If your gums bleed when you brush your teeth, it’s unlikely the cause is brushing too hard. The more common reason (especially if you’re experiencing little to no pain) is periodontal (gum) disease caused by the accumulation of bacterial deposits known as dental plaque and calculus where your teeth and gums meet. This bacterial dental plaque results in an infection in the soft tissues of the gum; the body responds to this infection with antibodies, which in turn cause the gums to become swollen, or inflamed. As this biological “war” rages on, both the infection and inflammation become chronic. The tissues are weakened from this disease process and bleed easily. Bleeding gums, then, is an important warning sign of possible gum disease. As the infection progresses the normal attachment between the teeth and gums begins to break down and form pockets in the void. The infection will continue within these pockets, eventually spreading deeper into the gums and bone. The gum tissue may begin to recede, resulting in bone loss and, if untreated, to tooth loss. In the early stages of the disease, bleeding gums could be the only symptom you notice. It’s possible the bleeding may eventually stop, but this doesn’t mean the disease has, and is more likely advancing. If you’ve encountered bleeding gums, you should visit us as soon as possible for a complete examination. There’s a two-pronged approach for treating gum disease. The first prong — and top priority — is to remove as much of the offending bacterial plaque and harder deposits (calculus) as possible, along with the possibility of follow-up antibacterial and antibiotic treatment. This may require more than one session, but it’s necessary in stopping the disease. The second prong is instituting proper oral hygiene: daily brushing and flossing (using proper techniques we can teach you) and semi-annual professional cleanings in our office to remove any plaque or calculus not removed with brushing. Bleeding gums is your body’s way of telling you something isn’t right with your gums. The sooner you seek diagnosis and treatment, the better your chances of halting the damage caused by the disease. If you would like more information on bleeding gums as a warning sign of gum 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 “Bleeding Gums.”

If you’re missing a tooth, you’re not alone; in fact 35 million Americans are missing all of their teeth in at least one jaw! Whether it’s one tooth or many, it’s important to replace what’s missing. Depending on the number of teeth lost, the potential drawbacks to doing nothing may become hard to ignore: impediments to eating, interference with speech, and unaesthetic appearance, for example. Traditional bridges and dentures are the most affordable options for replacing teeth. Tooth implants — tiny titanium, screw-like substitutes for a tooth’s natural root to which natural-looking dental crowns are attached — are pricier but offer an important extra benefit. In addition to addressing the common problems previously mentioned, by acting like the original tooth root, an implant can maintain or stimulate “remodeling,” of the jawbone below. Without a tooth root to provide stimulation, mature bone cells will continue to be removed, or resorbed, but no new bone cells will regenerate to replace them, leading to a progressive loss of bone width, height and density. The more teeth are lost, and with less bone structure to support it, the whole shape of the face can change. Unfortunately, when greater numbers of teeth must be replaced, implants can become financially unrealistic for some people. But in appropriate cases there is a third option: a bridge or denture/implant hybrid. In the case of a bridge intended to fill a gap when multiple teeth are missing, an implant can be used on either side of the gap to support the bridge, leaving the natural teeth undisturbed. Strategically placed implants can be used to support a removable denture, too. If you would like more information about dental implants, 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 “Dental Implants: Your Best Option For Replacing Teeth.”

