Bite Problems

One of the issues we see in our practice is abnormally worn teeth. Sometimes patients are aware of this problem, and sometimes the change has taken place over such a long period of time that they aren’t aware of the issue until it’s brought to their attention. The normal amount of wear on teeth (according to occlusion experts/bite related experts) is 1mm over the course of 100 years. When you’re losing tooth structure faster than that, that’s pathologic (meaning that you have a high potential of having occlusal disease). Also, there shouldn’t be chronic pain in the muscles around the jaw.

Bite-related issues can be one of the most challenging things we deal with in our practice. We sometimes see patients who come in where they have worn their teeth down to half, or come in with teeth where the tongue-side are hollowed out and the teeth are now extremely thin. When patients wait several years to be seen, this allows several years worth of damage to have the time to add up. This can lead to a need for fairly extensive reconstructive dentistry. These are some of the more complicated items that our practice helps patients with.

● Do your jaw muscles get sore or tired from chewing hard (protein bars) or chewy (gum) foods?
● Are your teeth wearing down or are your front teeth getting shorter/thinner?
● Are the front teeth feeling like they hit more prominently when you bite?
● Do you feel like you have to squeeze to get your back teeth to touch?
● Do you have to search for your bite
○ When you close your lower jaw to your upper teeth, do you know where they will meet? – Is it different each time?
○ Is it even on both sides
○ Do you have to search for your bite?
○ Do you have more than one bite?
● Are your teeth loose or wiggly?
● Do you have a nervous habit of biting items that shouldn’t be bitten? your nails? Pens or pencils? Ice?
● Do you grind your teeth at night?

If you feel that you relate to any of the above, feel free to call us at 360-734-6620 as we are accepting new patients, and would be happy to schedule an appointment with you.

Cavities: Myths and Hopes

The Caries Infection

Cavities are holes or soft spots that form in teeth as a result of the caries disease. Caries is an infection with the type of bacteria that can cause these holes in teeth. An infection is 1) an abnormal amount of bacteria, 2) bacteria that are living in an abnormal place, or 3) both. The caries disease is an abnormal amount of the type of mouth bacteria that like to make and live in acid. It is located in the thin biofilm on your teeth. Most types of bacteria living in the mouth are not acid loving and do not contribute to making cavities.

Contracting caries most often results from a variety of things happening simultaneously. First, you need to get the kind of germs that cause cavities (cariogenic) introduced into your mouth. They are often transmitted through common interactions like kissing and the sharing of foods and utensils. Then, conditions have to be right for those bacteria to settle and replace some of the non-cavity causing bacteria living in the biofilm on your teeth. Those conditions are made more favorable for the caries-type bacteria by having a diet that is high in the frequency of acidic foods. Also, a diet that frequently consists of sugar-containing foods allows the biofilm bacteria to make acid for about 30 minutes after each and every sugar exposure. These things create a favorable environment that allows the caries bacteria to multiply to a harmful level and become the infection.

Acquiring Cavities

Acquiring cavities, or holes in teeth, from this infection depends on several things. The first is saliva. Saliva protects teeth by washing away and diluting the acids, while simultaneously buffering teeth from the damage acids cause. People with dry-mouth problems caused by diseases or medications are especially prone to getting cavities, as they lack this protection. The next factor is the hardness of the tooth structure itself. Genetics play a role in this. Harder teeth are more resistant to acid attack. Tooth hardness can be changed with fluoride; it makes teeth harder, so acids can’t as easily dissolve them and make holes in them. Diet is a huge component! Sugar and acid attack the tooth structure every time they are in the mouth. The caries bacteria will make acid for about 30 minutes after each exposure to any sugar. Acid softens the teeth and eventually creates the hole or cavity. Lastly, having a lot of bacteria or a heavy amount of plaque on your teeth allows a greater number of bacteria to make more acid. When the layer of caries bacteria becomes very thick, more acid is produced. Getting cavities depends not only on having an abnormal amount of cariogenic bacteria but also on lower resistance to the bacteria’s harmful effects in the above categories. Some of these factors can be controlled by the patient, and some (like inherited tooth hardness) cannot.

Myths about cavities:

Myth #1

Brushing and flossing prevent cavities.

Brushing and flossing help minimize excess amounts of bacteria, but cavity-causing types of biofilm bacteria that live right against the tooth still remain after brushing and flossing in enough numbers to cause cavities.

Myth #2

Rinsing or brushing after eating sugar will prevent cavities.

The biofilm cavity-causing bacteria make acid for about 30 minutes after each sugar exposure. Rinsing and brushing don’t shorten this event.

Myth #3

Fluoride prevents cavities.

