timberlake dental

What Causes Cold Sores and Fever Blisters?

Cold sores and fever blisters have these names because people once believed they were the result of colds and fevers.  They are not caused by colds or fevers, but colds and fevers can put you at risk for them.

What is a Cold Sore/Fever Blister?

A cold sore and a fever blister are the same thing.  From here on, we will refer to them as cold sores, just for the sake of simplicity.  Cold sores consist of a small cluster of fluid-filled bumps, which burst to form tiny ulcers.  These ulcers then scab over while healing.  They can occur on the lips, which is most common, or on the inside of the mouth.  Inside the mouth, they typically appear on the roof of the mouth.

Most people who get cold sores frequently recognize the tingly feeling you get right before a cold sore appears.  This is called the prodromal phase.  If you catch it in this early stage, medications can shorten their lifespan and reduce their intensity.

What Causes Cold Sores?

The scientific name of cold sores is oral herpetic lesions because they are caused by the Herpes Simplex Virus-1.  This is not the same virus that causes genital herpes.  Oral herpes and genital herpes are caused by two different strains of the herpes simplex viruses.

In general, oral herpes lesions are HSV-1, and genital herpes lesions are HSV-2.  Over 3.7 billion people have HSV-1, and in most of those people, it does not cause any sores.  However, in other people, it causes painful and even embarrassing oral sores.

The billions of people who have the HSV-1 virus in their body usually have no symptoms at all.  Because the virus is inactive but present all the time, it is likely to become active when your immune system is down.

This is why things like colds and fevers can predispose you to cold sores.  When your body is trying to fight off something else, HSV-1 can creep up and cause active lesions.  Cold sores also commonly occur after sun exposure and dental visits.  Any minor damage to the lips (UV rays from sun exposure or minor stretching during a teeth cleaning) can be enough to spark a cold sore

How Do You Get HSV-1?

The virus that causes HSV-1 is so common that most people are exposed to it by the age of one year.  One person transmits the virus to another via oral-to-oral contact, like kissing or sharing drinks and eating utensils.  While it is possible to transmit the virus anytime, it is more likely to happen when you have an active sore.

How to Reduce Your Risk of Getting a Cold Sore?

There are a few steps you can take to make cold sores less likely.  These are not foolproof, but they may lower your risk.

  • Always wear chapstick with sunscreen protection of SPF 15 or greater.
  • Make sure your lips are well lubricated with Vaseline or chapstick before, throughout and after a dental procedure.
  • Take care of your immune system. Make healthy food and drink choices, and try to prevent any minor illnesses.
  • Avoid kissing or sharing drinks and eating utensils with anyone who has an active cold sore.
  • Reduce stress as much as possible, and get plenty of sleep.

How to Reduce Your Symptoms Once You Have a Cold Sore?

If a cold sore is already present, here are some tips for managing your symptoms.

  • Catch it as early as possible! When you use the available anti-viral treatments early, the sores are smaller, less painful, and short in duration.
  • Learn from your past. If you have had cold sores in the past that do not respond well to over-the-counter ointments like abreva®, talk to Dr. Chowning.  There are prescription medications that may work better for you.
  • Do not touch it! The blisters of cold sores should never be squeezed or popped.  This introduces bacteria to the sore and increases the risk of an infected sore.
  • Keep it clean. Do not put makeup over the sore.
  • Avoid kissing loved ones and sharing food and drinks.
  • Throw away chapstick used over an active sore.

Do You Suffer from Cold Sores? 

Talk to Dr. Chowning at your next visit about how you can reduce the risk of developing cold sores and how to treat them when they do occur.

Dental Insurance: Are You Throwing Away Money?

Some of the most common questions we answer at Timberlake Dental are about dental insurance.  Dental insurance plans and the benefits they provide can be very confusing.  There are thousands of different plans, and many of them even share the same name.   So just knowing that you have Blue Cross Blue Shield will not get you very far when it comes to figuring out your dental benefits.

Our front office staff has been working with our patients for years to help them get the most out of their dental insurance.  We have noticed some trends in recent years that may affect your dental care.  While insurance premiums have stayed the same or increased, the provided benefits have actually decreased.  This means that even though you or your company may be paying the same amount or more, you are receiving a lower dollar amount of dental benefits.

How Do Dental Insurance Benefits Work?

Dental insurance is not like medical insurance at all.  If required, dental insurance deductibles are usually under $100, and are collected at your first dental visit of the insurance plan year.  Most insurance plans follow a calendar year; some use a different fiscal year, like August-to-August, which is important to know.   This matters when it comes to maximizing your benefits.

