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You’ve always taken care of your child’s smile. You make sure thorough brushing and flossing take place twice a day. You serve foods high in vitamins and minerals and low in sugar. You make and keep regular dental appointments at our New York, NY office. But even with the best dental routines, sometimes conditions can occur that will require additional professional care.

One of these conditions can affect your child’s enamel while the tooth is still forming. When baby teeth or adult teeth appear, you might notice white, creamy yellow, or brown spots in otherwise healthy-looking enamel. These spots are softer and rougher than normal hard, smooth enamel. Because of their texture and color, such teeth are often referred to as “chalky teeth,” but this condition is actually known as enamel hypomineralization.

What is hypomineralization?

Enamel is the strongest substance in our bodies—stronger even than bones. Enamel is largely composed of minerals. If something disrupts the process of enamel development in baby or adult teeth, the result can be abnormally low mineral content in the enamel. This leaves teeth weaker and more likely to suffer decay and damage.

Premature birth, low birth weight, and other pre-natal factors have been suggested as risk factors for hypomineralization in primary teeth enamel. Permanent teeth can be vulnerable to this condition as well. Adult teeth are forming in young children well before they make an appearance. It’s been suggested that certain early childhood factors, such as recurring high fevers, some diseases, even specific antibiotics, can interrupt the formation of the enamel and lead to hypomineralization of adult teeth.

What are the results of enamel hypomineralization?

Children with this condition are much more likely to experience rapid tooth decay because of their weaker, more porous enamel, especially in the molars. Further, they tend not to respond as well to the numbing effects of local dental anesthetics, while their teeth tend to be more sensitive to pain. Cases can be mild, moderate, or severe. In severe cases, teeth might require crowns or possibly extractions, but even mild discoloration and other cosmetic problems can lead to self-consciousness in your child.

How can we help?

Catching this condition early is very important. If your child has had any medical conditions that might affect tooth development, let Dr. David Shipper and Dr. Howard Vogel know even before that first tooth comes in. If you notice anything unusual about a new baby or adult tooth, give us a call. For primary or permanent teeth, the sooner we can begin treatment, the better the long-term outlook.

We might suggest fluoride applications or desensitizing treatments. We can apply sealants to reduce the risk of cavities, and use bonding to restore discolored or weak patches in the tooth. Both of these methods have greater success if the enamel near the affected area is in good condition, so early treatment is vital. If teeth require more protection, crowns are often the best choice. We will design a treatment program to suit your child’s individual needs now and for the future.

How can you help?

Dental hygiene is important for every child, but especially for a child with weak and porous enamel. Because children with hypomineralized enamel develop cavities more quickly that those with strong enamel, it is very important to watch your child’s diet and keep to a regular, careful, and thorough routine of brushing and flossing at home. Be attentive to any sensitivity problems, and be sure to follow any suggestions we might have for strengthening enamel.

Remember, early diagnosis and treatment is always best! If at any time you notice chalky patches, or have any other concerns about the appearance of your child’s teeth, if they seem to be causing your child pain or are unusually sensitive, call Dr. David Shipper and Dr. Howard Vogel immediately. We want to work with you to treat any current problems and to prevent new ones.

If you were to put your toothbrush bristles under a high-powered microscope, what you would see might give you nightmares: millions of bacteria, busily crawling up and down your toothbrush bristles, consuming proteins that came from your mouth, and still clinging to the bristles even after you’ve rinsed them with water.

Rinsing your toothbrush after brushing removes some of those ferociously hungry bacteria, but not all. The American Dental Association says that bacterial infestations develop on toothbrushes within a month of daily use. The ADA also states that unless a toothbrush is sterilized before being packaged, it’s going to come with bacteria – free of charge!

Germs and Frayed Bristles: the Demise of a Toothbrush

Dr. David Shipper and Dr. Howard Vogel and our staff recommend that you toss your old toothbrush in the trash and purchase a new one every three months. Children tend to bite on their toothbrushes, which makes the bristles degrade and fray faster. Chances are kids may need to have their toothbrushes changed more frequently.

Where do they hide?

Bacteria are tenacious little germs that head for those concealed areas between toothbrush bristles. They are highly adaptable and exist in every type of extreme environment. Some people actually go so far as to put their toothbrush in a microwave for a few seconds to kill germs, but this doesn't always work either. In fact, you may only end up with a toothbrush that’s as bendable as a Gumby doll – and still covered with germs.

Feed a Cold, Starve a Fever, and Get Rid of Your Toothbrush

When you have a head cold, your mouth is teeming with bacteria gleefully roaming around, and gobbling mucus and dead skin cells. If you brush your teeth while suffering a sinus condition, the brush will act like a magnet for ravenous bacteria. Use your old toothbrush while you are sick, but as soon as you feel better, throw it away and get a new one. Otherwise you could possibly re-infect yourself with the same cold germs!

Modern dentistry has made the most of today’s technological innovations. And we’ve come a long way from the fraying sticks our ancestors used as toothbrushes.

On the other hand, while it’s a lot better than a fraying stick, the manual toothbrush model you’ve used for years might be ready for an upgrade. Should you take this opportunity to try out some new technology offering all the bells and whistles? Let’s answer that question by asking a few more questions.

Happy with your manual brush?

