The use of Silver Diamine Fluoride in halting tooth decay

smiling boys

Last night I was pleasantly surprised to watch a feature on the PBS News Hour broadcast about the use of silver diamine fluoride (SDF) in dentistry. SDF is nothing new to dentistry, having been used for many years in other countries, but is now thankfully making its way into the mainstream of dentistry in the U.S.

Silver nitrate has been used here for decades, mainly in the past, as a preventive treatment for tooth decay in children and as a chemical agent to cauterize some soft tissue lesions. It has largely fallen out of favor with the advent of newer, and often better, therapies.

SDF on the other hand offers a combination of caries arresting ability through the use of silver with the enamel strengthening effect of fluoride. Originally approved in the U.S. as a desensitizing agent, we have been using it here in the office for the past several years to prevent decay as well.

SDF has been shown to be up to 80% effective in some studies in children at halting decay in primary teeth and is also of benefit in elderly patients and those with disabilities. It is applied directly to the teeth without the need for drilling or anesthesia! The main disadvantage of SDF is that it will permanently stain teeth black, so that often limits situations where it can be used.

As always, I invite you to call with any questions about this novel therapy. Feel free to contact us at Dr. Laurence Stone in Doylestown, PA at 215-230-7667.

How to Eat Candy This Halloween

Trick or Treater with pumpkinWith Halloween fast approaching many of us are starting to think about all that candy! And yes, those dentists among us will again be considering all of the potential dental harm that could result from all that candy. But not to worry! If you have been doing your homework throughout the year – brushing twice a day and flossing all of your teeth once a day – you should not have to worry about the occasional (i.e. Halloween) splurge. Nevertheless, to minimize the possible harm from all those sweets, here are a few tips on how to eat candy:

Chocolate
Chocolate, especially dark chocolate is probably your best option. Dark chocolate has less sugar than milk chocolate, thereby offering fewer carbohydrates to the bacteria that reduce sugar to harmful cavity producing acids. Chocolate also washes off your teeth easier than stickier types of candy.

Sticky and Gummy Candies
These are the worst types of candy to eat. They are harder to remove and stay on the teeth longer, giving the bacteria more time to produce  harmful acids.

Hard Candies
Hard candies are also problematic. They can contribute to tooth fractures if bitten into and also permit sugars to be in contact with the teeth for a longer period of time.

Sour Candies
Sour candies are themselves acidic and if sweetened with sugar produce a double whammy of acids.

Popcorn Balls
Popcorn Balls are sticky, sugary and can be hard. They can get stuck between your teeth as well. A more acceptable snack would be popcorn by itself!

I could go on, but you get the idea! Minimize your exposure to sweets, play it smart and above all, have a great Halloween! If you want to learn more about healthy snacks for Halloween, visit MouthHealthy.org‘s recent article on 7 Tooth-Friendly Halloween Treats.

As always, my staff and I are available to address any concerns you have about any impact of candy or food on your teeth. Don’t hesitate ask us the next time you visit our office Dr. Laurence Stone in Doylestown, PA, or feel free to contact us at 215-230-7667.

Photo courtesy of MouthHealthy.org

 

Charcoal Toothpastes to Clean Teeth?

There are now more than 50 toothpastes available in the U.S. containing charcoal in one form or another offering health and cosmetic benefits not available in other toothpastes. Manufacturers are making claims that these dentifrices can reduce tooth decay, help with tooth remineralization and even improve whitening of teeth.

While only 4 of these toothpastes were found to contain fluoride, a recent exhaustive search of the literature found the truth on all these positive claims to be quite the opposite!

  1. There are no lab studies or any scientific evidence to support any of these claims. In fact, many of these products will do exactly the opposite!
  2. It is a well establishes fact that charcoal contains various polyaromatic hydrocarbons, some of which are regarded as human carcinogens!!

Avoid any toothpastes or other oral health care products containing charcoal in any form!
Feel free to discuss this with us at your next visit. As always, my staff and I are always available to address any concerns you have about the proper way to brush. Don’t hesitate ask us the next time you visit our office Dr. Laurence Stone in Doylestown, PA , or feel free to contact us at 215-230-7667.

