Our Blog

“What is the strongest substance in the body?” If this question comes up on trivia night, be prepared to impress your team when you confidently answer, “Tooth enamel!”

Tooth enamel? The reason for this surprising answer lies in the biology of our teeth. Minerals make up well over 90% of our enamel, a much higher percentage than is found anywhere else in the body, including our bones. But unlike bone tissue, which can heal and regenerate, tooth enamel cannot. Even though it is extremely strong, enamel can be damaged by a process called demineralization.

Demineralization

Demineralization is a result of acids at work in our mouths. Acids actually break down the minerals in our enamel, making the enamel softer. Over time, bacteria attack deeper into the tooth, eventually leading to decay. Acidic foods like sodas, citrus, pickles, and coffee are obvious culprits in providing an acidic environment, but there are other problem foods as well. We all have bacteria in our mouths, which can be helpful or harmful. The bacteria in plaque use the sugars and starches we eat to produce even more acids.

This process is something that takes place very quickly. In fact, even brushing too soon after eating something acidic can damage the demineralized surface of a tooth. Waiting at least 20 to 30 minutes to brush gives our bodies a chance to restore the enamel surface in a process called remineralization.

Remineralization

Our bodies are actually designed to help protect our enamel, and the most important part of this process is saliva production. Saliva cleanses our teeth and reduces levels of acidity. And our saliva constantly washes important minerals over our teeth. Calcium and phosphate ions rebuild and strengthen molecules where demineralization has taken place. This process is called remineralization.

We have other ways to help the remineralization process along. Fluoride toothpastes and fluoridated water speed up the movement of mineral building blocks back to the surface of the tooth. Fluoride also strengthens our teeth so that they resist acids and demineralization better than teeth without fluoride, making them less vulnerable to cavities.

New products are available for home and professional use that are designed to increase remineralization—talk to Dr. Vincent Cardinale and Dr. Chris Moody at our Naples, FL office if you would like the latest recommendations. In fact, talk to us about tooth-friendly menus, the best toothpastes, brushing techniques, and all the ways to keep your enamel its healthiest. You’ll be answering all those trivia questions with a strong, confident smile!

We’re all friends here, so if you sometimes feel a bit nervous before your dental appointment, no judging! Ask us about any worries you might have. We are happy to explain procedures, equipment, and sedation options so you know just how safe and comfortable your experience can be. And if X-rays are a concern, we can put your mind at ease here as well.

What Exactly Are X-rays?

Sometimes patients feel reluctant about the process of imaging because X-rays are a kind of radiation. But the fact is, radiation is all around us. We are exposed to radiation naturally from our soil and water, sun and air, as well as from modern inventions such as cell phones, Wi-Fi, and air travel.

Why is radiation so common? Because matter throughout the universe constantly gives off energy, and the energy that is emitted is termed radiation. This radiation takes two forms—as particles (which we don’t need to consider!) and as traveling rays. This second type is known as electromagnetic radiation, created by photons traveling in regular waves at the speed of light.

We are exposed to electromagnetic radiation every day, because, whether we can see them or not, these different wavelengths and frequencies create various forms of light. Radio waves, microwaves, infrared, visible, and ultraviolet light, X-rays, and gamma rays are all part of the electromagnetic light spectrum.

Different types of radiation on this spectrum have different wavelengths and different frequencies, and produce different amounts of energy. Longer wavelengths mean lower frequencies and less energy. Because X-rays have shorter wavelengths and higher frequencies than, for example, radio waves and visible light, they have more energy.

How Do Dental X-rays Work?

An X-ray machine produces a very narrow beam of X-ray photons. This beam passes through the body and captures images of our teeth and jaws on special film or digital sensors inside the mouth (intraoral X-rays), or on film or sensors located outside the mouth (extraoral X-rays). These X-ray images are also known as radiographs.

Why are X-rays able to take pictures inside our bodies? Remember that higher energy we talked about earlier? This energy enables X-rays to pass through the softer, less dense parts of our bodies, which are seen as gray background in a radiograph. But some substances in our bodies absorb X-rays, such as the calcium found in our bones and teeth. This is why they show up as sharp white images in radiographs.  

There are different types of common dental X-rays which are used for a number of reasons:

• Bitewing X-rays, which are used to check on the health of the back teeth.
• Periapical X-rays, which allow us to look at one or two specific teeth from crown to root.
• Occlusal X-rays, which show the entire arch of teeth in the upper or lower jaw.
• Panoramic X-rays, which use a special machine to rotate around the head to create a complete two-dimensional picture of teeth and jaws.
• Cone Beam Computed Tomography, an external device which uses digital images to create a three-dimensional picture of the teeth and jaws.

Why Do We Need X-rays?

