Modern vs Historical Dental Practices

Did you know barbers were the go-to people for concerns about your teeth? In the past, they not only groomed your face but also extracted and whitened your teeth. It wasn’t until 1840 that the first college Baltimore College of Dental Surgery opened. Today, the United States has over 60 schools and dentistry is considered a specialized practice. Let’s take a look back and see how modern dentistry came to be.

Toothbrushes, Toothpaste, and Floss

  • In ancient times chew sticks were used to help keep the mouth clean, they believed that it would get rid of unwanted particles.
  • The first toothbrush was made in China in 1498, handles were made from animal bones or bamboo, and the bristles came from the back of a pigs neck.
  • In 1824 soap was put into toothpaste and in the 1850s chalk was added.

Nowadays toothbrushes are available in different sizes, shapes, and colors. The handles are plastic and the bristles are made of nylon. Which is a long way from bones and bristles!


In 1873, Colgate produced the first toothpaste in a jar and by the 1890’s toothpaste was packaged in tubes. Imagine dipping your toothbrush into a jar. Now imagine everyone in your house dipping their toothbrush into that same jar. Doesn’t it just make you appreciate the growth in this field?

Source: Colgate

In 1815 silk thread was recommended for cleaning in between teeth and by the 1940’s nylon became the standard.

Source: Oral-B

Modern Dental Techniques

Modernized dentistry has greatly reduced the risk for infections and implants, crowns, and bridges, are now common cosmetic procedures.  Modern crowns are made of composite, porcelain, and metals. They strengthen damaged teeth and can improve your tooth’s overall shape. Bridges are used to fill the tooth gaps and are secured with a neighboring crown on each side.

Dental implants are now the standard of care for missing teeth. These titanium roots are placed into your jawbone and fuse over time. Implants can anchor crowns, bridges, and dentures. They’ve gained popularity as they look and feel natural like your own teeth.



  • Crowns were made of human teeth, gold, ivory, and bone.
  • Bridges were gold and a sign of wealth.

Gold Crown.png



  • Whole tooth implants were from deceased lower class citizens, slaves or animals, and infections were common.
  • Seashells, sculpted bamboo, and copper were also used.
  • Iron pins supported a gold tooth to showcase your riches.

Do you consider using people’s teeth to replace yours as resourceful or gross?

In the 1970’s orthodontists said goodbye to headgear and wiring and hello to stainless steel brackets. To fix your bite hooks are placed in your mouth and you will get a pack of rubber bands, slowly adjusting your jaw position with tension over many months.

Giving thanks to new technology we have another option called Invisalign. Packaged as a set of clear plastic aligners, every two weeks you change the tray. There are slight changes to each aligner and your teeth will slowly adjust into the perfect smile of your dreams. Besides not having metal in your mouth, Invisalign is taken out before every meal and snack. Is remembering to take them on and off too much of a hassle?



  • One of the first forms of teeth straightening had animal intestines as cords and it wrapped around each individual tooth.
  • Gold bands were also used and preferred because they didn’t rust. Silver was also used and wasn’t as expensive.
  • Ivory and wood were also used.

Can you believe that current teeth whitening procedures were accidentally discovered? In the past, peroxide was used to help strengthen patient’s gums but they got whiter teeth. Today teeth whitening can be done in office or with a take-home whitening kit from your dentist.


  • Ancient Romans used human urine because the ammonia is an amazing stain remover.
  • Ancient Egyptians used ground pumice stone and white vinegar to make a whitening paste.
  • Barbers could file your teeth down and spread acid on them to help you have a whiter smile.

Putting someone else’s teeth to replace yours is unheard of today because of our modern resources and technologies. Today dentistry is a specialized practice and after earning a dental degree, dentists are required to annually continue their education. Reflecting back to where dentistry once was, we can remember where this field started and appreciate its success.


George A. Malkemus DDS
2 Padre Pkwy #200, Rohnert Park, CA 94928
Phone | (707) 585-8595


Modern vs Historical Dental Practices

What do you know about TMD?

