Periapical (root-tip) Abscess
A periapical (root-tip) abscess is a pocket of infection at the base of a tooth's root. The tooth becomes abscessed after the pulp (nerve) of the tooth becomes infected. A periapical abscess is usually caused by deep decay or an accident (trauma to the tooth involving nerve damage). A periapically abscessed tooth will require either Pulp Therapy or an Extraction. In some cases an antibiotic will also be prescribed.
A lateral abscess is similar to a periapical abscess, but develops along the lateral surface of the tooth's root. In this case, the infection comes from outside the tooth instead of from within. A lateral abscess can either be gingival (located near the gum line) or periodontal (located deeper in the periodontal tissues). Since most cases of lateral abscess are due to periodontitis (gum disease), treatment is part of an overall periodontal (gum) treatment program.
An abscessed tooth may be sensitive or painful, and if left untreated can lead to damage of underlying permanent teeth and/or cause facial swelling and become life-threatening.
ACCIDENTS / EMERGENCIES
Tooth Knocked Out
Do not wipe the tooth clean. If the accident happened at home, place the tooth in a glass of milk. If the accident happened at your child's school, most school nurses will have a particular solution on hand to place a lost permanent tooth called Hanks Balanced Salt Solution. If that is not available, milk will work just fine. The goal is to soak the tooth to prevent it from drying out until your child can be evaluated. Call our office immediately. Sometimes, if the tooth is placed back in its socket soon enough by your child's dentist, the tooth can be saved. Time is critical in this situation!
Broken and Chipped Tooth
Remove the fractured piece to prevent choking and don't chew on anything hard. Call your dentist immediately. Some teeth can be filled. More severe cases may need to be crowned. If the tooth has broken into the nerve the tooth will need Root Canal Therapy and a Crown, or it will need to be extracted.
If you were hit by an object, call your dentist immediately. Depending on the severity of the blow, your dentist may let the tooth "tighten-up" on its own, or your dentist may bond the tooth to the uninjured teeth next to it for support until it heals. The tooth may turn dark and/or abscess after an accident. That may happen immediately, or it could be years later. If the tooth does eventually abscess, it will require Extraction or Root Canal Therapy and a Crown just like any other abscessed tooth.
Lacerated (Cut) Lip or Tongue
Apply pressure to stop or slow the bleeding. If the wound is severe or doesn't stop bleeding, call your dentist or go to the Emergency Room at the hospital immediately. The wound may require stitches to stop the bleeding, prevent infection and to help it properly heal.
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Many people have allergies to dust and pollen. Some people have specific allergies to certain medications or materials. You will be asked about any specific allergies your child may have on their new-patient questionnaire. Be sure to let us know prior to treatment if they have allergies to any of the following:
Allergies to Medications
If your child has ever had an allergic reaction to any medication, including dental anesthetics, please let us know. If you can't remember the name of the medication, we can contact the health care provider that used or prescribed the medication to get the name. We have alternate anesthetics that can be used in case of allergies to certain dental anesthetics ("numbing" agents). There are alternate drugs that can be prescribed in case of allergies to oral antibiotics or analgesics (pain relievers).
Allergies to Materials
If your child is allergic to Latex, please notify us prior to treatment and we will be happy to use vinyl or Nitrile gloves instead. If they have any other allergies we should be aware of, please let us know so we can provide a comfortable environment for your child.
Tooth ankylosis is the fusion of the tooth to the bone, preventing the tooth from erupting. This can happen in both primary ("baby") teeth and permanent teeth, and may occur at any stage during development or eruption. The cause of this condition is still uncertain. Theories include trauma and heredity. An exam and x-ray are the main diagnostic methods for determining ankylosis. Some cases require surgical extractions for orthodontic and functional purposes.
BAD BREATH / HALITOSIS
Many times bad breath is caused by the bacteria in the mouth and on the tongue. Sometimes it can be an indication of gum disease. Either way, your first stop to address persistent breath problems should be our office, because if gum disease is present, it must be treated promptly to avoid tooth loss.
Possible causes for halitosis are:
- Tooth Decay
- Periodontal (Gum) Disease
- Inadequate Oral Hygiene (not brushing and flossing)
- Odor-Causing Foods
- Use of Tobacco Products
- Sinus or Respiratory Infection
- Sinus Drainage
- Mouth Breathing
- Some Medical Disorders
- Some Medications
The dentist can help you determine the cause, and if the cause is an oral condition, a treatment plan can be developed to combat this common problem.
