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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 Anchorage, AK 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. Michelle Slezewski and Dr. Paul Engibous 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!

You find yourself drowsy and irritable all day. Or you have trouble sleeping, and when you do, you snore loudly throughout the night punctuated with silent pauses where you aren’t breathing at all. Or your loved ones tell you that you’ve been keeping them awake with your snoring or frightening them awake when you gasp for breath. Whatever symptom may have brought you to the doctor, you’ve been diagnosed with obstructive sleep apnea, and now it’s time to get this sleep disorder under control.

Obstructive sleep apnea occurs when the tissue in the back of the throat relaxes, partially blocking the airway, or structural problems in the mouth and throat (such as enlarged tonsils or tongue) obstruct air flow. The tissue around the air passage vibrates with every breath causing those annoying snoring sounds. More dangerous, an obstructed airway means that there is not enough oxygen getting into the lungs. The struggle to breathe wakes us, interrupting the deep sleep we need to function. Untreated, the results of sleep apnea can range from drowsiness and irritability to a greater risk of high blood pressure, heart disease, and stroke. Luckily, there are several approaches to combatting this form of sleep apnea, including life style changes, surgery or breathing machines, and orthodontic appliances.

• Lifestyle Changes

Sleep apnea is more likely to affect those who are overweight, smoke, use alcohol, take certain medications, or sleep on their backs. If you can make changes in your lifestyle that will restore the quality of your sleep, this is a great first option.

• Surgery or Breathing Machines

Sometimes obstruction of the airway is caused by structural problems in the throat or mouth. Tissue can be reshaped or removed during surgery to widen and stabilize the breathing passage. Or you might be prescribed a machine such as a CPAP (continuous positive airway pressure) machine, which blows pressurized air through a tube and mask to keep the airway open during sleep.

• Oral Appliances

Dr. Michelle Slezewski and Dr. Paul Engibous can also be an important resource if you struggle with obstructive sleep apnea. Many people suffering from this disorder prefer an oral appliance for its effectiveness, comfort, and convenience. One common oral sleep appliance is designed to support your lower jaw in a forward position. This jaw movement increases the open space of your airway as you sleep. Other appliances can prevent the tongue from blocking the airway and obstructing air flow. These appliances resemble mouthguards and retainers, and, like them, are custom made just for you. We will recommend the type of appliance best suited to your needs, and will take a model of your mouth and teeth so that a lab can craft an appliance that will be a perfect fit. We will adjust it for comfort if necessary, instruct you on its use and care, and schedule follow up treatment to make sure the appliance is treating your sleep apnea as efficiently as possible.

Whether you opt for a change of lifestyle habits, a CPAP machine, surgery, or an oral appliance, it is important that you treat this sleeping disorder. Left untreated, obstructive sleep apnea can have many serious consequences. If you suspect you might have sleep apnea, talk to us during your next visit at our Anchorage, AK office. You deserve a good—and healthy—night’s sleep.

By no stretch is it rare for your gums to hurt during and after flossing. Even some bleeding is to be expected. This is especially true if you have not flossed in a long time. However, if your gums do indeed hurt when you floss, and unbearably so, there are some things you can do.

Be Gentle

Perhaps the most obvious way to combat gum soreness and bleeding is to be gentle. One of the most common occurrences of these gum problems is over-aggressive flossing. In other words, if you are too rough on your gums while flossing, either because you are out of practice or because you are in a hurry, soreness and hurting is to be expected. Instead, try taking your time and be gentle. Also, if you are just starting out, be patient and consistent, your gums will become more conditioned over time.

Use an Alternative Method

If being consistent and gentle does not work, there are other alternative methods of flossing that you can try. You can also try a water floss machine, or what is sometimes called a water pick. The device essentially shoots water into the crevasses between your teeth, and in other areas of your mouth, in order to dislodge food and plaque. These oral instruments also come with different attachments that allow you to reach many of the hard to see and reach areas of your mouth. And lastly, you can always buy floss that is not as abrasive to your gums. There is floss that comes with soft and gentle coatings that will do less harm to your gums while they are adjusting to the good oral hygiene habit you are creating.

Flossing is one of the easiest parts of oral hygiene to overlook. When you first start out, it is common that you may want to stop because of the pain it can initially cause. However, if you try one, or all, of the above mentioned methods, you will give yourself the best chance of being success with your flossing, and it won't hurt as much.

For more flossing tips, schedule an appointment at our Anchorage, AK office and askDr. Michelle Slezewski and Dr. Paul Engibous or a member of our team!

Biofilm is a protective home for bacteria that’s composed of microorganisms. Biofilm can be found in wet places such as ponds, sewers, and bathroom drains, and it also grows on metals and minerals.

But biofilm can also be found in your mouth, in either healthy or diseased form. Both are composed of the same compounds, but when they combine with certain amino acids or chemicals, diseased biofilm will begin to destroy your enamel. You might notice this as a slimy yellow buildup of dental plaque on the surface of your teeth.

Biofilm takes form when free-swimming bacterial cells land on a surface and attach in a cluster. The cells begin to multiply and form a micro-colony that promotes diverse bacterial species to grow. To prevent biofilm from settling in your mouth to begin with, make sure to keep up your daily oral routine.

Any mouth appliances you use should also be scrubbed or soaked in cleaner as often as possible. You should pick a toothpaste that has antibacterial ingredients, rinse with mouthwash, and floss daily.

There are many ways to treat diseased biofilm. One is to kill the microorganisms through the use of chlorhexidine, triclosan, and mineral agents that reduce the degree of plaque formed in your mouth.

Another way is to make sure to go to your regular cleanings every six months with Dr. Michelle Slezewski and Dr. Paul Engibous. During your cleaning, we remove excess biofilm that’s accumulated on your teeth over the past six months.

Don’t forget that it’s also essential to keep a healthy amount of biofilm in your mouth, though. This type of biofilm protects your body from disease and is replicated every twenty minutes. If you have a healthy amount of good biofilm, the chances of your mouth producing harmful bacteria decreases.

Ask about biofilm during your next appointment at our Anchorage, AK office if you’ve noticed any irregular yellow-colored buildup on your teeth. Dr. Michelle Slezewski and Dr. Paul Engibous will make sure your mouth has a healthy balance of biofilm.

The best way to create a healthy environment in your mouth is to stay on track with your oral health regimen. Prevention is the best method when it comes to your dental hygiene and fighting diseased biofilm.