TMD – Facial Jaw Joint Pain

Temporomandibular Disorder (TMD) is a condition that causes pain in the jaw joint, known as the temporomandibular joint [TMJ], and the muscles that control jaw movement and chewing.  TMD affects an estimated 10 million Americans per year. TMD symptoms can closely resemble the symptoms that cause ear and sinus infections, and some headaches and facial nerve pain. TMD pain can range from slight achy discomfort to severe dysfunction with the inability to open.

Cavaties (4).png

The TMJ is the most complicated joint in the body, working as three joints in one.  The TMJ works as a hinge during opening and closing.  It also slides forward and back as well as sliding from side to side.  The joint is able to do these involved movements by having the condyle, the rounded end of the lower jaw bone (mandible) move under a disc that acts as a shock absorber between the socket of the temporal bone and the condyle.  Ligaments surround the disc, like numerous rubber bands that hold the joint together but allow movement.  When the disc becomes out of alignment or worn out or the ligaments become damaged, TMD can develop. Sometimes the damage can lead to a bone on bone relationship and an arthritic joint.

Symptoms of TMD

The symptoms of TMD will usually involve more than one of the numerous TMJ components: muscles, nerves, tendons, ligaments, bones, connective tissue, and the teeth. Referred pain from TMD is common, particularly headaches and earaches. Due to the proximity of the ear to the TMJ, TMD pain can often be confused with ear pain.

Upon opening and closing, joint sounds and deviations of the jaw are common with TMD. The sounds produced with TMD are usually described as a “click” or a “pop” when a single sound is heard and as “crepitus” when there are multiple, rough, grinding sounds. Pain is the most significant symptom of TMD.

Symptoms associated with TMJ disorders may be:

* Biting or chewing difficulty or discomfort

* Clicking, popping, or grating sound when opening or closing the mouth

* Dull, aching pain in the face

* Earache (particularly in the morning)

* Headache (particularly in the morning)

* Hearing loss

* Migraine (particularly in the morning)

* Jaw pain or tenderness in the jaw

* Reduced ability to open or close the mouth

* Tinnitus

* Neck and shoulder pain

Causes of TMD

There are various causes of TMD including:

– Degenerative joint disease, including arthritis, an inflammation of the joints that can affect the jaw joint.

– Bruxism: grinding or clenching of the teeth putting a strain on the chewing muscles and the jaw joint.

-Trauma:  injury to the face from sports falls or auto accidents causing a displaced disc, dislocated jaw or a fractured jaw.

-Habits that wear or overstretch the TMJ, such as, excessive gum chewing, nail biting or overly large bites of food.

– Genetically abnormal TMJ or jaw structure.

– The constant habit of holding the jaw in an unnatural position, during growth at a young age, particularly holding the jaw in a forward position called jaw thrusting.

– Misaligned bite causing strain on the TMJ, often due to dental neglect with decay or missing teeth.

– Orthodontic tooth alignment that misaligns the TMJ.  This was a problem prior to 25 years ago when TMD was unknown.  Now the joint position is always considered when moving teeth for bite correction.

Treatment for TMD

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Symptoms of TMD seem to have peaks and valleys like riding a roller coaster. Many times the symptoms resolve themselves and go away within a short period of time, a few days, weeks or months after initial treatment. Initial treatment of acute pain includes:

1] High doses of Ibuprofen [2400mg per day] and acetaminophen [3000mg] with lots of water for pain relief and anti-inflammation. Stronger pain relievers can be prescribed if needed.

2] Alternate use of hot and cold packs on the face every 15 minutes.

3] Referral to a physical therapist to use ultrasound, biofeedback and stretching exercises to relax the jaw muscles.

4] Eating soft foods.

5] Fabrication of a bite guard or TMJ repositioning stint, similar to a night guard, use for teeth clenching and grinding.  A bite guard keeps that natural relaxed space between the teeth and takes the strain off the muscles.

6] Stress reduction in lifestyle. Keeping a relaxed lifestyle goes a long way to preventing TMD.

Some patients suffer long-term chronic pain.  Treatment for chronic pain includes use of long-term pain, anti-inflammatory, or muscle relaxant medications along with physical therapy, wearing a TMJ repositioning stint and stress reduction.  Surgical intervention is a last resort treatment; results can be unpredictable.

