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DealingwiththeRealityofIncreasedDiseaseRiskwithBraces

Wearing braces is all about the future: you undergo many months of treatment to gain a lifetime of better mouth function and a more attractive smile.

In the meantime, though, you'll have to deal with a few new realities during treatment: restrictions on foods, limitations with mouth function, and (perhaps) embarrassment over your new “metallic” smile.

There's one reality, though, that trumps all others in importance: your risk for developing dental disease increases significantly during orthodontic treatment. The brackets and wires of your braces make it more difficult to remove bacterial plaque, the main cause of dental disease, which allows places for disease-causing bacteria to thrive. To combat this, you'll need to step up your hygiene efforts to remove daily plaque.

One sign your efforts might not be getting the job done is red, swollen or bleeding gums. Although gums can swell in reaction to the braces themselves, it's often because plaque-induced periodontal (gum) disease has infected the gum tissues.

Gum disease is an aggressive infection. If it isn't stopped it can damage the gums and underlying bone that support your teeth — damage that could eventually lead to tooth loss. To stop it, we must remove plaque from all tooth and gum surfaces, even below the gum line. In some advanced cases it may even be necessary to remove the braces to better treat the disease.

That's why preventing gum disease through effective hygiene is so important. Besides continuing routine visits with your family dentist, you should also brush and floss every day to remove plaque. Be sure you're brushing above and below the braces. It may be helpful to use an interproximal brush specifically designed to maneuver around these tight spaces. You can also use a floss threader or a water irrigator to make the job of flossing easier.

If you do notice gum redness, swelling or bleeding, don't delay — call your dentist at once. An examination will determine if you have gum disease and to what degree, which will guide treatment. The sooner this happens, the less the impact on your dental health and your orthodontic treatment.

If you would like more information on dental care while wearing braces, 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 “Gum Swelling During Orthodontics.”

By Enchanting Dentistry
April 24, 2017
Category: Oral Health
InTodaysNFLOralHygieneTakesCenterStage

Everyone knows that in the game of football, quarterbacks are looked up to as team leaders. That's why we're so pleased to see some NFL QB's setting great examples of… wait for it… excellent oral hygiene.

First, at the 2016 season opener against the Broncos, Cam Newton of the Carolina Panthers was spotted on the bench; in his hands was a strand of dental floss. In between plays, the 2105 MVP was observed giving his hard-to-reach tooth surfaces a good cleaning with the floss.

Later, Buffalo Bills QB Tyrod Taylor was seen on the sideline of a game against the 49ers — with a bottle of mouthwash. Taylor took a swig, swished it around his mouth for a minute, and spit it out. Was he trying to make his breath fresher in the huddle when he called out plays?

Maybe… but in fact, a good mouthrinse can be much more than a short-lived breath freshener.

Cosmetic rinses can leave your breath with a minty taste or pleasant smell — but the sensation is only temporary. And while there's nothing wrong with having good-smelling breath, using a cosmetic mouthwash doesn't improve your oral hygiene — in fact, it can actually mask odors that may indicate a problem, such as tooth decay or gum disease.

Using a therapeutic mouthrinse, however, can actually enhance your oral health. Many commonly available therapeutic rinses contain anti-cariogenic (cavity-fighting) ingredients, such as fluoride; these can help prevent tooth decay and cavity formation by strengthening tooth enamel. Others contain antibacterial ingredients; these can help control the harmful oral bacteria found in plaque — the sticky film that can build up on your teeth in between cleanings. Some antibacterial mouthrinses are available over-the-counter, while others are prescription-only. When used along with brushing and flossing, they can reduce gum disease (gingivitis) and promote good oral health.

So why did Taylor rinse? His coach Rex Ryan later explained that he was cleaning out his mouth after a hard hit, which may have caused some bleeding. Ryan also noted, “He [Taylor] does have the best smelling breath in the league for any quarterback.” The coach didn't explain how he knows that — but never mind. The takeaway is that a cosmetic rinse may be OK for a quick fix — but when it comes to good oral hygiene, using a therapeutic mouthrinse as a part of your daily routine (along with flossing and brushing) can really step up your game.

If you would like more information about mouthrinses and oral hygiene, contact us or schedule a consultation.

KeeptheSpacebetweenanImplant-SupportedBridgeandtheGumsClean

Dental implants can do more than replace individual teeth — a few well-placed implants can support other restorations like a fixed bridge. The natural integration that occurs between the bone and the implant's titanium post creates a strong, durable hold for both implant and the supported restoration.

But if a bone-implant connection weakens, the implant could be in danger of failing. This can occur because of periodontal (gum) disease caused by dental plaque, a thin film of built-up food particles and bacteria on the teeth. Untreated, the infection can ultimately spread from the gums to the bone and cause it to diminish in volume. If the bone loss occurs around an implant the threaded surface of the post may be exposed, inviting more plaque buildup. This can trigger more bone loss and eventually implant failure.

That's why you must brush and floss daily to remove plaque on and around your fixed bridge just as you do your natural teeth. Brushing around a bridge could be difficult with a traditional brush, so you may want to use an interproximal brush designed for just such situations. Be sure any utensil you use contains only plastic parts — metal creates microscopic scratches in the restoration materials that could harbor plaque.