The tooth structure can be made more resistant to acid dissolution, but tooth enamel can’t be turned into to armor — the tooth can still dissolve with enough acid attacks.

Myth #4

Removing the decay from your teeth and placing dental restorations get rid of caries.

Removing the decay and placing dental restorations will fix the hole (the cavity), but it does not address the abnormally high level of acid-producing bacteria in the biofilm on all of the teeth. The caries infection in the biofilm remains. This is why patients often get cavities even after having dental work done.

Cavity-Prevention Tips

Though none of the tips below provide a cure for dental caries, when practiced together they make preventing the disease a real possibility.

  • Minimize the frequency of sugar and acid-containing foods in your diet.
  • Brush and floss to prevent excess bacteria from making extra acid on your teeth.
  • Rinse with a base-containing mouthwash (Cari-Free® treatment rinse followed by maintenance rinse) to expose the acidic biofilm bacteria to an acid-neutralizing base. This creates an environment that acid-producing bacteria don’t like.
  • Use prescription-strength fluoride toothpaste and rinses (such as Cari-Free toothpaste and maintenance rinse). This hardens the outer layer of the tooth and makes it harder to dissolve or decay.
  • Use high-concentration xylitol products (Cari-Free gum and/or lollipops). Xylitol is a sugar alcohol that hinders the harmful bacteria’s ability to make acid from sugar.
  • Get your cavities fixed so the holes don’t act as caries bacteria reservoirs.
  • Encourage friends and family to do the same in an effort minimize cross-infecting one another.
  • If you have a salivary flow problem, use xylitol moistening sprays (Cari-Free CTx2 spray). Avoid eating hard candies containing sugar, as the combination of sugar and dry mouth is destructive to healthy teeth. Ask us if you may be a candidate for pilocarpine medication to increase salivary flow.
  • Get dental checkups on a regular basis. If you’re getting cavities, you don’t want the situation to worsen.

These things all work together, and the more of them you do, the fewer problems you’re likely to have. Our office stocks a number of Cari-Free products, like the CTx4 Toothpaste, CTx3 Rinse and the CTx4 Treatment Rinse. If we’re out of stock, or if you see something on their website ( that we don’t normally carry, let us know and we’ll get it ordered for you. Quite simply, they are the best we’ve found so far.

We are working on implementing a new diagnostic protocol in the office to try to help patients monitor their cavity risk and prevention progress.

Do You Know How Food Affects Your Teeth?

We all know it’s good to brush your teeth at least twice a day. It’s even better to brush after eating, but unfortunately most of us don’t have the time for that.

Cavities form as a result of tooth decay. Tooth decay is caused by the acidity in foods. Acidity levels, also known as pH levels vary by the type of food and drink.

Take a look at the pH Level chart below to see if what you are eating or drinking is increasing your risk for cavities.

cavities and tooth decay

If it’s been over six months since you have seen Dr. Yaremko, make sure to book your appointment with Eric Yaremko DMD, PS. in Bellingham, WA to ensure that your teeth stay healthy. Your hygienist at our office can also provide you with other ways to prevent tooth decay.

Strawberry Kiwi Smoothie – A Recipe For Strong, Healthy Teeth

Keep your smile bright and your teeth healthy! Just like your bones, your teeth stay strong when you consume enough calcium and vitamin D. Milk, Strawberries and broccoli are all foods that can help prevent trips to the dentist. Enjoy this Strawberry-Kiwi Smoothie to get some cavity-fighting nutrients.

Refreshing and easy to make, one serving provides almost twice the amount of vitamin C you need for an entire day! Consume tooth-strengthening calcium and vitamin D from the milk in this strawberry smoothie.

During your next appointment at Eric Yaremko, DMD, PS make sure to ask your hygienist for other tips for keeping your smile bright.

Prep Time: 10 mins
Servings: 2


  • 1 1/2 cups fat-free milk
  • 1 cup strawberries, hulled and quartered
  • 2 kiwi, peeled and quartered (about 1/2 cup)
  • 2 tablespoon mint, fresh, chopped, plus two sprigs for garnish (optional)
  • 1 tablespoon sugar, granulated, or sugar substitute
  • 1 cup ice cubes, crushed


Combine the milk, strawberries, kiwis, chopped mint, sugar or sugar substitute, and ice in a blender or food processor. Blend until desired consistency.  Garnish with fresh mint and serve.

Nutrition Facts

Amount per Serving
Calories: 155
Total Fat: 0 g
Cholesterol: 0 mg
Sodium: 81 mg
Total Carbohydrate: 32 g
Dietary Fiber: 4 g
Protein: 8 g