- Periodontal Disease
- Dental Implants
- Temporomandibular Disorder
- Dental Anesthesia
- Baby Bottle Tooth Decay
- When to Get Braces
- Tooth Bleaching or Whitening
- Bruxism (Teeth Grinding)
- Composite Resins (White Fillings)
What is periodontal disease?
Periodontal (gum) disease may result from gingivitis, an inflammation of the gums usually caused by the presence of bacteria in plaque. Plaque is the sticky film that accumulates on teeth both above and below the gum line. Without regular dental checkups, periodontal disease may result if gingivitis is left untreated. It also can cause inflammation and destruction of tissues surrounding and supporting teeth, gums (gingiva), bone and fibers which hold the gums to the teeth. A number of factors increase the probability of developing periodontal disease, including diabetes, smoking, poor oral hygiene, diet, and genetic makeup; and it is the primary cause of tooth loss in adults.
How are periodontal disease and diabetes related?
It is estimated that 12 to 14 million people, or one-third of the population in the United States, have diabetes, but only one-half of these individuals are diagnosed.
Studies have shown that diabetics are more susceptible to the development of oral infections and periodontal disease than those who do not have diabetes. Oral infections tend to be more severe in diabetic patients than non-diabetic patients. And, diabetics who do not have good control over their blood sugar levels tend to have more oral health problems. These infections occur more often after puberty and in aging patients.
What types of problems could I experience?
Diabetics may experience diminished salivary flow and burning mouth or tongue. Dry mouth (xerostomia) also may develop, causing an increased incidence of decay. Gum recession has been found to occur more frequently and more extensively in moderate- and poorly-controlled diabetic patients because plaque responds differently, creating more harmful proteins in -9the gums. To prevent problems with bacterial infections in the mouth, your dentist may prescribe antibiotics, medicated mouth rinses, and more frequent cleanings.
How can I stay healthy?
Make sure to take extra good care of your mouth and have dental infections treated immediately. Diabetics who receive good dental care and have good insulin control typically have a better chance at avoiding gum disease.
Diet and exercise may be the most important changes that diabetics can make to improve their quality of life and their oral health. Diabetic patients should be sure both their medical and dental care providers are aware of their medical history and periodontal status.
To keep teeth and gums strong, diabetic patients should be aware of their blood sugar levels in addition to having their triglycerides and cholesterol levels checked on a regular basis. These may have a direct correlation on your chances of obtaining periodontal disease.
What is the best time to receive dental care?
If your blood sugar is not under control, talk with both your dentist and physician about receiving elective dental care. Dental procedures should be as short and as stress free as possible. Also make morning appointments because blood glucose levels tend to be under better control at this time of day.
If you have a scheduled appointment, eat and take your medications as directed. See your dentist on a regular basis, k
What is a denture?
A denture is a removable replacement for missing teeth and adjacent tissues. It is made of acrylic resin, sometimes in combination with various metals. Complete dentures replace all the teeth, while a partial denture fills in the spaces created by missing teeth and prevents other teeth from changing position. Complete dentures are either "conventional" or "immediate." A conventional denture is placed in the mouth about a month after all the teeth are removed to allow for proper healing, whereas an immediate denture is placed as soon as the teeth are removed. The drawback behind an immediate denture is that it
may require more adjustments after the healing has taken place.
Who needs a denture?
Candidates for complete dentures have lost most or all of their teeth. A partial denture is suitable for those who have some natural teeth remaining. A denture improves chewing ability and speech, and provides support for facial muscles. It will greatly enhance the facial appearance and smile.
What happens when you get a denture?
A dentist can make a full conventional denture when all teeth have been lost or all extraction sites have healed (up to eight weeks or longer.) The denture process takes about one month and five appointments: the initial diagnosis is made; an impression and a wax bite are made to determine vertical dimensions and proper jaw position; a "try-in" is placed to assure proper color, shape and fit; and the patient's final denture is placed, following any minor adjustments.
