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Burning issues.

Burning issues.

Acidity is a huge topic in dentistry, but often having acid reflux is grossly overlooked. Acid reflux is the backward flow of stomach acids into the esophagus or the food tube. GERD (gastroesophageal reflux disease) is said to be a more severe form of acid reflux. Having acid reflux can cause heartburn, irritations, a sour taste in the back of the throat, and much more. Because I am not a professional on the matter, I do not think I am the best person to explain the causes, symptoms, and treatments for acid reflux. I am, however, an expert on oral conditions pertaining to patients.

As stated before, acid reflux causes stomach acid to regurgitate into the tube connecting the mouth to the stomach. Healthline.com stated that approximately 60% of adults experience some sort or acid reflux! That is a lot of acid to worry about! The concern in dentistry is that stomach acid can (and does) very easily erode tooth enamel.

The exposure to stomach acid in the mouth can cause erosion of tooth enamel, tissue irritations such as sores or inflammation, and possible fractures of crowns. Stomach acid is normally in the range of 1.2- 3.5 (VERY acidic), while the oral cavity averages around 6.2-7.5 (neutral). Erosion of tooth enamel occurs around a pH of 5.7.

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The white arrows are pointing to all of the areas of acid erosion on the tongue side of this person’s teeth! That is a lot of wear!

One of the many purposes of saliva is to rinse the mouth of any irregularity such as acids (and bases). The process of remineralization from saliva takes about 20 minutes after exposure. This means, once your mouth is exposed to acids through eating, drinking, or acid reflux, it takes the saliva (without the help of mouth rinses) about 20 minutes to bring the acidity level in the mouth back to a non-damaging level. Unfortunately, when the acids from the stomach flourish for long periods of time the saliva is unable to neutralize the acid and erosion can occur.

Why is erosion a big deal? With acid  (or any type of) erosion, the teeth become thin, brittle, sensitive, and unprotected from the external environment. Erosion removes the strong enamel layer of the teeth and exposes the softer dentin layer that is easily broken down. The dentin layer exposes tiny ‘pores’ in the teeth that make changes in the oral environment sensitive. This is why some people experience temperature sensitivity. The ‘pores’ of the teeth are similar to very tiny tunnels that lead to the nerve of the tooth causing ‘flare-ups’ when drinking cold water.

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The ‘Enamel’ is the strong protective layer of the teeth, the ‘Dentin’ is the softer layer below the enamel. This picture shows a damaged tooth with the two layers exposed.

With the enamel layer being depleted, the integrity or strength of the teeth is very small. I will often see patients that have broken, cracked or painful teeth due to having ‘thin’ enamel. With the thinner and weaker tooth structure, eating becomes complicated. Taking a bite out of firm foods such as apples, carrots, or some steaks could cause fractures to the teeth. Once breakage occurs dental treatments such as fillings, crowns, implants, and veneers are required for optimal comfort and to prevent further damage. Thin enamel also causes yellowing or other discoloration of the teeth!

Thankfully, there are things you can do to help protect the teeth! I recommend always rinsing with a plain warm water rinse after eating and drinking anything. The water will aid saliva in the neutralizing of the mouth and it is VERY inexpensive. There are also numerous products I recommend using if you have a ‘high acidity’ diet. “CloSYS” is my number one recommended mouth rinse to help reduce the cavity risk and decrease acid levels in the mouth. I have numerous patients that have great results with this product, and it is relatively inexpensive for being a specialty rinse. I also recommend ACT Alcohol Free Anticavity Fluoride Rinse. ACT rinse has great remineralizing properties. My final recommendation would be to discuss your acid reflux with your primary care physician. Fortunately, there are quite a few solutions to help reduce the symptoms associated with acid reflux!

As always, I welcome ANY of your dental questions! Hopefully, this information and all of these recommendations can help! As always, If you have any questions or concerns don’t be afraid to post a comment or send an email! I am always happy to answer your burning dental questions. Have a great day, and don’t forget to smile today!

-DentalBritt

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Team White Teeth.

