How Does a Cavity Form Under a Crown?

A crown that has been improperly fit will not sit well below the gum line of the tooth it covers. Food particles become trapped in this area, allowing the tooth to become the target of bacteria and decay, since it is difficult to brush or keep this area clean. This will result in a cavity forming on the tooth, having a root canal' to remove the nerve endings of the tooth and adding a new crown.  Also as crowns age the crown margins will become open as a patient's gums tend to recede, becoming a food trap and place for patients to keep clean.

A cavity starts as a pin hole in a tooth and is caused by bacteria developing and resulting in decay. When the cavity is ignored, it gets larger and causes what was once a small spot of decay to grow and get larger or undermine underneath a crown. When the cavity is not cleaned out by the dentist, the decay eventually reaches the nerve and cause a toothache. At this point, the nerve will need to be removed during a root canal and the tooth replaced with a crown or replace the old crown with a new crown.

Removing the roots of a badly decayed tooth eliminates the pain and swelling within the tooth. This is is known as having a root canal procedure. The roots of the tooth are completely removed, and the top of the tooth is prepared for further care by the dentist.

When the root canal is fully healed and sealed, Dr. Steppler reshapes the size of the tooth, adds a post and core into the tooth area where the root has been removed and places the new crown on top of the prepared tooth.

Pain Caused by a High Filling

If you've ever received a filling at the dentist's office, you probably vaguely remember the dentist putting a piece of colored paper in your mouth and telling you to bite together.  Then, the dentist probably asked, "Does that feel too high?"

Since the mouth is generally numbed during a filling, it's often hard to tell if a filling is too high while you're sitting in the dental chair.  Also, the sooner we tell the dentist that it feels alright, the faster we can get out of their office and on with our life!

Sometimes, a few days after receiving a filling you may notice that your filling is a little too high.  When you bite together, the filling and its opposing tooth may be the first teeth to touch.  It may create an uneven bite.  However, the worst side-effect of a high filling is pain!

Why Does a High Filling Hurt and Cause Pain? 

 

The tooth is supported in bone by a thin layer of tissue called the periodontal ligament.  When you have a filling that is too high, the tooth gets pressed down a lot harder and it makes this ligament very tender.
All of the tissues of our body can get tender when put under stress.  For example, if you work outside in the garden all day pulling weeds without any gloves on, your hands will get red and inflamed.  As a result, the body sends an extra amount of blood to your hands to help them heal.  They get red, inflamed, and very tender as part of the healing process.  This is what happens with the periodontal ligament when it gets compressed much more than usual due to a high filling.

The technical term for this is symptomatic apical periodontitis or acute apical periodontitis.
 

How to Stop the Pain Caused by Symptomatic Apical Periodontitis

 

In order to stop the pain, the cause must be removed.  That means you need to call our office and let us know that the filling is too high.  The process of adjusting it and re-checking your bite should only take a few minutes and usually there isn't a charge for it -- after all, the filling was high in the first place because it wasn't adjusted enough.

How Long Will It Be Until the Pain Stops?

 

After Dr. Steppler has adjusted the filling, the peridontal ligament will still need some time to heal from the additional stress that was placed upon it.

This healing process can take anywhere from a one day to two weeks.  As a general rule, if you are still in pain after more than two weeks you should call us back to make an appointment, as this could be a sign that something else is wrong with your teeth.

Don't be shy about calling our office – the quicker that a problem is resolved, the less likely it is to develop into something more serious.

Over -The-Counter Teeth Whitening vs Professional Treatments

Many of the companies that produce the professional teeth whitening systems also have over-the-counter (OTC) options available to those who want whiter teeth without visiting a cosmetic dentist.

OTC products will often claim that you get the same results from their method as you could obtain from a professional tooth whitening treatment. This statement, although true in one sense, is very misleading. The idea is that OTC smile whitening products provide the same effect over a longer period of time by using a lower concentration of bleach (5% - 10%). Claims state that professional tooth whitening provides faster results by using a higher concentration of bleach (15% - 30%). This is the difference between repeating the treatment every night for days or weeks, and leaving the dentist office with a noticeably brighter smile after only a single visit.