If all of our dental conditions were visible on the surface, there would be no need for X-rays. But there are many conditions that can only be discovered with the use of imaging—infection, decay, a decrease in bone density, or injuries, for example, can show up as darker areas in the teeth or jaws. Among their many diagnostic uses, X-rays can help us find:

• Cavities between teeth or under old fillings
• Damage to the tooth’s pulp which might require root canal treatment
• Injuries to teeth or roots after trauma
• Abscesses, tumors, or other conditions that might be causing swelling or pain
• Position and development of wisdom teeth
• Ideal placement for implants
• Health and density of the jaw and alveolar bone

X-rays can also serve an important preventative role, by discovering small problems before they become major ones.

How Do Dentists Make Sure Your X-rays Are As Safe As They Can Be?

First of all, the amount of radiation you are exposed to with a dental X-ray is very small. In fact, a set of bitewing X-rays exposes us to slightly less than the amount of radiation we are exposed to through our natural surroundings in just one day. Even so, Dr. Vincent Cardinale and Dr. Chris Moody and our team are committed to making sure patients are exposed to as little radiation as possible.

Radiologists, the physicians who specialize in imaging procedures and diagnoses, recommend that all dentists and doctors follow the safety principal known as ALARA: “As Low As Reasonably Achievable.” This means using the lowest X-ray exposure necessary to achieve precise diagnostic results for all dental and medical patients.

The guidelines recommended for X-rays and other imaging have been designed to make sure all patients have the safest experience possible whenever they visit the dentist or the doctor. We ensure that imaging is safe and effective in a number of ways:

• We take X-rays only when they are necessary.
• We provide protective gear, such as apron shields and thyroid collars, whenever needed.
• We make use of modern X-ray equipment, for both traditional X-rays and digital X-rays, which exposes patients to a lower amount of radiation than ever before.
• When treating children, we set exposure times based on each child’s size and age.

And now that we’ve talked about some things you might like to know,

Please Let Us Know If . . .

• You’re a new patient, with previous X-rays taken during regular exams or for specific procedures. Ask to have your older X-rays sent to our office. With digital X-ray technology, this transfer can be accomplished with e-mail! Having your dental history available lets us notice any changes that have taken place.
• You’re pregnant, or think you might be pregnant. Even though radiation exposure is very low with dental radiographs, unless there is a dental emergency, dentists and doctors recommend against X-rays for pregnant patients.

X-rays play an important part in helping us make sure your teeth stay their healthiest. If you have any concerns, contact our Naples, FL office. When it comes to making sure you’re comfortable with all of our procedures, including any X-rays that might be necessary, we’re happy to give you all the inside information!

When working out, studying late, or any time we feel like a bit of a boost would come in handy, energy drinks are a common go-to for many teens and adults. Energy drinks promise more focus and vitality, all wrapped up in clever names and eye-catching graphic designs. What they can’t promise, though, is a drink that’s good for your dental health.

Why? Because most energy drinks come with a high concentration of caffeine, acids, and/or sugar.

• Caffeine Consequences

Before we talk about your dental health, a word about caffeine. Too much caffeine in a short period can leave us jittery, anxious, irritable, and sleepless. A cup of coffee has about 100 mg of caffeine, and some energy drinks have three to four times that much.

While the recommended daily limit for adults who aren’t pregnant is 400 mg of caffeine, doctors suggest a much lower limit for children and teenagers. Among other reasons, sleep is especially important for developing brains and bodies, and caffeine interferes with healthy sleep.

You might have to go online to find out how various energy drinks measure up and compare in terms of caffeine, but taking the time to check them out is well worth it. Now, back to your dental health!

• Acid Attacks

Many energy drinks are very acidic. The tart flavors of energy drinks might please your palate, but they attack your enamel.

Our mouths are their healthiest when our saliva is neutral, balanced between acidic and basic on the pH scale. That’s somewhere around a 7 on a scale of 0-14, where lower numbers mean more acidic conditions. That burning feeling we get from acid reflux when stomach acids back up? That’s because stomach acid is a 1-2 on the pH scale.  Many energy drinks rate an eye-opening (and not in an energetic way!) 1.5-3.5 on the pH scale, which means your teeth are bathing in acids.

Even tooth enamel, the strongest substance in the body, can’t stand up to these acids, because acids break down the mineral structure of your enamel. If your teeth are more sensitive to heat and cold, if they appear darker as the white outer layer of enamel thins, if your dentist has discovered weak spots in your enamel—you might be experiencing demineralization. Once enamel is gone, it can’t be replaced.

• Surplus Sugar

A well-known source of quick energy is sugar. A little more biology and chemistry here—sugar is a food which our bodies can break down quickly. And when sugar molecules break down, this breakdown releases energy—energy which we use to fuel essential bodily functions. This quick burst of sugar energy is why many energy drinks contain lots of added sugar. Some brands have more than 60 grams of sugar per serving—and 60 grams is almost 5 tablespoons!

We get all the sugar we require for our daily energy needs from the natural sugars found in fruits, dairy, even some vegetables and grains. With added sugars, we’re just adding empty calories, affecting the balance of our blood sugar and hormones, and increasing the risk of chronic health conditions—all while providing a convenient food source for the bacteria in plaque.

