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By Edward C. Smith, DMD, MPH, LLC
September 20, 2020
Category: Oral Health
WhatTaraLipinskiDoestoProtectOneofHerMostValuableAssets-HerSmile

Tara Lipinski loves to smile. And for good reason: The Olympic-gold medalist has enjoyed a spectacular career in ladies' figure skating. Besides also winning gold in the U.S. Nationals and the Grand Prix Final, in 1997 Lipinski became the youngest skater ever to win a World Figure Skating title. Now a sports commentator and television producer, Lipinski still loves to show her smile—and counts it as one of her most important assets. She also knows the importance of protecting her smile with daily hygiene habits and regular dental care.

Our teeth endure a lot over our lifetime. Tough as they are, though, they're still vulnerable to disease, trauma and the effects of aging. To protect them, it's essential that we brush and floss every day to remove bacterial plaque—that thin accumulating film on teeth most responsible for tooth decay and gum disease.

To keep her smile in top shape and reduce her chances of dental disease, Lipinski flosses and brushes daily, the latter at least twice a day. She also uses a tongue scraper, a small handheld device about the size of a toothbrush, to remove odor-causing bacteria and debris from the tongue.

Lipinski is also diligent about visiting the dentist for professional cleanings and checkups at least twice a year because even a dedicated brusher and flosser like her can still miss dental plaque that can then harden into tartar. Dental hygienists have the training and tools to clear away any lingering plaque and tartar that could increase your disease risk. It's also a good time for the dentist to check your teeth and gums for any developing problems.

The high pressure world of competitive figure skating and now her media career may also have contributed to another threat to Lipinski's smile: a teeth-grinding habit. Teeth grinding is the unconscious action—often while asleep—of clenching the jaws together and producing abnormally high biting forces. Often a result of chronic stress, teeth grinding can accelerate tooth wear and damage the gum ligaments attached to teeth. To help minimize these effects, Lipinski's dentist created a custom mouthguard to wear at night. The slick plastic surface of the guard prevents the teeth from generating any damaging biting forces when they clench together.

The importance of an attractive smile isn't unique to celebrities and media stars like Tara Lipinski. A great smile breeds confidence for anyone—and it can enhance your career, family and social relationships. Protect this invaluable asset with daily oral hygiene, regular dental visits and prompt treatment for disease or trauma.

If you would like more information about protecting your smile, please contact us or schedule an appointment. To learn more, read the Dear Doctor magazine articles “Tooth Decay” and “Teeth Grinding.”

By Edward C. Smith, DMD, MPH, LLC
September 10, 2020
Category: Oral Health
Tags: sedation dentistry  
SedationTherapycanreduceAnxietyinChildrenduringDentalVisits

Making sure children are comfortable when visiting the dentist is an essential part of creating a lifetime habit of dental care. We recommend children start dental visits around their first birthday.

But for some children this may not be enough — despite parents’ and dentists’ best efforts they may still develop an inordinate fear of dental visits and even routine procedures. This kind of anxiety could inhibit them now and later in life from receiving needed dental care.

To relieve this anxiety, dentists have developed sedation therapy for children. Not to be confused with anesthesia, which numbs pain, sedation uses drugs to place a patient in a relaxed state. Depending on the drugs and dosage used, we’re able to achieve anywhere from a light state of relaxation to a deep suppression of consciousness. The approach is similar to one used with adults, although drug dosages and applications will differ with children.

 If we’re planning to use sedation with your child we recommend you feed them a low-fat dinner the night before and then refrain from any other foods or liquids until after treatment the next day. Just before the procedure (and after we’ve evaluated them physically to be sure they’re healthy enough for the sedation medication), we’ll administer the sedative, usually Midazolam and Hydroxyzine. Taken by mouth in a syrup form, this places them in a mildly relaxed state.

During the procedure a designated staff member will continually monitor their pulse, breathing, blood pressure and other vital signs. We may also take other protective measures like special chair positioning or immobilization to keep movement to a minimum.

After the procedure, your child will remain in the office until their vital signs return to pre-sedation levels. Once at home, you should keep an eye on them for the rest of the day. They should not return to school or regular activities until the next day.

As sedation medication and techniques continue to advance, they’re becoming a routine part of dental care. If your child experiences anxiety, this can help make dental visits more pleasant and more likely to become part of their life from now on.

If you would like more information on taking the anxiety out of children’s dental care, 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 “Sedation Dentistry for Kids.”

By Edward C. Smith, DMD, MPH, LLC
August 31, 2020
Category: Oral Health
Tags: toothache  
YourToothacheMightSignalaProblemOtherThaninYourMouth

You expect a decayed tooth, a fracture or a gum infection to be the cause for that toothache causing you grief. Sometimes, though, the answer may be “none of the above”—there's nothing wrong going on in your mouth to cause the pain.

You pain is real—but its source is elsewhere in the body, a situation known as referred pain. It's important to find out the pain's true source to determine what kind of treatment you'll need to alleviate it.

Here are some of the likely candidates for a “toothache” that's not a toothache.

Facial nerves. Tooth pain may be associated with trigeminal neuralgia, a misfiring disorder of the trigeminal nerves that course through either side of the face. The nerve is divided into three branches, two of which are located in the upper face and one in the lower jaw. Because they're interconnected, a problem with one of the branches in other parts of the face could be felt in the branch around the jaw.