If you like your manual toothbrush and it’s doing the job, by all means, stick with it. But even your old familiar brush can evolve:

• There are lots of bristle options, but soft bristles are almost always the way to go. Medium and hard bristles can be too abrasive for your enamel.
• Heads come in a variety of sizes, so make sure the head size is comfortable. You want to be able to maneuver to reach every tooth surface, which a too-large brush head just can’t do.
• Try a different handle shape if you’re having trouble maneuvering and keeping a firm grip.
• Change your brush regularly. Brushes are effective for about three months before the bristles start to fray and breakdown. This is a good opportunity to experiment with different brands and styles.

Does your old brush suit your current needs?

Different types of manual toothbrushes are available for effective and comfortable brushing when you need options that a typical brush doesn’t provide:

• Special orthodontic toothbrushes are designed with bristles trimmed to fit around brackets and wires and smaller heads to reach into tight places.
• For those with mobility issues, brushes with larger or easy-grip handles make cleaning more comfortable.
• Brushes with extra-soft bristles are available if you have enamel erosion or sensitive gums.
• Because many women find their gums become especially sensitive during pregnancy, there are brushes designed especially for moms-to-be.

Is it time to go electric?

If you haven’t tried an electric toothbrush before, you might find that getting braces is a great reason to give one a spin.

• Electric toothbrushes can outperform manual models. A dedicated brusher might manage hundreds of brushstrokes for each minute of brushing, while an electric brush can provide thousands. If, despite your regular brushing, you have plaque build-up, an electric brush might be a good alternative to your manual brush.
• Models are available which can alert you when you’re brushing too hard—which is important for your enamel if you’re a heavy-handed brusher.
• If you tend to *think* you’ve brushed for the recommended two minutes, but have *actually* brushed 32 seconds, some electric brushes come with timers!
• There are tapered electric orthodontic brush heads designed just for people with braces.
• Electric brushes have bigger handles and can be easier to grip.

Is your current brush doing the job?

So, should you stick with the familiar toothbrush that’s worked for you all these years, or take this opportunity to try out some new technology that offers all the bells and whistles? The answer is clear: the right brush for you is the one that works!

If your regular checkups show that plaque is under control, you’re doing just fine with the brush in hand. If you or Dr. David Shipper and Dr. Howard Vogel notice plaque buildup, it’s time to consider making some changes. Whether it’s a question of tools, techniques, or time spent brushing, your New York, NY dental team has the answers you need for state-of-the-art dental hygiene.

Diastema is a medical term meaning “space between”—or what Dr. David Shipper and Dr. Howard Vogel and our team less formally call a gap between the teeth. Such gaps are common for children as they make the transition from baby teeth to adult teeth, and usually close when all the permanent teeth arrive. But not always!

Sometimes a gap, usually between the upper front teeth, stays with you into adulthood, but doesn’t affect your perfectly heathy teeth. Sometimes a diastema develops due to medical conditions or trauma. Whether you would like to close a gap for cosmetic reasons, or need to address gaps that have developed because of dental problems, your treatment will depend on the causes of the diastema.

• The Relationship of Jaws and Teeth

Most of the time, we think of braces as straightening crooked teeth. For many braces wearers, the jaw can’t accommodate all of the adult teeth without crowding. But it’s also possible to have too much space for incoming teeth, and this can lead to a gap between two or more teeth. Orthodontic treatment is a common choice to close this kind of gap, using braces or clear aligners to move the teeth closer together.

• Prominent Labial Frenulum

The labial frenulum is a band of muscular tissue that connects the upper lip and the top of the gums. If it is too large, tissue can extend beyond the top of the front teeth. A gap develops when the front teeth simply can’t meet because of the tissue between them.  Oral surgery can reduce the size of the frenulum, if necessary, and often orthodontic treatment is the go-to option to close the diastema.

• Small Teeth or Small Gap

Occasionally, a few teeth are noticeably smaller than their neighbors. Bonding, veneers, and crowns can be used to enlarge these teeth, making them proportionate to the teeth around them. These treatments can also be successful in reducing a gap between the front teeth.

• Missing Teeth

Sometimes people are born missing a tooth. Sometimes people lose a tooth to injury or decay. And while the space left by a missing or lost tooth is a noticeable gap in itself, the remaining teeth can shift to fill the void, causing other gaps to develop as well. A dental implant or bridge can both replace a missing tooth and maintain the normal spacing of the teeth that surround it.

• Gum Disease

Left untreated, periodontitis (gum disease) can damage or even destroy the bone tissue which holds and supports the teeth. This, in turn, leads to “tooth mobility,” or loose teeth. Spaces between the teeth become more noticeable and larger over time. After the gum disease is treated, patient and dentist can explore options for reducing or eliminating spaces between the teeth.

• Harmful Oral Habits

Tongue thrusting and thumb sucking are two habits that can affect the alignment of the front teeth. Both behaviors pressure the teeth to move forward, which can cause separations between them. Learning how to change these behaviors will help prevent or stop the expansion of a diastema and potentially serious malocclusions (bad bites).

If you would like to discuss your diastema for aesthetic reasons, talk to Dr. David Shipper and Dr. Howard Vogel for ways to reduce or eliminate the gap. If your diastema is the result of a medical condition, we will be able to recommend treatment options available at our New York, NY office. If you’re teeth and gums are healthy, and you enjoy the individuality of your diastema . . .

• Embrace the Space!

A diastema can be a signature look for you and your smile. Normal brushing, flossing, and regular dental care will keep your smile bright, healthy, and uniquely you. And if you’re happy, healthy, and confidant, why, there’s no reason to mind the gap at all!