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A Shingles Outbreak Could Interrupt Your Dental Care

Posted on: May 3, 2021 by Arpit

A shingles outbreak can be painful and embarrassing. It could also interfere with many areas of your life, including dental care.

Chicken Pox

Known medically as herpes zoster, the shingle is a viral form of chicken pox. The virus can lie dormant for many years or decades in people that had chicken pox as a child, breaking out later in life (sometimes repeatedly). It’s estimated about a quarter of people who had chicken pox as a child and about 90% of adults will experience a shingles outbreak.

In the beginning, a person with shingles may notice itching or burning skin irritation and numbness or sensitivity to touch. In time, a red, crusty rash can develop, usually forming a belted or striped pattern on the torso, head, or facial areas. The patterning is caused by the virus’s disruption of nerves that serve those parts of the body.

Shingles could impact your dental care because they can be contagious early in an outbreak. It can be transmitted to other people via contact with the rash or airborne respiratory particles. Dental staff members or patients who are pregnant, undergoing cancer treatment, or with other conditions compromising their immune systems can develop serious health problems if they contract the virus.

If you have an upcoming appointment, it’s best to let your dentist know you’ve been diagnosed with shingles. If your treatment involves physical contact that could spread the virus, they may wish to reschedule you until the outbreak clears.

Antiviral Treatments

There are ways to hasten the healing process with antiviral treatments like acyclovir or famciclovir. For best results, these treatments should begin within 3 days of a shingles outbreak. There is also a shingles vaccine that can help you avoid an outbreak altogether. The U.S. Centers for Disease Control (CDC) recommend it for adults over 60.

Having shingles can be painful and stressful and pose a major interruption to your daily life and routine. With proper management, though, it can be contained so you can get on with your life—and your dental care.

If you would like more information on managing shingles and dental care, 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 “Shingles, Herpes Zoster.”

Limiting Refined Sugar In Your Diet Can Reduce Risk Of Tooth Decay

Posted on: May 3, 2021 by Arpit

“Cut down on sweets, especially between meals” is perhaps one of the least popular words of advice we dentists regularly give. We’re not trying to be killjoys, but the facts are undeniable. Both the amount and frequency of sugar consumption contribute to tooth decay. Our concern isn’t the naturally occurring sugars in fruits, vegetables, grains, or dairy products, but rather refined or “free” sugars added to foods to sweeten them.

World Health Organization and the U.S. Food and Drug Administration

The World Health Organization and the U.S. Food and Drug Administration advise consuming no more than 50 grams (about ten teaspoons) of sugar daily. Unfortunately, our nation’s average per person is much higher: we annually consume around 140 pounds per capita of refined sugars like table sugar or high fructose corn syrup. It’s more than three times the recommended amount. Soft drinks are the single largest source of these in our diets. Americans drink an average of 52 gallons every year.

The connection between sugar and tooth decay begins with bacteria fermenting sugar in the mouth after eating. This creates high levels of acid, which causes the mineral content of tooth enamel to soften and erode. It makes the teeth more susceptible to decay. Saliva naturally neutralizes acid, but it takes thirty minutes to keep the mouth’s pH normal. Saliva can’t keep up if sugars are continually present from constant snacking or sipping on soft drinks for long periods.

You can reduce the sugar-decay connection with a few dietary changes. Limit your intake of sugar-added foods and beverages to no more than recommended levels. Consume sweets and soft drinks only at meal times; replace sugar-added foods with fresh fruits and vegetables and foods that inhibit the fermentation process (like cheese or black and green teas); and consider using mint or chewing gum products sweetened with xylitol, a natural alcohol-based sugar that inhibits bacterial growth.

Last but not least, practice good oral hygiene with daily brushing and flossing, along with regular office cleanings and checkups. These practices and limits on refined sugar in your diet will go a long way toward keeping your teeth and mouth healthy and cavity-free.

If you would like more information on the relationship between sugar and dental disease, 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 “Nutrition & Oral Health.”

Lingual Braces Offer A Less Visible Alternative To Traditional Braces

Posted on: May 3, 2021 by Arpit

We’re all familiar with tried and true traditional braces and perhaps with newer clear aligners for realigning teeth. But there’s an even more, novel way quickly becoming popular: lingual braces.

This type of brace performs the same function as the traditional but in an opposite way. Rather than bonded to the front of the teeth like labial (“lip-side”) braces, these are bonded to the back of the teeth on the tongue (or “lingual”) side. While labial braces move teeth by applying pressure through “pushing,” lingual braces “pull” the teeth to where they need to be.

