Dr. Jennifer Rankin

It is important for you to go to your dentist. Typically we will assess the status of the tooth now and monitor it over time. Additionally, it may be indicated to stabilize the tooth to prevent too much movement.

I would recommend whitening first to see what shade you are able to get the adjacent teeth lightened to and then do a crown. Crowns and fillings do not whiten.
Hope this helps.

Dr. Rankin

There may be several reasons for the "crash" you are experiencing, but the main thing to remember is that the mouth and body are connected. Generally people do not realize the oral-systemic connection, but it is real. Depending upon how long you had the infection, yes, your body may still be trying to recover. Were you on antibiotics and if so for how long? This may have disrupted your gut bacteria which is a primary player in the immune system. It is important to get not only that gut bacteria back into balance but also your immune system. This can be done through proper nutrition and possibly the addition of a probiotic. If you are still feeling down after 3 weeks total, I would consult with your MD to be sure there is not an underlying medical issue. If nothing is found to be medically wrong, I would seek out a professional nutrition experience (this could be a dentist, functional medicine doctor, naturopath and the list goes on). I hope this helps.

Electric toothbrushes, when used properly, definitely do a better job in cleaning teeth compared to a manual brush.
Hope this helps!

Dr. Rankin

It depends on if the stains are superficial or related to development of the teeth. Cleanings will remove superficial staining as will whitening products. You may also want to consider an electric toothbrush if you are not already doing so.

Hope this helps.

There are several reasons for dry mouth. The most common is due to medications. Be sure to read the labels on any medications you might be taking to see if dry mouth is a side effect. Other causes are alcohol containing mouth rinses, diabetes or pre-diabetes, certain autoimmune diseases, and high salt intake. It may be worth a visit to your physician to rule out any systemic causes.
In health,
Dr. Rankin

That really is a loaded question as there are a number of variables that determine the longevity of a filling. One is the placement of the restoration by the dentist. If there was a gap in the restoration where the tooth and the restoration meet or if there was any type of contamination during placement, then there is greater chance for decay to develop. The patient's home care, including frequency of brushing and consistency of flossing, play a roll as well as the concentration of caries producing bacteria in a patient's mouth and the amount, consistency and components of saliva.

With all that being said, it is very difficult to be able to provide a specific answer to your question. I hope, however, that understanding all the factors involved helps create a better understanding.

Sincerely,
Dr. Rankin

Over time, the staining becomes more difficult to remove. There is some permeability with the enamel so the smoke can stain permanently over time. There are some great whitening options that your dentist can provide, but the smoking will require more frequency in using the whitening products. Your best best, not only for your teeth, but your overall health, is to stop the smoking. There are several smoking cessation options available.

Sincerely,
Dr. Rankin

Bone loss is typically the result of pathogenic bacteria that have invaded the bone. As a diabetic, your body is at higher risk for periodontal disease because your immune system is compromised. In order to reduce the bacterial invasion and further bone loss, it is important to see your dentist more frequently, usually 3-4 times per year as opposed to twice. This allows us to continually disrupt the bacteria and minimize the negative effects. You may want to ask your dentist if he/she does any oral DNA testing as this gives specific information on the bacteria that are at high levels so that treatment can be targeted. Your nutrition is also critical. Keeping systemic inflammation down aids in better oral health.

I hope this helps. If you have further questions, I am happy to respond.

In health,
Dr. Jennifer Rankin

Yes, there is the potential to cause damage with too much pressure. The same holds true for too much pressure with floss and use of the tooth brush. I would leave the pressure at half way. Your hygienist would notice if there is damage being done.

Sincerely,
Dr. Rankin

Lack of calcium absolutely impacts teeth and tooth development. However, there are many other sources of calcium than dairy, and many of these are better options anyway.

For example: Dietary Sources
The richest food sources of calcium include:
- Cheeses, such as Parmesan, Romano, gruyere, cheddar, American, mozzarella, and feta
- Low-fat dairy products, such as milk and yogurt
- Tofu
- Blackstrap molasses
Other good sources of calcium include:
- Almonds
- Brewer's yeast
- Bok choy
- Brazil nuts
- Broccoli
- Cabbage
- Dried figs
- Kelp
- Dark leafy greens (such as dandelion, turnip, collard, mustard, kale, and Swiss chard)
- Hazelnuts
- Oysters
- Sardines
- Canned salmon

Foods that are fortified with calcium -- such as juices, soy milk, rice milk, tofu and cereals -- are also good sources of this mineral.

This is the source that I took this from, if you wish to read the entire article: http://www.lifescript.com/health/a-z/adam/alternative_medicine/supplement/c/calcium.aspx <http://www.lifescript.com/health/a-z/adam/alternative_medicine/supplement/c/calcium.aspx>

I hope this helps.

