Posts Tagged ‘teeth’

Did you know: allergies caused by pollen can make your teeth hurt?

Those beautiful weeds coming out now can be a source of pain for your teeth: sinus problems that are worsened with the onset of pollen season often show up as tooth pain.

Allergic rhinitis involves inflammation of the mucous membranes of the nose, eyes, eustachian tubes, middle ear, sinuses, and throat (pharynx), and is characterized by symptoms that consist of any combination of the following: sneezing, itching (of nose, eyes, ears, palate), runny nose (rhinorrhea), postnasal drip, congestion, dental pain (upper back teeth, and even lower back teeth), inability to perceive odors (anosmia), headache, earache, tearing, red eyes, eye swelling, fatigue, drowsiness, and malaise. Allergic rhinitis is the most common cause of rhinitis. It is an extremely common condition, affecting approximately 20% of the population.

A common sign associated with allergic rhinitis is “allergic shiners”, dark circles around the eyes (related to vasodilation or nasal congestion). [Symptom versus sign: a symptom can more simply be defined as any feature which is noticed by the patient. A sign is noticed by other people. It is not necessarily the nature of the sign or symptom which defines it, but who observes it.]

How can you tell if it is your sinuses making your teeth hurt? Read the rest of this entry »

Did you know: allergies caused by pollen can make your teeth hurt?

Those beautiful blossoms coming out now can be a source of pain for your teeth: sinus problems that are worsened with the onset of pollen season often show up as tooth pain.

Allergic rhinitis involves inflammation of the mucous membranes of the nose, eyes, eustachian tubes, middle ear, sinuses, and throat (pharynx), and is characterized by symptoms that consist of any combination of the following: sneezing, itching (of nose, eyes, ears, palate), runny nose (rhinorrhea), postnasal drip, congestion, dental pain (upper back teeth, and even lower back teeth), inability to perceive odors (anosmia), headache, earache, tearing, red eyes, eye swelling, fatigue, drowsiness, and malaise. Allergic rhinitis is the most common cause of rhinitis. It is an extremely common condition, affecting approximately 20% of the population.

A common sign associated with allergic rhinitis is “allergic shiners”, dark circles around the eyes (related to vasodilation or nasal congestion). [Symptom versus sign: a symptom can more simply be defined as any feature which is noticed by the patient. A sign is noticed by other people. It is not necessarily the nature of the sign or symptom which defines it, but who observes it.]

How can you tell if it is your sinuses making your teeth hurt? Read the rest of this entry »

Colgate has two new sensitivity toothpastes: Colgate Sensitive Enamel Protect and Colgate Sensitive Multi Protection. Their introduction is a tremendous advantage for people with tooth sensitivity, increasing the options for effective sensitive toothpaste. Up to now the only sensitive toothpastes with tartar control were Sensodyne Full Protection and Sensodyne Tartar Control. If I recommend sensitive toothpaste I only recommend one with tartar control.

Read the rest of this entry »

They’re back. Seasonal allergies, and soon the flu.

A lot of people are coming in for their dental appointment and report having a cold for a couple weeks, sore throat, headaches, and feeling run down – with the HIGH pollen count (click here for our local pollen count), it’s is most likely you have seasonal allergy symptoms.

The Seasonal Flu Vaccine

And … it’s time again to think about getting a flu shot, which is generally offered between September and mid-November - typically before the late-fall to early-winter start of flu season. It takes up to two weeks to build immunity after a flu shot. Read the rest of this entry »

For more than 50 years, the American Dental Association (ADA) has promoted the protective value of wearing properly fitted mouthguards while participating in athletic or recreational activities that carry a risk of dental injury. Some sports require a mouthguard and most recommend one. Safety is essential to maintaining oral health, and a properly fitted mouthguard can minimize the risks of sustaining oral injuries during participation in sports.

• the ready-made, or stock, mouthguard;
• the mouth-formed, “boil-and-bite” protector;
• the custom-made model, either vacuum-formed or pressure-laminated by a dentist or a dental laboratory (based on the dentist’s instructions); a custom made mouthguard is not usually made until all the permanent teeth have erupted (not counting wisdom teeth)

People of all ages are encouraged to use a properly fitted mouthguard in any sporting or recreational activity that may pose a risk of injury. The best mouthguard is one that is utilized during sport activities. While custom mouthguards are considered by many to be the most protective option, other mouthguards can be effective if they: 1) fit well, 2) are worn properly and 3) stay in place.