The most common cause of TMD is muscle pain from bruxism at night, causing facial muscle pain. Treatment with a bite guard used at night is usually successful in about 80% of TMD cases.  It is important to know that when the jaw muscles are in their relaxed state, there should be space between the teeth.  The only time teeth should touch is when chewing. The jaw muscles contract with strong force with closing. Incredible strain can be put on the muscles with grinding and clenching, causing muscle pain and cramping.  A mouth guard keeps space between the teeth, so the muscle stays in their relaxed un-contracted position.

Amazing TMD Cure

Many years ago, I treated a 34-year-old woman who complained of a severe ache in her left jaw joint that radiated pain throughout her entire face when eating.  Upon examination, I could see and feel her left TMJ jet out a ¼ inch when she closed down with a loud popping sound. All of her teeth fit together well and she had never worn braces.  I took a mold of her teeth in her ideal TMJ position, which was vastly different from her existing bite. Our biting position is based on a constant memory of our teeth touching.  Without a constant touching of the teeth, the biting position changes to the hinge of the joint.  When the teeth biting position is different from the ideal joint position, unnatural forces are put on the joint resulting in pain. Looking closely at her ideal joint position, her teeth were totally misaligned.  Her left row of teeth did not touch at all, having a ¼+ inch gap.  I made her a TMJ stint to wear to change her to the ideal jaw position.

After 4 days, all her symptoms went away wearing the stint.  She wore the stint for 2 years till it wore out.  Due to finances, she did not have braces to move the teeth or purchase a new stint.  But she trained her muscles to stay in that position, only chewing on her right side, for her left side was still unable to touch.  Amazingly after 2 more years in that position, all her teeth moved into a healthy bite. Teeth continue to grow out of the gums (erupt) until they are stopped and balanced by the opposing teeth.  Uppers go down and lowers go up till meeting, and the teeth on the left side of her mouth actually erupted until they met, that is, they began to move out of the gums even at 35 years of age!

I surmise that she had a habit she developed very young where she held her jaw to the side and her teeth erupted to fit that position. She is now in her 60s and has never had another problem.

I wish this story was true for everyone, but some people have chronic pain that is never cured.  Luckily treatment is effective for most people.


George A. Malkemus DDS
2 Padre Pkwy #200, Rohnert Park, CA 94928
Phone | (707) 585-8595



What do you know about TMD?

Back to Healthy Living

Tubbs Fire

The shock and reality are still upon us from the fires and will continue for many years.  My mother-in-law Mary lost her house on Fountain Grove Ridge.  She is lucky to be alive, being rescued and escaping only with her purse and her cat Meeko.  She is 88 and lived alone in a large single story house.  When she was 64, she had a massive stroke, which she was lucky to survive, but left her without being able to speak, with swallowing problems and use of only her left hand. Her husband Don came down with Parkinson’s Syndrome, which advanced rapidly and he passed away in January of 2005.

Thanks to Kyle Audiss of Rohnert Park, who was going door to door to help people evacuate in Fountain Grove, Mary was saved.  At 2:30 p.m., a neighbor pointed Kyle to Mary’s house and told him there is an older woman who lives alone there and she might need help.  He rescued and drove her and Meeko 7 miles away, taking over an hour through chaos on Brush Creek road to my sister-in-law Adriene’s house in Bennett Valley at 4 a.m.  They were evacuated an hour and a half later from Bennett Valley and came to my house in Cotati.  Thanks again Kyle – a True Hero.

Mary is now living with my wife Mary Alice and I and she is doing well considering her loss. It is still early but she seems to be adapting well.  I installed stair rails on both sides to allow Mary to navigate our house.  Change is constant, and loss can be devastating, but we must carry on and persevere through difficult times. Most of us are great with change, as long as it was our idea.  But change imposed from the outside is difficult to cope.  But if we can accept that nothing is permanent and change is inevitable and if we can adapt, then we can stay positive and joyful.  I saw ‘Spamalot” at Spreckels Performing Arts Center on Saturday – a wonderful, laughable comic relief.  I highly recommend the show.  The theme song is “Stay on the Sunny-Side of Life”.

