All posts by smileroot

It’s Time To Kick That Ice-Chewing Habit

It’s Time To Kick That Ice-Chewing Habit

CHEWING ICE MIGHT SEEM refreshing in the moment, but it’s not doing any favors for your teeth in the long run. Today we’re going to take a look at why ice chewing is such a common habit despite the dangers it poses, as well as what someone with this habit can do to stop.

Compulsive Ice Eating

The scientific name for compulsive ice eating is pagophagia. This goes beyond a simple habit and enters the territory of a mental disorder. Getting cravings for ice can be a sign of an eating disorder called pica, which involves a compulsion to eat things with no nutritional value, such as ice, clay, hair, and dirt. Pica is often the result of a nutritional deficiency.

Iron Deficiency Anemia

Studies have shown a correlation between compulsive ice eating and iron deficiency anemia, which is pretty common, with 20 percent of women, 50 percent of pregnant women, and 3 percent of men being iron deficient. Without enough iron in the blood, the red blood cells can’t effectively do their job of carrying oxygen throughout the body.

What does iron have to do with ice? Well, researchers theorize that chewing ice sends more blood to the brain, temporarily improving alertness and clarity of thought. This feels good, and so they keep doing it even when it causes dental problems.

Ice Versus Your Teeth

Our teeth are not designed to crunch against solid ice, and they are particularly not designed to chew through several trays of ice cubes a day. Doing this can destroy tooth enamel over time, not just because ice is hard but because it’s cold. The enamel expands and contracts due to these extreme temperature changes, creating tiny cracks in it and making it much weaker, just like pavement in snowy climates. All of this leaves the teeth painfully sensitive to hot and cold and far more vulnerable to cavities.

The texture of the ice can also cause injuries to gum tissue, which you may not even notice because of the numbing effect of the cold, and sometimes the ice can actually chip or break a tooth!

Breaking The Ice Eating Habit

The first step to kicking the ice eating habit is to find out what’s causing it. If the ice chewing is a symptom of anemia, getting iron supplements may eliminate the cravings, so it will be much easier to stop. If it’s pica, there are interventions to explore such as therapy and medication.

There’s also plenty you can do on your own. You can replace the crunchy texture of ice with baby carrots or apple chunks. If you struggle to give up the ice altogether, try letting slivers of ice melt on your tongue like candy rather than crunching on them. This will spare your teeth and gums from the damage of chewing the ice.

Your Dental And Health Care Professionals Can Help

If ice chewing is something you struggle with, make sure to schedule appointments with your doctor and dentist. Iron deficiency can cause a number of other problems besides triggering ice cravings, and it’s important to get diagnosed and treated before it gets worse, particularly for pregnant women.

Now go put that ice-chewing habit on ice!

Top image used under CC0 Public Domain license. Image cropped and modified from original.

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Plaque, Tartar, And Your Teeth

Plaque, Tartar, And Your Teeth

PLAQUE AND TARTAR are two words that you probably hear a lot when you come in for a dental cleaning. You might already know that they cause tooth decay and gum disease, but do you know what they are? Let’s take a closer look at these two substances that are a constant threat to our oral health.

Stage 1: Plaque

Dental plaque is a soft, sticky, colorless biofilm composed of bacteria, food particles, and saliva. It builds up on and between our teeth and beneath our gums every day. If you’ve ever forgotten to brush in the morning or at night, you’ve probably felt that unpleasant texture with your tongue.

Plaque contains millions of bacteria, and this bacteria digests leftover sugars and starches from the food we eat, then excretes acid onto our teeth. Because plaque is soft, it can be removed with simple brushing and flossing, but we have to be thorough and diligent to get as much of it as possible.

Stage 2: Tartar

The reason it’s so important to scrub away the plaque is that when plaque is allowed to sit on the teeth too long, it becomes tartar. Tartar is a hard, yellow or brown substance that bonds to tooth enamel and can only be removed at a professional cleaning appointment.

How does this transformation happen? When the acid excreted by oral bacteria comes into contact with minerals in our saliva, it causes a chemical reaction that hardens the plaque into tartar. The risk of tartar buildup is higher for people with braces, dry mouth, crowded teeth, or a smoking habit, and it also increases with age.