I recommend a custom-made mouthguard, because experience and literature suggests that they generally provide better retention and comfort, less interference with speech and breathing, and more adaptability to orthodontic appliances.

One study found that boil-and-bite mouthguards can become dangerously thin in critical areas during formation, losing between 70 and 99 percent of their occlusal [chewing surface] thickness. Furthermore, laboratory impact tests of boil-and-bite mouth protectors have reported less adequate cushioning, retention and absorption than offered by custom-made mouthguards. A 1994 study noted that more than 40 percent of athletes wearing self-adapted mouthguards reported a loose fit, and two of three said they were too bulky. [from the Journal of the American Dental Association: Using mouthguards to reduce the incidence and severity of sports-related oral injuries.]

Care for Your Mouthguard (from ADA recommendations)

• Before and after each use, rinse with cold water. You can clean it with toothpaste and a toothbrush.
• Occasionally clean the mouthguard in cool, soapy water and rinse it thoroughly.
• Place the mouthguard in a firm, perforated container to store or transport it. This permits air circulation and helps to prevent damage.
• To minimize distortion, avoid high temperatures, e.g. very hot water, hot surfaces, or prolonged exposure to direct sunlight.
• Like any other sports gear, a mouthguard will wear out, making it less effective – replace as necessary.

PlaySafe is the leading custom fabricated sports mouthguard worldwide. Invented in 1982, PlaySafe has become the top choice in custom fabricated mouthguards for athletes in Europe, Australia and the United States. PlaySafe has the advantage over boil-and-bite mouthguards due to their superior fit and retention. Available in six levels of protection*, they range from one to three layers of laminated material with a final chewing surface thickness between 3 and 5 mm. The PlaySafe mouthguard can be customized with stickers, team logos, optional helmet strap (in red or black), and is available in a variety of colors. It usually takes about 2 weeks from the initial appointment to have your mouthguard.

PlaySafe Six Levels of Protection

• Junior: 1 layer of EVA material (3mm) with added incisal and occlusal protection. Designed specifically for children with mixed dentition (both baby and permanent teeth).
• Light: 2 layers of laminated EVA (3mm) material. Designed for wrestling, volleyball, mountain biking, and motocross. (Only available in clear, bright yellow, bright red, light blue or green.)
• Light Pro: 3 layers of laminated EVA (3.5mm) material (one hardened layer). Specially designed to provide maximum comfort and protection for all sports.
• Medium: 2 layers of laminated EVA (5mm) material. Specially fabricated for soccer, rugby, basketball, softball, rollerblading, and skateboarding.
• Heavy: 2 layers of laminated EVA (5mm) mate-rial with 3 unique power dispersion bands. Specially designed for baseball, foot-ball, racquetball, martial arts and boxing.
• Heavy Pro: 3 layers of laminated EVA (5mm) material (one hardened layer). Custom fabricated for ice, field and street hockey along with kick-boxing & other heavy contact sports where blows from pointed objects are expected.

Did you know: allergies caused by pollen can make your teeth hurt?

Those beautiful blossoms coming out now can be a source of pain for your teeth: sinus problems that are worsened with the onset of pollen season often show up as tooth pain.

Allergic rhinitis involves inflammation of the mucous membranes of the nose, eyes, eustachian tubes, middle ear, sinuses, and throat (pharynx), and is characterized by symptoms that consist of any combination of the following: sneezing, itching (of nose, eyes, ears, palate), runny nose (rhinorrhea), postnasal drip, congestion, dental pain (upper back teeth, and even lower back teeth), inability to perceive odors (anosmia), headache, earache, tearing, red eyes, eye swelling, fatigue, drowsiness, and malaise. Allergic rhinitis is the most common cause of rhinitis. It is an extremely common condition, affecting approximately 20% of the population.

A common sign associated with allergic rhinitis is “allergic shiners”, dark circles around the eyes (related to vasodilation or nasal congestion). [Symptom versus sign: a symptom can more simply be defined as any feature which is noticed by the patient. A sign is noticed by other people. It is not necessarily the nature of the sign or symptom which defines it, but who observes it.]

