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.”
“No man is an island….” So wrote the poet John Donne four centuries ago. And while he meant the unity of humanity, the metaphor could equally apply to the interdependence of the various parts of the human body, including the mouth. According to recent scientific research, your mouth isn’t an “island” either.
Much of this research has focused on periodontal (gum) disease, an infection most often caused by bacterial plaque that triggers inflammation in the gum tissues. Although an important part of the body’s defenses, if the inflammation becomes chronic it can damage the gums and weaken their attachment to the teeth. Supporting bone may also deteriorate leading eventually to tooth loss.
Avoiding that outcome is good reason alone for treating and controlling gum disease. But there’s another reason—the possible effect the infection may have on the rest of the body, especially if you have one or more systemic health issues. It may be possible for bacteria to enter the bloodstream through the diseased gum tissues to affect other parts of the body or possibly make other inflammatory conditions worse.
One such condition is diabetes, a disease which affects nearly one person in ten. Normally the hormone insulin helps turn dietary sugars into energy for the body’s cells. But with diabetes either the body doesn’t produce enough insulin or the available insulin can’t metabolize sugar effectively. The disease can cause or complicate many other serious health situations.
There appears to be some links between diabetes and gum disease, including that they both fuel chronic inflammation. This may explain why diabetics with uncontrolled gum disease also often have poor blood sugar levels. Conversely, diabetics often have an exaggerated inflammatory response to gum disease bacteria compared to someone without diabetes.
The good news, though, is that bringing systemic diseases like diabetes under control may have a positive effect on the treatment of gum disease. It may also mean that properly treating gum disease could also help you manage not only diabetes, but also other conditions like cardiovascular disease, osteoporosis, or rheumatoid arthritis. Taking care of your teeth and gums may not only bring greater health to your mouth, but to the rest of your body as well.
If you would like more information on treating dental diseases like gum 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 “Good Oral Health Leads to Better Health Overall.”
Although periodontal (gum) disease usually affects your gums first, your teeth may eventually suffer. That’s because the disease can damage both attaching gum tissues and supporting bone.
One advanced sign of this is when one or more teeth become loose. A loose tooth is an alarm bell that you’re about to lose it.
Fortunately, we can often treat loose diseased teeth with a two-phase approach. First and foremost, we need to bring the gum infection under control by removing plaque and calculus (tartar) — the “fuel” for the infection — from all tooth and gum surfaces. Depending on how extensive it is, we have options: we can use specially designed hand instruments to remove plaque and calculus, ultrasonic equipment that loosens and flushes plaque and calculus away, or, if necessary, conventional or laser surgery.
Depending on the extent of the infection, in some cases we may need to use regenerative surgical techniques like gum and bone grafting to replace lost tissue. Healing takes time, though, which leads to the second phase of treatment — securing the loose tooth during gum healing.
The most common way is through a bite adjustment, where teeth are altered to equilibrate chewing forces evenly. This results in all the teeth being hit at the same time allowing the loose teeth to heal and tighten up.
Another option is splinting teeth together. Although there are different methods, the basic idea is to join the loose teeth with stable teeth like pickets in a fence. One way is to bond splinting material across the back surfaces of the involved teeth. Another way is to cut in a small channel across the teeth and insert and bond a rigid strip of metal to splint the teeth in place.
The splint is usually a temporary measure while the gums heal. In some situations, though, we may need to perform a permanent splint by crowning the affected teeth and then splinting the crowns together. If you have a grinding habit we may also prescribe a night guard to limit the damage done while you sleep.
Before deciding on which technique is best for you, we would first need to evaluate the health of the affected teeth to see whether the effort would be worth it. It could be the tooth’s supporting bone structure has become so deteriorated that it might be better to extract the tooth and consider an implant or other replacement. First, though, we would attempt if at all practical to save the tooth — and the sooner we begin treating it, the better your chances for such an outcome.
If you would like more information on loose teeth and gum 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 “Treatment for Loose Teeth.”
You don’t have to be a dental professional to appreciate a beautiful smile. Likewise, you’ll also know when something’s not quite right with one.
Such can be the case when a tooth fails to erupt properly, causing most or all of the crown to remain below the gum line, a condition known as impaction. Upper canines (or “eyeteeth,” for their location in the arch under the eyes) are especially susceptible to impaction: located on either side of the lateral incisors, which are on either side of the central incisors (the two center front teeth).
The upper canines are important both for function and appearance. Working with their lower counterparts they help cut through food as we chew, so you lose some of that efficiency when they don’t erupt properly. Impacted teeth are susceptible to abscesses and cysts, and can impinge upon and damage the roots of other teeth. And just as importantly, their absence also disrupts the smile as nearby teeth tend to move or “drift” toward the open space.
Rather than remove the impacted canines as is often done with back teeth, it may be more advantageous for both function and appearance to “coax” them into full eruption. This requires first pinpointing their exact location below the gums using x-rays or cone beam 3-D imaging.
If the teeth are in reasonably good position we must first prepare them for orthodontic treatment by surgically exposing the crown from the gums and bonding a small bracket to it. We then attach a small gold chain to the bracket that extends outside of the gums when we suture them back into place. The chain is attached to orthodontic hardware that exerts pressure on the impacted tooth for several months to “pull” it out into the arch.
This procedure has the best chance of success if undertaken before the end of jaw development in early adulthood. Otherwise, it may be better to remove the impacted canines and replace them with dental implants, followed by orthodontic treatment of other teeth to restore their proper position and bite relationships. In either case, your impacted upper canines don’t have to be a problem — we can restore both your mouth function and your smile.
If you would like more information on impacted teeth 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 “Exposing Impacted Canines.”
Recent articles published by the Academy of General Dentistry, indicate how cosmetic dentistry have changed American’s lives. Due to new advances in dentistry, many people are now able to enjoy Hollywood smiles without the agony of crowns or braces.
There are many types of cosmetic procedures that can be performed by our office, Porcelain Veneers is one of the three of the most common.
Procedure: Porcelain veneers are thin ceramic shells adhered onto the surface of prepared teeth in much the same way that false fingernails are applied. Veneers correct or camouflage severe discoloration, damage, misalignment, or teeth that are poorly shaped.
Visits: Two—one to prepare the teeth and make impressions, the other to apply and finish the veneer.
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