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Posts for category: Dental Procedures

SomeBiteProblemsMayRequiretheHelpofOtherToolsinConjunctionWithBraces

If you're into social media, you might have run across the idea that there's nothing to straightening your teeth. According to some SM influencers, you can even do it yourself with a few rubber bands. But the truth is, the mechanics of moving teeth are much more complex—and taking orthodontics into your own hands can cause extensive dental damage.

In reality, all bite problems (malocclusions) require the advanced knowledge and expertise of an orthodontist to correct them safely and effectively. Some, in fact, may require other devices along with braces or clear aligners to achieve the desired outcome for a particular malocclusion.

Here are a few of those additional tools an orthodontist may use and why they may be needed.

Headgear. Some malocclusions result not just from misaligned teeth, but problems with jaw or facial structure development. To accommodate additional factors like this, an orthodontist may include headgear during treatment, usually a strap running around the back of a patient's head or neck and attached in the front to brackets bonded to the teeth (usually the molars). Wearing this headgear for several hours a day can improve jaw and facial development.

Elastics. Unlike basic rubber bands DIYers might use to move their teeth (often with damaging results), elastics are specialized bands designed for targeted tooth movement. They're needed for bite problems that require moving some teeth and not moving others. As such, elastics can be applied in conjunction with braces to perform either intended task—move or prevent movement for specific teeth.

Anchorage. One of the tools often used with elastics for targeted tooth movement are temporary anchorage devices (TADs). These are typically tiny screws imbedded into the jawbone a short distance from fixed braces. An elastic band connected to the braces at a specific point is then attached to the TAD, which serves as an anchor point for the elastic.

These and other devices can help orthodontists achieve a successful correction for certain individual bite problems. And unlike the DIY methods touted on the Internet, these additional tools help them do it safely.

If you would like more information on straightening teeth through orthodontics, 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 “Orthodontic Headgear & Other Anchorage Appliances.”

PorcelainVeneersTransformRealHousewivesStarsSmileSpoiledbyTeethGrinding

Dorit Kemsley isn't shy. Best known to fans as an outspoken and sometimes outrageous cast member of the reality show Real Housewives of Beverly Hills, Kemsley is never reticent about “mixing it up” with fellow castmates or their significant others. Recently, though, she confessed to something that left her less than confident: her smile.

Kemsley has been self-conscious about her smile because her teeth looked noticeably short, worn down from an unconscious habit of grinding her teeth. Although teeth grinding is more common among children (who normally grow out of it by adolescence), it can persist into adulthood, usually from difficulties managing high stress (a likely component in the fashion designer/reality show star's busy life).

Stress-induced teeth grinding can occur during waking hours or, more likely, during deep sleep. The accumulating, long-term effects from the habit can lead not only to worn teeth but to weakened gum support, a high risk of tooth fracture or jaw pain and dysfunction.

So, how do you know if you grind your teeth, especially if it's only happening at night? Typical signs include sore jaws after awaking from sleep, increased tooth pain or sensitivity or, like Kemsley, a noticeable difference in your tooth length. Your family or sleeping partner may also complain about the “skin-crawling” noise you make during the night.

There are ways to lessen the effects of teeth grinding. The first step is to have us verify the underlying cause for the habit. If it's tension from stress, then you might reduce the habit's occurrences by learning better stress management or relaxation techniques through individual counseling, group support or biofeedback therapy. We can also fit you with a mouth guard to wear at night or through the day that reduces the force generated during teeth grinding.

And if you've already experienced accelerated tooth wear like Kemsley with a resultant “small teeth” smile, you might pursue the same solution as the RHOBH star: dental veneers. These thin, life-like wafers of porcelain are custom-made to mask imperfections like chips, staining, slight tooth gaps and, yes, worn teeth.

Veneers are often less expensive and invasive than other cosmetic techniques, yet they can have a transformative effect, as Kemsley's Instagram followers have seen. In conjunction with other dental treatments needed to repair any underlying damage caused by a grinding habit, veneers are an effective fix for the smile you present to the world.

If you suspect you may have a grinding habit, see us for a complete examination. From there, we'll help you protect your teeth and your smile.

If you would like more information on teeth grinding habits and their effects, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Teeth Grinding.”

By Todd G. Yoshino DDS
January 11, 2021
Category: Dental Procedures
Tags: dental implant  
TwoMajorCausesforImplantFailureandHowYouCanPreventThem

Dental implants are a reliable way to replace teeth. More than 95% of implants survive ten years after their installation, and many of these could conceivably continue for decades.

But that still leaves a tiny few that don't reach the ten-year mark. Some fail early because the implant didn't integrate fully with the bone to create a durable hold. But others fail later—usually for one of two major causes.

Some failures occur due to over-stressing of the implant from abnormally high biting forces, usually because of teeth grinding. People who have this involuntary habit generate excessive force as they grind their teeth, which can damage implants (as well as natural teeth). To reduce this force, a patient's dentist can fit them with a biteguard they wear in the mouth to prevent teeth from making solid contact with each other during a grinding episode.

Fortunately, teeth grinding isn't that prevalent among adults—but that can't be said about the other major cause for implant failure: periodontal (gum) disease. This is a bacterial infection caused by dental plaque, a thin, bacterial film that accumulates on teeth. The implant itself isn't affected by the infection, but the gums and underlying bone supporting the implant can be.