Dental insurance plans always have a “maximum”.  These range from $1000-2500.  There are a few great plans that offer higher maximums, but they are rare.  Dental insurance benefits pay up to their stated maximum, and then the patient is responsible for 100% of any fees that accrue past that.

The important thing to understand about a benefit maximum is that any benefits you do not use during the plan’s year are not carried over to the following year.  They are simply lost.

How Can I Maximize My Benefits?

Do not wait until the end of the year!  Many people forget about their dental insurance until December and then attempt to get all of their dental work done in a short amount of time.  In order for our team at Timberlake Dental to help you get the most out of your insurance plan, we need to see you as soon as possible.  Our experts will help you with the following things:

  • Know your plan’s benefit calendar. If your benefits renew in August instead of January, that may change the timing of your treatment.
  • Know your maximum. If your plan offers $2000 in dental benefits, and you are in need of treatment, you should proceed with treatment before the end of the plan’s calendar.  Otherwise, those benefits are lost.

Your care at Timberlake Dental is always based on what is best for your health, and our dentist will treat you with excellence and compassion regardless of the presence or absence of dental insurance benefits.  In all cases, Dr. Chowning creates a customized treatment plan for each person’s specific dental needs.  Only then will our insurance experts help you prioritize the timing and financing of each prescribed procedure so you get the most out of your dental insurance.

How Can I Find Out What Benefits I Have?

Call our office today at 940-382-1750 to speak with one of our insurance experts about your specific plan.  They can answer all of your questions and set you up to see Dr. Chowning as soon as possible.

The Best & Worst Halloween Candy for Your Teeth

Halloween is here, and we know what that means: drawers, buckets and baskets full of candy!  And your kids are dreamin’ if they think they are keeping it all to themselves.

In the days and weeks following Halloween, we know you will increase your candy intake dramatically (as compared to other “normal” times of year).  While technically ALL candy is bad for your teeth, this blog will tell you which candies are worse than others.

The Worst Candy for Your Teeth

Not all candy is created equal.  There are some types of candy that are particularly bad for your teeth because of their high sugar content, texture, and how long they stay in contact with your teeth.

Obviously high sugar content is bad!  These types of candy provide the bad, cavity-causing bacteria in your mouth with plenty of fuel with which to cause cavities.

The texture of candy matters because the length of time your teeth are exposed to sugar is an important factor in cavities.  Chewy, sticky, or gummy candies can stick to the surface of the teeth, providing cavity bugs with ample time to eat the sugar and make lots of harmful acid.  Unfortunately, this does include a traditional Halloween favorite: candy corns.

Hard candies or lollipops that you hold in your mouth or suck on for long periods of time also provide a constantly supply of food to these bad bacteria.

This also includes mints that contain sugar.  Many people suck on sugar-free mints, which is fine.  But those plain old Starlight red and white mints are packed full of sugar!

The Best Candy for Your Teeth

There is one type of candy that is not terrible for your teeth.  Do not misinterpret this.  It is not good for your teeth either.  It just isn’t as bad as the ones listed above.

Chocolate is not terribly bad for your teeth because it contains some fat.  The darker the chocolate, the less harmful it is to your teeth.  This does NOT include chocolate candy bars that contain sticky caramel or nougat.  The stickiness of those types of candy filling negates any good effect from the fat in the chocolate.

Chocolate with nuts is your best bet.  Both the chocolate and the nuts contain good fat and protein, which do not cause cavities.  So grab a Hershey’s Special Dark with Almonds and watch your favorite scary movie!

What to Do after Eating Any Candy

There are a few ways you can care for your teeth that lower the risk of any dental problems resulting from all this Halloween candy!

  1. Make sure you are doing a great job cleaning your teeth! Brush (the right way) twice daily, and floss every night before bed.
  2. Add a fluoride mouthrinse to your nighttime routine. Fluoride strengthens enamel and makes cavities less likely to happen.
  3. After enjoying some candy, rinse your mouth with water to remove any sugary debris and neutralize the acid produced by those bad bacteria.
  4. Have your candy as dessert! Instead of eating it in between meals as a snack, eat the candy with a meal.  This lowers its ability to cause cavities.

Don’t let your Halloween habits give you a smile that will scare people!

Do You Have More Questions about Candy?

Call us today at 940-382-1750 to schedule a consultation with Dr. Chowning.  He can answer every question you have about candy and its effects on your teeth.

Happy Halloween from Timberlake Dental! 

What Happens if I Don’t Wear My Nightguard?

If Dr. Chowning and our hygienists have recommended a nightguard for clenching or grinding, that means they have seen signs of damage to your teeth, gums, muscles or jaws.  As part of our commitment to preventive dentistry, we believe it is essential to catch these signs of damage as early as possible and give you the tools to prevent more!

