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Posts for category: Oral Health

HerbalRemedyHelpsAlleviatePainandSwellingAfterDentalProcedures

Alternative medicines — also known as herbal or homeopathic remedies — have grown in popularity in recent decades. Because they don’t think of these remedies as “medicines,” many people will try them based on their friends’ advice or an internet search — with or without a doctor’s advice. Any herbal remedy, though, should be viewed as a real drug with real, and often significant, side-effects.

With that said, many of these alternative treatments are safe and effective if taken in an appropriate manner. Arnica Montana, a member of the daisy family, is a good example: various preparations of this herb have been found to reduce pain and inflammation caused by sprains or bruising, as well as control infection by killing bacteria. It’s also one herbal application that’s finding a home in the field of dentistry.

You can find many products containing Arnica, particularly topical applications made from the herb’s roots and dried flowers. It’s common to find Arnica in tinctures (the herb mixed in with a gel), tea infusions and a variety of ointments; the best-selling topical product is a gel containing 8% of the Arnica herb.

Many dentists are now prescribing Arnica to patients following invasive procedures like gum surgery, root canal treatment, implant surgery or wisdom teeth extraction to help reduce swelling and bruising. In this case, topical applications won’t work: directly applying a topical treatment to open mouth wounds can cause mucositis (an irritation of the lining of the mouth) and reactions in people with allergies to plants related to daisies. Dentists prescribe a programmed capsule regimen taken orally for four days after the procedure. This has been shown to lessen the length and degree of recovery time.

Any medicine, whether traditional or non-traditional, can have unintended consequences. Know the facts about what you’re taking, and be sure you consult with your doctor or dentist before trying any herbal remedy.

If you would like more information on Arnica Montana and similar remedies, 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 “Herbal and Homeopathic Remedies.”

UltrasonicScalerscanEffectivelyCleanMostPatientsGumTissues

While you may most associate professional dental cleanings with that “squeaky” clean feeling you have afterward, there is a much higher goal. What is also referred to as “non-surgical periodontal therapy,” these cleanings seek to remove bacterial plaque and tartar (hard deposits) not only from the visible portions of the tooth but also the root surfaces (scaling), so as to reduce the risk and occurrence of periodontal gum disease.

For generations, this was primarily achieved by dental hygienists using hand-held instruments specially designed to manually remove plaque from tooth surfaces. Since the 1950s, though, a new technology known as ultrasonic or power scaling has become more prevalent in use. Initially only used in the outer most portions of the gum tissue (the supra-gingival area) power scaling is increasingly employed to clean the sub-gingival area, much closer to the tooth roots. As this technology has developed, it’s been shown to be just as effective, if not superior in some cases, to manual scaling for removing plaque and tartar.

Ultrasonic or power scalers work by emitting high vibration energy that crushes and removes plaque and calculus (tartar). The resulting shockwaves also tend to disrupt bacterial cell function. The hygienist uses water to flush away the dislodged calculus. They have a number of advantages over manual scaling: they’re quite effective on deep gum pockets, especially when specially designed tips are used; they require less time than manual scaling; and when used correctly power scalers are gentler to tooth structures.

However, they do have a few drawbacks. Because they produce an aerosol effect, power scalers can project contaminants from the patient’s mouth into the atmosphere, requiring special protective equipment for the hygienist. They’re not recommended for patients with hypersensitive teeth, especially regarding temperature change, or for teeth with areas of de-mineralization (the loss of mineral content in the enamel). Care should be taken when they’re used with implants or porcelain or composite crowns — specially designed tips are necessary to avoid scratching the restoration. They may also have an effect on cardiac pacemakers.

In the end, the best approach is a combination of both power and manual scaling techniques. Depending on your individual needs, ultrasonic scaling can do an effective job in removing plaque and tartar and help you avoid gum disease.

If you would like more information on ultrasonic cleaning techniques, 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 Cleanings Using Ultrasonic Scalers.”

By Drake Tollefson DDS
April 01, 2014
Category: Oral Health
Tags: gummy smile  
TreatingaGummySmileDependsonitsCause

Something about your smile isn’t quite right. It’s too “gummy” — too much of the upper gum line is visible and it looks out of proportion to your teeth and lips. Most dentists identify a smile as too gummy if four millimeters or more (approximately an eighth of an inch) of the gum tissue is visible at a full smile.

Fortunately, there are ways to minimize this effect. It’s important, though, to first determine the true cause before we embark on any treatment plan.

Your teeth may be the actual cause. As we mature, teeth “erupt” through the gums and the supporting bone and appear in the mouth. They continue to erupt until meeting their “antagonists,” the opposing teeth from the opposite jaw. In addition, the gums go to the proper position where the root meets the enamel of the teeth around late adolescence. The normal result is a length of the crown (the visible portion of the tooth) of approximately 10 mm.

If the teeth don’t erupt fully or the gums don’t go to their proper position, the teeth appear shorter and the gums more prominent. Using a surgical technique called crown lengthening, we remove excess gum tissue and, if necessary, reshape the underlying bone to reveal the proper amount of tooth length. Teeth also shorten due to excessive wear; the teeth continue to erupt to compensate for the wear that occurs over time. The attached gum tissue follows with the tooth. This can be corrected with orthodontic treatment (for bite correction) and porcelain veneers.

