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What Tobacco Does to Your Teeth

Smoking Tobacco or using it in any form has wide-reaching harmful effects on the whole body, not just the teeth. It causes heart disease, emphysema, and lung and mouth cancers. Using tobacco products has a very negative effect on your oral health as well. Some of the most obvious effects smoking cigarettes has are bad breath, tooth discoloration and loss of ability to taste and smell, but there can be more serious periodontal problems.

These changes in oral health are caused by smoking cigarettes and using tobacco:

The lining in your mouth and salivary gland openings on the roof of the mouth become inflamed which can lead to severe mouth sensitivity. Cigarette smokers often develop leukoplakia, which is white patches inside the mouth which are considered precancerous. If you need encouragement to quit smoking, a study published in the Journal of American Dental Association found that the mouth lesion, leukoplakia, completely resolved within 6 weeks of quitting in 97.5% of patients with lesions. Further, tooth decay is amplified by smoking because it increases the build-up of plaque and tartar on teeth. Tooth decay damages the tooth and gums, but with smoking, there is an increased loss of bone within the jaw.

Nicotinamides cause the blood vessels to reduce in diameter by 80% reducing the blood flow by this amount slowing healing down to one-fifth of the normal healing time.

Tooth extractions, periodontal treatments, and/or oral surgery are common consequences for the effects smoking cigarettes has on your teeth. However, because of the incessant smoking, those who undergo surgery experience a delayed healing process. Some smokers are not even qualified for these surgeries because of their smoking.

Finally, and perhaps the scariest side effect smoking cigarettes have is developing oral cancer which can lead to premature death and is very painful. For more information on oral cancer and symptoms to look for, visit:

How does smoking lead to gum disease? Tobacco products cause periodontal problems by interfering with the normal function of gum tissue cells, causing gum line recession and bone detachment. Because of this abnormal cell function, smokers are more susceptible to infections. Because of the reduction in blood flow to the gums, mouth wounds cannot heal properly which is why many smokers are not good candidates for oral surgery.

Unfortunately, smokeless tobacco products do not reduce your oral health risks. Smokeless tobacco contains at least 28 chemicals that have been shown to increase the risk of oral cancer, cancer of the throat and esophagus. Further, chewing tobacco contains a higher level of nicotine which makes it even harder to quit than cigarettes. Smokeless tobacco irritates your gum tissue, causing it to recede from your teeth. Additionally, most smokeless tobacco products come with flavor additives which are sugar based. A study published in the Journal of the American Dental Association showed that chewing tobacco users were four times more likely than nonusers to develop tooth decay. Although these are not technically smoking side effects, tobacco use still causes major dental health problems.

We are happy to include some links to the American Cancer Society page of statistics.

For tips and programs to help quit smoking tobacco visit:


Dental and Oral Consequences of Bulimia

Erosion of teeth from Bulimia

You would be surprised to know how many people suffer from Bulimia because they are often able to hide it from there friends.  It is more difficult to conceal the secret from your dentist because of the signs which show in the mouth.


Teeth eroded away by stomach acid

Top ten detrimental effects of Bulimia on your teeth

1.    Smooth enamel without stain or loss of enamel and dentine from the biting surfaces and inner surfaces of the teeth.  This is the result of erosion the effect of the stomach acid dissolving the teeth away by repeated vomiting.

2.    The teeth are highly prone to decay, and become sensitive and may even have nerve damage requiring root canal therapy.

3.    The margins of fillings in the back teeth may appear higher than the surfaces of the tooth enamel in the surrounding tooth.

womans face distorted by bulimia 4.    The cheeks at the corner of the jaw may become enlarged because the Parotid gland swells.  This swelling is common in bulimics.  The enlargement of the gland is related to the duration and severity of vomiting.

5.    Dry mouth is also a common symptom of Bulimia.  The amount of saliva secreted is affected by abuse of laxatives, by diuretics, and by dehydration from fasting and vomiting.

Tissue changes bulimia lower

6.    Gum tissue trauma and changes in the character of the gums.  This condition is due to ingesting large amounts of food and by the force of vomiting. also by the presence of the irritant of gastric juices in the mouth.  If objects are used to force vomiting they can injure the soft pallet.  Dehydration will affect gum tissue.

