Ever since childhood, when her career as a model and actress took off, Brooke Shields has enjoyed worldwide recognition — through advertisements for designer jeans, appearances on The Muppet Show, and starring roles in big-screen films. But not long ago, that familiar face was spotted in an unusual place: wearing a nasal anesthesia mask at the dentist's office. In fact, Shields posted the photo to her own Instagram account, with the caption “More dental surgery! I grind my teeth!” And judging by the number of comments the post received, she's far from alone.
In fact, researchers estimate that around one in ten adults have dental issues that stem from teeth grinding, which is also called bruxism. (Many children also grind their teeth, but it rarely causes serious problems, and is often outgrown.) About half of the people who are teeth grinders report problems like persistent headaches, jaw tenderness and sore teeth. Bruxism may also result in excessive tooth wear, and may damage dental work like crowns and bridges; in severe cases, loosened or fractured teeth have been reported.
Researchers have been studying teeth grinding for many years; their findings seem to indicate that it has no single cause. However, there are a number of factors that play a significant role in this condition. One is the anatomy of the jaw itself, and the effect of worn or misaligned teeth on the bite. Another factor relates to changes in brain activity that occur during the sleep cycle. In fact, nocturnal (nighttime) bruxism is now classified as a sleep-related movement disorder. Still other factors, such as the use of tobacco, alcohol and drugs, and a high level of stress or anxiety, can make an individual more likely to experience bruxism.
What can be done for people whose teeth grinding is causing problems? Since this condition may have many causes, a number of different treatments are available. Successful management of bruxism often begins by striving to eliminate the factors that may cause problems — for example, making lifestyle changes to improve your health, creating a soothing nighttime environment, and trying stress-reduction techniques; these may include anything from warm baths and soft music at bedtime, to meditation and mindfulness exercises.
Several dental treatments are also available, including a custom-made occlusal guard (night guard) that can keep your teeth from being damaged by grinding. In some cases, a bite adjustment may also be recommended: In this procedure, a small amount of enamel is removed from a tooth to change the way it contacts the opposite tooth, thereby lessening the biting force on it. More invasive techniques (such as surgery) are rarely needed.
A little tooth grinding once in a while can be a normal response to stress; in fact, becoming aware of the condition is often the first step to controlling it. But if you begin to notice issues that could stem from bruxism — or if the loud grinding sounds cause problems for your sleeping partner — it may be time to contact us or schedule an appointment. You can read more about bruxism in the Dear Doctor magazine article “Stress and Tooth Habits.”
Dental injuries result in thousands of visits to the emergency room every year, and many of these injuries occur while engaging in sports and recreational activities. Whether playing on an organized team or joining a spontaneous game with friends, athletes are much more likely to suffer a dental injury when not wearing a mouthguard. Five national dental organizations have joined together for National Facial Protection Month to urge athletes to use a mouthguard during both practice and games.
The American Dental Association and the Academy for Sports Dentistry recommend using mouthguards for over 30 sporting activities. While it comes as no surprise that mouthguards are recommended for football, hockey and basketball, the list also includes many activities that may not immediately come to mind—among them, surfing, ultimate frisbee, skateboarding, volleyball, skiing and bicycle riding.
In short, it’s wise to protect your smile while participating in any activity where your teeth may make contact with a hard surface. A properly fitted mouthguard can prevent injuries to the teeth, mouth and jaw, and may even help protect against head and neck injuries. Even those who participate in casual recreational activities should consider a mouthguard as an insurance policy against future pain and expense.
There are three types of mouthguards: a stock mouthguard that is bought ready to use from your neighborhood store, the “boil-and-bite” type that is formed to the mouth after being softened in hot water, and a custom-made mouthguard that is available from the dental office. Although any mouthguard is better than no protection at all, the best protection and most comfortable fit comes from a mouthguard that is custom-made by your dentist.
If you have questions about preventing dental injuries, please contact our office or schedule a consultation. You can learn more in the Dear Doctor magazine articles “Athletic Mouthguards” and “The Field-Side Guide to Dental Injuries.”
Like other living tissue, your teeth can feel. Dentin, the layer below the enamel, houses fluid-filled conduits that transmit temperature or pressure sensations to a nerve network within the tooth’s inner pulp. It’s so effective that incoming sensations must be buffered — “toned down”— to avoid a painful overload of the nerves. The enamel above the gum line and a bone-like substance called cementum below help do this.
Unfortunately, if teeth lose this protection they can become hypersensitive. This can cause a flash of sharp pain while eating or drinking something cold or hot or just biting down.
There are a number of causes for tooth sensitivity, any of which can influence how we treat it. While you’ll need a dental exam to know for sure, your hypersensitivity will more than likely stem from one of these 3 problems.
Periodontal (gum) disease. This is an infection caused by bacterial plaque, a thin film of bacteria and food particles that accumulates on the teeth due to poor oral hygiene. The inflamed gum tissues weaken and detach from the teeth, causing them to shrink back or recede. This leaves the cementum unprotected, which easily erodes and exposes the dentin to acid and bacteria — and hypersensitivity. Clinically removing the plaque helps the affected gums heal. In extreme cases, the gums may need surgical grafting to regenerate.
