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By Endodontics & Periodontics Associates, PA
January 03, 2020
Category: Oral Health
4ThingstoDotoKeepYourChildsDentalDevelopmentonTrack

When you’re expecting a new baby, there’s a lot to prepare: outfitting the nursery, stocking up on diapers or choosing a pediatrician. It’s also not too early to consider how to protect your new child’s dental development.

From birth through adolescence, a child’s mouth goes through a whirlwind of growth. Hopefully, it all follows a normal track, but detours can arise like tooth decay or bite problems.

Here are 4 things you can do to keep your child’s dental development on track.

Start oral hygiene before teeth. Daily oral hygiene is essential toward helping your child avoid tooth decay. And don’t wait for teeth to come in—begin wiping their gums with a clean, damp cloth right after nursing. When teeth do appear, switch to brushing with just a smear of toothpaste and then add flossing as more teeth come in.

Begin regular dental visits. The American Dental Association recommends pediatric dental visits around the first birthday. The possibility of tooth decay becomes a concern around this time as the primary teeth are steadily erupting. Starting earlier rather than later may also help your child adjust to the routine of dental visits that they’ll most likely carry on as they get older.

Control their sugar consumption. Because sugar is a prime food source for disease-causing bacteria, you should keep your child’s sugar consumption as controlled as possible. For example, don’t put a baby to bed with a bottle filled with a sugary liquid (including juice and breast milk)—the constant presence of the liquid during nap time encourages bacterial growth and acid production.

Get an orthodontic evaluation. While we often associate orthodontic treatment with the teen years, it may be possible to head off bite problems earlier. So, see an orthodontist for a bite evaluation when your child is around age 6. If there are signs of a developing problem, certain techniques could help stop or slow them from getting worse, helping you avoid extensive and expensive treatment later.

With a newborn coming, you and your family have a lot on your plate. Be sure, though, not to forget making plans for keeping their teeth and gums healthy.

If you would like more information on dental care for your child, 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 “Age One Dental Visit.”

By Endodontics & Periodontics Associates, PA
December 24, 2019
Category: Dental Procedures
ALittleOrthodonticMagicCouldHelpanImpactedToothErupt

Bite problems aren't limited to teeth simply out of position. The problem could be some teeth aren't there—visibly, that is. They still exist below the gums and bone, but they've been crowded out and blocked from erupting. We call this condition impaction.

Any tooth can become impacted and affect the bite, but a person's smile suffers more if it involves visible front teeth. This is especially so if the teeth in question are upper canines or "eye teeth"—the smile doesn't look normal without these pointed teeth on either side of the central and lateral incisors.

Impacted teeth can also contribute to more than a cosmetic problem: they're more susceptible to abscesses (pockets of infection) or root damage both to themselves or neighboring teeth. To minimize these potential health issues, we'll often remove impacted teeth surgically (as is often done with wisdom teeth).

But because of their important role in not only appearance but also bite function, we may first try to assist impacted canines to fully erupt before considering extraction. It takes a bit of orthodontic "magic," but it can be done.

Before we can make that decision, though, we want to precisely locate the impacted teeth's positions and how it may affect other teeth. This initial evaluation, often with advanced diagnostics like CT scanning or digital x-rays, helps us determine if the impacted teeth are in a workable position to save. If they're not, we may then need to consider removing them and ultimately replacing them with a dental implant or similar restoration.

But if their position is workable and there are no other impediments, we can proceed with helping them erupt. To do this we'll have to first expose them by creating a small opening in the gums through minor surgery. We then bond a small bracket to the tooth, to which we'll attach a small chain that we then attach to orthodontic braces. This enables us to exert continuous pressure on the tooth.

Over time, the pressure coaxes the tooth to erupt. We may still need to apply other forms of orthodontics and cosmetic procedures, but using this procedure to rescue impacted canines can produce a healthier and more attractive smile.

If you would like more information on treating complex bite problems, 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 “Exposing Impacted Canines.”

By Endodontics & Periodontics Associates, PA
December 14, 2019
Category: Oral Health
FindOutHowTheseFamousCelebritiesProtectTheirSmilesFromTeethGrinding

The fast-paced world of sports and entertainment isn’t all glitz and glamour. These high-profile industries create a unique kind of emotional and mental stress on celebrities. For many of them, a way to “let off steam” is an oral habit known as teeth grinding.

Teeth grinding is an involuntary habit in which a person bites and grinds their teeth outside of normal activities like eating or speaking. It’s common among young children, who usually grow out of it, but it can also affect adults, especially those who deal with chronic stress. If not addressed, teeth grinding can eventually wear down teeth, damage gum attachments or fracture weaker teeth. It can even contribute to tooth loss.

A number of well-known personalities in the spotlight struggle with teeth grinding, including actress Vivica Fox, model and TV host Chrissy Teigen, and star athletes Tara Lipinski and Milos Raonic of ice skating and tennis fame, respectively. The habit represents not only a threat to their dental health, but also to one of their most important career assets: an attractive and inviting smile. Fortunately, though, they each use a similar device to manage their teeth grinding.

Besides seeking ways to better manage life stress, individuals with a teeth-grinding habit can protect their teeth with a custom mouthguard from their dentist. Made of slick plastic, this device is worn over the teeth, usually while sleeping, to minimize dental damage. During a grinding episode, the teeth can’t make contact with each other due to the guard’s glossy surface—they simply slide away from each other. This reduces the biting forces and eliminates the potential for wear, the main sources of dental damage.

