Most people associate bacteria with disease and ill health. But the real story about the trillions of microscopic organisms now living in and on your body is a bit more complicated. With recent advances in genetic code research scientists are learning that many of these microorganisms you’re hosting are actually beneficial for you — including your teeth and gums.

Beginning at birth and throughout your lifetime you are continually developing a distinct microbiome — actual communities of bacteria and other microorganisms that inhabit your body. As your microbiome develops it helps train your immune system to distinguish between “good” bacteria that help with digestion and other bodily processes and “bad” bacteria that cause disease.  And it continually adapts to changes in what we eat, the pets we acquire or the drugs we take.

But lifestyle choices like diet can also have a detrimental effect, causing harmful bacteria to become dominant. This seems to be the case with Streptococcus mutans, the bacterial strain most associated with tooth decay. Scientists have analyzed biofilm (plaque deposits on teeth) from the pre-industrial era before 1900 and compared it with modern biofilm samples. They’ve found Streptococcus mutans levels to be much higher in modern biofilm, which they directly attribute to the modern Western diet.

As we gain a better understanding of these findings and of the role of bacteria in our lives, it could change many health recommendations not only about diet but about medications too. In the fight against disease, for example, we’ve used antibiotics to eradicate infection-causing microorganisms, but with a broad destructive ability that can also kill many beneficial strains of bacteria. It’s hoped as our knowledge grows we’ll be able to create newer drugs that more narrowly target harmful microorganisms while not affecting beneficial ones.

There’s a new appreciation emerging for bacteria’s role in our lives. As a result efforts to rebalance a person’s microbiome when they become sick may eventually become a critical element in healthcare treatment strategies. The benefits of this strategy for health, including for our teeth and gums, could be quite impressive.

If you would like more information on the role of bacteria in oral 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 “New Research Shows Bacteria Essential to Health.”

If you’ve had a total joint replacement or similar procedure, you will want your surgeon to decide if you need to take an antibiotic before you undergo dental work. This is a precaution to prevent a serious infection known as bacteremia.

Bacteremia occurs when bacteria become too prevalent in the bloodstream and cause infection in other parts of the body, especially in joints and bone with prosthetic (replacement) substances. It’s believed that during invasive dental procedures bacteria in the mouth can enter the bloodstream through incisions and other soft tissue disruptions.

Joint infections are a serious matter and can require extensive therapy to bring it under control. Out of this concern, the use of antibiotics as a prophylactic (preventive measure) against bacteremia once included a wide range of patients for a variety of conditions and procedures. But after an in-depth study in 2007, the American Dental Association concluded that the risks for many of these patient groups for infection triggered by a dental procedure was extremely low and didn’t warrant the use of antibiotic premedication therapy.

As a result, recommendations for antibiotic therapy changed in 2009, eliminating many groups previously recommended for premedication. But because of the seriousness of joint infection, The American Academy of Orthopedic Surgeons still recommends the therapy for joint replacement patients about to undergo any invasive procedure, including dental work. It’s especially needed for patients who also have some form of inflammatory arthritis, a weakened immune system, insulin-dependent diabetes, hemophilia, malnourishment or a previous infection in an artificial joint.

The guidelines for antibiotic premedication can be complex. It’s best, then, to speak with both your orthopedic surgeon and us about whether you should undergo antibiotic therapy before you undergo a dental procedure. The ultimate goal is to reduce the risks of any disease and to keep both your mouth and your body safe from infection.

If you would like more information on the use of antibiotics in dental care, 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 “Premedication for Dental Treatment.”

Your tooth enamel’s main nemesis is oral acid: normally produced by bacteria, foods or beverages, acid can dissolve enamel’s mineral content and cause erosion and decay. But acid might be a bigger problem for you if you also have gastroesophageal reflux disease or GERD.

GERD is a digestive condition in which stomach acid backs up into the digestive tract. Normally, a ring of muscle at the end of the esophagus prevents stomach acid from coming up into it. But if it weakens, this powerful acid can splash up into the esophagus and irritate its more delicate lining and result in a burning sensation known as heartburn or acid indigestion.

The problem for teeth, though, is that GERD could cause stomach acid to potentially come up into the mouth. Because of its high acidic pH (2.0 or less), stomach acid can cause major erosion in tooth enamel, leaving them pitted, yellow and sensitive. If not caught and treated early, some of your teeth could be damaged to the point that they have a questionable prognosis.

There are some things you can do to minimize GERD’s effect on your dental health. First and foremost, see a doctor about managing your symptoms, which might include medication. Be sure you also inform your dentist that you have GERD and what medications you’re taking.

