The Challenges of Dentistry Part 2

In my last blog I started talking about tooth decay. You’ll remember I said many things are needed to allow decay to happen.  Bacteria, plaque, sugar, and acids all need to be present for a cavity to start.  Last time I wrote about bacteria and plaque.  This time I will discuss sugar and acids.

The role of sugar in tooth decay is where I am getting in the nutrition aspect of this blog. Sugar is necessary for decay to occur.  The bacteria in your mouth feeds on sugars to grow.  The biproducts of this combination are acids.  Acids are what break down tooth structure causing cavities.  By limiting or eliminating sugar, tooth decay does not occur.  While it is almost impossible to eliminate sugar from our diets, we can control the amount, the frequency of intake and the duration of the bacteria’s exposure to sugar.

Americans eat too much sugar. The recommended daily allowance of sugar is 24 grams for females and 36 grams for males. A bowl of cereal for breakfast, a yogurt at lunch and a couple of cookies or a bowl of ice cream after dinner and you are near or over the limit. I encourage patients to concentrate on frequency and duration.  Try to cut down on how many times you eat sugar through out the day.  Give your teeth several hours between sugar exposures.  The saliva needs a chance to rinse away some of the sugar and restore the mouth to a more neutral environment.  (I will talk more about that when I cover acids).

The duration of sugar exposure is also very important. Having a glass of juice or pop is far less harmful to your teeth if you cut down on the amount of time you spend drinking it.  I am not saying guzzle your drinks, but having a glass of something sweet over a twenty-minute period is better that having a glass of pop by your desk and sipping it all afternoon long.  Again, giving the mouth time to recover from an exposure helps cut down on the bacterial growth.


This month I have talked about tooth decay. If you want to prevent cavities you need to cut down on plaque by brushing and flossing every day.  A mechanical toothbrush is best.  The right toothpaste is important, it needs to have fluoride.  There is no substitute for flossing.  A fluoridated mouthwash helps.  You need to watch the amounts of sugar you consume.  Read food labels.  You also need to control the frequency of your sugar intake, and the duration of your exposure to sugar.

Next month I’ll talk about sensitivity and dry mouth. They will both tie into what we have already talked about.

Thanks for reading,

Dr. Bruce



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The Challenges of Dentistry (Part 1)

One of the best things about being a dentist is that different days bring different challenges. Some are easy, some are baffling, and some are just plain fun.  However, most of our time is spent on five things:  Decay, gum disease, sensitivity, dry mouth, and broken teeth.

Today I’m going to talk about decay. I’m starting with this for a couple reasons.  The first is the fact that decay is the number one thing we deal with.  The second is that our amazing scheduling coordinator Kristen told me it is nutrition awareness month and I should do a blog about that.  I was unaware!  Anyway, I figured decay is dependent on nutrition to some extent so why not.

Tooth decay, or “caries” destroys tooth structure causing defects we call cavities. Many things are needed to allow decay to happen.  Bacteria, plaque, sugar, and acids all need to be present for a cavity to start.

Everyone has bacteria in their mouth. Some people have more caries causing bacteria, some have more gum disease causing bacteria.  The type of bacteria you have cannot be altered.  This comes from predetermined genetics.  However, the levels of bacteria can be controlled.  This is where plaque comes in.

Bacteria need plaque to stick to teeth. Without plaque, this bacteria is relatively harmless.  The best-known way to keep plaque off your teeth is to brush and floss.  Nothing can substitute for that!  All the products on all the infomercials cannot remove plaque like effective brushing and flossing.

We have found, and studies confirm, that a mechanical tooth brush does a better job of removing plaque than a manual brush. We see amazing results from people using a vibrating tooth brush like Sonicare. A toothpaste containing fluoride helps kill cavity forming bacteria as well as helping to refortify weakened tooth structure. While any fluoride containing toothpaste is acceptable, there are some really good toothpastes out there right now that not only help remove plaque, but also help fight gingivitis and tartar build up.  Many toothpastes also provide minerals for the rebuilding of damaged tooth surfaces.  The two I like the best are Crest Pro Health and Colgate Total.