I love having white teeth, you probably do or would too. I’m also fortunate… I have been blessed with white teeth, for the most part. I also take care of them so I know what, if anything, is staining them. I don’t whiten or bleach my teeth often, and when I do, it does not last very long. Unfortunately, having naturally white teeth is dependent on how your enamel has formed. Fortunately, there are options if you don’t have white teeth already. White teeth are very dependent on how you treat them when you’re eating and drinking.
EVERYTHING stains your teeth, and I mean EVERYTHING, well except milk and water… but let’s be honest, how many people think about that.There are SO MANY PRODUCTS that claim they are “healthy” or “non-damaging” to the tooth structure or surface while whitening. These ‘miracle products’ are not as nice as you would think. Unfortunately, if you want white teeth, you’re going to have to deal with a little sensitivity. I believe you can do it. Real talk, there is no such thing as “100% all natural/healthy/non-sensitivity” whitening products. They will either make your teeth sensitive or will not work. ALL WHITENING PRODUCTS damage your teeth in some way, either permanently or temporarily… Let me explain.
Charcoal: PERMANENTLY Breaks down enamel, and is irreversible damage
Baking soda: PERMANENTLY Breaks down enamel, same as charcoal, with less intense effect, long-term use will be irreversible damage
whitening gels: (peroxide derivative): TEMPORARILY weakens enamel
gels with light: (peroxide derivative): TEMPORARILY weakens enamelWhitening toothpaste: (baking soda/peroxide derivative): PERMANENTLY or temporarily weakens enamel
Lemon or strawberry: PERMANENTLY damages enamel through acid erosion

For me, whitening reminds me of dying my hair, which I do all the time. For some people, your hair can take numerous color changes with minimal damage, while others can only dye their hair twice and have irreversible damage that needs to be removed. The difference between dying your hair and using charcoal to clean your teeth? Your teeth cannot regrow. Once your enamel is gone, you have to have replacements such as crowns, veneers, implants, or bridges, depending on the situation.

The best way to prevent damage? preventing stains in the first place. Like I said before, anything with the exception of milk and water will stain your teeth, especially wine, coffee, tea, beets, and berries. With staining foods, I suggest not eating them for long periods of time. For example, when you decide you would like to have blue berries, blackberries, and rasberries, eat them, eat as many as you want! But don’t eat them sporatically for several hours throughout the day. the same goes for beets, or cherries, or anything else that may stain. As a rule of thumb, if something will stain a plain white shirt, it will stain your teeth.

Once you’re finished eating your deliciously staining foods use a simple warm water mouth rinse. The warm water will be gentle if you have any sensitivity, and it will help flush the color from your teeth. This is certainly the least expensive way to help keep those pearly whites shining.

Next, make sure to brush and floss approximately 20 minutes after consuming any foods. Thankfully beverages are much easier to clean off of the teeth, and a rinse is sufficient. I also recommend drinking EVERYTHING through a straw. I know this may feel odd, and unnecessary, but it works. I am an AVID wine and coffee drinker. Like every single day, without fail. I swear by drinking through a straw. This is also a very simple and fairly inexpensive way to keep those stains at bay.

Finally, the last recommendation I have would be to deal with the sensitivity and whiten. Whitening is not always ridiculously expensive like in professional products. In my dental office, I always recommend my patients to use Crest whitening strips.

Crest White strips- 14 treatment option

Crest whitening utilizes Carbamide Peroxide (a hydrogen peroxide compound) to whiten. The difference between Crest white strips, and professional whitening is a concentration. Most over the counter white strip options are around 5-6% concentration. Professional whitening ranges from 10-40% concentration.

Crest white strips are great because they have various options, for example if you’d like to have white teeth in a relatively short amount of time, I recommend the white strips that are a ‘7 treatments’ or seven days. There are other options that are anywhere from 14- 30 days, or treatments. Crest also offers ‘express’ whitening. I personally have not used these, but again they have the same main ingredent, Carbamide peroxide.

Although its choosing one evil over the other, I suggest using temporarily damaging products, which I know does not sound awesome. Either way, If you’re whitening, you’re damaging. My best suggestion for preventing damage and keeping sparkly whites would be avoid stains in the first place.

