My Blog
By Boca Raton Dental Care - Manreet K. Singh, DMD
February 16, 2018
Category: Oral Health
Tags: fluoride  
3CommonSourcesofFluorideYouMightNotKnowAbout

In the early 1900s, a Colorado dentist noticed his patients had fewer cavities than the norm. He soon found the cause: naturally occurring fluoride in their drinking water. That discovery led to what is now heralded as one of the most important public health measures of the last century — the use of fluoride to prevent tooth decay.

While you're most likely familiar with fluoride toothpaste and other fluoridated hygiene products, there are other sources of this chemical you should know about — especially if you're trying to manage your family's fluoride intake. Here are 3 of these common sources for fluoride.

Fluoridated drinking water. Roughly three-quarters of U.S. water utilities add fluoride to their drinking water supply under regulations governed by the Environmental Protection Agency. The federal government currently recommends 0.7 milligrams of fluoride per liter of water as the optimum balance of maximum protection from tooth decay and minimal risk of a type of tooth staining called dental fluorosis. You can contact your local water service to find out if they add fluoride and how much.

Processed and natural foods. Many processed food manufacturers use fluoridated water in their processes. Although not always indicated on the packaging, there are often traces of fluoride in cereals, canned soups, fruit juices or soda. Many varieties of seafood naturally contain high levels of fluoride and infant formula reconstituted with fluoridated water can exceed the level of fluoride in breast or cow's milk. Beer and wine drinkers may also consume significant levels of fluoride with their favorite adult beverage, particularly Zinfandel, Chardonnay or Cabernet Sauvignon wines.

Clinical prevention measures. As part of a child's regular dental treatment, dentists may apply topical fluoride to developing teeth, especially for children deemed at high risk for tooth decay. This additional fluoride can be applied in various forms including rinses, gels or varnishes. The additional fluoride helps strengthen a child's developing enamel and tooth roots.

How much fluoride your family ingests depends on a number of factors like your drinking water, food purchases and dental hygiene products and procedures. If you have any concerns about how much fluoride you're encountering in your daily life, please be sure and discuss them with your dentist.

If you would like more information on fluoride's benefits for dental health, 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 “Fluoride & Fluoridation in Dentistry.”

By Boca Raton Dental Care - Manreet K. Singh, DMD
February 01, 2018
Category: Oral Health
GoodOralHygieneJustasImportantforImplantsasforNaturalTeeth

Dental implants are known for their durability as well as life-like beauty. Thanks to their unique construction and ability to integrate with bone, they have a very high success rate and can last for decades.

But while they’re less problematic than other restorations, we still can’t “set them and forget them.” While the implants themselves aren’t susceptible to disease, the supporting gums, bone and adjacent teeth are. If you want them to last as long as possible, you’ll need to care for them and the rest of your mouth through daily oral hygiene and semi-annual office cleanings.

With that said, there are a few differences in how we perform hygiene tasks with implants. This is due to the way in which they attach to the jaw, as the titanium post is inserted directly into the bone. Natural teeth, on the other hand, are held in place by the periodontal ligament, a strong connective tissue that lies between the teeth and bone. The ligament holds the teeth firmly in place while also allowing minute tooth movement in response to changes in the mouth.

The ligament also has an ample blood supply that assists with fighting infection that may arise in the tooth and its supporting gums. Without this extra source of defense, infections that arise around an implant can grow quickly into a condition known as peri-implantitis and lead to rapid bone loss that could cause the implant to fail.

That’s why you and your hygienist must be ever vigilant to the buildup of plaque, the bacterial film that gives rise to dental disease, around implants and adjacent teeth. This includes removing plaque buildup from implant surfaces, although your hygienist will use tools (scalers or curettes) made of plastic or resin rather than traditional metal to avoid scratching the implant’s dental material. They’ll likewise use nylon or plastic tips with ultrasonic equipment (which uses high vibration to loosen plaque) and lower power settings with water irrigation devices.

Keeping infection at bay with effective hygiene is the number one maintenance goal with dental implants. Doing your part along with your hygienist will help you get the most of this investment in your smile.

If you would like more information on oral hygiene with dental implants, 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 “Dental Implant Maintenance.”

By Boca Raton Dental Care - Manreet K. Singh, DMD
January 17, 2018
Category: Dental Procedures
Tags: dental implants  
YourHealthCouldAffecttheLongevityofaDentalImplant

There’s a lot to like about dental implants for replacing missing teeth. Not only are they life-like, but because they replace the root they also function much like a natural tooth. They also have another unique benefit: a track record for long-lasting durability. It’s estimated more than 95% of implants survive at least ten years, with a potential longevity of more than 40 years.

But even with this impressive record, we should still look at the few that didn’t and determine the reasons why they failed. We’ll soon find that a great number of those reasons will have to do with both oral and general health.

For example, implants rely on adequate bone structure for support. Over time bone cells grow and adhere to the implant’s titanium surface to create the durable hold responsible for their longevity. But if conditions like periodontal (gum) disease have damaged the bone, there might not be enough to support an implant.

We may be able to address this inadequacy at the outset with a bone graft to encourage growth, gaining enough perhaps to eventually support an implant. But if bone loss is too extensive, it may be necessary to opt for a different type of restoration.

