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Millions of people, around Wilmington and beyond, wear green on St. Patrick’s Day so they can show their spirit for the holiday and avoid getting pinched. While it may be easy for you to throw on a green shirt, sport a St. Patrick’s Day button, or wear a pair of emerald-hued shoes, if you’re an avid St. Patty’s Day enthusiast you may want to try something different this year. Dr. Keller and Dr. Tibbs thought of a few ideas that will help you take your holiday spirit to the next level:

Visit Chicago’s Green River

If you happen to be near the Windy City during St. Patrick’s Day or you’re thinking of planning a trip, don’t miss out on going downtown to watch the large-scale celebration that kicks off when the city dyes the river bright green. According to the Chicago Sun-Times, Chicago has been celebrating the holiday with this tradition for more than 50 years, with tens of thousands of people gathering annually to witness the mysterious dying process and the stunning result.

Don Green Face Paint

Just like an avid sports fan on game day, you can use green face paints to showcase your enthusiasm for this holiday. Avoid breakouts or allergic reactions by only using paints that are specifically meant to be applied to the skin. A little bit of face paint can cover a large area, so feel free to get creative and decorate the whole family on St. Patrick’s Day.

Eat Green All Day

Not a fan of green eggs and ham? With the increasing popularity of green smoothies, there’s no better time to get in on this health craze. To create a green smoothie without the aid of food coloring, you can simply blend a generous amount of a leafy green vegetable, such as spinach or kale, with the ingredients that you would typically use to make a smoothie, like fruit, ice, milk, or juice. Keep the trend going throughout the day by using those same vegetables to create a green soup, egg salad, or a batch of bright green pastries. As an added bonus, you’ll get a healthy dose of vitamins without changing the taste of most of these foods.

If your old holiday routine has gotten stale, leave your green T-shirt in the drawer and try one or all of these tips. Don’t be surprised if you have so much fun that you decide to start a new, annual St. Patrick’s Day tradition! Have a happy St. Paddy’s day from Montchanin Implant Center!

If you are expecting, it is critical to maintain a healthy lifestyle to ensure both your health and the health of your little one. This includes maintaining your regimen of brushing twice per day and flossing. It also includes regular visits to our Wilmington office, as recommended by the American Academy of Periodontology (AAP), who suggest that women who are pregnant or considering pregnancy undergo a periodontal evaluation.

Women who are pregnant are particularly susceptible to gingivitis, a mild form of periodontal disease that is characterized by reddening, swelling, and bleeding of the gums. It is a condition that is not to be overlooked and can be treated and reversed by Dr. Keller and Dr. Tibbs.

Research at the University of North Carolina has indicated a connection between periodontal disease and an increased risk of low birth weight, a serious issue that affects roughly one in ten babies born in the United States. Low birth-weight babies may be at risk to have respiratory, intestinal, and heart issues. They also face long-term health problems such as vision and hearing loss, delayed motor skills, and potential learning disabilities, according to the Center for Disease Control and Prevention.

Besides the possibility of leading to low birth weight of your baby, gingivitis, if left undetected and untreated, can also lead to periodontitis, a much more serious gum disease that attacks the gum tissue and the bone supporting the teeth. Periodontal diseases can lead to tooth loss and are associated with other serious conditions such as diabetes and cardiovascular disease.

Maintaining periodontal health is an important part of a healthy pregnancy. Seeking timely treatment for gum disease is important not just for your personal health, but also for the health of your baby. Early diagnosis of periodontal disease can give you peace of mind that both you and your baby will be healthy. To learn more about preventing gum disease, or to schedule your periodontal evaluation or cleaning at Montchanin Implant Center, please give us a call today!

Ideally, it should never hurt when you floss your teeth. But if you haven’t flossed in a long while or don’t do it regularly, you may experience sore or bleeding gums. You should floss every day to avoid pain and maintain the best oral hygiene. In the meantime, there are a few things you can do to make flossing a little more pleasant.

Be Gentle

If your gums are sensitive, take your time and be gentle while flossing. Rough flossing can lead to more irritation and soreness. Also, daily flossing should help your gums become acclimated to the practice, and as a result, irritation should decrease over time.

Use an Alternative Method

If you still feel discomfort after being gentle, an alternative method of flossing may work better for you. A water floss machine or Waterpik can dislodge food particles and plaque without irritating your gums. Also, some brands of floss have a soft coating that make them less harsh and harmful to your gums.

Many people tend to forget or skip flossing, but it is one of the most important steps your dental hygiene routine and shouldn’t be neglected. If you are consistent about flossing, your gums should become used to it and won’t be so irritated in time.

For more flossing tips, schedule an appointment at our Wilmington office and ask Dr. Keller and Dr. Tibbs or a member of our team!

There are many understandable reasons why you might be feeling less than enthusiastic about your upcoming periodontal treatment.  Perhaps anxiety is an issue, or your teeth are extremely sensitive. You may have a low pain threshold, an easily triggered gag reflex, or require longer or more complex work during your visit. These are also excellent reasons to consider sedation dentistry.

Of course, Dr. Keller and Dr. Tibbs will always try our best to make sure that every procedure is pain free. A local anesthetic will be provided to numb the treatment area completely. You might decide that this all that you need, especially for relatively simple procedures. But if you would prefer to remain completely aware, but feel less anxious, if you would like deep sedation throughout the entire procedure, or if you want something in between, talk to us about making sedation part of your treatment.

The most common methods of sedation include:

• Oral Sedation

Usually, oral medications that reduce anxiety are given in pill form. The level of sedation and how much you will be aware during your procedure will depend on the dosage, and you will need time to recover from the drug’s effects after we are done.

• Nitrous Oxide

Commonly referred to as “laughing gas,” this has been used since the 1800’s to relieve dental anxiety and reduce pain.  Today’s equipment is designed to provide a precise mixture of nitrous oxide and oxygen inhaled through a mask that you will wear throughout the procedure. Once the mask is removed, you will recover quickly.

• IV Sedation

Medication will be delivered through an intravenous line placed in a vein. This delivery system allows the sedative to take effect very quickly, unlike oral sedation, and adjustments to the sedation level can be made throughout the procedure. This method will also require recovery time when your work is complete.

Because your concerns and condition are unique, we will tailor your sedation to fit your specific needs, and our experience and training enable us to recommend the sedation that is best for you. We will take a careful health history to make sure that whichever medication is used won’t interact with your other medications or affect any pre-existing medical conditions.

Our Wilmington office is trained to administer and monitor all these forms of sedation. Because sedation is a regular part of our practice, we have the medical knowledge and skill to provide you with a safe and comfortable periodontal experience. If you think sedation dentistry might be right for you, this procedure is something we are happy to discuss before your appointment.

When we think of Valentine’s Day, we think of cards, flowers, and chocolates. We think of girlfriends celebrating being single together and couples celebrating their relationship. We think of all things pink and red taking over every pharmacy and grocery store imaginable. But what Dr. Keller and Dr. Tibbs and our team would like to think of is when and how this joyous, love-filled day began.

Several martyrs’ stories are associated with the origins of Valentine’s Day. One of the most widely known suggests that Valentine was a Roman priest who went against the law at a time when marriage had been banned for young men. He continued to perform marriage ceremonies for young lovers in secret and when he was discovered, he was sentenced to death.

Another tale claims that Valentine was killed for helping Christians escape from Roman prisons. Yet another says that Valentine himself sent the first valentine when he fell in love with a girl and sent her a letter and signed it, “From your Valentine.”

Other claims suggest that it all began when Geoffrey Chaucer, an Englishman often referred to as the father of English literature, wrote a poem that was the first to connect St. Valentine to romance. From there, it evolved into a day when lovers would express their feelings for each other. Cue the flowers, sweets, and cards!

Regardless of where the holiday came from, these stories all have one thing in common: They celebrate the love we are capable of as human beings. And though that’s largely in a romantic spirit these days, it doesn’t have to be. You could celebrate love for a sister, a friend, a parent, even a pet.

We hope all our patients know how much we love them! Wishing you all a very happy Valentine’s Day from the team at Montchanin Implant Center!

There are several conditions that might require a visit to the periodontist. Periodontists like Dr. Keller and Dr. Tibbs are specialists in the treatment of gum disease and problems affecting the tissue surrounding the teeth. Your general dentist might recommend seeing a periodontist for any of these conditions:

• Early signs of periodontal disease

If you notice that your gums are red or swollen, or if you see bleeding when you brush and floss, a visit to your dentist is in order. He or she can let you know if you need to schedule a trip to the periodontist, or if you can be treated by your regular dentist.

• Receding gums

When gums recede, your teeth experience not only more sensitivity, but also possible bone and tissue loss. Periodontists are skilled in treating gum recession with gum grafts and regeneration therapy if required.

• Pain when eating or sensitivity to heat and cold

These symptoms could be a sign that pockets have formed in the gum tissue as periodontal disease causes the gums to pull away from the teeth. Pockets around the teeth can hold bacteria, leading to infection, or expose parts of the root, leading to tooth sensitivity.

• Your bite has shifted or you notice loose teeth

As gum disease progresses, the gums pull away from the teeth, leaving the bone and connective tissue exposed to infection. Infection can cause loss of the bone structure supporting the teeth, leading to loose teeth or a change in your normal bite.

• If you are considering a dental implant

Periodontists will make sure the underlying bone is healthy and has enough density for an implant, can build up the bone if necessary with augmentation procedures, and will place the implant in the bone.

Finally, if you smoke, have a family history of gum disease, or have a systemic disease such as diabetes or heart disease, an evaluation by a periodontist is a good idea. Often, the early stages of periodontal disease are invisible. Frequent checkups with your regular dentist will help prevent periodontal disease before it develops. And if your general dentist recommends an evaluation at our Wilmington office, rest assured that you will be treated by a doctor with the training and knowledge necessary to help you to the best possible outcome for both your smile and your overall health!

Why does gum disease develop? Our mouths are home to bacteria, which form a film called plaque. Plaque sticks to the surfaces of our teeth, at the gumline, and can even grow below the gumline. And this bacterial growth leads to inflammation and gum disease.

When the disease progresses, the gums gradually pull away from the teeth leaving pockets which can be home to infection. Toxins can attack the bone structures and connective tissue, which support our teeth. Left untreated, periodontal disease can lead to serious infection and even tooth loss.

Because we are dealing with bacteria, it makes sense that antibiotics are one way to combat gum disease. Depending on the condition of your gums, we might suggest one of the following treatments:

• Mouthwashes—there are mouthwashes available with a prescription that are stronger than over-the-counter antibiotic formulas, and can be used after brushing and flossing.
• Topical Ointments—These ointments or gels are applied directly to the gums, most often used for mild forms of the disease.
• Time-release Treatments—If there is severe inflammation in a pocket, we might place a biodegradable powder, chip, or gel containing antibiotics directly in the affected area. These minute methods release antibiotics over a period of time as they dissolve.
• Pills and Capsules—For more serious periodontal disease, you could be prescribed an oral antibiotic. Take in pill or capsule form as recommended, and always finish the entire prescription.

Talk to Dr. Keller and Dr. Tibbs at our Wilmington office before beginning a course of antibiotics. It’s important to know if you have any allergies to medications, what to look for if you might have an allergy you didn’t know about, if you are pregnant or breast-feeding, or if you have any health concerns that would prohibit antibiotic use. Talk to us about possible side effects and how to use the medication most successfully. With proper treatment, we can treat gum disease as quickly and effectively as possible, and provide advice on maintaining a periodontal routine that will keep your gums and teeth healthy for years to come.

Healthy teeth make you happy to share your smile with the world. But there’s more to your smile than its beauty! There’s a lot of hard work going on, as well.

Teeth Are Designed for Healthy Eating and Digestion

Because humans are omnivores, we can eat both meat and plants. That’s why our teeth have different shapes—they’re designed to help us process different types of food. 

• Incisors, our front teeth, have sharpish edges to help cut through meats and other firm foods when we bite.
• Canines, the pointed teeth, help tear food into bite-size portions.
• Premolars are flat topped teeth with two cusps, raised points which help grind food.
• Molars are the flat-topped teeth in the rear of the mouth. They have four cusps to grind and crush food into a paste-like consistency. 

So: Incisors and canines bite and tear food into smaller pieces, which molars and premolars then crush and grind into a paste. Bite, tear, crush, grind—why all this food aggression? Because that’s the key to healthy digestion! 

Chewing is the first step in digestion. Effective chewing:

• Starts the process of breaking food down into digestible particles.
• Increases saliva production. Saliva binds food particles so that we can swallow easily.
• Expands the surface area of food particles, which allows the digestive system to extract nutrients more efficiently. 

When gum disease causes bite pain, loose teeth, or tooth loss, it can be hard to chew food as thoroughly as you should. Swallowing can be difficult. Digestion can suffer. In fact, healthy teeth are essential to healthy digestion. 

Teeth Have Other Important Jobs As Well

• Speaking

Our teeth work with our tongues and lips to form many of the phonetic sounds which make up daily speech. Try making a “th” sound, for example! Missing teeth can affect our ability to pronounce words clearly.

• Maintaining Bone Density

Eating and chewing stimulate cell-producing tissues in the jawbone, enabling them to rebuild and replace aging or damaged cells. When a tooth is lost, the bone directly beneath can no longer replace cells as effectively without the stimulating pressure of chewing. This section of the jawbone will shrink and lose density over time.

• Maintaining Tooth Alignment

 A lost tooth leaves a gap. The remaining teeth can shift to fill the empty space, putting your teeth, and possibly your bite, out of alignment. 

• Shaping the Face

Just like our bone structure, our teeth help give shape to our faces. Missing teeth can affect the appearance of chins, lips, and cheeks. Replacing lost teeth with dentures, bridges, or dental implants can restore facial symmetry.

Teeth Are Only Up to the Job with Your Help

You’re in charge! Daily brushing and flossing, eating a healthy diet, and regular visits to your dentist for exams and cleanings will help make sure your teeth are able to perform their many duties. And for our teeth to thrive, the structures which support them need to be healthy as well. 

Gum disease is one of the leading causes of tooth loss in adults. Left untreated, gum disease causes gum recession, bone loss, loose teeth, and, eventually, tooth loss. If you’re experiencing gum disease, if you need a gum or bone graft to rebuild your tooth’s supporting structures, or if you’ve lost a tooth and are considering a dental implant, talk to your periodontist. You want your teeth working their best for you—that’s the secret to a beautiful smile!

The best way to protect yourself from gum disease is to be proactive: practice good oral hygiene at home and schedule regular checkups and cleanings in your dentist’s office.

How do you know if your dental routine is doing the job? There are specific symptoms you might notice when you brush and floss, and less obvious signs of gum disease your dentist will look for during your dental exams.

The early stage of gum disease is known as gingivitis. It’s generally caused by poor dental hygiene, although certain diseases, age, hormones, and a number of other factors can also put you at risk. It’s time to talk to your dentist about your gum health if you notice any of these symptoms:

• Bright red or purple gums
• Swollen gums
• Pain or tenderness
• Bleeding when brushing or flossing
• Persistent bad breath
• Receding gums

And sometimes, there are no obvious symptoms at all. That’s why regular checkups are so important. If you have gingivitis, careful attention to your oral hygiene, professional cleaning, prescription mouthwash, or other treatments as needed can reverse the effects of gingivitis and restore your gums to their normal, healthy state.

Why be so proactive? Because, left untreated, gingivitis leads to more serious gum disease, called periodontitis.

The bacteria in plaque and tartar cause inflammation, and inflammation leads the gum tissue to pull away from the teeth, forming pockets which become deeper over time. Here, where brushing can’t reach, bacteria continue to multiply, leading to further inflammation, infection, and the eventual breakdown of gum and bone tissues.

The results of untreated periodontitis can be very serious, including:

• Significant gum recession, leaving roots more vulnerable to decay
• Periodontal abscesses
• Loose teeth, or teeth that shift from their proper positions
• Bone loss in the area surrounding the teeth
• Tooth loss

If your dentist sees signs of advanced gum disease, you may be referred to our Wilmington periodontal office.

Periodontists like Dr. Keller and Dr. Tibbs specialize in the diagnosis, prevention, and treatment of gum disease. After dental school, a periodontal degree requires three years of additional advanced education. Periodontists have the training and skill to perform surgical and non-surgical procedures to treat gum disease, as well as to perform cosmetic procedures and place dental implants.

Periodontists are trained to diagnose and treat periodontitis with a number of procedures which they will recommend based on your specific needs. Among the treatments they provide to restore your gum health:

• Topical, time-release, or oral medication
• Scaling and root planing, non-surgical deep cleaning procedures which remove plaque and tartar above and below the gum line, and smooth tooth roots to remove bacteria and help the gum tissue reattach to the teeth
• Flap surgery to treat persistent gum infection, reduce pocket depth, and re-secure the gums snugly around the teeth
• Bone grafts, gum grafts, and other regenerative procedures which help restore and repair tissue damaged by gum disease

If your dentist recommends a periodontal consultation, be proactive. The best way to protect yourself from the serious consequences of untreated gum disease is to see a specialist in this field. Your periodontist has the knowledge and experience to stop gum disease from progressing, treat damaged bone and gum tissue, and restore your healthy smile.

Gum disease starts quietly and invisibly, but can lead to very serious and noticeable consequences if left untreated. Excess plaque and bacteria around the gum line cause irritation. This irritation can result in the gums pulling away from the teeth. When the gums pull away, they leave pockets between the gums and teeth which become home to more bacteria, leading to more irritation and infection. Gum pockets can get larger, resulting in more severe irritation and infection that can lead to bone loss around the tooth and eventually loss of the tooth itself.

The good news is that we can intervene at any of these stages to provide the periodontal care which will help restore your gums and teeth to health.  One of the procedures we use is osseous surgery. “Osseous” refers to bone tissue, and this treatment works to restore the bone structures supporting your teeth if gum disease has damaged or weakened them.

Healthy gums fit tightly around the teeth, keeping bacteria from affecting the roots and bone. Small pockets can be cleaned in our Wilmington office and plaque removed from tooth areas normally hidden by the gums. But if the pocket has become too deep, normal home and even office cleanings cannot fully treat the gum and bone tissue involved. The bone which holds our teeth securely in our jaws can become pitted and irregular. Osseous surgery can be used not only to clean the area, but to restore gum and bone tissue to health.

After an anesthetic numbs the area, your periodontist will fold back the gum tissue around the affected tooth and bone. The gums will be carefully cleaned. If the bone has become pitted, this offers bacteria another place to grow and cause damage to your tooth structures. We will smooth damaged areas of the bone to their natural shape, where your gum tissue will find it easier to attach to the healthy bone. When we have finished, the gums will be secured around the tooth. After surgery, the pockets will be reduced in size, and you should be able to return to a normal routine of regular gum care.

We know the idea of oral surgery can be intimidating, so talk Dr. Keller and Dr. Tibbs us about osseous surgery if it has been recommended for you. We are experienced in preventing gum disease from causing more damage, and in gently restoring your gums and bone to health for your most attractive and lasting smile.

New Year’s Day marks the beginning of the calendar year in most parts of the world. The holiday is celebrated on January 1st of each year. Customs and celebrations vary by country, religion, and even individual desires. Whether celebrated quietly or with gusto, the day brings the start of new opportunities for those that observe it.

United States and Canada

In both the US and Canada, celebrations begin on New Year’s Eve. At midnight on January 1st the New Year is welcomed with bells, horns, whistles, and other noisemakers. Fireworks are often part of the celebrations. In New York City, Times Square comes alive with revelers. In Toronto, there are large celebrations which may feature concerts, late-night partying, sporting events, and fireworks, with free public transit service during peak party times. Many individuals in North America greet the year by making resolutions for improvements in their lives.

China

In China, many people celebrate two forms of a new year. They may observe January 1st, but the traditional Chinese New Year is based on a lunar calendar. Parades with paper lanterns and dragons made from silk are a significant part of the festivities. Legends say that the dragon spends most of its time in hibernation so fireworks are used to keep the dragon awake.

Jewish Celebration

Jewish New Year’s observances begin with Rosh Hashanah, the first day of the New Year, and end with Yom Kippur, the Day of Atonement. This ten-day celebration is held in September or October, based on the Hebrew calendar. The New Year is not marked as much with loud celebrations as with personal insight to mend wrongs and resolve to better oneself.

Other countries and cultures also have different dates for New Year’s Day observances:

• Vietnam observes the New Year in February
• In Iran, the day is celebrated on March 21st
• Islamic cultures often observe the tenth day of the month of Muharram
• Russian Orthodox observers use the Julian calendar and celebrate on January 14th
• Buddhist celebrations are held from April 13th through 15th

If you observe New Year’s Day by making healthy resolutions, include dental care in your plans with Dr. Keller and Dr. Tibbs. The health of your teeth and gums contributes to your overall health. Caring for your mouth now can prevent many dental problems later in life. Montchanin Implant Center wishes you a healthy, prosperous, and happy New Year!

Periodontal health — which refers to the condition of the structures that support your teeth — is an important part of your oral and overall health. However, periodontal health becomes even more important when you're pregnant. Bad oral health can have detrimental effects on the health of your unborn child and can lead to low-birth weight babies and giving birth to a pre-term baby, according to reports by the American Academy of Periodontology (AAP), the European Federation of Periodontology (EFP), and several research studies.

Periodontal disease (gum disease) is a set of chronic, bacteria-induced, inflammatory diseases that attack the gum tissue and in more severe cases, the bones supporting the teeth. Early signs of periodontal disease usually include tenderness, swelling, and redness. Symptoms can also include bleeding gums when flossing or brushing, receding gums, loose teeth, and bad breath. These signs shouldn't be ignored, especially if you're pregnant.

Prevention is the best tool you have to fight periodontal disease. Here are some steps you can take to keep your gums in tiptop shape:

• Brush your teeth properly twice a day – angle your toothbrush at the gum line to help disrupt the bacterial growth that eventually leads to periodontal disease, and make sure you don't brush too hard.
• Floss daily and clean behind the back molars on the top and bottom of your mouth.
• Use antiseptic mouthwash to rid your mouth of the bacteria that can cause gum disease.
• Get regular checkups at our Wilmington office to ensure you have no signs of periodontal disease and that your oral hygiene habits are effective.

Dr. Keller and Dr. Tibbs and our team urge women to care for their periodontal health during pregnancy to avoid complications. If you have any questions regarding periodontal health and how it affects you and your baby's overall health, please contact our Wilmington office for more information.

There are many ways in which your oral health has an impact on your overall general health. There are naturally occurring bacteria in the mouth. Some of those bacteria, including strep and staph, are harmful, while other bacteria are essential for the balance of intestinal flora. The healthier your mouth is, the less likely it is the harmful bacteria will travel to other parts of your body to infect it and make you sick. There is much more to good dental hygiene than brushing and flossing.

Historical Methods of Maintaining Oral Health

Ancient civilizations relied on natural remedies for maintaining oral health. Around 250 AD, the Kemetic Egyptians used myrrh and other herbs as antiseptics for treating infected gums. Two centuries later, the Nubians, who lived in the Nile River valley, drank beer to ease the pain of infected teeth. That probably sounds crazy, but their beer was effective because they used grains that were contaminated with the same bacteria that produce the antibiotic tetracycline.

Today's Biggest Dental Hygiene Challenge

In the past, tooth decay was more of an issue because there was no routine dental care, and problems that are routinely treated today went untreated. Thanks to fluoridated water, and toothpastes containing fluoride, tooth decay is far less problematic than it was a century or more ago. Gum disease has replaced tooth decay as the most serious dental problem facing people today. According to the American Dental Association, a staggering 80 percent of Americans over age 65 suffer from some form of periodontal disease.

Ironically, if that infection attacked any other part of your body, especially in a place where it was clearly visible, you would head to your doctor for treatment immediately. People tend to ignore gum tenderness and bleeding. When the tenderness and bleeding aren't treated, the inflammation can turn into periodontitis. The longer you allow the inflammation to go untreated, the greater the likelihood that it will affect other body parts. Make sure to visit Dr. Keller and Dr. Tibbs at Montchanin Implant Center regularly to be proactive about dental health!

Researchers are now discovering that untreated inflammation in the mouth acts as a driving force for multiple chronic illnesses, including clogged arteries, heart attacks, arthritis, and even cancer. That inflammation is one of many hypotheses that may explain how chronic infections can trigger systemic diseases, and even intensify existing ones. Bacterial overgrowth in the inflamed gum tissue can enter the bloodstream through the food you eat, and from daily brushing.

Caring for your mouth at home is just as important as visiting our office for exams!

You brush and floss thoroughly twice a day. You have regular checkups. Everything seems fine on the periodontal radar. Sometimes, however, even healthy gums can become sensitive and irritated. Is it something you did? Maybe! Here are some common causes of gum irritation and sensitivity that you might not be aware of.

• Brushing Bravado

One of the most important tools for gum health is one we use at least twice a day—the simple toothbrush. Two minutes at night and two in the morning reduce the bacteria and plaque that lead to serious gum disease, known as periodontitis. And while preventing tooth decay and gum disease are the primary goals of brushing, let’s also protect delicate gum tissue from injuries and irritation caused by too-forceful brushing.

Try using a brush with soft bristles and brushing with short strokes and gentle pressure, especially if you know you have a tendency to be a bit heavy-handed. Massaging rather than scrubbing will clean teeth and gums just fine.

• Fierce Flossing

Just because we can use dental floss to slice cakes or cookie dough logs doesn’t mean we should apply the same pressure to our gums! While a firm sawing motion seems like the obvious way to clean between teeth and gums, you can actually cause irritation and bleeding that way.

Insert the floss between your teeth carefully, bring it to the gumline, and move the floss with gentle pressure up and down and around the tooth surface. This technique will make sure that you remove food particles and plaque from beneath the gumline without causing your gums any trauma. Ask us about the best flossing techniques—we know them all.

• Appliance Aches

You know how helpful your braces/retainers/mouth guards/dentures are. You just wish that your helpful appliance was a little less irritating to sensitive gum tissue.

This is a problem that often disappears as you get used to your new appliance. But if pain or irritation persists or gets worse, give us a call. We want to make sure your appliance fits properly, and make any necessary adjustments to ensure your comfort.

• Peroxide Problems

Most home whitening kits use peroxide-based gels or treated strips to remove surface stains from the teeth. Those same bleaching agents that make enamel whiter can also cause gum sensitivity and irritation. If you use whitening strips or gel trays, be careful to keep the peroxide solution away from gum tissue. But because these systems are one-size-fits-all, that is often easier said than done.

If you have sensitive gums, one solution is a professional office whitening. We’ll check on your gum (and tooth) health first, and monitor and protect your gums throughout the procedure. If you still want to whiten at home, we can create custom trays for you that will provide more complete exposure to the whitening solution for your teeth, and less exposure for your gums, than over-the-counter products.

• Still Smoking?

Studies have shown a strong link between gum health and smoking and other forms of tobacco use. Smokers are much more likely to suffer from gum disease than non-smokers, and those who have smoked for a long time, or who smoke heavily, have an even higher risk of developing periodontal disease. Some studies suggest that smokers don’t respond as well to treatment as non-smokers.  Unfortunately, it appears that smoking and tobacco use help mask the obvious symptoms of gum disease (redness and bleeding), which could lead smokers to delay getting treatment. If you smoke, talk to us about ways to quit.

We talk a lot about periodontal health because it is so important. Periodontitis can lead to infection, loss of bone around the tooth, and even eventual tooth loss. If you are suffering from any of the signs of gum disease—swelling, redness, bleeding, pain—give our Wilmington office a call. Whether it’s as simple as making a few lifestyle changes, or a problem requiring professional dental treatment, being proactive with your dental care is more than good for your gums—it’s good for your health!

Need some gift ideas for family members and friends who seem to have absolutely everything? Who are impossible to shop for? Who tell you not to worry, it’s the thought that counts? Well, we have a few suggestions which will show the people on your gift list that you’ve put a lot of thought into their gifts this holiday season. 

You love to see your friends and family smile, so we’ve come up with some smile-worthy ideas designed for their specific interests. 

Environmental Ally

The world is becoming a more eco-conscious place, and happily this transformation includes products designed for personal care. Put together a spa basket which is good for your friend’s comfort, dental health, and the planet!

A recycled gift box filled with environmentally friendly bath products and organic cotton face cloths becomes even more mindful with the addition of bamboo or recycled plastic toothbrushes, zero-waste fluoride toothpaste tablets, and biodegradable picks and floss. 

Don’t forget to include a colorful, insulated water bottle for sustainable hydration—and hydration sustains tooth and gum health as well! Healthy planet/healthy smile.

Talented Techie

If your friend or relative is cutting edge high-tech, maybe it’s time for a dental upgrade. 

Modern electric toothbrushes offer plenty of options for the tech-savvy. They come with different settings for brushing and massaging. They can let brushers know if they’ve brushed long enough, if they’re brushing too hard, or when the brush head needs to be retired. Smart models even link to apps, which can, among other things, map out any missed spots in brushing coverage or suggest more effective brushing angles. 

And for an extra thoughtful touch, include a packet of plaque disclosing tablets. Chew one of these helpful little tablets and they will reveal any plaque that’s still on the teeth and near the gums.

Adventure Seeker

How about a new backpack or carry-all for outdoor or travel adventures? A travel first aid kit is always a welcome addition for the person on the go.

Go the extra step and help a friend be prepared for anything with an emergency dental kit. You can find these lightweight kits in stores or online, or you can assemble one yourself with a travel-size toothbrush and toothpaste, floss, a travel mirror, cotton rolls, pain relievers, and even temporary fillings. Include a pack of sugar-free gum—it helps with altitude changes and hydration. Ask Dr. Keller and Dr. Tibbs or the team at Montchanin Implant Center for suggestions!

Film Buff

If your bestie likes nothing better than an evening spent in front of the home screen, consider a subscription or gift card for a streaming service tailored to his or her favorites, whether it’s classic films, sci-fi, action, rom-coms, or epic adventures. 

And don’t forget the binge-watch treats! Fill a basket with dental-friendly goodies like fresh fruits, nuts, and dark chocolate. Include a collection of simple sparkling waters or a gift card for vitamin-rich smoothies. Who needs sugary candies and sodas with options like these?

Timeless Trendsetter

Older relatives might love a selection of modern gifts designed with old-fashioned comfort in mind, such as an automatic jar opener and a selection of jams, trekking poles for easier hiking, or wireless earbuds for enjoying music or an audio book.

For a lifetime of healthy smiles, consider adding a water flosser to your gift basket. Gum disease is a leading cause of tooth loss for older Americans. Water flossers are a great way to eliminate stubborn plaque, especially when mobility issues make manual flossing difficult. Adjustable water pressure applies just the right amount of cleaning power, and the flow can be directed to the gumline, between teeth, or anywhere necessary. 

No matter who’s on your shopping list, tailoring your gifts to both their interests and their well-being is a great way to share happy, healthy holiday smiles with family and friends in Wilmington.

At Montchanin Implant Center, we love to celebrate the holidays with vigor! Dr. Keller and Dr. Tibbs would love to share some unique ways of celebrating Thanksgiving from beyond the Wilmington area to the national level!

When Americans sit down to dinner on the last Thursday of November, the day that Abraham Lincoln designated as the day on which Thanksgiving would be celebrated, they do so thinking that the first Thanksgiving feast was held at Plymouth in 1621. According to National Geographic, the Spanish explorer Francisco Vásquez Coronado and his men celebrated a feast of Thanksgiving in Texas in 1541, giving Texas the distinction of being the first place where Thanksgiving was celebrated.

Different Types of Celebrations

Native Americans had rituals around which they celebrated in hopes of ensuring a bountiful harvest. The Cherokees had a Green Corn Dance that they did for this very purpose. The Pilgrims (not to be confused with the Puritans,) rejected any type of public religious display. They held a three-day long non-religious Thanksgiving feast. Although they said grace, the focus of their celebration was on feasting, drinking alcohol (they did have beer,) and playing games.

The Pilgrims at the Plymouth Plantation celebrated a different day of Thanksgiving in 1623. Plagued by a crop-destroying drought, the settlers prayed for relief. They even fasted. A few days later, they got the rain they so desperately needed. Soon thereafter, they received another blessing when Captain Miles Standish came with staples they couldn't otherwise get. He also told them that a Dutch supply ship was en route. In gratitude for the abundance of good fortune, the Plymouth settlers celebrated a day of prayer and Thanksgiving on June 30, 1623.

The Story of Squanto

No discussion of Thanksgiving is complete without a discussion of Squanto, or Tisquantum, as he was known among his people, the Patuxet Indians. It is believed that he was born sometime around 1580. As he returned to his village after a long journey, he and several other Native Americans were kidnapped by Jamestown colonist, Thomas Hunt. Hunt put them on a ship heading to Spain where they were to be sold into slavery.

As fate would have it, some local friars rescued him and many of the other kidnapped natives. Squanto was educated by the friars. Eventually, after asking for freedom so he could return to North America, he ended up in London where he spent time working as a ship builder. By 1619, he was finally able to get passage on a ship headed to New England with other Pilgrims.

Upon arriving at Plymouth Rock, he learned that his entire tribe was wiped out by diseases that accompanied earlier settlers from Europe. In gratitude for passage on their ship, he helped them set up a settlement on the very land where his people once lived. They called the settlement Plymouth. Since they knew nothing about how to survive, let alone how to find food, Squanto taught them everything, from how to plant corn and other crops, how to fertilize them, how and where to get fish and eels and much more.

After a devastating winter during which many settlers died, thanks to Squanto's teaching, they had an abundant harvest. After that harvest, they honored him with a feast. It is this feast of 1621 which was celebrated between the Pilgrims and Wampanoag Indians that is widely considered the first Thanksgiving celebration.

About the Meal of the Plymouth Settlers

Surviving journals of Edward Winslow that are housed at Plymouth Plantation indicate that the first Thanksgiving feast was nothing like what Americans eat today. The meal consisted of venison, various types of wild fowl (including wild turkey,) and Indian corn. There were no cranberries, stuffing, pumpkin pie, potatoes, or any of the other “traditional” foods that appear on modern menus.

Today, Thanksgiving is celebrated on the fourth Thursday of November, the day that Abraham Lincoln designated as the holiday. It is still a day of feasting, and for some, a day of prayer and thanksgiving. For others, it is a celebration of gathering, especially for families. Still others may celebrate in entirely different ways, including watching college football bowl games, or by playing family games.

If you ever wonder why you're so tired after the Thanksgiving meal, it's because turkey contains an amino acid, tryptophan, and it sets off chemicals whose chain reaction combine to make people sleepy.

When we think about improving our smile, we generally focus on our teeth. Are they straight enough? White enough? Your orthodontist and dentist can provide suggestions for these issues if they concern you. But there is another essential part of our smiles which should not be neglected: our gums.

You might know that periodontal dentistry is your best option for treating gum disease. We are also trained and skilled in cosmetic procedures which can make a remarkable difference in your smile and even improve your periodontal health.

• Crown Lengthening & Gum Contouring

People sometimes worry that their teeth are too short, or their smiles are too “gummy.” Problems like this can actually be caused by too much gum tissue. We can carefully remove or reshape excess gum tissue, and bone tissue if needed, to reveal more of your teeth. This process is known as “crown lengthening.” We then contour the remaining gum tissue for an attractive gumline that works together with your teeth and lips for a beautifully proportioned smile.

• Gum Grafts

On the other hand, sometimes recessive gums can lead to too much of the tooth being exposed. A gum graft, where graft tissue is carefully positioned to restore the receding gum, can both improve the appearance of a smile and protect the exposed root area from damage or decay.

• Bone Grafts

When you lose a tooth, it is important to decide on a treatment plan early. The longer a tooth is missing, the more likely that the bone and tissue beneath it will start to recede. Without the necessary bone density and area, an implant cannot be performed. If gum disease has caused bone loss, it can endanger the health of the teeth nearby.  If you have lost bone due to a missing tooth, infection, trauma or gum disease, talk to us about bone grafting, to restore your bone now and prevent future bone loss.

