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Fluoride: A Comprehensive Examination

Julie Mastbrook2020-06-11T13:28:22+00:00September 19th, 2019|Oral Health|

Fluoride. We’re all familiar with the substance. In fact, it’s so common in our modern society, that we tend to take for granted what a complex mineral it actually is.

The Basics of Fluoride

So, what exactly is fluoride anyway? If you’re hunting for it on the Periodic Table, you’ll need to update your search a bit. Fluoride actually gets its name from the naturally occurring element Fluorine (F). Fluorine in its purest state is a gas that can be irritating to people when they are exposed to it. However, add a little sodium into the mix and suddenly, you have the fluoride we’re all familiar with; an easily dissolvable, safe in small doses, inhibitor of dental cavities substance. Fluoride can be found in everything from the water you drink to the food you eat. Additionally, it’s used to help waterproof and stainproof items (think Gore Tex®) and is even used in welding as well as the process of frosting glass.

Fluoride in Our Water

Let’s start our fluoride journey with a short lesson in history. Chances are, the tap water you’re currently drinking is supplemented with a small amount of fluoride to aid the general population in maintaining a healthy, white smile. But did you ever consider how the idea to add fluoride to your water came to be? You might be surprised to learn that the first city to add fluoride to their water, Grand Rapids, Michigan, did so back in 1944. However, this was not before over 40 years of research was performed as a way to better understand the relationship between teeth and fluoride.

Dr. Trendley Dean, head of the Dental Hygiene Unit at the National Institute of Health, was responsible for the initial introduction of fluoride into the public water system. As a doctor, he witnessed mottled enamel in populations where the water supply contained a higher concentration of fluoride. While he noticed that mottled enamel from excess fluoride exposure created unsightly brown spots on teeth, he also observed that those same patients had an unexpectedly high resistance to cavities. This triggered the idea that smaller, more manageable doses of fluoride could potentially be beneficial to communities as a whole. He presented his findings to the city of Grand Rapids and convinced them to add it to the community’s water supply. After 15 years of testing, it was determined that children born after the fluoride had been introduced into the city’s system decreased their risk of getting cavities by as high as 60%. Today over 200 million Americans benefit from the addition of fluoride in their water systems and worldwide that number is even higher.

The Benefits of Fluoride

We now have a better understanding of what fluoride is and where it comes from, but what about the risks and benefits? As with any substance, there is a laundry list for both. Let’s first explore some of the benefits of using fluoride, especially as it pertains to human health.

When we think of the benefits of using fluoride, our minds instantly turn to the positive outcomes in dental health and for good reason. Study after study proves the benefits that the consistent use of fluoride has on our smiles and, in turn, our overall health. Here are a few quick facts taken from the American Dental Association (ADA) as it relates to fluoride:

Fluoride is a natural substance
It is safe and effective in protecting against tooth decay
Fluoride in drinking water has reduced tooth decay in the US by 20% to 40%
Children specifically have seen a 35% reduction in decayed or missing baby teeth
Fluoride not only helps prevent cavities but also helps to strengthen enamel
It can reduce the occurrence of demineralized enamel in addition to aiding in the remineralization of currently affected areas

Fluoride also has benefits to human health outside of teeth. A recent study published in 2018 in the Journal of Fluorine Chemistry provides evidence that adding fluoride into cancer-fighting drugs can increase their overall effectiveness. Researchers learned that the addition of fluoride helped anti-cancer drugs to better permeate membranes and more effectively target the bad cancer cells versus traditional chemotherapy which targets both good and bad cells. Creating a more targeted and stable cancer-fighting drug can essentially help people to live longer and maintain a higher quality of life.

Understanding the Risks

While fluoride has revolutionized modern-day dental care, it can still pose risks if consumed at elevated levels. Let’s dive in and examine a couple of the more common risks and side effects caused by excessive fluoride consumption.

Dental Fluorosis is a condition that can occur in young children under the age of eight who are exposed to excessive amounts of fluoride. It appears on the teeth as white streaks or spots and can usually be detected by your dentist. Children at this age are still developing their adult teeth beneath the gum line which is where the condition can occur. Once teeth penetrate through the gum line, fluorosis will stop developing. Typically, mild fluorosis will not affect the way a child’s teeth function and can sometimes improve the enamel’s ability to fight decay. That being said, it is always best to aim for the right level of fluoride for your child’s needs. Here are a few helpful tips to ensure your child is on the right track with their fluoride consumption.

CHILDREN UNDER 3 YEARS OLD

If possible, breastfeed your child exclusively for the first six months and then add in solids while continuing to breastfeed for at least 12 months.
If you are using formula, be sure to consult with your doctor regarding the best type to use as some infant formulas contain fluoride in the powder which, if mixed with fluoridated water, could potentially cause extra fluoride to be consumed.
Once teeth begin to appear, follow the ADA guidelines that suggest brushing teeth twice a day.
Be sure to use no more than the recommended amount of toothpaste when cleaning your child’s teeth.

CHILDREN AGES 3 TO 8

Continue to follow the ADA guidelines that suggest brushing teeth twice daily.
Teach children to only use a pea-sized amount of toothpaste when brushing their teeth. A little goes a long way!
Educate your children on fluoride safety by showing them how to spit out their toothpaste when finished instead of swallowing. Fluoride-free toothpaste works great at this age to help prevent swallowing accidents.
Never use mouthwash at this age because many times kids will swallow more than they spit out due to the fact that they don’t yet have a fully matured swallowing reflex.

Skeletal Fluorosis is a more severe condition caused by excess fluoride over a prolonged period of typically 10 or more years. In addition to affecting the teeth, skeletal fluorosis can also affect the bones and joints causing severe pain and sometimes even disability. This type of fluorosis is present worldwide and is endemic in certain countries with water supplies containing naturally elevated levels of fluoride.

Other potential issues and side effects of excess fluoride include acne, fertility issues, high blood pressure, and hyperparathyroidism. It is important to note that none of these issues will result from simply drinking tap water. All of these outcomes are a result of excess fluoride consumption in addition to regulated levels. If digested in the proper dose, the health benefits of fluoride almost always outweigh the risks.

