Posted on Wed, May 09, 2012 @ 03:11 PM
Fluoride is a wonderful way to protect your smile, but it’s not the only product out there that can help keep your smile healthy and beautiful. There are several other products, both over the counter and available through our dentists that, when used in conjunction with fluoride, promote a healthier smile.
Xylitol
Xylitol is one of the first sugar substitutes used. It is derived from birch trees and can also be found in the fibers of many fruits and vegetables.
Xylitol helps promote a healthy mouth in several different ways. The bacteria that cause dental caries cannot metabolize xylitol. These bacteria try to consume the xylitol, but they are starved. The more common method of killing these caries causing bacteria using an alcohol mouth rinse can dry out your mouth as well as kill any good bacteria. Xylitol can help stimulate saliva flow which helps remineralize your teeth.
Eating xylitol after a meal or snack helps return your mouth’s pH to a less acidic state. After eating, your mouth’s pH lowers to an acidic state which can weaken your teeth’s enamel. Weakened enamel is more susceptible to erosion and decay. By bringing your pH up using a little bit of xylitol, your teeth are better protected.
Our Evanston dentists Drs. James and Robert Stephens recommend eating 6 grams of xylitol a day to get the most benefit from it. Xylitol comes in many different forms that make it fun and easy to eat 6 grams. Try replacing the sugar in your coffee or tea with Xylitol. Or visit Dr. John’s Candies to see the range of xylitol candy available. (Contact our office to learn how to save 7.5% at Dr. John’s!)
Recaldent
Recaldent contains casein phosphopeptides - amorphous calcium phosphate. Calcium and phosphate are used to remineralize tooth enamel. Recaldent allows more of these minerals to be bioavailable for your salvia to use. Relcadent can be found in combination with fluoride in MI Paste, but it is also found in Trident Xtra Care gum.
Cervitec
Cervitec is an antibiotic varnish applied by your dental professional. Cervitec contains chlorohexidine and thymol to help control bacteria and alleviate sensitivity. It is applied in a varnish, which allows it to be applied to specific sites that may be at increased risk, such as exposed root surfaces. The varnish also allows the Cervitec to be longer lasting than a mouth rinse, as the antibiotic is sealed close to the tooth and is able to enter the tubules in your enamel.
Adding some of these products to your oral hygiene routine in conjunction with fluoride treatments can help to increase your oral health. Drs. James and Robert Stephens are always happy to discuss your risk for dental caries and help you get on the track to a healthy happy smile.
Posted on Wed, May 02, 2012 @ 11:13 AM
A wonderful way to supplement your yearly dental professional fluoride treatment is with at home fluoride treatments. There are several different options, and we recommend different options to different people depending on their age, habits, and risk for tooth decay.
Over the counter fluoride treatments
Our number one recommendation for over the counter fluoride treatment is a using a fluoride toothpaste. Using a fluoride toothpaste twice a day to clean your teeth allows the fluoride to be available to help strengthen and protect against cavities.
You can also use fluoride mouthwash, such as A.C.T. rinse, in conjunction with your routine brushing and flossing. This mouthwash can be used once a day. As the fluoride is not applied directly to your teeth, as it is with an in-office fluoride varnish treatment, eating and drinking isn’t recommended for 30 minutes after you use the mouthwash.
Using over the counter options to supplement your professional fluoride treatments helps maintain a level of bio available fluoride in your mouth year round.
Make sure you are supervising young children with over the counter fluoride products to ensure they don’t ingest any. The ADA does not recommend using fluoride toothpaste for children under the age of 2 or fluoride mouthwash for children under the age of 6. These children are at a greater risk of ingesting the products.
Prescription fluoride treatments
Over the counter fluoride treatments provide anywhere from 0.05% sodium fluoride to 0.12% sodium fluoride. For patients who are at a higher risk for caries, there are products available by prescription with higher concentrations of fluoride.
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Prevident toothpaste and mouth rinses have a higher concentration of fluoride and can be prescribed by your dentist.
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Clinpro 5000 toothpaste has both a higher concentration of fluoride, as well as Tri-Calcium Phosphate. Your tooth enamel is made of crystalized calcium phosphate, so the Tri-Calcium Phosphate works with the fluoride to remineralize your teeth and reverse white spots.
