There’s been a growing awareness about the effects of gluten, a protein found in grains like wheat, rye and sometimes oats, on certain people. An estimated 1 in 133 Americans have Celiac Disease (CD), a gluten-related disorder that causes the body’s immune system to work against itself. And if you have CD, you could eventually face dental problems like enamel pitting and erosion. When a person with CD consumes gluten, their immune system mistakenly identifies the protein as malicious and attacks it. The attack occurs in the membranes that line the digestive system, which in the process destroys cilia, tiny hair-like structures that aid in food absorption. This disrupts the body’s normal absorption of nutrients, which can lead to a number of systemic conditions including intestinal cancer. Because of the lack of nutrients, your teeth’s enamel may develop defects. You may begin to see dull spots or pitting, or chalky grooves in its normally shiny surface: this is a sign you’ve lost surface enamel crystals (decalcification). You may also be more susceptible to outbreaks of aphthous ulcers (canker sores). Because symptoms can be misdiagnosed or go unnoticed, it may be years before you know you have CD. You can, however, get a definitive diagnosis through a blood test for gluten antibodies, which is then confirmed with a biopsy of a tissue specimen from the intestine. While there’s ongoing research for CD-related medication, there’s currently only one recognized treatment for it — remove gluten from your diet. This is much harder than it sounds, and requires knowing what you can and can’t eat, along with strict monitoring of food package labeling. Thankfully, the world is becoming better educated in this respect as more food manufacturers are clearly labeling products containing gluten and restaurants are providing gluten-free menu options. Once you have dietary controls in place, your dental issues can be treated as any other person, with one exception: none of the products used in treatment like polishing paste or fluoride gels should contain gluten, and must be verified before using. CD is a serious condition that could even become life-threatening. Knowing you or someone in your family has it will help you protect both your overall health and your teeth. If you would like more information on the gluten’s effect on dental health, 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 article “Gluten & Dental Problems.”

There’s really no secret to keeping your child’s teeth healthy — good, daily hygiene habits, regular dental visits and early treatment for emerging problems. It’s a lot easier for those things to happen if your child feels comfortable with dental care and visiting the dentist. Sadly, that’s not always the case: many children develop an unhealthy fear of the dentist because the initial relationship may have been mishandled. Here, then, are 3 tips that will help you foster a healthy relationship between your child and their dentist. Visit the dentist before their first birthday. From a health standpoint, dental visits should begin soon after your child’s first teeth emerge (erupt) in the mouth. Visiting the dentist by their first birthday also improves the chances they’ll develop a sufficient level of comfort with the visits, more so than if you waited a year or two longer. Choose your dentist with your child’s sense of security and comfort in mind. When you’re looking for a dentist to care for your child, think of it as looking for a “new member of the family.” It’s important to find an office environment that’s kid-friendly and staff members that work well with children. Some dentists specialize in pediatric dentistry and many general dentists have additional training in working with children. The key is a dental team that has a good, trust-building rapport with children. Set an example, both in the home and at the dentist. Children learn quite a bit watching what their caregivers say and how they react in potentially stressful situations. If dental care is important to you personally, it’s more likely to become important to your child. And when you visit the dentist with your child, be sure to project calm and a sense that it’s routine — if you display tenseness or nervousness your child may take that as a sign that visiting the dentist is something to fear. You want your child to learn that the dentist is their friend who’s there to help them. That lesson should begin early with the right dental team — and by making dental care a priority in your own life. If you would like more information on dental care for your child, 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 article “Taking the Stress out of Dentistry for Kids.”

Dental implants have become the standard for long-term tooth replacement. From mechanics to movie stars, people from all walks of life have discovered the advantages of replacing a missing tooth with an implant. Obviously, restoring your smile is a definite advantage, but an implant can also help to maintain the health of your jawbone and adjacent teeth. The implant is a small, screw-like titanium post that is placed into your jawbone to function as the root part of the tooth. The living bone tissue will actually attach to the titanium post, fusing them together. This will not only provide a sturdy anchor for a natural-looking crown, but will provide stability for bridgework or dentures. You will then be able to smile, chew and talk as if all of your teeth are natural. The procedure will also help to stabilize the bone, reducing long-term bone loss that occurs when a missing tooth is not replaced. At this point, if you are thinking that there must be a lot of pain involved, I have good news for you. There is very little pain involved after the procedure is completed and no pain at all during the procedure. Typically, it is a routine surgery that takes place in a dentist’s office under local anesthesia where the immediate area is numbed. If there is any apprehension at all about the procedure, we will offer alternative anesthesia or sedation options during the planning process. To determine who will be a good candidate for the implant procedure, a plan must be in place to assure the success of the implant. Part of the plan includes: Reviewing your past medical and dental history. We must know your complete past and present medical history and medication use, since good health is essential. There are certain conditions and diseases that can affect the healing of an implant. Performing a comprehensive dental examination. An evaluation of your dental problems and needs will determine if implants are in your best interests. An assessment of the health and mass of the jawbone as well as the number and location of the implant(s) that are needed to restore your bite and smile back to health will also be determined. When the implant procedure has been successfully completed, there is one more step. As with your natural teeth, preventive maintenance is crucial for long-term success. A daily routine of brushing and flossing along with regular professional dental cleanings and checkups will help ensure continued gum health and proper functioning of your implants. If you are wondering whether dental implants are right for you, contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can also learn more about dental implants by reading the Dear Doctor magazine articles “Dental Implants” and “Dental Implant Surgery.”

