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You’ve always taken care of your child’s smile. You make sure thorough brushing and flossing take place twice a day. You serve foods high in vitamins and minerals and low in sugar. You make and keep regular dental appointments at our Mason office. But even with the best dental routines, sometimes conditions can occur that will require additional professional care.

One of these conditions can affect your child’s enamel while the tooth is still forming. When baby teeth or adult teeth appear, you might notice white, creamy yellow, or brown spots in otherwise healthy-looking enamel. These spots are softer and rougher than normal hard, smooth enamel. Because of their texture and color, such teeth are often referred to as “chalky teeth,” but this condition is actually known as enamel hypomineralization.

What is hypomineralization?

Enamel is the strongest substance in our bodies—stronger even than bones. Enamel is largely composed of minerals. If something disrupts the process of enamel development in baby or adult teeth, the result can be abnormally low mineral content in the enamel. This leaves teeth weaker and more likely to suffer decay and damage.

Premature birth, low birth weight, and other pre-natal factors have been suggested as risk factors for hypomineralization in primary teeth enamel. Permanent teeth can be vulnerable to this condition as well. Adult teeth are forming in young children well before they make an appearance. It’s been suggested that certain early childhood factors, such as recurring high fevers, some diseases, even specific antibiotics, can interrupt the formation of the enamel and lead to hypomineralization of adult teeth.

What are the results of enamel hypomineralization?

Children with this condition are much more likely to experience rapid tooth decay because of their weaker, more porous enamel, especially in the molars. Further, they tend not to respond as well to the numbing effects of local dental anesthetics, while their teeth tend to be more sensitive to pain. Cases can be mild, moderate, or severe. In severe cases, teeth might require crowns or possibly extractions, but even mild discoloration and other cosmetic problems can lead to self-consciousness in your child.

How can we help?

Catching this condition early is very important. If your child has had any medical conditions that might affect tooth development, let Dr. Nymberg know even before that first tooth comes in. If you notice anything unusual about a new baby or adult tooth, give us a call. For primary or permanent teeth, the sooner we can begin treatment, the better the long-term outlook.

We might suggest fluoride applications or desensitizing treatments. We can apply sealants to reduce the risk of cavities, and use bonding to restore discolored or weak patches in the tooth. Both of these methods have greater success if the enamel near the affected area is in good condition, so early treatment is vital. If teeth require more protection, crowns are often the best choice. We will design a treatment program to suit your child’s individual needs now and for the future.

How can you help?

Dental hygiene is important for every child, but especially for a child with weak and porous enamel. Because children with hypomineralized enamel develop cavities more quickly that those with strong enamel, it is very important to watch your child’s diet and keep to a regular, careful, and thorough routine of brushing and flossing at home. Be attentive to any sensitivity problems, and be sure to follow any suggestions we might have for strengthening enamel.

Remember, early diagnosis and treatment is always best! If at any time you notice chalky patches, or have any other concerns about the appearance of your child’s teeth, if they seem to be causing your child pain or are unusually sensitive, call Dr. Nymberg immediately. We want to work with you to treat any current problems and to prevent new ones.

According to the Centers for Disease Control and Prevention, half of adults age 30 and over suffer from some form of gum disease. Caused by plaque buildup, gum disease is an infection of the tissue that surrounds and supports the teeth. In its advanced stages, it is known as periodontal disease. If left untreated, it can result in the loss of tissue and bone that support the teeth, causing teeth loss. It’s a preventable condition seen far too often by Dr. Nymberg.

Research between periodontal disease and other diseases is ongoing. Some studies have indicated that gum disease is linked to other health conditions such as stroke or diabetes. Furthermore, while most factors that lead to periodontal disease are dependent on the individual (genetics, diet, poor oral hygiene) there is a possibility that periodontitis is capable of spreading from one person to another.

What the Research Says

Periodontitis is a gum infection, and the bacteria that cause the gums to become infected travels in saliva. Researches have used DNA coding techniques to track the path of infection from one person to another. In other words, kissing and close contact play a role in the transmission of the infection, so if you’re married to a spouse with periodontal disease, then your chances of having gum problems are slightly increased. Other studies have indicated that saliva contact is common in family settings through coughing, sneezing, and shared utensils and food. Children with parents who have periodontal disease are at a somewhat higher risk of developing it. At the same time, just because you exchange bacteria with your loved ones doesn’t mean you will get periodontal disease.

It is important to note that the scientific evidence supporting the spread of periodontal disease is limited and ongoing. The best way to prevent gum disease is through proper plaque control, which includes brushing, flossing, mouthwash, and twice a year trips for professional cleanings. Contact our Mason office if you have any questions about periodontal disease.

We’ve all learned a lot about keeping healthy lately. Thorough hand washing, disinfecting cell phones and keyboards, wiping down shopping carts and door handles—all these low-maintenance cleaning habits can have a high impact on our health.

So, in that spirit, let’s talk about low maintenance cleaning routines for something you put in your mouth at least twice a day—your toothbrush.

Brushing Habits

Don’t let germs hitch a ride on your toothbrush before you even begin! Make sure your hands are clean before brushing, and rinse off your toothbrush before you put it in your mouth.

After brushing, be sure to rinse your brush carefully to get rid of leftover toothpaste, food particles, and other debris. And don’t forget to clean your toothbrush holder regularly. Talk to Dr. Nymberg or your hygienist when you visit our Mason office for suggestions for deep cleaning brushes to eliminate bacteria if that’s a concern.