• Dental Implants

Dental implants make your smile complete again, which is certainly an aesthetic improvement, but is also important for the health of your remaining teeth and jaw. We are trained not only to place the implant in the jaw, but to analyze bone health first for the most successful implant outcome.

You are already on your way to your best possible smile. And just as you’re committed to working with your regular dentist for checkups and cleaning, and working with your orthodontist if you see the need for alignment and bite improvements, there are some cosmetic areas where a periodontist is uniquely qualified to help. If you are concerned about the appearance or health of your gums and the bones beneath them, call our Wilmington office! Dr. Keller and Dr. Tibbs can answer any questions you may have and provide suggestions for making sure your gums and the supporting structures around your teeth are not only their healthiest, but a beautiful addition to your best, most confident smile.

For those of our patients at Montchanin Implant Center who suffer from periodontal (gum) disease, we proudly offer topical or oral antibiotics to help reduce or entirely eliminate disease-causing bacteria. It can also help fight the bacterial infection causing gingivitis, a mild form of periodontal disease that is characterized by reddening, swelling, and bleeding of the gums.

Dr. Keller and Dr. Tibbs may recommend systemic or topical antibiotics in conjuncture with scaling and root planing, as well as other procedures. These antibiotics include:

• Tetracycline: The primary drugs used in the fight against bacteria, tetracycline includes antibacterial properties which help reduce inflammation and block collagenase, a protein which destroys the connective tissue and bone.
• Azithromycin: This antibiotic is known to reduce bacterial growth associated with periodontitis, and is regularly used to reduce inflammation in those patients who are heavy smokers.
• Metronidazole (Flagyl): This antibiotic may be prescribed to those patients suffering from severe periodontitis. Metronidazole works best when used in a combination with amoxicillin or tetracycline.
• Ciprofloxacin: This antibiotic is used to specifically target A. actinomycetemcomitans, a slow-growing but harmful bacterium that contributes to gum disease.
• Amoxicillin: Only intended to fight bacteria and bacterial infections, amoxicillin does not kill bacteria but prevents microbes from forming walls that surround them, which is how bacteria reproduces and survives.
• Clindamycin: An antibiotic that works by stopping the development of bacteria, clindamycin is used to treat a variety of serious bacterial infections.

Most forms of gum disease can be treated without antibiotics, but the biggest advantage of using topical antibiotics to help treat the disease is that they are directed to their specific target areas, thus the entire body is not affected. The other advantages of topical antibiotics include reduced dosage and reduced side effects. Dr. Keller and Dr. Tibbs can discuss with you the advantages, as well as side effects, of each antibiotic during your visit.

To learn more, or to schedule your next visit at Montchanin Implant Center, please give us a call today at our convenient Wilmington office!

Dentine hypersensitivity can be described as a sharp and sudden pain caused by cold food and beverages. It’s present in more than half the population and result from receding gums that expose the root surfaces of your teeth.

That being said, hypersensitivity can be triggered by forceful tooth brushing, teeth whitening products, gum disease, and erosion from acid reflux, bulimia, or highly acidic foods. Symptoms can range from moderate to severe, depending on the cause and how quickly it’s treated.

Tooth sensitivity begins when the dentin develops some exposure. This layer that surrounds the nerve of the tooth is usually covered by gum tissue, but when recession takes place, the dentin can get exposed and the pain begins. The dentin contains numerous pores that run from the surface of the tooth inward. This direct connection to the nerve and blood supply of the tooth can be affected by external stimuli, such as the triggers cited above.

The good news is there are several different ways to treat dentinal hypersensitivity at Montchanin Implant Center.

Treatment of dentin tooth sensitivity begins by making an appointment with Dr. Keller and Dr. Tibbs. We encourage you to begin treatment sooner rather than later in order to figure out the cause and to reduce the pain you’re experiencing. In most cases, quick treatment options will solve the problem, including the use of desensitizing toothpaste, switching to a soft-bristled toothbrush, starting a daily fluoride rinse treatment, or minimizing teeth grinding with the help of a custom mouthguard.

For more serious cases, we may recommend you get crowns put on problematic teeth, start a gel or varnish fluoride treatment, or even schedule a surgical gum graft or root canal, depending on the cause and severity of your pain.

If you’re concerned about any tooth sensitivity you’re experiencing, please give our Wilmington office a call and schedule an appointment. Dr. Keller and Dr. Tibbs and our team want to help you identify the cause of your pain, and give you the best possible treatment plan. We look forward to seeing you to help alleviate discomfort and solve your tooth sensitivity.

Halitosis is the fancy, scientific word for “bad breath.” Dr. Keller and Dr. Tibbs and our team know there are several reasons why you may have halitosis; let’s look at a few:

• Gum disease (also known as periodontal disease) – There are five main types of gum disease, and each one can range from mild to severe. For example the most common one is gingivitis; it is caused by bacteria in the plaque that has been allowed to build up, usually as a result of poor oral hygiene. A more serious and uncommon type of gum disease is called necrotizing periodontal disease. It is most common in people who have a suppressed immune system.
• Smoking
• Dry Mouth – This can be caused by something as simple as a medication you take.
• Food – Of course, if you eat something that is potent like garlic, it is going to give you bad breath.
• Diseases of the Body – Some diseases such as sinus infections and diabetes, among a few other types of infections, can also cause you to have halitosis.

How to Get Rid of Halitosis

The most obvious answer to how to get rid of halitosis is to practice good oral hygiene, although, depending on the cause of halitosis it may not be that simple. If you have an infection that is causing the halitosis then you may need an antibiotic to clear up the infection and then the bad breath will go away. Here are more tips:

• Brush your teeth after every meal and before bed.
• Floss your teeth. The more plaque you get out of your teeth, the better chance you have of not getting cavities or bad breath.
• Address any medical conditions that are not related to your teeth that can be causing the halitosis.
• Ask Dr. Keller and Dr. Tibbs for a prescription mouthwash that kills bacteria.

Halitosis (bad breath) can be an embarrassing condition to live with, but there are plenty of ways to get rid of it permanently. Start by talking to a member of our team at our Wilmington office.

You might have noticed that the dental aisle of your drugstore is larger than ever, with more options than ever for getting the spaces between your teeth their cleanest. Flosses made with different shapes, materials, and coatings. Wooden dental sticks. Flexible plastic picks. Tiny interproximal brushes. Water flossers. With all these choices, what’s a conscientious person to do?

• Find What Works Best for You!

We’ve come a long way from the one-size-fits-all floss of our grandparents. Today’s plaque-removing tools are designed to make interdental cleaning easier and more efficient for users with a variety of different needs.

• Floss Choices

Flossing properly is a very effective way to get rid of the plaque that builds up between your teeth and along your gum line—not to mention the food particles which your brush may have missed. And now there are options to suit both your needs and your preferences.

Modern flosses come waxed or unwaxed, flat or rounded, made of natural or synthetic material, flavored or unflavored. There are flosses designed for specifically for braces and eco-friendly, biodegradable flosses. If you’re not happy with your regular floss, a different size, material, or texture might make all the difference.

Even with all these choices, though, flosses don’t always suit everyone. Luckily, if you’ve had trouble with floss, you have many other options available for interdental cleaning:

• Floss Picks

These tiny, handled tools hold a piece of dental floss in their curved end. You can direct the floss to the perfect spot, which is especially useful if you’re having trouble reaching your back teeth or have mobility issues.  Floss picks can be disposable or refillable, and come in different sizes to accommodate adults and children.

• Dental Picks

Back in the day, toothpicks were the go-to for dislodging food particles. But they weren’t designed for gum health and safety. Today, we have gentler, more efficient options for those of us who like the ease of using a pick and the convenience of being able to clean our teeth at work, at school, or on the go.

Triangular wooden picks are tapered to fit between the teeth and massage the gum line as they scour plaque from tooth enamel. Soft plastic picks are popular because their flexible tips fit easily in between the teeth, while their texture provides gentle scrubbing for your tooth enamel.

• Interproximal Brushes

Big name; tiny brush. These little cone-shaped brushes come in various sizes so they can fit snugly and comfortably between teeth whether widely or narrowly spaced. They’re especially handy for getting around wires if you wear braces.

• Water Flossers

These high-tech tools provide a pulsing stream of water to clean between the teeth. They’re particularly helpful for those with mobility issues and those with traditional or lingual braces. To make sure you’re getting the job done, choose a model with a dental seal of approval, which means it has been tested for safety and effectiveness.                                                                                                                                                                  

With so many options, you can sample different flossing alternatives until you find the one which works best for you.

• Technique Is Key

No matter which product you choose, the key to effective plaque removal is your technique. You need to be thorough. You need to be gentle enough to protect your delicate gums, but not so gentle that you don’t remove any plaque.

Whichever method you choose, carefully follow directions to get optimal cleaning benefits while protecting tooth enamel and gum tissue. And remember, you have an expert ally in your corner—Dr. Keller and Dr. Tibbs! If your periodontist is seeing a lot of plaque buildup at your next exam, ask for tips to improve your interdental cleaning technique and suggestions for the best products to accommodate your specific needs.

• Choose It—Then Use It!

Even after deciding on the best tool and technique, your teeth and gums won’t benefit from your research if your floss or pick or brush or water flosser is languishing in the medicine cabinet. While dentists recommend flossing at least once each day, if you have braces or a tendency toward cavities or gum disease, your periodontist might recommend flossing more often.

Why is flossing so important? Even with the best brushing technique, it can be hard to reach plaque and food particles caught between the teeth and near the gum line. Removing plaque from between teeth can help prevent cavities, and it’s especially important for gum health.

Plaque and tartar are extremely irritating to gum tissue. This irritation causes inflammation, and you’ll soon start to see the first signs of gingivitis (early gum disease)—swelling, redness, bleeding, bad breath—when flossing is hit or miss. Over time, left untreated, gingivitis can lead to periodontitis, a serious form of gum disease which can cause tooth and bone loss.

When caught early, you can often reverse the irritation, inflammation, and unpleasant symptoms of gingivitis with a week or two of careful brushing and flossing. If your gums are bothering you despite your careful cleaning, it’s time to visit our Wilmington periodontal office. There are lots of options available for getting your teeth their cleanest—but you have only one smile!

Dr. Keller and Dr. Tibbs and our team hear this question a lot. While many people believe periodontal disease is an adult problem, studies have indicated that periodontal disease, also known as gum disease, as well as other serious infections such as gingivitis and periodontitis, are prevalent among kids and adolescents. First, let’s identify the differences between gingivitis, periodontitis, and periodontal disease.

Gingivitis

Gingivitis is a type of periodontal disease in which only your child’s gums are affected. Characterized by swollen and red gums that bleed easily, gingivitis causes an inflammation of the gums, and is the first stage and mildest form of periodontal disease. The good news is that gingivitis is often reversible. Treatment for gingivitis includes having your child come in for a professional teeth cleaning. It also includes daily brushing, which will help eliminate plaque from the surfaces of your child’s teeth. Your child should also get in the habit of flossing daily to remove plaque and food particles wedged in the crevices between his or her teeth.

Periodontitis

If left untreated, gingivitis can progress to periodontitis, the advanced stage of gum disease that can not only damage your child’s gum tissue, but also destroy the underlying bone which supports the teeth. Eventually, teeth can become loose and may have to be removed. In some cases, the bacteria from the ensuing infection may also be distributed to other areas of the body via the bloodstream.

Periodontal Disease

Periodontal disease is a chronic bacterial infection of the gums, periodontal ligament, and bone that surround and support your child’s teeth. Periodontal disease causes gums to become red, swollen, and tender, and can even cause the gums to recede (pull away) from the teeth. If left untreated, periodontal disease can lead to tooth loss.

Having persistent at-home oral care regimen is a critical step in your child’s fight against periodontal disease. But sometimes brushing and flossing are simply not enough. Having your child’s teeth cleaned twice a year, or as recommended, is crucial.

Early diagnosis of gingivitis, periodontitis, and periodontal disease can give you and your child peace of mind. If you are concerned your child is suffering from gum disease, we recommend that you give us a call at our Wilmington office. We look forward to working with you and giving your child a smile to last a lifetime!

Dr. Keller and Dr. Tibbs and our team at Montchanin Implant Center understand that many of our patients have a fear of dentistry. You may be concerned about experiencing pain from sensitive teeth or routine procedures. General anxiety is also common. Do not put off visiting our Wilmington office; we offer various types of sedation to take the pain and fear out of your dental procedure.

Nitrous Oxide Sedation

For many patients, nitrous oxide, combined with local anesthetics, will both provide pain relief and reduce anxiety. Nitrous oxide is beneficial because the dosage can be regulated during treatment and patients are normally capable of driving shortly after the procedure is completed.

Oral or Injected Sedation

With oral sedation, you may be given a pill or liquid to consume several hours before your procedure. You will not be able to drive yourself to the appointment. An oral liquid is often given to children before any shots or intravenous anesthesia. An intramuscular injection may be given at the office that provides relaxation benefits for 20 to 30 minutes.

Nitrous Oxide with an Oral Sedative

If you experience higher levels of anxiety, an oral or injected sedative can be offered before nitrous oxide is started. This is also effective for reducing anxiety regarding the injection of local anesthetics. A liquid medication followed by nitrous oxide is beneficial for children. This combination can produce a deep sedation level.

General Anesthesia

This type of anesthesia can be offered as an inhaled gas or intravenous liquid. If no oral sedative is given before the general anesthesia is administered, you should wake up quickly after your procedure is complete. An injection, pill, or liquid medication can be offered to reduce anxiety before intravenous sedation begins. Intravenous sedation can also be used at moderate-to-deep sedation levels without complete loss of consciousness.

Do not hesitate to ask Dr. Keller and Dr. Tibbs about receiving sedation or pain prevention when you visit. We will be glad to explain the options we have available and answer all your questions to ensure that your exam is pleasant for you.

Dr. Keller and Dr. Tibbs, as well as our team at Montchanin Implant Center, would like to give those patients with flex spend, health savings, or insurance benefits a friendly end of the year reminder that it’s high time to schedule your dental visits so you optimize your benefit.

Now is the time to reserve your appointment with us. Space is limited and we tend to get busy around the holidays, so don’t wait to give us a call at our convenient Wilmington office!

From the time you were small, you’ve been warned about the dangers of plaque. Why? Because:

• It’s an unappealing film that sticks to your teeth
• It causes cavities
• It causes gum disease

And really, do we need to know much more than this to motivate us to brush? But if you’re in a curious mood, you might be wondering just how this soft, fuzzy film accomplishes all that damage. Let’s take a closer look at the sticky problem of plaque.

How does plaque form?

We live with hundreds of species of oral bacteria, most of which are harmless, and some of which are actually beneficial. But when our oral ecosystem gets out of balance, problems can occur. For example, without regular and thorough brushing and flossing, we start to build up plaque.

Plaque starts forming within hours of your last brushing. And even though plaque fits the very definition of “seems to appear overnight,” this biofilm is actually a complex microbial community with several different stages of development.

• It starts with saliva.

Saliva is vital to our oral health, because it keeps us hydrated, washes away food particles, neutralizes acids in the mouth, and provides minerals, which keep our enamel strong. Saliva also contains proteins, which help form a healthy, protective film on the tooth surface. This film is called a pellicle.

• Bacteria attach to the pellicle.

There are species of oral bacteria that are able to attach themselves to the pellicle film within hours of its formation. As they become more firmly attached, they begin to grow and divide to form colonies, and are known as the early colonizers of the plaque biofilm.

• A complex biofilm forms.

If you’ve skipped brushing for a few days (please don’t!), you’ll notice a fuzzy, sometimes discolored film on your enamel—that’s a thriving plaque community, and it only takes a matter of days to go from invisible to unpleasant.

If you’re not removing plaque regularly, it can harden further and become tartar. And once you have tartar buildup, you’ll need the care of a dental professional to remove it.

• What happens if we ignore plaque and tartar?

We get cavities and gum disease.

How does plaque cause cavities?

• The bacteria in plaque, like all organisms, need nutrients.

Our normal oral environment and the food in our everyday diets provide the nutrients plaque needs. Foods such as carbohydrates, starches, and sugars are most easily converted into acids, which is why we recommend that you enjoy them in moderation.

• The biofilm promotes acid production.

Within the plaque film, anaerobic bacteria (bacteria that don’t use oxygen) convert sugars and starches into acids. As the plaque film becomes denser, it blocks acid-neutralizing saliva and oxygen from reaching these bacteria close to the tooth’s surface, creating an ideal environment for the bacteria to produce their acid waste products.

• Acids attack enamel.

The sticky nature of plaque keeps these acids in contact with tooth enamel, where, over time, acids dissolve minerals in enamel, weakening the mineral structure of the tooth.

How does plaque cause gum disease?

• Bacteria cause inflammation and gingivitis.

The bacteria in plaque irritate the delicate tissue of the gums, which causes an inflammation response which can leave your gums swollen, red, bleeding, or tender. This early form of gum disease is gingivitis. Fortunately, good dental care and careful brushing and flossing can usually prevent and even eliminate gingivitis.

• Plaque and tartar can lead to periodontitis.

When plaque and tartar build up around and below the gum line, the gums pull away from the teeth, leaving pockets where bacteria collect, leading to infection as well as inflammation. Infections and constant inflammation not only harm gum tissue, they can destroy the bone supporting the teeth. This serious gum condition is periodontitis, and should be treated immediately to avoid further infection and even tooth loss.

How do we fight plaque?

From the time you were small, you’ve learned how to fight plaque:

• Brush at least twice a day for two minutes, and be sure to brush all of your tooth surfaces and around the gum line.
• Floss to remove plaque from between the teeth and near the gum line.
• See your dentist as recommended for a thorough professional cleaning.

Be proactive. If you have any questions, talk to us about the best way to keep plaque at bay. If you have plaque and tartar that has spread below the gum line, talk to Dr. Keller and Dr. Tibbs about procedures such as scaling and planing. These non-surgical, deep cleaning treatments available at our Wilmington office remove plaque and tartar around the roots and smooth away rough surfaces where bacteria can hide.

We’ve only brushed up on some plaque basics, because there is a lot more to discover about this complex biofilm. Happily, even with all there is to learn about plaque’s growth and development, it’s reassuring to know that getting rid of it is quite simple—with just a soft-bristled brush, some dental floss, and a few minutes of your time each day, you’re on the way to a healthy, happy, plaque-free smile.

Congratulations! You’ve made the decision to replace a missing tooth with an implant. While an implant will restore the appearance of your smile, you also know that there are many reasons that an implant will improve your health, too.

A missing tooth causes structural problems as well as cosmetic ones. Remaining teeth can shift to fill the gap, leading to wear and bite problems. Without the stimulation of biting and chewing, bone tissue under the lost tooth gradually shrinks and is resorbed. The shapes of our jaws, cheeks and lips can be affected. Replacing a lost tooth with an implant can not only restore the appearance of your smile, but maintain it.

And implant procedures have a very high rate of success. Implants are made of materials compatible with the body, and surgically placed in the jaw to act as anchors for replacement teeth. The implant will actually integrate with the bone growing around it for strong, stable, and long-lasting support. After the time it takes for the implant to integrate and the area around it to heal, a crown, designed to match your own teeth perfectly, will be securely attached to the implant post.

What can you do to help the healing process? Follow our instructions carefully. Dr. Keller and Dr. Tibbs will give you suggestions for the time immediately following the procedure as well as instructions on the importance of keeping the area clean while healing takes place. And one very important favor you can do yourself? If you smoke, this is the time to stop.

Studies have shown that smokers have a significantly increased risk of dental problems and implant failures, and there are several theories as to why.

• Smoking slows the healing process. Some studies indicate that smoking impairs blood flow in the gums, so that less oxygen and fewer nutrients are delivered to healing tissue.
• Smokers tend to be more vulnerable to gum disease.
• Smoking has been linked to a weaker immune system, so it’s harder to fight off an infection or to heal from one.
• More marginal bone loss around implants is seen in smokers than in non-smokers.
• Peri-implantitis, an inflammation of the gum tissue around the implant that can lead to bone loss and implant failure, is also more common in smokers.

Now that you have decided on a dental implant at our Wilmington office, make one more decision to ensure the success of the procedure. Talk to us about ways to quit smoking before your implant, and how to reduce the chance of smoking-related complications. We know that quitting can be difficult, but your improved smile—and your improved health—are worth it!

Since gum disease is one of the most common adult diseases, it’s no wonder periodontists like Dr. Keller and Dr. Tibbs stress the importance of prevention. Effective brushing and flossing, regular dental appointments for exams and cleanings, and a prompt visit to our Wilmington office if you notice symptoms of gingivitis (early gum disease) are all important steps to prevent more serious periodontal disease from developing.

One more step you can add to keep your gums their healthiest? Add some gum-healthy foods to your shopping cart! To see how your diet can help prevent gum disease, let’s look at what can cause gum disease.

When plaque builds up between teeth and gums, the bacteria found in plaque cause our gum tissue to become inflamed, swollen, and painful. Left untreated, the gums pull away from the teeth, leaving pockets where bacteria collect and can cause infection.

Prolonged inflammation can lead to the destruction of gum tissue and the connective tissues which anchor our teeth to the alveolar bone in the jaw. Bone loss and even tooth loss can result from untreated gum disease.

Fortunately for us, there are foods that fight inflammation, help with healing, and strengthen and support gum tissue before problems develop. Let’s take a look at some of the valuable gum-healthy nutrients you can add to your diet with some tasty additions to your shopping list:

• Vitamin A

This vitamin is essential for the health and healing of mucous membranes, including both our gums and the soft membranes in our mouths. Vitamin A is found in animal products such as dairy foods, meat, and liver, or formed in the body from beta-carotenes, found in plant foods such as carrots, peppers, pumpkin, squash, and sweet potatoes.

• Vitamin C

Vitamin C is one of the so-called “essential nutrients.” These are nutrients that are necessary for our bodies to function properly, and which can only be supplied in our diets. Vitamin C is needed to help our bodies produce collagen, the substance that provides support and structure to our tissues. It also helps us repair tissue, and is a powerful antioxidant. One of the obvious signs that your diet doesn’t contain enough vitamin C is inflamed and bleeding gums.

When we think vitamin C, we instantly picture citrus fruits. Oranges, lemons, limes, grapefruit, and all their cousins are a wonderful source of vitamin C. Looking for a little more variety? You’re in luck! Fruit fans can load up on strawberries, kiwi fruit, mangos, and papayas. Love your veggies? Red peppers, kale, cauliflower, Brussels sprouts, and broccoli contain more vitamin C per serving than a medium orange.

• Vitamin D

Vitamin D, of course, is essential for dental health because it helps us absorb the calcium that keep teeth (and bones) strong. And there’s more! It helps the body fight infection and reduce inflammation, and studies have suggested a link between vitamin D and better gum health.

Sunlight exposure leads our bodies to produce vitamin D naturally, but it is available in foods as well. Fatty fish, such as salmon, tuna, and herring, are a rich source of the vitamin, as are cod liver oil and egg yolks. It’s also available in foods fortified with vitamin D, such as cow’s milk, soy milk, orange juice, and even many cereals. And while you’re getting the benefit of vitamin D from dairy, you’re also enjoying the proteins they contain, one of which helps neutralize acids in the mouth that can irritate gums. Bonus!

• Iron

Iron deficiency can lead to a common form of anemia, where your body isn’t creating enough red blood cells to deliver the oxygen your tissues need. (In fact, one of the most noticeable symptoms of anemia is pale gums.) This condition can cause a number of problems, including an immune system that doesn’t work as well as it should. A strong immune system helps us fight infection, including gum disease and other oral infections.

A diet rich in iron can help prevent anemia. We absorb the most iron from foods such as meat, eggs, and fish, but iron is also present in beans, lentils, leafy greens, whole grains, nuts, and prunes if you’re looking for flavorful vegetarian options.

• Omega-3s

Research has shown a possible relationship between getting the recommended dietary amounts of omega-3s and a lower occurrence of periodontitis. In other studies, omega-3s have shown promise in reducing the periodontal inflammation that can lead to severe gum disease.

Our bodies can’t produce omega-3 fatty acids on their own, but fatty fish such as salmon, tuna, herring, and sardines, a variety of high-fat seeds and nuts, and plant oils contain several different types of omega-3 fatty acids. Some foods are fortified with omega-3s, or your doctor might recommend fish oil (and algae oil for vegetarians) as a supplement.

Speaking of supplements, why not just add vitamin, mineral, and other nutritional supplements to our daily diet? Believe it or not, there can actually be too much of a good thing. Body chemistry requires balance, so talk to your doctor about whether or not supplements are necessary in your particular diet, and just what kinds and how much to take.

Whew! That’s a lot to think about for one shopping cart, but that’s just a small portion of the many foods—and the many vitamins and minerals—you can add to your menu to support oral health in a tasty, effective, and positive way.

After all, when we think about the “do’s and don’ts” of a dental-healthy diet, it’s all too often a collection of “don’ts.” Don’t eat a lot of sugar. Avoid acidic foods and beverages. Cut down on refined carbs.

And all of those suggestions are important, because the early stages of gingivitis are often easy to miss. So, let’s not forget the things we can actually do to be proactive with our gum health. Besides good dental hygiene and regular check-ups, eating a well-balanced diet helps keep your gums their healthiest.

Periodontists are specialists in the diagnosis of gum disease and the treatment of all the structures that support the teeth. And while we are trained and experienced in the most effective procedures for treating periodontal disease, we are also experts in providing you with the most up-to-date suggestions for prevention. If you have any questions or concerns about maintaining your periodontal health, contact our Wilmington periodontal office. We could provide you with some food for thought!

On the last Wednesday in September, we celebrate “Women’s Health and Fitness Day.” Because your oral health plays such a large role in your general health and well-being, let’s look at a few of the ways you can treat yourself with the care you need and deserve at different stages of your life.

Puberty 

Puberty begins around the ages of 8 to 13, and typically lasts from 2-5 years. During this time, our bodies begin to produce the hormones estrogen and progesterone, which affect not just the reproductive organs, but our brains, hearts, skin, hair, bones, and more. These hormones can also affect our oral health.

• Gingivitis

Hormonal fluctuations make gum tissue more sensitive to irritants like plaque and bacteria. You might find that your gums are swollen, tender, red, or bleed easily. 

What you can do:

Keeping up with your dental hygiene is the best defense against gingivitis. Even if your gums feel a bit tender, it’s important to keep up with your brushing and flossing because proactive dental hygiene can reverse gingivitis before the condition becomes more serious. If symptoms persist, a visit to the dentist is in order.

Menstruation

• Menstruation gingivitis

Elevated hormone levels can also cause gingivitis during the menstrual cycle, usually beginning a few days before the start of your period and ending soon after your period begins. Some women also experience canker sores and swollen salivary glands during this window.

What you can do:

Be mindful of any oral changes during your menstrual cycle. Pay special attention to dental hygiene, and, if you develop canker sores, talk to your dentist or doctor about the best way to care for yourself while they heal.

Pregnancy

Pregnancy brings about many physical changes, including potential changes in your oral health.

• Pregnancy Gingivitis

Pregnancy hormones cause an increase in the blood supply to your gums while at the same time making them more vulnerable to irritation from bacteria and plaque. You may find that your gums are redder, more swollen, and more likely to bleed when brushing. 

• Loose Teeth

During pregnancy, increased hormone production helps relax and loosen ligaments and joints in preparation for birth. Teeth are held in place by ligaments, and you might be alarmed to discover your teeth are looser as well. Typically, this situation resolves when the baby is born.

• Pregnancy Granulomas

Some pregnant women may also experience pregnancy granulomas. These dark red swellings are benign tumors which appear along the gumline. These generally shrink on their own, but, if a granuloma is causing you pain or discomfort, it can be removed surgically.

What you can do:

Let your dental team at Montchanin Periodontics and Implantology know right away when you learn that you’re pregnant. You’ll get helpful advice about brushing and flossing techniques, pregnancy-related oral conditions to look out for, when to schedule dental treatment and cleanings, a tooth-healthy diet, and more. If you have concerns about gum disease, see your periodontist or dentist to make sure your gums are healthy.

Menopause and Later Years

As we age, there’s an increased risk of oral health issues.

• Osteoporosis

Osteoporosis causes loss of density in the bones—including the bones and bone tissue which hold our teeth in place. Studies indicate that women with osteoporosis suffer significantly higher tooth loss than women who don’t have the disease.

• Dry Mouth

Saliva helps protect the teeth from cavities by washing away bacteria and food particles and by neutralizing acids in the mouth. Reduced estrogen production, medications, and medical conditions such as diabetes can all cause dry mouth. 

• Gum Disease

About 2/3 of older Americans have gum disease, which is one of the leading causes of tooth loss in adults. Lower hormone levels have been linked to increases in periodontal diseases.

• Oral Cancer

Oral cancer is more common as we age, and, while men are affected almost three times as often as women, we should be aware of the common symptoms of oral cancer, including a sore in the mouth which doesn’t heal, a lump or thickening in the mouth, red or white patches on the tongue, gums, and other oral tissues, loose teeth, or persistent earaches or discomfort when eating or swallowing.

What you can do:

Visit your dentist and doctor for preventative care and whenever you are concerned about your oral health! Whether it’s helping you prevent gum disease, osteoporosis, and dry mouth or discovering dental and medical conditions early, when they are more likely to be treated successfully, regular visits to your health care professionals can help ensure that you have years of happy smiles ahead.

Hormonal changes throughout life make us vulnerable to gingivitis and other gum problems. When you suffer from persistent gum disease at any stage of life, make sure a periodontist is one of your go-to health care experts. Gum health is essential to oral health, and periodontists are the specialists in diagnosing and treating gum disease, whether it’s recurring gingivitis or destructive periodontitis. 

Missed the date this year? No worries! Women’s Health and Fitness Day is one day in September, but every day in the calendar is a good day to think about your oral health. Partner with Dr. Keller and Dr. Tibbs, your dentist, and your doctor to help make your healthy smile something to celebrate all year long! Make an appointment with Montchanin Periodontics and Implantology in Wilmington today!

Labor Day honors the contributions that workers have made to this country, and for many Americans, the holiday is a great time to relax at home with family and friends. But there are quite a few people who celebrate the holiday by getting out of town, with an estimated 33 million people traveling more than 50 miles over Labor Day weekend each year. If you’re dreaming of a great Labor Day escape but you’re not quite sure where to go, here are a few ideas from our team at Montchanin Periodontics and Implantology to give you some travel inspiration.

Explore a National Park

On a national holiday like Labor Day, it’s only fitting to experience the beauty of America’s landscapes by heading to the nearest national park. If you’re confined to an office most days of the year, national parks can provide a relaxing and scenic escape, whether you’re by yourself, traveling with a group of friends, or bringing the whole family along. Depending on how close you live to the nearest park, you can stay for an afternoon or for longer than a week. With 58 parks located in 27 states, there are plenty of beautiful areas to choose from.

Chow Down in a BBQ Haven

Barbecuing is a popular Labor Day activity, but instead of sweating over your own grill or oven, try visiting one of the country’s BBQ capitals. U.S. News and World Report names Memphis as the top BBQ destination, with more than 80 BBQ restaurants in the city, most notably Corky’s BBQ and Central BBQ. Kansas City is also known for the sweet taste of its sauces, while central Texas is said to have perfected the technique of smoking tender and flavorful brisket.

Relax on the Beach

Many people think of Labor Day as the unofficial start of fall, which brings cooler temperatures, more rain, and for many people, an end to lazy days at the beach. End your beach days with a bang by taking a trip to one of the coasts or to a lakeside beach. For an added dose of festivity, find a city or town that celebrates the occasion with a fireworks display over the water.

Whether you’re looking to turn your getaway into a full week affair or you simply want to experience a quick escape, make the most of your holiday by changing your surrounding scenery. Happy Labor Day from the Periodontist practice of Dr. Keller and Dr. Tibbs!

Water picks, sometimes called “oral irrigators,” make an excellent addition to your regular home care regimen of brushing and flossing. Especially helpful to those who suffer from periodontal disease and those patients of ours undergoing orthodontic treatment with full-bracketed braces, water picks use powerful tiny bursts of water to dislodge food scraps, bacteria, and other debris nestled in the crevices of your mouth. Children undergoing orthodontic treatment may find using a water pick is beneficial if their toothbrush bristles tend to get caught on their wires or brackets.

When you use a water pick, you’re not only dislodging any particles or debris and bacteria you might have missed when brushing, you are also gently massaging the gums, which helps promote blood flow in the gums and keeps them healthy. While water picks are an excellent addition to your daily fight against gingivitis and other periodontal diseases, they are incapable of fully removing plaque, which is why Dr. Keller and Dr. Tibbs and our team at Montchanin Periodontics and Implantology want to remind you to keep brushing and flossing every day.

If you have sensitive teeth or gums and find it uncomfortable to floss daily, water picks are a good alternative to reduce discomfort while effectively cleaning between teeth. Diabetics sometimes prefer water picks to flossing because they don't cause bleeding of the gums, which can be a problem with floss. If you have a permanent bridge, crowns, or other dental restoration, you may find that a water pick helps you keep the area around the restorations clean.

So how do you choose the right water pick?

Water picks are available for home or portable use. The home versions tend to be larger and use standard electrical outlets, while portable models use batteries. Aside from the size difference, they work in the same manner, both using pulsating water streams. A more crucial difference between water picks is the ability to adjust the pressure. Most home models will let you choose from several pressure settings, depending on how sensitive your teeth and gums are. Most portable models have only one pressure setting. If you want to use mouthwash or a dental rinse in your water pick, check the label first; some models suggest using water only.

Please give us a call at our Wilmington office if you have any questions about water picks, or ask Dr. Keller and Dr. Tibbs during your next visit!

An article was released to the public stating that dental X-rays contribute to a type of brain cancer. After reading an article like this, your first thought may be to avoid dental X-rays, but you may want to hold off on that quick judgment. As with any treatment we offer at Montchanin Periodontics and Implantology, education is your most valuable tool in deciding what is best for you.

How often dental X-rays are taken is based on risk for infection, physical symptoms, and clinical findings. The American Dental Association (ADA) is a governing body over the dental profession. The ADA states, “ . . . healthy adults receive routine mouth X-rays every two to three years. Dental X-rays are recommended every one to two years for children and every 1.5 to three years for teens. Children often require more X-rays than adults because of their developing teeth and jaws and increased likelihood for cavities.”

A "caries risk category" often determines how often dental X-rays are taken. The most recent documented resource to determine a caries risk is Caries Management by Risk Assessment (CAMBRA). This was adopted by the ADA and is used by dental professionals giving interval recommendations for X-rays.

With knowledge of your risk for dental infection, you will be informed by Dr. Keller and Dr. Tibbs of the interval at which dental X-rays should be taken. You can rest assured that the standards published by the ADA have been researched extensively and are there to protect your personal health and safety.

Dental X-rays are most commonly digital, which significantly reduces exposure. There is more radiation exposure from the sun or in an airplane than in a dental X-ray. It is common practice to use a lead apron with a thyroid collar for protection during X-ray exposure.

Having a cavity means having an active, potentially harmful infection. Diagnosing such infection with minimal exposure through digital dental X-rays at our Wilmington office does more good than harm.

Do you ever find yourself gnawing at your nails? Nail-biting is a very common and difficult to break habit which usually has its beginnings in childhood. It can leave your fingers and nail beds red and swollen. But if you think that your nails are the only ones getting roughed up by nail-biting you'd be mistaken—so are your teeth!

