If you’ve recently had a dental implant placed, congratulations! You have made a good investment in your smile that should last for a lifetime — if you take proper care of it. This is easy to do with a good oral hygiene routine and regular professional cleanings. Here are some important things to keep in mind about implant care: Implants can last as long as teeth. A dental implant made of titanium will fuse to the bone surrounding it and function just like a natural tooth. It is a highly successful method of tooth replacement that succeeds more than 95% of the time. Implants and natural teeth attach to surrounding bone and gums very differently. A natural tooth does not actually fuse to the bone that surrounds it. Instead, it is held in place by a periodontal ligament (“peri” – around; “odont” – tooth) made up of tiny fibers that insert into the bone on one side and into the tooth on the other. Farther up, these collagen fibers attach the tooth to the gum tissue. Implants and the crowns that go on top of them are not anchored to the gum in this way. An understanding of this biology is important for maintaining good periodontal health when implants are present. We will go over this with you so can care for your implants correctly. Infection is the enemy. Bacterial infection is a concern with both natural teeth and implant-supported teeth. A bacterial biofilm (plaque) builds up daily on implant teeth, just as it does on natural teeth. If it is not regularly cleared away, various oral infections can develop. In the case of natural teeth, this might result in tooth decay, gum disease, and the loss of tooth-supporting bone. Implants can’t decay, but they can be threatened by a rapidly progressing infection known as peri-implantits (“peri” – around; implant “itis” – inflammation), which can lead to a well-like or dish-shaped loss of bone around the implant. The implant can become loose as greater amounts of bone is lost. Good oral hygiene is as important as ever. Daily removal of bacterial biofilm is key to preventing peri-implantitis. You’ll want to make sure you brush your teeth twice daily with a soft brush and fluoride toothpaste, and floss gently at least once per day. Your dental hygienist has an important role to play. Professional cleanings here at our dental office are also still as necessary as ever, if not more so. Dental hygienists have special instruments they use to clean areas around your implant that can’t be reached by your brush or floss — without scratching the surfaces of your implant components. If you would like more information about dental implants, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment. You can also read more by reading the Dear Doctor magazine article “Dental Implant Maintenance.”

Singer Olivia Newton-John’s daughter Chloe is now a lovely, grown woman, but Olivia recently recounted to Dear Doctor magazine a rather creative method she found to sooth Chloe’s teething troubles many years ago. “When Chloe was a baby and teething I remember using a frozen bagel for her sore gums,” Olivia said. “She loved it!” Cold is often very soothing to a teething child’s gums. In fact, the American Academy of Pediatric Dentistry (AAPD) recommends using a clean, chilled, rubber teething ring, or cold wet washcloth. Chilled pacifiers can also be helpful. Be sure not to freeze teething rings or pacifiers as ice can actually burn sensitive mouth tissues. Older teethers can sometimes find relieve from cold foods such as popsicles (or bagels!) but make sure your child eats these sugar-containing foods only at mealtimes so as not to promote tooth decay. If your baby has not yet begun the teething (or tooth-eruption) process, you can expect it to begin usually between six and nine months. It may, however, start as early as three months or as late as twelve months. Teething symptoms vary among children, as does the length of time it takes for a tooth to make its appearance. But many parents notice the following signs: Irritability Biting and gnawing Gum swelling Chin (facial) rash Disrupted sleeping patterns Ear rubbing Drooling Decreased appetite These symptoms are usually most bothersome during the week that the tooth is breaking (erupting) through the gums, starting about four days before and lasting about three days after the tooth appears. Occasionally, teething discomfort can be considerable. If that is the case with your baby, you can give her or him acetaminophen or ibuprofen in the appropriate dose (check with your pharmacist if you’re not sure what that is). The medicine should be swallowed — not massaged into the gums, as this can also burn. Numbing agents should not be used for children under 2, except under the advice and supervision of a healthcare professional. If you would like to learn more about teething or any other child-related oral health issue, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. If you would like to read Dear Doctor’s entire interview with Olivia Newton-John, please see “Olivia Newton-John.” Dear Doctor also has more on “Teething Troubles.”

