My Blog

By Bruce E. Hanley DDS
January 10, 2022
Category: Oral Health
Tags: fluoride  
ALittleFluorideGoesaLongWayinProtectingYourFamilysTeeth

A popular Sixties-era hair cream touted their product with the tagline, "A little dab'll do ya!" In other words, it didn't take much to make your hair look awesome.

Something similar could be said about fluoride. Tiny amounts of this "wonder" chemical in hygiene products and drinking water are widely credited with giving people a big boost in protection against tooth decay.

A Colorado dentist is credited with first noticing fluoride's beneficial effects early in the Twentieth Century. Although many of his patients' teeth had brownish staining (more about that in a moment), he also noticed they had a low incidence of cavities. He soon traced the effect to fluoride naturally occurring in their drinking water.

Fast forward to today, and fluoride is routinely added in trace amounts to dental care products and by water utilities to the drinking water supply. It's discovery and application have been heralded as one of the top public health successes of the Twentieth Century.

Fluoride, though, seems a little too amazing for some. Over its history of use in dental care, critics of fluoride have argued the chemical contributes to severe health problems like low IQ, cancer or birth defects.

But after several decades of study, the only documented health risk posed by fluoride is a condition called fluorosis, a form of staining that gives the teeth a brown, mottled appearance (remember our Colorado residents?). It's mainly a cosmetic problem, however, and poses no substantial threat to a person's oral or general health.

And, it's easily prevented. Since it's caused by too much fluoride in prolonged contact with the teeth, fluorosis can be avoided by limiting fluoride intake to the minimum necessary to be effective. Along these lines, the U.S. Public Health Service recently reduced its recommended amounts added to drinking water 0.7 milligrams per liter (mg/L) of water. Evidence indicated fluoride's effectiveness even at these lower amounts.

You may also want to talk with your dentist about how much fluoride your family is ingesting, including from hidden sources like certain foods, infant formula or bottled water. Even if you need to reduce your family's intake of fluoride, though, a little in your life can help keep your family's teeth in good health.

If you would like more information on the benefits of fluoride in dental care, 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 “Fluoride & Fluoridation in Dentistry.”

By Bruce E. Hanley DDS
December 31, 2021
Category: Oral Health
Tags: oral health   osteoporosis  
SomeOsteoporosisTreatmentsCouldImpactDentalCare

Millions of Americans live with osteoporosis, a degenerative bone disease that can turn a minor fall into a potential bone fracture. Literally meaning "porous bone," osteoporosis causes the natural marrow spaces in bone tissue to progressively grow larger and weaken the remaining bone.

Many osteoporosis patients take medication to slow the disease's process. But due to the dynamic nature of bone, some of these drugs can have unintended consequences—consequences that could affect dental care.

As living tissue, bone is literally "coming and going." Certain cells called osteoblasts continuously produce new bone, while others called osteoclasts remove older tissue to make way for the new. Drugs like bisphosphonates and RANKL inhibitors interrupt this process by destroying some of the osteoclasts.

As a result, more of the older bone remains past its normal lifespan, helping the bone overall to retain strength. But ongoing research is beginning to hint that this may only be a short-term gain. The older, longer lasting bone is more fragile than newer bone, and tends to become more brittle and prone to fracture the longer a patient takes the drug. This tissue can also die but still remain intact, a condition known as osteonecrosis.

The femur (the large upper leg bone) and the jawbone are the bones of the body most susceptible to osteonecrosis. Dentists are most concerned when this happens in the latter: Its occurrence could lead to complications during invasive procedures like oral surgery or implant placement.

Because of this possibility, you should keep your dentist informed regarding any treatments you're undergoing for osteoporosis, especially when planning upcoming dental procedures like oral surgery or implant placement. You might be able to lower your risk by taking a "drug holiday," coming off of certain medications for about three months before your dental work.

As always, you shouldn't stop medication without your doctor's guidance. But research has shown drug holidays of short duration won't worsen your osteoporosis. If you're already showing signs of osteonecrosis in the jaw, a short absence from your prescription along with antiseptic mouthrinses and heightened oral hygiene could help reverse it.

Fortunately, the risk for dental complications related to osteoporosis medication remains low. And, by working closely with both your dentist and your physician, you can ensure it stays that way.

If you would like more information on osteoporosis and your dental care, 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 “Osteoporosis Drugs & Dental Treatment.”

By Bruce E. Hanley DDS
December 22, 2021
Category: Cosmetic Dentistry
Tags: teeth whitening  

Your teeth look yellow, grey, or just downright dingy, but it’s not your fault! There are many reasons which may have caused your smile to lose its luster. Fortunately, in-office teeth whitening might be the solution you need for a perfectly white, bright smile. Dr. Bruce Hanley in Arlington, VA can help make your smile movie-star beautiful.

Why Are My Teeth Discolored?

When you’re young, your teeth are beautifully white. Over time, they can become yellow, grey, or dingy-looking. There are many reasons for this:

The food and drinks you choose can discolor your teeth. Beverages like wine, coffee, and tea are notorious for causing your teeth to lose their shine. The pigments in these drinks and even foods you eat like turmeric attach to your tooth enamel, causing them to become stained.

Tar and nicotine in tobacco products stain teeth. Tar and nicotine are very discoloring in combination. 

Your teeth get less white with age. Beneath the top layer of your enamel is a soft layer called dentin. Over time,  the enamel wears away to reveal the naturally yellowish-colored dentin beneath. 

Medications may stain teeth. Antihistamines, antipsychotics, or even high blood pressure medication can cause teeth discoloration. People who took tetracycline when they were younger may experience tooth discoloration, and even their children may experience it if it was taken while pregnant.

Injuries cause teeth to look less white. The loss of blood flow to the root of a tooth can cause it to appear less white and bright, and instead appear a grey tone. 

