Archives for August 2019

Due to the hard work that the masseter muscles have to perform while clenching they undergo, Hypertrophy, which may lead to the appearance of a severe square jaw.

The teeth can be protected overnight with the use of an occlusal splint or a night guard. But botulinum toxin, or more commonly known as botox, can effectively control the uncomfortable symptoms instead of an occlusal splint for some patients.  Dr. Kaufman provides a treatment with Botulinum Toxin Type A., to relieve the symptoms of jaw soreness, headaches, and other unpleasant problems associated with Bruxism. Botulinum toxin treatments for Bruxism can also soften the appearance of the jaw line. The effects of Botulinum toxin used for treating Bruxism typically lasts for three to four months.

Don’t  continue to suffer from sore head, jaw and neck muscles or wait for the teeth to chip and break please make an appointment to see Dr. Kaufmam to have the condition assessed.

Anterior crossbite is relatively a common presentation in the mixed dentition stage. It happens when the upper incisors develop behind the lower incisors. When the child is young, it is relatively easy to guide the erupting teeth to their correct position with a simple appliance. As shown in a completed treatment by Dr. Kaufman.

Don’t wait for the malformations to be more entrenched and difficult to treat. If you feel that your child’s teeth are starting to erupt in the wrong way or there are any missing teeth, please make an appointment to see Dr. Kaufman to have them checked.

Pregnancy can lead to dental problems, including gum disease and increased risk of tooth decay. Research has found a link between gum disease in pregnant women and premature birth with low birth weight. Common issues affecting dental health during pregnancy include:

• Gum problems
• Gingivitis (gum inflammation) – this is more likely to occur during the second trimester. Symptoms include swelling of the gums and bleeding, particularly during brushing and flossing between teeth
• Gum overgrowth also known as pregnancy epulis, which may or may not resolve after the birth of the baby
• Vomiting
• Cravings for sugary foods
• Retching while brushing teeth
• Mobile teeth which usually firm up after the birth of the baby

During pregnancy, the gum problems that occur are not due to increased plaque, but an increased response to plaque as a result of increased hormone levels. However, with proper hygiene at home and professional help from a dentist, good oral health can be maintained during pregnancy.

Pre-pregnancy and dental health

Women are less likely to have dental problems during pregnancy if they already have good oral hygiene habits. Steps for good oral hygiene include:

• Brushing teeth at least twice daily with fluoridated toothpaste
• Flossing between teeth
• Following a healthy diet
• Visiting the dentist regularly

It is important for women planning to become pregnant to visit the dentist and have a check-up. It is more convenient to have elective procedures done before conception.

Dental health during pregnancy

Women should not avoid the dentist during pregnancy. Routine dental treatment is safe during pregnancy. Women should advise their dentist if they are pregnant when scheduling their dental appointment.

Common dental health issues during pregnancy

Vomiting

Pregnancy hormones soften the ring of muscle that keeps food inside the stomach. Gastric reflux (regurgitating food or drink) or the vomiting associated with morning sickness can coat your teeth with strong stomach acids. Repeated reflux and vomiting can damage tooth enamel and increase the risk of decay. Suggestions for pregnant women experiencing vomiting include:

• Don’t brush your teeth immediately after vomiting. While the teeth are covered in stomach acids, the vigorous action of the toothbrush may scratch the tooth enamel. Wait at least an hour after vomiting before brushing teeth
• Rinse your mouth with water (preferably fluoridated tap water) after vomiting, which will assist in removing acids
• Follow up with a fluoridated mouthwash
• A dab of fluoridated toothpaste smeared over the teeth can replace a fluoridated mouth rinse. Rinse thoroughly with water
• A dentist can provide further information and individualised advice.

