Dr. Bob's Blog
EmmaRobertsConfessestoHavingaMajorSweetToothWhileExpecting

Emma Roberts, star of American Horror Story (and niece of actress Julia Roberts), welcomed her first child at the end of 2020. She confessed that her love of sweets made pregnancy challenging. She couldn't get enough of cupcakes with sprinkles and a Salt & Straw ice cream flavor called The Great Candycopia. But Roberts isn't unique. Hormonal changes in pregnancy often bring heightened cravings for certain foods. Unfortunately, this can increase an expectant mother's risk for dental disease, especially if they're consuming more sugary foods.

In fact, around four in ten expectant women will develop a form of periodontal disease called pregnancy gingivitis. It begins with dental plaque, a thin film that forms on tooth surfaces filled with oral bacteria that can infect the gums. And what do these bacteria love to eat? Yep—sugar, the same thing many women crave during pregnancy.

So, if you're expecting a baby, what can you do to minimize your risk for dental disease?

Practice oral hygiene. Removing dental plaque by brushing and flossing daily is the most important thing you can do personally to prevent both tooth decay and gum disease. It's even more important given the physical and hormonal changes that occur when you're pregnant. Be sure, then, that you're diligent about brushing and flossing every day without fail.

Control your sugar intake. If you have strong cravings for sweets, cutting back may be about as easy as stopping an elephant on a rampage through the jungle. But do give your best effort to eating more dairy- and protein-rich foods rather than refined carbohydrates like pastries or candies. Not only will reducing sugar help you avoid dental disease, these other foods will help strengthen your teeth.

Maintain regular dental visits. Seeing us for regular cleanings further reduces your disease risk. We can clean your teeth of any plaque deposits you might have missed, especially hardened plaque called tartar that's nearly impossible to remove with brushing and flossing. We'll also monitor your teeth and gums for any developing disease that requires further treatment.

Undergo needed treatments. Concerned for their baby's safety, many expectant mothers are hesitant about undergoing dental procedures. But both the American Congress of Obstetricians and Gynecologists and the American Dental Association endorse necessary dental treatments during pregnancy, even if they include local anesthesia. We will make you have only a safe type of anesthesia, and we can advise you when it is prudent to postpone certain treatments, such as some elective procedures, until after the baby is born.

Emma Roberts got through a healthy pregnancy—cravings and all—and is now enjoying her new baby boy. Whether you're a celebrity like Emma Roberts or not, expecting a baby is an exciting life moment. Follow these tips to keep your teeth and gums healthy throughout your pregnancy, and be sure to let the dental team know of your pregnancy before any treatment.

If you would like more information about dental care during pregnancy, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Pregnancy and Oral Health.”

By Dr. Malenius
September 03, 2021
Category: Dental Procedures
Tags: dental implants  
4ReasonstoConsiderDentalImplants

Along with fessing up to cherry tree surgery and tossing silver dollars across the Potomac River, George Washington is also famously known for wearing wooden dentures. Although we can't verify the first two legends, we can confirm Washington did indeed wear dentures, but not of wood—hippopotamus ivory and (yikes!) donated human teeth—but not wood.

Although they seem primitive to us today, Washington's dentures were the best that could be produced at the time. Still, the Father of Our Country suffered mightily from his dentures, both in physical discomfort and social embarrassment. Regarding the latter, our first president's dentures contorted his lips and mouth in an unattractive way, faintly discernable in Gilbert Stuart's famous portraits of our first president.

If only Washington had lived in a later era, he might have been able to avoid all that dental unpleasantness. Besides better versions of dentures, he might also have benefited from an entirely new way of replacing teeth—dental implants. Just four decades after this state-of-the-art restoration was first introduced, we now recognize implants as the "Gold Standard" for tooth replacement.

In recognition of Dental Implant Month in September, here are 4 reasons why dental implants might be the right tooth replacement choice for you.

Life-like. While other restorations provide a reasonable facsimile of natural teeth, implants take like-likeness to another level. That's because the implant replaces the root, which then allows for a life-like crown to be attached to it. By positioning it properly, implants and the subsequent crown can blend seamlessly with other teeth to create an overall natural smile appearance.

Durable. Implants owe their long-term durability (more than 95% still functioning after ten years) to a special affinity between bone and the titanium post imbedded in the jaw. Bone cells readily grow and adhere to the implant's surface, resulting over time in a more secure hold than other restorations. By the way, this increased bone growth around implants can help slow or even stop progressive bone loss.