You should also floss between the bridge and gums as well as between any natural teeth. While this can be difficult with traditional flossing methods, there are some tools to make it easier.

One is a floss threader, a small tool with a loop on one end and a stiff plastic edge on the other. With floss threaded through the loop, you gently guide the edged end between the bridge and gums. Once it passes through, you wrap the two ends of the floss with your fingers as you would normally and work it along each side of the nearest implants.

You can also use pre-cut floss sections with stiffened ends to pass through the gap, or an oral irrigator that loosens and flushes away plaque with a pressurized water stream. Just be sure you flush debris away from the gum and not toward it.

Keeping all surfaces of your implant-supported bridgework clean of plaque is necessary for its longevity. Be sure you also visit your dentist regularly for more thorough cleanings.

If you would like more information on oral hygiene with dental implants, please contact us or schedule an appointment for a consultation.

By Enchanting Dentistry
April 01, 2017
Category: Oral Health
DrTravisStorkDontIgnoreBleedingGums

Are bleeding gums something you should be concerned about? Dear Doctor magazine recently posed that question to Dr. Travis Stork, an emergency room physician and host of the syndicated TV show The Doctors. He answered with two questions of his own: “If you started bleeding from your eyeball, would you seek medical attention?” Needless to say, most everyone would. “So,” he asked, “why is it that when we bleed all the time when we floss that we think it’s no big deal?” As it turns out, that’s an excellent question — and one that’s often misunderstood.

First of all, let’s clarify what we mean by “bleeding all the time.” As many as 90 percent of people occasionally experience bleeding gums when they clean their teeth — particularly if they don’t do it often, or are just starting a flossing routine. But if your gums bleed regularly when you brush or floss, it almost certainly means there’s a problem. Many think bleeding gums is a sign they are brushing too hard; this is possible, but unlikely. It’s much more probable that irritated and bleeding gums are a sign of periodontal (gum) disease.

How common is this malady? According to the U.S. Centers for Disease Control, nearly half of all  Americans over age 30 have mild, moderate or severe gum disease — and that number increases to 70.1 percent for those over 65! Periodontal disease can occur when a bacteria-rich biofilm in the mouth (also called plaque) is allowed to build up on tooth and gum surfaces. Plaque causes the gums to become inflamed, as the immune system responds to the bacteria. Eventually, this can cause gum tissue to pull away from the teeth, forming bacteria-filled “pockets” under the gum surface. If left untreated, it can lead to more serious infection, and even tooth loss.

What should you do if your gums bleed regularly when brushing or flossing? The first step is to come in for a thorough examination. In combination with a regular oral exam (and possibly x-rays or other diagnostic tests), a simple (and painless) instrument called a periodontal probe can be used to determine how far any periodontal disease may have progressed. Armed with this information, we can determine the most effective way to fight the battle against gum disease.

Above all, don’t wait too long to come in for an exam! As Dr. Stork notes, bleeding gums are “a sign that things aren’t quite right.”  If you would like more information about bleeding gums, please contact us or schedule an appointment. You can read more in the Dear Doctor magazine article “Bleeding Gums.” You can read the entire interview with Dr. Travis Stork in Dear Doctor magazine.

By Enchanting Dentistry
March 17, 2017
Category: Oral Health
Tags: oral health   cancer  
BeAlerttotheUnintendedConsequencesofCancerTreatmenttoOralHealth

Thanks to treatments like chemotherapy and radiation, your chances of surviving cancer are greater than ever. These treatments, however, often produce unwelcome side effects. Treating throat or oral cancer, for example, could damage your mouth's salivary glands or bone.

Saliva is essential to oral health, providing antibodies to curb the growth of disease-causing bacteria and neutralizing acid, which can erode enamel. But salivary glands damaged during cancer treatment may not be able to produce enough saliva. The resulting “dry mouth” creates an environment conducive to bacterial growth and elevated acid levels.

You can help reduce the effects of dry mouth during your treatment (and after, if the damage is permanent) by drinking more water or by using substances that stimulate saliva. Cutting back on acidic foods and beverages will also help lower your mouth's acidity. And be sure to keep up daily oral hygiene and regular dental visits.

The more ominous threat to oral health during cancer treatment, though, is osteoradionecrosis. This occurs when radiation targets specific areas of bone. The bone can lose blood supply and living cellular tissue, which inhibit its ability to heal or replenish itself. If this occurs in the jawbone of teeth that may be lost, the bone tissue could be adversely affected during healing.

Depending on your treatment needs, your risk for osteoradionecrosis might be unavoidable if teeth are to be lost. It's important we discuss that risk because it could impact future dental treatment. In the worst case, before cancer treatment, we may not be able to save affected teeth and your restorative options might be limited.

If your risk of osteoradionecrosis is minimal, though, we may be able to restore any resulting damaged or missing teeth with a wide range of options like dental implants or crowns before or after your cancer treatment.

As with other aspects of health, taking care of your teeth and gums while undergoing cancer treatment can be challenging; some problems may be unavoidable. But with a proper dental treatment plan during and after chemotherapy and radiation, we can minimize those problems and help to eventually restore your smile.

If you would like more information on smile restoration after cancer, please contact us or schedule an appointment for a consultation.





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