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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 Lebanon, NJ 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. DeCasperis 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!

Whether it’s your first child or you’re an experienced mom, pregnancy is an exciting time—which you’ll be able to enjoy much more once the days of morning sickness are over.

Morning sickness affects most pregnant women, and can present in any number of ways. It might take the form of mild nausea, or cause frequent vomiting. It often occurs in the morning hours, but can take place at any time of day. It’s usually over with by the second trimester, or it can last weeks longer. Because of this wide variety of symptoms, morning sickness is more accurately referred to as NVP, the nausea and vomiting of pregnancy.

Your doctor can recommend safe and effective ways to deal with NVP, especially when symptoms are more severe. We have some recommendations to minimize the effect of morning sickness on your dental health.

Wait, dental health? That’s right. Besides its more obvious unpleasant consequences, NVP can cause problems for your teeth and gums. We have a few suggestions for getting you through the weeks of morning sickness with easy and effective strategies to protect your oral health.

Prevent Acid Damage

Vomiting and heartburn with reflux expose the teeth to stomach acids. Tooth enamel is the strongest substance in the body, but it’s not safe from acid attacks.

Normally, the pH balance in our mouths is neutral, around a 7 on a scale of 0 to 14. When acidic conditions lower the oral pH to 5.5 or below, the minerals in enamel begin to dissolve, leading to sensitivity and, eventually, cavities. The pH of our stomach acid ranges from 1.5 to 2.5. This is great for digesting food, but not great at all for enamel and sensitive gum tissue.

Whenever we vomit, the immediate (and understandable!) impulse is to reach for our toothbrushes. But this is an impulse we should resist. Because acids weaken tooth enamel, scouring the teeth with a toothbrush right away can cause more erosive damage. Instead,

• Wait half an hour or more before brushing to give your enamel time to recover its strength.
• In the meantime, rinse with water and perhaps a bit of toothpaste or diluted, doctor-approved mouthwash.

Keep Hydrated

Another consequence of frequent vomiting is dehydration. It’s always important to keep our bodies properly hydrated, and this is particularly true during pregnancy.

Hydration is also essential for oral health. Saliva helps wash away the bacteria and food particles which cause cavities and irritate the gums—especially important now, since pregnancy hormones can leave you more vulnerable to gingivitis and other forms of gum disease.

• Drink water as recommended by your doctor. It’s healthy, it hydrates, and it helps prevent cavities and gum disease. Win/win/win.
• Whichever fluids are your favorites, drinking them in measured amounts through the day will be more effective and more appetizing than drinking large amounts once or twice a day to catch up.
• You have a busy life, so make things easy on yourself. If you need to hydrate more, keep track of your hydration goals with an app or a phone notification. There are even “smart bottles” to track your intake. Or go old school, and fill a bottle marked with timed measurements to remind you to hydrate through your day.

When The Very Idea of Brushing Is Nauseating . . .

When just the thought of brushing is unappetizing, we have suggestions which might help.

• Postpone brushing until later in the day when you feel better. Rinse with water first thing in the morning instead.
• Trade in your regular toothbrush for one with a smaller brush head. This can help prevent the gag reflex.
• Brush slowly, using small strokes.
• If brushing the back teeth is particularly triggering, try deep breathing or sitting down to brush.

We want to help you enjoy a healthy pregnancy. Let us know when you first learn you’re pregnant. We have some valuable tips for the coming months, including suggestions for reducing the dental effects of NVP. Fortunately, morning sickness is temporary, and we’re here with ideas to help your beautiful smile last a lifetime!

Should a quick bite between meals make us feel guilty? Or worse, make our teeth suffer a greater risk of cavities? Let’s avoid both those possibilities! We have several tooth-healthy snacking strategies designed to help you keep your enamel cavity-free while preventing snacker’s remorse.

But first, a word or two about why we may find snacking unappetizing.

• Please, Don’t Feed the Bacteria!

The bacteria in plaque feed on sugars and leave acidic waste products behind. These acids attack enamel, dissolving the calcium and phosphorus minerals that keep it strong. Weakened enamel leaves teeth vulnerable to decay. That’s why Dr. DeCasperis and our Lebanon, NJ team recommend avoiding a steady diet of sugary treats.

Even if you’re not reaching for a soda, or grabbing a candy bar, many snack foods are filled with added sugars. Check the nutritional labels before you indulge to avoid sugar surprises.

• Off Balance?

Bacteria plus sugar equals more acidic conditions in the mouth. This change in the oral pH balance also reduces our natural defenses against cavity-causing acids.

A well-balanced oral environment depends on saliva to keep acids in check. Saliva washes away lingering food particles after meals, and it neutralizes acidic conditions in the mouth over the course of the day.

How does snacking interfere? Immediately after eating or drinking, acids in saliva increase. It takes about 20 minutes for saliva’s neutralizing process to begin. When we snack throughout the day, saliva doesn’t have a chance to reduce acids as long or as effectively.

