timberlake dental

What is Xylitol, and How Can it Make My Mouth Healthier?

Xylitol is slowly making its way to the top of the list of sugar alternatives and sweeteners for people trying to cut back on sugar intake.  Lowering sugar consumption is good for your entire body, not just your teeth.  Of course, dentists have always urged people to limit the amount of sugar they eat or drink on a daily basis.  Now we have a great alternative to recommend!

What is Xylitol?

Xylitol is a naturally occurring sugar alcohol, derived from plants.  The most commonly used source of xylitol today is corncobs.  Xylitol contains one-third the calories of sugar, so while it is a better choice, it is not calorie free.  It is similar in sweetness to sugar.

Researchers have studied xylitol for over 40 years to determine its usefulness as a sweetener, its safety, and its effect on the body.  Our blog will focus on its effect on your oral health.

What is the Effect of Xylitol on My Risk for Cavities?

Research studies show that xylitol has an anticavity effect.  It stops harmful acid-producing bacteria in its tracks.  Bacteria cause cavities on teeth by producing a strong acid that can dissolve hard tooth enamel.  Xylitol slows down or completely stops the process of acid formation in these bacteria, thereby protecting your enamel.

The flavor of xylitol also stimulates saliva production.  Saliva is the body’s natural defense against cavities.  Without it, teeth are at risk for cavities and gum disease because bacteria can proliferate at a faster rate.

Not only does xylitol stop the bad guys (the bacteria causing cavities); it also strengthens the good guy (saliva).

What is the Effect of Xylitol on the Whole Mouth?

Xylitol helps maintain a healthy mouth by promoting all of the benefits provided by saliva.  Saliva lubricates the mouth, protecting against sores and ulcers as well as lip, cheek and tongue biting.  Saliva raises the pH in the mouth, protecting against harmful acid attacks from both bacteria and the food and drinks we consume.  Saliva contains enzymes that start the digestion process, so our chewing is more effective.  Saliva washes away food debris and plaque buildup, lowering the risk for cavities and gum disease.

Xylitol adds all of these benefits to the mouth by promoting saliva!

Are There any Side Effects of Xylitol?


Some people experience GI upset after consuming large amounts of xylitol.  These side effects include diarrhea, abdominal cramping and gas.  They do subside as soon as you stop consuming xylitol.

Also, xylitol does contain a small amount of carbohydrates, so diabetics should continue to monitor their blood sugar levels closely.

How Should I Use Xylitol?

Xylitol is available over-the-counter in many forms:

  • Chewing gum
  • Mints or hard candy
  • Granulated, like sugar
  • Mouthwash
  • Toothpastes
  • Discs that adhere to the inside of your mouth

Chewing Gum

The simplest way to add xylitol to your daily routine is by purchasing Ice Cubes chewing gum and chewing several pieces every day.  This gum is the easiest source of xylitol to add to your routine because it is available at every major grocery store or drugstore in many flavors.  It is a wonderful way to get your kids to fight cavities.  By chewing a piece of xylitol-containing gum after a meal, you help return your mouth to a neutral pH as quickly as possible.

You should NOT chew xylitol gum if you have problems with your jaw joints (TMJs).  If you start to have any pain or clicking sounds in your joints, stop chewing gum and call us immediately.

Mints or Candies

Xylitol mints or candies are a great option for patients with TMJ problems who cannot chew gum.  They are a little more difficult to find as they are usually only sold in health food stores.  You can always order them on amazon.  A few brands are Epic, Spry, and Zellie’s.

Xylitol mints are also a great option for just after meals or acidic drinks to help neutralize your mouth.

Granulated Xylitol

You can find granulated xylitol in most health food stores, and you use it just like sugar.  You can add it to your coffee or use it in baking at approximately the same amount as sugar.  You may need to experiment with it a little to get your recipes to taste just right.

Oral Hygiene Products

Oral care products like mouthwash and toothpastes also contain xylitol.  The xylitol sweetener helps improve the flavor and provides the anticavity benefits described above.  Some brands of oral care products containing xylitol include CariFree, Spry, OxyFresh, and NOW.

Intraoral Adhering Discs

Probably the newest option in xylitol delivery, intraoral discs like XyliMelts provide the best overnight dry mouth protection there is.  These lubricating “stickers” adhere to the inside of your mouth and release a xylitol-containing gel throughout the night.  The xylitol stimulates saliva, and the gel itself creates a lubricating effect.

These discs are a wonderful tool for fighting cavities in people who suffer from dry mouth.  If your mouth is consistently dry, and you have a high cavity risk, add XyliMelts to your bedtime routine.

