My Blog
By Pappas Family Dentistry
July 22, 2018
Category: Oral Health
Tags: teeth grinding  
KeepaWatchfulEyeonYourChildsTeethGrindingHabit

It can be alarming to be awakened in the middle of the night by a screeching, gritting sound coming from your child’s bedroom. No, it’s not a scene from a horror movie: it’s your child grinding their teeth as they sleep — a behavior so prevalent in children under eleven it’s considered normal.

That doesn’t mean, however, you should completely ignore it. While it isn’t harmful for most children, a few can encounter tooth wear, pain or trouble sleeping that calls for some form of intervention.

The causes for tooth grinding and similar habits known collectively as bruxism aren’t thoroughly understood, but in children it’s believed linked to the immaturity of the neuromuscular system that controls chewing. Some point to shifts from one stage of sleep to another — more than 80% of grinding episodes occur in lighter stages of sleep and only 5% to 10% during the deeper Rapid-Eye-Movement (REM) stage. It also seems prevalent in children who snore or have other symptoms of sleep apnea.

One primary concern is how the behavior can affect teeth, particularly through abnormal wear. The teeth, of course, make hundreds of contacts with each other every day during eating, speaking or jaw movement. If, however, the forces generated during these contacts chronically exceed normal parameters, as with bruxism, it can cause accelerated tooth wear. This can result in a higher susceptibility to tooth decay and appearance changes later in life.

If your child is exhibiting problems associated with teeth grinding, there are ways to address it. We may recommend a thin, plastic mouthguard they wear while sleeping that prevents the teeth from making solid contact with each other. We may also refer you to an ear, nose and throat specialist if we suspect signs of sleep apnea. And, children under severe psychological stress, which can also trigger teeth grinding, could benefit from behavioral therapy.

The good news is most grinding habits fade as children enter their teens. In the meantime, keep a watchful eye and see us if you notice any indications this common habit is affecting their health and well-being.

If you would like more information on teeth grinding habits, 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 “When Children Grind Their Teeth.”

By Pappas Family Dentistry
July 12, 2018
Category: Dental Procedures
Tags: x-rays  
TheSimpleBitewingX-RayisaGameChangerforMaintainingDentalHealth

X-rays are such a routine part of dental care that it's easy to overlook how much this technology has revolutionized detecting and treating tooth decay. It's safe to say x-rays have helped save hundreds of millions of teeth over the last hundred years.

Thanks to its unique properties these invisible electro-magnetic waves give us precise images of the interior structure of teeth and gums. It's so precise that we can clearly detect even a small spot of softened, decayed tooth structure on an exposed x-ray film, often before it becomes visible to the naked eye. As a result, we can begin treating the decay earlier, minimizing the damage and increasing the chances for preserving the tooth.

There are a variety of ways we can utilize x-ray technology in diagnosing dental problems. The one, though, that's used the most is called the bitewing. The name comes from wing-like tabs extending out from a thin frame holding a segment of unexposed film. A technician places the frame inside the patient's mouth with the film on the tongue side of the teeth, and has them bite down on the tabs to hold the frame still. They then aim a camera at the patient's outer cheek, which then emits a very short burst of x-ray energy to expose the film.

Bitewings are popular because they give a full view of the back and side teeth, where decay is often hard to detect, with very little radiation exposure to the patient. And as x-ray technology has progressed over the years with digital processing and more efficient equipment, we can acquire sharper images with even less exposure. We've also developed standard protocols for when and how often we perform x-rays, so that we're getting the most diagnostic benefit for the least amount of exposure time.

Those few minutes getting an x-ray may seem routine, but the benefits to your dental health are truly amazing. The bitewing and other forms of x-rays play a huge role in helping us keep your teeth as healthy as they possibly can.

If you would like more information on x-ray diagnostics, 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 “Bitewing X-Rays.”

By Pappas Family Dentistry
July 01, 2018
Category: Oral Health
JamieFoxxChipsaTooth-ThisTimebyAccident

Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.

“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…

For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.

When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.

A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.

But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.

Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!

If you have questions about repairing chipped teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”

By Pappas Family Dentistry
June 21, 2018
Category: Dental Procedures
Tags: dentures  
QuizTestYourKnowledgeonDentures

Since as many as 26 percent of older U.S. adults have lost all their teeth, there are a large number Americans who wear full removable dentures, also known as false teeth. You may be one of them.

