Whitening Your Smile Smoking & Your Mouth
How we look and how we perceive ourselves has much to do with
The use of the word “smoking” and the phrase “good oral
our self-esteem. When the color of our teeth makes us embarrassed
health” in the same sentence just doesn’t go together.
to smile, it’s probably time to get our teeth whitened (bleached).
As one ages, teeth may darken from coffee, tea, smoking, berries
There are 9,000 deaths a year in the
and other substances that get into microcracks in the enamel,
U.S. from oral cancer and tobacco use
causing discoloration. Some people have gray or brown bands on their teeth caused by an early childhood fever or tetracycline
medication taken when the tooth enamel was forming. In some parts of the country where fluoride is found in naturally high concentrations in the drinking water, individuals have developed
Not only does smoking leave brown stains and sticky tar
teeth with bright white patches or dark brown blotches (mottled
deposits on your teeth or dentures, but it contributes to halitosis
(bad breath). It’s not uncommon to see red inflammation on the palate (roof of the mouth) from the high temperatures generated
Not everyone is a candidate for bleaching. Teeth discolored from
by cigarette, cigar and pipe smoking.
aging have the best results. If you have tooth-colored resin or composite fillings in your front teeth, they will not change color
Smoking is a major risk factor in periodontal (gum) disease. As
from bleaching and will stick out like a sore thumb after the
shown by 20 years of research, smokers are two to three times
procedure. If you would like to have your teeth whitened, call it to
more likely to develop periodontitis (bone loss). Tooth loss is
your dentist’s attention at your next check-up visit. If you are not a
much more prevalent than in non-smokers. Studies have shown
good candidate, he or she can suggest alternatives such as bonding
a higher rate of dental implant failures for those who smoke.
Even second-hand smoke poses danger, especially for children.
There are various options to whitening your teeth. Bleaching can be
When children breathe in smoke, it can affect the development
an in-office procedure (chairside). It may involve several
and eruption of their permanent teeth.
appointments of 30-60 minutes each. The bleaching agent is applied to y our teeth and activated with a special light.
The good news is that “kicking the habit” greatly reduces the risk of developing oral cancer. After 10 years of cessation, the
There is also an at-home procedure wherein you will wear a
risk is similar to that of a non-smoker. There are a number of
custom-made mouthguard filled with a bleaching gel for two hours
ways to stop without experiencing extreme withdrawal
daily, or at night, for approximately two weeks.
symptoms including the nicotine patch, nicotine gum and nicotine spray or inhaler.
Some toothpastes have added whitening agents and can be used as an adjunct to the other two procedures. In any case, there is no reason to ever again suffer the embarrassment of discolored teeth.
Diabetes: Dental Tips
A number of studies have shown that people with periodontitis are more likely
Diabetes can cause serious problems in your mouth. You can do something
to develop cardiovascular disease than individuals without periodontal infection.
One such study suggests that the risk of fatal heart disease doubles for persons with severe periodontal disease.
If you have diabetes, make sure you take care of your mouth. People with diabetes are at risk for mouth infections, especially periodontal (gum) disease.
Part of the link between these two diseases may be discovered through novel
Periodontal disease can damage the gum and bone that hold your teeth in place
investigations of the opportunistic, infectious bacteria that colonize the mouth.
and may lead to painful chewing problems. Some people with serious gum
Scientists theorize that certain types of these bacteria, which form biofilms and
disease lose their teeth. Periodontal disease may also make it hard to control your
cause periodontal disease, also activate white blood cells in the body to release
pro-inflammatory mediators that may contribute to heart disease and stroke.
Other problems diabetes can cause are dry mouth and a fungal infection called
To explore the underlying inflammatory responses common to both diseases,
thrush. Dry mouth happens when you do not have enough saliva – the fluid that
NIDCR grantees are examining periodontal disease measures (pocket depth
keeps your mouth wet. Diabetes may also cause the glucose level in your saliva
where gingival tissues have pulled away from tooth surfaces and where there is
to increase. Together, these problems may lead to thrush, which causes painful
loss of tissue) and biological responses in 14,000 people enrolled in an extensive
study of heart disease sponsored by the National Heart, Lung and Blood Institute. Scientists will also analyze gingival crevicular fluid constituents that
You can keep your teeth and gums healthy. By controlling your blood glucose,
may contain pro-inflammatory mediators associated with heart disease, as well
brushing and flossing everyday, and visiting a dentist regularly, you can help
as blood samples to identify antibodies to periodontal pathogens.
prevent periodontal disease. If your diabetes is not under control, you are more likely to develop problems in your mouth.