New denture wearers need time to get accustomed to their new "teeth" because even
the best fitting dentures will feel awkward at first. While most patients can begin to
speak normally within a few hours, many patients report discomfort with eating for
several days to a few weeks. To get accustomed to chewing with a new denture, start
with soft, easy-to-chew foods. In addition, denture wearers often notice a slight change
in facial appearance, increased salivary flow, or minor speech difficulty.
How do you care for a denture?
A denture is fragile, so it is important to handle it with care. Remove and brush the
denture daily, preferably with a brush designed specifically for cleaning dentures, using
either a denture cleanser or toothpastes. Never use harsh, abrasive cleansers, including
abrasives toothpastes, because they may scratch the surface of the denture. Don't
sterilize your denture with boiling water because it will cause it to become warped. If you wear a partial denture be sure to remove it before brushing your natural teeth.
When not in use, soak it in a cleanser solution or in water. Get in the habit of keeping
the denture in the same safe and handy place to reduce the likelihood of misplacement.
Should a denture be worn at night?
While you may be advised to wear your denture almost constantly during the first two
weeks- even while you sleep-under normal circumstances it is considered best to remove it at night. Research has shown that removing the denture for at least eight hours during either the day or night allows the gum tissue to rest and allows normal stimulation and cleansing by the tongue and saliva. This promotes better long-term health of the gums.
Continue seeing your dentist regularly
It is important to continue having regular dental checkups so that a dentist can examine
oral tissues for signs of disease or cancer. As of aging, your mouth will continue to
change as the bone under your denture shrinks or recedes. To maintain a proper fit over
time, it may be necessary to adjust your denture or possibly remake your denture. Never attempt to adjust a denture yourself and do not use denture adhesives for a prolonged period because it can contribute to bone loss. When in doubt, consult your dentist.
What is a dental implant?
A dental implant is an artificial tooth root (synthetic material) that is surgically anchored into your jaw to hold a replacement tooth or bridge in place. The benefit of using implants is that they don't rely on neighboring teeth for support, they are permanent and stable. Implants are a good solution to tooth loss because they look and feel like natural teeth.
Implant material is made from different types of metallic and bone-like ceramic materials that are compatible with body tissue. There are different types of dental implants: the first is placed directly into the jaw bone, like natural tooth roots; the second is used when the jaw structure is limited, therefore, a custom-made metal framework fits directly on the existing bone.
Can anyone receive dental implants?
Talk with your dentist about whether you are an implant candidate. You must be in good health and have the proper bone structure and healthy gums for the implant to stay in place. People who are unable to wear dentures may also be good candidates. If you suffer from chronic problems, such as clenching or bruxism, or systemic diseases, such as diabetes, the success rate for implants decreases dramatically. Additionally, people who smoke or drink alcohol may not be good candidates.
What can I expect during this procedure?
The dentist must perform surgery to anchor the "artificial root" into or on your jaw bone. The procedure is done in the dental office with local anesthesia. Medications may be prescribed for soreness.
How long does the process take?
The process can take up to nine months to complete. Technology, however, is trying to decrease the healing time involved. Each patient heals differently, so times will vary. After the screws and posts are placed surgically, the healing process can take up to six months and the fitting of replacement teeth no more than two months.
What is the success rate of implants?
The success rate for implants depends on the tooth's purpose and location in the mouth. The success rate is about 95 percent for those placed in the front of the lower jaw and 85 percent for those placed in the sides and rear of the upper jaw.
How do I care for implants?
Your overall health may affect the success rate of dental implants. Poor oral hygiene is a big reason why some implants fail. It is important to floss and brush around the fixtures at least twice a day, without metal objects. Your dentist will give you specific instructions on how to care for your new implants. Additional cleanings of up to four times per year may be necessary to ensure that you retain healthy gums.
What is the cost of implants?
Since implants involve surgery and are more involved, they cost more than traditional bridge work. However, some dental procedures and portions of the restoration may be covered by dental and medical insurance policies. Your dentist can help you with this process.