Fluoride in Food

In addition to toothpaste and tap water, you might be surprised to learn that fluoride also exists in some of the everyday foods we eat. Let’s examine a few of the options below.

Black Tea – a single cup of black tea can contain as much as 9% of a man’s daily fluoride needs and up to 13% of a woman’s. This fluoride is found in the tea leaves themselves and is not due to the use of fluoridated water. Older leaves contain more fluoride than younger leaves and green tea contains higher levels than black. Higher quality tea tends to consist of younger leaves, so when looking at brands, quality really does matter in this instance. Adding fluoridated water to your tea will up the overall percentage.

White Wine – One glass of white wine such as chardonnay, can contain up to 7.5% of a man’s daily fluoride needs and up to 10% of a woman’s. Wine consumption should be limited to no more than two glasses a day for men and one glass for women. Additionally, choosing wines produced outside of California and/or the United States will typically also lower the levels of fluoride in the product.

Canned Crab – While other kinds of seafood such as oysters also contain fluoride, canned crab takes the crown for the highest levels. A 3.5 ounce serving of canned crab contains just over 5% of a man’s daily allowance and 7% of a woman’s.

Baked Potatoes – One decent-sized baking potato contains approximated 3.5% of a man’s daily intake of fluoride while for women that number is a bit higher at around 5%.

To put these numbers into a bit more perspective, note that daily intake overall for men should be 4 milligrams whereas for women it’s a bit less at 3 milligrams.

Fluoride is a vital tool in the fight for healthy teeth and gums. When used correctly, it can prevent cavities from forming and help you to maintain a bright, white smile. If you have any additional questions about fluoride or are curious about how we use fluoride to aid in your dental health, please don’t hesitate to contact our office at any time. We look forward to hearing from you!

Works Cited

Biolase. “Five Fascinating Facts About Fluoride.” BIOLASE, 24 Aug. 2018, https://www.biolase.com/blog/five-fascinating-facts-fluoride/.

“Fluoride.” Oral Health Foundation, https://www.dentalhealth.org/fluoride.

“Fluorosis.” Mouth Healthy TM, American Dental Association, https://www.mouthhealthy.org/en/az-topics/f/fluorosis.

Kerns, Michelle. “Foods Containing Fluoride.” LIVESTRONG.COM, Leaf Group, https://www.livestrong.com/article/532986-foods-containing-fluoride/.

Krishnamachari, K A. “Skeletal Fluorosis in Humans: a Review of Recent Progress in the Understanding of the Disease.” Progress in Food & Nutrition Science, U.S. National Library of Medicine, 1986, https://www.ncbi.nlm.nih.gov/pubmed/3295994.

Nordqvist, Christian. “Fluoride: Risks, Uses, and Side Effects.” Medical News Today, MediLexicon International, 21 Feb. 2018, https://www.medicalnewstoday.com/articles/154164.php.

“The Story of Fluoridation.” National Institute of Dental and Craniofacial Research, U.S. Department of Health and Human Services, July 2018, https://www.nidcr.nih.gov/health-info/fluoride/the-story-of-fluoridation.

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The ABC’s of Whitening Toothpaste

Julie Mastbrook2020-07-16T16:54:54+00:00July 8th, 2019|Dental Trends, General, Oral Health, Teeth Cleaning, Teeth Whitening|

Teeth whitening is on the rise across the country. In 2018 alone, over 40.5 million people used some form of bleaching product to improve their smiles. Whitening toothpaste, in particular, is marketed as an affordable way to brighten your smile, but is it actually doing more harm than good?

A Brief History of Tooth Whitening

Despite its recent rise in popularity, you might be surprised to learn that the process of teeth whitening has been around for over 4,000 years. Egyptians were some of the first known people to follow the practice. They used ground pumice stone soaked in vinegar to improve their overall smiles. As time progressed, so did the methods. During the 1600’s people actually relied on their barbers to whiten their teeth in addition to cutting their hair. The barber would file the teeth down and then soak them in nitric acid as a way to whiten someone’s smile. Fluoride was discovered as a way to protect teeth in the early 19th century and toothpaste as we currently know it began to make its way to the public around 1945. Finally, in 1989, Rembrandt officially launched the first whitening toothpaste into the grocery market effectively empowering the general public to whiten their teeth with an affordable over-the-counter product.

Today there are hundreds of different brands of whitening toothpaste to choose from and not all are created equal. With everything from big names to natural alternatives vying for space on the shelves, it’s hard to know which path to take.

Understanding Extrinsic vs. Intrinsic Tooth Whitening

In order to understand how whitening toothpaste affects your smile, it’s helpful to first understand how the process of whitening works. When we observe stains on our teeth, we are generally seeing two types, extrinsic and intrinsic. Extrinsic stains are considered surface stains whereas intrinsic stains run deeper inside the tooth and are more difficult to remedy.

Causes of extrinsic stains include:	Causes of intrinsic stains include:
Coffee or tea	Tooth decay
Dark fruits such as blueberries and cherries	Overuse of fluoride
Red wines	Cracks/Scratches in enamel
Dark vegetables such as carrots and beets	Genetics
Smoking or Chewing Tobacco	Certain Antibiotics (Tetracycline based)

Over the counter products such as whitening toothpaste and strips are only strong enough to handle extrinsic stains. For intrinsic stains, it is recommended that you see a cosmetic dentist to learn more about safe, professional procedures that may be available to you.

How Whitening Toothpaste Works

Contrary to its name, one of the main ways whitening toothpaste works to remove stains is through abrasion. Tiny silica particles are added to the paste and are used to essentially “scratch” the stains off of your teeth. While this method may initially remove some of the discolorations, overuse can actually cause staining to become worse. This is because the abrasive material doesn’t just eliminate the tinge, it also scratches through the protective enamel. Loss of enamel can eventually lead to deeper, more permanent intrinsic staining. As the unprotected dentin becomes increasingly exposed to everyday food and drink, discoloration is able to penetrate past the surface and into the underlying layers of the tooth below.

In addition to abrasive particles, whitening toothpaste can also contain bleaching agents. The two most common bleaching agents used to whiten teeth in toothpaste include hydrogen peroxide and carbamide peroxide. While these ingredients are shown to be effective at whitening teeth, they should always be used in moderation as overuse can lead to demineralization of your teeth and if swallowed, can potentially inflame your internal organs or cause internal bleeding.

