Oral Health Can Prove Challenging in Your Senior Years

A focus on dental care in senior citizens is just as important as it is for children. Indeed, oral health in your later years can be a major factor in your quality of life.

For one, aging effects on other parts of the body can make dental care more challenging. Some hygiene tasks once performed easily become harder — arthritis, for example, or loss of muscle strength may make it difficult to hold a toothbrush or floss. In such cases, you may need to find new ways to make the task easier: a power toothbrush with a larger handle; pre-loaded floss holders or a water flosser; or adaptations to a manual brush to make it easier to hold, like attaching a tennis ball or bike handle.

Other age-related conditions — and their treatments — can negatively impact oral health. Less saliva production, which is a consequence of aging or certain drugs, increases the risk of tooth decay or periodontal (gum) disease. Older adults often develop gastric reflux problems that can introduce tooth enamel-eroding stomach acid into the mouth. And medications called bisphosphonates, often prescribed to treat osteoporosis, may interfere in rare cases with bone healing after tooth extraction or similar procedures.

Prior dental work can also prove challenging to treating dental disease. It becomes more difficult to preserve teeth threatened with decay if there are significant restorations or appliances to work around. Pain perception can also diminish with age, so that dental disease may not be noticed until later stages when significant damage has already occurred.

Oral care requires more attention as we grow older, or as we care for older family members. Your best defense against disease is to continue regular six-month visits with us. In addition to normal cleanings and checkups, we’ll also screen for oral cancer (a more prevalent occurrence in older adults), review your prescriptions or other supplements and medications for any possible side effects to oral health, check the fit of any dentures or other restorations and evaluate the effectiveness of your hygiene.

While other age-related conditions may capture the majority of your attention, you shouldn’t allow that to neglect your dental care. With your continued efforts, along with our support and your family’s, you can continue to enjoy good oral health throughout your lifetime.

If you would like more information on dental care for senior adults, please contact us today at (708) 848-2853 to make an appointment for a consultation.

Cosmetic Questions to Ask to Get You on the Right Path to a Better Smile

For some time now, you’ve noticed things about your teeth and gums — your overall smile — that you would like to change. But you’re in unfamiliar territory: you don’t know where to begin.

Here, then, are a few basic cosmetic dentistry questions you should ask yourself and us to get you moving in the right direction.

Am I a candidate for cosmetic dentistry? Invariably, the answer is yes — there’s always a way to enhance your appearance, starting with basic hygiene or whitening. But whether you’re a candidate for a particular procedure will depend on a full examination of your mouth — a “smile analysis” — to assess its current condition and needs, and what cosmetic options would best fit those needs.

Are my expectations realistic? That will first depend on what we find with your smile analysis. It will, however, also include studying the bigger picture — how certain changes might affect not only your smile but your overall facial appearance. Your wants and desires are extremely important in this process, but they should also be balanced with a dose of reality — some things may not be in your best interest health-wise to undertake, or are not in keeping with basic aesthetic principles of beauty.

Will I be able to have an idea beforehand how the changes will look? We’ve come a long way in providing patients ways to preview their new smile before undertaking a procedure. It’s often possible to “see” your proposed smile through computer simulation, or in some cases “test drive” it with temporary (provisional) crowns or veneers. For restorations involving porcelain crowns, it may be possible to take your input and fine-tune the shape and color of the permanent crown before it’s completed.

What will it cost? This will depend on the treatment plan we develop. Some treatments like teeth whitening are relatively inexpensive, while procedures like dental implants or orthodontics are major investments. You should also consider the costs to your time — some treatments require only a single visit, while others may take months or even years to complete. Depending on your financial means and comfort level, cost will need to be factored into the final plan, as well as your expectations.

If you would like more information on cosmetic dentistry, please contact us today at (708) 848-2853 to make an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Cosmetic Dentistry: A Time for a Change.”

Managing Gum Disease Could Benefit Other Conditions You May Have

Nearly half of all Americans have some form of periodontal (gum) disease. Without proper daily hygiene and treatment, this aggressive disease can ultimately cause tooth loss. It also appears the effects of gum disease reach beyond the mouth, as researchers have found relationships between it and other systemic diseases.

