Interesting (and Sometimes Shocking) Facts from Dental History

Dentures of the Past

Nothing like a look back in the past to see how far you’ve come, am I right? Today’s blog was a request from our fabulous front office coordinator, Becca. Enjoy!

• Dentistry is one of the oldest professions. Early in recorded history, a Sumerian text described “tooth worms” as the cause of dental decay, an idea that wasn’t proven false until the 1700s.

• The first book to be published purely on the topic of dentistry was in 1530 titled, The Little Medicinal Book for All Kinds of Diseases and Infirmities of the Teeth.

• The Etruscans of Italy used gold bands to attach human and animal teeth as far back as 700 BC. In today’s Mexico, they’ve found dentures dating from 2500 BC, made from wolf teeth. . The first recorded wooden dentures in Japan appeared in 16th century. During the 18th century, dentists experimented with dentures made out of human teeth, animal teeth and carved ivory. Dentures were usually made by goldsmiths and ivory turners. United States President, George Washington, was famous for having wooden teeth. While he did wear dentures, they were made with ivory from hippos and elephants, real human teeth, gold, rivets, spiral springs- not wood.

• One of the most common medical practitioners in Europe during the Middle Ages was the “barber surgeon”. In this era, barbers were called upon to not only cut hair with their razors, but also to conduct many surgeries and pull teeth.

• In 1723, Pierre Fauchard, a French surgeon credited as the father of modern dentistry, published a book called, The Surgeon Dentist, a Treatise on Teeth. For the first time, he provided a documented comprehensive system for preventing dental issues and treating teeth. Fauchard introduced dental fillings and proposed that acids from sugar led to tooth decay.

• In 1840, Baltimore College of Dental Surgery, the first dental college opened. Harvard University Dental School was the first university-affiliated dental institution founded in 1867.

• Colgate mass produced the first toothpaste in 1873 and mass-produced toothbrushes a few years later.

• Around 1765, Paul Revere, who would later become famous for warning Colonial troops that the British were coming, was also trained as a dentist by America’s first dentist, John Baker, in addition to being a silversmith.

• Imagine having to feel all your dental work without Novocaine. We take it for granted now, but it wasn’t invented until 1903! We can all thank the German chemist Alfred Einhorn who invented it.

We hope you enjoyed this look back at our adventurous dental history. Don’t worry - if you’re having any dental issues of your own, you can rest assured we have much more advanced and painless procedures to take care of you! Feel free to give us a call anytime at 541-482-4995.

6 Toothbrushing Mistakes You're Likely Making

We’re always thrilled to see patients invested in taking care of the oral health. But there are a few brushing related mistakes that are made quite often - we’re talking every day! A few simple tweaks to your routine may make a big difference, so today we’re sharing these common errors to get to on the right track.

1. You use the wrong brush
   First and foremost, we recommend ultrasonic toothbrushes. We can guess with pretty great accuracy if someone uses an electric toothbrush - the results are that obvious! An ultrasonic toothbrush is one that uses a very high frequency of vibration referred to as ultrasound to remove plaque and bacteria from the teeth. Additionally, anything other than a soft brush has the potential to harm not only the teeth but the gums as well. Always use a “soft” bristled brush.

2. You don’t brush at the right time of day
   The most important time to brush your teeth is before bed. Sleep is the longest period of the day you’re not eating and therefore the best time for the bacteria that cause tooth decay and gum disease to “feed”. Another small change can be made for people who brush their teeth before breakfast - suds up those chompers afterwards instead, for optimal oral health.

3. You ignore the rest of your mouth
   Don’t forget to care for your tongue! The tongue can harbor food and bacteria in the tiny crevices between “papillae” (little bumps on the top of your tongue that help grip food while chewing) . Use your tooth brush lightly on your tongue and then follow with a tongue scraper to get rid of harmful bacteria.

4. Not brushing long enough
   The American Dental Association recommends brushing twice a day for 2 minutes each time. Two minutes feel like a long time when you’re doing something less stimulating (to most … not us of course!). This is one reason we love electric toothbrushes - they keep you honest with their built in two minutes timers.

5. Not using proper technique
   Many people are surprised to find, later in life, that they’ve been brushing the wrong way. But the truth is, proper brushing and flossing can be a little tricky! Don’t hesitate to get exact recommendation from your dentist or hygienist and ask any questions. We love these conversations! Most commonly, mistakes have to do with the angle of the brush, brush strokes and flossing motions.

6. You don’t replace your brush
   You should replace your brush every 3-4 months, more frequently if the bristles become worn. Worn down bristles aren’t as effective. You should also change your brush out after you’ve been sick.

   As always, the Soulsmile team is available to address any concerns you have about the proper way to brush. Don’t hesitate ask us the next time you visit our office. Feel free to give us a call at 541.482.4995. Happy brushing!

Common Dental Emergencies and How to Handle Them

What’s considered a dental emergency? Typically we would consider a dental issue that requires immediate medical attention to save the tooth, continuous gum bleeding that needs to be stopped or severe pain as a dental emergency. It’s unfortunate that most hospitals and Emergency Departments are not equipped for or trained in dental emergencies. No matter where you are located or having a dental emergency, it is usually better to seek out immediate care for a dentist rather than a hospital if you can find one. In this blog, we are covering the most common dental emergencies and some advice on how to handle the situation until you can receive proper care.

Trauma to the Face and Mouth

Emergencies or trauma involving the face and mouth that require immediate medical attention include jaw fractures, jaw dislocations, serious cuts or lacerations to the face and mouth, or an abscess or infection that is very swollen or affecting your breathing or swallowing.

These are situations where you'd want to call 911 or go to a hospital ER. Don't wait for a dentist's office to handle a potentially life-threatening condition.

A Cracked or Broken Tooth

A cracked or broken tooth is one of the most common dental emergencies seen by dentists. Regardless of how the tooth cracks, we often see situations where the nerve of the tooth gets exposed, causing a great deal of pain and discomfort. An exposed nerve is also extremely sensitive to temperature fluctuations - especially cold.