And while we’re talking about germs, how about…

• Flushing Habits

Most toothbrushes share their living space with another bathroom essential—the toilet. Every time we flush, microscopic particles are propelled through the air. And while no definitive relationship has been shown between flushing and disease transmission, closing the toilet lid before flushing is an easy way to reduce unpleasant particle transmission—and reduce the possible risk of toothbrush contamination.

• Airing? Yes!

Keeping a toothbrush in a dark, moist environment is the perfect setting for bacterial growth. Instead, let your toothbrush air dry after use in an upright position. Give it a shake first for a head start on the drying process.

• Sharing? No

We’re not talking about sharing a brush, which you would never do. We’re talking about sharing toothbrush holders. If your brush touches other brushes, you’re probably sharing germs as well as space, which can be especially problematic if someone in the house has immune concerns. Toothbrushes shouldn’t be too close to other toothbrushes, no matter how close you are to the other brush’s owner!

Finally, no matter how well you take care of your toothbrush, there comes a time when you must part with even the cleanest and best-maintained of brushes. After three or four months, bristles become frayed. This means you’re not getting the most effective plaque-removal from your brush. And to be on the safe side, consider retiring your toothbrush if you’ve been ill.

Dental self-care is a vital part of keeping yourself healthy, and a clean toothbrush is a simple way to support your oral health. High impact/low maintenance—win/win.

From the time you were small, you’ve been warned about the dangers of plaque. Why? Because:

• It’s an unappealing film that sticks to your teeth
• It causes cavities
• It causes gum disease

And really, do we need to know much more than this to motivate us to brush? But if you’re in a curious mood, you might be wondering just how this soft, fuzzy film accomplishes all that damage. Let’s take a closer look at the sticky problem of plaque.

How does plaque form?

We live with hundreds of species of oral bacteria, most of which are harmless, and some of which are actually beneficial. But when our oral ecosystem gets out of balance, problems can occur. For example, without regular and thorough brushing and flossing, we start to build up plaque.

Plaque starts forming within hours of your last brushing. And even though plaque fits the very definition of “seems to appear overnight,” this biofilm is actually a complex microbial community with several different stages of development.

• It starts with saliva.

Saliva is vital to our oral health, because it keeps us hydrated, washes away food particles, neutralizes acids in the mouth, and provides minerals which keep our enamel strong. Saliva also contains proteins, which help form a healthy, protective film on the tooth surface. This film is called a pellicle.

• Bacteria attach to the pellicle.

There are species of oral bacteria that are able to attach themselves to the pellicle film within hours of its formation. As they become more firmly attached, they begin to grow and divide to form colonies, and are known as the early colonizers of the plaque biofilm.

• A complex biofilm forms.

If you’ve skipped brushing for a few days (please don’t!), you’ll notice a fuzzy, sometimes discolored film on your enamel—that’s a thriving plaque community, and it only takes a matter of days to go from invisible to unpleasant.

If you’re not removing plaque regularly, it can harden further and become tartar. And once you have tartar buildup, you’ll need the care of a dental professional to remove it.

• What happens if we ignore plaque and tartar?

We get cavities and gum disease.

How does plaque cause cavities?

• The bacteria in plaque, like all organisms, need nutrients.

Our normal oral environment and the food in our everyday diets provide the nutrients plaque needs. And, as we mentioned above, certain types of oral bacteria convert these nutrients into acids. Foods such as carbohydrates, starches, and sugars are most easily converted into acids, which is why we recommend that you enjoy them in moderation.

• The biofilm promotes acid production.

Within the plaque film, anaerobic bacteria (bacteria which don’t use oxygen) convert sugars and starches into acids. As the plaque film becomes denser, it blocks acid-neutralizing saliva and oxygen from reaching these bacteria close to the tooth’s surface, creating an ideal environment for the bacteria to produce their acid waste products.

• Acids attack enamel.

The sticky nature of plaque keeps these acids in contact with tooth enamel, where, over time, acids dissolve minerals in enamel, weakening the mineral structure of the tooth.

How does plaque cause gum disease?

• Bacteria cause inflammation and gingivitis.

The bacteria in plaque irritate the delicate tissue of the gums, which causes an inflammation response which can leave your gums swollen, red, bleeding, or tender. This early form of gum disease is gingivitis. Fortunately, good dental care and careful brushing and flossing can usually prevent and even eliminate gingivitis.

• Plaque and tartar can lead to periodontitis.

When plaque and tartar build up around and below the gumline, the gums pull away from the teeth, leaving pockets where bacteria collect, leading to infection as well as inflammation. Infections and constant inflammation not only harm gum tissue, they can destroy the bone supporting the teeth. This serious gum condition is periodontitis, and should be treated immediately to avoid further infection and even tooth loss.

How do we fight plaque?

From the time you were small, you’ve learned how to fight plaque:

• Brush at least twice a day for two minutes, and be sure to brush all of your tooth surfaces and around the gumline.
• Floss to remove plaque from between the teeth and near the gumline.
• Visit our Mason office for a thorough professional cleaning.

Be proactive. If you have any questions, talk to Dr. Nymberg about the best way to keep plaque at bay. We can show you the most effective ways to brush and floss, recommend anti-plaque toothpastes and rinses, even suggest plaque-revealing tablets if you’re missing some trouble spots.

We’ve only brushed up on some plaque basics, because there is a lot more to discover about this complex biofilm. Happily, even with all there is to learn about plaque’s growth and development, it’s reassuring to know that getting rid of it is quite simple—with just a soft-bristled brush, some dental floss, and a few minutes of your time each day, you’re on the way to a healthy, happy, plaque-free smile.