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One of the most common clues that you might have anemia is found in your smile. If you’ve noticed that your gums are suddenly paler than they used to be, it could be a sign that you’re anemic. What does this mean for your general health—and your oral health?

There are several types of anemia, which have can be caused by different medical conditions and which can cause different symptoms. The most common form of anemia, and one of the most easily treated, is iron-deficiency anemia.

Iron is essential to our health. Why? It’s all about the red blood cells. First, some biology.

Every cell in your body needs energy to live and to function. Cells get this energy from the foods we eat, which are broken down into a simple sugar called glucose. Glucose molecules are transported by our blood cells to reach all parts of the body. But that’s only the first step.

Energy is released into the cells when the chemical bonds holding glucose molecules together are broken. And this requires oxygen. Once inside our cells, glucose and oxygen react, breaking the chemical bonds of the glucose molecules, reconfiguring their atoms to create carbon dioxide and water byproducts—and releasing energy into a form your cells can use.

So, how do we move this oxygen from our lungs to our cells to start the process? That would be our red blood cells again. But this process can’t happen without adequate iron. More biology!

Red blood cells contain a protein called hemoglobin, and hemoglobin contains iron. In fact, well over half of the iron in our body is found in our red bloods cells. And here’s the key to iron’s importance: iron attracts oxygen molecules.

Hemoglobin picks up oxygen in our lungs and delivers it throughout the body, where it becomes glucose’s essential partner in fueling our cells. Without enough iron, your body won’t be able to create the red blood cells it needs so that all of your cells, tissues, and organs can get the oxygen they need to function efficiently.

When might you suspect that you’re anemic? Your gums, the lining of the mouth, the inside of your lower eyelids, and your skin can take on a paler hue—the classic sign of anemia. But other symptoms which you might not necessarily associate with anemia are also common, including:

• Fatigue
• Heart palpitations
• Cold hands and feet
• Dizziness
• Irritability
• Difficulty Concentrating
• Pica (the desire to eat non-food items)

And because anemia affects the whole body, your oral health isn’t immune. It’s not just a matter of pale gums. Iron deficiencies can cause:

• Sores and ulcers in the mouth
• Cracks on the sides of the mouth
• Pain, redness, and/or swelling of the tongue
• Loss of papillae (those little bumps on your tongue which hold your taste buds)
• Tooth damage caused by pica
• Dry mouth, which increases your risk for cavities, gum disease, oral infections, and bad breath

Iron-deficiency anemia can have several causes, among them insufficient iron in the diet, medical conditions which cause bleeding (such as ulcers), heavy menstruation, pregnancy, or growth spurts in children and teenagers. Treatment will depend on the cause of your anemia. It might be as simple as a change in diet or an iron supplement, or it might require further treatment options. Do consult with Drs. Emily Ruthven and Daniel Cepeda before taking iron supplements, as too much iron causes iron toxicity, which can be very dangerous.

If Drs. Emily Ruthven and Daniel Cepeda and our team suggest that you might be anemic, or if you notice changes you think might be caused by anemia, see your physician for a simple blood test. Besides iron-deficiency anemia, there are other forms of anemia and other diseases which can mimic these symptoms, so it’s important to get a doctor’s diagnosis. If you have been diagnosed with anemia, let our North Appleton dental team know.

One last “if”: If you do have iron-deficiency anemia, don’t delay treatment. The sooner your red bloods cells are back at their peak, the sooner you—and your gums—will be back in the pink!

If you have been bringing your baby in for regular checkups since that first tooth arrived, you might expect that he or she is already familiar with Drs. Emily Ruthven and Daniel Cepeda and our staff. Often, though, months pass between visits, which is a very long time for a child. How can you make your preschooler’s return visit a happy one? We have some suggestions!

Before Your Visit

• Prepare your child for her visit. Simple explanations are best for a young child. You might tell your daughter that a dentist is a doctor who helps keep her teeth strong and healthy. Let her know a bit about what will happen. Being told, “You will sit in a special chair,” or, “Can you open wide so we can count your teeth?” will give her some idea of what it’s like to visit our office.
• There are many entertaining books for young children about visiting the dentist. Reading some of these to her for a few days before the appointment will let her know what to expect.
• Use playtime to prepare. You might count your daughter’s teeth or let her “play dentist” and brush the teeth of her favorite doll or stuffed animal.

