Posts for category: Oral Health
Teeth-replacing dental implants not only look life-like, they’re made to last. For one thing, the metals and dental materials used in them are impervious to bacterial infection.
But that doesn’t mean implants are impervious to failure. Implants depend on the bone and other natural mouth structures for support. If the bone becomes weakened due to disease, the implant could become unstable and ultimately fail.
Peri-implantitis, the condition that can lead to this kind of failure, is a major concern for implant longevity. It’s a type of periodontal (gum) disease triggered by plaque, a thin film of food particles that can build up quickly in the absence of adequate brushing and flossing. The gum tissues around the implant become infected and inflamed.
If the infection isn’t properly treated with renewed oral hygiene and clinical plaque removal, it could spread below the gum line and begin to damage the underlying gum tissues and bone. This could destroy the all-important connection between the titanium implant post and the bone. The implant could eventually loosen and become completely detached from the bone.
The key is early intervention before the bone becomes damaged. Besides plaque removal we may also need to apply antibiotics in some form to control the growth of disease-causing bacteria. If the disease has fairly advanced we may also need to consider surgical repair to strengthen the attachment between implant and bone.
You can help to avoid peri-implantitis altogether by practicing consistent daily brushing and flossing around all your teeth including the implant, and seeing your dentist at least twice a year for cleanings and checkups. And by all means see your dentist if you notice any signs of gum swelling, redness or bleeding. Staying on top of your gum health will help not only the natural tissues and remaining teeth in your mouth, it will help preserve your implants for decades to come.
Athletes in contact sports are at significant risk for traumatic injury to their teeth and mouth. It’s estimated 600,000 emergency room visits each year involve a sports-related dental injury.
Athletic mouthguards have become the premier safeguard against sports-related oral injuries. First worn by professional boxers in the 1920s, mouthguards are now required for use by various sports associations and leagues — from amateur youth to professional — for a number of sports. The National Collegiate Athletic Association (NCAA), for example, requires their use during play for hockey, lacrosse, field hockey and football. The American Dental Association recommends mouthguards for 29 sports or exercise activities.
But do mouthguards actually prevent injury? To answer that question in a scientific manner, the Journal of Sports Medicine published an evidence-based report in 2007 on mouthguard effectiveness for preventing or reducing the severity of oral-facial injuries and concussions. While the report objectively analyzed many of the problems and issues associated with mouthguards (like materials, design and durability), it concluded the risk of an oral-facial injury was nearly two times greater without the wearing of a mouthguard.
That being said, most dentists and other professionals in sports safety would advise not all mouthguards are alike. The stock, “off the shelf” mouthguard found in many retail stores with limited size offerings is the least expensive, but also least protective, of mouthguard types. Mouth-formed or “boil-and-bite” protectors, which are softened in boiling water and then bit down on by the player to form the fit, are better than the stock version — however, they often don’t cover all of the player’s back teeth.
The best option is a custom-designed guard made by a dentist for the individual patient. Although relatively expensive (costs range in the hundreds, compared with $25 or less for a stock guard), they provide the highest recognized level of mouth protection.
The bottom line: a mouthguard is a must-wear part of any uniform for any sport that involves contact or high velocity objects of play. If you or a family member is a contact sport athlete, it’s essential you protect your teeth and mouth with a custom-fit, high quality mouthguard.
If you would like more information on mouthguards, 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 “Athletic Mouthguards.”
What makes a beautiful smile? The teeth, of course: bright, evenly shaped and precisely aligned with each other. But your teeth can be as perfect as can be and your smile will still appear unattractive.
The reason? Your gums show more than they should when you smile.
What's considered a gummy smile is largely a matter of perception that can vary from person to person. As a rule of thumb, though, we consider a smile “gummy” if four millimeters (mm) or more of the gums show.
Fortunately, we can minimize the gums' prominence and make your smile more attractive. But what methods we use will depend on why your gums stand out. And it's not always because of the gums themselves.
It could be your teeth didn't erupt normally during dental development. Mature crown (the visible part of the tooth) length is normally about 10 mm with a width about 75-85% of that. But an abnormal eruption could result in teeth that appear too short, which can make the gums stand out more. We can correct this with a surgical procedure called crown lengthening in which we remove excess gum tissue and, if necessary, reshape the underlying bone to expose more of the tooth crown.
