My Blog
By Raul A. Montalvo, D.D.S.
January 14, 2020
Category: Oral Health
Tags: oral cancer  
TobaccoOneBaseballTraditionWeCanDoWithout

While sports like football, basketball and soccer have exploded in popularity over the last few decades, many Americans still have a soft spot for the granddaddy of them all: baseball. While technology has changed many aspects of the game, many of its endearing traditions live on.

Unfortunately, one baseball tradition isn’t so endearing and definitely hazardous to health—tobacco, primarily the smokeless variety. Players and coaches alike, even down to the high school level, have promoted or at least tolerated its use.

But there are signs this particular baseball tradition is losing steam. Not long ago, the San Francisco Giants became the first major league baseball team to prohibit tobacco in its home stadium—on the field as well as in the stands. The move was largely in response to a law passed by the City of San Francisco, but it does illustrate a growing trend to discourage tobacco use in baseball.

While smoking, chewing or dipping tobacco can certainly impact a person’s overall health, it can be especially damaging to the teeth, gums and mouth. Our top oral health concern with tobacco is cancer: Research has shown some correlation between tobacco use (especially smokeless) and a higher risk of oral cancer.

You need look no further than the highest ranks of baseball itself to notice a link between tobacco and oral cancer. Although from different eras, Babe Ruth and Tony Gwynn, both avid tobacco users, died from oral cancer. Other players like pitcher Curt Schilling have been diagnosed and treated for oral cancer.

Cancer isn’t the only threat tobacco poses to oral health. The nicotine in tobacco can constrict blood vessels in the mouth; this in turn reduces the normal flow of nutrients and disease-fighting immune cells to the teeth and gums. As a result, tobacco users are much more susceptible to contracting tooth decay and gum disease than non-users, and heal more slowly after treatment.

That’s why it’s important, especially in youth baseball, to discourage tobacco use on the field. While most of baseball’s traditions are worthy of preservation, the chapter on tobacco needs to close.

If you would like more information on the oral health effects of tobacco, please contact us or schedule an appointment for a consultation.

By Raul A. Montalvo, D.D.S.
January 04, 2020
Category: Dental Procedures
Tags: toothache  
WhatsCausingYourToothacheTheAnswerDeterminesYourTreatment

Pain has a purpose: it tells us when something's wrong with our bodies. Sometimes it's obvious, like a cut or bruise. Sometimes, though, it takes a bit of sleuthing to find out what's wrong.

That can be the case with a toothache. One possible cause is perhaps the most obvious: something's wrong with the tooth. More specifically, decay has invaded the tooth's inner pulp, which is filled with an intricate network of nerves that react to infection by emitting pain. The pain can feel dull or sharp, constant or intermittent.

But decay isn't the only cause for tooth pain: periodontal (gum) disease can trigger similar reactions. Bacteria living in dental plaque, a thin film of food particles on tooth surfaces, infect the gums. This weakens the tissues and can cause them to shrink back (recede) from the teeth and expose the roots. As a result, the teeth can become painfully sensitive to hot or cold foods or when biting down.

Finding the true pain source determines how we treat it. If decay has invaded the pulp you'll need a root canal treatment to clean out the infection and fill the resulting void with a special filling; this not only saves the tooth, it ends the pain. If the gums are infected, we'll need to aggressively remove all plaque and calculus (hardened plaque deposits) to restore the gums to health.

To further complicate matters, an infection from tooth decay could eventually affect the gums and supporting bone, just as a gum infection could enter the tooth by way of the roots. Once the infection crosses from tooth to gums (or gums to tooth), the tooth's long-term outlook grows dim.

So, if you're noticing any kind of tooth pain, or you have swollen, reddened or bleeding gums, you should call us for an appointment as soon as possible. The sooner we can diagnose the problem and begin appropriate treatment the better your chances of a good outcome — and an end to the pain.

If you would like more information on diagnosing and treating tooth pain, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Confusing Tooth Pain: Combined Root Canal and Gum Problems.”

By Raul A. Montalvo, D.D.S.
December 25, 2019
Category: Oral Health
Tags: nutrition   tooth decay   sugar  
LimitSugarinYourDietforBetterOralandGeneralHealth

Even after decades emphasizing oral hygiene and supplemental fluoride to fight dental disease, we’re now seeing an increase in tooth decay, especially among children. What’s causing this alarming trend?

Many in both the dental and medical professions link this and other health problems to a rise in the amount and consumption of sugar added to food products. A number of years ago our annual average consumption of added sugar was about 4 pounds per person; today, it’s closer to 90 pounds.

The increase in sugar consumption can be traced to the 1970s when the food industry began adding more sugar to make processed foods stripped of oils and fats taste better. Today, 77% of the approximately 600,000 food items sold in the United States contain some form of sugar (under a variety of names).