Inflammation, the body’s response to infection, is at the center of these relationships. In the case of gum disease, periodontal tissues become inflamed as the body attempts to isolate and fight the infection. If the inflammation becomes chronic, however, it will begin to damage gum tissues.

Inflammation is also a major feature of diabetes, a condition in which the pancreas doesn’t produce enough insulin. Without enough of this hormone that transforms sugar into usable energy for the body, the sugar accumulates in the blood stream; as a result, the patient becomes more susceptible to an exaggerated inflammatory response when the body encounters an infection. This is especially true for periodontal infections: the resulting inflammation can be greater and harder to control in diabetic patients. What’s more, uncontrolled gum disease may worsen their blood sugar levels.

Although not as prominent as with diabetes, cardiovascular disease also seems to share a connection with gum disease. This collection of chronic conditions like high blood pressure or restricted blood vessel flow raises the risk of heart attack or stroke. Like gum disease, inflammation is a major component in the progression of cardiovascular disease — in fact, both diseases leave similar chemical “markers” in the blood that indicate their early development.

Ongoing research has also produced some promising treatment findings for both gum disease and inflammatory diseases, which also include osteoporosis, respiratory disease and rheumatoid arthritis. We’re now finding in many cases that treating one side of the disease connection can have positive effects on the other side. For example, diabetics who receive professional treatment for gum disease may see better blood sugar control.

With this in mind, the best approach is to practice effective, daily oral hygiene to reduce the risk of gum disease, coupled with regular office cleanings and checkups. Not only will this help you maintain optimum oral health, it may also contribute to better management of other conditions you may have.

If you would like more information on the relationship between periodontal (gum) disease and other diseases, please contact us today at (708) 848-2853 to make an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Good Oral Health Leads to Better Health Overall.”

More Pros Are Using Mouthguards…So Should You!

When he isn’t among the ten players vying for position on the basketball court, Cole Aldrich of the New York Knicks sometimes lets his dangle behind one ear. Mason Plumlee, who plays for the Brooklyn Nets, slips his snugly inside one of his socks during off times. Other players can be seen at timeouts gnawing on them nervously, or tucking them into spandex waistbands. But when the whistle blows, they go into the mouth before the players get on the court.

We’re talking about protective mouthguards, of course. According to a recent story in the New York Times, only a handful of basketball players wore them regularly a few years ago. Today, more and more are wearing them, both in practice and during games. What’s the reason for the change?

Partly, it’s the result of better design and improved construction; today’s mouthguards are more comfortable and better-fitting than ever. Part of it comes from mounting evidence that they work: Research studies have consistently demonstrated the benefits of wearing a mouthguard — not only to protect the teeth, but also to reduce the risk of concussion. And partly, it stems from the growing acceptance that safety is an important aspect of all athletic activity.

If the pros are doing it — shouldn’t you be too? While you may think that only contact sports (such as football) are risky, the fact is that “non-contact” sports like baseball and basketball account for the majority of dental injuries. In fact, the American Dental Association recommends you wear a mouthguard when you participate in activities like handball, soccer, surfing and weight lifting — as well as boxing, skydiving, martial arts and “extreme sports” — whatever that may mean to you.

What’s the best kind of mouthguard? It’s the one that you actually wear, of course! And the most comfortable and best-fitting mouthguard is the one that’s custom-made for you by your dentist. Sure, you can pick up an off-the-shelf mouthguard at a big box store; but it can’t offer you the same level of protection and comfort you’ll get from a mouthguard that is made from a model of your own teeth. Custom-made mouthguards from your dentist are reasonably priced — and by preventing dental trauma, they can save an untold amount of hurt… both to your body and to your pocketbook.

So take a tip from the pros: Get a custom-made mouthguard, and wear it every time you play. But when you’re done playing… how about putting it away in a case?

If you would like more information about custom-made athletic mouthguards, please contact us today at (708) 848-2853 to make an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “An Introduction to Sports Injuries & Dentistry” and “Athletic Mouthguards.”

