Posts for: October, 2013

Participating in athletic activities offers numerous well-documented health benefits — not to mention instilling the intangible values of discipline, teamwork and goal-setting. Of course, in nearly every sport, the possibility of injury exists as well. But don't let that stop you or someone you love from playing! Instead, you can learn about the potential hazards of dental injury, and take some practical steps to minimize the risk.
It should come as no surprise that injury to the mouth is an ever-present possibility in so-called “collision” sports like football and ice hockey. But did you know that the greatest number of dental injuries result from the games of baseball and basketball, which are often played informally? Even non-contact sports like skiing, bicycling and skateboarding carry a real risk of injury.
Who suffers dental injury? Men are slightly more likely than women — but only by a small percentage. Injury peaks in the teenage years, and seems to decrease afterward — but older athletes tend to have more severe problems. In short, most anyone who participates in sports is subject to possible dental injury.
Besides the obvious aesthetic imperfections, a damaged or missing tooth can also result in functional problems with the bite — a potentially serious condition. If a tooth can't be immediately replanted, restoring it can be expensive: The total cost of each tooth replacement is estimated at $10,000-$20,000 over a lifetime. So tooth damage or loss can cause a multitude of troubles.
The American Dental Association (ADA) has recommended that participants in all of the sports mentioned above — as well as two dozen others — should wear a custom-fitted mouthguard. Why? Because when it comes to dental injury, an ounce of prevention really is worth a pound of cure.
Numerous studies have shown that wearing a custom-fitted mouthguard is an effective way to prevent dental injury. According to the Academy of General Dentistry, mouthguards prevent some 200,000 injuries each year. And the ADA says that athletes who don't wear mouthguards are 60 times more likely to sustain harm to the teeth than those who do wear them.
Off-the-shelf mouthguards in a limited range of sizes are available at many sporting-goods stores. But these can't compare to the superior protection and durability offered by a mouthguard that's custom-made just for you. Using an exact model of your teeth, we can individually fabricate a piece of protective gear that fits correctly and feels comfortable in your mouth. A custom mouthguard may be more economical than you think — yet its real payoff comes in preventing dental injury.
If you have questions about mouthguards or sports-related dental injuries, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Athletic Mouthguards” and “An Introduction to Sports Injuries & Dentistry.”

There's nothing quite like watching your son or daughter compete on the athletic field. It's a mixture of anticipation, pride — and occasionally, anxiety. Despite all the protective gear and training, kids are sometimes injured playing the sports they love. In fact, when it comes to dental injuries, teens are the most susceptible of any age group. Here's what you should know about preventing sports-related dental injuries in kids.
Of course you know that football and hockey players should always wear mouthguards, both at games and during practice. But don't forget about kids who play soccer, do gymnastics, wrestle or play basketball. According to the American Dental Association (ADA) these athletes — along with participants in about 20 other sports — also need to wear this important piece of protective gear. In fact, the ADA states that not wearing a mouthguard makes an athlete 60 times more likely to sustain dental injury!
In selecting a mouthguard, there are three basic options to choose from: the “off-the-shelf” type, the so-called “boil and bite” protector, and the custom-fitted mouthguard that we can fabricate. Let's look briefly at all three.
The first type, available at many sporting goods stores, comes in a limited range of sizes, and an unknown range of quality. It's the least expensive option, offering a minimal level of protection that's probably better than nothing.
The second type, although popular, is also limited in its protection. This one is designed to be immersed in hot water, and then formed in the mouth using finger, tongue and bite pressure. If it can be made to fit adequately, it's probably better than the first type — though it often lacks proper extensions, and fails to cover the back teeth. Also, upon impact, the rubber-like material will distort and not offer as much protection as you would like to have.
The third is a piece of quality sports equipment that's custom-made for your child's mouth (or your own). To fabricate this mouthguard, we first make a model of the individual's teeth, and then mold the protector to fit just right. Made from tough, high-quality material, it's designed to cover all teeth, back and front, without being excessively bulky. It can even be made to accommodate growing teeth and jaws. And, it's reasonable in cost.
To paraphrase the ADA's recommendation, the best mouthguard is the one you wear. A comfortable, correctly-fitted mouthguard is easy to wear — and it can help prevent dental injury, giving you one less thing to worry about. Now, if you could just get you child to keep her eye on the ball.
If you have questions about mouthguards or sports-related dental injuries, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Athletic Mouthguards” and “An Introduction to Sports Injuries & Dentistry.”