Because, just like our bodies find it easy to convert sugar to energy, the oral bacteria which cause cavities find it easy to convert sugar to acids. And just like the acids in foods, these acids attack the tooth’s mineral structure and break down its strength. Eventually, the weak spots in enamel grow larger and deeper and become cavities.

While most labels don’t let you know how much caffeine you’re getting, or the pH of the liquid inside, you can see how much sugar is being added to your diet with every can or bottle. Do look for added sugars before you choose your beverages.

If you have several energy drinks a day, a soft drink or two, plus the occasional sports drink—you’re bathing your teeth in acids and sugar all day long. With any beverage high in sugars and acids, limit your consumption. Rinse with water afterward, and don’t brush for about an hour to give your enamel time to remineralize after being exposed to the acids in your drink.

Better yet, choose healthier alternatives. Water is still the best way to hydrate. Try adding protein and carbs to your diet for more energy. Make sure you’re getting the vitamins you need with a balanced diet. If you see signs of enamel erosion, talk to Dr. Vincent Cardinale and Dr. Chris Moody. The temporary boost you get from a bottle of caffeine, acids, and sugar might seem tempting, but it can have long-lasting consequences for your dental health!

Is this a trick question? After all, you probably already know quite a lot about cavities:

• It all begins when bacteria-filled plaque sticks to teeth and starts to attack enamel. How?
• Because the bacteria in plaque use the sugars and other foods we eat to produce acids.
• These acids gradually weaken teeth by dissolving minerals which help make up our enamel (a process called demineralization).
• Over time, a hole, or cavity, develops in the tooth surface.
• Left untreated, bacterial decay can spread to the inside of the tooth, creating a more serious cavity.

Some cavities aren’t discovered until you visit our Naples, FL office, but sometimes there are clear signs that there’s a problem.

• You have tooth pain or sensitivity.
• Your tooth changes color in spots where the enamel has decayed.
• You might even notice enamel loss when a cavity is large enough.

So, if you have any of these symptoms, it’s a cavity, right? It might be—but it might not. Sometimes, because the symptoms are similar, what we suspect is a cavity is really enamel erosion.

The bacteria-created acids weaken enamel. But it’s not just bacteria that subject our teeth to acids—we do it ourselves with our choice of food and drink. Acidic foods are one of the leading causes of tooth erosion.

Our normal saliva pH level is around a 7, which is neutral. Any number lower is acidic; any number higher is alkaline. Acidic foods have a low pH (the pH of lemon juice, for example, measures between 2 and 3), and can reduce our normal, neutral pH level. When saliva pH levels drop to 5.5 or lower, tooth enamel starts to demineralize, just as it does when exposed to the acids from oral bacteria.

Regularly snacking on citrus and other acidic fruits, wine, fruit juices, flavored teas, sour candies, and other acidic foods can cause enamel erosion. Especially erosive are sports drinks, energy drinks, and colas, because they contain some combination of citric acid, phosphoric acid and/or carbonation.

The symptoms of tooth erosion and damaged enamel can be very similar to those caused by cavities:

• You suffer tooth pain or sensitivity
• Your teeth appear discolored, as the enamel thins to reveal the yellowish dentin underneath
• You notice missing enamel—your teeth become rounded or have little pits known as cupping

You call Dr. Vincent Cardinale and Dr. Chris Moody right away if you suspect a cavity. Be just as proactive if you suspect erosion. Even though your symptoms may not have been caused by plaque and bacteria, acidic erosion from your diet leaves weakened enamel just as vulnerable to cavities and decay.

How to avoid erosion?

• Enjoy acidic foods sparingly, or as part of a meal. This helps your saliva pH stay in the neutral zone.
• Balance acidic foods with low-acid choices to help neutralize acids and restore a normal pH balance. (A good reason to pair wine or fruits with cheese.)
• Use a straw! This simple solution keeps erosive drinks from bathing your teeth in acids.
• Drink water instead of an acidic beverage, or drink it afterward to rinse your mouth. The pH of pure water? A perfect, neutral 7.
• And what about brushing right after eating or drinking something acidic? Ask Dr. Vincent Cardinale and Dr. Chris Moody if you should rush for your brush. We may recommend waiting 30 minutes or so after an acidic treat to give teeth time to remineralize after acids weaken them. Otherwise, brushing might cause more wear and tear on your enamel.
• Finally, while foods are often the source of acid erosion, medical conditions can cause erosion as well. Talk to us about ways to minimize erosion while addressing your medical needs.

There’s no trick to it—watching your diet, brushing and flossing as recommended, using a fluoride toothpaste, and visiting Cardinale Dentistry for regular checkups will help prevent tooth erosion. We can restore eroded enamel with bonding, veneers, or crowns if the erosion is serious. Better still is to catch erosion before symptoms appear to keep your teeth their strongest for a lifetime of healthy, beautiful smiles.