Can an App Help You Brush Your Teeth?

If you’re the kind of person who can’t do without a smart phone, you’ve probably heard the expression “There’s an app for that!” These nifty little programs let you get directions, check the weather, watch stock prices… even optimize your sleep patterns and make high-pitched dog whistles. And shortly, you’ll be able to check how well you’ve been brushing your teeth.

News reports have mentioned a soon-to-be-available toothbrush that will interface with an app on your smart phone. The brush has sensors that record how much time you spend brushing, whether you reach all parts of your mouth, and whether you brush correctly (with up and down motions, not just side to side). It charts your oral hygiene habits, scores your brushing technique — and, if you allow it, shares information about how well (or poorly) you’re doing with your family, friends… even your dentist.

So do you need to run out and buy one of these gizmos as soon as they’re available? Of course not! However, anything that encourages you to take better care of your oral hygiene can’t hurt. A wise dentist once said: The important thing is not the brush, but the hand that holds it.

If you’re a “gadget person,” you may be intrigued by the device’s high-tech design, and the fact that it interfaces with your phone. Plus, maybe the idea of compiling (and sharing) your brushing record has a certain appeal. On the other hand, you might prefer a sleek, light electric brush that doesn’t keep track of your movements. Or maybe the simplest brush of all — a manual one, with soft bristles and a comfortable handle — works best for you.

The most important thing is that you regularly practice good oral hygiene: Brush twice a day, for two minutes each time, and floss once a day. Use whichever brush is best for you, and be sure to change it every three months, or when the bristles get stiff. Stay away from sugary snacks between meals (they contribute to decay by keeping your teeth bathed in acidic byproducts). Don’t use tobacco in any form, or chew on things that don’t belong in your mouth. And remember to come in for regular exams and professional cleanings. If an app helps you do these things — we’re all for it.

If you would like to learn more about maintaining good oral hygiene, please contact us today at (708) 848-2853 to make an appointment for a consultation. For more information, see the Dear Doctor magazine article “Top 10 Oral Health Tips For Children.”

Treatment Options to Keep Stress From Causing Dental Problems

Chronic stress can cause any number of physical problems like back pain, insomnia or stomach ulcers. In the mouth, it can also be the cause of teeth grinding or clenching habits that may lead to pain and tooth damage.

Besides toothaches and jaw pain, stress-related teeth grinding may also be causing your teeth to wear at a faster than normal rate. While the teeth can withstand normal forces generated from biting and chewing, a grinding habit could be subjecting the teeth to forces beyond their normal range. Over time, this could produce excessive tooth wear and contribute to future tooth loss.

Here, then, are some of the treatment options we may use to stop the effects of stress-related dental habits and provide you with relief from pain and dysfunction.

Drug Therapy. Chronic teeth grinding can cause pain and muscle spasms. We can reduce pain with a mild anti-inflammatory pain reliever (like ibuprofen), and spasms with a prescribed muscle relaxant drug. If you have sleep issues, you might also benefit from occasional sleep aid medication.

A Night or Occlusal Guard. Also known as a bite guard, this appliance made of wear-resistant acrylic plastic is custom-fitted to the contours of your bite. The guard is worn over your upper teeth while you sleep or when the habit manifests; the lower teeth then glide over the hard, smooth surface of the guard without biting down. This helps rest the jaw muscles and reduce pain.

Orthodontic Treatment. Your clenching habit may be triggered or intensified because of a problem with your bite, known as a malocclusion. We can correct or limit this problem by either moving the teeth into a more proper position or, if the malocclusion is mild, even out the bite by reshaping the teeth in a procedure known as occlusal (bite) equilibration.

Psychological Treatment. While the preceding treatments can help alleviate or correct dental or oral structural problems, they may not address the underlying cause for a grinding habit — your psychological response to stress. If you’re not coping with stress in a healthy way, you may benefit from treatments in behavioral medicine, which include biofeedback or psychological counseling.

If you would like more information on dental issues related to stress, please contact us today at (708) 848-2853 to make an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Stress & Tooth Habits.”

