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CrownLengtheningHelpsusTreatHardtoReachCavities

While we often associate tooth decay with cavities forming in a tooth’s visible or biting surfaces, the occurrence of this all too common disease isn’t limited to those areas. Cavities can develop in any part of a tooth exposed to bacteria.

Gum recession, the shrinking back of the gums from the teeth, can cause such exposure in areas normally covered by the gums. Because these areas are usually more vulnerable to infection when exposed, cavities can develop at or right below the gum line. Because of their location it can be difficult to fill them or perform other treatments.

One way to make it less difficult is to perform a crown lengthening procedure. While the term sounds like we’re increasing the size of the tooth, we’re actually surgically altering the gums to access more of the affected tooth surface for treatment. It’s typically performed in a dental office with local anesthesia by a general dentist or a periodontist, a specialist in the gums.

During the procedure, the dentist starts by making small incisions in the gums to create a tissue “flap” that can be lifted out of the way. This exposes the underlying bone, which they then reshape to support the gum tissue once it’s re-situated in its new position. The dentist then sutures the gums back in place. Once the gums heal, the decayed area is ready for treatment.

Crown lengthening is also useful for other situations besides treating cavities. If a tooth has broken off at the gum line, for example, there may not be enough remaining structure to support a crown. Crown lengthening can make more of the underlying tooth available for the crown to “grab” onto. It’s also useful in some cases of “gummy smiles,” in which too much of the gum tissue is visible in proportion to the tooth size.

Because crown lengthening often involves removing some of the bone and is thus irreversible, you should discuss this procedure with your dentist in depth beforehand. It could be, though, this minor procedure might make it easier to preserve your teeth and even make them look more attractive.

If you would like more information on crown lengthening, please contact us or schedule an appointment for a consultation.

WillieWonkasChocolateFactoryWasNotSoSweettoCastsTeeth

The classic movie Willie Wonka & the Chocolate Factory, starring Gene Wilder, still brings back sweet memories of childhood to people everywhere. Recently, the news broke that a remake of the beloved 1971 film is in now development in Hollywood. But at a reunion of the original cast members a few years ago, child star Denise Nickerson revealed that her role as gum-chewing Violet Beauregard caused a problem: she ended up with 13 cavities as a result of having to chew gum constantly during the filming!

It should come as no surprise that indulging in sugary treats can lead to cavities: The sugar in your diet feeds harmful bacteria that can cause tooth decay and other dental problems. Yet lots of kids (not to mention the child inside many adults) still crave the satisfaction that gum, candy and other sweets can bring. Is there any way to enjoy sweet treats and minimize the consequences to your oral health?

First, let’s point out that there are lots of healthy alternatives to sugary snacks. Fresh vegetables, fruits and cheeses are delicious options that are far healthier for you and your kids. Presenting a variety of appealing choices—like colorful cut-up carrots, bite-sized cheese bits and luscious-looking fruits and berries can make it easier (and more fun) to eat healthy foods. And getting kids off the sugar habit is a great way to help them avoid many health problems in the future.

For those who enjoy chewing gum, sugarless gum is a good option. In fact, chewing sugarless gum increases the flow of healthful saliva in the mouth, which can help neutralize the bacteria-produced acids that cause cavities. Gums that have the ADA (American Dental Association) Seal of Acceptance have passed clinical tests for safety and effectiveness.

But if you do allow sugary snacks, there are still a few ways to minimize the potential damage. Restrict the consumption of sweets to around mealtimes, so the mouth isn’t constantly inundated with sugar. Drink plenty of water to encourage saliva flow, and avoid sugary and acidic beverages like soda (even diet soda) and “sports” or “energy” drinks. Brush twice daily with fluoride toothpaste and floss once a day. And don’t forget to visit our office regularly for routine checkups and cleanings. It’s the best way to get a “golden ticket” to good oral health.

If you would like more information about sugar, cavities and oral health, please call our office to arrange a consultation. You can learn more in the Dear Doctor magazine articles “Nutrition & Oral Health” and “The Bitter Truth About Sugar.”

HowKathyBatesRetainsHerMovie-StarSmile

In her decades-long career, renowned actress Kathy Bates has won Golden Globes, Emmys, and many other honors. Bates began acting in her twenties, but didn't achieve national recognition until she won the best actress Oscar for Misery — when she was 42 years old! “I was told early on that because of my physique and my look, I'd probably blossom more in my middle age,” she recently told Dear Doctor magazine. “[That] has certainly been true.” So if there's one lesson we can take from her success, it might be that persistence pays off.

When it comes to her smile, Kathy also recognizes the value of persistence. Now 67, the veteran actress had orthodontic treatment in her 50's to straighten her teeth. Yet she is still conscientious about wearing her retainer. “I wear a retainer every night,” she said. “I got lazy about it once, and then it was very difficult to put the retainer back in. So I was aware that the teeth really do move.”

Indeed they do. In fact, the ability to move teeth is what makes orthodontic treatment work. By applying consistent and gentle forces, the teeth can be shifted into better positions in the smile. That's called the active stage of orthodontic treatment. Once that stage is over, another begins: the retention stage. The purpose of retention is to keep that straightened smile looking as good as it did when the braces came off. And that's where the retainer comes in.