Is my dentist trained in implant therapy?
Dentists who have received training through an extensive program can complete this procedure. Your dentist may perform the procedure or consult with a team of dental health specialists to produce the result discussed with you. Ask your dentist questions about his or her training in implant therapy.
What is the Temporomandibular Joint?
The temporomandibular joint (TMJ) is a joint that slides and rotates just in front of your ear, consisting of the temporal bone (side and base of the skull) and the mandible (lower jaw). Mastication (chewing) muscles connect the lower jaw to the skull, allowing you to move your jaw forward, sideways, and open and close.
The joint works properly when the lower jaw and its joint (both the right and left) are synchronized during movement. Temporomandibular Disorder (TMD) may occur when the jaw twists during opening, closing or side-motion movements. These movements affect the jaw joint and the muscles that control chewing.
What is Temporomandibular Disorder?
TMD describes a variety of conditions that affect jaw muscles, temporomandibular joints, and nerves associated with chronic facial pain. Symptoms may occur on one or both sides of the face, head or jaw, or develop after an injury. TMD affects more than twice as many women than men and is the most common non-dental related chronic orofacial pain.
What causes TMD?
Normal function for this muscle group includes chewing, swallowing, speech and communication. Most experts suggest that certain tasks, either mental or physical, cause or aggravate TMD, such as strenuous physical tasks or stressful situations. Most discomfort is caused from overuse of the muscles, specifically clenching or grinding teeth (bruxism).
These excessive habits tire the jaw muscles and lead to discomfort, such as headaches or neck pain. Additionally, abnormal function can lead to worn or sensitive teeth, traumatized soft tissues, muscle soreness, jaw discomfort when eating, and temporal (side) headaches.
What TMD symptoms can I experience?
An earache without an infection
Jaw pain or soreness that is more prevalent in the morning orlate afternoon
Jaw pain when you chew, bite or yawn
Clicking when opening and closing your mouth
Difficulty opening and closing your mouth
Locked or stiff jaw when you talk, yawn or eat
Sensitive teeth when no dental problems can be found
What can I do to treat TMD?
The majority of cases can be treated by unloading (resting) the joint, taking a non-aspirin pain reliever and practicing stress management and relaxation techniques. It's important to break bad habits to ease the symptoms. Most treatment for TMD is simple, often can be done at home, and does not need surgery. For example, control clenching or grinding during the day by sticking your tongue between your teeth. If you still experience pain, you may be grinding or clenching your teeth at night. So see your dentist for a nighttime mouthguard.
Most people will experience relief with minor treatment. More severe cases may be treated with physical therapy, ice and hot packs, posture training and orthopedic appliance therapy (splint). Eating soft foods and avoiding chewing gum also help relax the muscles.
Is TMD permanent?
The condition is often cyclical and may recur during times of stress, good or bad. As the patient, you should be active in your treatment, by being aware of the causes of your jaw problems after seeing a dentist for a diagnosis regime. Make routine dental appointments, so your doctor can check TMD on a regular basis.
Why do I need anesthesia at the dental office?
To make your dental visit as comfortable as possible, your dentist may suggest anesthesia to reduce or eliminate any pain or anxiety that may be related to your dental treatment. The type of anesthesia required for any dental procedure depends on the needs or preferences of the patient.
How do I know if I'm a candidate for dental anesthesia?
You and your dentist will decide what level of anesthesia is right for you. Some patients prefer a higher level of anesthesia than others. Children, people with special needs, such as mental retardation, and those with a condition, such as a dental phobia may require a higher level of anesthesia. The type of anesthesia administered by your dentist is more dependent on individual patient preferences than specific dental procedures.
What are the levels of dental anesthesia?
Local anesthesia is produced by the application or injection of a drug to eliminate pain in a specific area in the mouth. Topical anesthetics are frequently used by your dentist to numb an area in preparation for administering an injectable local anesthetic. Injectable local anesthetics, such as Lidocaine, numb mouth tissues in a specific area of your mouth for a short period of time. Your dentist will probably inject a local anesthetic before filling cavities, preparing your teeth for crowns, or for any surgical procedure. Local anesthesia is the most commonly used form of anesthesia in the dental office.
