Douglas County Dental Clinic

Have you ever gone to the dentist to get a checkup, and you hear the dentist call out to the assistant something like, "3 DFL, 11 MO, 22 B?" No, they're not playing some odd form of BINGO, they're calling out tooth numbers and surfaces of the tooth that might need treatment or have existing treatment! Here's a little bit of information on what all of those numbers and letters mean.

The Universal numbering system is a dental notation system for associating information to a specific tooth, and is commonly used in the United States. The uppercase letters A through T are used for primary teeth and the numbers 1 - 32 are used for permanent teeth. The tooth designated "1" is the top right third molar (wisdom tooth) and the count continues along the upper teeth to the left side. Then the count begins at the bottom left third molar, designated number 17, and continues along the bottom teeth to the right side.

So now that you know what the numbers mean, what do the letters after the numbers mean? When the dentist calls out "MFL," what he or she is saying is "mesial, facial, lingual," which is dental terminology for the surfaces of a tooth that has decay or some other issue going on with it. The most common surfaces of a tooth to call out are:

• Mesial - towards the midline of the mouth.
• Incisal / Occlusal - the biting surfaces of the teeth.
• Distal - away from the midline of the mouth.
• Lingual - the side of a tooth touching the tongue.
• Facial / Buccal - the side of a tooth touching the lips or cheeks.

So next time you go to the dentist and you hear her call out, "#11 MFL," you'll have an idea about what she's talking about!

First, let's start with a bit of information about dentures from Wikipedia:

Dentures, also known as false teeth, are prosthetic devices constructed to replace missing teeth, and which are supported by surrounding soft and hard tissues of the oral cavity. Conventional dentures are removable, however there are many different denture designs, some which rely on bonding or clasping onto teeth or dental implants. There are two main categories of dentures, depending on whether they are used to replace missing teeth on the mandibular arch or the maxillary arch.

Around 700BC, Etruscans in northern Italy made dentures out of human or other animal teeth. These deteriorated quickly but, being easy to produce, were popular until the mid-19th century.

The oldest useful complete denture appeared in Japan, and has been traced to the ganjyoji temple in Kii Province, Japan. It was a wooden denture made of Buxus microphylla, and used by Nakaoka Tei (–20 April 1538). This wooden denture had almost the same shape as modern dentures retained by suction. It also shaped to cover each condition of teeth loss. Wooden dentures were used in Japan up until the Meiji period.

London's Peter de la Roche is believed to be one of the first 'Operators for the Teeth', men who fashioned themselves as specialists in dental work. Often these men were professional goldsmiths, ivory turners or students of barber-surgeons.

The first porcelain dentures were made around 1770 by Alexis Duchâteau. In 1791, the first British patent was granted to Nicholas Dubois De Chemant, previous assistant to Duchateau, for "De Chemant's Specification", "a composition for the purpose of making of artificial teeth either single double or in rows or in complete sets, and also springs for fastening or affixing the same in a more easy and effectual manner than any hitherto discovered which said teeth may be made of any shade or colour, which they will retain for any length of time and will consequently more perfectly resemble the natural teeth." He began selling his wares in 1792, with most of his porcelain paste supplied by Wedgwood.

In London in 1820, Claudius Ash, a goldsmith by trade, began manufacturing high-quality porcelain dentures mounted on 18-carat gold plates. Later dentures were made of Vulcanite from the 1850s on, a form of hardened rubber (Claudius Ash’s company was the leading European manufacturer of dental Vulcanite) into which porcelain teeth were set, and then, in the 20th century, acrylic resin and other plastics.

Here in Douglas County, there are a variety of dental practices that can make you a full or partial denture, but there are a couple of places in the area that we normally refer our patients to due to being a bit more affordable for our patient population.

One of these places is Affordable Dentures in Topeka. They have some of the best prices on dentures, and they specialize in prosthodontics. Affordable Dentures can be reached at 785-228-5678 and their full set of economy dentures start at $340.

Dr. Hartman & Associates in Bonner Springs is another office we have been referring patients to for years. Their basic full denture starts at $870 and they can be reached at 913-441-1600.

Thank you Wikipedia for all of the Creative Commons content to use in this post!

While chemotherapy helps treat cancer, it can also cause other things to happen in your body called side effects.  Some of these problems affect the mouth and could cause you to delay or stop treatment.

