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From the clinical perspective, dentistry is similar around the world. Dentists, like Dr. Varble, Dr. Dill, and Dr. Wong, go to school, obtain a license, and work hard to prevent and treat tooth decay, gum disease, oral infections, throat or oral cancer, tooth loss, and other conditions that might limit a person’s ability to smile, bite, chew, or speak. The quality of dental care, however, and the payment method for dental services varies between nations.

Dentistry throughout the World

Developed countries have more dentists per capita than do developing nations, according to the World Health Organization. There is one dentist for every 150,000 people in Africa, for example, as compared to about one dentist for every 2,000 citizens of an industrialized nation. The lack of dentists in developing nations means that dental care is restricted to pain management and emergency care.

Dentistry often reflects the cultural views of a nation. Some cultures acknowledge only the functional aspect of teeth, so dentists focus on preventing tooth decay, gum disease, and tooth loss. Other cultures emphasize aesthetic appearances, so dentists there provide cosmetic procedures in addition to essential oral care.

Each nation imposes its own education and licensure requirements for dentists but most require some college before four years of dental school. The graduate must then pass local or national exams to practice in that region. European schools and standards are similar to the United States.

From the business perspective, dentistry varies between nations. In the United States, a dentist presents to the patient one bill that includes all of the treatment costs, such as the dentist, his assistant, tools, and labs. This allows the dentist to charge a single, easy-to-pay fee for individual procedures, and gives him an opportunity to mark up items and make a profit.

Across much of Europe, a dentist presents two bills to her patient – one for the dentist and another for the lab. This approach may stem from a cultural belief that profiting from healthcare is unethical and that healthcare should be available to consumers at actual cost; public dental clinics and subsidies ensures all citizens have access to dental care, regardless of ability to pay. In most cases, the government is both overseer and provider of dental care.

While the role of the dentist is nearly the same in every country – to ensure the oral health of the citizens – dental care is different in each nation. Regardless, you can rest assured that the care you receive at our Creve Coeur or St. Charles office is held to the highest standard.

The Good News

Carbohydrates are one of the body’s essential macronutrients (along with protein and fat). We use carbs to convert the food we eat into energy. How does this work? It’s a sophisticated process:

• Carbs break down into sugars as we digest them
• Sugars are absorbed into our bloodstream
• The pancreas releases insulin when blood sugar levels rise
• Insulin enables sugars to move from our blood to our cells
• Cells throughout the body use this sugar for energy.

Without the necessary amount of carbohydrates, our bodies lose a vital source of energy. So, why are carbs a dental concern?

The Bad News

Some foods immediately begin breaking down into sugars in the mouth. Sugars are a favorite food source for the oral bacteria that form plaque. They use this sugar to produce the acids that weaken our enamel and lead to cavities. And the more often we eat these foods, and the longer they remain in the mouth, the more damage our enamel suffers.

But there’s a silver lining! We can be healthier physically and get a jump on preventing damage from sugary treats by becoming more discriminating in our choice of carbs and timing our indulgences wisely.

Good Carb/Bad Carb

Unprocessed, complex carbohydrates are found in foods like whole-grain breads and cereals, legumes, and vegetables. They contain the vitamins, minerals, and fibers which are lost when foods are refined. They are composed of larger, more complex molecules, and so they break down gradually for sustained energy.

Some simple carbohydrates break down into sugars more quickly, but also offer important vitamins, minerals, and fiber. Fruits and dairy products, for example, are an important part of a balanced diet.

But some carbs are not pulling their nutritional weight. Refined sugars (think candies, desserts, and sodas) and refined starches (white bread and rice, potato chips, pastries) break down quickly into sugar in the mouth. Worse, many of these foods tend to stick around. Sticky sugars and sticky starches cling to our enamel and hide between the teeth and in the crevices of our molars. Not only do these treats provide a sugary feast for acid-producing bacteria, they take their time doing it!

So, What to Do?

