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During the second week in April, we recognize and celebrate the expert care dental hygienists provide. Let’s take a moment this week to explore how the special skills of this valued member of your dental team in Middleton, WI enrich your dental health.

Regular Cleanings

Dentists typically recommend routine dental examinations twice a year, and these visits will almost always include an in-office cleaning by your hygienist. Dental hygienists are highly trained healthcare professionals who are specialists in caring for your teeth and gums.

• Plaque and tartar need to be removed from tooth enamel to help prevent cavities and gum disease. While you can brush away plaque, it takes a dental professional to remove tartar, which is plaque which has mineralized over time. The hygienists who work with Dr. Joel Hartjes and Dr. Jon Szewczyk might use a hand scaler, an ultrasonic scaler, or both tools to gently scrape sticky plaque and hardened tartar from your tooth enamel.
• Your cleaning will also include polishing, where surface stains on the enamel are removed using a gentle abrasive. This cleaning might be done with a special toothpaste applied with a small rotating cup or with an air polisher, which removes stains with a stream of fine abrasive powder, water, and pressurized air.
• An expert flossing will remove any remaining plaque from between the teeth.

Deep Cleaning

Hygienists help prevent gum disease. Plaque and tartar on tooth surfaces below the gum line increase your risk of gum disease. Irritated gum tissue gradually pulls away from the teeth, creating pockets of bacteria and causing inflammation and infection.

• Your hygienist will use a probe to gently measure the depth of the space between the teeth and gums. Deeper than normal spaces or bleeding could be a sign of gum disease.
• Tartar on the tooth surface below the gum line will be removed using a treatment called scaling, a non-surgical procedure where your hygienist uses hand scalers or ultrasonic tools to carefully scrape hardened plaque from the tooth.
• Root planing might be done to smooth the root surfaces so that gum tissue can attach snugly around the teeth again, protecting the roots from plaque buildup and bacteria.

Preventative and Cosmetic Care

Some hygienists work with dentists to help provide additional diagnostic, preventative, and cosmetic services:

• X-rays and digital imaging.
• Oral cancer screenings.
• Sealants, thin plastic coatings which protect the top surfaces of molars—the most likely places to develop cavities—from accumulating food particles and plaque.
• Fluoride treatment, if recommended, applied in varnish, foam, or gel form.
• Professional whitening treatments.

Education

Finally, your dental hygienist is an educator!

• When it comes to brushing, there are effective techniques and . . . not so effective techniques. Your hygienist can teach you the best way to clean away food particles and plaque and the best tools for the job.
• During a cleaning, your hygienist will point out any spots where plaque has built up. Discovering the spots where you tend to leave plaque behind allows you to do a better, more thorough cleaning job at home.
• Flossing can be difficult for some of us because we have braces, or because of the way our teeth are aligned, or because of dexterity issues. Your hygienist can show you the best way to floss, as well as recommend products such as specially designed flosses or water flossers which will make flossing easier and more effective.

The dental hygienists at Hartstone Dental are skilled professionals who work to create cleaner, brighter, healthier smiles for their patients every day. This week, we appreciate them for helping us achieve the beautiful smiles we get to appreciate all year long!

We’re not talking about caring for major appliances here—the refrigerators, dishwashers, and washing machines which make our lives easier. We’re talking about much smaller scale appliances which produce major results for our oral care—the dental appliances which give us healthier, more attractive smiles!

A dental appliance is simply any device which helps promote dental health. And while that definition is awfully broad, you still might be surprised at the many types of dental work which qualify! Today, we look at “fixed” appliances. These restorations or devices stay in the mouth, unlike removeable appliances like mouthguards and aligners. How do they work for us, and how do we provide the care they need to work effectively?

Fillings, Crowns, and Dental Implants

Dental restorations such as crowns and fillings, which protect the structure of your teeth, are considered appliances. So are dental implants. Implants use a post surgically implanted in the bone to act as the tooth’s “root.” When the post has fused with the bone, a crown is bonded to the implanted post for a tooth which functions—and looks—like your natural teeth.