If this happens, you should immediately book an appointment with Dr. Kivel and let our team know you are in pain so we can get you in the same day. If you are away on vacation and in a great deal of pain, we would encourage you to seek out a dentist in the area who can help you right away. Being in Ashland, we see lots of visitors here for the Shakespeare Festival or other leisure, and similarly, we can help them out while they are far from their “home” dentist. While you wait for an appointment, you can gently bite a fresh piece of gauge, and definitely avoid cold drinks and foods. This can protect the nerve from further damage.

Keep in mind that this type of dental emergency is almost always avoidable! By keeping up with regular dental exams and completing recommended dental treatment, you can avoid this type of situation. Dr. Kivel can usually see potential problems and tae steps to prevent them. There is a joke around the dental profession about how teeth always “wait” to cause a problem until you are on vacation, at a graduation or other equally unfortunate timed event!

A Knocked Out Tooth

A knocked out tooth is yet another common dental emergency. Almost everyone can think of a time when they or someone they knew had a tooth knocked out, often times as a child. In this situation, retrieve the tooth and hold it by the crown to rinse it thoroughly with water. During this process, take care not to remove any soft tissues attached to the tooth.

If you (or the affected person) are willing, you can try to gently insert the tooth back in the socket, but do not force it. If at all possible, try to visit Soulsmile (or a dentist in your area) within thirty minutes of the accident. It is ideal to transport the tooth (or teeth) either in a container of milk or in the patient's mouth.

A Crown That Comes Off

If the crown falls off due to injury, you should visit a dentist right away! This situation should be treated as a “knocked out tooth” above.

More commonly, a crown comes off while eating, brushing your teeth or flossing. In this case, the crown can sometimes be reattached by a dentist. However, there are times that the tooth has an ongoing issue (like decay or nerve damage) that will require a new crown to be fabricated or additional treatment. One way to get an idea if it will be possible to reattach the crown is to look inside it. If it is “clean” with no tissues or tooth material, it might be able to be used!

While you wait for an appointment, it's a good idea to place the crown back on temporarily to protect the underlying tooth structure and nerve. You can purchase over-the-counter denture cream at your local drugstore. You can also use a small dab of toothpaste. Before you use the denture cream, be sure to carefully determine the correct way it’s supposed to fit on your tooth. Test the fit before applying the cream. If it's on correctly, it should feel comfortable when you close your teeth together. Avoid biting down too hard or you may damage your crown.

An Abscess or Infection

A tooth abscess is a pocket of pus that develops due to a bacterial infection in the mouth. Abscesses can develop on different parts of the tooth, and because they will not go away on their own, it is incredibly important to treat them as soon as they develop. The symptoms of a tooth abscess are sensitivity to hot or cold, severe toothache, sensitivity to pressure, fever, facial swelling, swollen lymph nodes in the jaw and neck area. If you notice a sudden rush of foul tasting fluid in your mouth followed by pain relief, it is likely that your abscess has ruptured.

Treatment for a dental abscess at Soulsmile will consist of draining the pus from your abscess and treating the infection with antibiotics. Treatment often requires a root canal to thoroughly remove the decayed portion of your nerve, which can save the abscessed tooth; otherwise, the tooth must be removed. The bacterial infection from a tooth abscess can be incredibly dangerous if it spreads to your jaw, neck, or brain, or if you develop sepsis, which is a life-threatening infection that spreads through your body, so we encourage you to seek help as soon as possible

Contact Us to Be Seen Right Away

At Soulsmile, we are highly adept at handling every kind of dental emergency. We also place a premium on keeping people out of pain and handling emergencies promptly. We can always get you in on the same ay for a dental emergency. We also list Dr. Kivel’s emergency line on our voicemail which can be called or texted outside of our regular hours. And the best thing is, we always handle emergency cases on a preferential basis. Give us a call at 541.482.4955 to book an appointment.

Dental Insurance and FSA ... Use It or Lose It!

Did you know that dental insurance benefits do not roll over from year to year?

Millions of people in the US leave unused dental benefits on the table each year. The National Association of Dental Plans estimates that only 2.8% of people with PPO plans reach their plan's annual maximum. Additionally, many people now have FSAs (Flexible Spending Accounts) which can help pay for their dental care. These type of plans often "run out" on December 31st as well. Here's how we suggest you make the most of any remaining benefits you might have ...

Traditional Dental Insurance 

Many people with dental benefits get them through their employers, though individual plans are also available through Health Insurance Marketplaces established by the Affordable Care Act. Remember, when you buy a plan you and your employer are paying some premium – upfront dollars – that are wasted if you don’t see your dentist.

When You Need to Use Them By

Many insurance companies have a benefit deadline of December 31, and this means that any of your unused benefits don’t roll over into the New Year for most dental plans. Still, some plans may end at different times of the year, so check your plan document or ask your employer to be sure. 

Tips for Making the Most of Your Plan

The key with this type of coverage is to take advantage of any benefits before they expire for the year.

• Prevention is better than treatment both for your health as well as your pocketbook. Most plans typically pay 100% for preventive visits, so if you’re duet, this is a good time to schedule one.

• Start thinking about using your coverage early. During a dental appointment this fall, talk to Dr. Kivel about what your dental needs are and what treatment you might need before the end of the year. Make any upcoming appointments early so you can take care of them before the holidays.

• Once you've determined what your dental needs are, you can work with our front office coordinator or your insurance company directly to figure out what is covered. You can call your plan using the 800 telephone number on your identification card, or usually go to their website for information.

Flexible Spending Accounts

A Flexible Spending Account (FSA) is an account you can set up for healthcare costs. During open enrollment, you choose how much money to put into this account, and a portion of this amount is deducted from each paycheck pre-tax. FSAs generally cover services or products that help keep your mouth healthy, including cleanings, braces needed for dental health reasons, benefit plan co-pays, dentures and more. This huge benefit of this account is spending money that has not been taxed on your health expenses.

Many FSAs work like debit cards, and you can use that card to pay for various medical and dental expenses, including some products available at your local drugstore. 

When You Need to Use Them By

Generally, you must use the money in an FSA within the plan year by December 31. However, your plan may offer one of two options that give you a little more time to spend what’s in your account:

• Some provide a grace period of up to 2½ extra months to use the money in your FSA.

• Others may allow you to carry over up to $500 per year to use in the following year.

Whether it’s at the end of the year or a grace period, you lose any money you haven’t spent. Check with your employer or FSA administrator to see what your plan allows.

