Braces for Adults

With more nearly 1.5 million patients last year, adult orthodontics are certainly on the rise. Adulthood can certainly be a time where finances and resources align to make the dream of straighter teeth a reality. Wether used on their own or in combination with other cosmetic dental procedures, braces can create a dramatic change in almost any smile. 

Many adult patients will opt for traditional wire-and-bracket braces. These orthodontic appliances are the most versatile option, achieving most tooth movements with ease. The entire procedure is overseen by an orthodontist, who directs and refines treatment on the fly.  The most obvious drawbacks to this type of orthodontics is the esthetics of the exposed appliance. In fixing this, some specialists place tooth colored brackets that better blend in with the surrounding tooth enamel. A second drawback is the increased time devoted to oral hygiene. Brushing and (particularly) flossing become more difficult with a metal bar running across the teeth. However, there are many readily available products that make keeping your braces clean a no brainer. 

For those wishing to avoid the appearance of traditional orthodontics, removable Invisalign trays might be an ideal choice. Here, a series of trays are custom fitted to your teeth to gently push them to their desired positions. Since nothing is truly anchored to the teeth/mouth, tooth movements take a longer time. Additionally, some types of adjustments are difficult/impossible without traditional braces. Invisalign works great for minor corrections, crowding, or correcting orthodontic relapse (for those who have reoccurring tooth movement after finishing childhood orthodontic treatment). 

There are always a number of great options for perfecting and maximizing your smile. Braces and trays represent the ideal solution for those looking for straighter and more evenly spaced teeth. If you would like to know more about your cosmetic options, please call our office to schedule an exam!

Dental Questions: What's the difference between sealants and fillings?

A recent study released by the Journal of the American Dental Association identified dental sealants as one of the most effective means of reducing cavities in children. Sealants were found to be more effective than fluoride varnish at preventing decay and are associated with a 70%-80% reduction in cavities in the pits and grooves of teeth. 

A dental sealant is administered by cleaning the tooth surface, fillings the grooves with a resin material and adjusting any high points that interfere with biting/chewing. This may sound similar to the way that a traditional dental filing is performed because it is essentially the same procedure. The main differences come from the goals of the treatments and the amount of modification to the tooth. 

A dental filling is provided to remove active decay from a tooth's enamel and dentin. They usually extend 3-5 millimeters into the tooth and are used as a reparative treatment. By taking out the damaged areas, we can halt bacteria's progression into the tooth. In contrast, a sealant is performed on an undecayed tooth as a preventative measure. Typically, no tooth structure is removed. The end goal is to "seal out" food and bacteria from the deep grooves in our teeth. These tiny nooks create a perfect spot to catch food, harbor bacteria and avoid cleaning (most times the grooves are too thin to be reached by a toothbrush bristle!). 

In total, there are many similarities between traditional fillings and sealants. However, placing a sealant takes less time, requires less tooth structure to be removed and is an overall less traumatic experience for young patients. If you would like to know if you or a family member would benefit from sealants, please call our office to schedule an appointment!

Stimulating Stem Cells With Dental Fillings

You have probably seen headlines across the internet discussing new a newly invented dental filling that stimulates stem cells within the teeth. Researchers at The University of Nottingham and Harvard University came together and created this material that is proposed to change the face of dentistry. While this discovery has huge implications for dental care, many articles oversell its proposed abilities. 

In discussing how this material is supposed to work, it is important to understand the anatomic structure of teeth. Every tooth has three general layers: enamel, dentin and pulp tissue. The enamel is mostly mineral and happens to be the hardest structure in the human body. It is also the layer most resistant to tooth decay. Beneath the enamel lies the softer and porous inner dentin. The pulp tissue is the innermost layer that contains nerves, blood supply and stem cells. These new fillings rely on changing the pulp's response to trauma and inflammation. 

Unfortunately, dental pulp tissue is not very resilient. Trauma, extreme temperatures, deep fillings and bacteria can all cause the pulp to become inflamed and/or die, necessitating a root canal. However, if the attack is moving slowly enough, the pulp may shrink itself by laying down new dentin and "move away" from the irritating source. The new filling material hopes to capitalize on this mechanism when placing deep fillings near the pulp tissue. Instead of causing the nerve to die, the substance hopes to induce the tooth to lay down more dentin, creating a safe and natural barrier between the tooth and filling. 

