Office News

By J. Bradford Smith, D.D.S.
January 17, 2020
Category: Oral Health
DentalInjuryIsJustaTemporarySetbackforBasketballStarKevinLove

The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.

In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?

The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.

Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.

So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”

Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.

If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”

By J. Bradford Smith, D.D.S.
January 07, 2020
Category: Oral Health
Tags: sugar   nutrition  
ReduceSugarConsumption-foraHealthierMouthandBody

Tooth decay doesn't appear out of nowhere. It begins with bacteria, which produce acid that softens and erodes tooth enamel. Without adequate enamel protection, cavities can develop.

So, one of our prevention goals is to decrease populations of disease-causing bacteria. One way is to deprive them of carbohydrates, a prime food source, most notably refined sugar. That's why for decades dentists have instructed patients to limit their intake of sugar, especially between meal snacks.

Ironically, we're now consuming more rather than less sugar from a generation ago. The higher consumption impacts more than dental health — it's believed to be a contributing factor in many health problems, especially in children. Thirty years ago it was nearly impossible to find a child in the U.S. with type 2 diabetes: today, there are over 50,000 documented juvenile cases.

Cutting back isn't easy. For one thing, we're hard-wired for sweet-tasting foods. Our ancestors trusted such foods when there was limited food safety knowledge. Most of us today still have our "sweet tooth."

There's also another factor: the processed food industry. When food researchers concluded fats were a health hazard the government changed dietary guidelines. Food processors faced a problem because they used fats as a flavor enhancer. To restore flavor they began adding small amounts of sugar to foods like lunch meat, bread, tomato sauce and peanut butter. Today, three-quarters of the 600,000 available processed food items contain some form of added sugar.

Although difficult given your available supermarket choices, limiting your sugar intake to the recommended 6 teaspoons a day will reduce your risk for dental and some general diseases. There are things you can do: replace processed foods with more fresh fruits and vegetables; read food labels for sugar content to make better purchasing decisions; drink water for hydration rather than soda (which can contain two-thirds of your daily recommended sugar allowance), sports drinks or juices; and exercise regularly.

Keeping your sugar consumption under control will help you reduce the risk of tooth decay. You'll be helping your overall health too.

If you would like more information on the effect of sugar on health, 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 “The Bitter Truth about Sugar.”

By J. Bradford Smith, D.D.S.
December 28, 2019
Category: Dental Procedures
Tags: air abrasion  
AirAbrasionCouldbeaMorePleasantAlternativetotheDentalDrill

While it may not be one of your favorite features in the dental office, the dental drill is nevertheless necessary for treating problem teeth. It’s used primarily for removing decayed or damaged structure and preparing a tooth for fillings or other restorations.

Dental drills have been used for decades and are quite effective — but they have their drawbacks. Their rotating burrs often remove portions of healthy tooth structure along with decayed material. Friction from the drill action can cause discomfort, so local anesthesia is usually needed. Drills can also emit a high-pitched machine noise that’s unsettling to many patients.

There’s a growing alternative to the drill, known as air abrasion. Although the technology has been around since the 1950s, the development of new suction pumps that capture the resulting dust from its use has made it more palatable as an option to the traditional drill.

Also known as particle abrasion, the technique uses a pressurized stream of fine particles (usually aluminum oxide, an abrasive powder) directed at teeth to wear away (abrade) the tooth’s structural surface. We can be quite precise in the amount of surface material removed, so it’s useful for diminishing stains or roughing the surface for bonding materials like composite resin. We’re also able to remove decayed material with very little impact on surrounding healthy structure, and you may not need anesthesia during the procedure.

While this quiet alternative to the noisier drill is quite versatile, it does have its limitations. It’s not that efficient for preparing larger cavities for restoration or for removing older amalgam fillings. The teeth to be treated must be carefully isolated to prevent the fine particle dust produced from being swallowed by the patient or spread into the air. High-volume suction equipment is a must or the procedure will create a “sandstorm” of particles in the room.

Still, for situations suited to it and with proper isolation measures, air abrasion can be effective and comfortable. If the technology continues to improve, the dental drill may soon become a relic of the past.

If you would like more information on procedures using air abrasion, 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 “Air Abrasion Technology.”