To help prevent serious problems, see a dentist ideally 1 month before starting chemotherapy.

Chemotherapy is the use of drugs to treat cancer.  These drugs kill cancer cells, but they may also harm normal cells, including cells in the mouth.  Side effects include problems with your teeth and gums; the soft, moist lining of your mouth; and the glands that make saliva (spit).  

You can do a lot to keep your mouth healthy during chemotherapy.  The first step is to see a dentist before you start cancer treatment.  Once your treatment starts, it’s important to look in your mouth every day for sores or other changes.  These tips can help prevent and treat a sore mouth:

• Drink a lot of water.
• Suck on ice chips.
• Use sugarless gum or sugar-free hard candy.
• Use saliva substitute to help moisten your mouth.
• Use an extra-soft toothbrush and brush in the morning and at night.
• Don't use mouthwashes with alcohol.
• Floss your teeth gently each day. If your gums bleed or hurt, avoid those areas.
• Rinse your mouth several times a day with a salt water rinse.
• Avoid crunchy foods that can cut the gums and soft tissues of the mouth.

Don't hesitate to contact your dentist or your medical doctor if your mouth hurts or if you experience other oral health related issues while undergoing chemo.

Information for this blog post was taken from the National Institute of Dental and Craniofacial Research's booklet, "Chemotherapy And Your Mouth."

Are you tired of being told what to do in order to maintain good oral health? How about being told what NOT to do?

1) Do NOT drink sugary drinks throughout the day. Sure making a 5 foot tall pyramid out of soda cans is fun, but it doesn't do much to help your oral health.

2) Do NOT snack on too many carbohydrate laden foods throughout the day. Cavity bugs thrive on carbs, and they especially love foods like crackers because they stick to your teeth!

3) Do NOT play sports without a mouth guard. You want to look cool on roller derby night, but you certainly don't want your teeth knocked out, right?

4) Do NOT share food with your infant or toddler. Sure, you might love the taste of strained peas and carrots, but did you know that sharing food with your baby can transfer the germs that cause cavities to their mouths?

5) Do NOT skip out on flossing. It's a chore. Nobody likes to do it. But let's put it this way, you should only floss the teeth that you want to keep!

People used to think that as you got older you naturally lost your teeth. We now know that’s not true. By following easy steps for keeping your teeth and gums –healthy plus seeing your dentist regularly—you can have your teeth for a lifetime!

What Is Plaque?

Plaque is made up of invisible masses of harmful germs that live in the mouth and stick to the teeth.

• Some types of plaque cause tooth decay. 
• Other types of plaque cause gum disease.

Red, puffy or bleeding gums can be the first signs of gum disease. If gum disease is not treated, the tissues holding the teeth in place are destroyed and the teeth are eventually lost.

Dental plaque is difficult to see unless it’s stained, You can stain plaque by chewing red “disclosing tablets,” found at grocery stores and drug stores, or by using a cotton swab to smear green food coloring on your teeth. The red or green color left on the teeth will show you where there is still plaque—and where you have to brush again to remove it. Stain and examine your teeth regularly to make sure you are removing all plaque. Ask your dentist or dental hygienist if your plaque removal techniques are o.k.

How To Get Rid Of Plaque

Step One: Floss

Use floss to remove germs and food particles between teeth. Rinse. Ease the floss into place gently. Do not snap it into place—this could harm your gums.

Step Two: Brush Your Teeth

Use any tooth brushing method that is comfortable, but do not scrub hard back and forth. Small circular motions and short back and forth motions work well. Rinse.

To prevent decay, it’s what’s on the toothbrush that counts. Use fluoride toothpaste. Fluoride is what protects teeth from decay.

Remember: Food residues, especially sweets, provide nutrients for the germs that cause tooth decay, as well as those that cause gum disease. That’s why it is important to remove all food residues, as well as plaque, from teeth. Remove plaque at least once a day—twice a day is better. If you brush and floss once daily, do it before going to bed.

About Oral Cancer

Oral cancer includes cancers of the mouth and the pharynx (the back of the throat).

Oral cancer accounts for roughly two percent of all cancers diagnosed annually in the United States. Approximately 35,000 people will be diagnosed with oral cancer each year and about 7,600 will die from the disease. 

On average, 60 percent of those with the disease will survive more than 5 years. 

Oral cancer most often occurs in people over the age of 40 and affects more than twice as many men as women.

