Dental Health for Young Adults
Ep. 25 : Total Health Dentistry with Dr. Ali
- Featured in publications such as Alive Magazine, The Globe and Mail, and The Toronto Star
- Sought by hundreds of Naturopathic Doctors across Ontario
- Planning guest lectures on his approach to Total Health Dentistry along with world-renowned Dr. Thomas Rau MD.
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This is the age group where looks really matter and a healthy smile is a massive asset. In this podcast rerelease you will discover what makes a great smile, DIY tooth whitening plus, what to watch out for – the early alarm bells of how dental health can affect the overall health for young adults.
In the first of its kind dentists-to-patient podcast, you’ll gain incredibly valuable insight into the mouth-body connection. You won’t hear any fluffy filler here. You’ll actually be able to connect the dots. Join us for a worthy jolt of insight on the Total Health Dentistry podcast with Dr. Ali.
Hey, everyone, it’s Dr. Ali. In this episode, you’ll gain a worthy jolt of insight about Total Health Dentistry for young adulthood. In the last episode, we focused on Total Health Dentistry for ages seven to 19. If you’ve missed the opening five-part series, which laid out the framework for what constitutes Total Health Dentistry, make sure you go back and check out the first five episodes, as it will give this episode and future ones greater context.
In the last episode, we discussed airway-focused braces, a very, very critical topic. We also looked at teeth whitening, and we cleared up some common controversies with wisdom teeth. In this episode, which is part of a 10-part series, we will discuss, “Hey, how’s my smile,” and early alarm bells? All right, the early adulthood years. Matt, this is your episode, my man.
Matt: I’m excited. Let’s do it.
All right. In general, this is a period of relatively few dental appointments and needs. Hopefully, if your teeth alignment and bite wasn’t great growing up, it was addressed. Hopefully, if you didn’t have room for your wisdom teeth and they were removed. However, even if you had braces and your teeth are straight, one of two things may be happening. First of all, even though the bite looks good, it might not feel right. That’s possible.
Secondly, our teeth may be shifting and starting to go back to crowded. My goal for my patients in this age group is to actually lay off of them and do only really what’s necessary, since it’s probably the most unsettled stage of life. Between leisure and work, they’re never home for the most part. Also, usually budget is tight, so I try to just do the minimum to keep a healthy mouth. However, if I see early warning signs, then I don’t take it lightly. I will intercept, and more on that in a bit.
“Hey, how’s my smile?” All right, let’s face it. This is the age group where looks really, really matter. I’ve had many 60-year-old men tell me they’re okay with the missing tooth that shows when they smile, but I’ve never had a 21-year-old man or woman say to me, “Yeah, just leave that gap in my smile. It’s fine.” That’s never happened. While a bright, vibrant, healthy smile is a massive asset at any age, it’s really a big priority for most in this age group. However, however you want to word it, however you want to package it, politically incorrect or corrected, in this age group, humans are looking for companionship, with an urge stronger than in any other age group. For many, this begins with a vibrant smile.
In future episodes, we will look at the anatomy of a great smile in greater detail. What makes a great smile? We will also look at my personal favourite smile pattern, what I call the Weston Price smile and bite. Make sure you tune in to those in future episodes.
For now, let’s discuss a bit, since it’s so very relevant in this age category, let’s discuss the smiles a bit. Basically a smile comes down to a few key factors. Proportions. Okay? Nothing is as important as proportions. Now, I know what you’re thinking. You’re probably thinking, what? Colour, right? Shade.
The most important thing. It’s not.
It’s the least important thing. Proportions is incredibly important. Facial profile, okay, that’s the second really important thing. Finally, it’s the teeth shade and the alignment.
Let’s talk about proportions. Picture a person walking down the street, and they have great proportions. Let’s say they’re an Olympic swimmer. Let’s say they’re wearing an old set of jogging pants, maybe it’s ripped, old sneakers, et cetera. Would they look unattractive? No. They would look like a pro athlete who’s just happened to be dressed down on a day off or something. Their proportions would override the cover that they’re putting on and the colour. They could be poorly colour-ly matched. They could be wearing whatever it is.
Now, let’s say we take a cartoon-like character, and we give them a huge head and narrow shoulders and narrow hips, and we put designer clothes on them. Does that person look attractive? Well, no, because it doesn’t matter what they do to cover the disproportionance that they have. The proportions dominate. Is that clear? Does that analogy work?
Matt: Yeah, absolutely. Yeah.
