Lansing's Dental Discussion
By Holly Scott-Hetchler DDS
October 28, 2020
Category: Dental Procedures
HowAFVsAlfonsoRibeiroSavedHisTooth

Remembered fondly by fans as the wacky but loveable Carlton on The Fresh Prince of Bel-Air, Alfonso Ribeiro is currently in his fifth year hosting America's Funniest Videos. It's the perfect gig for the 48-year-old actor, who loves to laugh and make others laugh as well. This is quite the opposite experience from one he had a few years ago that he remembers all too well: a severely decayed tooth.

After seeing his dentist for an intense toothache, Ribeiro learned he had advanced tooth decay and would need root canal treatment. Ribeiro wasn't thrilled by the news. Like many of us, he thought the procedure would be unpleasant. But he found afterward that not only was the root canal painless, his toothache had vanished.

More importantly, the root canal treatment saved his tooth, as it has for millions of others over the last century. If you're facing a situation similar to Alfonso Ribeiro's, here's a quick look at the procedure that could rescue your endangered tooth.

Getting ready. In preparation for root canal therapy, the tooth and surrounding gums are numbed, often first with a swab of local anesthesia to deaden the surface area in preparation for the injection of the main anesthesia below the surface. A dental dam is then placed to isolate the infected tooth from its neighbors to prevent cross-contamination.

Accessing the interior. To get to the infection, a small access hole is drilled. The location depends on the tooth: in larger back teeth, a hole is drilled through the biting surface, and in front teeth, a hole is drilled on the backside. This access allows us to insert special tools to accomplish the next steps in the procedure.

Cleaning, shaping and filling. Small tools are used to remove the diseased tissue from the interior tooth pulp and root canals. Then the empty spaces are disinfected. This, in effect, stops the infection. Next, the root canals inside the tooth are shaped to allow them to better accept a special filling called gutta percha. The access hole is then sealed to further protect the tooth from future infection, and a temporary crown is placed.

A new crown to boot. Within a couple weeks, we'll cap the tooth with a long-lasting lifelike crown (or a filling on certain teeth). This adds further protection for the tooth against infection, helps strengthen the tooth's structure, and restores the tooth's appearance.

Without this procedure, the chances of a tooth surviving this level of advanced decay are very slim. But undergoing a root canal, as Alfonso Ribeiro did, can give your tooth a real fighting chance.

If you would like more information about root canal treatments, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “A Step-By-Step Guide to Root Canal Treatment” and “Root Canal Treatment: How Long Will It Last?

By Holly Scott-Hetchler DDS
October 18, 2020
Category: Oral Health
Tags: oral health  
4WaysSalivaProtectsYourMouthAgainstDisease

Brushing and flossing daily, and dental visits at least twice a year: These are the essential things you should be doing to protect your teeth and gums against dental disease. But you're also getting an automatic assist from your body through saliva, that humble fluid swishing around in your mouth, to protect your oral health.

It's more than simply “mouth water”: Without saliva and its various components, your risk for tooth decay or periodontal (gum) disease would be much higher. Here are 4 ways saliva helps you keep your teeth and gums healthy.

Cleansing. Chewing prepares your food for digestion, but in the process produces tiny particles of food debris. Settling on tooth surfaces, these bits become part of the dental plaque that forms on your teeth and develops the ideal breeding ground for disease-causing bacteria. Saliva helps rinse away much of this debris—particularly sugar, the primary food source for bacteria.

Protection. Saliva is the first line defense against disease-causing microorganisms entering the mouth. The primary source of this protection is a protein-based antibody called Immunoglobulin A (IgA), which directly fights infection-causing organisms. Another protein in saliva, lactoferrin (also found in tears), interferes with bacterial growth.

Buffering. The main enemy of tooth enamel is mouth acid, produced by oral bacteria and the foods that we eat. Saliva neutralizes acid to help the mouth maintain its normally neutral pH range. And it works fast: Saliva can buffer acid and restore balance within thirty minutes to an hour after eating.

