In recent decades civilization's millennia-long search for clean, safe drinking water has become much easier with modern purification methods. Today, there are few places in the United States without adequate access to potable water. And about three-fourths of the nation's tap water systems add fluoride, credited with helping to reduce tooth decay over the past half century.
But in recent years some have voiced concerns about the safety of tap water and popularizing an alternative: bottled water. Manufacturers of bottled water routinely market their products as safer and healthier than what comes out of your faucet.
But is that true? A few years ago a non-profit consumer organization called the Environmental Working Group (EWG) performed a detailed, comprehensive study of bottled water. Here's some of what they found.
Lack of transparency. It's not always easy to uncover bottled water sources (in some cases, it might actually begin as tap water), how it's processed, or what's in it. That's because unlike water utilities, which are rigorously monitored by the Environmental Protection Agency (EPA), the Food and Drug Administration (FDA) oversees bottled water production with less strenuous guidelines on labeling. Eight out of the top 10 selling brands were less than forthcoming about their water's contents in EWG's investigation.
Higher cost. According to the EPA, the average consumer cost in the last decade for tap water was $2.00 per 1,000 gallons (0.2 cents per gallon). The retail cost for even bulk bottled water is exponentially higher. It can be a costly expenditure for a family to obtain most of their potable water by way of bottled—while still paying for tap water for bathing and other necessities.
Environmental impact. Bottled water is often marketed as the better environmental choice. But bottled water production, packaging and distribution can pose a significant environmental impact. EWG estimated the total production and distribution of bottled water consumes more than 30 million barrels of oil each year. And disposable plastic water bottles have become one of the fastest growing solid waste items at about 4 billion pounds annually.
While there are credible concerns about tap water contaminants, consumers can usually take matters into their own hands with an affordable and effective household filtering system. EWG therefore recommends filtered tap water instead of bottled water for household use.
If you would like more information on drinking water options, 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 “Bottled Water: Health or Hype?”
Mouth injuries in children and teens are more common than you might think: about one out of three boys and one out of four girls will have experienced an injury before they graduate from high school. Besides contact sports, other types of accidents like car crashes or falls are high on the cause list.
Although most dental injuries aren’t considered true emergencies, there are a few where prompt action may mean the difference between ultimately saving or losing a tooth. One such situation is a knocked out tooth.
In the event of a knocked out (or avulsed) tooth, your primary goal is to place the tooth back into the empty socket as quickly as possible. Teeth that have been out of the mouth for less than five minutes have the best chance of reattachment and survival. The first step is to quickly locate the missing tooth.
Once you’ve found it, use only cold, clean water run or poured over the tooth to carefully clean off dirt or debris (no soaps or cleansers). You should also avoid touching the tooth root or scrubbing any part of it. After cleaning it of debris, gently place the tooth back in its socket, then immediately contact us or visit an emergency room. While you’re en route to our office the patient should carefully hold the tooth in place. If the tooth can’t be immediately placed into the socket (the patient is unconscious, for example), then you should place the tooth in a clean container and keep it moist with cold milk, a sterile saline solution or even the patient’s saliva.
Taking these steps increases the chances of a successful re-implantation, although the injury may ultimately affect the tooth’s lifespan. Replanted teeth can suffer from root resorption (where the root tissue dissolves) or a process known as ankylosis in which the tooth fuses directly to the jawbone with no healthy periodontal ligament in between. Either of these conditions can lead to tooth loss.
Still, it’s worthwhile to try to save the tooth, even if for a few more years. Those extra years can help you prepare for a future restoration.
If you would like more information on responding to dental injuries, 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 “Accidental Tooth Loss.”
The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.
In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?
The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.
Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.
So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”
Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.
If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”
While most tooth loss stems from dental disease or injury, another major cause is a condition known as cracked tooth syndrome. What begins as a microscopic crack in an individual tooth’s enamel could ultimately grow to a fracture that endangers its survival.
