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Posts for: June, 2020

By W. Robert Howarth, DDS, FASD, Family and Sports Dentistry
June 21, 2020
Category: Oral Health
Tags: tooth decay  
PreventionandEarlyDetectionofRootCavitiesCouldSaveaTooth

Tooth decay is one of two dental diseases most responsible for tooth loss (gum disease being the other). In the absence of treatment, what starts as a hole or cavity in a tooth's outer layers can steadily advance toward its interior.

Most people associate cavities with the crown, the part of a tooth you can see. But cavities can also occur in a tooth's roots, especially with older adults. Root cavities pose two distinct difficulties: They can lead to more rapid decay spread than crown cavities within a tooth; and they're harder to detect.

Tooth roots are ordinarily covered by the gums, which protects them from bacterial plaque, the main cause for decay. But roots can become exposed due to receding gums, a common problem with seniors who are more susceptible to gum disease.

Unlike the enamel-covered crowns, tooth roots depend on gum coverage for protection against bacteria and the acid they produce. Without this coverage, the only thing standing between tooth decay and the roots is a thin material called cementum.

If decay does enter a tooth's interior, saving it often requires a root canal treatment to remove decayed tissue in the inner pulp and root canals, and then replacing it with a filling. But if we're able to discover a root cavity in its early stages, we may be able to fill it like a crown cavity.

The best strategy, though, is to prevent root cavities from forming. This starts with a dedicated daily regimen of brushing and flossing to remove dental plaque. If you're at high risk for root cavities, we may also recommend antibacterial mouthrinses and other aids.

Regular dental visits are also a must: a minimum of twice-a-year dental cleanings to remove stubborn plaque and calculus (hardened plaque) deposits. For added protection against root cavities, we can also apply fluoride varnish to strengthen teeth. And regular visits are the best way to detect any cavity in its early stages when treatment is less invasive.

A heightened risk of dental problems like root cavities are a part of the aging process. But partnering together, we can lower that risk and increase the longevity of your teeth.

If you would like more information on root cavities, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Root Cavities.”


By W. Robert Howarth, DDS, FASD, Family and Sports Dentistry
June 11, 2020
Category: Oral Health
Tags: gummy smile  
WhyIsYourSmileGummyHereAre4Possibilities

What makes a beautiful smile? Beautiful teeth, for sure. But there's also another component that can make or break your smile, regardless of your teeth's condition: your gums. Although their primary function is to protect and stabilize the teeth, your gums also enhance them aesthetically by providing an attractive frame.

But just as a painting displayed in an oversized frame can lose some of its appeal, so can your smile if the size of your gums appears out of proportion with your teeth. Normally, a smile that displays more than four millimeters of gum tissue is considered “gummy.”

There are some things we can do to improve your gum to teeth ratios. What we do will depend on which of the following is the actual cause for your gummy smile.

Excess gum tissue. We'll start with the obvious: you have excess gum tissue that obscures some of the visible tooth crown. We can often correct this with a surgical procedure called “crown lengthening,” which removes some of the excess tissue and then reshapes the gums and bone to expose more teeth length.

Teeth that appear too short. The problem may not be your gums — it could be your teeth appear too short. This can happen if the teeth didn't erupt fully, or if they've worn down due to aging or a grinding habit. One option here is to “lengthen” the tooth cosmetically with veneers, crowns or other bonding techniques.

Higher lip movement. Rather than your teeth and gums being out of size proportion, your upper lip may be rising too high when you smile, a condition known as hypermobility. One temporary fix is through Botox injections that paralyze the lip muscles and prevent their movement from overextending. We could also use periodontal surgery to perform a lip stabilization procedure that permanently corrects the upper lip movement.

Overextended jaw. Your gums may seem more prominent if your upper jaw extends too far down and forward. In this case, orthognathic (jaw straightening) surgery might be used to reposition the jaw relative to its connection with the skull. Setting the jaw up and back in this way would reduce the prominence of the gums when you smile.

As you can see, treatments range from cosmetic techniques to moderate surgical procedures. A full dental exam will help determine which if any of these measures could reduce gumminess and improve your smile.

If you would like more information on correcting gummy smiles, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Gummy Smiles.”


By W. Robert Howarth, DDS, FASD, Family and Sports Dentistry
June 01, 2020
Category: Oral Health
Tags: nutrition   oral cancer  
DietandLifestyleChangesCouldLowerYourRiskofOralCancer

Oral cancer is one of the more dangerous malignancies people face. But there are ways you can reduce your risk of this deadly disease through changes in lifestyle habits and behaviors.

Two of the better known behaviors for increased oral cancer risk are immoderate consumption of alcohol and the use of tobacco, particularly chewing tobacco and snuff. Eliminating these, especially the latter, can vastly improve your odds of avoiding cancer. Another factor is a strain of the human papilloma virus (HPV 16) that's transmitted sexually, which you can avoid through safe sex practices.

In addition to these lifestyle changes, there's one more you should make to lower your oral cancer risk: adjustments to your diet. Research over the last half century has provided ample evidence of a link between the foods we eat and our risk of all types of cancers, including oral.

The biggest concern is over certain elements in some foods that can damage DNA, the molecular “operating instructions” that regulate the formation and function of our bodies' cells. These elements are collectively known as carcinogens because of their role in cancer formation.

An example of a carcinogen is a group of chemicals called nitrosamines. These form during preservation processes using nitrites in meats like bacon or ham. They're also found in beer or certain preserved fish. To limit your consumption of nitrosamines, you should reduce these and other processed products and replace them with fresh fruits and vegetables, or organic meats and dairy products.

Our DNA can also be damaged by unstable molecules called free radicals that arise during normal cellular function. But there are also substances known as antioxidants that help protect the cells from free radical damage. Many plant-based foods contain nutrients like vitamins C and E that have antioxidant properties, so including them in your diet could help reduce your oral cancer risk.

Several clinical studies over the years have been consistent in their findings that a diet rich in fresh fruits and vegetables can reduce the risk of oral or throat cancers, as well as other forms of cancer. Making changes to your diet in that direction, plus other lifestyle changes, could help you avoid this devastating oral disease.

If you would like more information on preventing oral cancer, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Diet and Prevention of Oral Cancer.”