How can you tell if it is your sinuses making your teeth hurt? Read the rest of this entry »

DO

• Often you will be leaving with gauze to bite on.  Keep this gauze in place for up to 30 minutes.  If needed (notable oozing, bleeding), after this time gently remove and discard this gauze.  Replace it with another (two gauze folded in quarters), slightly damp with water.  Bite on this gauze for another 30 minutes, then gently remove and discard.
• Keep PRESSURE on a gauze until the bleeding stops. If HEAVY bleeding continues for more than an hour call us. We always give you extra gauze if needed.
• It is useful to apply pressure and a cold pack to reduce swelling, especially for difficult / impacted extractions. This can be applied to the outside of the mouth but make sure any local anesthetic has worn off or you may get frost bite.  Never use a hot compress as this will increase the swelling.
• It is normal to find a little bleeding, even for a couple days. To help stop oozing, you can take a tea bag (not herbal), wet it, squeeze all the water out, place it over the extraction area and bite on it for 20 minutes. The tannic acid in the tea constricts tiny blood vessels in the wound and helps to form a clot and stop the bleeding.
• Avoid alcohol beverages and hot liquids for 24 hours. These beverages will make the wound bleed more.
• Drink plenty of fluids (water is best).
• Try to eat soft, nutritious foods for the next few meals.
• Reduce strenuous activity for 24 hours.
• On the following day (after 24 hours) very gently rinse (not swishing) your mouth with warm salt water (1/4 – 1/2 tsp. salt in 5 ounces of water) after every meal for two to three days.
• It is normal to experience some discomfort, and to notice a little swelling.
• If you have received a prescription for pain or an antibiotic, please take the medication as directed.
• If you have been directed to use an ice pack, please follow the instructions.
• On the evening after your extraction it’s a good idea to place an old towel on your pillow to prevent any blood spots.

DON’T

• Do not smoke, a minimum of 24 hours, better if not for 48 hours.
• Do not rinse vigorously for one week.
• Do not drink through a straw for one week.
• For the first day after the operation do not rinse, poke or brush the area of surgery.
• Do not suck on candy, mints, etc. for at least one week.
• Do not spit vigorously.

If you have prolonged / severe pain, bleeding, swelling, or fever after an extraction, call – don’t wait.

Teeth are meant to touch and chew against one another, and to fit like very well designed gears. When teeth don’t fit ideally, and one or more teeth touch harder than another, there are significant long-term consequences. The reason for adjusting the bite is to avoid the continued process of damage and destruction that will occur if the conditions are left alone.

teeth touching too hard

Many people clench and/or grind their teeth. This is very common, and usually occurs with increased frequency and intensity during times of stress. Clenching and grinding of teeth although common, usually does NOT occur if teeth fit well. It is also true that even if someone does not detect that they are clenching or grinding their teeth they still can have destructive forces on them. Bite guards (often also called night guards) have long been used to treat clenching and grinding, and they can be useful if symptoms persist even after teeth have been accurately reshaped. [The bite guard of choice that I recommend and have used for almost 10 years is an NTI bite guard.]

When the jaws close and teeth touch together, the jaws act as hinges. The teeth should come together evenly, at the same time, with evenly distributed force, without any tooth or teeth touching before another. When teeth don’t touch evenly, this puts stress on the teeth, supporting bone, jaw joints and muscles.

gum and bone receding

If teeth are substantially out of position, then orthodontics (braces, retainers, etc.) are indicated. If other symptoms are present, such as muscle or jaw joint problems, other treatments may be indicated. When teeth are fairly well aligned, and still not touching perfectly, then reshaping them to fit more gently is indicated. The process of reshaping can include just a few teeth or all teeth. In fact, almost all people require bite adjustment when braces are completed, because even though teeth are aligned, the points and grooves are still not touching perfectly.

Reshaping the teeth to make them fit better and touch more gently harmonizes the relationship between the teeth, the jaw joints and the muscles. Reshaping is referred to by various names:  bite adjustment, occlusal adjustment, equilibration, or selective grinding – they all mean the same thing.

The points and grooves of teeth can tolerate the forces placed on them on specific parts of each tooth. These are identified by different means, and the areas not supposed to touching are reshaped. See the picture below where red indicator marks on teeth show where opposing teeth touch.

red indicator marks where opposing teeth touch

 Reasons Teeth Can Fit Less Than Ideally

• teeth crowded or crooked
• teeth out of alignment
• missing or extra teeth
• worn/broken fillings/crowns
• poorly shaped fillings/crowns
• unusual tooth shape
• jaw position
• tooth size
• jaw size
• muscle dysfunction
• nerve damage
• tumors or cysts
• accident or trauma

Symptoms that involve muscles, jaw joints, and face-head-neck pain may have other causes as well, that must be ruled out. Nonetheless, when the teeth are touching too hard, this too must be addressed.