What Kind of Damage Results from Nighttime Clenching and/or Grinding?

There are many different ways clenching and/or grinding damages the teeth.  It is not likely for a single person to show all of these signs of damage.  Your dentist and hygienist will put together the pieces of the puzzle if you show signs that point to a bad nighttime habit.

It is important to note that because this happens when you are asleep, you do not have control over it!  This is why nightguards are so instrumental in protecting you against this subconscious habit.

Some of the damage caused by nighttime clenching and/or grinding is listed below with a brief explanation of each.

Cracked teeth

Enamel is strong.  It is the hardest substance in the human body, even harder than your bones.  Although it is the hardest material in our bodies, it is not meant to absorb forces heavier than normal chewing.  We have seen countless teeth cracked by heavy clenching or grinding.  Teeth weakened by cavities or large fillings are more likely to crack because their enamel has already been disrupted.  Heavy clenching forces during sleep can even crack teeth that are otherwise perfectly healthy.

Cracked teeth range from minor surface cracks to through-and-through tooth fractures.  Treatment of these cracks depends on the extent of the crack.  Cracks in enamel allow bacteria to penetrate the tooth, making cavities more common in cracked teeth.

Attrition (Wearing Away of Enamel)

Attrition is a condition that occurs when clenching or grinding causes a slow gradual wearing away of the enamel, resulting in a flattened and shortened tooth or teeth.  Attrition is very common in people who have clenched their teeth for a long period of time.  Heavy attrition usually means that the enamel is completely missing, and the core of the tooth (dentin) is exposed.  Not only is attrition unhealthy for teeth, it also makes for an unattractive smile.  Unfortunately, flatter, shorter teeth make you look old.

Severe attrition can require extensive dental work to rebuild the teeth to their original contour.  Catching it early and taking preventive action (like wearing a nightguard) can prevent the need for lots of expensive dental treatment in the future.

Gum Recession

Forces that are too heavy cause microscopic movements and flexing in the teeth.  Sometimes these forces affect the attachment of the gums to the teeth.  The gums tend to back away or recede from these inappropriate forces.  Gum recession exposes the roots of the teeth, increases your risk for cavities, and causes sensitive teeth!

When severe, gum recession requires grafting surgery to repair it.  Just like attrition, catching gum recession early and taking preventive action can save you time and money in the dental chair.

Headaches and Facial Pain

Many patients experience symptoms in their head and facial muscles from heavy clenching and/or grinding while they sleep.  The muscles that close the teeth together are skeletal muscles, just like your biceps.  If they receive lots of exercise, they get larger and may cause soreness.

How Does a Nightguard Help?

A nightguard is a physical barrier between your teeth.  It prevents attrition by separating the teeth so that they cannot grind away enamel.  A nightguard prevents things like cracks, gum recession, and headaches by reducing the amount of force your jaw muscles can produce.

Because the teeth cannot completely clench when a nightguard is in the way, the muscles cannot fully contract.  This takes away some of the strength of the clenching and grinding.

What if I Clench or Grind My Teeth During the Day?

Daytime clenching is a little more complicated because most people cannot wear a thick acrylic mouth appliance throughout their day.  It interferes with speaking, so unless you work alone at home without having to speak to anyone, it is a little impractical.

If you catch yourself clenching or grinding your teeth as you work, drive, exercise, or do chores, please talk to Dr. Chowning.  He has great information on habit-breaking techniques that can help you gain control of this daytime habit.

Do You Need a Nightguard?

If you know you are clenching or grinding your teeth at night, you probably need a nightguard.  If you’re not sure, ask Dr. Chowning, or one of our highly-trained dental hygienists.  They can tell you if you exhibit signs of this habit and get you pointed in the right direction: PREVENTION!

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HPV: What is it, and What Does it Have to Do with Oral Cancer?

What is HPV?

HPV stands for Human Papillomavirus.  It is an often-undetected viral infection that infects an estimated 6.2 million new people each year.  It is the most common sexually transmitted virus in the United States.  HPV does not cause any symptoms at the time of infection, so most people are unaware that they have it.

There are hundreds of different strains of the virus, and nine are known cancer-causers.  The CDC estimates that more than 80% of Americans will have an HPV infection in their lifetime.  Most people have non-cancer-causing strains, and their bodies’ immune systems naturally clear the virus within 2 years of infection.

The vast majority of people infected with HPV do NOT develop cancer.

What Does HPV have to do with Oral Cancer?

Oral cancer has historically been the disease of the 60 year old white male smoker.  The cancer was usually located in the front of the mouth and easily correlated to tobacco and alcohol use.