Two more causes of a gummy smile are when a person has a hyper-mobile upper lip — the upper lip can raise too much lift when smiling — and an upper jaw length that appears too long for the face. If lips rise higher than the normal 6-8 mm when we smile, too much of the gum line appears. This can be treated temporarily with Botox injections to reduce the mobility of the muscles, or there is a surgical procedure that reduces the mobility of the upper lip. For an elongated upper jaw, orthognathic (“to straighten the jaw”) surgery relocates the jaw to a more upward position that diminishes the amount of gum tissue that shows during smiling.

Treatments for a gummy smile range from simple techniques to more complex surgical procedures. Only a thorough dental exam will reveal the best treatment path to follow.

If you would like more information on treatments for “gummy” smiles, 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 “Gummy Smiles.”

By Drake Tollefson DDS
March 24, 2014
Category: Oral Health
Tags: oral health   oral hygiene  
TLCforYourToothbrush

Your toothbrush serves the invaluable purpose of minimizing bacterial buildup (plaque) that can irritate gums and lead to periodontal disease, infection of the bone and tissues supporting your teeth. Brushing also helps dislodge food particles that certain oral bacteria would otherwise feed on, producing acids in the process that can eat through protective tooth enamel and the vulnerable dentin below. Given its importance to your oral health, you can maximize your toothbrush’s effectiveness by using and storing it properly, and replacing it (or the brush head if you have a powered model) regularly.

Using and Storing Your Brush
All that’s needed to dislodge plaque from oral surfaces is a relaxed grip and a gentle jiggling motion. Too much pressure can wear away tooth enamel, cause gum tissue to recede, and shorten the life of your brush head.

When you’re done using your brush:

  1. Thoroughly rinse it to remove any remaining tooth paste, food particles, etc.
  2. If you’re super-vigilant, you also can disinfect your brush by soaking it in mouthwash, brush-sanitizing rinse, or a half water/half hydrogen peroxide solution, or dipping it in boiling water for 5 to 10 seconds.
  3. Air dry in an upright position and do not routinely cover your toothbrush or store it in a closed container. A dark, moist environment is more conducive to the growth of microorganisms.

Replacing and Recycling Your Toothbrush
Even with the best of care, toothbrush bristles become frayed and worn and their cleaning effectiveness diminishes after 3 or 4 months, according to the American Dental Association, though it could be sooner depending on factors unique to each patient. Besides checking the bristles regularly, a good way of keeping track is to write the date you start using your toothbrush in permanent pen on a big-enough spot on the handle (or doing it on masking tape applied to the base of a power brush).

Once your brush has passed its useful life for oral hygiene, you can still get plenty of mileage out of it. You’ll find plenty of ideas on the internet for cleaning grout between tiles and grime-filled spots around taps and toilet lid hinges; removing mud from boot treads; scrubbing off corrosion from around car battery terminals and more!

If you would like more information about oral hygiene, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Toothbrush Lifespan” and “Manual vs Powered Toothbrushes.”

ToothPainDuringPressureChangesCouldBeWarningofaBiggerProblem

People who fly or scuba dive know firsthand how changes in atmospheric pressure can affect the body: as minor as a popping in the ears, or as life-threatening as decompression sickness. Pressure changes can also cause pain and discomfort in your teeth and sinuses — in fact, severe pain could be a sign of a bigger problem.

Barotrauma (baro – “pressure;” trauma – “injury”), also known as a “squeeze,” occurs when the unequal air pressures outside and inside the body attempt to equalize. Many of the body's organs and structures are filled with air within rigid walls; the force created by equalization presses against these walls and associated nerves, which in turn causes the pain.

The sinus cavities and the middle ear spaces are especially sensitive. Each of these has small openings that help with pressure equalization. However, they can become swollen or blocked with mucous (as when you have a head cold), which slows equalization and contributes to the pain.

It's also possible to experience tooth pain during pressure change. This is because the back teeth in the upper jaw share the same nerve pathways as the upper jaw sinuses — pain originating from the sinuses can be felt in the teeth, and vice-versa. In fact, it's because of this shared pathway that pressure changes can amplify pain from a tooth with a deeper problem, such as a crack, fracture or a defect in dental work.

Besides problems with your teeth, the severe pain could also be related to temporo-mandibular joint dysfunction (TMD), which is pain or discomfort in the small joint that connects your lower jaw to your skull. There are a number of causes for this, but a common one for scuba divers is an ill-fitted regulator mouthpiece that they are biting down on too hard while diving. A custom-fitted mouthpiece could help alleviate the problem.

If you've been experiencing tooth pain during pressure change events, you should see us for an examination before you fly or dive again. There might be more to your pain — and correcting these underlying problems could save you extreme discomfort in the future.

If you would like more information on the effects of atmospheric pressure changes on teeth, 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 “Pressure Changes Can Cause Tooth & Sinus Pain.”