Common Dental Issues that Arise From the Use of Whitening Toothpaste

Some common dental issues that arise when using whitening toothpaste include sensitivity, retracting gum lines, and even increased discoloration as the enamel breaks down and stains are able to penetrate to deeper levels inside the tooth.

Sensitivity – sensitivity can occur for a number of reasons. Some of these include overuse of whitening toothpaste, keeping the paste on your teeth for an extended period of time, and allowing the toothpaste to penetrate through cracks or openings that are exposing the inner dentin. It should be noted that it’s never a good thing to feel sensitivity from the use of whitening toothpaste. If you have this issue, stop using the toothpaste and consult with your dentist for alternative options.

Receding Gums – if whitening products aren’t used properly and in moderation, they can irritate the gums and cause them to recede. Receding gum lines are harmful for a number of reasons. Healthy oral tissue is important not only to help prevent your teeth from getting infected but also to protect the internal area of the tooth from negative exposure to bacteria and germs. When whitening toothpaste isn’t used properly, it can cause permanent damage to gum lines, causing them to recede, and eventually exposing the vulnerable dentin and root below.

Loss of Enamel – both abrasive particles and bleaching agents can lead to a loss of enamel over time. It’s important to understand that enamel does not grow back so great care should be taken any time you choose to use a whitening product. Always consult with your dentist before using over-the-counter products so they can instruct on the safest way to achieve the results you want.

The Dangers of Children Using Whitening Toothpaste

While whitening toothpaste is problematic for adults, it can be even more detrimental to children. The American Academy of Pediatric Dentistry recommends that all children under the age of 15 refrain from teeth whitening. This is because a child’s enamel is thinner than an adult’s and the nerve and dentin on the inside of the tooth are still developing. Tooth enamel isn’t fully calcified until approximately two years after the permanent teeth finish emerging. The Pediatric Safety Organization warns of teenage use of whitening products in particular. Teenagers are at a greater risk for misuse and/or overuse because they tend to want to hasten or intensify the process without fully understanding the consequences. This can cause the developing teeth to become over-oxidized, resulting in a permanent breakdown of the teeth’s structure.

In general, improper use of these types of whitening products before a child’s smile is fully developed can result in increased sensitivity, demineralization of the enamel, and variations in tooth color. Children with braces or other mouth hardware are also at risk of uneven coloring to their teeth, as the portion of the tooth that is covered will not be affected by the whitener and will end up showing as a different shade from the exposed portions of the teeth.

Natural Alternatives to Traditional Teeth Whitening

Having whiter teeth doesn’t necessarily equate to a healthier smile. However, if you decide you want to brighten your smile using safer, more natural methods, you have a handful of options at your disposal.

Oil Pulling – oil pulling has been shown to have numerous benefits for oral health. In addition to killing the bacteria in your mouth that is responsible for plaque and gum disease, it also helps to reduce inflammation. Currently, there is no definitive evidence showing that oil pulling whitens teeth, however, many people who use the practice claim they notice a visible whitening of their teeth. Add to the fact that it’s a safe and beneficial method overall, and there’s really no reason not to give it a try to see if it works for you.

To try oil pulling, simply choose an oil of your choice (recommended options include coconut, olive, and sesame) and swish it around in your mouth for 5 to 20 minutes. You can also use a soft toothbrush to apply the oil or wipe it over your teeth with a washcloth.

Baking Soda – Sodium Bicarbonate, or baking soda as it is commonly called, is another natural product that can help to whiten your teeth. When used properly, it can reduce plaque, fight bad breath, help maintain a healthy pH inside your mouth, and assist in the overall whitening of your teeth. For the safest use with regards to oral health, it is recommended that you mix a teaspoon of baking soda with enough water to form a paste. Gently apply the mixture using either your finger or a soft toothbrush and let it sit on your teeth for approximately two minutes followed by a thorough rinse. You can apply this tincture multiple times per week for best results. Just be careful to apply gently as baking soda is abrasive and can harm your enamel if applied too strongly and too often.

Apple Cider Vinegar – apple cider vinegar is another effective way to help whiten your teeth. The reason vinegar works as a whitener is because it contains acetic acid which helps to remove the plaque and clean teeth. To use vinegar effectively as a whitener, mix one part vinegar with three parts water and swish in your mouth for about a minute. Be sure to spit it out once you’re finished. A couple of tips to remember when using Apple Cider Vinegar include:

Always dilute the vinegar with water before swishing. Straight vinegar has a highly acidic pH and will damage the enamel on your teeth if overused.

Only use organic brands of apple cider vinegar. This is because non-organic brands are typically pasteurized, which removes the majority of the beneficial properties contained in the vinegar.

Be sure to wait at least 30 minutes before brushing your teeth after use. Residual vinegar remains on your teeth and can harm your enamel if you brush while it’s still present.

Brush and Rinse After Eating and Drinking – being vigilant about your teeth after eating and drinking can really make a difference in the amount of staining you accumulate over time. Make an effort, when possible, to brush your teeth after eating food and drink so that you can alleviate stains before they happen. If you drink coffee or other staining drinks, try to follow it up with a glass of water to help mitigate the effects. Regular coffee drinkers or smokers may also want to consider a visit to the dentist every three months instead of six to help keep their smile bright and healthy.

Naturally, one of the best ways to keep a sparkling, white smile is to take care of your teeth on a daily basis. Brush at least twice a day for two minutes at a time, floss regularly, and visit your dentist every six months. If you are interested in learning more about professional teeth whitening, please feel free to call our office. We’ll be happy to help answer any questions you might have and discuss how we can safely and effectively help you to achieve a brighter, whiter smile.

– Julie Mastbrook

Works Cited

“Apple Cider Vinegar Teeth Whitening: Can You Safely Use Apple Cider Vinegar to Whiten Teeth?” Emergency Dentists USA, www.emergencydentistsusa.com/apple-cider-vinegar-teeth-whitening/.

“Apple Cider Vinegar vs. Organic Apple Cider Vinegar.” LIVESTRONG.COM, Leaf Group, www.livestrong.com/article/107959-apple-cider-vinegar-vs.-organic/.