Low impact. Dental bridges are another well-regarded tooth replacement option, but with a major downside: The natural teeth on either side of the missing teeth gap must be crowned to support the bridge. To prepare them, we must permanently alter these teeth. Implants, though, don't require this form of support, and so have a negligible effect on other teeth.

Versatile. Although implants are a practical choice for individual tooth restorations, multiple teeth replacements can get expensive. Implants, though, can also be incorporated into other restorations: Four to six implants can support an entire removable denture or fixed bridge. Implant-supported restorations are more durable than the traditional versions, while also encouraging better bone health.

If you need to replace teeth and would like to consider dental implants, see us for a complete examination. You may be an ideal candidate for this "best of the best" dental restoration.

If you would like more information about dental implants, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Dental Implants.”

By Dr. Malenius
August 24, 2021
Category: Oral Health
Tags: tooth decay  
HowtoPreventToothDecayinYourSpecialNeedsChild

Preventing tooth decay from developing in your child's teeth requires a strong commitment to daily oral hygiene. But if you have a child with a chronic physical or behavioral condition, you might find it difficult to keep that commitment in the light of other pressing health needs.

But tooth decay is just as important a health issue as the others with which you may contend. Because primary teeth guide incoming permanent teeth to erupt properly, losing them prematurely can lead to a poor bite and other associated problems. This could further diminish their quality of life already compromised by their chronic condition.

Helping your special needs child avoid tooth decay isn't easy—but it can be done. Here's how!

Brush and floss for them. Normally, a parent's goal is to help their children learn to care for their teeth on their own. But depending on the nature of your child's chronic disease, that may not be possible. Instead, you may need to take an active role in their daily hygiene for the foreseeable future, even brushing and flossing for them if necessary.

Model proper dental care. Even so, it's still a good idea to guide them toward performing oral hygiene tasks without assistance, according to their abilities. This could be a long road, though, one that requires your active participation. You can ease this process by continuously modeling good dental care behavior for them through brushing and flossing together.

See an understanding dentist. Although caring for a special needs child can be isolating, you don't have to go at it alone. That includes taking care of their teeth and gums: A dentist who has both training and experience in treating children with chronic health conditions can become an important partner in your efforts to fight tooth decay.

Communicate between all care providers. Likewise, having everyone involved in your child's care on the same page can make decay prevention a much easier process. Be sure then to share your concerns about your child's needs, including dental care, with attending physicians, therapists and, of course, dentists.

If you would like more information on dental care for special needs 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 “Managing Tooth Decay in Children With Chronic Diseases.”

By Dr. Malenius
August 14, 2021
Category: Oral Health
Tags: tmj disorder  
YourToothacheMightActuallybeUnrelatedtoYourTeeth

When you see your dentist about mouth pain, you expect to hear that it's a decayed or fractured tooth, or maybe a gum infection. But you might be surprised if your dentist tells you there's nothing going on inside your mouth to cause the pain.

It's not that far-fetched: The pain could be originating elsewhere. This is known as referred pain, where pain radiates from its origin to another part of the body.

Unless there's an obvious oral cause for the pain, it's best not to undertake any treatment involving the mouth until we've pinpointed the actual cause. That said, the cause is usually not too far away.

Facial nerve disorders. The trigeminal nerve courses on either side of the face from the upper skull through the cheeks and ends around the lower jaw. But if portions of the nerve's protective sheathing become damaged, the slightest touch on the face could trigger prolonged pain. Because of its proximity to the jaw, the pain can often be misidentified as a toothache.

Jaw joint pain. When joints connecting the lower jaw to the skull become traumatized and inflamed, a condition known as Temporomandibular joint disorder (TMD), the pain can radiate toward the jaw. In some cases, the person may easily mistake the muscle pain and spasming for a toothache.

Ear infection. As with TMD, your "toothache" may actually stem from an ear infection or congestion radiating pain into the jaw. It can also happen in the opposite direction—ear pain could actually be the referred pain of an infected back tooth—emphasizing the importance of precisely determining the originating source of any pain in the jaws or face.