The term “makeover” is a powerful word in today’s society. It’s used for a variety of things — hair, body, lawn — that need more than a different style, a little toning or some new shrubs. A makeover is a transformation, replacing the dissatisfying status quo with something new and dynamic. Your smile and its various components — teeth, gums, jaw structure and facial features — might also be a candidate for a makeover. This involves more than just a few modifications. It’s the answer to a smile we avoid showing in photos, cover with our hand when we’re speaking or laughing, or makes us feel older than we really are. In other words, it’s a comprehensive change to a smile that inhibits us from fully expressing ourselves in our friend, family or career relationships. Of course, for any makeover to succeed, it must follow a plan. A smile transformation is no different. The process begins with what we call a “smile analysis”: a comprehensive examination that determines the exact condition of your entire mouth. This enables us to identify problems and defects, understand how they interact with your other facial features, and then recommend a treatment plan that effectively addresses these issues. The plan isn’t complete, though, without your input. You may want a complete renovation — to restore missing teeth or change their shape, color and brilliance. On the other hand, you may be more comfortable with a few subtle changes, perhaps even keeping slight imperfections that you see as part of the real “you.” Whichever path you take, the end result is a smile that makes you happy, and proud to show to others. The various techniques and materials available through cosmetic or restorative dentistry can turn any disappointing smile into a beautiful one. Your journey to that newer, brighter smile begins with your next dental visit. If you would like more information on smile makeovers through restorative or cosmetic dentistry, 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 article “The Impact of a Smile Makeover.”

Since boxers first began using them a century ago, athletic mouthguards are now standard safety equipment for most contact sports. Without them, dental injuries would skyrocket. But a recent study in the peer-reviewed journal, General Dentistry, indicates there’s another important reason to wear a mouthguard for contact sports or exercise: you may be able to significantly reduce your risk for a mild traumatic brain injury (MTBI), better known as a concussion. It’s believed the mouthguard absorbs some of the force generated during contact, resulting in less pressure to the brain. That reduction is even more significant if your mouth-guard has been custom-made by a dentist. That last finding is important, because not all mouthguards on the market are equal. There are three basic categories of mouthguards — stock, “boil and bite,” and custom. Stock mouthguards come in limited sizes; they’re relatively inexpensive, but they provide the least level of protection. “Boil and bite” can be customized after purchase to the wearer’s bite, but they don’t always provide complete coverage of back teeth. Custom mouthguards are designed and fashioned by a dentist; they’re relatively expensive (running in the hundreds of dollars), but there’s ample evidence they provide the highest level of protection from mouth injuries. The General Dentistry study also corroborates custom mouthguards’ effectiveness in preventing concussions. The study followed approximately 400 football players from six different high school teams. While all the players wore the same type of helmet, half of them wore custom-made mouthguards and the other half wore stock guards. 8.3% of the athletes wearing stock guards experienced a concussion injury; by contrast only 3.6% of those with custom guards sustained an injury — greater than half fewer occurrences. The study also highlights the need not to rely solely on helmets or other protective headgear for concussion prevention. It’s important to include mouthguards along with other athletic protective gear to lower injury risk as much as possible. So when considering how you can provide the optimum injury protection for you or your child, be sure to include an athletic mouthguard, preferably one that’s custom-made. We’ll be happy to advise you further on what you need to know to prevent traumatic dental injuries, as well as concussions. If you would like more information on custom-fit mouthguards, 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 article “Mouthguards.”

