Smiles By Design

Ankyloglossia

Ankyloglossia, often referred to as “tongue tie,” is a common congenital anomaly that is usually detected soon after birth. It is characterized by partial fusion-or in rare cases, total fusion-of the tongue to floor of the mouth due to an abnormality of the lingual frenulum.

By definition, a frenulum, which is a small frenum, is a narrow fold of mucous membrane connecting a moveable part to a fixed part. Its purpose is to stabilize and check undue movement of that part. The lingual frenulum is generally under the mid-portion of the tongue. As such, it can help to stabilize the base of the tongue but does not interfere with tongue tip movement. With ankyloglossia, however, the lingual frenulum has an anterior attachment near the tip of the tongue and may also be unusually short. This causes virtual adhesion of the tongue tip to the floor of the mouth and can result in restricted tongue tip movement to some extent.

The diagnostic characteristics of ankyloglossia are easy to detect. Usually, the patient is unable to protrude the tongue past the edge of the lower gingiva or mandibular incisors. With protrusion attempts, the tongue tip becomes notched in midline, resulting in a heart-shaped edge. In addition, the patient is unable to touch the roof of the mouth with the tongue tip when the mouth is open. A diagnostic classification system of severity has been proposed by Kotlow (1999).

The prevalence of ankyloglossia is unclear, since the reported figures vary significantly from less than 1% to as frequent as 97% in newborns (Lewis & Counihan, 1965). More recent reports place the prevalence at about 4%-5% in newborns (Messner et al., 2000; Ricke et al., 2005).

Although ankyloglossia can be significant at birth, the severity and functional effects tend to decrease with time and oral growth. During the first 4 to 5 years of life, the oral cavity changes significantly in shape and size. The alveolar ridge grows in height, the teeth begin to erupt, and the tongue grows and narrows at the tip. At the same time, the lingual frenulum recedes, stretches, and may even rupture. Therefore, as the child grows, the severity of the tongue-tie lessens and the initial restrictions of lingual movement are diminished.

Benign Migratory Glossitis

Migratory glossitis is a psoriasis-like or psoriasis-related condition of the tongue resulting in the production of snaky white lines on the tops and sides, often with small parallel grooves adjacent to them. As in psoriasis, these lines “roam” around the tongue, changing locations or appearances on a weekly, sometimes daily, basis. Many times these lines slowly radiate from a central area of smooth red mucosa, i.e. the normal tongue papillae or “bumps” disappear temporarily. The latter appearance often imparts an appearance similar to that of a globe of the Earth, with irregular white lines representing outlines of continents, hence, the common name for this disease: geographic tongue. Occasional patients have no white lines but have instead smooth red patches, sometimes with small grooves at their edges. Migratory glossitis is usually without symptoms, but some may complain of a burning or tingling sensation, often from secondary fungus or bacterial infection, possibly from a developing anemia (unrelated to the geographic tongue). No treatment is normally needed, but antifungal and antibacterial medications may be used for symptomatic cases; topical or systemic cortisone or prednisone may also be effective. There is no malignant potential.

Cavities

a chemical that helps to prevent decay of the tooth. the inner most layer of a tooth.where silver, and mercury are combined to make a filling. A term used by dentists for decay. a pit or area ravaged by decay. the layer under enamel. outside the dentin, this layer is very strong. Plaque: this substance looks like a soft substance that clings to a tooth. This substance is, in fact the bacteria, protozoa, mycoplasmas, yeasts and viruses clumped in a gel-like material. This mix also contains byproducts from the bacteria, some WBC, debris from mood and some body tissue. Plaque starts forming after a tooth is cleaned; it takes about 60 min for plaque to build up. As time goes on, different types of microorganisms appear, and the plaque thickens. This plaque gets bigger when the bacteria cling to teeth and begin to multiply.

