By Alan N. Parnes, DDS, PC
November 14, 2017
Category: Oral Health
LifeIsSometimesaGrindforBrookeShields

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.”

By Alan N. Parnes, DDS, PC
October 30, 2017
Category: Oral Health
Tags: oral hygiene   oral health  
HelpYourChildDevelopGoodOralHabitsandAvoidBadOnes

We all have habits: things we do every day often without consciously thinking. Some of them are good; some not so much. And many of them took root in childhood.

That's why it's important to help your children form good habits in their formative years, especially regarding oral health. Here are 4 areas to focus on developing good dental habits — and avoiding bad ones.

Keep teeth and gums clean. The best defense against dental disease is stopping plaque, a thin film of bacteria and food particles, from building up on tooth surfaces. That means brushing and flossing each day, along with regular dental cleanings and checkups. You should begin cleaning your child's teeth as soon as they appear in the mouth with a clean towel or rag at first and later brushing them. Eventually, teach your children to brush and floss for themselves. Dental visits should also begin around their first birthday.

A nutritious diet equals healthy teeth. The saying, “You are what you eat,” is especially true about teeth. Help your child form a nutritious diet habit by providing meals rich in fresh fruits and vegetables, quality protein and dairy products. You should also restrict their sugar intake, a primary food for bacteria that cause tooth decay; try to limit sweets to mealtimes and avoid constant snacking.

Avoid habits with hidden dangers. Actually, this one is about you — and what you might be doing to increase your child's risk for dental disease. Avoid actions that increase the chances of transmitting oral bacteria from you to your infant, like kissing on the lips or licking a pacifier to clean it. You should also avoid giving your child night-time bottles or sippy cups filled with milk, formula or any sweetened liquid — likewise for pacifiers dipped in something sweet.

Steer them away from future bad habits. As children become teenagers, they're eager to stretch their wings. While this is normal and good, they can get into habits with dire consequences for oral health. You should by all means steer them away from tobacco use or oral piercings (tongue and lip bolts especially can wreak havoc on tooth structure) that can harm their teeth and gums.

If you would like more information on dental care for children, 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 “Dentistry & Oral Health for Children.”

By Alan N. Parnes, DDS, PC
October 22, 2017
Category: Dental Procedures
Tags: root canal   root resorption  
RootResorptioninAdultTeethisaCauseforConcern

As a new permanent tooth develops, the roots undergo a process of breakdown and growth. As older cells dissolve (a process called resorption), they’re replaced by newer cells laid down (deposition) as the jaw develops. Once the jaw development ends in early adulthood, root resorption normally stops. It’s a concern, then, if it continues.

Abnormal root resorption most often begins outside of the tooth and works its way in, beginning usually around the neck-like (or cervical) region of the tooth. Also known as external cervical resorption (ECR), the condition usually shows first as pink spots where the enamel is being undermined. As these spots continue to erode, they develop into cavity-like areas.

While its causes haven’t been fully confirmed, ECR has been linked to excessive pressure on teeth during orthodontic treatment, periodontal ligament trauma, teeth-grinding or other excessive force habits, and bleaching techniques performed inside a tooth. Fortunately, ECR is a rare occurrence, and most people who’ve had these problems won’t experience it.

When it does occur, though, it must be treated as quickly as possible because the damage can progress swiftly. Treatment depends on the size and location of the resorption: a small site can often be treated by surgically accessing the tooth through the gum tissue and removing the offending tissue cells. This is often followed with tooth-colored dental material that’s bonded to the tooth to replace lost structure.

A root canal treatment may be necessary if the damage has extended to the pulp, the tooth’s interior. However, there’s a point where the resorption becomes too extensive to save the tooth. In these cases, it may be necessary to remove the tooth and replace it with a dental implant or similar tooth restoration.

In its early stages, ECR may be difficult to detect, and even in cases where it’s been diagnosed more advanced diagnostics like a CBCT scanner may be needed to gauge the extent of damage. In any case, it’s important that you have your teeth examined on a regular basis, at least twice a year. In the rare chance you’ve developed ECR, the quicker it’s found and treatment begun, the better your chances of preserving the tooth.

If you would like more information on root resorption, please contact us or schedule an appointment for a consultation.