Keeping Plaque And Tartar Under Control

A rigorous oral hygiene routine, paired with regular professional cleanings, is the best way to control the plaque in your mouth and prevent it from hardening into tartar. Here are some of the things a good routine should include:

  • Brush twice a day for two minutes, making sure to brush all surfaces of the teeth and paying special attention to the gum line.
  • Floss or use a water flosser daily to clean the plaque and food debris left in those hard-to-reach spots between the teeth.
  • Choose an anti-plaque toothpaste.
  • Consider getting an electric toothbrush for more effective plaque removal, and replace your toothbrush (or the head of your electric toothbrush) regularly.
  • Give oral bacteria less fuel by cutting down on sugary foods and drinks.
  • Avoid smoking, which increases plaque and tartar.
  • Schedule dental cleanings once every six months.

Win The Battle For Your Dental Health

It might seem discouraging to think that plaque will creep back up throughout the day even after you brush and floss thoroughly. A better perspective is that it only takes a few minutes each morning and night to win the daily battle against plaque and tartar, and you can improve the odds for your teeth even more with regular dental visits!

Together, we can keep those teeth plaque and tartar free!

Top image by Flickr user sittered used under Creative Commons Attribution-Sharealike 4.0 license. Image cropped and modified from original.
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Too Few Or Too Many Adult Teeth?

Too Few Or Too Many Adult Teeth?

DEPENDING ON HOW MANY wisdom teeth come in and whether or not they have to be removed, most adults have 28-32 adult teeth. There are a few outliers in either direction, however. Some people have fewer teeth than they should (called hypodontia or congenitally missing teeth), while others have one or more extra (called hyperdontia or supernumerary teeth). How does this happen and what do we do about it?

Congenitally Missing Teeth

Between 2-4 percent of the population has at least one tooth missing from the adult set. The most common teeth affected by this condition are wisdom teeth, lower second premolars, and upper lateral incisors. It’s not really an issue to be missing wisdom teeth, but missing incisors and premolars can cause difficulties with chewing, the surrounding teeth may shift, and the decreased jaw support can lead to additional tooth loss.

The reason for congenitally missing teeth is nearly always genetics,which is why you tend to see it run in families. Sometimes it happens in conjunction with a larger genetic disorder like Down syndrome or ectodermal dysplasia.

Supernumerary Teeth

At the other end of the dental spectrum is hyperdontia, where extra teeth develop in the jaw. It happens more often with adult teeth than baby teeth. We don’t fully understand what causes this condition, but one leading theory is that it could be the result of a tooth bud dividing abnormally, producing two teeth instead of one.

Supernumerary teeth aren’t always shaped like normal teeth. They can also be peg-shaped, have multiple cusps, or simply be a mass of dental tissue. However they develop, they often don’t have room to erupt, so they remain impacted in the gums, causing crowding and alignment problems for the normal teeth.

Treatment For Hypodontia And Hyperdontia

The typical treatment for extra teeth is to extract them if there isn’t room for them, but dealing with a congenitally missing tooth can be more complicated. Depending on the age of the patient and how long the tooth has been missing, different options may be better. The first step is usually orthodontic treatment so that the gap will be wide enough to fit a replacement tooth. These come in a few forms:

  • Removable partial dentures are a simple solution. They can be attached to a retainer or anchored in place by the surrounding teeth.
  • Dental bridges “bridge” the gaps by anchoring to the neighboring teeth, but unlike dentures, they’re cemented in place.
  • The most permanent solution is a dental implant, which functions like a normal tooth. An implant consists of a post fixed in the jaw bone with a crown on top that matches the natural teeth. Implants can also provide support for bridges when multiple teeth are missing.

Let’s Take A Look At Those Teeth

With regular dental appointments, we can catch cases of hypodontia and hyperdontia early on and make a plan for how to address it. Keep up with your daily dental hygiene routine, keep scheduling those regular appointments, and give us a call if you have any questions about these rare conditions!

Keep on smiling!

Top image by Flickr user Héctor Arango used under Creative Commons Attribution-Sharealike 4.0 license. Image cropped and modified from original.

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Repeat After Us: Teeth Are Not Tools

Repeat After Us: Teeth Are Not Tools

OUR TEETH ARE pretty amazing, and there’s a lot they can do. They chew our food, they provide structural support for the lower third of our faces, they help us speak clearly, and they give us our beautiful smiles. However, many people also find other uses for their teeth, which can be very dangerous. Teeth are not tools, and shouldn’t be used in place of them.