By J. Bradford Smith, D.D.S.
December 18, 2019
Category: Dental Procedures
HeresHowWeCanJazzupYourHolidaySmileThisSeason

The holidays have officially begun! Between Thanksgiving and New Year’s Eve, it’s fairly certain you’re going to be spending time with lots of folks. From family gatherings to neighborhood open houses to the office holiday party, you’ll find yourself rubbing elbows with all the in-laws and out-laws in your social orbit. And because it’s the season of cheer, you’ll probably smile—a lot.

So, before the festivities go full tilt, take a little time to freshen up that wonderful smile of yours. Here are a few suggestions for having a smile this holiday season that you’re confident to put on display.

Dental cleanings. While professional dental cleanings primarily remove any lingering disease-causing plaque and tartar, they can have the secondary benefit of improving your smile’s appearance. So, if it’s close to time for your regular dental visit or you would simply like to give your teeth a quick polish, schedule a cleaning appointment for a little extra holiday sparkle.

Teeth whitening. You can gain a noticeable increase in smile brightness with a professional whitening application. With our advanced bleaching solutions and techniques, we can precisely control the level of brightness you desire, from a more subdued natural white to a dazzling “Hollywood” shine. And with care, the effect could last for several months or even years with an occasional touch-up.

Bonding. A chipped tooth can stand out from your smile like a smudge on a masterpiece painting. In many cases, though, we can repair minor chips and other defects by bonding composite resin to the tooth in a single visit. The process is simple: We color-match the resin to the tooth, then apply, shape and cure it. Your tooth will look good as new.

Porcelain veneers. For a more durable and comprehensive solution, consider veneers for dental flaws you do not wish to live with. These thin wafers of porcelain are permanently bonded to the front of teeth to mask chips, heavy staining or slight misalignments. And they are quite affordable compared to more extensive cosmetic restorations.

All of these cosmetic options can fit into most people’s budgets and don’t take a lot of time in the dentist’s chair. Veneers are the one slight exception: These require more than one visit to the dental office because they are custom-made for you in a dental lab. Also note that veneers often require the permanent removal of tooth enamel, so the tooth will require a veneer or other restorative covering from then on.

All in all, though, it doesn’t take much to put some much-needed zing back into your smile. In most cases, it only takes one visit—just in time to brighten up your holiday season.

If you would like more information about smile enhancement, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Porcelain Veneers.”

By J. Bradford Smith, D.D.S.
December 08, 2019
Category: Oral Health
Tags: celebrity smiles   retainer  
MargotRobbieKnowsAGreatSmileIsWorthProtecting

On the big screen, Australian-born actress Margot Robbie may be best known for playing devil-may-care anti-heroes—like Suicide Squad member Harley Quinn and notorious figure skater Tonya Harding. But recently, a discussion of her role in Peter Rabbit proved that in real life, she’s making healthier choices. When asked whether it was hard to voice a character with a speech impediment, she revealed that she wears retainers in her mouth at night, which gives her a noticeable lisp.

“I actually have two retainers,” she explained, “one for my bottom teeth which is for grinding my teeth, and one for my top teeth which is just so my teeth don't move.”

Clearly Robbie is serious about protecting her dazzling smile. And she has good reasons for wearing both of those retainers. So first, let’s talk about retainers for teeth grinding.

Also called bruxism, teeth grinding affects around 10 percent of adults at one time or another, and is often associated with stress. If you wake up with headaches, sore teeth or irritated gums, or your sleeping partner complains of grinding noises at night, you may be suffering from nighttime teeth grinding without even being aware of it.

A type of retainer called an occlusal guard is frequently recommended to alleviate the symptoms of bruxism. Typically made of plastic, this appliance fits comfortably over your teeth and prevents them from being damaged when they rub against each other. In combination with stress reduction techniques and other conservative treatments, it’s often the best way to manage teeth grinding.

Orthodontic retainers are also well-established treatment devices. While appliances like braces or aligners cause teeth to move into better positions, retainers are designed to keep teeth from moving—helping them to stay in those positions. After active orthodontic treatment, a period of retention is needed to allow the bite to stabilize. Otherwise, the teeth can drift right back to their old locations, undoing the time and effort of orthodontic treatment.

So Robbie has the right idea there too. However, for those who don’t relish the idea of wearing a plastic appliance, it’s often possible to bond a wire retainer to the back surfaces of the teeth, where it’s invisible. No matter which kind you choose, wearing a retainer can help keep your smile looking great for many years to come.

If you have questions about teeth grinding or orthodontic retainers, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Teeth Grinding” and “The Importance of Orthodontic Retainers.”





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