What Puts Someone At Risk?

• Tobacco And Alcohol Use

Most cases of oral cancer are linked to cigarette smoking, heavy alcohol use, or the use of both tobacco and alcohol together.Using tobacco plus alcohol poses a much greater risk than using either substance alone.

• HPV

Infection with the sexually transmitted human papillomavirus (specifically the HPV 16 type) has been linked to a subset of oral cancers.

• Age

Risk increases with age. Oral cancer most often occurs in people over the age of 40.

• Sun Exposure

Cancer of the lip can be caused by sun exposure.

• Diet

A diet low in fruits and vegetables may play a role in oral cancer development.

Tooth and gum problems can happen to anyone. A sticky film full of germs, called plaque, builds up on your teeth. High blood glucose helps germs, also called bacteria, grow. Then you can get red, sore, and swollen gums that bleed when you brush your teeth.

People with diabetes can have tooth and gum problems more often if their blood glucose stays high. High blood glucose can make tooth and gum problems worse. You can even lose your teeth.

Smoking makes it more likely for you to get a bad case of gum disease, especially if you have diabetes and are age 45 or older.

How do I know if I have damage to my teeth and gums?

If you have one or more of these problems, you may have tooth and gum damage from diabetes:

● red, sore, swollen gums

● bleeding gums

● gums pulling away from your teeth so your teeth look long

● loose or sensitive teeth 

● bad breath 

● a bite that feels different 

● dentures—false teeth—that do not fit well

How can I keep my teeth and gums healthy?

● Keep your blood glucose as close to normal as possible.

● Use dental floss at least once a day. Flossing helps prevent the buildup of plaque on your teeth. Plaque can harden and grow under your gums and cause problems. Using a sawing motion, gently bring the floss between the teeth, scraping from bottom to top several times.

● Brush your teeth after each meal and snack. Use a soft toothbrush. Turn the bristles against the gum line and brush gently. Use small, circular motions. Brush the front, back, and top of each tooth.

● If you wear false teeth, keep them clean. 

● Call your dentist right away if you have problems with your teeth and gums.

● Call your dentist if you have red, sore, or bleeding gums; gums that are pulling away from your teeth; a sore tooth that could be infected; or soreness from your dentures.

● Get your teeth cleaned and your gums checked by your dentist twice a year.

● If your dentist tells you about a problem, take care of it right away.

● Be sure your dentist knows that you have diabetes.

● If you smoke, talk with your doctor about ways to quit smoking.

More information about diabetes and your oral health is available from the National Diabetes Information Clearinghouse and the National Institute of Dental and Craniofacial Research.

What is a pediatric dentist?

Pediatric dentists are the pediatricians of dentistry.  After competing four years of dental school, the pediatric dentist goes on for an additional two to three years of specialty training.  Due to the specialty training, pediatric dental practices are dedicated to treating children from infancy through the teen years.  Children's physical, psychological and emotional growth and development are areas expertise addressed in the specialty education.  Just as important as the specialized education involved in becoming a pediatric dentist, the dentist and his staff should treat children because they want to and because they enjoy it.

When should my child have his/her first dental visit?

If your infant has any oral or dental condition that bothers you or appears to be out of the ordinary, then he/she should be seen regardless of age.  In unique situations we have seen children as early as their first week of life. This includes any problems with trauma to the teeth or mouth.

The American Academy of Pediatric Dentistry recommends that children receive an oral health risk assessment by six months of age, and that they establish a dental home by 12 months of age.  The reason for these recommendations is that some infants will develop cavities within months of the time that teeth erupt into the mouth.  Often these early cavities are caused by feeding and oral hygiene habits.  These early cavities may be avoided if the parents are counseled in these two areas as the first teeth are erupting.

We recommend that you come with your infant shortly after his/her first teeth have erupted. We will help you with home oral hygiene, diet, pacifier or finger habits, fluorides, toothpaste and injury prevention.  Both Mom and Dad are welcome at these appointments.  With professional guidance and demonstration, effective prevention can be stress free, easy and fun for the whole family.  Families who embrace early parental involvement in home dental care for their children can, very predictably, expect a lifetime with few, if any, dental problems.