While brushing is essential, flossing is the number one thing you can do to prevent tooth decay.  Most of adult decay (teens on up) begins where the teeth touch.  We call this the contact area.  If you don’t disrupt the bacteria sitting between your teeth on a daily basis tooth break down begins.  Floss is the only thing that effectively breaks that contact and allows oxygen to stop bacterial growth.  Floss is also vital in cleaning away plaque along the edges of filling and crowns.  These edges are often below the gum line where a tooth brush can’t reach.

We often recommend mouth washes for patients with high decay rates. A mouth wash containing fluoride.  This helps reduce the bacterial levels after you have brushed and flossed.  The fluoride in the mouth wash not only helps kill cavity forming bacteria, it also binds with the freshly cleaned tooth surface to strengthen the tooth against future decay as well as cut down on tooth sensitivity.

Watch for my next entry. We will talk about the role of sugars and acids in the decay process.

Thanks for reading,

Dr. Bruce

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February is Heart Health Month

Why do we care? Maybe because heart disease is the number one cause of death in the United States.  Cardiovascular diseases claim more lives than all forms of cancer combined.  Coronary heart disease is the most common type of heart disease.  It claims over 350,000 lives annually.  Every year over 700,000 people have heart attacks.  That is one every 34 seconds.  The direct and indirect costs of heart disease totals more than $320 BILLION dollars every year.

Who is at risk? 80% of people who die from heart disease are over 65, but heart disease can occur at any age.  If you have a family history of heart disease, you are at greater risk.  High cholesterol and high blood pressure increase the risk of coronary disease.  So does physical inactivity.  In addition, smokers are twice as likely to suffer a heart attack as non-smokers.  Passive smoke also increased your risk of heart problems.  People who are overweight are more likely to develop heart disease.  Alcohol in access (more than one drink a day) is also a risk. Finally, more than 80% of diabetics suffer some form of heart or blood vessel disease.

What can we do? We can work to reduce our risk of heart disease.  Here are recommendations to get heart healthy.

  1. Exercise.   Aerobic activity 30 minutes a day, five days a week is recommended.
  2. Watch your diet. Avoid salt, as well as saturated fats and Trans fats. Increase foods high in unsaturated fats.
  3. Maintain a healthy body weight.
  4. Take fish oil supplements.
  5. Avoid smoking, chewing tobacco and recreational drug use.
  6. Limit alcohol intake.
  7. See a doctor regularly.

Why is this dentist telling me about heart health? First of all, we are health care professionals.  We care about your overall health.  We screen for high blood pressure and we look for oral signs of diabetes.  We firmly believe that good oral health leads to good overall health.  There seems to be a correlation between periodontal disease and heart disease, so our aggressive periodontal disease protocol will hopefully benefit more than your gum tissue.  We work hard to give you the best oral health possible so that you may have the best chance of optimal overall health.  Now, do your part!

Thanks for reading,

Dr. Bruce

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2017 – Where Did It go?

In less than 2 weeks the year will be over. The holidays will be behind us and the only thing to look forward to will be Ground Hog’s Day.  A day where we will blame a rodent for the never ending blahs of winter in the Midwest.

So, before that post-holiday depression sets in, let’s celebrate 2017 one more time. Our office had many events worth rejoicing over.  Our hygienist Jenn and our assistant Melissa both had babies.  It was the second child for both.  Jenn had a girl and Melissa had a boy.  Both are back to work and trying to keep that balance between home and work.  We are happy for both of them and also overjoyed to have them back at work.

We welcomed two new employees to our team in 2017. Lyndsey came to us as an assistant to fill in while Melissa was on leave.  We loved her so much we found a way to keep her on part time.  Now she is pregnant with her first child.  We are excited for her and wish her the very best as she starts her new family chapter.  Hopefully we fit into her life in the future.

Kelly came in to shadow and help out one day and made a great impression. When we had a hygiene spot open up we called and added her to our team.  She has stepped in and is doing a great job.  We are lucky to have her.

Brittney was an assistant with us for 9 years and left to pursue other interests. We were excited and proud to have her rejoin us after almost 4 years away.  She is a part time assistant and blending in like she never left.

Melissa and Heather both celebrated a 10 year anniversary with us this fall. It is a great source of pride for our practice to have employees stay for long careers.  In addition to Heather and Melissa blessing us for over ten years we’ve had Judy for over 17 years and Rachel and Carrie for over 23 years each.  These are the people that keep our practice moving forward.