Conscious sedation can be used to help you relax during a dental procedure. Your dentist may administer an anti-anxiety agent, such as nitrous oxide, or a sedative, in combination with a local anesthetic for pain. During conscious sedation, you will remain calm during treatment, yet rational and responsive to speech and touch. Anti-anxiety agents and sedatives can be administered by mouth, inhalation or injection.
Deep sedation and general anesthesia is used for complex procedures and for patients who have trouble controlling their movements or need a deeper level of anesthesia during treatment. During deep sedation you will be unable to respond appropriately to verbal commands. During general anesthesia you will be unconscious.
What should I tell my dentist before receiving anesthesia?
Your dentist needs to know about all the medications that you are taking, any allergic reactions you've had to medicines in the past, and your past and present health conditions. It's important that you answer your dentist's questions completely and ask about your concerns. This way your dentist will be sure to tell you everything you need to know before receiving treatment. For example, in some cases, your anesthesia treatment may require that you suspend certain medications or abstain from eating or drinking for a period of time before the treatment.
Is anesthesia in the dental office safe?
Although taking any medication involves a certain amount of risk, the drugs that produce anesthesia are entirely safe when administered by a trained anesthesia provider. The best thing to do is ask questions about any procedure that you are not familiar with. Ask about alternatives, training, the doctor's commitment to continuing education and the credentials of other personnel in the dental office who might be assisting with your treatment. Good communication between the dentist and the patient is the best way of insuring safety.
Members of the Academy of General Dentistry (AGD) are required to take 75 hours of continuing dental education every three years to remain in good standing. The AGD Fellowship and Mastership awards reflect additional hours of experience and study.
Academy of General Dentistry
What's baby bottle tooth decay?
Baby bottle tooth decay is caused by the frequent and long-term exposure of a child's teeth to liquids containing sugars. Among these liquids are milk, formula, fruit juice, sodas, and other sweetened drinks. The sugars in these liquids pool around the infant's teeth and gums, feeding the bacteria that cause plaque. Every time a child consumes a sugary liquid, acid attacks the teeth and gums. After numerous attacks, tooth decay can begin.
The condition also is associated with breast-fed infants who have prolonged feeding habits or with children whose pacifiers are frequently dipped in honey, sugar or syrup. The sweet fluids left in the mouth increases the chances of cavities while the infant is sleeping.
How can I prevent baby bottle tooth decay?
Never allow children to fall asleep with a bottle containing milk, formula, juice or other sweetened liquids. Clean and massage the baby's gums to help establish healthy teeth and to aid in teething. Wrap a moistened gauze square or washcloth around the finger and gently massage the gums and gingival tissues. This should be done once a day.
Plaque removal activities should begin upon eruption of the first baby tooth. When brushing a child's teeth, use a soft toothbrush and a pea-shaped amount of fluoride toothpaste. Parents should first bring their child to the dentist when the child is between six and 12 months old.
Will changes in my child's diet help prevent baby bottle tooth decay?
Preventing baby bottle tooth decay involves changes in a child's diet. A series of small changes over a period of time is usually easier, and eventually leads to better oral health.
To incorporate these changes:
Gradually dilute the bottle contents with water over a period of 2-3 weeks.
Once that period is over, if you give a child a bottle, fill it with water or give the child a clean pacifier recommended by a dentist. The only safe liquid to put in a bottle to prevent baby bottle tooth decay is water.
Decrease consumption of sugar, especially between meals.
Children should be weaned from the bottle as soon as they can drink from a cup, but the bottle should not be taken away too soon, since the sucking motion aids in the development of facial muscles, as well as the tongue.
Why should I be worried about baby bottle tooth decay?
