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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 Appleton, WI 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. Dale Scharine and Dr. Mark Pflum 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!

We want our children to have every advantage, including oral health. That’s why you encourage your child to brush twice a day. You keep the sugary treats to a minimum. You schedule dental exams and cleanings at our Appleton, WI office.

So, how did your child get a cavity? What to do to prevent more tooth decay?

First, don’t feel guilty. Some people are more prone to cavities, even with diligent brushing and flossing. But to make sure children have all the advantages when it comes to preventing cavities, we have some tips which might improve their dental habits.

• Better Brushing

Even for adults, brushing technique can be haphazard! Brushing’s not as effective without covering all the tooth surfaces (inside, outside, and molar tops), holding the brush at a 45° angle, gently brushing the teeth with small strokes, brushing for at least two minutes, and flossing between the teeth at least once a day.

Until children develop the motor skills to brush by themselves (around age six or seven), you can help by monitoring their brushing and flossing. If you like, you can use these four minutes a day for fun as well as dental care by playing music, awarding stickers, using an app with entertaining timers, or having your child mirror your brushing habits as you brush together.

And do make your child’s life easier with the right tools. Brush heads should be small enough to fit in little mouths comfortably, and bristles should always be soft. Floss, too, should be soft and flexible. Don’t forget to retire your child’s brush after three or four months—bristles start to fray and won’t clean effectively.

• Sealing the Deal

Ask about dental sealants. This treatment provides a protective coating for your child’s molars. Cavities are so common in molars because the tops of these teeth are quite uneven. Food particles and plaque are trapped in grooves where brushes have a hard time reaching.

The sealant process is a simple and safe one. Healthy teeth are cleaned and dried, an etching solution prepares the tooth surface, a thin coat of sealant is applied, and the coating is hardened under a curing light.

Dr. Dale Scharine and Dr. Mark Pflum might recommend sealants when your child’s first adult molars erupt. Enamel takes a while to develop its full strength, so new molars are especially vulnerable to cavities. Sealants typically last from three to five years, and studies have shown a dramatic reduction in cavities when teeth are treated with sealants.

• Fluoride Helps Prevent Cavities—in Two Ways!

Fluoride helps strengthen enamel in developing teeth. Because many communities have fluoride available in their water systems, your child gets the benefit of this natural mineral.

If you’re providing your child with fluoride toothpaste, you’re helping prevent cavities in the teeth, which have already erupted. The acids from oral bacteria weaken the mineral structure of enamel, which is the first step in forming a cavity. Fluoride helps repair weakened enamel in a process known as “remineralization.”

Dr. Dale Scharine and Dr. Mark Pflum can let you know the amount of fluoride that is right for your child, including how much or how little fluoride toothpaste to use, a prescription supplement if your water doesn’t contain fluoride, or the application of a fluoride treatment directly to your child’s teeth.

• Avoid Tricky Treats

Some treats are much better than others. We’re not talking taste, though. When it comes to dental health, texture and time are more important.

When your child enjoys a plain chocolate bar, saliva helps wash away sugary food particles. Sticky candies and starches, like caramels and potato chips, are a “stickier” problem. They cling to enamel, providing lots of sugar as fuel for cavity-creating bacteria. Similarly, drinking a soda with lunch (not every day, of course!) provides a short exposure to sugars. Sipping sodas throughout the day is like bathing teeth in sugar for hours at a time.

To eliminate some of the treats bacteria love, choose snacks with an eye to how they affect teeth throughout the day, and teach your child to brush or rinse with water after eating.

• Schedule Regular Dental Exams and Cleanings

Most children should be visiting Elite Smiles Dental twice a year, even during the baby teeth years. Dr. Dale Scharine and Dr. Mark Pflum will monitor your child’s primary teeth and developing teeth and bite. And a professional cleaning removes built up plaque that even the most dedicated brusher might miss.

If you have any concerns about cavities and their prevention, Dr. Dale Scharine and Dr. Mark Pflum will have suggestions tailored to your child’s individual needs. Us working together to make sure your child has a healthy, confident smile? That’s a partnership that will provide lifelong advantages!

We all want to live our healthiest lives. We know that part of keeping ourselves healthy is regular visits to our Appleton, WI office for checkups and necessary dental work. And that dental work might require an X-ray. Should the amount of radiation in an X-ray concern us?

First, it is helpful to know that the radiation you are exposed to from a dental X-ray is very small. A set of most bitewing X-rays, for example, produces an amount of exposure about equal to the amount of background radiation we get from our normal surroundings in a typical day. We also take care to minimize your exposure even further by using specially designed equipment and protective shielding, and taking only necessary X-rays. If your child is very young, if you are pregnant, or if you have other health concerns, talk to us about the advisability of X-rays and whether they are essential to treatment.

Second, much of our careful general examination will be done visually. Dr. Dale Scharine and Dr. Mark Pflum can check for cavities and other problems and assess tooth and gum health. But sometimes, there are conditions which can’t be detected without an X-ray.

• Decay that isn’t visible in an oral exam—if a small cavity develops between teeth, or is hidden underneath a filling, an X-ray will catch it before more damage can take place.
• Infection—An X-ray will reveal infections such as abscesses that can damage both bone and tooth, and gum disease that has harmed bone and connective tissue.
• Orthodontic and periodontal issues—We might need an X-ray to determine the spacing and development of your child’s incoming teeth and maturing jaw structure, to properly create braces for adults or children, or to place an implant within the jawbone.
• If you are a new patient, it is helpful to have complete X-rays taken as a baseline of your current dental health and previous dental work. This baseline allows us to track tooth and jaw development, if necessary, and to evaluate any future changes that might be a concern. (If you have had X-rays taken in another office, we can help you have them transferred so we have a background of your dental history.)

Even though the radiation from a dental X-ray is minimal, be assured that we will never request any unnecessary procedure. When we recommend an X-ray, we do so to make sure there is no decay or infection threatening the health of your gums and teeth, and that we have the essential knowledge we need to treat any dental, periodontal, or orthodontic condition. Because we all want to live our healthiest lives—and part of that healthy life is both active and proactive dental care.

One of the most enjoyable parts of looking at family pictures is finding resemblances. You have your father’s brown eyes and your grandmother’s curly hair. You’ve got your aunt’s basketball height and your cousin’s freckles. But some similarities might not be so appealing—could one of those be a family tendency toward gum disease?

Studies have shown that periodontal disease appears to have some kind of genetic component, especially for serious diseases and those that appear early in the patient’s life. Aggressive periodontitis, for example, a relatively uncommon disease which causes rapid bone loss around certain teeth, is often more common among members of the same family. Other studies suggest there might be a genetic link between our immune response and the development of chronic periodontitis. So far, however, the link between genetics and gum disease is still under investigation.

We do know that environmental factors are an important trigger for gum disease. Failure to brush and floss, smoking, diet, stress, medical conditions such as diabetes—all can influence the health of our gums. The best way to overcome these factors is your own proactive approach! Thorough brushing and flossing, regular checkups and cleanings, proper nutrition, and avoiding smoking are all time-tested ways to keep your gums and teeth healthy. If you have a medical condition, proper treatment and medication will also help protect your oral health.

During your examination with Dr. Dale Scharine and Dr. Mark Pflum at our Appleton, WI office, please tell us about any family history of periodontal disease, your own gum care routine, and any habits or conditions which might influence your health. We can tailor treatment and offer suggestions for prevention based on a thorough knowledge of your medical history. We have many options available today for preventing and treating gum disease. Let’s make sure all your family albums are filled with beaming smiles—that’s the most appealing resemblance of all!