Times have changed.  As researchers noticed an increase in oral cancers among younger non-smokers toward the back of the mouth and throat, they looked for the reason behind this change.   What they found was an extremely high prevalence of HPV infection in these “new” oral cancers.

The strain HPV16, which is also associated with cervical cancer in women, is the same culprit in newer oral cancers.

How Does This Change Things?

The demographics of oral cancer have changed.  Dentists typically held to a 75/25 rule: 75% of oral cancers are tobacco-related, and 25% are not.  That rule no longer applies.  Oral cancer affects people of all ages with no history of tobacco or alcohol use.  A recent Swedish study showed that 60% of oral cancer patients tested were infected with HPV.

This means there is no specific profile for oral cancer anymore.  All people are at risk, and all must be screened regularly.  At Timberlake Dental, we perform a comprehensive oral cancer screening on every patient (even children) at every professional cleaning visit.  Our doctors and dental hygienists are trained in the detection of suspicious lesions that could be dangerous.

Who has the Highest Risk for HPV-related Oral Cancers?

The statistics show that non-smoking white males aged 35-55 years with an active sexual history are at the highest risk.  The more sexual partners, the higher the risk.  Patients with weakened immune systems are also at a higher risk because their bodies will not naturally clear the infection as most do.

How Can I Find Out if I Have HPV?

You can request a test from your medical doctor.  Most women will have this test performed with their yearly exams with an Ob/Gyn.

What if I Do Have HPV?

  • Don’t freak out. Most people have this virus at some point in their lifetimes.  Having an HPV infection does not mean you will get oral cancer.  It only means you may have a higher risk for developing oral cancer.
  • Check your mouth monthly! Note any unusual lumps, bumps or sores.  If they do not go away on their own within 2 weeks, make an appointment to see your dentist ASAP for an evaluation.
  • Keep your mouth healthy! Oral cancer rates are higher among patients with oral disease (like cavities and gum disease).  Keeping your mouth healthy boosts your immune system and lowers your risk.
  • Practice safe sex and limit the number of sexual partners. Your risk for dangerous strains of HPV, which are closely linked to cancer, increases with more sexual partners.

Want More Information on HPV-Related Oral Cancer?

The Oral Cancer Foundation provides statistics, advice and links to research about HPV and Oral Cancer.  Or call 940-382-1750 to schedule a consultation with Dr. Chowning.  He can answer any oral cancer question you may have and perform a thorough oral cancer screening while you’re there.

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What Exactly is Preventive Dentistry?

There are many different categories within the realm of dental treatment.  In our opinion, the most important category is PREVENTIVE dentistry.

At Timberlake Dental, we are committed to practicing conservative and preventive dentistry.  We believe those two go hand in hand.  In order to be as conservative as possible, we need to help each and every patient prevent dental problems.  Big dental problems require extensive dental treatment.  By being preventive, we either intercept developing dental problems early or completely prevent them from happening!

Why is Preventive Dentistry So Important?

It Saves You Money!

Ever heard that saying, “An ounce of prevention is worth a pound of cure”?  When you spend a little money on preventive dentistry, you are saving a lot of money by preventing the need for future dental work.

Just as maintenance for your car is less expensive than repair work, preventive dentistry is always less expensive than restorative (or repair) dentistry.

It Keeps You Out of the Dental Chair!

We know . . . no matter how much you like us, you still do not want to be in the dental chair having a problem repaired.  When you have fewer dental problems because you have been preventive, you need less dental work.  This means you get to spend less and less time in the dental chair.

Of course, we cannot prevent every possible dental problem.  Things like congenital problems and injuries do happen and are not preventable.  Because there are some things we cannot prevent, we should make every effort to prevent the things that we can!

It is the Only Option for a Completely Healthy Mouth!

Yes, it is great to save money.  And of course, no one wants to spend more time in the dental chair.  But the greatest advantage of preventive dentistry is the fact that it keeps your mouth healthy!

Good health is priceless.  There is nothing better than having a mouth free of cavities, cracks and gum disease.  It looks beautiful, it does its job well, and it promotes a long healthy life.

What Dental Procedures Fall into the Category of Preventive Dentistry?

Professional Teeth Cleanings

You can prevent gum disease by sticking to a consistent schedule of professional teeth cleanings with our awesome hygienists.  Gum disease occurs when plaque (the soft, sticky stuff made of bacteria and food debris) stays on the teeth for too long.  Plaque acts like a toxin, and your gums and supporting jaw bone do not like it!  Plaque quickly hardens into tartar (also called calculus), which is also a toxin.

When plaque and tartar remain on the teeth for a long period of time, your body produces an inflammatory reaction.  This inflammation destroys the jawbone, which undermines the foundation of your teeth!  Without any intervention, gum disease gets worse and worse.

