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Posts for category: Oral Health

By Digiorno Dental Fitness
January 18, 2019
Category: Oral Health
Tags: tooth decay  
HowaNewApproachtoTreatingDecayCouldBenefitYou

Dental caries (tooth decay) is a leading cause of tooth loss. But with prompt diagnosis and care we can often stop it before it causes too much damage.

The traditional treatment approach is simple: remove all diseased tooth structure and then restore the tooth with a filling. But this otherwise effective treatment has one drawback: you may lose significant healthy structure to accommodate a suitable filling or to make vulnerable areas easier to clean from bacterial plaque.

That's why a new treatment approach called minimally invasive dentistry (MID) is becoming more common. The goal of MID is to remove as little of a tooth's natural enamel and dentin as possible. This leaves the treated tooth stronger and healthier, and could reduce long-term dental costs too.

Here's how MID could change your future dental care.

Better risk assessment. MID includes a treatment protocol called caries management by risk assessment (CAMBRA). With CAMBRA, we evaluate your individual tooth decay risk, including oral bacteria levels, the quality of saliva flow to neutralize mouth acid, and sugar consumption. We then use our findings to customize a treatment plan that targets your areas of highest risk.

New detection methods. The real key to fighting tooth decay is to find it before it can destroy tooth structure with the help of new diagnostic technology. Besides advances in x-ray imaging that provide better views with less radiation exposure, we're also using powerful dental microscopes, lasers and infrared photography to show us more about your teeth than we can see with the naked eye.

"Less is More" treatments. In contrast to the dental drill, many dentists are now using air abrasion rather than a dental drill to remove decayed tooth material. Air abrasion emits tiny material particles within a pressurized air stream that leaves more healthy tooth structure intact than with drilling. We're also using new filling materials like composite resin that not only resemble natural tooth color, but require less structural removal than other types of fillings.

Using MID, we can treat tooth decay while preserving more of your natural teeth. This promises better long-term outcomes for future dental health.

If you would like more information on new treatments for tooth decay, 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 “Minimally Invasive Dentistry: When Less Care is More.”

DentalInjuryIsJustaTemporarySetbackforBasketballStarKevinLove

The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.

In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?

The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.

Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.

So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”

Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.

If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”

PreventWhiteSpotsonTeethWhileWearingBraceswithDiligentOralHygiene

After months of wearing braces it's time for the big reveal: your new and improved smile! Your once crooked teeth are now straight and uniform.

But a look in the mirror at your straighter teeth might still reveal something out of place: small chalky-white spots dotting the enamel. These are most likely white spot lesions (WSLs), points on the enamel that have incurred mineral loss. It happens because mouth acid shielded by your braces contacted the teeth at those points for too long.

Most mouth acid is the waste product of bacteria that thrive in dental plaque, a thin film of food particles that can build up on tooth surfaces. High levels of acid are a definite sign that plaque hasn't been removed effectively through brushing and flossing.

But normal hygiene can be difficult while wearing braces: it's not easy to maneuver around brackets and wires to reach every area of tooth surface. Specialized tooth brushes can help, as well as floss threaders that help maneuver floss more easily through the wires. A water irrigator that uses pulsating water to remove plaque between teeth is another option.

However, if in spite of stepped-up hygiene efforts WSLs still develop, we can treat them when we've removed your braces. One way is to help re-mineralize the affected tooth surfaces through over-the-counter or prescription fluoride pastes or gels. It's also possible re-mineralization will occur naturally without external help.

While your teeth are sound, their appearance might be diminished by WSLs. We can improve this by injecting a liquid tooth-colored resin below the enamel surface. After hardening with a curing light, the spot will appear less opaque and more like a normal translucent tooth surface. In extreme cases we may need to consider porcelain veneers to cosmetically improve the tooth appearance.

In the meantime while wearing braces, practice thorough dental hygiene and keep up your regular cleaning visits with your general dentist. If you do notice any unusual white spots around your braces, be sure to see your dentist or orthodontist as soon as possible.

If you would like more information on dental care during orthodontic treatment, 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 “White Spots on Teeth during Orthodontic Treatment.”

