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By Edward C. Smith, DMD, MPH, LLC
June 07, 2021
Category: Dental Procedures
Tags: oral health  
CTImagingTechnologyCanImproveOutcomesforComplexDentalProblems

The mouth is a crowded place with nerves, blood vessels and sinus cavities sharing common space with the teeth and gums. Although important in their own right, these structures can also hinder treatment for complex dental situations like dental implant surgery or impacted teeth.

Treating these and similar situations depends on getting an accurate depiction of “what lies beneath.” Conventional x-rays help, but their two-dimensional images don't always give the full picture. There's another way—cone beam computed tomography (CBCT).

Similar to CT scanning, CBCT uses x-ray energy to take hundreds of “sliced” images that are then re-assembled with special software to create a three-dimensional model viewable on a computer screen. CBCT is different, though, in that it employs a scanning device that revolves around a patient's head, which emits a cone-shaped beam of x-rays to capture the images.

A dentist can manipulate the resulting 3-D model on screen to study revealed oral structures from various angles to pinpoint potential obstacles like nerves or blood vessels. The detailed model may also aid in uncovering the underlying causes of a jaw joint disorder or sleep apnea.

CT technology isn't the only advanced imaging system used in healthcare. Another is magnetic resonance imaging (MRI), which excites hydrogen atoms in water molecules. This produces different vibration rates in individual tissue structures, which are then translated into detailed images of these structures. Unlike CT or CBCT, MRI doesn't use x-ray energy, but rather a magnetic field and radio waves to produce the atomic vibrations.

But while providing good detail of soft tissues, MRI imaging doesn't perform as well as CBCT with harder tissues like bone or teeth. As to the potential risks of CBCT involving x-ray radiation exposure, dentists follow much the same safety protocols as they do with conventional x-rays. As such, they utilize CBCT only when the benefits far outweigh the potential x-ray exposure risks.

And, CBCT won't be replacing conventional x-rays any time soon—the older technology is often the more practical diagnostic tool for less invasive dental situations. But when a situation requires the most detailed and comprehensive image possible, CBCT can make a big difference.

If you would like more information on advanced dental diagnostics, 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 “Getting the Full Picture With Cone Beam Dental Scans.”

By Edward C. Smith, DMD, MPH, LLC
May 28, 2021
Category: Oral Health
Tags: oral health  
AnEatingDisorderMayShowItselfinTheMouth

Although dental care is our primary focus, we dentists are also on the lookout for other health problems that may manifest in the mouth. That's why we're sometimes the first to suspect a patient may have an eating disorder.

Eating disorders are abnormal dietary patterns that can arise from mental or emotional issues, the most common being anorexia nervosa and bulimia nervosa. Each has different behaviors: Anorexics abnormally restrict their food intake (“self-starvation”), while bulimics typically eat heavily and then induce vomiting (“binge and purge”).

Although bulimics are more likely to binge and purge, anorexics may also induce vomiting. That practice in particular can leave a clue for dentists. While vomiting, powerful stomach acid enters the mouth, which can then soften and erode tooth enamel.

It's the pattern of erosion a dentist may notice more than the erosion itself that may indicate an eating disorder. A person while vomiting normally places their tongue against the back of the lower teeth, which somewhat shields them from acid. The more exposed upper teeth will thus tend to show more erosion than the bottom teeth.

A dentist may also notice other signs of an eating disorder. Enlarged salivary glands or a reddened throat and tongue could indicate the use of fingers or objects to induce vomiting. Lack of oral hygiene can be a sign of anorexia, while signs of over-aggressive brushing or flossing may hint of bulimia.

For the sake of the person's overall well-being, the eating disorder should be addressed through professional counseling and therapy. An excellent starting point is the website nationaleatingdisorders.org, sponsored by the National Eating Disorders Association.

The therapy process can be lengthy, so patients should also take steps to protect their teeth in the interim. One important measure is to rinse out the mouth following purging with a little baking soda mixed with water. This will help neutralize oral acid and reduces the risk of erosion. Proper brushing and flossing and regular dental visits can also help prevent dental disease.

An eating disorder can be traumatic for both patients and their families, and can take time to overcome. Even so, patients can reduce its effect on their dental health.

If you would like more information on eating disorders and 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 “Bulimia, Anorexia & Oral Health.”

By Edward C. Smith, DMD, MPH, LLC
May 18, 2021
Category: Dental Procedures
ZacEfronsSmileTransformationCouldHappentoYou

Actor Zac Efron has one of the top smiles in a business known for beautiful smiles. Bursting on the scene in 2006 at age 18 in High School Musical, Efron has steadily increased his range of acting roles. He recently starred as Ted Bundy on Netflix, wearing prosthetics to match the notorious serial killer's crooked teeth.

With his growing fame, Efron's attractive smile has become one of his more memorable attributes. But it wasn't always so. Before Hollywood, Efron's smile was less than perfect with small, uneven teeth and a gap between his top front teeth. Before and after pictures, though, make it quite apparent that the actor has undergone a significant smile makeover.

While fans are abuzz on the 411 regarding his dental work, Efron himself has been hush-hush about his smile transformation. We won't join the speculation: Instead, here are a few possible ways you can get a more attractive smile like Zac Efron.

Teeth whitening. A single-visit, non-invasive teeth whitening procedure can transform your dull, stained teeth into a brighter, more attractive smile. Although the effect isn't permanent, it could last a few years with a professional whitening and good oral practices. Having it done professionally also gives you more control over the level of shading you prefer—from soft natural white to dazzling Hollywood bright.