Bleeding gums are a sign of inflammation or infection. Healthy gums do not bleed. Brush and floss the area well. If bleeding persists for greater than 2 weeks contact the dental office immediately for an appointment.
Inflammation or Infection can lead to Gum Disease and tooth loss. Bleeding gums can often be your first indication of inflammation or infection. Early stages of Gum Disease are rarely painful, so bleeding gums may be your only indication of Gum Disease!
BROKEN / CHIPPED TOOTH
Contact your dentist immediately...
Be prepared to answer the following questions:
- Do you see redness inside the tooth or is it coming from the gums?
- Is the tooth loose or "wiggly"?
- Has it moved from its normal position prior to injury?
- Can your child bite their teeth together?
The answers to these questions will determine what is considered urgent or can be treated the next day.
While waiting on a response from the doctor, quick action can save the tooth, prevent infection and reduce the need for extensive dental treatment. Rinse the mouth with water and apply cold compresses to reduce swelling if the lip also was injured. If you can find the broken tooth fragment, place it in cold milk and bring it with you to the dental office.
CAVITIES / DECAY
Tooth Decay begins when the protein of your saliva combines with the sugars and carbohydrates of food particles left on and between your teeth. This combination creates bacteria-laden plaque, from which acid is produced that eats away at the hard enamel shell around your tooth. Left unchecked, a hole will be created in the enamel and a cavity will rapidly form in the softer dentin which lies under the enamel. When a cavity advances deep into the tooth, it may produce increased sensitivity to foods that are cold, hot, or sweet. But not all cavities will cause a toothache. If they are small or progressing slowly, they may only be detected by a dentist before they cause pain. Cavities on the front teeth are easiest for a person to see, and they will show as a light or dark brown spot. If a cavity forms in between the teeth, it may only be visible on an Xray. If the cavity is caught in time, usually a Filling will correct the problem. Larger cavities may require a Crown. However, if nothing is done and the decay spreads, the sensitive pulp (nerve) may become involved, often causing an Abscess, and Root Canal Therapy or Extraction may be required.
If you have a cracked tooth as a result of a very recent trauma or accident, contact your dentist immediately!
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When a tooth is cracked, a filling may not seal the crack.A crown may have to be placed over the tooth to hold it and the crack together. If the crack is not restored, the tooth will become sensitive to chewing pressure, or will eventually break. It is important to restore a cracked tooth before it breaks, because in some cases a broken tooth cannot be filled or crowned and must be extracted.
Teeth begin to form in the second trimester of pregnancy.Several factors can lead to discoloration of a child's tooth. Infants with serious health conditions, premature birth, or widespread infections may develop discolored teeth. Tooth discoloration can also be a result of tooth decay due to bad feeding habits. Parents or caregivers may allow young children to fall asleep with bottles or while nursing, which allows sugars to remain on the teeth and harm the enamel. Establishing good dental habits early and maintaining dental hygiene can help prevent or minimize tooth discoloration in children.
Often parents are concerned about the yellowingof their child's permanent teeth. This is perfectly normal. Adult teeth tend to be less white than baby teeth and have pronounced ridges because they have not been used yet for biting and chewing. They also tend to look bigger, especially the first few to erupt.
EARLY CHILDHOOD CARIES
Baby Bottle Tooth Decay or Baby Bottle Syndrome or Early Childhood Caries is the rapid decay of baby teeth in an infant or child from frequent exposure, for long periods of time, to liquids containing sugars. The upper front teeth are most commonly affected.
The problem is usually caused by a baby falling asleepwhile nursing a bottle or while breast feeding. While the child is asleep, the sugary liquid pools around the front teeth. The bacteria living in every baby’s mouth then turns the sugars to acid which causes decay.
Common sources of liquids high in sugars are:
- A bottle containing formula, milk, soda, or juice
- A pacifier dipped in honey
- Breast milk
You can help prevent Baby Bottle Syndrome by:
- Cleaning your child's teeth daily
- Not allowing your child to fall asleep with a bottle filled with juice, milk, or formula
- Not allowing your child to sip on a bottle filled with juice, milk, or formula for long periods of time as a pacifier
- Giving your child plain water when he or she is thirsty
- Making sure your child gets the fluoride needed to prevent decay
- Making regular dental appointments for your child beginning when their first tooth erupts
Our doctors can provide you with more information which can improve the care of your child’s teeth and maximize their oral health.