By staying on track with consistent professional teeth cleanings, you prevent this process from progressing.  The schedule of consistent teeth cleanings can be different for people with different circumstances.  Some patients need to have their teeth cleaned every three months.  Others do well and fight gum disease by seeing our dental hygienists every six months.  What is important is knowing which schedule is best at preventing gum disease for YOU!

Fluoride Treatments

Fluoride is a naturally occurring mineral that strengthens enamel and fights cavities.  Fluoride is in most toothpastes and many mouth rinses.  In our office, we offer a professional fluoride treatment.  A high strength concentration sticks to the teeth and packs a punch to boost the strength of your teeth!

Fluoride treatments are wonderful preventive tools for patients with a high risk for getting new cavities, people with sensitive teeth, and patients who have a hard time keeping their teeth clean (small children, the elderly, or those with physical and mental challenges).

Dental Sealants

Sealants are not just for kids!  Many people assume so because dental insurance often pays for sealants in children but not in adults.  Everyone can benefit from sealants.  Ask around the next time you are in our office.  You will find that most of us (all adults!) have sealants on our teeth.

Sealants form a protective coating over the biting surface of the back teeth where deep pits and grooves are high risk sites for cavities.  Sealants make the treated surface easier to clean, with less food being stuck in the grooves.  A $60 sealant can prevent the future need for a $250 filling!

Custom Nightguard

A nightguard is a hard appliance worn over the teeth while you sleep.  The purpose is to separate and protect the teeth from heavy clenching or grinding forces.

We see cracked teeth every single day.  So many people are damaging their teeth with nighttime clenching or grinding.  This leads to expensive dental work like crowns and even root canals.

By wearing a custom-fit nightguard while you sleep, you can prevent cracks and fractures on the teeth.  This is invaluable!  Cracked teeth are difficult for your dentist to diagnose, and treatment is often unpredictable.  Prevent them!

Are You Interested in Preventing Dental Problems?

Call our office today at 940-382-1750 to schedule a consultation with Dr. Chowning.  He will assess your specific risk areas and give you recommendations for preventive dental options.  Our goal is to keep your mouth as healthy as possible!

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Toothpicks, Ice Chewing and Other Bad Habits

We all have bad habits.  Some of these just waste our time, but others can actually be harmful.  In dentistry, we worry about habits that can damage your teeth and gums.  This blog will highlight some of the most common bad habits we see and the damage they can cause.


Good old fashioned wooden toothpicks are a bad habit, as far as your teeth and gums are concerned.  Many patients use toothpicks to dislodge food that is stuck between the teeth.  Others just like to hold a toothpick in the mouth and chew on it for a awhile.  Now matter how a toothpick is used, it is not appropriate inside your mouth.

Wood is brittle and easily splinters.  These splinters can become embedded in the gum tissue, creating major inflammation.  If left in place, they can lead to severe gum infections.  Dentists remove splinters from infected gum tissue on a regular basis.  Severe cases require additional gum treatments to help your tissue heal!

It is also abrasive to the tooth.  Over time, repeated friction between a wooden toothpick and the tooth at the gum line will actually remove tooth structure.  In general, people use toothpicks in an area we call a “black triangle”.  When gums recede and no longer fill in the space between two teeth, there is an air gap between the teeth and the gums, usually in the shape of a triangle.  This is a perfect spot for food to hang out.  It also seems like a perfect spot for a toothpick.

Repeated use of a toothpick will alter the shape of this black triangle until it perfectly fits that toothpick.  All tooth structure is precious and should be preserved at all costs.  Don’t use toothpicks!

Ice Chewing

We know.  You don’t even think about it.  You just chew your ice as a habit.  This habit can lead to big dental problems and expensive dental treatment!

Ice chewing is bad for your teeth for two reasons.

  1. The hard, brittle nature of ice requires too much force from the teeth to break it. Chewing ice greatly increases your risk for cracking your teeth.
  2. The temperature difference between ice and your mouth’s natural temperature causes cracks. Just like a sharp temperature change on your glass windshield can create cracks, the difference in the temperature of your mouth and the ice you chew creates small cracks in the enamel.  This weakens your tooth and makes it more susceptible to larger fractures and cavities.

People who chew ice are very likely to crack their teeth.  At the very least, cracked teeth require a dental crown.  At the most, a crack can go all the way to the root of a tooth, forcing your dentist to extract the tooth!  Don’t chew ice!

Smokeless Tobacco

Smokeless tobacco like chewing tobacco or dipping snuff can kill you.  This is more important than damage to your teeth and gums.

Tobacco causes oral cancer. 

In addition to cancer, smokeless tobacco also causes staining and erosion on your teeth.  Don’t use smokeless tobacco!