Teeth Are Not Bottle-Openers

Tooth enamel is the hardest substance in the human body, so it might seem like that makes teeth perfect to use when you don’t have a bottle opener handy, right? Wrong. Tooth enamel isn’t just hard, it’s brittle,and it is not designed to win a fight against materials like metal and glass.

Using your teeth as a bottle opener can easily chip, crack, or break them, as well as risking damage to the soft tissues of the lips and gums if you slip. Doing it over and over again can even cause your teeth to shift out of their proper alignment and wear down unevenly. It isn’t worth it.

Teeth Are Not Nutcrackers

Like with trying to open a bottle, trying to crack a hard walnut, pecan, or even pistachio shells and popcorn kernels between your teeth risks chipping or cracking the teeth instead. Teeth that are already weaker due to decay or a filling are at even greater risk of damage.

Teeth Are Not An Extra Hand

When your hands are busy, it can be very convenient to hold a pencil, sewing pins, or maybe a few nails between your teeth. However, making a habit out of doing this can have a number of consequences. If you trip, the items in your mouth could cause a serious injury. If a yawn or hiccup catches you by surprise, you might even end up swallowing or choking on the object. And over time, you can wear down your enamel. Pencils would be better off behind your ear, pins in a cushion, and nails in a utility belt until you’re ready to use them.

Teeth Are Not Scissors (Or Nailclippers)

A particularly common way people use their teeth as tools is to bite through packing tape instead of using scissors, and some people even try to use their teeth to cut through wire. It takes much greater biting pressure to cut through non-food items than it does to chew food,and cutting things requires grinding the teeth together. This wears down the chewing surfaces and risks chipping and fracturing.

A nail-biting habit is particularly bad, both for the teeth and for the nails. The germs from the nails increase the risk of tooth decay, teeth will become worn down more quickly and shift out of alignment, and pieces of fingernail can damage the gum tissue, all while the nails themselves are left ragged and misshapen.

Protect Your Teeth By Using Them Right

Cracked and fractured teeth are the third highest cause of tooth loss. Don’t take risks with your teeth by using them as tools. Save yourself an expensive emergency dental visit; use your teeth only for what they are meant for and continue your daily brushing and flossing routine to keep them healthy.

We love to see our patients’ smiles!

Top image used under CC0 Public Domain license. Image cropped and modified from original.
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You’ll Be Smiling Again With Dental Implants

You’ll Be Smiling Again With Dental Implants

TOOTH DECAY, ACCIDENTS, and sports-related injuries are a few of the most common causes of tooth loss, but thanks to modern dentistry, we don’t need to live with a gap in our smiles. Among the most effective ways to fill in the gaps are dental implants.

Implants Versus False Teeth

Dentures (whether partial or full) are a time-honored solution for missing teeth, but they aren’t without their drawbacks. If they aren’t fitted well or properly secured, they may slip and fall out frequently, and they can also lead to soreness in the gums and jaw. Unlike real teeth, dentures don’t stimulate the jawbones, which results in gradual bone loss.

Unlike dentures, implants are surgically placed in the jawbone beneath the gums, the metal posts serving as new roots for replacement teeth that look and act just like natural teeth. Dentures may be cheaper than implants, but that’s the only advantage they offer. Implants prevent bone loss and stay in place while you’re speaking or enjoying your favorite foods, and you can brush them just like your regular teeth!

Types Of Implants

Depending on how healthy the patient’s jawbone is, we may recommend either endosteal or subperiosteal implants. Endosteal implants are ideal for patients with healthy jawbone. These consist of titanium posts placed into the jaw with oral surgery. After a healing period, a crown is placed on top in a second surgery.

Patients with insufficient bone to support endosteal implants may still be eligible for subperiosteal implants, which consist of metal frames placed between the jawbone and gum tissue. Posts are added to this framework and protrude from the gumline so that crowns can be attached to them.

Even if you don’t need implants, you might benefit from artificial crowns:

Should Implants Come Before Or After Braces?

Typically, when a patient needs orthodontic treatment as well as one or more implants, braces come first. This is because an implant won’t move once it’s in the jaw. Sometimes, an implant can be placed before or during orthodontic treatment, and then it might be used as an anchor to help the natural teeth move into their proper place.

