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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!