GUM DISEASE / GINGIVITIS
What is Gum Disease?
According to the American Dental Association, at least 60% of adults in the United States have moderate-to-severe gum disease! No doubt, you've heard some of the terms: Plaque, Tartar, Calculus, Gingivitis, Periodontitis, Pyorrhea, Periodontal Disease, Gum Disease. But what does it all mean? Quite simply, Gum Disease (Periodontal Disease) starts when plaque and tartar (calculus) are allowed to accumulate at the base of your teeth. The bacteria in the plaque leads to an infection in the gums (gingiva) called Gingivitis. Left untreated, the infection spreads to the tissue and bone that holds your teeth in place, a condition called Periodontitis (Pyorrhea). Because of the bacterial infection associated with Periodontitis, tooth abscesses are also common.
What are the Signs of Gum Disease?
Gum Disease is rarely painful, especially in the early stages. Although there may be no visible signs, some of the common indications of Gum Disease are:
- Gums that bleed when you brush or floss (healthy gums will not bleed)
- Gums that are red, swollen, or tender
- Gums that have pulled away from the teeth (receded)
- Pus (infection) between the teeth and gums
- Loose permanent teeth or separating (drifting) teeth
- Changes in the way your teeth fit together when chewing
- Persistent bad breath
What are the Dangers of Gum Disease?
Gum Disease is the leading cause of tooth loss among adults. More importantly, the infection releases toxins into the bloodstream leading to serious health risks:
Sources: National Institute of Dental & Craniofacial Research
and American Heart Association
Is There a Cure?
Gum Treatment can effectively be used to treat and control even advanced cases of Periodontitis (Pyorrhea), but the more advanced the disease, the more likely it will lead to tooth loss. Prevention and Early Detection are your best defenses against Gum Disease. It is critical to catch and treat Gum Disease early before destruction of bone and tissue has compromised your oral health.
How Can I Prevent Gum Disease?
The best "brushers" in the world will naturally build up tartar on their teeth. Even patients with "healthy" gums and teeth should see their dentist regularly to remove the build-up of tartar and check for the formation of new cavities. Patients with Gum Disease, or patients that build up large amounts of tartar, may need to have their teeth cleaned frequently to help control the amount of bacteria in the mouth. At your regular recall appointments (Cleanings), we always evaluate the condition of your gums.
A thorough exam, which includes x-rays, visual inspection, and an analysis of hard and soft tissue, helps determine the health of your gums.
If you have any specific questions about Gum Disease that weren't answered here, or if you would like an appointment for a Gum Disease screening, please Contact Us.
Gum pain can be caused by many things, such as:
- Toothbrush trauma
- Food trauma (e.g. spicy food, hot food, or jagged food fragment)
- Mouth ulcer (of various types)
- Gum Disease
- Herpes Simplex
- Tooth erupting
- Impacted tooth
- Oral cancer
- Various other conditions
If gum pain persists, it is important to Contact Us for an appointment to determine the cause and begin treatment, if needed.
Impacted teeth are unerupted or partially erupted teeth that cannot fully erupt due to:
- Lack of space (crowding)
- Misalignment (tooth is rotated out of position)
- Conflicting position (another tooth has erupted over that position)
- Ankylosis - when other causes of impaction are not corrected in a timely manner, the roots of the impacted tooth can fuse to the surrounding bone creating a tooth frozen in an unerupted or partially erupted state.
An impacted tooth simply means that it is "stuck" and cannot erupt into function. Patients frequently develop problems with impacted third molar (wisdom) teeth. These teeth get "stuck" in the back of the jaw and can develop painful infections among a host of other problems. Since there is rarely a functional need for wisdom teeth, they are usually extracted.
The maxillary cuspid (upper eye tooth) is the second most common tooth to become impacted. The cuspid tooth is a critical tooth in the dental arch and plays an important role in your "bite". The cuspid teeth are very strong biting teeth which have the longest roots of any human teeth. They are designed to be the first teeth that touch when your jaws close together so they guide the rest of the teeth into the proper bite. An orthodontist can place braces to open spaces to allow for proper eruption of the adult teeth.