According to a study by the Academy of General Dentistry, those who bite their nails, clench their teeth, or chew on pencils are at much higher risk to develop bruxism (unintentional grinding of the teeth). Bruxism can lead to tooth sensitivity, tooth loss, receding gums, headaches, and general facial pain.

Those are some nasty sounding side effects from chewing on your nails. Most nail-biting is a sign of stress or anxiety and its something you should deal with. So what steps can you take if you have a nail-biting habit?

There are several things you can do to ease up on nail-biting:

• Trim your nails shorter and/or get regular manicures – Trimming your nails shorter is an effective remedy. In so doing, they'll be less tempting and more difficult to bite on. If you also get regular manicures, you’ll be less likely to ruin the investment you’ve made in your hands and fingernails!
• Find a different kind of stress reduction – Try meditation, deep breathing, practicing qigong or yoga, or doing something that will keep your hands occupied like squeezing a stress ball or playing with a yo-yo.
• Wear a bitter-tasting nail polish – When your nails taste awful, you won't bite them! Clear or colored, it doesn't matter. This is also a helpful technique for helping children get over the habit.
• Figure out what triggers your nail-biting – Sometimes it's triggered by stress or anxiety and other times it can be a physical stressor, like having hang nails. Knowing what situations cause you to bite your nails will help you to avoid them and break the habit.
• Wear gloves or bandages on your fingers – If you've tried the steps above and they aren't working, this technique can prove effective since your fingernails won't be accessible to bite.

If you're still having trouble with nail-biting after trying these self-help steps, it's best to consult your doctor, dermatologist, or Dr. Keller and Dr. Tibbs. For some, it may also be the sign of a deeper psychological or emotional problem.

Whatever the cause, nail-biting is a habit you need to break for your physical and emotional well-being. If you have any questions about the effects it can have on your oral health, please don't hesitate to ask Dr. Keller and Dr. Tibbs during your next visit to our Wilmington office.

Gum disease, also called periodontal disease, is an infection of the gum tissues, and is something seen all too often by Dr. Keller and Dr. Tibbs. Extending from inflammation of the gums (gingivitis) to more serious infections and complications (periodontitis), there is a wide range of gum disease severity.

Not only does gum disease affect the health of your mouth and teeth, but according to the National Institute of Dental and Craniofacial Research, it can affect your general health as well. This is because an infection in the mouth as a result of gum disease can travel to other parts of your body through the bloodstream. Gum disease is also a risk factor for heart disease, and can play a role in blood sugar levels.

Causes and Risk Factors

Gum disease is essentially caused by the build-up of bacteria in your mouth. If you brush and floss every day, this bacteria is washed away, but if not, it turns into plaque. If left unchecked, this plaque buildup can lead to gum disease.

Some of the common risk factors for gum disease include not taking good care of your teeth, failing to have one’s teeth cleaned every six months, experiencing hormonal changes, smoking cigarettes, developing diabetes, being genetically exposed to gum disease, or taking certain types of medications.

Gingivitis versus Periodontitis

There are two main types of gum disease: gingivitis and periodontitis. Both are bad for you, but gingivitis is less severe. It is typically the first stage, and involves inflammation of the gums from plaque and tartar on the teeth. If your gums are swollen and bleed, this is a sign of gingivitis.

Periodontitis, a more severe case of gum disease, occurs when your gums pull away from the teeth and pockets form. These pockets are a concern because they can harbor infection.

Treatments for Gum Disease

Treatments for gum disease depend on the cause and severity. Deep cleaning to remove the plaque underneath the gum line – called root scaling and planing – is one of the most common treatments for gum disease. Antibiotics placed under the gums to rid you of an infection or reduce the inflammation may also be advised. In some cases, surgical procedures, including flap surgery and bone and tissue grafts, are needed.

If you have bleeding or swollen gums, pockets between your gums and teeth, pain, or other issues, you might have gum disease. Visit Montchanin Periodontics and Implantology for an exam and learn the best course of action.

Pregnancy involves a lot of alterations in your health. Montchanin Periodontics and Implantology is here to help you understand the oral health aspects of your pregnancy.

As you may already know, your body becomes more susceptible to bacterial complications. In terms of oral health, you may be at a higher risk for gingivitis and periodontal disease during the course of your pregnancy.

The hormonal changes in your body can create a more welcoming environment for gum infections, including gingivitis. Although you may continue to brush and floss on a regular basis, and maintain your schedule of cleaning appointments, you are still prone to an increased risk of gingivitis. Your gums may feel more sensitive and become more prone to bleeding because of the increased amount of blood flowing through your body. This can also be a side effect of periodontal disease, which nearly 40% of pregnant women have.

In order to avoid painful dental visits, you should attempt to brush more than twice a day and always floss regularly. We recommend investing in a good mouthwash for extra protection against plaque buildup. Other oral conditions to watch out for during pregnancy include oral gingival lesions, tooth mobility, tooth erosion, and dental caries.

Keeping your oral health in top shape will prevent bacteria from circulating to other places in your body during pregnancy. Your immune system is more likely to be compromised, which means you generally face an increased risk for illnesses.

Don’t forget that you share nutrients and pathogens with your baby, so it’s crucial to reduce your risks in every possible way. If you think you may be experiencing an oral health issue during your pregnancy, please call our Wilmington office to schedule an appointment, and we will be happy to help you.

We all know that brushing your teeth and flossing regularly keeps your smile sparkly and bright, but did you realize that cleaning your teeth can actually help your heart? Recent research suggests that people with periodontal disease also have a higher cardiovascular risk, which means they are more vulnerable to heart attacks or stroke. It’s probably not time to throw away those running shoes in favor of a new toothbrush, but this is an added incentive to maintain good oral hygiene.

Relationship between Periodontal Disease and Cardiovascular Health

In 2003, researchers from the University of Buffalo conducted analyses which suggested that patients with gum disease were also at elevated risk of cardiovascular problems. Furthermore, people with more severe cases of gum disease have even poorer heart health. Although the exact causes of this relationship remain unknown, scientists continue to explore the impact of oral hygiene on broader health.

One hypothesis is that poor oral hygiene leads to inflammation, which negatively affects the heart. Gum disease occurs when bacteria build up in the mouth, and feed off sugars found in food. These bacteria release compounds that contribute to inflammation and red, swollen gums. The same inflammatory compounds may affect the heart, increasing overall cardiovascular risk.

Protect Your Teeth, Protect Your Heart

Taking a few commonsense measures can go a long way to improving your oral health and your cardiovascular risk. Consider the following:

• Brush twice daily, and floss at least once per day. Brushing your teeth at least twice a day cleans away the harmful bacteria that contribute to gum disease. Similarly, flossing your teeth ensures that dangerous bacteria that build up between each tooth get swept away. These simple steps are the easiest ways to reduce your risk of periodontal disease.
• Eat healthy foods. Those sugary snacks that you love so much don’t help your teeth. Whenever possible, stick to a healthy diet of fruits, vegetables, and whole-grain foods. For example, grab an apple or a few celery sticks for a mid-afternoon snack, rather than indulging in that candy bar.
• Drink water. Staying hydrated doesn’t just help your body – it also swishes bad bacteria away from your tooth and gum surface. Drinking plenty of water improves your overall oral health. It’s particularly helpful after eating a sugary or sticky snack, because water can reduce plaque buildup.
• Visit Montchanin Periodontics and Implantology. Dr. Keller and Dr. Tibbs and our staff will monitor your mouth for signs of periodontal disease and can make specific recommendations to keep your mouth – and your heart – safer.

Most people think braces are all about their teeth. While it is true orthodontics is meant to move your teeth into proper position, there's more to it than that. To safely move your teeth with braces, you're going to need healthy and stable gums (or periodontium—the tissues that support your teeth).

For this reason it's critical to have your periodontal health evaluated prior to getting braces. This applies particularly to adults, since a 2013 study by the Center For Disease Control found that an estimated 47.2% of adults 30 years of age and older had periodontitis (gum disease). If you do have periodontitis, moving your teeth with braces will only make things worse.

Conversely, there is also risk for periodontal disease if you don't get orthodontic treatment. Malocclusion, as well as crooked and spaced teeth, can all contribute to periodontal disease. In these situations your teeth and gums are more difficult to clean and become breeding grounds for disease causing bacteria. Bad oral hygiene combined with these traits can greatly contribute to the development of periodontitis.

So, periodontics and braces have a tricky relationship. On one hand, you shouldn't get braces if you show signs of developing or have periodontitis, while on the other hand, braces can help prevent the possibility of developing periodontitis by correcting the bite and straightening the teeth.

If you are 30 years of age or older and are considering getting braces, it would be wise to first:

• Let Dr. Keller and Dr. Tibbs know about your desire to get braces
• Get an exam to make sure you're in good periodontal health and a good candidate for braces
• If you are a good candidate, keep an eye on your teeth and gums and get regular dental checkups throughout your entire course of treatment.

If you are in any doubt about the status of your teeth and gums, it's always best to get them checked before embarking with braces treatment. For more information or to have your periodontal health assessed for braces treatment, please contact our Wilmington office.

Happy Independence Day from Dr. Keller and Dr. Tibbs and team! The Fourth of July celebrations in America may have changed a lot over the years, but there is no doubt that we Americans love to celebrate the anniversary of our country's independence! Today we're devoting the Montchanin Periodontics and Implantology blog to some fun facts about the Fourth!

• My, how we have grown! This year the United States Census Bureau estimates that our country has 313.9 million residents celebrating the Fourth of July this year, but back in 1776 there were just 2.5 million members of the country.
• Our country loves to show how proud that we are of our independence. Did you know that there are 31 United States places with the word “Liberty” in their names? The state of Iowa actually has four towns with the word Liberty in the name: Libertyville, New Liberty, North Liberty, and West Liberty.
• The United States loves Fourth of July food! It is expected that around 150 million hot dogs are eaten on the Fourth each year. One of the Fourth's most popular sides, potato salad, goes just perfectly with the hotdogs and hamburgers that are standard Fourth of July fare. Some people choose potato chips instead, but we wouldn't have such a plethora of potatoes if not for the prodigious production of the states of Idaho and Washington -- they provide about half of all the potatoes in the United States today!
• Americans love celebrating the Fourth outdoors: About 74 million Americans fire up their BBQ grill every Fourth of July.
• The Chinese contribution: Did you know that Americans have spent more than $211 million on fireworks that were imported from China?

No matter how your family chooses to celebrate the Fourth, stay safe, take precautions, and don't forget to brush after your fabulous Fourth feast!

No, we don’t mean the latest foamy offering from your favorite microbrewery. When you’re thirsty, one of the best options available is literally at your fingertips—tap water, straight from your faucet. It might not be the most adventurous choice, but drinking a tall glass of fresh tap water is refreshing in so many healthy ways.

Physical Health

Water conveniently available at home is much more than a convenience. We need to keep hydrated, because our bodies are made to run on water. To name just a few of its benefits, water provides nutrients to organs and cells, eliminates waste, regulates our temperature, and protects our joints and delicate tissues. Dr. Keller and Dr. Tibbs and our Wilmington team will tell you all about the importance of proper hydration when it comes to your mouth, gums, and teeth, but here are a few highlights:

• We need to be hydrated to produce enough saliva. Saliva, which is more than 90% water, helps prevent cavities and protect enamel by both washing away bacteria and balancing acids in the mouth which can cause decay.
• Tooth enamel is so strong because it’s made of calcium and phosphate. These minerals are leached from our enamel by both bacteria-produced acids and dietary acids. Saliva also contains calcium and phosphate, and, with fluoride, restores these minerals in our enamel, leaving teeth stronger and less likely to develop cavities.
• As a bonus, a quick rinse with water when you can’t brush after eating is a great way to remove food particles left behand—especially healthy when you’ve had sugary or acidic foods.

Ecological Health

If you want to reduce waste, one of the easiest ways to do so is to use tap water instead of bottled water.

• Bottled water has a carbon footprint. It takes energy (and additional water) to create plastic and glass bottles, to label them, and to transport them. Water piped into your home from local sources? No bottles, labels, or long road trips necessary.
• Water bottles should be recycled. Unfortunately, many cities don’t offer, or have stopped offering, recycling. Plastic and glass empties end up in landfills, littering our neighborhoods, or in our waters.

Budget Health

Getting your daily hydration from bottles can add up quickly.

• Bottled water can cost hundreds of times as much as tap water. While local water prices vary, the average gallon of tap water costs less than a penny. No matter what kind of sale your local store is offering, bottled water will never be the bargain tap water is.
• When you buy many small bottles instead of a few larger ones, or choose more expensive “designer” water, your costs can mount up even more.
• When you need to bring water with you for work, sports, or other activities, consider filling a reusable bottle with water from home.

Dental Health

Getting the recommended amount of fluoride in your diet is one of the single best things you can do for your dental health. Fortunately, many communities make this easy for us by providing fluoridated drinking water.

• Fluoride works with the calcium and phosphate in your saliva to create stronger enamel, so cavities can’t form as easily when your teeth are exposed to plaque and food particles.
• Fluoride helps strengthen your child’s permanent teeth as they develop, and helps prevent cavities in both baby teeth and permanent teeth as children grow.
• If your community doesn’t offer fluoridated water, ask Dr. Keller and Dr. Tibbs for the best way to get the fluoride you need to protect your teeth.

For the good of your body, your planet, your wallet, and last, but most certainly not least, the health of your teeth and gums, consider a glass of water. So many benefits—and you have them all on tap!

February is Gum Disease Awareness month, a timely reminder that preventing gum disease is one of the best ways to protect our oral health. 

Gum disease is easily treated in its earliest stages. Left untreated, the progressive nature of gum disease makes it one of the leading causes of tooth loss in adults. 

Let’s take a moment in this shortest month of the year to discuss how understanding, treating, and, above all, preventing gum disease can help us enjoy long-lasting healthy smiles.

How Gum Disease Develops

Gingivitis is the first, mild stage of gum disease. 

• Gingivitis begins with plaque. 
• Plaque irritates gum tissue, causing inflammation, which is the body’s reaction to injury or infection. 
• Typical symptoms include gums which are swollen or red. The gums might feel tender or bleed easily when you brush or floss. You could develop persistent bad breath. 

With proper care, gingivitis is reversible. Because gingivitis symptoms can be very mild, they’re sometimes overlooked. That’s why it’s important to keep up with regular checkups to discover and treat the disease in its earliest stages. 

Periodontitis is a serious gum disease which is destructive to the structures which support our teeth: gums, connective tissue, and bone. 

• Plaque, when it’s not removed, hardens into tartar, which can form on the tooth above and below the gumline. 
• The gums pull away from plaque and tartar deposits, creating a space between the gum tissue and tooth roots. 
• As the gums continue to recede, pockets form between the teeth and gums.
• Infection-causing oral bacteria thrive in these pockets. Gum infections can lead to painful abscesses—but gum disease is not just an infection.
• The body normally responds to bacterial infection with inflammation. With periodontitis, this inflammation becomes destructive chronic inflammation. 
• Over time, chronic inflammation and infection break down the gum tissue, bone, and connective tissue holding teeth in place. Teeth become loose or shift out of alignment.

The tooth’s support structure eventually becomes so compromised that extraction is the only option. That’s why prompt treatment is essential.

Treating Gum Disease

Several options are available to treat gum disease, depending on its severity.

Treatment for gingivitis can be as simple as paying more careful attention to your brushing and flossing and, if necessary, seeing your dentist for a professional cleaning. In some cases, your dentist might recommend an antimicrobial mouthwash or rinse.

Periodontitis is best treated by a periodontist, and treatment will be based on how advanced the condition is. Periodontists have years of specialized study after dental school devoted to treating the supporting structures surrounding the teeth. A periodontist, such as Dr. Keller and Dr. Tibbs, can provide:

• Topical, oral, or time-release medications to treat infection.
• Non-surgical deep cleaning procedures called scaling and root planing to remove plaque and tartar above and below the gumline, allowing gum tissue to reattach to the tooth. 
• Flap surgery for more advanced gum infection which reduces pocket depth and re-secures the gums snugly around the teeth.
• If needed, bone grafts, gum grafts, and other regenerative procedures which help repair and restore damaged tissue.

Preventing Gum Disease

What many people aren’t aware of is just how preventable gum disease is! 

• Brush twice a day, or as often as your dentist recommends. 
  • Use proper brushing technique, angling your brush toward the gums to gently clean around and below the gum line. 
  • Use a soft-bristled brush to protect both gum tissue and tooth enamel.
• Floss once each day or as directed by your dentist. Flossing removes food particles and plaque between the teeth, and it also helps remove plaque from the area around the gum line.
• Conditions such as family history, hormonal changes, medical conditions, age, poor diet, smoking, and other factors can increase your chances of developing gum disease. Talk to Dr. Keller and Dr. Tibbs if you are in a higher risk group about proactive gum care.
• See your dentist regularly. Gum disease can be invisible in its beginning stages. Discovered early, treatment is simple and effective. 
• Having your teeth cleaned every six months, or as recommended, will remove tartar buildup which brushing alone can’t handle. You can get tips for better brushing and flossing techniques from the team at Montchanin Periodontics and Implantology in Wilmington, too!

Last, while gum health is essential for dental health, you may not be aware that healthy gums could affect more than just your oral health. Scientists are studying the potential links between gum disease and conditions such as heart disease, diabetes, and arthritis.  

Even when it seems like there aren’t enough days in the month or hours in the day, it takes just a few minutes daily to care for your gums and teeth. And when you’re aware of just how much those few minutes mean to a healthy smile, it’s time well spent!

Bad breath, or halitosis, is probably not a matter of life or death. But it can make you feel self-conscious and have a negative impact on your life. The majority of people suffering from bad breath are dealing with oral bacterial. However, there are other causes of this embarrassing problem. Learning more can help you fight this solvable problem.

Five Causes of Embarrassingly Bad Breath

1. Dry Mouth. A decrease in saliva flow can be caused by several things. Most often, medication or mouth breathing are the culprits. As saliva helps wash away food particles from your mouth, it prevents bad breath. Dry mouth can be dealt with by stimulating salivation.
2. Gum Disease and Poor Oral Hygiene. Not brushing and flossing well enough or with enough frequency can lead to gum disease, which leads to bad breath. Halitosis can be a sign that plaque is present on your teeth.
3. Food-Related Bad Breath. Food particles that aren't brushed or flossed away attract bacteria that leads to bad breath. It's especially important to brush after eating strong-smelling foods, such as garlic or onions.
4. Smoking and Tobacco. Tobacco is bad for your health, and that includes your oral health. Smoking or chewing tobacco can contribute toward the development of gum disease, as well as oral cancer.
5. Mouth Infections and Other Medical Problems. A mouth infection, sinus infection or even the common cold can cause you to temporarily have bad breath. Even conditions such as diabetes and reflux can cause halitosis. It's always wise to see Dr. Keller and Dr. Tibbs to help determine the cause.

We are Your Ally

Even if you maintain good oral hygiene, it's important to see Dr. Keller and Dr. Tibbs at our Wilmington office to deal with or avoid problems with bad breath. We can help you uncover the cause of halitosis, while also providing solutions that allow you to enjoy fresh breath without relying on mints and breath fresheners. As is the case with all things related to oral health, we are your number-one ally when it comes to eliminating the problem of bad breath.

Part of presenting our best faces to the world is making sure our smiles are bright and our breath is fresh. Sure, we’ve all been embarrassed by an occasional pungent reminder of that garlic bread we just couldn’t pass up, but with daily brushing and flossing, fresh breath is the norm. Until it isn’t.

If you’ve been carefully avoiding strong foods in your diet, if you’ve started brushing a lot more often, if you’re relying on mints and mouthwash to get you through the day, and you still have bad breath, it’s time to see your dentist or doctor.

Chronic bad breath can be a symptom of tooth decay, dry mouth, oral infections, diabetes, kidney disease, and many other medical or dental problems. It can also be a red flag for serious gum disease, or periodontitis.

How does gum disease cause persistent bad breath? The bacteria and plaque that we are careful to brush away from the surface of our teeth can also stick below the gum line. These bacteria irritate the tissues around them, and the area becomes inflamed. Pockets form around the teeth where bacteria collect and multiply, becoming the source of that unpleasant odor.

And, while bad breath is an embarrassing consequence of gum disease, there are other consequences that are far more serious. Infection causes inflammation, and untreated infection and inflammation lead to the breakdown of gum and bone tissue and, eventually, even tooth loss.

If your dentist discovers signs of advanced gum disease, it’s time to give a periodontist like Dr. Keller and Dr. Tibbs a call! Because this dental specialty requires three additional years of study after dental school, focusing on the treatment of periodontal disease and cosmetic restorations, periodontists have the knowledge and experience to treat the cause of your gum disease and to restore your gum and bone health.

What can your periodontist do for you? Periodontists are skilled in many procedures that can be used to save gums and teeth, including:

• Antibiotic therapy, which can be used alone or with other procedures to treat periodontitis.
• Non-surgical treatments, such as scaling and root planing, which remove plaque and tartar from areas of the teeth above and below the gum line and clean and smooth tooth surfaces.
• Flap surgery, which allows the periodontist to remove tartar, smooth any irregular tooth surfaces, and then reposition the gum tissue snugly around the teeth to eliminate pockets where bacteria can multiply.
• Bone and gum grafts, bone surgery, and surgical tissue regeneration, to replace and repair damaged bone and gum tissue.

If you are experiencing persistent bad breath, talk to your dentist or doctor about the possible causes, and whether a visit to our Wilmington office is in order. Periodontal treatment can stop the progression of gum disease, and even restore damaged tissue and bone to make sure you keep your teeth for a lifetime. And one additional bonus? The return of your bright smile and fresh breath. Let your periodontist help you breathe easy once again!

Xerostomia, commonly known as dry mouth, is a condition in which the salivary glands in the mouth don’t produce enough saliva. Saliva keeps the mouth moist and cleanses it of bacteria. A lack of it makes for an uncomfortably dry mouth that is also more susceptible to infection and disease.

Symptoms of dry mouth include:

• Dryness or a sticky feeling
• Frequent thirst
• Burning sensations or redness in the throat or on the tongue
• A sore throat or hoarseness
• Difficulty chewing, swallowing, or tasting food

Dry mouth usually comes about as a side effect of certain medications or medical conditions, but can also be caused by damage to the salivary glands because of injury or surgery.

If you're experiencing any of the symptoms of dry mouth, here are a few tips for what to do:

Double-check medications: If you are taking any prescription or over-the-counter medications, speak with Dr. Keller and Dr. Tibbs to see if any of these could be causing the dry mouth as a side effect.

There may be ways to alleviate the symptoms.

• Stay hydrated: Whether you have dry mouth or not, it’s essential to stay hydrated. Drink plenty of fresh and pure water throughout the day. A good rule of thumb is to drink eight eight-ounce glasses of water a day.
• Suck or chew on a natural, sugar-free candy or gum: Sucking on candy or chewing gum will keep your salivary glands producing saliva. Healthier versions of sugar-free candy and gum are available these days. Some are made with xylitol, a sugar alcohol that actually helps prevent tooth decay.
• Add moisture to your living spaces: Try adding a vaporizer to your bedroom or the rooms where you spend the most time. It’s best for your home to have a humidity level of between 40 to 50%. Anything less than 30% is too low. You can measure humidity with a hygrometer, which is easy to find at your local department store or online.

These are just a few general tips, but if you’re experiencing the symptoms of dry mouth often and it’s interfering with your life, pay a visit to our Wilmington office. That way you’re more likely to get to the root of the problem.

Memorial Day is not only a federal holiday in the United States, but it is a day of observance and remembrance of those who died in service. Originally known as Decoration Day, this solemn day has been marked on calendars since the end of the American Civil War as a day to commemorate both the Confederate and Union soldiers who fought and died in the war.

Marking the graves of fallen soldiers with flowers, wreaths, or other tokens has been practiced throughout history, but it wasn't until the mark of the end of the Civil War that a special day was decided upon as the one to spend in remembrance. By 1890, every state in the country was observing Decoration Day. It wasn't until 1967 when the name formally changed from Decoration Day to Memorial Day, in order to encompass all fallen American soldiers in all wars and conflicts. In June of 1968, Congress moved the official date of Memorial Day to the last Monday in May in order to create a three day weekend.

Today, while there is certainly an air of remembrance on Memorial Day, it has become more a day of spending time with family, friends, and other loved ones. This day is also heralded as the start of summer, with many schools finishing for the year around this time. Our team at Montchanin Periodontics and Implantology remembers it as a day to take solace and remembered those lost.

Traditional observances of Memorial Day are still held, and they often involve raising the American Flag then lowering it to a half-staff position until noon, and then raising it once again to its full height afterwards. The flag is lowered to remember those who've lost their lives while in service to their country, and then it is raised to signify our willingness to not let their sacrifice be in vain.

From community parades in the Wilmington area, backyard cook-outs, and fireworks to formal ceremonies, Memorial Day is commemorated in many different ways. No matter how you choose to spend this day, take a moment to remember those who've lost their lives in an effort to preserve our freedom.

Medical doctors and dental health professionals, like Dr. Keller and Dr. Tibbs, have debated over the connection (or lack thereof) between gum disease and heart disease. While there still is no unanimous consensus on whether there is a link – or the extent to any link there may be – several studies offer some interesting insight into possible correlations that may prove that there are some common factors that point to a likely correlation between the two.

Could there be a link between gum disease and heart disease?

Dr. Simone Ricketts reported on the findings of an Australian study of 80 patients in Profile Magazine. That study showed that 70% of the patients who participated in the study and needed heart transplants also had gum disease. She noted that other studies show a similar pattern, indicating that patients who needed heart transplants or other cardiac surgery procedures, were more likely to have dental problems.

Not Just Heart Disease Linked to Gum Disease

It isn’t just heart disease that experts are linking to periodontal disease, however. More and more evidence is showing that many chronic inflammatory diseases such as diabetes can be linked to periodontal disease. Poor oral hygiene resulting in gum disease was evident in blood tests that showed positive markers for inflammation.

Experts looked at a combination of over 120 medical studies focusing on a link between dental health and heart health. The findings of that research were published in the Journal of Periodontology and the American Journal of Cardiology. While there was no agreement on a definitive link, the research showed some promising results, and offer information that may be helpful to both dental health professionals and their patients.

On its own, gum disease increases the risk of developing coronary artery disease. Data from the National Health and Nutrition Examination Survey (NHANES) showed that gum disease increases the risk factor for blood vessel and artery diseases when those arteries supply blood to the brain.

This is especially important for strokes because they are a common cause of inadequate blood flow to the brain. Data from another study of 50,000+ people found a higher risk of stroke among people with gum disease and tooth loss.

The study did, however, show two very important connections between gum and heart disease:

• Both the gums of people with gum disease and the blood vessels of people who had atherosclerosis tested positive for similar types of bacteria.
• Both patients with atherosclerosis and those with gum disease showed the presence of inflammation in their bodies.

Patients need to understand the importance of taking care of their mouths and doing whatever is necessary to ensure or support heart health – even if there is no guarantee that doing so will prevent either disease.

Just like that, it’s almost summertime. As the spring season ends, perhaps these lighter, brighter days are inspiring you to do a bit of last-minute spring cleaning. Or perhaps they’re not. No judgment here!

What Dr. Keller and Dr. Tibbs can recommend wholeheartedly is finishing the season with a clean, sparkling smile. And we have some bright ideas for you!

Refresh Your Cleaning Technique

Tooth brushing can become so automatic that we don’t think about the basics anymore. And suddenly, we’ve finished brushing in half the time we used to, and, hey, how long has that floss been sitting on the counter, anyway? We suggest some mindful cleaning for a healthier smile.

• Spend two minutes brushing, at least twice each day.
• Make sure you reach all the surfaces of your teeth, inside, outside, and on top of your molars.
• Use short, gentle brush strokes, covering a tooth or two at a time.
• Angle your brush to clean along the gum line. Plaque around the gums leads to irritation and inflammation, and is a common cause of gum disease.
• Use vertical strokes to clean the inside of your front teeth.
• Floss at least once each day.

Good Cleaning Requires Good Tools

Since we’re tidying up, let’s talk about some helpful cleaning tools. Is your toothbrush looking a bit—long in the tooth?  

After three to four months of brushing, your toothbrush bristles start to break down. Frayed and matted bristles can’t clean as effectively as a toothbrush in top shape. Each change of season is a good time to remind yourself to change brushes.

And, while you’re shopping, remember:

• Soft bristles are almost always all any brusher needs. Even medium bristles can be abrasive to tooth enamel and gums. And brush gently—scrubbing is also abrasive.
• If you use an electric toothbrush, those toothbrush heads need to be replaced, too! In fact, because these brushes often have shorter bristles, heads might need to be replaced every two to three months.
• Use fluoride toothpaste to clean and protect your teeth.
• Don’t forget the floss!

If you’re not a fan of your current floss, take another look at the dental aisle in your local store. There are lots of new flossing options out there just waiting to be sampled. Or consider a water flosser. Water flossers can be an effective and gentle means of cleaning bacteria from periodontal pockets for those with gum disease. Your periodontist can help you find just the right floss or water flosser for your one-of-a-kind smile.

And speaking of your dental team . . .

Some Cleaning Jobs Require Professional Help

If you suffer from gum disease, a twice-a-year cleaning with your dentist might not be enough to keep your teeth and gums their healthiest. In this case, your periodontist, a specialist in treating conditions of the gums, bones, and tissues surrounding the teeth, can perform a more thorough deep cleaning at our Wilmington office. This procedure is non-surgical, and makes use of two types of cleaning:

• Scaling, to remove bacteria, plaque, and tartar above and below the gum line.
• Planing, to smooth the roots of the teeth. This process clears away bacteria and the rough spots where bacteria collect, and provides a smooth tooth surface for gum attachment.

Because periodontal cleanings are more thorough, they can take more than one appointment to complete and might require a local anesthetic. You might also be given medications to help the healing process. A follow up appointment will be scheduled to see whether further treatment is necessary.

Spring’s coming to an end, but taking care of your dental health is always in season! A clean smile isn’t just a more confident smile, it’s a healthier one. Talk to your periodontist for more tips to create your best and brightest smile at any time of year.

Whether you’ve lost a tooth from decay, are preparing for dentures, or were born with a gap where a tooth should have been, you could be a candidate for dental implants.

Dental implants have changed a lot since their debut in 1965, thanks to continuing advances in design and technology. Today, you no longer have to worry about whether dental implants might have a negative aesthetic impact on your smile.

So what are dental implants? Pretty much what they sound like: An implant is a replacement tooth that substitutes for a missing natural one. It gets placed through several steps; it’s a process that can take a few months.

The initial step involves the surgical implantation of the implant root, which resembles a small screw. After that’s placed, the top is covered with gum tissue to enable it to heal faster. This is an essential phase in the process, since this portion of the implant will serve as the base of support for everything else.

In the second step, the implant gets uncovered and an implant restoration (or crown) is created and affixed to it. After that, you’ve got yourself a new tooth!

While dental implants require a little special care, it’s all easily manageable. All you have to do at home is make sure you brush and floss your implant daily, the same as you would for any other tooth. Although an implant can’t develop a cavity, if something were to get stuck in it, that could lead to a gum infection.

If you have any other questions about dental implants, give our Wilmington office a call!

During the early days of the environmental awareness movement, those who demonstrated against pollution, toxic chemicals, and the general public health were known as hippies. The early 1970s were a time of change, and assertions that we needed to pay more attention to the Earth's atmosphere were generally dismissed. But within a couple decades, it had become clear that the previous generation was right; the citizens of the world needed to become more environmentally conscious.

Many people feel that they can't make a difference if they don't do something big. But caring for the environment doesn't have to be an all-or-nothing concept. In fact, the little things you do can add up to make a great impact, especially in our community. Here are a few ways you can help the environment on Earth Day, April 22nd and all year around.

Four Small Ways to be Environmentally Friendly

• Recycle Your Textiles. Nearly 21 million tons of textiles are added to American landfills each year, according to the Environmental Protection Agency. Donating your unwanted clothing to a secondhand store or an organization that repurposes fabric helps cut down on solid waste and conserves natural resources.
• Reduce Usage of Disposables. Plastic bottles and bags, disposable diapers and other things we can use and toss out are convenient, but they're not necessary. Simply choosing to replace one of type of disposable with a reusable product can help you cut down on waste that has a large negative impact on our environment.
• Conserve Water. If everyone in the United States turned off the water while brushing their teeth, more than 1.5 million gallons of water could be conserved. Turn the water on long enough to wet your toothbrush for brushing and rinsing, and then immediately turn the water off again.
• Turn Off the Lights. Flip the light switch to "Off" if you're going to leave a particular room for 15 minutes or more. This will conserve energy on incandescent light bulbs and cut down on cooling costs.

It's not necessary to be an activist or install solar panels all over your home to help the environment. Although you can do these things, the little everyday measures make a big difference in helping to conserve energy and the environment, while reducing your carbon footprint. Our team at Montchanin Periodontics and Implantology wants to remind you to celebrate Earth Day and help the environment, knowing that it will benefit your and your children's generation.

Eating, talking, smiling—consciously or unconsciously, so much of daily life is influenced by our oral health. And here’s one more thought to chew on: oral health affects digestive health as well.

After all, digestion doesn’t begin the moment food reaches the stomach—it begins before we swallow that very first bite. The digestive process gets its start in two ways:

• Mastication

“Chew your food properly.” Probably every child has heard this piece of helpful advice, because it’s hazardous to swallow large pieces of food. But there’s more to it! There’s a positive benefit for your digestive system when you keep chewing until that mouthful has been pulverized into a uniform, almost paste-like consistency.

But even though chewing food properly leads to easier digestion, dental problems can make the simple act of eating difficult and uncomfortable. Missing teeth or tooth pain can lead to swallowing food before it’s been properly broken down and softened, making it harder for your meal to make its way down the esophagus and more work to digest.

• Saliva Production

As it happens, there’s science behind the expression “mouthwatering.” When we smell something tasty, or have a bite to eat, or sometimes even think about a favorite food, our saliva glands increase production—and this increase has a digestive purpose.

Saliva contains digestive enzymes. These enzymes help break carbohydrate molecules into smaller sugar molecules, which are easier for our bodies to digest and use for energy. Saliva also contains enzymes that begin the digestion of fat and help neutralize acids as we eat, and, for those who suffer from acid reflux, helps wash acids back into the stomach.

When your oral health is compromised, the normally smooth operation of your digestive system can suffer as well.

• Replacing Missing Teeth

Losing one or more of your teeth has a real impact on your ability to bite and chew as easily as you should. Not only that, when you’ve lost a tooth, your other teeth and your jaw are affected.

When chewing forces are distributed unevenly because a tooth is missing from its specific spot, you can experience tooth pain and tooth movement. Tooth misalignment can change your bite and cause strain on the temporomandibular joint. And without the stimulation of biting and chewing, the bone underneath a missing tooth can shrink.

Whenever a tooth or teeth are lost, it’s important to see Dr. Keller and Dr. Tibbs right away for treatment. If a tooth needs to be extracted, it’s important to get professional care. After losing a tooth, you have several options to restore your smile, including dentures, bridges, and dental implants.

Implants are one of the most effective and long-lasting solutions for resuming your normal eating habits. They function like your natural teeth, and, like your natural teeth, stimulate the jawbone as you chew to prevent the bone from shrinking over time.

Periodontists like Dr. Keller and Dr. Tibbs are experts in implant procedures. Because they are specialists in treating the gum tissue and bone structure surrounding the teeth, they are ideally qualified to help you restore the function and appearance of your smile.

Whether you need a single implant or a multiple implant, talk to a member of our Wilmington team to learn all about your options.

What is oral cancer?

April is Oral Cancer Awareness Month. If you have been putting off a visit to our Wilmington office, now is an excellent time to schedule one. Regular visits to Montchanin Implant Center can be the first line of defense against oral cancer, by identifying early warning signs of the disease, or helping you with preventive care tips to lower your chances of developing it.

