Boise Dentist Blog

The professional blog of Doctors Dan Bruce, Steve Bruce and Rob Ririe

Nutrition and Dental Health

Dr. Dan Bruce - Wednesday, May 15, 2013

Nutrition and Dental Health

By: Carmen Oldenburg, MA, CHES

Guest author Carmen Oldenburg is a Health Educator and Mind/Body Specialist and helps patients with lifestyle education and health and wellness coaching.

Poor nutrition affects the entire immune system, thereby increasing susceptibility to many disorders. People with lowered immune systems have been shown to be at higher risk for periodontal disease. Additionally, research shows a link between oral health and systemic conditions, such as diabetes and cardiovascular disease. So eating a variety of foods as part of a well-balanced diet may not only improve your dental health, but increasing fiber and vitamin intake may also reduce the risk of other diseases.

Diet and nutritional advice for healthy teeth and gums:

First and foremost in developing strong teeth and gums is to ensure a balanced diet or an anti-inflammatory diet. An anti-inflammatory diet is based on the general concept that constant or out-of-control inflammation leads to ill health, and that eating to avoid constant inflammation promotes better health and can ward off disease.

Carbohydrates consist of non-starchy vegetables, fruits, starchy vegetables, grains, and legumes. Approximately 45% of an individual’s diet should come from this category of foods with the bulk of the foods coming from non-starchy vegetables. However, most Americans are eating less than 2-3 servings of vegetables and fruits a day and instead are eating the bulk of carbohydrates from the starches like grains and potatoes. Too many carbohydrates, sugars (for example, from cake, cookies, candies, milk, and other sugary foods and beverages), and savory foods and starches (for example, pretzels and potato chips) can cause tooth decay. How long carbohydrates remain on the teeth is the main culprit that leads to tooth decay. On the other hand, eating 5-8 half cup servings of non-starchy vegetables (e.g., leafy greens, broccoli) provides high levels of antioxidants, calcium for stronger teeth and a good source of fiber.

Protein provides a supply of amino acids that help to preserve and build muscle, and heal musculoskeletal tissues. Adequate protein is needed every day. It helps to maintain your muscles, and the amino acids are the building blocks for many important cell reactions. The average adult needs approximately 35% of their diet in the form of plant and/or lean animal proteins. Protein is important for the formation of teeth. In children, malnutrition of protein causes significant delay in eruption of primary teeth and studies suggest a relationship between early malnutrition and susceptibility to cavities later. In addition, protein and fat protect teeth from cavity-causing acids created as carbohydrates ferment.

Eating healthy fats has a direct impact on inflammation in the body. Sources of omega-3 and omega-9 fatty acids help to reduce inflammation in the body. Unfortunately, the average American diet includes too many foods rich in omega-6 fatty acids, found in processed and fast foods, and far too few rich in omega-3 and 9 fatty acids, such as those found in cold-water fish or nuts/seeds. When that balance is out of whack, inflammation can set in. The average adult needs about 20% of their diet in healthy fats. Omega-9 fats include avocado, olive oil, and almonds, to name a few. Sources of omega-3 fats include flax seeds and oil (don’t heat flax), sardines, ocean salmon, and walnuts.

Here are some tips for selecting and eating foods that are more healthful to your teeth:

