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Our teeth are a lot more complicated than they look. Beneath that shiny white surface is an entire system of different cell tissues working together to keep each tooth vital and healthy.

• Enamel, the protective exterior of the crown (the visible part of the tooth), is the strongest substance in the body and the first line of defense against damage to our teeth.
• Dentin, the hard tissue under the enamel and cementum, has microscopic tubules that connect to the pulp.
• Pulp, the tissue at the center of the tooth, contains the nerves, blood vessels, and connective tissue that keep the tooth alive.
• Cementum, composed of connective tissue which forms the protective exterior of the root, also attaches to fibers in the periodontal ligaments which hold the teeth securely in the jaw.

Because cementum is below the gum line, it’s generally safe from the cavity-causing conditions that our enamel is exposed to every day. But there are still potential hazards that we should be aware of.

• Cementum Erosion

With a name like “cementum,” it’s logical to assume that this is the hardest tissue in the body. Actually, however, that distinction goes to our enamel. And if even our enamel can be damaged by bacteria and plaque, cementum doesn’t stand a chance!

How does cementum come in contact with cavity-causing bacteria? Gums often recede as a natural part of the aging process, leaving part of the root exposed. Gum disease, failure to brush and floss regularly, and heavy-handed brushing can lead to early gum recession. The newly exposed cementum is now exposed to the same conditions, which cause cavities in our enamel. But a root cavity can be trickier to treat and, because the cementum is not as strong as enamel, can progress more quickly. And if a cavity reaches the pulp, a root canal could be necessary.

But the erosion of cementum doesn’t have to result in a cavity to cause discomfort. When cementum is removed, the dentin beneath is exposed. Dentin, you’ll recall, contains tiny tubes that connect to the pulp of the tooth. The result? Conditions such as heat, cold, even an intake of air can cause tooth sensitivity as they stimulate the nerves in the pulp. If your hot coffee or ice cream cone is suddenly causing you pain, let us know. There are treatments, which can reduce tooth sensitivity.

• Gum Disease (Periodontitis)

In more severe cases of gum disease, the gums pull away from the teeth leaving pockets, which harbor plaque and bacteria. Left untreated, these pockets can become home to infections, which attack and destroy bone structure and connective tissue. Caught early, a treatment called tooth scaling and planing can help. In this type of deep cleaning, your dentist or endodontist will remove plaque and tartar and then smooth the root surface to make it harder for bacteria and plaque to stick. If the gums have receded too far, a gum graft might be necessary to protect the exposed roots.

• Trauma

The same traumas that can damage teeth above the gum line can result in injuries below it. Chewing on hard objects (ice, hard candies, wooden pencils), bruxism (tooth grinding), and sports injuries or accidents can cause cracks in the cementum. If your root is split or fractured, it might be possible to save your tooth, but sometimes extraction is the best option.

So how do you protect your cementum, hidden as it is under your gum line? The same way you protect the more visible parts of your teeth!

• Keep to a healthy daily routine of brushing and flossing. This will help prevent gum disease and keep gum recession at bay. Using a soft brush and brushing firmly but gently will remove plaque while protecting both enamel and cementum. If you notice tooth sensitivity, give us a call!
• Come in to our Ashland office for regular dental exams. The best treatment for gum disease is prevention. When you come in for regular checkups, we are able to discover early signs of gum disease before it becomes a serious problem. If you are suffering from more advanced periodontitis, there are treatments available.
• Safety first when it comes to your smile. If you chew on hard objects, talk to Dr. John Zarrella and Dr. Peter C. Rider about how to break the habit. If you grind your teeth, see us for solutions. If you play sports, let us know—often a mouthguard can help protect your teeth from injuries that could otherwise lead to more complex procedures or even tooth loss.

Maintaining your healthy dental habits is a lot like cementum—the foundation of a beautiful smile. Nothing complicated about that!

Many people think dental fluorosis is a disease, but it’s not; it’s a condition that affects the appearance of your tooth’s enamel, not the function or health of the teeth. These changes may vary from tiny, white, barely noticeable spots to very noticeable staining, discoloration, and brown markings. The spots and stains left by fluorosis are permanent and may darken over time.

Dental fluorosis occurs in children who are excessively exposed to fluoride between 20 and 30 months of age. Only children ages eight years and younger can develop dental fluorosis. Why? That is the period when permanent teeth are still developing under the gums. For kids, fluorosis can cause significant embarrassment and anxiety about the appearance of their teeth. No matter how much they might brush and floss, the fluorosis stains do not go away.

