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It seems like the ads are everywhere these days—repair your enamel and reverse tooth decay with a tube of toothpaste! Are these claims too good to be true? Let’s dive into the science of tooth decay—how decay develops and how (and if!) it can be reversed.

Teeth can stand up to the powerful pressures of biting and chewing because over 95% of our enamel is made up of minerals. Calcium and phosphate ions in our teeth bond to form a crystal structure called hydroxyapatite. Because of the strength of this crystalline design, tooth enamel is the hardest substance in our bodies, even stronger than our bones. 

But bones, like most other parts of our bodies, are living tissue, which means that they can create new cells to replace old or damaged cells. Tooth enamel can’t regenerate new cells to repair itself. This means that when a cavity has made a hole in the tooth, the enamel can’t grow back. And, while enamel structure is very strong, it’s also vulnerable to damage—specifically, damage from acids. 

Our teeth are exposed to acids throughout the day, whether they are acids created by plaque bacteria or the acidic foods and drinks we consume. Acids dissolve mineral bonds, stripping calcium and phosphate minerals from the enamel and leaving weak spots in the tooth surface. This process is called demineralization. Demineralization is the first stage of tooth decay.

The good news? Our bodies are designed with a built-in defense mechanism to prevent demineralization from causing lasting damage. All through the day, saliva helps wash away acids in the mouth and bathes our teeth with new calcium and phosphate ions. These ions bond with the calcium and phosphate in our enamel, restoring enamel strength. This protective repair process is called remineralization. 

Now for the bad news. In the tug of war between demineralization and remineralization, saliva can only do so much. If your diet is heavy with acids, if you don’t brush away acid-producing plaque bacteria regularly, if you eat a lot of the sugars and starches which feed plaque bacteria, the remineralizing effects of saliva can’t keep up with the demineralizing effects of acids.

The first visible sign of demineralization is often a white spot on the tooth where minerals have been stripped from enamel. Studies have shown that enamel-strengthening toothpaste can be effective in this very first stage of tooth decay. Toothpastes which advertise enamel repair generally contain one or more of these ingredients:

• Calcium Phosphate
• Hydroxyapatite
• Fluoride 

Toothpastes with calcium phosphate or hydroxyapatite contain calcium and phosphate minerals, the building blocks of tooth enamel. Studies have suggested that these minerals can replace the calcium and phosphate ions stripped from enamel. These toothpastes may or may not contain fluoride, which is something you should discuss with your dentist before deciding on a specific toothpaste.

Fluoride toothpastes remineralize enamel—and more! Fluoride ions are attracted to the tooth’s surface, and, when fluoride ions join with the calcium and phosphate ions there, they form fluorapatite. Fluorapatite crystals are larger, stronger, and more resistant to acids than hydroxyapatite crystals. And, once bonded with tooth enamel, fluoride attracts the calcium and phosphate ions in saliva to remineralize the teeth more quickly. 

Why consider enamel-repair toothpaste? 

Once enamel is gone, it’s gone for good. If excess demineralization isn’t treated, a weak spot on the tooth surface will continue to erode, growing bigger and deeper until it becomes a hole in the enamel. This is a cavity, and your dentist will need to treat and repair your tooth to prevent the cavity from growing and potentially exposing the tooth’s pulp to bacteria and infection. 

If you wear braces, you want to be especially careful about excess demineralization. Because it can be hard to brush and floss effectively with braces, white spots and discolored patches are a common concern for those with braces, especially on the enamel around brackets.  

Talk to Dr. Iwei Huang at our Chicago office about which toothpastes can help restore a healthy balance between the ongoing cycles of demineralization and remineralization when you have braces. While tooth-repair toothpaste can’t fix cavities, these products can often strengthen demineralized enamel and reverse this earliest stage of tooth decay.

Orthodontic treatment involves a lot more than just straightening your teeth. For a healthy smile, your bite must be healthy as well! This means that the upper and lower jaws need to fit together properly and comfortably.

If your bite is out of alignment because of jaw misalignment, orthodontic treatment can help correct the shape and position of your jaws with devices called functional appliances. These appliances are most often used for young patients whose bones are still growing, and are designed to treat malocclusions, or bite problems.

Common malocclusions such as overbites and overjets can occur when the upper teeth protrude further than they should, or the lower jaw is positioned too far back, or both. The Twin Block appliance can be used in such cases to help move your lower jaw and teeth into alignment with your upper jaw.

Why “Twin”? Because the Twin Block appliance is two separate pieces, each made of wire and smooth acrylic. Both pieces are crafted to fit precisely over your upper and lower arches and can be adjusted as your treatment progresses. The top plate can also be adjusted, if necessary, to widen the upper palate.

Why “Block”? Acrylic blocks cover the biting surfaces of several of your upper and lower teeth. These blocks fit together like a 3D puzzle. When you bite down, the upper blocks interlock with the lower blocks, pushing the lower blocks forward just a bit before you can bite down completely. Over time, bit by bit (and bite by bite), the Twin Block appliance advances your lower jaw and teeth to create a balanced, comfortable bite.

For the quickest and best results, you should wear your Twin Block appliance as directed. It’s made to be worn comfortably while you sleep, eat, and otherwise go about your day. (It’s a good idea to check with our Chicago orthodontic team to see about removing it when you’re active, especially for swimming and contact sports.) When it’s time to brush, the Twin Block appliance is removable. This means that you can clean your teeth and your appliance easily.

And, while it’s made to work hard for you, it’s not indestructible. Don’t expose your appliance to heat or hot water, as the plastic may warp. Use the cleaning methods we recommend. Finally, when your appliance is out of your mouth, keep it in its case! You don’t want your appliance to end up carefully wrapped in a napkin in the nearby recycling bin. Or, even worse, in your dog’s mouth instead of yours.

