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Posts for category: Oral Health

ReducingToothSensitivitywillDependontheCause

If you're one of over 30% of Americans who wince in pain when eating and drinking certain foods and beverages, you may have tooth sensitivity. Although there are a number of possible causes, the most common place to look first is tooth dentin.

Lying just under the enamel, dentin consists of tiny tubules that transmit sensations like pressure or temperature variation to the nerves of the inner pulp. The enamel, the gums and a covering on the roots called cementum help dampen these sensations.

But over-aggressive brushing or periodontal (gum) disease can cause the gums to shrink back (recede) and expose the dentin below the gum line; it can also cause cementum to erode from the roots. This exposure amplifies sensations to the nerves. Now when you eat or drink something hot or cold or simply bite down, the nerves inside the dentin receive the full brunt of the sensation and signal pain.

Enamel erosion can also expose dentin, caused by mouth acid in contact with the enamel for prolonged periods. Acid softens the minerals in enamel, which then dissolve (resorb) into the body. Acid is a byproduct of bacteria which live in dental plaque, a thin film of food particles that builds up on teeth due to poor oral hygiene. Mouth acid may also increase from gastric reflux or consuming acidic foods or beverages.

Once we pinpoint the cause of your tooth sensitivity we can begin proper treatment, first and foremost for any disease that's a factor. If you have gum disease, we focus on removing bacterial plaque (the cause for the infection) from all tooth and gum surfaces. This helps stop gum recession, but advanced cases may require grafting surgery to cover the root surfaces.

You may also benefit from other measures to reduce sensitivity: applying less pressure when you brush; using hygiene products like toothpastes that block sensations to the dentin tubules or slow nerve action; and receiving additional fluoride to strengthen enamel.

There are effective ways to reduce your tooth sensitivity. Determining which to use in your case will depend on the cause.

If you would like more information on tooth sensitivity, 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 “Treatment of Tooth Sensitivity: Understanding Your Options.”

November 20, 2018
Category: Oral Health
Tags: oral health   GERD  
TheConnectionBetweenGERDandOralHealth

Not coincidentally, GERD Awareness Week overlaps with the Thanksgiving holiday. Many people get acid indigestion from time to time, especially during this month of major feasting, but if you suffer from more than occasional acid reflux, you may be among the 20 percent of U.S. adults with gastroesophageal reflux disease, or GERD. For many individuals, painful heartburn often accompanies acid reflux; however, for others there are few or no symptoms. In the latter situation, dentists may be the first to suspect GERD based on what we see during a regular dental exam.

With GERD, acid washes up from the stomach into the esophagus or throat, and even into the mouth. If the condition is not treated, the repeated contact with acid can lead to ulcers and cause pre-cancerous cell changes along the esophagus lining. In addition, the acids can eat away at tooth enamel and harm the soft tissues of the mouth, which may result in severely eroded teeth and chronic gum disease. Unfortunately for those who have relatively minor symptoms, GERD may go undetected until serious damage has been done. For this reason, diagnosis and treatment of GERD is very important.

You can play a big role in managing your GERD symptoms. Besides taking any over-the-counter or prescription medication your doctor recommends, you can help control acid reflux by eating smaller meals, avoiding foods and beverages that trigger heartburn, refraining from eating within three hours of bedtime, and resisting the urge to recline right after eating. Also, quitting smoking and taking off extra weight can help greatly.

Further, it is important to take steps to protect your teeth if you suffer from GERD. Here are some tips:

  • Neutralize acid by chewing on an antacid tablet or rinsing your mouth with half a teaspoon of baking soda mixed into a cup of water.
  • Don't brush your teeth immediately after an episode of acid reflux, as this could damage the weakened tooth enamel. Instead, rinse your mouth with water to dilute the acid and wait an hour before you brush to allow your saliva to rebuild the minerals on the surface of your teeth.
  • Schedule regular dental visits to monitor the health of your teeth and gums. Depending on your specific situation, we may recommend a particular treatment to help strengthen your teeth.

Our goal is to help you preserve your teeth for life, so be sure to tell us if you have been diagnosed with GERD or any other medical condition. If you have questions, contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “GERD and Oral Health” and “Tooth Decay: How to Assess Your Risk.”

