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PracticeDailyHygienetoAvoidGumSwellingWhileWearingBraces

Straightening your smile doesn't happen overnight—it can involve months or even years of orthodontic treatment. And although the end result is well worth it, the long process can make it difficult to keep your gums healthy, especially while wearing braces.

Gum swelling in particular is a common problem for braces wearers with two potential sources. First, orthodontic hardware makes it difficult to keep teeth clean of dental plaque, a thin bacterial film that can cause gum disease. Plaque and its hardened counterpart tartar can trigger a gum infection, which in turn triggers inflammation. As a result, affected gums appear swollen and red, and can easily bleed.

Gum tissues may also react to braces pressing against them and develop hypertrophy (or hyperplasia), an increase in individual tissue cell growth. If this overgrowth occurs, it may not get resolved until after your braces have been removed.

As long as the hypertrophy doesn't appear to have weakened gum attachment with the teeth, it's usually not a big concern. But what is a concern is that hypertrophy could increase a braces wearer's difficulties with oral hygiene and give rise to a true gum infection that could endanger dental attachment. Advanced cases could require surgical correction or removal of the braces altogether to adequately treat the infection.

The best way to avoid a worst case scenario is to be as diligent as possible with daily brushing and flossing. Fortunately, there are several tools that can make it easier with braces. Interproximal brushes, tiny brushes that can fit into the narrow spaces between the teeth and the braces, can be used in conjunction with your regular toothbrush.

Flossing is also easier if you use a floss threader or a water flosser. The latter utilizes a pump to emit a pulsating jet of water to break loose plaque between teeth and flush it away. Clinical studies have shown the effectiveness of water flossers for removing plaque in braces wearers as opposed to not flossing at all.

A faithful daily hygiene practice and twice-a-year cleanings and checkups with your regular dentist can help minimize your chances of gum swelling. Doing so will help ensure you'll complete your orthodontic treatment on the way to healthier and more attractive smile.

If you would like more information on teeth and gum care while wearing braces, 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 “Gum Swelling During Orthodontics.”

CatchRootResorptionEarlyforBestChancesofSavingYourTooth

As your dental provider, we're always alert for signs of tooth decay or periodontal (gum) disease, the two leading causes of tooth loss. But we're also watching for less common conditions that could be just as devastating.

Root resorption falls into this latter category: it occurs when a tooth's root structure begins to break down and dissolve (or resorb).  It's a normal process in primary ("baby") teeth to allow them to loosen and give way when permanent teeth are ready to erupt.

It's not normal, though, for permanent teeth. Something internally or—more commonly—externally causes the root structure to break down. External resorption usually occurs at the neck-like or cervical area of a tooth around the gum line. Known as external cervical resorption (ECR), it can first appear as small, pinkish spots on the enamel. These spots contain abnormal cells that cause the actual damage to the root.

We don't fully understand how root resorption occurs, but we have identified certain factors that favor its development. For example, it may develop if a person has experienced too much force against the teeth during orthodontic treatment. Injury to the periodontal ligaments, teeth-grinding habits or some dental procedures like internal bleaching may also contribute to later root resorption.

Early diagnosis is a major part of effective treatment for root resorption. Because it's usually painless and easily overlooked, resorption is often too difficult to detect in its early stages without x-rays—a good reason for regular dental exams. Beginning spots or lesions are usually small enough to surgically remove the tissue cells causing the damage and then filled with a tooth-colored filling material. If it has advanced further, we may also need to perform a root canal treatment.

At some point, the damage from root resorption can be too great, in which case it might be best to remove the tooth and replace it with a dental implant or similar restoration. That's why catching root resorption early through regular dental exams can give you the edge for saving your tooth.

If you would like more information on diagnosing and treating root resorption, 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 “Root Resorption: An Unusual Phenomenon.”

3ThingsYouCanDotoHelpYourChildAvoidToothDecay

As a parent, you’re all about helping your kids grow up healthy. But there are some obstacles that can make that difficult. One in particular is tooth decay, which could interfere with their dental development.

A bacterial infection, tooth decay destroys dental tissue—and untreated it could lead to tooth loss. This could severely derail a child’s normal development, even if it’s one of their primary (“baby”) teeth. That’s why preventing tooth decay or treating it promptly when it occurs should be one of your top priorities for your child’s dental health.

Here are 3 things you can do to minimize your child’s risk of tooth decay.

Start oral hygiene early. Your best defense against tooth decay is to clean your child’s teeth daily of dental plaque, a thin film of bacteria and food particles that’s the main driver for dental disease. The best way to do this is with brushing and flossing, so begin performing these tasks with your child as soon as their teeth begin to appear. Oral hygiene is also important before their teeth come in—simply wipe your infant’s gums after nursing with a clean damp cloth to reduce bacteria in the mouth.

