Alex was a lifeguard for seven years, every summer. I once asked him how many times he’d prevented a potential mouth injury during his watch and I was stunned to hear, “almost every day I worked”. Some folks slipped while walking way too fast (a.k.a. running), a few got hung up on deck chairs, but most met the side or bottom of the pool with more force than expected.
Interestingly, many patients that hurt their mouth don’t come in with any superficial wounds because the face heals so quickly. They arrive at our practice with a front tooth that is loose, chipped, or painful, because it has cracked vertically. Depending on the angle of the crack, it may be difficult to see even on an x-ray. But the x-ray does help us determine whether the nerve is damaged. Sometimes we “trans-illuminate”, bouncing the light from over the dental chair onto a mouth mirror and then aiming this light at the sensitive tooth from different angles.
Once we narrow down the extent of damage, we will determine whether a crown, root canal, or removal is necessary. If there is no pain present, we may “wait and see” how or if the traumatized tooth “heals” itself.
I urge parents to add a paragraph on mouth injuries to their Pool Safety Rules, within the next month. My own children were required to sit on a deck chair for 15 minutes when any adult saw a violation of the rules. I doubled it when they were a “repeat offender”. Now, some use this method with their own children!
Contact http://www.wintersetdental.com/contactif your need assistance after any mouth injury.
Some dental procedures would be best performed outside the mouth, particularly if they involve lots of bacteria or foul-tasting material that is unavoidable. However, this is impossible. That’s why I use a “dental dam” for certain procedures. It is a six-inch square of thin latex rubber, or silicone, that slips over 1-5 teeth and is held in place by small metal “clamps” that hug teeth near the gum line. Once this clamp is secured in place, this square is stretched over a metal frame outside the mouth, creating a dry area of operation for me and a “raincoat” that prevents bad tasting material from entering your mouth. Blood or saliva cannot penetrate this barrier, either. This is significant when I use “adhesive” to make a filling more durable.
I still remember practicing the insertion of a dental dam in dental school. I had to punch a tiny hole in the latex, stretch it to fit over a large tooth, then use an odd “pliers” to cinch the correct size of clamp around a tooth. Every dental student struggled. Most were still struggling on the seventh time they tried!
Since a well-trained dental assistant, which was unavailable in dental school, can perform chairside procedures to accomplish the same result, some practices no longer use dental dams. But I think that there is still merit in the dental dam for some procedures or specific patients.
Contact Winterset Dental to schedule your appointment.
Mary Ann lived alone in a retirement community when she first came to our practice. She’d been an actress back in the day and still dressed up, with nails painted, to come to her appointments. Still vivacious as ever, the whole office loved to see her.
Mary Ann had worn caps (sometimes called “crowns”) on her front teeth for years, and she flashed a smile often. Her bone support was excellent. At a recent exam, she asked if I could change the color of her caps by painting them. She wanted to take years off of her age! She also wanted them “longer” because her lip line was lower than her original smile, so not as much of her teeth showed. That phenomenon is typical as people age.
I absolutely love cases like these. You see, I need to balance the color of her facial tones with the color of each cap, and the shape of the teeth to the natural interdigitation of her “bite” (no, she isn’t going to bite ME!) when she closes. If I create super-white teeth, they will look unusual on an elderly face, and she won’t like this. They will look “false”. If I create super-long teeth, it may affect her speech or place too much downward pressure on her lower front teeth. Hence, the term “the art of dentistry”.
Once designed and ready to be cemented in place, I decided to use temporary cement. This gave Mary a chance to speak and chew with her longer teeth, for a few days. Then I cemented it permanently. Several community retirees noticed and they are now my patients.
Contact Winterset Dental for our anti-aging smile makeover.
We all procrastinate occasionally but my long-time patient, Phil, makes it a hobby. He drives a rusted, 17-year old car that he calls “Chitty Chitty Bang Bang”, because he doesn’t have time to look for a new one, despite the fact that he retired at 62. We are all entitled to these choices. However, Phil also procrastinates his dental treatment…and toothbrushing.