If you have older children who are already patients in the practice, then you already have a "dental home. "  Additionally, you have been introduced to the home preventive dental care practices that we recommend.  Use the same techniques that you have already seen and heard for your newest edition.  If you are having any problems or concerns you are welcome to bring your infant along with your older children so that we can answer your questions.  If you have older children in the practice, are comfortable with your home preventive dental care routine, and don't have any questions or concerns about the oral/dental health of your infant, we recommend that your child come for a first dental visit at age three.

What should I tell my child before the first visit?

When you talk with your child about his/her first dental visit we recommend that you emphasize both honesty and a positive attitude.  Please do not talk to your child about any dental anxieties that you may have.  "The dentist will be very kind and gentle when he counts your teeth," and "Mommy will be with you all the time," are good places to start.  Answer all the questions that your child asks to the best of your ability without making a "big deal" out of the experience.  I have found that mothers are very good at predicting their child's behavior for his/her first dental visit.  Some children will feel more at ease if they know, in advance, every detail about the upcoming experience.  Others do better if they know nothing at all.   Remember, every child is an individual.  Prepare your child so that he/she has the best chance for a good experience.  We will use our training and experience along with the information that you give us to do the same.

What will happen at the first dental visit?

Together your dentist will review your child's health history, and will then discuss what your main concern is about your child's teeth and oral health.  The dentist will examine your child's head, neck, teeth and intra-oral soft tissues. The occlusion, or the way that the teeth are aligned and function together, will also be evaluated.  Radiographs or x-rays will be made only if they are needed to make an accurate and complete diagnosis of your child's dental health.  The dentist should then discuss his findings from the examination and answer any questions that you have.  Also, your child's teeth will be cleaned and he/she will be given a topical fluoride treatment.

What are dental sealants and how do they work?

Sealants are tooth colored resins that are applied to the biting surfaces of posterior teeth in order to help keep them cavity free.  Sealants bond to the enamel and fill in the grooved and pitted surfaces of the tooth to prevent food particles and dental plaque from accumulating and causing cavities.  Fast and comfortable to apply, sealants are a valuable part of our preventive program.

Can thumb sucking be harmful to my child's teeth?

Thumb and pacifier habits can cause changes in tooth alignment and to the way that the upper and lower jaws fit together.  Fortunately, these changes will usually correct spontaneously if the habit is stopped before the front permanent teeth start to erupt (usually age 6 to 7).  Pacifier habits are often easier for your child to stop than thumb or finger habits.  If your child is having a problem with a thumb or pacifier habit beyond the age of 6 to 7, it should be evaluated on an individual basis.  Your dentist will help you find which of the many possible solutions would be best for your child.

My child grinds their teeth.  What should I do about this?

Bruxism, or grinding the teeth together, is a common occurrence in children.  Bruxism often leads to the abnormal wearing away of the tooth structure which is called attrition.  Although bruxism has been studied extensively, we still do not know how to stop an individual from doing it.  An adult who bruxes and who also has significant attrition will often be advised to wear a "bite guard" appliance to control the damage to his teeth.

Treatment of bruxism in children who still have baby teeth (children usually have baby teeth up to age 12 to 13) poses some unique considerations and problems which can include: children have a tendency to either lose or not wear "bite guard" appliances; "bite guard" appliances don't fit well when baby teeth are getting loose, falling out, and being replaced by permanent teeth; "bite guard" appliances are expensive; and even though the baby teeth are being worn down due to the bruxing habit, they will be replaced by permanent teeth.  Also, many children stop their bruxing habit and the resultant attrition as they transition from baby teeth to permanent teeth.

In light of the above considerations concerning bruxism and attrition, it is rarely treated in children.   There are unique situations; however, where treatment is needed when children still have some baby teeth, these unique situations require evaluation on an individual basis.  Adolescents (usually older than age 12 to 13) who have erupted all their permanent teeth and continue to brux to a degree that they cause significant wearing away of tooth structure need to be evaluated for a "bite guard" appliance.

How can I protect my child's teeth during a sporting event?

We see many sports related injuries to the teeth.  We definitely recommend that your child use a soft plastic mouth protector while participating in sporting events.  Commercial mouth guards are effective if they are worn.  Unfortunately, the commercial mouth guards are not custom fit and are not as comfortable as those made in our office.  If your child will not wear the mouth guard from the sporting goods store, then you should consider one that is custom made in a dental office to protect his/her teeth from sports related injuries.

I've been told that my child has to be put to sleep or hospitalized in order to have his/her dental treatment completed.  Do I have any other choices?