It’s proportions. In our smile, the proportions of our gum and smile line, in relationship to our face, our jaw, neck, all play a key role in establishing what are called golden proportions. You can Google golden proportions for more info.
Well, how do you know if your smile is in golden proportions? Well, if you’ve whitened your teeth, and if there is nothing obvious that is crooked or black, but your smile still just doesn’t look as pleasing as you think it should, that’s a hint. There’s probably some disproportion there. Proportions is the first thing I look at when my patient wants to do something to enhance their smile. We always think, “Oh, it’s the whiteness or the yellowness of the teeth,” but that’s why you’re a Total Health Dentistry listener, Matt. You get the straight goods on all of these things dental.
Okay? The second aspect of how a smile is, is the facial profile. Here is another lesser-known factor that really can influence our smile, is the facial profile. When we look at someone from the side profile, a person has either a convex profile, meaning their nose and upper jaw are more forward than their lower jaw. This is actually the most common profile. They can have a concave profile. It’s where their lower jaw protrudes past the upper jaw, and then there’s a straight profile, is where the nose and the upper jaw and the lower jaw and the chin, they’re basically almost all in a straight line. Okay, so those are three types of profiles.
Now, beauty is indeed in the eye of the beholder, and so if you’re loving your profile, then that’s a beautiful thing. My role is to help someone who may be concerned about their profile and just doesn’t know why exactly they’re not happy with their profile, why they’re concerned, and those who also don’t know what their options might be. They might know their profile is the issue, but they have no idea how to fix it or address it.
Matt: Or even if they can, right?
Or if it can be, exactly. As I’m talking about this, I’m reminded of just how little we talk about facial profile in dentistry, and certainly proportions. Yet, they’re actually huge topics when it comes to vibrant and natural smiles. That’s what you get as a listener of the Total Health Dentistry podcast. No fluffy stuff, just a straight good. I just got reinvigorated as I was thinking about this content and sharing it with everyone.
To change one’s facial profile, surgery is always an option. Do jaw surgery, nose surgery, chin surgery, et cetera, but you probably already knew about those. What you may not know about is that, we can change a person’s profile with braces, and in particular, airway-focused braces. Have you heard me talk about airway on this podcast before, Matt?
Matt: A couple of times, I guess. It’s important.
All right. You see, when an individual has good airway nutrition and structure, nature already knows how to create those golden proportions. Think about how beautiful that is. When those three things are in balance, airway, nutrition and structure, nature already has got it figured out. The chances are, let’s put it this way, if your airway and nutrition and structure are really good, there’s almost no chance that your proportions are off. It’s automatically baked in. You’re going to have great proportions almost certainly. I can look at a person’s face, and within five seconds, I can tell if they were nursed, if they had allergies growing up-
How their general digestion status is, broadly I can tell what they’re eating, what their basic nutritional sensitivities are, how their airway is. Never mind when I look in their mouth. I mean, that’s a whole other wealth of info I can gather, which I’ll cover in a future episode called Dental CSI. Stay tuned for that.
That’ll be fun.
By addressing a person’s airway with Total Health Industry and airway-focused braces, we can positively affect their facial profile. When I have my patient in the chair, I can give them specifics, but for now I can say that, in general, we want to move everything forward within reason to optimize the airway. That’s how we alter the profile and improve the airway.
The most common and most dramatic and easiest nonsurgical facial profile enhancement we can make is to use braces, and move the lower jaw forward. Okay? Move the lower jaw forward. If it is too far back, like in a very, very convex profile, that’s what we would do. There are some exciting new advances in orthodontics that we just didn’t have even a couple of years ago. Ask your dentist, your orthodontist, for his or her best recommendations. Of course, we are doing that routinely for many of our patients as part of Total Health Dentistry, in my practice, in this young adult age group, or even younger or even older. We’re doing airway for all ages.
Now the next episode, we will be in, a little bit, the middle age, middle-life age group. I’ll have some actually more exciting Total Health Dentistry options to enhance facial profile without surgery.
Last, the third aspect of how a smile looks is the shade. Okay? That’s what everybody always thinks about. Finally, we get to the shade and the alignment of the teeth, is last. Why do I talk about it last? Because it’s the one that people think about first. I decided to do this podcast and put in all the time and effort, because I simply knew that these conversations weren’t really happening, or happening very often. I knew all the talk about smiles was about white versus yellow, straight versus crooked. Yet, there’s so much more.