This may be the truth – but it's not the whole truth. Cosmetic dentists whiten your teeth using a higher concentration of bleach, in conjunction with a laser tooth whitening system, such as Britesmile® or Rembrandt® or ZOOM®. These systems apply a certain light frequency that activates their proprietary bleaching compound to enhance the whitening effect.

The professional laser teeth whitening procedure is one of the most cost and time-effective aesthetic dental procedures available. “For a minimal fee, a patient can enter Dr. Steppler's dental office and walk out less than two hours later with a significantly brighter and whiter smile.”

There are more reasons to choose professional tooth whitening over store-bought tooth bleaching products:

· Those that do not incorporate a tray can have uneven, “blotchy,” results. Saliva can dilute the mixture, or your tongue could wipe away some areas, leaving them untreated.

· Many OTC teeth whitening products contain glycerin, which could dry out your tooth enamel.

· Over-the-Counter systems to whiten teeth often use “whitening strips.” These are good for brightening the front surface of your teeth, but cannot do an adequate job of bleaching the cracks and crevices between teeth. The contrast between a bright, white tooth and the dark grooves between teeth can look like terrible cavities, or wide gaps.

If you are just hoping to lighten the fronts of your teeth a shade or two, over-the-counter tooth whitening products may work as an option. However, if you would like a winning, movie star-bright smile, professional tooth whitening is the only way to go!

Allergies, Sinus Pain and Tooth Pain

 

If we seem obsessed with seasonal allergies, it is because everyone is suffering this year more than usual. Everyone is continually surprised by the odd pains they experience as side effects of their "hay fever," like pains in their molars. Let's start at the beginning.

The human body tries to eliminate those pesky allergens with mucus. Yes, the mucus really wants to be your friend, an ally in this battle; but if the mucus doesn't flow out, when you try to blow it out, it hangs around in your sinuses creating congestion and causing pressure and pain. We have many sinus cavities in our skulls, but the ones on either side of your nose (aka the maxillary sinuses) need to drain upward, an action not so easily accomplished if we are upright, which we are for most of the day. These sinuses sit on your upper jaw, and when congested they can put pressure on the surrounding areas causing pain in your upper teeth, cheeks, and right below the eyes. If your sinuses become inflamed or infected, the pain could be even more extreme. Not only do those allergens make your eyes and nose run, they can indirectly create tooth pain.

If you are experiencing dental pain and are prone to allergies accompanied by nasal congestion and sinus infections, then you can probably assume that sinus pressure is causing the pain in your teeth. If you're not so sure, give our office a call.

Dental X-rays In the News: again!

  

Last week the conversation for many of us turned to dental radiographs (x-rays) thanks to the news media and medical research. Yale School of Public Health completed a study of over 1500 people and correlated their “remembered” exposure to x-rays with development of meningioma. first reaction to this is to rebuke the study, so I went to get the details. The first thing to consider is that the exposure to dental radiographs and frequency was based on the patient’s memory, even of their childhood years, not on hard data where they scoured through old dental records. The next challenge is that the average age of the patients they included was 58. Our current technology for dental x-rays is far different; more sensitive film speeds or digital along with better equipment have dramatically reduced the exposure.  Current dental radiographs expose the patient to 2-3 mrads for four bitewings and 10-20 mrads for a full set. The problem is that all of this information makes those of us who work in the dental profession feel better about radiographs, but what about our patients?

As a team in our office we do two things that are very important regarding dental x-rays. First, we follow all of the guidelines to maximize your safety using new, low radiation digital technology. Our equipment is checked and maintained and we will always use proper shielding. Second, we recommend using the ADA guidelines as a standard, but in an individual way based on what we know about dental health and the risk for cavities or gum disease. We are proud of both of these things and happy to share them with anyone.

So how often “should” we take x-rays? The word “should” implies there is a right and a wrong answer. We like to think of it as a “could”. We could set up a standard of annual bitewings and a full set every three years. The problem is that it may be too often for some patients and not often enough for others. The other challenge is deciding which films to take. Our patients with bone loss from periodontal disease are better diagnosed with vertical bitewings, but we may need a full-series of x-rays for the removal of wisdom teeth. Instead of defending a protocol, we diagnose the need for x-rays one patient at a time, with them, based on their individual needs.