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MI PastePlus is a paste that you rub on your teeth twice a day. It contains fluoride as well as Recaldent. Recaldent contains casein phosphopeptite and calcium phosphate which helps remineralize your teeth and reverse white spots.
Prescription strength fluoride treatments should be used in conjunction with your regular oral hygiene routine to provide the best benefit. If you are using a prescription strength fluoride toothpaste, our doctors recommend using it as a replacement for your regular toothpaste before bed.
As of yet there is no fool proof product to protect against dental caries, but with a comprehensive at home fluoride program you can help to strengthen and protect your teeth. If your at home care doesn’t seem to be enough, talk to our Evanston dentists to find out what other options are available to help keep your smile healthy and beautiful.
Posted on Wed, Apr 25, 2012 @ 10:40 AM
This week we will start a series about the use of fluoride. We will cover the risks and benefits of fluoride use as well as application methods. Next week we will explore different types of at-home fluoride and the following week we will discuss adjuncts to fluoride.
Benefits of Fluoride 
Fluoride is an anion that helps remineralization in tooth enamel. Fluoride that enters our system through our diet can help strengthen our teeth before they erupt. As we age, the fluoride we consume becomes part of our saliva helping with remineralization.
Why we need it
As the bacteria in your mouth metabolize sugar, they produce lactic acid. This acid promotes erosion of tooth enamel which leads to greater penetration by caries causing bacteria. Tooth enamel that is remineralized using fluoride has a slightly different structure that makes it stronger and less susceptible to acid erosion.
Fluoride in our water supply
Fluoride was first added to a water supply in 1945 in Grand Rapids, MI. Since then many more communities have followed suit. Fluoride is naturally occurring in some water supplies, but not to the levels needed to provide optimal benefit to protect against tooth decay. The ADA states “Studies conducted throughout the past 65 years have consistently shown that the fluoridation of community water supplies is safe and effective in preventing dental decay in both children and adults.” As dental caries is the most wide spread disease affecting 60-90% of school children worldwide and nearly 100% of adults (source), adding fluoride to the water supply is one of the most effective ways to passively prevent against tooth decay. Adding fluoride to the water supply reduces instances of tooth decay by 20 to 40% (source).
Risks associated with Fluoride
The risks of fluoride are minimal when compared to the rewards. Frequent ingestion of fluoride during tooth development (up to age 8) can cause dental fluorosis. After tooth development is complete, fluorosis can no longer occur. Dental fluorosis most commonly presents as white spot or streaks in the adult teeth. More severe fluorosis may result in pitting or brown spots, though this is not common. The CDC recommends monitoring children’s use of fluoridated toothpastes to ensure that the toothpaste is spit out. The ADA recommends not using fluoride mouth rinses until the child is 6 years old and their swallowing reflex is fully developed (source).
Fluorosis can often be corrected using several different techniques including micro abrasion, composite restoration, or veneers.
Fluoride treatments at our office
Our Evanston dentists, James and Robert Stephens, recommend fluoride treatments twice a year for children and once a year for adults. In office fluoride treatments can be in the form of foam fluoride placed in trays, or fluoride varnish painted on your teeth. At Stephens Dentistry we choose to use the fluoride varnish for many reasons. Fluoride varnish has a higher concentration of fluoride and is applied directly to your teeth, allowing the fluoride to be available as needed to remineralize your teeth. The varnish is sticky, so the fluoride stays and can’t be rinsed off, unlike the foam fluoride. This also means that there is less chance for the fluoride to be ingested and contribute to fluorosis.
Posted on Wed, Apr 18, 2012 @ 11:22 AM
Permanent teeth begin coming in around 6 or 7 years of age and, if properlly cared for, may last the rest of your child’s life. That’s 70 to 80 years (maybe more!) of wear and tear for those teeth to make it through. A great way to start protecting your child’s permanent teeth is to have sealants applied as they erupt.
Sealants are resin coatings that are applied to the pits and fissures on the biting surface of your child’s teeth. This coating creates a barrier to keep decay out of these hard to clean areas, thereby helping prevent cavities. By forgoing sealants, all those pits and fissures of your child’s teeth are exposed to wear, decay, and acid erosion which can weaken your child’s teeth and cause cavities.
Our Evanston dentists recommend having sealants applied to children’s permanent molars as each set of molars become fully erupted. This allows minimum time for the fissures and pits to be exposed to decay. If taken care of properly and monitored by a dental professional, these sealants should last between 5 and 10 years.