this substance looks like a soft substance that clings to a tooth. This substance is, in fact the bacteria, protozoa, mycoplasmas, yeasts and viruses clumped in a gel-like material. This mix also contains byproducts from the bacteria, some WBC, debris from mood and some body tissue. Plaque starts forming after a tooth is cleaned; it takes about 60 min for plaque to build up. As time goes on, different types of microorganisms appear, and the plaque thickens. This plaque gets bigger when the bacteria cling to teeth and begin to multiply. Calculus —Calculus is not only a difficult type of math, it is also an advanced from of plaque. If plaque is not gotten rid of quickly, is absorbs calcium and phosphorus from minerals in the saliva and calcifies into a much harder substance called calculus. This is not the end, new plaque can from on top of calculus to from even more calculus. A dentist can rid the teeth of calculus with the proper tools however, all that is required is a simple cleaning with the proper tools, flossing is not sufficient for removing calculus.

—Calculus is not only a difficult type of math, it is also an advanced from of plaque. If plaque is not gotten rid of quickly, is absorbs calcium and phosphorus from minerals in the saliva and calcifies into a much harder substance called calculus. This is not the end, new plaque can from on top of calculus to from even more calculus. A dentist can rid the teeth of calculus with the proper tools however, all that is required is a simple cleaning with the proper tools, flossing is not sufficient for removing calculus. Saliva — Saliva is produced in and secreted from salivary glands. The basic secretory units of salivary glands are clusters of cells called an acini. These cells secrete a fluid that contains water, electrolytes, mucus and enzymes, all of which flow out of the acinus into collecting ducts. There is not much appreciation for saliva, but this simple bodily fluid is very essential to the health of the oral cavity, it even has enzymes in it that can break down carbohydrates! Saliva helps to keep bacteria and viruses out of the mouth while keeping the alkane levels in the mouth a safe level. It also helps to lubricate the surfaces of the teeth so food cannot cling to them as easily.

—Saliva is produced in and secreted from salivary glands. The basic secretory units of salivary glands are clusters of cells called an acini. These cells secrete a fluid that contains water, electrolytes, mucus and enzymes, all of which flow out of the acinus into collecting ducts.There is not much appreciation for saliva, but this simple bodily fluid is very essential to the health of the oral cavity, it even has enzymes in it that can break down carbohydrates! Saliva helps to keep bacteria and viruses out of the mouth while keeping the alkane levels in the mouth a safe level. It also helps to lubricate the surfaces of the teeth so food cannot cling to them as easily. Bacteria — Our mouths contain many different kinds of bacteria with some being beneficial for the mouth. They help control destructive bacteria, Streptococcus mutans one of the bacteria that causes the most damage. It produces acid after it attaches to the teeth.

— Our mouths contain many different kinds of bacteria with some being beneficial for the mouth. They help control destructive bacteria, one of the bacteria that causes the most damage. It produces acid after it attaches to the teeth. Causes for tooth decay

Sugars, especially sucrose, react with bacteria to produce acid. The acid from the bacteria can decay your teeth.

It’s not just candy and ice cream we’re talking about. All carbohydrate foods, as they are digested, eventually break down into simple sugars, such as glucose and fructose. Some of this digestion begins in the mouth. Foods that break down into simple sugars in the mouth are called fermentable carbohydrates. These include the obvious sugary foods, such as cookies, cakes, soft drinks and candy, but also pretzels, crackers, bananas, potato chips and breakfast cereals. The sugars in these foods combine with the bacteria normally in the mouth to form acids. These acids cause the mineral crystals inside the teeth to begin to dissolve.

The dental caries lesion forms when these acids start to dissolve a tooth’s outer protective layer, the enamel. A cavity forms when the tooth decay breaks through the enamel to the underlying layers of the tooth. You can reverse a caries lesion (before it becomes a cavity) by using a variety of fluoride products. These include fluoridated water, fluoride rinses for use at home, and, of course, any commonly used fluoridated toothpaste.

Every time you eat, the bacteria in your mouth produce acid. Therefore, the more times you eat the more times your teeth are exposed to an acid attack.