Why Your Teeth Are Important

Teeth are important because:

• They help you chew your food – without teeth we would have to drink liquids and miss out on some wonderful, nutritious and delicious foods.
• They help form words – If you lose a tooth you will notice you talk differently then you did before. Imagine what it would be like if you lost all your teeth at once. It would be hard to talk so other people could understand.
• They help make you look happy – Clean and well taken care of teeth show other people that you care about yourself. Clean teeth will also make you feel good about yourself and others will see that in your healthy white smile.

When you take care of your teeth by brushing, flossing every day and regular dental visits at our office, your teeth will remain strong and healthy. It is important to start good habits now so when your older taking care of your teeth will be easy. When you get older and grow in your adult teeth they will be the only teeth you have for the rest of your life so you better start good habits and take care of them now!

Bleeding Gums Are Not Normal

 

Fallacies exist about bleeding gums. They usually come about because people want to ignore the problem. Many people simply do not want to believe bleeding gums are not normal. They think if they forget about it, it will go away. This is not the case. The problems indicated by bleeding gums will not disappear. More importantly, the cause or causes of bleeding gums will continue to exist.

What Causes Bleeding Gums?

There are several possible causes for bleeding gums. You could suffer from a medical problem such as hemophilia. You could have diabetes or Van Willebrand’s disease. There is also the possibility that your medication can be the cause. If you are on blood thinners, for example, your gums may bleed. Oral cancer, hormonal changes and vitamin deficiencies can also result in bleeding gums.

Yet, the major cause of bleeding gums is the growth of bacteria in the mouth. If you do not take proper care of your gums, bacteria will increase. If it does, the following will occur:

• Bacteria will continue to grow
• As they increase in numbers, they release toxins into your gum tissue
• Your gums become sensitive. They are swollen and may begin to bleed when brushing occurs
• Bacteria also begin to form a whitish-grey sticky substance on your teeth. This is plaque
• Plaque grows on your teeth. As it does so, further toxins enter your tissue and create pockets in your gums. This begins to separate the placement of your teeth
• It becomes difficult to eat hard foods such as fruit without noticing the changes in your teeth
• Tartar takes the place of some plaque
• Overtime, you develop constant bad breath
• Bacteria continue to release toxins, the gap between your teeth and gums widen, becoming visible.
• As the gaps becomes larger, your teeth begin to loosen
• When the gum disease enters its serious stages, you may lose teeth as they fall out

Bleeding gums is part of a process called gum disease. In the beginning, your gums may bleed only when brushing. Later, they may bleed when you eat. Touching your gums may hurt and cause bleeding to occur.  The more sensitive your gums become, the more advanced the disease is. You will progress over time from the early stages of gum disease – gingivitis, to the later stages – periodontitis. Periodontitis has no cure. There is no remedy, only a treatment. This may include the replacement of your teeth.

If you are suffering from bleeding gums, you may have gingivitis. Your dentist can help you treat it. You, yourself, can create a plan to make bleeding gums a thing of the past. The plan is a thorough and proper dental oral hygiene program and continous maintenance.

Ending The Abnormality Of Bleeding Gums

Once you recognize bleeding gums to be abnormal, you are on your way to getting rid of them and gum disease. After you consider what causes your gums to bleed, you can treat it immediately. It all starts, easily enough with a toothbrush and toothpaste. Simply brush your teeth everyday with recommended toothpaste, such as all-natural botanical product. Combine this with daily flossing using the correct width of floss. Add to it a daily rinse or gargle with non-alcohol-based mouthwash or plain salt water.

The final ingredient to this gum disease free program involves your dentist. Be sure to see Dr. Steppler once a year for a dental check-up, followed with visits twice annually to our dental hygienist. This is for your teeth cleaning. We will make sure all plaque is gone and your mouth is healthy. Follow our regular hygiene program schedule, and you should say farewell forever to bleeding gums.

Conclusion

Bleeding gums are not normal. They are a symptom of a more serious problem. Once the cause is identified, we can treat it. Treatment usually involves the daily execution of a proper dental oral hygiene program. If you stick with this program, you can keep bleeding gums from being a “normal” part of your life.

