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Our teeth are a lot more complicated than they look. Beneath that shiny white surface is an entire system of different cell tissues working together to keep each tooth vital and healthy.

• Enamel, the protective exterior of the crown (the visible part of the tooth), is the strongest substance in the body and the first line of defense against damage to our teeth.
• Dentin, the hard tissue under the enamel and cementum, has microscopic tubules that connect to the pulp.
• Pulp, the tissue at the center of the tooth, contains the nerves, blood vessels, and connective tissue that keep the tooth alive.
• Cementum, composed of connective tissue which forms the protective exterior of the root, also attaches to fibers in the periodontal ligaments which hold the teeth securely in the jaw.

Because cementum is below the gum line, it’s generally safe from the cavity-causing conditions that our enamel is exposed to every day. But there are still potential hazards that we should be aware of.

• Cementum Erosion

With a name like “cementum,” it’s logical to assume that this is the hardest tissue in the body. Actually, however, that distinction goes to our enamel. And if even our enamel can be damaged by bacteria and plaque, cementum doesn’t stand a chance!

How does cementum come in contact with cavity-causing bacteria? Gums often recede as a natural part of the aging process, leaving part of the root exposed. Gum disease, failure to brush and floss regularly, and heavy-handed brushing can lead to early gum recession. The newly exposed cementum is now exposed to the same conditions, which cause cavities in our enamel. But a root cavity can be trickier to treat and, because the cementum is not as strong as enamel, can progress more quickly. And if a cavity reaches the pulp, a root canal could be necessary.

But the erosion of cementum doesn’t have to result in a cavity to cause discomfort. When cementum is removed, the dentin beneath is exposed. Dentin, you’ll recall, contains tiny tubes that connect to the pulp of the tooth. The result? Conditions such as heat, cold, even an intake of air can cause tooth sensitivity as they stimulate the nerves in the pulp. If your hot coffee or ice cream cone is suddenly causing you pain, let us know. There are treatments, which can reduce tooth sensitivity.

• Gum Disease (Periodontitis)

In more severe cases of gum disease, the gums pull away from the teeth leaving pockets, which harbor plaque and bacteria. Left untreated, these pockets can become home to infections, which attack and destroy bone structure and connective tissue. Caught early, a treatment called tooth scaling and planing can help. In this type of deep cleaning, your dentist or endodontist will remove plaque and tartar and then smooth the root surface to make it harder for bacteria and plaque to stick. If the gums have receded too far, a gum graft might be necessary to protect the exposed roots.

• Trauma

The same traumas that can damage teeth above the gum line can result in injuries below it. Chewing on hard objects (ice, hard candies, wooden pencils), bruxism (tooth grinding), and sports injuries or accidents can cause cracks in the cementum. If your root is split or fractured, it might be possible to save your tooth, but sometimes extraction is the best option.

So how do you protect your cementum, hidden as it is under your gum line? The same way you protect the more visible parts of your teeth!

• Keep to a healthy daily routine of brushing and flossing. This will help prevent gum disease and keep gum recession at bay. Using a soft brush and brushing firmly but gently will remove plaque while protecting both enamel and cementum. If you notice tooth sensitivity, give us a call!
• Come in to our Walnut Creek, California office for regular dental exams. The best treatment for gum disease is prevention. When you come in for regular checkups, we are able to discover early signs of gum disease before it becomes a serious problem. If you are suffering from more advanced periodontitis, there are treatments available.
• Safety first when it comes to your smile. If you chew on hard objects, talk to Dr. Cynthia Stephenson about how to break the habit. If you grind your teeth, see us for solutions. If you play sports, let us know—often a mouthguard can help protect your teeth from injuries that could otherwise lead to more complex procedures or even tooth loss.

Maintaining your healthy dental habits is a lot like cementum—the foundation of a beautiful smile. Nothing complicated about that!

You never know when a dental problem may arise. Unfortunately, they don’t necessarily occur during office hours. Dr. Cynthia Stephenson can provide you with the proper information and treatment options to prevent the problem from becoming worse.

Abscess

An abscess is a bacterial infection, and will normally cause pain and swelling around the affected tooth and gum area. Though antibiotics are not always necessary, you should be seen by Dr. Cynthia Stephenson as soon as possible. If left untreated, the infection may grow and cause more serious issues.

Toothache

Toothaches can have many causes. Sometimes it’s as simple as food lodged between your tooth and gums. Rinse your mouth with warm water and try flossing the area to dislodge the particle. If your gums begin to bleed, stop flossing.