How much do you know about dentures? See if you can answer the following questions connected with lost teeth and dentures.

  1. Which word refers to the loss of all permanent teeth?
    1. Atrophy
    2. Prosthetic
    3. Edentulism
    4. Periodontal
  2. What is the name given to the bone that surrounds, supports, and connects to your teeth?
    1. Periodontal
    2. Metacarpal
    3. Tibia
    4. Alveolar
  3. What tissue attaches the teeth to the bone that supports your teeth?
    1. Periodontal Ligament
    2. Periodontal Muscle
    3. Parietal Ligament
    4. Achilles Tendon
  4. When a person loses teeth, the stimulus that keeps the underlying bone healthy is also lost, and the bone resorbs or melts away. Pressure transmitted by dentures through the gums to the bone can accentuate this process, which is called
    1. Dystrophy
    2. Atrophy
    3. Hypertrophy
    4. None of the above
  5. A device that replaces a missing body part such as an arm or leg, eye, tooth or teeth is referred to as
    1. Robotic
    2. Imaginary
    3. Exotic
    4. Prosthetic
  6. When teeth have to be extracted, bone loss can be minimized by bone grafting. Bone grafting materials are usually a sterile powdered form of
    1. Allograft (human tissue)
    2. Xenograft (animal tissue)
    3. Both
    4. Neither
  7. Wearers of full dentures must re-learn to manipulate the jaw joints, ligaments, nerves, and muscles to work differently in order to speak, bite, and chew. The name for this system of interconnected body mechanisms, originating with the root words for “mouth” and “jaw,” is
    1. Boca biting
    2. Stomatognathic
    3. Periodontal
    4. None of the above
  8. A type of plastic that is artistically formed and colored to make prosthetic teeth and gums look natural is called
    1. methyl methacrylate
    2. beta barbital
    3. rayon
    4. polystyrene
  9. Success in denture wearing depends on
    1. The skill of the dentist
    2. The talent of the laboratory technician
    3. The willing collaboration of the patient
    4. All of the above

Answers: 1c, 2d, 3a, 4b, 5d, 6c, 7b, 8a, 9d. How well did you do? If you have additional questions about full removable dentures, don’t hesitate to ask us.

Contact us today to schedule an appointment or to discuss your questions about dentures. You can also learn more by reading the Dear Doctor article, “Removable Full Dentures.”

By Pappas Family Dentistry
June 11, 2018
Category: Dental Procedures
TeensMayNeedaTemporaryReplacementforMissingTeeth

Tooth replacement at any age is a challenge, but especially for teenagers. Dental implants in particular may not be possible yet for teens or young adults whose jaws are still developing. Because it’s imbedded directly into bone, the implant will not move with the jaw as jaw growth occurs, making it look potentially unattractive.

The best solution could be a temporary replacement until their jaw reaches maturity. One such option is a removable partial denture (RPD), an artificial tooth set in an acrylic base that resembles gum tissue. Although we associate dentures with older adults, an RPD works well for teens as a temporary measure. Perhaps the best version for a younger person utilizes metal clips that fit over adjacent teeth and hold the RPD in place. Although quite resilient, the wearer needs to be careful when biting into something hard (like an apple or similar firm fruit) or the artificial tooth may break off.

Another option, a bonded bridge, is a fixed solution similar to a traditional bridge. Whereas a traditional bridge is supported by crowns affixed to the teeth on either side of the empty socket (and requiring extensive alteration of the teeth to accommodate them), a bonded bridge attaches to the supporting teeth with wing-like projections of dental material that attaches to the backs of the adjacent teeth, hidden from view. Although not as secure as a traditional bridge, they can conceivably endure until the teen’s jaw structure is ready for an implant or other permanent solution.

Choosing between an RPD and a bonded bridge will depend on a number of factors, including the teen’s individual bite, clenching or biting habits and the health and strength of supporting bone and gums. Regardless of the type of solution chosen, it’s important to maintain good oral hygiene, especially around a bridge. If bacterial plaque is allowed to build up on tooth surfaces, it could result in an infection that can damage both gums and bone, and reduce the chances of a successful implant in the future.

All these and other considerations should be discussed after a thorough examination. From there, we can advise you on the best course of action to restore both appearance and function until it’s time for a permanent restoration.

If you would like more information on temporary tooth replacements for teens, please contact us or schedule an appointment for a consultation.





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