Saturday, December 21, 2013

Benefits of chewing gum on teeth

In season with the approaching holidays, I would like to elaborate a little more on the oral benefits of chewing sugar-free gum.  Sugar-free gum can actually play a helpful in one's proper oral care routine.

Tooth decay is a prevalent and leading chronic disease among children, and among adults in certain geographic and socioeconomic areas.  Hence its importance that dentists and dental hygienists realize the impact of teeth decay, and how to promote oral health education and how to help protect one's teeth from dental caries.

Family Bellevue Dentist Sugar Free Gum
Orbit Sugar Free Gum
One such method to lessen the risk of tooth decay is by chewing sugar-free gum.  In chewing the gum, it promotes and stimulates salivary flow (ie. increased saliva production from the Submandibular gland and the Parotid gland).  Saliva production is increased up to ten times the normal rate; this helps protect teeth by washing food debris away from the teeth, and also neutralize the acids found in food/drinks by raising the pH levels.   Saliva also protects the mucosal lines of the oral cavity by promoting sufficient hydration and thus helps prevent desiccation (drying).

A good time to chew sugar free gum are between the times one brushes during their teeth in the morning and at night. This could be as much as a 12-15 hour gap where one's teeth is more susceptible to tooth decay.

Examples of sugar free gum include Orbit and Trident.

If you have any questions on the role of sugar free gum in one's diet, be sure to consult with your Bellevue family dentist or hygienist.  Happy holidays!

Warm Regards,
Dr. Peter Chien
(425) 614-1600

Friday, December 13, 2013

Holiday Foods and Treats, dental eats?

Holiday treats, oral health, from Bellevue Family Dentist
Holiday Treats and Oral Health, a Dentist perspective

Now that the holidays are upon us, there are likely plenty of foods and drinks that tempt our appetite.
Have you wondered which how these tasty treats affect our oral health?

Let's take a look at a few foods and drinks, and how they affect your teeth and gums:

The good ones:
Sparkling Water - Water is great for your body and teeth and gums alike. It hydrates your body and teeth alike, and also helps wash away plaque and bacteria away from your teeth.  As long as the sparkling water does not contain sugar (if it contains flavors, that's okay), Dr. Chien and your dental hygienist at Bellevue Family Dentistry in Bellevue, WA recommends you drink away!
Chewing Gum (sugar free) - Chewing gum promotes salivary flow, which helps remove bacteria and plaque off the teeth's enamel.  Studies have shown that chewing gum is correlated with lower risk of dental decay and cavities.
Sugar free and pure cocoa - Coca has been to have a power positive affect one's cardiovascular health, and it has also shown be cariostatic (halts development of dental decay).  Try mixing cocoa with hot water and a splash of sweet and low for a delicious sugar free drink that is good for your teeth!

The not so good:
Milk - Though milk is good for the development of strong teeth and bones due to its high calcium and Vitamin D content, milk contains lactose, a type of sugar.  Infants and toddlers should be kept from drinking milk at night during bed time to prevent baby bottle decay.  Otherwise drink milk during the day and be sure to brush your teeth immediately afterwards.
Candy cane - This popular candy is made 100% from sugar and sugar products. It really adheres to the teeth's enamel and promotes plaque buildup, gum disease, and tooth decay.
Cookies and cake - Often loaded with sugars and unhealthy fats, it can be unhealthy for the body and teeth, increasing the risk of cavities.  Try to find sugar free and low fat cookies and cake when possible.
Coffee - People sometimes have a tendency to load their coffee with sugars and high fat milk sweeteners.  Plus coffee can promote extrinsic tooth stains that may be difficult to remove, even during a dental cleaning.
Regardless of times though, be sure to always brush and floss your teeth daily to help prevent cavities and gum disease.

If you have any questions about how some of the above foods and drinks can affect your teeth during these holiday times, your family dentist in Bellevue is here to address your concerns. 

Warm Regards,
Dr. Peter Chien
(425) 614-1600

Saturday, December 7, 2013

Dental handpieces

Dentist Bellevue dental handpiece
You may be wondering what type of equipment your dentist uses when he/she works on your tooth.  The "drill" is actually called a hand piece, and there are two types of "drills" or dental handpieces your dentist typically uses, the high speed and the low speed.

