During your lifetime you’ll eat thousands of meals — and generate a lot of force from chewing over the years. But thanks to a support system of gum tissues and bone, your teeth can normally handle it.
What your teeth can’t handle, though, are higher than normal chewing forces on a continual basis. This can happen if you grind your teeth, which can produce 20-30 times the normal force. The habit often arises in adults because of high stress and often occurs during sleep.
These abnormal forces can stretch the periodontal ligaments that hold teeth in place, cause the teeth to become loose and at increased risk for loss. The best treatment strategy is to reduce clenching with, for example, muscle relaxants or anti-inflammatory drugs or lower the effects with a mouth guard that won’t allow the teeth to make solid contact during clenching.
Your teeth can also become loose even with normal chewing forces if you have advanced periodontal (gum) disease. Gum disease arises from dental plaque, a thin film of bacteria and food particles left on teeth due to poor oral hygiene. As it builds up, it causes inflammation of the gum tissues resulting in bone loss and causing the gums to detach from the teeth, increasing pocket depth.
Our first step in this case is to treat the gum disease by removing plaque and calculus (tartar) from all tooth and gum surfaces. This includes infected areas below the gum line and around the roots, a circumstance that could require surgical access.
As treatment progresses in either of these scenarios the gum tissues heal and often regain their attachment to the teeth. But that can take time, so we may need to stabilize any loose teeth in the short term. The most common way is to splint them to other secure teeth. This is done by using a clear acrylic bonding material to join the loose teeth together with a strip of metal or other rigid material (like joining pickets in a fence).
When symptoms arise, quick action is the key to preventing lost teeth. If you notice swollen, painful or bleeding gums or especially loose teeth, don’t delay — contact us so we can begin treatment as soon as possible.
If you would like more information on the causes and treatments for loose teeth, 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 “Loose Teeth.”
Can you have healthy teeth and still have gum disease? Absolutely! And if you don’t believe us, just ask actor David Ramsey. The cast member of TV hits such as Dexter and Arrow said in a recent interview that up to the present day, he has never had a single cavity. Yet at a routine dental visit during his college years, Ramsey’s dentist pointed out how easily his gums bled during the exam. This was an early sign of periodontal (gum) disease, the dentist told him.
“I learned that just because you don’t have cavities, doesn’t mean you don’t have periodontal disease,” Ramsey said.
Apparently, Ramsey had always been very conscientious about brushing his teeth but he never flossed them.
“This isn’t just some strange phenomenon that exists just in my house — a lot of people who brush don’t really floss,” he noted.
Unfortunately, that’s true — and we’d certainly like to change it. So why is flossing so important?
Oral diseases such as tooth decay and periodontal disease often start when dental plaque, a bacteria-laden film that collects on teeth, is allowed to build up. These sticky deposits can harden into a substance called tartar or calculus, which is irritating to the gums and must be removed during a professional teeth cleaning.
Brushing teeth is one way to remove soft plaque, but it is not effective at reaching bacteria or food debris between teeth. That’s where flossing comes in. Floss can fit into spaces that your toothbrush never reaches. In fact, if you don’t floss, you’re leaving about a thirdÂ to half of your tooth surfaces unclean — and, as David Ramsey found out, that’s a path to periodontal disease.
Since then, however, Ramsey has become a meticulous flosser, and he proudly notes that the long-ago dental appointment “was the last we heard of any type of gum disease.”
Let that be the same for you! Just remember to brush and floss, eat a good diet low in sugar, and come in to the dental office for regular professional cleanings.
If you would like more information on flossing or periodontal disease, please contact us today to schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Understanding Gum (Periodontal) Disease.”
It’s estimated that between 10 and 40 million adults in the U.S. suffer from chronic jaw pain and disability. Healthcare providers refer to it as temporomandibular joint disorder (TMJD), a group of conditions characterized by pain and limited function with the jaw joints, as well as related muscles and tissues.
People with TMJD often experience popping, clicking or grating sounds when they move their lower jaw. The more serious symptoms, however, are severe pain and limited movement of the jaw. The causes of TMJD haven’t been fully substantiated, but it’s believed to be influenced by a person’s genetic background, their gender (most patients are women of childbearing age), their environment and behavioral habits. This uncertainty about the underlying causes has made it difficult to improve treatment strategies for the disorder.
One promising area of research, though, is suspected connections between TMJD and other health problems. In one survey of over 1,500 TMJD patients, nearly two-thirds indicated they had three or more other chronic conditions. Among the most frequently named were fibromyalgia, chronic fatigue syndrome, rheumatoid arthritis, and sleep disturbances.
We’re not quite sure how or why TMJD might be linked to these other conditions, but further study is underway. Researchers hope any knowledge uncovered could lead to advances in our ability to diagnose, treat and prevent TMJD.
Until then, the more traditional treatment approach remains the best course of action: medication to relax muscles and relieve pain; thermal therapies using hot and cold compresses during flare-ups; and physical therapy. Switching to softer foods temporarily may also give jaw muscles a rest from over-activity. Although jaw surgery is an option, we should consider it a last resort after other therapies have proven altogether ineffective in relieving pain and restoring function.
If you suspect you have TMJD, please visit a medical doctor first. Other conditions could mimic the symptoms of the disorder and would need to be ruled out first. If the diagnosis is TMJD, you’re not alone. You can receive information, support and updates on the latest research by visiting the TMJ Association at www.tmj.org.
If you would like more information on chronic jaw pain, 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 “Chronic Jaw Pain and Associated Conditions.”
Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.
“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…
For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.
When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.
A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.
But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.
Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!
If you have questions about repairing chipped teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”
Good nutrition is essential for your child's developing teeth and gums as well as the rest of their body. You do what you can to provide them not just nutritious meals but also healthy snacks for other times of the day.
But once they begin school, you can't watch out for them all the time. They could be away several hours where they might be tempted to make unhealthy snack choices.
What can you do to lessen their chances of unhealthy snacking at school?
Engage with the school and their snack offerings. A set of U.S. Department of Agriculture regulatory guidelines called Smart Snacks in Schools sets minimum nutritional standards for snacks offered on school grounds. These guidelines promote whole grains, fruits, vegetables and low-fat dairy products and limit calories, fat, salt and, of particular importance to dental health, sugar. The guidelines, though, are only a minimum, so join with other parents to encourage your school to exceed those snack nutrition minimums whenever possible.
Educate your child about nutrition. Good nutrition starts at home: it's important not only to offer wholesome foods but to also teach your child why some foods are better for their body (and their teeth) than others. By encouraging a lifestyle of healthy eating both in practice and knowledge, you'll find it easier to set limits on their snack choices away from home.
Send snacks with them to school. If you're unsure your child will make the right choices, especially if they're young, than send snacks with them to school. Be sure, though, what you're sending is as appealing as the school choices. Try a little creativity: popcorn with a zing of cinnamon or cheese; decorative snacks; or easy to eat bite-sized fruit or vegetables. The more they like what you're sending, the less likely they'll choose something else.
In some ways snacking could be the Achilles' heel in providing your child the right foods for good dental health. By following the tips above, though, you can help raise the chances they'll eat the best snacks for strong teeth and gums.
If you would like more information on nutrition 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 “Snacking at School.”
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