• Cleaning—Clean your restorations and implants just like you would your natural teeth. This means brushing at least twice each day for two minutes and flossing once each day to protect both your dental work and your oral health.
• Diet—While restorations allow you to eat normally, it’s best to treat both your natural teeth and your restorations with care. Hard foods can crack or damage enamel, implants, and restorations. Chewy, sticky foods like caramels can dislodge restorations.

Fixed Orthodontic Appliances

If you or your child are in orthodontic treatment, you know that taking good care of orthodontic appliances will help treatment progress as quickly and comfortably as possible. Traditional braces and functional appliances like palatal expanders and the Herbst® and Forsus™ appliances are commonly used to help patients achieve their best smiles. Because these appliances stay in the mouth until treatment is complete, caring for them can present some day-to-day challenges.

• Cleaning—You might need to brush and floss after every meal and snack to prevent plaque buildup and to keep food particles from sticking to braces and/or functional appliances. Your orthodontist will provide instructions for daily cleaning routines.
• Helpful tools—Interproximal brushes, flosses designed for braces, and water flossers can make cleaning teeth and appliances easier and more effective. Talk to your dental team at Hartstone Dental to learn the best tools and techniques for your specific needs.
• Diet—Sticky, chewy, hard, and crunchy foods are not on the menu when you have a fixed appliance! Sticky and chewy foods like caramels can damage appliances and are difficult to clean from appliances and enamel. Hard foods require biting pressure which can damage appliances—and your teeth! Crunchy foods can leave hard little particles stuck in and under appliances. Your orthodontist has all the details on choosing foods which are good for your teeth and your orthodontics.
• Stick to your orthodontic routine—Keeping up with your appointments and adjustments keeps your treatment on track and allows your orthodontist to discover any problems with your appliances. If you have any concerns about an appliance, it’s always a good idea to call your orthodontist’s office immediately.

Bridges

Bridges complete smiles when a tooth or teeth are missing, enabling normal speaking, biting, and chewing. Bridges also help prevent the remaining teeth from shifting out of place.

To create a custom bridge, a prosthetic tooth or row of teeth are attached to crowns placed on adjacent natural teeth, or attached with wings bonded to adjacent natural teeth, or secured to carefully placed implant posts. The type of bridge your dentist recommends will depend on your preferences, the health of your surrounding teeth, and the number and location of the missing teeth.

• Cleaning— Because the artificial teeth in the bridge are often connected to each other and/or to surrounding teeth, typical flossing between teeth isn’t always possible. Special flosses, interproximal brushes or water picks can make sure the areas under the bridge and adjacent to your natural teeth are free of plaque and food particles. Dr. Joel Hartjes and Dr. Jon Szewczyk can recommend the best tools and techniques.
• Diet—A bridge-friendly diet is a lot like a healthy orthodontic diet. Avoid hard and chewy foods like nuts and caramels which can damage or loosen your bridge. Foods like corn on the cob, tough meats, hard breads, and apples require more biting force, which can loosen a bridge over time. Cutting foods into smaller pieces and choosing softer food options will help extend the life of your bridge. Your dental team in Middleton, WI is a great source of information on the healthiest diet for you and your dental work.

Implant-Supported Dentures

Permanent, fixed dentures remain in the mouth, anchored by implant posts strategically placed in the jaw. Like individual implant posts, these are placed surgically and require time to heal. When the posts have fused with the bone, an individually crafted denture is secured to them.

• Cleaning—Once the dentures are secured to the posts, brush and floss as you would with your natural teeth. A water flosser is helpful for cleaning under and around the denture.
• For best maintenance, Dr. Joel Hartjes and Dr. Jon Szewczyk can remove your denture for professional cleaning as needed.
• Once you have become used to your dentures, you can eat normally (although it’s best to avoid small, crunchy particles which can get trapped under the denture).

So many appliances, helping us protect our dental health and comfort in so many ways! And there are a few additional steps we can take to make sure these appliances perform at their best:

• Watch out for destructive dental habits. Nail biting, chewing on pencils or other objects, using teeth as tools to open bags or bottle caps, crunching on ice—any behaviors which can damage teeth can also damage appliances.
• Keep up with regular dental exams. Dr. Joel Hartjes and Dr. Jon Szewczyk can assess the health of your teeth and gums as well as the condition of your appliances.
• Don’t ignore problems! Call your dental team at once if you notice any damage to your teeth or appliances.