Flu Vaccine

So it is time to get back to normal healthy living.  I was lucky to get my yearly flu vaccine Thursday before the fire.  The flu season is from November to April, with most cases occurring between late December and early March.  Getting the shot before the flu season is now in full force and gives the body a chance to build up immunity to the flu virus. It takes about two weeks for protection to develop and about six weeks after getting the flu shot to be fully protected.

If you haven’t had the flu lately, you may have forgotten just how miserable the flu can make you feel. Symptoms come on suddenly and may last several days to several weeks.  Symptoms include fever with chills, sore throat, muscle aches, fatigue, coughing, headache, vomiting, and runny or stuffy nose.  But there is more to fear than fever, fatigue, and nagging aches and pains. From 5% to 20% of the US population gets the flu every year, with 200,000 hospitalized and 36,000 deaths.

The highest rate of flu is found with school-age children, who then spread the disease to the more vulnerable age groups, the elderly and the young.  Death rates from flu complications are highest among those 65 and older.   Hospitalization is equally high among elderly and children under the age of 2.  Children age 2 to 5 have the highest rates for visiting an emergency room or their doctor because of the flu.

Health officials recommend that all adults and children over the age of 6 months, but with few exceptions, should get the flu vaccine.  The emphasis is on stopping the spread of flu among kids, which will then keep them from spreading the disease to the wider population.  The idea is that vaccinating most kids will not only spare them from the aches and pains of the flu, and missed days of school, but will hinder the spread of the illness throughout the rest of society.

A high-dose flu shot is recommended for people 65 and older to provide additional protection using four inactivated flu stains compared to three used in the regular dose.  Also, note that the cost of the high-dose flu shot is totally covered if you have Medicare.

The flu shot is needed every year.  Flu protection wears off yearly since the flu virus is constantly changing. That’s why the vaccine is updated each year to include the most current strains of the virus.  Scientists try to predict each year what the prominent viruses will be and develop the appropriate vaccine.

The flu vaccine reduces the average person’s chances of catching the flu by up to 80% during flu season. Because the vaccine only prevents infection with some of the common yearly viruses that can cause flu-like symptoms, it isn’t a 100% guarantee against getting sick.  However, usually, the flu symptoms will be fewer, short lasting and milder after a flu shot.

Most people do not experience any side effects from the flu shot. Some of those vaccinated may have soreness or swelling at the site of the injection or mild side effects, such as a headache or a low-grade fever.  Although these side effects may last for a day, the flu can make you seriously sick for two to three weeks or even longer.   I haven’t had any side effects from the injection this year or any years previous.

A common myth about the flu shot is that it can actually cause the flu. But the flu vaccine used in the United States is made from killed influenza viruses, which means that it’s impossible to catch the flu by receiving a flu shot.

Other Vaccinations

Many other vaccinations are recommended on a ten-year booster schedule:

* Tetanus, diphtheria, pertussis (whooping cough)

* Measles, mumps, rubella

* Chickenpox

* Pneumococcal

* Hepatitis A

* Hepatitis B

* Meningococcal

The shingle’s vaccination is recommended for individuals over 60 years old.

Bottom line:  One of the best ways to protect your health is with a yearly flu vaccine and keeping up with ten-year booster vaccinations.  I have been getting the flu shot every year for over 25 years and I have rarely been sick, even though I am in close quarters with people every day in the dental office.

Enjoy Life and Keep Smiling!

George A. Malkemus DDS
2 Padre Pkwy #200, Rohnert Park, CA 94928
Phone | (707) 585-8595

Back to Healthy Living

10 Ghoulish Disorders That Will Have You Flying to the Dentist

While most of us love a good horror story, in the world of dentistry, sometimes the truth is more frightening than any Hollywood flick! Curl up and dig in to 10 of the creepiest dental ailments you have ever heard of:

  1. Amelogenesis Imperfecta: Tooth Enamel Disease

10.pngAmelogenesis Imperfecta is a congenital disease. Causing small teeth with very thin tooth enamel, a discolored smile is the tip of the iceberg here. These tiny chompers often suffer from painful sensitivity and lots of breakage. Diagnosed by your dentist, treatments are available for every level of severity.