Axe, Josh. “6 Ways to Naturally Whiten Your Teeth.” Dr. Axe, 9 Mar. 2018, draxe.com/6-ways-to-naturally-whiten-your-teeth/.

“History of Toothpaste – Toothbrush History.” History of Toothpaste – Toothbrush History, www.colgate.com/en-us/oral-health/basics/brushing-and-flossing/history-of-toothbrushes-and-toothpastes.

“Is Teeth Whitening Safe For Children?” Kids Dental Online – Plano & Carrollton, www.kidsdentalonline.com/dental-topics/teeth-whitening-safe-children/.

Lee, Sean S., et al. “Tooth Whitening in Children and Adolescents: A Literature Review.” American Academy of Pediatric Dentistry, Pediatric Dentistry, 17 Aug. 2005, www.aapd.org/globalassets/media/publications/archives/lee-27-5.pdf.

Pesce, Nicole Lyn. “The Dark Side of Teeth-Whitening Strips.” MarketWatch, 10 Apr. 2019, www.marketwatch.com/story/the-dark-side-of-teeth-whitening-strips-2019-04-10.

“The Risks of Tooth Whitening Toothpastes | Winston Salem Dentist.” Distinctive Dental, 30 Nov. 2017, www.distinctivelydental.com/can-whitening-toothpastes-damage-teeth/.

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Finding an Experienced Dentist in Monroe, North Carolina

Andrae Bergeron2020-07-16T16:55:10+00:00June 17th, 2019|Adam Brown DDS, Dental Crowns, Dental Insurance, Dental Trends, General, Oral Health, Teeth Whitening|

There are fewer things more stressful than finding a new health provider, much less finding an office and staff to trust you and your family’s smile with. Whether you’re searching for the right dentist to advise your oral health regimen, or are simply in the market for a new dentist, Carolina’s Dental Choice wants to equip you with the right knowledge to find an experienced dentist suited for your treatment needs.

Find an Experienced Dentist—Don’t Get Unnecessary Treatments

In need of a second opinion after getting a hefty price estimate for a procedure, you’re not sure you really need? Had a bad experience with a previous dentist and searching for a new practice to rebuild trust with? Waited so long for a dental visit that you’re just ready for a fresh start and motivation? No judgments and no worries! Finding an experienced dentist does not have to be an ordeal.

It is easy to get overwhelmed by your search for the right dentist. From Google searches, Yelp reviews, to scouring websites and seeking out word of mouth recommendations, there are many ways in which we try to find a great dentist. If you’ve moved recently or switched insurance companies, it can also be difficult to move on from a long-time dentist and find another that meets all of your expectations.

Where should you even start? We have laid out the most important considerations in your search for the right experienced dentist.

Question 1: What makes a good dental practice?

You have probably asked yourself this before. What makes a good dentist? Is it a staff of gentle hygienists? A dentist who spends time in the room with the patient? The cheapest treatment options around? Let’s discuss it!

Expectations should be met with every point of contact, including staff

Whether you are making your first call to inquire about services, scheduling an appointment, or entering the practice, the staff should be welcoming to patients. Practices that leave patients in the waiting room without greeting and without respect for patients’ time are red flags that the dental practice does not respect the time of their clients. A friendly, punctual staff ensures that the visit is great from start to finish.

Active listening

Between the hygienists and the dentist, you need a practice that listens to what you say. As the patient, you are the best advocate and knowledge base of your own health, and a good dental practice values that. By listening to your concerns and requests, and acting on what they hear, rather than talking over the patient or not spending and giving the time to the patient to speak their concerns, the patient will collaborate with the dental practice to ensure they are receiving the best treatment options.

Attempts to know the patient

In a larger practice, we do not expect our dentists to know the patient’s entire history, but no patient wants to feel like another file on the shelf. A dentist taking the time to know you can affect the level of care that the patient gets. Whether that’s making friendly conversation or taking a few minutes to read your chart, attempting to know the patient can make all the difference in your dental care.

Question 2: What are the warning signs of a bad dentist?

Fraudulent dentists certainly are not the norm, but more often than you would think, dishonest practices have impacted patients in their long-term trust in dentistry and their own oral health. The wrong dentist is more concerned with his pocketbook rather than the overall health of your mouth, meaning he may recommend and perform unnecessary treatments. Procedures that aren’t necessary can wreak havoc on your mouth and lead to further problems down the road.

Signs of Fraudulent Practice

Urgency without explanation:

If your dentist identifies an issue that is not a dental emergency and tells you a procedure needs to be done immediately, you should start by asking why and for full disclosure on the procedure itself. If you are in a new dentist’s chair for a regular cleaning and suddenly you’re bombarded with procedures of a type you’ve never needed before, or that you did not enter the practice asking for help with, then it may be a red flag. When the dentist is vague on the reasoning for procedures, he may be pressuring you into going forward without understanding all of your options.

If it sounds too good to be true, then it probably is:

Some dentists offer very discounted, or even free cleanings as a way to get patients in the door. Once in the chair, they may either hit you with fees that were never mentioned as part of the deal or as mentioned before, pressure you into procedures with intensity.

Lack of Patient Education:

As we mentioned before, the sign of a great dentist is one who educates patients and ensures that decisions are made collectively between the patient and dentist. It is not good practice when dentists and hygienists are not willing to take time and explain the dental issues and recommended procedures to the patient. Even the act of not showing patients their x-rays can be a red flag. Your dentist should take the time to discuss what is shown in your x-rays, point out any lesions or unhealthy teeth, and talk through the treatment plan with the findings.

Question 3: How does dentistry become susceptible to fraud, and how can I determine if I am part of fraudulent dentistry?

We know that for the majority of dentists out there, it took years of hard work and building trust among their patients to make a successful dental practice. But, as in any profession, there are a small number of professionals out there who turn to taking shortcuts for financial gain. For the medical profession in general, medical diagnoses can be subjective. Because of this, we have a number of suggestions to improve patient advocacy.

Understand how your insurance works with the dental practice.