Tooth Brushing Mistakes You Make Every Day

  1. worn and new toothbrushesYou don’t clean at the right time of day
    If you were to only brush once a day when would be the best time? Night time of course! When you are sleeping is the longest period of the day when you are not eating, and therefore, feeding the bacteria that cause tooth decay and gum disease. As I speak to people every day, another mistake I encounter is that many people brush upon arising in the morning before breakfast. It’s OK to freshen your breath in the morning but remember to brush after you eat. After all, you wouldn’t take a shower before exercising at the gym and not after!
  2. You use the wrong brush
    Anything other than a soft brush has the potential to harm not only the teeth but the gums as well. Plaque is soft and can be removed easily. Remember, it’s not how hard you brush, it’s how thoroughly you brush. Always use a soft brush.
  3. You ignore the rest of your mouth
    Your tongue harbors food and bacteria in the tiny crevices between the “papillae” on the back of the tongue. Use a tongue scraper or your brush to get rid of these harmful bacteria. (It can improve your breath as well!)
  4. Not using proper technique
    Believe it or not, I was in dental practice for 2 years before I learned how to floss properly! Many people never really learned how to brush properly either and many dental professionals are guilty of paying “lip service” to proper oral hygiene without actually showing their patients how to do it properly. Always check with us if you have any doubts. Never “scrub” and don’t apply too much pressure.
  5. Not brushing long enough
    The American Dental Association recommends brushing twice a day for 2 minutes each time. Two minutes is a long time if you’re watching the clock! That’s one reason why I’m a fan of electric toothbrushes is that they operate on a timer for 2 minutes so you don’t have to think about it.
  6. You don’t replace your brush
    You should probably replace your brush every 3-4 months, more frequently if the bristles become worn. Worn bristles won’t effectively remove plaque and bacteria. And don’t forget to replace your brush immediately if you’ve been sick! Bacteria and viruses from an illness can reside in the bristles and potentially re-infect you.

Happy Brushing!  As always, my staff and I are always available to address any concerns you have about the proper way to brush. Don’t hesitate ask us the next time you visit our office Dr. Laurence Stone in Doylestown, PA , or feel free to contact us at 215-230-7667.

7 Ways to Prevent Bad Breath

tongue-scraper-photoIn my last blog I discussed some of the causes of bad breath. Here are a few bad breath prevention methods recommended by the American Dental Association that you can follow to avoid these annoying breath problems!

  1. Brush and Floss
    Meticulous home care is essential to controlling the bacteria often associated with bad breath. Proper brushing and flossing are the first line of defense in preventing bad breath.
  2. Keep Your Tongue Clean
    Using a tongue scraper or brush to remove bacterial laden film from the surface of the tongue may be an easy fix for a breath problem. Don’t neglect this important step when doing your oral hygiene.
  3. Mouthwash
    While I’m not a huge fan of mouthwashes for the purpose of masking bad breath (it’s a little like ” sweeping the dirt under the rug”), they can provide temporary relief. Just don’t rely too heavily on them, and never as a substitute for good home care!
  4. Clean Your Dentures
    If you are a denture wearer, always remove them at night and clean the inside of your mouth as well as the dentures themselves. I would also recommend taking them out after every meal to remove odor causing food debris.
  5. Monitor Your Saliva
    Saliva has antibacterial properties that help prevent tooth decay, gum disease and yes, bad breath. If you suffer from occasional dry mouth, try chewing some sugar free Xylitol gum. The very act of chewing stimulates salivary flow. If it is a recurrent problem – see me!!
  6. Quit Smoking
    Smoking (as well as chewing tobacco) is one of the worst breath offenders. Giving up tobacco will improve your breath and your health.
  7. See Your Dentist Regularly
    Having your teeth professionally cleaned and your mouth examined by a dentist is the best way to rule out more serious causes of bad breath. Identifying the exact cause of the problem is key in selecting the right solution!

In the meantime, if you have any questions regarding how to prevent bad breath, don’t hesitate ask us the next time you visit our office Dr. Laurence Stone in Doylestown, PA , or feel free to contact me or the staff at my office any time at 215-230-7667.

Photo courtesy of MouthHealthy.org

Six Causes of Bad Breath

There are many reasons for having bad breath and while most are innocuous, bad breath can be a sign of something more serious! According to the American Dental Association, 50% of adults have had bad breath. Here are six causes of bad breath of which you should be aware.

  1. Bacteria – There are hundreds of bacteria that are indigenous to the human oral cavity. These bacteria help to initiate the digestive process but also contribute to Dental Plaque formation. Without good oral hygiene these bacteria will contribute to bad breath.
  2. Dry Mouth – Dry mouth (the absence of saliva) can be caused by many medications, problems with the salivary glands or simply by breathing through the mouth. Saliva has many anti-bacterial properties and without sufficient saliva, bacteria can overtake the mouth and cause odors.
  3. Gum Disease – Simply put, bacterial plaque causes gum disease. Bad breath is one of the subtle warning signs for gum disease.
  4. Food – Aromatic compounds in foods like onions and garlic are eliminated through the lungs, not the digestive tract! No matter how good your home care, these foods will cause breath problems!
  5. Smoking – Smoking causes bad breath as well as a whole host of other potentially more serious problems like gum disease and cancer. It also affects your ability to smell and your sense of taste.
  6. Medical conditions – Bad breath can result from sinus problems, liver or kidney diseases, gastric reflux or any of a host of other causes. In the absence of other obvious causes, referral to a physician may be needed.