Source: Genetic and Rare Diseases Information Center

 9. Hyperdontia: Extra Teeth

This rare condition affects a very small percentage of children. Sometimes tied to a genetic disorder, but can also occur for unknown reasons, a child develops extra teeth hidden in their gums. With extraction often the best course of action, left unattended these extra teeth can prevent or delay the eruption of permanent teeth and wreak havoc on the child’s bite. Yes, even those suffering from hyperdontia should still brush and floss twice a day!

Source: Colgate

  1. Papillon-Lefevre Syndrome (PLS): Premature Tooth Loss

8.pngBy the age of five, kids with PLS usually have many loose primary teeth. This can become a severe issue without regular dental care. But what’s the cause? The root of the problem stems from a missing enzyme causing a connective tissue issue. As skin infections are also common with PLS, routine care requires a team of specialists; usually including pediatricians, surgeons, dermatologists, among of course, dentists, periodontist and prosthodontists.

What’s even more frightening is the possibility of losing all permanent teeth… as a teenager! Such is so, as teens often choose to have any remaining teeth removed and wear dentures.

Source: National Organization for Rare Disorders

  1. Talon Cusps: Claw-Like Teeth

7.pngJust as it sounds, these abnormal tooth sprouts look like the shape of an eagle’s talon at the back of a child’s tooth.  If left to fester, potential problems include crowding, gum irritation, bad bite, and of course the accumulation of plaque.

Dare not scrape these off! Talon cusps require common treatment from your dentist, such as grinding down or a root canal.

Source: Journal of the Canadian Dental Association

  1. Geminated Teeth: Mega Tooth

This is as if the tooth root has had twins. This anomaly manifests itself when two teeth develop from a single tooth bud. Turning into an oversized and disfigured tooth, your dentist will be on the lookout for the trouble it’s causing to nearby teeth.

Your dentist will be on the lookout for a bad bite, tooth decay in the area and overcrowding of neighboring teeth. Depending on size, it’s possible the tooth could cause little impact. However, most cases need extraction or other procedures to bring it down to normal size. Beware! These teeth aren’t easily flossed so using anti-bacterial mouthwash is advised.

Source: National Institute of Health

  1. Tonsilloliths: Tonsil Debris

Ever heard of tonsil stones? When this buildup of bacteria and debris gets trapped in and around your tonsils it’s no joke. Especially considering they range in size from a grain of rice to that of a large grape!

What causes this troublesome throat rubble? Chronic tonsillitis and poor dental hygiene are the usual culprits.  While not always visible, if they’re lurking you’ll likely smell it first! Bad breath, sore throat, and trouble swallowing as the most reported symptoms. Tonsils are delicate, and removing the stones requires the expert hand of a true professional.

Source:  Live Scicence

  1. Black Hairy Tongue: Like. It. Sounds…

Harmless as it may be, this fearsome condition will attract unwanted attention. If not from looks, the radiating smell will turn heads… and your stomach with a metallic taste. Caused by the building up of dead skin cells, this creepy accumulation does offer some relief in how it’s treated. Oral hygiene. Brush your tongue or using a tongue scraper daily should clear things up. If it persists, visit your dentist as reoccurrence risk runs high.

Source: WebMD

  1. Salivary Gland Stones: Clogged Salivary Glands

3.pngThink kidney stones in your mouth. They’re painful and can cause neck swelling. As saliva is full of calcium, these startling stones store up in sucking on sour candy to get the saliva juices flowing. Caution! Stones can grow large enough for surgical removal.

Source: National Center for Biotechnology Information

  1. The Disgusting Truth About Your Toothbrush: dun dun dun!

Your toothbrush is a bacteria magnet. The dirty little secret it hides is really more like 10 million bacteria— including E. coli and Staph. Truly a terrifying thought! Here are some empowering tips to keeping your brush as clean as possible:

  • Replace your toothbrush after 3 months. Sooner if the bristles become frayed and always after the flu or a cold.
  • Not all toothpaste is created equal. Look for ones with triclosan or copolymer to help kill mouth bacteria.
  • Rinse the bristles after every use. Soaking in antibacterial mouthwash or hydrogen peroxide also helps.
  • In this case, sharing is not caring. Each brush is factory built for one mouth. Remember, 10 million bacteria…
  • Air dry between uses and don’t let toothbrush heads touch. Remember, 10 million bacteria…
  • Flush with the toilet seat down. We smell molecules of whatever it is giving off the stench. Remember E. coli…

