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When you’re pregnant, you expect physical changes. That’s part of the excitement of the journey! What isn’t expected—and not nearly as exciting—is when your familiar smile seems to be changing as well.

If you’ve noticed that your teeth feel loose, or that your regular tooth alignment has shifted, you might be experiencing one of the unexpected, but quite common, side effects of pregnancy—tooth mobility.

How is this “wiggle room” possible? After all, you’re making sure that you’re eating a diet rich in protein, vitamins, and minerals, including calcium, vitamin D, and all the other nutrients which keep teeth and gums healthy. You’re brushing and flossing regularly to prevent cavities and gum disease. You haven’t changed your healthy dental habits, so why are you seeing different results?

The answer lies in the hormonal changes which occur with pregnancy. Your body has significantly increased production of hormones such as estrogen, progesterone, and relaxin. One of the benefits of these higher hormonal levels is their relaxing effect on your ligaments and joints. Relaxed ligaments and joints help make pregnancy and childbirth easier.

But you can’t target hormones just where they’ll be most useful. An increase in hormones affects the ligaments and joints throughout your body. And while this explanation might seem unrelated to loose teeth, it is, in fact, the “root” of the matter.

A complex support system holds our teeth securely in their sockets. Instead of being rigidly fused to the jaw, each tooth root is surrounded by a periodontal ligament within the socket. This ligament is largely made of flexible connective tissue, and attaches to both the root of the tooth and the bone tissue of the jaw, holding the tooth in place. Its flexibility helps cushion your tooth from pressure and impact, and allows the tooth movement which makes orthodontic work possible.

The hormones which relax ligaments and joints throughout the body have that same relaxing effect on the flexible ligaments and joints in the mouth. So it’s not uncommon to find that your teeth feel a bit looser, or that your customary tooth alignment has shifted, or that you’re experiencing discomfort in your jaw joint, especially if you grind or clench your teeth.

Fortunately, while loose teeth are alarming, it’s most often only a temporary condition. Your teeth and ligaments should return to their normal, stable status after your baby is born. But because dental health can impact on your pregnancy, see us if you notice any changes in your smile. We want to rule out any other causes of tooth mobility, including gum disease, tooth abscesses, or other serious conditions.

Other proactive prenatal tips to keep your smile its healthiest?

• Call us when you learn about your pregnancy. We can offer suggestions for caring for yourself and your dental health during this exciting time.
• Keep up with your dental hygiene. Brushing and flossing are more important than ever to keep your gums healthy.
• And, because your gums might be more prone to gingivitis now, extra cleanings as needed can keep plaque buildup from forming.
• Don’t forget your regular appointments at our Lebanon, NJ dental office for exams and cleanings. We want to help prevent any small problems from becoming larger ones.

Pregnancy is a time of many physical changes. Dr. DeCasperis will work with you to ensure that one thing which remains constant is your beautiful, healthy smile!

We’re used to seeing athletes wearing mouthguards at practice or play, because dental trauma is one of the most common (and predictable) sports injuries. But it’s not just athletes who are at risk, and there are some events in our daily lives that we just can’t predict. Car accidents, falls, workplace injuries, even innocent playground structures can take their toll on our smiles.

A major chip or a crack in your tooth is upsetting enough, and should be seen by Dr. DeCasperis as soon as possible. It’s even more unnerving when a tooth is knocked out completely. The technical term for a tooth which has been knocked out is an avulsed tooth, and it is a true dental emergency.

If you should suffer a partially or completely dislodged tooth, there is a possibility that your tooth can be reimplanted—if the damage isn’t too severe and if you get to our office immediately.

How can a lost tooth be saved? This is possible because of the complex biological engineering that anchors our teeth within the jaw. The root of a tooth is surrounded by the periodontal ligament. This connective tissue attaches the tooth to the alveolar bone of the jaw. When a tooth is knocked out, this ligament splits apart, leaving some tissue on the tooth root and some within the tooth’s socket.

To successfully reimplant a tooth, the connective tissue cells around the root of the tooth need to be vital, so that they can begin to reattach to the connective tissue left in the socket. Over time, this reattachment is complete, and the tooth becomes firmly anchored to the bone again.

It’s important to protect your tooth before you see Dr. DeCasperis to make sure there will be enough healthy tissue for reattachment. First of all,

• Don’t panic! If you or a friend or family member lose a tooth, call your dentist or your emergency health care provider as soon as possible. You will get specific instructions for your specific situation.

If you are unable to reach a healthcare provider immediately, there are some general rules for taking care of an avulsed tooth:

• Find the lost tooth. Don’t touch the root—use the crown, or top part of the tooth, to pick it up. You are trying to preserve and protect the connective tissue on the root surface.