Although lingual braces are no better or worse than other orthodontic methods, they do have some advantages if you’re involved in sports or similar physical activities where mouth contact with traditional braces could cause lip or gum damage or if your work or lifestyle includes frequent snacking or eating, which requires continually removing clear aligners. And like aligners, lingual braces aren’t noticeable to the outside world.

But lingual braces typically cost as much as 15-35% more than traditional braces. They can initially be uncomfortable for patients as the tongue makes contact with the hardware. While most patients acclimate to this, some don’t. And like traditional braces, brushing and flossing your teeth while wearing them effectively is hard. This can be overcome, though, by using a water flosser and scheduling more frequent dental cleanings while you’re wearing them.

For the most part, lingual braces can correct any poor bite (malocclusion) correctable with labial braces. The treatment time is comparable, ranging from several weeks to a couple of years, depending on the malocclusion. And, as with any other orthodontic care method, you’ll need to wear a retainer once they’re removed.

Lingual braces have only been available in a limited fashion for a few years, but their availability is growing as more orthodontists train in the new method. If you’re interested in the lingual braces approach, talk to your orthodontist or visit www.lingualbraces.org to learn more.

If you would like more information on lingual braces, 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 “Lingual Braces: A Truly Invisible Way to Straighten Teeth.”

Dr. Travis Stork: If Only I’d Worn A Mouthguard!

Posted on: May 3, 2021 by Arpit

If we could go back in time, we all probably have a few things we wish we could change. Recently, Dr. Travis Stork, emergency room physician and host of the syndicated TV show The Doctors, shared one of his do-over dreams with Dear Doctor magazine: “If I [could have] gone back and told myself as a teenager what to do, I would have worn a mouthguard, not only to protect my teeth but also to help potentially reduce risk of concussion.”

What prompted this wish? The fact that as a teenage basketball player, Stork received an elbow to the mouth that caused his two front teeth to be knocked out of place. The teeth were put back in position, but they soon became darker and began to hurt. Eventually, both were successfully restored with dental crowns. Still, it was a painful (and costly) injury that could have been avoided.

You might not realize it, but basketball ranks among the riskier sports when it comes to dental injuries. Yet it’s far from the only one. In fact, according to the American Dental Association (ADA), there are some two dozen others — including baseball, hockey, surfing and bicycling — that carry a heightened risk of dental injury. The ADA recommends wearing a high-quality mouthguard whenever you’re playing those sports.

Mouthguards have come a long way since they were introduced as protective equipment for boxers in the early 1900’s. Today, three different types are widely available: stock “off-the-shelf” types that come in just a few sizes; mouth-formed “boil-and-bite” types that you adapt to the general contours of your mouth; and custom-made high-quality mouthguards that are made just for you at the dental office.

Of all three types, the dentist-made mouthguards are consistently found to be the most comfortable and best-fitting, offering your teeth the greatest protection. What’s more, recent studies suggest that custom-fabricated mouthguards can provide an additional defense against concussion — in fact, they are twice as effective as the other types. That’s why you’ll see more and more professional athletes (and plenty of amateurs as well) sporting custom-made mouthguards at games and practices.

“I would have saved myself a lot of dental heartaches if I had worn a mouthguard,” noted Dr. Stork. So take his advice: Wear a mouthguard whenever you play sports — unless you’d like to meet him (or one of his medical colleagues) in a professional capacity…

If you would like more information about mouthguards, please contact us or schedule an appointment for a consultation. You can read more in the Dear Doctor magazine article “Athletic Mouthguards.”

Want To Improve Your Athletic Performance? Try Tuning Up Your Dental Care

Posted on: May 3, 2021 by Arpit

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Understanding The Benefits – And Limitations – Of Dental Insurance

Posted on: May 3, 2021 by Arpit

Most of us think of insurance as a means to protect us and our families from unforeseen loss. While that’s the general definition, some insurance plans — like dental — don’t quite work that way.

The typical dental plan actually works more like a discount coupon for dental services. Most are part of an employer-based benefit package and usually “fee-for-service”: the insurance company pays for part or sometimes the entire bill after your dental visit based on a fee schedule laid out in the policy.

A plan’s benefits depend on what the insurer offers to cover and what level of coverage your employer (or you) are willing to pay for. Typically, the more items covered under the policy, the higher the premium. Any deductibles (the amount you must pay out of pocket before receiving any plan benefits) can also affect the premium — the lower the deductible, the higher the premium.

