Jeffrey L. Hardenburg DDS

If you’re missing one or more teeth, it probably affects your smile and you may also notice a difference in chewing and speaking.

But there are options available to help you restore your smile and limit other problems.

For example, a bridge – sometimes called a fixed partial denture – replaces missing teeth with artificial teeth.

Bridges help maintain the shape of your face, as well as reducing the stress in your bite by replacing missing teeth.

They literally bridge the gap where one or more teeth may have been previously.

The restoration can be made from gold, alloys, porcelain or a combination of these materials and it is bonded onto surrounding teeth for support.

Bridges can be removable so that you can take them out and clean them or fixed and so can only be removed by a dentist.

An implant bridge attaches artificial teeth directly to the jaw or under the gum tissue.

Your dentist will recommend which approach is best for you.

Whatever type of bridge you choose, its success depends on its foundation. So it’s very important to keep your remaining teeth healthy and strong.

You probably don’t give too much thought to the saliva in your mouth but, if you think of it like a bloodstream you’ll realize how important it is.

Like blood, saliva helps build and maintain the health of the soft and hard tissues.

It removes waste products from the mouth and offers first-line protection against microbial invasion that might lead to disease.

Saliva is derived from blood and therefore can also be used to detect disease.

Saliva enhances enamel protection by providing high levels of calcium and phosphate ions. It contains the minerals that maintain the integrity of the enamel surface and helps protect against caries.

When salivary flow is reduced, oral health deteriorates – much in the same way body tissues suffer if blood circulation is disrupted.

Patients with dry mouths (xerostomia) experience difficulty chewing, speaking and swallowing. A major cause of dry mouth is medication – almost eighty percent of the most commonly prescribed medications lead to dry mouth.

Chewing gum after a snack or meal stimulates salivary flow, clearing food from the mouth and neutralizing plaque acid.

Your saliva is important to your oral health both for preventing disease and in helping to diagnose problems.

Your dentures were made to fit you precisely and, if they are cared for properly, they do not change shape.

But you may sometimes find that they can become loose due to natural changes in the gums and bone supporting them. As the jawbone begins to shrink, so do the gums.

If you find your dentures no longer fit properly, see your dentist as soon as possible so adjustments can be made.

Trying to change the fit of your dentures yourself can damage them and make them unrepairable so this would be a costly experiment!

Ill-fitting dentures repaired at home can also irritate the gums, tongue and cheeks.

In an emergency, you could use denture adhesives to keep the dentures stable until you are able to see the dentist.

Even if you no longer have your natural teeth, its still important to see your dentist regularly for an oral examination.

The dentist will examine your mouth to check for any problem with the gum ridges, the tongue and the joints of the jaw, as well as screen for oral cancer.

For a variety of reasons, many older adults are more susceptible to oral diseases, including oral cancer. About 95 percent of all cancers are found in people over age 40. However, many of these cancers are treatable if detected early.

Oral tissues are also checked for signs of other diseases that can first manifest themselves in the mouth.

Living with dentures can be comfortable if you continue to care for your oral hygiene and make regular visits to your dentist for a checkup.

With many people concerned about the taste and purity of tap water, the sales of bottled water have increased significantly in recent years.

Tap water goes through a process of purification designed to eliminate suspended materials, remove tastes and odors and kill microorganisms.

Fluoride is added to most tap water supplies with the aim of reducing cavities.

Fluoride becomes incorporated into our teeth as they develop and makes them more resistant to decay. It can reverse the progress of early cavities and reduce the need for dental treatment.

Mass water fluoridation has played an important role in reducing tooth decay.

The problem with bottled waters is that they usually don’t contain fluoride.

So there is a risk that drinking bottled water can increase the risk of cavities for some people.

If you drink a lot of bottled water, you can make up for this by using fluoride toothpaste and mouth rinse.

Your dentist may even suggest a fluoride supplement if they notice an increase in cavities.

Correcting problems with crowded and crooked teeth not only gives you a better smile, it also leads to a healthier mouth.

Malocclusion, also known as bad bite, involves teeth that are crowded or crooked.

Sometimes, the upper and lower jaws may not meet properly and, although the teeth may appear straight, the individual may have an uneven bite.

Problems such as protruding, crowded or irregularly spaced teeth may be inherited. But thumb-sucking, losing teeth prematurely and accidents also can lead to these conditions.

As well as spoiling your smile, crooked and crowded teeth make cleaning the mouth difficult. This can lead to tooth decay, gum disease and possibly tooth loss.

A bad bite can also interfere with chewing and speaking, cause abnormal wear to tooth enamel and lead to problems with the jaws.

Orthodontic treatment can help correcting these problems giving you a better smile but, more importantly, creating a healthier mouth.

Your dentist will advise you on how orthodontic treatment could help you.

Gum disease also known as periodontal disease – is an infection of the tissues surrounding and supporting the teeth and its a major cause of tooth loss in adults.

But its usually painless so you may not even know you have it.

Its caused by plaque a sticky film of bacteria that constantly forms on the teeth. These bacteria create toxins that can damage the gums.

The early stage of gum disease is called gingivitis. In this stage, the gums can become red, swollen and bleed easily. At this stage, you can usually still reverse the disease by daily brushing and flossing.

The more advanced stage of gum disease is known as periodontitis. At this stage, the gums and bone that support the teeth can become seriously damaged. The teeth may then become loose, fall out or have to be removed by a dentist.

Its therefore very important to look out for any signs of gum disease. These signs include:

– Gums that bleed when you brush your teeth
– Red, swollen or tender gums
– Gums that have pulled away from the teeth
– Bad breath that doesn’t go away
– Pus between your teeth and gums
– Loose teeth
– Change in the way your teeth fit together when you bite
– Change in the fit of partial dentures

If you notice any of these signs, contact you dentist quickly and theyll help you take action to make improvements.

