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LikeJohnnyManzielYouMayNeedanOralSurgeonforaMajorDentalProblem

QB sensation Johnny Manziel has had a varied career in professional football. After playing two seasons for the NFL Cleveland Browns, he quarterbacked for a number of teams in the Canadian Football League. More recently, he joined the Zappers in the new Fan Controlled Football league (FCF). But then with only a few games under his belt, he was waylaid by an emergency dental situation.

It's unclear what the situation was, but it was serious enough to involve oral surgery. As a result, he was forced to miss the Zappers' final regular-season game. His experience is a reminder that some dental problems can't wait—you have to attend to them immediately or risk severe long-term consequences.

Manziel's recent dental problem also highlights a very important specialty of dentistry—oral surgery. Oral surgeons are uniquely trained and qualified to treat and correct a number of oral problems.

Tooth extraction. Although some teeth can be removed by a general dentist, some have complications like multiple roots or impaction that make regular extractions problematic. An oral surgeon may be needed to surgically remove these kinds of problem teeth.

Disease. Oral surgeons often intervene with diseases attacking areas involving the jaws or face. This includes serious infections that could become life-threatening if they're not promptly treated by surgical means.

Bite improvement. Some poor bites (malocclusions) arise from a mismatch in the sizes of the jaws.  An oral surgeon may be able to correct this through orthognathic surgery to reposition the jaw to the skull. This may compensate for the difference in jaw sizes and reduce the bite problem.

Implants. Dental implants are one of the best ways to replace teeth, either as a standalone tooth or as support for a fixed dental bridge or a removable denture.  In some cases, it may be better for an oral surgeon to place the implants into a patient's jawbone.

Reconstruction. Injuries or birth defects like a cleft lip or palate can alter the appearance and function of the face, jaws or mouth. An oral surgeon may be able to perform procedures that repair the damage and correct oral or facial deformities.

Sleep apnea. Obstructive sleep apnea is usually caused by the tongue relaxing against the back of the throat during sleep and blocking the airway. But other anatomical structures like tonsils or adenoids can do the same thing. An oral surgeon could address this situation by surgically altering obstructing tissues.

It's likely most of your dental care won't require the services of an oral surgeon. But when you do need surgical treatment, like Johnny Manziel, these dental specialists can make a big difference in your oral health.

If you would like more information about oral surgery, please contact us or schedule a consultation.

KeeptheImplantsSupportingYourBridgeCleanofDentalPlaque

Dental implants have revolutionized restorative dentistry. Not only are they the top choice for individual tooth replacement, implants also improve upon traditional dental work.

Dental bridges are a case in point. A few well-placed implants can support a fixed bridge instead of natural teeth, as with a traditional bridge. Furthermore, a fixed, implant-supported bridge can replace all the teeth on a jaw.

But although convenient, we can't simply install an implant-supported bridge and forget about it. We must also protect it from what might seem at first an unlikely threat—periodontal (gum) disease.

Although the bridge materials themselves are impervious to infection, the natural tissues that underly the implants—the gums and bone—are not. An infection plaguing the gums around an implant can eventually reach the bone, weakening it to the point that it can no longer support the imbedded implants. As the implants fail, so does the bridge.

To guard against this, patients must regularly remove any buildup of plaque, a thin biofilm that feeds disease-causing bacteria, adhering to the implant surfaces in the space between the bridge and the gums. To do this, you'll need to floss—but not in the traditional way. You'll need some form of tool to accomplish the job.

One such tool is a floss threader. Similar to a large needle, the threader has an eye opening at one end through which you insert a section of floss. You then gently pass the threader between the bridge and the gums toward the tongue.

Once through, you release the floss from the threader, and holding each end, you work the floss along the implant surfaces within reach. You then repeat the threading process for other sections until you've flossed around all the implants.

You might also use a water flosser, a device that directs a spray of water between the bridge and gums. The pressure from the spray loosens and flushes away any plaque around the implants.

Whatever the method, it's important to use it every day to reduce the threat of gum disease. You should also see your dentist regularly for further cleanings and checkups. Keeping your implants clean helps ensure gum disease won't ruin your fixed bridge—or your attractive smile.

If you would like more information on keeping your dental work clean, 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 “Oral Hygiene for Fixed Bridgework.”

HeresWhyStartingYourChildsDentalVisitsbyAge1IsaSmartIdea

As parents, we want to do everything possible to help our kids stay healthy—and that includes their teeth. And just like other aspects of their health, it's better not to go at dental care alone. That's why we recommend beginning your child's regular dental visits no later than their first birthday.

You may think that's a bit premature, given the few teeth a child may have when they're a year old. But there are solid reasons why early childhood dental visits are a smart move, especially if you're playing the long game for their future dental health and development.

Minimizes damaging tooth decay. If a child loses just one primary tooth to decay, it could have an adverse, cascading effect on their developing bite. Dental visits begun sooner rather than later are more likely to catch and treat tooth decay, as well as provide other preventive measures that can ensure primary teeth aren't lost prematurely.

Provides you a partner for your child's dental care. A child's dental development and health depend on what you do in the home—daily oral hygiene, monitoring for signs of disease and avoiding habits that promote tooth decay. Regular dental visits help support the home front by providing you helpful insight and advice for supporting your child's dental health.