Chrissy Teigen, co-host with LL Cool J on the game show Lip Sync Battle, wears her custom-made guard regularly at night. She even showed off her guard to her fans once during a selfie-video posted on Snapchat and Twitter. Vivica Fox, best known for her role in Independence Day, also wears her guard at night, and for an additional reason: The guard helps protect her porcelain veneers, which could be damaged if they encounter too much biting force.

Mouthguards are a prominent part of sports, usually to protect the teeth and gums from injury. Some athletes, though, wear them because of their teeth grinding habit. Tara Lipinski, world renowned figure skater and media personality, keeps hers on hand to wear at night even when she travels. And Milos Raonic, one of the world’s top professional tennis players, wears his during matches—the heat of competition tends to trigger his own teeth-grinding habit.

These kinds of mouthguards aren’t exclusive to celebrities. If you or a family member contends with this bothersome habit, we may be able to create a custom mouthguard for you. It won’t stop teeth grinding, but it could help protect your teeth—and your smile.

If you would like more information about protecting your smile, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Teeth Grinding” and “When Children Grind Their Teeth.”

By Endodontics & Periodontics Associates, PA
December 04, 2019
Category: Dental Procedures
TeensMayNeedaTemporaryRestorationforMissingTeeth

While not as prevalent as adults, teenagers can have missing teeth, usually from injury or from never having been formed. Fortunately, life-like dental implants can replace missing teeth. But unfortunately for teens, implants aren't usually a good option—yet.

That's because a teenager's jaws are still growing, and will continue until early adulthood. Dental implants don't adjust to this growth like natural teeth and will eventually look out of place. It's best, then, to consider a temporary restoration for a teenager. And, there are two excellent options: one removable and one fixed.

The first is a removable partial denture (RPD). Like a full denture, an RPD has an acrylic base that resembles gum tissue, to which prosthetic (false) teeth are attached to match the positions of the missing teeth. It's usually held in place with metal or nylon clips that slide under part of the natural teeth at the gum line.

RPDs are versatile and durable. But they're not designed to be worn indefinitely, so they can be damaged if subjected to excessive biting forces like biting into something hard. And, peer-pressured teens may also feel self-consciousness about wearing a “denture.”

The other option is a bonded bridge. It's similar to a traditional bridge, except how it's supported in the mouth. A traditional bridge gains its support from the crowns on each end attached to natural teeth, which must be permanently altered for them. By contrast, a bonded bridge has strips of dental material extending from both sides of its back that are bonded to the back of the adjacent natural teeth.

With the bonding material behind the bridge, it can't be seen—and the natural teeth won't require permanent alteration. But a bonded bridge is usually more costly than an RPD and less secure than a traditional bridge. And not every teen is a viable candidate for one: issues like how the teeth fit together and if the teen has a tooth grinding habit could be strikes against this fixed option.

Your dentist can help you sort out the best of these options for your teen. If cared for and maintained properly, either restoration can buy you time until your teen is ready for dental implants.

If you would like more information on restoring a teenager's 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 “Temporary Tooth Replacement for Teens: What Are the Options?

By Endodontics & Periodontics Associates, PA
November 24, 2019
Category: Oral Health
Tags: tmj disorders  
SeekCoordinatedTreatmentIfYouHaveBothTMDandFibromyalgia

Fibromyalgia is a chronic condition that produces widespread pain and stiffness in the muscles and joints. The pain, muscle spasms and tingling it causes can disrupt sleep, alter moods and impair memory function.

Dealing with just this one condition can be overwhelming. But did you know 3 out 4 fibromyalgia patients also develop chronic pain and dysfunction involving their jaw joints? Known collectively as temporomandibular joint disorders (TMD), these jaw joint problems cause pain, muscle spasms and difficulty moving the jaws that can interfere with eating and speaking. TMD can also contribute to headaches and earaches.

Many researchers believe this prevalence of TMD among fibromyalgia patients stems from both conditions originating from the same primary cause—a malfunction within the central nervous system. In both cases, the brain and spinal cord may not be able to process pain signals in a normal fashion. This malfunction could also be generating and amplifying pain signals even when nerves are receiving no stimulation.

For decades now, the most effective treatment strategy for TMD has been to manage the symptoms with physical therapy and exercises, thermal therapy or medications. Relief for fibromyalgia has depended on medication and relaxation techniques like biofeedback therapy. But with the evidence of some connection between the two conditions, it may be helpful to coordinate treatment for both with a team approach involving all your healthcare providers, rather than treat them separately.

To that end, make sure both your dentist or physician treating you for TMD and your physician treating your fibromyalgia each know about the other condition. Consulting together, your healthcare team may find treatments (like certain drugs that counteract neurotransmitter imbalances) that might help reduce symptoms in both conditions. And cognitive-behavioral therapy, meditation and other therapeutic pain management techniques can help you cope with the pain.

Continued research into these two debilitating conditions and the possible links between them may have an effect on how we treat both. A holistic approach to treating them could be the wave of the future.

If you would like more information on the links between TMD and other chronic pain 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 “Fibromyalgia and Temporomandibular Disorders.”





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