One way to lessen the effect of higher acid in the mouth is to stimulate saliva production, which helps neutralize acid. You can do this by drinking plenty of water, taking a saliva booster or chewing xylitol-sweetened gum. You can also rinse with plain water or water mixed with baking soda (1/2 teaspoon to a cup of water), or chew an antacid tablet to help balance your mouth’s pH level.

And don’t forget to look out for your enamel. Be sure you’re practicing daily brushing and flossing and using fluoride hygiene products to strengthen it. Your dentist can also apply topical solutions or prescribe special rinses with higher concentrations of fluoride.

GERD can be an unpleasant experience that escalates into major problems. Don’t let it compromise your dental health.

If you would like more information on managing oral health with acid reflux disease, please contact us or schedule an appointment for a consultation.

The monarchs of the world experience the same health issues as their subjects—but they often tend to be hush-hush about it. Recently, though, the normally reticent Queen Elizabeth II let some young dental patients in on a lesser known fact about Her Majesty's teeth.

While touring a new dental hospital, the queen told some children being fitted for braces that she too “had wires” once upon a time. She also said, “I think it's worth it in the end.”

The queen isn't the only member of the House of Windsor to need help with a poor bite. Both Princes William and Harry have worn braces, as have other members of the royal family. A propensity for overbites, underbites and other malocclusions (poor bites) can indeed pass down through families, whether of noble or common lineage.

Fortunately, there are many ways to correct congenital malocclusions, depending on their type and severity. Here are 3 of them.

Braces and clear aligners. Braces are the tried and true way to straighten misaligned teeth, while the clear aligner method—removable plastic mouth trays—is the relative “new kid on the block.” Braces are indeed effective for a wide range of malocclusions, but their wires and brackets make it difficult to brush and floss, and they're not particularly attractive. Clear aligners solve both of these issues, though they may not handle more complex malocclusions as well as braces.

Palatal expanders. When the upper jaw develops too narrowly, a malocclusion may result from teeth crowding into too small a space. But before the upper jaw bones fuse together in late childhood, orthodontists can fit a device called a palatal expander inside the upper teeth, which exerts gentle outward pressure on the teeth. This encourages more bone growth in the center to widen the jaw and help prevent a difficult malocclusion from forming.

Specialized braces for impacted teeth. An impacted tooth, which remains partially or completely hidden in the gums, can impede dental health, function and appearance. But we may be able to coax some impacted teeth like the front canines into full eruption. This requires a special orthodontic technique in which a bracket is surgically attached to the impacted tooth's crown. A chain connected to the bracket is then looped over other orthodontic hardware to gradually pull the tooth down where it should be.

Although some techniques like palatal expanders are best undertaken in early dental development, people of any age and reasonably good health can have a problem bite corrected with other methods. If you are among those who benefit from orthodontics, you'll have something in common with the Sovereign of the British Isles: a healthy, attractive and straighter smile.

If you would like more information about orthodontic treatment options, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “The Magic of Orthodontics.”

Dental implants aren't simply prosthetic teeth, but rather an innovative system that restores both smile appearance and dental function. And while an implant can indeed replace a single tooth, they can do so much more. Integrated with removable dentures or a fixed bridge, they provide a secure solution to multiple missing teeth.

Implants essentially replace a missing tooth's root, the basis for their lifelikeness and functionality. As such, they're also the most sophisticated restoration used today, requiring a high degree of technical and aesthetic skill to place them properly. In reality, implantation is more a process than a procedure.

If you're considering implants, that process begins with a comprehensive dental exam. During the exam, we'll assess the exact condition of your oral and facial structures like the length of remaining teeth, your bite and jaw dimensions. We'll use this information to plan the type and placement of your implants. The exam may also reveal problems like bone loss that might postpone your implants or suggest another form of restoration.

Using digital technology, we then locate the exact positions for your implants on the jaw to ensure the best outcome. This often results in the creation of a surgical guide, a plastic template placed over the jaw that accurately pinpoints the locations for the drilling sequence during implant surgery.

In most cases once the implants are surgically installed, gum tissue may be sutured over the implant to protect it while it integrates with the bone. In some cases, though, a visible crown may be placed immediately, so the patient can enjoy a tooth-filled smile the same day. This immediate crown, though, is temporary and will be replaced with a more durable, permanent one in a few months.

During this interim, the titanium in the implant post will attract bone cell growth, which will build up on the implant surface. This increased bone contact will help secure the implant fully in the jaw, giving the implant its signature durability.

Once the integration is complete, the permanent crown is affixed to the implant (or implants in the case of a fixed or removable dental appliance). It may have been a long road, but you'll have the closest thing to real teeth.

If you would like more information on implant restorations, 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 “New Teeth in One Day.”