Nail Biting

There are two big reasons nail biting is bad for you.

  1. It introduces more bacteria into your mouth. Our hands and fingernails are dirty!  You never want to introduce this bacteria and dirt into your mouth.
  2. It puts improper forces onto the front teeth, making them weaker and more likely to chip and break.

Biting your nails can lead to jagged edges at the bottom of your front teeth.  Not only does this look bad, it can also be expensive to fix.  Don’t bite your fingernails!

Using Your Teeth as Tools

We are constantly repairing patients’ teeth that have been chipped or broken from using their teeth as tools.  Hairdressers often hold hair pins between their teeth.  Fishermen use their front teeth to cut fishing line.  People use their teeth to tear open packages of fruit snacks for their children.  The possibilities are almost endless.

Teeth are not tools.  When we use them as such, we run the risk of breaking them, requiring extensive and expensive dental treatment for repair.  Commit to using your teeth only for their proper tasks: eating, speaking, smiling!  Don’t use your teeth as tool!

Do You Have Questions about Another Habit that Could Affect Your Teeth?

Call 940-382-1750 today to set up a consultation with Dr. Chowning.  He can answer all of your questions about what a specific habit could do to your teeth and gums.

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Professional Fluoride Treatments: What You Need to Know

At Timberlake Dental, we practice preventive dentistry.  This means we give our patients the tools they need to prevent dental problems.  One of the most important tools of preventive dentistry is the application of a professional fluoride treatment.

Professional fluoride treatments, also called “varnish”, pack a punch that you cannot get from using fluoride toothpaste or mouthwash every day.

What is Fluoride?

Fluoride is a naturally occurring mineral that is present in varying levels in the earth and therefore also in our groundwater.  Scientific research shows that when fluoride is incorporated into enamel, that enamel is stronger and more resistant to cavities.  As studies proved the great benefits of fluoride for teeth, communities began adding it to their community water supply.  Grand Rapids, MI, was the first city to add fluoride to its water in 1945.

The Center for Disease Control calls community water fluoridation one of the ten great public health achievements of the 20th century!

Is Fluoride Safe?

That’s a great question, and you will get different answers from different sources.  Fluoride is the topic of a decades-long controversy that was typically fought at the community level, when water fluoridation came up for discussion.  Nowadays, it is a topic of controversy on many blogs and health-related websites.

The reason for the controversy is the toxic effects of an overdosage of fluoride.  In correct amounts, fluoride strengthens enamel and fights cavities with no ill effects to the rest of the body.  However, in extremely high levels, it can cause neurological and skeletal problems.

Many vitamins and minerals are toxic if taken in the wrong amounts.  Fluoride is no exception.  This makes research and professional oversight even more important.

When used properly, fluoride helps maintain a healthy mouth for life!

What is a Professional Fluoride Treatment?

Fluoride is available in toothpastes, gels and mouthrinses.  The specific type of fluoride this blog addresses is a professional fluoride treatment called a fluoride varnish.

A varnish is a high-strength fluoride carried in a sticky gel that adheres to the teeth for several hours.  The extended release of a fluoride varnish allows the mineral to be absorbed by the teeth for up to 24 hours.

Research shows that professional fluoride treatments decrease cavity risk, strengthen enamel against damage from acid, and reduce tooth sensitivity.

What does a Professional Fluoride Treatment Involve?

It goes on quickly with a simple paintbrush and causes no discomfort at all.  This makes it easy to apply on children or special needs patients.  Your dentist or dental hygienist can literally apply fluoride varnish to teeth in under 20 seconds.  Because a varnish sticks to the teeth, it eliminates the risk of swallowing the fluoride. 

A fluoride varnish does not require a 30-minute interval with no eating or drinking afterward.  The patient is free to eat and drink immediately.

Who Needs Professional Fluoride Treatments?

The list of people who can benefit from professional fluoride treatments is a pretty long one.  It includes anyone with a high risk for cavities or other enamel damage and anyone experiencing sensitive teeth.  The following describe specific scenarios of people who could benefit from professional fluoride treatments.

  • Anyone who frequently develops new cavities
  • A person who has already had a lot of dental work
  • Patients with acid reflux, GERD, frequent vomiting, or another condition that brings stomach acid into the mouth
  • People with a diet consisting of very acidic foods and drinks (fruit, kombucha, teas, sparkling water, etc . . .)
  • Anyone with sensitive teeth due to gum recession
  • Someone with unexplained tooth sensitivity
  • Anyone who cannot whiten his or her teeth due to sensitivity
  • A patient who avoids professional teeth cleanings specifically because they make the teeth more sensitive
  • People who have difficulty in cleaning their teeth well: including children, the elderly, and those with physical disabilities

Do You Think You Need a Professional Fluoride Treatment?

