April is National Stress Awareness Month. But what does stress have to do with dentistry? According to the American Academy of Sleep Medicine, if you have a Type A personality or are under a lot of stress, you are more likely to suffer from a condition called bruxism, which means you habitually grind or gnash your teeth. One in ten adults grind their teeth, and the rate is much higher in stressful professions. In fact, the bruxism rate is seven times higher among police officers!
Many people grind their teeth in their sleep without realizing it, so how would you know if you are a "sleep bruxer"? If your spouse frequently elbows you in the ribs because of the grinding sounds you make, that could be your first clue. Unfortunately, dental damage is another common sign. Some people find out they are nighttime teeth grinders only when they are examined by a dentist since bruxing often leads to wear patterns on the teeth that only happen because of this behavior. Other complications can also develop: The condition can interfere with sleep, result in headaches and cause soreness in the face, neck or jaw. Chronic or severe nighttime teeth grinding can damage dental work, such as veneers, bridgework, crowns and fillings, and can result in teeth that are worn down, chipped, fractured or loose.
The most common treatment is a custom-made night guard made of high-impact plastic that allows you to sleep while preventing your upper and lower teeth from coming into contact. Although a night guard will protect your teeth and dental work, it won't stop the grinding behavior. Therefore, finding and treating the cause should be a priority.
The Bruxism Association estimates that 70 percent of teeth grinding behavior is related to stress. If you are a bruxer, you can try muscle relaxation exercises, stretching and breathing exercises, stress reduction techniques and, where feasible, any lifestyle changes that can allow you to reduce the number of stressors in your life. Prescription muscle relaxants may also help. In addition, teeth grinding may be related to sleep apnea. This possibility should be investigated since sleep apnea can have some serious health consequences—we offer effective treatments for this condition as well.
We can spot signs of bruxism, so it's important to come in for regular dental checkups. We look for early indications of dental damage and can help you protect your smile. If you have questions about teeth grinding or would like to discuss possible symptoms, please contact our office or schedule an appointment for a consultation. You can read more in the Dear Doctor magazine articles “Teeth Grinding” and “Stress & Tooth Habits.”
Most of us wouldn't think of buying a new car without a “test drive.” It's a serious investment, so you want to make sure you're comfortable with your new ride.
Like an auto purchase, the plan you and your dentist agree on to cosmetically enhance your teeth and gums — a “smile makeover” — is a significant investment. Wouldn't it be nice to “test drive” your future smile before you undergo any procedures?
Actually, you can — two ways, in fact. For one, your dentist could use computer imaging software that alters a photo of your face to show how your smile will appear after dental work. These computer enhancements are a great planning tool for making decisions on the look you want to achieve.
But even the best computer images only provide a static, two-dimensional representation of your new smile. It can't capture all the angles and movement dynamics of any proposed changes. That's where the other way, a trial smile, is a true test drive — you can see your future smile in action.
With a trial smile, your dentist temporarily places tooth-colored material called composite resin on your teeth to simulate the proposed changes. The resin can be shaped and sculpted to create a life-like replica that you'll be able to view in all three spatial dimensions. What's more it will give you a chance not only to see what your new smile will look like, but to actually experience how it feels in your mouth.
Creating a trial smile is an added expense and it's only available during your consultation visit — the dentist will need to remove the resin before you leave. But you'll still be able to get a good impression of what your final smile will be like. You'll also be able to take photos you can show to family and friends to get their impressions of your proposed new look.
A trial smile allows you to know beforehand what your dental work investment will provide you, and even fine-tune your makeover plan before work begins. With this particular kind of “test drive” you'll have greater assurance that you'll be happy and satisfied with the end results.
If you would like more information on trial smiles, 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 “Testing Your Smile Makeover.”
When your favorite baseball team wins, it's hard not to get excited — especially if you're right there in the stadium. It's even better when a player tosses the ball to fans. But sometimes, in the heat of the moment, things can go awry.
That's what happened during a recent game at New York's Yankee Stadium. After catching the ball that ended the game in an 8-2 Dodgers win, Los Angeles outfielder Yasiel Puig tossed it into a cheering crowd of supporters. “I saw it coming at me and I remember thinking, 'I don't have a glove to catch this ball,'” Dodgers fan Alyssa Gerharter told the New York Daily News. “I felt it hit me and I could feel immediately with my tongue there's a hole. And I looked down at my hand and saw there's a tooth in my hand.”
Ouch. Just like that, one fan's dream became… a not-so-good dream. But fortunately for the 25-year-old software engineer, things went uphill from there. Ushers quickly escorted her into a first-aid room at the stadium. She was then rushed to a nearby hospital, where the upper front tooth was re-inserted into her jaw. After a follow-up appointment at her dentist's office the next day, Gerharter said she remains hopeful the re-inserted tooth will fuse with the bone, and won't require replacement.
