More than 20 million people in the United States use electronic cigarettes or e-cigs as an alternative to tobacco smoking. While many users believe "vaping" is a healthier alternative to regular cigarettes, recent research into the health effects of e-cigs could put a damper on that belief. There's particular concern among dentists that this popular habit could harm users' dental health.

E-cigs are made with a chamber that holds the liquid vaping solution and a heating mechanism to heat the liquid and vaporize it. Users inhale the vapor, which contains nicotine and flavorings, as they would a traditional cigarette.

The nicotine alone can be problematic for dental health as we'll see in a moment. But the vapor also contains aerosols that some research indicates could damage the inner skin linings of the mouth in a similar fashion to the smoke of traditional cigarettes. One study by researchers with the Université Laval in Quebec, Canada found evidence that e-cig vapor increased the death rate of mouth cells, and led to greater cell irregularities over time.

According to other studies, there's evidence that e-cig vapor may disrupt the balance of the oral microbiome, the communities of both beneficial and harmful bacteria that normally live in the mouth. The imbalance in favor of more harmful bacteria could increase the risk for dental disease, particularly periodontal (gum) disease.

Finally, nicotine from e-cigs seemed to create similar conditions in the mouth as it does with tobacco. Nicotine in any form can constrict blood vessels and reduce the body's ability to fight infection and to heal. Research indicates both forms of nicotine increase the risk for dental disease and make treatment more difficult.

These findings only identify conditions created by e-cigs that could be problematic for future dental health. Although we don't fully understand the long-term health effects of this new habit, based on the evidence so far the mouth may not fare so well. It's looking like e-cigs may be no safer for your teeth and gums than the cigarettes they replace.

If you would like more information on the health risks of electronic cigarettes, please contact us or schedule an appointment for a consultation.

The 2019 Grammy Awards was a star-studded night packed with memorable performances. One standout came from the young Canadian singer Shawn Mendes, who sang a powerful duet of his hit song "In My Blood" with pop diva Miley Cyrus. But that duo's stellar smiles weren't always quite as camera-ready as they looked that night.

"I had braces for four and a half years," Mendes told an interviewer not long ago. "There's lots and lots and lots of photo evidence, I'm sure you can pull up a few." (In fact, finding one is as easy as searching "Sean Mendes braces.")

Wearing braces puts Mendes in good company: It's estimated that over 4 million people in the U.S. alone wear braces in a typical year—and about a quarter of them are adults! (And by the way: When she was a teenager, Miley Cyrus had braces, too!)

Today, there are a number of alternatives to traditional metal braces, such as tooth-colored braces, clear plastic aligners, and invisible lingual braces (the kind Cyrus wore). However, regular metal braces remain the most common choice for orthodontic treatment. They are often the most economical option, and can be used to treat a wide variety of bite problems (which dentists call malocclusions).

Having straighter teeth can boost your self-confidence—along with helping you bite, breathe, chew, and even speak more effectively. Plus, teeth that are in good alignment and have adequate space in between are easier to clean; this can help you keep your mouth free of gum disease and tooth decay for years to come.

Many people think getting braces is something that happens in adolescence—but as long as your mouth is otherwise healthy, there's no upper age limit for orthodontic treatment. In fact, many celebrities—like Lauren Hutton, Tom Cruise and Faith Hill—got braces as adults. But if traditional braces aren't a good fit with your self-image, it's possible that one of the less noticeable options, such as lingual braces or clear aligners, could work for you.

What's the first step to getting straighter teeth? Come in to the office for an evaluation! We will give you a complete oral examination to find out if there are any problems (like gum disease or tooth decay) that could interfere with orthodontic treatment. Then we will determine exactly how your teeth should be re-positioned to achieve a better smile, and recommend one or more options to get you there.

If you have questions about orthodontic treatment, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Magic of Orthodontics” and “Lingual Braces: A Truly Invisible Way to Straighten Teeth.”

Each year, over a million Americans venture abroad for healthcare, with roughly half for dental treatment. Cost is the main reason — “medical tourists” believe they can save substantially on treatment, even with travel.

But before undertaking such a venture for dental work, there are some things you should take into consideration. For one, although quality care exists all over the world, you’ll also find different standards of care. In the United States, for example, not only must dental providers graduate from accredited schools, they must also pass state examinations before they can practice (specialists even more). In some parts of the world, educational standards aren’t as difficult to attain. You may also find differing standards for infection control, drug applications or appliances: for example, you may find a lower quality in implant or crown materials or craftsmanship than you might expect in the U.S.