If you fall into one of those categories and would like to discuss the benefits of professional fluoride treatments with Dr. Chowning, call us today at 940-382-1750 to set up a consultation.  He will explain your specific risk areas and how fluoride treatments can give you a healthier lifespan of your teeth.

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Activated Charcoal and other DIY Teeth Whitening Trends

You have probably seen it as you scroll through your Facebook, Instagram or Pinterest feed: do-it-yourself teeth whitening.  The trend of attempting to whiten your teeth with “all-natural” or over-the-counter ingredients and without the endorsement of a dentist has gained widespread popularity in recent years.  It’s no surprise that everyone wants whiter teeth.  Our goal at Timberlake Dental is for you to achieve your cosmetic goals while maintaining the best possible health of your mouth. 

There are dangers associated with some of the DIY whitening trends, and it is important to know these dangers before you attempt any of the techniques promoted as “teeth whitening hacks”.

The Two Biggest Dangers: Abrasion and Acid Erosion

  • Abrasion – Abrasion is defined as a wearing away, grinding or scraping by friction.  In dentistry, it is the wearing away of surface tooth structure by friction with another surface or material.  This is one of the dangers of DIY whitening trends that use rough, coarse or abrasive materials to polish superficial stains off of enamel.  Very mild abrasion is the mechanism of action of whitening toothpastes; they contain small, coarse particles that clean the surface stains from the outer layer of enamel.  If the wrong material is used (something that is too coarse), or if an approved material is used in the wrong manner (using an ADA approved whitening toothpaste with a hard toothbrush in aggressive motions), rather than simply removing surface stains, you can actually remove enamel!  Removing enamel will make the teeth thinner, weaker, more sensitive, and ironically, yellower over time.
  • Acid erosion – Acid erosion is the gradual destruction of tooth structure by the chemical action of acid on enamel. Dentists see severe acid erosion on patients who have a habit of sucking on lemons or patients with bulimia.  Acid erosion of teeth can also be a complication of acid reflux or GERD.  Many of the DIY whitening techniques recommend using acidic fruit juices or fruit pieces, which over time, can cause acid erosion on the teeth.

Activated Charcoal Powder and Charcoal Toothpastes

Its rise in recent popularity might make you think this is a new use for charcoal, but charcoal has actually been used in oral hygiene for thousands of years.  Hippocrates documented using it in ancient Greece.  The American Dental Association has responded to the rising interest in charcoal as an oral hygiene product by publishing a literature review of all published scientific research studies regarding charcoal and charcoal toothpastes.  The goal was to find evidence in scientific research for the safety and effectiveness of using this material on the teeth. The results of the literature review state that there is not enough support by scientific research to claim that charcoal is safe for enamel and is an effective tooth whitener.  The literature reviewed showed some mixed results, and the majority concluded that there is a risk of enamel abrasion.  The literature review also included a study of 50 charcoal powders and toothpastes available for purchase on the internet, and none of them has achieved the Seal of Approval by the American Dental Association.

In short, activated charcoal cannot be deemed safe by dentists for use on teeth.

DIY Teeth Whitening using Lemon Juice

Many other home whitening trends advise you to mix lemon juice with baking soda for a homemade whitening toothpaste.  Another technique recommends rubbing your teeth with the inside of a banana peel, and one site calls for a paste made from strawberries.  All of these fruits are acidic (lemon juice = 2, strawberries = 3.0-3.9, and bananas = 4.5-5.2) and are not meant to stay in contact with your teeth for longer than it takes to eat them.

You should never purposefully apply any acid to your teeth. 

The enamel is weakened, increasing your cavity risk, causing tooth sensitivity, and irreversibly damaging the teeth.

Still Interested in DIY Teeth Whitening?

Please discuss your ideas with Dr. Chowning.  He will be able to advise you on which specific techniques may be safe for you and which could be especially dangerous.  He can also answer any questions about the safety and effectiveness of professional teeth whitening offered at Timberlake Dental.  Call 940-382-1750 today to schedule a whitening consultation with Dr. Chowning.

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Aphthous Ulcers (Canker Sores)

If you have never had a mouth ulcer, thank your lucky stars!  They are terribly painful and interfere with eating, speaking, and brushing your teeth.  The most prevalent type of mouth ulcer is an aphthous ulcer, and it is commonly referred to as a canker sore.  Aphthous ulcers are unusual in that, even now in 2018, we still do not know exactly what causes them.  There are many studies showing correlation between certain diets, vitamin deficiencies, hormone changes, and stress levels with the occurrence of aphthous ulcers.  But correlation is not the same as causation.

What are aphthous ulcers?