The levels of tooth decay

A white spot appears on the enamel where the tooth has started to weaken inside. At this stage, the tooth can repair the weakened area with the help of fluoride and minerals in saliva. But if the decay continues and breaks through the surface of the enamel, the damage is permanent. The decay must be cleaned out and the cavity filled by a dentist. Left untreated, the decay will worsen and destroy a tooth all the way through the outer enamel layer, through the inside dentin layer and down to the pulp or nerve of the tooth.

In young children, teeth that have recently emerged have weak enamel and are highly susceptible to acid decay. A type of decay called baby bottle tooth decay or early childhood caries destroys enamel quickly and is common in children. This type of decay can eat through enamel and leave a large cavity in a matter of months.

Older adults sometimes have chronic caries: cavities that don’t seem to get any worse or do so at a very slow rate. Teeth with chronic caries will tend to be darker in color because the edges of the cavities become stained from normal eating and drinking.

Root caries (decay in the roots of the teeth) is more common in older adults. Older adults are more likely to have gums that have receded from years of hard brushing or periodontal disease. They also are more likely to have dry mouth xerostomia which increases the risk of decay. Dry mouth is caused by many common medicines. Be sure to ask the doctor or pharmacist if any of your medicines cause dry mouth.

Decay can form beneath fillings or other restorations, such as crowns. Sometimes, bacteria and food particles can slip into a tooth if a filling hasn’t been placed properly or if the filling cracks or pulls away from the tooth, leaving a gap.

Preventative dental care

Dental research has identified factors that increase your risk of getting decay. Next time you visit the dental office, ask about your risk factors and discuss the best ways to reduce your risks and limit dental decay.

Everyone should brush at least twice a day, preferably three times or after every meal. In addition, you should floss at least twice a day. These activities remove plaque, which is a complex mass of bacteria that constantly forms on your teeth. If plaque isn’t removed every day, it can process sugars found in most foods and drinks to form acids that lead to decay. Bacterial plaque also causes gingivitis and other periodontal diseases. It’s important to brush and floss correctly and thoroughly, removing plaque from all tooth surfaces and where the tooth meets the gums. If plaque is not removed, it can lead to gum problems and cavities. To prevent your teeth from decaying, you can do two things — strengthen your teeth’s defenses with fluoride and sealants, and reduce the number of bacteria in your mouth. Flouride trengthens teeth by penetrating the tooth structure and replacing lost minerals to repair acid damage. Everyone should brush with a fluoride toothpaste every day. Dental offices sometimes recommend additional toothpastes, gels and mouthrinses for both children and adults. Sealants are protective coatings placed over the tops of chewing teeth — molars and premolars. They block bacteria and acids from sticking in the tiny grooves on the chewing surfaces of these teeth. Children should get sealants soon after their teeth erupt into the mouth.

Although you can never get rid of all the bacteria in your mouth, you can control bacteria by brushing regularly and flossing daily, seeing your dentist and dental hygienist regularly for a thorough cleaning and check-up, and reducing the number of times each day that you consume fermentable carbohydrates.

Some prescription mouthwashes (those that contain chlorhexidine) can help prevent decay by reducing the number of bacteria in the mouth. Chewing sugarless gums, especially those with xylitol, can help reduce decay and increase the flow of saliva.

Dentist

Information on Dentistry

A dental hygienist performs many of the fundamental functions that we experience in a typical Dentist office visit. With a licensed degree as a Registered Dental Hygienist (RDH), these professionals are skilled in preventative dental care. However, a hygienist is not a dentist, but is often consulted more in a seattle dentist’s office visit for preventative dentistry.Dental hygienists are usually the people to see for x-rays and regular teeth cleaning. Oral examinations and dental work, such as fillings and various treatments, are done by the dentist directly. Under their RDH license, hygienists are specialized in removing plaque and calculus, along with treating diseased gum tissue.