Source: Huffington Post

  1. Hand-Foot-and-Mouth disease: Virus

1.pngImagine having sores in your mouth, on your hands, feet, and even your legs. A very unpleasant condition, hand-foot-and-mouth disease is easily spread through coughing and sneezing. So, halt the spread with frequent hand washing, and while infected, keep the kisses under wraps.

This nasty virus is most common among children under 10 but adults can contract it as well. With symptoms lasting about a week, see a physician if the sore mouth and throat prevent drinking.

Source: Mayo Clinic

Spook ‘Em in Style!

When was your last dental exam? Call today to schedule your next appointment or request online!

George A. Malkemus DDS
2 Padre Pkwy #200, Rohnert Park, CA 94928
Phone | (707) 585-8595

10 Ghoulish Disorders That Will Have You Flying to the Dentist

Taking the Bite Out of Cavities


Cavities. They hurt, they look bad, and they are not fun to fix. What’s the best way to deal with a cavity? Try not to get one in the first place. A cavity doesn’t happen overnight and it’s not caused by a single event. A series of events have to line up to create that painful hole in your tooth. Knowing how cavities start may give you some insight into how to stop them.

STEP ONE: Plaque Build up

CavatiesA multitude of bacteria live in your mouth. The ones that produce the acids (mutans streptococci and lactobacilli) live in the plaque on your teeth. Plaque is a sticky, colorless biofilm, filled with bacteria that can cover your teeth. Enamel, the protective, thin coating around the tooth is extremely hard, actually the second hardest substance in nature behind diamonds.  Dentist use diamond impregnated burs to drill through enamel when treating teeth for cavities.  But acids secreted by bacteria can eat through enamel, a process called demineralization. Once through the outer enamel, decay can advance rapidly through the soft internal parts of a tooth.

Every time you eat or drink you leave a little food behind on your teeth for the bacteria to dine on; they secrete acid, which eats away the enamel-producing a cavity. The bacteria especially like it if you’re eating sugary or starchy foods.  Sticky sugary foods are particularly bad, like candy or raisins. Acidic drinks and food add to the demineralization of enamel.

With the first bite or sip, the clock is ticking. Within minutes, the bacteria convert these sugars and starches to acids. Saliva is designed to neutralize the acids and protect the teeth, but it takes in the neighborhood of twenty minutes to do its job. So, the more often you eat the less time your saliva has to repair the damage. If you have a hamburger at noon, cookies at one, then and a cola at 1:30, you’re not giving your mouth enough time to recover from the acid attack.

Leave plaque alone and it will build up on your teeth.  Bacteria double their populations every 20 minutes forming more and more plague until you brush and floss again.  That is why, it is best to brush after every meal, since bacteria just ‘party on’, using new food debris to grow, secrete acid and make plaque.  Plaque essentially forms a shield that prevents the saliva from rinsing away the acids while holding them directly against the teeth’s surfaces, allowing the acids to seep into your teeth. That’s the beginning of the end.

STEP TWO: Demineralization

The older the plaque is, the more acids it holds in place, and the more demineralization it can inflict. The acid-filled plaque that has now found a comfortable spot on your teeth, if left undisturbed, will begin to dissolve the teeth’s mineral layer, essentially turning it from a solid to a liquid. Over time, that demineralization leads to the formation of a cavity.

Recently, a 17-year-old boy, who had been a patient for many years with no cavities, came in for his 6-month dental examination.  Amazingly, he had gum line black cavities on every tooth.  It turns out he had been working, flipping burgers at a fast-food restaurant for the last 3 months.  Due to the heat while cooking, he had been sipping continual on coke.  The acid and sugar from the coke, constantly bathing his teeth, had cause the decay to occur in a short time.  Many ‘health’ drinks contain high concentrations of sugar and acid as well as soft drinks, so be careful.