• Keep fruits, vegetables, nuts and seeds in your house to offer as "healthy snacks" instead of carbohydrates. Buy foods that are sugar-free or unsweetened or preferably natural such as whole foods like fruits, vegetables, nuts and seeds. Choose fruits and vegetables that contain a high volume of water, such as pears, melons, celery, and cucumbers. Limit bananas and raisins, as these contain concentrated sugar. You should brush immediately after eating fruits.
• Avoid sticky, chewy foods. Foods that cling to your teeth promote tooth decay. So when you snack, avoid soft, sweet, sticky foods such as cakes, candy and dried fruits. Instead, choose healthy foods such as nuts, seeds, raw vegetables, and plain yogurt. Try to brush teeth immediately after eating.
• Serve sugary treats with meals, not as snacks. If you plan to have sweets, eat them as desserts immediately following the meal. There’s usually an increased amount of saliva in the mouth around mealtime, making it easier to wash food away from teeth. The mealtime beverage also helps to wash away food particles on teeth.
• Drink plain water instead of juice or soda. Juices, sodas, and even milk contain sugar. Water does not harm the teeth and aids in washing away any food particles that may be clinging to teeth.
• Include good sources of calcium in your diet to build strong teeth. Good sources include green leafy vegetables and cruciferous vegetables like broccoli. Eating 5-8 half-cup servings of vegetables per day helps fight inflammation in the entire body.
• Avoid eating fermentable carbohydrates by themselves. When you eat fermentable carbohydrates, such as crackers, cookies and chips, eat them as part of your meal, instead of by themselves. Combinations of foods neutralize acids in the mouth and inhibit tooth decay. For example, an apple with some nut butter provides a great snack by balancing the fructose from the apple with some healthy fat and protein from the nut butter. Your snack will be just as satisfying and better for your dental health as well as balancing blood sugar with some protein.
• Get in the habit of eating as few snacks as possible. The frequency of snacking is far more important than the quantity consumed. Time between meals allows saliva to wash away food particles that bacteria would otherwise feast on. Frequent snacking, without brushing immediately afterwards, provides constant fuel to feed bacteria, which leads to plaque development and tooth decay. Try to limit snacks as much as possible and to no more than one or two a day. Brush teeth immediately after consuming the snack, if possible.
• Avoid sugary foods that linger on the teeth. Lollipops, hard candies, cough drops, and mints all contribute to tooth decay because they continuously coat the teeth with sugar.
• Never put your baby to bed with a bottle filled with milk, formula, juice, or soda. If your baby needs a bottle at bedtime, fill it with plain water.


The Cleveland Clinic
Institute of Functional Medicine

Oral Cancer Awareness Month

Dr. Dan Bruce - Tuesday, April 09, 2013

We are partnering with the Oral Cancer Foundation to offer free oral cancer screenings to the public on April 26th from 11 a.m. to 2 p.m.The screenings will take place at both Boise Downtown Dental and Bay Pointe Dental. Please take advantage of this opportunity and call 208-336-0003 or 208-376-2920 to schedule your screening!

Dental bonding: An affordable option to improve the appearance of your teeth.

Dr. Dan Bruce - Tuesday, January 29, 2013

Dental bonding can be an economical way to fix discolored, broken or chipped teeth. Bonding is a cosmetic dentistry procedure in which a tooth-colored composite material is applied to a tooth, sculpted into shape, hardened and polished. It is called bonding because the material bonds to the tooth. Dental bonding is ideal for small cosmetic dentistry work, such as fixing a broken or chipped tooth or closing small gaps between the teeth.

Compared with other cosmetic procedures, such as veneers, bonding is relatively inexpensive, quick, and painless. Bonding may not be appropriate for all patients, so a consultation with your dentist is necessary to determine if you are a good candidate. It is also important to be aware that bonding is not as durable as porcelain crowns and veneers and in certain situations can become stained or chipped over time. Your dentist can discuss all the benefits, risks, and options with you.

Combined with take home whitening trays, bonding can dramatically improve the overall appearance of your teeth without breaking the bank!

Did you know our office provides Invisalign?

Dr. Dan Bruce - Thursday, December 27, 2012

For those of you who have heard about Invisalign, but aren't quite sure what it is, this post is for you! Invisalign is a system of clear retainers that move the teeth in small increments. This form of treatment has several advantages vs. conventional treatment. The first is esthetics--the trays are clear and are not as noticeable as brackets. Second, the trays are removable for eating and brushing and flossing, so it is easier to keep your teeth clean during treatment.  