7.    It is not uncommon for irritated areas or a callus to develop on the top surface of right or left forefinger or the back of the hand.  This is caused by rubbing the finger or back of the hand on the incisal edges of the upper anterior teeth while inducing vomiting.

Calloused hand small bulimia8.    There are conditions which tend to occur with bulimia. For example, three-fourths of bulimics have serious anxiety disorders and many experience depression. People with bulimia may also develop alcohol or drug dependencies. These conditions can also affect your dental health and any medications to treat them may affect your dental treatment plan. Make your dentist aware of any medications you are taking, as well as their doses.

9.    Many people with bulimia may have a chronic sore throat and small hemorrhages under the skin of the palate.  They also may have swallowing impairments.

10.    Many people with bulimia may be malnourished, which can cause anemia, poor healing and increase the risk of periodontal disease.

Ten most Important Dental Treatments for Bulimia

1.    Start with rigorous hygiene and home care.

2.    Frequent regular professional dental cleanings, with In-office fluoride applications to prevent further erosion and decrease dentin sensitivity.

3.    Daily home application of fluoride in custom trays to neutralize acids and to promote remineralization of the enamel.

4.    Rinsing their mouth with water immediately after vomiting to decrease the acidity in the mouth, and with a bicarbonate of soda solution to neutralize the acid completely.

5.     Do NOT brush teeth after vomiting, it will lead to excessive enamel erosion.

6.     Commitment to professional treatment.

7.     Use desensitizing toothpaste to decrease dentinal sensitivity.

8.     Esthetic treatment should not be done during the active phase of this disorder.  Restoring esthetics can be done in the recovery stage.  When treating during RECOVERY their teeth may need to be restored to normal appearance.

9.     To help dry mouth, drink water to keep your mouth moist.

10.    There are also saliva replacements your dentist can prescribe if necessary.

Open view of mouth after repaired

Crowns protecting upper and lower teeth

open mouth lower tooth wear cuspid

What is a Cuspid Lift?

Cuspid protection is the bodies natural way of preventing the teeth from being damaged.  The eye teeth have the longest strongest roots of all the teeth in the dental arches, and they resist lateral pressure really well.  The eye teeth have a nervous innovation which causes the teeth to part and stops biting when the force is excessive.  They provide ramps up which they slide causing the back teeth to separate and the front teeth to stop striking when we grind from side to side.  This prevents bone loss around the molars and the bending of the teeth which results in enamel being lost and their necks, a process called Abfraction.

What is Bruxism Grind?

Bruxers grind their eye teeth down and cause the back teeth to touch excessively hard and wear down, this also allows the front teeth to become chipped and mars the smile.

The Best Solution for Bruxers Grind

While a bite guard protects against this,  cuspid lifts are a more permanent solution, replacing the missing tooth structure.  They can be made of gold which lasts really well, but today they are usually made of porcelain veneers or complete crowns on the eye teeth.

Cuspid clinched teeth

Almost imperceptible in the smile they open the "Bite" when grinding to the side.

open mouth showing cuspid

The bite opening on Crown with cuspid lift

Porcelain crown lifts repaired teeth

Crowns with cuspid protection that open the "bite"

Neil McLeod Portrait

Tempro-Mandibular Joint Dysfunction Syndrome (TMJ)

TMJ is a common condition affecting a wide variety of people. TMJ is characterized by severe headaches, jaw pain of varying degrees, grinding teeth, and an intermittent ringing in the ears. The vast majority of TMJ sufferers are unaware that the root cause of these problems is something that a dentist can effectively treat.

The symptoms of TMJ are debilitating and can greatly interfere with everyday life. The comfort and general well being of the patient are at the heart of the dental practice, so pain relief is the first consideration of the dentist. The dentist is able to test, diagnose, and devise an immediate plan to treat the underlying causes of the TMJ disorder.

Reasons for treating TMJ

TMJ sufferers report that their symptoms generally worsen during periods of prolonged or unexpected stress and that intense outbreaks of the condition can lead to neck pain and dizziness.