Overaggressive brushing. While a lack of oral hygiene can contribute to gum recession, ironically too much hygiene — brushing too hard for too long — can damage your gums and cause them to recede. Brushing really doesn’t require a lot of elbow grease — a gentle scrubbing motion over all tooth surfaces is sufficient to remove plaque. Fine-tuning your brushing will help your gums to recover and heal.
Mouth acid. Although quite strong, enamel has one formidable enemy: acid, which can erode enamel and expose the dentin. Over-indulgence in acidic foods and beverages can make your mouth more acidic; more likely, though, bacterial plaque will again be the culprit, because bacteria excrete an acidic waste product. You can reduce mouth acid with daily brushing and flossing and consuming less acidic foods and beverages.
If you’re experiencing any kind of tooth pain, see us for an examination. We’ll determine the cause and initiate the appropriate treatment to regain your oral health.
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.”
If you’re undergoing your first root canal treatment, it’s understandable if you’re apprehensive. So, let’s cut to the chase about your biggest fear: a root canal treatment doesn’t cause pain, it relieves it — and saves your tooth too.
You need this procedure because decay has spread deep into your tooth’s inner pulp. The infection has already attacked the nerves bundled within the pulp chamber, the source of the pain that led you to us in the first place.
The real concern, though, is the infection continuing to travel through the canals of the tooth root. If that happens, you’re in danger of not only losing the tooth, but also losing surrounding bone, adjacent teeth or damaging other important structures close by. Our goal is simple: remove the infected pulp tissue and seal the empty chamber and root canals from further infection with a special filling.
We begin by numbing the tooth with local anesthesia — you won’t feel anything but slight pressure as we work. After placing a dental dam — a thin sheet of rubber or vinyl — around the affected tooth to maintain a clean work area, we drill a small hole through the biting surface of a back tooth or in the rear surface of a front tooth. We’ll use this hole to access the pulp, where we’ll first remove all the dead and diseased tissue from the chamber. We’ll then disinfect the chamber and root canals with antiseptic and antibacterial solutions.
After some shaping, we’ll fill the chamber and canals, usually with gutta-percha that’s malleable when heated and can be compressed into and against the walls of the root canals to completely seal them. We’ll then seal the access hole.
You may have a few days of mild discomfort afterward, which can be managed generally with pain relievers like aspirin or ibuprofen. Later, we’ll permanently restore the tooth using filling to seal the root canal inside the tooth followed by a custom crown that’s fit over and bonded to the tooth. This will further minimize chances of a re-infection.
If we’ve recommended a root canal, then we think your tooth should be saved instead of extracted. The procedure will end the pain you’ve been suffering and give your tooth a new lease on life.
If you would like more information on root canal treatment, 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 “A Step-By-Step Guide to Root Canal Treatment.”
In February, the American Dental Association sponsors Children’s Dental Health Month to raise awareness about the importance of good oral health for kids of all ages. It’s a great time to focus on concerns unique to children—teething, for example. This stage of development can be stressful for children and parents alike. Just ask tennis legend (and new mom) Serena Williams. When her baby daughter recently began teething, the Olympic gold medalist and multi-Grand-Slam champion asked her instagram followers for help:
“Teething… is so hard. Poor Alexis Olympia has been so uncomfortable. She cried so much… I almost need my mom to come and hold me to sleep cause I’m so stressed. Help? Anyone?”
We certainly sympathize with Serena’s plight. The process of teething—where a child’s primary teeth start to emerge (erupt) from below the gum line—can make both baby and parents irritable in the daytime and sleepless at night. While a few infants are born with tiny teeth already showing, most kids’ teeth begin emerging at age 4-7 months.
Teething is an important milestone in baby’s growth…but it’s one that’s not always cause for celebration. It can lead to pain, drooling, gnawing, and biting; ear rubbing and gum swelling; decreased appetite and disrupted sleeping patterns. And did we mention that irritability and stress are common as well? But if you notice fever, diarrhea, or widespread rash, it may be wise to consult your dentist or pediatrician.
What can you do to ease the discomfort of teething? The American Dental Association (ADA) has a few recommendations: Try soothing the gums by rubbing them gently with a clean finger or a cool, moist towel or washcloth; or let your baby chew on a cold (but not frozen) teething ring or pacifier.
If your pediatrician recommends it, over-the-counter medications like acetaminophen or ibuprofen can be used for persistent teething pain—but make sure to use the correct dosage and wait the proper amount of time between doses.
There are also a few things you should NEVER do. Don’t give alcohol to a baby in any form, and don’t rub any medications on baby’s gums. Don’t give a baby anything to chew on that’s unsafe (bones, breakable items, etc). And don’t use teething gels containing benzociane, lidocaine or certain homeopathic ingredients: According to a recent FDA warning, they may pose a danger to infants, including risks of rare but serious medical conditions. Feel free to check with us if you are not sure whether a particular remedy is safe for your baby.
There’s no doubt that teething can be stressful. But it’s a sign of normal development—and in time it will pass…like babyhood itself. If you’re concerned about your child’s teething or would like more information, please contact us or schedule a consultation. You can learn more in the Dear Doctor magazine article “Teething Troubles.”
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