Difficult or Not, Plaque Removal is Necessary for Stopping Gum Disease

When we refer to periodontal (gum) disease, we’re actually talking about a family of progressive, infectious diseases that attack the gums and other tissues attached to the teeth. Caused primarily by bacterial plaque left on tooth surfaces from inefficient oral hygiene, gum disease can ultimately lead to tooth loss.

There’s only one way to stop the infection and restore health to diseased tissues — remove all of the offending plaque and calculus (hardened plaque deposits) possible from tooth and gum surfaces, including below the gum line at the roots. The basic tools for this task are specialized hand instruments called scalers or ultrasonic equipment that vibrates plaque loose. A series of cleaning sessions using these tools could stop the infection and promote healing if followed with a consistent, efficient daily hygiene habit.

There are times, however, when the infection has progressed so deeply below the gum line or into the tissues that it requires other procedures to remove the plaque and infected tissue. One such situation is the formation of an abscess within the gum tissues, a pus-filled sac that has developed in response to infection. After administering local anesthesia, the abscess must be treated to remove the cause and allow the infectious fluid to drain. The area is then thoroughly flushed with saline or an antibacterial solution.

The gum tissues are not completely attached to the tooth surface for a small distance creating a space. These spaces are called periodontal pockets when they are inflamed and continue to deepen as the disease progresses. These inflamed and sometimes pus-filled pockets form when tissues damaged by the infection detach from the teeth. If the pockets are located near the gum line, it may be possible to clean out the infectious material using scaling techniques. If, however, they’re located four or more millimeters below the gum line a technique known as root planing may be needed, where plaque and calculus are shaved or “planed” from the root surface. As the disease progresses and the pockets deepen, it may also be necessary for surgical intervention to gain access to the tooth roots.

To stop gum disease and promote soft tissue healing, we should use any or all treatment tools at our disposal to reach even the most difficult places for removing plaque and calculus. The end result — a saved tooth — is well worth the effort.

If you would like more information on treating periodontal disease, please contact us today at (708) 848-2853 to make an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Treating Difficult Areas of Periodontal Disease.”

Determining the Right Whitening Approach is Key to Brightening a Dull Smile

Bright, naturally white teeth are a key component in a beautiful smile. But the opposite is also true: nothing diminishes an otherwise attractive smile more than stained or discolored teeth.

There is good news, however, about tooth staining: it can be greatly reduced with the right whitening technique. But before taking action we need to first uncover the cause for the staining — whether from the outside or inside of the tooth, or a combination of both.

If it’s an external cause — known as extrinsic staining — our diet is usually the source. Foods and beverages that contain tannins, like red wine, coffee or tea fall in this category, as do foods with pigments called carotenes as found in carrots and oranges. Besides limiting consumption of stain-causing foods and maintaining daily oral hygiene, you can also diminish extrinsic staining with a bleaching application.

There are two basic ways to approach this: with either a professional application at our office or with a home kit purchased at a pharmacy or retail store. Although both types use similar chemicals, the professional application is usually stronger and the whitening effect is obtained quicker and may last longer.

Discoloration can also occur within a tooth, known as intrinsic staining, and for various reasons. It can occur during tooth development, as with childhood overexposure to fluoride or from the antibiotic tetracycline. Poor development of enamel or dentin (the main sources of natural tooth color), tooth decay, root canal treatments or trauma are also common causes of intrinsic discoloration.

There are techniques to reduce the effects of intrinsic staining, such as placing a bleaching agent inside the tooth following a root canal treatment. In some cases, the best approach may be to restore the tooth with a crown or porcelain veneer. The latter choice is a thin layer of dental material that is permanently bonded to the outer, visible portion of the tooth: it’s life-like color and appearance covers the discoloration, effectively renewing the person’s smile.

If you’ve been embarrassed by stained teeth, visit us for a complete examination. We’ll recommend the right course of action to turn your dull smile into a bright, attractive one.

If you would like more information on treatments for teeth staining, please contact us today at (708) 848-2853 to make an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Teeth Whitening.”