Talk To Us About Implants

Over three million people in the U.S. alone have at least one dental implant, so you’ll be in excellent company if you choose this option to complete your smile. If you have a missing tooth and need to fill that gap, give us a call to schedule an appointment! We’ll evaluate the health of your jawbone and see what type of implant will be best for you.

We love our patients’ smiles!

Top image by Flickr user SupportPDX used under Creative Commons Attribution-Sharealike 4.0 license. Image cropped and modified from original.
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How Clean Is Your Tongue?

How Clean Is Your Tongue?

“BRUSH YOUR TEETH for two full minutes twice a day and floss your teeth once a day.” You’ve probably lost count of how many times you’ve heard that, but how often have you heard that you should be cleaning your tongue every day too?

The Difference A Clean Tongue Makes

More bacteria likes to live on our tongues than just about anywhere else on our bodies. That’s because all those tiny crevices in the tongue’s surface are prime real estate for all kinds of pathogens. If we don’t actively keep our tongues clean, the harmful bacteria will stay put and multiply, causing bad breath and contributing to tooth decay on the inner surfaces of our teeth.

Another reason to regularly get rid of all that tongue bacteria is that it can dramatically improve your sense of taste. When the tongue is covered in bacteria, the tastebuds have a hard time doing their job, but with the bacteria gone, they’re free to absorb all those delicious flavors at their full capacity. Yum!

Chemical digestion begins in our mouths, and a clean tongue makes this process more effective too. So, if you want to enjoy your favorite foods as much as possible, keep your breath clean and fresh, and improve your digestive health, clean your tongue!

Finding The Best Tools For Cleaning Your Tongue

Keeping your tongue clean takes more than swishing mouthwash or rinsing with water. The bacteria hiding in all those tiny grooves is very stubborn, and washing with liquid won’t be enough do dislodge them. To really clear off the biofilm of bacteria, you need to scrape it with a tongue-scraper.

If you don’t find these in the grocery store near the toothbrushes, you can order one online, and some toothbrushes have tongue scrapers built in on the reverse side. Between brushing and rinsing your teeth is the best time to scrape your tongue. Start at the back and work forward, and try to get as much of the surface area as you can.

For the first few days, you might be surprised by how much biofilm comes away with the tongue scraper, but the longer you stick with it, the cleaner your tongue will become, until it seems like you’re scraping away nothing but clean spit. See if you notice the difference in your breath and your sense of taste when you get to this point!

Tongue-Scraping Is Older Than You Think

If you’ve never heard of tongue-scraping before, you might think it’s a new idea, but it’s actually been around since ancient times in some cultures. It’s part of the daily hygiene routine in Ayurveda, the traditional medicine of India. Tongue-scraping tools have been made of many different materials across the centuries, including copper, silver, gold, ivory, whalebone, and tortoiseshell. Today, they’re typically plastic or stainless steel.

Have Any Questions About Tongue Cleaning?

If you have questions about tongue cleaning or would like our recommendations on the best tools for the job, just give us a call! We’re always happy to help our patients improve their daily dental hygiene regimens, and we look forward to seeing you at your next appointment!

Thank you for being such wonderful patients!

Top image by Flickr user Jon Russell used under Creative Commons Attribution-Sharealike 4.0 license. Image cropped and modified from original.

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Smile To Improve Your Day — And Your Health!

Smile To Improve Your Day — And Your Health!

“IT TAKES MORE MUSCLES to frown than to smile,” the old cliché goes, so you should smile more to conserve energy. Well, it turns out the cliché is false. Smiling takes at least ten muscles, while as few as six are required for a frown. A better expression would be “smile to burn more calories,” but that isn’t the only benefit you’ll get from flashing those pearly whites more often.

The Feedback Loop Between Smiling And Happiness

When we smile, it sets off a chemical reaction in our bodies and brains. We release endorphins, the feel-good hormones. The amazing thing is that we can release these endorphins simply by the act of smiling, even if it’s fake! Smiling and happiness are so closely tied together in our brains that it doesn’t matter which one comes first. If you’re having a rough day and want to feel better, smiling is a great, simple first step to take.

