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By Gregory M Blackstone DDS
July 12, 2018
Category: Dental Procedures
DontBreakItLikeBeckham

During his former career as a professional footballer (that's a soccer star to U.S. sports fans) David Beckham was known for his skill at “bending” a soccer ball. His ability to make the ball curve in mid-flight — to avoid a defender or score a goal — led scores of kids to try to “bend it like Beckham.” But just recently, while enjoying a vacation in Canada with his family, “Becks” tried snowboarding for the first time — and in the process, broke one of his front teeth.

Some fans worried that the missing tooth could be a “red card” for Beckham's current modeling career… but fortunately, he headed straight to the dental office as soon as he arrived back in England. Exactly what kind of treatment is needed for a broken tooth? It all depends where the break is and how badly the tooth is damaged.

For a minor crack or chip, cosmetic bonding may offer a quick and effective solution. In this procedure, a composite resin, in a color custom-made to match the tooth, is applied in liquid form and cured (hardened) with a special light. Several layers of bonding material can be applied to re-construct a larger area of missing tooth, and chips that have been saved can sometimes be reattached as well.

When more tooth structure is missing, dental veneers may be the preferred restorative option. Veneers are wafer-thin shells that are bonded to the front surface of the teeth. They can not only correct small chips or cracks, but can also improve the color, spacing, and shape of your teeth.

But if the damage exposes the soft inner pulp of the tooth, root canal treatment will be needed to save the tooth. In this procedure, the inflamed or infected pulp tissue is removed and the tooth sealed against re-infection; if a root canal is not done when needed, the tooth will have an increased risk for extraction in the future. Following a root canal, a tooth is often restored with a crown (cap), which can look good and function well for many years.

Sometimes, a tooth may be knocked completely out of its socket; or, a severely damaged tooth may need to be extracted (removed). In either situation, the best option for restoration is a dental implant. Here, a tiny screw-like device made of titanium metal is inserted into the jaw bone in a minor surgical procedure. Over time, it fuses with the living bone to form a solid anchorage. A lifelike crown is attached, which provides aesthetic appeal and full function for the replacement tooth.

So how's Beckham holding up? According to sources, “David is a trooper and didn't make a fuss. He took it all in his stride." Maybe next time he hits the slopes, he'll heed the advice of dental experts and wear a custom-made mouthguard…

If you have questions about restoring damaged teeth, please contact our office to schedule a consultation. You can read more in the Dear Doctor magazine articles “Trauma and Nerve Damage to Teeth” and “Children's Dental Concerns and Injuries.”

By Gregory M Blackstone DDS
July 01, 2018
Category: Oral Health
KeepWatchforBiteProblemswithyourChildsTeeth

Around ages 6 to 8, a child's primary teeth will begin to loosen to make way for their permanent teeth. If all goes well, the new set will come in straight with the upper teeth slightly overlapping the bottom.

But sometimes it doesn't go that well: a child may instead develop a poor bite (malocclusion) that interferes with normal function. If we can detect the early signs of a developing malocclusion, however, we may be able to intervene and lessen its impact. You as a parent can play a vital role in this early detection.

The first thing you should be watching for is teeth spacing. Normal teeth come in straight with a slight gap between them. But there are two abnormal extremes to look for: teeth having no space between them or crowded together in a crooked, haphazard manner; or they seem to have too much space between them, which indicates a possible discrepancy between the teeth and jaw sizes.

You should also notice how the teeth come together or “bite.” If you notice the lower front teeth biting in front of the upper (the opposite of normal) it may be a developing underbite. If you see a space between the upper and lower teeth when they bite down, this is a sign of an open bite. Or, if the upper front teeth seem to come down too far over the lower, this could mean a deep bite: in extreme cases the lower teeth actually bite into the roof of the mouth behind the upper teeth.

You should also look for crossbites, in which the teeth in one part of the mouth bite abnormally in front or behind their counterparts, while teeth in other parts bite normally. For example, you might notice if the back upper teeth bite inside the lower teeth (abnormal), while the front upper teeth bite outside the lower front teeth (normal).

The important thing is to note anything that doesn't look right or seems inconsistent with how your child's teeth look or how they function. Even if you aren't sure it's an issue, contact us anyway for an examination. If it really is a developing bite problem, starting treatment now may lessen the extent and cost of treatment later.

If you would like more information on bite development in children, please contact us or schedule an appointment for a consultation.

By Gregory M Blackstone DDS
June 21, 2018
Category: Dental Procedures
3ThingsYouMayNotKnowAboutOrthodontics

It’s a common sight to see someone wearing braces—and not just teens or pre-teens. In the last few decades, people in their adult years (even late in life) are transforming their smiles through orthodontics.

If you’re an adult considering treatment to straighten your teeth, this particular dental specialty might be an unfamiliar world to you. Here are 3 things you may not know about orthodontics.

Orthodontic treatment cooperates with nature. There would be no orthodontics if teeth couldn’t move naturally. Teeth are actually held in place by an elastic tissue called the periodontal ligament that lies between the teeth and bone. Small fibers from the ligament tightly attach to the teeth on one side and to the bone on the other. Although it feels like the teeth are rigidly in place, the ligament allows for micro-movements in response to changes in the mouth. One such change is the force applied by orthodontic appliances like braces, which causes the bone to remodel in the direction of the desired position.

