Back to School: A parent’s review of children’s dental basics

back to school

Now that the summer is almost over, it is time to get your kids into the dentist before school starts back up!  In the meantime, here is a review of things to do for your children.

Babies should not be sent to bed with a bottle.  If they need a bottle, use water instead of milk or a sugary drink.  Make sure your baby gets some fluoride from their water.  If they use a pacifier, discontinue it after age 2, as it can cause developmental problems with their jaws or teeth.  Rub gums and teeth with a wet wash cloth to clean baby’s teeth.  (No need to use toothpaste at this age.)

As children get older, you may assist in the brushing and flossing of their teeth.  Use a small pea sized amount of toothpaste on a child sized toothbrush.  Brush for 2 minutes, 2 times per day.  It is best after breakfast and at bedtime.  You can play their favorite song and have them brush for the entire song, which may be about two minutes long.  Brushing reduces the growth of plaque which is the sticky film of bacteria which can cause cavities and gum disease.  You may also help with flossing. We recommend flossing once/day.

Bring kids in to see the dentist at a young age to start them on a good path for oral health.  We typically see kids around age 2 or 3 for their first dental visit.

When planning meals and lunches for the kids, there are foods that are good for oral health.  Those that contain calcium such as milk, yogurt, cheese, greens such as spinach and kale, and beans are helpful to teeth and jaws, which are primarily made of calcium.  Iron helps with brain development and fights against anemia.  Iron is in red meat, beans and iron fortified low sugar cereals.  Vitamin C helps to keep gums healthy, and is in oranges, red peppers, strawberries and broccoli.

Things you may want to avoid would include too many sugary snacks, like cookies, candy, sports drinks and fruit juices.  Moderation is the key for carbohydrates such as chips, bread, pasta, cracker and pretzels, since their breakdown releases acid on teeth which may lead to decay.  Another acid exposure may come from carbonated drinks such as sodas.  Sodas can lead to loss of enamel, decay and sensitive teeth for those who drink a lot of them.

So before your kids are back in school, review their oral health, get them in to see their dentist, and plan for healthy lunches and snacks to give them the best dental health possible!

Elizabeth Fleming, DDS and the staff at Desert Ridge Smiles

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Speech Therapy vs Laser Frenectomy for Tongue-Tied Dental Patient

ImageImageAnkyloglossia or Tongue-Tied is a condition that is present in some newborns, where the frenum, a thickened band of tissue under the tongue, is shortened and attached to the end of the tongue.  This can cause decreased mobility in the tongue, and can affect feeding, speech and oral hygiene.

The sounds that are most commonly affected due to ankyloglossia are “D”, “L”, “R”, “S”, “T”, “Th”, and “Z”.  Most often, these children see a speech pathologist when they are tongue-tied, to help them learn to enunciate these sounds better.

A frenectomy can be performed very easily with the use of topical anesthesia and a soft tissue laser, which frees up the tongue and allows for better movement.  These photos were from a 12 year old boy who had the procedure done in our office.  Followup picture was one week after surgery was done.  When asked if the surgery was worth it, the young patient said, “Absolutely!”.  He had been seeing a speech therapist his whole life, prior to the frenectomy.

To see if this procedure is right for you or your kids, contact your dentist for an oral examination.

We welcome your comments and suggestions!

Dr. Elizabeth J Fleming and the Staff at Desert Ridge Smiles.  

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Dental Dilemmas: Dry Mouth (Xerostomia)

Pinnacle Peak and other photos_0449Does your mouth feel drier than the Arizona desert? There are different things that may be contributing to this problem:

  • Medications, such as those used to treat anxiety or depression, pain medications, antihistamines, decongestants, and those used to treat incontinence or Parkinson’s disease.
  • Damage to the salivary glands due to radiation or chemotherapy treatments.
  • Certain conditions or diseases such as Sjogren’s, Alzheimer’s, or Stroke.

Saliva is used as a natural digestive aid, and helps with chewing and swallowing.  With a decrease in salivary output, tooth decay and gum disease are more likely to occur.  In cases of dry mouth, you need to practice exceptional oral hygiene techniques to cut down on the risk of dental problems:

  1. Brush your teeth at least two times/day, but preferably after every meal and before bedtime.
  2. Floss daily.
  3. Use fluoride containing toothpaste.
  4. Visit your dentist regularly for checkups (at least 2x/year).  Extra prescription fluoride may be helpful to decrease the harmful effects of dry mouth. Discuss this with your dentist.

There are over the counter artificial saliva products available that may help with minor decreases in salivary function.  Prescription medication may be needed in more severe cases of xerostomia to increase the production of saliva.

