Thursday, January 31, 2013

Are Your Teeth Getting Longer?

Are your teeth starting to look longer as you age?
Long appearance of teeth due to aggressive brushing
Ever hear the phrase “long in the tooth?”  Well, this phrase was originally used to refer to older people and horses.  Unlike humans, horses teeth continue to grow as they age, which indicates that horses with long teeth are older.  However, human teeth don’t continue to grow with age, but they can appear to look longer as people age.  There are many factors that can explain why teeth appear to lengthen as people age….

·        Gum Recession –  causes of gum recession are as follows…

o   Vigorous Hygiene (bushing too hard)

o   Bruxism – or grinding your teeth (which can also shorten teeth)

o   Extensive orthodontic treatment

o   Trauma – such as an accident

·        Periodontal Disease – In the advanced stages of gum disease, or gingivitis.  This is an infection in the gums and underlying bone.  When left untreated, bacteria begins to destroy the underlying bone and gum tissue leaving teeth mobile, or wiggly, while exposing the root of the tooth. Over 70% of Americans have some form of gum disease.  This can only be treated by your dentist.  This is also the number cause of premature tooth loss and can cause many health concerns, including cardiovascular problems.

·        Habits

o   Chewing ice

o   Smoking or using smokeless tobacco

o   Certain recreational drugs

It was once thought that losing our teeth was part of the natural aging process.  However, we now know that with proper care, healthy habits, healthy diet and regular dental visits premature tooth loss can be a thing of the past. If you have noticed you are starting to get “long in the tooth” talk to your dentist about your options. Dentistry has come a long way and there are many options to help you maintain a youthful smile for your entire life!
Written by: Carrie Owens

Dr. Cisneros maintains a practice in Freeburg and Columbia, IL. Both are in the Greater St Louis, MO area. For more information on a wide variety of subjects, please visit

Wednesday, January 23, 2013

Botox Parties: Are They Safe?

Most people want to stay young. Botox is a great tool in helping you keep your face young.

In recent years, BOTOX® parties have become quite trendy. Botox parties are sometimes held in private homes and are not much different than Pampered Chef® parties. They are also held in beauty salons and in clinical settings such as a doctor's office.

This topic has become quite heated. There are many so called "beauty experts" that hold these parties. The problem here is that these self proclaimed experts have very limited knowledge of the facial anatomy. They see a wrinkle and proceed to simply administer Botox in these areas. Botox inhibits muscular contraction. So, when a muscle is injected, the muscle will relax. This can provide the desired effects. However, when the wrong muscles relax, the facial features may appear to be deformed or asymmetrical.

Many doctors including myself discourage the administration of Botox in an uncontrolled setting performed by inadequately trained people. Some things to consider are:
  • Does the provider have a thorough understanding of the facial anatomy?
  • Does the provider have a thorough understanding of the medicaments being administered?
  • Does the provider have adequate record keeping and follow up protocol?
  • Do they review your medical history?
  • Does the provider provide informed consent?
  • Are there any privacy issues?
  • Does the provider have a license or credentials to administer medicaments?
  • Does the provider know how to deal with complications?
  • Is there alcohol being consumed at these parties?
  • Is the product being administered counterfeit Botox?
  • Is the facility clean and safe?
In summary, Botox parties are very safe in the hands of competent and credentialed practitioners. However, in the hands of a "beauty professional" at a random party or at the neighborhood salon offering cheap prices, you are rolling the dice.

Dr. Cisneros maintains a practice in Freeburg and Columbia, IL. Both are in the Greater St Louis, MO area. For more information on a wide variety of subjects, please visit

Wednesday, January 16, 2013

Cold Sensitive Teeth

One of the most frequent questions I get is about sensitive teeth. There are many potential reasons for sensitivity. Sometimes this could be a minor nuisance, whereas in other cases, this could be much more serious.

