Fresh breath and an attractive smile are common goals, but proper oral hygiene is much more important than what shows when you open your mouth: It can have a big impact on your overall health and happiness.
"How healthy people's teeth are depends on how good they are about brushing, flossing and visiting the dentist," says Dr. Glenn Schmidt, who practices family dentistry at Riverbend Dental Clinic.
It also can influence their overall health. "If you have periodontal (gum) disease, it can literally affect your heart and your brain and give you a greater chance of a heart attack," he says. "For a woman with gum disease who is pregnant, it can produce a low birth-weight baby.
"If you have gum disease, you have bacteria and toxins that are released into your bloodstream. Your body reacts to it, and it causes inflammation in your blood vessels, and [that inflammation is] one of the causes of stroke (in the brain) and heart attacks. Likewise, plaque can escape into your blood vessels and is treated as a foreign body and stimulates an immune response. If it keeps stimulating an immune response, it's going to make you sick."
Many gum diseases can be cured with a good cleaning over several visits, and often, not only will discomfort in the gums disappear, but the patient will feel better in general, Schmidt says.
As with most health issues, prevention is key. Maintaining dental health is relatively easy and doesn't take the investment in time, effort and money as other areas, such as physical fitness. For the most part, it requires just a few minutes each day.
"There are so many affordable over-the-counter products and toothbrushes that are good (plus) fluoride in the water for kids," says Dr. Deborah Lesem, whose Lakeview practice focuses on general and cosmetic dentistry."
What are the most important things you can do? "Get a sonic toothbrush and floss," she says.
Good oral hygiene habits should be established even before a child can hold a toothbrush. A dentist can detect minor problems such as cavities, cracked teeth and enamel deterioration during regular check-ups and repair them before they progress to tooth loss or gum disease. The American Academy of Pediatric Dentists recommends parents take their child to a dentist when they get their first tooth or by their first birthday. As soon as a tooth bud bursts through the gum, parents should clean the tooth using a clean cloth or gauze until they are able to use a small toothbrush.
Dr. Steven Holmes of Uptown Pediatric Dentistry says there are several basic tenants to prevent tooth decay and gum disease, especially in children. "Go to bed with clean teeth," he says. "Avoid sugary and sticky foods because sticky food hangs around on your teeth longer. Eating a cheese snack after a meal helps decrease the acidity in your mouth." Acid in the mouth can attack and weaken tooth enamel, which makes teeth more susceptible to decay.
The American Dental Association emphasizes a balanced diet based on the Department of Agriculture's food pyramid is as important for your mouth as it is for the rest of your body, but Holmes says the reality of Americans' diets often strays from those guidelines. "We are a fast-food society; we consume a lot of soft drinks and sports drinks," he says. "Sports drinks are high in carbs and tend to be a high-sugar product. We see kids consuming more of that than soft drinks. They have acidity, so it accelerates the breakdown of (tooth) enamel."
Fortunately, modern dentistry has lots of tools to keep teeth in shape. There are sealants that can be applied to teeth to make them decay-resistant, fillings that maintain a tooth's integrity once the decay has been removed, hygiene therapies to remove plaque and cure gum diseases and even bone grafts and implants to replace lost teeth with titanium and porcelain replicas.
"There's almost nothing that can't be fixed," Lesem says. "There are so many ways to restore the teeth. Cosmetically there are lots of things you can do that aren't too expensive. There are fillings that look like gums, they're pink, for people who have a receding gum line. We have patients who don't want to go with veneers or orthodontics, so they'll go with bonding to get their teeth to look a little nicer." Bonding can be used to repair chips, close gaps and make uneven teeth aligned at the bottom. "Usually bonding is the most popular. It looks good, and it's easily repairable and very sturdy," she says. "You don't usually have to trim the teeth, and it is reversible."
Adults in particular are turning to Invisalign braces to straighten their teeth without the hardware commonly seen on adolescents and teenagers. Invisalign braces start at about $5,000, but a generic called Essix recently hit the market for between $1,500 and $2,000, Schmidt says.
Even those who have lost teeth can regain dental integrity with implants instead of dentures, bridges or crowns. Dr. Walter Jackson, an oral and maxillofacial surgeon with Jackson Oral Surgery & Implants, says implants are superior to dentures because they are more permanent, secure and can preserve the bone of the jaw. They cost more than dentures, but are a better investment in the long run, he says.
"The gold standard really is implants," says Jackson, who also performs bone grafting for patients who have lost too much of their jaw bone to support an implant. "Implants are made of titanium. They have a property that allows them to attach very strongly to the bone around them. Titanium doesn't rust and decay, so the retention rate of an implant is 98 percent."
The implant is a screw-shaped titanium device that takes the place of the root of the tooth from the gum line down. Once the dental implant is placed and the gums have healed, a dentist builds a porcelain tooth on top of it.
"Implants are much more comfortable for a patient than a tooth extraction and sometimes even a root canal," Jackson says. "The inside of the bone doesn't have a real pain problem; it's the gum that can hurt. People think [implants] are going to be quite painful, but patients are usually surprised how little pain is involved."
Even people who opt for dentures can benefit from implants placed in the back of the mouth to add stability and comfort to false teeth. "If someone has a loose denture and they want stability, you put an implant in the upper and lower jaw," Jackson says. An attachment placed on the inside of the dentures hooks them to the implant. "They work quite well. At night, you can take them out and put them in Listerine and in the morning pop them right in."
The ultimate goal of dentists is to help patients keep their teeth intact and looking good and their gums healthy. To do that, people need to develop good hygiene habits early and have regular dental check-ups, which not only include X-rays to detect cavities or other problems but also screening for oral cancers.
"Half of my work is hygiene and positive guidance to help kids and families maintain a cavity-free mouth," Holmes says. "The other half is working on kids who don't have a cavity-free life.
"There are plenty of kids in New Orleans who haven't been to a dentist in years. There are always kids who don't have regular dental care in every city. In New Orleans, we're fortunate that Children's Hospital has a Tooth Bus (that provides discounted dental care in a mobile office) and LSU has a dental school (that also provides services for less than most private practices). Those are great, because trying to find a private office in the city that takes Medicaid can be a challenge. LSU and Children's Hospital have been the backbone for some of the kids who have trouble finding access to care."
Information about how to keep our mouths healthy is readily available, he says, but not everyone is putting the knowledge into practice."With the advent of Google and the Internet, some people have more knowledge about dental issues," Holmes says. "Generally speaking, our dental intelligence should be improving, but there is still a lot of guidance that is needed, and that goes across all socioeconomic levels."
With the variety and quality of procedures available, almost everyone should be able to have a perfect smile. Lesem says that can lead to a beneficial chain reaction: If you like your teeth, you feel confident, more outgoing and smile more, which leads to a positive response from those around you, which in turn can make you happier.
"Having healthy teeth and healthy gums makes a difference in quality of life," Schmidt agrees. "Plus, it's statistically proven that people who have nicer smiles tend to get better-paying jobs."