This additional sugar, however, has produced an unintended consequence: sugar triggers the release of a brain chemical called dopamine that regulates our sense of reward when we engage in a desirable behavior. The excess dopamine creates a weak addiction to sugar, which then leads to overconsumption, contributing to our current obesity epidemic and the rise in health problems like heart disease or Type 2 diabetes. This is especially alarming among children: thirty years ago Type 2 diabetes was unheard of among children — today there are over 55,000 diagnosed pediatric cases.

For both you and your family’s general and dental health, you should consider ways to reduce your sugar intake: purchase and eat most of your food from the “outer edges” of your supermarket — meats, dairy, and fresh vegetables and fruits (which do contain the sugar fructose, but are mostly fiber that slows the liver’s processing of the sugar); limit processed foods with added sugar, and learn to recognize its inclusion in products by reading ingredients labels. You should also be wary of sweetened beverages such as sodas, sports drinks, teas or juices, and try to drink more water.

The recommended daily sugar consumption is less than six teaspoons a day (about two-thirds the amount in one can of soda). By restricting this consumption, you’ll improve your general health and reduce your risk for dental disease.

If you would like more information on the general and dental health effects of sugar, please contact us or schedule an appointment for a consultation.

By Raul A. Montalvo, D.D.S.
December 15, 2019
Category: Dental Procedures
TheRealTruthBehindEdHelmsMissingToothinTheHangover

Ed Helms is best known for his role as the self-absorbed, Ivy League sales rep, Andy Bernard, on television's The Office. But to millions of fans he's also Stu, a member of a bachelor trip to Las Vegas in the 2009 movie The Hangover. In it, Stu and his friends wake up from a wild night on the Strip to find some things missing: the groom-to-be, their memories and, for Stu, a front tooth.

In reality, the missing tooth gag wasn't a Hollywood makeup or CGI (computer-generated imagery) trick—it was Ed Helm's actual missing tooth. According to Helms, the front tooth in question never developed and he had obtained a dental implant to replace it. He had the implant crown removed for the Hangover movie and then replaced after filming.

Helms' dental situation isn't that unusual. Although most of the 170 million-plus teeth missing from Americans' mouths are due to disease or trauma, a few happened because the teeth never formed. While most of these congenitally missing teeth are in the back of the mouth, a few, as in Helms' case, involve front teeth in the “smile zone,” which can profoundly affect appearance.

Fortunately, people missing undeveloped teeth have several good options to restore their smiles and dental function. The kind of tooth missing could help determine which option to use. For example, a bridge supported by the teeth on either side of the gap might work well if the teeth on either side are in need of crowns.

If the missing tooth happens to be one or both of the lateral incisors (on either side of the centermost teeth), it could be possible to move the canine teeth (the pointy ones, also called eye teeth) to fill the gap. This technique, known as canine substitution, may also require further modification—either by softening the canines' pointed tips, crowning them or applying veneers—to help the repositioned teeth look more natural.

The optimal solution, though, is to replace a missing tooth with a dental implant which then has a lifelike crown attached to it, as Ed Helms did to get his winning smile. Implant-supported replacement teeth are closest to natural teeth in terms of both appearance and function. Implants, though, shouldn't be placed until the jaw has fully developed, usually in early adulthood. A younger person may need a temporary restoration like a bonded bridge or a partial denture until they're ready for an implant.

Whatever the method, there's an effective way to restore missing teeth. Seeing us for an initial exam is the first step toward your own winning smile.

If you would like more information about restoring missing teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Dental Implants.”

By Raul A. Montalvo, D.D.S.
December 05, 2019
Category: Oral Health
Tags: saliva  
DiseaseDetection-SalivasNewRole

For over a century now, health providers have depended on blood and urine samples to diagnose many forms of disease. Very soon, though, we may routinely use a different bodily fluid that's easier and cheaper to collect: saliva.

Secreted by six hundred or more glands in the mouth, saliva performs a number of important functions for digestion and overall oral health. Saliva lubricates the mouth to make food easier to swallow. Its enzymes begin the digestion process breaking down food even before we swallow. It also helps wash out food particles that could build up as plaque on the teeth and harbor disease-causing bacteria.

In terms of dental health, its greatest role is as a neutralizer of food acid. It's natural after we eat for the acid levels in the mouth to rise above normal. If acid remains in contact with enamel for an extended period of time it can soften the enamel's minerals and make it easier for them to erode. Within thirty minutes to an hour after eating, saliva neutralizes acid and restores the mouth's normal pH level. Saliva also contains calcium and phosphate materials, which helps restore some of the minerals the enamel may have lost from the acid contact.

But we're discovering saliva can do even more: we can now use it as an indicator for certain conditions in the body. Like blood or urine, saliva contains molecules that can serve as biological markers for different types of disease. By employing devices calibrated to detect these markers, we can use saliva to uncover cancer, diabetes or other systemic conditions.

As these particular devices are manufactured and become more available, the use of saliva for disease diagnosis will rise. In the future, you may not need a trip to the bathroom or wince at a needle stick — a swab of your saliva will do!

If you would like more information on saliva's role in your health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Saliva: How it is Used to Diagnose Disease.”





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