Retching while brushing teeth

Some pregnant women find that brushing their teeth, particularly molars, provokes retching. Suggestions for pregnant women experiencing retching include:

• Use a brush with a small head, such as a brush made for toddlers
• Take your time. Slow down your brushing action
• It may help to close the eyes and concentrate on breathing
• Try other distractions, such as listening to music
• Alternatively, brush teeth with water and follow up with a fluoridated mouthwash. Go back to brushing with fluoridated toothpaste as soon as possible

Food cravings

Some women experience unusual food cravings (and food avoidance) while they are pregnant. A regular desire for sugary snacks may increase the risk of tooth decay. Pregnant women should snack on low-sugar foods instead. Suggestions for pregnant women experiencing sweet food cravings include:

• Try to choose healthier sweet options such as fresh fruits
• Rinse your mouth with water or milk or brush your teeth after eating sugary snacks. This will help to remove decay causing sugars from your teeth

Dental health after pregnancy

If gum problems occur during pregnancy, it is important for women to have their gums checked by a dentist after they have given birth. While most types of gum problems caused by pregnancy hormones resolve after birth, a small number of women may have developed a deeper level of gum disease that will need treatment to resolve. Women should practice good oral hygiene after their baby is born. Whilst with a newborn, it can be difficult to find time alone, mothers should ensure they:

• Brush teeth twice a day with fluoridated toothpaste
• Clean between teeth daily with floss or interdental brushes
• Drink fluoridated tap water
• Limit intake of high sugar foods
• Have regular dental check ups

*By Kate Jameson, Policy and Research Officer, Australian Dental Association.

Based on extensive epidemiological and laboratory studies demonstrating the benefits of breastfeeding, the World Health Organisation (WHO) recommends exclusive breastfeeding for infants in the first six months of life. In addition, the guidelines recommend that breastfeeding should continue until two years and beyond supplemented with nutritionally adequate and safe complementary foods to meet evolving nutritional requirements. Importantly, current guidelines do not recommend a time to cease breastfeeding or provide any information about patterns of feeding or discuss the association between infant feeding and dental caries.

Breastfeeding has been shown to reduce the incidence and/or severity of infectious diseases and improve a range of other health outcomes, with benefits even extending into adulthood. Lower rates of otitis media (middle ear infections) and sudden infant death syndrome have been reported in children who are breastfed. Research from the United States reveals that post neonatal mortality is 21% lower among breastfed infants. A range of benefits have also been described for mothers who breastfeed. Finally, improved maternal and child health outcomes lead to a range of benefits for families and the wider community, such as reduced healthcare costs.

Early childhood caries (ECC) is the presence of one or more decayed, missing or filled tooth surfaces in a child under the age of six. It is associated with increased caries risk in the permanent dentition, increased number of hospitalisations and emergency visits, increased treatment costs, delayed growth and development, loss of school days, diminished ability to learn and reduced oral health related quality of life. ECC is a significant problem affecting Australian children, with severity increasing as socioeconomic statuses decreases. The role of infant feeding practices, including breastfeeding, bottle feeding and the use of infant formula in ECC is not fully understood but needs to be considered carefully when providing dietary advice to patients.

There is limited evidence for an association between dental caries and breastfeeding, mostly due to poor study design. However, there is moderate to weak evidence that prolonged, nocturnal and on-demand feeding is associated with ECC. In a recent Japanese study, the prevalence of ECC was significantly higher amongst children who were breastfed beyond 18 months of age, compared to those who stopped breastfeeding at six months. The authors suggest that a decline in maternal protective elements such as immunoglobulins and minerals such as calcium and phosphate in breast milk with prolonged breastfeeding may reduce its benefits and therefore increase potential for dental caries. In discussions with parents, clinicians should bear in mind the clear benefits of breastfeeding and the multi-factorial nature of dental caries. As such, recommendations against on-demand feeding after eruption of the first primary tooth should be complemented with broader dietary advice regarding reducing other sources of sugar-containing foods and drinks and appropriate oral hygiene practices.

There is evidence that prolonged bottle feeding with bovine milk and added sucrose results in pooling of milk on the tooth surface, which can lead to early establishment of Streptococcus mutans in the oral cavity. There is debate as to whether there is a clear link between prolonged bottle feeding and early childhood caries. However, what is clear is that feeding at night is a major risk factor. Parents should be counselled regarding the risks of nocturnal feeding, and bottles during the night (apart from those containing plain water) should be discouraged. It has been established that parents need significant amounts of support to change behaviours; they may need to be referred to an appropriate service to help with bedtime routines and to be provided with strategies other than nocturnal feeding to help placate their child.