WARNING!  Xylitol is toxic to dogs!

Make sure to keep any xylitol, even chewing gum containers, out of the reach of any dog.  You could be in for a very expensive vet bill, or even worse, the death of your pet.

Do You Have More Questions about Xylitol?

Call 940-382-1750 today to schedule a consultation with Dr. Chowning.  He can answer any question you may have about cavity risk and how xylitol can help you.

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Is Dental Care Dangerous When I am Pregnant?

Great question!  The short answer is no.  The long answer is that pregnancy actually makes dental care more important.  Read on.

During pregnancy, your body goes through so many changes.  Some of these changes affect your mouth.  There are also things in your mouth that can affect your growing baby.

Here are the things you need to know about pregnancy and your mouth!

  1. Pregnancy hormones make your gums go crazy!

Many of our pregnant patients suffer from a condition called pregnancy-induced gingivitis.  We also call it hormone-induced gingivitis, because it can affect kids during puberty and women during menopause.

The surges in hormone levels wreak havoc on your gums, causing severe inflammation.  Gums look bright red and puffy.  They also bleed at the slightest irritation.

It is important to keep your teeth and gums as healthy as possible because even minor plaque buildup will set off the gingivitis that is so aggravated by your hormones.

  1. Morning sickness can make oral hygiene difficult.

Many of our pregnant patients tell us that taking care of their teeth is so much harder due to an extremely sensitive gag reflex.  Brushing the molars can make some people throw up.  Reaching the fingers toward the back of the mouth for flossing may give a choking sensation.

One tip that can help with this is to use flossers with a long handle.  This keeps your fingers out of your mouth and reduces your risk of gagging.

  1. Severe morning sickness can cause acid erosion on your teeth.

The constant vomiting and acid reflux of morning sickness brings up powerful stomach acid into the mouth.  This extremely low pH is very dangerous to tooth enamel.

If you suffer from this problem, it’s important to rinse your mouth with neutral pH water after any vomiting.  Bringing the pH back to normal is essential in protecting your enamel.

Consistent vomiting can lead to dehydration, which also poses a threat to your teeth.  You may need to speak to your Ob/Gyn about anti-nausea medication.

  1. Dental care is absolutely essential during pregnancy!

Because of numbers 1-3 above, dental care is essential during a pregnancy.  Your gums are at risk for severe inflammation, and your teeth are at risk for cavities and erosion.  It is more important than ever to be preventive!

Fight pregnancy-induced gingivitis by staying on a frequent schedule with professional teeth cleanings.  Many of our patients need cleanings every 3 months during pregnancy to help maintain healthy gums.

More frequent dental cleanings also helps reduce your risk for cavities because we are helping you remove the dangerous bacteria that plaque contains.  This is particularly important if you are having difficulty brushing and flossing your teeth.

  1. We modify dental care during pregnancy.

There are some conditions, like severe gum disease, large cavities, or dental infections, that require urgent treatment.  The risk of the dental work causing a problem is much lower than the risk of the infection harming your baby.

At Timberlake Dental, our dentist works with your other healthcare professionals to make sure you are receiving the safest and best care possible.  We follow this protocol for health concerns of all types, like high blood pressure, diabetes, or autoimmune conditions.

We take pregnancy and your safety very seriously.  Research has shown that the safest time to have dental work is during your second trimester.  Dr. Chowning will obtain clearance from your Ob/Gyn to perform any necessary dental work.  He will get specific permission for dental x-rays and local anesthetic.

Are You Pregnant or Have a Loved One Who Is?

Call 972-347-1145 today to schedule an evaluation with Dr. Chowning.  He will discuss your specific risk areas with you and help you develop a plan to keep your mouth healthy throughout your pregnancy! 

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What Does Sleep Apnea Have to Do with My Teeth?

Many of our newer patients are surprised to hear us asking about their quality of sleep.  To some, it may seem like sleep problems and dentistry are completely unrelated.

There is a two-way link between dentistry and sleep-disordered breathing issues like sleep apnea.

What is Sleep Apnea?

Sleep apnea is a condition when a person stops breathing for any amount of time while he is sleeping.  The word “apnea” simply means not breathing.  The diagnosis of mild, moderate or severe sleep apnea depends on the number of times a person stops breathing per hour.

When sleep apnea results from a faulty signal in the brain, it is a central sleep apnea.  When a physical closure of the airway causes a person to stop breathing, it is an obstructive sleep apnea.

This blog deals primarily with obstructive sleep apnea.

