The most important part of dental health maintenance isn’t what your dentist does—it’s what you do every day when you brush and floss your teeth. And all you really need is a multi-tufted, soft bristle toothbrush, toothpaste, a roll of dental floss—plus a little effort from your hands and fingers.
Of course, manual power isn’t your only option—an electric or battery-powered toothbrush is a convenient and, for people with strength or dexterity issues, a necessary way to remove disease-causing plaque from tooth surfaces. You have a similar option with flossing—a water flosser.
Although water flossers (or oral irrigators) have been around since the early 1960s, they’ve become more efficient and less expensive in recent years. A water flosser delivers a pulsating stream of pressurized water between the teeth through a handheld device that resembles a power toothbrush, but with a special tip. The water action loosens plaque and then flushes it away.
While the convenience these devices provide over traditional flossing is a major selling point, they’re also quite beneficial for people with special challenges keeping plaque from accumulating between teeth. People wearing braces or other orthodontic devices, for example, may find it much more difficult to effectively maneuver thread floss around their hardware. Water flossing can be an effective alternative.
But is water flossing a good method for removing between-teeth plaque? If performed properly, yes. A 2008 study, for example, reviewed orthodontic patients who used water flossing compared to those only brushing. The study found that those using water flossing were able to remove five times as much plaque as the non-flossing group.
If you’re considering water flossing over traditional flossing thread, talk with your dental hygienist. He or she can give you advice on purchasing a water flosser, as well as how to use the device for optimum performance. It could be a great and more convenient way to keep plaque from between your teeth and harming your dental health.
If you would like more information on water flossing, 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 “Cleaning between Your Teeth: How Water Flossing can help.”
Life would be harrowing if we had no ability to feel pain. Although experiencing it is unpleasant, pain's purpose is to alert us to something wrong in our body. Without pain diseases and other problems could worsen to the point of life-threatening.
But pain without a purpose — the nerves simply misfiring — can make life miserable. This can happen with the trigeminal nerves that exit the brain stem and end on each side of the face. Each nerve has three branches that serve the upper, middle and lower parts of the face and jaw.
When they don't work properly, trigeminal nerves can give rise to a disorder known as trigeminal neuralgia. Beginning often as an occasional twinge, they may escalate to several seconds of mild to excruciating pain occurring over weeks, months or even years. An episode may erupt from chewing, speaking or even lightly touching of the face.
We see this condition most often in people over fifty, particularly women. We don't know the exact cause, but there's strong suspicion that the nerve's protective sheath has been damaged, similar to what occurs with multiple sclerosis or other inflammatory conditions. Another possibility is a blood vessel putting pressure on the nerve and disrupting its normal operation. Such an impinged nerve might transmit pain signals at the slightest stimulation and then fail to “switch off” when the stimulation stops.
Although we can't cure trigeminal neuralgia, we can help you manage it and reduce discomfort during episodes. We'll first try conservative, less-invasive techniques, like signal-blocking medications or drugs that reduce abnormal firing.
If these aren't effective, we may then recommend a surgical solution. One such procedure is known as percutaneous treatment in which we insert a thin needle to selectively damage nerve fibers to prevent their firing. If we've determined an artery or vein has compressed the nerve, we might surgically relocate the vessel. These techniques can be quite effective but they do have possible side effects like numbness or hearing loss.
If you've experienced facial pain, don't continue to suffer. Visit us for a complete examination and learn about your options for pain relief. More than likely, there's a way to reduce your pain and improve your quality of life.
If you would like more information on facial pain, 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 “Trigeminal Neuralgia.”
Families of children with chronic conditions face many challenges. One that often takes a back seat to other pressing needs is the prevention of tooth decay. But although difficult, it still deserves caregivers’ attention because of the dental disease’s potential long-term impact on oral health.
Chronically ill children are often at higher risk for tooth decay, most commonly due to challenges in practicing effective oral hygiene. Some conditions create severe physical, mental or behavioral impairments in children’s ability to brush and floss: for example, they may have a heightened gag reflex to toothpaste in their mouth or they may not be able to physically perform these tasks on their own.
Some children may be taking medications that inhibit salivary flow as a side effect. Saliva is critical for disease prevention because it both neutralizes mouth acid (which can erode tooth enamel) and is a first line of defense against disease-causing bacteria. And a child’s diet, while designed to support treatment of their chronic condition, may conversely not be the best for supporting their dental health.
It’s best if caregivers and their dentists develop a strategy for decay prevention, which should include the following:
- Regular dental visits beginning at Age One. Besides monitoring dental health, dental visits also provide cleanings and other preventive measures like topical fluoride or sealants;
- Brushing and flossing support. Depending on a child’s physical and mental capacities, caregivers (or an older sibling) may need to model brushing and flossing, or perform the tasks for the child;
- Medication and diet changes. If medications are causing dry mouth, caregivers can speak to their physicians about possible alternatives; likewise, they should see if modifications can be made to their diet to better support dental health.
