Our Blog

What's in toothpaste and how does it work?

March 21st, 2018

Dr. Steven Kolnes and Dr. Nicola Khoury and our team recommend that you brush your teeth two to three times a day, for at least two minutes each time. But have you ever wondered what’s in toothpaste and how it actually works? The mouth is home to more than 500 types of microorganisms that feed on leftover food that gets stuck on and around your teeth. Toothpaste is the best line of defense against all those pesky microorganisms (especially when you brush two to three times a day). Here’s how it works.


Toothpaste contains mild abrasive additives that combat microorganisms and fight plaque. When you brush, the abrasives in toothpaste dislodge food particles and microorganisms more effectively than if you simply brush your teeth with water. The abrasives also work to remove food stains and polish the surface of the tooth. Some toothpastes include ingredients like triclosan and Xylitol. These chemicals prevent the growth of bacteria that produce plaque. Plaque not only causes cavities, but it can also lead to more dangerous issues like periodontal disease.


Fluoride is key ingredient in toothpaste. As the microorganisms in your mouth feed off the leftover food particles, they leave behind acid and sulfur byproducts that wear away the enamel of the teeth. This is the fancy, technical way of saying that the acid on your teeth causes cavities. As for the sulfur byproduct –well, that’s just a fancy, scientific name for bad breath. Fluoride works to fight the acid and help protect the teeth. By brushing, the fluoride is incorporated into the tooth enamel, which in turn makes the tooth more resistant to acid and plaque.

Flavoring and Sweetening Agents

Not all toothpaste tastes the same, right? The type of flavoring or sweetening agents added to the toothpaste doesn't have anything to do with fighting microorganisms and plaque, but taste is one of the most important selling points in finding a toothpaste brand you like. Flavoring agents mask the taste of some of the other ingredients in toothpaste, and without those agents chances are nobody would be brushing their teeth two to three time a day.

Surprising Ways to Prevent Cavities

March 14th, 2018

There are numerous ways to prevent cavities. Some, like brushing your teeth regularly and visiting our Milpitas, CA office, are more obvious than others. Beyond the standard methods of preventing cavities there are a number of different ways to keep your mouth healthy that you might also find surprising.

1. Reduce your consumption of carbs and sugar.

The consumption of sugar is ultimately the biggest catalyst for cavities. By limiting the sugar you consume both at meals and while snacking you will in turn be preventing cavities. But this goes for all carbs, not just sugar. See, even more complex, lower glycemic, carbs can lead to cavities in your mouth, so the best way to prevent them is to limit your carbohydrate intake. This is not to say that you have to cut out carbs all together, but by reducing your intake, you will prevent cavities and it can also lead to a healthier body overall.

2. Rinse your mouth with food-grade hydrogen peroxide.

For some people this may seem a little odd, but washing your mouth out with a food-grade hydrogen peroxide is an excellent way to prevent cavities. Doing so will kill harmful bacteria that accumulates in your mouth much in the same way applying the anti-septic to a cut does. That said, when you rinse your mouth out similar to how you would use a mouth wash, you want to make sure you don't swallow the hydrogen peroxide, spit it out instead.

3. Use a straw.

If you are someone that drinks a lot of sugary beverages a great way to prevent cavities is to use a straw. This way the sugar in the beverage does not come into contact with your teeth as much as it would if you were to drink straight from a glass, can, cup, or bottle.

4. Chew gum.

Chewing gum is another viable way of preventing cavities. You, of course, will need to chew a sugarless gum flavored with a substitute like Xylitol, and preferably with a cavity fighting ingredient in it.

5. Eat cheese.

Plain and simple cheese has a protein called casein which helps build calcium in your teeth which is vital to the integrity of your mouth and preventing cavities.

Osteoporosis and Oral Health

March 7th, 2018

Today, Dr. Steven Kolnes and Dr. Nicola Khoury and our team at Montague Dental Excellence thought we would examine the relationship between osteoporosis and oral health, since 40 million Americans have osteoporosis or are at high risk. Osteoporosis entails less density in bones, so they become easier to fracture. Research suggests a link between osteoporosis and bone loss in the jaw, which supports and anchors the teeth. Tooth loss affects one third of adults 65 and older.