Giving an infant a sugary drink at nap or nighttime is harmful because during sleep, the flow of saliva decreases, allowing the sugary liquids to linger on the child's teeth for an extended period of time. If left untreated, pain and infection can result. Severely decayed teeth may need to be extracted. If teeth are infected or lost too early due to baby bottle tooth decay, your child may develop poor eating habits, speech problems, crooked teeth, and damaged adult teeth. Healthy baby teeth will usually result in healthy permanent teeth.
What is "orthodontics," and why do people get braces?
Orthodontics is a special discipline of dentistry concerned with aligning the teeth and jaws to improve one's smile and oral health. "Ortho" means correct or straight, and "Odont" means tooth.
A dentist usually recommends braces to improve the patient's physical "orofacial" appearance. Through orthodontic treatment, problems like crooked or crowded teeth, overbites or underbites, incorrect jaw position and disorders of the jaw joints are corrected.
When is the right time for braces?
Patients with orthodontic problems can benefit from treatment at nearly any age. An ideal time for placement of braces is between 10 and 14 years of age, while the head and mouth are still growing and teeth are more accessible to straightening. However, because any adjustments in facial appearance can be traumatic to a child during these sensitive years, parents should discuss the matter with their children before braces are applied.
Good news! Braces aren't just for kids. More and more adults are also wearing braces to correct minor problems and to improve their smiles
What kind of braces will I have to wear?
Your dentist will know what appliance is best for your particular problem, but the patient often has a choice. Braces generally come in three varieties: The most popular type are brackets, metal or plastic, that are bonded to teeth and are far less noticeable. The "lingual" type of braces are brackets that attach to the back of teeth, hidden from view. Bands are the old-fashioned type that cover most of your teeth with metal bands that wrap around the teeth. All use wires to move the teeth to the desired position.
How long will I have to wear braces?
That depends upon your treatment plan. The more complicated your spacing or bite problem is, and the older you are, the longer the period of treatment, usually. Most patients can count on wearing full braces between 18 and 30 months, followed by the wearing of a retainer for at least a few months to set and align tissues surrounding straightened teeth.
Will treatment be uncomfortable?
The interconnecting wires are tightened at each visit, bearing mild pressure on the brackets or bands to shift teeth or jaws gradually into a desired position. Your teeth and jaws may feel slightly sore after each visit, but the discomfort is brief. Keep in mind also that some teeth may need to be extracted to make room for teeth being shifted with braces and for proper jaw alignment.
Do I have to avoid any foods or personal habits?
Yes. Cut down on sweets, chips and pop. Sugary and starchy foods generate acids and plaque that can cause tooth decay and promote gum disease.
Cut healthy, hard foods like carrots or apples into smaller pieces. Sticky, chewy sweets like caramel can cause wire damage and loosen brackets. Avoid hard and crunchy snacks that can break braces, including popcorn, nuts and hard candy. More dont's: ice cube chewing, thumb sucking, excessive mouth breathing, lip biting and pushing your tongue against your teeth.
What about home care of my teeth with braces?
With braces, oral hygiene is more important than ever. Braces have tiny spaces where food particles and plaque get trapped. Brush carefully after every meal with fluoride toothpaste and a soft-bristled toothbrush. Rinse thoroughly and check your teeth in the mirror to make sure they're clean. Take time to floss between braces and under wires with the help of a floss threader. Have your teeth cleaned every six months to keep your gums and teeth healthy. Insufficient cleaning while wearing braces can cause enamel staining around brackets or bands.
Who will provide my orthodontic treatment?
Your family general dentist is responsible for coordinating your dental treatment, and this could encompass any orthodontic treatment plan, including diagnosis, examinations and some orthodontic procedures. Your dentist may, however, refer you to an "orthodontist"-a specialist trained in the development, prevention and correction of irregularities of the teeth, bite and jaws and related facial abnormalities.
How can you brighten your smile?
