By E.M. Makhoul, DDS
July 19, 2018
Category: Oral Health
Tags: tooth decay  
3WaystoReducetheBacteriainYourMouththatCauseToothDecay

Tooth decay doesn’t suddenly appear out of the blue. Cavities and other damage are the result of a long process that begins with bacteria living in a thin biofilm on tooth surfaces known as plaque. These bacteria thrive on sugars from leftover food in your mouth and then produce acid as a waste product. Chronic high levels of acid cause your enamel, the protective layer of your teeth, to soften and erode.

While there are treatment options at each stage of decay — including crowning or even tooth replacement — the best approach is to try to prevent plaque buildup that supports disease-causing bacteria. Here are 3 of the best ways you can do that.

Brush and floss daily. It usually takes 12-24 hours for enough plaque buildup to support bacteria. By brushing and flossing at least once a day, you can remove most of this buildup, with twice a year dental cleanings to remove hard to reach plaque you may have missed. Be sure to use fluoride toothpaste to help strengthen enamel against high acid. And wait a half hour to an hour after eating before brushing to give saliva time to reduce the acid level in your mouth.

Cut back on sweets. You’re not the only one who loves sugary snack foods — so do oral bacteria. The more sugar and other carbohydrates they feast on, the more they produce acid. The best approach is to cut out sugar-rich snacks altogether and instead snack on fresh fruits, raw vegetables or dairy products. Limit sweet treats to meal times.

Use decay-fighting supplements. Your mouth and hygiene efforts may need a little assistance, especially if you have low saliva flow. You can boost this with an artificial saliva supplement as well as with products containing xylitol, an alcohol-based sugar. Xylitol also has an added benefit in the fight against decay because it inhibits bacterial growth. And be sure to talk with us first before taking any dental supplement.

If you would like more information on dental hygiene and care, 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 “Cost-Saving Treatment Alternatives.”

ChooseaMouthrinseCarefullyifyouwanttoEnhanceyourDentalHealth

Many people use a mouthrinse as part of their daily oral hygiene. If you’d also like to include a mouthrinse in your regimen, the kind you choose will depend on what you want it to do for you.

If your main desire is fresh breath, then a cosmetic rinse that imparts a minty smell to the mouth should fit the bill. That, however, is all they do — cosmetic mouthrinses don’t contribute to oral health beyond your personal satisfaction that your breath is free of bad odors. But, if you want more — added protection against dental disease, for example — then you’ll need to consider a therapeutic mouthrinse.

Therapeutic mouthrinses are usually described as anti-cariogenic (prevents decay) or anti-bacterial, and include both over-the-counter (OTC) and prescription rinses. Their purpose is to either strengthen teeth or reduce the mouth’s bacterial levels. Of the OTC variety, most contain a small amount of sodium fluoride, which can strengthen tooth enamel. They’ve proven highly effective: a number of studies show using a sodium fluoride mouthrinse in conjunction with brushing and flossing reduces the chances of new cavities forming.

A number of OTC rinses also have an anti-bacterial effect, usually provided by active ingredients such as triclosan, zinc or essential oils like menthol. Even a slight reduction in bacteria can help lessen the chances of gingivitis (gum inflammation), an early form of periodontal (gum) disease. Reducing bacteria levels may also help alleviate bad breath.

Some individuals, though, have higher than normal levels of bacteria, or a systemic weakness in fighting certain bacterial strains. If this is your case, you might benefit from a prescribed mouthrinse intended to lower bacterial levels. Most prescription mouthrinses contain chlorhexidine, which has been amply demonstrated as an effective anti-bacterial control of tooth decay and gum disease. Chlorhexidine prevents bacteria from adhering to the teeth and so disrupts plaque buildup, the main cause of dental disease. Its prolonged use will result in the dark staining of teeth in some people, but this can be removed during dental cleanings and teeth polishing. Long-term use is generally not preferred compared to getting the proper attention from regular cleanings and examinations.

If you would like more advice on adding a mouthrinse to your daily hygiene regimen, especially to help reduce your risk of dental disease, please feel free to discuss this with us at your next checkup. Regardless of which type of mouthrinse you choose, they should always be used as a complement to daily brushing and flossing, along with regular dental cleanings and checkups.

For more information on mouthrinses, please contact us to schedule an appointment for a consultation. 

SteelyDanFoundersDeathHighlightsImportanceofEarlyCancerDetection

Fans of the legendary rock band Steely Dan received some sad news a few months ago: Co-founder Walter Becker died unexpectedly at the age of 67. The cause of his death was an aggressive form of esophageal cancer. This disease, which is related to oral cancer, may not get as much attention as some others. Yet Becker's name is the latest addition to the list of well-known people whose lives it has cut short—including actor Humphrey Bogart, writer Christopher Hitchens, and TV personality Richard Dawson.

As its name implies, esophageal cancer affects the esophagus: the long, hollow tube that joins the throat to the stomach. Solid and liquid foods taken into the mouth pass through this tube on their way through the digestive system. Worldwide, it is the sixth most common cause of cancer deaths.