The Effects of Sleep Apnea on the Teeth

Increased Risk for Nighttime Grinding and/or Clenching

When a person stops breathing, the brain perceives a lack of oxygen very rapidly.  The brain then sends signals to various parts of the body to open the airway and breathe.

One of the ways your body subconsciously opens the airway is by closing the jaws and either tightly clenching the upper and lower teeth together or pressing the lower jaw forward.  This is how sleep apnea causes people to clench or grind their teeth.

The heavy forces placed on teeth by clenching and grinding are higher than normal chewing forces, and they damage the teeth, dental work, gums and jawbone.

All of the following are signs that you may be clenching or grinding your teeth.

  • Cracked teeth
  • Broken dental work, like fillings, crowns and bridges
  • Receding gums
  • Notches in the tooth by the gums
  • Flattening or shortening of the teeth
  • Loss of enamel on the biting surfaces

Many dentists are aware that the cause of these dental problems is teeth clenching and/or grinding.  At Timberlake Dental, Dr. Chowning looks deeper to find the cause of the grinding!

Increased Risk for Acid Erosion

Sleep apnea causes many people to suffer from acid reflux or GERD.  When an obstruction blocks the airway, the lungs create a suction effect when attempting to breathe.  This suction pulls acid up out of the stomach into the esophagus and mouth.

Stomach acid is extremely acidic and corrosive to teeth.  Just as acid can etch and soften glass, it can soften and weaken tooth enamel.  Patients with sleep apnea often show tell-tale signs of acid erosion on their enamel.  This acid does not effect dental work, so fillings appear to be protruding out of a tooth.  They are not actually protruding; they just appear so because the surrounding enamel has eroded away.

The Effects of the Jaws on Sleep Apnea

Many people know that obesity is a risk factor for obstructive sleep apnea.  The extra weight in the face, neck and tongue press on the airway causing a physical obstruction when laying down to sleep.

A lesser-known risk factor is the growth and development of the lower jaw.  Patients with a small lower jaw or severe overbite are at a high risk of sleep apnea because they are very likely to have a small airway.

Dr. Chowning has extensive training in evaluation of the growth and development of the jaws.  They can spot this risk factor very early in life.  When caught early, problems in jaw growth and development can be intercepted and corrected as your child grows.

Do You or a Loved One Have Sleep Apnea?

If you or a loved one have sleep apnea and are concerned about its effect on your teeth, please call today to schedule a consultation with Dr. Chowning. He will explain your specific risk factors for dental problems related to sleep-disordered breathing.

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I Just Ate a Candy Cane.  Now What?!?

It’s the most wonderful time of the year!  It could also be the sweetest.  Are you like Buddy the Elf?  “We elves try to stick to the four main food groups: candy, candy canes, candy corns, and syrup.”  While we love Buddy and that beloved Christmas movie, we’re not so sure about his nutritional advice.

While you and your family are enjoying the sweet treats of the season, keep these tips in mind to ward off “sugar bugs” (the cutesy name we use for the bacteria that cause cavities).

Helpful Tips for Fighting Cavities

When it comes to fighting cavities during the holiday season, you either have to say NO to the sweets or up your oral hygiene game.  Despite our reputation (as dentists) of wanting to take all the fun out of candy, we really do want you to enjoy the Christmas season!  Here are our tips for enjoying your holiday goodies and fighting cavities at the same time.

  1. Rinse with water!

Immediately after having candy or sweets, gently swish some plain old water around in your mouth.  This helps to dislodge small sugar-packed food or candy particles out of the nooks and crannies in your teeth.  It also brings the pH in your mouth back to neutral more quickly than it would return on its own.  The bacteria in our mouths produce acid when they eat sugar.  That acid is what does all the damage of cavities.  Keeping a neutral pH in your mouth is vital to fighting cavities.

  1. Chew sugar-free gum, preferably with xylitol.

Did you know your saliva is better than water?  It has a higher pH, and it contains enzymes that fight bacteria in your mouth.  By chewing sugar-free gum, you are stimulating the natural production of saliva.  Both the flavor of the gum and the chewing motion cause more saliva to flow.

Xylitol is a bonus!  Xylitol is a natural sugar alcohol found in plants that actually kills the bad bacteria in your mouth.  The bacteria eat xylitol, thinking it is sugar, but then they cannot digest it and die.  Our favorite xylitol-containing gum is Ice Cubes.  It comes in a wide variety of flavors and is available at most grocery stores and convenience stores.  Grab a few packs today and start chewing!