Re-mineralization. It's normal for acid to build up after eating, and for it to quickly remove minerals from surface enamel, a process called de-mineralization that can soften and weaken the enamel. But saliva helps restore some of these lost minerals as it's neutralizing acid. This re-mineralization re-strengthens enamel against tooth decay.

Saliva is so important for maintaining a healthy mouth, it's worth your efforts to protect it. Diminished saliva production not only produces an unpleasant dry mouth, it may increase your risk for disease. If this is a constant problem, speak to your dentist about causes and remedies. You'll be doing your teeth and gums a favor.

If you would like more information on the role of saliva in maintaining oral health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Saliva: How it is Used to Diagnose Disease.”

By Holly Scott-Hetchler DDS
October 08, 2020
Category: Oral Health
Tags: oral health  
MouthBreathingCanLeadtoSeriousOralProblemsEspeciallyforChildren

It's normal for people to breathe through their nose. And for good reason: Nasal breathing filters contaminants, warms and humidifies incoming air, and helps generate beneficial nitric oxide. Chronic mouth breathing, on the other hand, can trigger a number of harmful effects, especially for the teeth and gums.

Because our survival depends on continuous respiration, our bodies automatically seek out the air flow path of least resistance, normally through the nose. But if our nasal passages become obstructed, as with enlarged adenoids or sinus congestion, we may involuntarily breathe through the mouth.

This can lead to oral problems like chronic dry mouth, which not only creates an unpleasant mouth feel, it also produces the ideal environment for dental disease. And, it could cause an even more serious problem for children during jaw and teeth development.

This is because the tongue rests along the roof of the mouth (palate) while breathing through the nose. In this position, the tongue serves as a mold for the upper jaw and teeth while they're growing during childhood. During mouth breathing, however, the tongue moves away from the palate, depriving the jaw and teeth of this molding effect, and possibly resulting in a poor bite.

You can prevent these and other oral problems by seeing a healthcare professional as soon as you notice your child regularly breathing through their mouth. The best professional for this is an ENT, a medical specialist for conditions involving the ears, nose and throat. ENTs provide treatment for diagnosed obstructions involving the tonsils, adenoids and sinuses.

Even so, persistent mouth breathing may already have affected your child's bite. It may be prudent, then, to also have their bite evaluated by an orthodontist. There are interventional measures that can help get jaw development back on track and minimize future orthodontic treatment.

Finally, a child who has undergone treatment to remove nasal breathing obstructions usually reverts to nasal breathing automatically. But sometimes not: To “relearn” normal breathing, a child may need to undergo orofacial myofunctional therapy (OMT) with a certified therapist to retrain their facial muscles and tendons to breathe through the nose.

Your child's tendency to mouth breathing may not seem like a major problem. But prompt attention and treatment could prevent it from interrupting their dental development.

If you would like more information on correcting mouth breathing, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “The Trouble With Mouth Breathing.”

By Holly Scott-Hetchler DDS
September 28, 2020
Category: Oral Health
Tags: dry mouth  
TakeTheseStepstoAlleviateChronicDryMouth

You might be noticing some changes as you get older: You're getting winded easier and you're wondering why book or magazine print has suddenly shrunk (it didn't). Perhaps you've also noticed your mouth seems drier more often.

It could be a condition called xerostomia, in which your body isn't producing enough saliva. Older people are more prone to it because it's often a side effect of prescription drugs that can inhibit saliva production. Because seniors tend to take more medications than other age groups, xerostomia is a more common problem for them.

Xerostomia isn't a pleasant experience. More importantly, it's hazardous to your oral health. Saliva contains antibodies that fight bacterial infection, and it also neutralizes mouth acid that causes tooth decay. A lack of saliva puts you at greater risk for both tooth decay and gum disease.

Fortunately, there are things you can do to alleviate or ease the effects of xerostomia.