Tips for Making the Most of Your FSA

• Plan carefully so you don’t put more money in your account than you will spend within a year on dental or other health care costs.

• As with dental benefit plans, talk with Soulsmile this fall during regular appointments to see if you have any needs or procedures that need to be completed. You may be able to use your FSA to pay for these needs or use your FSA to pay any associated co-pays or co-insurance.

• Contact your FSA administrator for a list of covered services and products (usually referred to as eligible expenses). However, most FSA accounts cannot be used for cosmetic procedures and services like whitening, veneers or cosmetic braces.

• Make any remaining dental appointments as soon as you know you need them to ensure your FSA dollars can be used in time.

Have any questions regarding your own insurance plan, coverage or treatment needs? Call us at 541-482-4995 and we’ll be happy to help!

Drive a Different Kind of Hybrid: Dentures Supported by Dental Implants

Sometimes we see patients who, due to a variety of reasons, have lost most of their teeth. Estimates are that there are 35 million edentulous persons in the United States. In the past, these individuals would often be presented with the option to extract the remaining teeth and have dentures made. The problem with this is that dentures are known for feeling insecure and can make normal eating habits uncomfortable and embarrassing. An alternative could be to place dental implants for each of the missing teeth, but this is often a cost-prohibitive solution. However, using strategically placed implants to support a hybrid denture can be the perfect, middle-of-the-road option.

An implant-supported denture is one that is supported by dental implants placed beneath the gum line. They are also referred to as “overdentures”. The minimum number of implants is four, although more implants can be beneficial. After placing implants, the body will need some time to naturally fuse with the jaw bone, a process called “osseointegration”. A titanium or gold bar is then placed to hold the prosthetic teeth in place. This system creates a much more secure prosthetic than a denture that simply rests on the gums and will not slip around. The denture is then fixed in place by Dr. Kivel. It is not removable by the patient like typical dentures.  

What are the Benefits?

The most commonly reported benefit of a hybrid implant denture is the ability to eat, smile and speak with complete comfort and confidence again. It also comes at a significantly lower cost than a large number of implants. Lastly, the implant denture is easily cleaned, close to your natural teeth. You don’t have to take it out every time you want to brush - just keep up your normal hygiene habits.

What is the Dental Implant Process?

We are proud to offer a digital process for dental implant process in conjunction with specialists around the Rogue Valley. Below is a quick overview. 

Are you a Candidate?

Most patients who have lost an entire arch of teeth are eligible for hybrid implant dentures. One consideration is that the patient must be in reasonable good oral and overall health. The only way to confirm this, of course, is to book a free consultation appointment with Dr. Kivel at our Ashland, OR office. We can’t wait to help create a stable, secure, and complete smile!

Implant Supported vs. Implant Retained

There is another option to have implant retained dentures. In this option, the gums still absorb most of the force of the bite and the implants simple help retain the prosthetic. These type of dentures are removable . We find that many patients dislike the thought of having removable teeth, because it is a constant reminder of their tooth loss and feel comforted waking up with teeth in their mouth. For this reason, we typically lean towards a fully supported, more permanent option.

Invisalign Lifestyle FAQs

Invisalign has become one of the most popular treatments in the world since its debut in May of 2000. It easily enables patients to straighten their teeth without uncomfortable and unsightly metal. You can learn a lot about the basics of how it works throughout our website, but we’ve noticed most patients are really interested in how it will affect their day-to-day lives. So, today we are answering lifestyle-related questions to help you discover what you can expect during treatment.

Will Invisalign affect what and when I eat?

We joke around at Soulsmile about going on the “Invisalign diet”. In the big picture, eating whatever you want is one of the advantages of Invisalign (compared to traditional braces where food gets stuck easily), but it does take a moment to remove your aligners, eat, and then MOST patient will feel more comfortable if they do a quick brush before putting the aligners back on. Because of this process, many patients find they snack less and thus dub this reduction in food intake the “Invisalign diet”. When I personally did Invisalign, I didn’t eat less food, but I did consolidate my meals a bit more.

A couple more considerations - drinking only water when the aligners are in will keep your teeth clean and your trays nice and clear. Colored beverages can stain them a bit. I was known to occasionally drink white wine with them in, but I wouldn’t say that’s an “approved” tactic.

Will brushing my teeth be the same?

You’ll be able to brush and floss as normal, which is great! You just take your trays out. However, you’ll be adding a bit of time and effort to your routine to clean your aligners. You simply brush them with your toothbrush. My advice is to use an electric toothbrush (which you should already be using on your teeth anyway!). I once traveled with only a manual toothbrush and was shocked at how much more stained my aligners were during that time.

Invisalign also makes some cleaning crystals that you can use to soak your aligners in that work wonders!

Can I whiten my teeth while using Invisalign?

In most cases, patients will need small bumps adhered to select teeth (Invisalign calls them “attachments”) to help move the teeth. Because of this, whitening during treatment is not advised. You can definitely begin your treatment with a round of whitening and we certainly encourage a tune-up after you complete treatment and are ready to show off your beautiful new smile.

What if I have a special event? Can I leave my aligners at home?

Compliance is the number one factor in Invisalign success. It is essential that you wear your aligners for 20-22 out of 24 hours every day. That said, if you have an hour-long job interview, you’ll probably be just fine leaving them out. You can even try to keep your other eating periods shorter that day to make up for it. On the other hand, a day-long wedding may not be appropriate for skipping your aligners. Use your best judgment and wear them as much as possible. The rewards will last a lifetime!

Is Invisalign Comfortable?

Although there may be occasional discomfort due to the snug fit of starting with a new set of aligners, this usually subsides in a couple days and patients find them to be significantly more comfortable than metal braces. The new-aligner discomfort also seems to diminish a bit as treatment progresses.

What Is the Invisalign Treatment Process Like?

• First, a free consultation with Dr. Kivel is scheduled to discuss treatment and ensure that you are a candidate for Invisalign.
• Once treatment has been agreed upon, the Soulsmile team will take X-rays and impressions of your teeth. These will be used to create a 3-D image to map out the exact movements your teeth.
• Next, we will make a customized series of aligner trays from virtually invisible (and BPA-free) plastic that will gradually re-align your teeth!
• You will progress through the series (or change out) about every two weeks.
• You will need to wear your aligner trays for 20 to 22 hours daily, removing them only to eat, brush or floss.
• You will visit Soulsmile about every six weeks to make sure you’re teeth are moving as planned.
• As with braces, you may need to wear retainers after your Invisalign treatment in order to keep your teeth in their new position.