  1. Add a fluoride mouthrinse to your oral hygiene routine.

If you are not already using a mouthrinse, this is the time to start!  If you are using a mouthrinse, but it does not contain fluoride, it is time to make a switch.  Fluoride is the best ingredient in oral care products for fighting cavities.

Fluoride strengthens enamel, making it more resistant to acid attacks from bacteria.  By adding a fluoride rinse to your oral hygiene routine, you are making your teeth stronger and less likely to get cavities.

Because fluoride should stay on the teeth as long as possible, we recommend rinsing with a fluoride-containing mouthrinse AFTER brushing and flossing your teeth.  Do not rinse your mouth with water after rinsing with fluoride.  Let it be the last thing on your teeth before your head hits the pillow.

  1. Commit to great oral hygiene practices.

This is not the time of year to slack off with brushing and flossing your teeth!  People eat more sugar, drink more alcohol, and snack more frequently during the day in the holiday season.  All of these things increase the risk for cavities.

Make sure to stick to a consistent oral hygiene routine that includes:

  • Twice daily brushing, after breakfast and before bedtime
  • Once nightly flossing before bedtime
  • Rinsing with a fluoride mouthrinse after brushing and flossing
  • Use any additional teeth cleaning tools your dentist or dental hygienist have recommended, like a water flosser, interdental brushes, etc . . .
  1. Know your cavity risk.

Unfortunately, some people just have a higher risk for cavities than others do.  No, it’s not fair, but it is just the way things are.  If you have a high risk for cavities, these tips are even more important for you.

Do you know what your cavity risk level is?  If not, schedule a consultation with Dr. Chowning today.  He will assess your teeth and gums, telling you specifics about your risk areas.  Remember that old G.I. Joe saying: “Knowing is half the battle!”  That is certainly true for your cavity risk.  Once you know it, you can take the appropriate measures to fight it!

More Questions about Sweet Christmas Treats?

Call 940-382-1750 today to schedule a visit with Dr. Chowning or our dental hygienists.  We can answer any candy question you have!

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Healthy Holidays

The holidays are filled with fun gatherings of friends and family.  This time of year, more than any other, those gatherings seem to be overflowing with SUGAR.  Your office lounge is full of sweet treats from vendors and customers.  Your neighbors bring over tins of cookies and candy.  Maybe your stocking is stuffed with Hershey’s Miniatures.

The holidays are sweet, but don’t let the sugar overload give you a bad report at your next dental visit!

How to Keep Your Teeth Healthy During the Holidays

People often joke about their scales telling tales of Christmas indulgences.  In the same way, your teeth could be tattling on you for some bad habits throughout the holiday season.  No one wants to gain weight, and no one wants cavities.  These tips may not keep you from adding on a few pounds, but they will keep you from adding some extra dental visits.

Keep Good Habits, Cut Out the Bad Ones

Late night holiday parties may lead you to develop some bad habits, like midnight snacking, drinking late into the night, or going to bed without brushing and flossing.  Perhaps your family time is a little stressful and has you drinking more wine or indulging in some emotional eating.

Whatever the situation, if it causes you to consume a larger quantity of sweets and acidic drinks, or to consume them more frequently between meals, it could be damaging your teeth.

Try to stick to good habits of oral hygiene.  Make sure to brush your teeth in the morning after breakfast as you start your day, and at night before bed as you end your day.  Nightly flossing is a must for fighting cavities.  If you have a high cavity risk, add a mouthwash containing fluoride after you brush and floss.  This will strengthen your enamel and help you resist new cavities.

Limit Your Intake of Sweets and Acidic Drinks

Almost everyone knows that sugar causes cavities.  Many people do not know that acidic drinks can cause them, too.  What is an acidic drink?  The most common ones are listed here, but a general rule is this:  If it is not plain water, it is probably acidic.

  • Soft drinks like Coke and Dr. Pepper
  • Diet soft drinks
  • Sports drinks like Gatorade and Powerade
  • Sugar free sports drinks
  • Sparkling water like La Croix and Topo Chico
  • Coffee
  • Tea
  • Wine

Many of these are a double whammy because they are acidic, and they contain a very large amount of sugar.  As the acid in the drink lowers the pH of your mouth, the bad cavity-causing bacteria thrive and create cavities faster.

Choose Chocolate over Sticky Sweets

Chocolate is by far the best candy for your teeth.  The fat content helps to balance the high sugar level.  The darker the chocolate, the healthier it is for your teeth.