The high speed handpiece is controlled by a sensitive amount of air pressure placed on the foot control.  The maximum speed of the high speed handpiece is 350,000 rpm and requires 32 psi of air.

The high speed is typically used for:
  •  Initial cavity removal and preparation
  •  Preparation of a tooth for a crown.  
  •  It also used sometimes during a surgical preparation for a tooth during a surgical extraction.
The low speed handpiece is used for other operations, and has a speed range of 0 to 8,000 rpm and requires 40 pis of air.  The actual speed is also controlled by pressure on the foot control.  Unlike the high speed, the low speed handpiece can change direction of rotation (forward and reverse).  Such uses of the low speed include:
  • Cavity refinement/removal
  • Removal of decay
  • Finishing and polishing of an amalgam and resin restoration
  • Drilling pins and posts to assist in retention of a large filling
  • Prophylaxis (dental cleaning)
  • Laboratory grinding, finishing, and polishing
If you have any questions on the dental handpiece, be sure to ask your family or cosmetic dentist.

From your dentist in Bellevue,
Dr. Peter Chien
(425) 614-1600

Thursday, November 28, 2013

Dental crowns, what makes it stay on?

Bellevue Dentist Porcelain Crowns
Dental Porcelain Crowns

Dental crowns (ie. gold, porcelain fused to metal, and all porcelain) are used to reinforce a tooth's structural integrity and to allow normal functional occlusion.

But what makes the crown stay on the tooth?  A crown's retention is dependent on the following factors:

1) Taper.  The prepared tooth should ideally have 3 to 5 degrees of taper to allow for the restoration to be properly placed on the tooth. There should be no undercuts, as the restoration will not be able to be removed from the die and from the prepared tooth.  Conversely excess taper will limit the grip that the crown has on the prep, thus contributing to debonding of the restoration. Generally 6° of taper around the entire circumference of the prepared tooth, giving a combined taper of 12° at any given axial section through the prep is appropriate to both allow the crown for a proper fit and to allow enough retention.

2) Prep length.  The prepared tooth should also ideally have a minimum occlusal-gingival height of 4mm for molars and 3mm for anterior and premolars.  When such prep height is not possible, sometimes a core buildup is necessary to allow sufficient height and crown retention.

3) Adhesion.  There are two fundamental types of dental cements available, resin-based and acid-base cements.  Such cements allow the crown to adhere to the tooth by forming a chemical bond with the dentin and enamel.  The cement also forms an insulating and protective layer around the pulp.

If you have additional questions on the process of making sure a crown has sufficient retention, be sure to ask your family dentist.

From your family dentist in Bellevue,
Dr. Peter Chien

Wednesday, November 20, 2013

Floss, floss, floss :)

Bellevue Family Dentist Dental Floss
Dental Floss

It's mid November and patients are coming to the dental office to utilize their insurance benefits (a good thing!).  One trend I've been noticing is the hygienist talk to patients about flossing.  So I thought we can go through some benefits and pointers on why the dentist, hygienist, and American Dental Assocation favor the floss so much:

1) Dental floss is a composed of thin filaments; it can be made of plastic or silk, and is sometimes flavored.  Flossing removes food, bacteria, and plaque between the teeth.  It really is the best method to clean between the teeth, and around and underneath the gums.  Left alone, the bacteria can cause interproximal cavities (tooth decay).

The bacteria trapped between the teeth can then seep down into the gums, causing periodontal disease (gum and bone disease), gingival bleeding, and bone loss.

2) Flossing also helps clear out bad breath (halitosis).  The bacteria and food trapped between the teeth and left on the gums/gingiva can cause bacteria to grow within the warm and moist oral cavity, a favorable environment for bacteria.

3) Dental floss supplements tooth brushing.  Though tooth brushing is sufficient at removing bacteria and food debris/plaque, the toothbrush's bristles unfortunately cannot get between the teeth.  Some floss are waxed to facilitate movement between teeth.

4) Kids and adults of all ages should floss.  Ideally one should strive for daily flossing for optimal oral hygiene.  If not, a few times per week is better than no floss at all :)

If you have any questions regarding flossing, be sure to ask you family dentist and/or dental hygienist.  Remember to floss (and brush) lots!

From your family Bellevue dentist,
Dr. Peter Chien
(425) 614-1600

Monday, November 11, 2013

Busy lifestyle dental tips...