Daily fatigue or complaints of your snoring from family have led you to see your doctor about the problem. After an exam and a test session in a sleep lab, your problem now has a name — obstructive sleep apnea. This common sleep-related breathing disorder (SRBD) occurs when the soft tissues in the back of the throat over-relax during sleep. The relaxed tissues obstruct air flow to the trachea (windpipe) and cause “apnea,” where you cease to breathe. The lack of oxygen causes you to wake, even for a micro-second, to begin breathing again. This may occur multiple times throughout the night, diminishing the quality of your sleep and leading not only to drowsiness and daily fatigue but also contribute to cardiovascular disease or other systemic conditions. The most effective treatment for sleep apnea is the use of a Continuous Positive Airway Pressure (CPAP) machine while you sleep. The machine delivers pressurized air to a face mask you wear while you sleep; the additional pressure keeps the airway open. However, a CPAP machine does have a few disadvantages, including discomfort while attached to the machine, nasal congestion and dryness, or claustrophobia. These effects can be so pronounced for some patients, they’re unable to adjust themselves to the machine. If you have mild to moderate sleep apnea, there may be an alternative — a custom-fitted oral appliance we manufacture for you to wear in your mouth while you sleep. The appliance pulls the lower jaw forward resulting in a wider opening of the airway. In addition to being less cumbersome than a CPAP mask, an oral appliance is easier to wear, compact in size for easy travel and doesn’t require electricity. While an oral appliance is an effective alternative to a CPAP machine for many patients, it does have a few disadvantages including problems with saliva flow (too much or too little), muscle or teeth soreness and minor tooth or jaw movement. Still, an oral appliance might be the right solution to relieve your sleep apnea over the long-term. If you would like more information on treatments for sleep apnea, 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 “Sleep Disorders & Dentistry” and “Sleep Apnea FAQs.”

Periodontal (gum) disease is the most likely cause of a loose, permanent tooth. This progressive infection causes damage to the gums and bone tissues that hold teeth in place, leading to looseness and ultimately tooth loss. Gum disease, however, isn’t the only cause: although not as common, excessive biting forces over time may also lead to loose teeth. The excessive force stretches the periodontal ligaments that hold teeth in place, causing the teeth to become loose. This condition is called occlusal trauma. In its primary form, the patient habitually grinds or clenches their teeth, or bites or chews on hard objects like pencils or nails. Generating 20-30 times the normal biting force, these habits can cause considerable damage. It can also be a factor when gum disease is present — supporting bone becomes so weakened by the disease, even normal biting forces can cause mobility. If you recognize the early signs of grinding or clenching, particularly jaw soreness in the morning (since many instances of teeth grinding occur while we sleep), it’s important to seek treatment before teeth become loose. The symptoms are usually treated directly with muscle relaxants, an occlusal guard worn to soften the force when teeth bite down, or stress management, a major trigger for teeth grinding. The sooner you address the habit, the more likely you’ll avoid its consequences. If, however, you’re already noticing a loose tooth, treatment must then focus on preserving the tooth. Initially, the tooth may need to be splinted, physically joined to adjacent teeth to hold it in place while damaged tissues heal. In some cases, minute amounts of enamel may need to be removed from the tooth’s biting surfaces to help the tooth better absorb biting forces. Other treatments, including orthodontics and gum disease treatment, may also be included in your treatment plan. If you notice a loose tooth, it’s critical you contact us as soon as possible for an evaluation — if you delay you increase the chances of eventually losing it. The earlier you address it, the better your chances of preserving your tooth. If you would like more information on loose teeth, 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 article “Loose Teeth.”

A few days before the Oscars, Vanity Fair magazine asked Academy Awards host Neil Patrick Harris to name his most treasured possession. Was it his Tony award statuette for best leading actor in a musical? His star on the Hollywood Walk of Fame? The stethoscope he wore while playing teenaged doctor Doogie Howser on TV? No, as it turns out, the 41-year-old actor’s most treasured possession is… his wisdom teeth. Yes, you read that correctly. “Oddly, I still have my four wisdom teeth,” Harris said. “I refuse to let them go or I’ll lose my wise parts.” How odd is it for a 41-year-old to have wisdom teeth? Actually, not that odd at all. While it is true that wisdom teeth are often removed, there’s no one-size-fits-all approach to this. It all depends on whether they are causing problems now, or are likely to cause problems in the future. The trouble wisdom teeth cause is related to the fact that they are the last molars to come in, and that molars are large in size. By the time wisdom teeth appear between the ages of 17 and 21, there often is not enough room for them in the jaw. Sometimes it’s because you may have inherited a jaw size that’s too small for your tooth size; and generally speaking, the size of the human jaw has evolved to become smaller over time. If room is lacking, the adjacent molar (that came in earlier) can interfere with the path of eruption — causing the wisdom tooth to come in at an odd angle. The wisdom tooth can hit up against that other tooth, possibly causing pain or damaging the adjacent tooth. This is known as “impaction.” Sometimes the wisdom tooth breaks only partway through the gum tissue, leaving a space beneath the gum line that’s almost impossible to clean, causing infection. A serious oral infection can jeopardize the survival of teeth, and even spread to other parts of the body. If a wisdom tooth is impacted, will you know it? Not necessarily. A tooth can be impacted without causing pain. But we can see the position of your wisdom teeth on a dental x-ray and help you make an informed decision as to whether they should stay or go. If removal is the best course of action, rest assured that this procedure is completely routine and that your comfort and safety is our highest priority. If there is no great risk to keeping them, as Neil Patrick Harris has done, we can simply continue to monitor their condition at your regular dental checkups. It will be particularly important to make sure you are reaching those teeth with your brush and floss, and that you keep to your schedule of regular professional cleanings at the dental office. All healthy teeth are indeed worth treasuring. If you would like more information about wisdom teeth, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”

