50% consider the smile the first facial feature they notice.

80% are not happy with their smile.

Smile enhanced procedures outnumber eyelid surgeries 5 to 1.

32% of Americans cite bad breath as the least attractive trait of their co-workers.

38.5 total days an average American spends brushing teeth over lifetime.

73% of Americans would rather go grocery shopping than floss.

60% of people don’t know that a sore jaw, when combined with chest pain, can signal a heart attack, especially in women.

Dentists recommend that a toothbrush be kept at least six (6) feet away from a toilet to avoid airborne particles resulting from the flush.

A toothpick is the object most often choked on by Americans.

Every year, kids in North America spend close to half a billion dollars on chewing gum.

The number of cavities in the average mouth is down and people are keeping their teeth longer. People, on average, have healthier mouths than even 10 years ago.

The decline in tooth decay was greatest among kids but holds across every age group.

Only 40% of young people age 6 to 19 have ever had a cavity in their lives.  That’s down from 50% a decade ago.

Over the last ten years the proportion of people age 60 that had lost all their teeth had decreased from 33% to 25%.

Adults with post-high-school degrees had an average of three more teeth than those without a high school diploma.

Smokers remain three times more likely than non-smokers to lose all their teeth.  This figure has not changed from a decade ago.

Socio-economic status plays a definite role in one’s general and dental health.

33% of low-income adults have untreated decay.  This compared with 16% of middle- and higher-income adults.  19% of kids living in poverty have untreated decay compared with 8% of higher-income kids.

More people use blue toothbrushes than red ones.

Like fingerprints, everyone’s tongue print is different

The average woman smiles about 62 times a day! A man?  Only 8!

Kids laugh around 400 times a day. Grown-ups just 15.

Smilers in school yearbooks are more likely to have successful careers and marriages than their poker-faced peers.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. He has a special interest in treating sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com

Most people take saliva for granted, but saliva is necessary for proper digestion of food. Saliva also helps protect the mouth from dental decay, gum diseases and bad breath, because it has the natural ability to stop bacterial growth. Having a dry mouth can lead to a metallic taste in the mouth and the ability to taste food properly decreases. Saliva acts as a major defense mechanism that our bodies need to maintain good oral and systemic health.

Many people don’t realize they have dry mouth, otherwise known as xerostomia, and others find it debilitating. Regardless of whether you feel the effects or not, dry mouth can be very dangerous to your dental health. The most significant issues are rampant dental decay and gum disease.

So, what can cause dry mouth? There are multiple health related conditions and habits that can cause or add to a dry mouth, dry skin and general dryness of the entire body. One cause can be medications. There are over 3,000 prescription and over-the-counter products or medications that can cause dry mouth. You can be on a medication for years before the side effects show up. Dry mouth side effects can also last for a long time after you stop taking a medication.

What else can contribute to dry mouth? Here is a list: hypothyroidism, rheumatoid arthritis, lupus, anemia, Sjogren’s Syndrome, chemo therapy, alcohol consumption, ineffective salivary glands, stress, Alzheimer’s Disease, Parkinson’s Disease, diabetes, allergies, vitamin deficiencies, hypertension, radiation therapy, menopause, depression, smoking, and last but not least, aging.

How do you know if you suffer from, or are at risk for dry mouth? Here are some questions to assess your risk: Has your physician or pharmacist shared with you that a medication you are taking can cause dry mouth? Do you find that you wake up in the middle of the night with a cough or have a choking feeling and need a drink of water? We produce at least 50% less saliva at night so the side effects are more intense.

Does your tongue feel rough or do you tend to get mouth sores? Does your tongue stick to the roof of your mouth? Do crunchy foods such as potato chips or crackers “scratch” your mouth? Do you have dry, cracked lips and cracks at the corners of your mouth? Do you have thick and sticky saliva? Are your eyes dry and eyes drops are relatively ineffective? Is your skin still dry after using moisturizing lotion?

If you have a positive response to any of these questions, you are at risk from the damaging effects of dry mouth. The first thing to do is to eliminate any of the things that I mentioned as potential causes that are in your control, such as alcohol consumption and tobacco use. I also recommend that patients stay away from alcohol-based mouth rinses, tartar control and whitening toothpastes.