Drs. James and Robert Stephens clean the tooth or teeth to be sealed. Then they apply an etching agent to “rough up” the tooth. This roughing helps the sealant bond with the tooth – similar to sanding a surface prior to painting. The doctors then apply a BPA-free sealant and use a curing light to harden the material. As the procedure is relatively easy, the doctors will usually do several teeth at the same time, sometimes doing as many as twelve in one appointment!
Links for more information about sealants:
American Dental Association: Dental Sealants
Center for Disease Control: Dental Sealant FAQ
Posted on Wed, Apr 11, 2012 @ 03:09 PM
Let’s continuing on with our discussion about children’s teeth. Today we will discuss 1st molars. By the time these teeth start to appear your lovely little one has a mouth full of chompers; and yet you are seeing more signs of teething. This can only mean one thing; your child’s first molars are coming in.
Baby’s First Molars
First molars usually come in around year one. They are accompanied by a return of signs of teething, such as increased drooling and fussiness. The eruption of the molars may be more difficult than the eruption of the anterior teeth (teeth numbers C-H and M-R). As molars are larger and have a flat surface, sometimes they are more painful. For some children who have problems with teething, they may begin waking up in the middle of the night again due to discomfort. The second set of molars usually arrives around your child’s 2nd year. By three years old, your toddler should have a full set of 20 teeth – 12 anterior (front) and 4 posterior (back).
Our first set of teeth are called primary teeth. There are 20 in all and, unlike permanent teeth, they are labeled with letters. Starting on the upper right with A, they are labeled alphabetically across the top teeth, and then continue by dropping down to the lowers and then wrapping around:
As your child begins to have their primary teeth replaced by permanent teeth, their mouth will be a mixture of letters and numbers. As well as being a mixture of large and small teeth.
Time for Brushing
As your child's teeth begin erupting, use a fluoride free toothpaste to brush their teeth. Encourage them to spit the toothpaste out in preparation of fluoridated toothpaste. Move them to the fluoride toothpaste when they are ready, usually between 2-5. At age 6, you can continue to encourage good oral habits in your children by introducing a fluoride rinse (such as A.C.T.) into your child’s oral hygiene routine. The fluoride will help strengthen your child’s teeth, making them more resistant to decay. Introduce your child to floss and the idea of flossing by flossing in front of them. They may just surprise you and ask you to floss their new teeth!
The best way to get your child to practice good oral hygiene is to practice it yourself. Make sure your child sees you taking care of your teeth, and they’ll want to copy you. Give positive encouragement and you’ll end up with children with beautiful, healthy smiles!
Posted on Wed, Apr 04, 2012 @ 01:55 PM
When you are looking to improve your smile there are many different directions you can take. In today’s post we will be exploring one of the options available at our Evanston dental office to maximize your smile potential. Whether you are looking to correct worn teeth, discolored teeth, or a gap in your teeth, veneers may be the option for you.
A veneer in dentistry is a restoration that covers your original tooth. Unlike crowns, veneers allow you to retain the majority of your original tooth structure. Veneers can be a cosmetic solution, but in some instances veneers can be used in a restorative manner. There are several different options for veneers. At our office we offer one visit veneers using our CEREC milling machine and contact lens thin Lumineers®.
Dr. James Stephens has used Lumineers to restore an older, worn smile to a beautiful white smile:
Before After
He has also used Lumineers to correct a gap between front teeth:
Before After
In both cases, multiple veneers were used to preserve the color and look of the patient’s smile. Traditionally 6 or 8 veneers are done at the same time depending on how wide your smile is.
If you are interested in finding out if veneers are right for you, contact our office. We even have a special going on at our office right now! (Visit our Facebook page for more details.) Drs. James and Robert Stephens would be happy to sit down and go over your smile options with you.
Posted on Wed, Mar 28, 2012 @ 02:05 PM
Losing your first tooth shouldn’t be a traumatic experience. Most children lose their first tooth somewhere between 5 and 7 years of age. Every once in a while a child may lose their first tooth earlier due to an accident or emergency. This week we are going to cover these two options for children losing their first tooth.
Wiggle, Wiggle, Wiggle… 
One of the steps on the way to becoming a “big kid” is losing your first tooth. Children usually lose their teeth in the order that they first got them. Baby teeth fall out due to their roots dissolving, which makes room for the permanent teeth.