The Twin Block appliance might fit together like a puzzle, but there’s nothing puzzling about how to achieve your best and fastest results. Your success really depends on you. Follow Dr. Iwei Huang and our team’s advice, wear your appliance as directed, and you’ll be on your way to a healthy, comfortable bite and an attractive, confident smile!

Xylitol is a naturally occurring sweetener found in tree bark, plants, fruits, and vegetables. The human body also produces it in small amounts. It looks and tastes like sugar, so as part of a health regimen, most people require no willpower to use it.

Xylitol is safe (approved by the World Health Organization) because only a small amount is needed for health benefits. With a glycemic index of seven, it is safe for diabetics. It has less than three calories per gram and 40% fewer calories than other carbohydrates. If eaten in extremely large amounts too quickly, it has a laxative effect in humans.

Tooth decay happens when bacteria in your mouth consume the sugars you eat. When you eat food that contains ordinary sugar, it gives energy to the bacteria on your teeth, allowing them to multiply and start making acids that destroy the enamel on the teeth.

Since xylitol is a natural sweetener derived from the fibrous parts of plants, it does not break down like sugar, so it helps maintain a neutral pH level in the mouth. Xylitol also prevents bacteria from sticking to the teeth because they are unable to digest it. That is how it protects the teeth from cavities.

With xylitol, the acid attack is diminished. With less bacteria and acid, your teeth stay healthier. The frequency of xylitol ingestion is important: aim for five grams a day, or one gram every three hours.

Studies of xylitol use as either a sugar substitute or a small dietary addition have demonstrated a dramatic reduction in new cavities. It has also stopped and even reversed some existing cavities. This effect is long lasting and possibly permanent. Low cavity rates persist even years after the trials have been completed.

Xylitol needs to be one of the first ingredients in a product to be effective. It is convenient and easy to use. You can find it in health food stores and specialty grocery stores. Xylitol can be delivered to your teeth in chewing gum, tablets, or even candy and mints.

It also comes in toothpaste, mouth rinse, baby oral wipes, gel and pacifiers, nasal wash, dry mouth spray, a granulated form for cooking, granulated packets to add to drinks, and commercially prepared foods. It can replace sugar on a one-to-one ratio.

Sweet rewards in xylitol are good for the body and the teeth! If you have specific questions please feel free to contact Gold Coast Orthodontics. We look forward to seeing you soon!

Orthodontists and dentists use advanced procedures to treat and save teeth. But sometimes, a tooth just can’t be saved and needs to be extracted. Sometimes it’s due to extensive decay, or infection, or serious injury. Or sometimes, to create a healthy bite, an extraction is necessary during orthodontic treatment.

When does an orthodontist recommend an extraction? Conditions which call for extraction include:

• Incoming Wisdom Teeth

Not many people have enough space in their mouths for four wisdom teeth! And when there’s no room to erupt properly, wisdom teeth can become decayed or infected, push your other teeth out of place, and damage the roots of nearby molars. Extracting wisdom teeth protects your teeth and your bite alignment.

Usually, orthodontic treatment takes place before the wisdom teeth begin to erupt. But if yours start to make an appearance during treatment, your orthodontist and dentist will work together to schedule extraction without interfering too much with your orthodontic treatment plan.

• Tooth and Jaw Structure

Dr. Iwei Huang and the team at Gold Coast Orthodontics carefully plan your treatment based on examinations, X-rays, and/or 3D imaging. The goal is to align your teeth and jaws for an attractive smile and a healthy, functional bite. When overcrowding is severe, or if there is a serious malocclusion (bite problem), or if a particular tooth is unusually large or misshapen, your orthodontist might recommend an extraction.

Sometimes more room can be made for teeth with appliances such as palatal expanders or, in other cases, with the help of oral surgery. Extractions are only recommended when they are absolutely necessary.

• Baby Teeth Which Aren’t Coming Out 

Baby teeth normally fall out in a predictable pattern. Front teeth first, canines and molars last. Baby teeth have small roots, and these roots begin to break down when the adult teeth underneath put pressure on them as they start to erupt. As the root gets smaller and smaller, the baby tooth gets looser and looser—until it falls out. 

Sometimes, though, the roots of primary teeth don’t break down, and the baby teeth stay right where they are. This means that the permanent teeth have to erupt someplace else—usually behind those baby teeth. This creates a double row of teeth, and your permanent teeth can become crooked or overlap as they try to fit in. Extracting stubborn baby teeth allows your adult teeth to come in just where they’re supposed to. Because of their small roots, extracting primary teeth is usually simple and straightforward, and can be done in your dentist’s office. 

• Too Many Teeth

Most of us have 32 adult teeth, including wisdom teeth. It’s rare, but sometimes an extra, or supernumerary, tooth develops. Your jaw is most probably not equipped to accommodate any extras, so, in this case, the extra tooth or teeth are removed to give the rest of the teeth the space they need to avoid overlapping or crowding.

When your orthodontist recommends an extraction, it’s because it’s important for your dental health. Dr. Iwei Huang will refer you to a dentist or a specialist like a periodontist or oral surgeon, who will: 

• discuss the extraction procedure with you, including sedation options
• numb the area 
• gently loosen and then extract the tooth
• provide options for pain management after the procedure
• give you detailed instructions for aftercare
• work with your orthodontist to keep your treatment on schedule

Extraction is never your first choice, or your orthodontist’s! But when an extraction is necessary for tooth and bite alignment, everyone at Gold Coast Orthodontics in Chicago will coordinate a treatment plan to create your best—and healthiest—smile.