All right, so finally, shade and alignment. They’re certainly important factors in the smile. We’ve discussed teeth whitening in previous episodes, dentist-made or over-the-counter and DIY options. Please go back and listen to those previous episodes if you missed them. For the dentist-made whitening or over-the-counter whitening, I recommend 10% carbamide peroxide. For the do-it-yourself crowd. I love activated charcoal, various forms. Those are the ways you can whiten the shade.
Matt: What about for people with either crowns or caps, Ali?
Great question. That’s a great question. White crowns, okay, do not change shades.
They do not.
Matt: They can’t whiten their teeth.
It’s not natural teeth. They can whiten their own natural teeth, and then if those crowns don’t match that new shade that they want, yes, that’s the only choice we have, to replace those crowns to match the new whiter shade.
Or, let’s say you got a crown that was a lighter shade than the rest of your own natural teeth. Okay, then you can try to whiten your own natural teeth to match the new whiter shade of crown.
Matt: Would it be a good idea for someone who has a crown or a cap to come into the dentist first, just to kind of discuss it?
Dr. Ali: Absolutely.
Matt: Like, just don’t DIY it or anything like that?
Correct. Correct. I’ll just mention this. Tooth whitening is very safe and effective, but you have to make sure you don’t have cavities. You have to make sure you don’t have gum disease. If you have cavities, and you start doing DIY whitening with any form of peroxide, you’re going to worsen your cavity, 100%, so you have to make sure you don’t have cavities before you start whitening teeth.
Matt: What about charcoal with cavities and things like that? Is that a little bit more safer?
It is a little bit safer. Charcoal is not going to make your cavity worse. It’s not going to fix the cavity, of course, but it’s not going to make you worse.
Dr. Ali: Yes.
Matt: Right on.
All right. That was for shade. Of course, alignment issues, right, is another. If you’ve got some crowding or spaces in between your teeth, then certainly braces would work. There are many invisible type of braces many people know about now, or there are even ceramic brackets, there are white wires. We have almost invisible braces as well. Really today, we have some gorgeous options that we didn’t have for braces just a couple of years ago. For adults, or anybody who is worried about the look of braces, we have some really, really great options today available in dentistry.
Now, of course, don’t forget the airway. Please don’t straighten your teeth at the cost of closing or narrowing your arch and restricting your airway or tongue. Okay? Please be wary of that.
Okay. Then, so aside from the smile, we talked about the proportions, the facial profile, the colour, the alignment. The other thing I look for in this age category are early alarm bells. I look for early warning signs of something that is starting to go off the rails, but because the patient in this age is still just in their young adulthood, the damage is still not super evident. It will be in one to two decades, but I’m looking for early warning signs right now. If needed, we can get the train back on the rails.
I’d like to share a story with you, Matt. It’s of a female patient who had braces at around age 20 by an orthodontist in Montreal, a very reputable orthodontist. After the braces, the teeth looked great, and she was given a retainer as per the usual protocol. She wore her retainer faithfully.
I started to treat this patient in her mid-20s, so about five to six years after the braces were finished. She was actually starting to break down her molars a little too much, actually, for someone having straight teeth. She came to see me with some chipped and broken teeth. I did what I knew, and I used harder materials to fill the teeth so they didn’t break. I used gold or porcelain fillings. Then a couple of years later, all of the gold and the porcelain didn’t break. The chewing surfaces of the teeth didn’t break. The sides of the teeth, right at the gumline, began to chip away. There were little divots forming in the enamel. After stopping the breaking on the chewing surfaces of the teeth, the breaking didn’t stop. It just went to the side of the teeth.
Right? In Total Health Dentistry, when I see this, I know there is an underlying cause somewhere, and I’ve got to find it, or else my patient is going to lose a tooth. That’s very, very predictable. I concluded that she was just grinding and clenching her teeth. Actually, there’s an important difference between grinding and clenching, which will be covered in a future episode.
What did I do? I made my patient a night guard, and I was happy with that intervention and so was she. It seemed to be working, except that every few years she would complain of a very sensitive tooth here or there. I was seeing some more chipping on the sides of the teeth, and in general, her teeth were getting shorter.
Now, she’s about 35 in the storyline. It is about 15 years now after braces. If I was looking for early alarm bells, they were present. These are all the alarm bells that I was looking for. She was wearing a nightguard, she was breaking her teeth still, the sides of her teeth were chipping. Almost all her back teeth had these small chips at the gum line. The chewing surfaces of her molars didn’t have any points on them anymore. She had worn the tops-
Off of the teeth. I knew for a fact that she was wearing her nightguard every night. I knew this for a fact because this lovely young lady was my wife. Her diet was great, her oral hygiene was meticulous, so what was it? What was causing all this destruction? She was wearing her retainer, wearing a nightguard, she was doing everything she’s supposed to be doing.