Like oral cancer, esophageal cancer generally does not produce obvious symptoms in its early stages. As a result, by the time these diseases are discovered, both types of cancer are most often in their later stages, and often prove difficult to treat successfully. Another similarity is that dentists can play an important role in oral and esophageal cancer detection.

Many people see dentists more often than any other health care professionals—at recommended twice-yearly checkups, for example. During routine examinations, we check the mouth, tongue, neck and throat for possible signs of oral cancer. These may include lumps, swellings, discolorations, and other abnormalities—which, fortunately, are most often harmless. Other symptoms, including persistent coughing or hoarseness, difficulty swallowing, and unexplained weight loss, are common to both oral and esophageal cancer. Chest pain, worsening heartburn or indigestion and gastroesophageal reflux disease (GERD) can also alert us to the possibility of esophageal cancer.

Cancer may be a scary subject—but early detection and treatment can offer many people the best possible outcome. If you have questions about oral or esophageal cancer, call our office to schedule a consultation. 

TheImplantProcesscanbeShortenedDependingontheToothType

Dental implants are considered the premier option for tooth replacement. While all implant procedures follow the same general concept — a titanium post surgically inserted into the jawbone with an attached life-like crown — the installation process can vary.

From their earliest history, implants have usually been installed through a two-stage process. In the first stage, the surgeon inserts the titanium post in the bone and leaves it “submerged” below the gum level to protect it from oral bacteria and the effects of chewing and biting. About three months later after the bone attaches to the titanium (a process called osseointegration), the surgeon then performs the second stage by re-exposing the implant and attaching a temporary abutment and crown for the patient to wear while the permanent abutment and crown are fabricated and later attached in 2-6 weeks.

In recent years, advancements in materials and design have made possible a one-stage process that allows the implant to protrude above the gum line during osseointegration and shortens the process. After the initial three-month healing period, the implant is ready for “loading” with the permanent crown.

The choice between which of these two procedures should be used for your implants will first depend on the type of tooth being replaced. A front tooth benefits from the one-stage procedure for cosmetic reasons because the surgeon can install a temporary crown to the exposed abutment during osseointegration (as long as the temporary tooth isn’t in functional contact with other teeth). An implant for a back tooth, on the other hand, doesn't have a large cosmetic demand so those one stage procedures usually end up with an exposed healing abutment but no temporary crown.

The strength of the bone is also a factor. Some bone tends to be softer, particularly in the back of the mouth. There’s a chance the implant could move in this softer bone, adversely affecting the outcome. For this reason, the two-stage procedure can be the preferred approach for posterior teeth as it offers more protection from movement.

You can be sure we’ll consider all these and other factors during your initial examination, and then advise you on the best approach. Above all, we want to make sure — whether a one-stage or a two-stage implant process — the result is a smile you can be proud of.

If you would like more information on dental implants, please contact us to schedule an appointment for a consultation. 

OralSedationHelpsReduceAnxietyDuringDentalTreatment

Eliminating pain and discomfort is one of our major objectives during dental treatment. To that end, our profession has developed a number of anesthetic drugs and deliveries that ensures your experience in the dentist’s chair is as pain-free as possible.

But there’s another experience many people have with dental care that’s different from physical discomfort — emotional anxiety. These negative emotions can range from nervousness about a procedure to extreme fear. Very often the patient has no control over these emotions — they’ve become imbedded from earlier experiences or the influence of others.

Although each can influence and heighten the other, anxiety and physical discomfort are different and require a different approach. Physical pain and sensation is eliminated through anesthesia, either locally through topical application or injection or generally through intravenous medication that renders a person unconscious. Anxiety, on the other hand, requires first building a trustful relationship with an understanding dentist. But it may also call for certain drugs that sedate — promote a feeling of relaxation — rather than numb sensation.

We’ve incorporated a number of sedative medications in dentistry like Valium or Ativan that work well to reduce anxiety before and during treatment. Many are taken orally, usually just before scheduled treatment, and they dissipate from the system quickly afterward. Some medications also have “amnesic” qualities, meaning you won’t remember anything or little at all about the treatment period. This can be helpful in amassing positive treatment experiences that may diminish negative feelings you’ve developed about dental treatment.

It’s important, though, to find the right types of medication that work well for you. For that reason we’ll take a thorough medical history, including prescription or over-the-counter medications and supplements you’re taking and any medical conditions you may have. It’s also important to discuss your diet (certain foods can inhibit the action of some sedatives) as well as if you use tobacco or regularly drink alcoholic beverages.

Taken properly, oral sedation can effectively reduce your anxiety during treatment. As a result, it will be much easier and pleasant for you to receive the care you need for a healthy mouth.

If you would like more information on reducing anxiety during dental treatment, please contact us to schedule an appointment for a consultation. 





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E.M. Makhoul, DDS

 (949) 364-3724
 27871 Medical Center Rd. Ste 105
    Mission Viejo, CA, 92691-6405