In the meantime, if you have any questions regarding how to prevent bad breath, don’t hesitate ask us the next time you visit our office Dr. Laurence Stone in Doylestown, PA , or feel free to contact me or the staff at my office any time at 215-230-7667.  Next blog- 7 Solutions to Bad Breath!

7 Habits That Are Harmful to Your Teeth (and What to Do About Them)!

  1. Nail Biting
    Nail biting may be less common today but I still see it quite often. It can cause teeth and fillings to chip and wear.

    Solution: Be mSugary drinksindful. Paint your nails with a bitter tasting clear polish available at your local pharmacy.

  2. Brushing Too Hard
    Toothbrush abrasion is one of the leading causes of “notching” along the gum line and gingival (gum) recession.

    Solution: Always use a soft toothbrush and never “scrub”. It’s not how hard you brush but how thoroughly. Plaque is easily removed if you are meticulous with your home care. This is also another reason why I now prefer electric brushes. They are less likely to cause damage!

  3. Grinding and Clenching
    Bruxism (grinding) and clenching, especially at night while asleep, is a very destructive habit. It causes tooth wear, fracturing of dental restorations and can contribute to jaw joint dysfunction and muscle soreness.

    Solution: If it’s during the day you can catch yourself and stop. Remember the Rule: Lips together- teeth apart! While sleeping you don’t have that control and therefore would need a Night Guard to protect the teeth and jaw muscles.

  4. Chewing Ice Cubes
    It doesn’t take a genius to figure out that chewing ice cubes, “jaw breakers” or other rock hard objects has the potential to break things. I once broke a tooth trying to eat a frozen snickers bar!

    Solution: Don’t do it!

  5. Constant Snacking
    “Grazing” may not be so healthy for your teeth depending on what you eat. If you are frequently eating a lot of sugars or other refined carbohydrates, the bacteria in your mouth are constantly churning out acids which attack the enamel causing cavities.

    Solution: Snack on nuts and cheese if you’re feeling hungry. Better for you and your teeth.

  6. Using Your Teeth as Tools
    Teeth are for chewing food and nothing more! I see many emergencies from folks who thought they could use their teeth for something they weren’t intended for.

    Solution: Find the right tool for the job!

  7. Sugary and Acidic Drinks
    Sodas and energy drinks are the biggest culprits, especially if you sip on them throughout the day. The acids eat away at the enamel and promote an environment that decay causing bacteria love!

    Solution: Drink water. If you must have an occasional soda or energy drink, consume it at one sitting and rinse with water afterwards.

In the meantime, if you have any questions regarding how to protect your teeth, don’t hesitate ask us the next time you visit our office Dr. Laurence Stone in Doylestown, PA , or feel free to contact me or the staff at my office any time at 215-230-7667.

Ten Tips To Treat Dry Mouth

Prescription drugsDry mouth  (Xerostomia) is a problem faced by many folks which can be difficult to diagnose and treat. The most common cause among adults is various prescription medications. Sometimes our well meaning physicians prescribe medications independently of each other, the result being a multitude of dry mouth causing medications that potentiate each other, making the problem that much worse.

There are over 400 medications that cause dry mouth! Please speak with us as soon as possible if you are experiencing any of these problems. In the meantime, here are some tips to deal with dry mouth!

  1. Frequent sips of water will keep the mouth moist.
  1. Sleeping with a humidifier nearby will help moisten nasal passages.
  1. Only use alcohol free mouth rinses. (Alcohol dries out the oral tissues.)
  1. Avoid caffeine, alcohol and carbonated beverages, all of which can cause dry mouth.
  1. Chew Xylitol sweetened gum to stimulate salivary flow.
  1. Use over the counter (OTC) products like Biotene (toothpaste, mouth rinse, gum spray and   mouth moisturizer.)
  1. Avoid tobacco in all forms. Tobacco encourages the growth of oral bacteria   and irritates the nose and sinuses making them more vulnerable to infection.
  1. Check to make sure any medications you are taking do not cause dry mouth.
  2. Ask your dentist, physician about prescription medications that can increase salivary flow.
  3. See your dentist regularly!!

In the meantime, if you have any questions regarding dry mouth, don’t hesitate ask us the next time you visit our office Dr. Laurence Stone in Doylestown, PA , or feel free to contact me or the staff at my office any time at 215-230-7667.