Sinus pain. The large maxillary sinuses are located on either side of the face just above the back of the upper jaw. Because of its proximity, pain from a sinus infection can seem to be coming from one of the back molars. And as with ear infections, frequent sinus infections could in fact be caused by an infected tooth penetrating through the sinus floor.

These and other examples of possible referred pain illustrate how "tricky" a presumed toothache can be. Finding the true source of oral or facial pain will ensure you receive the proper treatment for lasting relief.

If you would like more information on oral or facial pain diagnosis and treatment, please contact us or schedule an appointment for a consultation.

BuffaloBillsStefonDiggsKnowsTheresNeveraBadPlacetoFloss

Buffalo Bills wide receiver Stefon Diggs wrapped up the NFL regular season in January, setting single-season records in both catches and receiving yards. The Bills handily beat the Miami Dolphins, earning themselves the second seed in the AFC playoffs, and Diggs certainly did his part, making 7 catches for 76 yards. But what set the internet ablaze was not Diggs' accomplishments on the field but rather what the camera caught him doing on the sidelines—flossing his teeth!

The Twitterverse erupted with Bills fans poking fun at Diggs. But Diggs is not ashamed of his good oral hygiene habits, and CBS play-by-play announcer Kevin Harlan expressed his support with “Dental hygiene is something to take note of, kids! There's never a bad place to floss” and “When you lead the NFL in catches and yards, you can floss anytime you want.”

We like to think so. There's an old joke among dentists:
Q. Which teeth do you need to floss?
A. Only the ones you want to keep.

Although this sounds humorous, it is borne out in research. Of note, a 2017 study showed that people who floss have a lower risk of tooth loss over periods of 5 years and 10 years, and a 2020 study found that older adults who flossed lost an average of 1 tooth in 5 years, while those who don't lost around 4 teeth in the same time period.

We in the dental profession stress the importance of flossing as a daily habit—and Stefon Diggs would likely agree—yet fewer than 1 in 3 Americans floss every day. The 2016 National Health and Nutrition Examination Survey (NHANES), conducted by the CDC's National Center for Health Statistics, revealed that only 30% of Americans floss every day, while 37% floss less than every day and 32% never floss.

The biggest enemy on the football field may be the opposing team, but the biggest enemy to your oral health is plaque, a sticky film of bacteria and food debris that builds up on tooth surfaces. Plaque can cause tooth decay and gum disease, the number one cause of tooth loss among adults. Flossing is necessary to remove plaque from between teeth and around the gums where a toothbrush can't reach. If not removed, plaque hardens into tartar, which can only be removed by the specialized tools used in the dental office. Regular professional dental cleanings are also needed to get at those hard-to-reach spots you may have missed.

If Diggs can find time to floss during a major NFL game, the rest of us can certainly find a couple minutes a day to do it. While we might not recommend Diggs' technique of flossing from one side of the mouth to the other, we commend his enthusiasm and commitment to keeping his teeth and gums healthy. Along with good dental hygiene at home—or on the sidelines if you are Stefon Diggs—regular professional dental cleanings and checkups play a key role in maintaining a healthy smile for life.

If you would like more information about keeping in the best dental health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Daily Oral Hygiene.”

DontIgnoreChronicMouthBreathing-ItCouldDisruptJawDevelopment

Although the air we breathe has one destination—the lungs—it can arrive there via two possible routes: through the nose or the mouth. In terms of survival, it matters little through which path air travels—just so it travels one of them!

In terms of health, though, breathing through the nose is more beneficial than through the mouth, and is our default breathing pattern. The nasal passages filter minute noxious particles and allergens. Air passing through these passages also produces nitric oxide, a gaseous substance that relaxes blood vessels and improves blood flow.

On the other hand, chronic mouth breathing during childhood can impact oral health. While breathing through the nose, the tongue rests against the roof of the mouth and thus becomes a mold around which the upper jaw and teeth develop. But mouth breathing places the tongue on the lower teeth, which deprives the upper jaw of support and can lead to an abnormal bite.

So why would people breathe through their mouth more than their nose? Simply put, it's more comfortable to do so. Because breathing is so critical for life, the body takes the path of least resistance to get air to the lungs. If obstructions caused by allergic reactions or swollen tonsils or adenoids are blocking the nasal pathway, the action moves to the mouth.