You should also notify your physician and dentist that you have, or are at risk for, dry mouth. There are many products on the market that can be effective to help with the symptoms, and also help to protect your teeth and gums. In addition, there are other prescription products, such as high-fluoride toothpastes and anti-oxidant hydrating toothpastes, mouthwashes and gels that you can only get from your dentist or physician.

Please take dry mouth seriously. The effects aren’t only annoying, but can also ruin your mouth.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. He has a special interest in treating sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com.

Many patients and dentists face a decision-making process when it comes to keeping a natural tooth with root canal therapy vs. removal of a tooth and replacing it with a dental implant. The introduction of dental implants has proven to be a pivotal technology in dentistry. In a profession that strives to help patients keep their dentition, the point when it becomes necessary to opt for dental implants is a judgment call.

So, is one treatment better than another? There have been many scientific papers written on this subject. In one more recent study published in the Journal of Dental Research the authors noted, “Both options should be seen as complementing each other, not as competing, and should serve the overall goal in dentistry, the long-term health and benefit of the patient, being least invasive and incorporating function, comfort, and esthetics. A tendency exists toward a simplified approach of ‘extraction and implant,’ but this is not always simple or ethical.”

In comparing many of the research studies, there seems to be a difference in what the implant studies define as their “survival” rate vs. “success” rate. Many dentists will tell patients that the survival rate for dental implants is in the 95% range but when looking at the research, the success rates of these same implants falls into the low to mid 70% range. Meanwhile, there are strict guidelines for root canal (endodontic) success.

In another study the authors compared the prognosis for implants and root canal treated teeth, and noted that “natural teeth exceed the life expectancy of implants at 10-year observation points, including root canal treated or periodontally compromised teeth.” Note: Periodontally compromised teeth are those with at least moderate bone loss.

In yet another study that compared root canal treated teeth with single-unit implants, researchers observed a positive outcome in 74% of the implants and 84% of the root canal treated teeth after seven to nine years. They also found significantly higher rates of complications and necessary interventions in the implant group, and patients needed more time to adjust to implant restorations.

Treatment outcomes differ significantly, depending on the experience of the clinician, and it is more significant in implants than in endodontic treatment. In one study, implant specialists achieved a 96% survival rate, while inexperienced practitioners only had a survival rate of 73%.  Meanwhile, researchers observed less of a difference when it came to clinician type and endodontic treatment in a multicenter study with 350 teeth meeting the inclusion criteria: General practitioners had a 90% survival rate, while root canal specialists had a 98% rate.

Now that you are thoroughly confused, how do you make a decision when posed with the question to keep a natural tooth with root canal therapy vs. a dental implant? There are many factors to consider, and each situation is unique. It is important to discuss the pros and cons with your dentist.

While dental implant treatment is absolutely the treatment of choice for many situations, keep in mind that many of the studies comparing the two treatment options suggest that “too many teeth are extracted in favor of dental implants”.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. He has a special interest in treating sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com

There are five major reasons that people do not get the necessary dental care they need; six if you count the recent pandemic. The other five are money, time, lack of concern, fear and trust. Let’s take a quick look at each one and see if any of them fit you, and what dentists often try to do to overcome these obstacles for patients.

Although you may think that money would be the number one reason people avoid ideal dental treatment, it is not. Even in tougher economic times, money, although a significant barrier for many, is still not the number one issue for most. Dental health, and good health in general, always requires some kind of investment.

Lack of dental insurance is a poor excuse for not getting regular dental maintenance. As I have said numerous times, dental insurance in not insurance; it is a benefit. If it were “insurance”, it would cover treatment that patients need. While not bad to have, the advantage is limited, based on insurance company’s unwillingness to raise the bar and change a system that hasn’t changed since the 1970’s.

Unfortunately, as of now, we have to face these facts, and it does not mean avoiding the dentist. Many dentists offer in-office payment plans, as well as plans through third party carriers, so patients can finance needed treatment. Two dental hygiene appointments a year costs way less than many other things people spend money on. If you drive your car for 20,000 miles without maintenance, something is bound to happen. The better you take care of your car, the less problems you’ll have.