- Boosting salivary flow. It’s especially important with children who have dry mouth to drink more water or use aids (like xylitol gum or candies) to boost salivary flow.
Although it requires extra effort and time to give attention to a chronically ill child’s dental health, it’s well worth it. By working to prevent tooth decay early in life, these children will be more likely to enjoy good dental health in the future.
If you would like more information on dental care for children with special needs, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Managing Tooth Decay in Children with Chronic Diseases.”
Want to know the exact wrong way to pry open a stubborn lid? Just ask Jimmy Fallon, host of NBC-TV’s popular “Tonight Show.” When the 40-year-old funnyman had trouble opening a tube of scar tissue repair gel with his hands, he decided to try using his teeth.
What happened next wasn’t funny: Attempting to remove the cap, Fallon chipped his front tooth, adding another medical problem to the serious finger injury he suffered a few weeks before (the same wound he was trying to take care of with the gel). If there’s a moral to this story, it might be this: Use the right tool for the job… and that tool isn’t your teeth!
Yet Fallon is hardly alone in his dilemma. According to the American Association of Endodontists, chipped teeth account for the majority of dental injuries. Fortunately, modern dentistry offers a number of great ways to restore damaged teeth.
If the chip is relatively small, it’s often possible to fix it with cosmetic bonding. In this procedure, tough, natural-looking resin is used to fill in the part of the tooth that has been lost. Built up layer by layer, the composite resin is cured with a special light until it’s hard, shiny… and difficult to tell from your natural teeth. Best of all, cosmetic bonding can often be done in one office visit, with little or no discomfort. It can last for up to ten years, so it’s great for kids who may be getting more permanent repairs later.
For larger chips or cracks, veneers or crowns may be suggested. Veneers are wafer-thin porcelain coverings that go over the entire front surface of one or more teeth. They can be used to repair minor to moderate defects, such as chips, discolorations, or spacing irregularities. They can also give you the “Hollywood white” smile you’ve seen on many celebrities.
Veneers are generally custom-made in a lab, and require more than one office visit. Because a small amount of tooth structure must be removed in order to put them in place, veneers are considered an irreversible treatment. But durable and long-lasting veneers are the restorations of choice for many people.
Crowns (also called caps) are used when even more of the tooth structure is missing. They can replace the entire visible part of the tooth, as long as the tooth’s roots remain viable. Crowns, like veneers, are custom-fabricated to match your teeth in size, shape and color; they are generally made in a dental lab and require more than one office visit. However, teeth restored with crowns function well, look natural, and can last for many years.
So what happened to Jimmy Fallon? We aren’t sure which restoration he received… but we do know that he was back on TV the same night, flashing a big smile.
If you would like more information about tooth restorations, please contact us or schedule a consultation. You can learn more in the Dear Doctor magazine articles “Porcelain Crowns & Veneers” and “Artistic Repair Of Front Teeth With Composite Resin.”
Porcelain veneers are one of the best ways to transform your teeth’s appearance with only a small amount of tooth preparation. But even that small amount could leave a veneered tooth permanently altered.
As the name implies, veneers are thin layers of custom-designed porcelain bonded to the outside of a tooth to cover defects. They’re usually ideal for minor chipping, staining or even slight tooth misalignments. But although they’re thin—often just a millimeter or so in thickness—they can still make a tooth appear or feel bulky.
To reduce this extra width, we usually need to remove some of the tooth’s surface enamel. Since enamel doesn’t replenish itself, this alteration could mean the tooth will require a restoration from then on.
But now, you may be able to take advantage of new advances in this popular restoration: No-Prep or Minimal Prep veneers that involve little to no tooth alteration. In most cases they’re simply bonded to the teeth with only slight enamel reshaping.
Because of their ultra-thinness, No-Prep veneers (usually between 0.3 to 0.5 mm, as thin as a contact lens) are bonded directly to teeth that are practically untouched beforehand. A Minimal Prep veneer usually requires only enamel reshaping with an abrasive tool before it’s placed. And unlike traditional veneers, they can often be removed if needed to return the teeth to their original form without another restoration.
These new veneers are best for people with small teeth, often from wear due to teeth grinding, narrow smiles (the side teeth aren’t visible while smiling), or slightly misshapen teeth like underdeveloped teeth that can appear peg-shaped. But people with oversized teeth, some malocclusions (bad bites) or similar dental situations may still require enamel removal to avoid bulkiness even with ultra-thin veneers.
If you don’t have those kinds of issues and your teeth are reasonably healthy, we can apply No-Prep or Minimal Prep veneers in as few as two appointments. The result could be life-changing as you gain a new smile you’re more than happy to share.
If you would like more information on no-prep veneers, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “No-Prep Porcelain Veneers.”
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