The most common cause for loose teeth in children is erupting permanent teeth. As permanent teeth begin to erupt, the roots of the primary teeth (baby teeth) dissolve and the teeth become loose. Primary teeth will generally fall out on their own at the appropriate time, but almost 10% of children have permanent teeth growing in behind or in front of baby teeth.
If there is not enough space available in the child's mouth then a permanent tooth can start erupting behind the baby tooth. This might also occur if the new tooth is not able to reabsorb the roots of a baby tooth at a fast rate. This means that it takes the easy way out and grows behind the baby tooth, taking the path of least resistance. This is most commonly seen in kids who are six years old and in the lower front teeth.
Generally, if the "TBT" is on the lower arch of the mouth, Dr. Watts will recommend that your child "wiggle" on the baby tooth for about 6 weeks to encourage it to come out on its own, however, if it does not fall out naturally they can extract it. It is a simple thing and you need not worry about it. This will make enough room in your child's mouth for the permanent teeth to emerge.
A "TBT" on the upper arch may be treated a little differently. The timing is more critical as to when an extraction of the upper baby tooth is recommended. Therefore, it is advised that you see your dentist as soon as possible.
Mal - occlusion literally means "poor closing" or "bad bite." A dental malocclusion occurs when the teeth are not lined up properly, even though the jaws may be properly aligned.
Correcting a malocclusion
Of course, more than one of the above factors may be involved, so it is important to obtain a professional evaluation. Left untreated, a malocclusion not only affects the patient's appearance, it can also lead to TMJ problems and an increased risk of decay and gum disease.
Our doctors will evaluate each individual case to determine the best course of action to prevent or correct the malocclusion.
Internal Resorption commonly known as "pink tooth"occurs when cells inside a tooth attack and eat away at the lining inside. This condition can affect both adult and baby teeth and is usually painless. The most common cause for internal resorption is trauma. If your child is hit in the face or has bitten into something hard, these can be triggers for internal resorption. Deciduous (baby tooth) root resorption can also cause a tooth to appear pink. This is a natural process that occurs when the permanent tooth begins to erupt underneath the baby tooth. In this case there is no need to be alarmed as the baby tooth will remain pink until it falls out and is replaced by the permanent tooth.
Injuries to the gum line or teeth can give teeth a pinkor gray tint usually because the blood supply is damaged. Baby teeth can lighten back to normal, but it may take a while. There is a small percentage where the tooth could be lost early or abscess. We like to monitor these teeth at your regular 6 month visits. A traumatized permanent tooth, however, that turns dark usually means the tooth is dead and will need a root canal to be saved in which case we will refer you to a specialist.
Teeth can be sensitive for many reasons.
Sensitivity to chewing pressure can be caused by:
- Cracked tooth
Sensitivity to sweet foods is usually caused by decay.
Hot and/or Cold
Sensitivity to hot and/or cold foods usually indicates:
- Worn Teeth (Attrition)
- Receded Gums
It is not unusual for recent dental restorations to be sensitive to hot, cold, or pressure. This sensitivity should decrease with time. If sensitivity from a recent dental restoration worsens or persists, contact your dentist.
Whitening can also temporarily cause mild sensitivity during treatment that disappears within a few days.
Sensitivity due to a dental problem will worsen with time and become a toothache. A toothache is not like a headache. It won't just go away, even if the pain temporarily subsides. The problem that is causing the pain will just get worse, as will the pain, and simple treatment may no longer be possible. (See our pages on cavities, root canals, abscesses, and extractions to see how a cavity progresses from a minor to a major problem). At the first sign of a toothache, contact your dentist.
Snoring in children has many causes. One cause is anatomical, such as a narrow throat, a constricted windpipe, a deviated septum or a small airway or sleep apnea. Structures in the throat and mouth, including the tongue, uvula and soft palate, can be vibrating against each other. Allergy attacks provoke swelling in the lining of the nose, interfering with breathing. Most commonly, enlarged tonsils and adenoids cause snoring in children. Referral to an Ear, Nose and Throat and possibly a Sleep Specialist to rule out sleep apnea may be recommended if the above oral signs are evident. An orthodontic evaluation may be necessary to determine need for early treatment.
Frequent mouth breathing and snoring can also cause dry, red, swollen gums. This can be especially noticeable around erupting baby and permanent front teeth.
Why Do Children Suck Their Thumbs?