Fixed appliances make our lives better. They improve oral health, allow us to eat and speak without difficulty, and create confident smiles. With conscientious care, your appliances will continue to work both comfortably and effectively.

Orthodontic treatment traditionally begins somewhere between the ages of 10 and 14—but there’s no need to stand on tradition where your family’s dental health is concerned! An orthodontic evaluation will let you know each family member’s best options for healthier, more confident smiles even before the tween years and even after reaching adulthood.

First Visit—By Age 7

The team at Hartstone Dental recommends that you schedule a first orthodontic evaluation for your child by age seven (or earlier if any bite problems or jaw asymmetry are apparent). By this age, most children have a mix of both adult and baby teeth, and orthodontists can determine whether the position and development of the teeth and jaws are on track.

During this visit, your orthodontist will also carefully assess how your child’s teeth and jaws fit together when biting down. Healthy occlusion, or bite, means that the teeth and jaws are aligned and work together comfortably. A malocclusion, or bad bite, means that there is a problem with this alignment.

Your orthodontist might discover:

• No issues for concern.
• A possibility for future orthodontic problems. In this case, follow-up appointments might be scheduled to determine whether and when treatment should occur.
• Orthodontic problems which are already evident, with a recommendation for early intervention.

Early Orthodontic Intervention—Ages 6-9

Some children can benefit from “interceptive orthodontics,” first stage orthodontic treatment begun around the ages of six to nine.

Early intervention can help prevent crowded teeth, protect protruding teeth, and correct jaw alignment problems.

• If a child has a small upper dental arch, palatal expanders can gently enlarge the arch to make room for the adult teeth to arrive without crowding.
• When a baby tooth is lost too soon, space maintainers save room for the adult tooth beneath it to erupt in just the right spot.
• Protruding front teeth have a higher risk of injury from falls or collisions, and treatment will help protect them.
• Treatment for malocclusions like overbites, underbites, and open bites helps create a more comfortable, symmetrical, and healthy bite while young bones are growing, and may prevent the necessity for more complicated treatment in the teen years.

Tween and Teen Years—Ages 10-14

It’s common to treat malocclusions during the tween/teen years. During this stage of development, it’s easier for teeth to move to their ideal positions, because most of the adult teeth have arrived and the jawbones haven’t completed their growth.

Today’s orthodontics offers teens a number of treatment options:

• Braces are smaller and more comfortable, and brackets come in a variety of colors and materials to blend in or stand out.
• Clear aligners are almost invisible, and can treat many types of mild to moderate malocclusions.
• Functional appliances like the Herbst® appliance, the Forsus™ device, the twin-block appliance, and headgear work with braces or aligners to help correct more complex malocclusions.

And there’s more—modern orthodontic options are more effective, taking less time to create a beautiful, healthy smile.

Older Patients of Any Age

As you’ve grown older, you may have noticed that your once-straight teeth are becoming a bit crowded. You may be suffering dental pain and injured teeth because of a long-term bite problem. You may have always wanted a more attractive, comfortable smile, but weren’t able to access treatment when you were younger.

Good news! As long as your teeth and gums are healthy, orthodontic treatment can be a great way to keep them healthy. And today’s orthodontics offer a much wider and less noticeable variety of treatment options than the larger metal braces you might remember from decades ago. Depending on your needs, your orthodontist could recommend:

• Traditional braces—brackets are smaller than ever and come in a choice of several materials and colors, including ceramic, tooth-colored, and clear brackets.
• Clear aligners—an almost invisible way to straighten teeth, and removeable when necessary (as long as they’re worn 20-22 hours each day).
• Lingual braces—the least visible treatment, because brackets and wires are attached behind the teeth.