Although Invisalign doesn't work well in all situations, it can be a great option for many patients. Some of the best Invisalign cases involve patients who had orthodontic treatment in the past and have had relapse. If you have questions, give us a call and learn more about treatment. If your situation is not an ideal Invisalign case, we can direct you to a great orthodontist in the area.

Case Study - Functional and Esthetic anterior crowns

Dr. Dan Bruce - Friday, July 20, 2012

Below is another case involving cosmetic porcelain crowns.  Our patient had been dealing with old fillings and discolored teeth for a long time.  He also wanted to correct the discrepancy between the widths of the two central incisors.  


Our treatment consisted of minor orthodontics with a retainer to move the lower anterior teeth into position.  We then whitened his teeth and created 4 porcelain crowns.  Our final product is esthetic, as well as functional and should protect the teeth that had large restorations in them for years to come.

Sleep and Memory, postings on Sharecare

Dr. Dan Bruce - Thursday, July 19, 2012

I wanted to use this post to introduce Sharecare, which is an information sharing site.  Users post healthcare questions and experts in that field answer the questions.  Since we treat a significant number of patients with oral appliances, I thought this particular question on memory and sleep was interesting.

Getting good quality and quantity of sleep is important for so many functions in our body.  Sleep apnea patients often have decreased REM sleep, which can affect memory. 

Keep checking with Sharecare to learn more about healthcare from expert sources!

Summer 2012 Newsletter

Dr. Dan Bruce - Tuesday, July 17, 2012


Happy 25th Anniversary Tammy!

We are excited to announce that this month marks the 25th year that Tammy has been working for Dr. Bruce. She is a valuable member of our team, and is much loved by her loyal patients. Tammy started working for Dr. Bruce in 1987 after she graduated from the dental hygiene program at Idaho State University. She said, "I'm very blessed to have such a wonderful place to work. I love and appreciate all my patients. It is very gratifying knowing that we strive to consistently provide the best quality care. That is what keeps me here."

Is It Snoring or Sleep Apnea?

About 80 million people in North America snore, and approximately 12 million Americans have sleep apnea. So what’s the difference, and why does it matter?
Snoring is caused by the vibration of the soft palate and uvula, occurring when the airway becomes obstructed during sleep. Several things can obstruct the airway and cause you to snore, including allergies, drinking before bed, being overweight, and having large tonsils or a deviated septum.
If you only snore occasionally, you probably have nothing to worry about. But chronic snoring can be a sign of sleep apnea, a more serious sleep disorder. People with sleep apnea stop breathing in their sleep – sometimes up to 100 hundred times an hour. Left untreated, sleep apnea can increase your chances of serious health conditions like high blood pressure, stroke and heart disease. At a minimum, you may feel groggy in the morning, fatigued or unable to concentrate during the day.
The good news is sleep apnea is treatable. The two most common ways to treat sleep apnea are continuous positive airway pressure (CPAP) therapy, which is administered by a physician, and oral appliance therapy, which is administered by a dentist. CPAP therapy can be very effective for people with sleep apnea, but some find it difficult to sleep with a mask. More people are increasingly turning to the oral appliances administered by dentists. Oral appliances are small, flexible devices that look like mouthguards. They increase the airway space and reduce air velocity and soft tissue vibration (snoring) by moving the lower jaw into a forward position. Patients who have tried both say that oral appliances are more comfortable to wear, easier to care for and very cost-effective.

If you think you may have sleep apnea, or can't tolerate CPAP, call us to schedule a sleep consultation appointment! We are one of the few offices in the area that is trained in the management of obstructive sleep apnea with oral appliances. We are also able to bill your medical insurance, which makes the appliances much more affordable.

Win an IPad 2!

We appreciate our wonderful patients who continue to refer their co-workers, family, and friends to come see us. To say thank you, we have started a new referral program!

When you refer a family member or friend who comes in for an exam, x-rays, and cleaning, you will be entered in a drawing for an iPad 2 or a $500 offiice credit (your choice). The first drawing is at the end of July, so there is still time to get your
name in!

Have a great summer!

