What Are Tooth Notches?

 Have you ever run your tongue along the base of your teeth and felt a small, wedge-shaped groove right at the gum line? These indentations are commonly known as tooth notches. While they might look like a small chip or even a cavity, they are often a different kind of dental issue altogether.

What Exactly Are They?

In the dental world, these notches are often called abfractions. They typically appear as V-shaped or wedge-shaped "divots" where your tooth meets your gums. Unlike cavities, which are caused by bacteria and decay, these notches are usually the result of physical stress or mechanical wear.

Common Causes

There isn't just one reason these grooves form, but the most frequent culprits include:

• Aggressive Brushing: Using a hard-bristled toothbrush or applying too much pressure can wear down the enamel at its thinnest point—the neck of the tooth.
• Teeth Grinding (Bruxism): Constant clenching or grinding puts immense pressure on your teeth, causing them to flex slightly. This "flexing" can cause tiny pieces of enamel to pop off near the gums.
• Misaligned Bite: If your teeth don't meet correctly, certain teeth may take on more force than others, leading to localized wear.
• Acidic Diet: Frequent exposure to acidic foods and drinks can soften your enamel, making it easier for physical forces to create a notch.

Should You Be Worried?

Most tooth notches are painless initially, but as they get deeper, they can lead to:

• Extreme Sensitivity: Since the protective enamel is missing, the sensitive inner layer (dentin) is exposed to hot and cold.
• Weakened Structure: Deep notches can make a tooth more prone to fracturing or breaking.
• Plaque Traps: These grooves can easily collect food and plaque, increasing your risk for actual cavities in that area.

How to Fix Them

If you notice a notch, your dentist might recommend:

1. Bonding: Using a tooth-colored resin to fill in the gap, protecting the tooth and restoring its look.
2. Night Guards: If grinding is the cause, a custom guard can prevent further damage.
3. Soft Brushes: Simply switching to a soft-bristled brush and a gentler technique can stop the notch from growing.

If you’ve spotted a notch in your smile, it’s a good idea to mention it at your next check-up!

Keep Smiling!

The Controversy Over Mercury (Amalgam) Fillings

Mercury "silver" fillings—also known as dental amalgams—are about 50% elemental mercury. While they’ve been used for over a century, they are increasingly controversial due to mercury vapor release.

Why the Concern?

Every time you chew, brush, or drink hot liquids, your fillings release tiny amounts of mercury vapor. This vapor is inhaled and absorbed into the bloodstream, where it can accumulate in the brain, kidneys, and liver over time.

Potential Risks

• Neurotoxicity: High levels of mercury are linked to tremors, memory loss, and cognitive decline.
• Autoimmune Issues: Some studies suggest a link between heavy metals and chronic inflammation.
• Environmental Impact: When removed improperly, dental mercury pollutes water systems.

What Should You Do?

Most health organizations don't recommend rushing to replace them unless they are cracked or leaking. However, if you choose to remove them, ensure your dentist uses the SMART protocol (Safe Mercury Amalgam Removal Technique) to prevent you from inhaling a massive dose of vapor during the process.

Keep Smiling!

The Sting of the Drill vs. The Sting of Rudeness

When we head to the dentist, most of us are already on edge. Whether it’s the sound of the drill or the fear of a needle, anxiety is a common guest in the waiting room. But often, the most painful part of a visit isn't the procedure—it’s rudeness.

A sharp word from the front desk or a dismissive attitude from a clinician does more than just ruin your mood; it erodes trust. When a patient feels disrespected, they are less likely to:

• Share their true concerns or pain levels.
• Return for essential follow-up care.
• Recommend the practice to others.

In a dental office, empathy is just as important as technical skill. A little kindness can turn a stressful appointment into a positive experience, while a lack of it can drive patients away for good. After all, a healthy smile starts with how a patient is treated the moment they walk through the door. 

Keep Smiling!

Botox And Dental?

What are your thoughts on Botox? Would you get Botox treatment if it meant it could help with specific dental problems?

Check out this article by Perfect Teeth:

"When you think about Botox chances are good you think about a Gen-Xer having it done to maintain their youthful appearance. You wouldn’t be wrong – Botox is by far the most popular cosmetic procedure out there with the American Society of Plastic Surgeons reporting over 7.4 million injections given in 2018.

And now dentists are getting in on the action. Have you heard about this trend of Botox in dentistry? It just might be the next big thing!

What is Botox?

According to the U.S. National Library of Medicine, Botox is a drug made from a toxin produced by the bacterium Clostridium botulinum. While it’s the same toxin that causes a life-threatening type of food poisoning called botulism, its use as an injectable paralytic has been FDA approved for cosmetic procedures and more. In fact, it’s now commonly used in small doses to treat a variety of health problems including excessive sweating, excessive blinking, overactive bladder and even migraines.

Botox works by blocking nerve signals that control muscle movement, which makes them unable to contract, temporarily softening the skin around the area that was injected. It typically takes a few hours for results to be seen and they usually last about three months.

Botox in Dentistry

For most people who hear the word “Botox”, they think of wrinkle reducing injections used in cosmetic procedures. While it is true Botox was approved by the FDA for such, it is now expanding in its application due to the nerve blocking benefits it offers. In fact, a trip to your dental office could include your dentist offering Botox.

While some dentists do use Botox for cosmetic procedures, there are many other uses for Botox in dentistry.