Looking at his most recent visits, his care begins with an overdue dental exam and cleaning. He needs a second appointment to finish the cleaning and evaluate his gum and bone support. We find a new cavity under an old molar filling and schedule an appointment to fix this, but he cancels. He cancels the next one, too, but shows up for the third one several months later because the tooth is now sensitive to sweets. As I remove the old filling to access the decay, I discover that the nerve is now infected because his decay has progressed into the “pulp chamber”, where the blood supply and sensors exist. Now he needs a root canal to remove the infected tissue and sterilize the area so all bacteria are gone. This makes the tooth more brittle, over time, so a crown is necessary to keep the tooth from cracking. Otherwise, the crack makes a portion of this tooth move when chewing and this causes discomfort to the surrounding tissues.
Well, Phil puts off the crown and the tooth cracks straight through the root four months later. The only course of action is to remove this tooth and place an implant (which may be unsuccessful if he procrastinates brushing) or a bridge because, if we leave this space open after it has healed, nearby teeth will drift into it. They may tip or rotate in the process. This alters the way his teeth come together, often changing the appearance of his smile as well.
Think about how much Phil’s procrastination has cost him already.
Contact Winterset Dental to schedule your appointment.
We all procrastinate occasionally but my long-time patient, Phil, makes it a hobby. He drives a rusted, 17-year old car that he calls “Chitty Chitty Bang Bang”, because he doesn’t have time to look for a new one, despite the fact that he retired at 62. We are all entitled to these choices. However, Phil also procrastinates his dental treatment…and toothbrushing.
Looking at his most recent visits, his care begins with an overdue dental exam and cleaning. He needs a second appointment to finish the cleaning and evaluate his gum and bone support. We find a new cavity under an old molar filling and schedule an appointment to fix this, but he cancels. He cancels the next one, too, but shows up for the third one several months later because the tooth is now sensitive to sweets. As I remove the old filling to access the decay, I discover that the nerve is now infected because his decay has progressed into the “pulp chamber”, where the blood supply and sensors exist. Now he needs a root canal to remove the infected tissue and sterilize the area so all bacteria are gone. This makes the tooth more brittle, over time, so a crown is necessary to keep the tooth from cracking. Otherwise, the crack makes a portion of this tooth move when chewing and this causes discomfort to the surrounding tissues.
Well, Phil puts off the crown and the tooth cracks straight through the root four months later. The only course of action is to remove this tooth and place an implant (which may be unsuccessful if he procrastinates brushing) or a bridge because, if we leave this space open after it has healed, nearby teeth will drift into it. They may tip or rotate in the process. This alters the way his teeth come together, often changing the appearance of his smile as well.
Think about how much Phil’s procrastination has cost him already.
Contact Winterset Dental to schedule your appointment.
It is not normal to “grind” your teeth together. Period. Several spouses complain to me that their partner grinds his/her teeth while sleeping, but they deny it. Grinding (formal term is “bruxism”) is usually blamed on stress, but that is hard to measure.
Initially, it is wise to make 2-3 dietary adjustments that include eliminating caffeine from your diet. People recognize that this is in sodas and coffee, but few realize that chocolate also contains caffeine. Similarly, research demonstrates that alcohol also intensifies grinding. Medications used to treat sleep disorders or ADHD also have tooth grinding as a typical side effect.
Chewing gum is also cited as a contributor to tooth grinding because it encourages your jaw muscles to strengthen, which makes people tend toward grinding.
If you catch yourself grinding your teeth or, more likely, clenching your teeth during the daytime, there is an exercise that trains these muscles to relax. Simply position the tip of the tongue between the front teeth on your top and bottom jaw, which causes your tongue to relax.
Contact Winterset Dental to schedule your appointment.
Sam was considered “stoic” when he first visited our practice. With a career in Criminal Defense, he had witnessed more than most. Perhaps that was why he never smiled?
When I first engaged him conversation, I noticed that his front teeth were so short that I couldn’t even see them when he spoke. The edges of a couple teeth poked out when he chuckled once. My oral exam explained it all. Sam had a nervous habit of rubbing his upper front teeth against his lower front teeth, so much so that they were shaped more like “boxes” than rectangles. He must have done this for years, but he claimed that he was only aware of the habit when he was really studying the details involved in a case. He saw no need to fix it because “it would just come back”. I could not convince him to wear a “nightguard” when sleeping, either.