A facelift at the Dentist? To better understand the issue and make an informed decision, it is important to know the training of each specialist.

Answer: This is one of the most common questions I get from a new patient who was dissatisfied with their previous dentist. The answer is not as simple as it might seem. In general, a patient who questions the accuracy of the dentist’s diagnosis falls into one of three categories. He or she is either fearful of having the treatment done, does not like how they were treated by dentist or the staff, or has not been given a clear explanation of what needs to be done and why. To put it simply, the patient does not trust the Dentist. When ever you have doubts about the type of treatment that you need, ask questions. In this instance, you might ask how you can have all those cavities and need crowns, but not have any pain. The dentist can then explain that most cavities will often have no symptoms. It is not until the cavity is fairly deep that you begin to feel sensitivity to cold or hot foods and beverages. By that time, the tooth will often require a root canal to treat the cavity that has infected it.

Most people come to their dentist with a cooperative attitude and in good faith. The Dentist is often someone they have known for many years, and trust. These dentists are usually able to provide the dental care necessary for their patients, and both are satisfied. When a person starts going to a new dentist, the situation is completely different. The patient and dentist have no experience or history with each other, and problems can sometimes occur. The Dentist’s style or communication skills may present a barrier to the patient. The patient may perceive a lack of confidence or competence from the new dentist. In these situations, it may be wise for the patient to seek a second opinion. I do not recommend that any patient proceed with dental treatment unless they have a high degree of confidence in their Dentist. Sometimes it is the dentist who needs a second opinion. In fact, I will ask my patient to go for a second opinion when the need arises. A good example is when I find what I suspect may be oral cancer. In this situation, I will refer my patient to an oral surgeon to get his diagnosis and treatment recommendations. A second opinion and teamwork between the seattle dentist, dental specialist, and patient are often vital to getting the best possible outcome.

There are some instances when second opinions are not helpful. It is when the second opinion becomes a fourth, fifth, sixth opinion, or more. These are the patients that keep hearing the same thing from each dentist, but hope to hear something different. If they do finally hear what they want to hear from the “seventh” Dentist, it may not be in their best interest. Laser tooth whitening is one option among many. It is preferable for some due to the short amount of time the procedure takes. This whitening treatment must be supervised by a seattle dentist. The effects of the treatment will vary from person to person. Teeth that appear yellowish will most likely achieve a better effect than someone who has grayish teeth.

Dentists diagnose, prevent, and treat problems with teeth or mouth tissue. They remove decay, fill cavities, examine x rays, place protective plastic sealants on children’s teeth, straighten teeth, and repair fractured teeth. They also perform corrective surgery on gums and supporting bones to treat gum diseases. Dentists extract teeth and make models and measurements for dentures to replace missing teeth. They provide instruction on diet, brushing, flossing, the use of fluorides, and other aspects of dental care. They also administer anesthetics and write prescriptions for antibiotics and other medications.

Dentists use a variety of equipment, including x-ray machines; drills; and instruments such as mouth mirrors, probes, forceps, brushes, and scalpels. They wear masks, gloves, and safety glasses to protect themselves and their patients from infectious diseases.

Most Dentist are general practitioners, handling a variety of dental needs. Other Dentist practice in any of nine specialty areas. Orthodontists, the largest group of specialists, straighten teeth by applying pressure to the teeth with braces or retainers. The next largest group, oral and maxillofacial surgeons, operates on the mouth and jaws. The remainder may specialize as pediatric dentists (focusing on dentistry for children); periodontists (treating gums and bone supporting the teeth); prosthodontists (replacing missing teeth with permanent fixtures, such as crowns and bridges, or with removable fixtures such as dentures); endodontists (performing root canal therapy); public health dentists (promoting good dental health and preventing dental diseases within the community); oral pathologists (studying oral diseases); or oral and maxillofacial radiologists (diagnosing diseases in the head and neck through the use of imaging technologies).