In Health,
Dr. Jennifer Rankin

This is really a question for your orthodontist or whomever is doing your orthodontic treatment. Typically the braces stay on until the end of treatment and you will go in every 4-6 weeks for wires to be changed. Once your orthodontic treatment is complete, it is imperative that you wear your retainer FOR THE REMAINDER OF YOUR LIFE to prevent any relapse.

Hope this helps,
Dr. Rankin

The shape of our teeth is genetic and we all start with somewhat pointed canines. People who have parafunctional habits like grinding, nail biting, or using their canines to "cut" things have a tendency to wear down the canine teeth so that they are flat or more flattened.
In Health,
Dr. Rankin

Gingivitis is inflammation of the gum tissues that surround the teeth. Gingivitis can range from slight to severe. In more severe cases, the gingival (gum) tissues look very red and puffy. Any bleeding of the gingival tissues indicate gingivitis and can be generalized throughout the mouth or localized in specific areas. Any time there is bleeding when you brush or floss, this is a sign of gingivitis. Generally it is not painful. If left untreated, gingivitis can lead to periodontal disease, characterized by bone loss and gingival inflammation. Your personal home care and regular appointments with your dental hygienist are the best way to minimize the risk. Home care includes brushing at least 2 times per day and flossing daily (proper technique here is critical). I like the addition of an electric toothbrush. =20

Certain medications and hormonal changes can also impact the gingival tissues, so be sure to always share your medical history with your dentist and dental hygienist. =20

In Health,
Dr. Rankin

There are 2 different tooth abscesses. One is a periodontal abscess. In this case, it tends to infection related to the gum tissues and the nerve of the tooth is still healthy. This can often be treated with by thoroughly cleaning out the area, which will require anesthetic. Sometimes an antibiotic is warranted. If there is periodontal pocketing that is deep (beyond 4-5mm), and the patient is not diligent about regular dental cleanings, the abscess can re-occur when the bacteria builds up within the periodontal pocket. =20
The second abscess relates to the vitality of the tooth. If the nerve dies an abscess will result if the tooth is not treated. When the nerve dies there are 2 options: tooth removal or root canal therapy (with a subsequent crown to prevent the tooth from fracturing). Left untreated the infection can spread into deeper tissues and even into the brain tissues. =20

There is typically pain associated with an abscess, though this is not always the case. Usually, there is biting pressure with an abscess. Hot and cold sensitivity generally occur prior to an abscess occurring. =20

It is true that secondary infections can occur with a tooth abscess. The mouth and the body are connected and each one affects the other. =20
Hope this helps!
Jennifer Rankin, DDS

If you are not using an electric toothbrush, that is the first thing I would recommend. There are several on the market, my favorite is Sonicare. Your manual toothbrush head should be changed every 3 months or when you notice that the bristles are beginning to splay.

In terms of diet, sugars, of course, will contribute to some additional build up, but other foods that can contribute to the plaque are simple carbs =E2=80=94 crackers, highly processed breads and pastas, cookies, granola bars. These break down to sugars quickly. Get more produce in the diet and if you are going to eat these simple carbs, eat along with fruits and veggies as this will help to cleanse those foods and keep them from sticking.
I hope this helps!

In Health,
Dr. Rankin

There are several factors that determine whether wisdom teeth are removed by a general dentist or an oral surgeon.
1. The amount of experience the general dentist has with wisdom tooth removal
2. The position of the wisdom teeth
3. If the patient wants to be sedated, then usually, the oral surgeon will be recommended as most general dentists are not licensed for general sedation
4. Difficulty of the procedure
5. Patient medical history - the more complicated, the more likely to refer to the surgeon

Keep in mind, the oral surgeon is considered the expert in this procedure and any general dentist is held to those same standards should he/she choose to perform the procedure.


I hope this helps.

Dr. Jennifer Rankin

It is possible that your toothpaste may be the cause. Have you recently changed the type of toothpaste you are using? I had a similar reaction using Crest Pro Health Toothpaste. It could also be a sensitivity to SLS (sodium laurel sulfate). Many toothpastes contain this ingredient as it makes the toothpaste foam more. SLS is also found in products like shampoo. I would try changing to a new toothpaste and see if the issue resolves. Then you will know for sure.

I hope this helps!

Dr. Rankin

Hello. When was your last visit to the dentist? When the gums are bleeding, this is a sign of infection. Unless the bacteria, plaque and calculus are removed, the tissues will remain sore. Flossing will help and it is very normal for them to bleed right now when you are flossing, because of the infection. Warm salt water rinses may help for the short term, but I would urge you to go to the dentist for a comprehensive assessment. I hope this helps.