Numerous in vivo and in vitro studies have demonstrated the ability of both bovine milk and soy-based infant formula to cause a significant decrease in pH and demineralisation of primary teeth, an effect that is further exacerbated with the addition of sucrose or fermentable carbohydrate. Infant formula has been reported to be more cariogenic than bovine and breast milk. Given the cariogenicity of infant formula, clinicians should recommend against night time and frequent feeding of infant formula, particularly in a nursing bottle. In the past, the use of infant formula has also been linked to increased fluorosis amongst young children, in both fluoridated and non-fluoridated communities. However reduction in the level of fluoride in formula powders by manufacturers in the early 1990s has allayed concerns regarding fluorosis. Recent evidence indicated that there is no difference in fluorosis among formula users in a fluoridated community but that the use of non-fluoridated water in mixing infant formula may be associated with increased caries risk. The National Health and Medical Research Council (NHMRC) recommends the use of cooled, boiled tap water to prepare infant formula.

When approaching discussions regarding possible dental implications of feeding practices it must be remembered the ways that parents choose to feed their infants can be a very personal choice. Families may have complex social and emotional reasons for the feeding practices they utilise in their home. While as oral health professionals we can counsel families regarding the implications of certain feeding practices, we must remember that decisions come down to the parents and families involved.

*By K Bach and MJ Silva

Paediatric Dentistry Program

Melbourne Dental School

University of Melbourne

On behalf of the Oral Health Committee, Australian Dental Association.

Charcoal has a long history of use, with its use intra-orally stemming from the capacity of roughly ground charcoal to abrade away stains and deposits on teeth and absorb noxious substances. These days, you will find charcoal in dental products, beauty products and even foods, such as bread and smoothies.

Information about charcoal dentifrices has been published in the British Dental Journal (BDJ) May 2019* paper which reviews the literature available, concluding that there is a lack of scientific data to support the use of these pastes and powders.

In summary, it concludes that:

• Most charcoal toothpastes do not contain fluoride and of the ones that do, consumers may still remain at increased risk of caries due to the absorptive capacity of activated charcoal; it has the capacity to remove fluoride and other active ions from toothpaste.
• Many of the charcoal-based dentifrices make claims of low abrasiveness; however, to date, these claims have not been independently verified. Particle size can influence the abrasiveness of the dentifrice.
• ‘Possible health risks exist’ considered to be related to the possible inclusion of human carcinogenic polyaromatic hydrocarbons in charcoal and the use of bentonite clay in some charcoal-based dentifrices. Bentonite clay is added due to its suggested ability to aid the binding properties of charcoal, ‘holding’ plaque, bacteria and stained material in the pores of the charcoal (and clay) which is brushed away leaving the surface of the tooth free of any deposits.
• Possible accumulation of charcoal particles in the periodontal pockets of patients with established periodontal disease can occur. This could result in grey/black discoloration of the tissues.
• Staining of the cavosurface margins and surface defects of composite restorations can occur. This can compromise aesthetics, particularly with anterior veneers or crowns with less than perfect supragingival margins.

The paper notes that there is a difference between whitening and bleaching teeth, and as with many over-the-counter-whitening products, these pastes and powders do not intrinsically affect tooth color but simply act by removing surface stain. It was reported that insufficient evidence was found to support claims of tooth whitening, let alone a bleaching effect.

In comparison to conventional oral hygiene product marketing, many charcoal dentifrices use marketing strategies that are attractive to consumers, by making use of wholesome words such as ‘natural’, ‘eco-friendly’, ‘organic’ and ‘herbal’. These terms were used in 88% of dentifrices examined, while 54% used at least two of these consumer-attracting terms.

With Australia’s Oral Health Tracker reporting only half of Australian adults (18+ years) brush their teeth twice per day, the marketing of charcoal dentifrices, which has led to an increase in people brushing their teeth once, if not twice per day, notes that the BDJ paper, be considered a positive.

