By Amanda Cobb, D.M.D.
June 18, 2019
Category: Oral Health
Tags: dental erosion  
TestYourKnowledgeAQuizonDentalErosion

1. What is dental erosion?
a. tooth decay; b. dissolving of tooth enamel by acids in food or drink; c. destruction of tooth material by wear; d. attacks on teeth by bacteria

2. Which of these drinks does not cause dental erosion?
a. orange juice; b. cola drinks; c. water; d. energy drinks

3. Soda sweetened with artificial sweeteners does not cause dental erosion.
a. true; b. false

4. Brushing your teeth immediately after consuming acidic food or drinks may make erosion worse.
a. true; b. false

5. Waiting after consuming acidic foods or drinks allows time for your saliva to neutralize the acid and add calcium back to the enamel in your teeth.
a. true; b. false

6. How long should you wait before brushing after consuming acidic foods or drinks?
a. 10 minutes; b. 20 minutes; c. 30 minutes to an hour d. eight hours

7. Loss of tooth surface material due to dental erosion is reversible.
a. true; b. false

8. People who suffer from bulimia, a psychological condition in which they frequently induce vomiting, often develop severe dental erosion from stomach acid.
a. true; b. false

9. What is the meaning of a low pH value?
a. high pH means high acidity; b. low pH means high acidity; c. neutral pH means high acidity; d. none of the above

10. Properties of a beverage that define their likelihood to erode your teeth are its acidity and its buffering capacity (resistance to being neutralized by saliva.)
a. true; b. false

11. Cola beverages, sports and energy drinks, and fruit juices have a low pH and high buffering capacity. What other factors determine their likelihood of causing dental erosion?
a. acid concentration; b. drinking them more frequently; c. swishing them around in your mouth; d. all of the above

12. How can you reduce dental erosion from the beverages you drink?
a. drink acidic beverages only at mealtimes and not all day long; b. drink beverages with added calcium; c. sip drinks through a straw to reduce contact with your teeth; d. all of the above

Answers: 1b, 2c, 3b, 4a, 5a, 6c, 7b, 8a, 9b, 10a, 11d, 12d

How did you score on our quiz? We hope you gained some information that will help you reduce dental erosion and preserve your teeth’s vital protective enamel.

Contact us today to schedule an appointment or to discuss your questions about acid erosion of teeth. You can also learn more by reading the Dear Doctor article, “Dental Erosion.”

ConsideranEffectiveandAffordableRPDforTeethReplacement

If you have a few missing teeth but can't afford dental implants or fixed bridgework, consider a removal partial denture (RPD). Although implants may be the superior choice aesthetically and functionally, an RPD can still effectively give you back your teeth.

RPDs are designed to replace one or more missing teeth but not a full arch like a full denture. Considered a permanent restoration, RPDs are also more durable than transitional "flippers," denture appliances that are flexible and light enough to be flipped out of the mouth with a flick of the tongue.

The key to both their affordability and durability is vitallium, a strong but lightweight metal alloy most often used in their frame construction. To it we attach artificial teeth usually made of porcelain or glass-filled resins that occupy the precise location of the missing teeth on the gum ridge. The artificial teeth and frame are surrounded by gum-colored plastic for a more natural look.

Each RPD is custom-made depending on the number and location of the missing teeth. Its construction will focus on minimizing any rocking movement of the RPD during chewing or biting. Too much of this movement could damage the adjacent teeth it's attaching to and cause the appliance to be uncomfortable to wear. We can stabilize the frame by precisely fitting it between teeth to buttress it. We also insert small rests or clasps made of vitallium at strategic points to grip teeth and minimize movement.

RPDs do have some downsides: their unique attachment with teeth encourages the accumulation of dental plaque, the thin bacterial film that's the leading cause of tooth decay and periodontal (gum) disease. These diseases can affect your remaining teeth's health and stability, which could in turn disrupt the fit of the RPD. Also, too much movement of the appliance can make the teeth to which it's attached become more mobile. It's important, then, if you wear a RPD to remove it daily for cleaning (and to thoroughly brush and floss your natural teeth), and to remove it at night to give the attaching teeth a rest.

A RPD can give you back the teeth you've lost for many years to come—if you take care of it. Maintaining both your RPD and the rest of your teeth and gums will help extend the life and use of this effective and affordable replacement restoration.

If you would like more information on teeth replacement options, 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 “Removable Partial Dentures: Still a Viable Tooth-Replacement Alternative.”

By Amanda Cobb, D.M.D.
May 29, 2019
Category: Dental Procedures
CrazyLittleThingCalledHyperdontia

The movie Bohemian Rhapsody celebrates the iconic rock band Queen and its legendary lead vocalist, Freddie Mercury. But when we see pictures of the flamboyant singer, many fans both old and new may wonder—what made Freddie’s toothy smile look the way it did? Here’s the answer: The singer was born with four extra teeth at the back of his mouth, which caused his front teeth to be pushed forward, giving him a noticeable overbite.

The presence of extra teeth—more than 20 primary (baby) teeth or 32 adult teeth—is a relatively rare condition called hyperdontia. Sometimes this condition causes no trouble, and an extra tooth (or two) isn’t even recognized until the person has an oral examination. In other situations, hyperdontia can create problems in the mouth such as crowding, malocclusion (bad bite) and periodontal disease. That’s when treatment may be recommended.