Your wedding is coming up and you want your smile to be it's brightest. Or maybe you have an important speaking engagement. Whatever the reason, tooth bleaching isn't just for the movie stars, and it isn't just for one day. Many people have had their teeth bleached, and probably millions more are thinking about it. The desire for a brighter smile with whiter teeth is very strong, and tooth bleaching safely lightens the color of the teeth, lasting for up to five years. The most effective and safest method of tooth bleaching is dentist-supervised.
Is bleaching for you?
Generally, bleaching is successful in at least 90 percent of patients, though it may not be
an option for everyone. Consider tooth bleaching if your teeth are darkened from age,
coffee, tea or smoking. Teeth darkened with the color of yellow, brown or orange
respond better to lightening. Other types of gray stains caused by fluorosis, smoking or
tetracycline are lightened, but results are not as dramatic. If you have very sensitive
teeth, periodontal disease, or teeth with worn enamel, your dentist may discourage
First, the dentist will determine whether you are a candidate for tooth bleaching and
what type of bleaching system would provide the best results. If you're in a hurry for
whiter teeth, you may decide to have your teeth lightened immediately. Your dentist will use either an in-office bleaching system or laser bleaching while you sit in the dental chair. However, most patients choose dentist-supervised at-home bleaching, which is more economical and provides the same results.
At the next appointment if you don't choose laser bleaching, the dentist or hygienist will
make impressions of your teeth to fabricate a mouthguard appliance for you. The
mouthguard is custom made for your mouth and is lightweight so that it can be worn
comfortably while you are awake or sleeping. The mouthguard is so thin that you should
even be able to talk and work while wearing your mouthguard. Along with the
mouthguard, you'll receive the bleaching materials. You'll be given instructions on how to
wear the mouthguard. Some bleaching systems recommend bleaching your teeth from
two to four hours a day. Generally this type of system requires three to six weeks to
complete, and works best on patients with sensitive teeth. Other systems recommend
bleaching at night while you sleep. This type of system usually requires only 10-14 days
How long does it last?
Lightness should last from one to five years, depending on your personal habits such as
smoking and drinking coffee and tea. At this point you may choose to get a touch up.
This procedure may not be as costly because you can probably still use the same
mouthguard. The re-treatment time also is much shorter than the original treatment time.
How does it work?
The active ingredient in most of the whitening agents is 10 percent carbamide peroxide
(CH4N2O2), also known as urea peroxide; when water contacts this white crystal, the
release of hydrogen peroxide lightens the teeth.
Is it safe? Any side effects?
Several studies, during the past five years, have proven bleaching to be safe and
effective. The American Dental Association has granted its seal of approval to some
tooth bleaching products. Some patients may experience slight gum irritation or tooth
sensitivity, which will resolve when the treatment ends.
What are realistic expectations?
No one can really predict how much lighter your teeth will become. Every case is
different. Typically, there is a two-shade improvement as seen on a dentist's shade
guide. The success rate depends upon the type of stain involved and your compliance.
Bleaching can only provide a shift in color from gray to a lighter shade of gray, for
example. Bleaching does not lighten artificial materials such as resins, silicants or
What is the best technique for brushing?
There are a number of effective brushing techniques. Patients are advised to check with their dentist or hygienist to determine which technique is best for them, since, tooth position and gum condition vary.
One effective, easy-to-remember technique involves using a circular or elliptical motion to brush a couple of teeth at a time, gradually covering the entire mouth.
Place a toothbrush beside your teeth at a 45-degree angle and gently brush teeth in an elliptical motion. Brush the outside of the teeth, inside the teeth, your tongue and the chewing surfaces and in between teeth. Using a back and forth motion causes the gum surface to recede, or can expose the root surface or make the root surface tender. You also risk wearing down the gum line.
Soft or hard bristles?
In general, a toothbrush head should be small (1" by 1/2") for easy access. It should have a long, wide handle for a firm grasp. It should have soft, nylon bristles with round ends. Some brushes are too abrasive and can wear down teeth. A soft, rounded, multi-tufted brush can clean teeth effectively. Press just firmly enough to reach the spaces between the teeth as well as the surface. Medium and hard bristles are not recommended.
