My Blog
By Barbara Preussner, DMD
July 15, 2019
Category: Oral Health
Tags: tmj disorders  
DoaLittleExtraFoodPreptoEaseTMDDiscomfort

Because it requires jaw movement, eating can be difficult and painful if you have a temporomandibular joint disorder (TMD). During flareups you may switch to foods that are easier to eat but may be less nutritious than those you're giving up.

But there are ways to keep healthier foods in your diet while minimizing TMD discomfort. In many cases, it's a matter of preparing your food differently. Here are a variety of food groups known for their nutritional value and what you can do to prepare them for easier eating with TMD.

Fruits and Vegetables. You should peel any fruits or vegetables with hard or chewy skin like apples, peaches or cucumbers. Try chopping or pureeing fruits and vegetables you can eat raw to reduce their size and make them easier to chew. Vegetables like carrots, potatoes, broccoli or cauliflower can be cooked, then chopped or mashed.

Legumes and nuts. Pod-based vegetables like beans or peas provide a number of nutritional elements, as do nuts with their healthy fats. Your motto with these foods should be "Not too large and not too hard." Be sure then to cook, mash or puree legumes that are larger than a pea. With nuts, try nut butters for a softer serving than eating them out of the shell.

Protein and Dairy. Any meats like poultry or beef should be cut into bite-sized pieces; you can also moisten them with broths, gravies or sauces for easier chewing, or braise or stew them in liquid to tenderize them. You can also consume most milk, yogurt or cheese products you can tolerate. If you can't, try alternatives like meal replacement or whey protein beverages.

Grains. Prepare grains by cooking them until they're softened. Hot cereals like oatmeal offer a lot of nutrition and they're relatively easy to eat. Toast your bread and cut the slice into smaller pieces to minimize jaw movement.

One last tip: take your time while eating. A slower rate not only helps you enjoy your food more, it reduces the amount of work your jaws perform while eating. Less jaw work can help further ease the discomfort of TMD.

If you would like more information on how to relieve TMD pain and dysfunction, 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 “What to Eat When TMJ Pain Flares Up.”

By Barbara Preussner, DMD
July 05, 2019
Category: Dental Procedures
DentalMagicTransformsSmiles

Magician Michel Grandinetti can levitate a 500-pound motorcycle, melt into a 7-foot-tall wall of solid steel, and make borrowed rings vanish and reappear baked inside bread. Yet the master illusionist admits to being in awe of the magic that dentists perform when it comes to transforming smiles. In fact, he told an interviewer that it’s “way more important magic than walking through a steel wall because you’re affecting people’s health… people’s confidence, and you’re really allowing people to… feel good about themselves.”

Michael speaks from experience. As a teenager, his own smile was enhanced through orthodontic treatment. Considering the career path he chose for himself — performing for multitudes both live and on TV — he calls wearing an orthodontic device (braces) to align his crooked teeth “life-changing.” He relies on his welcoming, slightly mischievous smile to welcome audiences and make the initial human connection.

A beautiful smile is definitely an asset regardless of whether you’re performing for thousands, passing another individual on a sidewalk or even, research suggests, interviewing for a job. Like Michael, however, some of us need a little help creating ours. If something about your teeth or gums is making you self-conscious and preventing you from smiling as broadly as you could be, we have plenty of solutions up our sleeve. Some of the most popular include:

  • Tooth Whitening. Professional whitening in the dental office achieves faster results than doing it yourself at home, but either approach can noticeably brighten your smile.
  • Bonding. A tooth-colored composite resin can be bonded to a tooth to replace missing tooth structure, such a chip.
  • Veneers. This is a hard, thin shell of tooth-colored material bonded to the front surface of a tooth to change its color, shape, size and/or length; mask dental imperfections like stains, cracks, or chips, and compensating for excessive gum tissue.
  • Crowns. Sometimes too much of a tooth is lost due to decay or trauma to support a veneer. Instead, capping it with a natural-looking porcelain crown can achieve the same types of improvements. A crown covers the entire tooth replacing more of its natural structure than a veneer does.