Oral Cancer Rates in America

Nearly 40,000 people in the U.S. will be diagnosed with oral cancer this year, and more than 8,000 die every year from this disease. It is a devastating illness: most people who are diagnosed with it do not live more than five years beyond their diagnosis. Oral cancer has a higher death rate than many other common cancers, including cervical cancer, testicular cancer, Hodgkin’s lymphoma, and thyroid or skin cancers. The high death rate results from the fact that most oral cancers go undiagnosed until the disease is well advanced and has spread to another part of the body—most often, the lymph nodes in the neck.

What causes oral cancer?

While there is no way to predict exactly which individuals will get oral cancer, there are some potential causes you should know about—because in some cases, you can minimize these risk factors.

• Age (most patients diagnosed with oral cancer are over the age of 40)
• Tobacco use, either from cigarettes or smokeless chewing tobacco
• Excessive alcohol consumption (especially in combination with tobacco use)
• Persistent viral infections, such as HPV16
• A diet low in fruits and vegetables

In addition, oral cancer tends to occur at a rate six times greater in men than in women, and more often for African Americans than other ethnic groups. No genetic links have been identified to explain the higher incidence in these populations, so lifestyle choices remain the likeliest cause.

Oral Cancer Treatments

Once a diagnosis has been made, treatment of oral cancer usually involves a multi-disciplinary team that includes surgeons, oncologists, dentists, nutritionists, and rehabilitation and restorative specialists. Our team will decide on the best approach for each patient, depending on the risk factors and how far the cancer has progressed. The strategy will be different in every case. Some of the most common methods include chemotherapy, radiation, and potential surgery.

Finding out you have cancer can be devastating news. If you are concerned that you might be at risk for developing oral cancer, talk to us about screenings and other things you can do to reduce your risk.

One of the most enjoyable parts of looking at family pictures is finding resemblances. You have your father’s brown eyes and your grandmother’s curly hair. You’ve got your aunt’s basketball height and your cousin’s freckles. But some similarities might not be so appealing—could one of those be a family tendency toward gum disease?

Studies have shown that periodontal disease appears to have some kind of genetic component, especially for serious diseases and those that appear early in the patient’s life. Aggressive periodontitis, for example, a relatively uncommon disease which causes rapid bone loss around certain teeth, is often more common among members of the same family. Other studies suggest there might be a genetic link between our immune response and the development of chronic periodontitis. So far, however, the link between genetics and gum disease is still under investigation.

We do know that environmental factors are an important trigger for gum disease. Failure to brush and floss, smoking, diet, stress, medical conditions such as diabetes—all can influence the health of our gums. The best way to overcome these factors is your own proactive approach! Thorough brushing and flossing, regular checkups and cleanings, proper nutrition, and avoiding smoking are all time-tested ways to keep your gums and teeth healthy. If you have a medical condition, proper treatment and medication will also help protect your oral health.

During your examination with Dr. Keller and Dr. Tibbs at our Wilmington office, please tell us about any family history of periodontal disease, your own gum care routine, and any habits or conditions which might influence your health. We can tailor treatment and offer suggestions for prevention based on a thorough knowledge of your medical history. We have many options available today for preventing and treating gum disease. Let’s make sure all your family albums are filled with beaming smiles—that’s the most appealing resemblance of all!

If you have started to notice that your teeth are more sensitive to hot and cold, or if you actually seem to have a longer smile than you used to, it could be that receding gums have left more of your tooth and root area exposed. This condition is not uncommon. While periodontal disease is often the cause of receding gums, injury, aging, genetics, even overly energetic brushing—all can lead to gum recession.

This is a gradual process, but over time gum recession can lead to dissatisfaction with your appearance, discomfort and sensitivity, and even tooth loss. Luckily, there are several options available to restore the appearance and health of your gums. One of the most effective is tissue grafting.

In this procedure, a thin section of tissue is used to replace the gum tissue that has receded. This new tissue will serve to restore a healthy gumline and protect tooth structure and placement. The method we recommend will be based on doing what is best for the condition of your gums.

• Pedicle Grafts

If you have a lot of gum tissue near the site to be repaired, a flap can be cut in the gum tissue close to the tooth being treated. That piece will be drawn over the root area and sutured into place.

• Connective Tissue Grafts

When there is not enough gum tissue near the tooth needing treatment, tissue from beneath the skin on the roof of your mouth can be used. Your doctor will create a flap, remove some connective tissue, and reattach the flap. The connective tissue will be sutured to the gum tissue surrounding the exposed root. This is the most common procedure used for grafting.

• Free Gingival Grafts

If your original gum tissue is very thin, more tissue might be needed for a graft. In this case, tissue will be removed from the roof of the mouth and sutured in place on your gum.

• Other Options

Other options such as donor grafts and specially treated collagen grafts may be considered if, for some reason, it wouldn’t be practical to use your own tissue.

Mild cases of gum recession might be helped without surgery, but, if a gum graft is necessary, call Dr. Keller and Dr. Tibbs at our Wilmington office. We will be happy to discuss the procedure and address any concerns you might have. Don’t be put off by the prospect of oral surgery. We will make this procedure as comfortable as possible using minimally invasive techniques. We will provide a prescription for pain medication, if needed, and tips for taking care of yourself gently afterward. Most of all, we can offer the best medical and cosmetic options for your individual smile if gum recession treatment is recommended. Our goal is the same as yours: to improve both the appearance and the health of your smile.

On March 17, everyone has a little Irish in them. St. Patrick’s Day is a joyous celebration of Irish heritage. The holiday originated as a commemoration of Saint Patrick, who brought Christianity to Ireland. The saint arrived in Ireland in 432 and earned the reputation of a champion of Irish Christianity. March 17th, the day of St. Patrick’s death, has been commemorated by the Irish for over 1,000 years. St. Patrick’s Day is still observed as a religious feast day by several Christian denominations, but it is better known in the public imagination as a rich celebration of Irish culture.

St. Patrick’s Day has been an official public holiday in Ireland since 1903. Each year, the Irish celebrate with a several-day festival that includes theater performances, music, fireworks, and festive parades. The celebration is also a public holiday in Northern Ireland, Montserrat, and Newfoundland and Labrador. In other parts of the world with heavy Irish populations, it is an unofficial celebration of Irish heritage. Parts of Great Britain, Canada, Argentina, South Korea, Switzerland, New Zealand, the United States, and Australia commemorate the holiday each year. Typical celebrations in these countries include drinking green beer, wearing green, eating traditional Irish foods, parades, and shamrock decorations.

Many people, Irish and non-Irish alike, take part in the “wearing of the green” on St. Patrick’s Day. In fact, the color originally associated with Saint Patrick was blue. His use of shamrocks to explain the Holy Trinity to the Irish made the green clover emblematic of the holiday, leading to the traditional green attire worn by thousands on St. Patrick’s Day. Other little-known facts about St. Patrick’s Day include the following:

• Each year, the United States and Ireland face off in a rugby competition called the “St. Patrick’s Day Test.”
• Montreal celebrates the holiday with an annual parade, which has been held each year since 1824. The Montreal city flag even features a shamrock in its corner, as a nod to its Irish heritage.
• The Guinness World Records named St. Patrick’s Day the “Friendliest Day of the Year.”
• Along with Valentine’s Day, St. Patrick’s Day is one of the most widely celebrated saint’s day in the world.

No matter your cultural heritage, St. Patrick’s Day is a great time to let loose and celebrate your inner Irish-ness! Don your greenest attire and exclaim “Erin go Bragh!” (Ireland forever!) to everyone you meet. From Dr. Keller and Dr. Tibbs - have a great St. Paddy’s day!

While you don’t have to wait to start eating right, March is the month the Academy of Nutrition and Dietetics asks everyone to pay special attention to what goes into our bodies. The Academy has designated the month of March for focusing the public’s awareness on what they eat.

What Not to Eat

The academy points out that the foods you eat have a direct effect on the health of your teeth and specifically on tooth decay. Bacteria rely on carbohydrates to thrive. That is why Dr. Keller and Dr. Tibbs and our team at Montchanin Implant Center tell our patients to cut back on both candy and sweets. They consist of simple sugars that feed the bacteria in your mouth and enhance tooth decay.

It’s the hidden sugars that will cost you, though. Get in the habit of reading labels on food and looking for products with added sugar. This includes ingredients that end with the suffix “ose.” When it comes to nutrition, these foods offer little value beyond satisfying that sweet tooth.

What You Should Eat

Turn to foods that not only taste good but are good for your teeth too. Dairy products, for example, provide the body with nutritional items that support tooth enamel. Foods high in protein feature phosphorus, a nutrient critical to oral health.

You can’t really go wrong by adding color to your diet, either. Fruits and vegetables make for a colorful plate and a healthy meal. Use some caution with acidic fruits like oranges or even tomatoes, because the acid can erode tooth enamel. It is better to include these foods in a meal instead of eating them by themselves.

Remember, good nutrition is something you should worry about all year long, not just when celebrating National Nutrition Month. March just serves as a fun reminder that eating right is a proactive step in managing your dental health.

We encourage you to give us a call at our Wilmington office to learn more!

Our team from Montchanin Implant Center understands the diagnosis of periodontal disease can be scary and confusing, but the good news in most cases is that it is treatable and manageable with a little work on the part of the patient.

Periodontal disease is an infection of the gum tissue, bone, and supporting structures for the teeth. In the past it was known as pyorrhea. Diagnosis is commonly made through a combination of dental X-rays, periodontal readings (called probe depths), and visual clinical findings.

The mouth is a gateway to the rest of the body and can provide clues to the patient’s overall health. In fact, the first signs of some chronic diseases appear in the oral cavity; they can be a hint for the dentist to refer the patient to a medical doctor for a thorough exam.

If left untreated, periodontal disease can lead to premature tooth loss, sensitivity, and chronic or acute mouth pain. If you have diabetes, you are more prone to periodontal disease and can experience greater difficulty controlling your blood glucose levels. The body ends up spending so much energy fighting the infection in the mouth that it cannot achieve balance elsewhere. Studies have shown that once periodontal disease is treated, the glucose levels become more responsive to control as well.

Standard treatments can include scale and root planing, medicated mouth rinse, and in some cases antibiotic therapy or laser therapy to help control bacteria while promoting healing. Periodontal disease can range from a few localized pockets to extensive and severe infection that may require surgery.

The process of scale and root planing may entail two to four appointments for treatment, with follow-up maintenance exams every three to four months to help prevent the spread of disease. In most cases you will be numbed for comfort during the procedure. After treatment you may feel a little sore—but you are taking steps to improve your health!

Scheduling an appointment with the Wilmington office of Dr. Keller and Dr. Tibbs will give you an accurate diagnosis and a range of treatment options. Periodontal disease is “silent,” which means you will not always experience pain as a signal of infection. When caught early and subjected to proper oral hygiene care on a daily basis, treatments are usually successful.

As with any surgery, post-procedure care is of utmost importance after getting periodontal surgery. Bleeding, pain, swelling, and other sensations are common and should be expected to a degree. This can manifest as small amounts of blood in your saliva, pain after anesthesia wears off, and swelling around the lips and cheeks. However, these symptoms should start improving after a several days.

Below you'll find recommendations from Dr. Keller and Dr. Tibbs on what you should do to make your post-procedure experience as quick and painless as possible:

Don't smoke - After your surgery you should definitely not smoke. Smoking will inhibit your body's ability to heal the surgical site.

Don't drink alcohol - If you are taking prescription or over-the-counter pain relievers, don't drink alcohol. And it is a good idea in general to avoid alcohol after surgery, since excess alcohol consumption suppresses immune system function and slows the healing process.

Take pain medication as prescribed or an alternative - Pain is to be expected for at least the first week after your procedure. If you choose to take the prescription medication that is prescribed to you, do so as directed. However some patients have found over-the-counter pain medication works for them. You may also consider natural herbs instead of pharmacological solutions. Try turmeric, arnica, or white willow bark (which is what aspirin is derived from, so the same warnings for aspirin apply to white willow bark.)

Eating with your surgical site in mind - It is best to chew on the other side of your mouth for the first several days so as not to irritate the surgical site. Avoid overly cold or hot foods as well. Softer foods like mashed potatoes, oatmeal, and fruit will be more comfortable to chew.

Avoid brushing the surgical site - You can start brushing and flossing your teeth the day after the procedure but avoid the surgical site.

Don't rinse for the first 24 hours - After the first day has passed you can rinse with a mild mouthwash to keep your mouth, dressing, and surgical site clean.

We're here to answer any questions you have after your procedure and will help you as best we can. Pay special attention to any excessive bleeding or discomfort. Contact our Wilmington office immediately if you have tried addressing the issue on your own but are still having trouble.

Did you know the actions leading to the beginnings of Valentine's Day were actually centered on the avoidance of war? A Catholic priest named Valentine defied the orders of the Emperor Claudius II and secretly married young men and their brides after the emperor had declared it illegal because only single, young men could be sent to war. Rather than lose potential soldiers to fight his war, Claudius attempted to hoard them by proclaiming marriage illegal.

Valentine continued to marry young couples anyway and, eventually, was put to death for it in 270 AD. Before his death, he sent a letter to a secret love and signed it “From your Valentine”. Nearly 1,800 years later, people are still signing letters and cards in this manner. This year, carry on the tradition started long ago, while adding your own twist. Here are a few suggestions.

Simple and Creative Valentine's Day Ideas

• Memorialize it with a Photo. Couples often have photos taken around Christmas, but Valentine's Day photos allow you to capitalize on romance. Famous couple Julia Child and her husband, Paul, had their picture taken together every Valentine's Day and included their sense of humor with silly props.
• Return to Your First Date Location. Even if your first date together was at a local hotdog stand, its sentimental value can make it a fun part of your Valentine's Day agenda. Be creative and make a treasure hunt with clues that lead your partner to the original date location, where you can express your love with flowers or a gift.
• “From Your Valentine” Messages. Deliver your message in a creative way to make this Valentine's Day stand out from the others. Bake your partner's favorite treat and write a message on it with a tube of icing, or draw a note on the steamed up mirror so it shows up when your partner takes a shower.

Although Valentine's Day is a day to celebrate love, it doesn't have to be a special day only for couples. If you're single, use this special day to shower yourself with love, because you're worth it! After all, the priest Valentine believed so strongly in the sanctity of love that he was willing to risk his life for it. Whether you're in a relationship or single, young or old, romantic or not, Valentine's Day is for you. Happy Valentine’s Day from the Periodontist office of Dr. Keller and Dr. Tibbs.

Some bone changes are a normal part of aging. Bone density starts decreasing around the age of 30, hormonal changes affect bone strength as we grow older, and the mineral content of our bones can change over time. Even as we live longer, healthier lives, some changes in our bones are often a normal part of the aging process.

But note we said “often,” not always! Decades ago, a sunken jaw, thinner lips, sagging facial muscles, and an altered profile were considered just another normal consequence of aging. This “collapsed” look was caused by bone loss in the jaws, especially the mandible, or lower jaw.

Today we know that maintaining size and density in our jawbones is important not only for our appearance, but for better oral health. Even better, we know several easy practices to keep those bones their healthiest. And, should your jawbone be affected by bone loss, Dr. Keller and Dr. Tibbs can offer many options to restore both function and appearance.

• Take Care of Your Teeth

Brushing twice a day, flossing daily, using fluoride toothpaste, seeing your dentist for regular exams and cleanings—when you follow recommended dental hygiene practices, you are doing more than simply preventing cavities; you are making sure you keep your teeth for a lifetime. And, because tooth loss inevitably leads to bone loss over time, you are protecting your bones as well.

The bone tissue which supports our teeth needs the stimulation of biting and chewing to stay healthy. Without that stimulation, bone area under a missing tooth gradually shrinks. The bone tissue is resorbed into the body, which, in a relatively short amount of time, can lead to a noticeable sunken spot where the tooth used to be. A dental implant will provide the tissue stimulation that a natural tooth would, and will prevent future bone loss in the jaw. And even if bone tissue has already been lost, Dr. Keller and Dr. Tibbs can recommend surgical bone grafting to achieve the right bone area and density to hold an implant.

• Don’t Neglect Your Gum Health

One of the most common causes of bone loss in the jaw is periodontal disease. For older patients, gingivitis, left untreated, can eventually lead to periodontitis (severe gum disease). This condition leads to the formation of pockets between your gums and teeth that become home to bacteria and infection. This infection can cause deterioration in the bone structure supporting the teeth.

Making sure you schedule regular dental exams will allow Dr. Keller and Dr. Tibbs to treat any signs of periodontitis when they are first detected. If you have any of the symptoms of gum disease, it’s important to treat the cause of these symptoms as soon as possible to protect your gums, teeth, and the jawbone beneath them.

Gingivitis can be reversible with proper care. Deep cleaning procedures such as scaling and root planing, topical and oral antibiotics, and oral surgeries such as flap surgery or bone and tissue grafting can help reverse the effects of periodontitis. Bone loss cannot be reversed, but a graft can replace lost bone and allow healthy tissue to regenerate.

• Consider implant-supported dentures

If you have suffered major tooth loss that requires a full or partial denture, consider appliances that are supported by implants. Remember, the loss of a single tooth causes resorption of the bone beneath it. If you are missing several or all of your teeth, your jawbone will shrink over that entire expanse of the alveolar ridge, the part of the jawbone which holds your teeth in their sockets.

Because dentures provide no stimulation to the underlying bone, normal bone resorption takes place. To add to the problem, the pressure of the denture on the ridge causes the bone to wear away further. As the bone continues to deteriorate, you will notice that the dentures no longer fit as well as they once did. For this reason, dentures often need to be replaced after a few years.

Implants, on the other hand, provide the same kind of pressure and stimulation to the jawbone that natural teeth do. The denture is securely attached to the implant, and doesn’t put harmful pressure on the bone below. Besides their natural appearance and secure fit, preventing further bone loss is a wonderful additional benefit of choosing dental implants to anchor full or partial dentures.

• Don’t Ignore Bone Loss

Thanks to modern medicine, we can combat even normal bone aging with diet, exercise, and medication. Thanks to modern dental medicine, we know that a shrinking jawbone is not an inevitable part of the aging process.

If you have lost a tooth or teeth, or if you have suffered an abscess or serious gum disease, you might be at risk for bone loss. Beyond making us look older, a shrinking jaw can affect speech, eating, and the alignment of our remaining teeth.

You can do a lot to keep your teeth and gums healthy, which will keep your jawbone—and your profile— healthy as well. But if you have suffered lost teeth or bone loss, contact our Wilmington office. As periodontists, we have the knowledge, skill, and experience to help counteract the effects of tooth and bone loss, leading to a lifetime filled with healthy and beautiful smiles.

When you’re pregnant, you expect physical changes. That’s part of the excitement of the journey! What isn’t expected—and not nearly as exciting—is when your familiar smile seems to be changing as well.

If you’ve noticed that your teeth feel loose, or that your regular tooth alignment has shifted, you might be experiencing one of the unexpected, but quite common, side effects of pregnancy—tooth mobility.

How is this “wiggle room” possible? After all, you’re making sure that you’re eating a diet rich in protein, vitamins, and minerals, including calcium, vitamin D, and all the other nutrients which keep teeth and gums healthy. You’re brushing and flossing regularly to prevent cavities and gum disease. You haven’t changed your healthy dental habits, so why are you seeing different results?

The answer lies in the hormonal changes that occur with pregnancy. Your body has significantly increased production of hormones such as estrogen, progesterone, and relaxin. One of the benefits of these higher hormonal levels is their relaxing effect on your ligaments and joints. Relaxed ligaments and joints help make pregnancy and childbirth easier.

But you can’t target hormones just where they’ll be most useful. An increase in hormones affects the ligaments and joints throughout your body. And while this explanation might seem unrelated to loose teeth, it is, in fact, the “root” of the matter.

A complex support system holds our teeth securely in their sockets. Instead of being rigidly fused to the jaw, each tooth root is surrounded by a periodontal ligament within the socket. This ligament is largely made of flexible connective tissue, and attaches to both the root of the tooth and the bone tissue of the jaw, holding the tooth in place. Its flexibility helps cushion your tooth from pressure and impact, and allows the tooth movement that makes orthodontic work possible.

The hormones that relax ligaments and joints throughout the body have that same relaxing effect on the flexible ligaments and joints in the mouth. So it’s not uncommon to find that your teeth feel a bit looser, or that your customary tooth alignment has shifted, or that you’re experiencing discomfort in your jaw joint, especially if you grind or clench your teeth.

All of this can be a bit worrying, but you can minimize your dental concerns during pregnancy.

• Call Dr. Keller and Dr. Tibbs when you first learn about your pregnancy. We can offer suggestions for caring for yourself and your dental health during this exciting time.
• Keep up with your dental hygiene. Brushing and flossing are more important than ever to keep your gums healthy.
• Because your gums might be more prone to gingivitis (early gum disease), extra cleanings as needed can keep plaque buildup from forming.
• Don’t forget your regular appointments for exams and cleanings, to help prevent any small problems from becoming larger ones.

Fortunately, while loose teeth are alarming, it’s most often only a temporary condition. Your teeth and ligaments should return to their normal, stable status after your baby is born. But because dental health can have an impact on pregnancy, see your dentist if you notice any changes in your smile. You want to rule out any other causes of tooth mobility, including gum disease. So, here’s one last important tip:

• If your dentist recommends that you see Dr. Keller and Dr. Tibbs for loose teeth or gum disease, make an appointment.

Those increased pregnancy hormones also increase your risk of periodontal disease. Be on the watch for early symptoms of gingivitis such as redness, swelling, pain, tenderness, bleeding, and bad breath. Gingivitis is often reversible and can be treated by your dentist.

If your dentist suspects more serious gum disease, a timely visit to a specialist in the treatment and care of your gums is a must. Periodontitis (advanced gum disease) causes infection and inflammation that can damage gum issue, ligament, and even bone. A periodontist like Dr. Keller and Dr. Tibbs can determine if your loose teeth have been caused by gum disease, and can suggest safe and effective treatments to restore your tooth and gum health.

Pregnancy is a time of many physical changes. Our Wilmington periodontal team will work with you to ensure that one thing that remains constant is your beautiful, healthy smile!

By now, everyone knows that smoking is bad for you. But the truth is its broad-reaching health effects are not all known by everyone. This is especially true of oral health. Smoking can have serious repercussions in this regard. To give you a better idea of how smoking can affect your oral health, Dr. Keller and Dr. Tibbs and our team have listed some issues that can arise.

Oral Cancer

Oral cancer can have steep ramifications for anyone that gets it. Surgery can be required to eliminate the cancer before it spreads to more vital parts of your body. Any type of cancer is about the worst health effect you can get, and this especially holds true to the affects that smoking has on your mouth. The type of mouth surgery required with oral cancer can leave your face deconstructed in certain areas, and it is all due to smoking or use of other tobacco products.

Tooth Discoloration and Bad Breath

At the very least, it is fair to say that as a smoker you will often have bad breath, and while you may try to cover it up with gum or mints, tooth discoloration is a whole other story. The chemicals and substances in cigarettes stick to your teeth staining them brown and yellow colors that are increasingly difficult to disguise.

Gum Disease and Loss of Bone

Another effect of smoking is the increased risk of gum disease. Your gums may start to recede, which can eventually lead to the loss of teeth. Smoking can also increase bone loss and density in your jaw which is vital to the health of your mouth. Gum disease and bone loss are two signs that smoking is definitely bad for your mouth.

When it comes to the health of your mouth, the question is not whether smoking affects your health, it's how does it affect your health and to what degree. If for no other reason than because smoking involves your mouth as its entry point, it is safe to say that it can have long-lasting and detrimental consequences on your oral health.

To learn more about smoking and your oral health, contact our Wilmington office to schedule an appointment with Dr. Keller and Dr. Tibbs.

Your regular dentist is a lot like your regular doctor. You see them both frequently for checkups and advice on maintaining your health. Your dentist is the one to visit for dental concerns such as discovering and treating cavities and gingivitis, fitting crowns and putting in fillings, performing simple extractions and many more of the procedures that keep our teeth and mouths healthy. And just as your general practitioner might refer you to a specialist if needed, your dentist might recommend a dental specialist called a periodontist like Dr. Keller and Dr. Tibbs for expert treatment of more serious periodontal conditions.

The word “periodontist” was coined from the Greek words for “around” and “tooth”—in other words, a practitioner whose specialty is the treatment of the supporting structures around our teeth. These structures include the gums, the bone tissue holding the tooth, and the connective tissue between tooth and bone. A degree in periodontology generally requires three additional years of post-doctoral study after dental school focused on the treatment of periodontal disease and cosmetic restorations.

What special care does a periodontist provide?

• Diagnosis and treatment of periodontal disease. Periodontitis is a disease of the gums and bones around the teeth caused by the body’s response to the bacteria in plaque. The earlier it is treated, the better. Untreated gum disease can lead to serious infection and tooth and bone loss.
• Surgical care for periodontal disease. This might involve gum grafting for receding gums or regeneration therapy to restore bone tissue.
• Debridement, scaling and root planing. These procedures remove excessive plaque and tartar from areas of the tooth above and below the gumline.
• Monitoring interactions with other health conditions. If you have diabetes, heart disease or other systemic diseases, it’s a good idea to have a periodontal evaluation. Pregnant women can also benefit from an exam if they develop gum swelling and bleeding as a result of the changes caused by pregnancy hormones.
• Implant placement. For those considering an implant, periodontists will make sure the underlying bone is healthy and has enough density for an implant, can build up the bone if needed, and will place the implant in the bone.

Your regular dentist is your first stop when taking care of your dental health. Gingivitis, the earliest stage of gum disease, can usually be treated by your regular dentist or dental hygienist. But if you need a specialist for more advanced periodontal disease, if you have medical issues that interact with gum health, or if you are considering a dental implant, Dr. Keller and Dr. Tibbs can provide you with the best possible care for your individual needs from the comfort of our Wilmington office.

Gum disease is about much more than pesky bleeding gums – it's a serious and progressive condition that, over time, can result in tooth loss, which in turn can have a significant bearing on your quality of life. Many people avoid being evaluated for gum disease because they worry that if they do have the condition, their only option will be to undergo surgery or let their teeth fall out. In fact, there are several non-surgical options to help treat gum disease (also called periodontal disease) and prevent eventual tooth loss. Wondering what they are? Here's a quick rundown of your options:

• Regular dental cleaning: When your gum disease is in its earliest stages, regular cleanings at least twice a year may be enough to ward off further development, especially if you rigorously follow your dentist's recommendations for home care, including regular flossing. To get your periodontal disease under control, you may need to have cleanings more than twice a year, returning to twice-yearly cleanings once your gums are healthy again.
• Scaling and root planing: These procedures involve deep cleaning above and below the gum line to remove plaque and tartar and to smooth rough spots on or near the root that can provide places for bacteria to lodge. Once the material below the gum line is removed, Dr. Keller and Dr. Tibbs may apply an antibacterial gel to help kill any bacteria that remain. Because these procedures involve using special instruments to reach deep pockets of plaque and bacteria, most patients opt for a local anesthetic to help avoid discomfort. For more advanced cases of gum disease, you may need two sessions to complete the procedure. Afterward, you may experience some slight discomfort and bleeding from your gums which will resolve soon afterward. We can recommend an over-the-counter pain reliever to help relieve any discomfort.
• Medication: Antibiotics can be used in some cases to help destroy bacteria beneath the gum line and help preserve the tooth's attachment and prevent loosening and eventual loss. Both over-the-counter and prescription mouthwashes are available, as well as oral antibiotics that can be used to destroy gum disease-causing bacteria. Toothpastes containing antibiotics are also available and are usually used in combination with other products or treatments.

If you're experiencing signs of periodontal disease – tender, bleeding or swollen gums, receding gums, gums that bleed after brushing, or loose teeth – delaying treatment is the worst thing you can do. Make an appointment at our Wilmington office and learn about all the options that can help you keep your teeth and gums as healthy as can be.

It’s a new year, and a resolution found on many lists is learning to be more mindful about healthy food choices. You might have set some of these goals yourself. Gaining, losing, or maintaining your current weight. More fruits and veggies. Better proteins. Less sugar. Fewer carbs. You want to make this new year your healthiest year yet.

And while you’re making your new and improved shopping list, don’t forget your oral health! Because while brushing and flossing are extremely important, your diet can also have very real benefits for your teeth and gums.

Stronger Teeth and Jaws

We often talk about teeth and bones together, and that’s natural. Calcium and phosphorus, as well as other minerals, make them the strongest parts of our bodies. When teeth lose mineral strength, they are more vulnerable to cavities, and bone loss in the jaw can cause loose or even lost teeth.

Making sure you get the recommended daily amount of the minerals and vitamins you need will help sustain and repair both teeth and bones. A diet rich in calcium, phosphorus, and vitamin D helps build strong bones and promotes bone density. While your teeth can’t create new enamel, minerals that are eroded by acids from plaque and acidic foods can be restored, or remineralized, with the calcium and phosphates in saliva.

• Calcium

Strong teeth and bones need calcium. More than 99% of the calcium in our bodies is located in our teeth and bones. How to make sure we get enough?

Dairy products are the traditional answer. Several servings of milk, cheese, or yogurt each day supply most of our needs. If you can’t eat dairy, though, calcium is also found in other foods, such as salmon, sardines, many dark leafy vegetables, and fortified juices, tofu, and cereals.

• Phosphorus

Calcium gets most of the attention when it comes to creating strong teeth and bones, but it’s not a solo act. We need phosphorus to make full use of the calcium in our diets.

Proteins like meat, fish, and poultry are good sources of phosphorus, as are beans, nuts, whole grains and dairy.

• Vitamin D

Vitamin D is a diet essential because it enables us to absorb the calcium and phosphorus that keep teeth and bones strong.

Most dairy and many other foods are fortified with vitamin D, such as cow’s milk, soymilk, orange juice, and cereals. Egg yolks and fatty fish, such as salmon, tuna, and herring, are also a rich natural source of the vitamin.

Healthy Gums

Gum disease is more than just a nuisance. Left untreated, gingivitis (early gum disease) can become periodontitis (serious gum disease). Periodontitis can cause infection, loose teeth, and tooth and bone loss.

Brushing and flossing promote gum health and help prevent gum disease, but your diet plays an important role, too.  

• Vitamin A

Vitamin A is essential for the health and healing of mucous membranes, including gum tissue and the soft membranes in the mouth.

You can get this vitamin directly from animal products such as dairy foods and meats, or it can be formed in the body from beta-carotenes. Think orange when you hit the produce aisle, because foods such as carrots, peppers, pumpkin, squash, and sweet potatoes are a rich source of beta-carotenes.

• Vitamin C

Vitamin C is one of the so-called “essential nutrients.” These are the nutrients that are necessary for our bodies to function properly, and which can only be supplied in our diets. Vitamin C is vital for healthy gums and soft tissue—in fact, one sign that your diet is deficient in vitamin C is inflamed and bleeding gums.

Citrus fruits, those oranges, lemons, limes, grapefruit, and all their cousins, are a wonderful source of vitamin C, but you have many other flavorful options. Fruits such as kiwis, mangos, papayas, and strawberries are rich in vitamin C. Step over to the vegetable aisle to load up on red peppers, kale, cauliflower, Brussels sprouts, and broccoli—all of which contain more vitamin C per serving than a medium orange!

Fewer Cavities

Plaque thrives on a diet of sugar. Oral bacteria in plaque use the sugars in our food to produce acids. These acids erode enamel and eventually lead to cavities. Limiting your sugar consumption and choosing complex carbohydrates over simple carbs are two ways to reduce your risk of cavities.

• Sugars

The usual suspects—candies, desserts, pastries, sodas—are sugar-filled items you’re familiar with. What might surprise you is the amount of sugar in sports drinks, fruit juices, flavored yogurts, breakfast cereals, and other standard grocery purchases. Checking labels for sugar content is a great way to cut down on unexpected sweeteners.

• Carbs

The refined starches in white bread, white rice, potato chips, and other simpler carbohydrates quickly break down into sugars. This is the kind of nutrition only plaque appreciates.

Instead, fill your cart with complex carbohydrates, which contain important vitamins, minerals, and fiber. Found in foods like whole-grain breads and cereals, legumes, and many vegetables, complex carbs break down slowly for longer-lasting energy.

Of course, these suggestions don’t cover everything on your healthy dental shopping list. We could add magnesium for bone density, vitamin B to prevent oral irritation and inflammation, vitamin K for bone strength, and more. To find out the best options for your healthiest smile, talk to Dr. Keller and Dr. Tibbs or a member of our Wilmington team about ideas for improving your daily diet.

Because besides leading to stronger teeth, healthier gums, and fewer cavities, a careful and conscious approach to your food choices has another wonderful benefit—a healthy dental diet is healthy for the rest of your body as well. Just something to be mindful of as we greet the new year!

If you’re scheduled for periodontal surgery at our Wilmington office in the near future, you probably have a lot of very important questions:

• Will it help? Your periodontist has the skill and experience to diagnose and treat problems caused by periodontal disease, perform periodontal plastic surgery, and place dental implants. Periodontists are experts in these specialties, so you are in good hands!
• Will it hurt? Your periodontist will offer you options for anesthesia, so you can choose the sedation experience which will make you most comfortable.
• What should I do after surgery? Don’t worry! Dr. Keller and Dr. Tibbs will give you clear instructions on caring for the surgical site, selecting soothing diet options, cleaning your mouth, and all of the other practices that will enable a speedy and smooth recovery.
• What should I wear? Wait—fashion questions?

Yes! Part of being prepared for your surgery is being as comfortable as you can be during and after the procedure. Happily, there is no strict dress code for periodontal surgery. It’s more a basic list of recommendations for what not to wear.

• Don’t wear something you’re not comfortable in. Generally, loose fitting clothing is best.
• Don’t wear clothing that might be difficult to clean. While you and your clothing will be well protected, blood, irrigation, and other staining hazards are all occasionally part of the surgical process.
• Don’t wear something that will be difficult to remove after surgery. No one wants to struggle out of a tight turtleneck even at the best of times!
• Don’t wear jewelry. And, by the way, this includes tongue and facial piercings.
• Don’t be afraid to layer. While the office staff will try to make sure you are as warm or as cool as you would like to be, it’s a good idea to bring a jacket or sweater for extra warmth.
• Don’t wear tight sleeves. Short sleeves or sleeves that can be rolled up easily allow access to your arm if you are having IV sedation or blood pressure monitoring.
• Don’t wear contact lenses, especially if you are planning on IV sedation or a general anesthetic, because your eyes might be closed throughout the procedure.

If you have any questions in advance of your periodontal surgery, give our Wilmington office a call. Planning ahead is always in fashion!

“Crown lengthening”? Probably not an expression most of us are familiar with! In fact, this is a common periodontal procedure designed to improve both the health and the appearance of our smiles by revealing more of the tooth surface usually hidden by our gums.

What is Crown Lengthening?

The “crown” is the part of our tooth covered by enamel, while the “lengthening” is actually the result of revealing more of the tooth. Usually, Dr. Keller and Dr. Tibbs will use a local anesthetic to numb the area, and remove gum tissue from the base of a specific tooth or teeth. If necessary, a small amount of bone tissue might be removed from the base of the tooth as well. This process exposes more tooth surface. When the ideal tooth length is visible, the tissue around it is then shaped for an even appearance and the repositioned gum tissue is often sutured in place. We will always tailor this treatment to your specific needs, so talk to us about our treatment plan for you. We will explain the surgery, after care, and follow-up visits.

Why Consider Crown Lengthening?

