Ever since childhood, when her career as a model and actress took off, Brooke Shields has enjoyed worldwide recognition — through advertisements for designer jeans, appearances on The Muppet Show, and starring roles in big-screen films. But not long ago, that familiar face was spotted in an unusual place: wearing a nasal anesthesia mask at the dentist's office. In fact, Shields posted the photo to her own Instagram account, with the caption “More dental surgery! I grind my teeth!” And judging by the number of comments the post received, she's far from alone.
In fact, researchers estimate that around one in ten adults have dental issues that stem from teeth grinding, which is also called bruxism. (Many children also grind their teeth, but it rarely causes serious problems, and is often outgrown.) About half of the people who are teeth grinders report problems like persistent headaches, jaw tenderness and sore teeth. Bruxism may also result in excessive tooth wear, and may damage dental work like crowns and bridges; in severe cases, loosened or fractured teeth have been reported.
Researchers have been studying teeth grinding for many years; their findings seem to indicate that it has no single cause. However, there are a number of factors that play a significant role in this condition. One is the anatomy of the jaw itself, and the effect of worn or misaligned teeth on the bite. Another factor relates to changes in brain activity that occur during the sleep cycle. In fact, nocturnal (nighttime) bruxism is now classified as a sleep-related movement disorder. Still other factors, such as the use of tobacco, alcohol and drugs, and a high level of stress or anxiety, can make an individual more likely to experience bruxism.
What can be done for people whose teeth grinding is causing problems? Since this condition may have many causes, a number of different treatments are available. Successful management of bruxism often begins by striving to eliminate the factors that may cause problems — for example, making lifestyle changes to improve your health, creating a soothing nighttime environment, and trying stress-reduction techniques; these may include anything from warm baths and soft music at bedtime, to meditation and mindfulness exercises.
Several dental treatments are also available, including a custom-made occlusal guard (night guard) that can keep your teeth from being damaged by grinding. In some cases, a bite adjustment may also be recommended: In this procedure, a small amount of enamel is removed from a tooth to change the way it contacts the opposite tooth, thereby lessening the biting force on it. More invasive techniques (such as surgery) are rarely needed.
A little tooth grinding once in a while can be a normal response to stress; in fact, becoming aware of the condition is often the first step to controlling it. But if you begin to notice issues that could stem from bruxism — or if the loud grinding sounds cause problems for your sleeping partner — it may be time to contact us or schedule an appointment. You can read more about bruxism in the Dear Doctor magazine article “Stress and Tooth Habits.”
After months of wearing braces it's time for the big reveal: your new and improved smile! Your once crooked teeth are now straight and uniform.
But a look in the mirror at your straighter teeth might still reveal something out of place: small chalky-white spots dotting the enamel. These are most likely white spot lesions (WSLs), points on the enamel that have incurred mineral loss. It happens because mouth acid shielded by your braces contacted the teeth at those points for too long.
Most mouth acid is the waste product of bacteria that thrive in dental plaque, a thin film of food particles that can build up on tooth surfaces. High levels of acid are a definite sign that plaque hasn't been removed effectively through brushing and flossing.
But normal hygiene can be difficult while wearing braces: it's not easy to maneuver around brackets and wires to reach every area of tooth surface. Specialized tooth brushes can help, as well as floss threaders that help maneuver floss more easily through the wires. A water irrigator that uses pulsating water to remove plaque between teeth is another option.
However, if in spite of stepped-up hygiene efforts WSLs still develop, we can treat them when we've removed your braces. One way is to help re-mineralize the affected tooth surfaces through over-the-counter or prescription fluoride pastes or gels. It's also possible re-mineralization will occur naturally without external help.
While your teeth are sound, their appearance might be diminished by WSLs. We can improve this by injecting a liquid tooth-colored resin below the enamel surface. After hardening with a curing light, the spot will appear less opaque and more like a normal translucent tooth surface. In extreme cases we may need to consider porcelain veneers to cosmetically improve the tooth appearance.
In the meantime while wearing braces, practice thorough dental hygiene and keep up your regular cleaning visits with your general dentist. If you do notice any unusual white spots around your braces, be sure to see your dentist or orthodontist as soon as possible.
If you would like more information on dental care during 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 “White Spots on Teeth during Orthodontic Treatment.”
Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.
“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…
For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.
When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.
A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.
But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.
Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!
If you have questions about repairing chipped teeth, 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.”