Last week we celebrated the one year anniversary for Kristen. She has been a tremendous addition to our team.  In one short year she has taken over the scheduling and become a valuable asset in our marketing department.  We are glad she finally joined our team.

Finally, we would like to recognize the team members who just showed up every day and made your visit easier and more pleasant. Thanks Jessica, Stacy and Sara.

From our family to yours, Merry Christmas and a very Happy New Year!

Dr. Bruce


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Last month I talked about fluoride and its importance in reducing decay in teeth. Having fluoride available topically and systemically has scientific evidence to back up its effectiveness in this regard.

As with any chemical or any government supported entity, there are controversies with fluoride. If you Google “fluoride” you will get information supporting fluoride, as well as many sites talking about the controversies.

The majority of the negativity surrounds the addition of fluoride to public water systems. Many claim that adding fluoride to the water is in essence poisoning the population.  I have read many of these articles.  A few of them have some valid concerns. However, I have not read anything that changes my mind about the benefits of the proper levels of fluoride.

You will notice I said “proper levels”. It is absolutely true that high levels of fluoride can be detrimental to your teeth.  Too much fluoride in growing teeth causes fluorosis.  Fluorosis gives teeth a mottled look.  They will be yellow or even brown and have a pitted appearance.  Fluorosis occurs in areas where the natural fluoride levels are too high.  This is why we insist that well water be tested before we prescribe a fluoride supplement.  Fluorosis can also occur when a child swallows too much fluoride.  This is why parents should control the amount of toothpaste children use (a small pea size amount) and keep toothpastes and fluoridated mouth washes in a safe place.

With any product, we need to be careful and follow directions and protocols. Many things we take for granted can be harmful if abused.  But like most things, fluoride is safe and effective when used properly.

More than 100 leading organizations in medicine and healthcare recognize that fluoride in water is a safe and effective way to prevent cavities. Some of these include the American Dental Association, the Centers for Disease Control and Prevention, the American Medical Association, the American Academy of Pediatrics, and the U.S. Surgeon General.

From my personal observations, I have seen the benefits of fluoride over my 35 years of practicing dentistry. I see the differences in children who get fluoridated city water and those who have well water.  I see the differences in patients who get regular fluoride treatments and those who choose not to.

Do your own research, make your own decision. The ADA has a lot of helpful information: Don’t be afraid to ask questions of your dental professionals.  We are here to help.  As for myself and my team, WE BELIEVE IN FLUORIDE!

Thanks for reading,

Dr. Bruce


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Fluoride: Let’s Celebrate its Benefits

Fluoride is a naturally occurring element that provides benefits to tooth enamel. When consumed in food, beverages or as a supplement, fluoride bonds with growing tooth structure to make the enamel stronger.  The enamel is the hard outer portion of a tooth.  The harder the enamel is, the more resistant it is to decay or cavities.

This type of fluoride treatment is called a systemic benefit. It is extremely important to children from 3 months old to at least age 10.  During these ages, teeth are forming and growing within the jaw.  The systemic fluoride, in the right amount, helps the forming enamel to be as strong and cavity resistant as possible.

In addition to systemic fluoride, it is important to expose your erupted teeth to fluoride. This is called topical fluoride.  Topical fluoride helps rebuild or re-mineralize weakened enamel.  In the right setting, fluoride can actually help reverse early tooth decay.  Topical fluoride typically comes from fluoride in toothpaste, mouthwashes and water. The most effective way to receive topical fluoride is at your next dental visit.  Fluoride varnish applied after a dental cleaning is the most effective topical fluoride available.  Insist on it!

Interestingly, systemic fluoride becomes part of your saliva which constantly coats your teeth giving systemic fluoride a topical benefit as well.

The benefits of fluoride have been known for many years. In 1945 the city of Grand Rapids, MI became the first city to add fluoride to its public water system.  Today almost 75% of public water systems add fluoride, including Wayland, MI.  Studies show that water fluoridation helps prevent tooth decay by at least 25%.  The Center for Disease Control and Prevention has proclaimed community water fluoridation as one of the ten great public health achievements of the 20th century.