Start dental visits early. By age 1, most children already have quite a few teeth, making it the recommended time to schedule their first dental visit. Not only will this and subsequent visits support your plaque removal efforts, they also give your dentist an opportunity to catch any emerging dental issues. Early visits can also help get your kids used to seeing the dentist, reducing the chances they’ll develop dental visit anxiety later in life.

Avoid “baby bottle decay.” Sugar is one of decay-causing bacteria’s favorite food sources, so restricting your child’s intake of this carbohydrate can lower their decay risk.  Besides limiting sugary snacks and sweets, be sure you do one more thing: eliminate sugar from the nighttime or naptime baby bottle. Parents often lay babies down to sleep with a bottle filled with sugary liquids like juice, milk or formula. Either avoid giving the bottle or make sure it only contains water.

If you would like more information on how to help your kids’ dental development stay on a healthy track, 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 “Top 10 Oral Health Tips for Children.”

TheRealTruthBehindEdHelmsMissingToothinTheHangover

Ed Helms is best known for his role as the self-absorbed, Ivy League sales rep, Andy Bernard, on television's The Office. But to millions of fans he's also Stu, a member of a bachelor trip to Las Vegas in the 2009 movie The Hangover. In it, Stu and his friends wake up from a wild night on the Strip to find some things missing: the groom-to-be, their memories and, for Stu, a front tooth.

In reality, the missing tooth gag wasn't a Hollywood makeup or CGI (computer-generated imagery) trick—it was Ed Helm's actual missing tooth. According to Helms, the front tooth in question never developed and he had obtained a dental implant to replace it. He had the implant crown removed for the Hangover movie and then replaced after filming.

Helms' dental situation isn't that unusual. Although most of the 170 million-plus teeth missing from Americans' mouths are due to disease or trauma, a few happened because the teeth never formed. While most of these congenitally missing teeth are in the back of the mouth, a few, as in Helms' case, involve front teeth in the “smile zone,” which can profoundly affect appearance.

Fortunately, people missing undeveloped teeth have several good options to restore their smiles and dental function. The kind of tooth missing could help determine which option to use. For example, a bridge supported by the teeth on either side of the gap might work well if the teeth on either side are in need of crowns.

If the missing tooth happens to be one or both of the lateral incisors (on either side of the centermost teeth), it could be possible to move the canine teeth (the pointy ones, also called eye teeth) to fill the gap. This technique, known as canine substitution, may also require further modification—either by softening the canines' pointed tips, crowning them or applying veneers—to help the repositioned teeth look more natural.

The optimal solution, though, is to replace a missing tooth with a dental implant which then has a lifelike crown attached to it, as Ed Helms did to get his winning smile. Implant-supported replacement teeth are closest to natural teeth in terms of both appearance and function. Implants, though, shouldn't be placed until the jaw has fully developed, usually in early adulthood. A younger person may need a temporary restoration like a bonded bridge or a partial denture until they're ready for an implant.

Whatever the method, there's an effective way to restore missing teeth. Seeing us for an initial exam is the first step toward your own winning smile.

If you would like more information about restoring missing teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Dental Implants.”

By Gavin J Green DDS
February 22, 2020
Category: Oral Health
Tags: oral health   nutrition  
FollowtheFast-FoodLeadCutBackSodasinYourChildsDiet

You can find some version of the ever popular kids’ meal at most major fast-food restaurants. It’s a neat little package: child’s size portions of burgers, chicken nuggets or sides—and often a small toy or treat to boot—all tucked into its own colorful cardboard container.

The drive-thru menu board at your favorite fast-food joint gives you plenty of choices to fill out your child’s meal. But you may notice something missing on many major chains’ kids’ menus—the mention of soft drinks as a beverage choice. You can still get one for your child’s meal, but the visual cue is no more on the menu board.

None of the “Big Three”—Burger King, McDonald’s or Wendy’s—post soft drinks as a menu item for their kid’s meals. It’s the result of an effort by health advocates promoting less soda consumption by children, the leading source of calories in the average child’s diet. With its high sugar content, it’s believed to be a major factor in the steep rise in child obesity over the last few years.

Sodas and similar beverages are also prime suspects in the prevalence of tooth decay among children. Besides sugar, these beverages are also high in acid, which can erode tooth enamel. These two ingredients combined in soda can drastically increase your child’s risk of tooth decay if they have a regular soda habit.

You can minimize this threat to their dental health by reducing their soda consumption. It’s important not to create a habit of automatically including sodas with every meal, especially when dining out. Instead, choose other beverages: Water by far is the best choice, followed by regular milk. Chocolate milk and juice are high in sugar, but they’re still a healthier choice than sodas due to their nutrient content.

Keeping sodas to a minimum could help benefit your child later in life by reducing their risk for heart disease, diabetes and other major health problems. It will also help them avoid tooth decay and the problems that that could cause for their current and future dental health.

If you would like more information on these and other effective practices for protecting your child against tooth decay, please contact us or schedule an appointment for a consultation.





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