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4AreasWeMayCheckDuringYourOlderLovedOnesRegularDentalVisit

While some aspects of regular dental visits are much the same for everyone, they can be more involved for an older adult. That’s because people later in life face an increased risk of dental disease and other age-related issues.

If you’re a caregiver for an older adult, you’ll want to be aware of these heightened risks. Here are 4 areas of concern we may check during their next regular dental visit.

Oral cancer. While it can occur at any age, cancer is more prevalent among older adults. Although rarer than other cancers, oral cancer’s survival rate is a dismal 50% after five years. This is because the disease is difficult to detect early or is misidentified as other conditions. To increase the odds of early detection (and better survival chances) we may perform a cancer screening during the visit.

Dental disease. The risks for tooth decay and periodontal (gum) disease also increase with age. A primary risk factor for older people is a lack of adequate saliva (the mouth’s natural disease fighter) often caused by medications or systemic conditions. We’ll watch carefully for any signs of disease, as well as assess their individual risk factors (including medications) for decreased oral health.

Dentures. If they wear dentures, we’ll check the appliance’s fit. While dentures can wear with use, the fit may also grow loose due to continuing bone loss in the jaw, a downside of denture wearing. We’ll make sure they still fit comfortably and aren’t stressing the gums or supporting teeth. It may be necessary to reline them or consider replacing them with a new set.

Oral hygiene. Brushing and flossing are just as important for older adults as for younger people for preventing dental disease, but often more difficult due to mental or physical impairment. We can note areas of bacterial plaque buildup and recommend ways to improve their hygiene efforts.

Depending on how well your older adult can care for themselves, it may be advisable for you to come with them when they visit us. Our dental team can provide valuable information and advice to help you help them have a healthier mouth.

If you would like more information on dental care for older adults, 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 “Aging & Dental Health.”

By Katelyn Nieten, DDS
May 12, 2019
Category: Dental Procedures
Tags: dental implant   bone loss  
AnImplantRestorationCouldPreventBoneLoss

Losing teeth continues to be an all too common experience for people, especially those in their senior years. Fortunately, there are several ways to replace them, ranging from partial or full dentures to implants.

Some, though, postpone or simply choose not to replace a lost tooth, often because of the cost. But putting off a dental restoration could have a long-term impact on your health, and not in a good way. Continuing bone deterioration is one of the top consequences of delayed restoration.

Like other bones in the body, the jawbone is living tissue with cells that form, grow and eventually wear out. At the end of their life, these older cells give way to new cells. Eating and chewing play an important role in maintaining this growth cycle: the forces we generate as we chew travel up through the tooth roots to stimulate bone growth in the jaw.

When a tooth goes missing, though, the stimulus ends. Over time the bone cell replacement rate can fall off and the bone slowly loses volume. To make matters worse, bone loss can continue beyond the immediate bone underlying the tooth and affect the rest of the jawbone. The jaw can shrink in height and width, and in time become weaker overall and more susceptible to fracture.

But dental implant restorations in particular could help stop or even reverse bone deterioration at the site of the missing teeth. The titanium post implanted in the jaw attracts bone cells, which grow and adhere to its surface. Over time the bone fills in and becomes stronger.

You don't want to wait too long, though, because implants depend on a minimum amount of bone present for secure placement. You should therefore undergo an implant restoration as soon as it's practical after tooth loss. Otherwise, although we may be able to restore some of the lost bone with bone grafting, you may need to consider another restorative option.

When it comes to replacing missing teeth, time isn't on your side. But the right kind of dental restoration undertaken promptly can make for a brighter, healthier future.

If you would like more information on restoring lost teeth, 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 “The Hidden Consequences of Losing Teeth.”

By Katelyn Nieten, DDS
May 02, 2019
Category: Oral Health
Tags: oral hygiene   tooth decay  
5QuestionstoAskYourselfAboutYourRiskforToothDecay

Among our most common diseases, tooth decay can be a big problem at any age: in the U.S., one in four children 5 and under has some form of the disease, as well as ninety percent of those 60 and older — and a quarter of those have suffered complete tooth loss.

Fortunately, we now know what needs to be done on a regular basis to prevent tooth decay. Unfortunately, many are uninformed about all they need to do to lower their risk.

Here, then, are 5 questions to ask yourself to see if you’re on the right prevention path or not.

Do I brush and floss daily? If not, you’re aiding and abetting the “enemy” — bacteria that cause tooth decay. Bacteria that make up plaque feed on any food remnants that adhere to tooth surfaces. Brushing at least once daily (twice is better) removes plaque, while flossing removes plaque between teeth that can’t be reached with a brush. Removing plaque will lower your mouth’s acid levels that cause a loss of minerals to the enamel surface.

Do I use the proper techniques for brushing and flossing? While it’s important to establish daily hygiene habits, if you’re not performing them properly you won’t realize the full benefit from your efforts. But don’t dismay — we can train you in the proper techniques for brushing and flossing your teeth.

Do I use fluoride toothpaste? This naturally-occurring chemical strengthens tooth enamel and makes it more resistant to decay. You can increase fluoride’s absorption rate into enamel by using hygiene products that contain it.