Hopefully, this information and all of these recommendations can help! As always, If you have any questions, or concerns don’t be afraid to post a comment or send an email! I am always happy to answer your burning dental questions. Have a great day, and don’t forget to smile today!

-DentalBritt

Pearly Whites

Pearly Whites

Tooth whitening or bleaching is such a large topic to talk about because SO MANY people are concerned with how their smile looks. I think most people are concerned about having yellow teeth as if white teeth is a power symbol. The truth is, not everyone’s teeth can be the perfect white that so many people admire.

The natural white coloration of teeth is due to a few different factors. Enamel for one is the greatest contributing factor. Your enamel is the pearly white exterior that makes up the surface of your smile. The second layer under the enamel is called dentin and is also a contributor to how white your teeth appear. Enamel color is based on heredity, mainly, because how thick the enamel is, determines the possibility of having naturally white teeth. The thinner the enamel, the more yellow-grey hues your teeth will display. Dentin is also a factor because the dentin creates a base color of the teeth against the enamel and can become stained with eating and drinking.

Whitening started as early as the 1960’s with a slightly different formula than what is used today. Currently, whitening products contain a few different ingredients, the most recognizable being peroxide.  When someone’s teeth become stained, there are a few different possibilities of what is happening. There are two main types of stain; extrinsic and intrinsic.

Extrinsic, or ‘outside’ stain occurs on the surfaces of teeth and can be cleaned off with a polish during routine cleaning. These stains can occur from things like eating and drinking. Intrinsic, or ‘inside’ stain could occur from certain medications, nicotine, root exposure, and aging. These stains are possibly reduced through whitening procedures.

Unfortunately, whitening does not work for everyone, and there are numerous ways to damage your teeth if you are trying to whiten at home. In the most basic form, I like to explain that stains, just like stains on your clothes, are a discoloration sticking to the tooth surfaces. When you whiten, those stained surfaces are broken down and erased.

I like to remind my patients that anything with the exception of water and milk can stain teeth. The biggest staining factors are red wines, coffee, tea, berries, and beets. If you are looking for solutions to help keep your teeth white, while not spending hundreds on whitening procedures, the easiest solution is to drink dark or staining liquids through a straw. 

As for products available over the counter for whitening, I have a few suggestions and a few ‘No go’s’. First, Always talk to your dental provider if you are looking for a more permanent solution to your yellowing teeth, and about what they are seeing for why your teeth may be discolored. I personally recommend patients try reducing their intake of staining products. Of course, I don’t want you to stop eating your favorite foods, but to reduce how much stain you are acquiring, make simple changes such as drinking staining beverages with a straw, rinsing your mouth with water after eating staining foods, and performing oral hygiene at least twice a day. Over the counter whitening strips available at most local drug stores are also a fairly inexpensive way to reduce stain. These products normally contain a similar solution to prescribed products with a lower concentration. I recommend taking a before and after picture to really see your improvement and keep in mind that if you see good results with over the counter products, you will see even better results with professional products. I also recommend looking into getting a whitening tray, provided by your dentist to continue your whitening routine.

For the products I DO NOT RECOMMEND; I have never and will never recommend any products that are abrasive such as charcoals or baking sodas. These types of products are similar to cleaning your teeth with sandpaper and break down the enamel. I am sure many people have seen on social media, brushing with activated charcoal is all the rage right now, and yes, you do see results; instantly! But with continued use, the enamel will be so broken down that they will be a permanent greyish brown. This color cannot be corrected with whitening! Not only is it not cute, but your teeth will become increasingly sensitive! The only way to fix this irreversible damage is to pay for crowns or veneers. Aint nobody got time for that! These products make teeth brittle, and more likely to fracture. I also do not recommend using acids such as lemon or any other fruit juices. These acids also erode the teeth and can cause some serious damage!

As a rule of thumb, if you have a question about a dental procedure just ask! I am more than willing to answer questions and help out when I can. 

If you have any questions, or concerns don’t be afraid to post a comment or send an email, I am always happy to answer your burning dental questions. Have a great day, and don’t forget to smile today! 

-DentalBritt