The habits of good dental care should begin as early as possible and its important to take steps to avoid problems with infants and children.

Children need strong, healthy teeth to chew their food and baby teeth also keep a space in the jaw for the adult teeth.

If a baby tooth is lost too early, the teeth beside it may drift into the empty space. So, when it’s time for the adult teeth to come in, there may not be enough room. This can make the teeth crooked or crowded.

The name given to decay in infants and children is baby bottle tooth decay.

It can destroy the teeth and most often occurs in the upper front teeth – though other teeth may also be affected.

Decay can happen when sweetened liquids are given to an infant and are then left clinging to their teeth for long periods. Many sweet liquids cause problems, including milk, formula and fruit juice.

What happens is that bacteria in the mouth use these sugars as food and then produce acids that attack the teeth.

It’s not just what you put in your child’s bottle that causes decay, but how often. Giving your child a bottle of sweetened liquid many times a day isn’t a good idea.

Here are some tips to avoid baby bottle tooth decay in your children:
– After each feeding, wipe the baby’s gums with a clean gauze pad. Begin brushing your child’s teeth when the first tooth erupts. Clean and massage gums in areas that remain toothless, and begin flossing when all the baby teeth have erupted, usually by age 2 or 2.
– Never allow your child to fall asleep with a bottle containing milk, formula, fruit juice or sweetened liquids.
– If your child needs a comforter between regular feedings, at night, or during naps, give them a clean pacifier recommended by your dentist or physician. Never give your child a pacifier dipped in any sweet liquid.
– Avoid filling your child’s bottle with liquids such as sugar water and soft drinks.
– If your local water supply does not contain fluoride (a substance that helps prevent tooth decay), ask your dentist how your child should get it.

Start dental visits by the child’s first birthday and make visits regularly.

If you think your child has dental problems, take the child to the dentist as soon as possible.

A newly born baby usually has no teeth visible but most have begun to develop primary or baby teeth.

These generally begin to appear about six months after birth.

Over their first few years, they will develop all 20 primary teeth and will usually have them all in place by age three.

The teething process is uncomfortable for many babies and they can become sleepless and irritable. They also might lose their appetite or drool more than usual.

If your infant has a fever or diarrhea while teething or continues to be cranky and uncomfortable, call your physician.

Sometimes when a tooth erupts, an eruption cyst may develop. The tooth will eventually rupture this as it pushes through the gums and these cysts are usually harmless and should be left alone.

If a baby has sore or tender gums when they are teething, it can help to gently rub the gum with a clean finger, a small, cool spoon or a wet gauze pad.

When this happens, your dentist or pediatrician may suggest a pacifier, teething ring or a special numbing salve for the gums.

When the teeth begin to erupt, you should brush them with a soft-bristled toothbrush and a little water to prevent tooth decay.

Toothpaste is not recommended until a child reaches age two. When a child begins using toothpaste, you need to supervise the brushing to make sure they don’t swallow it.

Regular dental checks should begin after your child’s first tooth appears or by their first birthday.

Osteoporosis is a disease that weakens bones and increases the risk of fractures.

It affects about 10 million Americans of whom 8 million are women and another 34 million are at risk of developing it.

So this is a disease that affects more women than cancer, heart disease and stroke combined.

But what does it have to do with your dental care?

Well, many people in these categories are treated with a group of prescription drugs called oral bisphosphonates. Studies have reported that these drugs reduce bone loss, increase bone density and reduce the risk of fractures.

But some people have been alarmed and confused by recent news reports about oral bisphosphonates because of uncommon complications that have been linked to these drugs.

The drugs have been associated with osteonecrosis of the jaw (ONJ), a rare but potentially serious condition that can cause severe destruction of the jawbone.

The true risk posed by oral bisphosphonates remains uncertain, but researchers seem to agree that it appears very small.

Given the risks associated with osteoporosis and the proven benefits of oral bisphosphonate therapy, you should not stop taking these medications before discussing the matter fully with your physician.

If your physician prescribes an oral bisphosphonate, its important to tell your dentist so that your health history form can be updated.

In this case, some dental procedures, such as extractions, may increase your risk of developing ONJ, so your dentist needs to be able to take your full health picture into account.

Dental plaque is a film that builds up on your teeth and, if it is not removed through good oral hygiene, it can lead to tooth decay and gum problems.

Over time it can ultimately form a hard, rough sediment known as dental tartar or calculus, which attracts further plaque buildup.

Calculus has to be removed by a trained professional such as a hygienist or dentist.

They may do this by manual tooth scaling or using an ultrasonic device.

If the buildup is light or moderate, the dentist or hygienist may use manual scaling instruments of various shapes and sizes.

If the buildup of tartar and stains is heavy, an ultrasonic cleaner may be used. This may be followed by hand scaling.

Build up of plaque can cause inflammation of the gums leading to breakdown of the connection between the teeth and the supporting structures.

Root planing is a procedure to treat gum disease by thoroughly scaling the roots of teeth to establish a smooth, calculus-free surface.

This treatment may require local anesthesia to prevent pain. Thorough periodontal scaling customarily involves several dental visits

If conditions are more advanced, surgery may be needed for complete debridement of the roots to arrest the disease process.

Some people tend to have more buildup of calculus than others and some may be more prone to periodontal inflammation or the development of tooth decay.

It’s therefore important to follow your hygienist’s advivce on how often to return for regular cleanings – even if your insurance only covers two a year.