Slower healing conditions caused by diseases like diabetes, osteoporosis or compromised immune systems can also impact implant success. If healing is impeded after placement surgery the implant may not integrate well with the bone. An infection that existed before surgery or resulted afterward could also have much the same effect.

Oral diseases, especially gum disease, can contribute to later implant failures. Although the implant’s materials won’t be affected by the infection, the surrounding gum tissues and bone can. An infection can quickly develop into a condition known as peri-implantitis that can weaken these supporting structures and cause the implant to loosen and give way. That’s why prompt treatment of gum disease is vital for an affected implant.

The bottom line: maintaining good oral and general health, or improving it, can help keep your implant out of the failure column. Perform daily brushing and flossing (even after you receive your implant) and see your dentist regularly to help stop dental disease. Don’t delay treatment for gum disease or other dental conditions. And seek medical care to bring any systemic diseases like diabetes under control.

If you would like more information on dental implants, 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 “Dental Implants: A Tooth-Replacement Method that Rarely Fails.”

By Boca Raton Dental Care - Manreet K. Singh, DMD
January 02, 2018
Category: Dental Procedures
JulianneHoughSharesaVideo-andaSong-AfterWisdomTeethComeOut

Once upon a time, celebrities tried hard to maintain the appearance of red-carpet glamour at all times. That meant keeping the more mundane aspects of their lives out of the spotlight: things like shopping, walking the dog and having oral surgery, for example.

That was then. Today, you can find plenty of celebs posting pictures from the dentist on social media. Take Julianne Hough, for example: In 2011 and 2013, she tweeted from the dental office. Then, not long ago, she shared a video taken after her wisdom teeth were removed in December 2016. In it, the 28-year-old actress and dancer cracked jokes and sang a loopy rendition of a Christmas carol, her mouth filled with gauze. Clearly, she was feeling relaxed and comfortable!

Lots of us enjoy seeing the human side of celebrities. But as dentists, we’re also glad when posts such as these help demystify a procedure that could be scary for some people.

Like having a root canal, the thought of extracting wisdom teeth (also called third molars) makes some folks shudder. Yet this routine procedure is performed more often than any other type of oral surgery. Why? Because wisdom teeth, which usually begin to erupt (emerge from beneath the gums) around age 17-25, have the potential to cause serious problems in the mouth. When these molars lack enough space to fully erupt in their normal positions, they are said to be “impacted.”

One potential problem with impacted wisdom teeth is crowding. Many people don’t have enough space in the jaw to accommodate another set of molars; when their wisdom teeth come in, other teeth can be damaged. Impacted wisdom teeth may also have an increased potential to cause periodontal disease, bacterial infection, and other issues.

Not all wisdom teeth need to be removed; after a complete examination, including x-rays and/or other diagnostic imaging, a recommendation will be made based on each individual’s situation. It may involve continued monitoring of the situation, orthodontics or extraction.

Wisdom tooth extraction is usually done right in the office, often with a type of anesthesia called “conscious sedation.”  Here, the patient is able to breathe normally and respond to stimuli (such as verbal directions), but remains free from pain. For people who are especially apprehensive about dental procedures, anti-anxiety mediation may also be given. After the procedure, prescription or over-the-counter pain medication may be used for a few days. If you feel like singing a few bars, as Julianne did, it’s up to you.

If you would like more information about wisdom tooth extraction, please call our office to arrange a consultation. You can learn more in the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”

By Boca Raton Dental Care - Manreet K. Singh, DMD
December 25, 2017
Category: Dental Procedures
Tags: gummy smile  
IsYourSmileTooGummyHeresHowWeMightBeAbletoImproveit

Your gums not only support and protect your teeth they also help present them in a visually attractive way. But some people’s gums seem to stand out too much — what’s commonly called a gummy smile — which diminishes their smile appeal. There’s no precise definition, but as a rule of thumb we consider a smile too gummy if four or more millimeters (about an eighth of an inch) of the gums show.

Fortunately, there are some techniques to improve a gummy smile. Which technique is best for you, though, will depend on why the gums are prominent — and causes vary. For example, you could have a gummy smile because your teeth appear too short compared to your gums.

Permanent teeth normally erupt to about 10 mm of visible length. But less than that, say 8 mm, could skew the visible proportion of gums to teeth too much toward the gums. Teeth can also appear shorter due to accelerated wear caused by grinding habits. Another cause could be the amount of upper lip rise when you smile. The lip may rise too high in a condition called hypermobility. This could reveal too much of the gums when you smile.

It’s important then to match the treatment to the cause. For example, we can enhance the appearance of shorter teeth through a surgical procedure known as crown lengthening. During this procedure a surgeon reshapes the gum tissues and underlying bone to expose more of the tooth’s length.

For upper lip hypermobility, we can restrict movement with Botox, a drug that paralyzes tiny parts of the involved muscles. This approach, though, will wear off in a few months — a more permanent solution is surgery to reposition the muscle attachments so as to prevent excessive movement.

If you’re concerned about a gummy smile, see us for a full examination and consultation. Once we know the reason why, we can offer a solution that will make your smile more attractive.

If you would like more information on enhancing the appearance of your gums, 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 “Gummy Smiles.”





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