The benefits may also be limited due to what a patient’s dentist charges for services. Most insurers pay benefits based on what they determine to be the “usual, customary and reasonable” (UCR) fee for a particular service. The dentist’s fees are most often higher, however, resulting in the patient paying a higher percentage of the bill.

Still, a dental work plan can work to your financial advantage, especially if it’s employer-based, with premiums paid by your employer. However, it may not be advantageous if you’re paying the premiums. For example, a person without insurance might spend, on average, $200 a year for basic dental care (mostly preventative — checkups and cleanings), while a person with insurance may have those expenses covered but is paying yearly premiums of $500 or more for the plan.

You should also consider one other factor: our first priority as dentists is to pursue the best course of treatment for your particular dental needs, which may not always align with what your policy covers. At the same time, we understand the limitations you may be under with your plan — we work in this world every day. We’ll certainly assist you in navigating the insurance waters to achieve the best care for what you can afford.

If you would like more information on dental insurance and other financial arrangements, 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 Insurance 101.”

Partial Dentures: An Affordable Alternative To More Expensive Restorations

Posted on: May 3, 2021 by Arpit

Dental implants are today’s preferred choice for replacing missing teeth. They’re the closest restoration to natural teeth—but at a price, especially for multiple teeth. If implants are beyond your current financial ability, an older, more affordable option is a removable partial denture (RPD).

Similar in concept to a full denture, a RPD replaces one or more missing teeth on a jaw. It usually consists of a lightweight but sturdy metal frame supporting a resin or plastic base (colored pink to mimic gum tissue). Prosthetic (false) teeth are attached to the base at the locations of the missing teeth. Unlike transitional dentures, RPDs are designed to last for many years.

Although simple in concept, RPDs certainly aren’t a “one-size-fits-all” option. To achieve long-term success with an RPD we must first consider the number of missing teeth and where they’re located in the jaw. This will dictate the type of layout and construction needed to create a custom RPD.

In addition, we’ll need to consider the health and condition of your remaining teeth. This can be important to an RPD’s design, especially if we intend to use them to support the RPD during wear. Support is a fundamental concern because we want to prevent the RPD from excessively moving in place.

Besides dental support, we’ll also need to take into account how the jaws function when they bite. The RPD’s design should evenly distribute the forces generated when you eat and chew so as not to create undue pressure on the bony ridges of the jaw upon which the RPD rests. Too much pressure could accelerate bone loss in the jaw, a common issue with dentures.

Creating a comfortably-fitting RPD with minimal impact on your dental health takes a lot of planning. But you’ll also have to maintain it to ensure lasting durability. You should clean your RPD daily and brush and floss the rest of your teeth to minimize the chances of developing tooth decay or periodontal (gum) disease. You can further discourage disease-causing bacterial growth by removing them at night while you sleep.

A RPD can be a viable alternative to more expensive restorations. And with the right design and proper care it could serve you and your smile for a long time to come.

If you would like more information on removable partial dentures, 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 “Removable Partial Dentures.”

Jimmy Fallon’s Daughter Loses A Tooth On National Television

Posted on: May 3, 2021 by Arpit

Even though coronavirus lockdowns have prevented TV hosts from taping live shows, they’re still giving us something to watch via virtual interviews. In the process, we’re given occasional glimpses into their home life. During a Tonight Show interview with Seahawks quarterback, Russell Wilson and his wife, R & B performer Ciara, Jimmy Fallon’s daughter Winnie interrupted with breaking news: She had just lost a tooth.

It was an exciting and endearing moment, as well as good television. But with 70 million American kids under 18, each with about 20 primary teeth to lose, it’s not an uncommon experience. Nevertheless, it’s still good to be prepared if your six-year-old is on the verge of losing that first tooth.

Primary teeth may be smaller than their successors, but they’re not inconsequential. Besides providing young children with the means to chew solid food and develop speech skills, primary teeth also serve as placeholders for the corresponding permanent teeth as they develop deep in the gums. That’s why it’s optimal for baby teeth to remain intact until they’re ready to come out.

When that time comes, the tooth’s roots will begin to dissolve and the tooth will gradually loosen in the socket. Looseness doesn’t automatically signal a baby tooth’s imminent end. But come out it will, so be patient.

Then again, if your child, dreaming of a few coins from the tooth fairy, is antsy to move things along, you might feel tempted to use some old folk method for dispatching the tooth—like attaching the tooth to a door handle with string and slamming the door, or maybe using a pair of pliers (yikes!). One young fellow in an online video tied his tooth to a football with a string and let it fly with a forward pass.

