My Blog
By Mathew L Stewart, DMD
December 30, 2019
Category: Oral Health
Tags: oral hygiene   braces  
BeVigilantwithDentalCareWhileWearingBraces

If you or a family member wears braces, you're used to visiting your orthodontist for adjustments and progress monitoring. But it's just as important that you continue regular visits with your family dentist, especially if you begin noticing abnormalities with your teeth and gums.

We need to be on alert for dental health because risks for disease increase during orthodontic treatment. Most oral infections arise from plaque, a thin film of bacteria and food particles on tooth surfaces. You avoid plaque buildup by brushing and flossing at least once a day and undergoing semi-annual office cleanings for any remaining plaque and calculus (hardened plaque deposits).

Braces, however, can complicate hygiene. It's harder to get into areas blocked by the brackets and wires with your brush or floss. This can quickly give rise to gingivitis, a form of periodontal (gum) disease characterized by gum swelling. If not treated, gum disease could eventually cause the gums to detach from the teeth and lead to bone and tooth loss.

The brackets and wires can also irritate the gums and cause them to swell or overgrow, a condition called hyperplasia. This further complicates proper hygiene, which then increases the risk for infection even more.

It takes more time and effort to brush and floss effectively while wearing braces. But it's necessary to prevent these problems. Interproximal brushes (which fit in the spaces between teeth) can help, as well as special floss threaders. You might also consider a water flosser, which use a high-pressured water spray to remove plaque between teeth.

And, don't neglect seeing us on a regular basis. If you notice gum swelling, redness or bleeding, contact us as soon as possible.

If the swelling is due to hyperplasia, treatment could wait until after the braces come off, as long as there doesn't appear to be any gum detachment from the teeth. If there is, though, you may need to see a periodontist (a gum specialist) for further evaluation. It may be necessary in advanced cases to remove the braces to treat the underlying gum condition.

It pays to keep a close eye on your teeth and gums while wearing braces. Catching problems before they become too serious will help ensure your new smile is just as healthy as it is attractive.

If you would like more information on dental care while undergoing 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 “Gum Swelling during Orthodontics.”

By Mathew L Stewart, DMD
December 20, 2019
Category: Dental Procedures
ARootCanalTreatmentWillImproveYourHealthNotHarmIt

If you’ve ever read online that root canal therapy causes cancer, don’t be alarmed—it doesn’t. What it does do is save a deeply decayed tooth that might otherwise be lost.

Tooth decay is caused by acid produced by bacteria, which dissolves enamel to create a hole or cavity. But it doesn’t stop there: decay can move on to infect the tooth’s innermost layer, the pulp filled with nerves and blood vessels. Unchecked, the resulting infection can travel through the root canals to eventually infect the bone.

A root canal treatment stops the infection before it goes this far. After administering a local anesthetic, we drill a small hole into the tooth to access the pulp chamber and root canals. We then remove all the diseased tissue, disinfect the space and then place a filling within the empty chamber and root canals to prevent further infection. We then seal the access hole and later crown the tooth to further protect and stabilize it.

It’s no exaggeration, then, to say that root canal treatments have saved millions of teeth. So, for all its beneficial effect, why is it considered by some to pose a health danger?

The germ for this notion comes from the early 20th Century when a dentist named Weston Price theorized that leaving a “dead” organ in place would harm the body. Since a root-canaled tooth with the pulp’s living tissue removed is technically no longer viable, it fit the category of “dead” tissue. Thus, according to this theory, maladies like cancer could arise because of the “dead” tooth.

Unfortunately, this theory has found a somewhat new life recently on the internet, even though it was thoroughly investigated and debunked in the 1950s. And as late as 2013, a study published in a journal of the American Medical Association found no increased cancer risk after root canal treatment, and even some evidence for a reduced risk.

So, if your dentist recommends root canal treatment, rest assured it’s needed to save your tooth. Rather than harm your health, it will improve it.

If you would like more information on root canal 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 “Root Canal Safety.”

By Mathew L Stewart, DMD
December 10, 2019
Category: Dental Procedures
J-LosUnluckyBreakChippingaToothonStage

Whether she’s singing, dancing or acting, Jennifer Lopez is a performer who is known for giving it all she’s got. But during one show, Lopez recently admitted, she gave a bit more then she had planned.

“I chipped my tooth on stage,” she told interviewers from Entertainment Tonight, “and had to finish the show….I went back thinking ‘Can I finish the show like this?’”

With that unlucky break, J-Lo joins a growing list of superstar singers—including Taylor Swift and Michael Buble—who have something in common: All have chipped their teeth on microphones while giving a performance.

But it’s not just celebs who have accidental dental trouble. Chips are among the most common dental injuries—and the front teeth, due to their position, are particularly susceptible. Unfortunately, they are also the most visible. But there are also a number of good ways to repair chipped, cracked or broken teeth short of replacing them.

