What is composite resin bonding?
This term refers to a kind of tooth-colored material that is a mixture of a plastic resin and a glass filler. The glass gives the mixture, or composite, strength and translucency that is similar to a natural tooth. The composite is bonded to the tooth by slightly abrading or roughening the tooth so that the resin fills in small cuts in the tooth surface and bonds with it. The end result functions and looks like part of the original tooth.

What is bonding used for?
This technique is a good way to restore chipped or stained teeth or to change a tooth's shape or color. It can also be used to restore parts of a tooth near the gum line where the gums have receded and left the root partially exposed.

What are the advantages of bonding?
Composite resin tooth restorations have several advantages.

• They take only a single dental visit because they are done right in the dental chair rather than having to be sent to a dental lab for preparation.
• They are less expensive than many other dental restorations.
• They leave most of the original tooth intact since little tooth preparation or drilling has to be done in order to make the composite material bond to the tooth.
• They can be made in a wide range of colors and can be matched well with the teeth around them.
• Because little of the original tooth has to be removed, they are a good choice for teens, whose dental arches (upper and lower jaws) are still developing.

What are the disadvantages of bonding?
The composite resin material is not as strong as the original tooth material, so the bonded restorations may not last over a long time. If it does last, the material may also stain as it ages.

When should you choose bonding?
Composite resin bonding is a good choice for a quick and attractive tooth restoration that may be replaced later by something more permanent, such as porcelain veneers.

Contact us today to schedule an appointment to discuss your questions about bonding. You can also learn more by reading the Dear Doctor magazine article “Repairing Chipped Teeth.”

Getting enough sleep is necessary for good health. We all know how energetic we feel when we are sleeping well at night. Yet, many of us do not feel rested, even after seven or eight hours of sleep. Let's answer some common questions about snoring and sleep apnea, problems that are often called sleep related breathing disorders (SRBD).

What is the purpose of sleep?
Scientists know we need sleep, at a particularly deep level, to be rested, but they are not sure why we need sleep. Sleep may have evolved as a way to conserve energy in the body, to conserve food supplies, or to reduce our risk during darkness. Sleep appears to give the brain a chance to store and organize its information and the body a chance to recuperate. Sleep studies have shown that in order to get the full benefits of sleep we need to sleep long and deeply enough to enter into a series of sleep cycles including Rapid Eye Movement (REM) and Non-Rapid Eye Movement (NREM) sleep.

What kinds of problems get in the way of the type of sleep we need?
There are eight main categories of sleep disorders, but the ones affecting the largest numbers of people are insomnia, SRBD, and Circadian Rhythm Sleep Disorders. SRBDs include snoring and Obstructive Sleep Apnea (OSA), which is a serious health problem.

How do I know if I have OSA or another SRBD?
Often, your bed-partner will tell you that you snore. Chronic loud snoring is an indicator of OSA. To make a diagnosis your physician must take a thorough sleep and medical history. The diagnosis may then be confirmed by a study in a sleep lab.

What causes sleep apnea or OSA?
Snoring and OSA happen when your tongue and other soft tissues in the back of your throat collapse backwards and block airflow through your upper airway or windpipe. You may briefly awaken as many as 50 times per night because of these breathing lapses. These brief awakenings, called micro-arousals, keep you from reaching the deep stage of sleep your body needs.

What are the treatments for sleep apnea?
Treatments include CPAP therapy, in which patients wear a mask while sleeping. The mask pushes air through the airway, keeping it open. In Oral Appliance Therapy (OAT) patients wear a device that moves the lower jaw forward, allowing more room for air to move down the airway. Oral surgical procedures and orthodontic approaches also have the goal of moving the tongue away from the throat. These are all treatments that can be carried out by a dentist who has training and experience in treatment of sleep disorders.

Contact us today to schedule an appointment to discuss your questions about sleep disorders and their treatments. You can also learn more by reading the Dear Doctor magazine articles “Sleep Disorders and Dentistry” and “Sleep Apnea Frequently Asked Questions.”