It is important to understand that (by design) this material is not an end-all solution to cavities and root canals. For starters, it would have little benefit over traditional fillings when used in shallow cavities far from the pulp. It would also not be of use in teeth that need root canals due to fracture, trauma or decay that extends entirely to the pulp. Many times, teeth need root canals not due to deep fillings that aggravate the pulp tissues, but rather because the bacteria have travelled through the enamel and dentin and have infected the inner tooth. Once the pulp comes in contact with outside microbes, it will almost certainly need a complete root canal treatment. 

Still, this new material has wonderful applications in the modern dental office. Many fillings that were previously given with a questionable prognosis can now be provided with increased likelihood of success. Likewise, this invention paves the road for future regenerative dental technologies. Who knows what the future holds in store! For more information on these new fillings and how they work, feel free to give our office a call or email us at staff@thousandoaksfamilydentistry.com

The Benefits of Sugar Free Gum

Are you a frequent gum-chewer? Men's Health Magazine recently published an article discussing how chewing sugar free gum can save you thousands of dollars in dental expenses. Find out why adding gum to your daily routine can help fight cavity causing bacteria!

Every time we eat or drink anything made with sugars or carbohydrates, our mouths turn acidic for a thirty minute period. This is caused by bacteria in our mouths processing sugars into their associated acids. Over time, the acid buildup weakens dental enamel and begins to form cavities in our teeth. These cavities tend to develop in areas that trap food, as bacteria have more fuel to turn into acid. This is one of the reasons why decay in common in between teeth and in the pits/grooves of posterior teeth. 

The Men's Health article correctly identifies that sugar free gum lacks the necessary ingredients to fuel bacterial acid production. In addition to this, gum helps loosen food that gets packed into our teeth after meals. Finally, chewing gum stimulates saliva flow which is a crucial factor in preventing tooth decay. Our saliva has incredible natural remineralizing properties and can have a tremendous effect on the progression of cavities.  

One topic the article does not address is the type of sweetener to look for in sugar free gum. Most brands use typical sugar substitutes like sorbitol and aspartame. However, chewing gum made with xylitol will add even more protective factors into your daily routine. Xylitol is a natural sugar alcohol that inhibits ability of bacteria to grow and stick to our teeth. While xylitol gum can be purchased at many stores, health food markets typically carry the best variety. You can also order it online from companies like Dr. John's Candies (our office's favorite!).

It is currently believed that Xylitol's maximum dental benefit comes from using it three to five times a day. However, it is not a substitute for flossing or brushing with a fluoride toothpaste. If you would like to know more about the protective factors of xylitol gum, how it is best used and what it does for our teeth, please give our office a call!

Link to Men's Health Article: www.menshealth.com/health/habit-save-money-dentist

Dentistry and Children's Teeth

If you ever took a fall or had a cavity as a child, you're probably thankful that we get two sets of teeth. Our primary dentition can certainly seem like a second chance to recover from youthful mishaps. You may be wondering why, if adult teeth will eventually take their place, do we perform restorative dental procedures on kids teeth? Crowns, fillings and even braces may seem excessive when you could simply "extract and wait" for the adult teeth to come in. On the contrary, primary teeth serve a number of important roles in establishing a healthy adult dentitition. 

One of the most basic goals of primary teeth is to hold space for the permanent teeth. They create markers for where the adult teeth need to erupt and keep adjacent teeth from crowding into the open spaces. Once you lose a primary tooth, the teeth on either side can start to drift into its space, blocking the adult tooth from eruption. Many times, children who lose a primary tooth prematurely will receive a space maintainer- a cemented retainer that keeps two teeth from coming closer together.

Primary teeth also play an important role in the development of the jawbones. This is the guiding principle behind interceptive orthodontics, where braces and orthodontic appliances are placed on baby teeth. By ensuring these teeth are in ideal locations, an orthodontist can guide the development of the jaws and palate while lessening the need for future adjustment. 