The most common cause of TMJ is the misalignment of the teeth, often called “bad bite.” It is possible for the dentist to realign or adjust the teeth without the need for painful or expensive surgeries. The realignment/adjustment will stop the pounding headaches, the jaw pain, and the dizziness.

The grinding teeth symptom is particularly common and usually occurs at night. The grinding will eventually erode the structure of the teeth and lead to much more severe dental problems in the future. Untreated TMJ is one of the prime underlying factors in eroded jawbones and loose teeth.

It is important for anyone experiencing the symptoms of TMJ to visit the dentist for an exact diagnosis.

What does treating TMJ involve?

TMJ could be a result of several different problems. A bad bite is the most common, but an injury resulting from a blow to the meniscus cartilage is also a possibility. Initially, the dentist will thoroughly examine the jaw area, the patients bite, take x-rays, and review the patient’s history in order to make an accurate diagnosis and recommend necessary treatment.

Once a firm diagnosis is attained, there are several ways in which relief can be provided. A specially molded bite guard can be created to stop teeth grinding during the night. A bite relationship analysis may be recommended by the dentist. The dentist can also provide advice on relaxation techniques which will lessen the effects of stress. As a last alternative, the dentist is also able to prescribe muscle relaxants.

A better option is to change the shape of the teeth and get rid of the bad bite completely, often called “realignment.” This is especially useful because it alleviates TMJ symptoms and may improve the aesthetic appearance of the teeth as well. Realignment involves adjusting the relationship between how the upper teeth come together with the lower teeth. This may require new restorations and/or adjusting the natural teeth as well. It is not a painful procedure, and it is one the dentist has performed with great success numerous times. As with any procedure, the dentist will be happy to answer questions and discuss symptoms, options, and treatments.

If you are experiencing any symptoms of TMJ, we encourage you to contact our office today to schedule an appointment.

Wisdom Teeth Pain and Symptoms 

Third molars, commonly referred to as wisdom teeth, are usually the last four of 32 teeth to erupt (surface) in the mouth, generally making their appearance between the ages of 17 to 25. They are located at the back of the mouth (top and bottom), near the entrance to the throat. The term “wisdom” stems from the idea that the molars surface at a time typically associated with increased maturity or “wisdom”.

In most cases, inadequate space in the mouth does not allow the wisdom teeth to erupt properly and become fully functional. When this happens, the tooth can become impacted (stuck) in an undesirable or potentially harmful position. If left untreated, impacted wisdom teeth can contribute to infection, damage to other teeth, and possibly cysts or tumors.

There are several types, or degrees, of impaction based on the actual depth of the teeth within the jaw:

Wisdom teeth coming in Soft Tissue Impaction

The upper portion of the tooth (the crown) has penetrated through the bone, but the gingiva (gum) is covering part or all of the tooth’s crown and has not positioned properly around the tooth. Because it is difficult to keep the area clean, food can become trapped below the gum and cause an infection and/or tooth decay, resulting in pain and swelling.

Partial Bony Impaction:

The tooth has partially erupted, but a portion of the crown remains submerged below the gum and surrounding jawbone. Again, because it is difficult to keep the area clean, or an infection will commonly occur.

Complete Bony Impaction:

The tooth is completely encased by jawbone. This will require more complex removal techniques.

Reasons to remove wisdom teeth

While not all wisdom teeth require removal, wisdom teeth extractions are most often performed because of an active problem such as pain, swelling, decay or infection, or as a preventative measure to avoid serious problems in the future. If impaction of one or more wisdom teeth is present and left untreated, a number of potentially harmful outcomes can occur, including:

  • Damage to nearby teeth: Second molars (the teeth directly in front of the wisdom teeth) can be adversely affected by impacted wisdom teeth, resulting in tooth decay (cavities), periodontal disease (gum disease) and possible bone loss.
  • Disease: Although uncommon, cysts and tumors can occur in the areas surrounding impacted wisdom teeth.
  • Infection: Bacteria and food can become trapped under the gum tissue, resulting in an infection. The infection can cause considerable pain and danger.
  • Tooth Crowding: It has been theorized that impacted wisdom teeth can put pressure on other teeth and cause them to become misaligned (crowded or twisted). This theory isn’t universally accepted by all dental professionals, and it has never been validated by any scientific studies.

