By Cynthiana Dental Center
March 09, 2018
Category: Dental Procedures

Somewhere around age 6, your child’s primary (baby) teeth will begin to give way to their permanent set. If all goes well, you’ll notice all the front teeth erupting in the right position: the top teeth slightly overlapping the bottom and all coming in without crowding.

Sometimes, though, the process doesn’t occur as it should and a bad bite (malocclusion) may develop. You can get a head start on treatment if you know what to look for. Here are a few problems for which you should see a dentist — or more likely an orthodontist — for a thorough evaluation.

Spacing problems. Teeth should normally come in right next to each other without a noticeable gap. But if you notice excessive space between the permanent front teeth especially, this may be an indication there’s a discrepancy in size between the teeth and the jaws. At the other end of the spectrum, if teeth on the same arch appear to overlap each other, this indicates crowding in which there’s not enough space for the teeth to erupt properly.

Bad bites. Malocclusions can take different forms. In an underbite, the front bottom teeth bite in front of the upper teeth. If there’s a noticeable gap between the upper and lower teeth when the jaws are closed, this is known as an open bite. Front teeth biting too far down over the lower teeth is a deep bite and could even include biting into the soft tissue of the hard palate. Cross bites can occur in either the front or back teeth: if in the front, some of the lower teeth will bite in front of the upper; if in the back, some of the lower teeth bite outside the upper rather than normally on the inside.

Abnormal eruptions. You should also be alert for protusions, in which the upper teeth or the jaw appears to be too far forward, or retrusions, in which the lower teeth or jaw appears to be too far back. You should also be concerned if permanent teeth erupt far from their normal position — this is especially likely if the primary tooth was also out of position, or was lost prematurely or not in the right order.

If you would like more information on monitoring your child’s dental health, please contact us or schedule an appointment for a consultation.

By Cynthiana Dental Center
March 01, 2018
Category: Oral Health
Tags: dry mouth  

There is much to contend with as we grow older, including a higher risk for dental disease. One possible contributing factor: dry mouth from a lack of saliva.

Also known as xerostomia, dry mouth occurs when the salivary glands secrete less than the normal two to four pints a day. Saliva performs a number of functions, but perhaps the most important for dental health is as an acid neutralizer. Within a half hour to hour after eating, saliva can restore the mouth's normal pH level to prevent acid from softening tooth enamel. When there isn't enough saliva, acid levels stay high leading to erosion of the enamel. This vastly increases the chances for tooth decay.

Although there are several causes for dry mouth, one of the more common is as a side effect from certain medications. It's estimated over 500 drugs — many taken by seniors — can cause dry mouth, including diuretics for high blood pressure and heart failure, antidepressants, and antihistamines. Some diseases like diabetes or Parkinson's may also reduce saliva flow, as well as radiation and chemotherapy.

If you've developed chronic dry mouth, there are some things that may help restore adequate saliva flow. If medication is the cause you can talk to your doctor about an alternative medication or add a few sips of water before swallowing the pills and a full glass afterwards. You should also drink plenty of non-caffeinated beverages (water is the best) during the day and cut back on sugary or acidic foods. And a cool-air humidifier running while you sleep may also help keep your mouth moist.

We may further recommend an over-the-counter or prescription stimulant for saliva. For example, xylitol, a natural alcohol sugar that's found in many gums and mints, has been found to stimulate saliva and reduce the risk of tooth decay as an added benefit.

Last but not least, be sure to brush and floss daily to remove disease-causing plaque and see us at least twice a year for cleanings and checkups (if your mouth is very dry, three to four times a year is a better prevention program). Managing chronic dry mouth along with proper oral hygiene will help ensure your mouth continues to stay healthy as you grow older.

If you would like more information on the causes and treatment for dry mouth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dry Mouth.”


Fans of the legendary rock band Steely Dan received some sad news a few months ago: Co-founder Walter Becker died unexpectedly at the age of 67. The cause of his death was an aggressive form of esophageal cancer. This disease, which is related to oral cancer, may not get as much attention as some others. Yet Becker's name is the latest addition to the list of well-known people whose lives it has cut short—including actor Humphrey Bogart, writer Christopher Hitchens, and TV personality Richard Dawson.

As its name implies, esophageal cancer affects the esophagus: the long, hollow tube that joins the throat to the stomach. Solid and liquid foods taken into the mouth pass through this tube on their way through the digestive system. Worldwide, it is the sixth most common cause of cancer deaths.

Like oral cancer, esophageal cancer generally does not produce obvious symptoms in its early stages. As a result, by the time these diseases are discovered, both types of cancer are most often in their later stages, and often prove difficult to treat successfully. Another similarity is that dentists can play an important role in oral and esophageal cancer detection.