Orthodontics. Like Efron, if your teeth aren't quite in proper alignment, straightening them can make a big difference in your appearance (and your oral health as well). Braces are the tried and true method for moving teeth, but you may also be able to choose clear aligner trays, which are much less noticeable than braces. And don't worry about your age: Anyone with reasonably good dental health can undergo orthodontics.

Bonding. We may be able to correct chips and other slight tooth flaws with durable composite resins. After preparing your tooth and matching the material to your particular color, we apply it directly to your tooth in successive layers. After hardening, the unsightly defect is no more—and your smile is more attractive.

Veneers. Dental veneers are the next step up for more advanced defects. We bond these thin, custom-made layers of dental porcelain to the front of teeth to mask chips, heavy staining and slight tooth gaps. Although we often need to permanently remove a small amount of tooth enamel, veneers are still less invasive than some other restorations. And your before and after could be just as amazing as Zac Efron's.

Improving one's smile isn't reserved for stars like Zac Efron. There are ways to correct just about any dental defect, many of which don't require an A-lister's bank account. With a little dental “magic,” you could transform your smile.

If you would like more information about how to give your smile a boost, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “The Magic of Orthodontics” and “Porcelain Veneers.”

By Edward C. Smith, DMD, MPH, LLC
May 08, 2021
Category: Oral Health
Tags: oral health  
EvidenceMountingThatVapingisHazardoustoYourOralHealth

It wasn't too many years ago that e-cigarettes were promoted as a healthier alternative to traditional cigarettes. “Vaping” was in and “smoking” was out.

But vaping's recent link with certain lung disorders, especially among younger users, has slowed the promotion train down considerably. And if respiratory health isn't enough, there's another reason to be wary of the practice—it's possible effect on oral health.

An e-cigarette is a handheld device with a reservoir that holds a mixture of water, flavoring, nicotine and other chemicals. The device heats up the liquid to transform it into a vapor that's then inhaled by the user. Technically, the vapor is an aerosol, a gaseous substance containing solid particles from chemical compounds.

Within this aerosol are a number of ingredients that can have a harmful effect on your teeth and gums. Foremost among them is nicotine, a chemical that's also a major ingredient in regular tobacco. Nicotine causes constriction of blood vessels, including those supplying the teeth and gums.

As these vessels constrict, they deliver to the teeth and gums fewer nutrients and antibodies to control infection. As a result, users of nicotine products, whether tobacco or e-cigarettes, will have a compounded risk for dental disease over a non-user.

E-cigarettes may in fact be worse than regular cigarettes in regards to nicotine. Cigarette nicotine is primarily inhaled into the lungs, while e-cigarette nicotine is absorbed by the mouth's mucous membranes, a much more efficient transfer. It's estimated that the amount of nicotine in one e-cigarette cartridge equals the nicotine from 20 cigarettes.

Nicotine isn't the only ingredient in e-cigarettes that could harm your mouth. Chemicals within the flavorings can irritate and dry out the mucous membranes of the mouth, as well as damage tooth enamel. There are a variety of other chemicals present like formaldehyde that could raise your risk for oral cancer.

Rather than a healthy alternative to smoking, e-cigarette users may simply be trading one form of health risk for another—and, in the case of your oral health, just as bad or worse. The best alternative for healthier teeth and gums is to leave both habits—smoking and vaping—far behind.

If you would like more information on vaping and oral health, 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 “Vaping and Oral Health.”

By Edward C. Smith, DMD, MPH, LLC
April 28, 2021
Category: Oral Health
Tags: oral health  
HowYouCanHelpYourSmileStayAttractiveasYouGetOlder

We can't stop getting older or completely avoid many of the consequences that come with aging. Even so, there are things we can do to age more gracefully.

That includes your smile, which can also suffer the ravages of time. Teeth naturally wear and yellow over the years. We're also more susceptible to both tooth decay and periodontal (gum) disease as we age.

You can help slow some of these age-related dental problems by simply caring for your teeth and gums. This includes not only brushing and flossing every day to remove dental plaque (which can cause disease and dull your smile), but also seeing a dentist every few months for more thorough cleanings.

You can also take advantage of certain cosmetic enhancements to address some of the age-related issues that could keep you from having a more youthful smile.

Discolored teeth. Teeth tend to get darker over time, the combination of stain-causing foods and beverages, habits like smoking and age-related changes in tooth structure. You may be able to temporarily attain a brighter smile with teeth whitening. For a more permanent effect, we can cover stained teeth with porcelain veneers, dental bonding or dental crowns.

Worn teeth. After decades of chewing and biting, teeth tend to wear, with habits like teeth grinding accelerating it. This can cause teeth to appear abnormally small with hard, sharpened edges in contrast to the soft, rounded contours of younger teeth. In some cases, we can restore softer tooth edges with enamel contouring and reshaping. For more severe wearing, veneers or crowns could once again provide a solution.

Recessed gums. Because of gum disease, over-aggressive brushing or a genetic disposition to thinner gums, gums can shrink back or “recede” from normal teeth coverage. This not only exposes vulnerable areas of the teeth to harmful bacteria, it can also make teeth appear longer than normal (hence the aging description, “long in the tooth”). We can address recession by treating any gum disease present and, in extreme cases, perform grafting surgery to help rebuild lost tissue.

Losing your attractive smile isn't inevitable as you get older. We can help you make sure your smile ages gracefully along with the rest of you.

If you would like more information on keeping a youthful smile, 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 Your Dentist Can Help You Look Younger.”





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