But chronic mouth breathing can often be treated, especially if addressed in early childhood. This may require the services of an ear, nose and throat specialist (ENT) and possible surgical intervention to correct anatomical obstructions. It's also prudent to have an orthodontist evaluate the bite and institute corrective interventions if it appears a child's jaw development is off-track.

Even after correcting obstructions, though, it may still be difficult for a child to overcome mouth breathing because the body has become habituated to breathing that way. They may need orofacial myofunctional therapy (OMT), which retrains the muscles in the face and mouth to breathe through the nose.

Chronic mouth breathing isn't something to be ignored. Early intervention could prevent future oral and dental problems and help the person regain the overall health benefits for nose breathing.

If you would like more information on overcoming chronic mouth breathing, 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 Trouble With Mouth Breathing.”

DentalTreatmentDependsonWhatsReallyCausingYourToothPain

Not all toothaches are alike: Some are sharp and last only a second or two; others throb continuously. You might feel the pain in one tooth, or it could be more generalized.

Because there are as many causes as there are kinds of dental pain, you can expect a few questions on specifics when you come to us with a toothache. Understanding first what kind of pain you have will help us more accurately diagnose the cause and determine the type of treatment you need.

Here are a few examples of dental pain and what could be causing it.

Temperature sensitivity. People sometimes experience a sudden jolt of pain when they eat or drink something cold or hot. If it only lasts for a moment or two, this could mean you have a small area of tooth decay, a loose filling, or an exposed root surface due to gum recession. If the pain lingers, though, you may have internal decay or the nerve tissue within the tooth has died. If so, you may require a root canal treatment.

Sharp pain when chewing. Problems like decay, a loose filling or a cracked tooth could cause pain when you bite down. We may be able to solve the problem with a filling (or repair an older one), or you may need more extensive treatment like a root canal. In any event, if you notice this as a recurring problem, don't wait on seeing us—the condition could worsen.

Dull pain near the jaw and sinuses. Because both the jaws and sinuses share the same nerve network, it's often hard to tell where the pain or pressure originates—it could be either. You may first want to see us or an endodontist to rule out tooth decay or another dental problem. If your teeth are healthy, your next step may be a visit with a physician to examine your sinuses.

As you can see, tooth pain can be a sign of a number of problems, both big and small. That's why it's important to see us as soon as possible for an examination and diagnosis. The sooner we can treat whatever is causing the pain, the sooner your discomfort will end.

If you would like more information on treating dental pain, 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 “Tooth Pain? Don't Wait!

GumSwellingCanHappenWithBraces-HeresHowtoAvoidIt

A few months into wearing braces you may notice your gums are swollen. It's likely you've developed periodontal (gum) disease.

Gum disease is a bacterial infection that usually begins with dental plaque. This thin, accumulated biofilm on teeth is filled with bacteria that cause dental disease. The more of it that remains on your teeth, the higher your risk for a gum infection.

In addition to regular dental cleanings, the best way for a person to reduce their gum disease risk is to remove plaque on a daily basis through brushing and flossing. Unfortunately, wearing braces complicates this: The brackets and wires affixed to your teeth can get in the way of your toothbrush and regular dental floss. As a result, you can easily miss plaque hidden around these bits of hardware.

Aside from gum disease, the braces themselves can irritate your gums. This irritation inflames the gums and may even cause more tissue to grow. Compound this overgrowth with a possible gum infection and it's no wonder your gums are severely swollen.

To lessen the chances of swollen gums with braces, you'll need to beef up your daily hygiene efforts. Simply put, it will typically take more time than normal to thoroughly clean around your braces. A few specialized tools, though, might make it easier.

An interproximal brush with a narrower head than a regular toothbrush is useful for accessing tight places around brackets. And a floss threader or a water flosser (which uses pressurized water to loosen and remove plaque) may help you better maneuver around wires to remove plaque between teeth.

Keeping your teeth clean as possible will certainly help you avoid gum swelling due to disease. But swelling from tissue overgrowth may not be resolved until your braces come off. In severe cases, it may even be necessary to remove the braces to treat the gums before resuming orthodontic treatment.

In any case, be as thorough as possible with your oral hygiene efforts during orthodontics and see your regular dentist for cleanings every six months. When you have completed orthodontic treatment, cleanings every six months are usually recommended. It's the best way to keep your gums healthy while you're wearing braces.

If you would like more information on dental care while wearing braces, 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 “Gum Swelling During Orthodontics.”





This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.