How long should I brush?
It might be a good idea to brush with the radio on, since dentists generally recommend brushing 3-4 minutes, the length of an average song. Using an egg timer is another way to measure your brushing time. Patients generally think they're brushing longer, but most spend less than a minute brushing.
To make sure you're doing a thorough job and not missing any spots, patients are advised to brush the full 3-4 minutes twice a day, instead of brushing quickly five or more times through the day.
Should I brush at work?
Definitely, but most Americans don't brush during the workday. Yet a recent survey by Oral-B Labor-atories and the Academy of General Dentistry shows if you keep a toothbrush at work, the chances you will brush during the day increase by 65 percent. Dentists recommend keeping a toothbrush at work.
Getting the debris off teeth right away stops sugary snacks from turning to damaging acids, and catches starchy foods like potato chips before they turn to cavity-causing sugar. If you brush with fluoride toothpaste in the morning and before going to bed, you don't even need to use toothpaste at work. You can just brush and rinse before heading back to the desk. If you don't have a toothbrush, rinsing your mouth with water for 30 seconds after lunch also helps.
The following tips may improve your work-time brushing habits:
Post a sticky note on your desk or computer at work as a reminder to brush teeth after lunch.
Brush teeth right after lunch, before you become absorbed in work.
Store your toothbrush and toothpaste at work in a convenient and handy place.
Make brushing your teeth part of your freshening up routine at work.
What is Bruxism?
Bruxism is the technical term for grinding and clenching that abrades teeth and may cause facial pain. People who grind and clench, called bruxers, unintentionally bite down too hard at inappropriate times, such as in their sleep. In addition to grinding teeth, bruxers also may bite their fingernails, pencils and chew the inside of their cheek. People usually aren't diagnosed with bruxism until it is too late because so many people don't realize they have the habit. Others mistakenly believe that their teeth must touch at all times. About one in three people suffer from bruxism, which can easily be treated by a dentist.
Can bruxism cause harm?
People who have otherwise healthy teeth and gums can clench so often and so hard that over time their teeth become sensitive. They experience jaw pain, tense muscles and headaches along with excessive wear on their teeth. Forceful biting when not eating may cause the jaw to move out of proper balance.
What are the signs?
When a person has bruxism, the tips of the teeth look flat. Teeth are worn down so much that the enamel is rubbed off, exposing the inside of the tooth, which is called dentin. When exposed, dentin may become sensitive. Bruxers may experience pain in their temporomandibular joint (TMJ)-the jaw-which may manifest itself as popping and clicking. Women have a higher prevalence of bruxism possibly because they are more likely to experience tissue alterations in the jaw resulting from clenching and grinding. Tongue indentations are another sign of clenching.
Stress and certain personality types are at the root of bruxism. For as long as humankind has existed, bruxism has affected people with nervous tension. Anger, pain and frustration can trigger bruxing. People who are aggressive, competitive and hurried also may be at a greater risk for bruxism.
What can be done about it?
During regular dental visits, the dentist automatically checks for physical signs of bruxism. If the dentist or patient notices signs of bruxism, the condition may be observed over several visits to be sure of the problem before recommending and starting therapy.
The objective of therapy is to get the bruxer to change behavior by learning how to rest the tongue, teeth and lips properly. When some people become aware of their problem, simply advising them to rest their tongue upward with teeth apart and lips shut may be enough to change their behavior and relieve discomfort. However, the dentist can make a plastic mouth appliance, such as a night guard that's worn to absorb the force of biting. This appliance can prevent future damage to the teeth and helps change the patient's destructive behavior. Biofeedback is used to treat daytime clenchers by using electronic instruments to measure muscle activity and to teach patients how to reduce muscle activity when the biting force becomes too great. Researchers are looking for other ways of treating bruxism, especially for those who tend to clench in their sleep. One researcher developed an experimental lip simulator that electrically stimulates the lip when a person bites down too hard while sleeping. However, that method is being refined because the stimulation can wake sleepers several times in a night.
