David W Hopewell DDS PLLC

People who have not followed adequate dental care for some years may have already lost most of their teeth and feel a little hopeless.

Sometimes they ask a dentist to remove the remaining teeth as they are often broken and have deep cavities.

It’s true that, sometimes, removal of the remaining teeth and replacing them with full dentures is the only option.

But more often there are other options available.

Some or all of the remaining teeth could be repaired and used in conjunction with a partial denture. While a full denture replaces all of the teeth on the upper or lower jaw, a partial denture replaces some of the teeth.

If only a few weak teeth remain on the upper jaw, it might be preferable to have them extracted and a full upper denture made. Full upper dentures can be more secure than lower ones as the upper denture gets added stability from the palate and is not easily dislodged by the tongue.

If only a few teeth remain on the lower jaw, however, the dentist will usually aim to save them and use a partial denture if necessary.

Ideally, all teeth that can be saved should be saved but this is not always possible – often due to finances.

In such cases, having teeth removed and dentures may be the only option.

Tooth decay or cavities result from destruction of the tooth enamel and can lead to a range of problems from toothache to bad breath.

Cavities occur when foods containing carbohydrates (sugars and starches) such as milk, sugared drinks, cakes or candy are frequently left on the teeth.

Bacteria that live in the mouth thrive on these foods, producing acids as a result. Over a period of time, these acids destroy tooth enamel, resulting in tooth decay.

Many people associate cavities with children but the changes that occur with aging make cavities an adult problem, too.

Recession of the gums away from the teeth, combined with an increased incidence of gum disease, can expose tooth roots to plaque.

Tooth roots are covered with cementum, a softer tissue than enamel. They are susceptible to decay and are more sensitive to touch and to hot and cold. The majority of people over age 50 have tooth-root decay.

Decay around the edges of fillings is also common to older adults. As many of them did not benefit from fluoride and modern preventive dental care when they were younger, they often have a number of dental fillings.

Over the years, these fillings may weaken, fracture and leak around the edges.

Bacteria accumulate in these tiny crevices causing acid to build up which leads to decay.

You can help prevent tooth decay by following these tips:

– Brush twice a day with fluoride toothpaste
– Clean between your teeth daily with floss or interdental cleaner
– Eat nutritious and balanced meals and limit snacking

It’s also worth asking your dentist about supplemental fluoride, which strengthens your teeth, and about dental sealants, a plastic protective coating which is applied to the chewing surfaces of the back teeth to protect them from decay.

In addition, it’s important to visit your dentist regularly for professional cleanings and oral examination.

Your smile makes a huge difference to what people think about you and how you feel about yourself.

And there are many options available to help you improve the look and brightness of your smile, including:

In-office bleaching: During chair-side bleaching, the dentist will apply either a protective gel to your gums or a rubber shield to protect the oral soft tissues. A bleaching agent is then applied to the teeth, and a special light may be used to enhance the action of the agent.

At-home bleaching: There are several types of products available for use at home, which can either be dispensed by your dentist or purchased over-the-counter. These include peroxide bleaching solutions, which actually bleach the tooth enamel. Peroxide-containing whiteners typically come in a gel and are placed in a mouth guard.

Whitening toothpastes: All toothpastes help remove surface stain through the action of mild abrasives. “Whitening” toothpastes include special chemical or polishing agents that are more effective at removing stains. However, unlike bleaches, they don’t alter the intrinsic color of teeth.

Start by speaking to your dentist. He or she will tell you if whitening procedures would be effective for you as whiteners may not correct all types of discoloration.

More than 1 million Americans are diagnosed with cancer each year and many of them will develop problems with their oral health as a result of their cancer treatment.

While it’s natural that they’ll be focused on their cancer treatment, it’s important not to overlook the importance of a dental examination as part of the process of maintaining overall health.

For example, radiation therapy of the head and neck area may lead to certain complications such as dry mouth, sensitive lesions in the oral cavity, hypersensitive teeth, rapid tooth decay and difficulty swallowing.

Chemotherapy and other medication can also have significant effects in the mouth.

To help prevent, minimize and manage such problems, the dentist and oncologist can work together – before and during cancer treatment.

Many medications lead to dry mouth, which can lead to a higher risk of gum disease and other problems. The dentist may therefore recommend a saliva replacement, an artificial saliva that is available over-the-counter at pharmacies.

Frequent fluoride applications may also be recommended.

If you are receiving treatment, schedule regular screenings with your dentist and contact your dentist or physician immediately on any sign of mouth infection. This may have serious implications for your overall health.

Your dentist and physician both want your treatment to be as safe and effective as possible.

Advancements in dental techniques and the increased focus on preventive dentistry means older adults are keeping their natural teeth longer than ever before.

A survey by the National Institute of Dental and Craniofacial Research showed that the rate of toothlessness in the 55 to 64 age group has dropped 60 percent since 1960.

Whatever your age, it’s important to practice good oral hygiene at home and to visit your dentist regularly. A few simple steps can help you maintain good oral health throughout your life.

Plaque, the sticky, colorless layer of bacteria that causes tooth decay and gum disease, can build up quickly on the teeth of older adults, particularly when they neglect oral hygiene. This can increase the risk for tooth decay and periodontal disease.