Fast forward about 3 years, and his daughter was now engaged. She actually asked him to get a denture so he would look happy as he walked her down the aisle! That was his moment of truth.
He scheduled a consultation with me and, fortunately, I talked him out of a denture. I measured the gap between his upper and lower teeth that had been produced from his habit and evaluated the bone health. Instead of dentures, Sam had several crowns (often called “caps”) placed on his front teeth, both top and bottom. Because these teeth are girded in cast metal, the sensation when rubbing teeth together was very different, so his habit went away on its own.
Contact Winterset Dental if your smile isn’t the same as it used to be.
I was startled to see the current teen fashions at the mall, recently. Thin is definitely “in”. I have had patients in my practice who are bulimic or anorexic, but they rarely put this on their medical history. Sometimes, I can spot someone who vomits frequently by the condition of the back of their front teeth. These eating disorders need to be addressed with professional counseling, but I also have my methods. I show photographs of people, not my patients, who have had these disorders for a length of time. I use them to educate those who don’t believe that anything will harm them.
Another phenomenon of our teen population is a fascination with “fresh breath”. They chew gum, suck on mints, or gulp soda pop into their mouths several times a day. From my perspective, they are repeatedly painting their teeth with sugar. As an alternative, removing plaque between teeth with dental floss and brushing the tongue goes a long way to achieving fresh breath.
Finally, I have to point out that tongue and facial piercings, now popular, have displaced gum tissue or damaged perfectly healthy teeth. They also serve as collection centers for bacteria that contribute to gum disease.
All I can ask is that parents establish guidelines for healthy and safe behaviors, plus enforce them. Your kids will thank you, eventually.
Contact Winterset Dental to schedule your appointment.
Almost everyone takes their tongue for granted. After all, you’ve swallowed and probably licked ice cream bars for your lifetime. You’ve pronounced words correctly and whistled. While I’m certain that you’ve never stuck your tongue out at someone (cough), I bet that you learned that it isn’t considered appropriate behavior.
Yet, I need to discuss a “tongue thrust reflex”, the abnormal motion of your tongue when swallowing. If you have ever seen someone with the biting edge of their front teeth tipped closer to their lips than normal, you’ve seen the results of a tongue thruster. This is accompanied by larger-than-normal spaces between teeth, as well. Often, the edge of one’s tongue has a scalloped appearance. Some people also lisp and many snore.
To solve this misbehaving muscle, children and adults often participate in Myofunctional Therapy, which trains their muscles to swallow correctly.
I don’t want new parents to worry, however. It is normal for newborns to thrust their tongues out for 3-4 months because they use this position to suck milk or formula. Parents often interpret this as a dislike of normal food. Others recognize that this is a defense mechanism which prevents the baby from allowing solid objects, including chunks of food, into their tiny “windpipes”.
Contact Winterset Dental to schedule your appointment.
I received so many comments about tongues that I chose follow up with a related topic! First things first, however, is to brush your tongue daily, from the back to the front. Dentists and hygienists consider a tongue to be a carpet of bacteria and, sometimes, the source of bad breath.
Your tongue can turn colors on its own, and this may be significant. If you have a deficiency of iron, vitamin B-12, or folic acid, your tongue turns bright pink. Gluten allergies may also do this. A white tongue comes from poor oral hygiene, smoking, and alcohol. There is also some suspicion that this may indicate an underlying problem, perhaps Hepatitis or allergies.
Your tongue can also look “hairy” if you undergo radiation therapy around the head and neck, take a significant course of antibiotics, use tobacco, or rinse with mouthwash too frequently. Drinking lots of coffee also does this.
Finally, a swollen tongue may indicate a medical condition or disease. We see it with tongue cancer, leukemia, anemia, overactive thyroid, and Strep throat. But if the tongue swells suddenly, it is considered a medical emergency. When you have tongue problems with a high fever, recurring pain or sores, or a problem that lasts more than two weeks, head for the medical doctor’s office.
Contact Winterset Dental to schedule your appointment.