Tooth Colored Fillings

 

When a tooth has decay or has been damaged, a dental restoration is needed to "restore" the tooth to its previous healthy condition. A dental filling is one of the most common and well-known types of restorations. A dental filling is used to repair decayed or damaged tooth surfaces. Most people have a few fillings in their mouth.

If you have old silver amalgam fillings, we can replace them with nearly-invisible tooth-colored fillings. These fillings are made out of a strong composite resin. Many of our patients have replaced their old silver fillings with fillings matched to their teeth. You can improve your smile instantly and relatively inexpensively by getting rid of the "silver or metal."

Another reason some of our patients have had their old silver fillings replaced is because they are concerned about the possible heavy metal toxicity of the mercury in the silver.

If you would like to replace your amalgam (silver) fillings, call us at 314-965-3500 to schedule a consultation. We are currently accepting new patients and would be happy to show you around our dental office and introduce you to our friendly team.

Smile – it increases your face value!

Does Antiseptic Mouthwash Replace Flossing?

  
An antiseptic mouthwash does not replace flossing and brushing, according to the American Dental Association. In fact, in most cases an antiseptic mouthwash is primarily cosmetic, unless it is prescribed by a dentist, meaning that the formula will be stronger and more effective. Mouthwashes and rinses can actually cover up smells which might indicate dental problems which need to be addressed. For this reason, dentists stress that regular dental care, including checkups, is very important.

In 2005, the company which makes Listerine® antiseptic mouthwash was specifically warned against using the phrase “as effective as flossing” in its advertisements. Flossing is a crucial element of dental care because it gets in between the teeth, removing embedded food and scouring away plaque. Flossing accesses places that a toothbrush cannot reach, and a fair amount of physical pressure is involved to make flossing effective. No mouthwash can mimic the action of flossing, despite advertising claims.

Because antiseptic mouthwash is swished around in the mouth, it cannot effectively remove plaque from the surface of the teeth. The mouthwash may kill bacteria, but only for a short period of time. Within a few hours, the natural flora of the mouth will have replenished itself, despite claims made by antiseptic mouthwash manufacturers. Brushing is also an important part of oral care, because it removes plaque from the surface of the teeth and can also be used to clean the tongue. Some antiseptic mouthwashes may also lead to dry mouth, because of the high alcohol content of some mouthwash products.

When a dentist prescribes antiseptic mouthwash, it is usually to treat a specific condition, and the mouthwash is formulated to act over a period of time longer than a few hours. Even so, the patient is directed to use the mouthwash frequently, and is told to continue flossing and brushing. In most cases, an antiseptic mouthwash merely removes oral debris and a small amount of bacteria. The primary benefit appears to be the fresher scent and taste of the breath, but if a consumer has bad breath, it is an indicator of ill health which should be addressed by a dentist, not an over the counter antiseptic mouthwash.

An antiseptic mouthwash should not be used instead of flossing and brushing. In order to be most effective, a mouthwash can be used after the teeth have been brushed and flossed, making them as clean as possible. It should be swished in the mouth firmly for 30 seconds to one minute. All of these aspects of home dental care should also be supplemented by regular visits to our practice for checkups and professional teeth cleanings.

What you eat can affect your teeth!

Americans are consuming foods and drinks high in sugar and starches more often and in larger portions than ever before.  It is clear that "junk" foods, drinks and foods high in carbs and fats gradually have replaced nutrious beverages and foods for many people.

Alarmingly, a steady diet of sugary foods and drinks can ruin teeth, especially among those who snack throughout the day.  When sugar is consumed over and over again in large amounts the harmful effect on teeth supplies food for bacteria which produces acid.  The acid in turn can eat away the enamel on teeth.

Almost all foods have some type of sugar that cannot and should not be eliminated from our diets.  Many of them contain important nutrients and add enjoyment to eating.  But there is extra risks for tooth decay if your diet is hight in sugars and starches.  Starches can be found in everything from bread to pretzels to salad dressing, so read labels and plan carefully for a balanced and nutritious diet.