If you get your water from a well you may be getting fluoride too. Many aquifers contain fluoride naturally.  If you have a well, get the water tested.  The right amount of fluoride is important. If your well water lacks sufficient fluoride your children should be getting a fluoride supplement.  Supplements can be obtained in vitamins from your pediatrician or as a stand-alone prescription from your dentist.

So, if you want to take advantage of nature’s cavity fighter you should make sure you are using a fluoridated toothpaste. Any toothpaste with the American Dental Association seal is great.  You can also consider a fluoridated mouthwash.  Again look for the ADA seal.  If your hygienist asks if you want a fluoride treatment, say “YES PLEASE!”  And if you are unsure of your water system, call your city and ask, or have your well water tested and talk to your dental provider.  Give your teeth all the advantages you can!

Thanks for reading,

Dr. Bruce

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Spring Sure Beats Winter!

Spring is officially here. The robins are back.  The flowers are poking through the ground.  Spring can bring a feeling of renewed hope and optimism.  The warmer temperatures and longer days certainly help.   We all need periods of spring in our lives.  Times when we can embrace the positive and be grateful for what we have.

It is easy to get emotionally lost in the cold and dark winter times of hardship. I struggle with this and I know many of you do too.  It’s easy to be down when long-term friends and employees retire, or move on to other things.  Dealing with new team members and learning how to work with them is challenging.  Then things start to click and you realize you have a new asset and things are once again spring-like.

Last summer we sold our house of 24 years and moved into a small 2 bedroom apartment. Now there was a winter-like moment in our lives.  Especially when it lasted all winter.  Last month we finally moved into our new home and the spring-like attitude is amazing.  The emotions of space, warmth and endless possibilities are overwhelming.  Making the short stint in the apartment seem insignificant.

I recently attended a memorial for a 39 year old young man who I have known for over 25 years. What a sad thing.  No sense can be made of his untimely death.  But meeting his young daughter was a sign that life will go on.  Seeing the family gathering together for the first time in years gave some additional purpose to the event.  The winter of that event will last a long time, but spring will come.  The signs are there.

Yesterday morning, a young man I admire very much lost his father suddenly. I feel so sad for him and his family.  It also got me thinking of my father.  He had his first heart attack in the early 80’s and I have been expecting that dreaded call of bad news almost every day since then.  But I still talk to him almost every week and he is still doing pretty well.  I realize every time I talk to him is like another unexpected spring day in our relationship.

Although I have been overwhelmed by the sad news yesterday morning, I must also appreciate the good things happening today. Our hygienist Jenn had her baby this afternoon.  Baby Avery sprang into the world at 7 pounds 0 ounces.  Mother and daughter are recovering nicely.  We all look forward to meeting the newest member of our dental family.

So even though winter comes and darkens our lives every now and again, we can always count on spring to follow. Join me in dealing with the winter like events as calmly as possible and let’s embrace the spring times of our lives and appreciate the beauty and joy that they bring.

Thanks for reading,

Dr. Bruce

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Kids are People Too!

In February we concentrate on children’s teeth. Here is a blog I wrote in 2011 about Children’s Dental Health!

Bruce Sexton DDS, Wayland, Michigan Family Dentistry

I’m sure many of us have heard that phrase before.  To me it means children deserve consideration.  They are an important and necessary part of our lives.  That thought leads me to my point this month:  Baby Teeth are Teeth Too!  They also are an important and necessary part of our lives that deserve consideration.  Because primary teeth (baby teeth) are eventually replaced by permanent teeth, many people don’t realize that primary teeth are very important for a child’s long-term dental health.

Children need strong, healthy teeth to chew their food.  Cavities and tooth loss can make it impossible for a child to eat properly.  This can affect his or her overall level of health.  Speech development can also be affected by premature tooth loss.  In addition, lost teeth can also lower a child’s self-esteem during the important formative years. 

Many of the primary teeth remain in the mouth until the…

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Looking Back at 58 Years of Frustration!

I turned 58 this week. So I took some time to reflect on those many, many years.

Less than a year before I was born, the Detroit Lions won the NFL Championship. Since then, the Lions have won ONE (1) playoff game.  That’s right, one playoff win in 58 years.  In 1991 they rode the emotional energy from a player injury to a division championship and a thrilling 38-6 win over Dallas to get into the NFC championship.  Which they lost 41-10!