What you eat (and how often you eat it) is a major factor in the ongoing battle to prevent tooth decay. High levels of sugar or similar carbohydrates in your diet could encourage the growth of bacteria that cause tooth decay. Constantly sipping on acidic beverages like sodas or sports drinks can lead to enamel erosion. You may be well aware of the kinds of foods that contribute to tooth decay. But did you know some foods can actually protect us from this damaging disease? Here are 4 kinds of foods believed to inhibit tooth decay. Cheese. This food formed from milk is rich in calcium and has a stimulating effect on saliva. By eating a little cheese after a sugary snack, the increase in saliva can help neutralize the acid produced by the bacteria feeding on the sugar; the added calcium will also strengthen tooth enamel. Fibrous plant foods. Beans, peanuts and leafy vegetables are rich in fiber and many require vigorous chewing. This in turn stimulates saliva flow, which as previously noted helps to neutralize high levels of acid. Black and green teas. Beverages brewed from these plants are rich in polyphenols and flavonoids, providing an antioxidant effect on cells. Black tea also contains fluoride, which helps strengthen tooth enamel. Chocolate. There’s some evidence that cocoa (from which chocolate is derived) may have some properties that inhibit tooth decay. But there is a catch — this evidence is based on unrefined cocoa, without the addition of any sugar. The high levels of sugar in processed chocolate negate this effect. Sorry chocolate lovers! Of course, any of these and similar foods (like cow’s milk) should be considered complements to a comprehensive prevention approach that includes daily oral hygiene, limits on sugar and acidic food consumption and regular dental cleanings and checkups. If you would like more information on preventing tooth decay, 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 article “Nutrition & Oral Health.”

When we refer to periodontal (gum) disease, we’re actually talking about a family of progressive, infectious diseases that attack the gums and other tissues attached to the teeth. Caused primarily by bacterial plaque left on tooth surfaces from inefficient oral hygiene, gum disease can ultimately lead to tooth loss. There’s only one way to stop the infection and restore health to diseased tissues — remove all of the offending plaque and calculus (hardened plaque deposits) possible from tooth and gum surfaces, including below the gum line at the roots. The basic tools for this task are specialized hand instruments called scalers or ultrasonic equipment that vibrates plaque loose. A series of cleaning sessions using these tools could stop the infection and promote healing if followed with a consistent, efficient daily hygiene habit. There are times, however, when the infection has progressed so deeply below the gum line or into the tissues that it requires other procedures to remove the plaque and infected tissue. One such situation is the formation of an abscess within the gum tissues, a pus-filled sac that has developed in response to infection. After administering local anesthesia, the abscess must be treated to remove the cause and allow the infectious fluid to drain. The area is then thoroughly flushed with saline or an antibacterial solution. The gum tissues are not completely attached to the tooth surface for a small distance creating a space. These spaces are called periodontal pockets when they are inflamed and continue to deepen as the disease progresses. These inflamed and sometimes pus-filled pockets form when tissues damaged by the infection detach from the teeth. If the pockets are located near the gum line, it may be possible to clean out the infectious material using scaling techniques. If, however, they’re located four or more millimeters below the gum line a technique known as root planing may be needed, where plaque and calculus are shaved or “planed” from the root surface. As the disease progresses and the pockets deepen, it may also be necessary for surgical intervention to gain access to the tooth roots. To stop gum disease and promote soft tissue healing, we should use any or all treatment tools at our disposal to reach even the most difficult places for removing plaque and calculus. The end result — a saved tooth — is well worth the effort. If you would like more information on treating periodontal disease, 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 article “Treating Difficult Areas of Periodontal Disease.”