Reduce your risk of tooth decay:

• If you choose to consume sugary foods and drinks, do so with meals.  Saliva production increases during meals and helps neutralize acid production and rinse food particles from the mouth.
• Limit between-meal snacks.  If you crave a snack, choose nutritious foods, and consider chewing sugarless gum afterward.  Sugarless gum increases saliva flow and helps wash out food and decay-producing acid.
• Drink more water.  Consuming optimally fluoridated water can help prevent tooth decay.  If you're choosing bottled water, check the label for the fluoride content.
• Brush your teeth twice daily and floss daily  with ADA - Accepted dental products.
• See us regularly for dental check-ups.

Types of Dental Examinations

This blog is covering the types of dental examinations that we use to aid in appropriate treatment. The first examination is the comprehensive oral evaluation. As the name implies, this is an examination that should involve the entire oral complex. This exam is done most frequently with a patient who is new to our dental practice or who has not been seen by their dentist for a number of years. During this exam, we will review the patients current and past medical history as well as the patients current and past dental history. There is often much to be learned before even looking in the patients mouth. A patients expectations, past dental treatment and anxiety level can all be discussed to aid in making the patient more comfortable and informed. Once we begin to examine the patient we will look at much more than teeth. We will also look at the patients periodontal (gums) health. This is accomplished by measuring the space between the teeth and gums.  Excessive tooth wear or mobility of teeth should also be noted. The comprehensive exam will also include an oral cancer screening and a review of any bite or TMJ (jaw joint) issues. After a visual examination, often a complete set of dental x-rays will be imaged. A complete radiographic series should be accomplished every 3-5 years depending on the patients condition. Occasionally, diagnostic molds (impressions) of the teeth will be taken as well as photographs of the mouth. All of this information will be used to determine the level of health and potential need for treatment.

The next type of exam to is the periodic exam. This is accomplished during the patients recare and follow up visits. A review of the medical and dental histories will be accomplished. Since the patient is known to the practice the depth of the exam is lessened but still involves evaluation of the entire oral cavity. This exam can be done by the dental hygienist or dentist, and commonly both. The need for current x-rays will be evaluated depending on the patients condition. The patient should have the results of the exam discussed, as well as any recommendations for necessary treatment.

The most obvious dental examination is the problem focused, or “emergency” exam. This type of exam would take place when a patient realizes that they have a problem and need to seek dental care. Commonly this would occur with the fracture of a tooth or filling or the occurence of pain or trauma. As you would imagine, a diagnosis will need to be made before treatment is rendered, and arriving at the correct diagnosis can be quite obvious, or it can be quite a challenge. Visual examination, past dental history, and appropriate dental x-rays are all tools to aid in arriving at a correct diagnosis.

Hopefully, this blog will help our patients understand that not all dental exams are the same. Each is critical to optimal dental health for the individuals that we treat.

Choosing a Toothpaste

Just the number of options you have when you buy a tube of toothpaste can be overwhelming. Should you go for tartar control? Fluoride? Both? Gel or Paste?  And don't forget to think about whitening toothpastes or formulas with all natural ingredients.

When it comes to choosing the best toothpaste for you, it's important to think about your unique oral health needs.

Toothpaste basics

Toothpaste, also known as dentifrice, is available in paste, gel, or powder form. Despite the many types of toothpastes that exist, there are some ingredients common to most varieties. These include:

• Abrasive agents. Scratchy materials, including calcium carbonate and silicates, help remove food, bacteria, and some stains from your teeth.
• Flavoring. Artificial sweeteners, including saccharin, are often added to toothpaste to make them taste better. While many people equate the flavor of toothpaste with mint, toothpaste is available in a variety of flavors, including cinnamon, lemon-lime, and even bubblegum (for kids -- or kids at heart).
• Humectants for moisture retention. Paste and gel formulations often contain substances like glycerol to prevent the toothpaste from drying out.
• Thickeners. Agents that add thickness to the toothpaste, including gums and gooey molecules found in some seaweeds, help achieve and maintain proper toothpaste texture.
• Detergents. Those suds you see when you brush your teeth are from detergents like sodium lauryl sulfate.