Here’s some advice from your dentist: Don’t. Trying to pull a tooth whose root hasn’t sufficiently dissolved could damage your child’s gum tissues and increase the risk of infection. It could also cause needless pain.

Left alone, the tooth will normally fall out on its own. If you think, though, that it’s truly on the verge (meaning it moves quite freely in the socket), you can pinch the tooth between your thumb and middle finger with a clean tissue and give it a gentle tug. If it’s ready, it should pop out. If it doesn’t, leave it be for another day or two before trying again.

Your child losing a tooth is an exciting moment, even if it isn’t being broadcast on national television. It will be more enjoyable for everyone if you let that moment come naturally.

If you would like more information on the importance and care of primary teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Importance of Baby Teeth.”

A Child’s Damaged Tooth May Require A Different Approach Than An Adult’s

Posted on: May 3, 2021 by Arpit

A traditional root canal procedure can be a “life-saver” for a decayed or injured tooth. But while it’s usually the best course for a damaged adult tooth, variations of the procedure are advisable for a new permanent tooth in a child or young adolescent.

This is because the inner pulp, the focus of the treatment, plays an important role in a young tooth’s development. When it first erupts a tooth’s dentin layer, the living tissue that makes up most of the body and roots of the tooth, hasn’t fully formed. The pulp increases the dentin layer over time in conjunction with jaw development.

Because a full root canal treatment removes all of the pulp tissue, it could interrupt any remaining dentin development in a young tooth. This could lead to poorly-formed roots and a less healthy tooth. For an immature permanent tooth, then, we would use variations of a root canal treatment depending on the nature and extent of the injury, the patient’s overall health and medications they may be taking.

Our main objective is to expose or remove as little of the pulp tissue as possible when treating the tooth. If the decay or injury hasn’t exposed the pulp, we may only need to remove the softened decayed or injured dentin while leaving harder dentin nearer the pulp intact. If, however, the pulp has become partially exposed by disease or injury, we would then perform a pulpotomy in which we remove only the exposed tissue and then place calcium hydroxide or mineral trioxide aggregate (MTA) to stimulate dentin growth that will eventually patch the exposure site.

In cases where tooth decay or injury has rendered an immature tooth’s pulp tissue unsalvageable, we may use a procedure known as apexification that seals off the open, cylindrical root end of the tooth. This will allow bone-like tissue to grow around the root to serve as added support for the tooth. Although it can save a tooth in the short run, the tooth’s long-term survival chances may be lower.

By using these and other techniques, we may be able to save your child’s immature tooth. At the very least, such a technique could postpone replacing the tooth until a more opportune time in adulthood.

If you would like more information on treating damaged teeth in children, 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 “Saving New Permanent Teeth after Injury.”

See Your Dentist To Find Out The Real Cause For Your Tooth Pain

Posted on: May 3, 2021 by Arpit

f you have tooth pain, we want to know about it. No, really—we want to know all about it. Is the pain sharp or dull? Is it emanating from one tooth or more generally? Is it constant, intermittent or only when you bite down?

Dentists ask questions like these because there are multiple causes for tooth pain with different treatment requirements. The more accurate the diagnosis, the quicker and more successful your treatment will be.

Here are 3 different examples of tooth pain and their possible causes and treatments.

Tooth sensitivity. If you feel a quick jolt of pain when you eat or drink something hot or cold, it may mean your gums have drawn back (receded) from your teeth to expose more sensitive areas. Gum recession is most often caused by gum disease, which we can treat by removing dental plaque, the main cause for the infection. In mild cases the gums may recover after treatment, but more advanced recession may require grafting surgery.

Dull ache around upper teeth. This type of pain might actually be a sinus problem, not a dental one. The upper back teeth share some of the same nerves as the sinus cavity just above them. See your dentist first to rule out deep decay or a tooth-grinding habit putting too much pressure on the teeth. If your dentist rules out an oral cause, you may need to see your family physician to check for a sinus infection.

Constant sharp pain. A throbbing pain seeming to come from one tooth may be a sign the tooth’s central pulp layer has become decayed. The resulting infection attacks the pulp’s nerves, which causes excruciating pain. Advanced decay of this sort requires a root canal treatment to remove the diseased tissue and fill the empty pulp chamber and root canals to prevent further infection. See your dentist even if the pain stops—the infection may have only killed the nerves but is still present and advancing.

Pain is the body’s warning system—so heed the tooth pain alert and see your dentist as soon as possible. The sooner the problem is identified and treated, the better your chances of returning to full dental health.

If you would like more information on tooth pain and what it means, 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 “Tooth Pain? Don’t Wait!”

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