April is National Stress Awareness Month. But what does stress have to do with dentistry? According to the American Academy of Sleep Medicine, if you have a Type A personality or are under a lot of stress, you are more likely to suffer from a condition called bruxism, which means you habitually grind or gnash your teeth. One in ten adults grind their teeth, and the rate is much higher in stressful professions. In fact, the bruxism rate is seven times higher among police officers!
Many people grind their teeth in their sleep without realizing it, so how would you know if you are a "sleep bruxer"? If your spouse frequently elbows you in the ribs because of the grinding sounds you make, that could be your first clue. Unfortunately, dental damage is another common sign. Some people find out they are nighttime teeth grinders only when they are examined by a dentist since bruxing often leads to wear patterns on the teeth that only happen because of this behavior. Other complications can also develop: The condition can interfere with sleep, result in headaches and cause soreness in the face, neck or jaw. Chronic or severe nighttime teeth grinding can damage dental work, such as veneers, bridgework, crowns and fillings, and can result in teeth that are worn down, chipped, fractured or loose.
The most common treatment is a custom-made night guard made of high-impact plastic that allows you to sleep while preventing your upper and lower teeth from coming into contact. Although a night guard will protect your teeth and dental work, it won't stop the grinding behavior. Therefore, finding and treating the cause should be a priority.
The Bruxism Association estimates that 70 percent of teeth grinding behavior is related to stress. If you are a bruxer, you can try muscle relaxation exercises, stretching and breathing exercises, stress reduction techniques and, where feasible, any lifestyle changes that can allow you to reduce the number of stressors in your life. Prescription muscle relaxants may also help. In addition, teeth grinding may be related to sleep apnea. This possibility should be investigated since sleep apnea can have some serious health consequences—we offer effective treatments for this condition as well.
We can spot signs of bruxism, so it's important to come in for regular dental checkups. We look for early indications of dental damage and can help you protect your smile. If you have questions about teeth grinding or would like to discuss possible symptoms, please contact our office or schedule an appointment for a consultation. You can read more in the Dear Doctor magazine articles “Teeth Grinding” and “Stress & Tooth Habits.”
Most often, all of your child’s primary teeth will eventually be replaced by permanent teeth, but you shouldn’t consider them less important — there are serious consequences for losing a primary tooth prematurely. Besides providing a means for a child to chew food and speak clearly, primary teeth also save space for the permanent teeth to erupt; a premature loss could lead to malocclusions (bad bites) that may result in costly orthodontic treatment later.
That’s why it’s important to fight tooth decay in primary teeth. By keeping them healthy and in place until it’s time for their departure, their permanent replacements have a better chance of erupting into their proper positions.
Here are 4 tips for preventing tooth decay in primary teeth:
Begin daily oral hygiene when teeth first appear. Begin brushing with fluoride toothpaste as soon as the first primary teeth come in. Brushing removes bacterial plaque, the primary cause of tooth decay, and fluoride strengthens enamel. Because they tend to swallow toothpaste rather than spit it out, use just a smear of toothpaste for infants and toddlers, and a pea-sized amount for ages two and older.
Start regular dental visits by the child’s first birthday. By beginning regular checkups around age 1, we’ll have a better chance of discovering developing tooth decay or other problems early. You’re also setting a good foundation for what should be a lifelong habit for optimum dental health.
Limit sugar consumption. The oral bacteria that cause tooth decay feed on leftover carbohydrates like sugar, so you should limit intake especially between meals. One culprit to watch out for: a bedtime bottle filled with formula, milk or fruit juices, all of which contain carbohydrates (sugar). Water or no bottle at all is a better alternative.
Consider topical fluoride or sealants for extra protection. In some circumstances, we may advise protecting the enamel of newly erupted teeth with an applied sealant. These protective coatings fill in porous pits and fissures in young teeth to deny access to disease. Supplemental fluoride will further strengthen young tooth enamel.
Taking these measures and remaining vigilant to the first signs of decay can go a long way toward preserving your child’s teeth. Their future oral health depends on it.
If you would like more information on dental care 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 “Dentistry & Oral Health for Children.”
A beautiful smile is a balanced smile, especially in regard to your gums. A normal smile usually shows 4 mm or less of gum tissue along with about 10 mm of tooth length. But if your gums show more than that, your smile may seem too gummy. In terms of perceived balance, this could detract from your smile's attractiveness.
Fortunately, you don't have to live with a gummy smile—there are various ways to correct or minimize its effect. First, though, we'll need to determine the underlying cause before deciding on the best treatment. And, there are several possible causes, the obvious being too much gum tissue present. Teeth that appear shorter due to wear or incomplete eruption could also make the gums appear larger.
We may be able to correct these size problems by surgically removing and reshaping excess gum tissues and possibly the underlying bone to reveal more of the teeth. We can also bond composite resins or porcelain veneers to shorter teeth to make them appear larger.
But not all gummy smile problems pertain directly to the teeth and gums; instead, it could be your upper lip moves too far up as you smile (hypermobility). Or, your upper jaw may be too long for your face, which can also cause too much of the gums to show during smiling.