Is there an age restriction for Invisalign?

We only recommend Invisalign for patients 18 and up for compliance issues. Fortunately, there is no upper-age limit! Invisalign is great for adults who previously thought they were “too old” to be wearing metal braces.

More Questions?

Hopefully, this answered questions you might have about Invisalign. If you live in Ashland, or Medford/the greater Rogue Valley, and have more questions, we would love to answer them - in person! Give us a call to schedule your free Invisalign consultation.

The Link Between Childhood Obesity and Poor Dental Health

Lots of studies in recent years have been proving the connection between dental health and overall health. But a study released at the end of last year explored the link between dental health and childhood obesity. The study researched the habits and stats among 271 Swedish children. They found that children with a higher amount of carries bacteria (which is responsible for cavities) also had significantly higher body mass index (BMI) and unhealthier eating habits. Their eating habits more frequently and consumed more foods rich in sugar. 

Because weight can be a sensitive subject, registered dietitian Louise Arvidsson advises focusing the conversation on dental health and the type of foods that can help or harm your teeth. Foods high in carbohydrates (starches and sugars) contribute considerably to the production of plaque and acids that break down tooth enamel which can eventually lead to cavities. 

Food suggestions for dental health AND overall health:

• yogurt
• leafy greens
• apples
• celery
• carrots
• almonds
• lean sources of protein such as lean beef, skinless poultry, and fish
• dry beans, peas, and other legumes
• plenty of water

Tooth decay is actually the single most common chronic childhood disease, but the good news is that we can prevent it and impact children's overall health when we educate them and teach them healthy hygiene habits. Remember to teach children to brush twice a day, floss daily and visit their dentist regularly. If you have any questions or would like to make an appointment for your own child, please contact us or give us a call at 541-482-4995.

Dental Insurance Terms Defined

We know it can be very hard to understand dental benefits. At Soulsmile, we are happy to bill insurance as a courtesy to our patients. Our team encounters dozens of different insurance providers, all with multiple plans and “levels” making it impossible to know the details of each one. We always encourage our patients to get to know their dental plan to have the best estimate of what is covered. The only problem with this is also needing to know what many of the insurance terms they throw around even mean. In this blog, we are going to help you understand some of the terms and ideas behind dental insurance so you can feel confident in understanding your benefits.

Annual Maximum

This is the grand total that your plan will pay for dental services for an individual or a family (if you’re under a family plan). Most “years” reset January 1st, but occasionally we see them reset at the enrollment date, so you’ll want to check on this for your plan.

Basic or Minor Services

This is one of a few common categories of dental services defined by insurance companies (along with Preventative and Major, each explained below). Basic services typically fillings, sealants, extractions, periodontal treatment and sometimes root canals. Usually, the same coinsurance (patient payment portion) percentage applies to all services in a group such as Basic.

Closed Network Plan

If you are enrolled in a closed network plan you must see a preselected dentist in order to receive benefits. If you go to an out-of-network office with this type of plan, you’ll need to pay for 100% of your services. More commonly, you’ll find a breakdown of coverage for both in-network and out-of-network dentists.

Coinsurance

This is your share of the cost of services, typically marked as a fixed percentage, of the contract allowance or “usual and customary” fee (see definition below). For example, a benefit paid at 80% by the plan leaves a 20% coinsurance obligation for the patient. This coinsurance applies after a required deductible is met (if necessary).

Contracted Dentist

A dentist who has a contract with your network. In this case, the dentist agrees to accept the insurance carrier’s fees as payment in full for services to plan members. Sometimes referred to as network dentist or participating dentist.

Deductible

A dollar amount that each patient enrolled in a plan (or family under a family plan) must pay before the insurance company begins paying benefits.

Diagnostic and/or Preventive Services

A category of services that usually includes exams, routine cleanings, X-rays and fluoride treatments. These fees are usually covered at 100% for in-network plans and 80% for out-of-network plans. Often times the difference for a patient to choose a dental office like Soulsmile, that might be out-of-network, for a normal exam and cleaning can be ~$20.

Effective date

The date that benefits begin for an enrolled patient. Please be sure to get this information from your insurance company if it is a new insurance plan. We often see patients’ plans with a wait period (often 6 months or 12 months after starting a new job and insurance plan). Sometimes the wait period only applies to selected categories of services.

Eligibility

Circumstances or conditions that determine who and when a patient is covered by the insurance plan. These may include the length of employment, job status, length of time an enrollee has been covered, dependency, dependents’ age.

Lifetime Maximum

The total dollar amount a plan will pay for care for the life of the enrollee or the plan. This type of limitation usually applies to a specific service such as orthodontic treatment.

Limitations and Exclusions

Dental plans often opt to not cover every dental procedure. Each carrier can provide you with a list of conditions that limit or exclude coverage under your plan. Limits are often related to frequency (for example, no more than two cleanings in a 12 month period).

Major Services

This category of services usually includes crowns, dentures, implants and oral surgery.

Out-of-Pocket Costs

Any amount the patient is responsible for, such as coinsurance, deductibles, costs above the annual maximum or cost for services not covered by the plan.

Pre-Treatment Estimate

Pre-treatment estimates are a written estimate of benefits provided by an insurance company in advance of proposed treatment. These are a very reliable way of finding out for a patient exactly what payment they would be responsible for at the time of service. Sometimes referred to as a predetermination.

Provider

Any licensed dentist who performs dental health services for the patient. This can also include dental specialists.

Usual and Customary Fees

This refers to the dollar amount set by an insurance carrier as a reasonable cost for a service. This term only comes into play when you are seeing a dentist who is out-of-network. This may also be referred to as the “allowed amount”. Let’s say your plan has an allowed amount of $98 for a cleaning, and your dentist’s fee is $111. The plan will pay 80% of $98, not $111. The difference in price will be the patient’s responsibility.