• Staying Power

Sticky and chewy snacks tend to stick to the tops of molars and between the teeth. This gives bacteria more fuel and more time to attack tooth enamel. It’s not just candies that are the culprits here. Chips, bread, pizza crusts, pastries—these simple carbs stick to teeth and break down easily into sugars.

But we promised some *positive* strategic snacking ideas. Here are some ways to make sure that snacking doesn’t put you at a much greater risk for cavities.

• Be Choosy

Avoid processed treats that are high in added sugars. If you’re craving something sweet, fresh fruits provide sweetness with vitamins included.

Crispy fruits such as apples and Bosc pears, as well as vegetables like celery and carrots, provide gentle scrubbing action to help clean teeth between brushings.

Snacking on cheese helps neutralize acids, and other dairy products are high in calcium and phosphorus, helping rebuild the minerals that acids leach out of enamel.

Eat whole grain breads, pastas, and pastries. They offer more nutrients, and don’t break down into sugars as easily.

Finally, when it’s time to indulge in a sugar-rich treat, save it for a meal. There’s a better chance that other foods will balance the acids created by sugar, and you’ll be getting the most out of saliva’s neutralizing abilities. Speaking of which,

• Stay Neutral

When you’re craving something flavorful without giving bacteria more fuel for acid production, consider sugar-free gum. Sugar-free gum saves you from adding sugar to your diet, and it increases saliva production as you chew. If we give you the all-clear, chewing a piece or two of gum during the day can help curb your sugar cravings and protect your enamel.

Thirsty? Drink water instead of sodas or energy drinks with your snacks. Water washes away food particles, cuts down on acidity, and provides fluoride to strengthen and protect teeth.

• To Brush or Not to Brush?

It’s always a good idea to brush after eating. But since eating sugary or acidic foods can leave enamel vulnerable to toothbrush abrasion, many dentists recommend waiting 30 minutes after you snack before brushing. Ask Dr. DeCasperis what’s best for your teeth.

If you can’t brush, rinse with water after eating or drinking.

If you wear braces or aligners, be sure to check with Dr. DeCasperis about snacking, gum, best times to brush, and any other diet questions.

Talk to Dr. DeCasperis about your snacking habits. Learning when and how to snack is as important as deciding what to snack on. Finding the perfect balance means you can enjoy a mid-day energy boost without guilt—and without risking tooth decay!

Your darling three-month old is crying and fussy—can she be teething already? Or, your happy baby boy has just celebrated his first birthday—with only one tooth in that beautiful, gummy smile. Is this normal? Probably! While baby teeth do typically erupt (come in) in the same order for all babies, and around the same time, there is still a lot of flexibility in the time it takes for a full, healthy smile to develop.

Baby teeth actually form before your baby is born, and those 20 teeth are there under the gums waiting to come out and shine. And even though there are no firm and fast dates for each of these primary teeth to erupt, it’s helpful to have a general overview of typical teething patterns so you know what to look forward to.

Incisors

These little teeth create a charming baby smile, and, if your finger has been in the wrong place at the wrong time, a very sharp one as well! That is because these tiny incisors are made to bite into foods. You might notice this when you introduce solid foods, even if the majority of your child’s “chewing” is done with her back gums. These teeth are the earliest to arrive.

• Six to ten months old: The lower central incisors (bottom front teeth) are often the first to come in.
• Eight to 12 months old: The upper incisors (8-12 months) are the next to show.
• Nine to 13 months old: The upper lateral incisors on each side of the front teeth arrive.
• Ten to 16 months old: The lower lateral incisors appear.

First Molars

Because these are larger teeth, babies often experience another bout of teething pain at this time. The large flat surface of each molar helps your child to chew and grind food, so he can handle a wider variety of foods and develop his chewing skills.

• 13 to 19 months old: You can generally expect to see the upper first molars arrive.
• 14 to 18 months old: The lower first molars appear.

Canines (Cuspids)

Fitting between the first molars and the incisors, the strong, pointed shape of the canine teeth allows your child to grip food and break it apart more easily.

• 16 to 22 months old: The upper two canines make their way into the space between the incisors and the first molars.
• 17 to 23 months old: The two lower canines appear.

Second Molars

By the age of three, most children have a full set of baby teeth.

• 23 to 31 months old: The second pair of bottom molars start erupting—you are in the home stretch!
• 25 to 33 months old: The upper second molars come in—completing that beautiful set of 20 teeth!

Baby teeth are extremely important, as Dr. DeCasperis will tell you when you visit our Lebanon, NJ office. They help your child eat and chew, develop face and jaw muscles, assist proper speech formation, and provide space for the adult teeth to come in properly. Now that your child’s smile is complete, keep providing him with the same care and attention you have been giving those little teeth since the arrival of the very first incisor.

It seems that so much of new parenthood is scheduling—when to feed her, when to put her to bed, how many hours between naps. But we soon find out that every baby is not on the same schedule, and the same is true for the arrival of their teeth. We should see your baby when that first tooth comes in, or by his or her first birthday. And if you ever have concerns at any time about your child’s teething schedule or teething delays, always feel free to give us a call.