What is a composite resin (white filling)?
A composite resin is a tooth-colored plastic mixture filled with glass (silicon dioxide). Introduced in the 1960s, dental composites were confined to the front teeth because they were not strong enough to withstand the pressure and wear generated by the back teeth. Since then, composites have been significantly improved and can be successfully placed in the back teeth as well. Composites are not only used to restore decayed areas, but are also used for cosmetic improvements of the smile by changing the color of the teeth or reshaping disfigured teeth.
How is a composite placed?
Following preparation, the dentist places the composite in layers, using a light specialized to harden each layer. When the process is finished, the dentist will shape the composite to fit the tooth. The dentist then polishes the composite to prevent staining and early wear.
How long does it take to place a composite?
It takes the dentist about 10-20 minutes longer to place a composite than a silver filling. Placement time depends on the size and location of the cavity-the larger the size, the longer it will take.
What is the cost?
Prices vary, but composites average about one-and-a-half to two times the price of a silver filling. Most dental insurance plans cover the cost of the composite up to the price of a silver filling, with the patient paying the difference. As composites continue to improve, insurance companies are more likely to increase their coverage of composites.
What are the advantages of composites?
Esthetics are the main advantage, since dentists can blend shades to create a color nearly identical to that of the actual tooth. Composites bond to the tooth to support the remaining tooth structure, which helps to prevent breakage and insulate the tooth from excessive temperature changes.
What are the disadvantages?
After receiving a composite, a patient may experience post-operative sensitivity. Also, the shade of the composite can change slightly if the patient drinks tea, coffee or other staining foods. The dentist can put a clear plastic coating over the composite to prevent the color from changing if a patient is particularly con-cerned about tooth color. Composites tend to wear out sooner than silver fillings in larger cavities, although they hold up as well in small cavities.
How long will a composite last?
Studies have shown that composites last 7-10 years, which is comparable to silver fillings except in very large restorations, where silver fillings last longer than composites.
What are crowns?
A crown is a restoration that covers, or "caps," a tooth to restore it to its normal shape and size, strengthening and improving the appearance of a tooth. Crowns are necessary when a tooth is generally broken down and fillings won't solve the problem. If a tooth is cracked, a crown holds the tooth together to seal the cracks so the damage doesn't get worse. Crowns are also used to support a large filling when there isn't enough of the tooth remaining, attach a bridge, protect weak teeth from fracturing, restore fractured teeth, or cover badly shaped or discolored teeth.
How is a crown placed?
To prepare the tooth for a crown, it is reduced so the crown can fit over it. An impression of teeth and gums is made and sent to the lab for the crown fabrication. A temporary crown is fitted over the tooth until the permanent crown is made. On the next visit, the dentist removes the temporary crown and cements the permanent crown onto the tooth.
Will it look natural?
Yes. The dentist's main goal is to create crowns that look like natural teeth. That is why dentists take an impression. To achieve a certain look, a number of factors are considered, such as the color, bite, shape, and length of your natural teeth. Any one of these factors alone can affect your appearance.
If you have a certain cosmetic look in mind for your crown, discuss it with your dentist at your initial visit. When the procedure is complete, your teeth will not only be stronger, but they may be more attractive.
Why crowns and not veneers?
Crowns require more tooth structure removal, hence, they cover more of the tooth than veneers. Crowns are stationary and are customarily indicated for teeth that have sustained significant loss of structure, or to replace missing teeth. Crowns may be placed on natural teeth or dental implants.
How should I take care of my crowns?
To prevent damaging or fracturing the crowns, avoid chewing hard foods, ice or other hard objects. You also want to avoid teeth grinding. Besides visiting your dentist and brushing twice a day, cleaning between your teeth is vital with crowns. Floss or interdental cleaners (specially shaped brushes and sticks) are important tools to remove plaque from the crown area where the gum meets the tooth. Plaque in that area can cause dental decay and gum disease.