I want to introduce a concept that isn’t actually a term that exists in dentistry. We have terms for various aspects of what I’m about to describe, but essentially, this is my own term and you can’t find it on Google and your dentist won’t be able to reference it, but I call it comfortable bite treatment. Comfortable bite treatment.
We all have or had a good and comfortable bite at some point, hopefully. For some of us, that is one exact precise bite, meaning, where the teeth meet, and anything other than that would be extremely uncomfortable. For some other people, it can be a huge range of bites, and most of those different bites are very, very comfortable. Here’s the kicker. Looks can be very, very deceiving. I meant this to be a short episode, so if you’re still listening, you or someone you know has experienced something like this.
Anyway, looks can be very deceiving. My wife’s teeth were straight, the bite looked good. It was textbook orthodontics, but it wasn’t comfortable for her. Her bite was like a trap for her, locking her teeth in and restricting her airway.
In episode three, we discussed the airway in a big way, and I gave the example of Harry Houdini and this Chinese water torture cell. What would he do to get oxygen? The answer is, anything. We are learning more and more about this in dentistry, but early research is showing just how important airway is. It may have a role to play in the destructive things we do to our teeth, either during apnea or during low oxygen.
Long story short, because she had worn off the tops of her molars, I had to find a new comfortable bite for her again and restore the lost enamel with porcelain. Except this time, I addressed the underlying cause. I gave her a bite that gave her great airway and was very comfortable to her muscles and our joints. I completed this comfortable bite treatment in August of 2016, and it’s now August of 2019, so three years later, she’s very comfortable. There’s no chipping of the enamel along the gumline, no breaking or even wearing of the porcelain.
I remember before we got her into a comfortable bite, she wore off the enamel tops of the teeth. Enamel is God’s best-made material for teeth, and she destroyed it. I replaced it with porcelain, which is not nearly as good as enamel, and no chipping and no even wear to speak up, so I know for sure she is in her comfortable bite. This whole comfortable bite treatment can be achieved with porcelain buildups, with braces, with dentures, lots of different ways. The key is to respect the airway and find that comfortable bite.
Now, just a few other questions you may be asking yourself to see if you have any early warning signs. Here’s some questions. Maybe, Matt, I can ask you. Is it comfortable to bite your back teeth together?
Excellent. Is it more comfortable to make your front teeth touch instead?
Good. Do you have chips on the sides of your enamel by your gumline?
Matt: I don’t think so.
You would almost know it, because sometimes you can run your fingernail along the gum line and you can feel a little divot.
That’s wonderful. If you’re answering no to those questions, chances are, you are in your comfortable bite, but if you said yes to those questions, yeah, you might not be. Now, another question, are you starting to wear the tops off of the molars, despite having straight teeth? That’s another question. If so, then you might not be in your comfortable bite. As you enter the next stage of life, this may take its toll on your teeth, gums and jaw joint. Okay? These are the early warning signs that I’m looking for at this age group.
In this episode, we learned about, what are the key Total Health Dentistry issues for young adults? We discussed how, in this age group, smile and dental cosmetics are so important when the need for companionship is so important. We explored how important proportion and facial profile are, followed by shade and alignment, which is what everybody thinks about first. Then, we ended with looking for early alarm bells, things like having an uncomfortable bite or damage to the structure of your teeth, gums, despite having straight teeth. Thanks for joining us.
Please note that Dr. Ali Farahani is a general dentist and that Total Health Dentistry is not a specialty of dentistry. While we make every effort to broadcast correct information, dentistry is a constantly changing science and art. One doctor may have a different way of doing things from another. Dr. Ali Farahani is simply presenting his views and opinions that will be as evidenced-based as possible. We welcome any comments, suggestions, or corrections of error.
Dr. Ali Farahani takes no money from drug or device companies. By listening to this podcast or reading this blog you agree not to use this podcast or blog as medical advice to treat any medical condition in either yourself or others, including, but not limited to patients that you are treating. Consult your own physician for any medical issues that you may be having. This entire disclaimer also applies to any guests or contributors to the podcast or blog. Under no circumstances shall Sante Family Dental, Dr. A. Farahani Dentistry Professional Corporation or Dr. Ali Farahani, or any of their employees, associates, or affiliates, any of the guests or contributors to the podcast or blog, be responsible for damages arising from use of this podcast or blog.
Ages 7 to 19
Mid-life part 1