If you're watching your weight or living with diabetes, you probably know the advantages of satisfying your sweet tooth with sugar substitutes rather than the real deal. Did you know that sugar substitutes can also help reduce your risk for tooth decay? One particular sugar stand-in, xylitol, might actually promote oral health!

Sugar substitutes are food additives that mimic the taste of sugar but supply little to no food energy (nutrition) and therefore zero or few calories. This is because they generally cannot be digested and absorbed by the body. They pass through largely unused and have little to no effect on blood sugar levels. Oral bacteria aren't able to process sugar substitutes either. They get significant nutrition from “real” sugars that pass through the mouth — generating tooth-eroding, cavity-promoting acids in the digestive process. A diet of artificial sweeteners eliminates or significantly curtails the acidity problem and essentially starves the “bad” bacteria so more tooth-friendly bacteria can crowd them out.

The Food and Drug Administration (FDA) has approved 6 artificial sweeteners (synthetically produced zero-calorie sugar substitutes) for use in the U.S.:

• Acesulfame K — Sunett®, Sweet One®
• Aspartame — Equal, NutraSweet
• Neotame — a modified form of aspartame
• Saccharin — Sweet'N Low, Sugar Twin
• Sucralose — Splenda
• Rebaudioside A — Truvia, Sun Crystals, Stevia in the Raw

There also are naturally occurring low-calorie sugar alcohols (polyols), used alone or in combination with an artificial sweetener. They are incompletely digested and absorbed slowly so the amount of calories they generate is minimal. Commonly used polyols include erythritol, maltitol, mannitol, sorbitol and xylitol. Research suggests that xylitol may help prevent tooth decay and promote oral health by reducing levels of the major acid-producing bacteria in the mouth, Streptococcus mutans.

Despite their virtues, there is debate regarding the safety of sugar substitutes — synthetic ones in particular. Currently the focus is on how they may affect taste perception, metabolism, and eating habits. From a dental perspective, however, the overall benefits for using xylitol are pretty clear!

If you would like more information about nutrition and oral 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.”

A habit can be defined as a recurrent, mostly unconscious pattern of behavior that is acquired through frequent repetition. However, there is much more to a habit than meets the eye. A major influence on childrenâ??s positive behaviors and habits are those in their environment, namely parents, siblings and peers.

Luckily, proper oral hygiene is actually one of the easier habits to instill in children. Beginning when children are toddlers and continuing into their teenage years, you can influence them to institute lifetime oral healthcare habits.

Here are a few tips to get you started:

Toddlers:

• Teach your Children How to Brush Properly. Starting at age two, when there are more teeth in your child's mouth, you should help your child establish a brushing routine. For toddlers, use a child's size soft toothbrush with water and a pea-sized amount of fluoride toothpaste. Children should be helped with brushing until at least age the age of six, at which point they will have developed enough dexterity.
• Encourage your Children to Stop Sucking Thumbs and Pacifiers by Age Three. Most children drop this habit on their own between the ages of two and four. However, problems can occur when sucking habits are allowed to go on too long, including jaw development issues and buck teeth. If you are having problems helping your child to modify his or her sucking habits, we are happy to offer you some advice and creative strategies.
• Set an Example of Healthy Eating Habits. A diet rich in sugar encourages the growth of acidogenic (acid-producing) bacteria, which cause tooth decay. Always choose water over sugary beverages, and encourage your children to do the same. When it comes to sweets, avoid sugary snacks between meals, and instead, snack on better options like fruits, vegetables and wheat crackers. Remember, if your children see you making these healthy decisions from an early age, they are likely to mimic your behaviors.

Pre-Teens and Teenagers:

• Get your Children Professional Custom-Fitted Mouthguards. These devices not only protect your children's teeth, but also the jawbones, jaw joints and soft tissues of the lip, cheeks, gums and tongue. A mouthguard made specifically for your child using a model of his or her teeth offers greater protection than an over-the-counter model.
• Warn your Teens about Oral Piercings. Tongue piercing and lip bolts create many risks for teeth and the tissues that surround them. Resulting tooth problems include chipping, sensitivity, and pain. Periodontal problems include gum recession, inflammation, infection, and bone loss. Make sure that your teen is aware of these risks.

If you would like more information about oral healthcare for your children, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “How to Help your Child Develop the Best Habits for Oral Health.”

Kids do lots of changing in the teen years, as bodies and minds begin the process of becoming more “grown up.” By now, parental reminders to brush teeth and go easy on sugary snacks might be met with rolled eyes and a groan. But there are still several ways that parents can help their teens to maintain good oral health.

1) Make sure kids get — and wear — a professionally made, custom-fitted mouthguard when playing sports.

The American Dental Association says athletes are 60 times more likely to suffer dental injury if they don't wear a mouthguard. These devices also protect the jaw, lips, cheeks, and tongue — not just the teeth. A mouthguard that's custom-made from a model of your child's teeth costs a little more, but offers greater protection than an off-the-shelf model.

2) Talk to your teens about the dangers of oral piercings.

Like tattoos and iPods, piercings are probably a sign of the times. But that doesn't make them harmless. Installing tongue and lip bolts creates a risk for the teeth and soft tissues that are nearby. Tooth chipping, sensitivity and pain, along with gum recession and infection, are some of the issues that may accompany an oral piercing. Remind teens that future dental problems may be a high price to pay for a fleeting fashion statement.