Bellevue Family Dentistry Healthy Tooth Tips

School is in full force and working parents are busy, constantly on the go.  It can be easy to forget about one's oral health.

Below are some ways to keep one's teeth healthy and in tip-top shape:

1) Brush twice a day with fluoridated toothpaste to strengthen your teeth's enamel.
2) Floss at least once a day to help remove bacteria and food trapped between the teeth (ie. the interproximal surfaces).  This will also help reduce your gums from bleeding, and help control gingivitis.
3) Eat healthy foods (ie. fresh meats, vegetables, milk) to promote good oral and systemic health.
4) Mouth wash to help rinse off excessive plaque and loosen food debris from the teeth
5) Drink milk fortified with Vitamin D, preferably 2-3 servings a day.  The calcium and vitamin D will not only strengthen your body's bones, but also the bones holding your teeth as calcium also plays a role in teeth retention.  For those lactose intolerant, look for milk products that are lactose free.
6) See your dentist regularly twice a year for checkups and cleanings.
7) Limit sugar frequency; it's okay to eat sugar, just make sure the sugar intake is in controlled quantities and that one brushes his/her teeth after sugar consumption to decrease caries/teeth cavities risk.
8) For those who travel, considering having a travel sized pouch with toothbrush, toothpaste, and floss.

From your family Bellevue dentist,
Dr. Peter Chien
(425) 614-1600

Thursday, October 31, 2013

Happy October 31st! Healthy benefits of sweets, and teeth!

Bellevue dentist Dr. Chien

October 31st is finally here!  Many kids and families celebrate harvest on this day, and it usually involves lots of sweets and sugars!  Believe it or not, your family dentist may actually be in favor of kids and adults eating sweets.  Below are some guidelines to follow from a dental perspective:

  • If possible, avoid hard whole sugar candies.  People usually like to leave these candies long term in the mouth, as the sugars from these candies can promote caries and cavities.  The bacteria in the oral cavity metabolize the sugars, resulting in a release of lactic acid that can cause dental decay.  A good alternative is to look for sugar free hard candies if possible.
  • Chocolate is good for you! JAMA and ADA studies have shown that cocoa has excellent health benefits for the cardiovascular system, and for your teeth and oral health.  Chocolate, which is derived from cocoa beans, contain antioxidants polyphenols, flavonoids, and tannins.  Polyphenols actually inhibit bacteria effects, which can decrease bad breath and lower risk of tooth decay.  Flavonoids have been shown to decrease rate of tooth decay.  And tannins have been shown to prevent bacteria from adhering onto teeth.  Dark chocolate is best, and try to choose chocolate that is at least 70% cocoa for optimal health and dental benefits.  
  • Chewing gum can help lower risk of cavities by promoting salivary flow.  With a healthy and excess flow of saliva, it helps "wash" teeth of plaque and sugars.   Watch out for gums that contain large amounts of sugars.  Sugarless gum is a good alternative to consider.
October 31st is a great time for adults and kids alike. Be safe everyone, and feel free to ask your family dentist if you have any questions on sugars and oral health.

From your local family Bellevue dentist,
Dr. Peter Chien
(425) 614-1600

Wednesday, October 23, 2013

Natural Looking Porcelain Crowns

Bellevue Dentist | Porcelain Crowns | Porcelain Veneers

Have you ever thought what makes porcelain dental crowns so natural looking and strong?

One type of porcelain crown is made from lithium disilicate, a ceramic restorative material that garners excellent esthetics.  With a flexural strength of 360-400 MPa, it has excellent strength and is suitable for anterior crowns where esthetics is desired, as the outside layer is veneered (or layered) to achieve optimal shade, value, chroma, and brightness.  One example is IPS e.max, where the crowns can be pressed or milled from an intra-oral digital scanning device, and then milled (fabricated) from an in-house lab milling machine.

For posterior teeth, a single layer monolithic lithium disilicate may be optimal as this uniform layer gives porcelain crowns outstanding strength.  Its flexural strength is near 1,000 MPa, and its compressive strength makes it as strong as gold and natural teeth.  This makes allows these crowns to be highly resistant to chipping and fracture, and its strength makes it a solid choice for even those who have bruxism (night time grinding) and severe Temporomandibular Disorders (TMD) and TMJ issues.