Beyond having a sense of your general dental coverage, you may not know how the dental practices interact before and after your dental visit. After scheduling your appointment, the staff at the dental practice will reach out to your dental insurance company to find out everything that is covered under your provider. So before you even enter the office, the experienced dentist will know everything that can be billed to you during your dental visit. Unfortunately, this can leave the patient vulnerable to receiving treatments that are more likely to be reimbursed by the insurance company, rather than what’s truly right for the teeth.

For example, a dentist may be choosing between a filling and a root canal for a patient. Taking the path with the root canal and crown is more lucrative for the dental practice. This is because it is common knowledge that root canals are easier to pass through an insurance company than a filling, and by receiving a root canal, you’re automatically approved for a crown. Root canals are easier to pass simply because the dentist can justify the root canal by claiming that the patient was in pain. The problem here is that the dentist may have just been able to perform a filling, which is a cheaper procedure and less invasive for the patient.

Now that there are some ways of identifying fraud, let’s talk about active ways to prevent getting in those situations in the first place.

Choose your dentist based on referrals

Your insurance company may be telling you which dentists to see, but take time to do your own research. Seek out others with the same insurance and ask for a recommendation. Or, if you have a current dentist in the same area but you have switched insurance policies, ask your dentist for a recommendation, or ask for a recommendation from a local dentist society or health professional. Just because the insurance company covers a dentist does not make it a suitable referral. Plus, seeking out opinions from family, friends, and co-workers can give recommendations backed by real experiences.

Consider going family-owned rather than corporate

Chain-dentistry practices drive patients through the door with heavy advertising and discounts, quick cleanings, free exams, and of course, hundreds or thousands of dollars in unnecessary dental work. Corporate dental chains can run on a quota-based model that can sometimes lead to practices working on the side of pushing unnecessary treatments.

Ask for the appointment time

Generally, a new patient appointment should take around an hour and a half. If the office tells you that appointment should only last about a half hour, they may be trying to rush you through what should be a thorough cleaning and appointment, rather than give you the time you deserve as a patient. If you’re an established patient, appointment time can vary, but a cleaning should take at least 45 minutes. If it lasts only 15 minutes, it’s time to start asking questions.

Always check your bill

In a true dental scam, a dentist might inflate claims or bill insurers for procedures that the patient didn’t receive. The best way to avoid this from happening is to ensure communication with your dentist, ask for an estimated price upfront (prior to sitting in the dental chair), and always checking your bill at checkout. According to the National Health Care Anti-Fraud Association, it is estimated that Americans lose about $68 billion dollars each year to healthcare fraud. Don’t be a victim of dental fraud; know the signs and do not be afraid to advocate for yourself as a patient.

Check the market rate for common procedures.

There are common procedures you have had before that you know the price for, but when dental pain strikes, sometimes you are willing to pay anything for it to get fixed. It’s at these times when it is most important to ensure that you are being offered a fair, market-rate price, and not just being offered the most expensive procedure that your insurance may or may not cover.

Seek other opinions.

If you have ever had a major dental procedure, it is likely that you might have sought out another opinion. One dentist may recommend that you need it, while another may not. This is totally normal, and encouraged, especially if you feel that any of the signs above are occurring.

Feel out the culture of the office.

While how you feel as a patient is important, seeing how the experienced dentist treats the staff can also impact the care you receive. The best doctors are attentive to patients and staff. If you have a bad feeling with your interaction from the front desk to the dental chair, how can you trust your oral health to the practice? You should feel safe and welcome at the dentist from the moment you walk in the door.

Find a dental provider who’s right for you and your family

Carolina’s Dental Choice is here to make you feel right at home, whether you’re new to the area or a longtime resident. Give us a call today if you’re in need of a welcoming, friendly face in the dental practice world at 704-289-9519.

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The Hidden Dangers of Mouthwash: What You Need to Know

Julie Mastbrook2021-02-05T18:11:46+00:00June 5th, 2019|Dental Trends, Dentist Office Monroe NC, Oral Health, Teeth Cleaning, Teeth Whitening|

Mouthwash is often touted as a safe and effective method for curing bad breath and improving overall oral health. But recent studies show that not all mouthwashes are created equal. Before you add a mouthwash to your daily dental regimen, take a minute to understand some of the potential dangers that might be hiding in that morning and evening routine.

The Problems with Conventional Mouthwash

While advertising may state that conventional mouthwash kills 99.9% of all bacteria, that’s not always the full dental story. Many conventional types of mouthwash contain up to a 26% alcohol content in addition to other dangerous ingredients. When you swish mouthwash twice a day in your mouth for an extended period of time, a number of things occur.

Alcohol destroys the friendly bacteria your body needs to maintain normal blood pressure and positive oral health. Think of it like an antibiotic for your mouth. It doesn’t distinguish between good and bad oral bacteria, it simply kills it all.
Conventional mouthwash dries out your mouth and affects saliva production. This can actually result in worsened breath over time in addition to increased cavity production because saliva acts as a natural barrier for both of these dental conditions.
Recent studies have shown that using conventional mouthwash may potentially lead to high blood pressure issues because of disruption with the body’s production of NO (Nitric Oxide), a molecule inside the body that helps to regulate blood pressure.

A sample of ingredients that are the biggest culprits for these dental issues include alcohol (associated with drying your mouth and killing bacteria), Chlorine Dioxide (used as a bleaching agent to whiten teeth), Chlorhexidine (an antiseptic that is also an allergen), and formaldehyde (dangers include cancer risk and respiratory problems).

Discovering Natural Mouthwash Alternatives

There are several natural mouthwash alternatives available over the counter that provide a safer option for those that want to maintain their daily swishing regimen. A few choices are listed below.

The Natural Dentist
This mouthwash can be found at most major retailers and is tailored towards those with sensitive teeth and gums. The ingredients are all natural and contain 20% Aloe Vera which is a natural antiseptic that replaces conventional use of Chlorhexidine without the side effects.
Therabreath
This mouthwash is also available at most major retailers and helps increase saliva production instead of drying out your mouth. It also uses natural ingredients including aloe vera and tea tree oil which is another natural antiseptic used to aid in overall oral health.
Oral Essentials
Created by dentists and thoroughly tested, this mouthwash contains sea salt to help maintain the healthy mineral balance in your mouth. In addition, you’ll find such natural ingredients as aloe vera, coconut oil (a natural teeth whitener), and essential oils (aids in freshening breath). This mouthwash can be found on Amazon in addition to other online retailers.

