Smile Pretty




Healthy teeth and gums make you look good - and feel good Maybe you've been too busy to make it to your dental cleaning appointments. And sometimes, at the end of a tough day, you just can't muster the energy to floss your teeth. Well, roll the dice if you must, but know that mounting evidence supports a link between oral and overall health, and the old tried and true methods for keeping teeth and gums in tiptop shape have not changed. "Oral problems are very preventable," says Neil S. Hiltunen, DMD, FAGD, of Hampton. Brushing and flossing, having check-ups on a regular basis and maintaining a good diet are the ticket to healthy teeth and gums, he says. Although these oral health tips aren't new, many people continue to ignore them. "The general public thinks everyone goes to the dentist," says Scott F. Bobbitt, DMD, FAGD, of Nashua. "In reality, only about 50 percent of the population goes to the dentist regularly. Think about that: Half of the people that you walk past on the street don't go to a dentist." This is especially problematic because dental trouble, of course, is likely to worsen if left untreated. "Oftentimes periodontal disease or cavities are asymptomatic," Hiltunen says. By the time symptoms such as pain or bleeding are noticeable, more extensive work is often required. About 95 percent of middle-aged adults have tooth decay, missing or filled permanent teeth, and decay among children is on the rise, according to the National Institutes of Health and the Centers for Disease Control and Prevention. It's no wonder dental disease is so prevalent, given the corrosive stuff that many of us drink on a daily basis. Soda and energy drink makers "are leading the way to creating dental disease," Bobbitt says, and bad behaviors create many of the dental woes that patients endure. "It's our diet, it's our behaviors, our habits, that create 80 percent of the bulk of my business. The worst offenders are the sugars in sodas and power drinks." Implants If bad choices or an accident do lead to tooth loss, at least dental implants can now help dentists better compensate for what's missing in your mouth. Although implants are not a recent change in dentistry, Hiltunen says their effect on some dental procedures has been "revolutionary," offering several advantages over previous approaches to tooth loss. One of the key benefits of implants is the stability they provide. An implant, basically a hollow titanium screw, is inserted in a patient's jaw bone and serves as an anchor for artificial teeth that are built up around the implant. Over time the bone bonds with the implant, a process called osseointegration. Earlier versions of implants were made of stainless steel, Bobbitt says, and failed to get incorporated. But today's titanium material is used by surgeons of various stripes for everything from dental work to hip transplants and reconstructive plastic surgery. "We're all using titanium in one form or another," Bobbitt says, "because titanium is biocompatible - your bone can grow on it." Implants can bring great relief to patients who suffer from loose dentures. Ill-fitting dentures can cause eating to be painful because food gets trapped between the gums and dentures. But with implants, dentures can be attached and secured. Another big benefit of implants is that they eliminate the need for grinding down healthy teeth that are adjacent to the gap created by a missing tooth. Traditional methods for filling a gap typically called for reducing neighboring teeth to make way for an appliance such as a bridge. With implants, the integrity of the teeth that surround the space created by a lost tooth remains intact. Plus, implants can offer quick results, Bobbitt says. "I can put implants in and, if the conditions are right in the bone, I can secure dentures in one hour," Bobbitt says. "It's amazing." Other advances in dentistry include lasers, CAD/CAM technology, and new fluoride treatments. Lasers: Used for a variety of applications including cavity detection and cutting tooth enamel, plus root canals, gum surgery and even canker treatment, lasers can be more comfortable for the patient and require less healing time than traditional methods. Some laser applications remain limited and need to evolve, Hiltunen says. CAD/CAM: Computerized design and manufacturing have changed the dental field by enabling dentists to bypass the traditional delay created by sending material related to procedures such as crowns, inlays and onlays and veneers to an outside laboratory and then waiting for a product to come back. Now, a dentist can restore teeth from start to finish, onsite. Dental work that used to take days or weeks can now be completed within one patient visit. Fluoride: There are new ways of applying fluoride in the dental office. Fluoride varnish, for instance, can be applied more easily than topical applications involving foams and trays, which can be messy, uncomfortable and have an unappealing taste, says Hiltunen. Fluoride varnish is used for kids and also adults who are prone to decay on the root surfaces on their teeth and is "a very effective way of helping to harden the tooth structure and reduce decay," Hiltunen says. Down in the mouth Is the bad economy likely to create more toothaches? Many people think they need insurance to go to a dentist, Bobbitt says. But visiting the dentist twice a year, with an annual exam and x-rays, will run you about $20 a month, he says. "People think you need insurance for that, you don't. You need to budget it." For uninsured patients or those pinching pennies in a down economy, Bobbitt says remember: "prevention is the name of the game and part of prevention is early diagnosis. If I don't get to diagnose things early, then you lose the benefit of having things done in an inexpensive manner." For instance, a small cavity that might cost around $100 to fill, if left untreated for two years, could suddenly bloom into a $2,500 root canal and crown repair job, and each of those procedures has a failure rate, Bobbitt says, causing your long-term prognosis to be a bit more uncertain. NH

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