Many well-known sources of fluoride may contribute to overexposure, including:

• Fluoridated mouth rinse, which young children may swallow
• Bottled water which is not tested for fluoride content
• Inappropriate use of fluoride supplements
• Exposure to water that is naturally or unnaturally fluoridated to levels well above the recommended levels

One way to reduce the risk for enamel fluorosis is to teach your children not to swallow topical fluoride products, such as toothpaste that contains fluoride. In fact, kids should use no more than a pea-sized amount of fluoride toothpaste when brushing, and children under the age of two shouldn’t use fluoride toothpaste at all.

Dental fluorosis can be treated with tooth bleaching, microabrasion, and conservative composite restorations or porcelain veneers. Please give us a call at our office to learn more or to schedule an appointment with Dr. John Zarrella and Dr. Peter C. Rider.

In dentistry, there are a wide variety of treatments, everything from elective procedures to those that are necessary and potentially lifesaving. So given the slew of treatment options, how do you choose what’s right for you? Our experts at Zarrella Dentistry have handpicked the three must-have procedures that we believe can benefit nearly every patient.

The first: A complete periodontal exam. If you are going to the dentist for scheduled cleanings, this exam should happen at least once a year. A periodontal exam is quick and relatively painless. The dentist or hygienist will carefully probe around each tooth to take measurements that show the health of the bone and its supporting tissue, all while looking for signs of any active infection. It has been suggested that there is a link between periodontal (gum) disease and the increased risk of some potentially fatal diseases such as heart disease, stroke, and diabetes. Signs of some diseases show up in the mouth sometimes before the patient is aware of changes in the body. Diabetes is one of these silent diseases. Many Americans are unaware that they have the disease until sudden and severe changes in the periodontal health of the teeth lead to a trip to the patient’s physician. And did you know that more adults lose teeth to periodontal disease than to cavities? A simple screening once a year can lead to saving your teeth.

The second treatment our team at Zarrella Dentistry recommends is a dental sealant; it’s not just for kids! Dental sealants provide a protective barrier from bacteria deep in the pits and grooves of the teeth where cavities often start. Sealants placed in childhood will often wear away in adulthood. Replacing a sealant as an adult can also help prevent decay in adulthood. This is a great cost-effective procedure for adults. Dental insurance will likely not cover sealants as an adult, but the cost of a sealant for prevention versus the cost of a filling is much less.

Our third must-have dental treatment is often the most fun: in-office whitening. Who doesn’t want an instantly dazzling smile? In-office whitening is one of the most dramatic and quick ways to brighten a smile. It will take a few years off your age in a two-hour period of time. Whitening is very safe and can give a patient newfound confidence to smile.

The food you feed your child can have a lasting effect on his or her oral health. In fact, diet plays a major role in whether a child develops cavities and decay, which can lead to many dental visits and potential tooth loss. So what should you feed your child to ensure he or she has a healthy smile for life?

Foods to Avoid

It is normal for your child to take interest in many foods -- especially those filled with sugar and carbohydrates. But as tasty as these foods are, they can cause rapid decay when eaten in excess. That’s not to say your child can never have sugar again. Dr. John Zarrella and Dr. Peter C. Rider and our staff suggest limiting starchy and sugary foods such as candy and potato chips as much as possible.

Remember that some seemingly healthy foods can present the threat of decay too. Some of the most common culprits are sticky foods like peanut butter, raisins, and granola bars, which can stick to the teeth after eating. If you serve these foods to your child, be sure to have him or her brush immediately after eating to remove any lingering sugary residue.

Beverages

Many beverages marketed toward children contain sugar servings that far exceed the daily recommendations from national health organizations. They suggest no more than three to four teaspoons of added sugar per day for young children.

Make an effort to serve only water to your child any time other than meal times. During meals, allow your child to have milk or juice, but in limited serving sizes. Most importantly, never allow your young child to sleep with a bottle or “sippie cup” full of juice or milk. Doing so can cause rapid tooth decay: a condition known as “baby bottle caries.”

A Healthy and Balance Diet

So long as your child is brushing regularly and eating a healthy, balanced diet full of fruits, vegetables, lean proteins and whole grains, you should have little or no problem with tooth decay. For more questions about how your child’s diet affects his or her oral health, contact our Ashland office to schedule a consultation.