• Treatment of Temporal Mandibular Joint Disorder (TMJ)  
• Treatment of bruxism (teeth grinding)
• Reducing a “gummy smile” without surgical intervention
• Adjustment of lips before or after denture placement or oral surgeries.

Should a Dentist Do Botox?

Botox as a purely cosmetic procedure will likely never be part of a dentist’s repertoire – as their first and primary goal is oral health care. But, because dentists have extensive training on oral and facial anatomy, health and function, some say there is no one better qualified to administer Botox than a dentist.

In fact, some proponents of the use of Botox in dentistry claim dentists are the most qualified, and offer a better experience because they administer oral and facial injections on a regular basis. This makes the injections quick and less painful, because they are done with a skilled hand.

While the use of Botox in dentistry is controversial to some, it seems there may be a place for Botox in dentistry, to help both medically and cosmetically. According to the American Academy of Facial Aesthetics about 10% of dentists are currently trained to administer Botox with more seeking training every day. The American Dental Association even offers Botox training for its members!

Is Botox in dentistry the next big thing? We don’t have a crystal ball, but it’s a trend we envision increasing especially as demand grows and more and more state dental boards support the practice."

Why Implants Sometimes Fail

 While dental implants have an impressive success rate of over 95%, they are not invincible. 

Implant failure is generally categorized by two factors when it occurs:

Early Failure: Happens within the first 3–6 months. This is usually due to the implant failing to fuse with the jawbone, a process called osseointegration.

Late Failure: Occurs years later, often after the implant has been functioning normally. This is typically caused by infection or mechanical stress.

Top Reasons Why Implants Fail

Peri-implantitis (Infection): This is the most common cause of late failure. It is a form of gum disease where bacteria build up around the implant, causing inflammation and bone loss. Poor oral hygiene is the primary culprit.

Insufficient Bone Support: For an implant to be stable, it needs enough healthy jawbone to anchor into. If the bone is too thin or soft, the implant may loosen.

Smoking and Lifestyle: Smoking is a major risk factor because it restricts blood flow to the gums, significantly slowing the healing process and increasing infection risk.

Medical Conditions: Uncontrolled diabetes, autoimmune diseases, and certain medications (like those for osteoporosis) can interfere with the body's ability to heal and integrate the implant.

Bite Stress (Overloading): Putting too much pressure on a new implant—such as chewing hard foods too soon or chronic teeth grinding (bruxism)—can cause the implant to shift or break.

Surgical Error: Improper placement, using low-quality materials, or overheating the bone during surgery can prevent the implant from ever bonding correctly.

How to Prevent Failure

Maintain Gold-Standard Hygiene: Brush and floss your implants just like natural teeth.

Regular Check-ups: Your dentist can spot early signs of bone loss or infection before they become permanent problems.

se an Experienced Surgeon: Precision in placement and thorough pre-surgical planning (like 3D scans) are critical for long-term success.

If you notice persistent pain, swelling, or any movement in your implant, contact your dentist immediately, as many "failing" implants can still be saved if caught early.

Bad Business Reviews, Formal Complaints and Social Media

 In this age of social media, bad news travels fast.  Faster than the speed of light, it seems.  One careless complaint can ruin a reputation, a practice or even a person.  Always try to keep that in mind when a problem arises and opt for civil communication, instead.  

There are many ways to resolve issues with your dentist, whether they are staff related, price discrepancies or quality of care issues. The key is communication. I certainly would not advise anyone to file a complaint with the board because a receptionist was rude, or post it on any review forum, ever! Only as a last resort would I suggest filing a board complaint for anything less than malpractice. 

This would be my suggestion instead: Consider a well written letter; certified, registered mail. Clearly state the problem (keeping opinions out), and state what you would consider to be a fair resolution. Send it directly to the dentist, return receipt. Allow him a reasonable amount of time to respond...10 days or so. Believe me, he will be much more receptive to a resolution than his receptionist or office manager because it is his license that is on the line!  Nine times out of ten the complaint will be resolved when it is approached this way. This method works! 

Keep Smiling! 

Can Oral Disease Affect Athletic Performance?

 According to University College London's Eastman Dental Institute, high levels of oral disease are found among Great Britain's (GB) elite athletes and are the leading cause of poor on-field performances.

This is the largest study of its kind, more than 350 athletes from nine different GB sports teams participated in this study which included an oral health assessment checking for tooth decay, tooth erosion, and gum disease. The athletes also had to fill out a questionnaire focusing on sleeping, eating, and self-confidence.

Results of the oral assessment: 49.1% of the athletes had untreated tooth decay, 77% had gingivitis, 30% reported having bleeding gums and only 1.1% had excellent oral health.

Results of the questionnaire: 32% of the athletes reported that these poor oral conditions negatively impact their sporting performance. 34.6%  inability to eat. 15.1%  relax and sleep 17.2%  smiling and self-confident.

After the study, Professor Ian Needleman made a few comments:

• "Nutrition in sports is heavily reliant on frequent carbohydrate intake, which is known to increase inflammation in the body and gum tissues.
•  "In sports where there is a lot of airflow, such as cycling and running, breathing hard can make the mouth dry so teeth lose the protective benefits of saliva and there is existing evidence of lower quality of saliva with intensive training. 
• "Stress is also clearly a risk factor, with some athletes reporting vomiting before every race, as a result of ore-competition anxiety." 
  
  
  
   *Whether you are an athlete or not, it's important to maintain good oral health by brushing and flossing regularly, eating a balanced diet, and visiting the dentist every 6 months for a routine check-up*