May 2015 Newsletter | Babineau Cosmetic & Family Dentistry

May 2015 Newsletter

May Newsletter July 15, 2015
In this issue

Acidic Foods And Your Tooth Enamel

Acid attack!

Many people consume carbonated beverages, fruit juice and highly acidic foods every day but probably don’t realize that they may be harming their teeth. The acid in the foods we eat and drink can cause tooth enamel to wear away and teeth can become sensitive and discolored. In many cases, it’s not what you eat and drink that is as important as how you consume these

What is tooth erosion?

Tooth erosion, or tooth wear, is the loss of tooth structure caused by the weakening of dental enamel. Dental enamel is the thin, outer layer of hard tissue that helps maintain the tooth’s structure and shape. When the enamel   weakens, it exposes the underlying dentin (the tissue that makes up the core of each tooth), causing the teeth to appear

What causes tooth erosion?

Tooth erosion may occur when the enamel on your teeth is weakened by the acid found in many foods and drinks. Usually the calcium contained in saliva will help remineralize (or strengthen) your teeth after you consume small amounts of acid; however, the presence of a lot of acid in your mouth does not allow for remineralization. Acid can come from many sources, including the

  • Carbonated drinks. All soft drinks (even diet varieties) contain a lot of acid and can dissolve enamel on your teeth very   quickly.
  • Fruit juice and wine. Juice and wine have similar effects on your teeth because they contain acid.
  • Fruit, pickles, yogurt and honey. These foods are acidic; don’t let them linger in your mouth. Swallow them as soon as   you’ve chewed them enough.
  • Bulimia and acid reflux. Bulimia and acid reflux also can cause tooth damage from stomach acids coming into contact with teeth. Medical and dental help should be sought for anyone who suffers from   either of these conditions.

What are some signs of tooth erosion?

Acid wear may lead to serious dental problems. It is important to notice the signs of tooth erosion in its early stages (sensitivity, discoloration and rounded teeth) before more severe damage occurs (cracks, severe sensitivity and other problems).

  • Sensitivity. Since protective enamel is wearing away, you may feel a twinge of pain when you consume hot, cold or sweet food and drink. As more enamel is worn away, teeth become increasingly sensitive.
  • Discoloration. Teeth can become slightly yellow because the thinning enamel layer exposes the underlying dentin.
  • Rounded teeth. Your teeth may have a rounded or ‘sand-blasted’ look.
  • Transparency. Your front teeth may appear slightly translucent near the biting edges.
  • Advanced discoloration. Teeth may become more yellow as more dentin is exposed because of the loss of protective tooth enamel.
  • Cracks. Small cracks and roughness may appear at the edges of teeth.
  • Cupping. Small dents may appear on the chewing surface of the teeth. Fillings also might appear to be rising up out of the tooth.

What can I do to prevent tooth erosion?

Because there are different reasons why you may experience tooth erosion (swishing carbonated drinks, drinking a lot of juice or wine, eating disorders), talk to your dentist about your habits so that a plan for preventive action can be determined. Be smart about how you consume acidic foods and you can continue enjoying the things you like. Here are some general ways to protect your

  • Reduce or eliminate drinking carbonated drinks. Instead, drink water, milk or tea — but skip the sugar and honey!
  • If you must consume acidic drinks, drink them quickly and use a straw so that the liquid is pushed to the back of the mouth. Don’t swish them around or hold them in your mouth for long periods.
  • Don’t let acidic foods linger in your mouth; swallow them as soon as you’ve chewed them enough so that they are ready to digest.
  • Instead of snacking on acidic foods throughout the day, eat these foods just during meal times in order to minimize the amount of time the acid is on the teeth.
  • After consuming high-acid food or drinks, rinse with water to neutralize the acids.
  • Chew sugar-free gum to produce more saliva, as this helps your teeth remineralize.
  • Brush with a soft toothbrush and be sure your toothpaste contains fluoride.
  • Your dentist may also recommend daily use of a toothpaste to reduce sensitivity (over-the-counter or prescription strength) or other products to counter the effects of erosion.