Communication can also be an obstacle. Language barriers make it more difficult to understand what to expect before, during and after a procedure, or to have your questions answered. It may also hinder your provider from fully accessing your medical and dental history, which could have an impact on your treatment and outcome. Limited communication also increases misunderstanding about services offered, charges and treatment expectations.

Finally, many dental procedures have multiple phases to them, some of which normally span several months and visits. Many who go abroad for more complex procedures may try to have them performed in a much shorter time frame. Doing so, however, could prove disappointing both in the quality of the final outcome and your own well-being under such an arduous schedule. Even if your dental work is performed in an exotic locale, recovering from extensive procedures where you must rest and refrain from strenuous activity is best performed in the comfort of your own home.

It’s important to get the facts before traveling to a foreign country for any medical or dental treatment, especially about a region’s accreditation and care standards, as well as what you can expect in terms of amenities and culture during your stay. One good source is the U.S. Center for Disease Control’s web page for medical tourism (//goo.gl/75iWBk).

Going abroad for dental care is a big decision — be sure you’re prepared.

If you would like more information on dental treatment abroad, 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 “Dental & Medical Tourism: It’s No Vacation.”

Aspirin has been a popular pain reliever and fever reducer for over a century. Its effect on the clotting mechanism of blood, however, has led to its widespread and often daily use in low dose form (81 mg) to help reduce the chances of heart attack or stroke in cardiovascular patients. While this has proven effective for many at risk for these conditions, it can complicate dental work.

Aspirin relieves pain by blocking the formation of prostaglandins; these chemicals stimulate inflammation, the body’s protective response to trauma or disease. Aspirin reduces this inflammatory response, which in turn eases the pain and reduces fever. It also causes blood platelets to stop them from clumping together. This inhibits clotting, which for healthy individuals could result in abnormal bleeding but is beneficial to those at risk for heart attack or stroke by keeping blood moving freely through narrowed or damaged blood vessels.

Even for individuals who benefit from regular aspirin therapy there are still risks for unwanted bleeding. Besides the danger it may pose during serious trauma or bleeding in the brain that could lead to a stroke, it can also complicate invasive medical procedures, including many in dentistry. For example, aspirin therapy could increase the rate and degree of bleeding during tooth extraction, root canal or other procedures that break the surface of soft tissue.

Bleeding gums after brushing is most often a sign of periodontal (gum) disease. But if you’re on an aspirin regimen, gum bleeding could be a side effect. A thorough dental examination will be necessary to determine whether your medication or gum disease is the root cause.

It’s important, then, to let us know if you’re regularly taking aspirin, including how often and at what dosage. This will help us make more accurate diagnoses of conditions in your mouth, and will enable us to take extra precautions for bleeding during any dental procedures you may undergo.

If you would like more information on the effects of aspirin and similar medications on dental treatment, 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 “Aspirin: Friend or Foe?”

Tooth enamel erosion is a serious issue for many children that can result in permanent impairment of oral health. The problem isn’t just bacterial acid that causes tooth decay — it’s also the high acid content of sodas, energy and sports drinks widely popular among children and teenagers today.

Enamel is made of the strongest substance in the human body, which enables it to shield the inner layers of the teeth from disease and other environmental factors. Its chief nemesis, though, is acid: when enamel interacts with high concentrations of acid for a prolonged time, its mineral content will begin to soften and dissolve, a process known as de-mineralization. Saliva is the enamel’s main protection against acid with the ability to neutralize (or buffer) acid and restore some of the enamel’s mineral content, usually within thirty minutes to an hour after we eat.

The high acid content of many popular beverages, however, can overwhelm saliva’s buffering ability, especially if a person is sipping for an extended time on an acidic drink. This kind of exposure is different from acid produced by bacteria that causes tooth decay: bacterial acid tends to concentrate in specific areas of the teeth, while the constant wash from acidic beverages will have a more generalized eroding effect on teeth.

This level of enamel loss is irreversible, which can leave a tooth in peril of decay and ultimate loss — and increase long-term dental care and costs. The best strategy is to have your child stop or significantly curtail drinking highly acidic beverages. Rather than drink sports beverages for hydration, substitute water, nature’s hydrator. Milk can also be a viable beverage substitute.

If you do allow some acidic beverages, try to limit them to mealtimes and discourage extended sipping. Look for drinks with added calcium as this can reduce the beverage’s erosive potential. The goal is to reduce the amount and duration beverage acid is in contact with tooth enamel.

Making these changes will help greatly to protect your child’s tooth enamel, and give saliva a chance to do its job protecting it. Your efforts will also increase your child’s chances of better dental health in the future.

If you would like more information on dental erosion, please contact us today to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Erosion.”