You can encourage your child to wiggle loose teeth to help them fall out, but we don’t recommend forcing out teeth before they are ready to come out. The root needs to disintegrate fully before the tooth comes out willingly. If the tooth is pulled early, the remaining root may cause problems or may become infected. If a loose tooth refuses to come out, you can always visit your dentist and have it extracted.
If you are concerned about your child’s primary teeth, or they don’t seem to be getting any looser, feel free to contact our Evanston dental office. Our doctors will be able to assess your child’s oral situation and advise you how to proceed.
Ouch!
Accidents happen, even more so with small children. Whether it’s a primary tooth or a permanent tooth, any injury that affects your child’s smile can be scary. We have some helpful hints to share from the American Dental Association:
Toothache: Rinse the mouth with warm water to clean it out. Gently use dental floss or an interdental cleaner to remove any food or other debris that may be caught between the teeth. Never put aspirin or any other painkiller against the gums near the aching tooth. This could burn gum tissue. If the toothache persists, make an appointment to see the dentist. Don’t rely on painkillers. They may temporarily relieve pain but only your dentist should evaluate the condition.
Knocked-out (avulsed) tooth: Try to find the tooth! This may not be as easy as you think if the injury took place on a playground, basketball court or while skateboarding, so try to stay calm. Hold the tooth by the crown and rinse the root in water if the tooth is dirty. Don’t scrub it or remove any attached tissue fragments. If it’s possible, gently insert and hold the tooth in its socket while you head to the dentist. If that’s not possible, put the tooth in a cup of milk and bring it to the dentist. Time is critical for successful reimplantation, so try to get to your dentist immediately.
Broken tooth: Rinse your mouth with warm water to clean the area. Use cold compresses on the outside of the cheek to help reduce the swelling. Bring broken piece to your dentist if possible.
Tongue or lip bites or wounds: Clean the area gently with a clean cloth and apply cold compresses to reduce any swelling. If the bleeding can’t be controlled, go to a hospital emergency room or clinic. You may able to reduce bleeding from the tongue by pulling it forward and using gauze to put pressure on the wound.
Objects caught between teeth: Try to gently remove the object with dental floss. Never use a sharp instrument to remove any object that is stuck between your teeth. If you can’t dislodge the object with floss, contact your dentist.
Possible broken jaw: Apply cold compresses to control swelling. Go to the hospital emergency room immediately.
As always, we are just a phone call away for emergencies and for your regular preventative appointments.
Posted on Wed, Mar 21, 2012 @ 01:25 PM
We started our blog posts off with information about dental insurance because we believe that it’s important for patients to understand their insurance. Now we’re going to move on to taking care of your smile throughout your life.
To start your children out on a great path to oral health, it is important to start young. Oral care should begin as soon as the first tooth erupts, or before. Parents should model good oral hygiene habits for their kids to follow. The Academy of General Dentistry says that “According to the U.S. Centers for Disease Control and Prevention, tooth decay affects children in the United States more than any other chronic infectious disease, highlighting the need for thorough oral care and regular dental visits.”
Beginning Oral Hygiene
According to the ADA, you should “begin brushing your child’s teeth with a little water as soon as the first tooth appears.” You can use a soft cloth or a baby toothbrush to clean your child’s teeth. If you’d like, you can clean your baby’s gums with a soft cloth before their teeth begin to appear to get them use to the feeling of something in their mouth. No toothpaste is necessary, but should you choose to use some, please check with your dentist or physician for recommendations.
First Dental Visit
“The American Dental Association recommends that a child be seen by a dentist as soon as his or her first tooth erupts, but at least no later than the first birthday.” (Source) This initial visit is considered a “well baby checkup.” The dentist will evaluate the child’s teeth and can help demonstrate how to properly care for your child’s teeth. At this time you can also speak to your dentist about any concerns you have about your child’s teeth or any oral habits (such as thumb sucking or pacifier usage).
Feel free to ask your dentist what to expect at the first appointment for your child. Usually it is an introductory appointment for your child to meet the dentist. Initial visits usually include introductions to the hygienist and the dentist, as well as introductions to dental equipment (such as Mr. Thirsty). Depending on the child’s age and if the child is cooperative, the dentist or hygienist may count the child’s teeth and buzz the child’s finger with a prophy angle to get them use to the feeling.
