My Blog

September 18, 2018
Category: Oral Health
Tags: mouthguards  
ProtectYourTeethDuringFootballSeason

Autumn begins in the month of September, a season that promises cooler days and longer nights. But more significantly for sports fans, September marks the start of football season. Football remains America’s favorite spectator sport—and it’s also played by countless college and high school athletes, as well as those who enjoy an occasional pickup game in the back yard or on the beach. Yet, like many contact sports, football (even touch football) carries a risk of injury—and one of the areas of the body most vulnerable to injury is the mouth.

Some of the most common dental injuries in contact sports include lacerations (cuts), tooth fractures, displacement (teeth pushed deeper into or out of their sockets), knocked-out teeth, and temporomandibular joint problems. While it’s hard to pin down the exact statistics, researchers estimate that over 5 million teeth are avulsed (completely knocked out) every year in the U.S. alone—a significant number of which are due to sports injuries. It is also estimated that the lifetime cost to treat an avulsed tooth ranges from $5,000 to $20,000!

Given the prevalence of sports-related dental injuries, it’s no wonder that protective devices have been developed to minimize the risk. Properly fitted mouthguards have been shown time and again to be effective at preventing many types of dental injuries. Yet the use of devices isn’t always required by rule-making organizations—and many casual players don’t use them at all. That’s a shame, because so many of the injuries are preventable.

Custom-made mouthguards are available right here at the dental office. Strong and durable, these protective devices are specially fabricated from a model of the player’s own teeth. That means they offer the maximum protection, yet can be comfortably worn during practices, backyard games or championships—an important consideration, since accidents often happen when least expected. (And if you’re a parent of a child who plays sports, that’s probably something you already know.)

It isn’t just football players who can benefit from mouthguards: Those with a passion for soccer, basketball, baseball, martial arts, and dozens of other sports can also get the protection they need from this small (but important) item. So this season, when you’re watching or playing your favorite game, think about the extra safety and peace of mind you could gain from a custom-made mouthguard.

If you have questions about custom-made mouthguards, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “An Introduction to Sports Injuries & Dentistry” and “Athletic Mouthguards.”

YourCaseofGingivitisCouldDevelopintoSomethingMoreHarmful

That bit of gum bleeding after you brush, along with redness and swelling, are strong signs you have gingivitis, a form of periodontal (gum) disease. Without treatment, though, your gingivitis could turn into something much more painful and unsightly — a condition commonly known as “trench mouth.”

Properly known as Acute Necrotizing Ulcerative Gingivitis (ANUG), the more colorful name arose from its frequent occurrence among soldiers during World War I. Although not contagious, many soldiers contracted it due to a lack of means to properly clean their teeth and gums and the anxiety associated with war. Inadequate hygiene and high stress still contribute to its occurrence today, along with smoking, medications that dry the mouth and reduced disease resistance — all of which create a perfect environment for bacterial growth.

ANUG can arise suddenly and be very painful. The cells in the gum tissue begin to die (“necrotizing”) and become swollen (“ulcerative”), especially the small triangle of gum tissue between the teeth called the papillae, which can appear yellowish. Patients also encounter a characteristic foul breath and taste. Untreated, ANUG can damage tissue and contribute to future tooth loss.

Fortunately, antibiotics and other treatments are quite effective in eradicating bacteria that cause the disease, so if caught early it’s completely reversible. We start with a complete examination to confirm the diagnosis and rule out other possible causes. We then attempt to relieve the pain and inflammation with non-steroidal, anti-inflammatory drugs like aspirin or ibuprofen and begin antibiotic treatment, most notably Metronidazole or amoxicillin. We may also prescribe a mouthrinse containing chlorhexidine and mild salt water rinses to further reduce the symptoms.

We must also treat any underlying gingivitis that gave rise to the more acute disease. Our goal here is remove any bacterial plaque and calculus (hardened plaque deposits) that have built up on tooth surfaces, particularly below the gums. Only then can we fully bring the disease under control.

It’s also important you become more consistent and effective with daily brushing and flossing, quit smoking, reduce undue stress, and get better rest and nutrition. Establishing these new habits and lifestyle changes will help ensure you’ll never have to experience trench mouth again.

If you would like more information on ANUG and other periodontal gum conditions, 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 “Painful Gums in Teens & Adults.”

DontLetYourLooseToothBecomeaLostTooth

Discovering a loose tooth can be exciting — if you're six, that is, and anticipating a windfall from the tooth fairy. If you're an adult, a loose tooth is a different story. You're in real danger of it becoming a lost tooth, and there won't be another one coming in to replace it.

Fortunately, that result isn't inevitable, but we have to take quick action if we're going to save your tooth. The first step is to find out why it's loose.

Tooth looseness occurs primarily because the gum and bone structures that hold teeth in place have been damaged in some way. Otherwise healthy teeth and gums can be injured in an accident or with dental habits like teeth grinding or clenching that increase the biting forces against teeth. The latter could require some intervention like a night guard to prevent teeth from grinding to reduce the abnormal biting force.