Fluoride toothpaste

The most important ingredient to look for when choosing toothpaste is fluoride.

Fluoride is a naturally occurring mineral. Its use has been instrumental in the dramatic drop in tooth decay and cavity occurrence that has taken place over the past 50 years. Bacteria in your mouth feed on sugars and starches that remain on your teeth after eating. Fluoride helps protect your teeth from the acid that is released when this happens. It does this in two ways. First, fluoride makes your tooth enamel stronger and less likely to suffer acid damage. Second, it can reverse the early stages of acid damage by remineralizing areas that have started to decay.

Using fluoride toothpaste is an important way to ensure that your teeth are reaping the benefits of this dental-friendly mineral. Don't think you can skip fluoride if you live in an area where the water is fluoridated. Studies have shown that using fluoride toothpaste helps increase the concentration of fluoride in the teeth, even in areas with water supplies containing high levels of the mineral.

Cold and Flu Season Is Here!

Cold and flu season is here yet again. The folks at Centers for Disease Control and Prevention say that a common cold usually includes sneezing, runny nose, sore throat and coughing. Symptoms can last for up to two weeks.

To promote a healthy and clean environment, Dr. Steppler and our entire staff give a great deal of attention to sanitation and sterilization in our office at all times, as well as following all requirements for sterilizing instruments and work surfaces. For the protection of other patients and our staff at Steppler Dental, we always ask that patients reschedule their appointments if they have any type of cold or illness that can infect others.

Also remember to constantly wash your hands and avoid contact with those who are ill! Stay Healthy!

Love Your Teeth This Valentine's Day

On Valentine’s Day, showing our love and appreciation for someone often is communicated with a heart-shaped box of scrumptious chocolate candy treats. Unbelievably, Americans buy more than 35 million heart-shaped boxes of chocolates each year. Here are some other statistics about Valentine’s sweets:

• Americans spend $345 million for Valentine’s candy each year
• Approximately 58 million pounds of chocolate are consumed around Valentine’s Day
• The average American consumes between 10 and 12 pounds of chocolate each year; more than 60 percent of all chocolates in America are enjoyed by women
• About 8 billion candy hearts are sold between Feb. 1 and Feb. 14

While most of us are aware that consuming large amounts of candy during this holiday can contribute to a larger waistline, we may not think about how sweets impact our oral health.

Impact of Sweets on Your Teeth

Each time bacteria come into contact with sugar in your mouth, acid is produced, which attacks your teeth for at least 20 minutes. And the bacteria that cause cavities thrive in sweets and sodas. Cavities are caused by tooth decay that destroys the tooth structures and can affect both the enamel and the inner layer of the tooth.

Sweets That are Tough on Your Teeth

Some foods and candies create more problems for your teeth than others, including those that are sticky, dissolve slowly or are sucked, such as lollipops, hard candies, toffee, gum drops, taffy, caramel corn, peanut brittle, dried fruit, chocolate-covered raisins and high-energy sports bars.

Keep Your Teeth Healthy

To maintain good oral health, brush your teeth at least twice a day, use floss daily, eat nutritious foods, limit snacks, including candy, pretzels, and chips, and visit Dr. Steppler regularly for cleanings and exams.

Facts About Sealants

What does it mean if  Dr. Steppler or Kathleen our hygienist tells you your child needs sealants? First of all, it’s an easy procedure with little to no discomfort – no numbing and if any drilling is done, it is minimal. And secondly, it’s one of the best proactive steps you can take to protect your child’s teeth against decay.

What we do is apply a thin coating of plastic or  composite in the grooves on the permanent back molar teeth. These “chewing surfaces” are the most likely places for children, and even teenagers, to develop tooth decay. The sealant or preventive restorative resin coats the tooth and helps keep food particles and germs from getting into the grooves. Think of it as locking down teeth with protective armor against the bacteria that would like to break in and do serious damage. Most sealants are clear, so you can’t even tell they are there, while some are tooth colored. Most children can barely feel the difference on their teeth.

While normally sealants are provided for children as soon as their permanent teeth come in, some adults may need sealants if they never received them as children or are at greater risk for cavities or decay.