When do you think is the earliest age that tooth decay can start? Would you be surprised to learn that the answer is… just two months! In spite of our best efforts, throughout the world tooth decay remains the most common chronic disease of childhood. And the unfortunate truth is, it’s largely preventable. Tooth decay is caused by harmful bacteria living in the mouth. These bacteria produce acids as a byproduct of feeding on the sugar we consume. The acids attack the hard enamel surfaces of the teeth, eventually making the small holes we know as cavities. For thousands of years, these bacteria have been thriving in the carbohydrate-rich environment of our mouths. Kids aren’t born with these germs — often, however, they are passed directly from caregiver to child. But there are things you can do to keep from passing the bacteria to your children. For example, don’t share toothbrushes; don’t put items in baby’s mouth after you have licked them or put them in yours; and, if you have untreated dental disease, try to avoid kissing the baby’s lips. (And for goodness sake, don’t pre-chew a baby’s food, no matter what any celebrity may suggest.) One effective way to control tooth decay is by reducing the amount of sugar in the diet. Sodas and candy aren’t the only culprits — fruit juices are also high in sugar. And remember, it’s not just what your child eats or drinks that matters, but when they consume it. Given time, saliva will neutralize and wash away the acids that bacteria produce. But if kids are constantly taking in sugar, the saliva can’t keep up. So give those little teeth a break — limit sugar to mealtimes, and avoid sweet treats at other times of day. What other steps can you take to stop tooth decay before it starts? It helps to identify kids who may be more susceptible to dental disease. Given the same diet with the same oral hygiene practices, some children are much more likely than others to develop tooth decay. If these high-risk kids receive preventive treatments — such as fluoride varnishes, help with diet modification, and other measures — early tooth decay can be successfully prevented, and even reversed in some cases. If you’re concerned that dental treatment may be too scary for little ones, you should know that we put a great deal of effort into making office visits as stress-free as possible. We have plenty of tricks to keep youngsters happy — and distracted — while we take care of business. You can help too… by maintaining a positive outlook and setting a good example. If you would like more information about cavity prevention for children, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine article “Taking the Stress Out of Dentistry for Kids.”

“Break a leg” is a well-known theatrical expression for wishing good luck to an actor about to go on stage. Singers should have one of their own…“Chip a tooth”! Apparently collisions between microphones and pearly whites are an occupational hazard for crooners. Taylor Swift became one of the latest casualties during a concert in Pittsburgh while belting out her hit “I Knew You Were Trouble.” The consummate professional, she didn’t miss a beat and kept on singing despite seeing a tooth chip hit the floor. After all, while chipping a tooth is an inconvenience, it’s not a permanent smile wrecker. Modern dentistry offers several options for restoring a damaged tooth to its original symmetry and luster, or even better! BondingDental cosmetic bonding is the quickest and lowest-cost option to repair a chip. This involves application of a composite filling material that is colored and shaped to match the original tooth. Bonding material can be used to replace the lost portion of tooth or to seamlessly reattach the lost portion if it has been preserved and is otherwise undamaged. Little to no removal of existing tooth surface is needed. VeneersA veneer can be used for slightly larger areas or discolored teeth. This is a thin, custom-made shell placed on the front of the tooth to give it a new “face.” Some removal of existing tooth surface may be necessary to fit a veneer so it is flush with the surfaces of surrounding intact teeth. CrownsWhen a relatively large portion of the tooth is missing, a crown is often the better choice. It fully encases the visible portion of the remaining tooth above the gum line and is shaped and sized to match the original. It can be made of tooth-colored porcelain fused to metal crowns or all-ceramic (optimal for highly visible areas). A small amount of the existing tooth surface will be removed to allow the crown to fit over it. If you would like more information about repairing a chipped tooth, 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 “Artistic Repair of Front Teeth With Composite Resin.”

