Pregnancy, Babies, and the Dentist

If you are pregnant or trying to become pregnant, you should inform your dentist so he or she can help you achieve optimal oral health for yourself and your baby.  It is recommended you continue your regular exam and dental cleaning schedule as recommended by your dentist.

Dental Tips for Pregnant Moms

• Brush your teeth twice a day with fluoridated toothpaste to remove plaque buildup.
• Floss daily to help remove plaque between the teeth.
• Inform your dentist and physician of any changes in your health, medication, and diet.
• Any elective dental procedures should be delayed until you give birth.  If dental treatment is necessary and recommended by your dentist, your dentist and obstetrician will advise you of any precautions to be taken. 
• Moms may develop pregnancy gingivitis, gum inflammation that may include swollen and bleeding gums.

What is Pregnancy Gingivitis

• Pregnancy gingivitis is gum inflammation induced by the mother's fluctuation in estrogen and progesterone.  Symptoms may include swollen and bleeding gums, sensitive teeth and gums, and gingival recession.
• Pregnancy gingivitis is common during the second through eighth month of pregnancy.
• Your dentist may recommend additional dental cleanings if the gingivitis promotes excessive bleeding and plaque buildup.

Nutrition Tips for the Mother

• Your baby's teeth develops during the first trimester, hence adequate calcium and vitamin D intake is important for baby's optimal teeth development
• A well rounded diet during all trimesters of pregnancy is needed for your baby to develop his or her teeth.  A balanced diet of fruits, vegetables, dairy, lean proteins, and essential fats is recommended.
• Morning sickness and nausea can make morning brushing difficult.  Be sure to consult with your dentist and obstetrician if you are not able to brush in the morning.
• Be sure to drink abundant amounts of water and calcium.  Water is good for your body and your baby's development.  Daily intake of water will also help clear your teeth free of plaque when you are not able to brush and floss consistently. 

If you have any questions or concerns regarding pregnancy and how it may affect your newborn, be sure to consult your family dentist.

From the desk of your gentle dentist in Bellevue,
Peter Chien, DMD, MPH
www.bellevuefamilydentistry.com
(425) 614-1600

How to remove tooth stains

Extrinsic Stains on Teeth

Stains on teeth often look like dark spots and patches on the outside and inside surfaces of the teeth, and many patients often ask on how to remove them during their dental cleaning visit.

There are typically two types of stains, extrinsic and intrinsic stains.

1. Extrinsic Stains may be caused by repeated short term exposures to tea, coffee, blueberries, wine, and food condiments like ketchup and soy sauce.  They may look like dark black and brown patches on certain parts of the teeth's external surfaces.
2. Intrinsic Stains may be caused by the antibiotic tetracycline taken when the patient as a young child or repeated heavy long term smoking and tobacco habits.  It may also be a result of malformation during embryonic development.  These type of stains may present itself as a dark gray or red internal discoloration where the entire tooth is discolored, and may be very difficult or near impossible to remove.

If the stains are extrinsic they can usually be removed during the cleaning appointment.  The dental hygienist or dentist may use a combination of a high speed vibration tip with water, and hand instruments like a scaler to physically remove the stains.  Water is needed to help cool the high speed tip as it vibrates and removes the stained spots.  A low speed polish may also be used to help smooth the teeth and remove any loose "dark spots."  Minor stains may also be removed by trying an abrasive toothpaste such as whitening toothpaste.

Intrinsic stains are often much harder to treat and remove.  If these stains are a result of food exposure where the teeth have turned "yellow" over time, teeth whitening may help lighten the teeth.

In cases where the intrinsic stains are gray or reddish stains are internal (inside) the teeth, they cannot be removed via a dental cleaning or traditional teeth whitening.  More viable options to address heavily dark or red internal stained teeth include porcelain crowns and veneers or internal bleaching.  Internal bleaching utilizes a high concentration of bleaching solution placed inside the tooth after it has a root canal that allows the tooth to whiten from the inside.

If you have any questions on teeth stains and how to remove the stains from your teeth, be sure to consult your family dentist or dental hygienist.

From the desk of your friendly gentle dentist in Bellevue,

Peter Chien, DMD, MPH
(425) 614-1600
www.bellevuefamilydentistry.com

Kids back to school dental tips

Back to school and the dentist

Parents and kids, it's back to school time, and below are some dental tips and hints to keep children's teeth and gums clean and healthy...and to help your kids off to a good start with great diet and oral health!

DIET

School days can be hectic and in a rush, so don't forget to include healthy snacks that are good for the teeth and the body.  Your body and mouth will appreciate it :)

• Celery and carrot sticks contain fiber and vitamin A; the fiber helps cleanse plaque from teeth
• Apple slices, crunchy fruit high in fiber promoted salivary flow that helps washes bacteria away
• Grapes, raisins, and cranberries are great snacks containing natural sugars for that quick pick me up
• Fruit and yogurt smoothies, high in calcium, good for teeth and bones
• Nonfat or lowfat milk which are rich in calcium and fortified Vitamin D, great for making your kid's teeth strong

ORAL HYGIENE

Important to make sure your children brush in the mornings when they wake up, and also brush and floss in the evening prior to bedtime.  Brush their tongue to remove bacteria and help keep their breath fresh.  If your kids are in current orthodontic treatment (ie. braces) it's especially important for them to brush and floss well, as plaque and bacteria can accumulate on the bands and brackets, and increase risk for cavities.