Fractures or cavities can also cause toothaches as well as sensitivity to heat or cold. Please schedule an appointment to ensure a minor problem doesn’t develop into a serious one. You may require acetaminophen or another pain reliever before your visit.

If you can’t be treated right away, keep these tips in mind:

• If you have fractured a tooth, rinse the area with warm water to keep the surfaces clean. Apply a cold compress to the outside of your facial area to reduce swelling.
• A tooth that has been knocked out should be kept moist, in a clean container, until you can receive treatment.
• Do not apply aspirin directly to a damaged tooth or gum area, because this can cause tissue irritation.
• If you suspect your jaw has been broken, go to an emergency room immediately.
• If you have bitten or damaged your lips or tongue, rinse your mouth well with warm water. If bleeding continues, seek other medical attention right away.

If you experience an emergency, please contact our Walnut Creek, California office and provide us with as much information as possible. This way, we can offer recommendations that will assist you until you’re able to arrive for an appointment.

Remember: procrastinating about getting treatment can turn a minor problem into a major one!

Congratulations! Your child is beginning to leave her bottle behind and has started to use her first sippy cup. And the best training cup is one that makes the transition from bottle to cup an efficient, timely, and healthy one.

The Right Training Cup

While a “no spill” cup seems like the perfect choice for toddler and parent alike, those cups are designed much like baby bottles. The same valve in the no-spill top that keeps the liquid from spilling requires your child to suck rather than sip to get a drink. If your child’s cup has a top with a spout, she will learn to sip from it. Two handles and a weighted base make spills less likely.

When to Use a Training Cup

Children can be introduced to a sippy cup before they are one year old, and we suggest phasing out the bottle between the ages of 12 and 24 months. Use a sippy cup as the source for all liquids at that age, and only when your child is thirsty and at mealtime to avoid overdrinking. The transition from sippy cup to regular cup should be a swift one.

Healthy Sipping Habits

The best first option in a sippy cup between meals is water. Milk or juice should be offered at mealtimes, when saliva production increases and helps neutralize the effects of these drinks on young teeth. And don’t let your child go to sleep with anything other than water—falling asleep with a cup filled with milk, juice, or other sugary drinks means these liquids stay in the mouth overnight. Finally, while a sippy cup is convenient and portable, don’t let your young child walk and sip at the same time to avoid injuries.

When your child comes to our Walnut Creek, California office for her first visit, please bring any questions you might have about training cups. We would be glad to share ways to make the move from bottle to cup both successful and safe!

When you chip a tooth badly, it can be a very nerve-wracking situation. Dr. Cynthia Stephenson and our team want to provide you with some information that can help if you ever suffer a chipped or broken tooth. The most common ways people break their teeth are by biting down on something hard, getting hit in the mouth, falling down, or developing cavities that weaken the tooth and allow it to be broken easily. There are a few things you can do if you find yourself in this situation, however.

First, we recommend that you investigate whether the tooth is partially chipped or completely broken. Unless you are experiencing a lot of pain or bleeding, this should not be treated as an emergency. You may call our office and we will try to schedule an appointment with you as soon as possible. Once we have evaluated the tooth during your appointment, we can start to treat it. For minor chips or cracks, we may simply smooth out the area or fill in the space so the crack doesn’t spread.

If your teeth show severe damage such as a serious break, split tooth, split root, or a decay-induced break, Dr. Cynthia Stephenson may need to take more time to fix the problem. If you need emergency dental care because a tooth has fallen out, call our practice immediately to schedule an appointment for that day. If you’re waiting for an emergency appointment, you can rinse your mouth with warm salt water and apply slight pressure to the area to stop the bleeding. We recommend using an ice pack to reduce swelling, but do not take any aspirin because that may increase the bleeding.

If your tooth has completely fallen out of the socket, hold it by the crown and rinse it under running water. Do not let the tooth become dry; instead, place it in salt water or milk until you get to our office. Dr. Cynthia Stephenson will determine whether the broken tooth can be salvaged or will need to be completely replaced.

We know how upsetting it can be to chip or break a tooth, which is why we want to guide you through this process. Most chipped teeth are usually just cosmetic problems, fortunately, but we know that dental emergencies can come up rather suddenly. Be sure to schedule an appointment at our Walnut Creek, California office as soon as an emergency situation occurs.