Sticky candies, like gumdrops, caramels, or any soft gummy treats, are the worst for your teeth.  Their sticky nature allows them to adhere to your tooth’s enamel for an extended period of time, giving the bacteria a longer feast.  The longer sugar sticks to the teeth, the more likely it is to cause a cavity.

Follow Up Sweets or Acidic Drinks with Water

After you enjoy a holiday treat, whether that is a candy cane or a glass of wine, follow it up with plain water.  Swish the water around to dislodge any sugary or acidic debris.  This helps bring your mouth back to a neutral pH until you can get to the bathroom to brush and floss.

If water is always the last thing you consume, you will lower your risk for getting cavities!

Don’t Let a Toothache Disrupt Your Christmas

If you have a tooth that is bothering you, do not put it off.  Trying to find emergency dental care over the holidays can be more painful than the toothache is!

Do not let an annoyance grow into an emergency.  If a tooth does not feel quite right, let us take a look at it before it gets any worse.  Call us ASAP to schedule an appointment before Christmas!

Merry Christmas from Timberlake Dental!

We wish our patients, friends and blog readers a lovely, joy-filled Christmas.  It is our privilege to care for you.

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Why Does My Dentist Ask So Many Questions about the Medicine I Take?

That’s a great question!  Both medicine and dentistry have changed drastically over the past few decades.

An old anecdote said that dentists built their offices on the second floor of buildings for a reason.  If the patient was healthy enough to climb the stairs to get to the dentist, he was healthy enough to have a tooth pulled.

Things are not quite so simple today.  First of all, we have elevators.  Secondly, and more importantly, we have more medications than ever, and these medications do have an impact on dentistry.  This blog will explain some of the reasons your complete medical history is so important to your dentist.

Your medications affect your mouth.

All medications have side effects, even over-the-counter ones.  It is important for your dentist to know what medications you take on a regular basis to help you care for your mouth.

Many meds cause dry mouth as a side effect.  A dry mouth is more than just an annoyance.  It can lead to serious dental problems, like cavities and gum disease.  A dry mouth also makes you more likely to have mouth sores and ulcers.

Other medications can affect things like bone density and wound healing, which can be very detrimental to a patient having oral surgery.  Some medications make the gums overgrow like crazy.  There are even some that affect your sense of taste.

If we do not know your medications, we may not be give you an accurate reason as to why you are experiencing certain mouth problems.  When we know what you are taking, we can take better care of your mouth.

Your medications affect our medications.

Most people do not think of anesthetic (“novocaine”) as a medication, but because of drug interactions, we must!

We inject medication every single day.  The ingredients in our local anesthetic injections can interact and interfere with medications you are taking.  In order to eliminate any complications that could arise, we have to know exactly what you are taking.

We also prescribe medications for dental infections, pain management, and TMJ problems.  The prescriptions we write could change the way your meds work.  For instance, certain antibiotics change the way birth control pills work.  And other medications affect the way antibiotics work.

Because of the countless types of prescription medications available today, it is impossible for us to guess what you are taking based on a list of medical concerns.  We need to know the name of the drug, the dosage, and the schedule you take it, so that we can ensure there will be no bad interactions with the medications we give you.

Your mouth may show whether your medications are working.

Did you know that certain health problems leave clues in your mouth?

Often, the dentist sees something in a dental evaluation that leads to questions about your overall health.  Dental hygienists can see signs of problems with hormones or blood sugar in your gums.

Many diseases have signs or symptoms that show up in the mouth.  If you are already taking medications for these diseases, and the oral symptoms are still present, that tells us that the medications may not be working as well as they should.

In addition to signs we see inside your mouth, we also may notice problems when taking your pulse and blood pressure.  If you are currently taking medication for high blood pressure, it is important to know whether or not that medicine is doing its job.

Your medications help us understand your overall health.

Contrary to what the division between medicine and dentistry implies, the mouth is not separate from the rest of the body!

The mouth is an important part of the body, and oral problems play an important role in your overall health.

When we perform treatment on various areas of your mouth, it can affect the rest of your body.  It is essential for us to know the exact state of your health so that we can plan for certain types of treatment.  We cannot discern the state of your health without knowing what meds you take.

This is of utmost importance when we are planning dental surgery, like a tooth extraction or dental implant.  The healing process is the most important factor in the long-term success of the dental treatment.  Both medical problems and the medications you take affect that healing process.

More Questions on What Your Medications Have to Do with Dental Treatment?

Call 940-382-1750 to schedule a consultation with Dr. Chowning.  He will closely study and discuss with you the details of your medical history to make sure that we provide you with the right dental care in the safest, most predictable way.