We hope so too. And in fact, she has as good a chance of a successful outcome as anyone, because she did everything right. If you're not sure what to do about a knocked-out tooth, here are the basics:
- locate the tooth, handle it carefully (don't touch the root surface), and if possible gently clean it with water
- try to open the person's mouth and find the place where the tooth came from
- carefully re-insert the tooth in its socket if possible, making sure it is facing the right way
- hold the tooth in place with a soft cloth as you rush to the dental office or the nearest urgent care facility
- if it can't be replaced in its socket, place the tooth in a special preservative solution or milk, or have the person hold it between the cheek and gum (making sure they won't swallow it) — and then seek immediate care at the dental office
- follow up at the dental office as recommended
In general, the quicker you perform these steps, the more likely it is that the tooth can be preserved. How quick is quick? The best outcomes are expected when re-implantation occurs in no more than five minutes. So if you're in this situation, don't wait: get (or give) appropriate first aid right away — it just might save a tooth!
If you would like more information about what to do in a dental emergency, contact us or schedule an appointment for a consultation. You can learn more the Dear Doctor articles “Knocked Out Tooth,” and “The Field-Side Guide to Dental Injuries.”
Sometimes, looking at old pictures can really bring memories back to life. Just ask Stefani Germanotta—the pop diva better known as Lady Gaga. In one scene from the recent documentary Five Foot Two, as family members sort through headshots from her teen years, her father proclaims: "Here, this proves she had braces!"
"If I had kept that gap, then I would have even more problems with Madonna," Lady Gaga replies, referencing an ongoing feud between the two musical celebrities.
The photos of Gaga's teenage smile reveal that the singer of hits like "Born This Way" once had a noticeable gap (which dentists call a diastema) between her front teeth. This condition is common in children, but often becomes less conspicuous with age. It isn't necessarily a problem: Lots of well-known people have extra space in their smiles, including ex-football player and TV host Michael Strahan, actress Anna Paquin…and fellow pop superstar Madonna. It hasn't hurt any of their careers.
Yet others would prefer a smile without the gap. Fortunately, diastema in children is generally not difficult to fix. One of the easiest ways to do so is with traditional braces or clear aligners. These orthodontic appliances, usually worn for a period of months, can actually move the teeth into positions that look more pleasing in the smile and function better in the bite. For many people, orthodontic treatment is a part of their emergence from adolescence into adulthood.
Braces and aligners, along with other specialized orthodontic appliances, can also remedy many bite problems besides diastema. They can correct misaligned teeth and spacing irregularities, fix overbites and underbites, and take care of numerous other types of malocclusions (bite problems).
The American Association of Orthodontists recommends that kids get screened for orthodontic problems at age 7. Even if an issue is found, most won't get treatment at this age—but in some instances, it's possible that early intervention can save a great deal of time, money and effort later. For example, while the jaw is still developing, its growth can be guided with special appliances that can make future orthodontic treatment go quicker and easier.
Yet orthodontics isn't just for children—adults can wear braces too! As long as teeth and gums are healthy, there's no upper age limit on orthodontic treatment. Instead of traditional silver braces, many adults choose tooth-colored braces or clear aligners to complement their more professional appearance.
So if your child is at the age where screening is recommended—or if you're unhappy with your own smile—ask us whether orthodontics could help. But if you get into a rivalry with Madonna…you're on your own.
If you have questions about orthodontic treatment, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Magic of Orthodontics” and “Orthodontics For The Older Adult.”
After ruling out other causes for your jaw pain, your doctor or dentist has made a diagnosis: a temporomandibular joint disorder (TMD). With TMD, your pain symptoms and other dysfunctions are due to a problem associated with the temporomandibular joint (TMJ) that connects your lower jaw (mandible) to your upper skull (cranium).
There are a number of treatment options, but most can be classified as either aggressive or conservative. Aggressive treatments are more interventional and target problems with the teeth such as bite problems or jaw relationships as they relate to the bite, which are thought to be underlying causes for TMD. Such treatments include orthodontics to realign teeth, crown or bridgework, or surgical treatment to the jaw or joint itself. These treatments are controversial and irreversible — with no guarantee of symptom relief.
It’s thought by many to be appropriate, then, to start with more conservative treatments. Many of these are based on treating the TMJ — which is a joint, a moveable bony structure connected by muscles and tendons — with an orthopedic approach, using treatments similar to those used for other joint problems.
Here, then, are some of those conservative therapies that may relieve your TMD pain and other symptoms.
Physical Therapy. Commonly used to treat pain and dysfunction in other joints, physical therapies like manual manipulation, massage, alternating hot and cold packs or exercises can be used to relax, stretch or retrain the muscles that operate the TMJ while reducing pain and inflammation.
Medications. Medications may be incorporated into the treatment plan to relieve pain, reduce inflammation or relax tense muscles. Besides prescription drugs, over-the-counter anti-inflammatory drugs (such as ibuprofen or acetaminophen) are also commonly used.
Bite Appliances. If night-time teeth grinding or clenching habits are a primary cause for the TMD, you may benefit from wearing an occlusal bite guard while you sleep, designed to specifically fit your upper teeth. Because the lower teeth can’t grip the guard’s smooth plastic surface when biting down, they’ll more likely produce less force. This gives the jaw muscles a chance to relax during sleep.
Diet changes. Changing to softer foods, which don’t require strenuous chewing, and eliminating the chewing gum habit will further help reduce stress on the TMJs and also give your muscles a chance to relax and heal.
If you would like more information on TMD and treatment options, 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 “Seeking Relief from TMD.”
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