Single tooth anterior implant using a 3d CT scan

Dr. Dan Bruce - Thursday, February 16, 2012

This week I was able to complete a long treatment process that started with a cracked front tooth.  Jeff originally had a root canal on his front tooth 25 years ago after trauma to the tooth.  He then had a crown which matched fairly well, but not perfectly.  Also, notice that the crown is wider than the adjacent central incisor and there are gaps near the gumline.  Finally, he had some recession around the front of the gumline.  Last year, the tooth started to hurt to biting and we noted a periodontal defect on the front of the tooth. After consultation with our endodontist, it was determined that the tooth had a vertical root fracture and was not savable.

The only choice was to extract the tooth and place a bone graft in the socket and where the portion of bone was due to the fracture of the tooth.  In the meantime, we bonded the original crown with a metal wire we imbedded into the crown.  This way the patient did not have to wear a retainer and the crown was used to adapt the soft tissue to the ideal contours.  When then had Jeff get a CT scan using the Galileos 3D scanner.  This scanner uses minimal radiation and allowed us to create a guide for placing the dental implant exactly where we wanted.  The implant was digitally placed in the best bone, with the best emergence profile.  A guide was made that fit to the patient's teeth and to guide the surgical drill to the precise depth and position we wanted.  
After placing the implant, a temporary abutment was placed with a crown to contour the gingiva.  We also placed small bonded composite fillings in the adjacent teeth to make them proportionally the correct shape.  We waited 5 months while the implant integrated to the bone.  During this time the temporary was completely out of Jeff's bite and we warned him not to eat anything with his front teeth.  Notice how the temporary is shorter than the original to keep it out of harm's way.

Finally, we took an impression and had Jeff go to our lab technician for a customized shade match.  We used a white zirconia abutment to attach the crown to the abutment.  Zirconia is strong and will not show through the tissue like a titanium abutment will.  It is also very biocompatible so we did not get any inflammation near the gingiva.  Below are the 2 pictures of the final crown.  The gums have adapted very well.  The color looks a little bit whiter in the one of the photos, but I believe it is because of the way the light bounces of the porcelain when we take a picture.  The smile photo is very indicative of the true color. Jeff is very happy with the result and given the situation, I think it turned out fantastic!  By the way, those are Jeff's fingers in the photos--We would obviously be wearing gloves.

-Dr. Dan Bruce

Give Kids a Smile, Boise, Idaho

Dr. Dan Bruce - Sunday, February 05, 2012

Friday, February 3rd was the national Give Kids a Smile day.  This is a national program which provides free dental care and education for children that need it.  So far, just under 10,000 dentists and almost 30,000 volunteers participated in the program.  It is estimated that more than 400,000 kids were seen.  Check out the ADA link for the latest information:

This is a great way to kick off National Children's Dental Health Month.  Since childhood caries is preventable, this gives us a chance to educate children and parents and treat many of the dental problems that can keep kids out of school and in pain. 

I am very proud that we had many of our office staff members volunteer to take part in this event at our Ustick location.  We have a great team at our office who collectively cares about the community they live in.  Way to go everyone! recent comments

Dr. Dan Bruce - Wednesday, December 21, 2011

Below are three different comments we received over the last month from recent patients at our Bay Pointe office, which is located on the Boise Bench.

"Incredible! I have not been as rested and have not had the resulting energy after a night's sleep until using the Somnomed!  Not even from my CPAP maching--not even close.  Finally!! Great sleep.  Thanks, Dr. Dan!" - Rodney, who recently switched from a different oral appliance to a Somnomed.

"I could tell a difference immediately.  I now dream every night, multiple times.  I feel more rested and my blood pressure has been reduced" - Melissa, treated by Dr. Dan Bruce with a Somnomed oral appliance. 

...and one of my personal favorites, "my teeth feel so clean I think I can talk faster!" - Dennis, after his periodontal maintenance (cleaning) visit.

Thank you to our wonderful patients for the kind words!