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JulianneHoughSharesaVideo-andaSong-AfterWisdomTeethComeOut

Once upon a time, celebrities tried hard to maintain the appearance of red-carpet glamour at all times. That meant keeping the more mundane aspects of their lives out of the spotlight: things like shopping, walking the dog and having oral surgery, for example.

That was then. Today, you can find plenty of celebs posting pictures from the dentist on social media. Take Julianne Hough, for example: In 2011 and 2013, she tweeted from the dental office. Then, not long ago, she shared a video taken after her wisdom teeth were removed in December 2016. In it, the 28-year-old actress and dancer cracked jokes and sang a loopy rendition of a Christmas carol, her mouth filled with gauze. Clearly, she was feeling relaxed and comfortable!

Lots of us enjoy seeing the human side of celebrities. But as dentists, we’re also glad when posts such as these help demystify a procedure that could be scary for some people.

Like having a root canal, the thought of extracting wisdom teeth (also called third molars) makes some folks shudder. Yet this routine procedure is performed more often than any other type of oral surgery. Why? Because wisdom teeth, which usually begin to erupt (emerge from beneath the gums) around age 17-25, have the potential to cause serious problems in the mouth. When these molars lack enough space to fully erupt in their normal positions, they are said to be “impacted.”

One potential problem with impacted wisdom teeth is crowding. Many people don’t have enough space in the jaw to accommodate another set of molars; when their wisdom teeth come in, other teeth can be damaged. Impacted wisdom teeth may also have an increased potential to cause periodontal disease, bacterial infection, and other issues.

Not all wisdom teeth need to be removed; after a complete examination, including x-rays and/or other diagnostic imaging, a recommendation will be made based on each individual’s situation. It may involve continued monitoring of the situation, orthodontics or extraction.

Wisdom tooth extraction is usually done right in the office, often with a type of anesthesia called “conscious sedation.”  Here, the patient is able to breathe normally and respond to stimuli (such as verbal directions), but remains free from pain. For people who are especially apprehensive about dental procedures, anti-anxiety mediation may also be given. After the procedure, prescription or over-the-counter pain medication may be used for a few days. If you feel like singing a few bars, as Julianne did, it’s up to you.

If you would like more information about wisdom tooth extraction, please call our office to arrange a consultation. You can learn more in the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”

By Tim O’Bryan, DDS.
June 08, 2018
Category: Oral Health
Tags: dental injury  
JuneIsNationalSafetyMonthBePreparedforDentalEmergencies

The National Safety Council has designated June as National Safety Month. A key component of staying safe is being prepared for emergencies, and this includes dental emergencies. Would you know what to do if you suffered any of the following dental mishaps?

Chipped tooth: One common dental injury is a chipped tooth. If this happens to you, save the missing chip if possible because we may be able to bond it back onto the tooth—but don’t be tempted to glue the chip back on by yourself! However, even without the missing chip, the tooth can most often be repaired with bonding material.

Cracked tooth: If you crack a tooth, rinse your mouth with warm water. If it is bleeding, hold a clean washcloth or gauze to the area until the bleeding stops, but don’t wiggle the tooth around or bite down hard. Keep in mind that the sooner your tooth is repaired, the better. Depending on how bad the crack is, if the tooth can be treated, it will most likely continue to function pain-free for years to come.

Displaced (“luxated”) tooth: If an injury causes your tooth to become loose, shoves it sideways or pushes it into or out of its socket, don’t try to force the tooth back into position on your own. Instead, call the dental office right away and leave it to us to bring the tooth back into its proper place and determine the extent of the injury.

Knocked out tooth: If a permanent tooth is knocked out of your mouth, pick it up without touching the root and rinse it off with cold water, but do not scrub. For the best chance of saving the tooth, place it firmly back in its socket within five minutes and hold it in position for a few minutes. If this is not possible, keep the tooth between your cheek and gum or in a glass of cold milk so that it doesn’t dry out. Call the dental office immediately.

If a baby tooth is knocked out, there is no need to place it back in the socket since baby teeth are not reattached. However, it is still important to have us examine the injury.

Being prepared for dental emergencies can help save a tooth as well as avoid more costly dental treatment down the road. But no matter what type of dental injury you have, it is important to come in for a consultation as the injury may extend beyond the part of the tooth that is visible. With today’s materials and technology, there’s a very good chance your smile can look as good as before—and often even better!