DENTAL TIPS AT SCHOOL

School days can be busy, so here are some ideas to help keep your kids' teeth and gums healthy at school:

• If your child has an orthodontic retainer, make sure the retainer is worn in the mouth at all times unless it's during lunch or snack time.  To prevent retainer loss, keep the retainer in sight at all times and make it habit to wear it when not eating.  It's not uncommon to see kids digging through the school trash  looking for a lost retainer!
• Avoid sucking on hard candy or chewing sugary gum during the day.  Try sugarless gum.
• Avoid sipping on soda or energy drinks during the day.  They are often high in sugar and the high phosphoric acid content can weaken the teeth's enamel.  Bottled or tap water are good substitutes. 
• The occasional soft or hard candy is OK.  Try to rinse the mouth with water after eating to help prevent sugar from remaining on the teeth.
• For lunch try to choose salads and low fat milk.

 If you have questions on how to help and improve your children's oral health at school, be sure to consult with your family dentist and hygienist.

From your gentle family dentist in Bellevue,
Peter Chien, DMD, MPH
www.bellevuefamilydentistry.com
(425) 614-1600

Pregnancy and Going to the Dentist

Pregnant? Might be time to the dentist!

There has long been a common misconception to avoid the dentist when one is pregnant.  The previous thought process was that dental treatment may cause complications during pregnancy.  However recent studies are suggesting that going to dentist while pregnant is actually a good idea because of the excessive time constraints the newborn baby may likely require after the mother has given birth.

Physicians and researchers have determined that a pregnant woman's oral health can directly affect the newborn's systemic and oral health.  For example, a common health concern is cavity causing bacteria such as Streptocacus Mutans can be directly transmitted from the mother to the fetus.  The newborn baby may then be exposed to the bacteria, which can then multiply and grow in the fetus' body, affecting the tooth's development even before the teeth are erupted.  Such excessive bacteria, if not removed, may increase risk of tooth decay and subsequently periodontal and gum disease.

Another common occurrence is if an expectant mother is experiencing tooth pain or has a dental emergency related infection, this may cause physical stress on the mother, which may then indirectly cause systemic stress on the fetus.

Unfortunately most pregnant mothers do not receive sufficient dental care.  Census data in 2010 from the Center for Disease Control show that less than fifty percent of expectant mothers had a dental cleaning while they were pregnant.

It is our hope to increase public awareness the importance of seeing a dentist when a mother is pregnant.  If you have any questions regarding pregnancy and its relationship on the mother's and newborn's oral health, be sure to consult with your family dentist and hygienist.

From your gentle family dentist in Bellevue and Redmond,
Peter Chien, DMD
www.bellevuefamilydentistry.com
425-614-1600

Thumbsucking

Child Thumbsucking

Thumbsucking is a perfectly natural habit children engage in.  Does your child suck his thumb and the parent may be wondering why.  Kids suck on their thumbs, pacifier, finger, or any other small object to give them more security, feel less lonely, and to help them observe their new surroundings.  Children may also suck their thumbs as they go to sleep.

At the age of six years old when children's permanent teeth begin to erupt, continuous thumb sucking may cause issues with the mouth's growth formation, the mouth's roof shape, and as well as teeth position and alignment.  The main factor that determines if a child may develop dental problems with thumbsucking is the intensity of the sucking.  Simply resting the thumb inside the mouth is much less likely to cause oral issues then vigorously sucking the thumb.

ORAL SIGNS OF THUMBSUCKING

• A very narrow and arched shaped upper palate
• Top front teeth are excessively flared outwards
• The child's entire upper teeth appears very narrow and arched

What are some things parents can do to help their child stop thumbsucking?

TIPS TO HELP YOUR CHILD STOP SUCKING THE THUMB

• Kids tend to suck their thumbs or fingers when they feel insecure or when they need a "blanket" for comfort.  Try finding the root cause of the insecurity issues and address them if possible.
• When the child goes to sleep, have the child wear gloves or a sock to discourage the habit.
• Place a bitter paste on the child's thumb after they go to sleep.  Your dentist may be able to prescribe a safe yet bitter medicine to coat the thumb.
• Praise him/her for not sucking the thumb
• If all else fails, have your dentist reinforce the importance of the need to stop sucking the thumb.  The dentist may refer the child to an Orthodontist to place an appliance (ie. fixed palatal crib) that makes thumbsucking uncomfortable to quell the habit.

Children typically stop sucking their thumb prior to the age of six when their permanent teeth start to erupt.  If you notice your child is still sucking their thumb beyond the age of six years old and you notice changes in the child's arch shape and teeth position, be sure to consult your family dentist or orthodontist.

Your family dentist in Bellevue,
Peter Chien, DMD, MPH
(425) 614-1600
www.bellevuefamilydentistry.com

Why do I need to floss my teeth?

