But sugar is not the only culprit. "Even healthful foods may be hard on teeth if they are acidic like citrus or sticky foods like dates. They also break down enamel," Dr. Cann says.
To prevent discoloration, "avoid dark drinks such as coffee, tea and red wine. If you do drink them, brush afterwards or even rinse your mouth," she says. Smoking is also a huge issue according to Dr. Puskas. It can lead to tooth discoloration, a build-up of plaque and tartar and increased risk of gum disease and developing oral cancer. To combat decay, Dr. Puskas recommends drinking tap water with fluoride.
Protection is Key
"Protect your teeth from trauma by not using them as tools to open packages, bite nails or chew ice," Dr. Puskas says. If you play a sport, you may want to consider wearing a mouth guard to prevent injury.
Dr. Cann recommends guarding the teeth at night as well. "If you clench or grind teeth, use a BPA-free night guard as a prevention and protection of teeth. This also will protect your investment of any dental treatment such as fillings and crowns," she says.
Clean Up Your Act
If you are looking to beautify your smile, start with getting the right cleaning products. "The Sonicare electric toothbrush is very effective because it has a timer, is good for the gums and is very thorough," Dr. Puskas says.
Dental technology has come a long way and has achieved many advances. New dental materials are much more lifelike, Dr. Puskas explains. Dr. Cann recommends BPA-free composite material for beautiful tooth-colored fillings and metal-free and biocompatible zirconia crowns. With CEREC technology, meaning for ceramic reconstruction, dentists create computer-assisted tooth reconstructions like crowns in a single office visit. Some patients choose to have old silver fillings replaced with these new materials when the old fillings have lost integrity or the tooth structure around the filling has crumbled.
Bleaching is not new, but it has become very widespread. "The extent of bleaching you can get in the office is so much better than over the counter. Once you bleach properly, it really does make a difference," Dr. Puskas says.
While store-bought bleaching strips will have some effects, daily bleaching with trays and products procured from the dentist will work even better. The best results can be obtained from an in-office procedure featuring light-activated bleach. Once the desired result has been achieved, the patient can maintain it easily by wearing a bleaching tray at home as needed.
"A lot of adults are straightening their teeth," Dr. Puskas says, thanks to great advances in orthodontics. Products like Invisalign, which is a series of removable aligners, are simple and effective. Not only do straight teeth offer a cosmetic enhancement, they also mean there is less trauma when biting and allow for easier flossing. Implants are a popular way to replace missing teeth, and with good reason. They have taken the place of bridges and dentures by providing the patient with a manmade tooth. The process consists of a surgeon implanting a titanium root into the bone in the gum, and once the root has osseointegrated into the bone, a crown is placed on top of the root. "It's just like having a natural tooth," Dr. Puskas says. "Patients are very happy with the result."
In addition to repairing stains, crookedness and missing teeth, dentists today can repair chipped teeth with tooth-colored filling, porcelain veneers or crowns. These procedures can also be used to change the shape of a patient's teeth. Gums can also be recontoured. If there is something you do not like about your smile, you should ask your dentist if it can be fixed. "Dentistry has improved so much," Dr. Puskas says. "The techniques have gotten so much better. We can really transform smiles."
If you're looking for a beautiful, youthful smile, there are plenty of cosmetic options available. Even so, the journey to oral health must begin and end with the simple habits of brushing, flossing and visiting your dentist.
Oral Cancers on the rise
Get screened with MOP
With actor Michael Douglas's admission that his throat cancer was caused by human papillomavirus (HPV), the general public is becoming aware of what physicians have feared for years - the growing epidemic of HPV-related oral cancers. A sexually transmitted disease, HPV is now a more common cause of throat and other oral cancers than tobacco. The strains of HPV that cause cervical cancer have begun to play a role in developing oral cancer, largely due to oral sex.
Get the facts and protect yourself.
The only test for HPV is the molecular oral pap (MOP), which involves a 30-second swish and rinse test. The MOP detects precancerous and cancerous cells in the throat. It is the only available test for examining three key factors: cellular changes, HPV virus and DNA changes.
Physicians recommend an annual screening for adults 18 and older. If oral cancer is detected early, the survival rate is 80 to 90 percent, but if found late, the chances of survival drop to 20 to 30 percent.
- Courtesy of Jeffrey M. Gallups, MD, FAC
Roberta D. Cann, DMD - Cann Dentistry, www.canndentistry.com
Dina J. Giesler, DDS MAGD - Atlanta Smiles and Wellness, www.atlantasmiles.com
Jane Puskas, DMD, PC - Jane C. Puskas DMD, PC, www.puskasdentistry.com
Jeffrey M. Gallups, MD, FACS, The ENT Institute, www.entinstitute.com