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Dr. John Zarrella and Dr. Peter C. Rider, as well as our team at Zarrella Dentistry, would like to give those patients with flex spend, health savings, or insurance benefits a friendly end of the year reminder that it’s high time to schedule your dental visits so you optimize your benefit.

Now is the time to reserve your appointment with us. Space is limited and we tend to get busy around the holidays, so don’t wait to give us a call at our convenient Ashland office!

Is this a trick question? After all, you probably already know quite a lot about cavities:

• It all begins when bacteria-filled plaque sticks to teeth and starts to attack enamel. How?
• Because the bacteria in plaque use the sugars and other foods we eat to produce acids.
• These acids gradually weaken teeth by dissolving minerals which help make up our enamel (a process called demineralization).
• Over time, a hole, or cavity, develops in the tooth surface.
• Left untreated, bacterial decay can spread to the inside of the tooth, creating a more serious cavity.

Some cavities aren’t discovered until you visit our Ashland office, but sometimes there are clear signs that there’s a problem.

• You have tooth pain or sensitivity.
• Your tooth changes color in spots where the enamel has decayed.
• You might even notice enamel loss when a cavity is large enough.

So, if you have any of these symptoms, it’s a cavity, right? It might be—but it might not. Sometimes, because the symptoms are similar, what we suspect is a cavity is really enamel erosion.

The bacteria-created acids weaken enamel. But it’s not just bacteria that subject our teeth to acids—we do it ourselves with our choice of food and drink. Acidic foods are one of the leading causes of tooth erosion.

Our normal saliva pH level is around a 7, which is neutral. Any number lower is acidic; any number higher is alkaline. Acidic foods have a low pH (the pH of lemon juice, for example, measures between 2 and 3), and can reduce our normal, neutral pH level. When saliva pH levels drop to 5.5 or lower, tooth enamel starts to demineralize, just as it does when exposed to the acids from oral bacteria.

Regularly snacking on citrus and other acidic fruits, wine, fruit juices, flavored teas, sour candies, and other acidic foods can cause enamel erosion. Especially erosive are sports drinks, energy drinks, and colas, because they contain some combination of citric acid, phosphoric acid and/or carbonation.

The symptoms of tooth erosion and damaged enamel can be very similar to those caused by cavities:

• You suffer tooth pain or sensitivity
• Your teeth appear discolored, as the enamel thins to reveal the yellowish dentin underneath
• You notice missing enamel—your teeth become rounded or have little pits known as cupping

You call Dr. John Zarrella and Dr. Peter C. Rider right away if you suspect a cavity. Be just as proactive if you suspect erosion. Even though your symptoms may not have been caused by plaque and bacteria, acidic erosion from your diet leaves weakened enamel just as vulnerable to cavities and decay.

How to avoid erosion?

• Enjoy acidic foods sparingly, or as part of a meal. This helps your saliva pH stay in the neutral zone.
• Balance acidic foods with low-acid choices to help neutralize acids and restore a normal pH balance. (A good reason to pair wine or fruits with cheese.)
• Use a straw! This simple solution keeps erosive drinks from bathing your teeth in acids.
• Drink water instead of an acidic beverage, or drink it afterward to rinse your mouth. The pH of pure water? A perfect, neutral 7.
• And what about brushing right after eating or drinking something acidic? Ask Dr. John Zarrella and Dr. Peter C. Rider if you should rush for your brush. We may recommend waiting 30 minutes or so after an acidic treat to give teeth time to remineralize after acids weaken them. Otherwise, brushing might cause more wear and tear on your enamel.
• Finally, while foods are often the source of acid erosion, medical conditions can cause erosion as well. Talk to us about ways to minimize erosion while addressing your medical needs.

There’s no trick to it—watching your diet, brushing and flossing as recommended, using a fluoride toothpaste, and visiting Zarrella Dentistry for regular checkups will help prevent tooth erosion. We can restore eroded enamel with bonding, veneers, or crowns if the erosion is serious. Better still is to catch erosion before symptoms appear to keep your teeth their strongest for a lifetime of healthy, beautiful smiles.

Women using medication to treat a variety of medical conditions are often unaware of the potential side effects. One common side effect of medications such as blood pressure medication, birth control pills, antidepressants, and cancer treatments is dry mouth. The technical term for dry mouth is xerostomia.

Xerostomia can lead to undesirable effects in the oral cavity including periodontal disease and a high rate of decay. Many women who have not had a cavity in years will return for their routine exam and suddenly be plagued with a multitude of cavities around crowns and at the gum line, or have active periodontal disease. The only thing that the patient may have changed in the past six months is starting a new medication.

