In recent decades civilization's millennia-long search for clean, safe drinking water has become much easier with modern purification methods. Today, there are few places in the United States without adequate access to potable water. And about three-fourths of the nation's tap water systems add fluoride, credited with helping to reduce tooth decay over the past half century.
But in recent years some have voiced concerns about the safety of tap water and popularizing an alternative: bottled water. Manufacturers of bottled water routinely market their products as safer and healthier than what comes out of your faucet.
But is that true? A few years ago a non-profit consumer organization called the Environmental Working Group (EWG) performed a detailed, comprehensive study of bottled water. Here's some of what they found.
Lack of transparency. It's not always easy to uncover bottled water sources (in some cases, it might actually begin as tap water), how it's processed, or what's in it. That's because unlike water utilities, which are rigorously monitored by the Environmental Protection Agency (EPA), the Food and Drug Administration (FDA) oversees bottled water production with less strenuous guidelines on labeling. Eight out of the top 10 selling brands were less than forthcoming about their water's contents in EWG's investigation.
Higher cost. According to the EPA, the average consumer cost in the last decade for tap water was $2.00 per 1,000 gallons (0.2 cents per gallon). The retail cost for even bulk bottled water is exponentially higher. It can be a costly expenditure for a family to obtain most of their potable water by way of bottled—while still paying for tap water for bathing and other necessities.
Environmental impact. Bottled water is often marketed as the better environmental choice. But bottled water production, packaging and distribution can pose a significant environmental impact. EWG estimated the total production and distribution of bottled water consumes more than 30 million barrels of oil each year. And disposable plastic water bottles have become one of the fastest growing solid waste items at about 4 billion pounds annually.
While there are credible concerns about tap water contaminants, consumers can usually take matters into their own hands with an affordable and effective household filtering system. EWG therefore recommends filtered tap water instead of bottled water for household use.
If you would like more information on drinking water options, 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 “Bottled Water: Health or Hype?”
Professional Hockey player Keith Yandle is the current NHL “iron man”—that is, he has earned the distinction of playing in the most consecutive games. On November 23, Yandle was in the first period of his 820th consecutive game when a flying puck knocked out or broke nine of his front teeth. He returned third period to play the rest of the game, reinforcing hockey players’ reputation for toughness. Since talking was uncomfortable, he texted sportswriter George Richards the following day: “Skating around with exposed roots in your mouth is not the best.”
We agree with Yandle wholeheartedly. What we don’t agree with is waiting even one day to seek treatment after serious dental trauma. It was only on the following day that Yandle went to the dentist. And after not missing a game in over 10 years, Yandle wasn’t going to let a hiccup like losing, breaking or cracking nearly a third of his teeth interfere with his iron man streak. He was back on the ice later that day to play his 821st game.
As dentists, we don’t award points for toughing it out. If anything, we give points for saving teeth—and that means getting to the dentist as soon as possible after suffering dental trauma and following these tips:
- If a tooth is knocked loose or pushed deeper into the socket, don’t force the tooth back into position.
- If you crack a tooth, rinse your mouth but don’t wiggle the tooth or bite down on it.
- If you chip or break a tooth, save the tooth fragment and store it in milk or saliva. You can keep it against the inside of your cheek (not recommend for small children who are at greater risk of swallowing the tooth).
- If the entire tooth comes out, pick up the tooth without touching the root end. Gently rinse it off and store it in milk or saliva. You can try to push the tooth back into the socket yourself, but many people feel uneasy about doing this. The important thing is to not let the tooth dry out and to contact us immediately. Go to the hospital if you cannot get to the dental office.
Although keeping natural teeth for life is our goal, sometimes the unexpected happens. If a tooth cannot be saved after injury or if a damaged tooth must be extracted, there are excellent tooth replacement options available. With today’s advanced dental implant technology, it is possible to have replacement teeth that are indistinguishable from your natural teeth—in terms of both look and function.
And always wear a mouthguard when playing contact sports! A custom mouthguard absorbs some of the forces of impact to help protect you against severe dental injury.
If you would like more information about how to protect against or treat dental trauma or about replacing teeth with dental implants, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Dental Implants: A Tooth-Replacement Method That Rarely Fails” and “The Field-Side Guide to Dental Injuries.”
The market for sugar alternatives has grown exponentially since saccharin was accidentally discovered in 1878. Today, saccharin has been joined by other FDA-approved zero-calorie artificial sweeteners, including aspartame (“Equal®” or “NutraSweet®”), sucralose (“Splenda®”) and rebaudioside A, derived from the stevia plant. You can also choose low-calorie alcohol sugars like erythritol or xylitol.
With rare exceptions, all these choices are widely considered safe substitutes for table sugar, high fructose corn syrup or other versions of this plentiful carbohydrate. Finding substitutes for sugar is a worthy health goal: besides its role in obesity, sugar is considered a contributing factor in cardiovascular disease and diabetes.