Sometimes you can tell the demineralization process has begun. If you see a white or brown spot on your tooth, or you have an area that is sensitive, you probably have demineralized enamel and an early cavity.  Sometimes if caught early enough your body can repair the enamel through a process called remineralization.

STEP THREE: Remineralization

Just like when you break your leg or cut your finger, your body kicks into action to try and heal the damage. When demineralization begins, your body immediately tries to shore up the weakening spot. If you continually add fuel to the fire with constant eating, you create a standoff situation. Your body is trying to repair the damage but your eating is adding more sugars that create more acids that increase the damage that your body is trying to repair. And because the acids work faster than your saliva does, the acids have the unfair advantage.

The most important time to brush and floss is after your last meal before bedtime.  Salvia flow stops during sleep, so bacteria continue to grow with the food debris left on the teeth during the night.  Some people only brush their teeth in the morning.  They wake up with a nasty taste in their mouth in the morning; brush their teeth to remove the bad taste.  Then they have breakfast and start the whole bacteria grow cycle again.  By the time they brush again the next morning, after numerous meals and snacking, there are billions of bacteria forming a thick plaque. This continual process forms an ever-deeper cavity.

STEP FOUR: Reversing the Process

Ironically, one of the things you can do to rebuild the damage done from eating is…eating. But this time, choose foods rich in minerals. Unprocessed, organic spinach and squash high in calcium, tuna, and eggs loaded with iron, bananas and broccoli full of potassium; all of these will add to the mineral supply your body needs to rebuild your teeth’s enamel.

Cavaties (1)Of course, the most important thing is good brushing and flossing techniques done frequently with regular dental checkups and cleanings.

To be your dentist’s star patient, you would only eat three meals a day, with no snacks, and brush and floss after every meal. But that’s unrealistic for most people. What you can do is reduce sugary, acidic foods and drink and rinse your mouth with water after eating – or use any device, such as a toothpick or a brush without toothpaste to remove food debris after eating.

One day, cavities may be a thing of the past. If you combat demineralization now, you will be on the leading edge of dental health and on your way to keeping your healthy smile for a lifetime.


George A. Malkemus DDS
2 Padre Pkwy #200, Rohnert Park, CA 94928
Phone | (707) 585-8595

Taking the Bite Out of Cavities

Tips & Tricks for Teeth Grinders

Bruxism, the medical term for teeth grinding and jaw clenching, affects both kids and adults. While often caused by high levels of stress, bruxism can also be triggered by a misaligned bite and sleep disorders. Regardless of your underlying issue, here are a few tips and tricks to help:

  1. Take Notice –Throughout the day notice if you’re clenching or grinding. Take a few deep breaths and place the tip of your tongue between your teeth. This helps the muscles in your jaw relax.Untitled design (1)
  2. Stop Chewing – On non-food items that is! Pencils, ice, etc. This also includes avoiding gum because it trains your jaw to clench and encourages teeth grinding.
  3. Cut Back – Avoid foods with added sugar, especially for children. Adults may find drinking alcohol intensify their condition. Cutting out liquor and limiting caffeine is recommended.
  4. Relax! – Especially before bedtime. Take a long bath, listen to mellow music, find what works best for you and enjoy it.
  5. See Your Dentist – It’s important to be properly diagnosed. We’ll partner together to find the best treatment plan for your well-being! Call and schedule an exam today (707) 585-8595

George A. Malkemus DDS
2 Padre Pkwy #200, Rohnert Park, CA 94928
Phone | (707) 585-8595

Tips & Tricks for Teeth Grinders

Gum Disease and Improved Treatments

Gum disease is rampant in our society.  More than half of all people over 18 have at least the early stage of gum disease called periodontal disease.  After age 35, three out of four adults are infected.   The major cause of tooth loss is gum disease.   Gum disease affects the entire body being correlated with heart disease, diabetes, strokes, ulcers, and pre-term births. Luckily, there are new advances in periodontal treatment. One of the best is the use of antibiotics put directly in the gums, a product called Arestin.

What is Periodontal Disease?