HowBigBangTheoryActressMayimBialikGetsHerKidstoFloss

How many actresses have portrayed a neuroscientist on a wildly successful TV comedy while actually holding an advanced degree in neuroscience? As far as we know, exactly one: Mayim Bialik, who plays the lovably geeky Amy Farrah Fowler on CBS' The Big Bang Theory… and earned her PhD from UCLA.

Acknowledging her nerdy side, Bialik recently told Dear Doctor magazine, “I'm different, and I can't not be different.” Yet when it comes to her family's oral health, she wants the same things we all want: good checkups and great-looking smiles. “We're big on teeth and oral care,” she said. “Flossing is really a pleasure in our house.”

How does she get her two young sons to do it?

Bialik uses convenient pre-loaded floss holders that come complete with floss and a handle. “I just keep them in a little glass right next to the toothbrushes so they're open, no one has to reach, they're just right there,” she said. “It's really become such a routine, I don't even have to ask them anymore.”

As many parents have discovered, establishing healthy routines is one of the best things you can do to maintain your family's oral health. Here are some other oral hygiene tips you can try at home:

Brush to the music — Plenty of pop songs are about two minutes long… and that's the length of time you should brush your teeth. If brushing in silence gets boring, add a soundtrack. When the music's over — you're done!

Flossing can be fun — If standard dental floss doesn't appeal, there are many different styles of floss holders, from functional ones to cartoon characters… even some with a martial-arts theme! Find the one that your kids like best, and encourage them to use it.

The eyes don't lie — To show your kids how well (or not) they are cleaning their teeth, try using an over-the-counter disclosing solution. This harmless product will temporarily stain any plaque or debris that got left behind after brushing, so they can immediately see where they missed, and how to improve their hygiene technique — which will lead to better health.

Have regular dental exams & cleanings — When kids see you're enthusiastic about going to the dental office, it helps them feel the same way… and afterward, you can point out how great it feels to have a clean, sparkling smile.

For more information about oral hygiene, please contact our office or schedule a consultation. You can read the interview with Mayim Bialik in the latest issue of Dear Doctor magazine.

By Gale Marana, DDS
November 06, 2018
Category: Oral Health
Tags: sleep apnea   snoring  
DontLetSleepApneaRuinYourSleep-orYourHealth

Sleep apnea is more than an annoyance. This chronic condition not only interferes with your alertness during the day, it may also contribute long-term to serious issues like cardiovascular disease.

Sleep apnea occurs when your airway becomes temporarily blocked during sleep. Of the possible causes, one of the most common is the tongue, which as it relaxes may cover and block the back of the throat. This lowers the body's oxygen level, which in turn alerts the brain to wake you to clear the airway. You usually go immediately back to sleep, unaware you've wakened. This can happen several times a night.

Although older people are at higher risk, anyone can have sleep apnea, even children with enlarged tonsils or adenoids. If you or a loved one regularly experiences fatigue, brain fog, irritability or loud snoring, sleep apnea could be the culprit. You'll need a complete medical examination to properly diagnose it.

If you do indeed have sleep apnea, there are a number of ways to treat it depending on its severity. One prominent way is with a Continuous Positive Airway Pressure (CPAP) machine that produces a higher air pressure in the mouth to force the tongue forward and keep the airway open.

While CPAP is effective, the pump, hose and face mask you must wear may become uncomfortable while you sleep. We may, however, be able to supply you with a less cumbersome device: a custom-made oral appliance you wear while you sleep. Similar to a retainer, this appliance mechanically pulls and holds the lower jaw forward, which in turn moves the tongue away from the airway opening.

This oral appliance won't work with all forms of sleep apnea, so you'll need an examination to see if you're a candidate. With more advanced conditions, you may even need surgery to reshape the airway or remove soft tissue obstructions around the opening.

Whichever treatment is best for your situation, it's well worth reducing your sleep apnea. Not enduring these nightly incidences of airway blockage will help ensure you're getting a good night's sleep — and enjoying a higher quality of health and life.

If you would like more information on treating sleep apnea, 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 “If You Snore, You Must Read More!

By Gale Marana, DDS
November 06, 2018
Category: Oral Health
JamieFoxxChipsaTooth-ThisTimebyAccident

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.”