Dentists have been saying for years that it helps to see children as early as possible — ideally, around the time they reach one year old. Just recently, an evidence-based study was released that backs this up: It shows that starting dental visits prior to age one actually reduces the cost of oral health care, and helps ensure that kids have pleasant dental experiences in the future. Why do young children need to go to the dentist if they only have one or two teeth (and they’re baby teeth, to boot)? For one thing, those early dental visits get a child used to the new sights and sounds of the office: the big chair, the shiny equipment, and the friendly staff who will be taking care of them. And even at this tender age, it’s not too soon to check for signs of decay, make sure gums are healthy, and show everyone the best techniques for keeping up good oral hygiene in a growing mouth. Still, it’s natural for a child to be a little nervous before an office visit. (Even grown-ups have been known to show some anxiety at the dental office from time to time.) To ease their way through, there are several techniques you can borrow from behavioral psychology to help make the experience as stress-free as possible. First… just relax. Remember that kids quickly pick up on non-verbal cues that tell them something’s wrong — so try and stay positive, and keep smiling. You should prepare the little ones for what’s coming — but not too much information, please! We go to great efforts to make children feel safe and comfortable in our care, and we can tell them all they need to know in age-appropriate terms. In fact, most of your child’s first dental visit may consist of a show-and-tell about what we do and what tools we use. Another thing to keep in mind is that parents are the major role models for their children, both in and out of the home. Kids naturally follow along — in both good and bad ways. If parents take good care of their own teeth, it helps kids develop good oral hygiene habits too. That includes brushing and flossing regularly, limiting sugary snacks between meals, and avoiding non-nutritious drinks — not only sodas, but also so-called “sports” and “energy” drinks, which can be extremely high in sugar and caffeine. Of course, regular visits to the dentist should also be a part of every adult’s oral hygiene program. If your child sees you relaxing in the chair, it’s much easier for them to do it too. And that’s good for everybody’s health. If you would like more information about children’s dental visits, please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine article “Taking the Stress Out of Dentistry for Kids.”

Your toothbrush serves the invaluable purpose of minimizing bacterial buildup (plaque) that can irritate gums and lead to periodontal disease, infection of the bone and tissues supporting your teeth. Brushing also helps dislodge food particles that certain oral bacteria would otherwise feed on, producing acids in the process that can eat through protective tooth enamel and the vulnerable dentin below. Given its importance to your oral health, you can maximize your toothbrush’s effectiveness by using and storing it properly, and replacing it (or the brush head if you have a powered model) regularly. Using and Storing Your BrushAll that’s needed to dislodge plaque from oral surfaces is a relaxed grip and a gentle jiggling motion. Too much pressure can wear away tooth enamel, cause gum tissue to recede, and shorten the life of your brush head. When you’re done using your brush: Thoroughly rinse it to remove any remaining tooth paste, food particles, etc. If you’re super-vigilant, you also can disinfect your brush by soaking it in mouthwash, brush-sanitizing rinse, or a half water/half hydrogen peroxide solution, or dipping it in boiling water for 5 to 10 seconds. Air dry in an upright position and do not routinely cover your toothbrush or store it in a closed container. A dark, moist environment is more conducive to the growth of microorganisms. Replacing and Recycling Your ToothbrushEven with the best of care, toothbrush bristles become frayed and worn and their cleaning effectiveness diminishes after 3 or 4 months, according to the American Dental Association, though it could be sooner depending on factors unique to each patient. Besides checking the bristles regularly, a good way of keeping track is to write the date you start using your toothbrush in permanent pen on a big-enough spot on the handle (or doing it on masking tape applied to the base of a power brush). Once your brush has passed its useful life for oral hygiene, you can still get plenty of mileage out of it. You’ll find plenty of ideas on the internet for cleaning grout between tiles and grime-filled spots around taps and toilet lid hinges; removing mud from boot treads; scrubbing off corrosion from around car battery terminals and more! If you would like more information about oral hygiene, 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 “Toothbrush Lifespan” and “Manual vs Powered Toothbrushes.”