Children suck on things because sucking is one of a baby's natural instincts. Sucking makes them feel secure and content, and may induce drowsiness. Prolonged thumbsucking (or pacifier sucking) interferes with the proper growth of the mouth and the alignment of the teeth. This improper development, if not corrected, will change the appearance of the child's face.
When Should Children Stop Sucking Their Thumbs?
Children should have ceased sucking between the ages of 2 to 4. If you are having trouble breaking your child's habit, try to:
Comfort him if he is feeling insecure. Sometimes children suck their thumb for a sense of security.
Instead of scolding your child for thumbsucking, praise him when he doesn't suck his thumb, especially during difficult periods.
Explain to older children the dangers of thumbsucking and involve them in choosing the method to break the habit.
If you need help stopping your child's thumbsucking habit, we can provide you with a patient-friendly dental appliance that will break the habit. Contact Us for more information and an appointment.
An open bite often results from thumbsucking or prolonged use of a pacifier. If the open bite is not corrected early, the child may develop a habit of deviated swallowing and/or anterior tongue thrust. (This is when the child presses against the back of his teeth repeatedly and subconsciously with his tongue). These habits lead to further dental problems and make correction of the open bite more difficult.
The best cure for open bite is to prevent it in the first place by eliminating thumbsucking and the use of pacifiers as early as possible for your child. Untreated, open bite can lead to facial malformation, abnormal speech patterns and significant orthodontic complications.
TMJ (JAW JOINT)
What is TMJ?
TMJ is an acronym for temporomandibular joint, which is a fancy way of saying jaw joint. Clinically, we refer to problems associated with the TMJ (jaw joint) as TMJ Syndrome or TMD (disorder). But many patients just call it "TMJ". Often, TMJ Syndrome presents itself as a popping sound and sensation near the jaw joint.
Who can have TMJ Syndrome?
TMJ problems can afflict people of all ages, although patients under 40 are more susceptible and it occurs more frequently in women.
What are the Symptoms of TMJ Syndrome?
TMJ Syndrome symptoms include:
- Earaches, stuffiness, or ringing in the ears
- Pain or soreness in and around the jaw joints
- Numbness in fingers and arms
- Difficulty swallowing
- Limited movement or locking of the jaw
- Clicking or grating sounds in the jaw joints
- Pain behind the eyes
- Neck, shoulder, or back pain
- Facial pain
- Unexplained loosening of teeth
Left untreated, the TMJ symptoms increase in number and severity as you get older.
What should I do if I suspect TMJ Syndrome?
Refrain from chewing gum or sticky candy as it may accelerate the syndrome. Often times using an over the counter analgesic (Ibuprofen) can help with the discomfort. Using a soft rubber mouthpiece, such as an athletic mouth guard, can ease the strain on the joint. If pain still persists contact your oral surgeon in order to determine the best course of treatment.
What is Tongue Thrusting?
Tongue thrusting is the abnormal habit of placing the tongue against the front teeth before and during the act of swallowing. During normal swallowing, the tongue should be placed on the roof of the mouth, not against the front teeth. Placing the tongue against the teeth develops the upper arch faster than the lower arch, protruding the front teeth making them appear "bucked".
Factors that can contribute to tongue thrusting include enlarged tongue, large tonsils, habitual thumb sucking, and pacifier use, as well as certain types of artificial nipples used in feeding infants. In addition, allergies or nasal congestion can cause the tongue to lie low in the mouth because of breathing obstruction, contributing to tongue thrusting.
Many orthodontists have completed dental treatment with what appeared to be good results, only to discover that the case relapsed because of the patient's tongue thrust. If the tongue is allowed to continue its pushing action against the teeth, it will continue to push the teeth forward and reverse the orthodontic work.
There are two methods for treating tongue thrusting. The patient may place an appliance similar to a nightguard in the mouth at night, or may wear a more permanent device that can be removed and adjusted by a dentist. The other method requires oral habit training, an exercise technique that re-educates the muscles associated with swallowing by changing the swallowing pattern. This method must be taught by a trained therapist.
If you notice your child repeatedly thrusting their tongue during swallowing, contact our office for an appointment.
TOOTH GRINDING / BRUXISM
What is Bruxism?
Grinding of teeth, also known as Bruxism, occurs in children as well as adults. Grinding of teeth generally occurs during sleep.
What if my Child is Grinding His or Her Teeth?
