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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 Naples, FL 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. Vincent Cardinale and Dr. Chris Moody 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!

A study conducted in Washington State in 2004 and another conducted in Madrid, Spain in 2012 both reported findings that support a direct relationship between parents’ dental fear and their child’s fear of the dentist.

The Washington study examined dental fear among 421 children ages 0.8 to 12.8 years old. They were patients at 21 different private pediatric dental practices in western Washington state. The Spanish study observed 183 children between the ages of seven and 12 as well as their parents.

The Washington study used responses from both parents and the Dental Sub-scale of the Child Fear Survey Schedule. The survey consisted of 15 questions, which invited answers based on the child’s level of fear. The scale was one to five: one meant the child wasn’t afraid at all, and five indicated he or she was terrified. The maximum possible points (based on the greatest fear) was 75.

Spanish researchers found a direct connection between parental dental fear levels and those among their kids. The most important new discovery from the Madrid study was that the greater the fear a father had of going to the dentist, the higher the level of fear among the other family members.

Parents, but especially fathers, who feared dental procedures appeared to pass those fears along to every member of the family. Parents can still have some control over fear levels in their children. It is best not to express your own concerns in front of kids; instead, explain why going to the dentist is important.

Dr. Vincent Cardinale and Dr. Chris Moody and our team work hard to make your child’s visit at our Naples, FL office as comfortable as possible. We understand some patients may be more fearful than others, and will do our best to help ease your child’s anxiety.

You brush and floss thoroughly twice a day. You have regular checkups. Everything seems fine on the periodontal radar. Sometimes, however, even healthy gums can become sensitive and irritated. Is it something you did? Maybe! Here are some common causes of gum irritation and sensitivity that you might not be aware of.

• Brushing Bravado

One of the most important tools for gum health is one we use at least twice a day—the simple toothbrush. Two minutes at night and two in the morning reduce the bacteria and plaque that lead to serious gum disease, known as periodontitis. And while preventing tooth decay and gum disease are the primary goals of brushing, let’s also protect delicate gum tissue from injuries and irritation caused by too-forceful brushing.

Try using a brush with soft bristles and brushing with short strokes and gentle pressure, especially if you know you have a tendency to be a bit heavy-handed. Massaging rather than scrubbing will clean teeth and gums just fine.

• Fierce Flossing

Just because we can use dental floss to slice cakes or cookie dough logs doesn’t mean we should apply the same pressure to our gums! While a firm sawing motion seems like the obvious way to clean between teeth and gums, you can actually cause irritation and bleeding that way.

Insert the floss between your teeth carefully, bring it to the gumline, and move the floss with gentle pressure up and down and around the tooth surface. This technique will make sure that you remove food particles and plaque from beneath the gumline without causing your gums any trauma. Ask us about the best flossing techniques—we know them all.

• Appliance Aches

You know how helpful your braces/retainers/mouth guards/dentures are. You just wish that your helpful appliance was a little less irritating to sensitive gum tissue.

This is a problem that often disappears as you get used to your new appliance. But if pain or irritation persists or gets worse, give us a call. We want to make sure your appliance fits properly, and make any necessary adjustments to ensure your comfort.

• Peroxide Problems

Most home whitening kits use peroxide-based gels or treated strips to remove surface stains from the teeth. Those same bleaching agents that make enamel whiter can also cause gum sensitivity and irritation. If you use whitening strips or gel trays, be careful to keep the peroxide solution away from gum tissue. But because these systems are one-size-fits-all, that is often easier said than done.

If you have sensitive gums, one solution is a professional office whitening. We’ll check on your gum (and tooth) health first, and monitor and protect your gums throughout the procedure. If you still want to whiten at home, we can create custom trays for you that will provide more complete exposure to the whitening solution for your teeth, and less exposure for your gums, than over-the-counter products.

• Still Smoking?

Studies have shown a strong link between gum health and smoking and other forms of tobacco use. Smokers are much more likely to suffer from gum disease than non-smokers, and those who have smoked for a long time, or who smoke heavily, have an even higher risk of developing periodontal disease. Some studies suggest that smokers don’t respond as well to treatment as non-smokers.  Unfortunately, it appears that smoking and tobacco use help mask the obvious symptoms of gum disease (redness and bleeding), which could lead smokers to delay getting treatment. If you smoke, talk to us about ways to quit.

We talk a lot about periodontal health because it is so important. Periodontitis can lead to infection, loss of bone around the tooth, and even eventual tooth loss. If you are suffering from any of the signs of gum disease—swelling, redness, bleeding, pain—give our Naples, FL office a call. Whether it’s as simple as making a few lifestyle changes, or a problem requiring professional dental treatment, being proactive with your dental care is more than good for your gums—it’s good for your health!

Oral hygiene has always been an important part of maintaining overall health. For thousands of years, humans have found ways to keep their teeth and mouths clean. According to the American Dental Association (ADA), “early forms of the toothbrush have existed for nearly 5,000 years.” But what exactly did the first toothbrush look like?

Toothbrush Timeline

With help from The Library of Congress, Dr. Vincent Cardinale and Dr. Chris Moody and our team have compiled a timeline with some interesting details about the evolution of the toothbrush:

• 3000 BC – Perhaps the earliest form of the toothbrush, the “chew stick” was used by Ancient civilizations. People would rub this thin twig with a frayed end against their teeth to remove food and plaque.
• 1498 – The bristle toothbrush was invented in China and had many similarities to the toothbrushes used today. These devices were made by attaching the stiff, coarse hairs from the back of a hog’s neck to handles that were typically made from bone or bamboo.
• 1938 – Signaling the end of the boar bristle, Dupont de Nemours introduced nylon bristles, and Americans welcomed Doctor West’s Miracle Toothbrush, the first nylon toothbrush.
• 1960 – The Squibb Company introduced Broxodent, one of the first electric toothbrushes, to the American market.

Toothbrushes Today

Today, there are many brands of toothbrushes that often advertise different benefits. The variety of options may seem overwhelming, but the most important thing is for you to find a toothbrush that you like and find easy to use.

The ADA recommends that you choose a toothbrush that fits comfortably and allows you to effectively reach all areas of your mouth. Whether you decide to use a manual or a powered toothbrush, make sure that you thoroughly clean all surfaces of your teeth twice a day.

Society has come a long way since the days of the chew stick, but one thing that remains the same is the importance of consistent and effective personal oral hygiene.