With upper lip hypermobility, we may be able to inhibit the lip muscles' movement temporarily with Botox injections that partially paralyze the muscles (the effect eventually wears off, so this treatment will need to be repeated). A periodontist, an oral surgeon, or a plastic surgeon could also permanently alter the upper lip movement through a surgical procedure. Surgery may also be necessary for an abnormally long upper jaw: orthognathic surgery re-positions the jaw to the skull, which can lessen the amount of gums showing.
If your smile is too gummy, we can transform it. But first, let's find out what the real cause is with a comprehensive dental examination. Once we know, we can better advise you on the best way to bring beautiful balance to your smile.
If you would like more information on improving a gummy 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 “Gummy Smiles.”
Mayim Bialik has spent a good part of her life in front of TV cameras: first as the child star of the hit comedy series Blossom, and more recently as Sheldon Cooper’s love interest — a nerdy neuroscientist — on The Big Bang Theory. (In between, she actually earned a PhD in neuroscience from UCLA…but that’s another story.) As a child, Bialik had a serious overbite — but with all her time on camera, braces were just not an option.
“I never had braces,” she recently told Dear Doctor – Dentistry & Oral Health magazine. “I was on TV at the time, and there weren’t a lot of creative solutions for kids who were on TV.” Instead, her orthodontist managed to straighten her teeth using retainers and headgear worn only at night.
Today, there are several virtually invisible options available to fix orthodontic issues — and you don’t have to be a child star to take advantage of them. In fact, both children and adults can benefit from these unobtrusive appliances.
Tooth colored braces are just like traditional metal braces, with one big difference: The brackets attached to teeth are made from a ceramic material that blends in with the natural color of teeth. All that’s visible is the thin archwire that runs horizontally across the teeth — and from a distance it’s hard to notice. Celebs like Tom Cruise and Faith Hill opted for this type of appliance.
Clear aligners are custom-made plastic trays that fit over the teeth. Each one, worn for about two weeks, moves the teeth just a bit; after several months, you’ll see a big change for the better in your smile. Best of all, clear aligners are virtually impossible to notice while you’re wearing them — which you’ll need to do for 22 hours each day. But you can remove them to eat, or for special occasions. Zac Efron and Katherine Heigl, among others, chose to wear clear aligners.
Lingual braces really are invisible. That’s because they go behind your teeth (on the tongue side), where they can’t be seen; otherwise they are similar to traditional metal braces. Lingual braces are placed on teeth differently, and wearing them often takes some getting used to at first. But those trade-offs are worth it for plenty of people. Which celebs wore lingual braces? Rumor has it that the list includes some top models, a well-known pop singer, and at least one British royal.
So what’s the best way to straighten your teeth and keep the orthodontic appliances unnoticeable? Just ask us! We’d be happy to help you choose the option that’s just right for you. You’ll get an individualized evaluation, a solution that fits your lifestyle — and a great-looking smile!
For more information about hard-to-see (or truly invisible) orthodontics, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Orthodontics for the Older Adult” and “Clear Aligners for Teenagers.”
After your son or daughter's dental exam, you expect to hear about cavities, poor bites or other dental problems. But your dentist might suggest a different kind of problem you didn't expect—an eating disorder.
It's not a fluke occurrence—a dental exam is a common way bulimia nervosa or anorexia nervosa come to light. That's because the teeth are often damaged by the behaviors of a patient with an eating disorder.
Most of this damage occurs because of purging, the practice of induced vomiting after eating. During vomiting stomach acid can enter the mouth and "wash" against the back of the teeth. After repeated episodes, the acid dissolves the mineral content of tooth enamel and causes it to erode. There's also a tell-tale pattern with eating disorders: because the tongue partially shields the back of the lower teeth while purging, the lower teeth may show less enamel erosion than the upper.
Hygiene practices, both negligent and too aggressive, can accelerate erosion. Anorexics often neglect basic grooming and hygiene like brushing and flossing, which increases the likelihood of dental disease. Bulimia patients, on the other hand, can be fastidious about their hygiene. They're more likely to brush immediately after purging, which can cause tiny bits of the enamel immediately softened by the acid wash to slough off.
In dealing with a family member's eating disorder, you should consider both a short and long-term approach to protect their dental health. In the sort-term the goal is to treat the current damage and minimize the extent of any future harm. In that regard, encourage them to rinse with water (mixed optionally with baking soda to help neutralize acid) after purging, and wait an hour before brushing. This will give saliva in the mouth a chance to fully neutralize any remaining acid. Your dentist may also recommend a sodium fluoride mouth rinse to help strengthen their tooth enamel.
For the long-term, your goal should be to help your loved one overcome this potentially life-threatening condition through counseling and therapy. To find out more about treatment resources near you, visit the National Eating Disorders Association website at nationaleatingdisorders.org. Taking steps to treat an eating disorder could save not only your loved one's dental health, but also their life.
If you would like more information on eating disorders and dental 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 “Bulimia, Anorexia & Oral Health.”
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