Posts for category: Oral Health
Periodontal (gum) disease is as common as it is destructive. Almost half of all adults 30 and older have some form—and those numbers increase to nearly three-quarters by age 65.
Fortunately, we have effective ways to treat this bacterial infection, especially if we catch it early. By thoroughly removing all plaque, the disease-causing, bacterial biofilm that accumulates on tooth surfaces, we can stop the infection and help the gums return to normal.
Unfortunately, though, you're at a greater risk for a repeat infection if you've already had gum disease. To lower your chances of future occurrences, we'll need to take your regular dental exams and cleanings to another level.
Although everyone benefits from routine dental care, if you've had gum disease you may see these and other changes in your normal dental visits.
More frequent visits. For most people, the frequency norm between dental cleanings and exams is about six months. But we may recommend more visits for you as a former gum disease patient: depending on the advancement of your disease, we might see you every three months once you've completed your initial treatment, and if your treatment required a periodontist, we may alternate maintenance appointments every three months.
Other treatments and medications. To control any increases in disease-causing bacteria, dentists may prescribe on-going medications or anti-bacterial applications. If you're on medication, we'll use your regular dental visits to monitor how well they're doing and modify your prescriptions as needed.
Long-term planning. Both dentist and patient must keep an eye out for the ongoing threat of another gum infection. It's helpful then to develop a plan for maintaining periodontal health and then revisiting and updating that plan as necessary. It may also be beneficial to perform certain procedures on the teeth and gums to make it easier to keep them clean in the future.
While everyone should take their oral health seriously, there's even greater reason to increase your vigilance if you've already had gum disease. With a little extra care, you can greatly reduce your chances of another bout with this destructive and aggressive disease.
If you would like more information on preventing recurring gum disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Periodontal Cleanings.”
For anyone else, having a tooth accidentally knocked out while practicing a dance routine would be a very big deal. But not for Dancing With The Stars contestant Noah Galloway. Galloway, an Iraq War veteran and a double amputee, took a kick to the face from his partner during a recent practice session, which knocked out a front tooth. As his horrified partner looked on, Galloway picked the missing tooth up from the floor, rinsed out his mouth, and quickly assessed his injury. “No big deal,” he told a cameraman capturing the scene.
Of course, not everyone would have the training — or the presence of mind — to do what Galloway did in that situation. But if you’re facing a serious dental trauma, such as a knocked out tooth, minutes count. Would you know what to do under those circumstances? Here’s a basic guide.
If a permanent tooth is completely knocked out of its socket, you need to act quickly. Once the injured person is stable, recover the tooth and gently clean it with water — but avoid grasping it by its roots! Next, if possible, place the tooth back in its socket in the jaw, making sure it is facing the correct way. Hold it in place with a damp cloth or gauze, and rush to the dental office, or to the emergency room if it’s after hours or if there appear to be other injuries.
If it isn’t possible to put the tooth back, you can place it between the cheek and gum, or in a plastic bag with the patient’s saliva, or in the special tooth-preserving liquid found in some first-aid kits. Either way, the sooner medical attention is received, the better the chances that the tooth can be saved.
When a tooth is loosened or displaced but not knocked out, you should receive dental attention within six hours of the accident. In the meantime, you can rinse the mouth with water and take over-the-counter anti-inflammatory medication (such as ibuprofen) to ease pain. A cold pack temporarily applied to the outside of the face can also help relieve discomfort.
When teeth are broken or chipped, you have up to 12 hours to get dental treatment.Â Follow the guidelines above for pain relief, but don’t forget to come in to the office even if the pain isn’t severe. Of course, if you experience bleeding that can’t be controlled after five minutes, dizziness, loss of consciousness or intense pain, seek emergency medical help right away.
And as for Noah Galloway:Â In an interview a few days later, he showed off his new smile, with the temporary bridge his dentist provided… and he even continued to dance with the same partner!
If you would like more information about dental trauma, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Trauma & Nerve Damage to Teeth” and “The Field-Side Guide to Dental Injuries.”
Your sweet, happy baby has suddenly become a gnawing, drooling bundle of irritation. Don't worry, though, no one has switched babies on you. Your child is teething.
For most children, their first teeth begin breaking through the gums around six to nine months. Usually by age three all twenty primary (“baby”) teeth have erupted. While the duration and intensity of teething differs among children, there are some common symptoms to expect.
Top of the list, of course, is irritability from pain, discomfort and disrupted sleep. You'll also notice increased gnawing, ear rubbing, decreased appetite, gum swelling or facial rash brought on by increased saliva (drooling). Teething symptoms seem to increase about four days before a tooth begins to break through the gums and taper off about three days after.
You may occasionally see bluish swellings along the gums known as eruption cysts. These typically aren't cause for concern: Â the cyst usually “pops” and disappears as the tooth breaks through it. On the other hand, diarrhea, body rashes or fever are causes for concern — if these occur you should call us or your pediatrician for an examination.