There are several different kinds of retainers, but all have the same purpose: To hold the teeth in their new positions and keep them from shifting back to where they were. We sometimes say teeth have a “memory” — not literally, but in the sense that if left alone, teeth tend to migrate back to their former locations. And if you've worn orthodontic appliances, like braces or aligners, that means right back where you started before treatment.

By holding the teeth in place, retainers help stabilize them in their new positions. They allow new bone and ligaments to re-form and mature around them, and give the gums time to remodel themselves. This process can take months to years to be complete. But you may not need to wear a retainer all the time: Often, removable retainers are worn 24 hours a day at first; later they are worn only at night. We will let you know what's best in your individual situation.

So take a tip from Kathy Bates, star of the hit TV series American Horror Story, and wear your retainer as instructed. That's the best way to keep your straight new smile from changing back to the way it was — and to keep a bad dream from coming true.

If you would like more information about orthodontic retainers, please contact us or schedule an appointment for a consultation. You can learn more about this topic in the Dear Doctor magazine articles “Why Orthodontic Retainers?” and “The Importance of Orthodontic Retainers.” The interview with Kathy Bates appears in the latest issue of Dear Doctor.

3ThingsYouNeedtoKnowaboutEasingAnxietyOverDentalVisits

Although dental visits are routine for most people, it’s a different experience for a few. About one in ten adults have high anxiety or fear of going to the dentist and may avoid it altogether—even when they have an acute situation.

If you’re one of those with dental visit anxiety there’s good news—we may be able to help you relax and have a more positive experience. Here are 3 things you need to know about reducing your anxiety at the dental office.

It starts with the dentist. While every patient deserves a compassionate, understanding dentist, it’s especially so if you suffer from dental visit anxiety. Having someone who will listen to your concerns in a non-judgmental way is the first step toward feeling more comfortable in the dentist’s chair. It also takes a sensitive practitioner to work with you on the best strategy for relaxation.

Relaxation often begins before your visit. There are various degrees of sedation (which isn’t the same as anesthesia—those methods block pain) depending on your level of anxiety. If you experience mild to moderate nervousness, an oral sedative an hour or so before your appointment could take the edge off and help you relax. Oral sedatives are also mild enough for use with other forms of sedation like nitrous oxide gas, and with local anesthesia.

High anxiety may require deeper sedation. If your level of anxiety is greater, however, we may recommend IV sedation to induce a much more relaxed state. The sedation drugs are delivered directly into your blood stream through a small needle inserted into a vein. Although you’re not unconscious as with general anesthesia, we can place you into a “semi-awake” state of reduced anxiety. The drugs used may also have an amnesiac effect so you won’t remember details about the procedure. This can help reinforce positive feelings about your visit and help reduce future anxiety.

If you’re anxious about dental visits, make an appointment with us to discuss your concerns. We’re sure we can work out a strategy to reduce your anxiety so you can receive the dental care you need.

If you would like more information on sedation therapy, 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 “IV Sedation in Dentistry.”

By Natasha Lee DMD
March 29, 2018
Category: Oral Health
Tags: oral cancer  
BaseballTobaccoandOralCancer

Spring means different things to different people—but to baseball fans, it means just one thing: the start of another thrilling season. All 30 Major League Baseball teams begin play this month, delighting fans from Toronto to Texas and everywhere in between.

The boys of spring carry on an age-old tradition—yet baseball is also changing with the times. Cigarette smoking has been banned at most ballparks for years; smokeless tobacco is next. About half of the MLB venues now prohibit tobacco of any kind, including “snuff” and “dip.” What’s more, a recent contract agreement bars new Major League players from using smokeless tobacco anywhere.

Why all the fuss? Because tobacco isn’t safe to use in any form. People who use smokeless tobacco get just as much highly addictive nicotine as cigarette smokers. Plus, they get a mouthful of chemicals that are known to cause cancer. This puts them at higher risk for oral cancer, cancer of the esophagus, pancreatic cancer and other diseases.

A number of renowned ballplayers like Babe Ruth, Curt Flood and Bill Tuttle died of oral cancer. The death of Hall of Famer Tony Gwinn in 2014 focused attention on tobacco use in baseball, and helped lead to the ban. Gwynn was convinced that his addiction to smokeless tobacco led to his getting oral cancer.

Yet tobacco isn’t the only cause of oral cancer. In fact, the disease is becoming more common in young people who do not smoke. That’s one more reason why it’s so important for people of all ages to keep to a regular schedule of routine dental exams. These visits offer a great opportunity to detect oral cancer in its earliest, most treatable stages.

So as you watch your favorite team, take a tip from the professional athletes’ playbook. If you don’t use tobacco, don’t start. If you do, now is a good time to quit. For help and support, call an expert at 1-800-QUIT-NOW or visit smokefree.gov.

If you have any questions about oral cancer, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Diet and Prevention of Oral Cancer.”





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