A crown is a common type of dental restoration that has been available, in different forms, for a long while. When properly done, it may last for decades — and if desired, it can be made to match the shade of the natural teeth so well that it’s nearly impossible to tell them apart. Some recent technological innovations may offer patients who need this treatment even more choices. To begin learning about dental crowns, let’s start with five facts everyone should know. Crowns are a type of restoration that can solve many dental problems. There are many factors that may cause the structure of a tooth to become compromised. It can be weakened by grinding or chipping, gradually removed by repeated dental fillings, or suddenly broken by trauma. Sometimes, a more conservative treatment (like inlays or veneers) may be enough to take care of the problem. When it isn’t, the missing tooth structure can be replaced by a crown. Crowns replicate the form and function of natural teeth. Because they must fit into your mouth perfectly and match your bite exactly, each crown is an individually-crafted item, made just for you. That means the form of a crown must look just like the tooth it replaces — before it was damaged. And, especially if it’s for a front tooth, a crown is often carefully designed to match the particular shade of your teeth. If you are unhappy about the color of your other front teeth, tooth whitening should be done first before your new crown is created to get the best results possible. Crowns can be made of different materials. For over a hundred years, crowns have been made of gold. While this extremely long-lasting material remains popular, its use has been declining recently due to aesthetic factors. Two tooth-colored alternatives are all-porcelain and porcelain-fused-to-metal crowns. The exact shade and luster of these substances can be made to closely simulate the natural teeth. Each has advantages and disadvantages in particular situations but we will be happy to make recommendations as to what is in your best interests. New technologies are changing the way crowns are prepared. Advances in the field of materials science have led to crowns being fabricated from more durable high-tech substances, like ceramics made of zirconium dioxide. And the availability of small-scale computer-aided design and manufacturing technologies means that in some situations, it’s possible for a crown to be fabricated right in the dental office, in minutes. Undoubtedly, these technologies will continue to improve in the future. Delivering a quality crown is a blend of science and art. No matter how high-tech the process becomes, producing a fully functional, long lasting and natural-looking crown remains a blend of aesthetics and science, seasoned with a healthy dose of clinical experience. It’s also a team effort involving a skillful dentist, a talented dental laboratory technician and a knowledgeable patient — you. If you would like more information about crowns, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Porcelain Crowns & Veneers,” “Gold or Porcelain Crowns,” and “Creating In-Office Dental Restorations With Computers.”

Lashinda Demus holds the U.S record in the 400 meter hurdles, with a time of 52.47 seconds, the third fastest ever recorded. While her twin 5-year-old boys cheered her on, she brought home a silver medal from the 2012 London Olympics. But when it comes to her full set of upper and lower braces, there’s no silver to be seen! Demus is a top-ranked competitor, a wife and a mom — and an adult who is currently in orthodontic treatment. With her dentist’s approval, she chose clear ceramic braces. These are just one of the treatment options available to adult patients, many of whom prefer a less noticeable style of orthodontic appliance. As many as three-quarters of adults are thought to have some form of orthodontic problem. Common issues include teeth that are crowded too closely together, or ones that have drifted too far apart after an extraction or other tooth loss. It is believed that straightened teeth are easier to clean and better for chewing — they can also improve an adult’s social life, and even his or her career prospects! Some grown-ups may hesitate to consider orthodontic treatment because they remember the “railroad tracks” they saw in junior high school. In fact, there have been many changes in orthodontic appliances in the past few years. Two popular choices for adults are colorless braces (the kind Demus wears) and clear orthodontic aligners. Colorless ceramic braces are made of high-tech composite materials. They resist staining, and are less noticeable because their translucent appearance blends with the teeth. Often, a single wire is the only part that’s plainly visible. Sometimes it’s even possible to place them on the lingual (tongue) side of the teeth. Clear aligners are an alternative to braces that are available to adults and teens. Instead of wires and attachments, these consist of a series of transparent, removable trays that are placed over the teeth and worn 20 hours per day. Over a period of six months to two years, the teeth are gradually straightened as you progress from one computer-designed tray to the next. Best of all, you can remove the trays completely to clean your teeth, and for important occasions. Which one is right for you? It depends. While aligners have been successful in treating mild to moderate spacing issues, more difficult problems with the bite may require a more traditional form of braces. Also, there are a few health problems which might need to be attended to before orthodontic treatment is begun. The best way to learn about your options is to come in for a consultation. But remember: if you want a better smile, it’s never too late. If you would like more information about orthodontic choices, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Orthodontics For The Older Adult” and “Clear Orthodontic Aligners.”

Periodontal or gum disease is an often silent disease that can cause significant damage to the health of your teeth and body. The reason it is so often classified as a silent disease is because it is chronic or longstanding and often without any symptoms or pain that most people associate with a disease until it may be too late. If you think you may have gum disease, here is what to look for: Bleeding gums — probably one of the most common and overlooked early warning signs that most people ignore is thinking that the bleeding is being caused by brushing their teeth too hard. The truth is that you would have to brush extremely hard to cause healthy gum tissues to bleed. Bad breath — something everyone has experienced; however, it can also be a warning sign of periodontal disease. This is especially true for people who hate or refuse to floss their teeth, thereby trapping literally billions of bacteria where they love to collect in the protected areas between the teeth. Redness, swelling, and/or receding gums — all signs of gum disease often accompanied by sensitivity of the gum tissues around the teeth. Chronic inflammation — long-standing gum inflammation is a sign that your gum tissues are not healing properly. Periodontal disease exhibits periods with bursts of activity followed by periods where the body tries to recover. Loose and/or moving teeth — that seem to be drifting into a new position, are visible signs that you are highly likely to have periodontal disease. Abscess formation — late stage gum disease is characterized by painful, swollen, red pockets of pus, which denotes an acute localized periodontal infection. If you have any of these signs, you need to make an appointment for a thorough evaluation. Otherwise, you could end up losing your teeth to the second most common disease known to man after tooth decay. To learn more about gum disease, continue reading, “Warning Signs of Periodontal (Gum) Disease.” Or, contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment.