Many people see dentists more often than any other health care professionals—at recommended twice-yearly checkups, for example. During routine examinations, we check the mouth, tongue, neck and throat for possible signs of oral cancer. These may include lumps, swellings, discolorations, and other abnormalities—which, fortunately, are most often harmless. Other symptoms, including persistent coughing or hoarseness, difficulty swallowing, and unexplained weight loss, are common to both oral and esophageal cancer. Chest pain, worsening heartburn or indigestion and gastroesophageal reflux disease (GERD) can also alert us to the possibility of esophageal cancer.

Cancer may be a scary subject—but early detection and treatment can offer many people the best possible outcome.┬áIf you have questions about oral or esophageal cancer, call our office or schedule a consultation. You can learn more in the Dear Doctor magazine article “Oral Cancer.”


Even though a child’s primary (“baby”) teeth eventually give way, it’s still important to treat them if they become decayed. Primary teeth serve as guides for the emerging permanent teeth — if they’re lost prematurely, the permanent tooth may come in misaligned.

If the decay, however, affects the tooth’s inner pulp, it poses complications. A similarly decayed adult tooth would be treated with a root canal in which all the pulp tissue, including nerve fibers and blood vessels, are removed before filling and sealing. Primary teeth, however, are more dependent on these nerves and blood vessels, and conventional filling materials can impede the tooth’s natural loss process. It’s better to use more conservative treatments with primary teeth depending on the degree of decay and how much of the pulp may be affected.

If the decay is near or just at the pulp, it’s possible to use an indirect pulp treatment to remove as much of the softer decay as possible while leaving harder remnants in place: this will help keep the pulp from exposure. This is then followed with an antibacterial agent and a filling to seal the tooth.

If the pulp is partially exposed but doesn’t appear infected, a technique called direct pulp capping could be used to cover or “cap” the exposed pulp with filling material, which creates a protective barrier against decay. If decay in a portion of the pulp is present, a pulpotomy can be performed to remove the infected pulp portion. It’s important with a pulpotomy to minimize the spread of further infection by appropriately dressing the wound and sealing the tooth during and after the procedure.

A pulpectomy to completely remove pulp tissue may be necessary if in the worst case scenario the pulp is completely infected. While this closely resembles a traditional root canal treatment, we must use sealant material that can be absorbed by the body. Using other sealants could inhibit the natural process when the primary tooth’s roots begin to dissolve (resorb) to allow it to eventually give way.

These all may seem like extraordinary efforts to save a tooth with such a short lifespan. But by giving primary teeth a second chance, their permanent successors will have a better chance of future good health.

If you would like more information on treating decay in primary teeth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Root Canal Treatment for Children’s Teeth.”

By Cynthiana Dental Center
February 05, 2018
Category: Dental Procedures
Tags: dentures  

Twenty-six percent of American adults between 65 and 74 have lost all their teeth to dental disease. This isn’t an appearance problem only—lack of teeth can also harm nutrition and physical well-being.

Fortunately, we have advanced restorative options that can effectively replace missing teeth. Of these, there’s a tried and true one that’s both affordable and effective: removable dentures.

Dentures are simple in design: a plastic or resin base, colored with a pinkish-red hue to resemble gums to which we attach prosthetic (false) teeth. But while the design concept isn’t complicated, the process for creating and fitting them can be quite involved: they must conform to an individual patient’s jaws and facial structure if they’re going to appear natural.

If you’re considering dentures, here’s some of what it will take to achieve a successful outcome.

Positioning the teeth. The position of the prosthetic teeth on the base greatly determines how natural they’ll appear and how well they’ll function. So, we’ll need to plan tooth placement beforehand based on your facial and jaw structures, as well as photos taken of you before tooth loss. We’ll also consider how large the teeth should be, how far to place them forward or back from the lips, and whether to include “imperfections” from your old look that you see as part of your appearance.

Simulating the gums. While the teeth are your smile’s stars, the gums are the supporting cast. It’s important that we create a denture base that attractively frames the teeth by determining how much of the gums show when you smile, or adding color and even textures to better resemble gum tissue. We can also add ridges behind the upper teeth to support speech.

Balancing the bite. Upper and lower dentures don’t operate in and of themselves—they must work cooperatively and efficiently with each other during eating or speaking. So while appearance matters, the bite’s bite adjustment or balance might matter more. That’s why we place a lot of attention into balancing and adjusting the bite after you receive your dentures to make sure you’re comfortable.

This is a detailed process that we may need to revisit from time to time to make sure your dentures’ fit remains tight and comfortable. Even so, modern advances in this traditional restoration continue to make them a solid choice for total tooth loss.

If you would like more information on denture restorations, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Removable Dentures.”

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