My Blog

Posts for: November, 2012

By Dr. Patrick H. Collins
November 27, 2012
Category: Oral Health
AreYouatHighRiskforToothDecay

A number of factors can lead to dental caries (tooth decay). To find out if you are at high risk, ask yourself these questions.

Is plaque visible in my mouth?
Dental plaque is a whitish film of bacteria that collects on your teeth. If it is clearly visible, it means that there is a lot of it. Among the bacteria in the plaque are those that produce tooth decay, particularly in an acidic environment. (A normal mouth is neutral, measured on the pH scale, midway between the extreme acidic and basic ends of the scale.)

Do I have a dry mouth?
Saliva protects your teeth against decay by neutralizing an acidic environment and adding minerals back to the outer surface of enamel of your teeth, so reduced saliva is a high risk for caries. Many medications can cause dry mouth as a side effect.

Do I eat a lot of snacks, particularly unhealthy ones?
Frequently eating sugars, refined carbohydrates, and acidic foods promotes the growth of decay-producing bacteria. The more frequently you eat, the longer your teeth are bathed in sugars and acids. Acidic foods not only promote bacterial growth, they also directly cause erosion of the tooth's hard surface by softening and dissolving the minerals in the enamel.

Do I wear retainers, orthodontic appliances, bite guards or night guards?
These appliances are recommended for various conditions, but they tend to restrict the flow of saliva over your teeth, cutting down on the benefits of saliva mentioned above.

Do my teeth have deep pits and fissures?
The shape of your teeth is determined by your heredity. If your teeth grew in with deep grooves (fissures) and pits in them, you are at higher risk for bacterial growth and resulting decay.

Do I have conditions that expose my teeth to acids?
If you have bulimia (a psychological condition in which individuals induce vomiting), or GERD (Gastro-Esophageal Reflux Disease), your teeth may be frequently exposed to stomach acids that can cause severe erosion to your teeth.

Do I already have cavities?
Visible cavities can range from those only visible with laser technology or x-ray examination to those a dentist can see with a naked eye. If you already have small cavities, you are at high risk for developing more.

Do I have white spots on my teeth?
White spots are often the first sign of decay in a tooth's enamel. At this point, the condition is often reversible with fluorides.

Have I had a cavity within the last three years?
Recent cavities point to a high risk of more cavities in the future, unless conditions in your mouth have significantly changed.

If you have any of these indications of high risk, contact us today and ask us for suggestions for changing the conditions in your mouth. You can also learn more by reading the Dear Doctor magazine article “Tooth Decay.”


By Dr. Patrick H. Collins
November 19, 2012
Category: Oral Health
Tags: braces   retainer  
WithoutRetainersYourInvestmentinYourChildsTeethMayBeWasted

The much anticipated day has arrived: your child's braces have been removed. You are really happy with the way your son's or daughter's smile looks now. All the time, money, and discomfort of having teeth straightened have been well worth it.

But did you know that the teeth could relapse into their old positions if your child doesn't wear a retainer every night?

Why is wearing a retainer necessary?
It is important for both you and your child to understand the reason for wearing a retainer. It has to do with how orthodontia works in causing teeth to move to more satisfactory positions.

The reason that orthodontia (“ortho” – straight, “odont” – tooth) works is that the tissues holding teeth in place are living and keep remodeling themselves. Teeth are suspended in the jawbone by the periodontal ligament (“peri” – around, “odont” – tooth), which suspends the tooth by extending from the cementum of the tooth on one side into the bone on the other. Cementum is the thin layer of calcified tissue covering the dentin of the root. When light forces are placed on it, the periodontal ligament can reform itself and adapt to the pressures it is under.

Orthodontists know how to keep the pressures during orthodontic treatment light enough to cause movement that is slow and steady but not so strong that the tissues are damaged. If too much force is applied, the process can cause damage to the periodontal tissues and tooth roots.

When the teeth have moved to their desired positions, they will continue slowly moving. The purpose of a retainer is to stabilize the teeth in their “finished” position. They must be retained in this position long enough that the bone and ligament can completely re-form around them, a process that can take several months.

Make it clear to your child that a retainer won't have to be worn forever. Once your child understands that it is very important to wear the retainer for a few months in order to stabilize that attractive new smile, it should be easy to convince him or her to use it nightly.

Contact us today to schedule an appointment to discuss your questions about retainers. You can also learn more by reading the Dear Doctor magazine article “Why Orthodontic Retainers?


By Dr. Patrick H. Collins
November 08, 2012
Category: Oral Health
Tags: oral health  
CracksinCornersoftheMouthAreTheySerious

If you are experiencing cracking in the corners of your mouth, you have a common condition called perleche or angular cheilitis. Perleche comes from a French word meaning “to lick,” because people tend to lick the irritated areas of their mouths. Angular cheilitis comes from cheil meaning “lip,” and itis meaning “inflammation.”

Sufferers from perleche are usually young children who drool in their sleep, young adults with braces, and older adults who have developed skin wrinkling with deep lines at the corners of their mouths. Perleche may become worse in the winter, when cold weather and dry air dries out the skin of your lips. You may lick your lips often to keep them moistened. This constant licking of the cracked areas can lead to infection, most commonly from a type of yeast called candida albicans. Sources of infection can also include dentures that are not cleaned frequently enough, missing teeth that cause facial changes and added skin wrinkling, and health conditions such as iron-deficiency anemia, vitamin B deficiency, diabetes and cancer.

Conditions associated with perleche can be treated in a number of ways. Yeast is a type of fungus, so to combat a chronic yeast infection you need antifungal medication. This may be taken orally or applied to the cracking places as an ointment. You may be asked to dissolve a medicated lozenge in your mouth and then swallow it, so that its medicine treats both the mouth surface and the entire body. Antifungal medications may be combined with other medications to lessen inflammation and assist skin repair.

If the skin-cracking is related to serious underlying conditions such as missing teeth, improperly fitting dentures, or systemic health conditions, these must be treated in order to keep the perleche from recurring. We can perform a dental assessment to check the health of your teeth, gums, and lips, and you may also want to visit a dermatologist to see if treatments can improve and rejuvenate the quality and appearance of your facial skin.

Contact us today to schedule an appointment to discuss your questions about cracks at the corners of your mouth. You can also learn more by reading the Dear Doctor magazine article “Cracked Corners of the Mouth.”