Nearly every parent and caregiver has experienced that almost instantaneous sick feeling when they see that their child has been injured, especially when it is an injury to the mouth and teeth. For some, it is just a bloody lip; however, if the accident chipped a tooth, then you may have a completely different situation on your hands. If the nerve of the tooth has not been damaged, you needn’t worry too much — a composite (plastic) tooth-colored restoration that is actually bonded to the tooth is an ideal material for repairing most broken or chipped teeth. Contact Dr. Cindy Sumarauw at 801-281-3500 as soon as possible to assess the extent of injury, so that proper and appropriate action can be taken. An additional reason why bonding with composite resin may be the ideal choice for repairing a child’s chipped tooth is that it can be custom created in virtually any shade so that it perfectly matches the damaged tooth and the surrounding teeth. It is also far less expensive than a crown, an important factor to consider when repairing a primary (baby) tooth that will eventually fall out to make room for a permanent tooth. If the injury is to a permanent tooth, a composite resin still may be ideal to use as a restoration until your child or teenager has stopped growing or playing contact sports. This is because your teenager may be too young for a more permanent restoration such as a crown or porcelain veneer. An important, proactive step you can take to be prepared for the next time your child has a dental injury is to download Dear Doctor’s Field-side Pocket Guide for Dental Injuries. This handy, quick reference guide is a must have for athletes, parents, caregivers, teachers, coaches or anyone who is often in an environment where a mouth injury is likely to occur. Knowing what to do and how quickly you must respond can make the critical difference between saving and losing a tooth.

Let’s talk about oral cancer. Yes, it’s a scary subject — but the truth is, the more you know about it, the better able you are to protect yourself. Who is more likely to get oral cancer? Because of your genetic disposition — heredity — men are twice as likely to develop oral cancer as women. African-Americans have a higher incidence than Caucasians. The disease is also related to aging, although in recent years many young people have been diagnosed with this disease. Are some habits related to development of oral cancer? Risk factors include use of tobacco in any form, both smoking and chewing, chronic exposure to sun, and consumption of alcohol. Moderate to heavy drinkers have a three to nine times greater risk than non-drinkers. Tobacco smokers are at five to nine times greater risk than non-users, and users of snuff or chewing tobacco are at four times greater risk than non-users. Where do most oral cancers occur? The most common areas are in the mouth itself, the lips, the tongue, and the pharynx (back of the mouth and throat). What are the statistics for survival after treatment for oral cancer? Conquering cancer depends most on early detection. Since most cases of oral cancer are discovered at a late stage, survival is poor, with less than 60% surviving five years after treatment. When oral cancers are detected early, the survival rate is more than 80%. What are some of the symptoms of oral cancer? Most oral cancers are “squamous” (small scale-shaped) cell carcinomas in the lining of the mouth. Signs of these cancers can be seen as white or red patches in the early pre-cancerous stage. These develop into an ulcer that does not heal. When should you seek medical help? If you notice color changes (white or red patches) or sores or ulcers anywhere in your mouth that do not heal within two or three weeks, go to your dentist for a checkup right away. Sometimes the sores resemble cold sores. A definitive diagnosis requires a tissue biopsy, in which a small piece of tissue is removed under anesthesia and taken to a lab for microscopic examination. What about regular routine examinations? An oral cancer examination should be part of your visit to our office. We will inspect your face, neck, lips and mouth for signs of cancer, feel the floor of the mouth and sides of the neck for any lumps, examine your tongue and the back of your throat. The American Cancer Society recommends a cancer related check-up annually for all individuals aged 40 and older and every three years for those between 20 and 29. Contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment to discuss your questions about oral cancer. You can also learn more by reading the Dear Doctor magazine article “Oral Cancer.”