Do-It-Yourself Mouthwash? Why not!

A quick search on the internet for do-it-yourself mouthwash will yield plenty of recipes for you to experiment with. When wading through the never-ending list of oral options, keep a few essential ingredients in mind.

Aloe Vera
As mentioned above, Aloe Vera is a top-notch replacement for the conventional mouthwash ingredient, Chlorhexidine. Studies have shown that it is equally as effective as an antiseptic but without all the harmful side effects.
Essential Oils
Essential Oils are a natural way to freshen breath without the drying effect of alcohol. They also contain antibacterial properties and oils such as lemon contain whitening properties to help keep your teeth shiny and bright.
Sea Salt and Baking Soda
Both these ingredients have strong benefits for oral health. Used as mouthwash ingredients, sea salt will help to restore the mineral balance of your mouth while baking soda will help to ease gingivitis and whiten teeth.

Final Thoughts on Mouthwash

Studies show that conventional mouthwashes are not as effective or as safe as typically advertised. They can contribute to dry mouth, mess with the balance of bacteria in your mouth and even cause increased gingivitis and cavity formation. The best way to keep your dental health in tip-top shape is to work on the problem from the inside out. Keep a balanced diet and stay away from processed foods and sugars. If you still want to make mouthwash a regular part of your dental routine, stick with all natural brands or create your own recipe so that you are in control of the ingredients going into your mouth and body. For more information, please contact Carolina’s Dental Choice.

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Is Sparkling Water Bad for Your Teeth?

Sam Nicolosi2020-07-16T16:55:40+00:00May 20th, 2019|Dentist Office Monroe NC, General, Oral Health|

There has been a lot of buzz lately about sparkling water, with many people touting it as an alternative to regular or diet sodas. Also, with the many flavorings out there now, sparkling and seltzer waters have become far more attractive as a choice for a soft drink. In fact, sales of sparkling water have doubled since 2011. That said, some have questioned whether sparkling water is bad for your teeth and, if so, how?

It is important to understand the impact of the trend in sparkling water consumption and its impact on your teeth. We want to delve into this controversy, clear up some misconceptions, and give you a few pointers so you can continue to take care of your oral health.

Firstly, it is important to understand that carbonated water has CO2 in it, which gives the bubbly effervescence to carbonated water. But when you drink the fizzy carbonated water, a chemical reaction transpires in your mouth, which turns the Co2 into carbonic acid. But know this: this is a relatively weak acid on its own, so unless you choose sparkling or seltzer waters flavored with citrus (and thus a more acidic sparkling water), the acidic levels are quite low.

In 2016 the Journal of the American Dental Association (JADA) released a study of the acidity of various beverages. As a baseline, spring water was used (it has a neutral acidity level of pH 7.4) to assess the acidity of sparkling waters. Sparkling water was found to have an average of pH 5 or 5.5 (for example, Perrier is 5.5), making them definitely acidic in nature. The ADA concluded that, on the whole, sparkling water exceeds the acidity of regular tap or spring water. Thus, our attitudes toward sparkling water need to be adjusted slightly, for sparkling water is not the same as any old, regular water.

However, the ADA has not found conclusive evidence of any kind that suggests drinking sparkling water is harmful to your tooth enamel. In fact, the acidity level of coffee is far higher, and thus worse, for your teeth than is sparkling water. Compare coffee’s pH level of up to 6 (depending on the coffee), in contrast to sparkling water’s pH 5 level, and you can see that coffee is a bigger culprit in tooth enamel’s loss.

Helpful Strategies

Don’t sip sparkling waters throughout the day, like you would spring or tap water. Rather, drink them in one sitting (in a short span of time), in order to decrease the length of exposure of your tooth enamel to the acidity levels.
If you have dry mouth, which is decreased salivation production due to other illnesses like diabetes, it is best to avoid acidic drinks of any kind.
Brush your teeth after consuming these drinks (and coffee, too, for that matter!). So many of us tend to think we should only brush after eating, forgetting that sugary or acidic elements in drinks we imbibe can be just as harmful to our oral health. So, carry a small toothbrush and toothpaste tube with you to take on the go, and brush after both eating and drinking anything (other than plain water).
Use a mouthwash twice a day, morning and evening. If you are a real enthusiast, you can certainly take a swish-and-spit moment after lunch, following a good tooth brushing. Mouthwash can clear away bacteria and harmful sugars from your teeth. Remember, acidity breaks down tooth enamel and then it is the bacteria, feeding on sugar in your mouth, that creates the problem. Mouthwash can eliminate the bacteria and wash away the sugar—this will preserve your tooth enamel as well.

On the whole, choosing seltzers and sparkling waters is a far better choice for your teeth than drinking regular or diet sodas. The pH levels of most seltzers and sparkling waters are better for your teeth than the average soda. However, from a basic health standpoint (which will always be the best choice for your teeth), drink eight glasses of tap or spring water a day. Plain, pH neutral water is the best choice for your health at every level. And, if you are apt to drink seltzers or sparkling waters, a single swig of plain water after you finish the can, with a bit of a swish of that plain water about your mouth, can help to wash away some of the acidic build-up.

Have more questions? Talk to your oral hygienist or one of our dentists at Carolinas Dental Choice.

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Radiography: An Essential Part of Carolina’s Dental Choice

Morgan Evans2020-07-16T16:56:30+00:00April 24th, 2019|Dental Trends, Oral Health|

If you have been to the dentist, you have probably had x-rays taken of your mouth. While annoying, and sometimes painful, these x-rays are an essential part of any dental-care plan. Despite their significance, some dentists do not offer radiography to their patients. At Carolina’s Dental Choice, we see the value in these x-rays and believe that they largely contribute to positive dental health.

The x-rays used for dentistry are known as radiographs. There are two kinds of radiographs: the extraoral, an x-ray is taken outside of the mouth; and the intraoral, which is an x-ray taken from within the patient’s mouth. Intraoral radiographs are the one most commonly seen in dentistry and the one you might easily recognize from your last dentist appointment. The intraoral radiograph has become such a prominent part of dentistry because of the high level of detail that the x-ray provides, which can show the tooth, bone, and supporting tissues in a patient’s mouth.

