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We are family   (I’ve got all my sisters with me?  Come on… you know you heard it in your head too)

A family dental practice is just what it sounds like – a practice that will treat your whole family.  Whether that includes a toddling two year old, a tenacious twenty-something, or toothless Ted, your husband’s eighty-eight year old father.  But to us, being a family practice means more.

For us, being a family practice means we’re run by a family.  Drs. Dana and Vicki, a husband and wife, and me, their daughter.  Our IT guy is my brother/one of Dr. Dana and Vicki’s sons.  And their other son, well, he’s not involved in running the office, but he still gets a piece of the family practice pie for putting up with endless hours of tooth talk during family get-togethers.

Beyond being a fun fact about our office, our providers being family has many benefits for our patients. For example, our doctors are always in communication with each other both in and away from the office. That means if you see me for a toothache but are a regular patient of either Dana or Vicki, they’ll flag me down ahead of time and let me know if they have any concerns regarding your dental health.  And after the visit, they get a thorough run-down from me.  We’ll discuss what I found and recommended so when you return to their care your treatment can proceed seamlessly.  Furthermore, being raised by my parents, they passed on their values of attention to detail, never thinking that OK is ‘good enough’, and preferring conservative, non-aggressive treatment planning.  So if you’re one of the many loyal patients my parents care for, you can feel safe seeing me when they’re gone because they taught me to treat as they treat.

 For us, being a family practice means our staff is like family.  As many of our patients know, Dr. Dana had one assistant for 32 ½ years – Betty. When Betty began working at the office Dr. Dana and Dr. Vicki were still starting out.  They each worked half a day (one worked the morning and one the afternoon) and they both worked with Betty.  When Dana and Vicki welcomed their third child – that’d be me, Kjersten – Dr. Dana announced he was going to start working full time with Betty, as he refused stay home with 3 kids. (thanks Dad). Betty then saw the whole Otterholt family grow up.  When I became interested in dentistry Betty showed me the ropes during a summer I spent interning at the office cleaning rooms and instruments.  And Betty was there when I joined the practice as a dentist this past fall.  After 32 ½ years, Betty retired earlier this year.  We were lucky to find an awesome assistant to step in to her shoes – Sandra – but of course, we continue to think of her often. 

 Though not as long as Betty, all our staff has all been with us for many years.  Cheryl, one of our wonderful receptionists, has been with us for 15 years. Marilee, Dr. Vicki’s assistant, joined our practice 10 years ago.  We are so grateful to have a family of long-term employees, who jive well with each other and work together as wonderfully as they do.  Staff turnover can be jarring for a patient – if the people you’ve become used to seeing during your routine visits and exams are no longer present, or furthermore, if your visits have never been greeted by a consistent staff. 

 And yes, for us, being a family practice means we happily treat whole families.  Dr. Dana and Dr. Vicki are coming up on their 40th Anniversary of opening Division Street Dental.  When I joined the practice this past fall, I asked my folks why they aren’t ready to retire yet.  They both replied, “I still love it [dentistry] too much.”  Specifically, they said it’s the patients they’re not ready to let go of. Both my Mom and Dad have told me stories of families they began treating when they first opened the practice, which they’re now seeing the 4th or 5th generations of. They’ve treated Mom, Dad, Grandpa, and the kids who were in early elementary school when they met. Now those kids are in their 30’s and have kids of their own.  Yes, we are family that loves teeth and loves dentistry.  But really, so much of what we love is forming relationships with our patients. 

So anyway.  No earth-shattering tooth talk for you to read today. Just some reflective thoughts etched out while I sip my morning coffee at my parent’s kitchen table… our practice is a family practice in every sense of the phrase – and that makes me happy.

– Dr. Kjersten Heron 
 posted – 6/14/16

EEK! My teeth are yellow!

Why are my teeth yellow? Why are my teeth brown? Why are my teeth extra white in these spots?  Questions about tooth color are some of the most common questions I’m asked as a dentist. Whether you’re trying to find the secret to a Hollywood white smile or simply have a yearning to learn about tooth shades, read on!

Diet

Diet is the most common factor people think of when it comes to the color of their teeth. Teas, coffee, colas, and wine all contribute to the external stain that can accumulate on the outside of your teeth. Have a coffee habit that’s impossible to kick? Don’t worry! The stain that accumulates on the outside of your teeth from diet can be polished away by your dentist or hygienist at your routine dental cleaning.