Implants are most in peril from a form of gum disease called Peri-implantitis, which spreads deeper into the gum tissues around implants faster than infections around natural teeth. That's because implants lack the gum attachment of real teeth, which supply a collagen barrier that slows the spread of infection. Peri-implantitis can quickly infect the supporting bone and eventually weaken its connection with the implant.

Because of its aggressiveness and speed, we must diagnose and treat peri-implantitis as soon as possible to limit any damage to the support structures around an implant. If you notice any swollen, reddened or bleeding gums, you should call your dentist as soon as possible for an examination.

And in light of this potential danger to your implants, you should also strive to prevent gum disease through daily oral hygiene. Brushing and flossing your teeth, including around your implants, removes harmful plaque buildup. This daily habit and regular dental cleanings will help you avoid a costly gum infection and ensure your implants are there for years to come.

If you would like more information on dental implants, 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 “Dental Implants: A Tooth-Replacement Method That Rarely Fails.”

By Todd G. Yoshino DDS
October 30, 2020
Category: Dental Procedures
Tags: celebrity smiles  
JimmyFallonsDaughterLosesaToothonNationalTelevision

Even though coronavirus lockdowns have prevented TV hosts from taping live shows, they're still giving us something to watch via virtual interviews. In the process, we're given occasional glimpses into their home life. During a Tonight Show interview with Seahawks quarterback Russell Wilson and his wife, R & B performer Ciara, Jimmy Fallon's daughter Winnie interrupted with breaking news: She had just lost a tooth.

It was an exciting and endearing moment, as well as good television. But with 70 million American kids under 18, each with about 20 primary teeth to lose, it's not an uncommon experience. Nevertheless, it's still good to be prepared if your six-year-old is on the verge of losing that first tooth.

Primary teeth may be smaller than their successors, but they're not inconsequential. Besides providing young children with the means to chew solid food and develop speech skills, primary teeth also serve as placeholders for the corresponding permanent teeth as they develop deep in the gums. That's why it's optimal for baby teeth to remain intact until they're ready to come out.

When that time comes, the tooth's roots will begin to dissolve and the tooth will gradually loosen in the socket. Looseness, though, doesn't automatically signal a baby tooth's imminent end. But come out it will, so be patient.

Then again, if your child, dreaming of a few coins from the tooth fairy, is antsy to move things along, you might feel tempted to use some old folk method for dispatching the tooth—like attaching the tooth to a door handle with string and slamming the door, or maybe using a pair of pliers (yikes!). One young fellow in an online video tied his tooth to a football with a string and let it fly with a forward pass.

Here's some advice from your dentist: Don't. Trying to pull a tooth whose root hasn't sufficiently dissolved could damage your child's gum tissues and increase the risk of infection. It could also cause needless pain.

Left alone, the tooth will normally fall out on its own. If you think, though, that it's truly on the verge (meaning it moves quite freely in the socket), you can pinch the tooth between your thumb and middle finger with a clean tissue and give it a gentle tug. If it's ready, it should pop out. If it doesn't, leave it be for another day or two before trying again.

Your child losing a tooth is an exciting moment, even if it isn't being broadcast on national television. It will be more enjoyable for everyone if you let that moment come naturally.

If you would like more information on the importance and care of primary teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Importance of Baby Teeth.”

By Todd G. Yoshino DDS
October 10, 2020
Category: Dental Procedures
Tags: dental implant  
CouldaMetalAllergyStopYouFromGettingDentalImplants

The subject of allergies covers a wide swath in medicine. Among other things, people have allergic reactions to animal fur, various foods and plant pollen. The effects are equally wide-ranging, anything from a mild rash to anaphylaxis, a life-threatening shutdown of the body's vital systems.

Approximately 5% of people are also allergic to various metals including nickel, cobalt, chromium and gold. Reactions to metal can occur when an allergic person comes in contact with items like jewelry, clothing or even mobile phones. There's even a chance of a metal allergy reaction from certain kinds of dental work.

It's unlikely, though, that you should be concerned if you're considering dental treatment or cosmetic work to upgrade your smile. Although allergic reactions like inflammation or a rash have been known to occur with amalgam “silver” fillings, it's quite rare. It's even less of a concern since “tooth-colored” materials for fillings are now outpacing the use of amalgam fillings, which are used in out-of-sight back teeth.

Of course, metal is used for other dental treatments besides fillings, including the most popular of tooth replacement systems, dental implants. An implant is essentially a metal post, usually made of pure titanium or a titanium alloy, which is imbedded into the jawbone. Even so, there's little chance you'll develop an allergic reaction to them.

For one thing, titanium is highly prized in both medical and dental treatments because of its biocompatibility. This means titanium devices like prosthetic joints and implants won't normally disrupt or cause reactions with human tissue. Titanium is also osteophilic: Bone cells readily grow and adhere to titanium surfaces, a major reason for dental implants' long-term durability.

That's not to say titanium allergies don't exist, but their occurrence is very low. One recent study detected a titanium allergy in only 0.6% of 1,500 implant patients who participated.

At worst, you may need to consider a different type of tooth replacement restoration in the rare chance you have a titanium allergy. More than likely, though, you'll be able obtain implants and enjoy the transformation they can bring to your smile.

If you would like more information on allergic reactions and dental restorations, 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 “Metal Allergies to Dental Implants.”