The research team will compare these measures with clinical indicators of heart disease, ultrasound measures of carotid vessel thickening, and the occurrence of
Take steps to keep your mouth healthy. Call your dentist when you notice a
heart attacks, stroke, and death to determine if there is a correlation. Should the
link between oral disease and heart disease be firmly established, future studies will focus on identifying the specific biological factors involved and transferring
If you have diabetes, follow these steps:
•Control your blood glucose.
•Brush and floss every day.
Oral Health & Wellness Content provided by NIH
•Visit your dentist regularly. Be sure to tell your dentist that you have diabetes.
•Tell your dentist if your dentures (false teeth) do not fit right, or if your gums are sore.
•Quit smoking. Smoking makes gum disease worse. Your physician or dentist can help you quit.
•Take time to check your mouth regularly for any problems. Sometimes people notice that their gums bleed when they brush and floss. Others notice dryness, soreness, white patches, or a bad taste in the mouth. All of these are reasons to visit your dentist.
Remember, good blood glucose control can help prevent mouth problems.
Care of Primary Teeth
The Body's Silent Alarm
Primary teeth are important for several reasons. They allow
One human mouth is home to more microorganisms than there are
the child to chew properly, maintain space for the later
people on our planet earth. The wide array of habitat renders the
eruption of the permanent teeth, and are needed for proper
mouth a microbial paradise, offering preferred accommodations on the
speech development. Early loss of primary teeth can lead to
cheek, or on the back of the tongue in an anaerobic crevice, or in the
future space crowding problems as the permanent teeth erupt.
moist, oxygen-deprived area between the tooth surface and the
Orthodontic correction may be required. In addition early loss
of primary teeth may cause some psychosocial issues for the
The mouth's microbial ecology, however, is extremely sensitive to the
child due to speech or appearance problems.
challenges that confront its human host throughout the lifespan and, therefore, can often change precipitously. From fetal life through senescence, the mouth's continued exposure to opportunistic infectious
Milk, sugar water, apple juice, or
pathogens is in balance with host immunity; the balance between these
any liquid containing sugar should
profoundly important processes often serves as a mirror for the
not be given to the child at bedtime.
detection of not only oral pathology, but also major systemic diseases.
It is especially in the soft tissues that this relationship is played out.
Prior to eruption of the child's first tooth, parents should wipe
The lips, tongue, gums, salivary glands, and oral mucosa can all warn
the child's mouth and gums with a clean damp cloth or gauze
of trouble in our general health. Because of their exquisite positioning
pad. Parents need to begin brushing a child's teeth at
in the body, these tissues and their fluids form a protective barrier of mucosal immunity to the outside world that when breached, signal
approximately six months or when the first primary teeth
clinical disease. They tell of direct assaults by a broad range of
begin to appear. The child's first visit to the dentist should be
systemic disorders such as diabetes, AIDS and Sjögren's syndrome, as
6 months after the first tooth erupts, but no later than 12
well as complications of treatments like cancer chemotherapy and
radiation. For some disorders, particularly AIDS and diabetes, oral tissues may reveal lesions or pathology that are the first signs of systemic disease.
"Baby bottle tooth decay" can be prevented by giving plain water at bedtime or during the night. Milk, sugar water, apple
Oral Opportunistic Infections: Links to Systemic Diseases
juice, or any liquid containing sugar should not be given to the child at bedtime as they can cause tooth decay if left on
The periodontium, comprised of the gingiva, bone and other
supporting tissues that anchor the teeth, plays a key role in the interplay between oral health and systemic disease. Infection in these tissues, primarily by gram-negative anaerobic bacteria, can initiate a
Fluoride, whether in the drinking water or in the form of
series of inflammatory and immunologic changes leading to the
tablets or vitamins, has been proven to be up to 70 percent
destruction of connective tissue and bone. Long considered a localized
effective in the prevention of tooth decay. Parents should
infection, periodontal diseases are now linked to a variety of
check with their dental or medical health care providers for
conditions with systemic implications.
instructions on when and how to get this protection.
