Cases of lyme disease have been going up in the last few years. Preventing the disease should be priority when going outdoors. In case a patient does become infected there are signs and symptoms a dentist can follow to aid in combating the disease. Signs of possible infection are headaches, TMJ pain and nonspecific pain. New ADA guidelines for detecting lyme disease were released recently. To read the full article click here.

“Sometimes the dental patient may present nonspecific orofacial pain and headaches that can mimic temporomandibular joint pain. Dentists should consider Lyme disease as a possible cause if a patient presents these or related symptoms and has no specific oral health problem. These patients should be referred to a physician.” – Dr. Stacey Van Scoyoc

As a dental professional I do believe in the benefits of fluoride. Controlling tooth decay economically makes more sense as is maintaining a healthy oral environment for total overall health. Yes, there are risks if you consume too much but the benefits outweigh the risks in controlling decay especially if used accordingly.

This is a good article on the definition of dental caries, fluoride use and it’s benefits in fighting tooth decay. This is from the Centers for Disease Control. Click here to access the article.

Oh well. I’m happy just as long as you’re brushing your teeth thoroughly, efficiently and more than twice a day. Good brushing and flossing shows when you come in for your twice a year dental hygiene visits.

Click here to read the NY Times blog.

When you smile do you notice a lot of gum showing? You might have what dentists call a ‘gummy smile’. For some people a ‘gummy smile’ can bother their appearance. Gummy smiles can be due to short upper lip, hyperactive lip, short teeth or too much maxilla. Simple surgeries like a gingivectomy can reduce the amount of gums while increasing the length of the teeth to make the smile more natural. Orthodontics (braces) are also an option. Today more people are opting for botox injections to control the upper lip from smiling too much. To determine what’s best for you if you do have a ‘gummy smile’ talk to your dentist first to discuss treatment options.

Click here to read full NY Times story.

Most people grind their teeth and it usual occurs while sleeping. We sometimes don’t know we grind our teeth unless someone tells us they heard it. Teeth grinding does take a toll on the teeth and also on the jaw joint. The teeth can crack slowly causing chipping and pain. Soreness of the jaw joint and muscles can occur.

When I suspect that a patient is grinding his/her teeth I will recommend wearing a nightguard to help alleviate muscle and joint soreness and also prevent any future cracking of the teeth. A nightguard can prevent future damage to teeth. For the cost of a nightguard it’s worth it to have one because restoring damaged teeth due to grinding can be quite expensive.

Nightguards are plastic appliances that cover the biting surfaces of either the top teeth or bottom teeth. The best nightguards are made to fit only the patient’s mouth. Generic nightguards sold in stores are ok but they tend to make the patient chew on the nightguard because most of the generic brands are made of softer plastic. Chewing can cause more pain to the jaw joint. Making a nightguard requires taking molds of the mouth and then a lab will fabricate the nightguard usually within two weeks of taking impressions. On delivery of the nightguard the dentist will adjust the fit and bite of the nightguard to ensure that the patient can wear it comfortably.

The main purpose of a nightguard is to relieve biting pressure on the teeth, relax the biting muscles especially at night during sleep and relieve pressure on the jaw joint. Economically it makes sense to wear a nightguard because it saves the teeth from wear and cracking and it saves the jaw from invasive procedures to relieve jaw pain. A nightguard will not prevent a patient from grinding but it will relieve his/her symptoms. If you suspect that you are grinding your teeth please talk to your dentist about treatment plans.

The root canal is one of the most feared of all dental procedures. Although a competent dentist can usually perform a root canal with minimal discomfort and with a high degree of success, problems can and do occur. When a tooth becomes infected, the treatment options include either root canal therapy or having the tooth removed. In most cases, root canal treatment is the preferred choice, because it is the only way to save the tooth.

Root canal consists of the dentist making a small hole in the tooth and then removing the tiny nerves and blood vessels within the root(s). The roots are then shaped, disinfected, and filled with an inert material. The procedure is usually successful about ninety percent of the time when properly performed.

When a root canal treated tooth is successful, a person will have no pain or other signs of infection. A root canal that is failing will usually continue to cause pain or discomfort, especially when biting down. A root canal can fail if some of the infected nerves and blood vessels are left inside the roots, the inert filling does not completely seal off the roots from bacteria, the tooth is damaged during the procedure, or the tooth fractures within the roots. A root canal is more likely to fail if a permanent filling or crown is not placed to protect the tooth. A root canal can fail within days, weeks, months to even many years after the procedure has been completed. Even if a root canal fails, there are options available. In many cases, the root canal can be retreated. If this is not possible, a procedure called an apicoectomy can be performed. An apicoectomy involves having the tip of the root surgically removed and then placing a filling over the severed root tip. If these measures fail, the tooth may have to be removed.