If your symptoms of dry mouth are less severe, here are some recommendations to help:

  • Breathe through your nose
  • Follow a low carbohydrate diet
  • Sip water frequently
  • Avoid caffeine, alcohol, and tobacco
  • Chew sugar-free gum
  • Use xylitol products
  • Keep up with oral hygiene at home
  • Get regular examinations at your dental office

For these and any other dental problems, visit us online:  We welcome your questions and comments!


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Periodontal Basics (or Why Brushing and Flossing are so important!)


So your dentist tells you that you have gingivitis, or worse yet, that you have bleeding pockets.  What does that mean and what can you do about it?

Bleeding or inflammation in any part of your body is not good.  Your goal for your mouth would be to step up your brushing and flossing techniques to eliminate the bacteria and plaque that cause these problems.  The response in your mouth to the bacteria and plaque is for the gums to become inflamed.  This residual plaque, which is a sticky film of bacteria, is the root of many dental problems. It produces acid on your teeth, causes decay, and should be removed at least every 24 hours.

The majority of the tooth surface can be cleaned by using a toothbrush.  Use either a soft bristle manual toothbrush using a circular motion for 2 minutes throughout your mouth or a good electric toothbrush with a small bristle head for 2 minutes.  My favorite electrics are Rotadent or Sonicare.

If you only use your toothbrush and don’t floss at least once/day, you will miss about 35% of the tooth surfaces and could end up with “flossing cavities” between the teeth, in addition to bleeding gums, which can lead into deepening pockets and more periodontal disease.

An added benefit of daily flossing would be in reducing bad breath!  Getting rid of the plaque and bacteria from between your teeth, keeps the acid production down, and reduces your chance of getting cavities.  Once the flossing removes the decomposing food, normally broken down by bacteria which produce acid, your rate of decay will be less and so will the bad breath!  But it must be done every 24 hours, or the plaque solidifies on the teeth, and then can only be removed by the dental office at your next cleaning.  We call solidified plaque tartar or calculus.

When calculus is present on your teeth, it is a major cause of gum inflammation and bleeding.  The longer it is present, the more likely the bone may become involved.  This is when the pocket depths increase as the bone is shrinking away from the calculus, and the gums are becoming more inflamed due to the calculus.  The biggest problem: gum inflammation can be reversible with good brushing and flossing, but once the bone becomes involved, it is not reversible and it is called periodontal disease.  With a diagnosis of periodontal disease, your cleanings would be done at 3-4 month intervals, since periodontal disease is not curable.  The goal would be to keep the plaque and inflammation under control to  maintain the current level of bone.  The best way to do this is with proper homecare: Brushing 2x/day and Flossing once/day, in addition to having regular cleanings at your dental office.

Remember: Daily plaque removal is good smile insurance!


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Why Diabetics Need Good Oral Health: Desert Ridge Smiles

Diabetes is a metabolic disease in which insulin is not regulating glucose properly.  It is one of the most common chronic illnesses, according to the CDC (Centers for Disease Control), and as of January 2011, 26 million Americans have diabetes and 79 million are considered pre-diabetic.

Glucose is what all cells use for energy production, including cells in the brain.  When insulin action is a problem, it triggers inflammation.  In the dental world, we see this as periodontal disease.  By controlling periodontal disease, a diabetic’s blood sugar control is also enhanced.

Diabetics are more prone to infections due to a weaker immune system.  Some ways to help repair the immune system include:

  • quitting smoking
  • eating a proper, well-balanced diet
  • brushing 2x/day, flossing 1x/day
  • exercising
  • weight loss

We monitor a patient’s risk for developing periodontal disease by reviewing peridontal probe scores, bleeding or inflammation points and medications at every hygiene maintenance visit.  Our goal is to keep inflammatory processes in the mouth to a minimum, by continually improving our patient’s oral health.

Complications of diabetes include: fatigue, dehydration, infection, eye disease, hearing loss, kidney disease, nerve damage in the hands and feet, high blood pressure, cardiovascular disease and gum and periodontal disease.

Diabetes can be managed by proper education-changing diet and nutrition, monitoring blood sugar regularly, exercising to lose weight, becoming healthier by quitting smoking, and monitoring your periodontal health at your dentist.  Remember: Good Oral Health Leads to Good Overall Health!

Elizabeth Fleming, DDS and Staff at Desert Ridge Smiles  20950 N Tatum Blvd Ste 280  Phx, AZ  85050 480-860-4300






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City of Phoenix Water Fluoridation: Good or Bad?

In Arizona, many cities have been adding fluoride to the water supply for years, resulting in a marked decrease in children with decayed teeth.  Coming in  September 2012, the Phoenix City Council will reassess fluoridation in the water system.