Many adults these days are opting for clear aligners to correct orthodontic problems that have long bothered them. Katherine Heigl is a perfect example. She had one tooth that was out of alignment, and wanted to have it fixed before her wedding day. “I got them [clear aligners] because of this wonky tooth,” Heigl told In Style magazine not long ago. “It’s awesome because every two weeks you switch to a new retainer. Pretty much the perfect way to describe Invisalign is Netflix for your teeth.” That’s actually a pretty good way to describe this highly user-friendly form of orthodontic treatment. Clear aligners are transparent, plastic oral appliances that are changed every two weeks so that your teeth can be moved a little bit at a time, according to a carefully staged sequence. Though they cover your teeth completely, clear aligners are barely noticeable. In fact, when Heigl excused herself before taking out her aligners to eat, her In Style interviewer said, “Who knew you wore them? I guess that’s the point of Invisalign.” Being able to remove the aligners for eating and, more importantly, teeth-cleaning, is another major advantage of this method of straightening teeth. Successful orthodontic treatment for adults depends on good periodontal health (“peri” – around; “odont” – tooth), and the best way to keep your gums and the underlying bone that supports your teeth healthy is to keep up an effective daily oral hygiene routine. Clear aligners have been improved in recent years to correct more complicated malocclusions (“mal” – bad; “occlusion” – bite) than previously; they can even work well for teenagers. But there are still some cases that call for traditional braces. We would be happy to explore all the different options for orthodontic treatment with you, whether you have crowded teeth, an overbite or underbite, or just one “wonky tooth.” If you would like more information about clear aligners, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can also learn more about clear aligners in general by reading the Dear Doctor magazine article “Clear Aligners For Teenagers.” Dear Doctor also has more on “Wedding Day Smiles.”

Did you know that severe tooth decay is America’s #1 chronic childhood disease? Actress Brady Reiter didn’t know either — until she became the star of the movie Tooth Fairy 2, and then joined forces with the National Children’s Oral Health Foundation: America’s ToothFairy®. “Before, I didn’t even realize what can happen to kids if they don’t take care of their teeth,” 11-year-old Brady recently told Dear Doctor magazine, after viewing photos of children suffering from severe tooth decay. “There are kids in America who don’t know that it’s important, or they just don’t have the resources to be able to take care of their teeth or to go to the dentist.” This young Tooth Fairy knows just how magical — and vital to a child’s self-esteem — a beautiful smile can be. “When you feel bad about opening up your mouth and smiling, a kid’s confidence just goes down the drain,” she said. NCOHF recently tapped 11-year-old Brady to head the America’s ToothFairy Kids Club, which offers kids personalized letters from the Tooth Fairy along with lots of encouraging oral health tips and fun activities — free! “I’m really excited to be part of it,” Brady told Dear Doctor. “Kids learn how to take care of their of smile by joining this club. By supporting America’s ToothFairy, we can help kids in need get dental care and have a healthy smile too. It’s really amazing!” While lots of kids get an occasional cavity, millions of children have tooth decay so severe that it interferes with their ability to eat, sleep, and concentrate in school. The good news is that tooth decay, a bacteria-induced infection, is preventable. “When kids join the club, they learn how to prevent tooth decay. When families support this great cause, we can help kids in need. And that’s what feels great — that we really can make kids’ futures better.” If you would like to enroll your child in the club — it’s free! — please visit www.AmericasToothFairyKids.org. And to make sure your child’s teeth and your own are decay-free and as healthy as possible, please contact Dr. Cindy Sumarauw at 801-281-3500 today to schedule your next appointment.

Teeth whitening is an extremely popular remedy for a lackluster smile, and with good reason: It works! So what’s the best way to whiten teeth? We recommend in-office teeth whitening treatments or at-home bleaching with custom-made flexible plastic trays. Either of these techniques will give you faster results than over-the-counter products while giving us the opportunity to monitor your individual response to the whitening process. In-office whitening can produce dramatic results in just one visit. The bleaching solutions used in this process are the strongest available, so we will take precautions to protect your gums before we start. We will then brush the bleach onto your teeth and leave it there for about an hour. Once the session is finished and the bleach is rinsed from your teeth, you will be delighted by the results! If you want your teeth to reach their maximum brightness, a second treatment can be scheduled. At-home bleaching with custom-made flexible plastic trays is also very effective, though you will bear a greater responsibility for sticking to the treatment regimen. We will first make a mold of your teeth that will be used to fabricate the bleaching trays. When the trays are ready, we will provide a prescription-strength bleaching solution in gel form. We will show you how to line the trays with the gel and then fit them over your teeth. You will generally need to repeat the bleaching process daily for about an hour until your desired results are achieved — usually about two weeks. Both methods above have advantages over OTC (over-the-counter) whitening products. The most important is that we can verify that your tooth discoloration is purely a cosmetic problem and not the result of an infection or other dental problem requiring treatment. Also, we can monitor your reaction to the whitening process and make adjustments as needed. Finally, we are always available for any questions that come up before, during or after bleaching. If you are interested in learning more about teeth whitening, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. For more information on teeth whitening, please see the Dear Doctor magazine articles “Important Teeth Whitening Questions Answered” and “Tooth Whitening Safety Tips.”