Most often related to age-related brittleness, expansion and contraction of the enamel surface because of hot foods followed by cold foods and beverages, or grinding habits, cracked tooth syndrome usually occurs in three phases. The first phase is the emergence of miniscule cracks in the outer enamel known as craze lines. These can be very difficult to detect even with x-rays, and usually calls for specialized detection methods such as probing with a sharp instrument (an explorer) or fiber-optic lighting with dye staining to highlight enamel abnormalities. If you have pain symptoms, we may ask you to bite down on a bite stick or rubber pad to locate the area by replicating the sensation.
In the next phase, the craze line grows into a crack that penetrates below the enamel into the tooth’s dentin. Pain becomes more prominent and the risk of infection increases. Left untreated, the crack may enter the third phase, a full break (fracture) occurring deep within the inner layers of the tooth. The deeper the fracture occurs, the more serious the danger to the tooth, especially if the pulp is exposed.
The best treatment approach is to attempt to detect and treat a crack as early as possible. Craze lines and moderate cracks can usually be repaired with restorative materials like composite resins. A deeper crack extending into the pulp may require a root canal treatment and the tooth covered with a permanent, protective crown.
If, however, the fracture is too deep, the tooth may be beyond repair and will need to be extracted and replaced with a dental implant or permanent bridge. In any event, the sooner a cracked tooth is discovered and treated, the greater your chance of avoiding pain, discomfort, and, ultimately, tooth loss.
If you would like more information on cracked tooth syndrome, 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 “Cracked Tooth Syndrome.”
National Fresh Breath Day is celebrated in August, but who doesn’t want fresh breath every day? Everyone has bad breath once in a while, so here are some tips to fight it.
1. Step up your oral hygiene routine.
Good oral hygiene is the first line of defense against bad breath. Brush your teeth morning and night and floss daily to remove much of the tiny food debris and plaque (colonies of oral bacteria) that can cause bad breath.
2. Don’t neglect your tongue.
A coated tongue can be a source of bad breath, so brush your tongue as well as your teeth or use a tongue scraper, which can be purchased in the oral health aisle of your local pharmacy.
3. Clean around your braces.
If you have braces, use an interdental brush or a water flosser to free trapped food particles.
4. Pay attention to your oral appliances.
If you wear dentures, be sure to clean them thoroughly every day, and brush your gums and the inside of your mouth as well. Bridgework also needs special attention: Clean carefully around the bridge and under the false tooth, as food can get stuck there.
5. Tackle dry mouth.
Dry mouth, a major cause of bad breath, can result from numerous medications, salivary gland problems, or breathing through the mouth instead of the nose due to sinus problems, sleep apnea, or other conditions. If your mouth is chronically dry, chew sugarless gum to stimulate saliva production, or ask about an over-the-counter or prescription saliva substitute.
6. Avoid extreme dieting.
Weight loss diets that advocate a stringent reduction in carbohydrates can lead to “keto breath.” This foul-smelling breath happens when the body burns fat instead of glucose for fuel.
7. Quit smoking.
In addition to smelling like cigarettes, people who smoke have less—as well as lower quality—saliva, which contributes to bad breath and poor oral health. If you need help quitting, talk with us or call (800) QUIT-NOW.
8. Be aware that some foods and beverages can leave stinky breath.
These include garlic, onions, strong spices, coffee, alcohol, cheese, and canned fish.
9. Keep up with regular dental visits.
Professional dental cleanings are necessary to get rid of hardened plaque (tartar) that can’t be removed by your brushing and flossing routine at home. We also check for gum disease, another cause of bad breath.
10. See your doctor.
Certain medical conditions like acid reflux, diabetes, and respiratory infections can cause bad breath. If you have an untreated health condition, make an appointment with your medical doctor.
If you are concerned about bad breath, please contact our office or schedule a consultation. You can learn more in the Dear Doctor magazine article “Bad Breath: More Than Just Embarrassing.”
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