Last updated: Nov 01, 2012
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You brush, you floss, you get your six-month checkup, and yet up pops a cavity, or major yellowing, or throbbing pain. While some of our teeth woes are genetic, we don't always get their care right, which can lead to serious problems—from an increased risk of preterm delivery if you're pregnant to heart disease. Worry not: It's easier than ever to treat your mouth right. These are the very best ways to keep your 32 chompers in top shape.


Problem No. 1: Cavities

The lowdown: The dreaded cavity is actually a little hole in your tooth caused by the destruction of the hard outer enamel. Grown-ups are less likely than children to develop new cavities because they tend to consume fewer sugary foods and drinks that create bacterial plaque, a sticky film that produces enamel-eroding acids. More often we get decay around the edges of old, weakened fillings. You can't be genetically prone to cavities per se, but you can be genetically prone to the bacterial plaque that causes them.

What it feels like: In the early stages of a small cavity, you might not feel anything. A more advanced one can make your tooth ache (especially after drinking something hot or cold); you might even feel a small hole.

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The Rx: If the cavity is so microscopic your doctor catches it only on a routine X-ray—which you should get every two years—she may give you a prescription for fluoride or do several in-office applications. "The fluoride remineralizes the tooth," meaning it builds enamel back up, explains Mark Wolff, DDS, a professor at the NYU School of Dentistry. If the cavity is larger, you'll need a filling. The most popular are composite, or plastic, ones designed to match the color of your teeth, and are usually covered by dental insurance. Since they're smaller than traditional metal or amalgam ones, your dentist has to remove less of your tooth. If you have a really large cavity, though, you may need a porcelain crown.

Problem No. 2: Gum disease

The lowdown: Plaque buildup can irritate your gums, causing swelling, redness, and bleeding. In the early stages, this is called gingivitis. If left untreated, bacteria can spread below your gum line, destroying tissue and bones and creating deep pockets between your teeth and gums. This means advanced gum disease, a.k.a. periodontitis; left untreated, it can lead to heart disease, diabetes, and even possibly rheumatoid arthritis.

What it feels like: Your gums may be sore and tender, and you'll see bleeding while brushing or flossing. If you've got periodontitis, your teeth may also look longer due to receding gums, and you'll have more irritation there.

The Rx: Your dentist should be able to detect gingivitis at your regular six-month checkup. You can reverse damage and catch problems early on by going in more frequently for cleanings—perhaps even four times a year—to remove all traces of plaque. And don't forget to floss! A Journal of Periodontology study found that performing this simple habit twice a day reduced bleeding in gums by 38 percent.



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Problem No. 3: Grinding

The lowdown: Also called bruxism, grinding is very common: "About 90 percent of my patients do it without realizing it," says Lawrence Singer, DMD, assistant clinical professor of dental surgery at George Washington University. It often happens in your sleep and is usually due to stress. If you don't treat it, it can lead to temporomandibular joint and muscle disorders (TMJ). This group of conditions causes pain and inflammation in the jaw and most commonly occurs in women ages 30 to 50, according to the Mayo Clinic.

What it feels like: Jaw soreness, clicking or popping, and, in extreme cases, even fractured teeth. You may also have inner-ear pain and frequent headaches. In one study, as many as 55 percent of patients with chronic headaches who were referred to a neurologist were found to actually have TMJ.

The Rx: Your dentist will prescribe a nighttime bite guard (it's often covered by insurance) to lessen the damage done by teeth gnashing. If you're feeling symptoms, tell your dentist ASAP—there may be damage to your jaw joint that could indicate TMJ. Treatments include prescription muscle relaxants or anti-inflammatories, especially before bedtime, as well as cognitive-behavioral therapy to help you manage your stress and learn relaxation techniques. If your dentist suggests surgery, get a second opinion, Dr. Singer warns: The National Institute of Dental and Craniofacial Research recommends that surgery be avoided.

Problem No. 4: Crooked teeth

The lowdown: As we get older, our lower front teeth are especially prone to shifting. Gum disease and grinding can speed that up.

What it feels like: While this is often a cosmetic problem, some people experience discomfort while chewing, jaw pain (because their bite's misaligned), or gingivitis (since crooked teeth are harder to clean).

The Rx: Why not embrace your slightly imperfect bite the way it is, à la actresses Jessica Paré (Mad Men) or Anna Paquin (True Blood)? If you're determined to go really straight, or are having symptoms like the ones listed above, try:

Veneers: A dentist bonds a thin layer of porcelain onto teeth and files it down. Best for one or two mildly crooked teeth. Cost: $1,200 to $2,000 each.

Aligners: If you've got mild crowding, you're a candidate for Invisalign, clear plastic molds you wear for 20 to 22 hours a day (results shown below). Cost: $5,000 to $6,000.

Braces: About 20 percent of people with braces are adults, and most are women, says the American Association of Orthodontists. Today's braces are more comfortable and less noticeable than the metal of your youth (brackets are smaller, too). Cost: $5,000 to $6,000.