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Are You Brushing the Right Way?

You may remember that old toothbrush commercial that ended with the dramatic phrase: “Brush . . . like a dentist!”

The ad implies that if you use this specific brand of toothbrush, then you will automatically brush like a dentist.  The reality is that you can brush like a dentist with any kind of toothbrush.

Here are the things you need to know in order to brush like a dentist.


When you do brush, it is important that you spend enough time on it to ensure that you are reaching every surface of every tooth.  On average, it takes about two minutes of brushing for you to properly clean a mouth full of teeth.

In general, there are three exposed surfaces of each tooth.  When you brush correctly, you take the time to clean the lip or cheek side, the tongue side, and the biting surface.  It is a good idea to have a consistent routine, starting in the same place each time so that you know you haven’t missed a spot.

Twice a Day

People build up plaque at different rates.  For some people with issues such as a dry mouth, plaque will form on the teeth very quickly, even right after brushing.  These patients may need to brush more frequently than twice a day.

The average, healthy person should brush no less than twice each day.  The best schedule is to brush after coffee and breakfast to start your day with a clean slate.  Then brush before bedtime so that you do not leave dangerous plaque buildup on the teeth while you sleep.

We find that many people brush only in the morning because they worry about bad breath as they come into contact with people throughout their day.  That can be great motivation to brush every day.

It is even more important to brush at night before bed.  When we sleep, our body naturally produces less saliva.  Saliva is an important cavity-fighting tool, and when it is not actively flowing, we are at higher risk for dental disease.  Because we know we have less saliva flow at night, we need to go into bed with as little plaque on the teeth as possible!  This is why brushing before bed is so important.


Do not ever use a hard or medium toothbrush!

They do not improve plaque removal, and they do increase your risk for enamel damage!  Medium and hard bristles on a toothbrush put you at risk for enamel abrasion.  Abrasion removes enamel and makes you more susceptible to cavities.  Many people choose hard bristled toothbrushes, assuming that they clean better than a soft bristled toothbrush.  This is simply not true.

Always use a soft toothbrush only!


Technique is the most important aspect of brushing.  You can brush for the right amount of time several times a day, but if you are doing it with the wrong technique, it won’t do you much good.

Maybe the problem originates in the term we use to describe our oral hygiene routine.  Many people brush their teeth, but miss the most important area of plaque buildup: the place where the teeth and gums meet.  A better term would be brushing the teeth and gums.  Unfortunately, a lot of people spend two minutes twice a day brushing the areas of the teeth which are least likely to have plaque buildup.  That makes the brushing least effective.

In order for brushing to matter, it must have the proper technique and lead to the best end result.  The desired end result is the removal of all plaque, bacteria and food debris from the teeth and gums.  The way to reach that result is by using the right technique, or to “brush like a dentist”.

We already discussed the need for reaching every surface of every tooth.  Now let’s explain how to reach the most common sites of plaque buildup.

Plaque has two favorite areas: 1) the tiny crevice where the gums meet the teeth, and 2) the space between the teeth where the toothbrush bristles do not reach.  We address #1 by brushing properly.  We address #2 by flossing (you didn’t think we forgot about flossing, did you?!?).

Brushing properly requires holding the toothbrush so that the bristles are at a 45-degree angle, pointing at the edge of the gums.  Using gentle, circular motions, the soft toothbrush bristles should lightly touch the gums on each tooth as you make your way around the mouth.  This technique takes some coordination and can be difficult for people with physical disabilities or restrictions (including young children).

If you have trouble achieving this technique with a manual toothbrush, you should consider using an electric toothbrush.  Electric toothbrushes have very soft bristles and are extremely effective at plaque removal.  Because they perform the movements for you, your job is simply to make sure the bristles reach every area of the tooth.

Need Help Developing the Right Brushing Technique?

Call 940-382-1750 today to schedule a consultation one of our wonderful dental hygienists.  They are experts at brushing technique and at giving you specific tips on reaching the areas you are prone to miss.

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Sjögren’s Syndrome

We care about your overall health, and we are especially interested on how the condition of your mouth impacts overall health.  There are also systemic conditions that affect the condition of the mouth, and one of those is the focus of today’s blog.

Sjögren’s Syndrome is a disorder that has huge ramifications for the health of your mouth, in addition to its effects of the rest of the body.  This blog will highlight the dental health concerns related to this disorder.

What is Sjögren’s Syndrome?