Sealants can last for many years. Occasionally, we may need to touch up the sealant on one or two teeth.  But just because your child has sealants doesn’t mean you can slow down with brushing, flossing and fluoride rinsing. Sealants are just one part of a  comprehensive, smart dental prevention plan for growing children.

Protecting Tooth Enamel

There's a lot more that goes into a great smile than just keeping the pearly whites, white.  Protecting tooth enamel plays an important role in having a beautiful and healthy smile.

What is tooth enamel?

Enamel is the thin outer covering of the tooth.  It's the hardest tissue in the human body and it helps protect teeth from the wear and tear that comes with chewing, biting and grinding.  It also helps insulate teeth from hot and cold, making it possible to enjoy ice cream or hot coffee.  While enamel is hard, it can chip or crack.  Once the enamel layer is lost, it cannot regenerate.

What causes enamel erosion?

Enamel erosion happens when acids wear away the enamel on teeth, which can lead to the loss of tooth structure.  The calcium that's in saliva will usually help strengthen teeth after you have a small amount of acid, but too much acid prevents that from happening.  Enamel erosion can be caused by a number of things:

• Excessive consumption of carbonated drinks - sodas and other carbonated drinks
• Fruit drinks (some acids in fruit drinks are more erosive than battery acid)
• Dry mouth or low salivary flow
• Diet (high in sugar and starches)
• Acid reflux disease
• Gastrointestinal problems
• Medications (aspirin, antihistamines)
• Genetics (inherited conditions)
• Environmental factors (friction, wear and tear, stress and corrosion)

Protecting Tooth Enamel

There are some simple things that you can do to help take care of your enamel and keep your teeth healthy:

• Brush and floss daily.
• Use fluoride toothpaste.
• See Dr. Steppler for regular check-ups and cleanings.
• Drink sodas in moderation.
• Be careful about other beverages also.
• Sip with a straw (helps acids from acidic drinks to bypass your teeth).
• Be mindful of snacking.
• Chew sugar-free gum.

Taking good care of your teeth lets you show off a great smile - and a healthy mouth - for a long time!

Bleeding Gums - Why does it happen?

Bleeding gums are the result of an inflammatory disease of the gums.

This is called gingivitis, healthy gums don’t bleed, even in cases of an irritation, such as brushing the teeth. They fit tightly around the teeth, have a light pink color and, when observed at close range, show a fine stippling, like an orange. Bleeding gums are always a sign of gum disease. Oftentimes, you don’t notice the bleeding directly – only when you brush your teeth or when lightly probed, there is a noticeable loss of blood. Bleeding gums in themselves are a symptom and not a disease. The disease associated with bleeding gums is an inflammation of the gums, so-called gingivitis.

The most frequent cause of gingivitis is plaque. So plaque not only causes cavities, but also inflammation of the gums.  Although plaque-induced gingivitis may be influenced by various factors such as medications, or hormonal changes (e.g., pregnancy, taking the pill, puberty), plaque is always the major cause and gets the ball rolling.

If the inflammation of the gums is not treated or treated incorrectly, then the inflammation may turn into a chronic inflammation of the gum tissues, or so-called periodontitis. Other causes of gingivitis are, e.g., fungal diseases, congenital – i.e., genetic – diseases, irritations due to foreign objects, also protruding crown margins or filling edges.

The determination of the cause is Dr. Steppler's first step in treatment. In most cases, professional oral hygiene, the removal of the causes, and educating our patients are sufficient to treat gingivitis. Periodontitis cannot be treated with oral hygiene; treatment can only be accomplished through periodontal scaling treatments followed by regular and more frequent periodontal maintenance visits with our hygienist.

Understanding Your Dental Insurance

A dental insurance plan is a contract between you and an insurance company that, in most cases, is coordinated by your employer. If that’s the case, the insurance company and your employer are responsible for negotiating the details of the plan. Because your dental office has no control over this contract, they cannot request additional coverage for you.  Having dental insurance is better than not having it, expecially if you get it through your job.  However, don't expect free or nearly-free care.  Dental insurance only assists you in the cost of your care, and will cover a portion of the cost not 100%.