Smile Your Pain And Stress Away

That rush of endorphins has a lot of benefits, and two of the most immediate ones are reducing pain and relieving stress. Endorphins are natural painkillers with no side effects, and they help us recover more quickly from stressful situations. A 2012 experiment demonstrated this by testing how long it took for subjects’ heart rates to return to normal after performing a stressful task. The smiling subjects were the fastest to recover!

Smile To Give Your Immune System A Boost

Over time, those short-term benefits from the endorphins released by smiling can compound into something much bigger. By smiling freely and often, we can make ourselves more resilient against all kinds of illnesses — even lowering our chances of getting cancer by reducing the number of stress-induced mutations our cells go through.

Smile To Live Longer!

When we think of the benefits of smiling, we usually don’t think much farther than how it makes us look younger and more attractive to the people around us, but in the end, smiling can actually add years to our lives. Smile as often as you can so that you can take full advantage of what it can do for you, and make sure you’re taking good care of your smile so that you feel more like sharing it.(INSERT VIDEO HERE)

Let’s See Those Gorgeous Smiles!

Did you know that children smile an average of twenty times as often as adults over the course of a day? Just imagine the health benefits we could enjoy as adults if we smiled as often as we did when we were little. We encourage all of our patients to find every reason you can to smile, and come see us twice a year so that we can help you keep your smile as healthy as it can be!

Our patients are our biggest reason to smile!

Top image by Flickr user David Long used under Creative Commons Attribution-Sharealike 4.0 license. Image cropped and modified from original.

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Don’t Take A Vacation From Oral Hygiene!

Don’t Take A Vacation From Oral Hygiene!

WITH THE ARRIVAL OF SUMMER comes the season of family vacations and exciting trips to new places. We’re as excited for it as our patients, but before everyone leaves to explore parts unknown, we want to give you a few tips and reminders about taking care of your teeth while you’re away from home.

Before You Go, See The Dentist

The last thing anyone wants while relaxing on a beach or enjoying the rides at a theme park is for their fun to be interrupted by a toothache or dental emergency. Depending where you go on your vacation, it might be hard to get proper dental treatment. You’ll save yourself a major potential hassle by simply scheduling a dental appointment before you leave!

A simple dental checkup will ensure that your teeth are clean and cavity-free when you start your trip. It’s especially important to get any restorations (e.g. crowns and fillings) checked in case they’re becoming loose, and untreated cavities and weakened dental work can become painful due to the pressure changes on flights.

Don’t Get Too Carried Away With Vacation Food

We can probably all agree that the food is often one of the best parts of any vacation, but that can make it easy to overdo it. Try to avoid eating too many sweet treats and snacks, and maybe keep a pack of sugar free gum handy to help prevent cavities.

Don’t Slack On Brushing And Flossing

When we’re at home, it’s easy to go through daily routines like brushing in the morning and brushing and flossing in the evening. Make sure to pack your toothbrush, toothpaste, and floss when you go, and quickly establish these routines in your new location.

One important thing to remember is that bacteria grows fast on a toothbrush that is damp and in an enclosed space, such as in luggage. Give your brush time to dry before you pack it, and store it somewhere it can get plenty of ventilation between uses.

Instead of leaving your toothbrush out on a hotel counter, try a simple solution like this:

Have A Great Vacation!

Following these tips will help you keep your teeth strong and healthy while you’re away from home. That should make it easier to flash a big, bright smile for the camera during your adventures! Have a wonderful time, and we look forward to seeing you again soon!

Thank you for trusting us with your dental health!

Top image used under CC0 Public Domain license. Image cropped and modified from original.

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Defeating Bad Breath

Defeating Bad Breath

WE’VE ALL BEEN THERE BEFORE — sitting in the middle of a job interview or a first date and realizing that our breath is far from minty fresh. Even when everything else is going perfectly, bad breath can be enough to ruin your confidence and turn a good experience sour. Why do we get bad breath, and what can we do to stop it?

Oral Bacteria And The Food We Eat

In order to effectively fight bad breath, it’s important to figure out what’s causing it. The simplest and most common cause is leftover food particles stuck between our teeth after a meal. The bacteria in our mouths break down these particles, and the end result doesn’t smell good. We can combat this with a good daily hygiene routine, including daily flossing, twice-daily brushing, scraping our tongues clean, and chewing sugar-free gum.