• If the tooth is dirty, gently rinse it in milk, saliva, or water. Don’t wipe it off, though. You could damage those connective tissue cells mentioned above.

• Place the tooth back in the socket, if possible. Gently hold it in place with your fingers or bite down (again, gently). You can also place the tooth in your mouth next to your cheek.

• If returning the tooth to the socket is not an option, or if you are worried about a child possibly swallowing the tooth, keep the tooth moist. Whole milk or solutions sold just for the purpose of preserving an avulsed tooth are better choices than water, which damage the tissue cells on the root. And never wrap the tooth tightly—this can also damage the connective tissue.

Above all,

• Don’t delay! The faster a tooth is reimplanted in its socket, the greater chance you have of keeping it. Really, every minute counts. Reimplantations are more successful if they take place within 30 minutes. After an hour out of the mouth, your tooth’s chances of successful reintegration are lower—but still worth pursuing!

What will Dr. DeCasperis do?

• Evaluate the avulsed tooth.

There are variables which can affect whether or not a lost tooth is a good candidate for reimplantation. Trying to replace a baby tooth, for example, could interfere with the formation of the adult tooth. An adult tooth that is broken will probably require a different type of treatment.

• Prevent infection.

You might be given antibiotics and a referral to your medical doctor for a tetanus booster if needed.

• Clean the site.

The socket will be gently irrigated to clean the area and to remove any clots that may have formed which can interfere with the tooth’s placement.

• Recommend or perform a root canal.

Nerves and blood vessels within the tooth’s pulp generally don’t recover after a serious traumatic injury, so a root canal procedure could be necessary to preserve the health of your tooth. This procedure might be done immediately, or might be recommended for a later date.

• Stabilize your tooth.

The tooth must be stabilized after being reimplanted, so Dr. DeCasperis will use a splint to anchor the tooth to the teeth next to it. The splint can be flexible or rigid, depending on the condition of the alveolar bone. Splinting generally takes from two to eight weeks, and you will be given detailed instructions for taking care of the area while you heal.

Losing a tooth is an alarming experience. But with prompt action, and a trip to our Lebanon, NJ office, it might be possible to make that loss only a temporary one.

We know that the foods we eat and drink can have a definite impact on our smiles. Staining is an unhappy side effect of many of our menu favorites. That’s why we sip red wine through a straw, rinse with water after a slice of blueberry pie, and cut back on the coffee and tea after a single cup (or two—we’re not perfect!). And sugar is the fuel for cavity-causing bacteria, so we try to substitute water for soda, or replace the hot fudge sundae with grilled fruit. And we always brush carefully after indulging.

So far, so good. But while we’re saving our brilliant smiles from stains and decay, let’s not forget one other source of diet-related damage—acids. Acidic foods and beverages can actually erode the surface of our enamel, leaving our teeth more vulnerable to sensitivity and discoloration.

What Is Dental Erosion?

Enamel is the strongest substance in our bodies—stronger than bone—but it is not indestructible. And acids are one of the major causes of enamel damage. (In fact, it’s the acids produced by bacteria that lead to cavities.) Luckily, our bodies are designed to protect our enamel. Saliva helps clean the teeth by washing away food particles and it neutralizes acidity as well. But a diet that’s too heavy in acidic foods can undo all this good work and upset the healthy pH balance in our mouths.

Why is this a problem? Because acidic environments actually cause the minerals in our enamel to break down, a process known as “demineralization.” This weakening of the enamel leaves teeth more sensitive to heat and cold. It can even lead to discolored teeth, as thinner enamel allows the brownish-yellow dentin underneath the enamel surface to become visible.

Are You Aware of Acids?

We can immediately guess at some of the most acidic foods. Citrus fruits and juices, tomatoes in their many culinary forms, anything pickled in vinegar, coffee, tea, wine—these foods are certainly acidic, but also a regular part of many a healthy diet. You don’t need to avoid these foods altogether, but it’s best to enjoy them as part of a meal or enjoy them sparingly. And balance out some of these high-acidity foods at mealtime with low-acidity choices like bananas, bread, and dairy products.

Other sources of damaging acids might surprise you. Studies have linked sodas, energy drinks, and sports drinks to higher levels of tooth erosion. The combination of citric acid, phosphoric acid and/or carbonation raises acidity levels in the mouth. And because we tend to sip them all day long, it’s like a continuing acid bath for our enamel. Water is always a healthy alternative for hydration, but if you do indulge in a soda or sports drink, rinse with water after drinking. And don’t swish—just swallow.

Won’t Brushing Help?

Yes, but watch your timing. Because the acids in foods weaken enamel, brushing right after a big glass of orange juice or a soda can actually be even more abrasive for tooth surfaces. We recommend waiting anywhere from 20-60 minutes to brush. This gives your saliva the chance to not only wash away acids, but to “remineralize” your teeth, bathing them in the phosphate and calcium ions that strengthen enamel.