Not only does the radiograph allow a dentist to see what is visible in a patient’s mouth, but it also allows him to see hidden dental structures, malignant and/or benign masses, signs of bone loss and/or wearing, and cavities, all of which might not be visible to the human eye but are detrimental to an individual’s dental health.

How It Works

Now that you know how important a radiograph can be to your dental health, you are probably wondering how they actually work. Surprisingly enough, they are actually quite simple. When your dentist asks you to put a film or sensor in your mouth, which is usually the most uncomfortable part of any radiograph, he is creating a base that is crucial to the image being taken. For a radiographic image to form, the radiation from the x-ray machine has to bounce off of the film or sensor and into your mouth. Different oral structures are penetrated by the radiation at different levels, which means they reflect different images on the film. For example,

teeth appear lighter because they are dense and do not allow for as much radiation to penetrate them. Dental caries (cavities), tooth decay, infections, periodontal ligaments, and alterations in bone density will typically appear darker on a radiograph since they are less dense as other dental structures. Based on the amount of radiation that is allowed to reflect on the film, an image is created that allows your dentist to see everything that is not visible to the naked eye, and then assess the best way to maintain your dental health.

At Carolina’s Dental Choice, our dentists see the value in a basic radiograph, like the ones previously discussed; but we do not stop there. Along with traditional radiographs, our office also offers three-dimensional (3D) imaging services. Our 3D digital device combines three different types of data with one x-ray unity; this cool tool is known as the Planmeca 3D imaging device. Proper use of this helps to accurately diagnose our patients since we understand that not all damage and disease is visible during a routine dental examination.

The Planmeca 3D imaging device is one of the newest innovations in radiography procedures. Instead of using standard x-ray film, the 3D images are digitally produced on a computer screen. Not only does this save production time since the images do not have to develop, but it also allows for them to be easily viewed, stored, or printed. On top of that, digital 3D imaging with the Planmeca only takes a fraction of the time and emits less radiation than a traditional x-ray would.

Our dental professionals at Carolina’s Dental Choice also use radiographs to help monitor periodontal diseases. By using x-rays, visual examinations, and professional cleaning techniques, our staff is able to play an effective role in minimizing the spread of common dental diseases.

Just like a regular dental examination, radiographs are crucial to a patient’s oral health. How often you need one depends on the success of your treatment plan and the advice of your dentist. If you are prone to tooth decay or cavities, then your dental professional may recommend that you get them annually or biannually. Being proactive and regularly checking for signs of decay can help your dentist plan for future treatment options and prevent major cosmetic issues in the future.

As Carolina’s Dental Choice, we offer the radiography services that will keep your smile beautiful. Come see us today!

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Tooth Extraction Explained at Carolina’s Dental Choice

Mary Sturk2020-07-16T16:56:44+00:00April 17th, 2019|Dental Insurance, Dental Trends, Oral Health|

Our team at Carolina’s Dental Choice knows that the word “extraction” can cause anxiety and even fear in some people. Many of us have had this procedure done, sometimes multiple times, and the reason a tooth needs to be extracted varies from patient to patient.

What Is Dental Extraction?

A dental extraction (also called exondontia or informally, tooth pulling) is the removal of teeth from the socket (dental alveolus) in the alveolar bone. Extractions are performed for a wide range of reasons, but most commonly because a tooth is unrestorable due to decay, periodontal disease, or dental trauma.

Tooth decay is the softening of your tooth enamel and refers to the damage of the structure of the tooth caused by acids that are created when plaque bacteria break down sugar in your mouth.

Periodontal diseases are infections of the structures around the teeth, which include the gums, periodontal ligament, and alveolar bone.

Traumatic dental injuries most often occur as a result of an accident or sports injury. The majority of these injuries are minor, such as chipped teeth. Occasionally though, a tooth will dislodge or even get knocked out completely.

Extraction Procedure

Typically, when undergoing a tooth extraction procedure, your dentist will numb the area with a local anesthetic before the procedure.

Common forms of local anesthesia are Novocaine and more popularly, Lidocaine, which is injected after the dentist numbs the area with an external numbing agent. Here are all the common forms of anesthesia:

Local Anesthesia—this is when medication is injected into the mouth to numb the area to be treated and block the nerves that transmit pain. This type of anesthesia is commonly used during fillings, treating gum disease, or preparing teeth for crowns.
Sedation—this method is usually administered by inhaling nitrous oxide, also known as laughing gas. It can also be administered orally in the form of a pill taken prior to the dental procedure. This form of anesthesia is commonly combined with a local anesthetic to help relieve anxiety and reduce pain.
General Anesthesia—this is the strongest form of anesthesia available for dental procedures and involves intravenous medications that produce a temporary loss of consciousness. General anesthesia is usually only used during oral surgery procedures.

You may have also heard of I.V. sedation and wondered if it were for you. Intravenous (I.V.) sedation has become more common and works well for those with fear of the dentist and dental procedures. It is also ideal for patients whose fear of dentistry has led to a large amounts of dental work needing to be completed. I.V. Sedation is also used for outpatient procedures, like colonoscopies. Referred to as “twilight sleep,” you will wake with little or no memory of the procedure. Anesthesia is given via the I.V. and recovery requires someone take you to/from the procedure.

If the extraction involves an impacted tooth, the tooth may be broken into pieces before it is removed. An impacted tooth is a tooth that, for some reason, has been blocked from breaking through the gum. Sometimes a tooth may be only partially impacted, meaning it has started to break through.

Your dentist will perform x-rays and thorough examinations before this stage and will explain the procedure and any other possible options. Often, with impacted teeth, there are no symptoms and only an x-ray will discover it.

Another reason teeth are extracted, especially in youth and young adults, is to make room in the mouth before planning to straighten remaining teeth. Teeth may also be extracted if they are so poorly positioned that they cannot possibly be straightened. A less common reason to extract a tooth is as a cheaper alternative to filling or placing a crown on a decayed tooth.