Causes Of Chronic Bad Breath

Chronic cases of bad breath (also called halitosis) might not be solved by good oral hygiene practices alone. Halitosis may be caused by:

Chronic conditions. Sometimes, bad breath is linked to conditions that you wouldn’t think are connected to oral hygiene, such as diabetes, liver or kidney disease, and acid reflux.

Medications. A common side-effect of medications is dry mouth. Without saliva to wash away food particles and neutralize acid, the mouth is vulnerable to problems like bad breath.

Mouth-breathing. Whether it happens by habit or because breathing through the nose is difficult, mouth-breathing tends to dry out the mouth, leading to the same problems as described above.

Mouth, nose, and throat infections. Bad breath can be the result of increased mucous when we have a cold or a sinus infection.

Pregnancy. Symptoms such as morning sickness and nausea can cause bad breath, because of the extra acid in the mouth. This is also a problem for people struggling with bulimia.

Tobacco products. Tobacco in any form leaves smelly chemicals in the mouth and can also dry it out. In addition, it increases the risk of oral cancer and gum disease, which negatively impact breath as well.

Tooth decay and gum disease. Poor dental health often goes hand-in-hand with chronic bad breath because cavities and periodontitis are caused by the same bacteria that produces those nasty-smelling chemicals.

Keeping Your Breath Fresh

Even if strict oral hygiene isn’t enough to keep the bad breath completely at bay, it will help to manage it, and treating the underlying cause may be able to eliminate it. If you are a habitual mouth-breather, try breathing through your nose more. Quitting smoking will eliminate a major cause of bad breath. If dry mouth is the problem, chew sugar-free gum and mints to stimulate saliva production, sip water, and use a humidifier to help keep up the moisture.

Your Dentist Can Help

Discovering the underlying cause of bad breath is a crucial step in fighting back, and the dentist is your best ally here. Schedule an appointment so that you can get the answers you need to fight bad breath the best way.

We want all our patients to feel confident about their breath

Top image used under CC0 Public Domain license. Image cropped and modified from original.

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Why Are My Teeth So Sensitive?

Why Are My Teeth So Sensitive?

IS A SIMPLE SPOONFUL of ice cream enough to make you cringe because of the pain in your teeth? Do you have to be careful when you drink hot coffee that none of it touches your chompers? If you know the feeling, then you’re one of millions who experience tooth sensitivity. Let’s take a closer look at what causes tooth sensitivity and what can we do about it.

How We Feel Sensation In Our Teeth

Each of our teeth is covered in a layer of protective enamel. Underneath this is dentin, which is a lot like bone. Dentin contains thousands of microscopic tubules that run through it from the inside of the tooth out to the enamel. At the core of each tooth is the pulp chamber, which contains nerves and blood vessels. Because of those tubules, the nerves inside the tooth can detect what’s happening on the tooth’s surface.

https://www.youtube.com/watch?v=7PH9n0t46Us

Common Causes Of Tooth Sensitivity

If the enamel wears away, the tubules become exposed and the nerves in the dental pulp suddenly get much more stimulation than they like. This is what makes enamel erosion one of the main causes of tooth sensitivity. Without enamel, the nerves get a nasty shock whenever anything too hot or cold, or even too sweet or sour, touches the outside of the tooth.

Root exposure from gum recession also leads to sensitivity. The enamel only covers the crown of the tooth, not the roots. Those are protected by the gums. If the gums recede (sometimes as the result of teeth grinding or improper brushing over time), it exposes the roots.

Cavities and tooth injuries can cause sensitivity as well, even if you’ve been taking great care of your gums and enamel.

Use The Right Tools To Protect Your Teeth

Fortunately for all of us, there are ways to fight back, even if our teeth are already sensitive. Using a soft-bristled brush will help prevent further enamel erosion or gum recession. There is also special toothpaste formulated for sensitive teeth. Avoiding sugary and acidic foods and drinks (particularly soda) is another way to help your teeth.

We Can Help You Fight Tooth Sensitivity

Your best ally in the fight against tooth sensitivity is the dentist! Schedule a dental appointment as soon as you notice a change in your sensitivity level, or if you’ve been struggling with it for a while. The dentist can help protect your teeth with a fluoride varnish, perform restoration work to combat enamel erosion, and may recommend a gum graft for receding gums or prescribe a toothpaste to help with sensitivity.

Together, we’ll keep your smile happy and healthy!

Top image used under CC0 Public Domain license. Image cropped and modified from original.

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