One of the most common parental concerns is the habit of many children, even late into childhood, to suck their thumbs or fingers. Many parents have asked us, “Could this affect their teeth?” The answer, unfortunately, is yes — thumb sucking can contribute to a malocclusion (bad bite) that could eventually require orthodontic treatment. Before making any assumptions, however, we need to understand the bigger picture. To begin with, infants have a different swallowing mechanism than adults and older children. When you as an adult swallow, you’ll notice the tip of your tongue positions itself just above the back of the top front teeth. An infant, however, will thrust their tongue between their upper and lower jaw as they swallow (also known as an infantile swallowing pattern or primary tongue thrust). The infant normally begins changing to an adult swallowing pattern when their primary (baby) teeth begin to erupt. However, if a child’s swallowing transition is slower than normal and the tongue rests between the jaws for a longer duration, it can inhibit the full eruption of teeth, believed to be the main cause of an open bite (a gap between the upper and lower teeth when the jaws are shut). The thumb during sucking resting between the teeth can have the same effect. Thumb sucking may not necessarily lead to a malocclusion — for example, an abnormally developing jawbone could be the culprit. If prolonged thumb sucking does become a concern, however, there are steps we can take to reduce the impact of the habit. We can install a thin metal “tongue crib” behind the upper and lower incisors that will not only discourage thumb sucking, but also help retrain the tongue not to rest between the upper and lower teeth. There are also exercise routines known as orofacial myofunctional therapy (OMT) that can retrain specific muscles in the mouth to encourage more normal chewing and swallowing patterns. These steps may not prevent future orthodontic treatment, but they could reduce its extent. The key is regular dental checkups and consultation to ensure your child’s teeth and bite are developing normally. If you would like more information on the effects of chronic thumb sucking on the mouth, 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 “How Thumb Sucking Affects the Bite.”

For some kids, having a cavity or two is just part of growing up. Not for Giuliana Rancic. When she was a child, the TV personality didn’t have a single cavity — and she still doesn’t. But for her husband Bill, co-star of the Style Network reality show Giuliana and Bill, it was a different story. A cavity-prone kid, he was never certain what a visit to the dentist might hold in store. “I can still remember the anticipation,” he recently told Dear Doctor magazine. “I always hoped I would get out of the checkups without a cavity!” Why do some people get more cavities than others? There are a number of factors at work, but to understand it better, let’s look at how tooth decay occurs. How Cavities FormCavities — also called dental caries — are small pits or holes in the teeth that are caused by tooth decay. Tooth decay itself is a chronic disease that can flare up when plaque isn’t kept under control. A thin, bacteria-laden film, plaque sticks to tooth surfaces both above and below the gum line, and can build up in the absence of effective oral hygiene. Of course, everyone has bacteria in their mouth, both “good” and “bad” (pathogenic) types. But when the bad guys outnumber the good, trouble can start. When you consume sweets, plaque bacteria process the sugars and release acid as a byproduct. The acid eats into tooth surfaces, causing decay — and cavities that need filling. Left untreated, decay can work its way into the tooth’s pulp, resulting in infection and pain. Eventually, treatment might involve a root canal — or, in the worst case, extraction. What can you do if you seem to be prone to cavities? One effective way to fight tooth decay is by maintaining good oral hygiene. Brush at least twice daily, for at least two minutes each time. Use a soft-bristled brush and a dab of fluoride toothpaste to clean all around your teeth. Most importantly, floss above and below the gum line, every day. And just as important, don’t forget to have regular dental checkups every six months. A Healthy BalanceAnother cavity-fighting strategy is eating a balanced diet. Avoid soda, sugary “energy” drinks and sweet treats — but if you choose to consume sugar, have it with meals instead of between meals. This will give your saliva, which has natural cavity-fighting properties, a chance to work. “It’s all about maintaining a healthy balance,” Giuliana told Dear Doctor. And Bill agrees: “I love nuts and fruit for a healthy snack,” he said, adding that he’s meticulous about brushing and flossing. And when the couple smiles, you can see how those healthy habits pay off. 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 learn more about this topic in the Dear Doctor magazine articles “Tooth Decay” and “Tooth Decay – How To Assess Your Risk.”