Treatment achieves more than an attractive smile. While turning your misaligned teeth into a beautiful, confident smile is an obvious benefit, it isn’t the only one. Teeth in proper positions function better during chewing and eating, which can impact digestion and other aspects of health. Misaligned teeth are also more difficult to keep clean of bacterial plaque, so straightening them could help reduce your risk of tooth decay or periodontal (gum) disease.

Possible complications can be overcome. Some problems can develop while wearing braces. Too much applied force could lead to the roots dissolving (root resorption), which could make a tooth shorter and endanger its viability. Braces can also contribute to a loss of calcium in small areas of tooth enamel, which can make the teeth more vulnerable to oral acid attack. However, both these scenarios can be anticipated: the orthodontist will watch for and monitor signs of root resorption and adjust the tension on the braces accordingly; and diligent oral hygiene plus regular dental cleanings will help prevent damage to the tooth enamel.

If you’re dreaming of a straighter and healthier smile, see us for a full examination. We’ll then be able to discuss with you your options for transforming your smile and your life.

If you would like more information on orthodontic treatment, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Moving Teeth with Orthodontics.”

By Gregory M Blackstone DDS
June 11, 2018
Category: Dental Procedures
IfYoureConsideringBracesHeresHowTheyWork

If you or a family member has problems with teeth alignment or your bite, you may be considering braces. This tried and true method can straighten out most smiles — but there's more to braces than you may realize.

For one thing, orthodontic treatment wouldn't work if it weren't for the natural mechanism for tooth movement that already exists in the mouth. It may seem your teeth are rigidly set in the jawbone but that's not how they maintain their attachment: that's the job of an elastic connective tissue known as the periodontal ligament that lies between the tooth and the bone. The ligament has tiny fibers that attach to the tooth on one side and to the bone on the other to actually hold the teeth in place, much like a hammock secured between two posts.

The ligament attachment also allows the teeth to move incrementally in response to environmental factors or the aging process. We harness this natural movement ability with braces to move teeth to a more desirable position. We first attach small brackets to the front crowns of the teeth (the visible portion) and then string arch wires through them. We then attach the wires to anchor points where we can adjust the amount of tension they're exerting through the brackets against the teeth. By gradually increasing that tension, the teeth respond as they would when any force is applied against them and begin to move.

By precisely controlling that movement we can transform a patient's smile. But we believe the advantages are more than cosmetic: the teeth will function better and will be easier to care for and keep clean. These benefits, though, have to be balanced with heightened risks for root resorption (something that occurs only about 10% of the time) in which the ends of the roots can shrink, or loss of mineral content in teeth enamel where the hardware makes it more difficult to remove bacterial plaque. These risks can be reduced by closely monitoring dental health during the entire treatment process and through stepped up efforts in daily oral hygiene.

The starting point for deciding on an orthodontic treatment is a thorough dental examination with x-rays or CT scan imaging. Once we have a complete picture of your misalignment problems and any other extenuating circumstances, we can recommend a treatment plan just for you.

If you would like more information on orthodontic treatment, 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 “Moving Teeth with Orthodontics.”

By Gregory M Blackstone DDS
June 01, 2018
Category: Oral Health
Tags: celebrity smiles   retainer  
MargotRobbieKnowsAGreatSmileIsWorthProtecting

On the big screen, Australian-born actress Margot Robbie may be best known for playing devil-may-care anti-heroes—like Suicide Squad member Harley Quinn and notorious figure skater Tonya Harding. But recently, a discussion of her role in Peter Rabbit proved that in real life, she’s making healthier choices. When asked whether it was hard to voice a character with a speech impediment, she revealed that she wears retainers in her mouth at night, which gives her a noticeable lisp.

“I actually have two retainers,” she explained, “one for my bottom teeth which is for grinding my teeth, and one for my top teeth which is just so my teeth don't move.”

Clearly Robbie is serious about protecting her dazzling smile. And she has good reasons for wearing both of those retainers. So first, let’s talk about retainers for teeth grinding.

Also called bruxism, teeth grinding affects around 10 percent of adults at one time or another, and is often associated with stress. If you wake up with headaches, sore teeth or irritated gums, or your sleeping partner complains of grinding noises at night, you may be suffering from nighttime teeth grinding without even being aware of it.

A type of retainer called an occlusal guard is frequently recommended to alleviate the symptoms of bruxism. Typically made of plastic, this appliance fits comfortably over your teeth and prevents them from being damaged when they rub against each other. In combination with stress reduction techniques and other conservative treatments, it’s often the best way to manage teeth grinding.

Orthodontic retainers are also well-established treatment devices. While appliances like braces or aligners cause teeth to move into better positions, retainers are designed to keep teeth from moving—helping them to stay in those positions. After active orthodontic treatment, a period of retention is needed to allow the bite to stabilize. Otherwise, the teeth can drift right back to their old locations, undoing the time and effort of orthodontic treatment.

So Robbie has the right idea there too. However, for those who don’t relish the idea of wearing a plastic appliance, it’s often possible to bond a wire retainer to the back surfaces of the teeth, where it’s invisible. No matter which kind you choose, wearing a retainer can help keep your smile looking great for many years to come.

If you have questions about teeth grinding or orthodontic retainers, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Teeth Grinding” and “The Importance of Orthodontic Retainers.”





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