Oral Health & Wellness Content provided by NIH
Preventive Dentistry: Fluorides
Preventive Dentistry: Sealants
The incorporation of fluoride into the tooth enamel allows the tooth to be
more resistant to demineralization by acid and ensuing tooth decay. Perhaps the most predictable and consistent preventive measure in
Applying sealants on the chewing surface of permanent teeth
dentistry is the ingestion of systemic (the blood stream) fluoride up to about age 14. If your community doesn't add fluoride to the water supply,
may offer some children supplemental protection against tooth
your child should be receiving drops of a fluoride/vitamin combination as
decay. Sealants are thin plastic coatings that seal off the pits
soon as possible after birth. The first permanent molars are already
and fissures (depressions and grooves) on the biting surface of
calcifying by three months of age. In this formative stage, the tooth will
incorporate the greatest amount of fluoride. Studies have shown that fluoride will not cross the placental barrier, so pregnant woman no longer
Sealants act as a barrier against
receive fluoride preparations. Systemic fluoride (at 1 part per million) is a
plaque and acids in these vulnerable
safe and effective way to dramatically reduce dental decay, along with the cost of dental treatment. Contact your dentist's office to learn if your water
areas on the chewing surface of the tooth.
is fluoridated, and if not, he or she will be able to prescribe the proper dosage.
While brushing and flossing can easily remove plaque (a sticky mixture of bacteria, food and debris) from the smooth surfaces
The incorporation of fluoride into the tooth enamel allows the tooth to be
of the teeth, they are sometimes ineffective at getting into the
more resistant to demineralization by acid and ensuing tooth decay.
Fluoride can also be applied topically to the surface of the teeth. This is
usually suggested for children up to age 18. Topical fluoride application is
Tooth decay is caused by the bacterial breakdown of food into
also effective and recommended for adults with rampant carries (tooth
acid, which dissolves away the enamel cover of the tooth.
decay, cavities); individuals wearing orthodontic appliances; and anyone
Sealants act as a barrier against plaque and acids in these
vulnerable areas on the chewing surface of the tooth.
There are a variety of alternatives for topical fluoride application.
1. Use fluoride toothpaste daily that has the Canadian Dental Association
Sealants are most effective if applied to the tooth soon after
(CDA) or American Dental Association (ADA) Seal of Acceptance.
eruption. A child's first permanent molars erupt at about age
2. Purchase fluoride mouth rinses from your local pharmacy.
six and at about 12 years of age for the second, permanent
molars. The pre-molars (bicuspids) are also prime
3. Visit your dentist's office. The dentist can provide a professional
candidates for sealants.
However, sealants are not always
application of topical fluoride for your children at their regular check-ups. He or she can also prescribe a home fluoride gel and fabricate custom trays
for its application when deemed necessary.
The application of sealants require no anesthesia. It can be
There are some precautions that should be followed. Fluoride products should
painted on in just a few minutes per tooth. As part of the
not be swallowed. Do not give a fluoridated mouth rinse to a child under
procedure, the teeth are first cleaned and the chewing surface is
age six. Supervise young children who are brushing with fluoridated
"conditioned" with a solution that helps the sealant bond to the
toothpaste. They should use only a "pea-size" amount of toothpaste on
enamel. Sometimes a "curing" light is utilized to hasten the
their brush. Fluoride toxicity can occur if a large amount of fluoride is
ingested in a short period of time. Symptoms include vomiting, nausea, diarrhea, abdominal pain or increased thirst. If your child is experiencing
Sealants typically last up to 5 years and are easily replaced if
any of these symptoms, induce vomiting or have him/her drink milk. Call
lost. They should be examined at each check-up.
your medical doctor or the dentist's office immediately.
Preventing Tooth Decay
Dentists may also suggest fluoride drops or vitamins for infants who
Tooth decay (caries, cavities) is probably the most prevalent
don't live in areas in which the public water supply is fluoridated.
oral disease, affecting almost everyone during his or her
Call your dentist to see if your water is fluoridated.
lifetime. The good news is that it isn't life threatening and isessentially preventable.
Diet is significant in caries prevention. . Studies have shown that the
Acid, if produced frequently, will demineralize (dissolve) the
nature and frequency of sugar intake is more important than the
tooth enamel structure, which is the hardest substance in the
amount. If the sugary food is very sticky, like caramel, gummy
bears or jam, it will remain on the teeth for a longer period of time. If you or your children are constantly snacking on sugary foods,
The tooth decay process begins with dental plaque (a sticky
there is a continuous acid attack on your teeth.
mixture of bacteria, food and debris). Bacteria, which naturallylive in everyone's mouth but thrive in plaque, utilize
What do we do to prevent this potential problem?
carbohydrates from food, especially refined sugar, to produce
sugar stay in the mouth for long periods of time. Stay away from
acid. Acid, if produced frequently, will demineralize (dissolve)
candies and chewing gum (unless sugarless) and refrain from
the tooth enamel structure, which is the hardest substance in
drinking soft drinks regularly (unless diet). Try to cut down on the
the human body. From there the acid will continue to eat
number of snacks per day. If you must snack, substitute foods that
through the underlying dentin layer until the bacteria and their
most people like but that don't promote tooth decay. Examples are
waste products reach the pulp (nerve). Left untreated, tooth
popcorn, pretzels, fruits, nuts, cheese and vegetables.
decay can lead to root infection and eventually loss of the tooth.
