Our practice believes in keeping our patients informed about their oral health. Each month we are going to provide information on the latest news in dentistry. If you have any topics that you want us to discuss, or give more insight into, please let us know. We want to make this as interactive as possible.

Previous Months

June/July 2008 - VizLite Plus
October 2007 - New Technology
January 2007 - Pediatric Dentistry

8726 West North Avenue
Wauwatosa, WI 53226
(414) 258-5351

Fall 2009

Tooth Erosion – A Growing Problem

Erosion – I’ve heard this word, what is it?
Although many people go to the dentist for their regular check-up with the hopes of being free of cavities and periodontal disease, there is a lot more to having good oral health. A growing problem among children, adolescents, and adults today is erosion of tooth structure. Although erosion can be explained simply as being loss of tooth structure due to the presence of acid in the oral cavity, the World Health Organization defines erosion as, “The progressive irreversible loss of dental hard tissue that is chemically etched away from tooth structure by extrinsic and/or intrinsic acids by a process that does not involve bacteria”. Unfortunately this irreversible loss of tooth structure may even be seen in those who have excellent oral hygiene and perfectly clean teeth.

What causes this (erosion) to happen to my teeth?
This damage to tooth structure is caused by the presence of acid in the mouth. Acid generally comes from our diet; however, those who suffer from gastroesophageal reflux disease and bulimia are at an increased risk of suffering from eroded tooth structure. The most common source of acid is from our diet. Acids in certain foods and drinks etch away at tooth structure exposing the underlying dentin, a layer of tooth structure that is not meant to be exposed to the oral cavity. Unfortunately once the enamel is gone and the dentin is exposed, it cannot be replaced. Some common sources of dietary acid are as follows:
∙ Citrus fruits, seedless raisins, dried apricots, orange squash,
∙ Soft drinks which include soda, sugar free soda, sports drinks, and fruit juices
∙ Sour flavored candy
∙ Salad dressings, vinegar conserves, and pickles
∙ Ciders, wines, and acidic herbal teas

If some of the items listed above are a surprise, it is because although they may not appear to be very acidic, they have a high level of titratable acid. Foods that have high amounts of titratable acid are more damaging or erosive to tooth structure because they leave an acidic environment in the mouth for an extended period of time.

How will I know if erosion is occurring in my mouth?
The most common signs of erosion are transparent edges of the front teeth, tooth surfaces that have a polished stone appearance, and lack of pits and grooves on the molars and premolars (teeth in the back of your mouth). In extreme cases, acid erosion can result in sensitivity, discoloration, and tooth destruction.

How can I prevent this from happening to my teeth?
Given that erosion is a process that usually occurs over an extended period of time, early identification and prevention is the key to success. The easiest way to prevent this damage is through altering our dietary habits. A few ideas of how one can accomplish this:
  ∙ Limit the number of times a day teeth are exposed to acidic foods and drinks
  ∙ Avoid habits such as sipping, swishing, or holding acidic drinks in the mouth
  ∙ Drink milk or eat cheese after exposure to an acid
  ∙ Use fluoridate toothpaste that is not abrasive
  ∙ Avoid giving children fruit juices or other acidic beverages in a bottle
    or sippie cup
  ∙ Wait at least thirty minutes to brush your teeth after consuming acidic
    foods and drinks

If you any questions or concerns please ask your hygienist or one of us at your next visit!

Digital x-rays, The Latest Technology:
This past spring the office invested in the latest technology available for dental x-rays. We have converted our dental x-ray system to the Schick © Digital System. The switch to digital dental x-rays allows us to provide even better dental care and more accurate diagnoses. Furthermore, the process of digitally capturing an image is much faster, safer and more comfortable for the patient.
  How do digital x-rays work?
We place a small sensor in your mouth. The sensor is connected to a computer by a thin wire. Next, an X-ray beam is sent through your teeth and into the sensor, which records the image of your teeth and sends it to the computer. The sensor can then be repositioned to photograph other sections of your teeth.

Why Digital Dental X-Rays are Better?
The digital dental X-ray system is more sensitive than dental X-ray film systems, so your exposure to X-rays is cut by as much as 90 percent. The large, color-enhanced images let you see what your dentist sees, so it's easier for you to understand how your dentist will treat your teeth. Your dental checkups take less time, and it's fun to watch this system work! Most patients are amazed. It also allows us to communicate more effectively with needed specialist (i.e. oral surgeon, endodontist) by emailing them your x-rays directly.

June/July 2008

The Latest Technology in Oral Cancer Screening: VizLite®Plus
One person dies every hour from oral cancer in the United States. Late detection of oral cancer is the primary cause that both the incidence and mortality rates of oral cancer continue to increase. As with most cancers, age is the primary risk factor for oral cancer.

Although we do a visual oral cancer screen on every patient, initially at the new patient exam and then at subsequent recall exams, use of the VizLite® Plus improves the dental professional’s ability to identify and evaluate suspicious areas at their earliest stages. Early detection of pre-cancerous tissue can minimize or eliminate the potentially disfiguring effects of oral cancer and possibly save your life. VizLite®Plus is an easy and painless examination that gives this practice the best chance to find any oral abnormalities you may have at the earliest possible stage.

Oral Cancer Risk Profile:
Increased risk: Patients age 18-39
Sexually active patients (HPV 16/18)
High Risk: Patients age 40 and older; tobacco users younger than age 40
Highest Risk: Patients age 40 or older and lifestyle risk factors (tobacco use); patients with history of oral cancer.