Common insurance plans

There are several kinds of dental insurance plans. The four most common kinds of plans are:

• direct reimbursement programs
• preferred provider organizations (PPO)
• capitation plans (also called dental health maintenance organizations- HMO)
• and indemnity or "usual, customary and reasonable" plans

Direct reimbursement programs

In direct reimbursement programs, your employer reimburses you directly for part or all of your dental treatment. All procedures and treatment methods are usually covered, and you can see any dentist you choose.

Preferred provider organizations

In a preferred provider organization, you must choose from a group of dentists who have agreed to discount their fees so that they can be a part of the organization.

Capitation plans

In a capitation plan (also called a dental health maintenance program), participating dentists are paid a set amount for each patient enrolled in the plan. Dentists are paid this set amount no matter how often you visit them (or don’t visit them) and no matter what kind of treatment you get. This generally means that the more work these dentists do for their patients, the less money they’ll make.

Indemnity plans

The most common insurance programs are indemnity plans, which are also called UCR programs. UCR stands for "usual, customary, and reasonable." In these plans, you may choose any dentist and pay on a traditional fee-for-service basis. The insurance company, who is paid a monthly premium by your employer, then reimburses you for between 50 and 80 percent of the dentist’s fee. You are responsible for the remaining 20 to 50 percent after meeting a pre-determined deductible payment. The amount of the deductible is set in the contract between your employer and the insurance company.

Referring to the program and its fees as "usual, customary, and reasonable" is misleading. Most people assume that insurance companies have gathered statistics and that these statistics are the basis for UCR fees. This is simply not true in many cases. These UCR fees often do not represent local dentists’ fees or the available treatment options. They may be, in fact, simply fees that are set by the insurance company. As a result, different insurance companies often have different UCR fees for the same geographic area and for the same group of dentists!

Behind the times

The annual limit of dental insurance benefits has hardly budged in forty years. Back in 1960, the average annual coverage maximum was one thousand dollars. Forty years later, it still sits at approximately one thousand dollars, despite inflation and cost of living increases.

The benefits have remained the same, but fees for procedures have tripled or even quadrupled. And most insurance plans often exclude new treatments they can label as "discretionary," including common treatments such as implants, porcelain veneers, orthodontic treatment, bonding, and whitening.

The choice is yours

If you were to build a house, would you rather have the least expensive contractor who used the cheapest materials and technologies? Or would you rather build a home that will last using quality materials?

You have similar choices when it comes to your dental and health care. In many cases, your insurance company wants you to consider only the cheapest dental procedures, but Dr. Steppler and Team believes that you should be able to choose the best dental treatment and materials for you and your family.

Steppler Dental Care works with most insurance dental plans

Dr. Steppler and his team are available to help patients wade through all the details of your plan; from copays to deductibles and limitations. Our team has worked with almost every dental insurance plan in the Greater St. Louis area and can can help you navigate the details while maintaining that beautiful smile of yours. Dr. Steppler is a progressive and proactive doctor who focuses on the latest methods and techniques that dentistry has to offer. He is dedicated to preserving your natural tooth structure, taking care of all your dental needs in a comfortable, caring and informative environment.

Why You Should See Your Dentist

Your dental exam can detect early signs of diseases.  Gum disease may be associated with other health problems like diabetes and heart disease. 

Oral health check-ups can detect tooth decay, gum disease, and oral cancer early.  Have dental exams at every stage of your life, you could have gum disease and not know it.  Also patients who wear dentures should have regular dental check-ups.

Five great reasons to get you your teeth cleaned:

1)  to learn about the best way to keep your teeth clean every day

2)  to keep your mouth healthy, which will help keep your whole body healthy

3)  to help prevent gum disease, which chould cause tooth loss

4)  to remove tartar (a hard build-up that makes it tough to clean your teeth)

5)  to get rid of stains on teeth that cannot be removed just by brushing and flossing

At every exam Dr. Steppler does, we check your mouth and neck for signs of disease.  Dr. Steppler will evaluate your general health when developing a plan for your oral treatment, and refer you to a physician if needed.

Your oral health is an important part of your overall health, so be sure you and your family come in for regular visits.