Cut back on spicy foods and caffeinated beverages. Spicy or salty foods can irritate your gum tissues and worsen dry mouth symptoms. Because it's a diuretic, caffeine causes you to lose more fluid, something you can't afford with xerostomia. Cutting back on both will improve your symptoms.

Drink more water. Increasing your daily water intake can help you produce more saliva. It also washes away food particles bacteria feed on and dilutes acid buildup, which can reduce your risk for dental disease.

Talk to your doctor and dentist. If you're taking medications with dry mouth side effects, ask your doctor about other alternatives. You can also ask your dentist about products you can use to boost saliva production.

Practice daily hygiene. Daily hygiene is important for everyone, but especially for those whose saliva flow is sub-par. Brushing and flossing clear away dental plaque, the top cause for dental disease. Along with regular dental visits, this practice can significantly reduce your risk for tooth decay and gum disease.

Taking these steps can help you avoid the discomfort that often accompanies xerostomia. It could also help you prevent diseases that could rob you of your dental health.

If you would like more information on dealing with dry mouth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “10 Tips for Dealing With Dry Mouth.”

By Holly Scott-Hetchler DDS
September 18, 2020
Category: Dental Procedures
ViggoMortensensRed-CarpetSmile

The Golden Globes ceremony is a night when Hollywood stars shine their brightest. At the recent red-carpet event, leading man Viggo Mortensen had plenty to smile about: Green Book, the movie in which he co-starred, picked up the award for Best Motion Picture—Musical or Comedy. But fans looking at the veteran actor's big smile today might not realize that it once looked very different. A few years ago, an accident during the filming of The Two Towers took a major chip out of Mortensen's front tooth!

That might be OK for some movies (think The Hangover or Dumb and Dumber)—but it's not so great for everyday life. Fortunately, Mortensen visited a dentist promptly, and now his smile is picture-perfect. How was that accomplished? He didn't say…but generally, the best treatment for a chipped tooth depends on how much of the tooth's structure is missing.

If the tooth has only a small chip or crack, it's often possible to restore it via cosmetic bonding. This procedure can be done right in the dental office, frequently in a single visit. Here's how it works: First the tooth is cleaned and prepared, and then a tooth-colored resin is applied to the area being restored. After it is cured (hardened) with a special light, additional layers may be applied to build up the missing structure. When properly cared for, a tooth restored this way can look good for several years.

For a longer-lasting restoration, veneers may be recommended. These are wafer-thin shells made of durable material (most often porcelain) that cover the front (visible) surfaces of teeth. Strong and lifelike, veneers can match the exact color of your natural teeth—or give you the bright, high-wattage smile you've always wanted. No wonder they're so popular in Hollywood! Because veneers are custom-made for you, getting them may require several office visits.

If a chip or crack extends to the inner pulp of the tooth, a root canal procedure will be needed to keep the tooth from becoming infected—a situation that could have serious consequences. But you shouldn't fear a root canal! The procedure generally causes no more discomfort than filling a cavity (though it takes a little longer), and it can help save teeth that would otherwise be lost. After a root canal, a crown (cap) is generally needed to restore the visible part of the tooth.

When a damaged tooth can't be restored, it needs to be extracted (removed) and replaced. Today's best option for tooth replacement is a dental implant—a small, screw-shaped post inserted into the bone of your jaw that anchors a lifelike, fully functional crown. Implants require very little special care and can look great for many years, making them a top choice for tooth replacement

If you have questions about chipped or damaged teeth, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Artistic Repair Of Front Teeth With Composite Resin” and “Porcelain Veneers.”

By Holly Scott-Hetchler DDS
September 08, 2020
Category: Dental Procedures
Tags: dental cleaning  
RemovingHardenedPlaqueReducesYourRiskofDisease

When you floss (you do floss, right?), you probably notice a sticky, yellowish substance called plaque stuck to the thread. This thin film of tiny food particles and bacteria is the reason you floss and brush in the first place: Because it's the main trigger for tooth decay and gum disease, removing it decreases your risk for disease.