Mt. Ashland Downhill Dummy 2018

It's no secret that the Soulsmile crew LOVES Mt. Ashland. You'll find most of us there all winter long enjoying the wonderful terrain and awesome atmosphere. If you haven't been to Mt. Ashland yet, you have to check it out! Even if you go just to get a bite or a drink in the newly renovated lodge, its worth it just for the incredible views and to experience this fantastic little slice of our Southern Oregon community. You can even time your visit with one of the many fun events, like the Downhill Dummy (see our video below), they put on throughout the season. Experience some local mountain fun!

Thanks to the Mt. Ashland team for everything you do!

The Scoop on Coffee Breath - More Than Just Coffee

Apparently, the five-year-old son of a friend recently confronted her just prior to his school-driveway departure. He said, "Don't even fink about kissing me when you drop me off at school. Your breff smells like coffee."

Unsurprisingly, caffeine is America's drug of choice. We consume a total of 700 million cups in a single day! We at Soulsmile love our coffee. There's always a fresh pot brewing in the team lounge and don't even get us started on all the awesome coffee joints in town (looking at you, Case, Noble and Mix!). Yes, it stains teeth. Yes, added sugar can contribute to cavities. But we are big believers of enjoying life's treats, especially when coupled with a proper hygiene routine. 

We do, however, care about coffee breath. Coffee breath is not simply the smell of coffe. If that were the case, "coffee breath" flavored ice cream would sound just as appealing as coffee ice cream. Any takers? Not here. Coffee breath is actually the smell of sugar-eating bacteria in your mouth laced with coffee. 

So how does your gorgeous cappuccino become a menacing platform for bacteria? It turns out the chemicals in coffee contribute to a slow down in the release of saliva. Saliva production is usually one of our mouth's best defenses, sloshing around to disrupt bacteria. With coffee, this lapse in saliva flow creates the perfect breeding ground for the more than 500 species of bacteria in your mouth. Studies have shown that showing milk in the mix can increase these effects even more.

Not pretty.

So, to keep your pearly whites smelling fresh, there are a handful of tips to offset the effects of coffee after consumption:

• Brush your teeth 
• Chew a piece of gum
• Drink water
• Eat something mouth-watering (think fruit, not bread)

Another factor to consider is your mouth's normal bacterial state. Bacteria grows exponentially. So the more bacteria that's present before coffee will contribute to more after coffee (and a worse smell). Come in for regular hygiene visits with Soulsmile, our Ashland OR dental office, and consult with our awesome team members on the best home care routines to keep your oral health in check at all times. 

Latest Dental Trend: Charcoal Toothpaste?!

You may have seen some pictures on Instagram or YouTubers posting videos of the latest, greatest dental trend - charcoal toothpaste. Move over oil-pulling ... this DIY whitening trend consists of smearing a charcoal-derived black mixture on your teeth and brushing with it. 

Proponents of the technique claim that because these mixtures are highly absorbent they can naturally solve surface stains. In fact, there are already medical applications for charcoal, like absorbing poisons in an accidental poisoning. Many "reviewers" online brush their teeth for 3-5 minutes with the mixture and then have seemingly whiter teeth afterwards. 

Currently, the American Dental Association has not evaluated or approved of charcoal toothpaste. In fact, a representative for the ADA has commented saying the trend is concerning because its abrasiveness is not yet known and could be causing damage to people's teeth. Did you know, teeth are the only part of our bodies that does not replenish or heal itself. Once they are gone or damaged, it's a done deal. Of course, we can help correct any problems, but we'd rather see them avoided in the first place. But this means your teeth are usually not where you want to do any experiments. Fun new hair color or crazy nails? Yes! They grow back. Your teeth - not so much.

Whitening your teeth can happen in two ways. One, by scrubbing surface stains. Or two, by bleaching to actually change the color of the dentin. The later method is many times more effective. Charcoal tooth paste only claims to affect surface stains anyway, so if you're looking for real results, consider a professional whitening systems. These penetrate the enamel making teeth 3-8 times shades whiter, with effects that last years. 

We've concluded that there is not enough evidence available yet to know if the supplement is hazardous, beneficial or benign. Our vote: wait until there are more studies (if that even happens before it falls out of favor). In the meantime, there are plenty of proven techniques and products for whiter teeth. Ask us at your next appointment about whitening options. We offer three levels to meet your needs and budget. As always, if you have any questions feel free to contact us or leave a comment below. 

Is Mouth Rinse a Must-Do?

Walking the aisles of an Ashland drugstore will reveal a plethora of mouthwashes and rinses. These products tout dozens of features like germ eradicating ingredients, fluoride or even teeth whitening. Many of our patients wonder about the benefits and if they should make mouthwash a part of their daily routine. 

Our short answer is that brushing and flossing are the two most critical habits that will affect your dental health. If you're doing a good job of these two, mouth wash is not a necessity. 

On the other hand, it simply doesn't hurt to add an additional aspect to your routine, like mouth wash. While it may not live up to every promise advertised, it can be beneficial. We like to advise mouth rinse after flossing to help wash away any excess particles of food which may have been dislodged during your flossing. 

One thing to keep in mind is that mouth wash will not necessarily help with bad breath. Often, bad breath is a result of dryness and the harsh alcohol content of many mouthwashes can worsen this condition. If fresh breath is one of your primary goals, we'd recommend selecting an alcohol-free variety. Plus, its easier to handle! Additionally, chronic bad breath is often a result of plaque build -up. Ask Jordon (or your own fabulous hygienist) at your next cleaning if she thinks this may be contributing to bad breath. If so, improving your brushing and flossing is much more likely to help. 

The bottom line is that you should never substitute proper flossing and brushing with mouthwash. But feel free to supplement your routine with a little rinse! If you have any specific questions, feel free to contact our Ashland dental office. If you want to make an appointment for a check up, you can call us at 541-482-4995. 

6 Surprising Habits That Can Wreck Your Teeth

We know all the list of things that can be bad for your teeth - soda, gummy candy, smoking, etc. But there are a handful of habits with the potential to wreck your chompers that may not be quite as obvious. Here's the low down ...

1. Chewing Ice

Ice can easily be thought of as harmless - its juts H20 after all. But crunching down on hard, frozen cubes can cause cracks, chips and wear on your teeth. If you chew ice regularly enough, you may even cause aches in the soft gum tissues around your teeth. Often times a habitual ice-chewer gets "shorter" tooth appearance from all the wear. Dr. Kivel can fix this cosmetic issue but will only do so after the patient has curbed their ice habit!