Bone density and dental concerns

  • Women with osteoporosis are three times more likely to experience tooth loss than those without it.
  • Low bone density results in other dental issues.
  • Osteoporosis is linked to less positive outcomes from oral surgery.

Ill-fitting dentures in post-menopausal women

Studies indicate that women over 50 with osteoporosis need new dentures up to three times more often than women who don’t have the disease. It can be so severe that it becomes impossible to fit dentures correctly, leading to nutritive losses.

Role of dental X-rays in osteoporosis

The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) released research that suggest dental X-rays may be used as a screening tool for osteoporosis. Researchers found that dental X-rays could separate people with osteoporosis from those with normal bone density. As dental professionals, our team at Montague Dental Excellence are in a unique position to screen people and refer them to the appropriate doctor for specialized care.

Effects of osteoporosis medications on oral health

A recent study showed that a rare disease, osteonecrosis, is caused by biophosphenates, a drug taken by people for treatment of osteoporosis. In most cases, the cause was linked to those who take IV biophosphenates for treatment of cancer, but in six percent of cases, the cause was oral biophosphenates. If you are taking a biophosphenate drug, let Dr. Steven Kolnes and Dr. Nicola Khoury know.

Symptoms of osteonecrosis

Some symptoms you may see are pain, swelling, or infection of the gums or jaw. Additionally, injured or recently treated gums may not heal: teeth will be loose, jaws may feel heavy and numb, or there may be exposed bone. Some of the steps you can take for healthy bones are to eat a healthy diet rich in calcium and vitamin D, regular physical exercise with weight-bearing activities, no smoking and limited use of alcohol, and report problems with teeth to our office, such as teeth that are loose, receding gums or detached gums, and dentures that don’t fit properly.

For more information about the connection between osteoporosis and oral health, or to schedule an appointment with Dr. Steven Kolnes and Dr. Nicola Khoury, please give us a call at our convenient Milpitas, CA office!

Why are my gums shrinking?

February 28th, 2018

If you’ve noticed that your teeth have appeared to be longer, you may be suffering from gum recession. This is a common problem among adults, and can result from several factors. If gum recession seems to be happening in your mouth, schedule an appointment at our Milpitas, CA office. We will take a look and figure out the cause, and help you decide on the best treatment.

The first thing Dr. Steven Kolnes and Dr. Nicola Khoury will do is take measurements of the recession to see if the cause could be periodontal disease. Based on how much attached gingiva is present on the gums, a varying amount of gum recession will be present.

The less bone support you have for your teeth, the higher the chance of tooth loss will be. If you have a high likelihood of tooth loss, it’s critical to address the problem right away.

Gum recession can also be caused by stress-related issues that lead to jaw clenching and teeth grinding in the night. This added, ongoing pressure puts extra stress on your teeth, which flexes them at the gum line.

If this happens over a long period, microscopic breaks in your enamel will cause your gum line to move away from your teeth. An occlusal guard may serve as a solution to gum recession caused by teeth grinding. Talk to Dr. Steven Kolnes and Dr. Nicola Khoury about this option if you consistently wake up with jaw pain, headaches, or uncomfortable pressure on the sides of your face.

The way you brush and floss your teeth may also cause gum recession. If you’re an aggressive brusher, make sure to purchase toothbrushes labeled “soft.” It’s best to brush your teeth in a circular motion in order to sweep over all your gum lines and remove the most plaque. Generally, brushing in a straight line can leave spots of plaque that lead to periodontal disease, which is a common cause of gum recession.

There are several options for treatment of gum recession. Depending on the cause, Dr. Steven Kolnes and Dr. Nicola Khoury will talk with you to decide the best treatment plan. Care may involve a deep cleaning or an antibiotic treatment. In serious cases, treatment might involve pocket-depth reduction, a soft tissue draft, or gum regeneration surgery.

These are just a few of the many potential causes of gum recession and how we can treat the problem. Unfortunately, gums do not grow back, and the consequences of ignoring this condition can be painful and time-consuming.

Please call our Milpitas, CA office to schedule an appointment if you’ve noticed any elongating of your teeth or recurring irritation of the gums. We will work as hard as possible to help rid you of your gum recession and prevent it from getting worse in the future.