My Blog
TeenagerswithMissingTeethUsuallyNeedaTemporaryRestoration

Anyone at any age, including older children and teenagers, can lose or be born missing a permanent tooth. And while those missing teeth can be restored, replacing them in patients who haven’t yet reached adulthood can be tricky.

That’s because their dental and facial development isn’t finished. This is especially problematic for dental implants because as the jaws continue to grow, a “non-growing” implant could eventually appear out of alignment with the surrounding natural teeth. That’s why it’s often better to install a temporary restoration until the jaws fully mature in early adulthood. Two great choices are a removable partial denture (RPD) or a bonded (“Maryland”) bridge.

While “dentures” and “teens” don’t seem to go together, an RPD in fact can effectively restore a teen’s lost dental function and appearance. Of the various types of RPDs the one usually recommended for teens has a hard acrylic base colored to resemble the gums, to which we attach prosthetic (“false”) teeth at their appropriate positions on the jaw.

Besides effectiveness, RPDs are easy to clean and maintain. On the downside, though, an RPD can break and—as a removable appliance—become lost. They can also lose their fit due to changes in jaw structure.

The bonded bridge is similar to a traditional fixed bridge. But there’s one big difference: traditional bridges crown the natural teeth on either side of the missing teeth to secure them in place. The supporting teeth must be significantly (and permanently) altered to accommodate the life-like crowns on either end of the bridge.

Instead, a bonded bridge affixes “wings” of dental material extending from the back of the bridge to the back of the natural teeth on either side. While not quite as strong as a regular bridge, the bonded bridge avoids altering any natural teeth.

While a fixed bridge conveniently stays in place, they’re more difficult than an RPD to keep clean. And while less prone to breakage, they aren’t entirely immune to certain stresses from biting and chewing especially in the presence of some poor bites (how the upper and lower teeth come together).

Choosing between the two restorations will depend on these and other factors. But either choice can serve your teen well until they’re able to permanently replace their missing teeth.

If you would like more information on dental restorations for teens, please contact us or schedule an appointment for a consultation.

ReducingTeethGrindingLeadstoBetterSleepandBetterDentalHealth

We all need a good night's sleep, both in quantity and quality. That's why the Better Sleep Council promotes Better Sleep Month every May with helpful tips on making sure you're not only getting enough sleep, but that it's also restful and therapeutic. The latter is crucial, especially if you have one problem that can diminish sleep quality: nocturnal teeth grinding.

Teeth grinding is the involuntary movement of the jaws outside of normal functioning like eating or speaking. You unconsciously grind teeth against teeth, increasing the pressure of biting forces beyond their normal range. It can occur while awake, but it is more common during sleep.

The habit is fairly widespread in children, thought to result from an immature chewing mechanism. Children normally outgrow the habit, and most healthcare providers don't consider it a major concern.

But teeth grinding can also carry over or arise in adulthood, fueled in large part by stress. It then becomes concerning: Chronic teeth grinding can accelerate normal age-related tooth wear and weaken or damage teeth or dental work. It may also contribute to jaw joint pain and dysfunction related to temporomandibular disorders (TMD).

If you notice frequent jaw tenderness or pain, or a family member says they've heard you grind your teeth at night, you should see us for a full examination. If you are diagnosed with teeth grinding, we can consider different means to bring it under control, depending on your case's severity and underlying causes.

Here are some things you can do:

Alter lifestyle habits. Alcohol and tobacco use have been associated with teeth grinding. To reduce episodes of nighttime teeth grinding, consider modifying (or, as with tobacco, stopping) your use of these and related substances. Altering your lifestyle in this way will likely also improve your overall health.

Manage stress. Teeth grinding can be a way the body “lets off steam” from the accumulated stress of difficult life situations. You may be able to reduce it through better stress management. Learn and practice stress reduction techniques like meditation or other forms of relaxation. You may also find counseling, biofeedback or group therapy beneficial.

Seek dental solutions. In severe cases, there are possible dental solutions to reducing the biting forces generated by teeth grinding. One way is to adjust the bite by removing some of the structure from teeth that may be more prominent than others. We may also be able to create a bite guard to wear at night that prevents teeth from making solid contact with each other.

These and other techniques can be used individually or together to create a customized treatment plan just for you. Minimizing teeth grinding will help ensure you're getting the most out of your sleep time, while protecting your dental health too.

If you would like more information about treatment for teeth grinding, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Teeth Grinding.”

By John M. Falace, DMD
May 12, 2020
Category: Oral Health
Tags: gum disease  
WithoutPromptInterventionGumDiseaseCouldDamageToothRoots

Periodontal (gum) disease often involves more than gum inflammation. The real danger is what this bacterial infection may be doing to tissues beneath the gum line—including tooth roots and supporting bone.

Gum disease can do extensive damage to the forked areas where the roots separate from the main tooth body. If one of these areas, known as a furcation, becomes infected, the associated bone may begin to diminish. And you may not even know it's happening.

Fortunately, we may be able to detect a furcation involvement using x-rays and tactile (touch) probing. The findings from our examination will not only verify a furcation involvement exists, but also how extensive it is according to a formal classification system that dentists use for planning further treatment.

A Class I involvement under this system signifies the beginning of bone loss, usually a slight groove in the bone. Class II signifies two or more millimeters of bone loss. Class III, also called a “through and through,” represents bone loss that extends from one side of the root to the other.