Most Dentist work 4 or 5 days a week. Some work evenings and weekends to meet their patients’ needs. Most full-time dentists work between 35 and 40 hours a week, but others work more. Initially, dentists may work more hours as they establish their practice. Experienced dentists often work fewer hours. Many continue in part-time practice well beyond the usual retirement age.

Most dentists are solo practitioners, meaning that they own their own businesses and work alone or with a small staff. Some Dentists have partners, and a few work for other Dentists as associate dentists.

All 50 States and the District of Columbia require dentists to be licensed. To qualify for a license in most States, candidates must graduate from 1 of the 56 dental schools accredited by the American Dental Association’s (ADA’s) Commission on Dental Accreditation in 2004, and then must pass written and practical examinations. Candidates may fulfill the written part of the State licensing requirements by passing the National Board Dental Examinations. Individual States or regional testing agencies administer the written or practical examinations.

Dental schools require a minimum of 2 years of college-level predental education, regardless of the major chosen. However, most dental students have at least a bachelor’s degree. Predental education emphasizes coursework in science, and many applicants to dental school major in a science such as biology or chemistry, while other applicants major in another subject and take many science courses as well. A few applicants are accepted to dental school after 2 or 3 years of college and complete their bachelor’s degree while attending dental school.

All dental schools require applicants to take the Dental Admissions Test (DAT). When selecting students, schools consider scores earned on the DAT, applicants’ grade point averages, and information gathered through recommendations and interviews. Competition for admission to dental school is keen.

Dental school usually lasts 4 academic years. Studies begin with classroom instruction and laboratory work in basic sciences, including anatomy, microbiology, biochemistry, and physiology. Beginning courses in clinical sciences, including laboratory techniques, also are provided at this time. During the last 2 years, students treat patients, usually in dental clinics, under the supervision of licensed dentists. Most dental schools award the degree of Doctor of Dental Surgery (DDS). The rest award an equivalent degree, Doctor of Dental Medicine (DMD).

Some dental school graduates work for established dentists as associates for 1 to 2 years to gain experience and save money to equip an office of their own. Most dental school graduates, however, purchase an established practice or open a new one immediately after graduation.

In 2004, 17 States licensed or certified dentists who intended to practice in a specialty area. Requirements include 2 to 4 years of postgraduate education and, in some cases, the completion of a special State examination. Most State licenses permit dentists to engage in both general and specialized practice. Dentist who want to teach or conduct research usually spend an additional 2 to 5 years in advanced dental training, in programs operated by dental schools or hospitals. According to the ADA, each year about 12 percent of new graduates enroll in postgraduate training programs to prepare for a dental specialty.

Dentist requires diagnostic ability and manual skills. Dentist should have good visual memory, excellent judgment regarding space and shape, a high degree of manual dexterity, and scientific ability. Good business sense, self-discipline, and good communication skills are helpful for success in private practice. High school and college students who want to become dentists should take courses in biology, chemistry, physics, health, and mathematics.

Employment of Dentist is projected to grow about a fast as average for all occupations through 2014. Although employment growth will provide some job opportunities, most jobs will result from the need to replace the large number of dentists expected to retire. Job prospects should be good as new dentists take over established practices or start their own.

Demand for dental care should grow substantially through 2014. As members of the baby-boom generation advance into middle age, a large number will need complicated dental work, such as bridges. In addition, elderly people are more likely to retain their teeth than were their predecessors, so they will require much more care than in the past. The younger generation will continue to need preventive checkups despite treatments such as fluoridation of the water supply, which decreases the incidence of tooth decay. However, employment of dentists is not expected to grow as rapidly as the demand for dental services. As their practices expand, dentists are likely to hire more dental hygienists and dental assistants to handle routine services.

Dentistwill increasingly provide care and instruction aimed at preventing the loss of teeth, rather than simply providing treatments such as fillings. Improvements in dental technology also will allow dentists to offer more effective and less painful treatment to their patients.

Redmond Dentist

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