By Digiorno Dental Fitness
November 19, 2018
Category: Oral Health
LifeIsSometimesaGrindforBrookeShields

Ever since childhood, when her career as a model and actress took off, Brooke Shields has enjoyed worldwide recognition — through advertisements for designer jeans, appearances on The Muppet Show, and starring roles in big-screen films. But not long ago, that familiar face was spotted in an unusual place: wearing a nasal anesthesia mask at the dentist's office. In fact, Shields posted the photo to her own Instagram account, with the caption “More dental surgery! I grind my teeth!” And judging by the number of comments the post received, she's far from alone.

In fact, researchers estimate that around one in ten adults have dental issues that stem from teeth grinding, which is also called bruxism. (Many children also grind their teeth, but it rarely causes serious problems, and is often outgrown.) About half of the people who are teeth grinders report problems like persistent headaches, jaw tenderness and sore teeth. Bruxism may also result in excessive tooth wear, and may damage dental work like crowns and bridges; in severe cases, loosened or fractured teeth have been reported.

Researchers have been studying teeth grinding for many years; their findings seem to indicate that it has no single cause. However, there are a number of factors that play a significant role in this condition. One is the anatomy of the jaw itself, and the effect of worn or misaligned teeth on the bite. Another factor relates to changes in brain activity that occur during the sleep cycle. In fact, nocturnal (nighttime) bruxism is now classified as a sleep-related movement disorder. Still other factors, such as the use of tobacco, alcohol and drugs, and a high level of stress or anxiety, can make an individual more likely to experience bruxism.

What can be done for people whose teeth grinding is causing problems? Since this condition may have many causes, a number of different treatments are available. Successful management of bruxism often begins by striving to eliminate the factors that may cause problems — for example, making lifestyle changes to improve your health, creating a soothing nighttime environment, and trying stress-reduction techniques; these may include anything from warm baths and soft music at bedtime, to meditation and mindfulness exercises.

Several dental treatments are also available, including a custom-made occlusal guard (night guard) that can keep your teeth from being damaged by grinding. In some cases, a bite adjustment may also be recommended: In this procedure, a small amount of enamel is removed from a tooth to change the way it contacts the opposite tooth, thereby lessening the biting force on it. More invasive techniques (such as surgery) are rarely needed.

A little tooth grinding once in a while can be a normal response to stress; in fact, becoming aware of the condition is often the first step to controlling it. But if you begin to notice issues that could stem from bruxism — or if the loud grinding sounds cause problems for your sleeping partner — it may be time to contact us or schedule an appointment. You can read more about bruxism in the Dear Doctor magazine article “Stress and Tooth Habits.”

By Digiorno Dental Fitness
November 09, 2018
Category: Oral Health
Tags: pediatric dentistry   x-rays  
AdvancedEquipmentandSafePracticesEnsureX-RaySafetyforChildren

When it comes to our children’s safety, there isn’t much nowadays that isn’t under scrutiny. Whether food, clothing, toys and more, we ask the same question: can it be harmful to children?

That also includes tried and true healthcare practices. One in particular, the routine x-ray, has been an integral part of dental care for nearly a century. As a means for detecting tooth decay much earlier than by sight, it has without a doubt helped save billions of teeth.

But is it safe for children? The reason to ask is because x-rays are an invisible form of electromagnetic radiation that can penetrate human tissue. As with other forms of radiation, elevated or frequent exposure to x-rays could damage tissue and increase the future risk of cancer.

But while there is potential for harm, dentists take great care to never expose patients, especially children, to that level or frequency of radiation. They incorporate a number of safeguards based on a principle followed by all healthcare professionals in regard to x-rays called ALARA, an acronym for “as low as reasonably achievable.” This means dentists and physicians use as low an exposure of x-ray energy as is needed to achieve a reasonable beneficial outcome. In dentistry, that’s identifying and treating tooth decay.

X-ray equipment advances are a good example of ALARA in action. Digital imaging, which has largely replaced film, requires less x-ray radiation for the same results than its older counterpart. Camera equipment has also become more efficient, with modern units containing lower settings for children to ensure the proper amount of exposure.

Dentists are also careful how often they take x-ray images with their patients, only doing so when absolutely necessary. As a result, dental patients by and large experience lower dosages of x-ray radiation in a year than they receive from natural radiation background sources found every day in the environment.

Dentists are committed to using x-ray technology in as safe and beneficial a way as possible. Still, if you have concerns please feel free to discuss it further with your dental provider. Both of you have the same goal—that your children have both healthy mouths and healthy bodies for the rest of their lives.

If you would like more information on x-ray safety for children, 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 “X-Ray Safety for Children.”