Children often grind their teeth when their teeth are erupting. This is not uncommon, nor is it a problem if it is mild. However, in more severe cases the child can develop a malocclusion. Malocclusion may then lead to TMJ problems or to a need for Orthodontics. If you have any concerns about your child's Bruxism, be sure to have our doctors check for signs of excessive wear so that treatment options can be discussed and implemented to prevent serious problems.
What about Bruxism in Adults?
Adults may grind their teeth at night due to:
The result of bruxism can be:
- Worn spots (attrition) that can lead to:
- Malocclusion (if the patient doesn't have already)
- Brittle teeth that require crowns
- TMJ problems
- Noise that sometimes disrupts the partner's sleep
How can Bruxism be Treated?
Sometimes, the damage caused by bruxismmust be addressed first. Any malocclusion, sensitivity, brittle teeth, or TMJ problems should be discussed with our doctors first to be sure those problems are resolved and that the subsequent treatment for bruxism prevents a recurrence of those problems. Further damage from bruxism can be prevented with a mouth guard that is worn during sleep. This guard is comfortable and easy for most people to wear. Contact Us for an appointment to stop the damage caused by bruxism and correct any serious problems.
This panoramic x-ray shows the impacted 3rd molars (wisdom teeth). The upper wisdom teeth are crowding the sinus cavity and may erode the roots of the 2nd molars. The lower wisdom teeth are impacted sideways and are likely to cause crowding of the lower teeth, leading to malocclusion
The teeth most likely to become impacted are the third molars, also known as "wisdom teeth." The first molars are also known as the 6-year molars since they generally erupt at around age 6, and the second molars are also known as the 12-year molars since they generally erupt at around age 12. If the third molars erupted normally, they might be called 18-year molars. But there is rarely enough space to fit these last teeth into the small space left behind the second molars, so the third molars often become impacted.
The most important thing to know about impacted wisdom teeth is that they almost always require extraction. The longer the extraction is postponed, the longer the tooth roots grow. When the tooth roots of an impacted tooth are allowed to develop, the risk of complication due to extraction increases significantly because the tooth roots may "wrap around" sensitive facial nerves.
What other reasons should I get my wisdom teeth removed?
To help prevent Infection, Decay, Damage to other teeth, Cysts, Tumors, and Periodontal disease.
Dr. Watts can refer your child to an Oral Surgeon to have their wisdom teeth extracted.
Attrition is the gradual loss of enamel through "wear". A small amount of attrition may be caused by normal speaking and eating, but this typically doesn't produce excessive wear. More extreme cases of attrition are typically caused by Bruxism, the grinding of teeth against teeth. Bruxism typically occurs at night while the patient sleeps, so often the patient is unaware of the grinding or enamel loss. Often times this problem will self correct once the permanent teeth erupt. As long as the grinding does not persist once the adult teeth come in, there is generally no reason to be concerned.
Abrasion is the wearing away of tooth enamel by a foreign object. Common causes of abrasion are:
- Brushing too hard or too long
- Fingernail biting, chewing on pens or pencils, holding needles or pins between the teeth, etc.
- Oral jewelry - Patients with pierced lips and/or tongue often wear away the enamel on adjacent teeth
Erosion is the chemical wear of tooth enamel. Typically this kind of wear is caused by an acid. Citric acid is one of the most common agents. Citrus fruit (lemons, limes, oranges, grapefruit) contain citric acid, as do most soft drinks and citrus juices (like lemonade). Some candies also contain citric acid. Many soft drinks contain additional harmful acids. Coffee and tea also contain corrosive acids. Bulimic individuals (people who intentionally and repeatedly induce vomiting) also expose their teeth to very strong stomach acids.
Occasional exposure to most dietary acids is rarely a problem, but repeated exposure to high levels of these acids can cause premature wear. Some common habits to avoid are:
- Regularly sucking on lemons or limes
- Regularly eating or sucking on candies, especially "sour" candies as they often contain sugar and citric acid!
- Drinking several soft drinks daily, even "diet" soft drinks
- Drinking several glasses of lemonade daily
- Drinking several cups of coffee or glasses of tea daily
Even if you only occasionally eat or drink highly acidic foods, it's a good idea to at least rinse your mouth with fresh water when you are finished in order to reduce the amount of time the acids have to work on your teeth.
If you would like us to examine your teeth to determine whether or not there is premature wear of enamel, please contact us for an evaluation. It is possible that a mouth guard can be fabricated to control or prevent the enamel loss.