Posts for category: Oral Health
On the big screen, Australian-born actress Margot Robbie may be best known for playing devil-may-care anti-heroes—like Suicide Squad member Harley Quinn and notorious figure skater Tonya Harding. But recently, a discussion of her role in Peter Rabbit proved that in real life, she’s making healthier choices. When asked whether it was hard to voice a character with a speech impediment, she revealed that she wears retainers in her mouth at night, which gives her a noticeable lisp.
“I actually have two retainers,” she explained, “one for my bottom teeth which is for grinding my teeth, and one for my top teeth which is just so my teeth don't move.”
Clearly Robbie is serious about protecting her dazzling smile. And she has good reasons for wearing both of those retainers. So first, let’s talk about retainers for teeth grinding.
Also called bruxism, teeth grinding affects around 10 percent of adults at one time or another, and is often associated with stress. If you wake up with headaches, sore teeth or irritated gums, or your sleeping partner complains of grinding noises at night, you may be suffering from nighttime teeth grinding without even being aware of it.
A type of retainer called an occlusal guard is frequently recommended to alleviate the symptoms of bruxism. Typically made of plastic, this appliance fits comfortably over your teeth and prevents them from being damaged when they rub against each other. In combination with stress reduction techniques and other conservative treatments, it’s often the best way to manage teeth grinding.
Orthodontic retainers are also well-established treatment devices. While appliances like braces or aligners cause teeth to move into better positions, retainers are designed to keep teeth from moving—helping them to stay in those positions. After active orthodontic treatment, a period of retention is needed to allow the bite to stabilize. Otherwise, the teeth can drift right back to their old locations, undoing the time and effort of orthodontic treatment.
So Robbie has the right idea there too. However, for those who don’t relish the idea of wearing a plastic appliance, it’s often possible to bond a wire retainer to the back surfaces of the teeth, where it’s invisible. No matter which kind you choose, wearing a retainer can help keep your smile looking great for many years to come.
If you have questions about teeth grinding or orthodontic retainers, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Teeth Grinding” and “The Importance of Orthodontic Retainers.”
Implant-supported fixed bridges are growing in popularity because they offer superior support to traditional bridges or dentures. They can also improve bone health thanks to the affinity between bone cells and the implants' titanium posts.
Even so, you'll still need to stay alert to the threat of periodontal (gum) disease. This bacterial infection usually triggered by dental plaque could ultimately infect the underlying bone and cause it to deteriorate. As a result the implants could loosen and cause you to lose your bridgework.
To avoid this you'll need to be as diligent with removing plaque from around your implants as you would with natural teeth. The best means for doing this is to floss around each implant post between the bridgework and the natural gums.
This type of flossing is quite different than with natural teeth where you work the floss in between each tooth. With your bridgework you'll need to thread the floss between it and the gums with the help of a floss threader, a small handheld device with a loop on one end and a stiff flat edge on the other.
To use it you'll first pull off about 18" of dental floss and thread it through the loop. You'll then gently work the sharper end between the gums and bridge from the cheek side toward the tongue. Once through to the tongue side, you'll hold one end of the floss and pull the floss threader away with the other until the floss is now underneath the bridge.
You'll then loop each end of the floss around your fingers on each hand and work the floss up and down the sides of the nearest tooth or implant. You'll then release one hand from the floss and pull the floss out from beneath the bridge. Rethread it in the threader and move to the next section of the bridge and clean those implants.
You can also use other methods like specialized floss with stiffened ends for threading, an oral irrigator (or "water flosser") that emits a pressurized spray of water to loosen plaque, or an interproximal brush that can reach into narrow spaces. If you choose an interproximal brush, however, be sure it's not made with metal wire, which can scratch the implant and create microscopic crevices for plaque.
Use the method you and your dentist think best to keep your implants plaque-free. Doing so will help reduce your risk of a gum infection that could endanger your implant-supported bridgework.
If you would like more information on implant-supported bridges, 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 “Oral Hygiene for Fixed Bridgework.”
Learning you’re pregnant can be a joyous moment. But it also means life is about to change as you focus on protecting you and your child from anything that endangers your health.
Because of these new concerns you might even hesitate about receiving dental care, especially involving anesthesia. But several medical organizations representing doctors, OB-GYN physicians and dentists wholeheartedly recommend continuing regular dental visits during pregnancy.
In fact, you should continue them because you’re pregnant: physical and hormonal changes during pregnancy could increase your risk of dental disease.
For, example, your consumption of carbohydrates (like sugar) could increase, which in turn increases your risk of tooth decay. You’ll also need to be more concerned about dental plaque, a thin bacterial film on your teeth that can cause disease. Hormonal changes during pregnancy may make you more sensitive to plaque, and thus more susceptible to disease — especially periodontal (gum) disease.