Do I constantly snack between meals? Saliva neutralizes acid remaining in the mouth after eating in about 30 to 60 minutes. If you’re constantly snacking or sipping acidic beverages, however, saliva can’t do this effectively. It’s best to limit snacking to a few, specific times and restrict acidic beverages to meal time only.

Do I visit the dentist for cleanings and checkups? While brushing and flossing reduce plaque, it can’t remove it from hard-to-reach places below the gums or harder deposits (calculus) that have developed. A professional cleaning twice a year removes the plaque and calculus left from daily hygiene. We can also gauge the health of your teeth and determine if tooth decay or gum disease may be developing.

If you would like more information on tooth decay prevention, 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 “Tooth Decay: How to Assess Your Risk.”

ADifferentKindofChipShotforProGolferDanielleKang

While the sport of golf may not look too dangerous from the sidelines, players know it can sometimes lead to mishaps. There are accidents involving golf carts and clubs, painful muscle and back injuries, and even the threat of lightning strikes on the greens. Yet it wasn’t any of these things that caused professional golfer Danielle Kang’s broken tooth on the opening day of the LPGA Singapore tournament.

“I was eating and it broke,” explained Kang. “My dentist told me, I've chipped another one before, and he said, you don't break it at that moment. It's been broken and it just chips off.” Fortunately, the winner of the 2017 Women’s PGA championship got immediate dental treatment, and went right back on the course to play a solid round, shooting 68.

Kang’s unlucky “chip shot” is far from a rare occurrence. In fact, chipped, fractured and broken teeth are among the most common dental injuries. The cause can be crunching too hard on a piece of ice or hard candy, a sudden accident or a blow to the face, or a tooth that’s weakened by decay or repetitive stress from a habit like nail biting. Feeling a broken tooth in your mouth can cause surprise and worry—but luckily, dentists have many ways of restoring the tooth’s appearance and function.

Exactly how a broken tooth is treated depends on how much of its structure is missing, and whether the soft tissue deep inside of it has been compromised. When a fracture exposes the tooth’s soft pulp it can easily become infected, which may lead to serious problems. In this situation, a root canal or extraction will likely be needed. This involves carefully removing the infected pulp tissue and disinfecting and sealing the “canals” (hollow spaces inside the tooth) to prevent further infection. The tooth can then be restored, often with a crown (cap) to replace the entire visible part. A timely root canal procedure can often save a tooth that would otherwise need to be extracted (removed).

For less serious chips, dental veneers may be an option. Made of durable and lifelike porcelain, veneers are translucent shells that go over the front surfaces of teeth. They can cover minor to moderate chips and cracks, and even correct size and spacing irregularities and discoloration. Veneers can be custom-made in a dental laboratory from a model of your teeth, and are cemented to teeth for a long-lasting and natural-looking restoration.

Minor chips can often be remedied via dental bonding. Here, layers of tooth-colored resin are applied to the surfaces being restored. The resin is shaped to fill in the missing structure and hardened by a special light. While not as long-lasting as other restoration methods, bonding is a relatively simple and inexpensive technique that can often be completed in just one office visit.

If you have questions about restoring chipped teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Porcelain Veneers” and “Artistic Repair of Chipped Teeth With Composite Resin.”

By Katelyn Nieten, DDS
April 12, 2019
Category: Oral Health
Tags: tooth decay  
RootDecayinYourLaterYearsCouldEndangerYourTeeth

As we age we become more susceptible to dental diseases. A common but often initially unnoticed problem for seniors is root decay.

We’re all familiar with tooth decay in the crown, the visible tooth above the gum line. Bacteria feeding on leftover sugar in the mouth produce acid, which at high levels erodes the teeth’s protective enamel. This forms cavities and, if untreated, deeper infection within the tooth that could reach the bone via the root canals.

But decay can also directly attack a tooth’s roots below the gum line. Roots are made of dentin and covered by a very thin layer of mineralized tooth structure called cementum.  Cementum, which is much softer than enamel, is often lost because of its thinness, thus exposing the root’s dentin. This can make the area more susceptible to decay than the enamel-covered crown. Normally, though, the roots also have the gums covering them as added protection against bacterial infection.

But gum recession (shrinkage), a common experience for people in their later years, can expose the root surfaces. As a result, the roots become much more susceptible to decay. And an ensuing infection could spread more quickly into the interior of the tooth than decay originating in the crown.

That’s why it’s important to remove the decayed material and fill the root cavity to prevent the infection’s spread. While similar to a crown filling, the treatment can be more difficult if the root cavity extends below the gum line. In this case, we may need to perform a surgical procedure to access the cavity.

There are other things we can do to help prevent root cavities or limit their damage. We can apply fluoride varnish to strengthen the teeth and provide extra protection against cavities, or prescribe a fluoride rinse for use at home. We can also keep an eye out and treat periodontal (gum) disease, the main cause for gum recession.

The most important thing, though, is what you do: brush and floss thoroughly each day to remove bacterial plaque and limit sugary or acidic foods in your diet. Preventing decay and treating cavities as soon as possible will help ensure you’ll keep your teeth healthy and functional all through your senior years.

If you would like more information on preventing and treating tooth decay, please contact us or schedule an appointment for a consultation.





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