The success of a root canal is highly dependent on the skill, experience and technique of the dentist performing it.

Now for something fun. Name as many famous people with dentistry in their family. Go…

• Mark Zuckerberg’s father.
• Miles Davis’ father
• Doc Holiday
• Mark McGwire’s father
• Kristi Yamaguchi’s father
• Paul Revere
• Ed Buchanan – actor
• Zane Grey – author
• Amanda Bynes’ father

Fishing Boat at Cabangtalan Beach, Ilocos Sur, Philippines

Floating Cottages at Cabangtalan Beach, Ilocos Sur, Philippines

I hadn’t been writing my blog because I was on vacation in the Philippines. I love the Philippines and I try to explore different parts of the country while I’m there. If you ever need advice on where to go in the Philippines email me, I can help with places to see and other things to experience.

Anyway, I was reminiscing about my trip and I thought that I’ve had a few patients who told me that they had to deal with dental emergencies while abroad. Luckily for me I’ve never had to experience a medical or dental emergency while on vacation. But it would behoove people to be prepared prior to getting on a plane. Some of the things I do before a trip is to pack medicines and other health aids such as vitamin C or Airborne, hydro-cortisone cream for itching, mosquito repellant, antibacterials and bandaids, pain relief pills and antibiotics (I recommend amoxicillin and maybe a Z pac but be sure with your doctor that you can fill a prescription. Taking antibiotics should be with caution).

Make sure to check with the Centers for Disease Control as to what vaccinations you will need for a particular country you will be visiting. The CDC also has a table of diseases that is particular to areas of the globe.

If you think you will be away for a long time get a physical and a dental check up. Some insurance companies do pay for overseas doctor visits but the majority of expenses is out of pocket.

For dental emergencies referrals by friends and family are a great way to see a dentist. You can also ask hotel staff to recommend a dentist close to your hotel. Most likely the dentist will perform paliative treatment (basic treatment to get you out of pain or discomfort) and then when you return from vacation go to your regular dentist for a final treatment plan.

A majority of us don’t usually experience a medical or dental emergency while on vacation but be prepared just in case and please stay safe.

Please brush your teeth and visit the dentist regularly!

Researchers at the University of Pennsylvania discovered that bacteria which cause periodontal disease can disarm the immune system.

Implants are restorations that enable a person to regain a tooth that they lost. Implants are great for aesthetic reasons and for functionality.

Placing implants is rather simple depending on thickness, width and length of bone at the implant site. Ideally there should be enough bone at the site to surround the implant for the implant to integrate with the bone. This will provide a good anchor for the final restoration. If there is not enough bone the surgeon may opt to place more bone at the implant site and allow for that to heal before placing the implant.

Once the implant is placed it takes about four months for the implant to integrate with the bone. The surgeon will test the integration and then place an abutment on top of the implant. This abutment is used by the general dentist to fabricate the final restoration (crown).

The process of implant surgery to the final restoration can be completed within 6 months. Tests for bone width and height have to be completed prior to implant placement for implant consideration. Temporary prosthesis such as temporary dentures or crowns also have to be implemented during implant healing so that the patient doesn’t compromise on function or aesthetics. Patients think that they will be toothless throughout the procedure but that is rarely the case. Patients will almost always wear a temporary crown or denture to fill in the gap.

Implants do cost quite a bit more than a conventional bridge or denture because it’s not covered by most insurances. However the cost benefit in the long run is much better than restoring a toothless space with bridges or dentures. The functionality and aesthetics are much better with an implant than bridges or dentures. Bridges are great restorations for replacing a missing tooth but functional wise you’re asking two teeth to chew for three teeth. If the gum and bone surrounding the two anchor teeth are compromised then keeping a bridge in the mouth is problematic as the bridge goes through it’s normal wear and tear. Bridges as with all crowns have margins that are easy to decay if not well maintained through good oral hygiene. Whereas if an implant is placed in the space it functions as it’s own tooth. The adjacent teeth can remain intact without placing crowns on them to hold a bridge so oral hygiene is much better with implants.

If you have any questions talk to your dentist for more information about implants and the pros and cons of having them. You can always drop me a line at drjane@janevaldedds.com.

Happy Smiling!