 

Why do I need to floss my teeth? Flossing is effective at removing food, bacteria, and plaque between your teeth and along the gum line where the toothbrush cannot reach. While tooth brushing removes bacteria and food debris on the outside surfaces of the teeth, the toothbrush cannot remove plaque and bacteria that is between the teeth.

BENEFITS OF FLOSSING

• Removes bacteria between the teeth
• Removes food and plaque that can be stuck and caught between your teeth and along the gum line
• Can help improve your breath and decrease likelihood of halitosis, bad breath.  Food and bacteria between the teeth can cause halitosis.
• Helps prevent cavities between your teeth.
• Helps prevent gingivitis (bleeding gums) and periodontitis and the possible need for deep cleaning
• Can help your teeth remain whiter by removing foods that can cause extrinsic stains
• If someone is currently undergoing orthodontics (braces), brackets and bands can act as an annoying food trap.  Flossing will help remove such food and bacteria stuck between the teeth.

 WHAT HAPPENS IF I DON'T FLOSS

• Increased risk of tooth decay
• Increased risk of gingivitis, gum bleeding, and bone disease
• Increased risk of halitosis (bad breath)
• If someone is currently undergoing orthodontics (braces), if one does not floss, this exponentially increases one's risk of gingivitis and tooth decay.

 HOW OFTEN SHOULD I FLOSS?

Studies have shown that daily flossing is efficient at removing bacteria, food, and plaque between the teeth.  Along with twice a day brushing, daily flossing is an effective method at keeping your teeth and gums healthy and vibrant. 

It's debatable whether one should floss before or after tooth brushing, but as long as the flossing is done daily, that's the important thing!

HOW SHOULD I FLOSS?

1. Start with approximately 18-20 inches of fresh new floss each time.  Waxed floss is a good choice as the wax may flossing easier go between the teeth.
2. Wind most of the floss around each of your middle fingers, leaving about an inch of floss in between the middle fingers
3. Hold the floss tightly between the thumb and index finger, and slide it up and down between the teeth gently
4. Very gently curve the floss at the end base of the tooth.  Make sure the floss gets underneath the gums.  Try not to force the floss down as this may injure or bruise the gums.
5. Use clean sections of the floss as you move tooth to tooth.
6. When done flossing, dispose of the floss and wash your hands with water and soap.
7. Repeat steps 1-6 daily.

If you have any questions about the importance of flossing your teeth, be sure to ask your dental hygienist and dentist.

Warm  Regards,

Peter Chien, DMD, MPH
www.bellevuefamilydentistry.com
425-615-1600

Warning Signs Impacted Wisdom Teeth

Impacted Wisdom Tooth

Wisdom teeth can have a mind of its own.  For the majority of people, they usually erupt from 17 years to 21 years of age.  Sometimes they don't develop at all, but when wisdom teeth (also known as 3rd molars) develop and erupt, they can cause pain and swelling.  Often times their may not be enough room for the wisdom teeth to erupt normally.  If there is not enough room for the wisdom teeth to come about, they are considered impacted, and which later on can cause issues.

There are two types of wisdom teeth impaction:

• SOFT TISSUE IMPACTION: When wisdom teeth attempt to erupt with insufficient room, the gums surrounding the tooth may be red, inflamed, puffy, and sore.  The gums may even bleed and  be painful to touch.
• HARD TISSUE IMPACTION: In some cases wisdom teeth may be positioned at a horizontal or semi-vertical angle.  These teeth may look like they are on the path to hit the adjacent tooth, possibly causing damage (external resorption or decay) to the tooth in front.

What are warning signs of impacted wisdom teeth to look out for?

1. There is a constant dull ache coming from the very back of your upper and lower teeth.  This ache may progress to severe pain that may radiate down the lower jaw, or up towards the sinus and temple of the forehead.  This pain may be suggestive of hard tissue impaction.
2. Your dentist takes a x-ray that shows the wisdom tooth is causing tooth decay and resorption (tooth damage) to the tooth in front.
3. You look in your mouth and see that the gums directly behind your last molars is swollen, puffy, and painful to touch.  The gums may also bleed to touch or by itself.

Treatment of impacted wisdom teeth:

• Palliative treatment - Sometimes pain from wisdom tooth impaction can be managed by a warm moist towel and non-steroidal medication (NSAIDS) such as ibuprofen or aspirin.  Such treatment is usually temporary however.
• Extraction - If the wisdom tooth is causing damage to the adjacent teeth, or palliative treatment is not able to provide relief, your dentist or oral surgeon would surgically remove the offending wisdom tooth. Extraction would also be required in soft tissue impaction cases where the gingival tissue continues to remain swollen and painful if due to the wisdom tooth.
• Doing nothing - A curious choice this may be, but because wisdom tooth movement can be so unpredictable, their movement may suddenly stop, thus halting the pain.  This may be a suitable conservative "watch and see" approach in milder cases.

If you have any questions regarding impacted wisdom teeth, be sure to consult your family dentist or oral surgeon.

Warm Regards,

Peter Chien, DMD, MPH
www.bellevuefamilydentistry.com
425-614-1600