Exactly what kind of treatment is needed? There’s a different answer for each individual, but in many cases the problem can be successfully resolved with tooth extraction (removal) and orthodontic treatment (such as braces).┬áSome people may be concerned about having teeth removed, whether it’s for this problem or another issue. But in skilled hands, this procedure is routine and relatively painless.

Teeth aren’t set rigidly in the jawbone like posts in cement—they are actually held in place dynamically by a fibrous membrane called the periodontal ligament. With careful manipulation of the tooth, these fibers can be dislodged and the tooth can be easily extracted. Of course, you won’t feel this happening because extraction is done under anesthesia (often via a numbing shot). In addition, you may be given a sedative or anti-anxiety medication to help you relax during the procedure.

After extraction, some bone grafting material may be placed in the tooth socket and gauze may be applied to control bleeding; sutures (stitches) are sometimes used as well. You’ll receive instructions on medication and post-extraction care before you go home. While you will probably feel discomfort in the area right after the procedure, in a week or so the healing process will be well underway.

Sometimes, dental problems like hyperdontia need immediate treatment because they can negatively affect your overall health; at other times, the issue may be mainly cosmetic. Freddie Mercury declined treatment because he was afraid dental work might interfere with his vocal range. But the decision to change the way your smile looks is up to you; after an examination, we can help you determine what treatment options are appropriate for your own situation.

If you have questions about tooth extraction or orthodontics, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Simple Tooth Extraction” and “The Magic of Orthodontics.”

By Amanda Cobb, D.M.D.
May 19, 2019
Category: Oral Health
Tags: oral health  
KeepingtheLidonAcidtoProtectYourToothEnamel

Enamel — that tough, outermost tooth layer — protects your teeth from all sorts of hazards, from bacterial attack to temperature extremes. But although the hardest substance in the human body, enamel has a mortal enemy — acid. High acid levels can cause the minerals in enamel to dissolve, a process called de-mineralization. And although saliva can neutralize these levels in approximately 45-60 minutes and restore some of the enamel’s lost minerals, a constant acidic environment can overwhelm this natural mechanism.

That’s why you should be careful with the amount and frequency of acidic foods and drinks like citrus fruits or coffee. You should be especially concerned about your intake of sodas, energy drinks or sports drinks. The latter in particular are designed to replace fluids and nutrients during intense exercise or sports events, but are often consumed as a regular beverage. And all these drinks mentioned are often sipped on throughout the day, resulting in a constant wash of acid in your mouth that can interrupt the protective response of saliva.

There’s one other source for high mouth acidity that comes not from outside the body but from within. GERD — Gastro Esophageal Reflux Disease — is a condition in which digestive acid refluxes (flows back) into the esophagus. While chronic acid reflux can damage the lining of the esophagus and lead to ulcers or even cancer, it may also pose a danger to teeth if the acid regularly rises into the mouth. Individuals encountering this will know it by the awful, acrid taste of vomit in their mouth.

To reduce the chances of high mouth acid due to food intake, limit the consumption of acidic foods and beverages to meal times and sports drink consumption to strenuous exercise or sporting events. Better yet, consider the greatest hydrator of all, water — with a neutral pH of 7.

If you’re experiencing chronic heartburn or other GERD symptoms, make an appointment to see your primary care doctor or a gastroenterologist as soon as possible. Many treatments are effective and will not only improve your general health but may also help preserve your tooth enamel.

If you would like more information on the effect of acid in the mouth and how to reduce it, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Dentistry & Oral Health for Children” and “GERD — Gastro Esophageal Reflux Disease.”

TeensMayNeedaTemporaryReplacementforMissingTeeth

Tooth replacement at any age is a challenge, but especially for teenagers. Dental implants in particular may not be possible yet for teens or young adults whose jaws are still developing. Because it’s imbedded directly into bone, the implant will not move with the jaw as jaw growth occurs, making it look potentially unattractive.

The best solution could be a temporary replacement until their jaw reaches maturity. One such option is a removable partial denture (RPD), an artificial tooth set in an acrylic base that resembles gum tissue. Although we associate dentures with older adults, an RPD works well for teens as a temporary measure. Perhaps the best version for a younger person utilizes metal clips that fit over adjacent teeth and hold the RPD in place. Although quite resilient, the wearer needs to be careful when biting into something hard (like an apple or similar firm fruit) or the artificial tooth may break off.

Another option, a bonded bridge, is a fixed solution similar to a traditional bridge. Whereas a traditional bridge is supported by crowns affixed to the teeth on either side of the empty socket (and requiring extensive alteration of the teeth to accommodate them), a bonded bridge attaches to the supporting teeth with wing-like projections of dental material that attaches to the backs of the adjacent teeth, hidden from view. Although not as secure as a traditional bridge, they can conceivably endure until the teen’s jaw structure is ready for an implant or other permanent solution.

Choosing between an RPD and a bonded bridge will depend on a number of factors, including the teen’s individual bite, clenching or biting habits and the health and strength of supporting bone and gums. Regardless of the type of solution chosen, it’s important to maintain good oral hygiene, especially around a bridge. If bacterial plaque is allowed to build up on tooth surfaces, it could result in an infection that can damage both gums and bone, and reduce the chances of a successful implant in the future.

All these and other considerations should be discussed after a thorough examination. From there, we can advise you on the best course of action to restore both appearance and function until it’s time for a permanent restoration.

If you would like more information on temporary tooth replacements for teens, please contact us or schedule an appointment for a consultation.





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Dr. Amanda Cobb, D.M.D.
P.O. Box 430549
29872 Overseas Hwy
Big Pine Key, FL 33043
305-872-4272

MM 29.75

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