If you have any questions regarding porcelain crowns, consult with your family dentist to see if they are suitable.

From your family Bellevue dentist,
Dr. Peter Chien
(425) 614-1600

Monday, October 14, 2013

Dental Sealants for Kids!

Bellevue Dentist Dental Teeth Sealants

Now that school is up and running again, parents may have heard their children's school nurse mention dental sealants.  So what are they?  Sealants are a protective plastic coating dentists place on posterior teeth (back teeth).  Posterior dentition, especially molars and premolars, have deep occlusal grooves, pits, and fissures.  These deep grooves are usually very fine and thin, they can be difficult to maintain proper oral hygiene.  The toothbrush's thickness is usually greater than that of the teeth's grooves, so bacteria and plaque have a high tendency to remain trapped inside the tooth.  The result is an increased likelihood of developing tooth decay.

Your dentist will first make sure the tooth's grooves are clean with a high powered flush and cleansing material.  After the tooth is properly cleaned of debris, the tooth properly dried and isolated, the sealant is flowed onto the tooth.  The sealant is then light cured and hardened, thereby protecting the grooves from potential decay (cavities).

Sealants can be a viable preventive treatment for kids and adults alike.  Dental sealants are not permanent and can wear away (ie. fall off) over time, but it's a great cost effective and simple method to help ward of cavities.

Your family dentist should be able to help you decide if dental sealants are suitable for you and your children's needs.

From your family Bellevue dentist,

Dr. Peter Chien
(425) 614-1600

Wednesday, October 2, 2013

Single Tooth Whitening


Do you have a single "dark colored" tooth?  Have you ever thought about getting it whiter so it blends in with the adjacent teeth?

Sometimes a single tooth can be discolored if it previously had root canal treatment.  If so, one option is to have that single tooth internally bleached.  How does it work?  Also called "walking bleach technique" your dentist may place either a high concentration of 35% hydrogen peroxide, carbamide perioxide, or sodium perborate.  The solution is left internally within the tooth for a few days, and the tooth is then re-evaluated for shade.  This internal bleaching is then repeated again if necessary.

This single tooth non-vital tooth whitening method is fairly noninvasive, and can be a conservative option compared to a veneer or crown.  Talk to your dentist to see if this "walking bleach technique" is right for you.

From your family Bellevue dentist,
Dr. Peter Chien
(425) 614-1600

Thursday, September 26, 2013

What is a dental emergency?

So, what is a dental emergency?

With all the hectic things in life, a dental emergency can unfortunately occur unexpectedly and at the most inconvenient times.  It can include:
  • Chipped front teeth
  • Broken crowns or veneers
  • Abscess
  • Tooth and gum pain
  • Lost denture tooth
  • A cavity that bothers you constantly or is extremely sensitive to cold and hot
  • Anything you feel that needs to be addressed right away
Dental emergencies have also gained a bad stigma, and can happen on vacation or on a business trip, and even start on Friday or Saturday night.  If you experience any of the conditions listed above, or even remotely believe anything in your mouth is bothering you, call your local dentist immediately for emergency dental care.  If you are not able to get in touch with a dental office, try calling a major hospital or trauma center and see if they have an on-staff dentist or oral surgeon.  The on-staff dentist or oral surgeon in general has fairly limited resources, but they may at least be able to give you temporary relief of pain until you are able to be seen by a general dentist.

Our website has additional information on dental emergencies if you would like more information.

From your family Bellevue dentist,
Dr. Peter Chien
(425) 614-1600

Wednesday, September 18, 2013

Dental cavities linked to lower risk of head and neck cancer

From the JAMA Otolarynology - Head & Neck Surgery, a new study conducted by scientists at the University of Buffalo in New York is suggesting that people with MORE cavities are actually at LOWER risk of developing head and neck cancer.

How are dental caries/tooth decay formed?  Persistent bacteria that remain on teeth feed on the plaque left over from food debris; as a result the bacteria release lactic enzyme that demineralize and literally erodes the enamel, causing a cavity and sometimes necessitating the need for a filling.  

The study suggests that aside from the harmful effects of the bacteria in the mouth on the teeth, these bacteria are actually beneficial in the saliva and inside the mouth's mucosa, and may be a protective factor against head and neck cancer.

