More than 20 million people in the United States use electronic cigarettes or e-cigs as an alternative to tobacco smoking. While many users believe "vaping" is a healthier alternative to regular cigarettes, recent research into the health effects of e-cigs could put a damper on that belief. There's particular concern among dentists that this popular habit could harm users' dental health.

E-cigs are made with a chamber that holds the liquid vaping solution and a heating mechanism to heat the liquid and vaporize it. Users inhale the vapor, which contains nicotine and flavorings, as they would a traditional cigarette.

The nicotine alone can be problematic for dental health as we'll see in a moment. But the vapor also contains aerosols that some research indicates could damage the inner skin linings of the mouth in a similar fashion to the smoke of traditional cigarettes. One study by researchers with the Université Laval in Quebec, Canada found evidence that e-cig vapor increased the death rate of mouth cells, and led to greater cell irregularities over time.

According to other studies, there's evidence that e-cig vapor may disrupt the balance of the oral microbiome, the communities of both beneficial and harmful bacteria that normally live in the mouth. The imbalance in favor of more harmful bacteria could increase the risk for dental disease, particularly periodontal (gum) disease.

Finally, nicotine from e-cigs seemed to create similar conditions in the mouth as it does with tobacco. Nicotine in any form can constrict blood vessels and reduce the body's ability to fight infection and to heal. Research indicates both forms of nicotine increase the risk for dental disease and make treatment more difficult.

These findings only identify conditions created by e-cigs that could be problematic for future dental health. Although we don't fully understand the long-term health effects of this new habit, based on the evidence so far the mouth may not fare so well. It's looking like e-cigs may be no safer for your teeth and gums than the cigarettes they replace.

If you would like more information on the health risks of electronic cigarettes, please contact us or schedule an appointment for a consultation.

If there's anything that makes Alfonso Ribeiro happier than his long-running gig as host of America's Funniest Home Videos, it's the time he gets to spend with his family: his wife Angela, their two young sons, and Alfonso's teenaged daughter. As the proud dad told Dear Doctor–Dentistry & Oral Health magazine, "The best part of being a father is the smiles and the warmth you get from your children."

Because Alfonso and Angela want to make sure those little smiles stay healthy, they are careful to keep on top of their kids' oral health at home—and with regular checkups at the dental office. If you, too, want to help your children get on the road to good oral health, here are five tips:

• Start off Right—Even before teeth emerge, gently wipe baby's gums with a clean, moist washcloth. When the first teeth appear, brush them with a tiny dab of fluoride on a soft-bristled toothbrush. Schedule an age-one dental visit for a complete evaluation, and to help your child get accustomed to the dental office.
• Teach Them Well—When they're first learning how to take care of their teeth, most kids need a lot of help. Be patient as you demonstrate the proper way to brush and floss…over and over again. When they're ready, let them try it themselves—but keep an eye on their progress, and offer help when it's needed.
• Watch What They Eat & Drink—Consuming foods high in sugar or starch may give kids momentary satisfaction…but these substances also feed the harmful bacteria that cause tooth decay. The same goes for sodas, juices and acidic drinks—the major sources of sugar in many children's diets. If you allow sugary snacks, limit them to around mealtimes—that gives the mouth a chance to recover its natural balance.
• Keep Up the Good Work—That means brushing twice a day and flossing at least once a day, every single day. If motivation is an issue, encourage your kids by letting them pick out a special brush, toothpaste or floss. You can also give stickers, or use a chart to show progress and provide a reward after a certain period of time. And don't forget to give them a good example to follow!
• Get Regular Dental Checkups—This applies to both kids and adults, but it's especially important during the years when they are rapidly growing! Timely treatment with sealants, topical fluoride applications or fillings can often help keep a small problem from turning into a major headache.

Bringing your kids to the dental office early—and regularly—is the best way to set them up for a lifetime of good checkups…even if they're a little nervous at first. Speaking of his youngest child, Alfonso Ribeiro said "I think the first time he was really frightened, but then the dentist made him feel better—and so since then, going back, it's actually a nice experience." Our goal is to provide this experience for every patient.

If you have questions about your child's dental hygiene routine, call the office or schedule a consultation. You can learn more in the Dear Doctor magazine article “How to Help Your Child Develop the Best Habits for Oral Health.”

Your child's oral development generates considerable changes during their "growing up" years. There are a number of things you can do to help support their development—but also things you shouldn't.

Here are 4 things not to do if you want your child to develop healthy teeth and gums.

Neglect daily oral hygiene. To set the best long-term course for optimum oral health, begin cleaning the inside of your child's mouth even before they have teeth. Simply use a clean wet washcloth to wipe their gums after feeding to reduce bacterial growth. Once you begin seeing teeth, start brushing them every day with just a smear of toothpaste; at about age 2 you can increase that to a pea-sized amount. And don't forget to teach them when they're ready to brush and floss on their own!