Identifies bite problems early. Although they usually develop gradually, there are often early signs of an emerging bite problem. Pediatric dentists especially are trained to notice early signs of an abnormal bite and refer you to an orthodontist for interventional treatment.

Reduces your child's dental visit anxiety. The unfamiliarity and clinical nature of a dental office can make a child susceptible to anxiety that could follow them into adulthood. Early childhood dental visits help normalize the dentist's office for your child, reduce anxiety and make it more likely they'll continue seeing the dentist later in life.

Life can be hectic with an infant in the home. But getting into the routine of regular dental visits at an early age is a worthwhile investment in healthier teeth and gums—now and in the future.

If you would like more information on good dental care practices for your child, 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 “Age One Dental Visit.”

PersistencePaysOffinFindingReliefFromChronicJawJointPain

Tenderness; headaches; difficulty chewing; excruciating pain. These are a few of the symptoms you could endure with a jaw joint or temporomandibular disorder (TMD or TMJ). This group of disorders disrupts the daily lives of millions of people around the world.

This month is TMJ Awareness Month, to shed light on these debilitating conditions and how best to manage them. Although controlling TMD isn't always easy, it can be done with the right blend of treatments.

The temporomandibular joint—actually a pair of joints connecting the lower jaw to the skull on either side of the face—is "ground zero" for TMD. These are ball-and-socket joints similar to the hip or shoulder, but with a unique addition—a cushioning disk that lies between the adjoining points of the two bones that temper the forces generated when you eat, speak or bite down.

Researchers believe TMD can arise from a variety of sources, including traumatic injury, psychological stress or mechanical dysfunction within the joint and cushioning disk. These problems can create blood flow constriction, which in turn causes the accumulation of chemical waste byproducts in the jaw muscles. This in turn and cause the muscles to spasm and become inflamed and sore.

Treatments are also as numerous as the possible causes of TMD. But for the most part, they range along a continuum of conservative to aggressive approaches.

On the conservative end, doctors treat TMD as a joint problem and borrow heavily from orthopedics. These types of treatments include the use of anti-inflammatory and muscle relaxing medications, icing or heating, stretching exercises, physical therapy and massage. Dentists may also provide mouth guard appliances for patients with clenching or tooth grinding habits to decrease biting forces.

On the more aggressive end are interventions like orthodontics or dental work. But, while these were common recommendations 20-30 years ago, it's no longer thought to be necessary for treating most TMD disorders and should not be recommended as a cure or solution for TMD.  At the furthest extreme is actual jaw surgery to relieve symptoms or repair damage within the joints. The latter, however, has not yet amassed a solid track record, and should be considered as a last resort.

Finding the right combination of therapies to give consistent relief sometimes requires a bit of trial and error. Most doctors recommend starting first with the most conservative methods before considering more aggressive measures. You should also undergo a complete dental exam to see if teeth or gum problems are contributing to your symptoms.

TMD can make your life miserable. But with some persistence and patience, you can find what works for a life without pain and dysfunction.

If you would like more information about managing TMD, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Seeking Relief From TMD.”

WhetherVotingforaCandidateorWisdomTeethYouCanChooseWisely

During election season, you'll often hear celebrities encouraging you to vote. But this year, Kaia Gerber, an up-and-coming model following the career path of her mother Cindy Crawford, made a unique election appeal—while getting her wisdom teeth removed.

With ice packs secured to her jaw, Gerber posted a selfie to social media right after her surgery. The caption read, “We don't need wisdom teeth to vote wisely.”

That's great advice—electing our leaders is one of the most important choices we make as a society. But Gerber's post also highlights another decision that bears careful consideration, whether or not to have your wisdom teeth removed.

Found in the very back of the mouth, wisdom teeth (or “third molars”) are usually the last of the permanent teeth to erupt between ages 17 and 25. But although their name may be a salute to coming of age, in reality wisdom teeth can be a pain. Because they're usually last to the party, they're often erupting in a jaw already crowded with teeth. Such a situation can be a recipe for numerous dental problems.

Crowded wisdom teeth may not erupt properly and remain totally or partially hidden within the gums (impaction). As such, they can impinge on and damage the roots of neighboring teeth, and can make overall hygiene more difficult, increasing the risk of dental disease. They can also help pressure other teeth out of position, resulting in an abnormal bite.

Because of this potential for problems, it's been a common practice in dentistry to remove wisdom teeth preemptively before any problems arise. As a result, wisdom teeth extractions are the top oral surgical procedure performed, with around 10 million of them removed every year.

But that practice is beginning to wane, as many dentists are now adopting more of a “wait and see” approach. If the wisdom teeth show signs of problems—impaction, tooth decay, gum disease or bite influence—removal is usually recommended. If not, though, the wisdom teeth are closely monitored during adolescence and early adulthood. If no problems develop, they may be left intact.

This approach works best if you maintain regular dental cleanings and checkups. During these visits, we'll be able to consistently evaluate the overall health of your mouth, particularly in relation to your wisdom teeth.

Just as getting information on candidates helps you decide your vote, this approach of watchful waiting can help us recommend the best course for your wisdom teeth. Whether you vote your wisdom teeth “in” or “out,” you'll be able to do it wisely.

If you would like more information about what's best to do about wisdom teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Wisdom Teeth.”





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