Periodontal disease is a chronic bacterial infection of the gums that causes damage to the gums, tissue, and bone around your teeth.  Periodontal disease is often painless, and usually develops slowly over many years, but may progress in rapid destructive stages.  The destruction of tissue and bone causes pockets around teeth that can lead to tooth loss.  Being warm and moist, gum pockets are an ideal environment for bacteria. The bacteria can feed on the sides of the pocket, increasing the pocket depth, which adds instability to the teeth. Bacteria form rough deposits, which are an irritation to the gums, causing gum bleeding and swelling.

Improved Treatments

Scaling and Root Planing

Often called a ‘Deep Cleaning’, scaling and root planing (SRP) is the first step in treating gum disease. Scaling removes plaque, tartar, and stains from the surface of the tooth and its root; planing smoothes the rough areas on the roots of teeth to promote healing.  Root Planing sounds like a rough carpenter term but actually is the fine smoothing of root surface using numerous light strokes.  The objective is to make the root surface super smooth by removing all the rough tartar and making it more difficult for the bacteria to adhere to the root surface.  Ultrasonic scalers comfortably speed up the process using ultrasonic vibration and warm water.  Depending on a person’s comfort needs, numbing with topical gel, anesthetic, headphones, nitrous oxide or conscious sedation can be used.

Arestin – Antibiotic Treatment

A recent advancement in periodontal treatment is the use of Arestin, an antibiotic treatment that is put into deep gum pockets during root planing.  Antibiotic treatment has been tried for many years but without an effective method of keeping the antibiotic in the gums until the advent of Arestin.

Arestin contains “Microspheres”, tiny, bead-like particles that are smaller than grains of sand and are not visible to the eye. The Microspheres are filled with the antibiotic minocycline, and they release the drug over time into the infected periodontal pocket, killing the bacteria that cause periodontal disease. Arestin Microspheres continue to fight the infection for up to 21 days.

Arestin is placed inside infected periodontal pockets just after the scaling and root planing (SRP) procedure is finished. Even though SRP removes a great deal of the bacteria that cause periodontal infection, the instruments used during this mechanical procedure can’t always reach the bacteria that hide in the bottom of pockets or in difficult to reach areas. Adding Arestin helps to kill the bacteria left behind, plus the slow release of Arestin allows the gum tissue to heal without the reinvasion of bacteria.

Amazing Results with Arestin

Since using Arestin for the past 3 years, I have seen amazing improvements in gum health. In the past teeth that were very loose with extremely deep gum pockets would be considered not savable and need an extraction. With the use of Arestin, many of these teeth have tightened up with major gum pocket reduction.  Two years ago, a 45-year-old woman had a loose first molar with a 12 mm pocket; extreme bone loss and I recommended extraction.  She wanted to try and save the tooth so I said we could try Arestin with scaling and root planning.  Amazingly the tooth tightened up.  She works hard on her dental hygiene and continues to have cleanings every three months. During those appoints, Arestin is added as needed. The tooth is still going strong today.

Avoiding Surgery

Arestin has helped avoid the need for gum surgery.  Surgery is very affective treatment, but is much more invasive and costly.  Plus with Arestin, the gum pocket can be retreated much easier. The most important aspect of periodontal treatment is the regular on-going maintenance visit, usually every 3 months.  It always bothers me when patients would have gum surgery, their gums would look great afterwards, and they would have regular cleaning appointments for awhile, doing great and then disappear for a few years, return and need surgery again.  Scaling and root planning with Arestin can often prevent that need. Often a periodontal pocket can be controlled with the retreatment of SRP and Arestin.

Periodontal Disease is often called ‘The Silent Killer’, because it can occur gradually and painlessly over time.  The good news is that gum disease can be stopped with professional treatment, such as SRP and Arestin.   So, please don’t wait until it hurts!  Have regular dental exams and cleanings.

Enjoy Life and Keep Smiling!

George Malkemus has had a Family and Cosmetic Dental Practice in Rohnert Park for over 22 years at 2 Padre Parkway, Suite 200. Call 585-8595, or email info@  Visit Dr. Malkemus’ Web site at

George A. Malkemus DDS
2 Padre Pkwy #200, Rohnert Park, CA 94928
Phone | (707) 585-8595

Gum Disease and Improved Treatments