2. Playing Sports (Without Proper Protection)

We love sports! All of us here at Soulsmile not only grew up playing many sports, but still take part in a myriad of outdoor sports including biking (motorized and non-motorized, running, surfing, kayaking - you name it! But we are also huge proponents of mouth protection! Mouth guards are a piece of molded plastic that protects your teeth. Without it, contact sports can easily result in chips or even a full tooth knock-out. We can make these for you or your whole team. Just contact us to schedule an appointment. 

3. Bottles Past Bedtime

Just like adults, a baby's teeth should be cleaned before bed. Putting a baby to sleep with a bottle of milk, formula or juice can put new teeth in harm's way. This can basically bathe the baby's teeth in sugars overnight. Its best to keep them out of the crib and establish a good hygiene routine. 

4. Tongue Piercings

Dentists have long lamented tongue piercings. Accidentally bumping a metal stud along teeth for years can definitely pose a risk to your teeth. In a study published by the Journal of Periodontology, "nearly half of the participants who wore either long or short barbells for four or more years had chipped teeth." The study also found receding gums in up to 50% of participants who had worn long-stemmed barbells for two or more years. Furthermore, the mouth is a haven for bacteria, making tongue piercings a likely candidate for infection and sores. Bottom line - research the health risks before you decide on a tongue piercing. 

5. Grinding

Bruxism (the fancy name for teeth grinding) wears teeth down over time. It is most often caused by stress and sleeping habits, making it a hard habit to control. We just wrote a whole blog on teeth grinding if you want to find out more about diagnosing an treating this condition. 

6. Cough Drops

We'd like to think that anything you find in the medicine aisle is healthy, but that's just not the case. Most cough drops are packed with sugar. We still love them, but recommend that after you sooth a sore throat with a lozenge, break out the toothbrush. Think of them like hard candy! 

Have any questions for us about habits that you suspect may be compromising your oral health? Feel free to write them in the comments section below or feel free to make an appointment with our Ashland, OR dental team here at Soulsmile. We'd love to have you in as a new patient! 

Teeth Grinding and Nightguards

Do you ever wake up in the morning with headaches or soreness in your jaw? Have you or your dentist ever noticed chips or small cracks in your teeth? If so, you may be grinding your teeth while you sleep. Don't worry - you're not alone. Its estimated that about 30 million people in the US do the same. 

This condition, known in dental as bruxism, is not life-threatening, but it can definitely cause damage to your teeth. It is probably also disrupting your sleeping habits. In this blog we'll discuss the causes, symptoms and solutions for bruxism and how the latest dental products can help you. 

Diagnosing Bruxism

Bruxism is not typically hard to spot. Most people suspect they grind their teeth. They usually either looked up their symptoms online or have been told by friends or family that they're grinding. 

During a dental exam, we can usually tell a patient has been grinding. We look for chips and damage to the tooth enamel as well as smoothly worn surfaces. We will also ask questions about jaw pain and/or headaches. One of the most significant concerns related to bruxism is that it often is an indicator of a sleep apnea - a very serious condition. 

Identifying Signs of Bruxing and Clentching

Treatment with Nightguards

The most common way to treat bruxism is with a nightguard. In fact, up to 70% of our regular patients use a nightguard. It's one of the easiest methods of prevention! This appliance is worn in the mouth during sleeping hours to prevent grinding. Nightguards are similar to athletic guards, but thicker and more rigid. These custom appliances are made with acrylic using a professional impression, ensuring a perfect fit. 

Another advantage of a custom-made night guard is the material. Acrylic is hard (opposed to store-bought "boil and bite" type of nightguards that are soft) and discourages further biting, clenching and grinding. These are the behaviors we're trying to eliminate! An over-the-counter biteguard isn’t made specifically for you, it’s meant to fit a wide variety of jaw and mouth sizes. Unfortunately, it will never fit perfectly. 

Ask Us About It!

If you suspect that you’re grinding, ask your regular dentist for help. He or she can confirm a diagnosis and work with you to develop a treatment plan. If you're in the Ashland or Rogue Valley area, contact us at Soulsmile. You can call us at 541-482-4995 to schedule an appointment. We'd love to help you sleep better. 

Recommended Dental Home Care Products

On a daily basis we are making recommendations to patients regarding products to improve their oral health care routine at home. We decided to consolidate our list for patients' easy access. Have any additional questions? Drop us a line!

Toothpaste

Winner: Tom's of Maine
Amazon Link: With Fluoride or Without Fluoride  or Children's

We like the fluoride version to help prevent cavities, but they offer non-flouridated version too. In general, our hygienist, Jordon, recommends looking for the ADA seal when deciding on a toothpaste. She says, "It means the product is scientifically supported. It has met the safety criteria and is proven to be effective." 

Toothbrush

Winner: Phillips Sonicare (Any model! You don't necessarily need all the bells and whistles)
Amazon Link

We love Sonicare toothbrushes! We don't even go on vacation without them. They are great for getting below the gum line which lowers plaque levels. They are also great for people with a loss of dexterity due to age or health conditions, as the toothbrush does most of the work for you through its unique sonic technology.

Go with a soft bristle head. Contrary to popular belief, hard bristles are not more effective and can cause damage to gums.  Remember to replace your toothbrush (or toothbrush head if using Sonicare) every 3 months or sooner if bristles look worn. 

Electric Dental Flosser

Winner: Sonicare AirFloss
Amazon Link

This product is great for flushing out debris. It is a fantastic options for patients with deep periodontal pockets (periodontal disease), complex restorative work, food traps or braces. Just remember that it is not meant to take the place of regular flossing. Another popular option is the brand Waterpik - we like these too, we just happen to prefer AirFloss. 

Mouthwash + Rinse

Winner: Listerine Total Care Zero Alcohol
Amazon Link 

Adding a mouth rinse to your hygiene routine is a great idea. We suggest rinsing after you floss to help remove any debris that was dislodged. Our favorite is the Listerine Total Care Zero Alcohol. It contains fluoride to help fight cavities and getting one that does not contain alcohol takes the harsh alcohol "sting" out of the process which can dissuade a lot of patients from using it regularly. 