• To Repair an Injured Tooth

Sometimes a tooth suffers an injury that makes it impossible to repair without crown lengthening. If a tooth is broken off at the gumline, or suffers a fracture that extends to the gumline, more of the tooth will need to be exposed so that there is enough remaining natural tooth to support a crown. Similarly, this procedure might also be necessary for a filling if decay has affected the tooth near the gumline. Crown lengthening can enable us to perform a restoration and save a tooth where an extraction might otherwise take place.

• For Cosmetic Improvement

An excess of gum tissue can lead to a “gummy” smile. Crown lengthening can reduce extra gum tissue and, if needed, bone tissue, to provide you with a well-proportioned smile. The gum tissue will be contoured for an even, attractive gumline. This process is carefully designed to create a balance of lips, teeth, and gums for your most appealing smile. Crown lengthening might also be advisable if more tooth surface is needed for veneers.

Call our Wilmington office if you have any questions about this procedure, whether for restorative or cosmetic reasons. “Crown lengthening” might be a term you’ve never heard before. But it might be exactly the procedure you need to ensure healthy teeth and a beautiful smile.

At Montchanin Implant Center, we know your dental health is closely connected to your overall health. We also know that the mouth can oftentimes be the first place to show signs of other bodily health issues.

Studies have shown possible links between periodontal (gum) disease and heart disease, and researchers have found that people with gum disease have an elevated risk of suffering from a stroke or developing coronary artery disease. Believe it or not, an estimated 70 to 80 percent of North American adults currently have some form of gum disease.

Gum disease, which affects the tissues that surround and support the teeth, is an infection caused by a sticky film of bacteria called plaque that forms on the teeth, mainly along the gum line. In its early stages, called gingivitis, gum disease can be treated by Dr. Keller and Dr. Tibbs and often reversed.

To help keep your mouth and heart healthy, we’ve provided following tips to help prevent problems before they arise:

• Brush your teeth with fluoride toothpaste at least twice a day. Make sure you brush gently beneath the gum line around each tooth.
• Floss at least once a day.
• Have a dental checkup and cleaning twice a year, or as recommended.
• Eat a healthy diet. This includes avoiding foods with a high concentration of sugars or starches and consuming more fruits and vegetables.
• Avoid tobacco and copious levels of alcohol. If you smoke, quit. And remember, heavy drinking dramatically increases the risk of developing mouth and throat cancer.

Don’t put off your next visit to Montchanin Implant Center any longer! If it has been a while since your last visit to our Wilmington office, please give us a call!

Fear of going to the dentist is more common than you may think. That’s why Dr. Keller and Dr. Tibbs and our team want to make your visit as relaxing as possible.

Your anxiety about pain or routine procedures doesn’t have to stop you from visiting our Wilmington office; we offer various types of sedation to remove the pain and stress from your dental procedure.

Nitrous Oxide Sedation

Nitrous oxide combined with local anesthetics ensures both pain relief and reduced anxiety for many patients. It’s useful because the dosage can be regulated during treatment, and patients are usually able to drive shortly after the procedure is completed.

Oral or Injected Sedation

With oral sedation, you may be given a pill or liquid to consume several hours before your treatment. Make sure someone will be available to drive you to your appointment, because you will not be able to drive yourself.

An oral liquid is often given to children before any shots or intravenous anesthesia. An intramuscular injection may be given at the office to provide relaxation benefits for 20 to 30 minutes.

Nitrous Oxide with an Oral Sedative

For patients with higher levels of anxiety, an oral or injected sedative can be offered before nitrous oxide begins. This can also be effective for reducing anxiety about the injection of local anesthetics itself. A liquid medication followed by nitrous oxide is beneficial for children to produce a deep sedation level.

General Anesthesia

This type of anesthesia can be offered as an inhaled gas or intravenous liquid. If no oral sedative is given before the general anesthesia is administered, you should wake up quickly after your procedure.

To reduce your anxiety, we can offer a pill or liquid medication before intravenous sedation starts. Intravenous sedation can also be used at moderate-to-deep sedation levels without complete loss of consciousness.

Dr. Keller and Dr. Tibbs and our team are happy to go over your sedation or pain prevention options when you visit. We’re here to ensure all your questions are answered and your procedure is a relaxing one.

At Montchanin Implant Center we love learning trivia and interesting facts about Thanksgiving! This year, Dr. Keller and Dr. Tibbs wanted to share some trivia that might help you feel a bit smarter at the holiday dinner table and help create some great conversation with friends and family.

The Turkey

There is no historical evidence that turkey was eaten at the first Thanksgiving dinner. It was a three-day party shared by the Wamponoag Indians and the pilgrims in 1621. Historians say they likely ate venison and seafood.

According to National Geographic, the dinner at the Plymouth colony was in October and included about 50 English colonists and 90 American Indian men. The first Thanksgiving dinner could have included corn, geese, and pumpkin.

Today, turkey is the meat of choice. According to the National Turkey Association, about 690 million pounds of turkey are consumed during Thanksgiving, or about 46 million turkeys.

The Side Dishes

The green bean casserole became popular about 50 years ago. Created by the Campbell Soup Company, it remains a popular side dish. According to Campbell’s, it was developed when the company was creating an annual holiday cookbook. The company now sells about $20 million worth of cream of mushroom soup each year, which is a major part of the recipe.

While there were likely plenty of cranberries for the pilgrims and Indians to enjoy, sugar was a luxury. What we know today as cranberry sauce was not around in those early Thanksgiving days. About 750 million pounds of cranberries are produced each year in the US, with about 30 percent consumed on Thanksgiving.

The Parade

Since Thanksgiving did not become a national holiday until Lincoln declared it in 1863, the annual parades were not yearly events until much later. The biggest parade that continues to draw crowds is the Macy's Thanksgiving Day Parade. Beginning in 1924 with about 400 employees, they marched from Convent Avenue to 145th Street in New York City. Famous for the huge hot-air balloons today, it was actually live animals borrowed from the Central Park Zoo that were the stars of the show then.

However you choose to spend your Thanksgiving holiday, we wish you a safe, happy and healthy holiday with those you love.

A lot of patients go at their teeth like they were sanding an old floor—that is to say, way too hard! Brushing too hard is probably the most common mistake patients make in their oral care routine, and it can be detrimental to the gums and teeth.

What can brushing too hard cause?

• Receding gums
• Bone loss around teeth
• Loss of teeth
• Tooth sensitivity, especially to hot and cold
• Worn down enamel

Brushing too hard wears away at your gums, which can lead to the neck of the teeth being exposed. This part of the tooth isn't covered by hard enamel like the rest of the tooth and hence the soft inner layer, or dentin, is exposed. Dentin is very sensitive to hot and cold and much more susceptible to bacterial decay. Once the gums recede due to improper brushing, it’s usually irreversible.

How to brush your teeth properly

You know you're supposed to brush your teeth twice a day, so why not do it right? First and foremost, you should only ever brush with a soft bristled brush—not medium or hard—unless directed otherwise by Dr. Keller and Dr. Tibbs. Unless you have braces or specific oral health issues, brushing twice a day for two minutes is usually plenty.

The main purpose of brushing is to remove plaque from your teeth and gums. Plaque is actually soft and is a buildup of bacteria, saliva, and food debris. You really don't need to brush hard to remove it, just make sure you aim your toothbrush at the gum line (where plaque grows) and brush in small circular motions, never a back-and-forth motion.

It's also wise to hold your toothbrush gently. People tend to brush harder the tighter they hold their toothbrush.

Still have questions about proper tooth brushing technique or gum health? Ask any staff member or Dr. Keller and Dr. Tibbs during your next visit to our Wilmington office; we'd be happy to help!

Did you know that there are certain foods you can eat which help to clean your teeth? We call them "detergent foods." In dentistry we look at the impact of food in three ways: the kind of food, how often it is eaten, and when it is eaten. Detergent foods should be the last piece of food you consume during a meal for best results. Think of them as the closest you can get to brushing your teeth.

A healthy diet is important for oral health as well as overall health, but here are some particular foods that can help clean your teeth and mouth:

• Carrots
• Apples
• Celery sticks
• Popcorn
• Cucumbers
• Pears
• Lettuce
• Cheese

As you can see, detergent foods are usually foods that are firm and crisp. They act like scrubbers on and around your teeth and gums and bring your mouth's pH back to 7.0, which is optimal.

Which foods are the worst for your teeth?

Cookies, cakes, breads, chips, crackers, soft drinks, dried fruit, and candies (what many people’s diets are full of) provide carbohydrates (sugar) to the bacteria in your mouth causing an acidic environment and increasing the chance of cavities and decay. These foods are sticky and don't rinse easily from your mouth. Avoid letting these foods sit on your teeth after eating them.

It also depends on how often you consume these foods throughout the day. For example, if you drink soft drinks, it's best to have it all in one sitting instead of sipping it all throughout the day. Doing so causes the perfect environment in your mouth for bacteria to flourish and your saliva never gets the chance to neutralize its pH.

This is where detergent foods can come into play. When you're about to finish your meal, have an apple, celery stick, or carrot. It will act like a "natural toothbrush." Also, try to make these detergent foods the basis for snacks you have throughout the day.

Always remember, these foods are not a replacement for brushing and flossing. You still need good dental hygiene regardless of what you're eating! For more tips and tricks for ideal oral health, ask Dr. Keller and Dr. Tibbs the next time you visit our Wilmington office!

Although teeth are strong enough to tear through food, they are also fragile. An accident such as a fall may loosen teeth or knock a tooth out entirely. When a child loses a baby tooth in this manner, no permanent damage is usually done. However, adults who loosen permanent teeth may need to visit our Wilmington office.

The Anatomy of a Loose Tooth

The hard external layer of teeth covers a more vulnerable interior. The center of a tooth consists of the pulp, which contains blood vessels and nerves. The entire tooth extends below the surface of the gums into the jaw. Special tissue called cementum and the periodontal ligament hold teeth in place, preventing them from moving.

When a fall or blow to the face loosens a tooth, the tissues anchoring a tooth to the jaw may be damaged. This results in a loosened tooth that wiggles in place. There may be inflammation or bleeding of the gums, which signals dental damage.

Dental Treatments for a Loose Tooth

The range of dental treatments for loose teeth varies by the severity of the problem. If your teeth are just slightly loose following a fall, it may be fine to wait a few days. Teeth often retighten on their own. Simply avoid chewing with that tooth and enjoy softer foods for a few days.

If a tooth is very loose or nearly falling out, call Dr. Keller and Dr. Tibbs immediately. Immediate placement of the tooth back into the socket is needed to ensure its survival. In general, a tooth must return to its socket within two hours or it may be lost.

In some cases, Dr. Keller and Dr. Tibbs may recommend splinting, in which teeth are joined together to strengthen them and reduce strain on an individual tooth. Tightening or straightening the tooth can restore your ability to chew regularly without stressing the loosened tooth.

Regardless of the extent of the problem, it is essential to keep the tooth clean to prevent decay. Brush carefully with a soft-bristled brush, and use mouthwash regularly to kill bacteria.

All Hallows' Eve, more commonly known as Halloween, is a yearly event celebrated on October 31, and one that is anticipated by the young and young at heart all over the world. Some scholars claim that Halloween originated from Celtic festivals that honored the dead or that celebrated the harvest, while others doubt that there's any connection at all to Samhain (a Gaelic harvest festival.) Regardless of its origin, our team at the Periodontist office of Dr. Keller and Dr. Tibbs hopes that Halloween is fun and enjoyed by all of our awesome patients!

Trick or treat?

In North America, Halloween is predominantly celebrated by children who dress up in costumes, which range from scary to cute, who then go around the neighborhood knocking on doors asking "trick or treat", and they are given candy in return. Trick-or-treating is a time honored tradition, and though many parents groan at the pounds and pounds of candy collected by youngsters and fear for the health of their teeth, there are a few things you can do to help their teeth stay in great shape until the candy is gone:

• Limit the amount of candy they can consume each day
• Have them brush their teeth after eating candy
• Avoid hard, chewy candies as they can stick in hard to brush places
• Keep candy out of sight to reduce temptation
• Don't buy candy too far in advance to limit pre-Halloween consumption
• Help or encourage your children to floss

Halloween Fun

Halloween isn't just about gorging on candy; there are other events associated with this festive day including carving jack-o'-lanterns, painting pumpkins, decorating sugar cookies, bobbing for apples, going to haunted houses, or just curling up on the couch with a bowl full of popcorn and watching some classic, scary movies.

Halloween Around the World

Some countries, like Australia, frown upon Halloween, claiming it is an American event and not based in Australian culture, while others like Italy have embraced the fun and celebrate much as Canadians and Americans do. Mexicans have been celebrating this fun day since around 1960, and it marks the beginning of the Day of the Dead festival. Some countries in Europe have come late to the party, but since the 1990s, countries like Sweden, Norway, and Germany have started celebrating Halloween as well, and finding children in costumes or having ghosts hanging in windows has become commonplace.

Halloween is about fun; stepping outside our normal lives and donning a costume or gathering with friends to knock on doors and ask for candy is as much a part of our culture as hot dogs and barbecue on Labor Day. Have a safe and happy Halloween from the team at Montchanin Implant Center!

We often have patients who ask, “Can drinking alcohol affect my oral health?” There are, in fact, a few reasons why that martini may not be good for your pearly whites.

In addition to creating an overly acidic environment in your mouth, alcohol severely dehydrates oral tissues because of its desiccant and diuretic properties. Because alcohol saps oral tissues of their moisture so readily, saliva glands can't keep enough saliva in the mouth to prevent dry mouth. In addition, saliva contains antibacterial properties that inhibits growth of anaerobic bacteria, a destructive type of oral bacterial responsible for tooth decay, gingivitis, chronic bad breath, and periodontitis.

What are anaerobic bacteria?

When there is a lack of saliva flow in the mouth and the mouth cannot naturally cleanse itself of oral debris (food particles, dead skin cell, mucous), conditions develop that promote activity of anaerobic bacteria, or bacteria that thrive in dry, airless places. These anaerobes also flourish when an unending supply of proteins (food debris) are available to consume, creating rapidly multiplying layers of plaque that stick to teeth and demineralizes tooth enamel unless removed by brushing and professional dental cleanings.

Oral Cancer and Alcohol

Acetaldehyde is a chemical compound leftover after the liver has metabolized alcohol. Capable of causing genetic mutations, acetaldehyde is also a known carcinogen that contributes to the ill feelings of hangovers. Although most metabolism of alcohol is done in the liver, evidence shows that metabolism also occurs outside the liver and that enzymes in the mouth could encourage accumulation of acetaldehyde in oral tissues.

When combined with poor oral health, smoking, and other detrimental lifestyle factors, alcohol may be considered a primary contributory factor in the development of oral cancer.

Even if you don't drink or drink only occasionally, remaining aware of symptoms that may indicate oral cancer will improve your chances of recovering successfully when you start treatment in the early stages of oral cancer. Signs include red or while speckled patches in the mouth, unexplained bleeding, lumps/swellings, chronic ear or throat pain, and areas of numbness in the mouth or on the face.

If you have any questions about alcohol and its connection to oral health, don’t hesitate to ask Dr. Keller and Dr. Tibbs at your next visit to our Wilmington office.

They’re refreshing and tasty. They’re easy to find and pretty cheap. They help us get through a long day or a long workout. They’re everywhere.

We know it’s hard to say no to an energy or sports drink. That’s why Dr. Keller and Dr. Tibbs and our team want to make sure you know the effects that energy and sports drinks can have on your smile and overall oral health. You might just think twice next time you crave one.

There’s a common misconception that sports and energy drinks are somehow healthier than soda beverages. None is particularly good for you, but because sports and energy drinks have higher acidity levels, they put you on a fast track to enamel erosion, which can lead to cavities over time. However, studies show that energy drinks may be the worst of the bunch.

In a study published in General Dentistry, the energy drinks that showed the highest acidity levels were 5-hour Energy, Monster, Rockstar, and Red Bull Sugar free. These drinks almost doubled in acidity when compared to sports drinks. The sports drinks that came in second as far as acidity levels go were Powerade, Gatorade, and Propel.

You may be thinking, “What's the big deal; lots of other drinks damage your teeth, too,” and you’re right. Even all-natural beverages like orange juice and other fruit juices, which are advertised as full of vitamins, contain acid that damages tooth enamel. The point here is that moderation is key.

We certainly encourage you to choose a glass of orange juice over an energy drink, but if you feel like you just can’t give up your sports and energy drink habit, then please consider the following tips:

• Limit yourself to a certain number of said beverages a week and stick to it.
• Rinse with water after consuming an energy or sports drink.
• Brush your teeth after an hour of downing the drink, so your mouth has time to return to its normal pH level.

If you have any questions, don’t hesitate to give us a call at our Wilmington office. Shoot us a message on Facebook, or let us know on your next visit!

Cancer has become a common word, and it seems like there is new research about it every day. We know antioxidants are important. We know some cancers are more treatable than others. We know some lifestyles and habits contribute to our cancer risk.

Smoking increases our risk of cancer, as does walking through a radioactive power plant. But there is a direct link to oral cancer that you many may not know about—the link between HPV (Human Papilloma Virus) and oral cancer.

This may come as a shock because it has been almost a taboo subject for some time. A person with HPV is at an extremely high risk of developing oral cancer. In fact, smoking is now second to HPV in causing oral cancer!

According to the Oral Cancer Foundation, “The human papilloma virus, particularly version 16, has now been shown to be sexually transmitted between partners, and is conclusively implicated in the increasing incidence of young non-smoking oral cancer patients. This is the same virus that is the causative agent, along with other versions of the virus, in more than 90% of all cervical cancers. It is the foundation's belief, based on recent revelations in peer reviewed published data in the last few years, that in people under the age of 50, HPV16 may even be replacing tobacco as the primary causative agent in the initiation of the disease process.” [http://www.oralcancerfoundation.org/facts/]

There is a test and a vaccine for HPV; please discuss it with your physician.

There are some devices that help detect oral cancer in its earliest forms. We all know that the survival rate for someone with cancer depends greatly on what stage the cancer is diagnosed. Talk to Dr. Keller and Dr. Tibbs if you have any concerns.

Please be aware and remember that when it comes to your own health, knowledge is power. When you have the knowledge to make an informed decision, you can make positive changes in your life. The mouth is an entry point for your body. Care for your mouth and it will care for you!

How better to spend the fall months than inside by the fireplace with a warm cup of cider and a book in hand? Dr. Keller and Dr. Tibbs and our team at Montchanin Implant Center encourage you to warm up your mind this fall season with a few great books. Sure it may be easy to put off reading when balancing a hectic schedule, but reading is vital to brain development. Besides, reading is always a blast!

This week, we thought we’d ask what you or your child are reading this fall. Do you have any suggestions for must-read books this year? Out of ideas for great fall reads? Ask us for suggestions, and we would be happy to provide a few. You may also ask a local librarian here in Wilmington for some ideas.

Happy reading! Be sure to share with us your fall picks or your all-time favorites below or on our Facebook page!

One of the greatest features our team at Montchanin Implant Center offers is the ability to see first-hand how we can help our patients. While X-rays help us detect any problems in your mouth and give us valuable information on what is bothering you, they often don’t give Dr. Keller and Dr. Tibbs a complete view of everything that is going on inside your mouth. With the use of an intraoral camera, we can see every aspect of your teeth and mouth with incredible detail, uncovering cracked or fractured teeth, excessive wear, carious lesions, cavities, or other issues that may be hidden. When we can discover oral problems early on, your treatment is much less invasive and often saves you money down the road.

An intraoral camera allows Dr. Keller and Dr. Tibbs to view clear, precise images of your mouth, teeth, and gums and allows us to make an accurate diagnosis.  With clear, defined, enlarged images, Dr. Keller and Dr. Tibbs and our team see details that standard mirror examinations may miss. It’s much easier to understand what is happening in your mouth if you can see the problem on a computer monitor, and it means faster diagnosis and less chair-time for our patients!

Intraoral cameras are small, about the size of a dental mirror, and emit a light onto the tooth. The tooth will emit a color that lets Dr. Keller and Dr. Tibbs determine if the tooth is healthy or diseased. Intraoral cameras also allow us to save your images on our office computer to provide a permanent record of treatments. These treatments can be printed for you, other specialists, and your lab or insurance companies.

For any questions about the intraoral camera, we encourage you to ask Dr. Keller and Dr. Tibbs or our team during your or your child’s next visit or by giving us a call at our convenient Wilmington office.

Sometimes food that’s good for your body isn’t necessarily the best for your teeth. Dr. Keller and Dr. Tibbs and our team want you to know which healthy foods can harm your teeth and gums, and what steps you can take to continue enjoying these foods, even when you’re dieting.

When you begin to substitute empty calories with whole foods, make sure you also remember to focus on your dental health. The majority of people tend to switch out sugary foods in favor of fruits and vegetables when they diet.

It’s worth knowing that most fruits are highly acidic and composed of natural sugars. Some of the highly acidic fruits to watch out for include apples, grapes, strawberries, pineapples, blueberries, oranges, and grapefruit. Moderation is key here, as with all other things. Fruits can be a great source of energy to help you through your day, but try not to overdo them.

Often, people also incorporate more leafy greens into their diets, which mean plenty of salads. Salad dressing is another item you’ll want to watch out for. Many dressings are filled with vinegars and sweeteners that include harmful acids, which change the pH of your mouth. When your mouth shifts from alkaline to acidic, your smile also turns to a higher risk for erosion and decay.

Rather than get rid of these foods altogether, simply change what you do after you eat them. Rinse your mouth out with water, brush your teeth, or eat alkalizing foods after consuming these acidic foods. Healthy alkalizing foods include dairy products such as eggs and yogurt, or any type of vegetable.

If you have questions regarding your current diet and its effect on your oral health, please contact our Wilmington office and speak with a member of our staff. If you’ve begun to make changes in your diet toward a healthier lifestyle, we hope these tips can help your make positive changes to your oral health. Our team at Montchanin Implant Center wants a healthy lifestyle to be a top priority in your life.

Dental implants are a marvel! They look just like your natural teeth, and, even better, they function just like your natural teeth. So, when you’re planning on a dental implant after an extraction, you want to make sure that your implant has the best chance of success—and we do, too. That’s why we might recommend a socket preservation procedure, where socket grafting takes place immediately after your extraction.

What is a socket graft, and what does it “preserve”? Let’s take a closer look.

Socket Preservation—A Logical Choice After Extraction

You’ve decided on a dental implant for some excellent reasons.

• A missing tooth can change the appearance of your smile.
• Your remaining teeth might shift to fill the empty space, causing alignment and bite problems.
• A lost tooth affects the amount, shape, and health of the bone surrounding your teeth.

No one wants to lose a tooth. Sometimes, though, due to injury or decay, an extraction is the only choice for your oral health. After your tooth is extracted, if the socket bone holding the tooth is perfectly healthy and the extraction is a simple one, we might be able to place an implant post in the socket right away.

But often, bone needs time to heal before placing an implant post, and you risk losing the bone size and density you need to make a future implant possible. How can you lose bone? That’s an unfortunate consequence of losing teeth. Teeth are important not just because they let us eat comfortably—they also help maintain bone health.

Without the stimulation of biting and chewing, the bone beneath the teeth begins a process called resorption. As older cells are absorbed back into the body, new bone cells aren’t produced as quickly to replace them. The alveolar bone, the thick ridge of the jaw which holds our sockets, shrinks in size. As the bone gets smaller, gum tissue shrinks around it, causing a sunken spot where your tooth used to be.

For a dental implant to anchor successfully in the jawbone, you need healthy bone that is high enough, wide enough, and dense enough to hold the implant post securely as it fuses with the bone.

A socket graft at the time of extraction provides two important benefits: grafting material fills the empty socket immediately, preserving the bone and gum area around it, and the graft material acts as scaffolding for new bone growth, creating a firm, dense foundation for your implant.

Grafting materials are gradually and safely absorbed as your new, healthy bone tissue replaces them. The result, after several months of healing, is an alveolar ridge with normal height and width and with the density needed to anchor an implant successfully.

The Grafting Procedure

Grafting material comes in different forms, including allografts (made from donor bone), synthetic grafts (made from synthetic materials which function like bone tissue), and autografts (bone taken from your own body). Growth factors may also be included in the grafting material to encourage new cell growth. Dr. Keller and Dr. Tibbs will recommend the type of graft which will work best for you.

A socket preservation procedure will frequently involve the following steps:

• Local anesthesia to numb the area before your extraction. You might choose sedation options as well, which we’re happy to discuss with you in advance.
• Careful cleaning of the site after the tooth is extracted.
• Filling the empty socket with bone grafting material.
• Placing a barrier or membrane over the graft to protect it as it heals.
• Suturing the surrounding gum tissue.

Aftercare Treatment

Aftercare treatment for a socket graft is a lot like the treatment for a tooth extraction. You’ll need to be careful around the graft area for several days as it heals, and we’ll give you specific instructions for your recovery. Normally, these may include:

• Don’t disturb or touch the area. Even pulling on lips or mouth to look at the site can put stress on your sutures.
• Immediately after the procedure, we can give you suggestions for reducing swelling and managing any pain you might be feeling.
• We’ll let you know when and how to rinse your mouth clean and when you can return to brushing. And no spitting!
• Eat carefully. We might recommend a liquid diet for a few days before transitioning to bland and cool soft foods. We’ll let you know the best diet for the period after your surgery. Don’t use a straw for your liquid diet, because suction can interfere with the wound.
• Treat yourself carefully for a few days by avoiding strenuous activities, including workouts.
• Don’t smoke. Smoking interferes with the healing process, and the suction involved does your graft no favors either.
• Visit our Wilmington office for follow up appointments as recommended. We’ll monitor your healing, and give you a timeline for your future implant.

Preserving your socket now instead of repairing it later has many advantages. Immediate placement of a graft protects bone size and density, eliminates the need for a potential bone grafting procedure in the future, and makes it possible for you to enjoy the natural look and feel of a dental implant as soon as possible.

Bone grafting is essential for many periodontal restorations, and we are specialists in this procedure. If you have an extraction scheduled, let’s discuss why socket preservation might be your best path to an efficient, timely, and successful dental implant.

Labor Day is upon us, and that means the non-official end to summer. Before the kids head back to school and temperatures start to cool down, this is your last chance to barbeque in the beautiful Wilmington community, head to the lake, and wear your favorite pair of white pants.

About Labor Day

Each year, Labor Day is celebrated on the first Monday of September. It is the one day of year Americans celebrate their achievements in work, which the US Department of Labor says has contributed to prosperity and well-being of America as a whole. Americans have been celebrating Labor Day since the 1880s, and today it is an official federal holiday.

Interesting Facts About Labor Day

• Every year, more than 30 million Americans travel over Labor Day weekend.
• Canada was the first to celebrate Labor Day, and the US soon followed.
• President Cleveland made Labor Day and official US holiday in 1894.
• Labor Day marks the beginning of the NFL and NCAA sports seasons for fans.
• Labor Day marks the end of hot dog season, when Americans consume seven billion hot dogs.

Thanks for being a valued patient of our Periodontist office. Our staff would like to wish you a safe and happy Labor Day weekend. Enjoy your time off!

The electronic toothbrush has undergone several technological advances since the 1960s. Everything from design and bristle motions to rotation, oscillation, and sonic vibration has led to dramatic changes in this necessary tool over time.

Rotation oscillation happens when the head of the toothbrush rotates from one direction to the other. The benefit of powered toothbrushes is that they can produce 50,000 strokes per minute, compared to 300 strokes with a manual toothbrush.

When you’re thinking about brush head size, smaller brush heads are best for hard-to-reach areas and small mouths. Brush heads should be replaced every three to six months as needed. A good way to save money is to designate a brush head for each family member which can be taken on and off a shared base motor.

Having a base motor or rechargeable toothbrush can deliver enough power on a full charge for a week of brushing, which makes it convenient for travel or when life gets busy. Some toothbrushes include audible signals that let you know when to switch the area of your mouth you’re brushing or when a full two minutes has gone by.

Do you have sensitive teeth? Studies have indicated that people tend to apply more pressure on their teeth when they use a manual toothbrush. This makes an electric toothbrush a preferable option if you’re having issues with sensitive teeth or gums.

There are even electric models with pressure sensors that will stop the brush from spinning when you press too hard against your teeth!

Everyone can benefit from having an electric toothbrush. A large handle size can be taken into consideration if a member of the household is young, or has a physical disability or arthritis. They’re even recommended for children in order to maintain good oral hygiene from a young age.

Biofilm is a term used for plaque or debris that builds up in your mouth. If not properly addressed, this can cause serious bacterial infections to your gums and teeth. If you want to remove biofilm in the most efficient way, an automatic toothbrush is the way to go.

When you're ready to make your decision, make sure to consult with Dr. Keller and Dr. Tibbs at our Wilmington office to decide which electric toothbrush is right for you!

Keeping on top of your oral health is key when it comes to making sure your whole body stays healthy. The bacteria that occur naturally in your mouth can produce harmful bacteria such as strep and staph, which can lead to serious infections and sickness.

When you follow good dental habits like daily brushing and flossing, and eat a healthy diet, you can discourage harmful bacteria from traveling from your mouth to other parts of your body. Protect yourself and learn more about the link between oral hygiene and a healthy body.

Until recently, tooth decay was more common because of the lack of regular dental care and research behind fluoride. Tooth decay is much less problematic today, due to fluoridated water and toothpastes that contain fluoride.

Nowadays, gum disease has replaced tooth decay as the most frequent dental problem. Periodontal disease is on the rise among adults because people don’t floss regularly and then ignore gum tenderness and bleeding. If left unchecked, periodontitis can cause inflammation that may cause harm to other parts of the body.

Oral Health and Chronic Disease

Many scientists believe inflammation-related infections can trigger systemic disease or intensify existing conditions. Remember, bacteria overgrowth in inflamed gum tissue is able to enter the bloodstream through your eating processes, which is why it’s so vital to visit our Wilmington office if you notice sustained gum irritation and inflammation in your mouth.

Caring for your teeth and gums every day can prevent the onset of disease and save you trouble in the future with regard to your body’s health. If you think you may be showing signs of periodontal disease, or notice anything else out of the norm, please contact Dr. Keller and Dr. Tibbs and schedule an appointment.

We want you to be proactive about your health!

“Dentists, periodontists … what’s the difference, anyway?” We hear our patients asking this question as they wonder about the difference between the two specialties. Periodontists like Dr. Keller and Dr. Tibbs are more than just oral health professionals. Unlike dentists, who act more like general practitioners, periodontists focus on treating the soft tissue (gums) and bones supporting the teeth, as well gum disorders. Sure, dentists can prevent the onset of gum disease through regular cleanings and prescribing medications. But it is periodontists who are required for more complex and advanced cases of gum disease called periodontitis, a gum infection that, if left untreated, can lead to tooth loss. Periodontitis is a condition that most dentists simply don’t treat. The most severe cases of periodontitis can even lead to serious health problems such as diabetes, heart disease, and cancers of the head, neck, and pancreas.

To make things simpler, we’ve come up reasons for when you should visit the dentist and when you should give us a call to book an appointment with Dr. Keller and Dr. Tibbs:

Visit your general dentist for:

• Checkups and cleanings
• X-rays
• Filling cavities
• Root canals
• Tooth extractions
• Crowns or bridges
• Select cosmetic procedures such as veneers, bonding, and teeth whitening
• Pediatric (children’s) care

Visit Dr. Keller and Dr. Tibbs for:

• Deep pocket cleanings (to remove debris and infection-causing bacteria)
• Bone grafts
• Soft tissue removal
• Scaling and root planing (deep cleaning)
• Implant replacement
• Crown lengthening
• Osteoplasty (hard tissue recontouring)
• Gingivoplasty (soft tissue recontouring)

To learn more about the differences between periodontists like Dr. Keller and Dr. Tibbs and your general dentist, or to schedule your next visit, please give us a call today! We look forward to seeing and treating you!

People who have diabetes are usually familiar with many of the other health risks they face, including damage to the nerves, eyes, heart, and kidneys. But did you know that if you have diabetes you also have a much greater chance of developing gum disease? It's true, and like other diseases related to diabetes, the risk potential severity of gum disease is directly related to how well blood sugar is controlled.

The Causes

In diabetics, there are two primary mechanisms that increase the risk of developing gum disease, also called periodontal disease:

• Bacterial growth: Bacteria love sugar including the glucose found in blood and bodily fluids. Elevated levels of sugar in saliva can provide a very hospitable environment for bacterial growth. The risk may be elevated if your gums bleed.
• Circulatory changes: In diabetes, the blood vessels become thick, making it more difficult for blood to carry oxygen to the gums and to carry away harmful waste products. This decrease in circulation can weaken the mouth's natural resistance to decay. If you smoke, circulation can become even more compromised, significantly increasing your risk of periodontal disease.

Preventing Gum Disease

If you're diabetic, the number-one key to preventing gum disease is to make sure you do all you can to keep your blood sugar under control. In fact, studies show diabetics who have excellent control of their blood sugar levels have no more risk for gum disease than those who don't have diabetes. Here are some other tips to keep your gums healthy:

• Floss your teeth gently, curving the floss so it can gently reach just below your gum line to remove plaque and food particles. Rinse your mouth when you're done flossing.
• Use a soft-bristle brush to brush teeth twice daily, using small circular motions. Avoid pressing too hard on tooth surfaces.
• Brush your tongue gently to remove germs that can hide there.
• Use an anti-bacterial mouthwash to kill germs that are hard to reach.
• Keep track of how well your blood sugar is controlled and let Dr. Keller and Dr. Tibbs know at each visit.
• Be aware that having diabetes may mean it takes you longer to heal after undergoing oral surgery.

Most importantly, be sure to visit our Wilmington office for regular checkups and tell Dr. Keller and Dr. Tibbs about your diabetes so you can be sure to get the care you need. Follow these steps, and you can enjoy healthy teeth and gums for years to come.

Act One: Those 20 adorable baby teeth which begin arriving when you’re about six months old and are probably gone by the time you’re twelve.

Act Two: The 32 (if you have all your wisdom teeth!) adult teeth which start showing up around the age of six, and need to last the rest of your lifetime. Unless there’s an . . .

Act Three: Where science has discovered a way to repair damaged teeth or create replacements for lost teeth that would look and function just like our original teeth.

Sounds like science fiction, doesn’t it?

In biological terms, of course, we’re not there yet. But teams of scientists around the world have been working toward just this goal—the ability to repair a tooth with its own biological material or even grow a new tooth when an adult tooth is seriously damaged or lost.

Because the pulp—the living tissue inside each tooth—contains dental stem cells, some researchers are studying whether these cells can be used to regenerate the living pulp inside a damaged tooth. Even more exciting, there’s research being done into the possibility of using these stem cells to rebuild an entire tooth—pulp, dentin, and hard enamel exterior. Because the supply of usable dental stem calls is quite small, and process of guiding these cells to create all the varied parts of the tooth is quite complex, this research is in its early stages.

In other studies, scientists have focused on tooth regeneration by studying the teeth of other species. Mice, for example, have front teeth with open roots. This allows these teeth to keep growing up as they wear down, because stem cells inside mouse gums are always working to create new tissue. Even though our teeth are not exactly comparable (no open roots in human teeth!), finding out just how this tissue regeneration works in mice and other animals might help find an answer for human tooth regeneration.

Right now, these scientific goals are just that—goals for a future day. But in the meantime, your quality of life doesn’t need to suffer when you lose an adult tooth. You can enjoy a third act right now with dental implants.

Cosmetic concerns aren’t the only reasons why you want your complete smile restored in the event of a lost tooth. A missing tooth can lead to many unpleasant consequences:

• Speaking and eating can become more difficult.
• Lack of stimulation from biting and chewing can cause the bone beneath the lost tooth to shrink.
• Other teeth can shift to fill the gap left behind, which can affect tooth, bite, and jaw alignment.
• Loss of teeth can lead to loss of confidence.

Unlike dentures or bridges, dental implants are designed to function just like your natural teeth.