If you or your child has a condition where a tooth extraction might be called for, please call Carolina’s Dental Choice at (704) 289-9519 to schedule an appointment.

The number of Americans missing at least one tooth is more than 120 million, so it’s not at all unusual to be missing one or more teeth for a variety of reasons, including those listed above.

What’s the deal with Wisdom Teeth?

One of the most common procedures is the removal of the “wisdom teeth.” What is this procedure and why do these teeth often need to be removed and what are the benefits? According to www.mayoclinic.org:

Wisdom tooth extraction is a surgical procedure to remove one or more wisdom teeth — the four permanent adult teeth located at the back corners of your mouth on the top and bottom.

If a wisdom tooth doesn’t have room to grow (impacted wisdom tooth), resulting in pain, infection, or other dental problems, you’ll likely need to have it pulled. Wisdom tooth extraction may be done by a dentist or an oral surgeon.

For many, the first use of dental anesthesia is during extraction of wisdom teeth (the four hindmost molars that come in during young adulthood), which can cause issues including moving other teeth around.

To prevent potential future problems, some dentists and oral surgeons recommend wisdom tooth extraction even if impacted teeth aren’t currently causing problems.

Wisdom teeth, or third molars, are the last permanent teeth to appear (erupt) in the mouth. These teeth usually appear between the ages of 17 and 25. Some people never develop wisdom teeth. For others, wisdom teeth erupt normally — just as their other molars did — and cause no problems.

Many people develop impacted wisdom teeth — teeth that don’t have enough room to erupt into the mouth or develop normally. Impacted wisdom teeth may erupt only partially or not at all.

An impacted wisdom tooth may:

Grow at an angle toward the next tooth (second molar)
Grow at an angle toward the back of the mouth
Grow at a right angle to the other teeth, as if the wisdom tooth is “lying down” within the jawbone
Grow straight up or down like other teeth but stay trapped within the jawbone

Problems with impacted wisdom teeth. You’ll likely need your impacted wisdom tooth pulled if it results in problems such as:

Pain
Trapping food and debris behind the wisdom tooth
Infection or gum disease (periodontal disease)
Tooth decay in a partially erupted wisdom tooth
Damage to a nearby tooth or surrounding bone
Development of a fluid-filled sac (cyst)

Preventing future dental problems. Dental specialists disagree about the value of extracting impacted wisdom teeth that aren’t causing problems (asymptomatic), because it is difficult to predict future problems with impacted wisdom teeth. However, here’s the rationale for preventive extraction:

Symptom-free wisdom teeth could still harbor disease.
If there isn’t enough space for the tooth to erupt, it’s often hard to get to it and clean it properly.
Serious complications with wisdom teeth happen less often in younger adults.
Older adults may experience difficulty with surgery and complications after surgery.

What to expect after a Dental Extraction

Immediately after an extraction, be sure to follow your dentist’s instructions. You may receive a prescription for a mild pain killer or antibiotic, but in most cases, over-the-counter medications will manage pain. Do not eat solid foods or smoke for 48 hours. Stick with soft foods like yogurt, soups, mashed potatoes, and smoothies (avoided fruit seeds). The soft tissue takes about 3-4 weeks to heal.

Keep an eye out for any signs of acute bleeding, pain, or swelling. This could indicate an infection.

Beware of Dry Socket

Dry socket (alveolar osteitis) is a painful dental condition that sometimes happens after you have a permanent adult tooth extracted. Dry socket is when the blood clot at the site of the tooth extraction fails to develop, or it dislodges or dissolves before the wound has healed.

Normally, a blood clot forms at the site of a tooth extraction. This blood clot serves as a protective layer over the underlying bone and nerve endings in the empty tooth socket. The clot also provides the foundation for the growth of new bone and for the development of soft tissue over the clot.

Exposure of the underlying bone and nerves results in intense pain, not only in the socket but also along the nerves radiating to the side of your face. The socket becomes inflamed and may fill with food debris, adding to the pain. If you develop dry socket, the pain usually begins one to three days after your tooth is removed.

Dry socket is the most common complication following tooth extractions, such as the removal of third molars (wisdom teeth). Over-the-counter medications alone won’t be enough to treat dry socket pain. Your dentist or oral surgeon can offer treatments to relieve your pain.

Signs and symptoms of dry socket may include:

Severe pain within a few days after a tooth extraction
Partial or total loss of the blood clot at the tooth extraction site, which you may notice as an empty-looking (dry) socket
Visible bone in the socket
Pain that radiates from the socket to your ear, eye, temple, or neck on the same side of your face as the extraction
Bad breath
Unpleasant taste in your mouth

When to see a doctor. A certain degree of pain and discomfort is normal after a tooth extraction. However, you should be able to manage normal pain with the pain reliever prescribed by your dentist or oral surgeon, and the pain should lessen with time.

If you develop new or worsening pain in the days after your tooth extraction, contact your dentist or oral surgeon immediately.

Expected Costs

The cost of a dental extraction can vary depending on your dentist’s fees and the scope of work. In some instances, extractions (such as wisdom teeth that are impacted) may need to be handled by a dental surgeon under anesthesia.

According to Member Benefits, who tracks the cost of dental work throughout the country, the cost of dental extraction (per tooth) can range from $75-$300 for a non-surgical extraction, and upwards of $650 for a single surgical extraction. Additional costs could include x-rays and exam fees.

If you have dental insurance, it will take a bite (no pun intended) out of your bill. Depending on your policy, it may cover up to 50% of the cost. At Carolina’s Dental Choice, we work with a variety of Dental Insurers, as well as, Medicaid. Our staff will help you understand the costs involved and file the insurance paperwork for you. If you don’t have insurance, we offer an In-House Dental Savings Plan that allows patients to receive treatment at a discounted price.

Carolina’s Dental Choice also welcomes new patients. Whether you have just moved to the Monroe/Charlotte area, are transferring your care from another practice, need to establish care with a dentist, or find yourself suddenly in need of dental service, we look forward to partnering with you for the benefit of your oral health.

As we’ve explored, the reasons for a dental extraction are varied. There is no need to be in pain or discomfort, or even embarrassment, if you feel you need help with dental issues. Our staff is ready to help you find solutions for your dental needs.

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