My Blog

By David E. Shapiro, DMD
August 13, 2018
Category: Oral Health
NoGleeinToothGrinding

Sure, it’s big news when celebs tweet selfies from the dental office… if you’re still living in the 20th century. But in Hollywood today, it’s harder to say who hasn’t posted snaps of themselves in the dentist’s chair than who has. Yet the pictures recently uploaded to Twitter by Mark Salling, the actor and singer who regularly appears as Noah “Puck” Puckerman on the popular TV series Glee, made us sit up and take notice.

“Getting my chipped tooth fixed. Also, apparently, I’m a big grinder,” read the caption. The photo showed a set of upper front teeth with visible chips on the biting surface. What’s so special about this seemingly mundane tweet? It’s a great way of bringing attention to a relatively common, but often overlooked problem: teeth clenching and grinding, also called bruxism.

Although bruxism is a habit that affects scores of people, many don’t even realize they have it. That’s because the condition may only become active at night. When the teeth are unconsciously ground together, the forces they produce can wear down the enamel, cause chipping or damage to teeth or dental work (such as veneers or fillings), or even loosen a tooth! While it’s common in children under 11 years old, in adults it can be a cause for concern.

Sometimes, mouth pain, soreness and visible damage alert individuals to their grinding habits; other times, a dental professional will notice the evidence of bruxism during an exam or cleaning: tooth sensitivity and telltale wear and tear on the chewing surfaces. Either way, it’s time to act.

Bruxism is most often caused by stress, which can negatively impact the body in many ways. It may also result from bite problems, the overuse of stimulating substances (caffeine, alcohol, tobacco, and illegal drugs), and as a side effect of certain medications. Sometimes, simply becoming aware of the habit can help a person get it under control. Common methods of stress reduction include exercise, meditation, a warm bath or a quiet period before bedtime; these can be tried while we monitor the situation to see if the problem is going away.

If stress reduction alone doesn’t do the trick, several other methods can be effective. When bruxism is caused by a minor bite problem, we can sometimes do a minor “bite adjustment” in the office. This involves removing a tiny bit of enamel from an individual tooth that is out of position, bringing it in line with the others. If it’s a more serious malocclusion, orthodontic appliances or other procedures may be recommended.

When grinding is severe enough to damage teeth or dental work, we may also recommend a custom-made night guard (occlusal guard), which you put in your mouth at bedtime. Comfortable and secure, this appliance prevents your teeth from being damaged by contacting each other, and protects your jaw joints from stresses due to excessive grinding forces.

Whether or not you have to smile for a living, teeth grinding can be a big problem. If you would like more information about this condition, call our office to schedule a consultation for a consultation.

By David E. Shapiro, DMD
August 03, 2018
Category: Oral Health
Tags: bad breath  
5CausesofBadBreathandWhatYouCanDoAboutIt

Unlike the months on either side, August isn't known for major holidays. But it does have one cause for celebration: National Fresh Breath Day! True, this observance will probably never achieve big-time recognition. Yet everyone would agree that fresh breath is something to appreciate! Unfortunately, bad breath is a persistent problem for many people. The first step in treating it is to identify the cause. Here are 5 common causes of bad breath:

1. Poor oral hygiene. Certain types of oral bacteria cause bad breath, and the mouth provides a perfect environment for them—especially when dental plaque and food debris is not well cleansed. So to keep your breath fresh, maintain a diligent oral hygiene routine. This includes brushing your teeth twice a day with fluoride toothpaste and flossing at least once a day. For an extra-clean mouth, use a tongue scraper—a plastic tool about the size of a toothbrush that's available in most drug stores. This will remove bacteria and food debris from your tongue for extra freshness.

2. Oral diseases. Bad odors in your mouth may also be caused by infections—which is what tooth decay and gum disease actually are. Sometimes old fillings wear out, allowing bacteria to re-infect a tooth that was once treated for decay. Other signs of these common oral diseases include tooth pain and bleeding or puffy gums. If you notice any of these, don't ignore it—make a dental appointment today!

3. Diet. Smelly foods will give you smelly breath; it's that simple. And the odors may linger after you have eaten them. When onion, garlic and other pungent foods are digested, their odor-producing substances enter your bloodstream and proceed to your lungs—which can affect how your breath smells. If you suspect your dietary habits are causing bad breath, try eliminating certain foods (at least temporarily) and see if that helps.

4. Dry mouth. Saliva helps cleanse your mouth, so reduced saliva flow can lead to bad breath. This accounts for "morning breath," which is caused when the mouth dries out during sleep (especially if you are a mouth-breather). However, some people don't produce enough saliva throughout the day. Sometimes it's just that they don't drink enough water. But a very common cause of chronic dry mouth is regular use of medications, both prescription and over-the-counter. If you notice that medication is drying out your mouth, let your doctor know. And stay hydrated!

5. Smoking. Given that smoking increases your risk for many serious diseases, including oral cancer, the fact that it can lead to bad breath seems almost trivial. Still, it's worth noting that smoking causes mouth odor both directly and indirectly by reducing the flow of saliva and promoting gum disease. In fact, tobacco in all forms is a hazard to your health.

If you'd like more information on bad breath, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Warning Signs of Periodontal (Gum) Disease” and “Dry Mouth.”