It's also a prime food for oral bacteria that cause dental disease. As bacteria consume sugar they produce acid as a byproduct. Acid softens and dissolves the mineral content in enamel, leading to erosion and the formation of cavities. While saliva normally neutralizes acid after we eat, constant snacking and higher quantities of sugar in our food make it difficult for it to control or neutralize acid in the oral environment.
Because most of us are hard-wired with a “sweet tooth,” it's difficult for many to cut back on sugar. Artificial sweeteners help reduce the amount of sugar in the diet with obvious benefits for general health. It can also make a big difference in your dental health by helping you prevent tooth decay.
One alcohol sugar may even go a step further. In addition to reducing the presence of sugar in the mouth, xylitol (found in chewing gums, candy and breath mints) also seems to reduce bacterial growth by interfering with their ability to ferment the sugar.
If you're considering using an artificial sweetener, get to know them first: some like aspartame aren't suitable for baked goods or cooking, while saccharine or sucralose are. People with a rare genetic condition called phenylketonuria also can't properly process aspartame in the body.
Be sure you also talk to us about artificial sweeteners' impact on oral health, especially the benefits of xylitol for dental care. Used in a wise and informed way, these sugar alternatives can improve both your oral and general health.
If you would like more information on artificial sweeteners impact on 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 “Artificial Sweeteners: Satisfying and Protecting your Sweet Tooth.”
Most children's permanent teeth erupt on a fairly predictable schedule. Sometimes, though, one or more teeth might not develop as they should — or at all.
These absent teeth pose functional problems for chewing and hygiene, which can affect long-term dental health. But they can also have a disruptive effect on an otherwise attractive smile if the missing teeth are the upper lateral incisors in the most visible part of the smile.
You normally find this pair of teeth on either side of the upper central incisors (the two front-most teeth). On the other side of the lateral incisors are the canine or eye teeth, known for their pointed appearance. Without the lateral incisors, the canines tend to drift into the space next to the central incisors. This can produce an odd appearance even a layperson will notice: only four teeth where there should be six!
It's possible to correct this abnormality, but it will take time and expense. The first step is usually to move the teeth in the upper jaw with braces to their correct position. This puts teeth where they should be and also opens space between the canines and central incisors so we can eventually replace the missing teeth with dental implants.
But the key to all this is timing. It's usually appropriate to undertake tooth movement with braces during late childhood or adolescence. But implants shouldn't be installed until the person's jaw fully matures, usually in early adulthood. An implant placed before then could eventually become misaligned.
To accommodate the time between bite correction and implant placement, the patient can wear a retainer appliance that will keep the newly created space open. We can also attach artificial teeth to the retainer to camouflage the empty space.
It usually takes a team of a family dentist, an orthodontist and a surgeon to see this kind of “smile makeover” project through, possibly over several years. But the gains in better aesthetics and health are well worth the time and expense.
If you would like more information on replacing non-developing 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 “When Permanent Teeth Don't Grow.”
The first week of April is National Public Health Week, putting the spotlight on health issues that impact us all. The popular practice of vaping is one of those top issues this year due to its connection with recent lung illnesses and deaths. But this isn't a new problem—dentists have been critics of vaping for some time now over the growing evidence of its effect on oral health.
Vaping is the popular term for inhaling aerosol vapors through an e-cigarette (or e-cig for short). The electronic device contains a small reservoir filled with flavored liquids that contain nicotine and other chemicals. The device heats the liquid, turning it into a vapor that's inhaled or “vaped” into the lungs.
Vaping has been touted by proponents as a safer alternative to cigarette smoking. But there's growing evidence that vaping isn't a kinder and gentler way to “smoke.” A good portion of that evidence comes from dentists who routinely treat oral problems caused or worsened by vaping.
In reality, the adverse effects of vaping on oral health aren't much different from smoking. Like smoking, vaping ingredients can irritate the inside of the mouth and cause dryness, an ideal environment for dental disease. And nicotine, the main chemical in both vaping and smoking, constricts blood vessels that deliver nutrients and disease-fighting antigens to the gums and teeth.
If these hazards weren't bad enough, recent clinical findings seem to indicate they're only the tip of the iceberg. Researchers from New York University's (NYU) College of Dentistry have found evidence from a combined study of cigarette smokers, e-cig users and non-smokers that vaping may significantly alter the mouth's microbiome to the ultimate detriment of oral health.
A “microbiome” is a term describing the intricate relationship between the millions of microorganisms inhabiting the human body and the body itself. While a few are malicious, many, namely in the gut and mouth, help the body obtain nutrients from food and fight against disease. Disrupting that delicate balance opens the door to diminished health.
The NYU researchers found that both smokers and e-cig users had higher levels of pathogenic bacteria in their saliva than non-smokers, suggesting both habits disrupted the mouth's microbiome balance enough to allow less benevolent bacteria to flourish. They also found that both smokers and e-cig users had significantly higher incidences of gum disease (72.5% and 42.5%, respectively) than non-smokers (28.2%).
If you're a smoker, a cessation program to quit the habit—not switching to vaping—is the way to a healthier life. If you would like more information about the effects of vaping on your oral health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Vaping and Oral Health.”
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