Wisdom teeth examination

As with any dental procedure, your dentist will want to initially conduct a thorough examination of the wisdom and surrounding teeth. Panoramic or digital x-rays will be taken in order for your dentist to evaluate the position of the wisdom teeth and determine if a current problem exists, or the likelihood of any potential future problems. The x-rays can also expose additional risk factors, such as deterioration or decay of nearby teeth. Early evaluation and treatment (typically in the mid-teen years) are recommended in order to identify potential problems and to improve the results for patients requiring wisdom teeth extractions. Only after a thorough examination can your dentist provide you with the best options for your particular case.

What does the removal of wisdom teeth involve?

Wisdom teeth removal is a common procedure, generally performed under local anesthesia, intravenous (IV) sedation, or general anesthesia by a specially trained dentist in an office surgery suite. The surgery does not require an overnight stay, and you will be released with post-operative instructions and medication (if necessary), to help manage any swelling or discomfort.

Bruxism one of the most common sleep disorders

Bruxism refers to an oral parafunctional activity which occurs in most humans at some point in their lives.  The grinding of the teeth and the clenching of the jaw are the two main characteristics of this condition, which can occur either during the day or at night.

image inside adult mouth upper

Bruxism is one of the most common known sleep disorders and causes most of its damage during sleeping hours.  The clenching and grinding which accompanies bruxism are symptomatic of a malfunctioning chewing reflex, which is turned off in non-sufferers when sleeping.  For sufferers, deep sleep or even naps, cause the reflex nerve control center in the brain to turn off, and the reflex pathways to become active.

Diagnosing Bruxism

Typically, the incisors and canines (front 6 upper and lower teeth) of opposing arches grind against each other laterally.  This side to side action puts undue strain on the medial pterygoid muscles and the temporomandibular joints.  Earache, depression, headaches, eating disorders and anxiety are amongst the most common symptoms of bruxism; which often accompanies chronic stress, Alzheimer’s disease, and alcohol abuse.

Bruxism is frequently misdiagnosed or not diagnosed at all, because it is only one of several potential causes of tooth wear.  Only a trained professional can tell the difference between bruxing wear and wear caused by overly aggressive brushing, acidic soft drinks, and abrasive foods.

A BiteStrip® is an economical device used to diagnose bruxism at home.  The device itself is a small electromyography which senses and monitors any activity in the jaw muscles during sleep.  The frequency and severity of the condition can then be assessed and the best treatment plan can be formulated.

The four main reason why bruxism should be promptly treated:

  • Gum recession and tooth loss – Bruxism is one of the leading causes of gum recession and tooth loss; firstly because it damages the soft tissue directly, and secondly because it leads to loose teeth and deep pockets where bacteria can colonize and destroy the supporting bone.
  • Occlusal trauma – The abnormal wear patterns on the occlusal (chewing) surfaces can lead to fractures in the teeth, which may require restorative treatment.
  • Arthritis – In severe and chronic cases, bruxing can eventually lead to painful arthritis in the temporomandibular (TMJ) joints (the joints that allow the jaw to open smoothly).
  • Myofascial pain – The grinding associated with bruxism can eventually shorten and blunt the teeth.  This can lead to muscle pain in the myofascial region and debilitating headaches.

Treatment options for night grinding and bruxism

There is no single cure for bruxism, though a variety of helpful devices and tools are available.  Here are some common ways in which bruxism is treated:

An acrylic mouthguard can be designed from tooth impressions to minimize the abrasive action of tooth surfaces during normal sleep.  Mouthguards should be worn on a long-term basis to help prevent tooth damage, damage to the temporomandibular joint and help to stabilize the occlusion.

Custom Bite guard contour

Ideal Acrylic "Bite Guard"

Other methods of treatment include relaxation exercises, stress management education, and biofeedback mechanisms.  When the bruxing is under control, there are a variety of dental procedures such as crowns, gum grafts and crown lengthening that can restore a pleasant aesthetic appearance to the smile.