Guidelines regarding the concentration of fluoride in water have recently been changed by the US Government's Department of Health and Human Services (HHS) and the Environmental Protection Agency (EPA). These agencies recommended a reduction of fluoride in water supplies to 0.7mg/L, modifying the original recommendations provided in 1962 by the US Public Health Service.

What is fluoride, and why add it to water supplies?
Fluoride is a chemical form of fluorine, a naturally occurring element. For decades, scientists have carried out studies on the effects of fluoride in water, and they have proved that fluoride strengthens tooth surfaces and makes them resistant to decay. A fluoride concentration of about one milligram per liter (1 mg/L), or 1 part per million (1ppm), in the water supply is associated with substantially fewer cavities. This concentration of fluoride (equivalent to a grain of salt in a gallon of water) has been found to have no negative health effects.

The Center for Disease Control (CDC) says that fluoridated water is one of the ten most effective public health measures of the 20th Century. The optimal amount of fluoride necessary to make teeth resistant to decay turns out to be between 0.7 and 1.20 milligrams per liter (mg/L). A certain amount of fluoride occurs naturally in water supplies, and communities have added fluoride to bring the amount up to the optimal recommendations.

How does fluoride you drink get into your teeth?
The fluoride you drink in your water is deposited in your bones. Bone is an active living substance that is constantly broken down and rebuilt as a normal body process. As this happens the fluoride is released into the blood, from which it can enter the saliva and act on the tooth surface.

What about fluoride from other sources?
Americans now have access to many sources of fluoride in addition to the water they drink. These include foods, beverages and toothpaste. As a result, dentists have begun to notice an increased prevalence of a condition known as Dental Fluorosis.

What is Dental Fluorosis?
Dental Fluorosis can occur when teeth, particularly in children, receive too much fluoride. This condition is a mottling or uneven staining of the tooth surface enamel. There may be small white spots or extensive brownish discolorations. The mottled enamel is still resistant to decay, but it may be unattractive in appearance.

What is the idea behind the new guidelines?
With the new guidelines, fluoride is kept at the lower end of the scale of the optimal concentration for strengthening teeth against decay. At this end, there is room to add consumption of fluoride from other sources such as foods or toothpaste. In short, it is the best of both worlds.

Contact us today to schedule an appointment to discuss your questions about fluoride. You can learn more by reading the Dear Doctor magazine articles “Fluoride & Fluoridation in Dentistry” and “New Fluoride Recommendations.”

In today's fast-paced society, nearly everyone is looking for reliable solutions to resolve problems almost instantly. Unfortunately, in many situations, bad breath cannot be cured that quickly. This is why we want to provide you with the following rules of thumb for treating your bad breath.

• Use a soft-bristled brush and a proper technique to clean your teeth at least twice a day, in the morning when you wake and before you go to bed.
• Floss your teeth at least once daily to remove the bacterial plaque and food particles between your teeth, as these are two known causes of bad breath and tooth decay.
• Clean your tongue, as it can often be the main culprit with too many odor-producing bacteria living on its surface. To clean your tongue, use a tongue scraper obtainable from a local drug or discount store, or brush your tongue with your toothbrush. Remember, a healthy tongue should be pink in color and not have a yellowish or brownish coating.
• Chew a sugar-free gum that contains xylitol, a natural, sugar-free sweetener that actually has been shown to help prevent caries (cavities) while improving your breath.
• Change your eating and drinking habits. Drinking plenty of tap water will not only keep your mouth hydrated (a dry mouth is another cause of bad breath), but it also can help prevent caries if you live in an area with fluoridated water. And by adding plenty of crunchy fruits and veggies such as carrots, celery and apples, you stimulate the production of saliva; thus keeping your mouth moist and rinsed out.

And last but not least, you can contact us today to schedule a consultation for an examination, cleaning and treatment plan. Or, you can learn more when you read the Dear Doctor article, “Bad Breath — More Than Just Embarrassing.”