Laura J. Martin, MD
Teeth are tough -- their enamel is the hardest part of the body -- but they're no match for neglect, misuse, or abuse. Here are some surefire ways to find out how vulnerable your teeth are -- trust us, you don't want to do this:
The ideal is to brush your teeth three times a day: after breakfast, lunch, and dinner. But if you do it too soon, you can scrub away tooth enamel that becomes softer in the acidic environment created in your mouth when you eat.
“Make sure you wait 30 to 60 minutes after each meal, which gives the acidity time to neutralize and the teeth time to remineralize," says Debra Gray King, DDS, FAACD, of the Atlanta Center for Cosmetic Dentistry.
Brushing too much, too hard, or with a hard-bristle brush can also erode your enamel. Brush gently, using circular strokes and a soft brush.
Flossing stimulates gum health by cleaning between the teeth and under the gum line. Gums bleed when you brush vigorously? That’s a sign of mild gingivitis, or inflammation of the gums, which can lead to tooth loss.
“You need to brush and floss your teeth every time you eat,” says Jeffrey Gross DDS, FAGD, a Cleveland dentist. “The longer food stays in contact with the teeth and the gums, the easier it is to create problems.”
Dentists recommend every six months, but most patients fail to comply. This allows plaque to form tartar, which attracts more plaque on its surface, carrying the plaque deeper within the gums. This can weaken supporting structures, such as bone.
“The sooner you find issues, the easier and a lot less expensive they will be to address,” King says.
Chomping ice and hard candy, not to mention popping off bottle caps and ripping open potato chip bags, can crack or break your teeth.
“People tend to do some wild things with their teeth,” King says. She recalls a patient in her 50s who habitually gripped the ropes of her sailboat’s mast between her teeth.
Over time, the woman’s natural teeth had worn to the point she needed porcelain veneers. Find a bottle opener or pair of scissors. And if you’re sailing, use your hands.
The Academy of General Dentistry (AGD) recommends mouthguards for many athletes.
“Anytime there is a strong chance for contact with other participants or hard surfaces, it is advisable to wear a mouthguard. Players who participate in basketball, softball, football, wrestling, soccer, lacrosse, rugby, in-line skating, and martial arts, as well as recreational sports such as skateboarding and bicycling, should wear mouthguards while competing,” the AGD’s web site states.
Some people clench or grind their teeth when bored, lifting something heavy or stressed; others do it while they sleep. Tooth-to-tooth clenching can wear down teeth and “make you look 10 to 20 years older,” King says.
Grinding also paves the way for cavities. “Aside from causing pressure and fractures, grinding wears away the top layer of enamel and the lower levels of enamel beyond the dentin, which can lead to decay,” Gross says. Can’t stop? Get fitted for a mouthguard.
Soda and sports drinks often have either too much sugar or, in the case of diet soda, too much acid. Fruit juices often contain sugar but compared to soda and sports drinks, are “a healthier choice” and water is even better yet, Gross says.
The surface of stained teeth is like sandpaper and attracts more bacteria, which can indirectly lead to tooth decay.
As wine editor for Dish magazine, Yvonne Lorkin of Christchurch, New Zealand, tastes thousands of wines each year. At 37, she spends more on dental upkeep than people twice her age.
“The constant onslaught of acid on my enamel is an occupational hazard, I guess, as we're swilling the wines around in our mouths rather than just swallowing,” Lorkin tells WebMD in an email interview.
Aside from cutting back, Gross recommends using a straw, when possible, so staining liquids bypass your teeth.
Chronic whitening or failing to follow instructions can lead to gum irritation and increased tooth sensitivity. Desensitizing toothpaste can help.
If you have very sensitive teeth, gum disease, or worn enamel, “your dentist may discourage whitening,” says Charles H. Perle, DMD, FAGD, a dentist in Jersey City, N.J. and a spokesman for the AGD. Check before starting any whitening treatment.
Most bottled water has little or no fluoride and most home filtration systems filter much of it out. Stick with fluoridated tap water since it’s “the most cost-effective way to prevent cavities and fight tooth decay,” Perle says. If your water isn’t fluoridated, your dentist may prescribe fluoride supplements.
When you speak, your tongue moves to make certain sounds and consequently “you’re jamming the metal piercing into your teeth,” Gross says. Fractured teeth may require veneers or crowns in a patient who otherwise doesn’t have other issues.
Jason Lazarus, CEO of Gadgets and Gear in Hauppauge, N.Y., got his tongue pierced and admits he played with it “all the time.” Lazarus says he was shocked when X-rays showed his front teeth “dramatically shaved and chipped” and immediately took his tongue ring out.
“I didn’t want my teeth to get worse,” Lazarus says. He has since spent $2,000 on laminates for his two front upper teeth.
Bulimia, which is characterized by bingeing and vomiting, can cause significant dental problems because of the stomach acids.
“The enamel is usually just kind of worn off, mostly on the front teeth, but even going to the back teeth,” King says. If the damage is done, you may need restorations.
Crystal methamphetamine, an illegal and highly addictive stimulant, can wreak havoc on your mouth. Users often crave sugary foods and drinks, clench their teeth, and have dry mouth. Telltale signs of “meth mouth” are rampant decay with blackened teeth on the verge of falling out.
“People on methamphetamines are notorious for not taking care of themselves,” Gross says. “By the time the patient is 25 or 30, they are looking at a full set of dentures.”
Oral contraceptives change a woman’s hormonal balance and can lead to chronic gum disease.
“Once they get off the medication, the damage is often done,” Gross says. Some over-the-counter cough medications have lots of sugar, and antihistamines can cause dry mouth, which can lead to decay since saliva protects the teeth.
Smoking is bad for teeth and gums. Stains make teeth more susceptible to bacteria. It’s also a factor in the development of periodontal or gum and bone disease.
“The smoke impedes the ability of the gum tissue to maintain a healthy state and fight off disease-creating bacteria,” Gross says. “Almost half of the people who are over 60 who wear dentures are smokers.”
SOURCES:Debra Gray King, DDS, FAACD, Atlanta Center for Cosmetic Dentistry.Jeffrey Gross DDS, FAGD, Cleveland.Yvonne Lorkin, writer and wine editor, Dish magazine, Christchurch, New Zealand.Charles H. Perle, DMD, FAGD, dentist, Jersey City, N.J.; spokesman, Academy of General Dentistry.Jason Lazarus, CEO, Gadgets and Gear, Hauppauge, N.Y.
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