Floss

Winner: POH No Wax Floss (great reviews online)
Amazon Link

The bottom line with floss is that any type of floss is better than none! Our recommendations are light in this category as it is mostly up to personal preference. Some tips from Jordon:

• If reaching the back teeth is difficult, try floss with a handle
• If shredding around crowns or fillings, try Glide floss
• Superfloss is great for under bridges, implants and braces
• A floss threader-aid can help get floss under bridges or braces as well. 

Interproximal Brushes

Winner: Interprox Plus
Amazon Link 

Interproximal brushes are great for larger spaces where floss is too thin. Also great for complex restorative areas. 

Periodontal Disease and Treatment

Background and Diagnosis

Periodontal disease is a bacteria-related inflammatory disease of the gums, the cementum that covers the root, the periodontal ligament and the bone around the tooth. Periodontitis can lead to pain, smell and tooth loss; in addition, it has been linked to heart disease and several other dangerous systemic conditions.

To determine if you have periodontal disease, and the extent of its progression, we begin by using a dental instrument to measure the pocket depth between your gums and your teeth. Ideally, the pocket depths around the teeth will range between 1 and 3 millimeters (mm). Gingivitis will appear as swollen gums and reveal pockets up to 4 mm.  Both can be remedied by a simple cleaning.

Periodontitis, however, will be accompanied by red, irritated, bleeding, sometimes sore gums or pus and pockets deeper than 5 mm. Xrays of periodontitis will often show hardened calculus around the teeth and may even show the bone loss itself. A more detailed cleaning is in order to address periodontitis.

A great deal more is learned about the specific causes and circumstances surrounding each patient’s condition during the treatment itself.

Treatment

To treat periodontitis, we remove the deposits of calcified plaque called calculus or tartar and any other bacterial toxins which become ingrained under the gumline and into the root surfaces. The process, known as scaling and root planing (“SRP”), utilizes ultrasonic and hand scaling instruments, ideally while the patient is under local anesthesia. Just a few areas are focused on at a time until a “deep” cleaning is achieved.  

In addition, the placement of a medicine called Arestin into pockets 5mm or greater is recommended. This medicine eliminates the harmful bacteria for 45 days following SRP.

Immediately following SRPs, it is recommended that patients use a Chlorhexidine Rinse, an antibacterial mouthwash that helps to control and kill the bacteria in your mouth that cause gum disease. We recommend that you rinse with chlorhexidine after brushing your teeth for one week following SRP and after future dental visits.

Existing bone loss related to periodontitis will not return with SRP.  But, SRP’s and a few changes to your routine cleaning protocol described below will help you keep your teeth for life.

After Care

Instead of a simple cleaning (“Adult Prophylaxis”), Periodontal Maintenance describes the type of routine office cleanings following SRP.  It is considered a basic service by insurance.

Periodontal Maintenance removes plaque and tartar from above and below the gumline, down the length of each tooth to where the root, gum and bone meet. Rough areas of the roots are maintained smooth, pocket depths are carefully monitored, and inflamed pockets are irrigated with antibacterial medicines if necessary.

After SRP treatment, most patients choose to have their teeth cleaned every 3 or 4 months to match the complexity of their dental condition that led to the periodontitis in the first place.  These factors include their natural plaque and tartar accumulation, bleeding, inflammation, pocket stability, the quality of their anticipated home care and their overall health risk factors.

Lastly, with a few meaningful changes to your at-home cleaning routine, periodontitis can be kept under control.  Brushing for two full minutes twice daily with an Philips Sonicare toothbrush and flossing once a day is usually adequate.  For difficult areas, christmas tree brushes (“proxy brushes”), enlarged floss (“super floss”) and Philips Airfloss are excellent aids. Consistent behavior change is the most important element in maintaining long term periodontal health.  Smoking has also been shown to contribute to periodontitis.

Related Pricing

*Dental insurance plans will often cover all or part of these costs.

More Information

Have more questions? We want you to have a complete understanding of your oral health and how to best maintain or improve it. You may want to do some research on your own.  Here are several internet search terms to help you get started:

• Periodontitis
• Gum disease
• Link of periodontitis to systemic health
• Scaling and Root Planing
• Periodontal Maintenance
• Arestin
• Chlorhexidine rinse
• Philips Sonicare
• Philips Airfloss
• Scaling and root planing and insurance
• Reasons for tooth loss
• Cause of bleeding gums
• Risk of deep periodontal pockets
• Periodontal surgery
• Options for missing teeth
• Dentures
• Implants
• Implants with periodontitis

Maximize Your Dental Benefits Before January

The end of the year is quickly approaching and with it, the end of another dental insurance benefit year. You're probably thinking more about stuffing and cranberries than dental benefits, but we'd recommend putting aside a bit of time in between your holiday plans to make sure you are maximizing benefits which will be lost as of January 1st. 

1. Don't Throw Away Money,!

Going into a new year with unused benefits is like tossing hard earned dollars you worked for all year. If you're like a majority of people, your insurance plan expires each calendar year. Unfortunately, your remaining benefits do NOT rollover - they expire! Trust us, your insurance company won't remind you of this. In fact, they bank on millions of Americans overlooking this and benefiting them instead of you. 

2. Find Out About Your Annual Maximum 

Each year, your insurance plan sets an annual maximum of dental work they will pay for. This is called the annual maximum. Each plan is different, but this amount is usually $1000-2500. You'll also want to find out how much you've already used this year (if you're a Soulsmile patient here in Ashland, call us - we can tell you!).

3. Consider Pending Treatment 

You may already have a tooth that's nagging at the back of your mind and you know needs to be fixed. Other times, patients may forget about treatment that is not a huge priority (like preventatively replacing old amalgam fillings that are prone to leaking). Give us a call or come in for an exam if you'd like to find out if you have any pending treatment we can put towards your benefits. 

If you have any questions, please call us at 541-482-4995. You can also call your insurance provider directly for more details regarding your unique plan. Our end-of-the-year schedule fills up quickly, so call us today to use up your benefits before its too late!

