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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 Los Gatos, CA 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. Werner 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!

Remember all the things your parents would tell you when you were growing up to scare you away from doing something? Like how lying might make your nose grow, misbehaving meant you wouldn’t get money from the tooth fairy, and swallowed chewing gum would build up in your stomach and stay there for years?

Maybe that last one stayed with you well beyond your teens, and occurred to you every time you accidentally (or purposely) swallowed a piece of gum. We don’t blame you. It’s a scary thought.

But is it true?

We hate to take the fun out of parental discipline, but swallowing a piece of chewing gum is pretty much like swallowing any other piece of food. It will move right through your digestive system with no danger of getting stuck for months, let alone seven years.

This doesn’t mean you should start swallowing all your gum from now on, but if it happens accidentally now and then, there’s no need to panic.

Another common gum myth is that sugar-free gum can help you lose weight. Although it is preferable to choose sugar-free gum over the extra-sweet variety, no studies have show that sugar-free gum will help you lose weight.

If you pop a piece of gum in your mouth after dinner to avoid dessert, it could help you avoid eating a few extra calories every day. But the consumption of sugar-free gum without any other effort will not help you shed pounds.

 If you really enjoy chewing gum, we strongly encourage you to select sugarless gum, because it lowers your risk for cavities. Many brands of sugarless gum contain xylitol, a natural sweetener that can, in fact, help fight bacteria that cause cavities and rinse away plaque.

So if you can’t kick the gum habit altogether, sugar-free is definitely the way to go!

If you have any questions about chewing gum, feel free to contact Dr. Werner at our Los Gatos, CA office.

A lot of patients go at their teeth like they were sanding an old floor—that is to say, way too hard! Brushing too hard is probably the most common mistake patients make in their oral care routine, and it can be detrimental to the gums and teeth.

What can brushing too hard cause?

• Receding gums
• Bone loss around teeth
• Loss of teeth
• Tooth sensitivity, especially to hot and cold
• Worn down enamel

Brushing too hard wears away at your gums, which can lead to the neck of the teeth being exposed. This part of the tooth isn't covered by hard enamel like the rest of the tooth and hence the soft inner layer, or dentin, is exposed. Dentin is very sensitive to hot and cold and much more susceptible to bacterial decay. Once the gums recede due to improper brushing, it’s usually irreversible.

How to brush your teeth properly

You know you're supposed to brush your teeth twice a day, so why not do it right? First and foremost, you should only ever brush with a soft bristled brush—not medium or hard—unless directed otherwise by Dr. Werner. Unless you have braces or specific oral health issues, brushing twice a day for two minutes is usually plenty.

The main purpose of brushing is to remove plaque from your teeth and gums. Plaque is actually soft and is a buildup of bacteria, saliva, and food debris. You really don't need to brush hard to remove it, just make sure you aim your toothbrush at the gum line (where plaque grows) and brush in small circular motions, never a back-and-forth motion.

It's also wise to hold your toothbrush gently. People tend to brush harder the tighter they hold their toothbrush.

Still have questions about proper tooth brushing technique or gum health? Ask any staff member or Dr. Werner during your next visit to our Los Gatos, CA office; we'd be happy to help!

Pregnancy leads to so many changes in your body, so it’s no surprise that your teeth and gums are affected as well! Dental care is very important during these months, so let’s look at some of the concerns you might have about treatments and procedures.

• Regular Exams and Cleaning

Yes and yes! Let us know you are pregnant when you make your appointment. Preventive care is especially important during pregnancy for keeping your gums healthy.

• Periodontal Care

Swollen and tender gums are often one of the first signs of pregnancy. Hormonal changes can make your gums more vulnerable to irritation and infection. Early gum disease, called gingivitis, should be treated promptly to avoid a more serious condition called periodontitis. This form of gum disease can actually cause the gums to pull away from the teeth, leading to pockets where infection can develop. Talk to us about scheduling extra cleanings, if needed, to avoid the plaque build-up that leads to gum disease.

• Regular Dental Work

If you need a cavity filled or a crown placed, talk to us about scheduling. It is important to keep your teeth healthy to avoid infection or more serious dental problems. If you do need restorative work, procedures are usually best treated during the second trimester, where morning sickness is less of a problem and reclining comfortably in the dental chair is easier than it would be in your third trimester.

• Emergency Work

If there is a dental emergency, call us immediately. You shouldn’t put off emergency work, as the complications of pain and infection can be harmful to you and your baby.

• Elective Treatments

If you are thinking about whitening your teeth or having other cosmetic dental work done, waiting until after your baby is born is usually recommended.

• X-rays

Most studies suggest that dental X-rays, because they are so limited in focus, are probably safe during pregnancy. But since there is no definitive answer at this time, it’s recommended to wait until after your baby is born for elective X-rays. In case of a dental emergency, however, an X-ray might be a necessity. If you are worried, talk to us about the shielding we use during X-rays, as well as scientific agreement about the safety of dental X-rays.

Let Dr. Werner know about your pregnancy, and we will work with you to schedule exams or treatments at our Los Gatos, CA office so that your dental experience is both comfortable and safe. If you have any concerns, call us immediately. We know your pregnancy brings many significant changes to your life, but our concern for your health and well-being—that’s unchanging!