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.”
The journey to a straighter smile with braces can be difficult. One of the biggest dangers you'll face is an increased risk of periodontal (gum) disease.
Gum disease is caused by dental plaque, a thin film of bacteria and food particles on tooth surfaces. To curtail plaque growth, you must brush and floss daily and visit your dentist regularly for more thorough cleanings. If you don't, accumulated plaque can trigger an infection with potentially disastrous consequences for your dental health.
But wearing braces can make you more vulnerable to gum disease. The braces and wires can get in the way of brushing and flossing. To add to the difficulty, the gums often react to being in close proximity to braces, causing their tissues to swell or overgrow. And if the patient is a teenager, the normal hormonal surge that occurs during these years could compound this vulnerability even more.
To prevent an infection, you'll need to practice extra diligence cleaning your teeth with brushing and flossing. It takes more time and effort, but it's worth it to lower your disease risk. To help even more, consider using tools like specialized brushes that can maneuver better around hardware and floss threaders that can get floss under wires. You might also consider a water flosser, which uses pressurized water to remove plaque between teeth.
In addition to your orthodontic visits, you should also maintain your regular cleaning schedule with your family dentist—or more often if they recommend. Besides cleaning, your dentist also monitors for signs of developing gum disease. They can also prescribe mouthrinses for controlling bacterial growth.
Even with diligent hygiene, your gums may still adversely react to the braces. This may not be a problem if your gum tissues don't appear to be detaching from the teeth. But your dentist or orthodontist may recommend you see a periodontist (a gum specialist) to help monitor that aspect of your care. In extreme cases, it may be necessary to remove the braces and allow the gums to heal.
Keeping your teeth clean and your mouth disease-free is no easy task while wearing braces. But it can be done—and with your dentist's help, you can achieve a straighter and healthier smile.
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.”
Years ago, disease or trauma robbed you of one of your teeth. At the time you might have opted for an affordable solution, like a partial denture. But now you'd like to restore that missing tooth with a dental implant, the most life-like tooth replacement available.
That's a great decision. But there may be a hiccup along the way to your new implant: the state of the underlying jawbone. Implants need a certain amount of bone for proper placement. If not enough is present, that may cause an interruption in your plans—and that could be a real possibility if your tooth has been missing for some time.
That's because, like other living tissues, bone has a growth cycle: Old bone cells die and dissolve, while new cells form to take their place. In the jaw, the force produced by teeth during chewing helps to keep this growth process in the bone functioning at a healthy pace.
When a tooth goes missing, though, so does this chewing stimulation. A lack of stimulation can slow the growth rate for that part of the bone and its volume can diminish over time. It's possible for a quarter of the bone volume to be lost within the first year after losing a tooth.
If you've experienced that level of bone loss, we may not be able to place an implant—yet. You might still have a few options. For one, we could attempt to regenerate some of the bone through grafting. Bone material grafted into the affected area can serve as a scaffold for new bone cells to form and adhere. Over time, this could result in a sufficient amount of regenerated bone to support a dental implant.
Another possibility might be to install a smaller diameter implant like those used to support removable dentures. Because they're smaller they require less bone than standard-sized implants. They're not for every situation, though, and are best suited for situations where aesthetics isn't a priority.
To know what your options are regarding an implant-based restoration, you'll need to undergo a thorough evaluation of your oral health, including supporting bone. Depending on your situation, you may still be able to renew your smile with this premier tooth replacement option.
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 After Previous Tooth Loss.”
Compared to other dental restorations—a few of which have been around for over a century—implants are a relatively recent development. But even though it's just now entering its fourth decade, recent advances have catapulted implant therapy well beyond where it began.
That's due mainly to digital technology. Two examples of this, computed tomography (CT) and 3-D printing, are increasing the accuracy and efficiency of implant placement.
Properly placing an implant is one of the most important elements in achieving a natural and attractive result. But finding the best location is often difficult due to a lack of suitable bone volume, the patient's bite or the proximity of anatomical structures like nerves and blood vessels. CT imaging, especially Cone Beam CT scanners (CBCT), is helping to make implant placement planning easier.
Unlike the static, two-dimensional views of standard x-rays, CBCT takes hundreds of images and digitally blends them together to create a virtual 3-D model of the patient's jaw and face. Dentists can view this highly detailed model on a computer monitor from various vantage points and better identify possible obstructions. With better information about what "lies beneath," they can more accurately pinpoint the best implant site.
Creating the ideal plan is one thing—successfully implementing it is another. Dentists often create a surgical guide that helps them drill in precisely the right positions during surgery. The guide, which resembles a mouthguard, fits over the gums and contains marker locations for drilling.
Many dentists are now using 3-D printing to create these surgical guides. A 3-D printer turns a digital model of the guide based on measurements of the patient's mouth and proposed implant locations into an actual physical object "printed out" layer by layer of special polymer material. The end product can be more precise than guides created by other means.
These and other technological developments are helping implant therapy rise to a new level of success. With the resulting increase in accuracy, efficiency and less treatment time, tomorrow's implant patients will be the ultimate beneficiaries.
If you would like more information on restoring missing teeth with 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 “How Technology Aids Dental Implant Therapy.”
While the sport of golf may not look too dangerous from the sidelines, players know it can sometimes lead to mishaps. There are accidents involving golf carts and clubs, painful muscle and back injuries, and even the threat of lightning strikes on the greens. Yet it wasn’t any of these things that caused professional golfer Danielle Kang’s broken tooth on the opening day of the LPGA Singapore tournament.
“I was eating and it broke,” explained Kang. “My dentist told me, I've chipped another one before, and he said, you don't break it at that moment. It's been broken and it just chips off.” Fortunately, the winner of the 2017 Women’s PGA championship got immediate dental treatment, and went right back on the course to play a solid round, shooting 68.
Kang’s unlucky “chip shot” is far from a rare occurrence. In fact, chipped, fractured and broken teeth are among the most common dental injuries. The cause can be crunching too hard on a piece of ice or hard candy, a sudden accident or a blow to the face, or a tooth that’s weakened by decay or repetitive stress from a habit like nail biting. Feeling a broken tooth in your mouth can cause surprise and worry—but luckily, dentists have many ways of restoring the tooth’s appearance and function.
Exactly how a broken tooth is treated depends on how much of its structure is missing, and whether the soft tissue deep inside of it has been compromised. When a fracture exposes the tooth’s soft pulp it can easily become infected, which may lead to serious problems. In this situation, a root canal or extraction will likely be needed. This involves carefully removing the infected pulp tissue and disinfecting and sealing the “canals” (hollow spaces inside the tooth) to prevent further infection. The tooth can then be restored, often with a crown (cap) to replace the entire visible part. A timely root canal procedure can often save a tooth that would otherwise need to be extracted (removed).
For less serious chips, dental veneers may be an option. Made of durable and lifelike porcelain, veneers are translucent shells that go over the front surfaces of teeth. They can cover minor to moderate chips and cracks, and even correct size and spacing irregularities and discoloration. Veneers can be custom-made in a dental laboratory from a model of your teeth, and are cemented to teeth for a long-lasting and natural-looking restoration.
Minor chips can often be remedied via dental bonding. Here, layers of tooth-colored resin are applied to the surfaces being restored. The resin is shaped to fill in the missing structure and hardened by a special light. While not as long-lasting as other restoration methods, bonding is a relatively simple and inexpensive technique that can often be completed in just one office visit.
If you have questions about restoring chipped teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Porcelain Veneers” and “Artistic Repair of Chipped Teeth With Composite Resin.”
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