To prepare your child for their first visit, talk to your child and build excitement for the appointment, but don’t make promises that you may not be able to keep, such as telling them that it won’t hurt. “’Avoid saying that everything will be fine, because if you child ends up needing a treatment, he might lose trust in both the dentist and you,’ says Joel H. Berg, D.D.S., M.S., Director of the Department of Dentistry at Seattle Children's Hospital.” (Source) Avoid bribing your child with a special toy or trip if they are well behaved. This may lead your little one to wondering why they would need to make a fuss and may cause them more apprehension.
Every parent wants the best for their child. Ensure your child’s smile lasts a lifetime by introducing great oral hygiene at an early age. If you have any questions about your child’s oral health, call our Evanston dental office to set up an appointment with Dr. James or Dr. Robert Stephens. Or leave a question below, we’ll help you get the answers that you need.
Posted on Wed, Mar 14, 2012 @ 02:25 PM
Today we are going to finish up our series on dental insurance with deductibles and maximums. These are two different limits that are defined in your insurance plan. Again, each insurance plan is different, so, to be certain, check with your insurance carrier to find out what applies to your benefit package. Deductibles in dental insurance are similar to deductibles in medical insurance. If you do have a deductible, you will have to pay it before the insurance will begin their coverage.
Deductibles in dental insurance can be as low as $25. Some insurance plans do not apply your deductible to preventative coverage – such as your routine hygiene appointment. Instead they pay the hygiene appointment at their normal coverage level, and apply the deductible to any additional services you need to have done – such as a filling or a crown. Other dental insurance plans don’t have a deductible at all.
Unlike deductibles, all dental insurance plans have a plan maximum. The plan maximum is the amount of money the insurance company will pay in a coverage year. Plan maximums renew at the beginning of the coverage year and any un-used benefits are lost at that time. If you have treatment that needs to be completed, you can work with your dentist to plan out a way to get the most out of your insurance and ensure that you don’t lose any of your benefits. To facilitate this, it is best to know how much is allocated to your plan maximum and what your insurance considers a coverage year.
A coverage year is not necessarily the same as a calendar year. Some plans use a school year as a coverage year, and some use your start date. Find out from your insurance what your coverage year is prior to starting major treatment to ensure you don’t go over your plan maximum. If you have new insurance, check to see if you have a waiting period for major treatment as well.
Over the past couple of weeks, we’ve shared several tips to help you understand your insurance. You may have noticed that the recurring theme is that you should check with your insurance company. Your insurance is a contract between yourself, your employer, and the insurance company. The more knowledge our patients have about their benefits, the better able we are to provide affordable quality dentistry. Let us know if you have any other questions about insurance, and we’ll be sure to answer them in a future post.
Posted on Thu, Mar 08, 2012 @ 01:41 PM
Continuing along with our insurance tips and definitions, today we will explore an insurance term called “usual and customary.”
As we discussed last week, dental insurance plans usually have different breakdowns of coverage. These are paid out at differing percentages, but percentages of what? Contrary to what most people believe, it is not a percentage of the dentist’s fees. Instead, it is a percentage of an allowed amount that the insurance company has set. This allowed amount is known as the insurance company’s usual and customary fee.
Insurance companies use different surveys to determine the usual and customary fee. These fees may be higher or lower than the dentists in your area. An insurance company may use a survey of dentists across the nation; across the Midwest; across Illinois, or across Evanston. Different surveys will result in a different usual and customary fee. When you visit an out-of-network provider, the insurance company pays the percentage of the usual and customary fee and the patient is responsible for the remaining percentage as well as the difference between the two fees.
An example would be a prophylaxis (cleaning) that is covered at 90% by the insurance company. Let’s say that the dentist charges $100 for a prophylaxis, but the insurance company’s usual and customary fee is $90. This means that the insurance company will cover 90% of $90, which is $81. The patient is responsible for the remaining $19 – $9 from the 10% the insurance didn’t cover of their usual and customary fee and the $10 difference between usual and customary and the doctor’s fee. Here is how the breakdown may look on an insurance form:
If this isn’t crazy enough, just wait! Check back with your friendly neighborhood Evanston dental office next week, when we bring deductibles into the mix. As you can see, insurance coverage can be a bit elaborate. The most accurate answer you can get as to what and how much your insurance company will cover is by asking them. So until next week, keep smiling and flossing.