Oral Health

The War on Sugar

Recently, I heard a story titled “From Detox To Elimination Diets, Skipping Sugar May Be The Best Bet” on All Things Considered (NPR). It’s amazing how many times I’ll talk to patients about their dietary habits and the variety of things they tell me – the worst I have heard so far is someone drinking 2 liters of Mountain Dew every day. Many of them have Type II Diabetes or are obese and have tried a variety of ways to lose weight: no red meat, only meat/no carbs, vegan, etc.  It’s also amazing how little information there is on the health benefits of each of them as seen in this article: Science On Diets Is Low In Essential InformationI am vegetarian and my husband as a result eats mostly vegetarian with some chicken/fish/pork scattered throughout the week but the only real dietary limitation we place on ourselves is sugar consumption. We love an occasional ice cream or dessert but everything in moderation.  (more…)


Sip All Day, Get Decay: Lemons

A popular trend for many people is drinking water with fresh squeezed lemon either in the morning or sipping it all day. Unfortunately, these diets and trends for ‘detox-ing’ aren’t supported by science and have led to an unfortunate rise in enamel erosion. The major positive is that drinking water (with or without lemons) keeps you hydrated but otherwise lemon in water doesn’t improve digestion, boost absorption of nutrients, nor does it really ‘detox’ your body.

Acidity in lemons reduces the surface hardness of tooth enamel and can cause erosion. If you brush your teeth soon after consuming the drink, the enamel is still soft and can easily erode. This enamel can never be replaced despite what the toothpaste commercials may purport. When it’s worn away, it exposes the softer underlying dentin (making the teeth look more yellow) and can cause sensitivity and cavities.

Minimize the risk of enamel erosion from acidic drinks:

  • Limit the frequency of acidic beverages throughout the day.
    • Try to limit acidic drinks to meal times only, to give the mouth a chance to restore to its optimal pH level
    • Drink water frequently during the day to help wash away acid
  • Don’t brush your teeth for at least half an hour to an hour after the drink
  • Rinse your mouth out with water or eat something like cheese to neutralize the acidity
  • Brush your teeth gently (don’t scrub hard)
  • Use a straw to limit the drink’s contact with the teeth
  • Chew sugar-free gum (this stimulates saliva which helps to neutralize the acidity)

Here’s a quick article about the medical side of the lemon water detox debate.


What does a cavity/filling look like?

What does a cavity/filling look like?

Cavities can form on any surface of a tooth. They are most common in the nooks and crannies of the biting surface and between teeth (where floss is rarely seen…). The areas between and below your teeth need to be evaluated with an x-ray so we take radiographs every year to every few years (depending on your risk of getting cavities) to make sure that you don’t have cavities starting between your teeth, under existing fillings, or any infections brewing at the root.

This photo shows you what a cavity looks like when the tooth is first accessed, the cavity cleaned out, and then the final filling in composite (tooth-colored filling) which is color matched to the existing tooth color. Unfortunately if the fillings aren’t kept very clean (yes, flossing comes into play…) chances of getting a cavity are higher since filling margins tend to attract and hold plaque and bacteria.

The green stretchy material you see around the teeth is called a rubber dam. It holds the oral fluids away from the materials used for the filling to ensure that there is limited moisture contamination when placing the filling. Not everybody uses them but I like to keep the materials I’m using from being ingested by my patients, a stronger filling, and less chance of leakage between the filling and tooth structure.