If you have a diet filled with healthy carbs (whole grains, fruit and vegetables, legumes, dairy products), you’re already on the right track. Kudos! But does this mean no desserts? Ever?

No! We all need a cookie sometimes. But you can decrease the chance of enamel damage by interrupting the carbs to cavities cycle.

First, if you are indulging in a rich dessert or some salty chips, better to do it as part of a meal. When you eat a full meal, your body produces more saliva. Saliva not only helps wash away food particles, it also helps neutralize the acids that damage enamel.

Secondly, if you eat simple carbs and sugars all day, your mouth and teeth are being treated to acids all day. If you are going for a snack, there are many great options that don’t use refined sugars and starches. Think fruit smoothies (with a big dollop of vegetables) or whole-grain crackers with hard cheese instead of a can of soda and a bag of pretzels.

Carbs aren’t really bad, they’re just misunderstood. Talk to Dr. Varble, Dr. Dill, and Dr. Wong at your next checkup at our Creve Coeur or St. Charles office for ideas for the best carbohydrate choices for healthy metabolisms and healthy smiles!

Biofilm, the protective housing for bacteria, is a hot topic in the medical and dental fields. Routinely taking an antibiotic for a bacterial infection has become more complicated because of biofilm. Bacterial infections may become resistant to antibiotics in part because the biofilm allows for communication among the bacteria, allowing the infection to be sustained.

You’re probably wondering, Dr. Varble, Dr. Dill, and Dr. Wong , what does this have to do with teeth? Since we’re dental professionals, we can tell you why it’s important and what you should know! There is biofilm in your mouth; healthy biofilm and diseased biofilm. Both are made of the same general compounds, but when combined with certain amino acids and cellular chemicals, the diseased biofilm conquers and destroys.

Periodontal disease, otherwise known as gum disease or pyorrhea, is a biofilm disease. If you are undergoing treatment for gum disease and you do not continue with the treatment plan the disease will progress and/or spread due to the biofilm.

There are several ways to treat diseased biofilm. But remember, antibiotics cannot touch the bacterial infection if the biofilm is established.

When your exam is complete, the Ultrasonic or Piezo Scaler should be used. This method of spraying water disturbs the biofilm and provides an opportunity to treat the infection causing bacteria.

Remember, we all need healthy biofilm. Just as your skin protects your body, biofilm housing good bacteria protects your body. The bacteria in the biofilm replicate every twenty minutes. If your body has healthy bacteria, low levels of hydrogen peroxide are produced by the biofilm, preventing harmful bacteria from residing. Harmful bacteria do not like oxygen.

At your exam, we will take measurements around your teeth checking for “pockets”. The higher the number, the deeper the pocket giving more room for harmful bacteria where there is no oxygen. Ask what your numbers are and be involved in restoring your healthy biofilm.

If your teeth don't line up like they used to any more, you may be suffering from temporomandibular joint disorder, often called TMD. This is a term that can actually be applied to any condition that occurs because the temporomandibular joint (TMJ) is inflamed.

The temporomandibular joint is essentially the hinge that holds your lower jaw to your skull, and when it is inflamed or damaged in any way, it can be extremely painful. You have two temporomandibular joint, one on each side of your jaw, and it is typical to experience TMD in both sides at the same time.

Shifting of the Teeth

The reason that your teeth may not line up as they once did is that the ball and socket joints are often out of alignment and, as mentioned above, often very inflamed as a result. In order to correct the problem, Dr. Varble, Dr. Dill, and Dr. Wong may prescribe dental orthotics such as a lower jaw splint.

Sometimes, the wisdom teeth can play a role in the shifting of the teeth as well. If shifting wisdom teeth is combined with TMD, it may be necessary to have your wisdom teeth removed. Dental splints may follow if your teeth don't shift back to their proper positions on their own.

TMD is certainly a difficult thing to deal with, so if you experience your teeth shifting, scheduling an appointment at our Creve Coeur or St. Charles office is the smartest course. We want to help you get your smile back, so give us a call anytime.