Here are a few reasons for cold sensitivity:
  • Metal restorations: Many people have fillings, crowns, bridges and other metallic restorations. The reason why there is often cold sensitivity with these types of restorations is that metal conducts temperature rather well. So any temperature change is readily noted.
  • Gum recession: When gums recede, the root surfaces of the teeth become exposed. These exposed root surfaces can be very sensitive to cold because there is no enamel covering the surface.
  • Decay: A surface that has decay is often cavitated. The break in the continuity of the enamel makes the tooth much more sensitive to cold.
  • Teeth with enlarged pulps: There are nerves and blood vessels inside every tooth. The space within the tooth that they occupy are called the pulp. Younger people have larger pulps. As we age, the space gets smaller. This means that the pulp of younger teeth are closer to the surface of the tooth. In other words, there is less tooth structure insulating the tooth. So in the absence of other issues, younger teeth are more likely to be sensitive to cold.
  • Temporary restorations: Temporary restorations simply do not fit as well as permanent restorations and are very likely to be cold sensitive. Click here to see a previous blog on temporaries.
  • "High" restorations: When you bite down, if there is a spot on a tooth or restoration that makes premature contact, it will cause more force to be applied to the tooth repetitively. The extra force on a single tooth will make it become sensitive to biting pressure. In addition, the tooth will also become more sensitive to cold. Fortunately, this can be fixed easily. A small amount of restorative material may just need to be polished away to decrease the biting pressure.
  • Defective restorations with open margins: If there is a gap in the interface between the restoration and a tooth, cold sensitivity is likely to become an issue. This is because of two things. The first is that there is simply a gap and the exposed tooth structure is quite sensitive. The second reason is that bacteria migrate into the spaces and infect the tooth structure. The decay that occurs is very toxic to the pulp. When the pulp becomes infected, the nerves become hypersensitive.
  • Trauma: When there is trauma to a tooth, the nerves and blood vessels within a tooth become inflamed. Since they are in a confined space with no room to expand, the pulp becomes incredibly hypersensitive.
  • Infected pulp: When this occurs, the pain will be incredibly intense. The pain may also linger for some time after the source of cold is removed. In addition, the tooth may experience a throbbing sensation.
If you are suffering from cold sensitivity get the advice of your dentist. Do not ignore the problem because it may lead to more complications and expense.

Dr. Cisneros maintains a practice in Freeburg and Columbia, IL. Both are in the Greater St Louis, MO area. For more information on a wide variety of subjects, please visit

Monday, January 7, 2013

Dry Mouth

It’s winter time and cold and flu season is upon us. What does this mean

for you? Well, with the drier air and stuffy nasal passages some people may

notice that they are experiencing a dry mouth for a number of reasons.

What is dry mouth? Dry mouth is a condition in which saliva is produced in

limited amounts. The medical term for dry mouth is xerostomia. Xerostomia

may seem like a minor problem but for people who experience it, it is a

nuisance and can also cause problems. Common problems associated with

dry mouth are increased risk of tooth decay and less enjoyment in food.

Some people complain of a discomfort caused by dry mouth, and say it is

comparable to having a mouthful of cotton.

Saliva helps to prevent tooth decay by limiting the amount of bacterial growth

and washing away any extra food particles. When saliva production is

reduced these benefits are diminished. Moreover, saliva helps people to enjoy

the taste of the their food and swallow their food more easily. People who

experience dry mouth often complain that their food is not as pleasurable and

eating is somewhat uncomfortable.

The most common causes of dry mouth are…

• Medications – This includes prescriptions and over-the-counter

medications. Many cold medications, including antihistamines and

decongestants can cause dry mouth.

• Mouth breathing – Allergies, a deviated septum, chronic sinus issues,

or unusually large adenoids can cause make people breath through

their mouths rather than through their noses. This will obviously

increase airflow through the mouth and will thereby cause the mouth

to become unusually dry.

• Illnesses – Many chronic and acute illnesses can dry out the mouth.

Diabetes for example is a chronic illness often associated with dry


• Cancer treatments – especially radiation treatments. Radiation can

destroy the salivary glands and thereby decrease salivary output.

• Recreational drugs – Some common drugs include alcohol, cocaine,

marijuana and nicotine. Even excessive caffeine can cause issues with a

dry mouth.

People who experience dry mouth should consult their dentist and doctor

for possible treatment options. Possible treatment options include various

types of salivary substitues, sugar-free chewing gum specifically made for

dry mouth, mouth sprays and rinses. If medication is the cause, possible

alternative medications can be explored. For some, mouth breathing may be

due to anatomical reasons, in which case surgery may be an option. If mouth

breathing is due to allergies, finding the proper allergy medications may be

beneficial. Some over-the-counter medications for colds and allergies can

cause dry mouth. It is important to work with your doctor or dentist to find a

solution that is right for you.

Written by: Carrie Owens

Dr. Cisneros maintains a practice in Freeburg and Columbia, IL. Both are in the Greater St Louis, MO area. For more information on a wide variety of subjects, please visit