But this isn't the only form of plaque you should be concerned about. That same sticky substance can also interact with your saliva and harden into what's commonly known as tartar. Dentists, however, have a different term: They refer to these calcified deposits as calculus. And it's just as much a source of disease as its softer counterpart.

You might have noticed that this form of plaque has the same name as an advanced type of mathematics. Although dental calculus has little in common with algebra's cousin, both terms trace their origins back to the same linguistic source. The word “calculus” in Latin means “small stone;” it became associated with math because stone pebbles were once used by merchants long ago to calculate sales and trades.

The term became associated with the substance on your teeth because the hardened plaque deposits resemble tiny stones or minerals—and they can be “as hard as a rock” to remove. In fact, because they adhere so firmly it's virtually impossible to remove calculus deposits with brushing or flossing alone. To effectively eliminate calculus from tooth surfaces (including under the gum line) requires the skills and special dental tools of dentists or dental hygienists.

That's why we recommend a minimum of two dental cleanings a year to remove any calculus buildup, as well as any pre-calcified plaque you might have missed with daily hygiene. Reducing both plaque and calculus on your teeth fully minimizes your risk of dental disease. What's more, removing the yellowish substance may also brighten your smile.

That's not to say daily brushing and flossing aren't important. By removing the bulk of plaque buildup, you reduce the amount that eventually becomes calculus. In other words, it takes both a daily oral hygiene practice and regular dental visits to keep your teeth healthy and beautiful.

If you would like more information on best oral hygiene practices, please contact us or schedule an appointment for a consultation.

By Holly Scott-Hetchler DDS
August 29, 2020
Category: Oral Health
Tags: oral hygiene  
UseThisProducttoCheckYourBrushingandFlossingEffectiveness

So…you faithfully brush and floss your teeth every day. Kudos to you! Along with regular dental visits, daily hygiene is the best thing you can do to keep your teeth and gums disease-free.

Dental plaque, that thin film of bacteria and food particles that builds up on teeth, is the number one cause for tooth decay and periodontal (gum) disease. Thoroughly removing it daily through brushing and flossing drastically reduces your chances for disease.

But just the acts of brushing and flossing aren’t enough—both are skills requiring some level of mastery for truly effective plaque removal. Otherwise, any leftover plaque could be an invitation for infection.

So, how can you tell if you’re getting the job done? One way is a quick swipe of the tongue across your teeth after brushing: If they still feel gritty rather than smooth, chances are you left some plaque behind.

A more comprehensive method, though, is with a plaque disclosing agent, a product found in stores that sell dental care items. These kits contain liquids, tablets or swabs that when applied to the teeth right after brushing or flossing temporarily dye any leftover plaque a particular color. You’ll be able to see the results for yourself in the mirror.

A plaque disclosing agent can also reveal patterns of remaining plaque that indicate where you need to improve your hygiene efforts. For example, a scalloping effect along the gum line could mean you’re not adequately reaching high enough in these areas with your brush as well as your floss.

The dye effect is temporary, but it might take a few hours for the staining to fade away. You should also avoid swallowing any solution and avoid getting it on your clothes. And while disclosing agents can help improve your hygiene skills, your dentist or hygienist is still your best resource for dental care advice—so keep up those regular dental visits.

If you would like more information on best hygiene practices, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Plaque Disclosing Agents.”

DeterminingtheRightWhiteningApproachisKeytoBrighteningaDullSmile

Bright, naturally white teeth are a key component in a beautiful smile. But the opposite is also true: nothing diminishes an otherwise attractive smile more than stained or discolored teeth.

There is good news, however, about tooth staining: it can be greatly reduced with the right whitening technique. But before taking action we need to first uncover the cause for the staining — whether from the outside or inside of the tooth, or a combination of both.

If it’s an external cause — known as extrinsic staining — our diet is usually the source. Foods and beverages that contain tannins, like red wine, coffee or tea fall in this category, as do foods with pigments called carotenes as found in carrots and oranges. Besides limiting consumption of stain-causing foods and maintaining daily oral hygiene, you can also diminish extrinsic staining with a bleaching application.