Read more about this study here:

Now does this mean that one should actually stop brushing and flossing?  Probably not, but rather take this article in heart and realize that one's oral health and body work in concert. Twice a day brushing combined with daily flossing is recommended for optimal oral and systemic health.

If you have any questions or concerns regarding oral hygiene, be sure to ask your family dentist or hygienist.  Have a great one!

From your Bellevue Dentist,
Dr. Peter Chien
(425) 614-1600

Thursday, September 12, 2013

Center for Disease Control gets over 220,000 smokers to quit

A recent 2013 study conducted by the Center for Disease Control shows that due its 2012 anti smoking campaign, it has influenced well over 220,000 smokers to quit.  As part of a massive $50+ million advertising campaign via print and television ads, it featured patients who suffered diseases associated with smoking: head and neck cancer including tongue, palate, and jaw cancers, asthma, heart disease, and stroke.

CDC Director Tom Frieden, MD, MPH, who explained in a video response to the study, said it best: 
"The impact of this ad campaign is further proof that sustained, hard-hitting media campaigns... save lives.  Tobacco companies spend more in three days than the CDC spends in a year running these ads. It is a David and Goliath fight."

The effects of smoking are well documented in medical, dental, and public health literature.  In addition to systemic side effects, smoking has been shown to cause teeth staining, dry mouth which may lead to increased risk of caries/tooth decay/cavities, periodontal disease, and higher likelihood of oral and tongue cancer.

There are products your dentist and doctor may be able to prescribe to help eliminate the smoking and tobacco habit.  Products to consider include Chantix, Zyban (Bupropion), and NicoDerm CQ patches.

If you have any questions, please discuss with your dentist which products and methods may be more suitable and helpful in your case.

From your Bellevue dentist

Dr. Peter Chien
(425) 614-1600

Wednesday, September 4, 2013

Start of the school year with proper diet and oral health.

The first week of September is usually a busy one, especially with families and kids returning from vacation, and kids returning and starting a new school year.  That said, here are somethings to keep in mind:
  • Did you know that some states require a child to have a dental exam as part of enrollment?  Georgia is one such state:  So be sure to check with your local school district to see if your child needs a visit to the pediatric or general dentist.
  • There are multiple factors influencing your child's progress and success at school; health is one of the most important ones.  Children need to be sufficiently healthy to learn, and children with cavities and gum disease are not deemed healthy.  Tooth decay is an oral infection that may get worse without treatment and are usually preventable and very treatable
  • Your child may likely need a snack during their time at school.  Try to make it fun and healthy!  Promote lots of naturally sweet fruits and crunchy vegetables instead of sugary drinks and candies.  Fruits, vegetables, and milk are great for the body, and help promote healthy and strong bone and teeth formation.  Calcium and Vitamin D in particular are great for teeth enamel and development.
  • It's also a great idea to give your a child a spare toothbrush, toothpaste, and floss as part of their arsenal in their backpack.  Brushing and flossing after each meal and snack is a good way to enhance their oral health.
  • School and work days can bush for everyone.  Children tend to imitate adult behavior, so if your child sees your brushing, flossing, and eating well, they should too! :)

If you have any questions regarding oral health care for your children, please don't hesitate to ask your family dentist.

From your family Bellevue dentist,
Dr. Peter Chien
(425) 614-1600

Tuesday, August 27, 2013

Whiten your teeth naturally... with strawberries!

A natural and alternative method to teeth whitening you can try at home is to use strawberries and baking soda.  The malic acid in the strawberries, together with the baking soda, can help remove minor extrinsic stains on the tooth enamel from foods/drinks such as tea, coffee, and certain dark juices.  Baking soda is a natural soft abrasive that is a good toothpaste substitute, though it does not have Fluoride.  The combination of the baking soda and the strawberries' malic acid may be just effective enough to help lighten your teeth.

Check out the article here:,,20410846,00.html

Warm regards from your family Bellevue Dentist,
Dr. Peter Chien
(425) 614-1600

Thursday, August 22, 2013

National Tooth Fairy Day!

Attention parents and kids!  August 22 is the "official" National Tooth Fairy Day.  Kids, any loose baby teeth about to come out?  Parents, be on the look out :)

Most of the time baby teeth come out fairly easily.  If a tooth appears to be extremely loose and looks ready to come out, encourage your child to wiggle it.  Sometimes I even encourage a bite out of an apple, carrot, or even a sandwich to help give the tooth an extra nudge.  A little bleeding is normal when the tooth comes out; if so, firm pressure on a cotton gauze will help stop the bleeding.