Sjögren’s Syndrome is a chronic autoimmune disorder in which the body attacks the glands that produce moisture.  In most cases, the most obvious damage is to the salivary glands and the glands producing tears.  It can also affect other mucous glands, like those in the respiratory and GI tracts.  The damage to these glands causes them to malfunction and not produce the saliva, tears or mucous that the body constantly needs.

Sjögren’s Syndrome affects over 4 million Americans, and 90% of those affected are women.  It can occur by itself, called primary Sjögren’s, or in the presence of other connective tissue disorders like lupus or rheumatoid arthritis, called secondary Sjögren’s.

What are the Symptoms of Sjögren’s Syndrome?

No two people are exactly alike, and patients with Sjögren’s can experience one or more of these symptoms.  The disorder usually begins with a mild case of dry mouth, of which many people are unaware.  For this reason, Sjögren’s is often undiagnosed until painful symptoms are noticed by the patient.

  • Inadequate saliva – dry mouth
  • Inadequate tears – dry eyes
  • Inadequate mucous production – dry airway, esophagus
  • Joint and muscle pain

What are the Functions of Saliva?

Saliva is more than just spit.  Saliva is vital to the healthy function of your mouth in all of its capacities.  It aids chewing, tasting, digestion, swallowing, speaking, and the maintenance of a healthy oral environment.

  • Lubrication – One of saliva’s most important roles is keeping the mouth moist. Without proper lubrication, the delicate tissues lining the mouth become dry, inflamed, and sensitive.  The cheeks, lips and tongue often stick to the teeth and suffer painful sores or ulcers.  The lubrication also extends into the throat and esophagus, aiding in swallowing.
  • pH balance – Healthy saliva has a pH slightly higher than neutral; it should be slightly alkaline. This counteracts the acids in foods and drinks we regularly ingest, and it fights the acids produced by disease-causing bacteria in the mouth.
  • Digestive enzymes – Saliva is not just water. It contains many essential ingredients for healthy digestion.  The very first step in the digestive process is the exposure of food to saliva.  The enzyme amylase in healthy saliva begins breaking down food molecules.
  • Taste – Saliva has a solvent effect on food. It carries food particles to the taste buds for a greater sensation of taste.  Patients with dry mouth often experience a decreased sense of taste.

What are the Dental Consequences of Sjögren’s Syndrome?

  • Ulcers and mouth sores – Dry tissue inside the mouth is extra-sensitive to any injury, and therefore more likely to develop ulcers or sores in response to any injury. Cheeks, lips, and the tongue cannot function properly without the lubrication provided by saliva.  They are more likely to get bitten.
  • Cavities – Without saliva neutralizing the oral cavity, the bacteria that cause cavities are able to proliferate and produce more acid. This acid damages and weakens enamel, making cavities much more likely.
  • Gum disease – Saliva contains an antibacterial component, without which the bacteria that cause gum disease thrive. Patients with a dry mouth have gum disease that is more persistent and difficult to treat.
  • Bad breath – Almost all bad breath is caused by an overgrowth of bacteria. We have already discussed how a lack of saliva allows bacteria to multiply.  Most people can relate to the sensation of waking up with a “cotton mouth” feeling and extreme bad breath.  Imagine having a mouth that dry all the time!
  • Thrush infection – Thrush is a fungal infection. The fungus is naturally present in a healthy mouth without causing any concerns.  In a dry mouth, it can take over.
  • Burning sensation – The lack of lubrication makes the lining of the cheeks, lips and tongue hypersensitive to every stimulus. This often creates a burning or tingling sensation to the inside of the mouth
  • Sensitivity to harsh chemicals in toothpastes and mouthrinses – A normal healthy mouth can handle some of the harsh ingredients in many over-the-counter oral care products, like essential oils and alcohol in mouthwash or the foaming Sodium Lauryl Sulfate in toothpastes. In an extremely dry mouth, these chemicals can cause painful burning or numbing sensations.
  • Difficulty speaking – The cheeks, lips and tongue simply cannot function well when the saliva production is impaired. The position of these tissues is essential to making certain sounds, so some patients notice changes in their speech when their mouths are extremely dry.
  • Difficulty swallowing – Saliva is necessary to form food into a bolus that can be swallowed and to lubricate the throat and esophagus during the swallowing process.

What is the Treatment for Sjögren’s Syndrome?

There is no cure for Sjögren’s Syndrome at this time.  All treatments are aimed at managing the symptoms of the disorder.  Specific to dentistry, we recommend the following protocol for any patients with extreme dry mouth or impaired salivary function.