There are three main types of aphthous ulcers: 1) minor, 2) major, and 3) herpetiform.  They all share similar appearance of a round or oval-shaped ulcer with an inflamed red border around a yellowish-white film that covers the deeper ulceration.

  1. Minor aphthous ulcers are the most common and least painful. They typically are less than 1 cm in diameter and last for 7-14 days.
  2. Major aphthous ulcers are much larger, up to 3 cm, and can last over a month. Due to their increased size and duration, they are much more painful.
  3. Herpetiform aphthous ulcers take their name from herpes lesions (also called cold sores) caused by a Herpes Simplex Virus, which occur in clusters. Herpetiform aphthous ulcers also occur in clusters and can easily be misdiagnosed as viral sores.  Herpes viral sores and aphthous ulcers differ in cause and location.  There is no virus associated with aphthous ulcers, and they only occur on freely movable mucosa.  This includes the inner lining of the lips, cheeks, tongue, floor of mouth and the soft palate.  Herpes lesions, or cold sores, occur on the outside of the lips or any attached gum tissue like the hard palate or gums covering the teeth.  When herpetiform aphthous ulcers form in a cluster, the ulcers often coalesce or blend together to form one very large, very painful ulcer.

What causes aphthous ulcers?

There is currently no scientific data identifying one specific cause of these ulcers.  The research studies have shown a correlation in the occurrence of aphthous ulcers with certain predisposing factors, listed here.

  • Genetics – Some studies suggest a genetic component because children are much more likely (90%) to experience aphthous ulcers if both of their parents have had them.
  • Certain GI problems – There is a high correlation between patients who experience aphthous ulcers and those with gastrointestinal issues like ulcerative colitis, Crohn’s disease and Celiac Disease.
  • Vitamin deficiencies – Some studies show a correlation between patients with aphthous ulcers and low levels of iron, vitamin B12, and folic acid.
  • Hormone levels – Many women experience aphthous ulcers at regular intervals correlating to their menstrual cycle.
  • Stress – Because stress cannot be quantitatively measured, this one is difficult to prove scientifically. But it’s no surprise to people who suffer with these ulcers that stress can make them more likely to appear.

  • Trauma – This is likely the most common cause of aphthous ulcers. Trauma can range from anything as simple as accidentally biting the inside of your lip or hitting your gums with the toothbrush to routine dental treatment or a complicated oral surgery procedure.

How are aphthous ulcers treated?

There are many ways to treat the painful symptoms of aphthous ulcers, but there is no cure to prevent them from recurring.  There are many options available, and it is best to discuss them with Dr. Chowning to figure out which one is best for your specific ulcers.  Some of the possible treatment options are listed here.

  • A topical gel or paste – Usually a prescription product, this is applied to the ulcer with a Q-tip or clean fingertip multiple times a day. It typically contains a steroid, which reduces the severity and duration of the ulcer, but does not change the frequency of occurrence.
  • A prescription mouthwash – Also used to alleviate symptoms only, this can contain an antibiotic, antifungal, steroid anti-inflammatory, antihistamine (like Benadryl), and antacid (which creates a thick coating over the oral lining). When used 4-6 times per day, it can reduce the symptoms of the painful ulcers.
  • Laser treatments – A laser can be used to treat the ulcer, which reduces inflammation and speeds up the healing process by making changes to the surface of the ulcer.
  • Dietary changes – Patients who are afflicted with frequent or multiple aphthous ulcers and have celiac disease or a gluten intolerance show a marked reduction in ulcer occurrence when gluten is eliminated from their diet. A very recent study has also shown an improvement in occurrence of ulcers when a dairy-free diet is observed.  This is based on a new study showing a higher level of antibodies to cow’s milk proteins in patients who have aphthous ulcers.
  • Vitamin therapy – In patients who do show deficiencies in iron, vitamin B12, and folic acid and experienced frequent aphthous ulcers, the ulcer occurrence rate decreased after vitamin therapy to treat those deficiencies.

What can you do about aphthous ulcers?

The most important step you can take is contacting your dentist as soon as you notice the lesion.  All of the above treatment modalities are most effective when started early in the life of the ulcer.

Ulcers are aggravated by acidic foods, spicy foods, and hot temperatures, so avoid them in order to reduce your painful symptoms.  Use caution when eating and talking so that you do not reinjure the area and cause the ulcer to last longer.  Cold can temporarily alleviate symptoms, so we do recommend drinking ice water and holding a piece of ice against the ulcer until you see the dentist for other treatment options.

Do you think you have an aphthous ulcer?

Call our office at 940-382-1750 to see Dr. Chowning for an evaluation.  He will help you get started on the best treatment to reduce the pain and length of your ulcer.