While teething must run its course, there are some things you can do to minimize your child's discomfort:
Provide them a clean, soft teething ring or pacifier to gnaw or chew — a wet washcloth (or a cold treat for older children) may also work. Chill it first to provide a pain-reducing effect, but don't freeze it — that could burn the gums.
Use a clean finger to massage swollen gums — gently rubbing the gums helps counteract the pressure caused by an erupting tooth.
Alleviate persistent pain with medication — With your doctor's recommendation, you can give them a child's dosage of acetaminophen or ibuprofen (not aspirin), to take the edge off teething pain.
There are also things you should not do, like applying rubbing alcohol to the gums or using products with Benzocaine®, a numbing agent, with children younger than two years of age. Be sure you consult us or a physician before administering any drugs.
While it isn't pleasant at the time, teething is part of your child's dental development. With your help, you can ease their discomfort for the relatively short time it lasts.
If you would like more information on relieving discomfort during teething, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Teething Troubles.”
It’s true — thumb sucking beyond age 4 can cause bite problems for permanent teeth. But prolonged thumb sucking is just one of a number of possible contributing factors for a bad bite (malocclusion). A dentist must identify all the factors involved when a bad bite is present — their involvement is essential for a successful treatment outcome.
A fairly benign habit for infants and toddlers, thumb sucking is related to an “infantile swallowing pattern” young children use by thrusting their tongues forward between the upper and lower teeth when they swallow. Around age 4, though, they usually transition to an adult swallowing pattern in which the tongue rests on the roof of the mouth just behind the front teeth. Thumb sucking stops for most children around the same time.
Thumb sucking beyond this age, though, can put increased pressure on incoming permanent teeth pushing them forward. This could lead to an “open bite” in which the upper and lower teeth don’t meet when the jaws are closed. The tongue may also continue to thrust forward when swallowing to seal the resulting gap, which further reinforces the open bite.
Before treating the bite with braces, we must first address the thumb sucking and improper tongue placement when swallowing — if either isn’t corrected the teeth could gradually revert to their previous positions after the braces come off. Besides behavioral incentives, we can also employ a thin metal appliance called a “tongue crib” placed behind the upper and lower incisors. A tongue crib discourages thumb sucking and makes it more difficult for the tongue to rest within the open bite gap when swallowing, which helps retrain it to a more normal position.
An open bite can also occur if the jaws develop with too much vertical growth. Like thumb sucking and improper tongue placement, abnormal jaw growth could ultimately cause orthodontic treatment to fail. In this case, though, surgery may be necessary to correct the jaw structure.
With all these possible variables, our first step needs to be a thorough orthodontic exam that identifies all the cause factors for your child’s specific malocclusion. Knowing if and how thumb sucking may have contributed to the poor bite will help us design a treatment strategy that’s successful.
If you would like more information on the causes of poor tooth position, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “How Thumb Sucking Affects the Bite.”
On the big screen, Australian-born actress Margot Robbie may be best known for playing devil-may-care anti-heroes—like Suicide Squad member Harley Quinn and notorious figure skater Tonya Harding. But recently, a discussion of her role in Peter Rabbit proved that in real life, she’s making healthier choices. When asked whether it was hard to voice a character with a speech impediment, she revealed that she wears retainers in her mouth at night, which gives her a noticeable lisp.
“I actually have two retainers,” she explained, “one for my bottom teeth which is for grinding my teeth, and one for my top teeth which is just so my teeth don't move.”
Clearly Robbie is serious about protecting her dazzling smile. And she has good reasons for wearing both of those retainers. So first, let’s talk about retainers for teeth grinding.
Also called bruxism, teeth grinding affects around 10 percent of adults at one time or another, and is often associated with stress. If you wake up with headaches, sore teeth or irritated gums, or your sleeping partner complains of grinding noises at night, you may be suffering from nighttime teeth grinding without even being aware of it.
A type of retainer called an occlusal guard is frequently recommended to alleviate the symptoms of bruxism. Typically made of plastic, this appliance fits comfortably over your teeth and prevents them from being damaged when they rub against each other. In combination with stress reduction techniques and other conservative treatments, it’s often the best way to manage teeth grinding.
Orthodontic retainers are also well-established treatment devices. While appliances like braces or aligners cause teeth to move into better positions, retainers are designed to keep teeth from moving—helping them to stay in those positions. After active orthodontic treatment, a period of retention is needed to allow the bite to stabilize. Otherwise, the teeth can drift right back to their old locations, undoing the time and effort of orthodontic treatment.
So Robbie has the right idea there too. However, for those who don’t relish the idea of wearing a plastic appliance, it’s often possible to bond a wire retainer to the back surfaces of the teeth, where it’s invisible. No matter which kind you choose, wearing a retainer can help keep your smile looking great for many years to come.
If you have questions about teeth grinding or orthodontic retainers, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Teeth Grinding” and “The Importance of Orthodontic Retainers.”