For minor to moderate chips, cosmetic bonding might be recommended. In this method, special high-tech resins, in shades that match your natural teeth, are applied to the tooth’s surface. Layers of resin, cured with a special light, will often restore the tooth to good appearance. Best of all, the whole process can often be done in just one visit to the dental office, and the results can last for several years.

For a more permanent repair—or if the damage is more extensive—dental veneers may be another option. Veneers are wafer-thin shells that cover the entire front surface of one or more teeth. Strong, durable and natural-looking, they can be used to repair moderate chips, cracks or irregularities. They can also help you get a “red-carpet” smile: brilliant white teeth with perfectly even spacing. That’s why veneers are so popular among Hollywood celebs—even those who haven’t chipped their teeth!

Fortunately, even if the tooth is extensively damaged, it’s usually possible to restore it with a crown (cap), a bridge—or a dental implant, today’s gold standard for whole-tooth replacement. But in many cases, a less complex type of restoration will do the trick.

Which tooth restoration method did J-Lo choose? She didn’t say—but luckily for her adoring fans, after the microphone mishap she went right back up on stage and finished the show.

If you have a chipped tooth but you need to make the show go on, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”

ALong-TermOrthodonticStrategyCouldHelpEnsureanAttractiveSmileLaterinLife

Orthodontics relies on certain mechanics in the mouth to move teeth to better positions. As the specialty has advanced, we've become ever more precise in moving teeth with braces, the “workhorse” of orthodontics, and other specialized appliances and techniques.

But although cooperating effectively with the mouth's natural ability for tooth movement is crucial for success, there's another aspect to consider if that success will be long-term: the growth and development of oral and facial structure. And not just development during childhood and adolescence: indeed, facial structure continues to change throughout a lifetime, including the senior years. Research has shown that although the rate of growth slows over time, it doesn't stop even for someone 80 years or older.

Our emerging understanding in this area has had an important impact on how and when we perform orthodontic treatment. As we develop a treatment strategy for an individual patient we consider not only the immediate outcome of a treatment, but also how it may change their facial appearance in the future. By taking continuing facial growth into consideration, we're more likely to achieve a new smile appearance that remains attractive later in life.

A key factor is to be sure we're initiating treatments at appropriate ages. We may detect developing bite problems as early as age 6, which might prompt preventive treatment at that time to diminish or even eliminate the problem. But it may also be prudent to wait on full-scale orthodontic treatment until late childhood or puberty. Furthermore, some form of orthodontic treatment might need to continue into early adulthood to ensure the most optimal outcome.

By taking a longer view of the treatment process, we're better able to work within the natural growth and development taking place now and in the future. As a result, a person is more likely to enjoy an attractive and youthful appearance even in their later years.

If you would like more information on aging factors for cosmetic enhancement, 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 “Understanding Aging Makes Beauty Timeless.”

By Mathew L Stewart, DMD
November 20, 2019
Category: Oral Health
Tags: tmj disorders  
SeekCoordinatedTreatmentIfYouHaveBothTMDandFibromyalgia

Fibromyalgia is a chronic condition that produces widespread pain and stiffness in the muscles and joints. The pain, muscle spasms and tingling it causes can disrupt sleep, alter moods and impair memory function.

Dealing with just this one condition can be overwhelming. But did you know 3 out 4 fibromyalgia patients also develop chronic pain and dysfunction involving their jaw joints? Known collectively as temporomandibular joint disorders (TMD), these jaw joint problems cause pain, muscle spasms and difficulty moving the jaws that can interfere with eating and speaking. TMD can also contribute to headaches and earaches.

Many researchers believe this prevalence of TMD among fibromyalgia patients stems from both conditions originating from the same primary cause—a malfunction within the central nervous system. In both cases, the brain and spinal cord may not be able to process pain signals in a normal fashion. This malfunction could also be generating and amplifying pain signals even when nerves are receiving no stimulation.

For decades now, the most effective treatment strategy for TMD has been to manage the symptoms with physical therapy and exercises, thermal therapy or medications. Relief for fibromyalgia has depended on medication and relaxation techniques like biofeedback therapy. But with the evidence of some connection between the two conditions, it may be helpful to coordinate treatment for both with a team approach involving all your healthcare providers, rather than treat them separately.

To that end, make sure both your dentist or physician treating you for TMD and your physician treating your fibromyalgia each know about the other condition. Consulting together, your healthcare team may find treatments (like certain drugs that counteract neurotransmitter imbalances) that might help reduce symptoms in both conditions. And cognitive-behavioral therapy, meditation and other therapeutic pain management techniques can help you cope with the pain.

Continued research into these two debilitating conditions and the possible links between them may have an effect on how we treat both. A holistic approach to treating them could be the wave of the future.

If you would like more information on the links between TMD and other chronic pain conditions, 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 “Fibromyalgia and Temporomandibular Disorders.”





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