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By Edward C. Smith, DMD, MPH, LLC
May 19, 2019
Category: Oral Health
Tags: tooth wear  
3ThingsYoucandotoSlowToothWear

Unlike our primitive ancestors, our teeth have it relatively easy. Human diets today are much more refined than their counterparts from thousands of years ago. Ancient teeth recovered from those bygone eras bear that out, showing much more wear on average than modern teeth.

Even so, our modern teeth still wear as we age—sometimes at an accelerated rate. But while you can't eliminate wearing entirely, you can take steps to minimize it and preserve your teeth in your later years. Here are 3 things you can do to slow your teeth's wearing process.

Prevent dental disease. Healthy teeth endure quite well even while being subjected to daily biting forces produced when we eat. But teeth weakened by tooth decay are more susceptible to wear. To avoid this, you should practice daily brushing and flossing to remove disease-causing dental plaque. And see your dentist at least twice a year for more thorough dental cleanings and checkups.

Straighten your bite. A poor bite, where the top and bottom teeth don't fit together properly, isn't just an appearance problem—it could also cause accelerated tooth wear. Having your bite orthodontically corrected not only gives you a new smile, it can also reduce abnormal biting forces that are contributing to wear. And don't let age stop you: except in cases of bone deterioration or other severe dental problems, older adults whose gums are healthy can undergo orthodontics and achieve healthy results.

Seek help for bruxism. The term bruxism refers to any involuntary habit of grinding teeth, which can produce abnormally high biting forces. Over time this can increase tooth wear or weaken teeth to the point of fracture or other severe damage. While bruxism is uncommon in adults, it's still a habit that needs to be addressed if it occurs. The usual culprit is high stress, which can be better managed through therapy or biofeedback. Your dentist can also fashion you a custom guard to wear that will prevent upper and lower teeth from wearing against each other.

If you would like more information on minimizing teeth wear, 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 and Why Teeth Wear.”

By Edward C. Smith, DMD, MPH, LLC
May 09, 2019
Category: Dental Procedures
Tags: dental implants  
GettingDentalImplantsRequiresMinorSurgery

Dental implants are best known as restorations for single missing teeth. But there’s more to them than that—they can also be used to support and secure removable dentures or fixed bridges.

That’s because a dental implant is actually a root replacement. A threaded titanium post is inserted directly into the jawbone where, over time, bone cells grow and adhere to it. This accumulated bone growth gives the implant its signature durability and contributes to its long-term success rate (95%-plus after ten years). It can support a single attached crown, or serve as an attachment point for a dental bridge or a connector for a removable denture.

The method and design of implants differentiates it from other restoration options. And there’s one other difference—implants require a minor surgical procedure to insert them into the jawbone.

While this might give you pause, implant surgery is no more complicated than a surgical tooth extraction. In most cases we can perform the procedure using local anesthesia (you’ll be awake the entire time) coupled with sedatives (if you have bouts of anxiety) to help you relax.

We first access the bone through small incisions in the gums and then create a small channel or hole in it. A surgical guide that fits over the teeth may be used to help pinpoint the exact location for the implant.

We then use a drilling sequence to progressively increase the size of the channel until it matches the implant size and shape. We’re then ready to insert the implant, which we remove at this time from its sterile packaging. We may then take a few x-rays to ensure the implant is in the right position, followed by closing the gums with sutures.

There may be a little discomfort for that day, but most patients can manage it with over-the-counter pain relievers like aspirin or ibuprofen. It’s what goes on over the next few weeks that’s of prime importance as the bone grows and adheres to the implant. Once they’re fully integrated, we’re ready to move to the next step of affixing your crown, bridge or denture to gain what you’ve waited so long for—your new implant-supported smile.

If you would like more information on dental implants, 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 “Dental Implant Surgery: What to Expect Before, During and After.”