There will be weeping and gnashing of teeth...
-Luke 13:28 - The Blog for

tooth guard to

When do I need a bite guard/night guard?

The Bite Guard sometimes referred to as Night Guard or occlusal splint as it is more correctly called, is a protective shield that is worn between the teeth.  It is principally used to protect the teeth from the damage of grinding or clenching of your teeth when asleep, or during periods of high stress.  The splint is also used to separate the upper and lower teeth while the dentist is analyzing the way the teeth come together, and for de-programming disadvantageous muscle habits that affect the position of the jaw in relation to the Temporo-Mandibular Joint.

A bite guard is not the same thing as a protective Mouthguard (which has a use in protecting the teeth during sporting or combative situations).

Soft night guards are rarely made and should not be worn for a long period of time or over many days because they cause the teeth to shift during clenching.

Dr. McLeod sitting at his desk with beautiful background scene

Dr. Neil McLeod

What is a bite guard?

The Bite Guard is usually made of hard clear plastic and covers all of the teeth in one arch, most commonly the upper arch of teeth.  Sometimes guards are made for the lower jaw, it depends on the jaw relationship and the problems being treated. The night guard covers all the teeth in one arch, and contact all the teeth in the opposing arch.  It is usually adjusted so that all the teeth contact when the jaw is in its rearmost midmost position, often called centric relation. Again this is all due to the grinding or clenching of the teeth.

A guard which is worn properly and kept clean can last about 36 months.
It is not uncommon for the jaw to shift to a more comfortable position when using a guard, and then both the guard and the teeth may need adjustments.

What type of bite guard is best?

Patients often ask if they can just get a guard from a pharmacy or sports store and if that will do.  The answer is no, I'm sorry.  These guards need to be very accurately made and should be hard, not soft and flexible, so a doctor needs to make and adjust them.

You should always bring your guard with you whenever you are coming to the dental office for a checkup or cleaning or for maintenance. Professional cleaning helps to preserve the usefulness of the appliance, and it may need to be modified with time.

Please don't leave your guard where your pets can find it.  They love the smell!

damaged and worn tooth guard


When you bend a stick too much, the stick breaks. When you grind on a tooth too much, the tooth flexes and the area that bends compresses the crystals of tooth structure which dislodge and dissolves leaving a notch on the root. The notch is at the bottom front of the dental crown near the gums and is called a dental abfraction. Years ago dentists and hygienists believed that it was from brushing too hard but many patients who do not brush have these notches. Dentists now know that the notches are not due to hard bristle brushes or hard brushing.

What do I need to know about Dental Abfraction?

The most common teeth to suffer from dental abfractions are the bicuspid teeth, especially the upper bicuspids but the notches can also be found on cuspids and molars. The notch is created because the minerals that form the dental root crack off and dissolve due to the grinding pressures. This exposes the tooth inner surfaces of the tooth that is closer to the nerve and causes tooth sensitivity to hot and cold. Desensitizing toothpaste like Denquel or Sensodyne help reduce the sensitivity, but the real cause is tooth grinding.

Showing a mouth with tooth abstraction

How to treat tooth abfractions?

Some dentists attempt to fill the abfraction with white dental fillings called composites but because the tooth still flexes and bends, these white filling often pop out leaving a bigger hole than the original notch. We recommend that patients first get a protective guard before attempting to fill their notches.

Up until now, research into the causes of abfractions seems to be divided into two camps- those who argue for toothbrushes and other artificial forces as the cause and those researchers who point to internal physiological sources as the culprit. The latter argument, though not providing a complete explanation, does offer a significant clue to the real cause of this troubling phenomenon.

Dealing with hypersensitivity of teeth with non-carious cervical lesions is a difficult task. These were thought to be erosion- abrasion lesions. It was Grippo, who originated the term ‘abfraction’, in 1991 to describe the pathologic loss of tooth enamel and dentin caused by biomechanical loading of forces.

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Dr. McLeod would love to improve your smile!

Dr. Neil McLeod, DDS

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