Photo courtesy of cdc.gov

 

6 Tips to Help With Tooth Sensitivity

tooth sensitivityTooth sensitivity is one of the most common complaints I encounter in the office, especially at this time of year when the weather gets frigid outdoors. Sensitivity results from exposure of the nerve endings that connect to the pulp tissue inside the tooth, commonly referred to as “the nerve”. This typically occurs when the protective tooth structure insulating the pulp is eroded or abraded away. So here are some tips that may help if you are experiencing this problem.

  1. Use a toothpaste designed to reduce sensitivity.

There is only one FDA approved active ingredient to reduce sensitivity – 5% potassium nitrate! This is contained in Crest Sensitive, Sensodyne Pronamel and several other over the counter toothpastes. The effectiveness of these toothpastes depends on regular usage over an extended period of time. Always check the ingredient labels to make sure they contain 5% potassium nitrate!

  1. Use a soft tooth brush.

As mentioned, sensitivity occurs when the protective outer layers of the teeth are lost from abrasion or wear. Overzealous scrubbing with a hard tooth brush is one cause that is easily avoided by using a soft brush and gently moving it in a circular motion along the gum lines. You will remove the disease causing dental plaque without promoting sensitivity.

  1. Keep up your routine

Those of you who have been with me for a while know that I give “homework” to our patients. Do it! Slacking off, i.e. around the holidays or while away at school, allows the bacteria in dental plaque to produce acids that further erode tooth structure. This promotes tooth decay, gum disease and of course, sensitivity.

  1. Make sure you are not grinding your teeth

Many of us grind our teeth when stressed, especially at night. Grinding (bruxism) creates premature and excessive wear on the teeth. This results in increased sensitivity and often sore jaw muscles. Check with your sleeping partner to make sure you’re not doing this at night. It’s more common than you think and is a major contributor to sensitivity.

  1. Avoid whitening toothpastes

Whitening toothpastes contain carbamide peroxide and frequently very abrasive compounds that wear away tooth structure. Carbamide peroxide becomes hydrogen peroxide in the mouth and promotes sensitivity. It should be avoided or at least done with professional supervision.

  1. Avoid acidic foods

Energy drinks, sodas and other acidic foods and beverages chemically erode tooth structure just like the bacterial plaque that live on our teeth. This promotes sensitivity. Occasionally when I indulge, as many of us do, I will rinse with water or chew some gum sweetened with xylitol to neutralize the acids immediately and then wait 30 minutes before brushing. Brushing too soon after consuming acidic foods can increase the amount of tooth wear!

I hope these few tips will help if you are experiencing tooth sensitivity. As always, please check with us if you experiencing this issue as sensitivity can also be a symptom of other and more serious problems. If you’re not certain about your technique, please ask us the next time you are in the office Don’t hesitate to contact me or the staff at my office, Dr. Laurence H. Stone, DDS, any time at 215-230-7667. We are only too happy to help. We look forward to seeing you soon!

7 Good Tooth Brushing Techniques for a Healthy 2017

Tips for Tooth BrushingStart the new year off right with these tips from the American Dental Association.

  1. Change your brush as soon as the bristles start fraying, about every 3 months, or sooner if needed. Also change your brush after recovering from an illness.
  2. Brush for 2 minutes at least twice a day. Most people only brush for about 45 seconds, which is why I like electric toothbrushes! Most of them have a timer and run for 2 minutes. That’s how much time it takes to do a thorough job of cleaning your teeth.
  3. Don’t brush too hard, another common mistake. It’s not how hard you brush that counts…it’s how thoroughly you brush. Disease causing plaque comes off easy enough with the right technique!
  4. Wait 30 minutes after eating before brushing, especially if you’ve been eating acidic foods like citrus or sodas. Rinse with water or chew xylitol sweetened gum if you must to prevent acid erosion from brushing too soon.
  5. Store your toothbrush upright and in the open air so that it can dry properly and not promote bacterial growth. Also, don’t store your brush adjacent to someone else’s, which could allow cross contamination.
  6. Don’t use a hard bristled brush, which can erode the outer surface of the teeth, especially along the gum line. Remember, it only takes soft bristles to remove the plaque.
  7. Always use proper technique when brushing. Brushing each surface of the tooth while holding the brush at a 45 degree angle toward the gum will ensure that you remove all of the plaque without causing damage to the teeth or gums.

If you’re not certain about your technique, please ask us the next time you are in the office Don’t hesitate to contact me or the staff at my office, Dr. Laurence H. Stone, DDS, any time at 215-230-7667. We are only too happy to help.

Best wishes for a happy and dentally healthy New Year!