If Kristi Yamaguchi’s kids inherit her figure skating ability, they might just be headed for the Olympics — after all, their mom won the gold medal for figure skating in the 1992 games. When it comes to teeth, however, she wouldn’t mind if they inherited her spouse’s instead. “My husband [fellow Olympian turned pro hockey player Bret Hedican] never had braces,” she recently told an interviewer. “I’m hoping they get his teeth.” When you look at the elegant skating star’s pearly smile, you’d never suspect she had dental problems. In fact, Kristi had four permanent teeth extracted to relieve the crowding in her mouth. She also wore braces to correct irregularities in both upper and lower teeth. Could orthodontics work the same “magic” for your kids — or yourself? It just might. The first step toward finding out is having an orthodontic evaluation. For kids, the right time for an initial evaluation is no later than age 7. By then, the first molars are usually present and your child’s bite pattern is establishing. Even though treatment may not begin for several more years, it’s helpful to know what problems may arise in your child’s individual situation — and to start treating them at just the right time. Orthodontics has progressed a great deal in the two decades since Yamaguchi’s braces came off. Today, small devices called palatal expanders are often used to create more space in the mouth, as an alternative to tooth extraction. There are also many new options for orthodontic appliances, in addition to standard metal braces. These include unobtrusive tooth-colored braces and lingual braces, which are applied to the tongue side of the teeth and can’t be seen. In some cases, clear plastic aligners can be used instead of braces, for a look that’s almost invisible. Adolescence is often the preferred time to do orthodontic treatment. By then, the permanent teeth have mostly come in, but there’s still some growing left to do. But age isn’t a factor that should stop you from getting the smile you’ve always wanted. About one in five orthodontic patients today is an adult — and those less-visible appliances can fit in well with the more “professional” image of an older person. Orthodontics can’t help make someone an Olympic athlete — only lots of talent and practice can do that. But it can make a big difference in a person’s appearance. “Once my braces came off, it was like — Wow! That looks so much nicer,” Yamaguchi recollected. And today, the mother of two, author, and philanthropist sports the same appealing smile she had on the podium at the Albertville Olympic Games. If you would like more information on how orthodontics could help you get the smile you’ve dreamed about, 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 “Early Orthodontic Evaluation” and “The Magic of Orthodontics.”

Cleaning dentures is an important part of wearing them. However, did you know that recent research has revealed a link between denture hygiene and overall health? The evidence shows that oral bacteria have been implicated in chronic obstructive pulmonary (lung) disease, bacterial endocarditis (“endo” – inside; “card” – heart), generalized infections of the respiratory tract and other systemic diseases. While it is never our intent to frighten you, we feel it is important that we share some important tips on maintaining and caring for your dentures so that your oral health does not negatively impact your general health. Our first tip focuses on fit, as denture slippage is an experience that anyone who wears dentures dreads. So if your dentures seem to slip or you have started increasing the amount of adhesive you are using to achieve the same level of denture retention that you had when first fitted, you need to make an appointment with us soon. Otherwise, an ill-fitting denture can cause discomfort, embarrassment and contribute to other oral health issues. Next, we must focus on cleaning your dentures. It is critical that you clean your dentures daily. However, you should never use harmful or abrasive cleansers. Nor should you ever place your dentures into boiling water! The best method for cleaning is to soak them daily in a non-abrasive denture cleaner. And when you remove them, gently brush them with a soft-bristled toothbrush. Our last tip concerns how long you wear your dentures each day. Even if your dentures are extremely comfortable — for example, you forget they are in — you should not wear them 24 hours a day. Why? Because you will develop a chronic yeast infection called, “denture stomatitis” due to stagnation that develops under dentures when the lubricating and antibacterial effects of saliva are impeded. Unfortunately, the constant pressure on the gum tissues caused by wearing dentures can accelerate jawbone loss over time. Give your mouth and tissues a rest by sleeping without your dentures in your mouth. To learn more tips, continue reading the Dear Doctor magazine article “Top Ten Tips For Denture Care & Maintenance.” Or please contact Dr. Cindy Sumarauw at 801-281-3500 to schedule an appointment for a consultation.