Can I Use an At-Home Treatment?

There are many home remedies for whiter teeth but they may not be the fastest, best, or healthiest. In some cases, whitening treatments won’t change your tooth color at all, particularly if you have crowns or veneers. Here are a few common at-home teeth whitening remedies:

  • Strips 
  • Pens
  • Toothpaste
  • Kits

According to scientific research conducted by the American Society of Biochemistry and Molecular Biology, some hydrogen-peroxide-based teeth whitening products change the protein inside the dentin layer. This layer keeps your teeth healthy. [1] If you’re going to apply a home-whitening product, it’s best to use one that contains an alternative ingredient or seek in-office treatment with a dentist instead.

Why are In-Office Whitening Treatments Better?

When you get your teeth whitened in-office you don’t have to wait weeks or months for results. Your gums are also protected to keep the hydrogen peroxide from irritating them. The results are also often more visually stunning since the solution penetrates deeper into the teeth.

To schedule a dental appointment for a bright, white new smile, contact Dr. Bruce Hanley in Arlington, VA  at (703) 524-7100.

3ThingsYouCanDotoKeepHolidaySweetsFromInterferingWithYourDentalHealth

In his iconic poem, "A Visit from St. Nicholas," Clement Moore wrote of children sleeping "while visions of sugar plums danced in their heads." Indeed, sweet treats are still interwoven into the holidays—and a prime reason why we tend to put on pounds during the season. It may also be why your next dental visit might come with some unpleasant news.

The starring actors in much of traditional holiday snacking and feasting are naturally-occurring or added sugars. Carbohydrates like refined sugar in particular can dramatically affect your dental health if you over-consume them, because they can feed the bacteria that causes both tooth decay and gum disease.

There are ways, though, to reduce their impact on your teeth and gums. You can, of course, go "cold turkey" and cut refined sugar out completely, as well as curtail other carbohydrates like refined flours and fruit. It's effective, but not much fun—and what are the holidays without fun?

More in line with "moderation in all things," there are other ways to minimize the impact of carbohydrates on your teeth and gums during the holiday season. Here are a few of them.

Limit refined sugar. While you and your family may not be up for banning sugar during the holidays, you can reduce it significantly. For instance, prepare more savory items rather than the sweeter kinds. If you must go for sweet, opt for naturally occurring sugars in fruit or dairy rather than refined table sugar or high fructose corn syrup.

Eat sweet treats with meals. Constant snacking often comes with the holiday season. And, why not—all those abundant goodies are just begging to be eaten. But noshing all the time never allows your mouth's saliva, which neutralizes the enamel-eroding acid produced by the bacteria fueled by sugar, a chance to finish its buffering. Instead, try as much as possible to limit treats to mealtimes.

Use different sweeteners. There are a number of alternative sweeteners to regular sugar, both natural and artificial. Some work better in baked goods, while others are more suitable for candies or beverages. Xylitol in particular, a sugar alcohol, actually discourages oral bacterial growth. You can also use natural sweetening agents like stevia or erythritol to help reduce refined sugar in your treats.

Even if you normally limit carbohydrates, it's understandable if their consumption rises during the holidays. That's why it's important you don't neglect daily brushing and flossing to help control bacterial plaque, the main driver for dental disease. Both effective oral hygiene and reining in the sweets will help your teeth and gums sail through the holidays into the new year.

If you would like more information about protecting your oral health during the holidays, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “The Bitter Truth About Sugar.”

TakeItFromTaylorSwift-LosingYourOrthodonticRetainerisNoFun

For nearly two decades, singer-songwriter Taylor Swift has dominated the pop and country charts. In December she launched her ninth studio album, called evermore, and in January she delighted fans by releasing two bonus tracks. And although her immense fame earns her plenty of celebrity gossip coverage, she's managed to avoid scandals that plague other superstars. She did, however, run into a bit of trouble a few years ago—and there's video to prove it. It seems Taylor once had a bad habit of losing her orthodontic retainer on the road.

She's not alone! Anyone who's had to wear a retainer knows how easy it is to misplace one. No, you won't need rehab—although you might get a mild scolding from your dentist like Taylor did in her tongue-in-cheek YouTube video. You do, though, face a bigger problem if you don't replace it: Not wearing a retainer could undo all the time and effort it took to acquire that straight, beautiful smile. That's because the same natural mechanism that makes moving teeth orthodontically possible can also work in reverse once the braces or clear aligners are removed and no longer exerting pressure on the teeth. Without that pressure, the ligaments that hold your teeth in place can “remember” where the teeth were originally and gradually move them back.

A retainer prevents this by applying just enough pressure to keep or “retain” the teeth in their new position. And it's really not the end of the world if you lose or break your retainer. You can have it replaced with a new one, but that's an unwelcome, added expense.

You do have another option other than the removable (and easily misplaced) kind: a bonded retainer, a thin wire bonded to the back of the teeth. You can't lose it because it's always with you—fixed in place until the orthodontist removes it. And because it's hidden behind the teeth, no one but you and your orthodontist need to know you're wearing it—something you can't always say about a removable one.

Bonded retainers do have a few disadvantages. The wire can feel odd to your tongue and may take a little time to get used to it. It can make flossing difficult, which can increase the risk of dental disease. However, interdental floss picks can help here.  And although you can't lose it, a bonded retainer can break if it encounters too much biting force—although that's rare.

Your choice of bonded or removable retainer depends mainly on your individual situation and what your orthodontist recommends. But, if losing a retainer is a concern, a bonded retainer may be the way to go. And take if from Taylor: It's better to keep your retainer than to lose it.

If you would like more information about protecting your smile after orthodontics, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “The Importance of Orthodontic Retainers.”





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