Dental insurance may not cover this advanced oral cancer screening. This practice prescribes the VizLite®Plus exam for all patients at increased risk, high risk and highest risk of oral cancer (adult patients age 18 and older and tobacco users of any age). We will offer the VizLite®Plus exam annually following the standard oral cancer examination of the oral cavity. Please ask your hygienist for more details at your next exam.

December 2007 – Teeth Whitening

What about whitening? Read below to find out what it is all about!
‘Tis the season – ask our hygienists about our Holiday special

Why are my teeth stained?
When you put stuff in your mouth -- food, cigarette smoke, coffee, etc - a layer gradually forms on top of the enamel layer. Basically, this foreign material accumulates to form a pellicle film over the enamel layer. A dentist or hygienist cleans away the majority of this film during your routine hygiene appointment.

Unfortunately, as we age, and as we regular drink dark sodas, red wine, coffee or tea etc., the pellicle layer sits on your teeth, and the staining foreign material gets into the enamel. Because the enamel layer is porous, staining agents can work their way down into the tooth, making it almost impossible to simply scour them away. The deeper stains are basically harmless, but many people find them unattractive.

How do we combat the stain?
Over the years, many dental companies have developed various whitening products to help assist you in removing this unattractive staining. They have found a way for bleaching chemicals to get down into the tooth enamel and set off a chemical reaction (specifically, an oxidation reaction) that breaks apart the staining compounds. Most tooth whiteners use one of two chemical agents: carbamide peroxide or hydrogen peroxide, to combat the stain on the teeth.

Types of Whitening Products:

Over the counter whitening – These products are accessible at most drug or grocery stores e.g. Crest White Strips or Agua Fresh Whitening. The OTC whitening systems have a smaller concentration of the whitening product, and thus may not work on all types of stains. However they are usually more cost effective than other whitening systems.
At-home whitening systems  – The at-home systems will often use 10 to 20 percent carbamide peroxide gels. To begin the at-home procedure, the dentist or hygienist will take impressions (molds) of your mouth, and then fabricate soft, custom mouth trays. To administer the treatment, place a pea size amount of gel into each tooth on the custom tray, and then place the tray in your mouth. You should wear this tray for at least 30 minutes or ˝ hour. Most whitening occurs in one to two weeks. In difficult cases, trays may need to be worn for up to six weeks.
One-hour whitening – This system involves the use of higher concentration of peroxide gel that is placed on your teeth directly. Afterwards, you then sit under a light for approximately 1 hour. Ideally, when treatment is done, you will have teeth that are 2-3 shades lighter. There is risk of increased sensitivity with this system, as well as there is no guarantee on the results. This is also the most expensive whitening system.

Dentist supervised systems have advantages and disadvantages when compared to over-the-counter tooth whitening products. The main advantage of the dentist supervised system is that the dentist can help determine if tooth whitening should be performed and if it will be effective for the patient. Patients with decayed teeth, infected gums, white spots on their teeth, and multiple tooth colored fillings or crowns (caps) on the front teeth may not be good candidates for tooth whitening. Please ask your dentist or your hygienist at your next hygiene appointment on their opinion and your options for a whiter, brighter smile.

OCTOBER 2007 – New Technology in Office

Dr. Crego’s office and staff are excited about the addition of their latest technology, Panmeca’s Digital Panoramic X-ray machine.  The recent purchase of this equipment allows us to be more efficient with our recall exams, and helps minimize the radiation exposure to our patients.  Furthermore it will allow us to determine if any of the following conditions are present in your mouth:

v     Neoplasms –( growths, cancerous or non-cancerous)

v     Impacted teeth – including wisdom teeth

v     Cysts or abscesses

v     Abnormal bone destruction

v     Jaw/joint relationship and any potential problems

v     Congenitally missing teeth or the presence of extra teeth

v     Fractures

v     Abnormal eruption patterns in growing children

v     Abnormal resorption of bone and teeth

v     Periodontal disease

v     Relationship of the teeth with the sinus

v     Nerve, tooth relationships

v     An aid in detecting the presence of calcifications with the carotid artery

If you have any questions, please feel free to ask
your hygienist, Dr. Crego or Dr. Russell.

JANUARY 2007 – Pediatric Dentistry

One of the most common questions that we hear at the practice is, “When should my child first see the dentist?”

Two major pediatric groups, the American Academy of Pediatrics (pediatricians) and the American Academy of Pediatric Dentists (pedodontists) both recommend that every child should have a “dental home” by the age of one year. The dental exam for a one year old child involves a visual exam by a dentist while the child is being held in the parent’s lap. The purpose of this initial visit is to establish a relationship with the parents and the child, as well as a way to identify any possible future dental problems. Another important part of this visit is to educate the parents about oral hygiene, proper diet and other possible causes for dental problems.

After the initial exam, if no initial problems are identified the child should be seen on an annual basis until the age of 3, where after the child should begin 6 month visits. This initial “dental home” is a resource for parents, and a way to prevent as many dental
problems as possible for young children.

For further information please visit the following web-sites:
The American Academy of Pediatric Dentistry (www.aapd.org)
The American Academy of Pediatrics (www.aap.org)


8726 West North Avenue
Wauwatosa, WI 53226
(414) 258-5351