Frequently Asked Questions about Invisalign®
Are you wondering what Invisalign treatment is really like, and what effect it will have on your day-to-day activities? Will it slur your speech? Will people even know you’re in treatment? You’re not alone in your concerns! Here are some of the most common questions we hear about Invisalign.

Arthritis and Gingivitis

Richard H. Nagelberg, DDS
The concept of a relationship between periodontal disease and rheumatoid arthritis (RA) was discussed more than 50 years ago. There is much about the origin of rheumatoid arthritis that is still unknown. The anatomic site at which RA-related autoimmunity is initiated and the timing are also elusive currently. Systemic inflammation and the autoimmune processes begin long
before the onset of perceptible joint inflammation.
Research suggests that RA-related autoimmunity may be initiated at a mucosal site years before the onset of joint symptoms. Potential sites of initiation include gastrointestinal, lung, and oral mucosa. Additional studies of individuals in the preclinical period of RA that can provide insight into the relationship between mucosal inflammation, RA-related autoantibody
generation, and subsequent joint inflammation in RA are needed. An improved understanding of the initial steps in the development of RA would provide insights into disease pathogenesis leading to more effective treatments and/or novel preventive strategies in RA (Demoruelle et al. 2014).
Since the publication of the first study in 2009 (Smolik et al.), which revealed the association between Porphyromonas gingivalis (Pg) and rheumatoid arthritis, a number of additional studies have been conducted that reach the same conclusion as the original one. The Smolik study indicated that further studies were needed to affirm their findings, and that affirmation is
well under way.
The body produces a number of enzymes called peptidylarginine deiminases (PADs). These enzymes convert the amino acid arginine within a peptide (i.e., protein building blocks) into peptidylcitrulline in a process known as citrullination. Protein citrullination plays a vital role in normal physiology, in which it is involved in the formation of rigid structures such as
skin, hair, and myelin sheaths, as well as other normal physiological effects in the body. So the enzyme PAD and the process of protein citrullination are important components of normal physiology. P. gingivalis is the only microbe known also to produce the enzyme PAD. Aberrant citrullination has been observed in a variety of diseases, including RA and diseases of the skin and nervous
Research findings indicate that oral citrullination of human and bacterial proteins by the PAD enzyme produced by P. gingivalis triggers an antibody response to the modified protein. This citrullination by the bacterial PAD occurs within the inflammatory context of periodontal diseases, including periodontitis and gingivitis. The body mounts an inflammatory response to
the citrullinated proteins. This inflammatory response occurs throughout the body, including the joints. The prevailing theory indicates that P. gingivalis-mediated citrullination triggers the autoimmunity typically seen in individuals who are genetically susceptible to rheumatoid arthritis. The autoimmune processes lead to the soft and hard tissue joint damage in individuals with
The sequence of events in which the disease process is initiated long before the onset of detectable joint damage in RA is reminiscent of the same long time frame for the development of type 2 diabetes. In that case, the insulin-producing beta cells in the pancreas can be burning out long before the signs of diabetes are noticed by the individual or their health-care
Research also suggests that individuals with RA have a higher incidence and severity of periodontal disease, and that treatment of gum disease can improve the symptoms of RA. These findings are very preliminary and cannot be understood to be conclusive. However, it is not premature to provide the status of research to patients as long as it is done in an
accurate, ethical manner. Promises of improvement in joint signs and symptoms would be examples of inappropriate verbiage. It would be ethical and appropriate to indicate that research suggests an association between periodontal disease,Pg, and rheumatoid arthritis, but that conclusive evidence does not yet exist. It would be appropriate to use salivary DNA testing to identify the presence of
Pg. It is appropriate and our responsibility to control every bit of periodontal disease. If a patient tests positive for Pg and does not have periodontal disease, it is appropriate to recommend a power toothbrush such as the Philips Sonicare FlexCare Platinum.
It is not too soon for responsible education, treatment, and recommendations. Our patients need not be in the dark about what the scientific community is discovering.
Richard Nagelberg, DDS, has practiced general dentistry in suburban Philadelphia for more than 30 years. He is a speaker, advisory board member, consultant, and key opinion leader for several dental companies and organizations. He lectures on a variety of topics centered on understanding the impact dental professionals have beyond the oral

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