The post, or base, of each implant fuses with the bone in your jaw, acting as a “root” for the implant. Once the post has fused with the bone around it, a crown designed to match your other teeth in shape and color is secured to the post. You can eat, speak, brush, floss, keep your bone healthy, and smile confidently just as you did before.

Will biological replacements be ready for your third act in the near future? Probably not. But that’s not to say this will never be possible! In the meantime, take care of your teeth with daily brushing and flossing, eat a dental-healthy diet, and visiting our Wilmington office as recommended.

You do your best to keep your teeth intact and in place—but if you lose one through trauma or decay, talk to Dr. Keller and Dr. Tibbs about an implant. Because in any stage of life, the most important result is the happy ending a healthy and confident smile brings you!

If you have a hard time understanding your dental insurance plan, particularly the treatments and services it covers, you’re not alone. That’s why Dr. Keller and Dr. Tibbs and our team have put together a cheat sheet to help you through them.

It’s common for patients to get lost in the morass of the terms and phrases that surface when you’re dealing with a dental insurance plan. Knowing the commonly used terms can help speed up the process and enable you to get the most out of your coverage.

Common Terms

Annual Maximum: The most your policy will pay per year for care at Montchanin Implant Center. It is often divided into cost per individual or per family.

Co-payment: Typically, a small amount the patient has to pay at the time of service before receiving care, and before the insurance pays for any portion of it.

Covered Services: A list of all the treatments, services, and procedures the insurance policy will cover fully under your contract.

Deductible: An amount you must pay out of pocket each year before the insurance company will contribute for any treatments or procedures. The amount can vary according to your plan.

Diagnostic Services: A category of treatments or procedures that most insurance plans will cover before the deductible, which may mean services that occur during preventive appointments with Dr. Keller and Dr. Tibbs, including X-rays or general screenings.

Exclusions: Dental services not covered under a dental benefit program.

In-Network: An insurance company will usually cover a larger portion of the cost of the care if you see an in-network provider for treatment.

Out-of-Network: If you visit someone who is not a part of your provider’s network, the insurance company may pay for a portion of the care, but you will be responsible for a significantly larger share out of your pocket.

Lifetime Maximum: The most that an insurance plan will pay toward care for an individual or family over the entire life of the patient(s).

Limitations: A list of all the procedures the insurance policy does not cover. Coverage may limit the timing or frequency of a specific treatment or procedure, or exclude some treatments altogether.

Member/Insured/Covered Person/Beneficiary/Enrollee:  A person who is eligible to receive benefits under an insurance plan.

Premium: The regular fee charged by third-party insurers and used to fund the dental plan.

Provider: Dr. Keller and Dr. Tibbs or other oral-health specialist who provides treatment.

Waiting Period: A specified amount of time that the patient must be enrolled with an insurance plan before it will pay for certain treatments.

It’s essential to understand the various insurance options available to you. Knowing what your insurance covers can save you major costs in the future.

Dr. Keller and Dr. Tibbs and our dental staff hope this list of terms will help you understand your dental insurance plan better. Be sure to review your plan and ask any questions you may have about your policy the next time you visit our Wilmington office.

It's a moment many of our patients have experienced. One second you're chewing on a piece of gum, then suddenly you forget to keep chewing and swallow the entire rubbery gob whole! It's at this point you remember your mother warning you as a child that if you swallow gum it will stake a claim and take up residency in your belly for seven years. Dr. Keller and Dr. Tibbs and our team at Montchanin Implant Center hate to take all the fun out of the mystery, but the truth is that chewing gum, when swallowed, will enter your stomach and move through your digestive system just like any other piece of food. So, if you ever accidentally swallow a piece of gum, there is no need to worry!

That being said, it's important to know that gum does not have any dietary benefits, so while it’s not exactly harmful to swallow, you still want to avoid swallowing it. If you are an avid gum-chewer, we encourage you to chew sugarless gum, especially if you are wearing braces, because gum with sugar can lead to cavities. Sugarless gum still has the same amount of flavor, but has fewer cavity-causing ingredients. In fact, many brands contain an additive called xylitol, a natural sweetener known to fight cavity-causing bacteria. Xylitol is also known to increase salivary flow as it rinses away plaque and acid.

The fact is, when the bacterium in your mouth breaks down sugar, what’s left behind is acid. This acid eats away at the enamel coating of your teeth, causing holes that we call cavities. Cavities can lead to other long-term mouth problems if they are not treated in time, so it is best to try and avoid overexposing your teeth to too many harmful substances!

If you have any questions about chewing gum, please contact our office. Happy (sugar-free) gum chewing!

The Fourth of July is a great time to get together with friends and family members for BBQ, games, fireworks, and other celebrations in honor of our country’s independence. While your fellow revelers eat hot dogs and wave flags, you can impress them by sharing these fascinating facts and historical tidbits about some of our country’s traditions and symbols from the team at Montchanin Implant Center.

The Statue of Liberty

With a torch in one hand and a tablet in the other, the Statue of Liberty is one of the most iconic and recognizable symbols of our country. However, as recognizable as certain parts of the statue are, not many people know that broken shackles, which represent oppression and tyranny, are lying at Lady Liberty’s feet. According to the Statue of Liberty-Ellis Island Foundation, the copper-plated lady weighs in at a whopping 450,000 tons and has been holding her torch up for more than 125 years, which must make for some impressive arm muscles.

Nathan’s Hot Dog Eating Contest

Since 1916, people have been flocking to Coney Island on the Fourth of July to witness what some people call the “superbowl of competitive eating.” Nathan’s Hot Dog Eating contest challenges competitors to devour as many hot dogs as they can in just ten minutes, with the current record holder swallowing a whopping 68 hot dogs! If you’d like to witness this bizarre and frenzied eating competition but you won’t be anywhere near Coney Island on the fourth, don’t worry. ESPN has been broadcasting this popular event for several years, so you can watch from the comfort of your couch while you eat a reasonably portioned meal.

The History Behind Fireworks

Viewing the nighttime fireworks display is exciting way to finish off the fourth. Many people know that these brilliant displays probably originated with the Chinese. However, many historians also believe that fireworks were stumbled upon when the Chinese roasted bamboo sticks over fires and watched them explode. After many years of roasting the sticks, a group of alchemists created an early form of gunpowder, which they stuffed into the bamboo sticks to create an even more powerful explosion, paving the way for the today’s modern fireworks.

Whether you’re planning on visiting the Statue of Liberty, watching fireworks in Wilmington, or even participating in a hot dog eating contest, Dr. Keller and Dr. Tibbs and our team hope you have a safe and fun-filled holiday. Happy Fourth of July!

One of the latest foods in dietary news is also one of the oldest—ancient grains. What makes these old-timers so appealing to modern tastes? Let’s run down the menu!

Why Are Some Grains Called “Ancient”?

Unlike grains such as modern wheat, which have been crossbred for hundreds of years to bring out certain qualities, ancient grains are generally considered to be grains which have been cultivated in the same way and in the same form for centuries.

Not All Grains Are the Same

Grains are harvested from the seeds, or kernels, which grow on top of cereal grasses. But because they have many of the same uses, and many of the same nutrients, ancient grains also include pseudocereals, which are seeds and fruits from non-grasses. These seeds can be ground just like grains or used whole. This is an important distinction for many diet-mindful people because grains derived from pseudocereals are gluten-free.

The Health Benefits of Ancient Grains

Ancient grains are whole grains. This means that the seeds of ancient grains have their bran, germ, and endosperm intact—which means that all their nutrients, proteins, and fiber also remain intact. Refined grains like white flour and white rice have removed many of these good-for-your-body elements by removing the bran and germ, leaving only the endosperm behind.

The Dental Benefits of Ancient Grains

Of course, any food that offers better nutrition is better for your teeth and gums. But there’s an added bonus in the more complex structure of intact grains—they take more time to digest.

With foods made with refined grains, digestion starts taking place quickly—in fact, saliva starts the digestive process right in our mouths while we eat. And as these carbs break down into sugars, they provide a feast for the oral bacteria which convert that sugar into acids.

These acids, in turn, attack tooth enamel, leaving weaker spots which can grow into cavities, and irritate delicate gum tissue. What’s more, refined carbs tend to be extra sticky, lingering in the mouth, between the teeth, and on the enamel instead of being washed away by saliva.

So, Have Any Suggestions for My Shopping List?

We do! Because all ancient grains are loaded with protein and fiber, they are all going to be a rich source of these healthy essentials. And they can offer additional minerals, vitamins, and antioxidants to your diet. If you’re inspired to add a bit of history and geography to your plate, here are some ancient grains to consider:

• Amaranth

Cultivated by the Aztecs, this gluten-free pseudocereal seed is high in manganese, magnesium, copper, phosphorus (which helps keep your enamel strong), and also provides vitamins B1 (thiamin), B6, and B9 (folic acid).

• Barley

Grown for thousands of years in Asia and Europe, barley is one of the first cultivated grains. In its whole grain form, barley offers us selenium, manganese, copper, vitamins B1 and B3 (niacin), and antioxidants. Whole barley has a very tough outer shell and takes quite a bit of cooking, so lightly pearled barley can be substituted with only a small loss of bran.

• Buckwheat

Originating in Asia, buckwheat quickly spread to Europe and eventually made its way to early American fields. Another pseudocereal, buckwheat seed is often ground for flour, and is a good source of copper, manganese, magnesium, phosphorus, vitamins B2 (riboflavin), and B3. Not to mention, gluten-free!

• Bulgur

Often used in Middle Eastern and Mediterranean cooking, bulgur is a cracked wheat cereal grain. Bulgur adds, among other nutrients, manganese, magnesium, copper, iron, and vitamins B3 and B6 to your diet.

• Farro

“Farro” comes from an Italian word which can refer to three different varieties of wheat, with different cooking times, textures, and flavors. These grains were first cultivated in the Middle East and the Mediterranean region thousands of years ago, and are still popular today thanks to their nutty flavor and chewy texture. Try farro for a tasty serving of magnesium, zinc, vitamin B3, and antioxidants.

• Freekeh

Common in Middle Eastern, North African, and Mediterranean cuisine, freekeh is another form of cracked wheat. It’s harvested when the plants are young, so it has extra protein and fiber, as well as being a good source of iron.

• Quinoa

Another pseudocereal, quinoa originated in South America. It’s gluten-free, and filled with minerals such as manganese, magnesium, phosphorus, and vitamin B9. It’s also a complete protein, which means it contains all nine of the amino acids our bodies can’t produce on their own.

• Spelt

One of the largest wheat crops in Europe, and grown around the world, spelt’s nutty taste is an added bonus to its stores of manganese, copper, phosphorus, and vitamin B3.

• Teff

The smallest of the ancient grains, teff is an African variety of millet, a pseudocereal full of nutrients such as manganese, copper, iron, and calcium (another mineral which is vital to dental health), as well as vitamins B1 and B6. Try brown teff for its naturally sweet flavor.

This is just a taste of the ancient grains available to you, with many others from around the world waiting to be harvested for your table. But you needn’t choose ancient grains to receive all the nutritional benefits of whole grains.

Brown rice, whole wheat products, corn, oats—all these common ingredients are easily available forms of whole grains. Check the grain aisle in your local market for some new ways to brighten your recipes, to increase your dietary protein and fiber, to add minerals and vitamins, and to provide some healthy alternatives to refined grains. Your body—and your teeth—might thank you!

Today's periodontal office is a very different place than it was in the past. Yes, perhaps the same issues are still being treated, but it's the way in which they are treated which has changed drastically. Now patients with periodontal disease (gum disease) have more options.

What patients must understand is that gum disease is an infection that progresses in stages. First it affects gum tissue, and then it moves to the bones supporting the teeth, which then progresses to loss of teeth if left untreated. The main goal of treatment is to control this infection before it becomes more serious or painful.

Cutting-edge technologies used by Dr. Keller and Dr. Tibbs now allow gum disease to be treated non-surgically, which is a huge advantage for patients who don't want to get gum surgery, can't afford it, or simply aren't good candidates for it. Here are some of the ways in which our office implements the latest in periodontal technologies:

• Ultrasound gum treatments –An ultrasonic cleaning device is used to break apart stubborn plaque and tartar, as well as bacteria. The tool vibrates at a high frequency while simultaneously spraying a thin stream of water. The stream is sprayed around the teeth and at the gum line to clean and help prevent the bacterial buildup that leads to gum disease.

• Laser therapy – A tiny diode laser is aimed at the gum line to kill disease-causing bacteria. This method is able to penetrate into the pockets between the teeth and gums, all with minimal discomfort and no surgery whatsoever.

• Panoramic X-rays – These X-rays give us a much more detailed view of your mouth and the structures that support it than traditional dental X-rays. The machine spins around your head 360 degrees to produce a digital X-ray in a matter of seconds. We're then able to refer to this digital image on the computer for effective and precise treatment planning.

• Intraoral camera – The head of this device contains a small camera used to show you what we see. It produces a live feed on the monitor so you get a better understanding of the issues in your mouth. This way we can better explain how we will go about treating them and what you can do about them, too.

Patients suffering from gum disease have more options and help than ever before. If you are currently a patient or would like to know about the treatment options we offer, please speak with one of our staff members or contact our Wilmington office.

It can be. There is more and more evidence to suggest people may be genetically susceptible to periodontal (gum) disease. According to a study published in the Journal of Clinical Periodontology, as much as 30 percent of the U.S. population may be genetically vulnerable to gum disease.

Research has suggested that bacteria causing periodontal disease are passed via saliva. This means that when family members come into contact with each other’s saliva by activities such as sharing drinks, they put themselves at risk for contracting periodontal disease. Based on this research, experts at the American Academy of Periodontology strongly recommend that all family members receive a periodontal disease screening if one of their family members has gum disease.

Despite persistent oral care habits such as brushing twice daily, flossing, and going to the dentist twice a year, these people may be more likely to develop periodontal disease at some point in their lifetime. Luckily, Dr. Keller and Dr. Tibbs and our team can identify these patients by having them undergo a genetic test that analyzes genes and can help us identify an person’s risk for periodontal disease, as well as getting them into early intervention treatment.

Periodontal disease prevention starts with a visit to our Wilmington office. During your appointment, Dr. Keller and Dr. Tibbs and our professional team can identify whether you have gum disease or if you are at risk for developing gum disease. Together we can take the necessary steps to treat the disease or prevent it entirely.

To learn more about preventing gum disease, or to schedule your next visit at Montchanin Implant Center, please give us a call today!

The community health awareness group Oral Health America has reported that 82 percent of adults are unaware of the role that infectious bacteria can play in tooth decay or cavities, and almost three out of five children aged 12 to 19 have tooth decay. Since June is National Smile Month, Dr. Keller and Dr. Tibbs and our team at Montchanin Implant Center thought we’d remind our patients about the importance of good oral hygiene visits between office visits.

To keep your family’s smiles healthy and beautiful for years to come, be sure to:

• Brush at least twice a day with fluoride toothpaste
• Floss every day to clean between your teeth
• Eat a healthy, well-balanced diet
• Reduce your intake of sugary foods and drinks
• Visit Dr. Keller and Dr. Tibbs for scheduled appointments

If you want to know more about healthy home care habits, feel free to ask our team at your next appointment, or ask us on Facebook!

You have probably counted a hundred reasons to stop smoking. It’s unhealthy. It’s expensive. It annoys the people around you. You have to schedule your day around the next cigarette. But here’s reason number 101: Did you know that one of the many side effects of smoking is the damage it does to your smile?

Your Appearance

One of the most obvious results of smoking is the constant yellowing and discoloration of your teeth. Tobacco stains can take longer to remove with home brushing and whitening. And, while a professional cleaning and whitening will make a world of difference, all that good work is undone once you start smoking again.

More important, no smile looks its best with periodontal disease and tooth loss. Smoking has been linked to the presence of more harmful oral bacteria and higher occurrences of cavities and gingivitis (early gum disease). Periodontitis, or severe gum disease, is much more common among smokers. Tooth loss is also much more likely.

Healing after Dental Surgery

Smoking slows the healing process. It has been linked to a weaker immune system, so it’s harder to fight off an infection or to heal from one.  And because of the harmful effect of smoking on bone tissue, there is a higher failure rate for dental implants among smokers. Bone density can be so compromised that an implant is not even an option.

Healing after Extractions

If you have a tooth extracted, the formation of a blood clot at the site of the removal is essential to avoid a condition called dry socket. Dry socket can lead to pain, serious infection, and other complications. Luckily, this clot is resilient and pretty hard to dislodge—unless you apply suction such as sipping through a straw or drawing smoke from a cigarette.

Oral Cancer

Research has shown that smoking is the single most serious risk factor for oral cancer. The good news is that this risk is cut dramatically if you quit!

Let Dr. Keller and Dr. Tibbs help you maintain your smile. We can offer many more reasons to give up the smoking habit, and we are happy to offer suggestions for quitting during your next visit to our Wilmington office. We want to protect your smile and your health as well. It doesn’t really matter which number on the list finally leads you to quit—every number on that list is your lucky number!

Memorial Day didn't become an official holiday until 1971, but Americans started gathering annually in the spring to remember those who lost their lives in war during the 1860s, right after the Civil War. Celebrated on the last Monday in May, people still decorate the grave sites of war veterans and hold memorial services, but Memorial Day has also evolved into a day that signifies the beginning of summer.

During the summer months, many people take road trips to visit family members. Some head off to the airport to enjoy a long-awaited vacation far away, while others look forward to spending time with friends and family at home. However you spend Memorial Day and the subsequent summer months, there are a few things you can take care of to ensure your summertime is enjoyable.

Checklist for an Enjoyable Summer

• Have the AC Checked. During the hottest days of summer, many families find themselves sweating it out due to a broken air conditioning system. Be proactive so you can avoid waiting for hours or days because the HVAC repair person is booked solid. Have your air conditioning system checked before or around Memorial Day each year.
• Ensure Security While You're Away. When you leave for vacation, the last thing you should have to worry about is the security of your home. Install a home security system, if possible, and put a timer on your lights so they go on and off at normal hours. You can also alert your local police department that you'll be gone, and ask them to drive by your house once in a while to make sure everything is okay.
• Visit Dr. Keller and Dr. Tibbs Before Vacation. Many people put off exams until after summer vacation. Avoid the crowds and make sure your physical and oral health are in top shape prior to vacation time so there are no unpleasant surprises.

Our team at Montchanin Implant Center wants you to look forward to Memorial Day and the days of summer by preparing to spend the time safely and comfortably. As you plan ahead, take care of your health and secure your home, you can place your focus on creating memories with family members and friends while enjoying your favorite Memorial Day traditions.

Toothpaste ads are usually all about the teeth. Cavity-fighting benefits. Whiter smiles. Reducing tooth sensitivity. But lately, we’re also hearing a lot about toothpastes which are formulated to clean, renew, and repair our gums. Maybe it’s time to consider whether a tube of gum-healthy toothpaste should be your new main squeeze.

Gum Health Affects Our Overall Health

According to the CDC, almost half of all adults over the age of 30 suffer from gum disease—and the percentages get even higher with age. And, just like tooth decay, gum disease is most commonly caused by bacterial plaque.

Plaque is a biofilm made up of saliva and food particles and millions of bacteria. Within hours after we’ve brushed and flossed, this sticky substance starts forming again on teeth and around the gum line.

Gingivitis, or early gum disease, occurs when plaque around the gum line irritates gum tissue, causing inflammation. You’ve probably noticed some symptoms of inflammation if you’ve ever neglected your brushing and flossing routine for even a day or two. Gums become red, or swollen, or tender, or bleed easily.

Careful attention to brushing and flossing is essential to prevent gingivitis and to reverse early symptoms. That’s because, left untreated, gingivitis can lead to periodontitis, a serious gum disease.

The bacteria in plaque produce toxins, which our immune systems react to with inflammation. Over time, this inflammation response causes the breakdown of the bone and ligament tissue which hold our teeth in place. Once-snug gum tissue starts to pull away from the teeth, creating pockets around the teeth where more bacteria collect. This leads to infection and further loss of bone and tissue.

Infection, loose teeth, and lost teeth cause chronic pain, difficulty eating and speaking, and alterations in facial appearance. And it’s not just our oral health which can be affected by gum disease. Studies have found connections between gum disease and other inflammatory diseases like rheumatoid arthritis and cardiovascular disease, and between gum disease and medical conditions such as xerostomia (dry mouth) and diabetes.

How Toothpastes Can Help Prevent Gum Disease

We already know that dentists recommend fluoride toothpaste because fluoride prevents cavities. Fluoride bonds with the calcium and phosphate ions in our tooth enamel, repairing weak spots. Even better, this new bond is stronger and more cavity-resistant than enamel alone.

When it comes to preventing gum disease as well as fighting cavities, though, not all fluoride formulas are the same. The common go-to ingredient in gum-healthy toothpastes is stannous fluoride. Like the more commonly used sodium fluoride, stannous fluoride reduces the risk of cavities and strengthens tooth enamel. And more! Studies have shown that stannous fluoride:

• Has anti-microbial agents which reduce the number of gingivitis-causing bacteria
• Disrupts plaque formation
• Continues working to reduce plaque levels even after brushing.

Because inflammation caused by bacterial plaque buildup is the most common cause of gingivitis, it makes sense that toothpastes which reduce bacteria and plaque can also reduce gum inflammation and gingival bleeding when used regularly.

But Toothpaste Can’t Do It All!

No matter which paste you use, you still need to be proactive with your dental health.

• Brush at least two minutes, at least twice each day, to stop plaque buildup. And use proper technique. Angle the brush toward the gums to gently clean around and below the gum line.
• Floss at least once a day. Flossing really does remove plaque between teeth and near the gum line which your toothbrush won’t.
• Use a soft-bristled brush. It protects both delicate gum tissue and strong enamel from abrasion.
• Keep up with your regular professional cleanings.
• For specialized periodontal treatment, make an appointment at our Wilmington periodontal office.

If you have sensitive, inflamed, or bleeding gums, or if you have any worries about your gum health, don’t take advice from a toothpaste carton.

Talk to Dr. Keller and Dr. Tibbs about the best toothpaste for your specific dental needs. Whether it’s a recommendation for a specific kind of toothpaste or rinse, prescription medication, or more advanced periodontal treatment such as deep cleaning procedures or gum surgery, we have the treatment options to help you keep your gums their healthiest!

Xylitol tastes sweet, but unlike sugar, it is not converted to acid that can cause your teeth to decay. It’s a naturally occurring sweetener found in plants, fruits, and vegetables; even the human body produces it in small amounts. Xylitol is widely used in sugar-free chewing gum, mints, candies, and even certain forms of medicine.

The World Health Organization has approved xylitol because only a small amount is needed for its health benefits. It’s even safe for diabetics, with a glycemic index of only seven. Xylitol has 40% fewer calories than other types of carbs: less than three calories per gram.

So how can this natural sweetener benefit your oral health? Take a look at the facts. Tooth decay starts when bacteria consumes the sugars left in your mouth. When you eat sugary foods, the bacteria on your teeth will multiply and make acid that can destroy your enamel.

Xylitol is derived from fibrous parts of plants, so it does not break down like a regular sugar. It actually helps maintain a neutral pH level in the mouth, which in turn prevents bacteria from sticking to the teeth. The bacteria are then unable to digest xylitol, which means your teeth won’t develop enamel damage and cavities.

Studies have shown the consumption of xylitol as a sugar substitute or a dietary addition had a dramatic reduction in new cavities and even reversed existing cavities. These effects are long lasting: low cavity rates remained years after the trials were done.

When there’s less bacteria and acid in your mouth due to xylitol, your teeth stay healthier. The more frequently it’s ingested, the more you will prevent enamel damage.

Aim to consume around five grams a day, or one gram every three hours if possible. You can do this by consuming gum, tablets, candy, or mints that have xylitol as one of the first ingredients after your meals. You can find these products in health food stores and specialty grocery stores.

Since xylitol replaces sugar on a one-to-one ratio, it’s used in several common items:

• Toothpaste
• Mouth rinse
• Baby oral wipes, gel, and pacifiers
• Nasal wash
• Dry mouth spray
• Granulated forms for cooking
• Granulated packets to add to drinks
• Commercially prepared foods

Make sure to pick up items that contain xylitol the next time you’re at the store! This is an easy way to maintain great oral health. If you have specific questions about xylitol, ask Dr. Keller and Dr. Tibbs during your next appointment at our Wilmington office.

Summer is almost here, which means a season full of vacations, adventures and great memories is just around the corner for our patients at Montchanin Implant Center.

Everyone wants a glowing and radiant white smile when the sun comes around and we have a few reminders to keep your pearly whites healthy and beautiful over the summer! Try to stay away from drinks that will stain your teeth like coffee, soft drinks, or dark colored juices. Not only will drinks like this weaken your enamel but they will also darken that fabulous smile you're working on! Another tip is to try and focus on brushing your teeth; everyone knows that when busy schedules start picking up, getting a good brushing session in tends to take the backseat! A good tip for keeping your mouth safe from staining and other possible pitfalls is to rinse your mouth with water after any meal you can’t fully brush your teeth after. Your teeth, inside and out, will benefit!

And remember, whether you are headed to a barbecue, a camping trip, or just having fun in the backyard this summer, we want to hear all about it! Make sure to let us know what you’re up to below or on our Facebook page! We also encourage you to post any photos from your adventures!

Inflamed gums are a fairly common dental issue, but unfortunately, many people don't take the problem seriously enough. If you ignore inflamed gums and continue your usual routine, you could be encouraging a much more severe inflammation problem, and the pain that goes along with that. Fortunately, it is quite easy to relieve inflamed gums if you use the tips below.

Use Soft Bristles

A soft-bristle toothbrush - the softest you can buy - is a must for anyone with inflamed gums. Anything that makes contact with your gums can cause you pain, so fine and soft bristles are always the best choice.

Use Sensitive Formula Toothpaste

The toothpaste marketed as “Sensitive Teeth Formula” contain special ingredients to help relieve sensitivity. When your gums are inflamed, even light brushing can cause some pain. Using a special toothpaste will help reduce that pain and make it easier to brush your teeth effectively. The effect becomes stronger as you use the toothpaste more, so use it for each brushing.

Visit Our Office

If your gums remain swollen for more than a few days or a week, set up an appointment with Dr. Keller and Dr. Tibbs. There is a long list of conditions that could be causing your swollen gums, everything from gum disease to pregnancy, so you need to find out where your issue is coming from. Most of the time, Dr. Keller and Dr. Tibbs can easily treat the swollen gum issue at our Wilmington office, or can give you an effective treatment to take home.

The idea for Earth Day was the brainchild of Gaylord Nelson, a senator from Wisconsin. He envisioned an Earth Day that would be a kind of environmental teach-in. The first Earth Day celebration took place on April 22, 1970, and a surprising 20 million people participated on that day. Ultimately, it became the largest organized celebration in US history.

Earth Day Over the Years

Over the years, the recognition of the day, and the number of people celebrating it all over the world, turned Earth Day into an international celebration. Because it is celebrated throughout the world, it is not only the largest international environmental observation, but it is also more widely celebrated than any other environmental event in the world. Today, Earth Day is celebrated in 175 countries where over 500 million people participate in celebrations.

The Earth Day Movement

The Earth Day movement is credited with developing the idea that people should “think green”. It encouraged congress to enact laws, including one that resulted in the creation of the Environmental Protection Agency. It also inspired the passage of the Endangered Species Act.

The Five R's and Their Importance

• Reduce – Reduce by avoiding unnecessary purchases. Reduce your use of materials that wind up in landfills. Reduce the use of chemicals around your house. Reduce your use of disposable bags, plates, cups, eating utensils, and batteries.
• Reuse – Instead of using plastic bags for your groceries or purchases, bring your own reusable bags. When you go to buy coffee at Starbucks, take a travel mug so you don't have to get your coffee in a disposable paper cup. Instead of storing food in disposable refrigerator containers, buy containers that can be washed and reused. Don't use regular batteries. Whenever possible, opt for rechargeable batteries that you can reuse.
• Recycle – Most cities offer a recycling program to collect used bottles, cans, and newspapers. Recycling includes collecting recyclable materials that would otherwise be considered waste, sorting and processing recyclables into raw materials such as fibers and manufacturing raw materials into new products.
• Re-buy – Make an effort to purchase things that are made through recycling. When purchasing furniture, look for items that are made from reclaimed wood. When buying paper for kids school work, computer printer paper, holiday cards, or anything else, make a point of purchasing recycled paper products. Instead of buying clothing at full retail price, shop for second hand clothing. You will save a lot of money by doing so!
• Rethink – Rethink the way you do things so that you do them in an eco-conscious way at all times. Instead of driving to work alone, consider taking the bus or going in a carpool. Walk or ride your bike when you're only going a short distance. Plan your shopping trips and errand runs so that you can do everything on one day, and do it in a way where you can save time and gas.

Other ways to "think green" include growing your own food, composting yard waste and food scraps, or by participating in local recycling programs. Join a group like Freecycle so you can share your unneeded and unwanted possessions with people who can use them. Likewise, you'll be able to get things you need or want for free.

Earth Day teaches people that the planet belongs to everyone, so everyone is equally responsible for protecting it. Although Earth Day is an environmental celebration, our team at Montchanin Implant Center wants to remind you that you don't have to wait until then to make changes that will allow you and your family to live a greener life.

Happy Earth Day from the team at Montchanin Implant Center.

Unless you're aware of the signs and symptoms of gum disease and how it's caused, it's possible that you may have unknowingly developed it. Often painless, gum disease -- or periodontal disease -- becomes progressively more serious when left untreated. As you learn more about the common causes of gum disease, you'll be better-equipped to maintain the best oral health possible.

Gingivitis & Periodontitis: Common Causes of Gum Disease

• Bacteria & Plaque. Bacteria in the mouth creates a sticky film over the teeth. Good hygiene practices help remove the bacteria and the plaque they cause. When plaque is not removed, it develops into a rock-like substance called tartar. This can only be removed by a dental professional.
• Smoking & Tobacco. If you're a smoker or use tobacco, you face a higher risk of developing gum disease. Additionally, tobacco use can lead to stained teeth, bad breath, and an increased risk of oral cancers.
• Certain Medications. Some medications that are taken for other health conditions can increase a person's risk of developing gum disease. If you take steroids, anti-epilepsy drugs, certain cancer therapy medications, or oral contraceptives, speak to Dr. Keller and Dr. Tibbs about how to maintain healthy gums.
• Medical Conditions. Certain medical conditions can impact the health of your gums. For instance, diabetics face an increased risk of gum disease due to the inflammatory chemicals present in their bodies. Always talk to our team about other health conditions to ensure we take that into account when treating you.

Take a Proactive Stance

Good oral hygiene practices and regular visits to our Wilmington office can help you eliminate or reduce the risks of developing gum disease. A thorough cleaning with your toothbrush and dental floss should take about three to five minutes. Brush your teeth a minimum of twice per day and floss at least once each day. Keep these tips in mind and you’ll be ready to prevent gum disease.

Happy Oral Cancer Awareness Month! We know oral cancer can be kind of a scary topic, but it’s worth using this opportunity to learn about the disease and spread knowledge so everyone becomes more aware. The more we know, the better we can work to prevent it!

Oral cancer is exactly what it sounds like: cancer that occurs anywhere in the mouth. It could occur on the tongue, the lips, the gums, the tongue, inside the cheek, or in the roof or floor of the mouth. Every  year, more than 8,000 people die from oral cancer. It’s a truly deadly disease.

The reason oral cancer scores a higher death rate than other common cancers such as testicular cancer, Hodgkin’s disease, thyroid cancer, cervical cancer, or even skin cancer, is because it often goes undetected until it's become too advanced and has spread to another part of the body.

So what causes this devastating disease? There is no clear answer, but some potential causes have been identified. By being aware of these, we can be alert and promote prevention of this illness:

• Age: Most patients who develop oral cancer are above the age of 40. If you’re over 40, make sure your doctor checks for signs of oral cancer and that you stay on your dental hygiene regimen.
• Tobacco: Excessive tobacco use, whether in the form of cigarette smoking or tobacco chewing, can be a substantial contributor and cause of oral cancer. So that’s another reason, among many, you should avoid tobacco.
• Alcohol: Excessive alcohol consumption can put you at risk because alcohol converts into a chemical called acetaldehyde, which damages the body’s DNA and blocks cells from repairing the damage. When paired with tobacco, the dehydrating effects of alcohol make it even easier for tobacco to infiltrate mouth tissue.
• Sun exposure: Your lips need SPF, too! Repeated sun exposure increases your risk of contracting cancer on your lips, especially the lower lip.
• Diet: Not getting all the nutrients you need, from vegetables and fruits for instance, can weaken your immune system and make you more vulnerable to the disease.

Obviously, many of these causes relate to lifestyle choices, which we have control over. It's all about balance, being aware, and making small tweaks to our habits if we need to.

If you’re concerned that you may be at risk for oral cancer, give us a call to talk about a screening. And if you’ve been putting off a visit to our Wilmington office, now is an excellent time to schedule one. Regular visits to the dentist can be the first line of defense against oral cancer!

Dr. Keller and Dr. Tibbs and our team recommend that you brush your teeth two to three times a day, for at least two minutes each time. But have you ever wondered what’s in toothpaste and how it actually works? The mouth is home to more than 500 types of microorganisms that feed on leftover food that gets stuck on and around your teeth. Toothpaste is the best line of defense against all those pesky microorganisms (especially when you brush two to three times a day). Here’s how it works.

Abrasives

Toothpaste contains mild abrasive additives that combat microorganisms and fight plaque. When you brush, the abrasives in toothpaste dislodge food particles and microorganisms more effectively than if you simply brush your teeth with water. The abrasives also work to remove food stains and polish the surface of the tooth. Some toothpastes include ingredients like triclosan and Xylitol. These chemicals prevent the growth of bacteria that produce plaque. Plaque not only causes cavities, but it can also lead to more dangerous issues like periodontal disease.

Fluoride

Fluoride is key ingredient in toothpaste. As the microorganisms in your mouth feed off the leftover food particles, they leave behind acid and sulfur byproducts that wear away the enamel of the teeth. This is the fancy, technical way of saying that the acid on your teeth causes cavities. As for the sulfur byproduct –well, that’s just a fancy, scientific name for bad breath. Fluoride works to fight the acid and help protect the teeth. By brushing, the fluoride is incorporated into the tooth enamel, which in turn makes the tooth more resistant to acid and plaque.

Flavoring and Sweetening Agents

Not all toothpaste tastes the same, right? The type of flavoring or sweetening agents added to the toothpaste doesn't have anything to do with fighting microorganisms and plaque, but taste is one of the most important selling points in finding a toothpaste brand you like. Flavoring agents mask the taste of some of the other ingredients in toothpaste, and without those agents chances are nobody would be brushing their teeth two to three time a day.

Taking care of your gums is one of the best ways to protect your smile. But sometimes, we treat our gums like an afterthought when it comes to dental care. It might surprise you to learn just how common gum disease is—and how damaging it can be for your oral health.

Surprising Fact #1:

About half of all adults have suffered or are suffering from some form of gum disease. And about half of all children do, too. As we age, the percentages jump—in fact, some studies estimate that eventually 70% of older adults will be affected by gum disease.

Surprising Fact #2:

The major cause of tooth loss in adults isn’t tooth decay or accidents or aging—it’s gum disease.

Surprising Fact #3:

Gum disease is progressive. The gingivitis that begins with a bit of redness or some minor bleeding when you brush might seem like a temporary annoyance. But when ignored, this early form of gum disease can lead to periodontitis, a serious gum condition which causes receding gums, loose teeth, bone and tissue damage, infections, and tooth loss.