There are two basic ways to approach this: with either a professional application at our office or with a home kit purchased at a pharmacy or retail store. Although both types use similar chemicals, the professional application is usually stronger and the whitening effect is obtained quicker and may last longer.

Discoloration can also occur within a tooth, known as intrinsic staining, and for various reasons. It can occur during tooth development, as with childhood overexposure to fluoride or from the antibiotic tetracycline. Poor development of enamel or dentin (the main sources of natural tooth color), tooth decay, root canal treatments or trauma are also common causes of intrinsic discoloration.

There are techniques to reduce the effects of intrinsic staining, such as placing a bleaching agent inside the tooth following a root canal treatment. In some cases, the best approach may be to restore the tooth with a crown or porcelain veneer. The latter choice is a thin layer of dental material that is permanently bonded to the outer, visible portion of the tooth: it’s life-like color and appearance covers the discoloration, effectively renewing the person’s smile.

If you’ve been embarrassed by stained teeth, visit us for a complete examination. We’ll recommend the right course of action to turn your dull smile into a bright, attractive one.

If you would like more information on treatments for teeth staining, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Teeth Whitening.”

By Holly Scott-Hetchler DDS
August 09, 2020
Category: Dental Procedures
HughJackmanIsAllSmilesforHisNewBroadway-InspiredShow

To anyone immersed in the “X-Men Universe” Hugh Jackman will always be Wolverine, a role he played in seven movies. But there’s more to this Australian actor than mutant bone claws and mutton chops that would make Elvis envious. Jackman has also starred in over 20 non-superhero films, including Les Misérables, for which he won a Golden Globe. He is also a Tony award-winning Broadway performer—with a winning smile.

With his famed character Logan/Wolverine fading in the rearview mirror, Jackman has returned to his musical roots. He will play Harold Hill in the Broadway revival of The Music Man, set to open in Fall 2020. And since May 2019 he’s been on world tour with Hugh Jackman: The Man. The Music. The Show., featuring Jackman and a supporting cast performing songs from favorite shows and films, including Les Misérables and the 2017 hit The Greatest Showman.

The Show, with 90 planned stops throughout Europe, North America and Oceania, is a decidedly different “universe” from the X-Men. As Wolverine, Jackman could get away with a scruffier look. But performing as Jean Valjean or the bigger-than-life P.T. Barnum, he has to bring a vastly different look to the role, which brings us to Jackman’s teeth…

Once upon a time, Jackman’s teeth were an unflattering gray—definitely not a good look for stage or film. So with the help of his dentist, Jackman set about upgrading his smile with teeth whitening. Teeth whitening is a great way to take a dull, stained smile and turn up the volume on its brightness—and attractiveness—a notch or two. A dentist applies a bleaching solution that stays in contact with the teeth for a few minutes. The process is often aided by special lighting.

A professional application is especially desirable if, like Jackman, you want “Goldilocks” brightness: not too little, not too much, but just right for you. Dentists can precisely control the tint level to get a brighter but more naturally looking white. Of course, you can also get a dazzling “Hollywood” smile if you so desire.

And although the effect of teeth whitening isn’t permanent, a dental application can last a while, depending on how well you manage foods and beverages that stain teeth. With a touchup now and then, you may be able to keep your brighter smile for years before undergoing the full procedure again.

One important note, though: This technique only works with outer enamel staining. If the discoloration originates from within the tooth, the bleaching agent will have to be placed internally, requiring access to the inside of the tooth. An alternative would be porcelain veneers to mask the discoloration, an option that also works when there is ultra-heavy enamel staining.

If you’re tired of your dull smile, talk with us about putting some pizzazz back into it. Teeth whitening could be your way to get a smile worthy of Broadway.

If you would like more information about teeth whitening, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Teeth Whitening” and “Whitening Traumatized Teeth.”





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