Beyond the developmental importance of primary teeth, they are critical in psychological and social factors as well. Missing multiple anterior teeth can be embarrassing or humiliating, particularly when children are not at the appropriate age of tooth loss. Moreover, the posterior teeth are important in chewing and processing food. Without the ability to chew, we miss out on important nutrients in our diet. Molars allow us to break down food, increase surface area and ultimately facilitate healthy digestion. 

In short, the primary teeth are an incredibly important part of childhood development. With this in mind, dentists do all they can to maintain these teeth through their healthy lifespans. If you want to know more about childhood dentition, the importance of brushing and flossing or dental development, please give our office a call!

Dental Questions: What is a flipper?

With the rise of dental implants, many patients are electing to have teeth extracted rather than spending time and money on a losing battle. Since implants can take months to heal before a crown is placed, there is now a question on what to do with the missing spaces in the meantime. While you can elect to leave these areas open in the interim, this is not an option when the implant is placed in the smile zone. For these situations, you may be made a flipper- or temporary denture. 

Flippers are also known as stay plates or temporary partial dentures. They are made of a hard, pink acrylic resin that supports the prosthetic teeth. They may also have a series of metal clasps that hold the frame firmly in place. Flippers differ from permanent dentures primarily in the way they rest on the teeth and gums. Partial dentures are fitted to the mouth so that the teeth serve as the primary supporting structures. If the gums have to be utilized in holding the denture, very specific areas are used, as to not cause any lasting damage. In contrast, flippers rest entirely on the gums and soft tissues. Over time, the constant pressure on gums can cause the underlying bone to resorb or irritate the periodontal tissues. With this in mind, they are inappropriate as permanent appliances. However, they can be a great interim solution in implant placement. 

Flippers are created by a dental laboratory and take about two weeks to complete. They typically blend seamlessly with the natural tissues and aren't noticeable as "denture teeth." If you would like to know more about flippers and how they can be a part of your implant treatment, please give our office a call!

Photographs at the dentist's office

If you have had a new patient exam at Thousand Oaks Family Dentistry, part of your appointment was dedicated to taking pictures of your face, smile and teeth. Depending on where you previously received care, this may have seemed like a strange proposition. However, photography is an increasingly useful tool in the modern dental practice that allows us to better serve our patients. 

In it's most simple form, photography gives us a baseline idea of how your teeth look. While x-rays allow us to see cavities, infections and bone levels, nothing short of a traditional photograph can clue us into the cosmetic history of your teeth. If, God forbid, you were in an accident that damaged your anterior teeth, these images would help us recreate your smile most accurately. Additionally, photos help us track changes over time. Acid erosion, staining and orthodontic movement are all best recorded using traditional photography.

In addition to creating a cosmetic record, photographs can help us in billing your insurance. Many times, insurance companies will not cover certain treatments unless they were used to treat tooth decay. This becomes a problem on the chewing surfaces of teeth,  where decay is usually visible to the naked eye but poorly imaged on x-rays. By the time decay on these surfaces is visible on an x-ray, the cavity usually extends almost entirely to the tooth nerve. In contrast, photographs allow us to document decay early and reduce the number of hiccups between you and your insurance provider. 

In total, photography is not a replacement for standard x-rays. However, they are a safe, quick and reliable supplement that helps us better serve our patients. If you have any more questions about dental photography, our exams or any other service offered at Thousand Oaks Family Dentistry, please give us a call. We are always here to serve any and all of your dental needs!

Hidden Sugars

While we typically think of tooth decay as a childhood disease, it can affect anyone at any age. In fact, while cavities are slowly declining in young children, 92% of adults over the age of 20 have some form of decay. This is largely attributed to "hidden sugars" in our daily diets. 

Nearly everyone tries to eat healthy and stay away from sweets and sugary drinks. However, it is important to understand that sugars can "hide" in the foods we eat every day. These hidden sugars are particularly detrimental when used as snacks or consumed over a long period of time. Duration, not quantity, is the most important factor in the decay process. A prime example of hidden sugars would be cheese crackers like Goldfish or Cheez-its. While they may have a low sugar content by recipe, our saliva can break down the carbohydrates into smaller glucose and fructose molecules. Combine this with the the crackers' sticky nature and you have a perfect storm for tooth decay!