Gingivitis

Gum disease begins quietly and invisibly, and it usually starts with plaque. Plaque along the gum line irritates our gum tissue. The body’s immune system responds and triggers inflammation. Gum tissue becomes swollen and red. The gums might feel tender, or bleed easily when you brush or floss.

If you’ve experienced any of these symptoms, it’s time to call our Wilmington office. Dr. Keller and Dr. Tibbs might recommend better brushing and flossing habits, a professional cleaning, and/or an anti-plaque treatment. At this stage, with proper care, gingivitis is reversible.

But left untreated, gingivitis can progress over time until it becomes periodontitis. Periodontitis affects not only gum tissue, but the bone and connective tissue which surround our teeth, supporting them and holding them firmly in place.

Mild Periodontitis

As plaque and tartar continue to irritate gum tissue above and below the gum line, inflammation increases, and the gums begin to pull away from the teeth. This is a problem, because the gums normally surround the tooth roots snugly, protecting them from plaque, bacteria, and other toxins.

When gum tissue pulls away, pockets are created between gums and teeth. These pockets become home to more bacteria, causing more irritation, inflammation, and infection. During this phase, the connective and bone tissue around the tooth’s roots might start to break down.

Moderate Periodontitis

As the disease progresses, pockets become deeper. The structures that hold the teeth in place continue to break down, and the teeth start to loosen. As the gums recede, tooth roots become more vulnerable to decay.

Advanced Periodontitis

When periodontitis has reached the advanced stage, there is significant loss of tissue and bone around the teeth. Teeth become looser and foul breath, pus, and pain when biting or chewing are common. Without prompt treatment, there’s a high risk of tooth loss.

Unlike gingivitis, periodontitis isn’t reversible, and requires professional care. Advanced treatments can do a lot to restore gum health:

• Topical, time-release, or oral medications treat infection.
• Scaling and root planing, which are non-surgical deep cleaning procedures, remove plaque and tartar above and below the gum line, and smooth tooth roots to remove bacteria and help the gum tissue reattach to the teeth.
• Flap surgery treats more advanced gum infection, reducing pocket depth and re-securing the gums snugly around the teeth.
• Bone grafts, gum grafts, and other regenerative procedures are available that help restore and repair tissue damaged by gum disease.

That’s good news, and there’s even better news: Because gum disease is typically triggered by plaque, it’s very preventable.

• Brush carefully at least twice each day for at least two minutes. Don’t forget to brush along the gum line!
• Use floss at least once each day or as directed by Dr. Keller and Dr. Tibbs. If you have trouble flossing, ask us for the flossing tools and techniques that will work best for you.
• See your dentist regularly to catch and treat early gum disease while it is still reversible.

While gum health is essential for dental health, healthy gums might mean more than just healthy teeth. Scientists are studying the potential links between gum disease and its effects on conditions such as heart disease, diabetes, and arthritis. Gum health should never be an afterthought. Taking care of your gums is one of the best things you can do to ensure a lifetime of healthy smiles.

“St. Patrick's Day is an enchanted time -- a day to begin transforming winter's dreams into summer's magic.” Adrienne Cook

Lucky green shamrocks, leprechauns, and pots of gold – it must be St. Patrick’s Day! If you’re not Irish, how do you go about celebrating St. Patrick’s Day? It’s easy: You just put on one of those tall leprechauns hats, dress in green from head to toe, and wear one of those carefree pins that say “Kiss Me, I’m Irish”. On St. Patrick’s Day, everyone is Irish, and that is the universal beauty of the holiday. Celtic pride does not discriminate.

Wondering what our team at Montchanin Implant Center is doing to celebrate March 17th? Well, we’ve thought about doing everything from handing out lucky gold coins (you know, the fake ones that are made of chocolate) to shamrock stickers. Maybe we’ll even give away green toothbrushes and floss! You’ll never know unless you come in to see Dr. Keller and Dr. Tibbs !

All kidding aside, St. Patrick’s Day is an important cultural and religious holiday. There are lavish parades and church services across Ireland on March 17th. Over time, however, the holiday has developed into a day to observe Irish culture in general. In places like England and the United States, where there is a large Irish Diaspora, the holiday has greater significance than other countries. From the streets of Boston to St. Patrick’s Cathedral in New York, it is a day of celebration, and many Americans of Irish descent will cook up a traditional meal of corned beef and cabbage.

So, to all of you with Irish ancestry, and to all of you who have decided to be Irish for the day, our office wishes you a Happy St. Patrick’s Day. Good luck looking for a pot of leprechaun gold, which is said to exist at the end of the rainbow. However, keep away from those sugary Lucky Charms; sweet cereals might taste good, but your kids’ teeth might not be feeling too lucky if they eat it for breakfast every day. Have a great St. Paddy’s Day!

At Montchanin Implant Center, we know the most common oral health diseases are tooth decay and periodontal disease (or gum disease), and both are among the easiest to prevent. One of the most common ways we recommend to boost your oral health is by improving your diet, because you (and your mouth) truly are what you eat. A healthy diet can lead to a healthy mouth and body, while an unhealthy diet can lead to the exact opposite.

The Role Nutrition Plays

While diet is not the only factor that leads to periodontal disease, studies suggest the disease may be more severe among patients whose diets lack essential nutrients. Poor diets will generally lead to a weaker immune system, leaving your body susceptible to all kinds of ailments, including periodontal disease.

A Well-Balanced Approach

There is no “magic” diet that we can recommend to improve your oral health, but the most important thing is to seek a well-balanced approach in your eating. While fad diets that emphasize one food group over another may help you lose weight in the short-term, they probably will not provide all the nutrients your body needs in the long run.

Meals should include a balance of lean meats or other healthy protein sources, colorful fruits and vegetables, whole grains, low-fat dairy, and healthy fats. Foods containing substantial amounts of sugar and salt should be consumed in moderation.

Soda and Sugar: A Dangerous Duo

Millions of gallons of soda are consumed every day in America, but sipping a cold soft drink can be very harmful to your teeth. Many of these beverages wear down the enamel that protects the teeth, which weakens and even destroys them over time. The American Beverage Association estimates that soft drinks account for almost 30 percent of all drink consumption in the U.S., averaging an annual total of about 50 gallons per person (up from only 20 gallons in the 1970s). For healthy teeth and a healthy body overall, try to limit your soda intake.

Sugar is another ubiquitous treat in our daily lives. When we eat sugar, naturally occurring bacteria in our mouths convert it to acids that attack tooth enamel. Consuming too much sugar can swiftly lead to tooth decay, cavities, and gum diseases like gingivitis. Most people do not even realize how much sugar they consume each day. It’s important to limit your daily sugar intake by reading the labels of all the food you eat, and sticking with natural food sources that are low in sugar, especially ones that minimize added sugar, such as fruits and vegetables.

If you have questions about your diet and how it may be affecting your oral health, talk to Dr. Keller and Dr. Tibbs about it. See you soon!

In a world where everything moves so quickly and teens and young adults find themselves pulling “all-nighters” or working long hours, energy drinks have grabbed the spotlight. You’ll have one (or three) and suddenly you have the drive you need to keep going.

The same can be said for sports drinks. It’s common for people to have one even when they’re not engaged in any strenuous physical activity, which is what they were designed for. People will drink them simply because they’ve grown to love the taste.

Although they might taste great and boost your energy, there’s a serious down side to consuming energy and sports drinks on a steady basis. Studies have shown that these drinks contain so much acid that they start to destroy your teeth after just five days of consistent use.

The acid in these drinks destroys your tooth enamel, which makes your teeth more vulnerable to bacteria. This can progress to staining, tooth decay, and hypersensitivity.

That’s why Dr. Keller and Dr. Tibbs and our team want to encourage you to try to limit the amount of sports and energy drinks you consume. If you do enjoy either or both of these drinks, you should make it a habit to rinse your mouth with water immediately after consumption, and brush your teeth about an hour later, after the period when acid has a softening effect on your enamel has passed.

If you feel like you’re already experiencing the side effects of heavy energy and sports drink consumption, visit our Wilmington office, and our team can provide solutions for how to prevent further damage from occurring. It’s never too late to change a bad habit!

While mouthwash goes a long way in improving your oral care, it is not a substitute for flossing. Mouthwashes and flossing provide different benefits that you should understand.

Mouthwash Benefits

Mouthwash comes in two categories. Some are considered cosmetic. This type of rinse provides temporary relief from bad breath and has a pleasant taste. These do not actually kill any bacteria.

Therapeutic mouthwashes provide the healthier benefits. These may contain different ingredients including fluoride or antimicrobial agents. This type is used to remove plaque buildup and reduce the potential for calculus formation. Therapeutic rinses can also help prevent cavities, bad breath, and gingivitis. In addition, Dr. Keller and Dr. Tibbs can prescribe special rinses to assist patients after periodontal surgery or other procedures.

Flossing Benefits

Flossing is what removes the plaque formation before it can harden and become calculus. While a rinse reduces buildup, only flossing will fully remove plaque, especially between teeth. The bristles on a toothbrush do not get between teeth completely. If plaque is not removed, it hardens into tartar or calculus. When this builds below the gum line, gum disease can start.

Types of Floss

Floss is available in a thin string form or a tape. It can be waxed or unwaxed. If you find flossing difficult, you might want to try a different type of floss. You can buy bulk floss in containers or purchase the disposable type with a plastic handle attached. This style can be easier for many individuals to use. Interdental picks are available for bridgework or other situations where regular floss cannot be used.

If you have questions regarding the best mouthwash or floss, or need tips for easier flossing, please ask our Wilmington team for advice. We will be glad to give you solutions to help keep your mouth clean and healthy.

Valentine’s Day is the holiday to celebrate all the treasured relationships in your life. It’s a time to honor love in all shapes and forms with cards, social gatherings, and sometimes even binge eating of sweets.

It's hard to look the other way when grocery stores and pharmacies are invaded with goodies connected to the Valentine’s Day theme, and especially if you’re on the receiving end of some of these sweets. We get it. In fact, we’re all for it!

However, we also support a cavity-free smile. So in the interest of your dental and general health, and because we think it’s genuinely tasty, Dr. Keller and Dr. Tibbs recommends an alternative to the Valentine treats you may be accustomed to: dark chocolate. 

Yes, Healthy Chocolate Exists

Studies have shown that dark chocolate is high in flavonoids, an ingredient found in the cocoa beans used to make chocolate. Flavonoids can help protect the body against toxins, reduce blood pressure, and improve blood flow to the heart and brain.

By opting for dark chocolate rather than milk chocolate, you get to reap these benefits! Pretty sweet, right? Just make sure to stick to high-quality dark chocolates that have undergone minimal processing.

Dark Chocolate, AKA Protector of Teeth

Not only does dark chocolate provide some nice benefits for your overall health, it also helps protect your teeth against cavities! According to the Texas A&M Health Science Center, dark chocolate contains high amounts of tannins, another ingredient present in cocoa beans.

Tannins can actually help prevent cavities by interfering with the bacteria that causes them. Think of them as scarecrows for bacteria. They don’t always prevail, but isn’t it nice to have them there?

Smooth Never Sticky

Unlike many popular candies, dark chocolate is less likely to stick in the crevices of your teeth. Chewy, gooey sweets are more likely to hang around in your mouth for longer periods of time, which means they raise the odds of your harboring cavity-creating bacteria.

While some dark chocolates have additives like caramel or marshmallow, it’s best to opt for the plain varieties, which are just as delicious. If you’re feeling festive, though, a dark chocolate with caramel is still better than a milk chocolate with caramel, so that’s the way to go!

While dark chocolate has some pretty sweet benefits, the most important thing to remember (whether you go the dark chocolate route or not), is that moderation is key. That being said, we hope you have fun satisfying your sweet tooth and shopping for treats for your friends and loved ones. Happy Valentine’s Day from all of us at Montchanin Implant Center!

The American Academy of Periodontology stresses the importance of good oral health since gum disease may be linked to heart disease and stroke. Thus far, no cause-and-effect relationship has been established, but there are multiple theories to explain the link between heart disease and periodontal disease. One theory suggests that oral bacteria may affect heart health when it enters the blood and attaches to the fatty plaque in the heart's blood vessels. This can cause the formation of blood clots. Another theory suggests the possibility that inflammation could be a contributing link between periodontal disease and heart disease. Gum disease increases plaque buildup, and inflamed gums may also contribute to the development of swollen or inflamed coronary arteries.

What is coronary artery disease?

Coronary artery disease is caused in part by the buildup of fatty proteins on the walls of the coronary arteries. Blood clots cut off blood flow, preventing oxygen and nutrients from getting to the heart. Both blood clots and the buildup of fatty proteins (also called plaque) on the walls of the coronary arteries may lead to a heart attack. Moreover, periodontal disease nearly doubles the likelihood that someone will suffer from coronary artery disease. Periodontal disease can also worsen existing heart conditions, so many patients who suffer from heart disease need to take antibiotics before any dental procedures. This is especially true of patients who are at greatest risk for contracting infective endocarditis (inflammation of the inner layer of the heart). The fact that more than 2,400 people die from heart disease each day makes it a major public health issue. It is also the leading killer of both men and women in the United States today.

What is periodontal disease?

Periodontal disease is a chronic inflammatory disease that destroys the bone and gum tissues around the teeth, reducing or potentially eradicating the system that supports your teeth. It affects roughly 75 percent of Americans, and is the leading cause of adult tooth loss. People who suffer from periodontal disease may notice that their gums swell and/or bleed when they brush their teeth.

Although there is no definitive proof to support the theory that oral bacteria affects the heart, it is widely acknowledged better oral health contributes to overall better health. When people take good care of their teeth, get thorough exams, and a professional cleaning twice a year, the buildup of plaque on the teeth is lessened. A healthy, well-balanced diet will also contribute to better oral and heart health. There is a lot of truth to the saying "you are what you eat." If you have any questions about you periodontal disease and your overall health, give our Wilmington office a call!

Periodontal disease is an infection of the tissues that surround and support your teeth. Our team at Montchanin Implant Center wants you to know that this common ailment can be fixed with little worry if treated properly.

Periodontal disease is usually identified through dental X-rays, probe depths, and visual exams. If left untreated, it can lead to tooth sensitivity, premature tooth loss, or discomfort and pain in your mouth. Some common symptoms to watch for include bleeding or swollen gums, bad breath, teeth movement, or jaw displacement.

Factors that may increase your risk of developing periodontal disease may include poor oral hygiene, smoking/chewing tobacco, genetics, stress, inadequate nutrition, pregnancy, diabetes, and some medications. Some of these causes are avoidable, but others are not.

If you have diabetes, you may be more prone to periodontal disease due to the greater difficulty in controlling blood glucose levels. Studies have shown that once periodontal disease is treated, glucose levels become more responsive to control as well. If your risk for periodontal disease is heightened by one of these factors, make sure to watch for the signs and keep up with your daily oral hygiene routine.

How can you treat this common disease that affects almost half of the population? Depending on the severity, treatment can include a medicated mouth rinse, antibiotic treatment, laser therapy, or scaling and root planing. It’s useful to recall that this condition can vary from mild to severe, which is why you should make an appointment at our Wilmington office if you notice any of the above symptoms.

At Montchanin Implant Center, we have been creating beautiful smiles for years. Whether you have visited Dr. Keller and Dr. Tibbs and our team for a week or for your entire life, we would love to hear your thoughts about your experience! In fact, we encourage you to leave a few words for us below or on our Facebook page!

We look forward to reading your feedback!

According to the National Institute of Dental and Craniofacial Research, more than 200 million Americans suffer from some degree of inflammation of the gums. Over the past decade, researchers have published studies that link the bacteria involved in periodontal disease to cardiovascular disease. The Centers for Disease Control and Prevention have connected oral infections to heart disease, diabetes, stroke, and low birth weights.

Studies suggest bacteria that cause periodontal disease are also responsible for causing a thickening of the carotid arteries, which increases the chance of a heart attack or stroke. Further research is being conducted to understand the link between oral health and heart disease better.

What is periodontal (gum) disease?

Dr. Keller and Dr. Tibbs and our team at Montchanin Implant Center hear this question all the time. Periodontal disease is an infection. Our mouths are filled with bacteria, and this bacteria forms plaque. If the plaque is not removed through brushing, flossing, and regular cleanings at the dentist, it hardens into tartar. If gingivitis (gum inflammation) is not treated early, it can advance to periodontitis. Bacteria get under the gum tissue and erode it as well as the bone that supports the teeth. The gums eventually pull away from the teeth, and infected pockets form.

Proving that periodontal gum disease is connected to heart disease has been difficult for researchers. However, there are two theories about to what might connect the processes.

• Bacteria are released in the bloodstream through chewing and tooth brushing. The same species of bacteria that causes gum disease has been discovered in the plaque in arteries in the heart.
• Inflammation in the mouth is a catalyst for inflammation throughout the rest of the body.

Practice good oral health habits

While the link between periodontitis and heart disease is not yet fully understood, you can prevent the possibility of health complications by practicing good oral health. It’s recommended that you brush and floss twice a day, as well as visit your dentist twice a year for a cleaning and exam. Oral health should not be taken for granted. By preventing oral diseases, you’re also minimizing the risk of having a heart attack or stroke.

To learn more about the connection between heart disease and oral health, or to schedule an appointment with Dr. Keller and Dr. Tibbs, please give us a call at our convenient Wilmington office! A clean mouth leads to a happy heart!

Have you ever looked in the mirror and noticed that your teeth looked longer? Does it seem like your gums are shrinking? This condition is called recession—many adults have it. Let’s look at some of the causes and what you can do about it.

During your exam at Montchanin Implant Center, we will take measurements to check for periodontal disease. Dental professionals take recession measurements to see how much attached gingiva is present. This is the kind of tissue that is most resilient to infection.

The more recession, the less attached gingiva. The less attached gingiva, the less bone support. The less bone support, the higher your chances of tooth loss. It is quite a domino effect.

Don’t lose hope. The effect can be halted once you know the cause of your recession.

Do you ever wake up with your jaw clenched, and/or a headache that originates just above your ears? Clenching or grinding your teeth can cause recession. When there is added stress on a tooth, it flexes at the gum line.

Over time this causes microscopic breaks in the enamel and then a notch appears. The gum line is forced to move away from its original position. If this is something you see in your mouth, we can discuss the possibility of an occlusal guard at your next visit.

How do you brush your teeth? Do you brush in a straight line or circles? What kind of bristles do you use? Are the bristles on your toothbrush frayed?

When you brush in a circle, you are sweeping all along the gum line, removing the plaque from most angles. When you brush in a straight line, you may often miss the concave portion of the gums. This leaves plaque behind and leads to gingivitis. Whenever gingivitis occurs, the body attacks supporting structures like bone while trying to get rid of the infection. This is periodontal disease, which can cause recession.

Recession may also result from an irritant on the gums, such as a bar from a partial denture or orthodontic appliance (braces).

Gums do not “grow back.” The most common treatment for advanced recession is a tissue graft. There are many different kinds of tissue grafts.

Other factors can cause recession. If you think recession is happening in your mouth, schedule an appointment with Dr. Keller and Dr. Tibbs to discuss your options, so you can make the appropriate treatment choice.

While modern dental science has made remarkable advances in treating oral diseases, prevention is always better than cure. To keep our mouth, gums, and teeth their healthiest, there are some simple practices we can follow to reduce dramatically the risk of developing some of the most common oral diseases.

Tooth Decay

We don’t usually think of tooth decay as a disease, but it is, in fact, the most common chronic disease in older children and adolescents. A great majority of adults have had at least some experience with decay. Left untreated, tooth decay can lead to pain, infection, tooth loss, and even loss of nearby bone in the jaw. Luckily, there are several time-tested ways to prevent cavities:

• Brush properly at least twice a day. Ask Dr. Keller and Dr. Tibbs for the best toothbrush for your individual needs (usually, a soft brush is best), the best technique for angling the brush to reach all of each tooth’s surfaces, and the amount of time you should spend brushing.
• Floss daily. Even with perfect brushing form, you are going to want to use floss to clean between the teeth and around the gum line.
• Use a fluoride toothpaste. Study after study has shown that the risk of cavities is reduced with regular use of a fluoride toothpaste or rinse.
• Watch your diet. Foods high in sugar and simple carbohydrates give cavity-causing bacteria the fuel they need to produce the acids which weaken enamel. On the other hand, a diet rich in protein, vitamins, and minerals is beneficial not only for your teeth, but for your whole body!
• See your dentist for regular checkups to find small problems and prevent them from becoming major ones. Your dentist can also give you tips on better oral hygiene if your brushing and flossing habits aren’t doing the job.

Gum Disease

Preventing gum disease is a lot like preventing tooth decay—your daily habits really make a difference. When plaque builds up around the teeth and gums, the bacteria in plaque cause gum tissue to become inflamed, swollen, and painful. Left untreated, the gums pull away from the teeth, leaving pockets where bacteria collect and lead to infection. Infections harm not only gum tissue, but can destroy the bone which supports the teeth. What can you do to prevent gum disease?

• Use proper brushing technique. Remember to angle the brush toward the gums to gently clean around and below the gum line.
• Floss daily—flossing removes particles and plaque between the teeth, and it also helps remove plaque from the area under the gum line.
• Smokers are at higher risk for gum disease, and smoking has been linked to slower healing. Giving up tobacco products of any kind is always a good way to protect your dental health.
• Regular dental exams will catch gingivitis (early gum disease) while it is still reversible. Periodontitis (serious gum disease) can require treatment by Dr. Keller and Dr. Tibbs. Certain diseases such as diabetes increase the risk of developing gum disease, so checkups are especially important.
• Having your teeth cleaned every six months, or as recommended, will remove plaque that brushing alone can’t handle. If there are signs of more serious gum disease, a periodontal cleaning will remove plaque and tartar from both above and below the gum line.

How Can Your Periodontist Help?

Periodontists like Dr. Keller and Dr. Tibbs have the advanced education and training not only to treat oral diseases, but to help repair the damage they can cause. A periodontist has experience in:

• Treating all forms of periodontal disease
• Periodontal cleanings such as scaling and root planning to remove plaque and tartar
• Regenerative treatment to restore bone lost to periodontal disease
• Implant surgery to provide a permanent, natural looking replacement for a lost tooth
• Regenerative procedures, if needed, to make sure the jawbone has the necessary size and density for a successful implant
• Gum surgeries to remove or reshape excess or damaged gum tissue
• Soft tissue grafts to treat exposed roots, receding gums, and gum tissue loss

An ounce of prevention is worth a pound of cure, and when it comes to your dental health, there’s a lot you can do to prevent oral diseases. But should you need treatment at our Wilmington office, we have the knowledge and experience to help restore the health of your mouth, teeth, and gums. After all, you can’t weigh the worth of your oral health—that’s priceless!

It's a habit many people have and not only can it be annoying to the people around you, it can be detrimental to your dental health. Chewing ice is so common that it even has its own name, pagophagia. We're not talking about a slushy or shaved ice (although those artificially sugary treats should be avoided too!) but more like the hunks of ice rattling around in the bottom of your glass.

Ice chewing can be a sign of emotional problems like stress or obsessive-compulsive disorder, but it can also be a marker for iron deficiency anemia and other physical problems. Then again, some people just like to have something to chew on. For whatever reason you find yourself chewing on it, it's a habit you need to break.

Chewing on ice can cause:

• Chipped and cracked teeth
• Damaged enamel
• Sore jaw muscles
• Damage to dental work such as crowns, fillings, or other appliances

If chewing on ice is becoming a problem in your life, don’t hesitate to speak with Dr. Keller and Dr. Tibbs about it. But if you find yourself still wanting to chew on something, here are a few alternatives to ice:

• Baby carrots
• Celery sticks
• Sugar-free (xylitol) gum

We know you need to chill sometimes, but chomping down your entire glass of ice is not the way to do it. If you have any other questions on the topic, feel free to talk with a member of our Wilmington team. It may be beneficial in solving the issue and helping to remediate any damage to your teeth.

You and your periodontist are essential partners in making sure you have the best dental care. You do your part by eating a tooth-healthy diet, brushing and flossing as recommended, seeing your dentist regularly, and making an appointment with Dr. Keller and Dr. Tibbs when your gums and supporting tooth structures need the care of a specialist.

And one more essential step you can take for your dental health? Let us know which prescriptions and over the counter medications you’re taking.

Medications Have Oral/Dental Side Effects

We’ve all grown used to hearing “Possible side effects include . . .” at the end of every pharmaceutical commercial. That’s because those unintended side effects can affect our health in any number of unexpected ways—and this includes gum health.

For example, a common side effect of many medications is xerostomia, or “dry mouth.” Saliva helps keep our teeth and gums healthy by washing away food particles and oral bacteria. A reduction in saliva production means more plaque and tartar can build up around the gums. Plaque and tartar buildup, in turn, is a common cause of gum disease.

Knowing a patient is taking one of the hundreds of medications which cause xerostomia allows Dr. Keller and Dr. Tibbs to both monitor the condition and suggest the most effective treatment options to control any unpleasant symptoms.

Besides dry mouth, gum sores and gingival enlargement are other well-known side effects that can affect your periodontal health. Knowing which medications you’re taking can provide Dr. Keller and Dr. Tibbs with essential information for the diagnosis and treatment of any medication’s side effects.

Medications Interact

Medication might be needed for your periodontal treatment. Because certain drugs, supplements, and even some vitamins and foods can affect the way our bodies metabolize, absorb, and respond to other medications, we need to know which medicines you’re taking to arrive at your best treatment options.

• There are different classes of antibiotics used to treat oral infections. Knowing your medical history enables Dr. Keller and Dr. Tibbs to choose an antibiotic option which won’t interact with your other medications.
• Local anesthetics such as lidocaine, which numb the area to be treated, can also interact with certain medications. Dr. Keller and Dr. Tibbs can prescribe an alternative local anesthetic or adjust the dosage as needed.
• If you will be using sedation during your procedure, you have several options, including nitrous oxide gas, oral sedation, or IV sedation. Be sure we know about all of your medications beforehand because of possible interactions. Changes can be made to the type of sedation and/or the dosage as needed.

Medications Impact Treatment

It’s important for Dr. Keller and Dr. Tibbs to know if any of your medications will affect standard treatments.

Anticoagulants, for example, are a necessary medication for preventing blood clots from forming, and are often prescribed for certain heart conditions, after joint replacement surgery, or for anyone at risk for developing blood clots. Because these medications prevent the blood from clotting, it’s important to let us know if you are taking such drugs before periodontal surgery.

If needed, Dr. Keller and Dr. Tibbs can work with you and your doctor to create a treatment plan that will be safe, effective, and designed to work with any of your medications. You should never discontinue taking your prescribed medications before dental work without medical approval, as this can be dangerous.

Your periodontist needs the most up to date information about your health to provide you with the best care possible. Knowing which medications you take and why you take them can help Dr. Keller and Dr. Tibbs:

• Diagnose and treat any side effects from non-dental medications which have affected your oral health,
• Prevent drug interactions from occurring, and
• Tailor your treatment to your specific medical needs.

Your prescriptions, over the counter medications, and even herbal supplements and vitamins are essential information. It’s a good idea to make a list before your next appointment at our Wilmington office so you have specific medications and their dosages at hand. It’s one small—but vital—step you can take to work with Dr. Keller and Dr. Tibbs for your best dental health!

Injuries to our teeth and gums can have harmful effects on the bone tissue and structures that support them. In turn, this damage can impact both the appearance and the health of our smiles. One of the ways we can protect our dental health and restore our smiles is with a technique called bone grafting, available at our Wilmington office.

What is Bone Grafting?

Bone grafting is a type of periodontal surgery. Bone tissue for grafting may be taken from your own body, or a graft material composed of donor tissue or synthetic substitutes can be used. This kind of graft will be absorbed gradually by the body as your own new, healthy bone tissue replaces it.

If you decide a bone graft is your best option, we will discuss the options for grafting with you beforehand, and use imaging to map out the area of bone loss and to create the best individual treatment plan for you. After anesthesia, an incision will be made in the gum tissue to reveal the damaged bone. Grafting material will be shaped and secured to the affected area, and sutures are generally used to close the incision. We will give you careful instructions for after care and follow-up visits. The time it takes for you to heal completely will depend on the type and size of the graft.

Why Consider a Bone Graft?

The bone structure that supports our teeth can be compromised in a number of ways. Dr. Keller and Dr. Tibbs might recommend a bone graft as your best option for treating many conditions which have both medical and cosmetic impacts.

• Tooth Loss Can Cause Bone Loss

The bone tissue which supports our teeth needs the stimulation of biting and chewing to stay healthy. Without that stimulation, the bone area under the missing tooth gradually shrinks. The bone tissue is resorbed into the body, which, in a relatively short amount of time, can lead to a noticeable sunken spot where the tooth used to be. A dental implant will provide the tissue stimulation that a natural tooth would, and will prevent future bone loss in the jaw. But if too much bone tissue has already been lost, you might need surgical bone grafting to achieve the right bone area and density to hold an implant.

• Gum Disease

As gum disease progresses, the gums pull away from the teeth, leaving the bone and connective tissue exposed to infection and bacteria. Infection and the body’s own response to bacteria can cause deterioration in the bone structure supporting the teeth, leading to loose teeth, a change in your normal bite, or even tooth loss. Bone loss cannot be reversed, but a graft can replace lost bone and allow healthy tissue to regenerate.

• Other Uses

Bone grafting can also be used to correct deformities in the jawbone, as part of nerve repositioning, to restore bone after trauma or long-term denture wear, and for other restorative and cosmetic uses.

Dr. Keller and Dr. Tibbs will recommend bone graft surgery when it will provide the best possible outcome for your individual needs. Because this is surgery, we are here to answer any questions you might have about the process and how we can provide the most skillful, gentlest, and least invasive treatment available. Above all, we want not only to protect your smile now, but to restore the strength and function of the bones which make it possible—for a lifetime of future smiles.

Thanksgiving marks the start to the holidays; a season filled with feasting, indulging, and spending time with family and friends are always special. Thanksgiving is a holiday meant for giving thanks, and while this may seem like such a natural celebration, the United States is only one of a handful of countries to officially celebrate with a holiday.

Unlike many holidays, Thanksgiving is a secular holiday, and it is celebrated on the fourth Thursday in November in the United States. In Canada, it is celebrated on the second Monday of October, which is, oddly enough, much closer to a time when harvests were likely gathered. In addition to the different dates, the origins of the celebration also share different roots.

Thanksgiving in the United States

Giving thanks for a bountiful harvest are not new, but the modern day holiday in the US can be traced to a celebration at Plymouth in Massachusetts in 1621. This feast of thanksgiving was inspired by a good harvest, and the tradition was simply continued on. At first, the colony at Plymouth didn't have enough food to feed everyone present, but the Native Americans helped by providing seeds and teaching them how to fish, and they soon began to be able to hold a feast worthy of the name. The tradition spread, and by the 1660s, most of New England was hosting a Thanksgiving feast in honor of the harvest.

Canadian Thanksgiving

An explorer of early Canada named Martin Frobisher is accredited for the first Canadian Thanksgiving. He survived the arduous journey from England through harsh weather conditions and rough terrain, and after his last voyage from Europe to present-day Nunavut, he held a formal ceremony to give thanks for his survival and good fortune. As time passed and more settlers arrived, a feast was added to what quickly became a yearly tradition. Another explorer, Samuel de Champlain, is linked to the first actual Thanksgiving celebration in honor of a successful harvest; settlers who arrived with him in New France celebrated the harvest with a bountiful feast.

A Modern Thanksgiving

Today, Thanksgiving is traditionally celebrated with the best of Americana. From feasts and football games to getting ready for the start of the Christmas shopping season, Thanksgiving means roasted turkey, pumpkin pie, and green bean casserole. No matter how you celebrate this momentous day, pause for a moment to give thanks for your friends, family, and all the bounties you’ve received. Happy Thanksgiving from Montchanin Implant Center!

Diabetes is a disease that affects the health of the entire body, including, of course, your mouth, gums, and teeth. We are trained to look for issues that might arise in our patients with diabetes, and are eager to help you maintain your dental health. What do we consider in order to give you the best treatment?

Your Teeth

Dry mouth can be a problem for diabetic patients, whether caused by blood sugar levels or medication, and this condition can lead to tooth decay. When we produce saliva, it not only helps wash away sugar in our mouths, it also helps remove the acids sugars produce which attack our enamel and lead to cavities.

Your Gums

People with diabetes are at higher risk for gum disease. With diabetes, the body is more susceptible to infection and finds it harder to fight bacteria. Early gum disease, called gingivitis, is inflammation caused by the body’s reaction to bacteria. Periodontitis, serious gum disease, leads to infections that can cause bone and tooth loss.

Other Oral Concerns

Dry mouth can lead to mouth ulcers, oral thrush, sores, and infections. And oral infections of any kind can be slower to heal when you have diabetes. We will give careful attention to any concerns you might have for your oral health, and will work with you to prevent any future problems.

Preventive dental care is important for all our patients, and we have special suggestions for you to help maintain your dental health and reduce the possibility of dental complications. Diabetes can lead to oral problems, and oral infections can in turn cause problems with controlling blood sugar, so a healthy mouth can lead to better health in general.

• Home Care

If dry mouth is a problem, talk to us about possible causes and treatments. Hydrate throughout the day, and avoid foods or beverages that lead to dehydration. Talk to us about the best products for use at home to prevent dry mouth.

Brush and floss after meals to reduce the presence of harmful bacteria and prevent the plaque buildup that leads to gum disease.

Above all, monitor your blood sugar carefully to ensure your body is at its best when combatting infection or when healing.

• Professional Dental Care

Be sure to visit our Wilmington office at least twice a year for a full examination and a professional cleaning. We can reduce the plaque that leads to gingivitis and more serious periodontal infection. We can monitor your oral health and recommend solutions for problems such as dry mouth. We will make your appointments based on what is best for your schedule. If any type of oral surgery is needed, we will schedule it with an understanding of the importance of healthy blood sugar levels for healing and recovery.

It’s important to make Dr. Keller and Dr. Tibbs part of your health support system. If you have diabetes, let us know. We will work with you to monitor the well-being of your teeth and gums and to suggest ways to promote your overall oral health. Let’s work together for healthy, happy smiles!

Diabetes is a chronic disease that increases the risk for many serious health problems, including severe gum disease. November is Diabetes Awareness Month, and it’s a great time for us at Montchanin Implant Center to remind our patients that the way you care for your teeth at home doesn’t just affect your oral health; keeping your mouth healthy is vital to your overall health, too.

Diabetes is the result of a deficiency, or lack of the hormone insulin to properly transport glucose (blood sugar) to the cells throughout the body. According to the American Diabetes Association, the most common types of diabetes are Type One (90-95 percent of cases), Type Two (five percent), and gestational or pregnancy diabetes. Women who have had gestational diabetes have a 35 to 60 percent chance of developing diabetes, mostly Type Two, in the ten to 20 years following their pregnancy.

In the past decade, researchers have found links between periodontal (gum) disease and diabetes. Not only are people with diabetes more vulnerable to gum disease, but diabetes may also have the potential to affect blood glucose control, as well as contribute to the advancement of diabetes.

Nearly 26 million Americans currently live with the disease, with an additional 79 million in the pre-diabetes stage. There is some good news we want you to know, however; you can protect your gums and teeth from the effects of diabetes by visiting our Wilmington office for an exam. Patients who are living with diabetes may require more often visits to ensure their dental health remains in tip-top shape. Many insurance plans provide expanded benefits for diabetic patients, and Dr. Keller and Dr. Tibbs can tell you how often you need to come in for an appointment.

For more information on how we can help, please do not hesitate to give us a call at our Wilmington office.

Halloween is fast approaching, and Dr. Keller and Dr. Tibbs wanted to be sure to wish our patients a happy day, no matter how you might celebrate this holiday. The Halloween that is familiar to most people today bears little resemblance to the original Halloween; back in the "old days" it wasn't even called Halloween!