Your otherwise beautiful smile has one noticeable flaw — one or more of your teeth are deeply discolored or stained. More than likely this staining is deep within the teeth, what we refer to as intrinsic staining. There are a number of reasons this can occur — from fillings or use of antibiotics, for example — and our first approach should be to attempt a whitening technique.
However, if that doesn't produce the desired result, porcelain laminate veneers are another option you might consider. Veneers are made of dental porcelain, a bio-compatible material that can be shaped and colored to closely match neighboring teeth. After a minimal amount of tooth reduction (removal of some of the enamel from the tooth surface) to prepare for the laminate, the veneers are then permanently bonded to the tooth surface and cover the discolored natural tooth. Besides changing the appearance of discolored or stained teeth, veneers can also be used to correct other imperfections such as chipped or misshapen teeth.
Patients, however, have a common question: how long will the veneers last? With proper care, veneers can last anywhere from seven years to more than twenty years. It's possible, though, to damage them — for example, you can break them if you bite down on something that goes beyond the porcelain's tolerance range, such as cracking nut shells with your teeth (not a good idea even for natural teeth!). You should also keep in mind that veneers are composed of inert, non-living material and are attached and surrounded by living gum tissue that can change over time. This process may eventually alter your appearance to the point that the veneer may need to be removed and reapplied to improve the look of your smile.
If a veneer is damaged, all is not necessarily lost. It may be possible to re-bond a loosened veneer or repair a chipped area. The worst case is replacement of the veneer altogether. Chances are, though, this will only happen after the veneer has already served you — and your smile — for many years.
If you would like more information on porcelain laminate veneers, 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 “Porcelain Veneers.”

Although traditional porcelain laminate veneers are much less invasive than other cosmetic dental applications, they still often require the removal of some of the surface tooth enamel, a process known as tooth reduction. Now, an alternative veneer treatment known as “no-prep” veneers eliminates this initial step of tooth reduction for some patients.
Although most reductions take very little of the tooth enamel, they do permanently alter the tooth. No-prep veneers are growing in popularity because the tooth is not permanently altered, allowing for two benefits: if desired, the veneer application can be reversed and the tooth returned to its original state; and there's more flexibility for patients to “test-drive” their new look with prototype veneers worn while the permanent veneers are manufactured, with changes made easily during this tryout period.
Dentists have long regarded at least a minimum of tooth reduction as absolutely necessary for the proper adhesion of veneers, and to avoid a bulky or over-contoured smile. And, while advances in no-prep veneers have largely addressed these concerns, it is true this option isn't for every patient considering a veneer application.
For example, patients with large or forward-positioned teeth are not good candidates for no-prep veneers. Patients who choose a veneer treatment over orthodontic treatment for certain conditions will likely need some tooth preparation to achieve an acceptable aesthetic result. For patients generally, no-prep veneers have a limited application range on the bottom jaw due to space limitations.
Simply put, traditional veneers are a more versatile option for most patients. On the other hand, no-prep veneers can be a good choice for patients with genetically small or misshapen teeth, teeth reduced by erosion or grinding, or those with narrow or diminished smiles.
If you're considering this option, our first step is to conduct a complete examination of your teeth and mouth. We'll carefully evaluate every aspect of your mouth structure and overall dental condition. If you fit the criteria, you may be able to avoid tooth reduction and still gain the smile you desire.
If you would like more information on no-prep veneers, 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 “Porcelain Veneers Without the Drill.”

Bad breath, medically known as halitosis (“halitus” – breath; “osis” – disorder) is an unpleasant condition that can negatively impact your personal and business relationships. It's more than just embarrassing! In fact, one recent survey found that three out of five people would rather work with someone who talks too loudly than with someone who has bad breath! Gum, mints and mouth rinses can temporarily remedy the situation, but not cure it permanently. So how much do you know about the underlying causes of bad breath?
The following true/false quiz will help you discover, while learning more about bad breath.
Questions
- The most common orally related sites associated with bad breath are the tongue and gums.
- Systemic (general body) medical conditions can't cause bad breath.
- Bad breath is always worse in the morning.
- Effective treatment depends on the underlying cause of the disease.
- Dentists can do very little to diagnose the cause of bad breath.
Answers
- True. The back of the tongue and diseased gums can become repositories for bacteria. In the case of the tongue they are from left over food deposits and even post-nasal drip. Bad breath that emanates from the tongue has a “rotten egg” odor caused by volatile sulfur compounds (VSCs).
- False. Medical conditions can cause bad breath including lung infections, liver disease, diabetes, kidney infections and cancer.
- True. Saliva flow decreases during the night making the mouth feel dry, and giving you that typical “morning breath” taste and odor upon wakening.
- True. As with any medical condition, uncovering the origin will dictate appropriate treatment. For example, tongue scraping or brushing can help eliminate odor that originate from the tongue. If the cause is disease related, the disease will need to be treated to control associated bad breath.
- False. There are several things dentists can do starting with a thorough medical history and oral examination. For example, decayed or abscessed teeth, diseased gums, coated tongue or infected tonsils are all common oral causes. We can also conduct breath tests to determine if the odor is emanating from the mouth or lungs, and test to determine the level of VSCs in the mouth.
Learn More
Worried about bad breath? Are you ready to trade your breath mints for a more permanent solution? Call our office today to schedule an oral examination. For more information about the causes of bad breath, read the Dear Doctor magazine article “Bad Breath: More Than Just Embarrassing.”