 

Age

As we age our teeth naturally become more yellow due to the wearing down and thinning of the outer enamel layer of teeth. When the enamel is thinner more of the underlying dentin’s yellow color shines through.

Smoking

And the reasons to put down that cigarette just keep on coming!  Beyond harming nearly every organ in the body and causing many diseases, smoking also stains your teeth.  If you’ve considered quitting smoking in the past but don’t know where to start, try calling 1-800-QUITNOW.  The number is easy to remember, it’s free, and they’ll help you put together a personalized quit plan.

Trauma

Maybe you had an unfortunate accident involving your face meeting your bicycle’s handlebars as an adolescent. Maybe you had an unfortunate accident of your face meeting Big-John’s fist at the local bar. (Remember, I’m not here to judge people.) Regardless, trauma featuring blunt force to teeth can absolutely result in teeth discoloring over time. Often following trauma to a tooth, the nerve running along the length of the tooth’s core will die. Over time the dead nerve will atrophy, or breakdown, and leak red blood cells. It’s the color from these leaked blood cells which causes a ‘dead tooth’ to darken over time. When the dead nerve is removed from a tooth through a root canal, the tooth can also be internally whitened, or bleached, reversing some of this darkening.

 

Discoloring from amalgam, aka ‘silver’ fillings

Amalgam fillings, commonly referred to as ‘silver’ fillings, can also stain a tooth over time.  It’s because of this staining and general show through that amalgam fillings are rarely used on front teeth – even on the tongue-side. Given this discoloration that can result from amalgam fillings, you may wonder why they would be placed at all instead of a white tooth colored filling, called a composite. In some areas of the mouth and in some circumstances (for example on a back tooth with a very large cavity in which the filling material will now make up a large part of the tooth) an amalgam filling will hold up and last longer than a composite filling will. Similarly, an amalgam filling can be more forgiving if you have less than ideal oral hygiene habits. This is a very minimal explanation of just a few reasons why our practice still encourages the use of amalgam restorations in situations when they make the most sense for our patient. I could probably write a whole blog on this topic alone!

Excessive Fluoride

When forming teeth are exposed to excessively high levels of fluoride they can develop white spots known as fluorosis. These areas of the teeth aren’t as strong as the surrounding normal enamel, and area at a higher risk of developing a cavity. Fluoride added to city water is carefully regulated so the ideal amount to prevent cavities is present and will not cause fluorosis. Fluorosis can result from living off well water, which can naturally contain high levels of fluoride in some areas of the country.

 

Tetracycline

Taking tetracycline while your teeth are developing is another way teeth can be formed discolored. Tetracycline stain results in darker, brown/grayish colored teeth. Interestingly, tetracycline stain will result in discoloration in a band or strip across teeth that correlates to what part of each tooth was developing while the tetracycline was taken. It reminds me of how the wood in the growth layers or age rings of a tree will record evidence of floods, droughts, and other environmental occurrences that occur during its lifetime. Tetracycline stain can be somewhat reversed by bleaching, however not very well. Completely treating the esthetic concerns of tetracycline stain generally means masking the stain in some form. Therefore, depending on the severity of the stain and other dental factors, treatment can range from overlaying composite veneers on the affected teeth, to lab fabricated porcelain veneers, to full coverage crowns.

 

In conclusion

There are many reasons for variation in tooth color.  Some of these are beyond our control while others are factors we can address if we so choose.  Thanks for reading this most recent entry in our exciting dental blog. I hope you learned something new!!

– Dr. Kjersten Heron 
posted 5/4/16 

What do you and Walter White have in common?

Remember in season one of Breaking Bad when Walter White uses acid to dispose of an inconveniently deceased character who no one remembers?  Don’t be like Mr. White.  Keep acid out of your mouth!

Many people have seen you tube videos of Coca-Cola being used to clean a toilet or remove rust from a car’s bumper, and know Coca-cola is bad for your teeth.  But did you know there are lots of other drinks that are also extremely erosive for teeth? What about Vitamin water? It’s just water right? Wrong!  Vitamin water has citric acid in it – one of the two ingredients in beverages that primarily causes dental erosion.  