JawSurgerymaybeNecessarytoCorrectSomeTypesofPoorBites

In a normal bite, the upper and lower teeth line up and fit together when you close your jaws. When they don’t, you have a poor bite or “malocclusion.” The most common cause is teeth out of position, which can be corrected by moving them with braces.

Sometimes, though, the size and position of the jaws is the primary cause for the malocclusion and not the teeth. If the discrepancy is minor, tooth movement alone might be sufficient; but if there’s a wide discrepancy in the symmetry of the face or the size of one jaw over the other then a surgical solution may be necessary. One common procedure is orthognathic surgery, which literally means to “straighten the jaw.”

A wide range of irregularities — both minor and major — can be corrected by adjusting and realigning the bone in the jaw. While orthognathic surgery can certainly improve your facial profile and smile, its main purpose is to restore function that’s been lost due to poor jaw alignment. Candidates for the surgery have difficulty chewing, biting or swallowing food, chronic pain or headaches related to the jaw joints, chronic mouth breathing and dry mouth, or sleep apnea.

In many cases, treatment involving orthognathic surgery requires a team approach between orthodontist, oral surgeon and general dentist. While the surgeon surgically alters and repairs the jaw or facial structure, the services of an orthodontist may still be needed to move teeth misaligned due to the underlying problem with the jaw structure. The general dentist ensures teeth and gums remain healthy during all the other treatment phases.

Orthognathic surgery can benefit both oral and general health, as well as improve the appearance of the entire face. The process, however, can be complicated: you or your family member will need to undergo a thorough examination to determine if you or they are a good candidate for the surgery. If so, the end result can be life-changing.

If you would like more information on the treatment of jaw development disorders, 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 “Jaw Surgery & Orthodontics.”

DiabetesDoesntHavetoStopYouFromAcquiringDentalImplants

One of the best and most successful tooth replacement choices available is the dental implant. No other restorative method is as similar in both form and function to a real tooth as an implant; and with a success rate of 95-plus percent after ten years, it’s one of the most durable.

But there can be extenuating circumstances that make obtaining an implant difficult or sometimes impossible. One possible problematic situation is the systemic disease diabetes.

Diabetes is a hormonal condition in which the body is unable to sufficiently regulate the amount of glucose (a basic sugar that provides energy to the body’s cells) within the blood stream. Normally, the pancreas produces the hormone insulin to reduce excess glucose. But diabetes interferes with this insulin production: if you have Type 1 diabetes, the pancreas has stopped producing insulin altogether; if you have the more common Type 2, the body doesn’t produce adequate insulin or it doesn’t respond sufficiently to the insulin produced.

Over time diabetes can affect other areas of health, especially wound healing. Because the condition gradually causes blood vessels to narrow and stiffen, the normal inflammatory response to disease or trauma can become prolonged. This in turn slows the rate of wound healing.

Slow wound healing can have a bearing on the recovery period just after implant surgery, especially the necessary integration process that takes place between the bone and the titanium metal implant that provides its signature strength. If that process is impeded by slow wound healing caused by diabetes, the risk increases dramatically for implant failure.

That’s the worst case scenario if you have diabetes, but only if your condition is out of control. If, however, you have your blood sugar levels well regulated through medication, diet and exercise, then your chances for implant success could easily be on par with someone without diabetes.

So if you’re diabetic and are considering dental implants for missing teeth, it’s important to discuss the possibility of obtaining them with both your dentist and the physician caring for your diabetes. With your overall healthcare team working together, there’s no reason why diabetes should stop you from enjoying this premiere restoration for missing teeth.

If you would like more information on obtaining dental implants, 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 “Dental Implants & Diabetes.”

FanofSuperheroFilmBlackPantherBreaksSteelWirewithHerMouth

Some moviegoers have been known to crunch popcorn, bite their fingers or grab their neighbor’s hands during the intense scenes of a thriller. But for one fan, the on-screen action in the new superhero film Black Panther led to a different reaction.

Sophia Robb, an 18-year-old Californian, had to make an emergency visit to the orthodontic office because she snapped the steel wire on her retainer while watching a battle scene featuring her Hollywood crush, Michael B. Jordan. Her jaw-clenching mishap went viral and even prompted an unexpected reply from the actor himself!

Meanwhile, Sophia got her retainer fixed pronto—which was exactly the right thing to do. The retention phase is a very important part of orthodontic treatment: If you don’t wear a retainer, the beautiful new smile you’re enjoying could become crooked again. That’s because if the teeth are not held in their new positions, they will naturally begin to drift back into their former locations—and you may have to start treatment all over again…

While it’s much more common to lose a removable retainer than to damage one, it is possible for even sturdy retainers to wear out or break. This includes traditional plastic-and-wire types (also called Hawley retainers), clear plastic retainers that are molded to fit your teeth (sometimes called Essix retainers), and bonded retainers: the kind that consists of a wire that’s permanently attached to the back side of your teeth. So whichever kind you use, do what Sophia did if you feel that anything is amiss—have it looked at right away!

When Black Panther co-star Michael B. Jordan heard about the retainer mishap, he sent a message to the teen: “Since I feel partly responsible for breaking your retainers let me know if I can replace them.” His young fan was grateful for the offer—but even more thrilled to have a celebrity twitter follower.

If you have questions about orthodontic retainers, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Importance of Orthodontic Retainers” and “Bonded Retainers.”





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