Process of Bite Adjustment

• diagnosis
• mark teeth
• reshape, polish
• monitor and re-evaluate  

The first step in the process of bite adjustment is to adequately diagnose that a problem exists. Many times an assumption is made that a problem = pain, when for issues related to the bite, pain is often one of the last symptoms. A comprehensive examination, including x-rays, is required to adequately diagnose conditions present. Sometimes models are made of your teeth and placed on an instrument called an articulator to simulate jaw and tooth movement and better diagnose your bite status. Other diagnostic tools may include joint x-rays, MRI, CT scan, electromyographs, T-Scan, MMPI, etc..

Signs, Symptoms and Consequences of Teeth Touching Unevenly 

• teeth become loose
• teeth chip and wear
• teeth become sensitive
• teeth move out of position
• notches in the teeth (abfractions)
• gums become sensitive
• gums and bone recede
• deeper gum crevices
• jaw joints make noise
• x-ray evidence of excessive force
• jaw joints become damaged
• muscles become tender
• headaches, migraines
• face, head, neck pain
• TMJ, TMD, MPDS

Next, teeth are marked with an indicator tape while teeth are closed and made to move in different directions simulating jaw movement. With the knowledge and experience about how and where teeth best tolerate forces placed on them, we reshape teeth so that they are not only touching where they are supposed to, but also with the degree of force that is distributed among teeth that can take the force. The actual reshaping is done with carbide or diamond tips and a handpiece (dental drill). See the picture above with red indicator marks on the teeth. A significant part of the reshaping process also involves making sure that the chewing and biting surfaces have the necessary point / groove pattern to allow food to escape while being chewed. A very flat surface can create great force on the tooth, and merely re-creating some more ideal groove pattern can alleviate the force on the tooth.  

Concerns About Bite Adjustment 

• taking tooth away
  When teeth fit unevenly, the enamel is already being worn away. Precision reshaping prevents future wear.
• will it hurt
  Only the enamel is reshaped, and enamel has no feeling. Occasionally, so much reshaping might be required that a filling or crown is necessary to give a tooth its proper contour, and in that case appropriate anesthesia is used.
• will it make teeth weaker
  The teeth are being weakened by the destructive forces placed on them, reshaping protects and strengthens them.

As the reshaping progresses, it often becomes apparent to the person that their bite is improving when they close their teeth together. This is actually a very helpful component to the process to rely on what the client feels as well.

It may take a number of visits to get the bite exactly right. As the larger discrepancies are reshaped at the initial visit, the client often discovers smaller spots that although the indicator markings seem accurate, the client can detect some teeth that touch just a little too much relative to other teeth. These are addressed at subsequent visits.

Once the reshaping is completed the reshaped areas are polished and checked.

It is important to note that once the bite is adjusted properly, your teeth may again in the future require some bite adjustment. If a comprehensive bite adjustment of all teeth is done, perhaps only a few teeth may require later adjustment. The reason for this is that over decades teeth can move slightly, teeth wear, etc., making the fit of teeth change some. It is always appropriate after the initial bite adjustment to monitor for further signs and symptoms, and to re-evaluate the effectiveness (reduction / elimination of symptoms) of the bite adjustment at future visits.

What Causes Decay?

Decay is caused by dental plaque, a thin, sticky colorless deposit of bacteria that constantly forms on everyone’s teeth. When food is eaten (not just sugar), the bacteria in plaque produce acids that attack the tooth enamel. After repeated acid attacks, the enamel breaks down, and a cavity (hole) is formed.

before after

 
What Is A Sealant?

A sealant is a plastic material that is applied to the grooves of teeth, where decay occurs most often. This sealant acts as a barrier, protecting the decay prone areas of the teeth from plaque germs.  Sealants are a safe, painless, and low-cost way to help protect your teeth from decay.  Sealants have been used for than 30 years.

How Are Sealants Beneficial?

Many teeth have tiny grooves that form as they develops.  These are pits and fissures.  This is where most decay occurs.  That’s because the bristles of a toothbrush can’t get down into the grooves to remove the food and bacteria that get trapped there.  By forming a thin covering over the pits and fissures, sealants keep out plaque and food, and thus decrease the risk of decay.

How Are Sealants Applied? 

• The tooth is cleaned.
• The tooth is dried, and cotton or other material is put around the tooth so it stays dry.
• A solution is put on the tooth surface that makes the tooth a little rough. (It is easier for the sealant to stick to a slightly rough tooth).
• The tooth is rinsed and dried. Then new cotton is put around the tooth so it stays dry.
• The sealant is applied in liquid form and is hardened by light in a seconds.