Crowded teeth and malocclusions often lead to lifelong problems, including worn or cracked enamel, headaches, jaw problems, increased risk of tooth decay and periodontal disease, and decreased self-confidence. Whether you’re graduating high school or getting ready for your golden reunion, it’s not too late for an orthodontic assessment. Talk to Dr. Joel Hartjes and Dr. Jon Szewczyk to discover whether your smile could benefit from treatment.

If you’re concerned about your own or your child’s orthodontic health, problems with alignment and bite are best treated as early as possible to prevent dental damage, improve self-confidence, and avoid more complicated treatment in the future. So, when’s the best time to schedule an orthodontic assessment in Middleton, WI? There’s no better time than today!

It seems like the ads are everywhere these days—repair your enamel and reverse tooth decay with a tube of toothpaste! Are these claims too good to be true? Let’s dive into the science of tooth decay—how decay develops and how (and if!) it can be reversed.

Teeth can stand up to the powerful pressures of biting and chewing because over 95% of our enamel is made up of minerals. Calcium and phosphate ions in our teeth bond to form a crystal structure called hydroxyapatite. Because of the strength of this crystalline design, tooth enamel is the hardest substance in our bodies, even stronger than our bones. 

But bones, like most other parts of our bodies, are living tissue, which means that they can create new cells to replace old or damaged cells. Tooth enamel can’t regenerate new cells to repair itself. This means that when a cavity has made a hole in the tooth, the enamel can’t grow back. And, while enamel structure is very strong, it’s also vulnerable to damage—specifically, damage from acids. 

Our teeth are exposed to acids throughout the day, whether they are acids created by plaque bacteria or the acidic foods and drinks we consume. Acids dissolve mineral bonds, stripping calcium and phosphate minerals from the enamel and leaving weak spots in the tooth surface. This process is called demineralization. Demineralization is the first stage of tooth decay.

The good news? Our bodies are designed with a built-in defense mechanism to prevent demineralization from causing lasting damage. All through the day, saliva helps wash away acids in the mouth and bathes our teeth with new calcium and phosphate ions. These ions bond with the calcium and phosphate in our enamel, restoring enamel strength. This protective repair process is called remineralization.

Now for the bad news. In the tug of war between demineralization and remineralization, saliva can only do so much. If your diet is heavy with acids, if you don’t brush away acid-producing plaque bacteria regularly, if you eat a lot of the sugars and starches which feed plaque bacteria, the remineralizing effects of saliva can’t keep up with the demineralizing effects of acids.

The first visible sign of demineralization is often a white spot on the tooth where minerals have been stripped from enamel. Studies have shown that enamel-strengthening toothpaste can be effective in this very first stage of tooth decay. Toothpastes which advertise enamel repair generally contain one or more of these ingredients:

• Calcium Phosphate
• Hydroxyapatite
• Fluoride 

Toothpastes with calcium phosphate or hydroxyapatite contain calcium and phosphate minerals, the building blocks of tooth enamel. Studies have suggested that these minerals can replace the calcium and phosphate ions stripped from enamel. These toothpastes may or may not contain fluoride, which is something you should discuss with your dentist before deciding on a specific toothpaste.

Fluoride toothpastes remineralize enamel—and more! Fluoride ions are attracted to the tooth’s surface, and, when fluoride ions join with the calcium and phosphate ions there, they form fluorapatite. Fluorapatite crystals are larger, stronger, and more resistant to acids than hydroxyapatite crystals. And, once bonded with tooth enamel, fluoride attracts the calcium and phosphate ions in saliva to remineralize the teeth more quickly. 

Why consider enamel-repair toothpaste? 

Once enamel is gone, it’s gone for good. If excess demineralization isn’t treated, a weak spot on the tooth surface will continue to erode, growing bigger and deeper until it becomes a hole in the enamel. This is a cavity, and your dentist will need to treat and repair your tooth to prevent the cavity from growing and potentially exposing the tooth’s pulp to bacteria and infection. 

Talk to Dr. Joel Hartjes and Dr. Jon Szewczyk at our Middleton, WI office about which toothpastes can help restore a healthy balance between the ongoing cycles of demineralization and remineralization. While tooth-repair toothpaste can’t fix cavities, these products can often strengthen demineralized enamel and reverse this earliest stage of tooth decay.