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When we don’t keep up with our dental hygiene, plaque buildup can result in three kinds of cavities. Pit and fissure cavities are found on the tops of molars, where food particles get stuck in the irregular surfaces. Smooth surface cavities are located on the smooth sides of teeth.

Wait. Top, all around the sides—what’s left for plaque to attack?

Our roots. The roots of our teeth are generally protected by their concealed position in the jaw. Sitting securely in alveolar bone, held firmly in place by connective tissue, with gum tissue snugly surrounding them, roots are generally not cavity prone.

But these cozy conditions can change. Due to gum disease, abrasive habits, or simply the passage of time, gums can recede and expose root surfaces. And this exposure can lead to root cavities.

If you look at a complete tooth, it looks like enamel is covering the entire tooth surface. In fact, enamel, the strongest substance in the body, only covers the visible part of the tooth, called the crown. The roots are covered by a substance called cementum, which is softer than enamel. And if enamel can’t stop decay, cementum is even more vulnerable when it’s exposed to plaque, bacteria, and acidic foods.

How do we protect our roots from decay? Protecting our gums is the first line of defense.

• Gum Disease

Receding gums caused by periodontitis can be treated by Dr. Keith J. Fabre Jr.. Deep cleaning procedures such as scaling and root planing can remove accumulated plaque and tartar, and help gum tissue reattach to teeth. For serious recession, gum grafts can replace lost tissue.

Early treatment can prevent recession. If you notice any signs of early gum disease, including bleeding, swelling, tenderness, or persistent bad breath, it’s time for a visit to our Marrero office.

• Gum Abrasion

It’s not just gum disease that can lead to gum recession. Some personal habits are hard on gums and teeth, and can leave roots exposed. If you bite your nails, grind your teeth, irritate your gums with oral piercings, you are at risk for gum recession. Talk to Dr. Keith J. Fabre Jr. about preventing abrasive damage.

A surprising cause of receding gums? Over-vigorous brushing. Use a soft-bristled brush—and don’t use a heavy hand when brushing—to protect your delicate gum tissue.

• Aging

As we age, our gums recede. So it’s no wonder that older adults are especially at risk for root cavities. That’s why it’s very important to keep up with brushing (at least two minutes twice a day) and flossing (once a day, or more often if needed) to prevent the buildup of plaque and tartar.

And it’s more important than ever to schedule regular dental exams and cleanings. Dr. Keith J. Fabre Jr. can help stop small problems from becoming major ones, and suggest brushing and flossing techniques, fluoride treatments, or other procedures to encourage gum and dental health.

If a cavity develops, no matter what kind, it should be treated as soon as possible. And time is especially important for a root cavity.

Because cementum is weaker than enamel, cavities can progress more quickly in roots. A cavity which has reached pulp tissue might require a root canal and a crown to restore tooth function. Serious decay could lead to extraction.

Don’t let root cavities undermine your dental health. If you notice any sign of gum disease or recession, it’s time for a visit to our Marrero office. After all, even though they go unnoticed, strong roots are the foundation of a healthy, attractive, life-long smile.

Whether it’s your first child or you’re an experienced mom, pregnancy is an exciting time—which you’ll be able to enjoy much more once the days of morning sickness are over.

Morning sickness affects most pregnant women, and can present in any number of ways. It might take the form of mild nausea, or cause frequent vomiting. It often occurs in the morning hours, but can take place at any time of day. It’s usually over with by the second trimester, or it can last weeks longer. Because of this wide variety of symptoms, morning sickness is more accurately referred to as NVP, the nausea and vomiting of pregnancy.

Your doctor can recommend safe and effective ways to deal with NVP, especially when symptoms are more severe. We have some recommendations to minimize the effect of morning sickness on your dental health.

Wait, dental health? That’s right. Besides its more obvious unpleasant consequences, NVP can cause problems for your teeth and gums. We have a few suggestions for getting you through the weeks of morning sickness with easy and effective strategies to protect your oral health.

Prevent Acid Damage

Vomiting and heartburn with reflux expose the teeth to stomach acids. Tooth enamel is the strongest substance in the body, but it’s not safe from acid attacks.

Normally, the pH balance in our mouths is neutral, around a 7 on a scale of 0 to 14. When acidic conditions lower the oral pH to 5.5 or below, the minerals in enamel begin to dissolve, leading to sensitivity and, eventually, cavities. The pH of our stomach acid ranges from 1.5 to 2.5. This is great for digesting food, but not great at all for enamel and sensitive gum tissue.

Whenever we vomit, the immediate (and understandable!) impulse is to reach for our toothbrushes. But this is an impulse we should resist. Because acids weaken tooth enamel, scouring the teeth with a toothbrush right away can cause more erosive damage. Instead,

• Wait half an hour or more before brushing to give your enamel time to recover its strength.
• In the meantime, rinse with water and perhaps a bit of toothpaste or diluted, doctor-approved mouthwash.

Keep Hydrated

Another consequence of frequent vomiting is dehydration. It’s always important to keep our bodies properly hydrated, and this is particularly true during pregnancy.

Hydration is also essential for oral health. Saliva helps wash away the bacteria and food particles which cause cavities and irritate the gums—especially important now, since pregnancy hormones can leave you more vulnerable to gingivitis and other forms of gum disease.

• Drink water as recommended by your doctor. It’s healthy, it hydrates, and it helps prevent cavities and gum disease. Win/win/win.
• Whichever fluids are your favorites, drinking them in measured amounts through the day will be more effective and more appetizing than drinking large amounts once or twice a day to catch up.
• You have a busy life, so make things easy on yourself. If you need to hydrate more, keep track of your hydration goals with an app or a phone notification. There are even “smart bottles” to track your intake. Or go old school, and fill a bottle marked with timed measurements to remind you to hydrate through your day.