Other sugars we consume aren't quite as discreet, but still manage to sneak in without us noticing. This is particularly true in an office environment where coworkers are constantly bringing in donuts, birthday cakes and sweet treats. While we may not plan or think of these foods as part of our diet, they still can have a serious effect on our teeth. 

Asking someone to give up their favorite snacks "cold turkey" is usually impossible. Instead, we suggest keeping the duration and number of snacking sessions to a minimum. For example, instead of eating a box of raisins over the course of an afternoon, try to consume all of them in an even fifteen minute period. Also, make sure to follow any snack or meal with a rinse of water and some xylitol gum. This combination is a quick and easy way to minimize bacterial activity after an influx of sugar.

If you would like to know more about tooth decay, what causes it and how we can stop the process, please call our office. The most important component of dental care is prevention, and we want to keep our patients equipped with the latest research in hygiene and oral health. 

Recent changes to our Root Canal Policies

Our office recently changed our protocols on finishing root canal procedures done by endodontic specialists. These changes reflect the safest and most effective dental practices known today. As with all procedures carried out at Thousand Oaks Family Dentistry, we put your treatment, comfort and convenience first!

When a root canal is finished, you are essentially left with a tooth sans nerve tissue and a small opening at the top. This opening is a necessary part of the root canal procedure that allows the endodontist to reach the nerve tissue and roots. Unfortunately, it is also a major deterrent to the long term structural integrity of the tooth. In order to restore strength to the tooth, the opening needs to be sealed with a special filling material called a core and finished off with a dental crown. This core material chemically bonds to the enamel and protects against fractures and cracks. Many times, a device called a post will be added to the core to provide more rigidity when necessary. Posts extend partially down one root and create an additional structural anchor for the core to adhere to. 

Historically, the endodontists we work with would complete the root canal procedure and place a temporary filling into the opening (a "temporary core). This material does not actually bond to dental enamel and only serves to keep bacteria and food out of the inner tooth. It is very easy to remove, allowing for the quick re-access of a tooth if the first root canal was unsuccessful. Patients then had to return to our office, have the temporary filling removed and have a permanent restoration placed. Not only did this create a new opportunity for bacteria to invade the tooth, it caused our patients to spend days to weeks functioning with a severely weakened tooth. 

Currently, our endodontic specialists are placing permanent posts and cores at the time of root canal completion. This ensures the tooth is continuously sealed and structurally reinforced prior to crown placement. While immediately placing a permanent core can make re-accessing the tooth more difficult, the positives largely outweigh any negatives. Very few teeth end up needing immediate re-access, and the continued structural support of the tooth is a far more important factor in long term root canal success. 

If you would like to know more about root canals, posts, cores or any other dental procedures, please call our office. We are always happy and excited to walk you through any part of your dental treatment!

Endodontists we work with

At Thousand Oaks Family Dentistry, we take our patient's individual needs very seriously. With this in mind, we have cultivated a network of highly skilled dental specialists to address any and every concern. For our patient who require root canals and other endodontic services, we are proud to work with Conejo-Simi Endodontics and Southern California Endodontic Group.

You may be referred to an endodontis' office to diagnose and treat certain types of tooth pain or resolve an infection. Specialists like Conejo-Simi Endo and So-Cal Endo have technology like microscopes and cone-beam CT scanners that can better visualize cracks, abscesses and root fractures on teeth. If the tooth in question is savable, an endodontist can then perform a root canal to remove infection or stop tooth pain. Their technical expertise shines in treating posterior teeth, where root anatomy can become complicated and difficult to visualize. Nevertheless, our specialists have years of experience and will always strive for the best treatments possible!

We typically refer to out to endodontists following an exam and X-rays. However, certain types of pain will clue us in to your need for a specialist even before looking in the mouth. Our office is positive that you will have a great experience at Conejo-Simi Endodontics or Southern California Endodontic Group. If you would like to know more about the specialists we refer to or why we use them, please give us a call!