But disease is often the root cause for tooth looseness. Periodontal (gum) disease, a bacterial infection triggered by bacterial plaque, can inflame and weaken gum tissues, eventually causing bone loss followed by the gum tissue detaching from the teeth. In this weakened condition even normal biting forces could loosen a tooth.

If gum disease is the primary culprit, our treatment starts there. By aggressively removing plaque and calculus (tartar) from the tooth surfaces, including deep below the gum line around the root, the gum tissues become less inflamed and begin to heal. This in turn can strengthen their attachment to a loose tooth. In more advanced cases, we may need to surgically graft lost bone and gum tissue to rebuild the attachment.

We may also need to stabilize a loose tooth while we're performing these other treatments. The most common way is to join or splint a loose tooth to nearby stable teeth. There are varieties of splints: one type involves rigid dental material bonded across the enamel of the loose tooth and its neighbors. In another, we cut a small channel in the involved teeth, and then insert a metal splint, bonding it within the channel.

Whatever needs to be done, we need to do it promptly — if you notice a loose tooth, contact us as soon as possible. The earlier we begin treatment the more likely we'll save your loose tooth.

If you would like more information on treating 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 “Treatment for Loose Teeth.”

SofiaVergaraObsessedWithOralHygiene

A woman as gorgeous and funny as Sofia Vergara surely planned to be a model and actress from the get-go, right? Wrong! Sofia’s first career choice actually was to be… a dentist! That’s right, the sexy star of TV’s Modern Family actually was only two semesters shy of finishing a dental degree in her native Columbia when she traded dental school for the small screen. Still, dental health remains a top priority for the actress and her son, Manolo.

“I’m obsessed,” she recently told People magazine. “My son thinks I’m crazy because I make him do a cleaning every three months. I try to bribe the dentist to make him to do it sooner!”

That’s what we call a healthy obsession (teeth-cleaning, not bribery). And while coming in for a professional cleaning every three months may not be necessary for everyone, some people — especially those who are particularly susceptible to gum disease — may benefit from professional cleanings on a three-month schedule. In fact, there is no one-size-fits-all approach to having professional teeth cleanings — but everyone needs this beneficial procedure on a regular basis.

Even if you are meticulous about your daily oral hygiene routine at home, there are plenty of reasons for regular checkups. They include:

  • Dental exam. Oral health problems such as tooth decay and gum disease are much easier — and less expensive — to treat in the earliest stages. You may not have symptoms of either disease early on, but we can spot the warning signs and take appropriate preventive or restorative measures.
  • Oral cancer screening. Oral cancer is not just a concern of the middle aged and elderly — young adults can be affected as well (even those who do not smoke). The survival rate for this deadly disease goes up tremendously if it is detected quickly, and an oral cancer screening is part of every routine dental visit.
  • Professional teeth cleaning. Calcified (hardened) dental plaque (tartar or calculus) can build up near the gum line over time — even if you brush and floss every day. These deposits can irritate your gums and create favorable conditions for tooth decay. You can’t remove tartar by flossing or brushing, but we can clear it away — and leave you with a bright, fresh-feeling smile!

So take a tip from Sofia Vergara, and don’t skimp on professional cleanings and checkups. If you want to know how often you should come in for routine dental checkups, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor articles “Dental Hygiene Visit” and “Dental Cleanings Using Ultrasonic Scalers.”

FindingtheRightSolutionforYourGummySmile

Even with picture perfect teeth, you may still be unhappy with your appearance. The problem: too much of your upper gums show when you smile.

There’s no precise standard for a “gummy smile”—it’s often a matter of perception. As a rule of thumb, though, we consider a smile “gummy” if four or more millimeters of upper gum tissue show while smiling. In any event if you perceive you have a gummy smile, it can greatly affect your self-confidence and overall well-being.

The good news is we can often correct or at least minimize a gummy smile. The first step, though, is to find out why the gums are so prominent.

There are a few possible causes: the most obvious, of course, is that there’s more than normal gum tissue present. But the cause could be the front teeth didn’t fully erupt in childhood and so the gums appear more prominent. Other causes include the upper lip moving too far upward when smiling (hypermobile) or an elongated upper jaw that’s out of proportion with the face.

Finding the exact cause or combination of causes will determine what approach we take to minimize your gummy smile. If too much gum tissue or not enough of  the teeth show, we can use a surgical procedure called crown lengthening to expose more of the crown (the visible part of a tooth), as well as remove excess gum tissues and reshape them and the underlying bone for a more proportional appearance.

A hypermobile upper lip can be treated with Botox, a cosmetic injection that temporarily paralyzes the lip muscles and restricts their movement. But for a permanent solution, we could consider a surgical procedure to limit upper lip movement.

Surgery may also be necessary for an abnormal jaw structure to reposition it in relation to the skull. If, on the other hand it’s the teeth’s position and not the jaw causing gum prominence, we may be able to correct it with orthodontics.

As you can see, there are several ways varying in complexity to correct a gummy smile. To know what will work best for you, you’ll need to undergo an orofacial examination to determine the underlying cause. It’s quite possible there’s a way to improve your smile and regain your self-confidence.

If you would like more information on improving a gummy smile, 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 “Gummy Smiles.”





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