The class of involvement will guide how we treat it. Obviously, the lower the class, the less extensive that treatment will be. That's why regular dental checkups or appointments at the first sign of gum problems are a must.

The first-line treatment for furcation involvements is much the same as for gum disease in general: We manually remove bacterial plaque, the main source of infection, from the root surfaces using hand instruments and ultrasonic equipment. This is often followed by localized antibiotics to further disinfect the area and stymie the further growth of the furcation involvement.

We also want to foster the regrowth of lost tissue, if at all possible. Classes II and III involvements may present a challenge in this regard, ultimately requiring grafting surgery to stimulate tissue regeneration.

The best approach by far is to prevent gum disease, the ultimate cause for a furcation involvement. You can reduce your chances of gum disease by brushing and flossing daily to remove disease-causing plaque. Regular dental cleanings and checkups, at least every six months, help round out this prevention strategy.

A furcation involvement could ultimately endanger a tooth's survival. We can stop that from happening—but we'll have to act promptly to achieve the best results.

If you would like more information on treating 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 “What are Furcations?

By John M. Falace, DMD
May 02, 2020
Category: Oral Health
NBAPlayersInjuryPointsOutNeedforMouthguards

Basketball isn't a contact sport—right? Maybe once upon a time that was true… but today, not so much. Just ask New York Knicks point guard Dennis Smith Jr. While scrambling for a loose ball in a recent game, Smith's mouth took a hit from an opposing player's elbow—and he came up missing a big part of his front tooth. It's a type of injury that has become common in this fast-paced game.

Research shows that when it comes to dental damage, basketball is a leader in the field. In fact, one study published in the Journal of the American Dental Association (JADA) found that intercollegiate athletes who play basketball suffered a rate of dental injuries several times higher than those who played baseball, volleyball or track—even football!

Part of the problem is the nature of the game: With ten fast-moving players competing for space on a small court, collisions are bound to occur. Yet football requires even closer and more aggressive contact. Why don't football players suffer as many orofacial (mouth and face) injuries?

The answer is protective gear. While football players are generally required to wear helmets and mouth guards, hoopsters are not. And, with a few notable exceptions (like Golden State Warriors player Stephen Curry), most don't—which is an unfortunate choice.

Yes, modern dentistry offers many different options for a great-looking, long lasting tooth restoration or replacement. Based on each individual's situation, it's certainly possible to restore a damaged tooth via cosmetic bonding, veneers, bridgework, crowns, or dental implants. But depending on what's needed, these treatments may involve considerable time and expense. It's better to prevent dental injuries before they happen—and the best way to do that is with a custom-made mouthguard.

Here at the dental office we can provide a high-quality mouthguard that's fabricated from an exact model of your mouth, so it fits perfectly. Custom-made mouthguards offer effective protection against injury and are the most comfortable to wear; that's vital, because if you don't wear a mouthguard, it's not helping. Those "off-the-rack" or "boil-and-bite" mouthguards just can't offer the same level of comfort and protection as one that's designed and made just for you.

Do mouthguards really work? The same JADA study mentioned above found that when basketball players were required to wear mouthguards, the injury rate was cut by more than half! So if you (or your children) love to play basketball—or baseball—or any sport where there's a danger of orofacial injury—a custom-made mouthguard is a good investment in your smile's future.

If you would like more information about custom-made athletic mouthguards, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Athletic Mouthguards” and “An Introduction to Sports Injuries & Dentistry.”

By John M. Falace, DMD
April 22, 2020
Category: Oral Health
Tags: tooth decay   sugar  
TooMuchSugarCanWreckMoreThanYourTeeth

You've heard it. Your parents heard it—maybe even your grandparents too. Dentists have been alerting people for more than half a century that high sugar consumption contributes to tooth decay.

That message hasn't changed because the facts behind it are the same in the 2020s as they were in the 1950s: The bacteria that cause tooth decay feast on sugar and other leftover carbohydrates in the mouth. This causes them to multiply and increase their production of acid, which softens and erodes tooth enamel.

What has changed though, especially over the last couple of decades, is a growing understanding of how sugar consumption may affect the rest of the body. Just like the evidence of sugar's relationship to tooth decay, current scientific studies are now showing there are strong links between sugar and diseases like diabetes, heart disease and liver disease.

What's startling about what researchers are finding is that cases of these diseases are growing, Especially in younger people. This is a parallel trend to our skyrocketing increases in per capita sugar consumption: the average American now eats the equivalent of 19.5 teaspoons of added sugar every day. Health experts generally agree we should consume no more than 6 teaspoons a day, and children 4.

This is vastly more than we consumed a generation ago. One reason is because processed food manufacturers have increased sugar in their products, hiding under technical, unfamiliar names in ingredient lists. But it's still sugar, and an estimated 74% of processed foods contain some form of it.

But the real surge in sugar has come from our increasing consumption of sodas, as well as energy and sports beverages. These beverages are high in sugar—you can meet your daily allowance with just one 12-oz can of soda. These beverages are now the leading source of sugar in our diets, and, according to experts, a highly dangerous way to consume it.

In effect, dentists of old were on to something: too much sugar is bad for your teeth. It now turns out that it may be bad for your overall health too. Strictly limiting it in your family's diet could help lower your risk of tooth decay and dangerous diseases like diabetes.

If you would like more information on sugar and your health, please contact us or schedule an appointment for a consultation.





This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.