While Coca-Cola Zero has a pH of 2.96, Dragonfruit Vitamin Water has a pH of 2.82! Remember, the lower a pH value is, the more acidic it is! And the more acidic a drink is, the worse it is for your teeth. Check out the table below from this month’s Journal of the American Dental Association entitled “The pH of beverages in the United States” to see pH values of 379 common US beverages.

We all know sugar is bad for our teeth. Sugar feeds the cavity causing bacteria that live in your mouth like Streptococcus mutans, allowing them to grow and thrive! Those bacteria then excrete waste that is acidic and eats away at your teeth forming a cavity. So what about diet beverages? Are they safe for teeth because they’re sugar free? Not necessarily! Even though they don’t contain sugar, most diet beverages still have either citric acid or phosphoric acid in them. These two ingredients are the primary cause for drinks having a low, acidic pH. Drinking something acidic is bad for teeth regardless of whether or not they contain sugar, because you bypass the acid producing bacteria and go straight for coating your teeth in acid! Low pH drinks cut out the middle man and are extremely efficient in causing tooth decay.

So every time you take a sip of your favorite Arizona Iced Tea (pH 2.89) – or other acidic beverage – you’re bathing your teeth in acid. It takes about 20 minutes after you stop drinking for your saliva to neutralize the acid in your mouth and get things back to a healthy neutral pH. That means if you’re continually sipping on something other than plain water, your saliva won’t ever have the time it needs to neutralize your oral environment. You’ll be launching a continuous assault of acid against your teeth!

So check out the tables below. See if your drink of choice is considered erosive. The tables categorize drinks by type – fruit juice, soda, energy drink, etc. – and then further subcategorize them as either extremely erosive (pH less than 3.0), erosive (pH3.0-3.99), or minimally erosive (pH greater than 4.0).

If your favorite thirst quencher is acidic, pay attention to how you drink it! Avoid sipping it over time. Instead, enjoy it in one straight go, or pair it with a meal. Drink it with a straw. Swish your mouth with water after you’ve finished to help speed your mouth’s transition back to neutral.

In short, leave the use of acid for breakdown of human tissues to the Walter Whites.

The below tables were taken from:

Reddy, Avanija, Don F. Norris, Stephanie S. Momeni, Belinda Waldo, and John D. Ruby. “The PH of Beverages in the United States.” The Journal of the American Dental Association 147.4 (2016): 255-63. Web.

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 – Dr. Kjersten Heron 
 posted 4/18/16

Help! My child’s front tooth was knocked out! 

It’s a beautiful spring day out. The sun is shining, and there’s a brisk breeze carrying the smell of freshly cut grass across the Bakerview playfields.  You’re beaming with pride as your Johnny steps up to the plate hungry for a home run. Next thing you know an errant pitch has left Johnny holding his mouth crying, while your stomach leaps into your throat.  Holding his displaced front tooth in his hand, you panic thinking your sweet boy will forever look like Halloween Jack-O-Lantern.  

But not to worry!  You’ve read our blog post on what to do following a dental trauma and know exactly what to do!

 

  1. When handling the knocked out tooth, always hold it by the crown, not the root! 
  • The root surface has vital cells on it that will play an important role in the recovery of the tooth.

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  1. If the tooth is dirty, gently rinse it with water.
  • Do not use chemicals or scrub the tooth – again, you want those tissues on the root surface left in place!
  • Do not dry the tooth
  1. Reposition the tooth in the socket as immediately as possible!
  • Studies have shown that teeth can be replanted with good prognosis if done quickly after their displacement.
  1. Bite down on a handkerchief or bandage to hold the tooth in place, and call your dentist.

If for some reason you can’t replant the tooth on your own, it still may be able to repositioned by your dentist! To give the tooth its best chance possible:

  1. Keep the tooth moist
  • Store it in a cup of milk or in your mouth next to your cheek.
  • Of course use common sense when having your child hold their knocked out tooth by their cheek – you don’t want to risk their swallowing or choking on it.
  1. See your dentist within 30 minutes
  • However if you can’t reach a dentist within 30 minutes, remember it’s still possible to save teeth that have been out of the mouth for an hour or more.

It can be very upsetting both for the child and parent when a tooth is displaced.  Remember our office is here for you and will do everything we can to help!  As a final note, remember this blog deals with knocked out permanent teeth only. You never want to replant a knocked out baby tooth – doing so may damage the underlying developing adult tooth. Have a happy Monday everybody!!

 – Dr. Kjersten Heron
posted 3/28/16

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