Allow unlimited sugar consumption. Besides the effect it has on overall health, sugar is also a prime food source for disease-causing oral bacteria. You can reduce the sugar available for bacterial growth by avoiding sugary snacks and limiting sweet foods to meal times. Less sugar means less bacterial growth—and a lower risk of tooth decay for your child.

Put them to bed with a sugary liquid-filled bottle.  Although a bedtime bottle may help calm your baby to sleep, it could also increase their risk of tooth decay. Allowing them to sip on sugar-filled liquids like juice, milk, formula or even breast milk encourages bacterial growth. Bacteria in turn produce acid, which can dissolve the minerals in enamel and open the door to tooth decay. Sipping through the night also deprives saliva of adequate time to neutralize acid.

Wait on dental visits until they're older. Dental and pediatric associations all recommend first taking your child to the dentist sooner rather than later—by their first birthday. Starting dental visits early will help you stay ahead of any developing tooth decay or other oral problems. And just as important, your child will have an easier time "warming up" to the dental office environment at a younger age than if you wait. Dental visit anxiety, on the other hand, could continue into adulthood and interfere with regular dental care.

If you would like more information on the best dental care practices for your child, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Top 10 Oral Health Tips for Children.”

For most of us, brushing and flossing is a routine part of daily life. But has it become such a routine that you may not be getting the most out of your daily regimen?

First, let's be clear about what you're trying to accomplish with these two important hygiene tasks, which is to remove as much accumulated dental plaque as possible. This thin film of bacteria and food particles is the primary cause for both tooth decay and periodontal (gum) disease.

So how can you tell if you're effectively cleaning dental plaque from your teeth? Here are 4 ways to check your brushing and flossing skills.

The tongue test. Move your tongue across the surface of your teeth, especially at the gum line, immediately after brushing and flossing. "Plaque-free" teeth will feel smooth and slick. If you feel any grittiness, though, you may be missing some plaque.

Floss check. For a similar effect after your daily hygiene take a fresh piece of floss and run it up and down your teeth. If the teeth are clean and you are using un-waxed floss, the floss should "squeak" as you move it up and down.

Disclosing agents. You can also occasionally use a plaque disclosing agent. This product contains a solution you apply to your teeth after brushing and flossing that will dye any leftover plaque a specific color. Disclosing agents are handy for uncovering specific areas that require more of your future hygiene attention.  And don't worry—the dye is temporary and will fade quickly.

Dental visits. For the ultimate test, visit your dentist at least twice a year. Not only can dental cleanings remove hard to reach plaque and calculus (hardened tartar), but your dentist or hygienist can evaluate how well you've been doing. Consider it your "final exam" for oral hygiene!

Be sure to also ask your dental provider for tips and training in better brushing and flossing. Becoming more effective at these critical tasks helps ensure you're keeping your teeth and gums free of disease.

If you would like more information on best oral hygiene practices, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Daily Oral Hygiene: Easy Habits for Maintaining Oral Health.”

November is National Diabetes Month—a time to focus on a disease that affects more than 400 million people around the world. What does diabetes have to do with oral health? Plenty! Here's a true-or-false quiz to test your knowledge on this important topic.

TRUE OR FALSE:

1. Diabetes and gum disease are connected.
TRUE. Studies have found a clear association between diabetes and gum (periodontal) disease, especially when diabetes is not well controlled. People with poorly controlled diabetes have a more severe inflammatory response to the bacteria that cause gum disease. While inflammation is normally a protective reaction of the body's immune system, too much inflammation can actually make the condition worse. In the case of gum disease, the reverse is also true: Untreated gum disease can worsen blood sugar levels in people with diabetes. The good news is that treatment of periodontal disease has been shown to improve blood sugar control.

2. People with diabetes can't have dental implants.
FALSE. Research has shown that dental implants can be a very successful tooth-replacement treatment for people with diabetes. But again, blood sugar control can be a factor. Dental implants are titanium posts that serve as artificial tooth roots. Minor surgery is required to insert an implant into the bone beneath the gums; a realistic-looking dental crown is later attached to it so it can look and function like a natural tooth. Studies have shown that it takes longer for the bone to heal around implants in people with poorly controlled diabetes. That doesn't make implant treatment impossible, but it does mean that it may be managed differently. For example, an implant may be allowed to heal for a longer period of time before a crown is attached to it.

3. People with diabetes can't do anything to improve their oral health.
FALSE. People with diabetes can have a very positive impact on their oral heath, by doing their best to control blood sugar levels with a healthy diet and exercise, and by sticking to an effective daily oral hygiene routine. This includes brushing twice a day for two minutes each time, and flossing at least once each day to remove bacterial plaque between teeth. Regular dental checkups and cleanings are also essential—not just for people with diabetes, but for everyone!

If you have additional questions about diabetes and oral health, please contact us or schedule an appointment for a consultation. You can learn more about diabetes and oral health by reading the Dear Doctor magazine article “Good Oral Health Leads to Better Health Overall.”