  1. Recognize your increased risk for cavities and gum disease. This means you need more frequent and more consistent visits to your dentist.  Patients with Sjögren’s Syndrome should never miss a professional teeth cleaning or dental evaluation.  Some patients need to have their teeth cleaned on a more frequent basis (for example, every three months instead of every six).
  2. Use oral care products specifically designed for patients with dry mouth. In order to prevent the burning sensation and harsh chemicals of most over-the-counter products, they should be avoided.  A great over-the-counter brand of dry-mouth-friendly products is Biotene®.  Their toothpastes and mouthrinses will not sting or burn, and their dry mouth sprays and gels are great adjuncts to keeping your mouth moist.  Chowning may also recommend prescription toothpastes or mouthrinses to decrease your risk for cavities and gum disease.
  3. Drink water throughout the day. Avoid drinks that will dehydrate you, like caffeine and alcohol.  Stay away from sodas and other high sugar drinks (they increase cavity risk).  It is essential to drink water while you eat to aid in swallowing your food.

Do You or Someone You Love have Sjögren’s Syndrome?

If you or someone you love has Sjögren’s Syndrome, call us today at 940-382-1750 to schedule a consultation with Dr. Chowning. He can assess your specific risks and needs while giving you valuable recommendations to keep your mouth healthy as you fight this difficult disorder.  For more information on Sjögren’s, click here.

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How to Have a Cavity-Free Holiday Season

The holidays are upon us, and you know what that means: parties, candy, drinking, and lots and lots of eating!  This time of year often leads to a deviation from our normal eating and drinking habits as well as the way we take care of ourselves.

Do not let the holidays put you at risk for damage to your teeth!  Follow these simple steps to stay cavity-free this holiday season.

  1. Try to have desserts with meals only.

We know this is a tough one.  There are extra helpings of pie in the fridge.  There are bowls full of candy everywhere.  Your neighbors bring you cookies and treats.

All this sticky, sugary goodness is very tempting, but it is also very bad for your teeth.  One way you can still enjoy these treats and not hurt your teeth is by partaking of your sweets with a meal instead of as a mid-day snack.  Saliva is our best defense against cavities.  Between meals, our saliva production goes down, which helps those sweet treats pack an extra punch on your enamel.  Having them with a meal means you’re protected by the saliva that comes naturally with eating a meal.

Keep your sweets to mealtime!

  1. Avoid heavy alcohol consumption.

Another tough one, especially if your family causes you stress.  Alcohol can harm the teeth in three ways.  1) It dries out your mouth.  2)  It contains sugars.  3)  It is acidic.

A dry mouth filled with sugary acid is a recipe for disaster.  The same tip applies to alcohol as to sweets: enjoy it with a meal.  Your saliva will counteract the dryness, the sugar, and the acid.

Another helpful hint: after drinking alcohol, rinse your mouth with water.  This also helps moisturize your mouth and counteract the effects of sugar and acid in the alcoholic drink.

  1. Force yourself to be diligent with your oral hygiene.

Having company in town or traveling to see family can lead to a disruption in your bedtime routine.  Make sure to prioritize keeping your teeth clean no matter where you are and what time you get to bed.

The changes that often occur in our diets during the holidays make consistent brushing and flossing even more important than they already are!

Nightly brushing and flossing is essential to good dental health.  At night, while we are sleeping, our bodies do not produce much saliva.  (This is a protective mechanism to keep us from choking on our own spit!)  Therefore, when you put your head on the pillow, your teeth are entering a higher risk situation.  Give them a fighting chance by removing all the plaque, food and bacteria from all the exposed tooth surfaces by brushing and flossing thoroughly.

  1. Head off a dental emergency!

Do not let a toothache ruin your holidays!  If you have not had a dental check-up in a while and something is bothering you, come see us as soon as possible.  Dr. Chowning will help you address any teeth problems that are in danger of turning into an emergency.  Dental emergencies not only cause pain; they also lead to unexpected expenses at an already expensive time of year.

Do not put off seeing the dentist when something starts to bother you.  We know this time of year is busy, but we also recognize that, while there is NEVER a good time for a toothache, the holidays are the worst time.  Let us help you prevent an emergency with your teeth.

If you know or suspect that you have a cavity, let’s fix it before Christmas rolls around.  Call today to be scheduled with Dr. Chowning.  Once the cavities are removed, you will officially be cavity-free for the holidays!

Need More Tips on How to Enjoy Healthy Holidays?

Call today to schedule an evaluation with Dr. Chowning.  He can help you learn your specific risk areas and take steps to reduce those risks and be cavity-free this Christmas!

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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.