In your search for the right toothpaste, you’re inundated with dozens of choices, each promising whiter teeth, fresher breath or fewer cavities. Cutting through the various marketing claims, though, you’ll find most toothpaste brands are surprisingly alike, each containing the same basic ingredients. Taken together, these ingredients help toothpaste perform its primary task — removing daily bacterial plaque from tooth surfaces.

Here, then, are some of the ingredients you’ll find — or want to find — in toothpaste.

Abrasives. A mild abrasive increases your brushing effectiveness removing sticky food remnants from teeth. And unlike the burnt, crushed eggshells of the ancient Egyptians or the brick dust used by 18th Century Brits, today’s toothpaste abrasives — hydrated silica (from sand), calcium carbonate or dicalcium phosphates — are much milder and friendlier to teeth.

Detergents. Some substances in plaque aren’t soluble, meaning they won’t break down in contact with water. Such substances require a detergent, also known as a surfactant. It performs a similar action as dishwashing or laundry soaps breaking down grease and stains — but the detergents used in toothpaste are much milder so as not to damage teeth or irritate gum tissues. The most common detergent, sodium lauryl sulfate, is gentle but effective for most people. If it does cause you irritation, however, you may want to look for a paste that doesn’t contain it.

Fluoride. This proven enamel strengthener has been routinely added to toothpaste since the 1950s, and is regarded as one of the most important defenses against tooth decay. If you’re checking ingredients labels, you’ll usually find it listed as sodium fluoride, stannous fluoride or sodium monofluorosphosphate (MFP). And since it inhibits bacterial growth, fluoride toothpastes don’t require preservative additives.

Humectants, binders and flavoring. Humectants help toothpaste retain moisture, while binders prevent blended ingredients from separating; without them your toothpaste would dry out quickly and require stirring before each use. And, without that sweet (though without added sugar) and normally mint flavoring, you wouldn’t find the average toothpaste very tasty.

The ADA Seal of Approval. Although not an ingredient, it’s still sound advice to look for it on toothpaste packaging. The seal indicates the product’s health claims and benefits are supported by the research standards set by the American Dental Society; and all ADA approved toothpastes will contain fluoride.

If you would like more information on toothpaste and other oral hygiene products, 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 “Toothpaste: What’s in it?”

Have you ever felt a hot, burning sensation in your mouth—like it had been scalded—but you didn't eat or drink anything that could have caused it?

While you may think you’re hallucinating, there’s another possibility: Burning Mouth Syndrome (BMS). This condition, which can last for years, produces sensations in the mouth of not only scalding or burning, but also tingling, numbness and a decline in your ability to taste. Patients may feel it throughout their mouth or only in localized areas like the lips, tongue or inside the cheeks.

The exact cause of BMS is also something of a mystery. It’s been theoretically linked to diabetes, vitamin or mineral deficiencies and psychological problems. Because it’s most common among women of menopausal age hormonal changes have been proposed as a factor, although hormone replacement therapy often doesn’t produce any symptomatic relief for BMS.

To complicate matters, other conditions often share the condition’s effects, which need to be ruled out first to arrive at a BMS diagnosis. A feeling of scalding could be the result of mouth dryness, caused by medications or systemic conditions that inhibit saliva flow. Some denture wearers may display some of the symptoms of BMS due to an allergic reaction to denture materials; others may have a similar reaction to the foaming agent sodium lauryl sulfate found in some toothpaste that can irritate the skin inside the mouth.

If these other possibilities can be ruled out, then you may have BMS. While unfortunately there’s no cure for the condition, there are ways to lessen its impact. There’s even the possibility that it will resolve itself over time.

Until then, keep your mouth moist by drinking lots of water or using saliva-stimulating products, limiting alcohol, caffeinated drinks or spicy foods and refraining from smoking. If you’re taking medications that could cause dry mouth, speak with your physician about changing to an alternative. And try to reduce stress in your life through exercise, mindfulness practices or support groups.

While BMS isn’t considered harmful to your physical health it can make life less enjoyable. Careful symptom management may help improve your quality of life.

If you would like more information on Burning Mouth Syndrome, 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 “Burning Mouth Syndrome: A Painful Puzzle.”

Via a recent Instagram post, pop diva Ariana Grande became the latest young celebrity to publicly acknowledge a dental milestone: having her wisdom teeth removed. The singer of hits such as “Break Free” and “Problem” posted an after-surgery picture of herself (wearing her signature cat-eye eyeliner), with a caption addressed to her teeth: “Peace out, final three wisdom teeth. It’s been real.”

With the post, Grande joined several other celebs (including Lily Allen, Paris Hilton and Emile Hirsch) who have shared their dental surgery experience with fans. Will "wisdom teeth removal" become a new trending topic on social media? We aren’t sure — but we can explain a bit about the procedure, and why many younger adults may need it.

Technically called the “third molars,” wisdom teeth usually begin to emerge from the gums between the ages of 17 and 25 — presumably, around the same time that a certain amount of wisdom emerges. Most people have four of these big molars, which are located all the way in the back of the mouth, on the left and right sides of the upper and lower jaws.