Life would be harrowing if we had no ability to feel pain. Although experiencing it is unpleasant, pain's purpose is to alert us to something wrong in our body. Without pain diseases and other problems could worsen to the point of life-threatening.
But pain without a purpose — the nerves simply misfiring — can make life miserable. This can happen with the trigeminal nerves that exit the brain stem and end on each side of the face. Each nerve has three branches that serve the upper, middle and lower parts of the face and jaw.
When they don't work properly, trigeminal nerves can give rise to a disorder known as trigeminal neuralgia. Beginning often as an occasional twinge, they may escalate to several seconds of mild to excruciating pain occurring over weeks, months or even years. An episode may erupt from chewing, speaking or even lightly touching of the face.
We see this condition most often in people over fifty, particularly women. We don't know the exact cause, but there's strong suspicion that the nerve's protective sheath has been damaged, similar to what occurs with multiple sclerosis or other inflammatory conditions. Another possibility is a blood vessel putting pressure on the nerve and disrupting its normal operation. Such an impinged nerve might transmit pain signals at the slightest stimulation and then fail to “switch off” when the stimulation stops.
Although we can't cure trigeminal neuralgia, we can help you manage it and reduce discomfort during episodes. We'll first try conservative, less-invasive techniques, like signal-blocking medications or drugs that reduce abnormal firing.
If these aren't effective, we may then recommend a surgical solution. One such procedure is known as percutaneous treatment in which we insert a thin needle to selectively damage nerve fibers to prevent their firing. If we've determined an artery or vein has compressed the nerve, we might surgically relocate the vessel. These techniques can be quite effective but they do have possible side effects like numbness or hearing loss.
If you've experienced facial pain, don't continue to suffer. Visit us for a complete examination and learn about your options for pain relief. More than likely, there's a way to reduce your pain and improve your quality of life.
If you would like more information on facial pain, 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 “Trigeminal Neuralgia.”
As is the case with most celebs today, Beyonce is no stranger to sharing on social media… but she really got our attention with a video she recently posted on instagram. The clip shows the superstar songstress — along with her adorable three-year old daughter Blue Ivy — flossing their teeth! In the background, a vocalist (sounding remarkably like her husband Jay-Z) repeats the phrase “flossin’…flossin’…” as mom and daughter appear to take care of their dental hygiene in time with the beat: https://instagram.com/p/073CF1vw07/?taken-by=beyonce
We’re happy that this clip highlights the importance of helping kids get an early start on good oral hygiene. And, according to authorities like the American Dental Association and the American Academy of Pediatric Dentistry, age 3 is about the right time for kids to begin getting involved in the care of their own teeth.
Of course, parents should start paying attention to their kids’ oral hygiene long before age three. In fact, as soon as baby’s tiny teeth make their first appearance, the teeth and gums can be cleaned with a soft brush or cloth and a smear of fluoride toothpaste, about the size of a grain of rice. Around age 3, kids will develop the ability to spit out toothpaste. That’s when you can increase the amount of toothpaste a little, and start explaining to them how you clean all around the teeth on the top and bottom of the mouth. Depending on your child’s dexterity, age 3 might be a good time to let them have a try at brushing by themselves.
Ready to help your kids take the first steps to a lifetime of good dental checkups? Place a pea-sized dab of fluoride toothpaste on a soft-bristled brush, and gently guide them as they clean in front, in back, on all surfaces of each tooth. At first, it’s a good idea to take turns brushing. That way, you can be sure they’re learning the right techniques and keeping their teeth plaque-free, while making the experience challenging and fun.
Most kids will need parental supervision and help with brushing until around age 6. As they develop better hand-eye coordination and the ability to follow through with the cleaning regimen, they can be left on their own more. But even the best may need some “brushing up” on their tooth-cleaning techniques from time to time.
What about flossing? While it’s an essential part of good oral hygiene, it does take a little more dexterity to do it properly. Flossing the gaps between teeth should be started when the teeth begin growing close to one another. Depending on how a child’s teeth are spaced, perhaps only the back ones will need to be flossed at first. Even after they learn to brush, kids may still need help flossing — but a floss holder (like the one Beyonce is using in the clip) can make the job a lot easier.
If you would like more information about maintaining your children’s oral hygiene, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Top 10 Oral Health Tips For Children” and “How to Help Your Child Develop the Best Habits for Oral Health.”
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