When The Very Idea of Brushing Is Nauseating . . .

When just the thought of brushing is unappetizing, we have suggestions which might help.

• Postpone brushing until later in the day when you feel better. Rinse with water first thing in the morning instead.
• Trade in your regular toothbrush for one with a smaller brush head. This can help prevent the gag reflex.
• Brush slowly, using small strokes.
• If brushing the back teeth is particularly triggering, try deep breathing or sitting down to brush.

We want to help you enjoy a healthy pregnancy. Let us know when you first learn you’re pregnant. We have some valuable tips for the coming months, including suggestions for reducing the dental effects of NVP. Fortunately, morning sickness is temporary, and we’re here with ideas to help your beautiful smile last a lifetime!

Oral health is an important and often overlooked component of an older person’s general health and well-being. Dr. Keith J. Fabre Jr. and our team know that for many of our older patients, oral health can become an issue when arthritis or other neurological problems render them unable to brush or floss their teeth as effectively as they once did. Today, we thought we would discuss four common oral health issues our older patients face and how they can avoid them:

Cavities: It’s not just children who get tooth decay—oral decay is a common disease in people 65 and older. Ninety-two percent of seniors 65 and older have had dental caries in their permanent teeth, according to the National Institute of Dental and Craniofacial Research. The risk for tooth decay increases because many older adults don’t go to the dentist as often as they used to, thus cavities go undetected and untreated for longer than they should. Keeping regular appointments with Dr. Keith J. Fabre Jr. is the key to getting cavities treated in a timely manner.

Difficulty eating: Oral health problems, whether from missing teeth, cavities, dentures that don’t fit, gum disease, or infection, can cause difficulty eating and can force people to adjust the quality, consistency, and balance of their diet.

Dry mouth: Also called xerostomia, dry mouth is a common issue for a lot of seniors. Our friends at the Oral Cancer Foundation estimate that 20 percent of elderly people suffer from dry mouth, which means the reduced flow of saliva (saliva plays a crucial role in preventing tooth decay). Many seniors are on multiple medications for a variety of chronic illnesses or conditions. Common medications taken that may cause dry mouth are decongestants, antihistamines, blood pressure medications, pain pills, incontinence medications, antidepressants, diuretics, muscle relaxers, and Parkinson’s disease medications. To help counter this, we suggest drinking lots of fluids and limiting your intake of caffeine and alcohol. We also encourage you to check with Dr. Keith J. Fabre Jr. during your next visit if you think your medications are causing your mouth to feel dry.

Gum Disease: Gum (periodontal) disease is an infection of the gums and surrounding tissues that hold teeth in place. While gum disease affects people of all ages, it typically becomes worse as people age. In its early stages, gum disease is painless, and most people have no idea that they have it. In more advanced cases, however, gum disease can cause sore gums and pain when chewing.

Gum disease, which can range from simple gum inflammation to serious disease, is usually caused by poor brushing and flossing habits that allow dental plaque to build up on the teeth. Plaque that is not removed can harden and form tartar that brushing simply does not clean. Only a professional cleaning at our office can remove tartar. The two forms of gum disease are gingivitis and periodontitis. In gingivitis, the gums become red, swollen, and can bleed easily; in periodontitis, gums pull away from the teeth and form spaces that become infected.

Proper brushing, flossing, and visiting our office regularly can prevent gum disease. Seniors with limited dexterity who have trouble gripping a toothbrush should ask Dr. Keith J. Fabre Jr. about modifying a handle for easier use or switching to a battery-powered toothbrush.

What do we know about osteoporosis? We may know that this disease makes the bones more brittle and vulnerable. We may know that osteoporosis is the cause of many a broken hip or curved spine as we age. We may even know that, for a number of reasons, women are far more likely to develop this disease. What we may not be aware of is the impact osteoporosis can have on our dental health.

“Osteoporosis” means “porous bones.” It is a disease that makes the bones more likely to fracture or break, as the body’s careful balance of absorbing old bone tissue and replacing it with new healthy bone tissue is disrupted. We lose bone tissue faster than we can create new, dense bone tissue. Why is this important for our dental health? Because the fitness of our teeth depends on the fitness of the bones surrounding and securing them in our jaws.

How does osteoporosis affect dental health?

• Osteoporosis reduces density in the bones and bone tissue that hold our teeth in place. Studies have shown that women with osteoporosis have significantly more tooth loss than women without the disease.
• Periodontitis, or gum disease, can also cause deterioration in the bone surrounding the teeth. This is a time to be proactive with gum health to avoid infections and further bone loss.
• Denture wearers may find that their dentures no longer fit properly due to changes in bone structure. Bone loss needs to be addressed promptly to avoid having to replace dentures.
• Rarely, bone-strengthening medications for osteoporosis can lead to serious jaw problems after dental procedures that involve the jawbone (such as extractions). Always tell us any medications you are taking before we schedule any dental treatment.

Unfortunately, osteoporosis often has no symptoms at all—until the first bone fracture. Checking our bone density is important as we age, and one way of discovering changes in bone density is through your regular dental checkups at our Marrero office. We can pinpoint changes in your X-rays through the years and will recommend that you see your physician if there is any indication of bone loss. If you have already been diagnosed with the disease, we have ideas to help maintain the health of your teeth and bones.

Many factors can increase your chance of developing osteoporosis. Age, illness, personal habits, medications, diet, genetics—any number of conditions can affect our bone health. Talk to us about osteoporosis. Dr. Keith J. Fabre Jr. would like to work with you to provide prevention and treatment to keep your teeth and bones strong and healthy for a lifetime of beautiful smiles. And that’s certainly good to know!