Festival of the Dead

Halloween started out as a Celtic festival of the dead that honored departed loved ones and signified a change in the cycle of the seasons. The Celtic people viewed Halloween, then called "Samhain," as a very special day – almost like our New Years day in fact, as their new calendar year began on November 1st. Samhain was the last day of autumn, so it was the time to harvest the last of the season's crops, store food away for winter, and situate livestock comfortably for the upcoming cold weather. The Celts believed that during this day, the last day of winter, the veil between this world and the spirit world is the thinnest, and that the living could communicate with departed loved ones most effectively on Samhain due to this.

Modern Halloween

Halloween as we know it today started because Christian missionaries were working to convert the Celtic people to Christianity. The Celts believed in religious concepts that were not supported by the Christian church, and these practices, which stemmed from Druidism, were perceived by the Christian church as being "devil worship" and dangerous.

When Pope Gregory the First instructed his missionaries to work at converting the Pagan people, he told them to try to incorporate some of the Pagan practices into Christian practices in a limited way. This meant that November 1st became "All Saints Day," which allowed Pagan people to still celebrate a beloved holiday without violating Christian beliefs.

Today, Halloween has evolved into a day devoted purely to fun, candy, and kids. What a change from its origins! We encourage all of our patients to have fun during the holiday, but be safe with the treats. Consider giving apples or fruit roll-ups to the kids instead of candy that is potentially damaging to the teeth and gums.

Remind kids to limit their candy and brush after eating it! Sweets can cause major tooth decay and aggrivate gum disease, so to avoid extra visits to our Wilmington office, make your Halloween a safe one!

Women using medication to treat a variety of medical conditions are often unaware of the potential side effects. One common side effect of medications such as blood pressure medication, birth control pills, antidepressants, and cancer treatments is dry mouth. The technical term for dry mouth is xerostomia.

Xerostomia can lead to undesirable effects in the oral cavity including periodontal disease and a high rate of decay. Many women who have not had a cavity in years will return for their routine exam and suddenly be plagued with a multitude of cavities around crowns and at the gum line, or have active periodontal disease. The only thing that the patient may have changed in the past six months is starting a new medication.

Saliva washes away bacteria and cleans the oral cavity, and when saliva flow is diminished harmful bacteria can flourish in the mouth leading to decay and gum disease. Many medications can reduce the flow of saliva without the patient realizing the side effect. Birth control pills can also lead to a higher risk of inflammation and bleeding gums. Patients undergoing cancer treatments, especially radiation to the head and neck region, are at a greatly heightened risk of oral complications due to the possibility of damage to the saliva glands.

There are many over the counter saliva substitutes and products to temporarily increase saliva production and help manage xerostomia. One great option for a woman with severe dry mouth or high decay rate is home fluoride treatments. These work in a number of ways, including custom fluoride trays that are worn for a short period of time daily at home, a prescription strength fluoride toothpaste, or an over the counter fluoride rinse. If you have more questions on fluoride treatments, make sure to ask Dr. Keller and Dr. Tibbs at your next visit to our office.

The benefits of many of the medications on the market outweigh the risks associated with xerostomia, however, with regular exams you can manage the risk and prevent many oral consequences of medications.

Gum disease is a common problem among adults, and one Dr. Keller and Dr. Tibbs and our periodontal team see all too often. Early stages of gum disease are known as gingivitis, or inflammation of the gums. This can progress to more serious gum disease known as periodontitis.

If you notice signs and symptoms of gum disease, take early action to prevent progression of gingivitis to more serious periodontitis and the risk of losing your teeth due to gum loss.

Watch for These Signs and Symptoms

It’s important to watch for signs and symptoms of gum disease, especially if you have risk factors. Early detection at home can help you get treatment sooner so that you don’t risk losing your teeth. These are the classic signs and symptoms of gum disease:

• Inflamed gums, or gums that are red or swollen
• Pain when you chew
• Teeth that are sensitive to heat, cold, sweets, or brushing
• Loose teeth
• Bad breath that you can’t get rid of by brushing or using mouthwash, even when you don’t eat particularly smelly food
• Gums that are sore to the touch or bleed easily, including when you brush your teeth
• Teeth that seem to be taller or longer due to receding gums
• A change in the way your teeth fit together when you bite
• A change in the way your dentures fit in your mouth

Signs We Look For

When you visit our Wilmington office, we will examine you to see how far your gum disease has progressed. We do this by:

• Discussing your medical history with you to see which risk factors you have
• Checking your gums to see if they are swollen or red, and how far the inflammation has progressed
• Measuring the depth of any pockets around your teeth using a type of ruler called a probe.

Treatment for Gum Disease

Brushing and flossing go a long way toward preventing bacteria from forming acid on your teeth and allowing tartar to build up. However, once you have the beginnings of gum disease, your regular brushing and flossing routine aren’t enough. Dr. Keller and Dr. Tibbs can provide more extensive treatment, such as:

• Deep cleaning through scaling and root planing
• Medications to fight the infection
• Surgical treatments, like bone or tissue grafting to replace lost tissue

If you think you may have gum disease, or are concerned about the state of your gum health, be sure to contact our Wilmington office to schedule an appointment. Together, we can help you achieve a lifetime of good oral health.

Adults are no strangers to feeling like there is never enough time in the day to get everything done. Your alarm clock rings and within minutes you ping pong around trying to spread peanut butter on sandwiches, answer your cell phone, remove the dog hair from your clothes, and make sure your child has completed his or her science fair project. Brushing your teeth can easily fall to the wayside. That is why our office promotes a simple, daily oral health regimen that you can easily incorporate into your busy lifestyle.

The American Dental Hygienists' Association (ADHA), in partnership with the Wrigley Jr. Company, is celebrating National Dental Hygiene Month (NDHM) during October. The ADHA encourages people to "Brush. Floss. Rinse. Chew...Keep it Clean, Keep it Healthy!" and offers some great tips for a quick and effective home oral health routine, below:

Oral Health Routine at Home

• Brushing your teeth twice daily is the most important thing you can do to diminish the accumulation of plaque and the potential for other oral problems such as cavities and gingivitis.
• Flossing once daily removes plaque and food from beneath the gums and between teeth that brushing alone cannot remove. Tooth decay and gum disease often begin in these areas.
• Rinsing your mouth with an antibacterial, non-alcohol based mouthwash kills plaque and gingivitis germs that brushing and flossing do not catch. We recommend using a mouthwash with the ADA Seal of Acceptance.
• Chewing sugar-free gum helps produce saliva, which battles cavities. The gum also neutralizes plaque, strengthens enamel, and removes remaining food. It is especially important to chew gum after eating or drinking.

It's easy to put the toothbrush down in order to take care of matters you feel are more urgent, but remember, a good oral health routine at home is the best way to prevent periodontal disease. "Periodontal disease is the most common cause of tooth loss in adults. An estimated 75 percent of Americans reportedly have some form of periodontal disease," said the ADHA. Periodontal disease also is linked to more serious illnesses such as diabetes and stroke.

Also, remember to keep regular visits with our office. Dr. Keller and Dr. Tibbs can help you learn more about proper care for your teeth and gums.

If you suffer from sensitive teeth, you already know the frustration of having a type of pain that is hard to deal with. Because tooth sensitivity is sometimes unpredictable, you can't necessarily take medication to ward off the pain like you could if you just felt a headache coming on.

However, there is still something you can do about sensitive teeth. Use the following tips to help put your sensitivity and pain problems with your teeth behind you!

Use the Right Toothbrush: Select a toothbrush made just for sensitive teeth, or the softest bristles possible. This helps you avoid putting any extra pressure on your teeth or gums.

Choose a Special Toothpaste: There are several good options for toothpastes made just for sensitive teeth today. Usually, toothpaste formulated for sensitive teeth will be fluoridated and use a non-abrasive formula. The toothpaste will help with the pain usually associated with brushing and flossing if you use it regularly.

Avoid Trigger Foods: You may have noticed certain trigger foods that cause tooth sensitivity and pain for you. Avoid these foods whenever possible, and if you absolutely must eat them, try to consume them in very small quantities. Trigger foods may include:

• Foods with high acid content for example citrus fruits
• Very hot or very cold foods
• Hard or crunchy foods

Visit Our Office

If your sensitive teeth problem is too serious to manage on your own, a visit to our Wilmington office may be in order. There are a couple of ways Dr. Keller and Dr. Tibbs can help:

• Fluoride Treatments: We can put a special fluoride formula on the most sensitive areas to help make your enamel stronger and to help lower pain levels.
• Sealing Exposed Roots:In some cases, your roots become exposed due to a receding gumline, which in turn causes teeth sensitivity and pain. We can apply a dental sealant that protects the exposed roots and reduces your pain dramatically.

Brushing your teeth properly removes the food particles and bacteria that can lead to tooth decay and gum disease. However, you do not want to scrub your teeth or gums heavily. A heavy hand can lead to tooth and gum erosion, as Dr. Keller and Dr. Tibbs and our staff see all too often.

You should also use a soft bristle toothbrush to avoid damaging the surface of your teeth. Make sure the head of the brush fits in your mouth, because if it is too large you will not be able to reach all tooth surfaces. Follow these steps to ensure you are brushing properly.

1. Use a small amount of toothpaste on your brush. The recommendation is a pea-sized amount or thin strip on the bristles.
2. Hold your toothbrush at a 45-degree angle to the surface of your teeth, angling towards your gums. Use a circular motion on all exterior tooth surfaces, and avoid back-and-forth “scrub” brushing.
3. Once you have cleaned the outer surfaces, hold the brush vertically and clean the inner teeth surfaces — the side of your teeth that face your tongue. Do not forget the inner surfaces of your front teeth.
4. Finally, finish by cleaning all the chewing surfaces of your teeth. You need to maintain a gentle touch, but make sure you get into the full depth of your molars. The entire process should take about two minutes.

Dr. Keller and Dr. Tibbs and our staff recommend changing your toothbrush every three to four months for best results. Do not forget to clean your tongue, which helps remove excess bacteria from your mouth. Special brushes are available just for cleaning your tongue, and they are easy to use.

Proper care of your teeth also requires flossing on a regular basis. Flossing can be performed before or after you brush. Following up with a quality mouthwash will provide you with even more protection. Do not be afraid to ask the Montchanin Implant Center team for tips on proper brushing and flossing.

If you’ve been following a vegetarian or vegan diet, you know that there’s much more to living a healthy life than simply avoiding meat products. Making sure your diet includes enough protein, as well as any nutrients that are primarily available in animal products, takes planning, and there’s no one-menu-fits-all solution.

Why? Because there’s no one menu that will suit all vegetarians. Specific vegetarian diets can allow for many different options:

• Vegan—a plant-based diet which excludes meat, fish, dairy, and egg products
• Ovo-vegetarian—includes eggs as a dietary option, but no dairy
• Lacto-vegetarian— includes dairy as a dietary option, but no eggs
• Lacto-ovo-vegetarian—a meat-free diet which allows both dairy products and eggs

If you are a pescatarian, who eats fish on occasion, or a flexitarian, who sometimes includes meat in a meal, your menu options are even broader.

So let’s look at the big picture—a healthy vegetarian diet is really more concerned with the foods you do eat for nutrition rather than the foods you don’t. You can create a meal plan rich in all your essential nutrients with a little research, no matter which type of vegetarian diet is your go-to choice.

And while you’re constructing your ideal menu guidelines, don’t forget about your dental nutrition!

In terms of keeping your teeth and gums their healthiest, what important vitamins and minerals are often missing from vegetarian and vegan diets? Let’s look at three of them.

• Calcium

Calcium is essential for maintaining strong bones and tooth enamel. Without enough calcium, a weakened jawbone leads to loose, and even lost, teeth. The acids in our food and the acids created by oral bacteria also weaken the minerals in enamel, including calcium. These weak spots can eventually become cavities. A diet rich in calcium not only supports the bones holding our teeth, but can even help repair, or remineralize, enamel which has been weakened by acidic erosion.

For vegetarians who include dairy in their diets, dairy products are a great way to include calcium. Milk, cheese, and yogurt are traditional and rich sources of this mineral.

For vegans, it’s a bit more challenging, but still doable! Non-dairy foods providing calcium include dark green vegetables (kale, broccoli, spinach), certain types of tofu, and fortified cereals, juices, and non-dairy milks.

• Vitamin D

Now you’re ready to put that calcium to work by making sure you have enough vitamin D in your diet. Vitamin D not only helps keep our bones healthy, it also enables our bodies to absorb calcium. Bonus—it’s been linked to better gum health in several studies.

So how to get more vitamin D? If you eat dairy, most dairy products have been fortified with vitamin D. If eggs are a part of your diet, egg yolks are a great source. Pescatarians can enjoy the benefits of vitamin D from fatty fish such as tuna and salmon.

Because we get most of our vitamin D from sun exposure or foods derived from animals, plant-based foods are not a practical way to obtain the vitamin D you need. But, just as non-vegetarians can get plentiful vitamin D from fortified dairy products, vegans also have options. Try adding cereals, juices, and non-dairy milks fortified with this essential nutrient to your diet, or take a vegan vitamin D supplement.

• Vitamin B12

Vitamin B12 is essential for healthy red blood cells, nerve cell development, brain function, and DNA production. (This is why it’s especially important for pregnant and nursing women.) Vitamin B12 can also impact your oral health. A B12 deficiency can cause a swollen, sore, or inflamed tongue, loss of taste, and gum, tongue, and mouth ulcers.

Unfortunately, vitamin B12 is reliably found only in animal foods and nutritional yeasts. If you would prefer an egg-free and dairy-free diet, look to B12 supplements or B12-fortified cereals, plant-based milks, energy bars, and other vegan options. This is a good subject to discuss with your physician, because even supplements and fortified foods might not provide enough B12.

In fact, Dr. Keller and Dr. Tibbs can be vital resources when you’re planning your healthiest vegetarian diet. The next time you visit our Wilmington office, ask for recommendations for supplements if you’re concerned that diet alone can’t provide for all of your nutrition essentials. Finally, care should be taken to ensure that, even with supplements, you get the proper amount of the vitamins and minerals you need.

As a vegetarian, you are used to the concept of care. Whether it was concern for nutrition, the planet, the animal world, or another reason that drew you to a vegetarian diet, be sure to care for your body as well as your dietary choices. Careful planning can ensure a diet which supports not only your general health, but your oral health, for a lifetime of nourishing—and well-nourished—smiles.

It's the end of summer, and fall is just around the corner. Soon the temperatures will cool down, the leaves will start to change, and Dr. Keller and Dr. Tibbs and our team at Montchanin Implant Center are sure that you’ll soon be thinking about Halloween costumes and Thanksgiving plans in no time. But wait! First, we want to know about your favorite parts of the summer! Did you go on a wonderful family trip? Did you pick up a new hobby? Did you try to spend as much time outside and in the sun as possible?

Share your favorite memories, stories, or photos with us by leaving a comment below or on our Facebook page.

Labor Day, celebrated on the first Monday each September here in the United States, is a holiday devoted to the American working community. The purpose of the holiday is honoring the country's workers and their contributions to the strength of our country as a whole.

How Labor Day Started

There is actually some debate as to the origins of Labor Day. It is uncertain whether Peter McGuire, a cofounder for the American Federation of Labor, or Matthew Maguire, who was the secretary of Central Labor Union of New York, had the great idea. However, the Central Labor Union's plans were what launched the first Labor Day in America.

The First Labor Day

The very first Labor Day was celebrated on September 5th, 1882. The Central Labor Union then held annual celebrations on September 5th for what they called a working man's holiday. By the year 1885, the Labor Day celebration had spread to many different industrial areas, and after that it began spreading to all industries in the United States.

Labor Day Today

Labor Day today is a huge United States holiday during which we honor the country's workers with a day of rest and relaxation or a day of picnics and parades. This holiday is truly one to honor the many people who work hard to contribute to the economic well-being of our great country!

Our team at Montchanin Implant Center hopes all of our patients celebrate Labor Day, and every holiday, safely and happily. Whether you stay in the Wilmington area, or travel out of town, have fun, and don't forget to brush!

Gingivitis is an early stage of gum disease that results when bacteria in your mouth cause inflammation in your gums. This is a common condition, and you can treat it effectively if you are aggressive. Otherwise, it could develop into more advanced gum disease, or periodontitis, and you could lose one or more teeth.

Watch for symptoms of gingivitis so you can ask Dr. Keller and Dr. Tibbs for help as soon as you need it. Strategies for treating gingivitis include thoroughly cleaning your teeth and assessing the scope of your gingivitis and how serious the problem is.

Gingivitis: Early Gum Disease

Your mouth contains many bacteria that form plaque, which is a sticky substance. You can get rid of plaque by brushing well, but if you don’t, it can build up on your teeth and form tartar. Bacteria can make your gums inflamed and cause pain and bleeding, or gingivitis. Other symptoms include loose teeth, bad breath, receding gums, and sensitive teeth. You’re at higher risk for gingivitis if you’re a smoker, if you have a weakened immune system, or if you have diabetes.

Assessment and Diagnosis

If you think you recognize the symptoms of gingivitis, contact our Wilmington office to make an appointment. We will ask you about your risk factors for gingivitis and examine your teeth and mouth for signs of red and swollen gums. We may also measure the pockets around your teeth. If they are larger than usual, your gingivitis may be more advanced. Finally, will take some X-rays to get a picture of the bone structure of your jaw.

Deep Cleaning

You can’t get rid of the tartar on your teeth just by brushing at home. Instead, you need a deep cleaning consisting of scaling and root planing. Scaling involves scraping the plaque off of your teeth, both below and above the line of your gum. In root planing, the rough surfaces of your teeth where tartar is more likely to build up are smoothed. A laser may be used to make the procedure more effective, more accurate, and more comfortable.

One of the most transformative advancements in dental restorations is the dental implant. Implants look just like natural teeth, they function just like natural teeth, and they help maintain jawbone health just like natural teeth. But the success of any implant procedure depends on the quality and quantity of the bone in which it’s placed. That’s why, before placing your implant, Dr. Keller and Dr. Tibbs might first suggest a common procedure known as ridge modification.

An implant consists of a metal post which is surgically placed in the jawbone. This post serves as the “root” of the dental implant. After several months, the post fuses with the bone surrounding it, as bone tissue grows around and attaches to the post surface. This process is called osseointegration, and it creates a strong, secure anchor for the abutment and crown which will be secured to the post when it heals.

Because of the strong pressures which biting, chewing, and clenching put on our teeth, the success of an implant depends on the strength of its integration into the jawbone. To make osseointegration possible, the bone must be healthy, with adequate size and density to hold the implant securely.

Ridge modification, also called ridge augmentation, is periodontal surgery. In this procedure, we use bone grafting to rebuild bone strength in the alveolar ridge (the part of the jawbone containing the tooth sockets) before placing a post. When is this procedure necessary?

Jawbone size and density can be compromised in several different ways, including:

• Resorption

When a tooth is missing, the bone ridge under the lost tooth gradually begins to shrink, a process called “resorption.” Over time, bone loss can lead to a noticeable indentation in the jawbone.

• Periodontitis

Serious gum disease is progressive. Without treatment, the gums begin to pull away from the teeth. This leaves bone and connective tissue exposed to destructive bacteria and infection, which can cause bone loss.

• Trauma

Bone damage caused by accident or injury might require bone replacement or recontouring.

• Bone structure and size

Sometimes the jaw ridge is too narrow or shallow to support an implant, especially in the back of the upper jaw near the sinus cavity, and will need added bone before an implant can be placed.   

Periodontists are specialists in bone grafting surgery, with years of advanced education and training in the treatment of the structures that support the teeth, including gums, connective tissues, and bone. Dr. Keller and Dr. Tibbs will recommend bone graft surgery if the success of your implant would be in jeopardy without it.

What will your surgery involve?

• Assessing bone quantity and quality

Using advanced imaging technology, we will evaluate your jaw’s condition, and map out any areas of bone loss.

• Designing your treatment plan

If a bone graft is your best option, we will recommend the best grafting materials for your needs. Bone grafting might use bone tissue taken from your own body, processed bone grafting material, or synthetic grafting material to replace and repair the damaged bone. We will also discuss your anesthesia and sedation options.

• Performing the Surgery

After anesthesia, an incision will be made in the gum tissue to reveal the damaged or missing bone. Grafting material will be shaped to restore the bone’s contours and secured to the affected area. The incision will then be closed. If you are here for an extraction, it may be possible to have augmentation done as part of the same procedure.

• Providing follow-up care

You’ll receive detailed careful instructions for after care and follow-up visits at our Wilmington periodontal office. The time it takes for you to heal completely will depend on the size and type of your graft.

• Placing your implant

Once the bone has healed, we can surgically place the post for a secure, long-lasting, and healthy implant.                   

If it’s been some time since you lost a tooth, if your jaw has been damaged by injury or trauma, if you have less-than-adequate bone size and density, it’s important to restore your bone before implant surgery can be successful. See us for an evaluation, and learn how a ridge modification procedure can help you improve your dental health and transform your smile.

Does your mouth always feel like it’s dry? If it does you may be suffering from xerostomia. Xerostomia is defined as dry mouth resulting from reduced or absent saliva flow. There are various medical conditions that can cause this type of dry mouth, which you can ask more questions next time you visit us at Montchanin Implant Center.

Xerostomia can factor into both minor and more serious health problems. It can affect the ability to eat and enjoy food and it can jeopardize one’s dental health. Some of the more common symptoms can include sore throat, burning sensation in the oral cavity or tongue, and difficulty swallowing.

One of the more serious problems associated with dry mouth is an increased risk of tooth decay. Decrease in saliva causes more plaque to form and there is less saliva to act as a buffer to the things we eat and drink. Less saliva also means more food debris is retained in the mouth. These things can lead to an increase in tooth decay.

So, what causes xerostomia?

There are several things that may cause xerostomia. Among the biggest culprits are prescription medications. Some examples are antihistamines, antidepressants, anti-hypertensives, anti-anxiety agents, anti-diarrheals, bronchodilators, and muscle relaxers.

Certain diseases can also cause dry mouth. The more common ones include rheumatoid arthritis, lupus, diabetes, hypertension, and thyroid disease. Xerostomia is also common in patients being treated for cancer. Head and neck radiation as well as certain chemotherapy drugs can cause severe dry mouth.

What should you do if you are experiencing dry mouth symptoms? First make sure to hydrate with plenty of water. If you are taking medications that cause xerostomia, make sure to drink water before taking the medication as well as a full glass of water with the medication. Be diligent with brushing and flossing and discuss your condition at your next appointment with Dr. Keller and Dr. Tibbs. We can recommend specific products to help moisten the oral cavity and reduce your symptoms such as saliva substitutes, xylitol products, and certain toothpastes. Another option may be a prescription home fluoride treatment to help prevent new cavities. You may want to try gum or candies to stimulate saliva flow but make sure they are sugar free! Avoid food and beverages that dehydrate such as caffeine and alcohol.

Xerostomia is a common problem that is currently on the rise. Our team can help you to reduce any symptoms and improve your comfort while living with a dry mouth. Contact our Wilmington office today!

Dental floss is similar to a lot of products that depend mainly on the consumer’s preference. Fact is, floss comes in a wide variety of flavors, coatings, and other variations, but all types of floss essentially do the same thing. After all, that is what is most important: that the dental floss you buy is functional—cleaning the areas in between your teeth. If you want to know what the best dental floss is, the answer is the kind that enables you to successfully and regularly clean those areas. So to help you find the right type of floss for you, here are some options.

Flavored Dental Floss

Many people that floss prefer a flavored dental floss because it freshens their breath even more than unscented floss. The latter can also take on the smells associated with bacteria in your mouth. And we all know how bad that can be. So, if flavored dental floss is what you prefer, and it allows you to floss your teeth regularly, then it is automatically best for your mouth.

Flossers

There are also products on the market called flossers, which usually consist of a plastic instrument with strung floss and a pick on the opposite end. This option can be both effective at cleaning the areas in between your teeth and scraping off plaque. These flossers also come flavored in mint and various other varieties.

Gentle Dental Floss

Some people find that typical dental floss is too harsh on their gums. For that reason some companies make floss with soft coatings that are less abrasive on the gums. For the most part these types of floss are just as effective as regular floss, and for those people that require a more sensitive approach to flossing, especially when just starting out, this is the best option.

Of the aforementioned options, it is difficult to name an absolute best type of floss. However, Dr. Keller and Dr. Tibbs and our team say that the type of floss that works best for you, giving you the greatest chance of succeeding at regular flossing, is the best. For more information on floss, contact our Wilmington office.

Dr. Keller and Dr. Tibbs and our team always tell our patients that if you value your overall health, not just your oral health, anytime is a good time to visit Montchanin Implant Center for a periodontal evaluation. Sometimes the only way to identify periodontal (gum) disease is through a comprehensive periodontal evaluation. If you notice any of the following periodontal disease symptoms outlined by the American Dental Association, it may be time to give us a call to schedule an exam:

• Gums that bleed easily or are swollen, red, or tender
• Gums that bleed while brushing, flossing, or eating hard foods
• Pus between your gums and teeth
• Sores in your mouth
• Gums that are receding or pulling away from the teeth, causing teeth to look longer than before
• Frequent bad breath or a bad taste in your mouth
• A change in the way teeth align when you bite
• A change in the way partial dentures fit

It is also important to note that it’s possible to have gum disease and have no warning signs. While studies have indicated that older people have the highest rates of periodontal disease, we recommend being seen by Dr. Keller and Dr. Tibbs sooner rather than later when dealing with gum disease. An evaluation at our office can not only help catch gingivitis, the early form of gum disease in time, but can also give you peace of mind. Gingivitis, if detected early, can be treated and eventually reversed.

Not doing anything, however, can lead to periodontal disease, which can in turn lead to tooth loss. The best way to avoid gum disease is to visit our Wilmington office for an evaluation. To schedule your visit, please give us a call today! We look forward to seeing you!

A vital step in your oral health routine is flossing. We hope our patients at Montchanin Implant Center maintain good oral hygiene, including daily flossing between each visit to our Wilmington office. A toothbrush is not always enough to get to the hard-to-reach areas of your mouth. When food remains between your teeth, bacteria starts to grow and will break down your enamel. This is where flossing comes in!

Should you floss before or after brushing?

Whatever your personal preference, you may floss before or after you brush your teeth. When you floss first, you can brush away any leftover dislodged food debris from your teeth. On the other hand, when you brush first, you will loosen the plaque between your teeth, which makes flossing more effective.

The essential aspect is that you floss thoroughly by using a fresh strand of floss and make sure to get between every tooth. Even if your teeth look and feel clean, don’t skip flossing or plaque will begin to build up on your teeth.

When is the best time to floss?

Although you should brush your teeth at least twice a day, Dr. Keller and Dr. Tibbs and our team recommend flossing your teeth thoroughly once a day. Many people prefer to floss before bed, so that plaque doesn’t sit between their teeth all night.

What kind of floss should I use?

You may choose between interdental cleaning picks or flexible floss strands to perform your daily flossing routine. If you have permanent oral appliances or restorations, be sure to follow the flossing instructions provided to you.

Do you need help flossing?

If you’re having trouble flossing or have questions about which floss is best for your teeth, contact our Wilmington office and we can provide you with support. Be sure to keep up with your daily flossing routine, and we will see you at your next appointment!

Flossing is one of the most important parts of your oral care routine. Many patients know they need to do it but find it difficult to fit into their busy lives. Well, here's the good news: flossing once a day is enough if you're doing a good job!

Some patients like to brush before they floss and others like to floss before they brush. Some like to floss in the morning when they have more energy, others like to floss at night so they can go to bed with a clean mouth. Don't get hung up on any of this, the important thing is that you floss and floss effectively no matter when you do it.

Effective flossing contributes to oral health in these ways:

• It reduces the chance of cavities between teeth, since cavities can only form on teeth covered with dental plaque and you're scraping that plaque away when you floss.
• Along with brushing, it reduces the amount of time the plaque is left on your teeth, allowing them to be in a state of healing and remineralization for longer.
• It removes plaque that accumulates at or below the gum line, aiding in the prevention of gum disease.

As you can see, flossing offers many benefits for such a simple and inexpensive technique. So if you're still wondering how much to floss, don't worry about it. Don't mistake the frequency of your flossing with the effectiveness of it. Choose a dental floss that you like and one time during the day when you can floss thoroughly and just do it! If you need more tips on how to floss correctly, ask Dr. Keller and Dr. Tibbs or any member of our Wilmington team—we'd be glad to help you pick up this healthy habit!

The dog days of summer are upon us, and what better time for Dr. Keller and Dr. Tibbs and our team to ask our patients about their summer!

Whether you visited our nation’s capital, went on a camping trip, or just stayed in Wilmington and relaxed, we want to know how you’re all spending your summer! Please feel free to share your summer plans and experiences with us below or on our Facebook page as summer rolls on!

Every year, Americans all over the world celebrate the birth of the country and its independence on the Fourth of July. There are countless ways that people celebrate and they range from community parades and large scale gatherings to concerts, fireworks displays, and smaller scale celebrations among family and friends. For some people, July 4th is synonymous with baseball, while for others it is all about the beach of barbecues. However you celebrate, you can be sure that red, white, and blue is visible everywhere throughout the area.

The Beginnings of Fourth of July Celebrations

Although it wasn't officially designated as a federal holiday until 1941, the actual tradition of celebrating Independence Day goes back to the time of the American Revolution (1775 – 1783). At the time of the American Revolution, representatives from the 13 colonies penned the resolution that ultimately declared their independence from Great Britain. The continental congress voted to adopt the Declaration of Independence on July 2nd of 1776. Two days later, Thomas Jefferson's famous document that is now known as the Declaration of Independence, was adopted by delegates representing the 13 colonies.

First States to Recognize the Fourth of July

In 1781, Massachusetts became the first state (or commonwealth) whose legislature resolved to designate July 4th as the date on which to celebrate the country's independence. Two years later, Boston became the first city to make an official designation to honor the country's birth with a holiday on July 4th. In that same year, North Carolina's governor, Alexander Martin, became the first governor to issue an official state order stipulating that July 4th was the day on which North Carolinians would celebrate the country's independence.

Fun Facts About the Fourth of July

• The reason the stars on the original flag were arranged in a circle is because it was believed that would indicate that all of the colonies were equal.
• Americans eat over 150 million hot dogs on July 4th.
• Imports of fireworks each year totals over $211 million.
• The first “official” Fourth of July party took place at the White House in 1801.
• Benjamin Franklin didn't want the national bird to be the bald eagle. He believed that the turkey was better suited to the coveted distinction. John Adams and Thomas Jefferson disagreed with him, and he was outvoted, so the bald eagle became the official bird of the United States.

For many, the tradition is something entirely different. Along the coastal areas of the United States, people may haul out huge pots to have lobster or other types of seafood boils. Others may spend the day in the bleachers at a baseball game, or at a park, cooking a great traditional meal over an open fire. No matter how or where you celebrate, one thing is certain: all Americans celebrate July 4th as the birth and independence of our country.

Dr. Keller and Dr. Tibbs and our team at Montchanin Implant Center wish you a safe and happy Fourth of July!

Dr. Keller and Dr. Tibbs and our team at Montchanin Implant Center know this is an exciting time as you anticipate the arrival of your new little one. We want to take this opportunity to provide you with some important information pertaining to your oral health during pregnancy. Just as the rest of your body is changing, the amount of bacteria in your mouth also changes. Scientists don’t understand all the reasons why, but during pregnancy, your mouth is more susceptible to bacterial complications that could result in increased risk for gingivitis or periodontal disease. What researchers do know is the change in hormones creates a more favorable environment for gum infections and diseases when you are pregnant.

You may experience an increase in gingivitis, even while continuing with regular daily brushing and flossing, and routine semi-annual month cleanings. You will likely complain of increased bleeding of the gums with routine daily care and more tenderness in the mouth. This is due, in part, to the increased blood flow and volume that naturally occurs with pregnancy. There is a greater amount of blood flowing through your veins, which translates into slightly engorged gum tissues. If gingivitis prevails, you may also experience pain and tenderness. We can help you navigate through your specific needs.

Brushing your teeth two times a day may not be quite enough. Similarly, if you only floss on occasion, consider making this activity a daily habit. Mouthwash is also advised, or sometimes a mild saltwater rinse may feel better than a commercial brand. Consider other products with xylitol and a WaterPik for additional cleaning.

Finally, we now know that bacteria in the mouth circulate throughout the body. These harmful bacteria compromise your immune system and may increase your risk for respiratory illness and cause other strains on your immune system. Remember that nutrients as well as pathogens are shared with your baby. If you feel tired or tempted to slack on your home-care routine, remember the importance and implications of your daily decisions on how your care for your oral health.

Contact our convenient Wilmington location if you have more specific questions. We’re here to help you!

Getting to the Root of the Problem(s)

While our roots are well-protected, they’re not indestructible! Several conditions can damage them. But we’re not just about problems—we also have some suggestions to keep your roots solid and intact for a lifetime.

• Traumatic Injury

A blow, a fall from a bike, a sports injury—any trauma which can hurt your visible tooth can hurt your roots as well. And it’s not just accidents that cause harm. Cracks in the tooth caused by oral habits like chewing on ice, pencils, or other hard objects can lead to root fractures.

You can help prevent root injuries by wearing a mouth guard whenever you are engaged in contact sports or any physical activity that might cause damage to your face or mouth. If you have harmful oral habits, talk to Dr. Keller and Dr. Tibbs about how to break them. And if you do suffer a dental injury, see us as soon as possible to avoid more serious complications.

• Bruxism

Bruxism, or tooth grinding, is most often an unconscious habit that takes place while you sleep. Grinding puts enormous pressure on teeth and their roots. The damage can be obvious, with cracked and worn crowns, but your roots can be affected, too. The strain of this constant pressure can stretch the periodontal ligament, causing loose teeth.

Night guards are one of the easiest ways to relieve pressure on individual teeth and roots. Your dentist can fabricate a night guard which will provide comfortable, effective protection for your teeth and jaw.

• Root Infections

Any infection in the pulp of the tooth will affect the roots as well. Your dentist will examine you carefully to see if a root canal is advisable. In this procedure, injured or infected pulp is removed from the pulp chambers and the root canals, the tooth is cleaned and filled, and, usually, a crown caps the tooth afterwards.

• Gum Recession

Finally, one of the best ways to protect your roots is to take care of the tissues surrounding them. A periodontist is a specialist in the diagnosis and treatment of the gums, bones, and other tissues supporting the teeth.

Gums often recede as we age, leaving part of the root exposed. Gum disease, failure to brush and floss regularly, and heavy-handed brushing can also lead to gum recession. The newly revealed cementum is now exposed to the plaque and acids which cause cavities in our enamel, and, since it’s not as strong as enamel, cementum is more vulnerable to erosion and cavities progress more quickly.

When more severe recession takes place, the gums pull away from the teeth, creating pockets which become home to plaque and bacteria. Left untreated, infection and inflammation can develop, attacking teeth, connective tissue, and bone.

Talk to your periodontist about scaling and planing procedures for a deep cleaning of the root surface, or grafting procedures to replace the gum tissue which protects your roots and bones.

Healthy roots help you keep your teeth for a lifetime, so it’s important to see your dentist as soon as possible if you have any symptoms of potential root or gum problems:

• Constant pain in tooth, gums, or jaw
• Pain when biting down
• Loose teeth
• Tooth discoloration
• Sensitivity to hot and cold
• Swelling or pain in the gums around a tooth
• Receding gums

Do your part by keeping up with daily brushing and flossing, seeing Dr. Keller and Dr. Tibbs for exams as recommended, and making an appointment at our Wilmington office if you are feeling any pain or discomfort. Strong roots are essential to our oral health, and a lifetime of healthy smiles is something we’re all rooting for!