Dental treatment in the hospital with general anesthesia is one option that you, as a parent, may consider for your child.  The factors that you need to evaluate when making this decision are: health risks to your child associated with general anesthesia; expense of hospitalization or sedation for dental treatment; amount of treatment that your child needs; and whether the dental treatment can be completed safely in the traditional setting at the pediatric dentist's office.

The decision to have your child's dental treatment done in the hospital under general anesthesia is a very difficult one for most parents to make.  In order to make an informed decision, many parents have found it helpful to accompany their child to at least one treatment appointment in the traditional setting at the pediatric dentist's office.  This gives you, as a parent, the opportunity to be with your child and to evaluate your child's response to the treatment procedures.

Dr. Dan and his staff will use their training and expertise to help you and your child manage any anxieties that either of you have.  If, after observing your child's treatment in the traditional setting, you favor hospitalization for your child's dental treatment, we will be happy to help you find a facility that will meet your needs.  Dr. Dan does not put children in the hospital for dental treatment.

What is baby bottle tooth decay and how can I prevent it?

Baby bottle tooth decay is a pattern of rapid decay associated with prolonged bottle feeding or nursing.   Otherwise healthy milk or fruit juices can cause extensive decay when they are in contact with the teeth for extended periods of time.  This destructive process often occurs when a child goes to sleep while breast feeding or bottle feeding.  During sleep, the flow of saliva is reduced and the natural self cleansing action of the mouth is diminished.  Avoid nursing children to sleep or putting anything other than water in their bedtime bottle.  Encourage your child to drink from a cup near his/her first birthday. Your child should be weaned from the bottle at 12-14 months of age.

Why does my child get cavities and what can I do to prevent dental decay?

Dental cavities or dental caries is a disease process, not an isolated event.  This disease process is constantly ongoing in all people, both children and adults.  A six month old child with a single erupted tooth could potentially develop a cavity if enough disease causing factors are working against the disease protecting factors.  The process of developing a cavity is best visualized as a balance between the disease causing factors, or pathological factors, and the disease protecting factors.  Very simply stated, if the combined effect of the disease causing factors outweighs the combined effect of the disease protecting factors, then dental cavities will develop.

Cavity causing factors are:

• poor oral hygiene or failure to remove bacterial plaque from tooth surfaces regularly and effectively
• high frequency of ingestion of fermentable carbohydrates
• sucrose and all foods that contain sucrose
• acquisition of mutans streptococci in dental plaque at age two or younger
• decreased salivary flow
• genetics
• orthodontic appliances
• enamel hypoplasia

Cavity preventing factors are:

• early preventive dental visit (by age one)
• parent education in cavity prevention
• increased salivary flow
• genetics
• effective daily removal of bacterial plaque from all teeth
• fluoride in toothpaste, fluoride rinse, fluoridated drinking water
• systemic fluoride supplement (if drinking water is not fluoridated)
• chlorhexidine mouthrinse
• dental sealants
• xylitol gum and xylitol artificial sweetener

So we return to the question: "Why did my child get a cavity?"  A simple answer would provide you, as a parent, a simple solution to the problem.  Unfortunately, the formation of dental cavities is rarely a "simple" process.  All of the above mentioned positive and negative factors, plus others that we don't yet fully understand, combine to result in dental decay.  As a start, we will advise you in the following areas that we have found make the most difference for the most people in reducing or stopping the formation of new cavities:

• Get involved with helping your child remove the dental plaque form his/her teeth at least once daily.  We will demonstrate the techniques that we recommend and that we have found to be effective.
• Use fluoride supplements as we will discuss with you in the office.
• Attempt to change dietary habits that are potentially cavity causing.

We will be glad to explain these options in more detail next time you visit our office.

What if my child has a toothache?

If your child is experiencing pain with a tooth, we will examine you child, determine the source of the pain, and discuss both the problem and the solution with you.  If it is safe for your child, the source of the pain will be treated the same day.  We save time in our schedule every day for emergencies.  This emergency time will be used to get your child out of pain.  Sometimes, due to swelling or dental abscesses, it is not safe to treat the source of the pain until your child has been medicated with antibiotics.  In this situation, we will give you a prescription for the swelling and the pain, and then schedule a time to treat the source of the pain.

About The Author

Visit Dr. Dan Howell's website for more information on pediatric dentistry.