By Alan N. Parnes, DDS, PC
October 07, 2017
Category: Dental Procedures
Tags: oral health   dental visit  
WhyYouNeedaLong-TermDentalCarePlan

Today’s healthcare patients are asking questions. They want to know the “why” behind the “what” that their care providers are recommending for their health.

There’s a similar trend in dentistry — and it’s one we dentists encourage. We want you to know the “why” behind your treatment options — because you’re as much a participant in your own dental health as we are. The more informed you are, the better equipped you’ll be to make decisions to maintain or improve your health and the appearance of your smile.

As your dental care partner, it’s also essential we help you develop a long-term care plan based on your needs. There are aspects of dental care that are routine: daily brushing and flossing, an oral-friendly diet, and regular dental cleanings and checkups to assess your oral health. But we also need to think strategically, especially if you have risk factors that could impact your future dental health.

To do this we follow a four-step dental care cycle. In Step 1 we identify all the potential risk factors you personally face. These include your potential for dental disease, which could lead to bone and tooth loss, and the state of your bite and jaw structure that could complicate future health. We’ll also take into account any factors that could now or eventually affect your smile appearance.

Once we’ve identified these various factors, we’ll then assess their possible impact on your health in Step 2, not just what may be happening now but what potentially could happen in the future. From there we move to Step 3: treating any current issues and initiating preventive measures to protect your future health.

In Step 4 we’ll monitor and maintain the level of health we’ve been able to reach with the preceding steps. We’ll continue in this stage until we detect an emerging issue, in which we’ll then repeat our cycle of care.

Maintaining this continuum will help reduce the chances of an unpleasant surprise in your dental health. We’ll be in a better position to see issues coming and help reduce their impact now so you can continue to have a healthy mouth and an attractive smile.

If you would like more information on planning your dental 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 “Successful Dental Treatment: Getting the Best Possible Results.”

By Alan N. Parnes, DDS, PC
September 22, 2017
Category: Dental Procedures
MasterIllusionistBenefitsfromtheMagicofOrthodontics

Magician Michael Grandinetti mystifies and astonishes audiences with his sleight of hand and mastery of illusion. But when he initially steps onto the stage, it’s his smile that grabs the attention. “The first thing… that an audience notices is your smile; it’s what really connects you as a person to them,” Michael told an interviewer.

He attributes his audience-pleasing smile to several years of orthodontic treatment as a teenager to straighten misaligned teeth, plus a lifetime of good oral care. “I’m so thankful that I did it,” he said about wearing orthodontic braces. “It was so beneficial. And… looking at the path I’ve chosen, it was life-changing.”

Orthodontics — the dental subspecialty focused on treating malocclusions (literally “bad bites”) — can indeed make life-changing improvements. Properly positioned teeth are integral to the aesthetics of any smile, and a smile that’s pleasing to look at boosts confidence and self-esteem and makes a terrific first impression. Studies have even linked having an attractive smile with greater professional success.

There can also be functional benefits such as improved biting/chewing and speech, and reduced strain on jaw muscles and joints. Additionally, well-aligned teeth are easier to clean and less likely to trap food particles that can lead to decay.

The Science Behind the Magic

There are more options than ever for correcting bites, but all capitalize on the fact that teeth are suspended in individual jawbone sockets by elastic periodontal ligaments that enable them to move. Orthodontic appliances (commonly called braces or clear aligners) place light, controlled forces on teeth in a calculated fashion to move them into their new desired alignment.

The “gold standard” in orthodontic treatment remains the orthodontic band for posterior (back) teeth and the bonded bracket for front teeth. Thin, flexible wires threaded through the brackets create the light forces needed for repositioning. Traditionally the brackets have been made of metal, but for those concerned about the aesthetics, they can also be made out of a clear material. Lingual braces, which are bonded to the back of teeth instead of the front, are another less visible option. The most discrete appliance is the removable clear aligner, which consists of a progression of custom-made clear trays that reposition teeth incrementally.

How’s that for a disappearing act?!

If you would like more information about orthodontic treatment please contact us or schedule an appointment for a consultation. You can also learn more about the subject by reading the Dear Doctor magazine article “The Magic of Orthodontics.”





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