I would suggest to have your kid's dentist evaluate the area if you notice:
  • The baby tooth is stubborn and doesn't seem to want to come out
  • The gums/gingiva around the tooth is bleeding or puffy
  • The baby (primary) tooth is blocking the permanent tooth from erupting and coming into place
  • Quite a few primary and permanent teeth are very close and crowded together
Crowded primary dentition is a possible predictor for orthodontic (braces) needs.  An early orthodontic evaluation can be helpful to see if braces may be needed in the future, and may even help reduce or eliminate extensive orthodontic treatment later on. 

From your family Bellevue dentist,
Dr. Peter Chien
(425) 614-1600 

Tuesday, August 20, 2013

Google glasses at the dentist

 Talk about advances in technology.  A physician made headlines by using Google glasses while in the operating room.  After reading about this surgeon, I wonder if Google glasses can make it to the dental field?  Would sound pretty awesome if it did. 
From your family Bellevue Dentist,
Dr. Peter Chien 
(425) 614-1600

Tuesday, August 13, 2013

Lose weight... by tongue surgery?

This is interesting news.  A US Surgeon has come up with a way to loose weight.  Called the "tongue patch diet" the surgeon places a mesh on the tongue, making it difficult for the mouth to swallow and to eat.  So far the surgeon has conducted his own studies and have shown it to be effective in dropping 16-18 pounds.  Check out the link and video here:
From your family Bellevue dentist,
Dr. Peter Chien

Tuesday, August 6, 2013

Toothbrush, stay away from....

Here's an interesting fact about toothbrushes.  Where do we usually brush our teeth?   Probably in the shower, or in front of the bathroom sink and mirror.  But have you given thought where the toilet is in relation to where you brush?

Did you know that when flushing the toilet, water particles from the toilet can travel airborne up to 6 feet away?  Yup, 6 feet, that's quiet a distance isn't?  It's a given that the toothbrush should be clean and only contain toothpaste and clean water, but what if it contained small particles of.... ok, I won't say it, but you get the idea :)

So next time you brush, you may want to stand a little further away from the toilet :)

From your family Bellevue dentist,
Dr. Peter Chien

Saturday, August 3, 2013

Baby boomers!

Americans are living longer than ever, and the segment of population >65 years old is expanding.  Hence it's even more important to take preventive measures to maintain your oral health, and the best way begins at home.  Daily brushing with a soft tooth brush and fluoridated toothpaste after meals, along with flossing one to two times a day, is a great and effective way to keep your teeth and gums healthy and free of plaque.  If you have a denture, be sure to brush it every day as well so its free of plaque and food debris.  Soaking the denture daily it in a denture cleanser is also a good way to keep your gums and adjacent teeth healthy.

Be sure to consult your dentist if you have any questions regarding preventive oral hygiene.

Warm Regards from your family Bellevue Dentist,
 Dr. Peter Chien

Tuesday, July 16, 2013

Summer 2013 has started in full swing!

Summer has started in full swing, and it's plenty sunny (and even hot!) in the Pacific Northwest.  Be sure to stay cool and keep hydrated at all times.  Drink plenty of water, lots of sunscreen, and be on the look out for the family pet as well.  And keep little ones close, pets on the leash, and heed traffic and pedestrian signs when possible.

Also with more outdoor activities, be on the look out for increased automobile and foot traffic.  With increased traffic comes increased physical activities.  Something to watch out for is for trauma to the face and teeth.  Lip and teeth injuries may occur during sports such as football, basketball, and baseball.  And as such, be sure to wear a sportsguard to help protect your teeth from fractures and trauma.  One can consider a sportsguard bought from an athletic store such as Sports Authority.  Sometimes store bought sportsguards may not have an ideal fit, so your dentist be able to custom fabricate one for you in the office.

Be sure to ask your local dentist if you have any questions on sportsguards and ways to protect your teeth while doing physical activities.

Stay safe everyone!

From your Bellevue dentist and Redmond family dentist at Bellevue Family Dentistry,
Peter Chien, DMD
(425) 614-1600