But when wisdom teeth begin to appear, there’s often a problem: Many people don’t have enough space in their jaws to accommodate them. When these molars lack sufficient space to fully erupt (emerge), they are said to be “impacted.” Impacted teeth can cause a number of serious problems: These may include pain, an increased potential for bacterial infections, periodontal disease, and even the formation of cysts (pockets of infection below the gum line), which can eventually lead to tooth and bone loss.

In most cases, the best treatment for impacted wisdom teeth is extraction (removal) of the problem teeth. Wisdom tooth extraction is a routine, in-office procedure that is usually performed under local anesthesia or “conscious sedation,” a type of anesthesia where the patient remains conscious (able to breathe normally and respond to stimuli), but is free from any pain or distress. Anti-anxiety medications may also be given, especially for those who are apprehensive about dental procedures.

So if you find you need your wisdom teeth extracted, don’t be afraid to “Break Free” like Ariana Grande did; whether you post the results on social media is entirely up to you. If you would like more information about wisdom tooth extraction, please call our office to schedule a consultation. You can learn more in the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”

With their durability, versatility and life-likeness, there’s no doubt dental implants have revolutionized teeth replacement. If you’re considering dental implants, however, there are some issues that could impact how and when you receive implants, or if you should consider another type of restoration.

Cost. Dental implants are initially more expensive than other tooth restorations, especially for multiple tooth replacement. However, be sure you consider the projected cost over the long-term, not just installation costs. Because of their durability, implants can last decades with little maintenance cost. In the long run, you may actually pay more for dental care with other types of restorations.

Bone health. Dental implants depend on a certain amount of bone to properly situate them for the best crown placement. If you’ve experienced extensive bone loss, however, there may not be enough to support the implant. This can often be overcome with grafting — immediately after extraction, at the time of implantation or a few months before implantation — to encourage bone growth. In some cases, though, bone loss may be so extensive you may need to consider an alternative restoration.

Gum Health. While implants themselves are impervious to infection, they’re supported by gum and bone tissues that can be affected. Infected tissues around an implant could eventually detach and lead to implant failure. If you have periodontal (gum) disease, we must first bring it under control and render your gums infection-free before installing implants. It’s also important to maintain effective oral hygiene and regular dental cleanings and checkups for optimum implant health.

Complications from osteoporosis. People with osteoporosis — in which the bones lose bone density and are more prone to fracture — are often treated with drugs known as bisphosphonates. In less than 1% of cases of long-term use, a patient may develop osteonecrosis in which the bone in the jaw may lose its vitality and die. As with bone loss, this condition could make implant placement difficult or impractical. Most dentists recommend stopping treatment of bisphosphonates for about three months before implant surgery.

If you have any of these issues or other complications with your oral health, be sure to discuss those with us before considering dental implants. With proper planning and care, most of these difficulties can be overcome for a successful outcome.

If you would like more information on pre-existing conditions that may affect implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Osteoporosis & Dental Implants” and “Infections around Implants.”

Your teeth and gums have a highly sensitive network of nerves. But while it can signal even the most subtle discomfort we may not be able to identify the cause with pinpoint accuracy. As a result, tooth pain could indicate more than one kind of problem including a decayed tooth, root sensitivity, infected gum tissues (like an abscess) or a dying pulp signaled by diseased nerve tissue inside the tooth.

On the other hand, not all tooth pain is the same: it can be dull or sharp, continuous or intermittent. It can feel like a constant, throbbing ache or a sharp wince when you eat or drink something cold or hot, or when you bite down. These differences could point our diagnostic examination in the right direction.

For example, sharp, throbbing pain could indicate deep tooth decay, especially if it suddenly stops. That would likely mean the nerves within the tooth pulp under attack by the infection have died and can no longer transmit pain. The infection, on the other hand is still very much active — this usually requires a root canal treatment (cleaning out the pulp and root canals of diseased and dead tissue and filling the empty spaces) if we’re to save the tooth.

If, however, you’re experiencing sensitivity from temperature or pressure, we could be facing at least a couple of scenarios. For one, your tooth could be fractured. More likely, though, periodontal (gum) disease triggered by bacterial plaque has caused the gum tissues to shrink back (recede) from the affected teeth so that the sensitive dentin layer is exposed and no longer protected by the gum tissue.

If we diagnose gum disease, we’ll need to aggressively remove bacterial plaque from all tooth and gum surfaces. This procedure might require more than one appointment and the possibility of surgery if we encounter deep pockets of infection, especially around the roots. If gum recession is severe you may also need grafting surgery to replace the missing gum tissue or to re-cover the exposed areas of your teeth.

So, knowing the source of tooth pain will direct the course of treatment to follow. With proper treatment, though, the chances are good we can not only restore your teeth and gums to optimum health but we can end the pain.

If you would like more information on treating tooth pain, 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 “Confusing Tooth Pain.”