Substitute foods that most people like but that don't promote tooth
There are visible signs of a cavity. Initially, it will appear as a
decay. Examples are popcorn, pretzels, fruits, nuts, cheese and
small white spot, which in time will turn brown. As the decay
continues, a hole in the tooth may become apparent. There are also warning symptoms such as sensitivity when brushing, to
Consuming sugary foods with a meal or for dessert has a less
hot or cold foods or to breathing in air. Of course, a painful
detrimental effect, because increased saliva flow during meals helps
to wash the food away. Also, after having a meal most people will brush their teeth. Keeping this in mind, it is better for children to eat
sweets at a time and place that allows them to brush soon afterwards. As your children are growing, make sure they get plenty of calcium (dairy products) so that their tooth enamel develops
The most important prevention technique is daily removal of
plaque with flossing and brushing. If possible, good oral hygiene should be practiced after every meal.
Finally, because you may be asymptomatic and unaware of the
They can also fabricate custom trays to be used at home with a
beginning of tooth decay, it is critical that you visit your dentist
gel fluoride for adults who have rampant caries or who are
every six months for a check-up. Some cavities are hard to detect,
predisposed to having tooth decay. Dentists may also suggest
especially those between the teeth. Sometimes, only bitewing x-rays
fluoride drops or vitamins for infants who don't live in areas in
can identify them. Your dentist will also give you a professional
which the public water supply is fluoridated. Call your dentist
prophylaxis (cleaning), which is an important part of prevention.
Pregnancy and Oral Health
There are two major dental concerns for pregnant women --
Pregnant women also risk developing "Pregnancy tumors" that
avoiding dental emergencies and/or treatment in the last
are benign growths that arise out of swollen gums. Normally,
trimester and preventing periodontal (gum) disease.
the treatment is to leave them alone until they break on their own. However, if they interfere with eating or oral hygiene,
If you are trying to become pregnant
or have recently learned that you are,
try to schedule a dental check-up and
Emerging evidence shows that periodontal disease may be a
significant risk factor for pre-term, low-birth weight babies.
a prophylaxis (cleaning) within the
Although more research is needed to confirm the direct
association to pregnancy outcomes, expectant mothers are advised to be concerned about periodontitis as with all other infections.
If you are trying to become pregnant or have recently learned that you are, you should try to schedule a dental
check-up and a prophylaxis (cleaning) within the first trimester. It is better to have dental work completed within
To prevent or minimize "pregnancy gingivitis," take extra care
the fourth to sixth month of pregnancy than to deal with
and time with good brushing and flossing techniques to
potential complications from anesthesia, medication or
remove plaque. It is advisable to have a professional
extensive procedures during the last trimester. If you have a
prophylaxis in the first or second trimester. Eat a good
dental emergency in the third trimester, consult your
balanced diet, getting plenty of vitamins C and B12. Smokers
obstetrician and call your dentist. Definitely postpone all
should refrain from smoking for the entire pregnancy. to see if
elective procedures until after you give birth.
It is common for pregnant women to develop "pregnancy gingivitis." Gingivitis is an inflammation of the gums and surrounding tissues. It is characterized by redness, swelling, tenderness and bleeding. The primary cause is an increased level of hormones - especially estrogen and progesterone, which correlates with an increase in dental plaque (a sticky mixture of bacteria, food and debris). This condition starts to become evident in the second trimester. If you had gingivitis prior to your pregnancy, it will probably worsen. Left untreated, it could lead to bone loss around the teeth.
SANTA BARBARA GASTROENTEROLOGY CONSULTANTS MEDICAL GROUP Name: __________________________ Facility: ☐ Santa Barbara Endoscopy Center ☐ Santa Barbara Cottage Hospital Procedu x e Date: _________________ Check In Time: __________________ ☐ Santa Ynez Cottage Hospital COLONOSCOPY PREPARATION SHEET: GOLYTELY/ DULCOLAX 5 Days Prior 4 Days Prior 3 Days P
COMMUNICABLE DISEASE REFERENCE CHART FOR SCHOOL PERSONNEL INCUBATION TRANSMISSION COMMON SYMPTOMS RECOMMENDATIONS Sudden onset with slight fever and itchy eruptions CASE: Exclude from school for at least 5 days which become vesicular (small blisters) within a few after eruptions first appear or until vesicles hours. Lesions commonly occur in successive crops, with several