Jaw joints. Temporomandibular Joint Disorders (TMD) can cause pain in the pair of joints that connect the lower jaw to the skull. The joints can become inflamed due to stress or trauma and the associated muscles begin spasming, causing severe pain. Because of their proximity to the teeth, the pain from the joints can radiate into the dental area and mimic a toothache.

Ear or sinus infections. Both the ears and the maxillary sinus are subject to infections that can cause severe pain and pressure. With the close proximity of both the ears and the sinus to the upper jaw, it's quite possible for pain originating in these structures to be felt within the mouth.

These are only a few of the possibilities that also include migraines, shingles, fibromyalgia and even vitamin deficiencies. As such, your dentist or physician may need to do a little detective work to locate the true cause. But the effort to locate where your mouth pain is actually coming from will help ensure you get the right treatment to give you lasting relief.

If you would like more information on referred tooth pain, 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 “Referred Pain: When a Toothache Is Not Really a Toothache.”

By Edward C. Smith, DMD, MPH, LLC
August 21, 2020
Category: Oral Health
Tags: oral hygiene  
FlossFirstorBrushFirstYouBetheJudge

Brushing and flossing are two of the best things you can do to fight dental disease and maintain healthy teeth and gums.

Or is it flossing and brushing? What we mean is, should you floss first or brush first?

There's virtually no debate among dental professionals about whether or not to perform both hygiene tasks. While brushing removes disease-causing plaque from the broad surfaces of teeth, flossing gets to deposits of this disease-causing, bacterial film lodged between the teeth that brushing can't reach. You don't want to neglect one task over the other if you want to fully minimize your risk of tooth decay or gum disease (and don't forget semi-annual dental cleanings too).

But where there is some debate—good-natured, of course—among dentists is over whether it's better hygiene-wise to brush before flossing or vice-versa. For those on Team Brush, you should pick up your toothbrush first for the best results.

By brushing before you floss, you'll remove most of the plaque that has accumulated since your last cleaning session. If you floss first, the flossing thread has to plow through a lot of the plaque that otherwise might be removed by brushing. For many, this can lead to an unpleasant sticky mess. By removing most of the plaque first via brushing, you can focus your flossing on the small amount left between teeth.

Team Floss, on the other hand, believes giving flossing first crack at loosening the plaque between teeth will make it easier for the detergent in the toothpaste to remove it out of the way during brushing. It may also better expose these in-between areas of teeth to the fluoride in your toothpaste while brushing. And because flossing is generally considered a bit more toilsome to do than brushing, tackling it first could increase the likelihood you'll actually floss and not neglect it after brushing.

So, which task should you perform first? Actually, it's up to you: Weighing both sides, it usually comes down to which way is the most comfortable for you and will give you the greatest impetus for flossing. Because no matter which “team” you're on, the important thing is this: Don't forget to floss.

If you would like more information on personal dental care, 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 “Daily Oral Hygiene.”

By Edward C. Smith, DMD, MPH, LLC
August 11, 2020
Category: Dental Procedures
YouCanHaveaStraighterSmile-JustLiketheQueenofEngland

The monarchs of the world experience the same health issues as their subjects—but they often tend to be hush-hush about it. Recently, though, the normally reticent Queen Elizabeth II let some young dental patients in on a lesser known fact about Her Majesty's teeth.

While touring a new dental hospital, the queen told some children being fitted for braces that she too “had wires” once upon a time. She also said, “I think it's worth it in the end.”

The queen isn't the only member of the House of Windsor to need help with a poor bite. Both Princes William and Harry have worn braces, as have other members of the royal family. A propensity for overbites, underbites and other malocclusions (poor bites) can indeed pass down through families, whether of noble or common lineage.

Fortunately, there are many ways to correct congenital malocclusions, depending on their type and severity. Here are 3 of them.

Braces and clear aligners. Braces are the tried and true way to straighten misaligned teeth, while the clear aligner method—removable plastic mouth trays—is the relative “new kid on the block.” Braces are indeed effective for a wide range of malocclusions, but their wires and brackets make it difficult to brush and floss, and they're not particularly attractive. Clear aligners solve both of these issues, though they may not handle more complex malocclusions as well as braces.

Palatal expanders. When the upper jaw develops too narrowly, a malocclusion may result from teeth crowding into too small a space. But before the upper jaw bones fuse together in late childhood, orthodontists can fit a device called a palatal expander inside the upper teeth, which exerts gentle outward pressure on the teeth. This encourages more bone growth in the center to widen the jaw and help prevent a difficult malocclusion from forming.

Specialized braces for impacted teeth. An impacted tooth, which remains partially or completely hidden in the gums, can impede dental health, function and appearance. But we may be able to coax some impacted teeth like the front canines into full eruption. This requires a special orthodontic technique in which a bracket is surgically attached to the impacted tooth's crown. A chain connected to the bracket is then looped over other orthodontic hardware to gradually pull the tooth down where it should be.

Although some techniques like palatal expanders are best undertaken in early dental development, people of any age and reasonably good health can have a problem bite corrected with other methods. If you are among those who benefit from orthodontics, you'll have something in common with the Sovereign of the British Isles: a healthy, attractive and straighter smile.

If you would like more information about orthodontic treatment options, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “The Magic of Orthodontics.”





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