Thursday, February 27, 2014

How to care for infant teeth

My son was born two months ago. This made me start thinking about the oral health of infants. There is so much to talk about, so I will just limit this blog to oral hygiene, fluoride, bottle decay and pacifiers.

Oral Hygiene

The best way to prepare an infant for a life-long oral hygiene regimen is to start early. You may want to start even before the infant has his first teeth which will come in at around 6 months of age. Simply use some gauze or a small towel and wipe the gums clean at least twice each day. This will get them accustomed to having their mouths cleaned daily.

The lower two front teeth will be the first ones to come in. Once they come in, use a small soft bristled toothbrush and brush the teeth gently. Even better yet, I prefer electric tooth brushes. Check out the blog on toothbrushes.


Another consideration is the use of fluoride. There is much debate on fluoride use. Many people are uninformed or do not understand the science regarding this topic. There are numerous anti-fluoride groups pushing for anti-fluoride legislation.

A typical anti-fluoride ad
The statement in this ad is indisputable
 (even though some continue to dispute it).

Fluoride use in low dosages is very beneficial to teeth. However, excessive amounts of fluoride discolor the teeth. In addition, excessive fluoride will make bones brittle and more susceptible to fractures.

There are special toothpastes made specifically for children that do not have fluoride. This is what you want to use in order to avoid swallowing of the paste and therefore a potential for excessive fluoride consumption.

In the United States, most municipal water supplies have fluoride in the optimal concentration range. It is impossible to get too much fluoride drinking from these water supplies. However, if your water source is from a well or from some other source that isn't maintained by a municipality, then the naturally occurring fluoride concentrations can vary widely. You can get these sources tested to determine what the actual concentration is.

Baby Bottle Caries

Once the teeth come in, we want to avoid letting the child fall asleep with a bottle in their mouths. The primary reason for this is a condition we call "baby bottle caries". What happens here is that milk which contains lactose (a sugar) will remain on the teeth for extended periods of time. This allows the decay process to occur over longer periods of time. The results are very predictable......decayed teeth.

If you feel that the child is soothed by falling asleep with a bottle in their mouths, and you feel like you must allow him to sleep with a bottle, then use water instead of milk.


Notice the front teeth do not come together.
I'm not a fan of pacifiers. The reasoning is that when an object is held in the mouth for an extended period of time, the bones of the mouth and the position of the teeth will be altered. This is true for any object including thumbs. What we find in these cases is flared front teeth that do not come together when the mouth is closed.

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

Tuesday, February 18, 2014

$99 Dentures

The title could be $199 Dentures or $299 Dentures or Same Day Dentures. It doesn't matter. The point I'm going to make is about super cheap same day dentures (and other options). 

There are many types of dentures. In general there are pre-made dentures and custom made dentures.

Cheap same day dentures:

One advantage of cheap same day dentures is obviously the price. Another advantage is same day service. Other than that, there are no other advantages. 

There are several significant disadvantages with cheap same day dentures. 
  • The fit is very poor. This in of itself presents other issues such as having a loose denture and a more rapid loss of jaw bone. The loss of bone then exacerbates the poor fit and looseness of the denture.
  • The aesthetics are very poor. You don't want to have ugly dentures that can be spotted a mile away. This is a common issue with prefabricated dentures.
  • The function is very poor. If the dentures aren't fitting well, then the dentures will not function the way they are supposed to.
For some people, this may be the only feasible option.

If you are looking for a better option, consider a custom made or implant supported denture.

Custom made dentures:

These dentures are significantly better. The fit, aesthetics and function are greatly improved.

The disadvantage with these is obviously that they cost more and often require multiple dental appointments before you get to take them home.

Implant supported dentures:

I would hate to wear a denture. They will never be as good as real teeth. But, if you find yourself in a position to have to wear one, this is the best denture you can get.

With these dentures, you won't have to have an excessive amount of acrylic in your mouth. Your mouth will therefore not be crammed with a foreign material. You will also be able to taste, feel the textures and temperatures of your foods. In addition, you won't have to worry about the dentures flopping around or even falling out at the most embarrassing and inopportune times.

The biggest drawback to these dentures of course is the cost. These are significantly more costly than cheap same day dentures or conventional custom dentures. 

One other disadvantage is that the entire process may take multiple visits and take several months or more.


Now that you know that there are several options, you can discuss with your dentist your particular circumstances and choose an option that best suits your needs.

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, February 5, 2014

Tongue Rings and Oral Piercings--Not So Sexy After All

Last week I wrote about tongue hygiene. This week my assistant Erica suggested I write something about tongue rings. So here it is.

I won't get into the discussion on whether or not tongue rings are fashionable or sexy. I will approach this from a medical/dental perspective.

Three things immediately come to mind when I see tongue rings:
  1. Broken Teeth
  2. Infections
  3. Gum Recession

Broken Teeth

We see this quite frequently. This occurs because the hard metal on the tongue ring constantly pounds on the teeth like a wrecking ball. The end result is very predictable. I recommend that a tongue ring never be worn. However, I know people will do what they please. So, if wearing a tongue ring is for you, at least have one that is made of a softer material that will make it less likely to break teeth.

Teeth broken by a tongue ring


The mouth has an incredible amount and variety of bacteria. Whenever a wound is created either accidentally or on purpose, we risk a potential infection. If the tongue is especially unclean, then an infection is much more likely to occur. I recommend you read last weeks blog--Tongue Hygiene.

There are two main concerns with an oral infection.

First, they can get out of control in a relatively short period of time. If allowed to progress, a person can become septic rather quickly. This is a life-threatening condition!

Secondly, when structures become infected, they enlarge. If too much tissue enlarges within the mouth and neck, then the airway will become obstructed. This is also a life-threatening condition! Many people have succumbed to infections that originated in the mouth.

An infected pierced tongue

Gum Recession

This is commonly seen in patients with oral piercings. Most often you'll see the recession on the tongue side with tongue rings. The picture below isn't a tongue ring. The process nevertheless is still the same. The gums recede wherever the material makes contact.

Gum recession caused by repeated trauma

We all have different needs and priorities. If you value a tongue ring because it makes you feel more fashionable, sexy or something else, I will not tell you what to do. However, please understand what the risks are.

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