Is water fluoridation a good thing or a bad thing?  Let’s look at the facts:

*  Fluoride is a mineral, not a medication, and is added at a therapeutic level depending on the natural content of fluoride in the water. Phoenix has added .7 to 1.2 mg/L to the city water.

* The CDC (Center for Disease Control & Prevention) recognizes community water fluoridation as one of ten great health achievements of the 20th century, by protecting teeth from decay.

* Reports in 2011 found Fluoride did not cause bone cancer, and was not found to be carcinogenic by the California Office of Environmental Health Assessment’s Cancer Identification Committee.

* Reputable organizations such as the American Dental Association, The World Health Organization, American Medical Association and many others recognize the health benefits of preventing decay by community water fluoridation.

* According to the April 2000 Journal of Dental Research, half of children between the ages of 5 and 17 have not had a cavity in their permanent teeth, due to the use of fluoride.

As a practicing dentist, I have seen children with the ill effects of being raised in non-fluoridated communities  and have also seen young adults with NO decay, as a result of fluoride exposure.  The only people I have seen with fluorosis due to too much fluoride exposure were kids from Mexico where many things are unregulated, and who lived in rural areas where well water with high fluoride content was the main water source.

I believe that taking fluoride out of the city water would be a mistake, especially for the children, who need extra fluoride protection during the formative years.  Water fluoridation has been effective at reducing cavities in both children and adults.  We have come this far in cavity prevention.  Why reverse this now?  Show your support to the Phoenix City Council for keeping water fluoridation in the City of Phoenix water, on September 11, 2012.

Elizabeth Fleming, DDS and the staff at Desert Ridge Smiles

20950 N Tatum Blvd Ste 280 Phoenix, AZ  85050  480-860-4300

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Is Sugar a Toxin?


As a dentist, I have always been concerned about consumption of sugar, and the correlation to the amount of decay present in my patients.

With the recent proposal of New York City Mayor  Michael Bloomberg to ban sodas and sweetened beverages over 16 ounces, do you wonder if that is a smart measure, or do you feel it is extreme?

In relation to health, over consumption of sugar leads to obesity, heart disease, high blood pressure and diabetes.  An obese citizen’s health care costs are 40% higher than a normal weight citizen’s.  Let’s work at reducing the amount of sugar eaten.

In sodas and other sports drinks, there is a type of sugar called High Fructose Corn Syrup (HFCS).  It provides calories, but they are empty calories, meaning no nutritional value.  This HFCS also sends your blood sugar spiking because it is quickly absorbed, and then your body is looking for another energy source quickly.  This fluctuation of energy highs and lows can create insulin resistance as your body works to keep blood sugars in balance.  Insulin resistance can lead to diseases such as heart disease, stroke, dementia, cancer and others.  Give your body the fuel it needs, rather than the empty calories from soda.

Processed foods, such as sugar, fat and salt-laden foods,  are also addictive.  You can binge on an entire bag of chips, or a quart of ice cream, but can’t see your self eating a bag of baby carrots.  Sugars stimulate the brain’s pleasure center, just like addictive drugs, and people can develop a tolerance which requires more and more to feel satisfied…just like a drug addict.

Liquid sugar calories like those in soda are the most addictive “food” in our diet, and account for up to 10-15% of daily calories consumed by the average teenager.  The American Medical Association has recommended less than 6 tsp sugar/day.  Soda has 10 tsp in one can!  Teens consume 34 tsp/day, so you can imagine the health and dental consequences these teens will have as they become adults, if they do not get educated on the deleterious effects of their sugar consumption.

Are diet sodas better, you ask?  Diet drinks have artificial sweeteners which disrupt the normal signals that control the hunger and “feeling full” mechanisms in your body. This will slow down your metabolism and not allow you to lose weight.  It is counterproductive to have a “diet” soda if it slows down your metabolism!

The sugars and acid in sodas can erode the enamel  on your teeth. An occassional soda is fine, but drinking 50 gallons of soda/year over many years is a problem! (Sarah Weir, author of Health Risks of Soda: Is it really so bad?)

Since Americans find it difficult to self regulate, maybe government taxation would help.  A soda tax would reduce soda consumption by 23%/year and save in healthcare costs $50 billion in 10 years according to Mark Hyman, MD, the author of The Blood Sugar Solution.

Is NY Mayor Bloomberg out of line for restricting the size of sodas in his city?  Not in my mind, if you look at the deleterious health effects of the overconsumption of sugar on a person’s body!  What do you think?

Dr. Elizabeth Fleming & The Staff at Desert Ridge Smiles 20950 N Tatum Blvd Ste 280 Phoenix, AZ  85050 480-860-4300

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