Another potential cause is how far your upper lip rises when you smile. Normally the lip rises only enough to reveal about 4 mm of teeth. In some cases, though, it may rise too high and show more of the gums. We can modify lip movement in a number of ways, including Botox injections to temporarily paralyze the lip. A more permanent solution is a lip stabilization procedure. It sounds bad, but it's a fairly simple procedure to surgically reposition the muscle attachments to restrict movement.
Your gummy smile may also result from an upper jaw too long for your facial structure. We can correct this with orthognathic (“ortho” – straighten, “gnathos” – jaw) surgery. During the procedure the surgeon permanently positions the jaw further up in the skull; this will reduce the amount of teeth and gums displayed when you smile.
Discovering the true cause of your gummy smile will determine how we treat it. After a complete oral examination, we can then discuss your options to transform your smile into a more attractive one.
If you would like more information on treating gummy smiles and other cosmetic problems, 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 “Gummy Smiles.”
Every February, the American Dental Association sponsors a campaign called National Children’s Dental Health Month. The purpose of this operation is to raise awareness about how important it is to get an early start on developing good dental hygiene habits — and how this can lead to a lifetime of healthy teeth and gums. So we thought this might be a good time to answer some of the most frequently asked questions about how to do exactly that:
When is it time to start cleaning my baby’s teeth?
As soon as you see one! The earlier your child gets used to a daily dental hygiene routine, the better. Baby teeth that have not fully emerged from beneath the gums can be wiped with a clean, moist washcloth after feedings. A tooth that has grown in completely should be brushed twice daily (once in the morning and once in the evening) with a soft, child-sized tooth brush and a thin smear of fluoride toothpaste. Fluoride is an important weapon against tooth decay, but you don’t want your child to swallow too much.
Can babies get cavities?
Absolutely — especially if they are allowed to fall asleep routinely with a bottle filled with anything but water. Milk, formula — even breast milk — all contain sugars that should not be left to pool around your baby’s teeth during sleep, facilitating decay. Juice is an even bigger no-no because it is not only sugary but also acidic.
Can’t I give my child sweets once in a while?
We realize total avoidance of sweets may not be realistic, as beneficial as this would be for your child’s teeth. If you are going to allow your child to have sweets once in a while, better that the treat be given immediately following a meal, and not as a between-meal snack. Soda should really be avoided completely — it’s that bad.
When should I take my child to the dentist for the first time?
The experts say: Get it done in year one. That’s right — even though your child won’t have many teeth by age 1, there’s a lot we can do at that first visit to ensure good oral health now and well into the future. We will do everything possible to make sure your little one has a positive first experience in the dental chair; this helps set the tone for the many important preventive visits yet to come. It’s also a great opportunity for you to ask any specific questions you may have, and receive hands-on instruction on how to care for your child’s teeth and gums.
If you would like more information about children’s oral health, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Taking the Stress Out of Dentistry for Kids” and “Age One Dental Visit.”
Question: What oral health issue do teenagers who wear orthodontic retainers and older folks who wear dentures have in common?
Answer: Both need to pay particular attention to cleaning their oral appliances.
The same goes for anyone who wears a nightguard to control tooth grinding, a mouthguard to protect teeth while playing sports, or a clear aligner for orthodontic treatment. Yet many people aren’t sure how to properly clean their appliances — so here are a few handy tips:
- Use toothpaste on your appliance — the ingredients in toothpaste, which are designed to polish the hard enamel of your teeth, are too abrasive for the soft plastic of oral appliances, and will cause scratches.
- Boil your appliance, or use bleach to clean it — both will end up breaking down and destroying the appliance. Don’t even use very hot water, as it can deform the plastic and make the appliance useless.
- Leave your appliance out on the nightstand, or anywhere else — pets and small children have been known to find (and destroy) oral appliances left lying around. Instead, store it properly in its special case.
- Use liquid dish detergent or hand soap to clean your appliance. A little mild soap plus warm water will do a great cleaning job. While you’re at it, get a brush just for the appliance — because, while it’s fine for plastic, you don’t want to brush your teeth with soap!
- Put a towel in the sink basin when you clean your appliance. Soapy appliances (especially dentures) can be slippery, and can be damaged by dropping — and that’s an expensive mishap.
- Consider investing in an ultrasonic cleaner. These inexpensive countertop devices are an excellent way to get the tiny ridges and crevices of your appliance really clean.
Whether you rely on dentures for everyday use, or just need to wear a retainer for a period of time, your oral appliance serves an important function. It may also represent a significant investment. That’s why it’s worthwhile to spend a few minutes each day giving these important items the care they need.