In fact, a specific form of gum disease called pregnancy gingivitis affects around 40% of expectant women at some point in their pregnancy. And if you already have gum disease, pregnancy could worsen it. Left untreated the disease could develop into more severe periodontitis, which may significantly damage your teeth’s support structures far below the gum line, leading to bone loss, which could result in the eventual loss of your teeth. Daily brushing and flossing, regular cleanings and checkups and, if your dentist prescribes it, antibacterial mouth rinses can help you stay ahead of it.
But what about other procedures while you’re pregnant? It may be best to wait on elective treatments for cosmetic purposes until after the baby is born. But some situations like deep tooth decay that could require a root canal treatment may become too serious to postpone.
Fortunately, several studies have shown it’s safe for pregnant women to undergo many dental procedures including tooth fillings or extractions. And receiving local anesthesia doesn’t appear to pose a danger either.
The important thing is to remain diligent with your own personal hygiene — brushing and flossing — and making other healthy choices like eating a nutritious diet. And be sure to let your dentist know about your pregnancy to help guide your dental treatment over the next few months.
Office cleanings and other minor procedures are a routine part of regular dental care. For some people, though, a routine visit could put them at slight risk for a serious illness.
The reason for this concern is a condition known as bacteremia. This occurs when bacteria, in this case from the mouth and conceivably during an office cleaning or other routine dental procedure, enters the bloodstream. Although for most people this isn’t a great issue, there’s been concern that bacteremia could further compromise the health of patients with or susceptible to other conditions like endocarditis (heart inflammation), prosthetic joints or compromised immune systems.
This concern grew out of a number of studies in the early 20th Century that seemed to show a link between dental bacteremia and infective endocarditis. At about mid-century it became a common practice to administer antibiotics before dental work (usually 2 grams of amoxicillin or an equivalent about an hour before) to high risk patients as a way of protecting them against infection. The practice later expanded to other health issues, including many heart conditions.
Beginning in 2007, however, guidelines developed jointly by the American Heart Association and the American Dental Association reduced the number of conditions recommended for antibiotic therapy. Based on these guidelines, we now recommend pre-procedure antibiotics if you have a history of infective endocarditis, artificial heart valves, certain repaired congenital heart defects, or heart transplant that develops a subsequent heart valve problem. Patients with prosthetic joints or immune system problems are no longer under the guidelines, but may still undergo antibiotic therapy if believed necessary by their individual physician.
If you have a condition that could qualify for antibiotic therapy, please be sure to discuss it with both your dentist and physician. We’ll work together to ensure any dental work you undergo won’t have an adverse effect on the rest of your health.
If you would like more information on antibiotic therapy and dental care, 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 “Antibiotics for Dental Visits.”
In your search for the right toothpaste, you’re inundated with dozens of choices, each promising whiter teeth, fresher breath or fewer cavities. Cutting through the various marketing claims, though, you’ll find most toothpaste brands are surprisingly alike, each containing the same basic ingredients. Taken together, these ingredients help toothpaste perform its primary task — removing daily bacterial plaque from tooth surfaces.
Here, then, are some of the ingredients you’ll find — or want to find — in toothpaste.
Abrasives. A mild abrasive increases your brushing effectiveness removing sticky food remnants from teeth. And unlike the burnt, crushed eggshells of the ancient Egyptians or the brick dust used by 18th Century Brits, today’s toothpaste abrasives — hydrated silica (from sand), calcium carbonate or dicalcium phosphates — are much milder and friendlier to teeth.
Detergents. Some substances in plaque aren’t soluble, meaning they won’t break down in contact with water. Such substances require a detergent, also known as a surfactant. It performs a similar action as dishwashing or laundry soaps breaking down grease and stains — but the detergents used in toothpaste are much milder so as not to damage teeth or irritate gum tissues. The most common detergent, sodium lauryl sulfate, is gentle but effective for most people. If it does cause you irritation, however, you may want to look for a paste that doesn’t contain it.
Fluoride. This proven enamel strengthener has been routinely added to toothpaste since the 1950s, and is regarded as one of the most important defenses against tooth decay. If you’re checking ingredients labels, you’ll usually find it listed as sodium fluoride, stannous fluoride or sodium monofluorosphosphate (MFP). And since it inhibits bacterial growth, fluoride toothpastes don’t require preservative additives.
Humectants, binders and flavoring. Humectants help toothpaste retain moisture, while binders prevent blended ingredients from separating; without them your toothpaste would dry out quickly and require stirring before each use. And, without that sweet (though without added sugar) and normally mint flavoring, you wouldn’t find the average toothpaste very tasty.
The ADA Seal of Approval. Although not an ingredient, it’s still sound advice to look for it on toothpaste packaging. The seal indicates the product’s health claims and benefits are supported by the research standards set by the American Dental Society; and all ADA approved toothpastes will contain fluoride.
If you would like more information on toothpaste and other oral hygiene products, 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 “Toothpaste: What’s in it?”