So it’s important to brush your teeth twice a day with fluoride toothpaste, and clean between your teeth daily with floss or interdental cleaners.

Regular dental checkups are also an important part of caring for your teeth.

This can help you save your teeth and gums and prevent other dental problems. It will save you time and money in the long-run as well.

If you have any kind of swelling in your gum, it almost certainly indicates a serious infection that should be treated urgently.

Dental abscesses result from a bacterial infection in the teeth or gums.

For example, it may come from an untreated cavity. Cavities result when some of the bacteria in our mouths mix with sugars and starches in our diet to produce acid.

This acid attacks the hard enamel coating of our teeth and, as the cavity gets deeper, it eventually infects the nerve and blood supply of the tooth.

In some cases, a dental abscess is caused by an infection of the gum. Bone loss from gum disease can create a pocket between the tooth, gum and bone.

When bacteria and other debris get into this pocket, an abscess can form.

The treatment for an abscess depends on how severe the infection is.

If the abscess has been caused by decay, root canal treatment may be needed or the tooth may even have to be removed.

If the abscess has been caused by the gum, the gum will need deep cleaning or surgical treatment. Again the tooth may need to be removed.

Sometimes, a small incision may be made into the gum to drain the abscess. If this happens, antibiotics and pain medication may be used to relieve discomfort.

If you wait until the gum is severely swollen before seeking treatment, the situation can become very serious.

The abscess at this stage can prevent you breathing properly and can be life-threatenting.

So if you have any signs of swelling in your gum, contact your dentist immediately.

A newly born baby usually has no teeth visible but most have begun to develop primary or baby teeth.

These generally begin to appear about six months after birth.

Over their first few years, they will develop all 20 primary teeth and will usually have them all in place by age three.

The teething process is uncomfortable for many babies and they can become sleepless and irritable. They also might lose their appetite or drool more than usual.

If your infant has a fever or diarrhea while teething or continues to be cranky and uncomfortable, call your physician.

Sometimes when a tooth erupts, an eruption cyst may develop. The tooth will eventually rupture this as it pushes through the gums and these cysts are usually harmless and should be left alone.

If a baby has sore or tender gums when they are teething, it can help to gently rub the gum with a clean finger, a small, cool spoon or a wet gauze pad.

When this happens, your dentist or pediatrician may suggest a pacifier, teething ring or a special “numbing” salve for the gums.

When the teeth begin to erupt, you should brush them with a soft-bristled toothbrush and a little water to prevent tooth decay.

Toothpaste is not recommended until a child reaches age two. When a child begins using toothpaste, you need to supervise the brushing to make sure they don’t swallow it.

Regular dental checks should begin after your child’s first tooth appears or by their first birthday.

Orthodontic appliances such as braces can be used to help straighten out crooked and crowded teeth.

This is not just about looking better; it also helps improve your dental health.

How they look may determine how you feel about wearing them but, these days, braces can be as inconspicuous as you want.

Brackets � the part of the braces that attaches to each tooth – can sometimes be attached to the back of the tooth, making them less noticeable.

The brackets can be made in a wide range of different materials such as metal, ceramic or plastic.

They can also be designed to look appealing. For example, they may be clear or tooth-colored. There can also be shaped in a variety of ways like hearts and footballs or created in favorite colors.

You could even go for gold-plated braces or glow-in-the-dark retainers!

People at any age can have a condition that makes it difficult for them to look after their own dental health.

This could affect people who suffer from a wide range of conditons such as stroke, spinal cord injury, multiple sclerosis, mental retardation, Down syndrome, genetic disorders, Alzheimer’s disease or arthritis.

However, people in all of these categories have the same dental needs as everyone else – they need daily brushing and flossing, regular dental visits and a balanced diet.

There are some steps caregivers can take to make it easier to look after people in those categories.

If the person is uncooperative or uncontrollable, try to explain what you are about to do and schedule the task for a time of day when they are rested.

Move in a calm, slow, reassuring manner to avoid startling them. Give praise and encourage them when they help themselves.

Support the person’s head, and take special care to prevent choking or gagging when the head is tilted back.

If the person is unable or unwilling to keep their mouth open, your dentist will explain how you can make and use a mouth prop.

Ask your dentist for advice on how to care for people with special needs and check if they have facilities for caring for these needs in the dental office.

It would be easy to get overwhelmed by the huge range of dental care products now available.

Even looking just at toothbrushes present a wide range of choices.

There are hundreds of manual and powered toothbrushes to choose from.

Start by looking for products that carry the American Dental Association Seal of Acceptance – this is an important symbol of a the product’s safety and effectiveness.

When you buy a toothbrush, replace it every three to four months. Replace it sooner if the bristles become frayed as a worn toothbrush will not clean your teeth properly.

Make it easy for your children to brush their teeth by choosing a child-sized toothbrush and make it more interesting for them by selecting fun colors and designs.

Often people who have difficulties with hand, arm or shoulder movements find that powered toothbrushes are the best choice. However, it’s also possible to make a few small changes to modify a manual toothbrush and make it easier to use.

For example, you can:

– Enlarge the handle with a sponge, rubber ball, or bicycle handle grip
– Lengthen the handle with a piece of wood or plastic
– Bend the handle slightly while running it under hot water

Your dentist will give you tips on what toothbrushes would be right for your needs.