Time is another excuse. We all use time as an excuse for many of the things in our lives we want to avoid or procrastinate on. The reality is, however, if we place something high enough in our value system, there is always time for it. In order to move something higher up in our value system, we must be enlightened enough to realize that this particular thing is of benefit to us. This brings me to the most common reason people avoid ideal dental care.

Lack of concern about dental health is prevalent with a large percentage of the population. Absence of pain is the biggest reason for this lack of concern. Other than a severe toothache and need for a root canal or extraction, there are few things that cause enough pain to bring someone to the dental office. Take gum disease; about 75% of the population has some form of this disease, but only 50% of the population goes to the dentist. Why? No pain. Absence of pain is a poor indicator of health.

Some people have fear about going to the dentist….and for good reason, due to bad past experiences or bad information. However, dentistry today should be a comfortable experience most of the time. For those that are still fearful, there are different medications dentists can use to ease the experience.

The last barrier to ideal treatment is trust. For a patient to move forward with treatment, it is essential the patient both like and trust the dentist. Although I am sure that the skills of your dentist are important to you, I am willing to bet that you would not stay with a dentist who you did not like or trust. Find someone you can connect with and build a strong doctor-patient relationship.

I believe that one of the best things a patient can do for their dental health is to find an office they like and trust……and stay there. Continuity of care is in the patient’s best interest. Find your dental home.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. He has a special interest in treating sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com

Did you know that keeping your toothbrush clean is just as important as keeping your mouth clean? After all, you use it every day to scrub plaque and bacteria off your teeth, gums, and tongue. That means after a brushing session, the bristles now carry all the germs and residue from your mouth. Unless the harmful substances are properly removed, your toothbrush won’t be as effective at cleaning your teeth. While you should be replacing it every three to four months, here are some ways you can keep it clean in the meantime.
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If you are an expert in a particular field it tends to mean you know quite a bit about that subject. It doesn’t mean you are always right, but you can usually at least have an intelligent conversation about your field. When a “journalist” writes a story about your area of expertise, I would be willing to bet, the expert (you), often cringes about the content. So goes the latest thing I have seen written about dentists and dentistry.

“Is Your Dentist Ripping You Off?” is the title of an online column that was forwarded to me. One of the best parts of this type of column are the comments to follow from such a wide range of people. Dentists commented, patients commented, hygienists and assistants commented, and many who don’t go to the dentist commented. Over the next few weeks I am going to take little pieces of the column and the comments and discuss them. I think it will make for some interesting discussions that I hope you will weigh in on.

Let’s lay the groundwork with summarizing the column itself. The author describes a “person near and dear” who returned from the dentist and was told they need two crowns for around $3000. The author called some other dentists in the area and found that there was a range of fees. Some of her comments follow:

“When I look at this bill, I wonder why I obsess about the weekly price fluctuations of Cheerios or the shrinking size of a can of tuna. All the economical choices a family makes in a year can be wiped out by a trip to the dentist.” She continues by questioning how there can be such a range in fees.

“So how can the first guy explain why his price is $450 higher? The office assistant told me ‘not all dentists are created equal,’ and of course, this dentist is one of the best in the area, using a great lab. But how can someone who is not a medical professional know if their dentist is worth their fees?”

I think these questions are excellent questions and are things that many people wonder about. Of course, there is no easy explanation. We will get deeper into that in another column. There is no doubt, dentistry can be expensive, but is it relative to everything else in life?

One of the most important suggestions the author had was, “don’t select a dentist on price alone.” While I believe this is true, the next logical question would be – What other factors do you use in selecting a dentist or health care provider? The author provided some other good information.

“Fees are one part of evaluating a dental practice, but you want to have confidence in the office, the people there, how they sterilize instruments, and the training and continuing education of the dentist. Does he or she seem to be looking out for your best interests over the long haul? What’s the dentist’s philosophy for keeping your teeth healthy for a lifetime?”

That is great advice. I would add to that looking at the practice website, reading testimonials of existing patients, and asking to visit the practice and meet the dentist and staff before committing.  That should be done at no charge.

Next week I will discuss some of the comments written after this column. That will be interesting. Looking forward to your comments as well.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. If there are certain topics you would like to see written about or questions you have please email them to him at