By Edward C. Smith, DMD, MPH, LLC
April 29, 2019
Category: Oral Health
WhyYouShouldFlossAroundtheImplantsSupportingYourBridge

We've been using bridges to replace missing teeth for decades. Now, recently-developed implant-supported bridges are even more dependable, promising greater durability and less interference with remaining natural teeth.

But just like other restorations, you'll need to keep implant bridges clean to ensure their longevity. Although both the bridge and implants are impervious to disease, the supporting gums and bone aren't. If they become infected, they can break down and your restoration will fail.

Cleaning an implant-supported bridge includes flossing around each of the implants to remove dental plaque, a thin film of food particles and bacteria most responsible for dental disease. To perform this task, you'll have to pass the floss between the bridge and gums to access the sides of each implant.

To help make it easier, you can use a tool like a floss threader, a thin, shaft-like device with a loop on one end and a needle-like point on the other. You'll first thread about 18" of floss through the end and then pass the threader between the bridge and gums with the sharp end toward the tongue.

With the threader completely through, you'll then wrap the floss around your fingers as with regular flossing and move the floss up and down each side of the implants you can access. You'll then pull the floss out, reload the threader and move to the next section, repeating this process until you've flossed each side of each implant.

You can also use pre-cut floss with a stiffened end to thread between the bridge and gums or an interproximal brush with a thin bristled head that can reach underneath the bridge. And you might consider using an oral irrigator, a pump device that sprays a stream of pressurized water to remove and flush away plaque around implants.

To round out your hygiene efforts, be sure you visit your dentist at least twice a year for dental cleanings. Your dentist can also advise you and give you training on keeping your implants clear of disease-causing plaque. Cleaning around your implants will help ensure your restoration will last.

If you would like more information on caring for your dental restoration, 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 “Oral Hygiene for Fixed Bridgework.”

By Edward C. Smith, DMD, MPH, LLC
April 19, 2019
Category: Oral Health
JamieFoxxChipsaTooth-ThisTimebyAccident

Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.

“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…

For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.

When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.

A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.

But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.

Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!

If you have questions about repairing chipped teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”

By Edward C. Smith, DMD, MPH, LLC
April 09, 2019
Category: Oral Health
Tags: oral cancer  
ToDetectOralCancerEarlySeeYourDentist

This month marks the 20th annual observance of Oral Cancer Awareness Month. Last year, over 50,000 people in the US were diagnosed with oral cancer, and over 10,000 people died from the disease. The 5-year survival rate for oral cancer is only around 57%, making it more deadly than many other types of cancer. But if oral cancer is caught and treated early, the 5-year survival rate jumps to over 80%. This is one reason why regular dental checkups are so important—we can be your best ally in detecting oral cancer in its early stages.

Oral cancer is particularly dangerous because it often develops without pain or obvious symptoms. Early detection greatly improves the chances of successful treatment, but signs of the disease frequently go unnoticed until the cancer is advanced. Fortunately, dentists and dental hygienists are trained to recognize signs of oral cancer in the early stages, when it is most treatable. Oral cancer can appear on any surface of the mouth and throat, with the tongue being the most common site, particularly along the sides, followed by the floor of the mouth. As part of a regular dental exam, we examine these surfaces for even subtle signs of the disease.

Screenings performed at the dental office are the best way to detect oral cancer, but between dental visits it's a good idea to check your own mouth for any of the following: white or red patches, lumps, hard spots, spots that bleed easily or sores that don't heal. Let us know if any of these symptoms don't go away on their own within two or three weeks.

Using tobacco in any form is a major risk factor for oral cancer, especially in combination with alcohol consumption. Although the majority of people diagnosed with oral cancer are over age 55, the fastest growing segment of new diagnoses are among young people due to the rise in cases of sexually transmitted human papillomavirus (HPV) in young adults.

A routine dental visit can do much more than preventing and treating tooth decay and gum disease—it might even save your life! If you have questions about oral cancer or are concerned about possible symptoms, call us as soon as possible to schedule an appointment for a consultation.





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