If you have questions about dental injuries, please contact our office or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Trauma and Nerve Damage to Teeth” and “Artistic Repair of Front Teeth with Composite Resin.”

By Tim O’Bryan, DDS.
May 29, 2018
Category: Dental Procedures
Tags: orthodontics   retainers  
RetainersHelpyouProtectYourNewlyAlignedTeeth

Orthodontics can produce an amazing smile transformation. With today’s advanced appliances and techniques even the most difficult malocclusions (bad bites) can be overcome. All of this innovation, however, depends on one basic anatomical fact: though firmly set in the mouth, our teeth can still move.

Teeth are actually held in place by the periodontal ligament, a strong, elastic tissue that attaches to them through tiny collagen fibers on one side of the ligament and to the jawbone with similar fibers on the other side. When pressure is placed against a tooth, the bone on the opposite side of the force begins to dissolve (resorb), allowing the tooth to move. As it moves, new bone is built up behind the tooth, to stabilize it. Orthodontists take advantage of this natural mechanism through orthodontic hardware like braces that applies pressure in the desired direction of movement, while the ligament and bone do the rest.

There is, though, a downside to this process. The teeth, bone and gum tissues can contain a kind of “memory” for the former natural position of the teeth. Over time, the lower front teeth tend to take a gradual migratory movement back towards their original position. Also, as we age the lower front teeth may crowd each other as there is a genetic influence for teeth to move to the midline of the face, causing a pressure that allows the skinny lower front teeth to slip behind each other. As a result of both of these tendencies, corrected teeth may retreat from their new positions.

To stop these tendencies, we use an appliance known as a retainer after braces or other hardware is removed. As the name implies, this appliance “retains” the teeth in their new position. For structural “memory,” the retainer will keep the teeth in their new position until the impulse to return to the old one has faded, about eighteen months. Retainers can also slow or stop the natural genetic influence of movement, but it may mean wearing a retainer for an indefinite period, especially individuals who’ve undergone orthodontic treatment later in life.

The length of time you’ll need to wear a retainer after braces — and what type, whether a removable appliance or one permanently attached — will depend on a number of factors including the type of malocclusion, your individual mouth structure and age. We’ll recommend the best option that ensures the best chance of keeping your teeth in their new position.

If you would like more information on retainers after 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 “Why Orthodontic Retainers?

CertainTreatmentsforOsteoporosisCouldComplicateOralSurgery

Although periodontal (gum) disease is the most common cause of bone loss in the mouth, women at or past menopause face another condition that could cause complications with their oral bone health — osteoporosis.

While normal bone goes through a balanced cycle of resorption (the dissolving of bone tissue) and re-growth, osteoporosis, a hormone-induced disease, tips the scale toward resorption. This reduces bone density, which weakens the bone and makes them more susceptible to fracture.

Some studies have shown a link between osteoporosis and existing gum disease; however, the greater concern at present from an oral health standpoint regards the side effects of a certain class of drugs called bisphosphonates used in the treatment of osteoporosis. Bisphosphonates slow excessive bone resorption, which helps restore normal balance to the bone growth cycle.

Some long-term users of bisphosphonates, however, may develop a complication in their jaw bone known as osteonecrosis in which isolated areas of the bone lose vitality and die. This can complicate certain types of oral surgery, particularly to install dental implants (which rely on stable bone for a successful outcome). While research is still ongoing, it does appear individuals at the highest risk of osteonecrosis are those with underlying cancers who receive high-dose intravenous bisphosphonate treatment every month for an extended period of time.

It’s important then that you let us know before any dental procedure if you’ve been diagnosed with osteoporosis and what treatment you’re receiving for it. If you’ve been taking a bisphosphonate for an extended period of time, we may recommend that you stop that treatment for three months (if possible) before undergoing oral surgery. While your risk of complications from osteonecrosis is relatively small, adding this extra precaution will further reduce that risk and help ensure a successful outcome for your scheduled dental procedure.

If you would like more information on osteoporosis and oral 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 articles “Osteoporosis & Dental Implants” and “Good Oral Health Leads to Better Health Overall.”

By Tim O’Bryan, DDS.
May 09, 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.”





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