Saliva washes away bacteria and cleans the oral cavity, and when saliva flow is diminished harmful bacteria can flourish in the mouth leading to decay and gum disease. Many medications can reduce the flow of saliva without the patient realizing the side effect. Birth control pills can also lead to a higher risk of inflammation and bleeding gums. Patients undergoing cancer treatments, especially radiation to the head and neck region, are at a greatly heightened risk of oral complications due to the possibility of damage to the saliva glands.

There are many over the counter saliva substitutes and products to temporarily increase saliva production and help manage xerostomia. One great option for a woman with severe dry mouth or high decay rate is home fluoride treatments. These work in a number of ways, including custom fluoride trays that are worn for a short period of time daily at home, a prescription strength fluoride toothpaste, or an over the counter fluoride rinse. If you have more questions on fluoride treatments, make sure to ask Dr. John Zarrella and Dr. Peter C. Rider at your next visit to our office.

The benefits of many of the medications on the market outweigh the risks associated with xerostomia, however, with regular exams you can manage the risk and prevent many oral consequences of medications.

Probably because, for many kids, molars do get more cavities. So let’s answer two better questions: Why do molars get more cavities? And, how can we help prevent them?

It’s the Pits. (And Fissures.)

The reason molars are so useful—and more likely to develop cavities—is because of their shape. Unlike our front teeth, which are used to bite through foods, molars are used to grind and chew. That’s why they are so much larger, with a flat surface on top. Well, not exactly flat.

When you look at a molar, you’ll notice that the top isn’t really smooth at all. It’s covered with little indentations known as pits and longer grooves called fissures. These irregular features both trap food particles and make it more difficult for bristles to clean them away. Cavities in molar surfaces are so common that they even have a specific name: “pit and fissure cavities.”

But molar biology does not mean tooth decay is inevitable! There are steps you can take to protect your children’s molars as they grow, while you’re providing them with dental strategies that will keep their adult molars healthy and cavity-free.

Preventing Pit and Fissure Cavities

• Don’t Just Brush—Brush Effectively

The first step in preventing any kind of cavity is brushing properly. Your child should be brushing at least two minutes, at least twice each day. And while the time we spend brushing is important, technique is also key.

When you’re showing your child how to brush, be sure that the tops of molars, upper and lower, get brushed thoroughly, with special emphasis on cleaning pits and fissures. Make sure the toothbrush is small enough to fit your child’s mouth comfortably and reach all the tooth surfaces. Replace worn-down brushes or electric toothbrush heads after three to four months when they no longer clean as effectively.

Your child will probably need adult supervision from toddler years through the early years of grade school to learn how to brush properly. This is time well spent, as your child learns cavity-preventing brushing techniques which will last a lifetime.

• Eat a Tooth-Healthy Diet

Plaque bacteria use the sugars in our food to make acids. These acids break down the mineral strength of tooth enamel and eventually lead to cavities. And because pits and fissures are great hiding places for bacteria and food particles (especially sticky ones), molars are even more at risk for cavities. Limiting sugary, sticky foods like sweet treats and simple carbs helps reduce that risk.

Acidic foods like flavored juices, sour candies, sodas, and power drinks also weaken enamel and can leave teeth more vulnerable to decay. Help your child avoid cavities by limiting acidic foods and drinks, making them part of a balanced meal, and/or rinsing with water after eating.

• Use Fluoride Toothpaste

Fluoride toothpaste not only reduces the risk of cavities, it also helps strengthen enamel that has been weakened by bacterial and dietary acids. Win-win!

• Ask About Sealants

Sealants are invisible, safe coatings which protect molars by preventing food and bacteria from getting trapped in their uneven surfaces. The top of the molar is first treated with an etching solution to allow the sealant to bond tightly to the tooth, a thin coat of sealant is painted on, and then it’s hardened under a curing light. That’s all there is to it.

Sealants are often recommended when children’s permanent molars first erupt, when they are especially at risk for cavities. Sealants can last from three to five years (or even longer), and studies have shown a dramatic reduction in cavities for patients who use sealants compared to patients with untreated teeth. Depending on your child’s individual needs, Dr. John Zarrella and Dr. Peter C. Rider might recommend a sealant for baby molars as well.

• Regular Exams and Cleanings

It might be hard for you to tell if your child’s molars have been affected by sticky plaque, or sugary foods, or acidic drinks, or inadequate brushing, or any other potential cavity-causers. It’s not a difficult job for Dr. John Zarrella and Dr. Peter C. Rider, though! Through regular checkups and cleanings at our Ashland office, we will discover any conditions that might lead to cavities, and, if necessary, treat small cavities before they lead to more serious decay.

Statistically, childhood molars have a greater chance of developing cavities than incisors and canines. Help your child beat the odds by understanding why these teeth are at risk and by working with your dental team to give your child years of healthy teeth now and a future filled with beautiful smiles!