3) Get professional help if you — or your teen — develop an addiction to tobacco, alcohol or drugs, or an eating disorder.

Nobody wants to admit they aren't in control. But peer pressure, body image concerns and a host of other issues may lead teens into dangerous behaviors. The negative effect of various addictions on one's general health is well-documented; with respect to oral health, there are particular concerns. Tobacco not only stains the teeth, but causes changes in the mouth that can lead to oral cancer. Erosion of the tooth enamel is both a diagnostic signal of a potential eating disorder, and a problem that needs treatment. Don't hesitate to ask questions, particularly when an examination reveals a potential problem, and be sure to seek professional help when needed.

If you would like more information about helping your teen maintain good oral 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 “How to Help Your Child Develop the Best Habits for Oral Health.”

Compared to traditional braces, orthodontic clear aligners seem miraculous in many ways, almost too good to be true. You may be wondering if they really work. The answer is yes — but they are not for everyone.

What are orthodontic aligners and how do they work?

Clear orthodontic aligners are an alternative to traditional braces that are used to move your teeth and transform your smile without much interference to your daily life. They are removable trays made of a clear plastic material that is essentially invisible.

When using aligners, a sequence of slightly different trays is custom-made to fit over your teeth. You must wear each one 20 hours a day for two weeks before changing to the next in the series. The aligners are computer generated, designed by state-of-the-art techniques based on models and images of your own teeth. They work because slight changes in the sequential aligners gradually shift your teeth. If they are worn consistently, the process takes from six months to two or three years.

Advantages over traditional braces are:

• The aligners can be removed for eating, drinking, brushing, flossing and social occasions.
• They have no rough edges or wires, making them more comfortable.
• Changes become visible quickly as your teeth move into their new, better positions.

Clear aligners are a good solution for correcting mild to moderately crowded or incorrectly spaced teeth. They are most effective if your back teeth already fit together properly. Clear aligners are usually effective in correcting simpler or tipping movements of teeth in two dimensions. For more complex movements, traditional braces may be required. Clear aligners are usually recommended for adults whose teeth and jaws are fully developed, and not for children.

When do you need traditional fixed braces?

Traditional braces are fixed brackets attached to the teeth through which narrow, flexible wires are threaded. They may be necessary if your teeth do not meet properly, creating too much overbite or underbite. Closing spaces where teeth are missing, rotating teeth, or other complicated situations probably make you a better candidate for traditional braces.

Each particular situation is unique. To find out if clear aligners are right for you, make an appointment with us for an assessment and diagnosis of your own situation. For more information see the Dear Doctor magazine article “Clear Orthodontic Aligners.”

Dental professionals sometimes use specialized words, and you may not be clear about exactly what we mean. Test yourself on some of the specialized vocabulary concerning tooth whitening. How many of the following can you define correctly?

1. Bleaching?
A method of making yellow, discolored teeth whiter. It is relatively inexpensive and safe, with few side effects.

2. External or extrinsic staining and whitening?
Extrinsic staining mainly results from diet and smoking. For example, foods such as red wine, coffee and tea can produce extrinsic stain. Teeth with these stains are bleached by placing whitening substance in direct contact with the living tooth surface.

3. Internal or intrinsic staining and whitening?
Intrinsic tooth discoloration is caused by changes in the structure of enamel, dentin, or pulp tissue deep within the root of the tooth. When the discoloration originates with the pulp tissue, root canal treatment may be needed to whiten the tooth from the inside.

4. Chromogenic material?
Color generating material that may get incorporated into the tooth's substance. It can be a result of wear and aging, or can be caused by inflammation within the tooth's pulp.

5. Carbamide Peroxide?
A bleaching agent discovered in the 1960s and frequently used for tooth whitening. When used, carbamide peroxide breaks into its component parts, hydrogen peroxide and urea, which bleach the colored organic molecules that have been incorporated between the crystals of the tooth's enamel.

6. Power Bleaching?
This technique is used for severely stained tooth. It uses a highly concentrated peroxide (35 to 45 percent) solution placed directly on the teeth, often activated by a heat or light source. This must be done in our office.

7. Tetracycline?
An antibiotic used to fight bacterial infections. It can result in tooth staining when taken by children whose teeth are still developing.

8. Rubber Dam?
Use of strong bleaching solutions requires protection for the gums and other sensitive tissues in your mouth. This is done using a rubber dam, a barrier to prevent the material from reaching your gums and the skin inside your mouth. Silicone and protective gels may also be used.

9. Whitening Strips?
Strips resembling band-aids that you can use in your home to whiten your teeth. They generally contain a solution of 10 percent or less carbamide peroxide gel. When using them, be sure to read the directions and follow them strictly to avoid injury or irritation.

10. Fade Rate?
The effects of bleaching may fade over time, from six months to two years. This is called the fade rate. It can be slowed down by avoiding habits such as smoking, along with food or drink that causes tooth staining.

Contact us today to schedule an appointment to discuss your questions about tooth whitening. You can also learn more by reading the Dear Doctor magazine article, “Teeth Whitening.”