Three Things to Know About Crowns Before Your Restoration

Today’s crowns, the visible part of a tooth replacement system, can effectively mimic the shape and color of natural teeth. But not all crowns are equal — so it’s best to be well-informed before you undergo a restoration on your natural teeth such as a single crown or bridgework — or if you need a crown on a dental implant that replaces a missing tooth.

To give you a starting point, here are 3 things to keep in mind about crowns as you consider a dental restoration.

Material composition. Most crowns in years past were made of a precious metal, most notably gold. What it lacked in appearance, it made up for in performance and durability. In recent years, dental porcelain has become the popular choice because of its ability to mimic the appearance and translucent color of natural teeth. Today’s porcelains are much stronger and are used more frequently for back teeth than in years past. A common recommendation for back teeth is a hybrid crown using metal and porcelain. Metal is incorporated beneath the porcelain in this type of crown to create a strong foundation and is also used along biting surfaces for strength. Porcelain is used in the more visible areas for esthetics.

The dental technician’s level of artistry. Most dentists sub-contract crown fabrication to dental laboratory technicians who may have varying levels of experience and artistic ability. A highly skilled technician can produce a crown that blends seamlessly with the patient’s remaining natural teeth.

Take a “test drive” of your future smile. Although we as dentists adhere to certain aesthetic principles, beauty is ultimately subjective — “in the eye of the beholder.” The final product must meet your expectations and level of comfort. If available, then, consider wearing temporary “trial smile” crowns as a preview of your new smile while your permanent set is under construction. This allows you to “try out” your future smile ahead of time, so you can make recommendations and sign off on the final set before it’s finished.

Undertaking any dental restoration is an important life step, both for your health and appearance. Being well-informed — especially about the crowns that you and others will see — will help you make wise choices that lead to a satisfying outcome.

If you would like more information on crowns, please contact us today at (708) 848-2853 to make an appointment for a consultation.

Treating TMD Like Other Joint-Related Problems

After ruling out other causes for your jaw pain, your doctor or dentist has made a diagnosis: a temporomandibular joint disorder (TMD). With TMD, your pain symptoms and other dysfunctions are due to a problem associated with the temporomandibular joint (TMJ) that connects your lower jaw (mandible) to your upper skull (cranium).

There are a number of treatment options, but most can be classified as either aggressive or conservative. Aggressive treatments are more interventional and target problems with the teeth such as bite problems or jaw relationships as they relate to the bite, which are thought to be underlying causes for TMD. Such treatments include orthodontics to realign teeth, crown or bridgework, or surgical treatment to the jaw or joint itself. These treatments are controversial and irreversible — with no guarantee of symptom relief.

It’s thought by many to be appropriate, then, to start with more conservative treatments. Many of these are based on treating the TMJ — which is a joint, a moveable bony structure connected by muscles and tendons — with an orthopedic approach, using treatments similar to those used for other joint problems.

Here, then, are some of those conservative therapies that may relieve your TMD pain and other symptoms.

Physical Therapy. Commonly used to treat pain and dysfunction in other joints, physical therapies like manual manipulation, massage, alternating hot and cold packs or exercises can be used to relax, stretch or retrain the muscles that operate the TMJ while reducing pain and inflammation.

Medications. Medications may be incorporated into the treatment plan to relieve pain, reduce inflammation or relax tense muscles. Besides prescription drugs, over-the-counter anti-inflammatory drugs (such as ibuprofen or acetaminophen) are also commonly used.

Bite Appliances. If night-time teeth grinding or clenching habits are a primary cause for the TMD, you may benefit from wearing an occlusal bite guard while you sleep, designed to specifically fit your upper teeth. Because the lower teeth can’t grip the guard’s smooth plastic surface when biting down, they’ll more likely produce less force. This gives the jaw muscles a chance to relax during sleep.

Diet changes. Changing to softer foods, which don’t require strenuous chewing, and eliminating the chewing gum habit will further help reduce stress on the TMJs and also give your muscles a chance to relax and heal.

If you would like more information on TMD and treatment options, please contact us today at (708) 848-2853 to make an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Seeking Relief from TMD.”