It is hoped that through education, patients who choose to use non-fluoridated dentifrices transition to use evidence-based products containing fluoride.

*Based on the article by Mikaela Chinotti, ADA Oral Health Promoter, published at the ADA News Bulletin, August 2019.

Mouth cancer, also known as oral cancer is used to describe a lesions that start in the mouth lesions. These most commonly occur on the lips, tongue and floor of the mouth but can also start in the cheeks, gums, roof of the mouth, tonsils and salivary glands.

What to look for?

• a swelling or a sore on your lip that won’t heel for more than 2 weeks
• lump in your neck
• difficult or painful swallowing
• bleeding or numbness in the mouth
• white or red patches on the mouth, tongue or gums
• unexplained weight loss.
• Loose teeth

Common reasons for mouth cancer.

In the past the common reason for oral cancer was smoking and consumption of acohol. Since today less people smoke it became apparent that there are other risk factors for most mouth cancers:

• Human Papillomavirus (HPV)
• Epstein-Barr virus (EBV)
• family history of mouth cancers
• poor oral hygiene and gum disease

This Saturday the 10th of August 2019 between the hours of 12pm and 3 pm Dr. Kaufman will be providing free oral cancer examinations at the Amcal+ Pharmacy Tooronga. Please come and have your mouth checked.

Plaque forms every day in our mouths from the food left there after eating. The bacteria in it produce acid, which can erode tooth enamel and cause tooth decay or infect the gums and cause gum disease.

Twice daily plaque removal with brushing and interdental cleaning keeps bacteria growth under control, so a quick swish of your toothbrush across your teeth won’t be enough. The soft, sticky consistency of plaque enables it to hide in hard to reach places below the gum line, irregular biting surfaces, or under overhanging restorations.

Because plaque has a color similar to your teeth, it’s hard to tell if you’ve successfully removed it. That’s where disclosing agents can help. These are solutions, swabs or tablets, with a dye that temporarily stains plaque while not staining tooth surfaces. Dr Kaufman uses them to show patients where they’re missing, when brushing and flossing, but you can also use them at home to see how you’re doing.

To find out if there is plaque after brushing and flossing, chew the disclosing tableting for example or swish the solution around your mouth for about thirty seconds and then spit it out. The dye will stain the plaque in a bright red color. There are even disclosing solutions that can display older plaque in a different color from newer plaque.

Once noticing the stained plaque in a mirror, brush and floss until you don’t see it anymore. The red stainig dye is safe in the mouth, but you should avoid swallowing or getting it on your clothes. Any dye on your lips, gums or tongue will eventually wear off in a few hours.

If you would like more information on how to perform effective oral hygiene, please ask Dr. Kaufman or schedule an appointment for a consultation.

But lets look at the facts, activated charcoal  is a fine grain powder made from wood, coconut shells, and other natural substances that are oxidized under extreme heat. Its main property is being extremely abrasive.

A review in the British Dental Journal from early 2019 found that charcoal provides little protection against tooth decay, and there is limited scientific evidence to support the other health claims. In fact, adding powdered charcoal to toothpaste can actually make things worse, by stripping the enamel layer which is the part of the tooth making its color more light. So if you’re using a charcoal-infused paste, you should be brushing very gently to avoid wearing down the surface enamel, which can make teeth more prone to staining in the long run.

In addition in an article in the BBC it was reported that charcoal tooth paste” When used too often in people with fillings, it can get into them and become difficult to get out,” making the fillings go dark.  “Charcoal particles can also get caught up in the gums and irritate them.” In addition it is important to point out that many charcoal-infused and natural toothpastes are formulated without fluoride, which is strongly recommended for preventing tooth decay.

In summary :

• Charcoal toothpaste is too abrasive for everyday use.
• Most charcoal toothpaste brands don’t contain fluoride.
• It may cause staining on some teeth.
• Charcoal’s effect on dental restorations can be detrimental.

If you would like to know more about whitening your teeth or whitening tooth paste, please make an make an appointment with Dr. Kaufman to learn about the best options for you!