If you notice any of the symptoms of dental erosion, including pain, sensitivity when you eat or drink something hot, cold or sweet, or yellow discoloration, talk to Dr. DeCasperis during your visit to our Lebanon, NJ office about what you can do to help protect and strengthen your teeth. Unfortunately, our bodies can’t produce new enamel. By avoiding foods that stain, by reducing sugars that lead to decay, and by limiting the acidic foods that erode our enamel, we give ourselves the best opportunity for a lifetime of beautiful, healthy smiles.

Even before a baby is born, those tiny baby teeth are already forming. Expectant mothers can help ensure that their children’s baby teeth will be strong and healthy by getting the recommended amounts of proteins, vitamins, and minerals in their prenatal diets.

But a mother can’t “eat for two” to make sure her child’s adult teeth are healthy—children’s permanent teeth begin real growth and development only after birth. What can we do to encourage strong permanent teeth as our children grow and develop? Here are four important building blocks parents can use to lay a healthy foundation for their children’s grown-up smiles.

Serve a Tooth-Healthy Diet

The same vitamins and minerals that help create baby teeth are essential for creating healthy adult teeth. Tooth enamel, the hardest substance in the body, is almost completely made up of calcium phosphate minerals.  A diet which provides the recommended amounts of calcium and phosphorus helps your child’s body grow strong enamel. And don’t forget vitamin D, which our bodies need to absorb calcium and phosphorus.

A tooth-healthy diet should include several servings of foods which provide calcium, such as dairy products (milk, yogurt, cheese), dark leafy vegetables, and fortified juices, cereals and tofu. Phosphorus can be found in proteins like meat, fish, and poultry, as well as beans, nuts, dairy, and whole grains. Egg yolks and fatty fish are natural sources of vitamin D, and it’s easily available in fortified foods such as cow’s milk, soy milk, cereals, and orange juice.

Use the Right Amount of Fluoride

Fluoride is called “Nature’s cavity fighter” for a reason. Fluoride reduces the risk of cavities and helps strengthen tooth enamel. Dr. DeCasperis can offer invaluable advice on when to start and how to use fluoride toothpaste to protect your child’s baby teeth and developing adult teeth.

Can there be too much of this good thing? While fluoride is a safe and effective way to protect teeth in normal, recommended amounts, too much fluoride can lead to fluorosis. This condition can cause cosmetic changes in the enamel of permanent teeth, from almost invisible lighter spots to darker spots and streaking.

How to make sure your child gets the right amount of fluoride?

For children under the age of three, use a dab of toothpaste no larger than a grain of rice. Ask Dr. DeCasperis if fluoride toothpaste is recommended.

Young children can’t always understand the idea of spitting and rinsing after brushing, so children between the ages of three and six should use only a pea-sized dab of fluoride toothpaste, and need you there to make sure they spit and rinse afterward.

Ask us about local water fluoride levels if you have any concerns about using tap water for drinking or for mixing formula, keep fluoride toothpastes and other products out of the reach of children, monitor your children while they brush, and always check with us before giving your child a fluoride rinse or supplement.

Help Your Child Retire Harmful Thumb Sucking and Pacifier Habits

Your child might self-comfort with the help of a pacifier or thumb sucking, which can be a valuable soothing habit. But it’s important to talk to Dr. DeCasperis to see just how long this soothing habit should last. Around the age of four, aggressive thumb or pacifier sucking can lead to problems for permanent teeth.

Vigorous sucking can cause protruding upper front teeth. Aggressive sucking can lead to changes in the shape of your child’s palate and jaw. Open bite malocclusions, where the upper and lower teeth are unable to meet, and overbites, where the upper teeth overlap the lower teeth more than they should, can also be the result of lengthy and forceful thumb sucking.

Take Care of Baby Teeth

Baby teeth are important! They bite and chew food, and they work with the tongue to help your child learn to pronounce words properly. And there’s one more important reason to make sure primary teeth stay healthy: they serve as the place holders which guide permanent teeth into their proper spots.

When a baby tooth is lost too early, due to decay or injury, the teeth on either side can drift into the empty space, preventing a permanent tooth from erupting where it needs to. Any misalignment or crowding which results may require orthodontic treatment in the future.

Call our Lebanon, NJ office if your child unexpectedly loses a baby tooth. There may be no cause for concern, or, if there’s a potential problem, an appliance called a “space maintainer,” which keeps the baby teeth from shifting out of place, can be fabricated especially for your child.

Your child’s adult teeth are being formed now. Work with us to make sure the building blocks of present and future dental health are in place. You’re giving your child the foundation for a lifetime of beautiful, grown-up smiles!