MI Paste™: An alternative to Flouride

Today's blog post comes from our resident hygienist, Laura Houghton, RDH:

A growing number of patients are seeking a health conscious alternative to fluoride for cavity prevention. One of the products I recommend on a daily basis is MI Paste™. This product uses calcium and phosphate to remineralize teeth. It is a water based, sugar free, and fluoride free paste. It also contains RECALDENT, which is a milk derivative that binds the calcium and phosphate to the teeth. Although standard MI Paste™ does not contain fluoride, MI Paste Plus™ does contain fluoride.

Benefits

There are many benefits to using this product, including non surgical treatment for a handful of dental symptoms. It helps alleviate dry mouth caused by many medications, and prevention of an acidic environment. Using this product during orthodontic treatment has shown to be one of the most effective ways to prevent white spot lesions around brackets, which is caused by lack of calcium. 

Patients seeking tooth whitening frequently have concerns with sensitivity after whitening. We recommend MI Paste™ application before and after whitening procedures to minimize sensitive teeth.

How To Apply

MI Paste™ is easy to use. There two methods we usually recommend,

1. If you have custom-made trays (often used for teeth whitening) you can use a small bit of the paste in them and leave undisturbed for three minutes. You would do this after brushing with your regular toothpaste.

2. Alternatively, you can simply take a small pea-sized dab of the paste on a cotton swap of finger and rub the paste all over the surfaces of your teeth. surface. Allow the paste to absorb into the surface by not touching or rinsing it for three minutes. 

If you have any questions about the product or want to know if it might be right for you, let us know. 

The Reasoning Behind Wisdom Teeth Removal

Most people's "wisdom teeth" (which we call third molars) begin to erupt around the late teens or early twenties. These will be the third and final set of molars to come in. Occasionally third molars can come in correctly aligned and offer more chewing power. In this event, you may decide to keep your wisdom teeth as long as you can maintain proper hygiene. More often, they are misaligned and can crowd other teeth. 

Why Do We Have Wisdom Teeth?

A popular theory suggests that the human diet used to consist of more rough food like leaves, meat and roots which required better chewing power. There has also been a size reduction in the human jaw and face over the past 20,000 years.

More and more people born today never develop third molars. 

Why Remove Wisdom Teeth?

While not every patient needs to have their wisdom teeth removed, the common situations will likely warrant their removal. 

1. Impacted Wisdom Teeth

When a third molar is "impacted" it means that gum tissue is completely covering the tooth and preventing it from erupting successfully through the gum. This is usually the result of a mouth that is too small to allow the room the teeth need. At times, this leads to bacteria or food getting lodged under the gums covering the wisdom tooth and can create an abscess. 

2. Partially Impacted Wisdom Teeth

Partial impaction means the tooth is only partially emerged from the gums. In this case, we almost always advise removing the tooth. Again, bacteria can be lodged underneath and because of the location in the very back of the mouth, a wisdom tooth is more susceptible to cavities and decay. 

3. Additional Reasons for Wisdom Tooth Removal

The following dental issues may also increase the likelihood that we recommend removal for your third molars.  

• Pain at or surrounding the third molar(s)
• Pain or swelling in the jaw or cheek area
• Infections of the soft tissues
• Gum disease
• Tooth decay
• Tumors or Cysts

If you are considering having your third molars removed, we are happy to consult with you on the topic. Dr. Kivel can address the health of your wisdom teeth, whether they have erupted and your overall oral health to determine the best next steps. Contact our Ashland, OR dental office to schedule an appointment with our friendly team. 

Pregnancy and Your Oral Health

Congratulations! If you’re reading this, it's likely that you or someone close to you is pregnant. Your body goes through many changes during pregnancy, including changes related to your oral health. These are primarily due to a surge in hormones like estrogen and progesterone. These same hormones which are integral to your growing baby can exaggerate the way your gums react to plaque. 

If plaque is not properly removed, it can cause gingivitis - marked by swollen, red gums which are more likely to bleed. You may notice an increase of bleeding from brushing or flossing. There’s a condition referred to as “pregnancy gingivitis” which affects most pregnant women and can begin as early as the second month. If you have gingivitis prior to becoming pregnant, your condition is likely to worsen. If left untreated, this can lead to periodontitis, a more serious form of gum disease and, because it is incurable, it will continue to affect you long after pregnancy. 

Occasionally, women also develop inflammatory, non-cancerous growths when their gums become irritated while pregnant. These growths, called “pregnancy tumors”, are usually harmless and can be left alone. They will generally reduce in size, until they disappear completely, after birth. If you have a tumor that is uncomfortable or interferes with your hygiene routine or chewing, let us know. Dr. Kivel may decide to remove it.  

Preventing Problems

Of course, we recommend excellent oral hygiene at all stages of life. But we understand that pregnancy creates additional risks and additional motivation for staying healthy. During this time, you’ll want to keep your teeth very clean, especially near the gumline. Brush at least twice a day, and after every meal if possible. For some women, brushing can contribute to feelings of morning sickness. If this happens to you, rinse your mouth with water or with anti-plaque mouthwashes and brush when you can. Floss thoroughly each day. 

Feel free to book more frequent than normal cleanings with Soulsmile at this time to supplement your own efforts. 

“Can gingivitis affect my baby?”

Unfortunately, there is research that suggests a link between gum disease and preterm, low-birthweight babies. In recent years we’ve come to realize that bacteria can enter the bloodstream through your gums and is linked to many serious issues, including heart disease. So it is not surprising to find that this can affect your pregnancy as well. The current theory proposes that when the bacteria travels to the uterus it triggers the production of prostaglandins, which are suspected to contribute to premature labor. The best prevention for this is excellent hygiene! 

“When should I visit Soulsmile?”

If you are pregnant or suspect you are, we’d encourage a visit right away! A checkup in your first trimester allows Dr. Kivel to assess your oral health and map out a dental plan for the rest of your pregnancy. A second trimester cleaning will let us monitor any changes and make sure the gums are being properly cleaned. 

“Are there dental procedures I should avoid?”

Routine care can generally be performed throughout pregnancy, but the best time for treatment is the fourth through sixth month. Your obstetrician may be consulted for dental emergencies that require anesthesia or if medication needs to be prescribed. Elective procedures should generally be delayed until after birth. 

Congratulations again! Please contact us if you’d like to schedule a visit or if you have any questions about related to your own pregnancy.