In the other 57 years, the Lions are 0-10 in the playoffs. As a matter of fact, that 1993 division championship was their last Division title.  To put that in perspective, the other 15 teams in the Lions’ conference (the NFC) have ALL won THREE (3) division titles since then.  That’s a lot of Lions fan frustration!

So, why am I a Lions fan? Unfortunately, that is also age related.  When I grew up there was no Sunday Ticket, no cable, no Sunday Night Football, no Thursday Night Football, there wasn’t even Monday Night Football.  There was a game on at 1pm Sunday and another at 4pm.  Since I grew up outside the NFL “Blackout Zone” (areas close to the team stadiums) we got to watch the Lions every week as part of a regional telecast.  This was a great way for the NFL to build fan interest for teams close to you.  However, no one took into account the fact that I got stuck with the Lions.

When I went to college in Ann Arbor, most of my friends were from the Detroit area and were, of course, Lions fans. I would go with them to Lions games, even taking part in the tradition of Lions home football on Thanksgiving Day several times.  One Monday night a car load of us drove to my house, 2 hours away, to watch the Lions since the NFL “Blackout Zone” included Ann Arbor.

Once I left school, I was hooked. A step-son who is a Bears fan and a son who is a Packers fan could not sway me.  I have spent many Sunday afternoons cheering and crying with my Lions.  I have watched Barry Sanders, one of the greatest running backs of all time.  As good as he was, he could only help the Lions to that one playoff win.  Calvin Johnson (a certain hall of famer) was a beast at wide receiver, yet he never played on a team that won a playoff game or a division title.  Charlie Sanders and Lem Barney are Hall of Fame favorites who could not carry the Lions over the hump.

Unfortunately, you get used to this as a Lions fan. This year we got to 9-4 after winning 8 out of 9 and coming from behind to win 7 of them.  At that point the Lions had a 2 game lead on the entire division with 3 games to play.  My thoughts:  “I wonder how we are going to blow it this time.”  And here we are!  We need to beat our biggest nemesis, the Green Bay Packers, in order to get our first Division Title in 23 years.  The Green Bay Packers are 39-16 against us since 1990.  (My son was born in 1990. If you wondered why he was a Packer fan: he’s smart!)

So I will be watching and cheering for my Lions this weekend. But as a too often burned fan, I am placing most of my hopes on The Giants beating the Redskins.  This will allow the Lions to reach the playoffs without having to win.  Seems appropriate.

Faithfully frustrated fan,

Dr. Bruce

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Happy Halloween!

I got to thinking about Halloween over the weekend. It is a very unique holiday.  How you view and celebrate depends on so many factors.  Your age is a big factor of course, but your community, your social group, your family background and even the weather factor in to how you will spend Halloween.  On top of that, Halloween has evolved over the years.  Even year to year the popular costumes change and what is socially acceptable or politically correct varies also.

As a child, my Halloween involved a simple costume (pirate, hobo, football player) and a planned route to maximize candy! My friends and I would meet at one side of town and cover as many streets as possible until we got to the other side of town.  Our small town was laid out in a grid making planning this route fairly simple.

High school and college involved parties and more elaborate costumes. Back then politically correct wasn’t a term yet, and many of the college costumes proved that.  When I first moved to Wayland, Halloween parties with new friends were a social event I looked forward to every year.

As a newly-wed, the couples costume was the most important thing. Then, as a parent, Halloween became all about showing off your child in their adorable costume.  After that, it was mostly about worrying if it would rain or snow, or how to get that winter jacket under the power ranger costume.

Today there is trunk trick or treating, Haunted Halls in schools and the Halloween weekend is just as important as the day itself. I see photos of parties on Facebook, and see the costumes of kids and adults.  Thinking about it makes me a little sad.  Sara and I haven’t dressed up in years.  We are moving to the country and may never get trick or treaters again.  Sara makes the occasional costume for a grown child of grandchild, but I think Halloween may be passing us by.

It’s a shame that a holiday with so many wonderful memories now may go by virtually unnoticed. Well, maybe I won’t let that happen. I will wear a costume at work and embrace Halloween.  I will provide candy and donuts for employees and patients.  I will make sure it is a fun day at the office.   After all, Halloween and all that candy is job security!!

Thanks for Reading,

Dr. Bruce

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