When You Arrive

• Your attitude can be contagious! If you treat a visit to the dentist like any other outing, chances are your child will too. Your calm presence is exactly what your child needs.
• You might want to come a bit early to let your son explore the office. Bring a favorite toy or book to keep him entertained if you need to. A favorite stuffed toy can be a comfort in an unfamiliar place.
• If you are with your child during his checkup, follow our lead. Don’t be concerned if your child seems uncooperative at first or even throws a tantrum—we are used to working with children, and have techniques to make his experience as relaxed and as positive as we possibly can.

We Are Here to Help

We are your partners in your child’s dental care. Call our North Appleton office anytime for suggestions about making your child’s visit a comfortable, comforting experience. Our goal is to start your child confidently on the road to a lifetime of empowering dental visits and lasting dental health.

Happily for all of us who like to celebrate with friends and family, there’s no need to be Irish to enjoy St. Patrick’s Day. Every March 17^th, many of us take the opportunity to display a bit of Gaelic spirit.

• Green Clothing (it’s tradition!)
• Green Hat (for a jaunty look)
• Green Shamrock (always the perfect accessory)
• Green Hair (for the adventurous among us)
• Green Grins?

Here’s where we draw the line. Emerald Isle? Delightful! Emerald smile? Not so beguiling.

That traditional St. Patrick’s party fare—green-frosted sweet treats and green-colored pastries and green-foamed beers—is full of green-tinted food dyes, which can leave us with teeth in subtle shamrock shades. Luckily, most of us will have only a very temporary tinge to remind us of our dietary shenanigans, and there are simple ways to rid yourself of the green sheen:

• Indulge sparingly in colorful cuisine, and drink water afterwards to rinse away green-dyed foods and beverages.
• Use a straw for green drinks.
• Brush your teeth. (Not only will you brush away the green, but you’ll brush away the sugars from sweet green desserts and the acids from sour green brews.)
• Try a whitening toothpaste.

One special note: if you’ve just whitened your smile, best to eliminate strong food dyes from your diet for a few days. Teeth are more sensitive to staining after whitening, because the whitening process temporarily makes them more porous. Give yourself a few days, and your enamel will be back to (stain)fighting strength.

So, celebrate on the 17^th and feel secure that on the 18^th, your smile won’t be “wearing the green” any longer. But if you find that you’re not happy with the appearance of your smile anytime during the year, if you have more permanent staining caused by natural darkening over time, or workdays fueled by black coffee, or a diet filled with tomato sauce, dark berries, red wine, and other tasty (but discoloring) food, you’re still in luck.

Ask Drs. Emily Ruthven and Daniel Cepeda about professional whitening procedures at our North Appleton office for a brighter, more confident smile. And with a bright, confident smile, every day’s a reason to celebrate!

Gum recession, a common result of gum disease, occurs when the gum tissue that surrounds the teeth wears away or pulls back, forming pockets between the gumline and exposing more of the tooth. Gum recession occurs gradually, so you might not know that you have it. Left untreated, gum recession can result in tooth loss. In addition, there are several studies that suggest that gum disease is associated with modest increases in coronary heart disease. Here are five ways to know if your gums are receding.

1. Healthy gums are firm, light pink, and very elastic. If your gums don’t fit that description, then it’s time to visit our North Appleton office. Red, swollen gums are a common symptom of gum disease, and may lead to gum recession.

2. Do your gums bleed easily when you brush or floss? If you have gum recession, even if you brush gently and with toothpaste specifically designed for sensitivity, it may still result in bleeding.

3. When you look in the mirror, do you see more of a tooth than you used to? This is one of the easiest ways to tell if you have gum recession. When gums recede, more of the tooth is visibly exposed. Look for lines or notches along the bottom of the teeth, as this typically indicates areas where the gums have receded.

4. One of the first signs of gum recession is tooth sensitivity. Does it hurt when you bite down or chew? The more gums recede, the more painful it is going to be. However, before you experience tooth sensitivity or pain, you may notice awkwardness when you bit down. When gum recession occurs, teeth can shift slightly, making it feel as if they are not properly aligned.

5. Loose teeth are a symptom of advanced gum recession and periodontal disease. In other words, the supporting bone structure of the teeth has already begun to deteriorate. If left untreated, it will result in tooth loss.

From deep cleaning (scaling) to gingival tissue grafting surgery, there are several ways to combat gum recession and periodontal disease. How gum recession is treated depends on how far advanced it is. Talk to Drs. Emily Ruthven and Daniel Cepeda about what options are best for you.