Who Should Have Sealants Applied And When?

Although children receive significant benefits from sealants, adults can also be at risk for pit and fissure decay and thus be candidates for sealants.

Children benefit from getting sealants on their permanent back teeth as soon as the teeth completely erupt – before decay attacks the teeth.  Teenagers and adults without decay or fillings in the grooves of their teeth also may benefit from sealants.

• The first permanent molars — called “6 year molars”– come in between the ages of 5 and 7.
• The second permanent molars –”12 year molars”– come in when a child is between 11 and 14 years old.
• The other teeth with pits and grooves — called “premolars” or “bicuspids”– right in front of the molars, also benefit from sealants.

Which Teeth Should Be Sealed? 

Only decay free teeth are sealed (see more about laser cavity detection, click here).  Usually the molars and premolars are sealed; however, any tooth (sometimes behind an upper front tooth) with a substantial groove that is not cleansable can benefit from a sealant.  Fluoride helps protect the smooth surfaces, but only sealants can keep food and bacteria from getting into the grooves of the teeth.

What About Baby Teeth? 

The baby molars often don’t need to be sealed.  However, it may be beneficial to seal the baby molars if there is a high risk of decay (sometimes too if there is not a permanent tooth to replace the baby tooth).  Since baby teeth are “space holders”, losing baby molars from decay can cause crowding when the permanent teeth come in.

How Long Does Sealing Take?

Generally, all the back teeth can be sealed in one 30 to 60-minute office visit.

Will Insurance Cover Sealants?

Many dental insurance plans cover all or part of the cost of sealants for children.  Check with your insurance company for details, because there are often age limits, even limits on which teeth may be covered.

How Long Do Sealants Last?

Sealants can last for many years, as much as 20 or more.  If they chip or come off, they can easily be replaced.  Any problems can be detected at your regular dental checkups.  As long as the sealants are in place (and done carefully), it is very difficult for decay to develop in the grooves.  You can help the sealants last by not chewing on ice cubes or hard or sticky candy.

Are Sealants Safe?

Yes.

The ADA is a professional association of dentists committed to the public’s oral health. As such, the ADA supports ongoing research on the safety of existing dental materials and in the development of new materials.  Based on current research the Association agrees with the authoritative government agencies that the low-level of BPA exposure that may result from dental sealants and composites poses no known health threat.

Reports from a 1996 study questioned the safety of sealants, and resurfaced again in 2001 in a commentary by MSNBC.  The 1996 study from the University of Granada in Spain questioned whether a raw ingredient used in the manufacture of sealants is leached out with subsequent detrimental estrogenic effects.  Further studies by the American Dental Association, researchers at the University of Nebraska Dental School, and Boston University School of Dental Medicine showed that if BPA is leached from sealants it is not detectable in blood tests and therefore does not represent an estrogenic hazard.  I feel very confident in both the safety and value of sealants for both adults and children.

Tooth loss can have a far-reaching effect on your dental health and personal appearance. When you lose one or more teeth, your remaining teeth can drift out of position. This can lead to a change in the bite, the loss of additional teeth, decay and gum disease.

Dental implants can be an effective method to replace one tooth or several teeth. Each implant consists of a metal anchor that is inserted into the jawbone (the implant), and a protruding post (abutment), which is outfitted with an artificial tooth (crown). Implants can also support a bridge, replace a partial denture or secure a denture. The process requires surgery and may take up to a year to complete.

Note: I restore the implant with the crown or bridge, the actual implant is placed by the oral surgeon or periodontist.

In the first procedure under anesthesia, a metal anchor (implant), or artificial root, is placed into the jawbone.  Bone grows around the anchor.  This takes about three to six months.	Next, a “healing” cap is placed when the implant is uncovered.
Then, the healing cap is removed and a metal post (abutment), may be attached to the anchor.	An impression or mold is made of the abutment, and the surrounding teeth.
When your gums and jawbone have healed, an artificial tooth (crown) is constructed, then screwed or cemented to the post.  Fitting your new tooth properly may take several appointments.
Single Tooth This type of prosthesis is used to replace one or two missing teeth.   Each prosthetic tooth attaches to its own implant.
Complete Denture This type of prosthesis replaces all the teeth in your upper or lower jaw.   The number of implants varies, depending on the type of prosthesis you choose.
Bridge This type of prosthesis can replace two or more teeth.  It is the most commonly performed implant procedure, and may require only two or three implants.