If you would like more information about ways in which you can transform your smile, please contact us or schedule an appointment for a consultation. You can also learn more about the techniques mentioned above by reading the Dear Doctor magazine articles “Teeth Whitening,” “Repairing Chipped Teeth,” and “Porcelain Crowns & Veneers.”

BeontheAlertforWhiteSpotsonTeethWhileWearingBraces

While wearing braces is the path to a healthier and more attractive smile, it can be a difficult journey. One of your biggest challenges will be keeping your teeth clean to avoid a higher risk of tooth decay.

Tooth decay starts with dental plaque, a thin film of bacteria and food particles that accumulates on teeth. Daily brushing and flossing clear this accumulation. But the hardware of braces makes it difficult to access all tooth surfaces, and can even become a haven for plaque.

One sign in particular of tooth decay while wearing braces is the appearance of chalk-like spots on the teeth known as white spot lesions (WSLs). WSLs occur because the minerals in the enamel beneath them have begun to break down in response to decay. The spots can eventually cause both structural and cosmetic problems for a tooth.

The best approach to WSLs is to prevent them from developing in the first place. You'll need to be extra vigilant with daily oral hygiene while wearing braces to reduce plaque buildup. To help with the increased difficulty you might consider using a special toothbrush designed to maneuver more closely around orthodontic hardware. You may also find using a water flosser to be a lot easier than flossing thread.

Preventing tooth decay and WSLs also includes what you eat or drink to reduce the effects of enamel de-mineralization. The bacteria that cause decay thrive on sugar, so limit your intake of sweetened foods and beverages. And to avoid excessive demineralization cut back on acidic foods as well.

If despite your best preventive efforts WSLs still form, we can take steps to minimize any damage. For one, we can give your enamel a boost with fluoride applications or other remineralization substances. We can also inject a tooth-colored resin beneath the surface of a WSL that will make it less noticeable.

With any of these and other treatments, though, the sooner we can treat the WSL the better the outcome. Practicing good hygiene and dietary habits, as well as keeping an eye out for any WSL formations, will do the most to protect your new and improved smile.

If you would like more information on preventing dental disease 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 “White Spots on Teeth During Orthodontic Treatment.”

By Barbara Preussner, DMD
June 15, 2019
Category: Dental Procedures
Tags: loose tooth  
SeeYourDentistASAPtoSaveYourLooseTooth

A loose adult tooth isn't normal. It could be loose because it's been subjected to high biting forces like those that occur with a tooth grinding habit. Or, it could be the result of periodontal (gum) disease or some other infection that has weakened some of the tooth's supporting gums and bone. Whatever the underlying cause, we'll need to act quickly to save your tooth.

Our first step is to find out this exact cause—that will determine what treatment course we need to follow. For a tooth grinding habit, for example, you might need to wear an occlusal guard or have your bite (teeth) adjusted. With gum disease, we'll focus on removing dental plaque, the thin film of bacteria and tartar (calculus) fueling the infection. This stops the infection and minimizes any further damage.

While we're treating the cause, we may also need to secure the loose tooth with splinting. This is a group of techniques used to join loose teeth to more stable neighboring teeth, similar to connecting pickets in a fence. Splinting can be either temporary or permanent.

Temporary splinting usually involves composite materials with or without strips of metal to bond the loose tooth to its neighbors as the periodontal structures heal. Once the tooth's natural attachments return to health, we may then remove the splint.

There are a couple of basic techniques we can use for temporary splinting. One way is to bond the splint material to the enamel across the loose tooth and the teeth chosen to support it (extra-coronal splinting). We can also cut a small channel across all the affected teeth and then insert metal ligatures and bond the splint material within the channel (intra-coronal).

If we're not confident the loose tooth will regain its natural gum attachment, we would then consider a permanent splint. The most prominent method involves crowning the loose tooth and supporting teeth with porcelain crowns. We then fuse the crowns together to create the needed stability for the loose teeth.

Whatever splinting method we use, it's important to always address the root cause for a tooth's looseness. That's why splinting usually accompanies other treatments. Splinting loose teeth will help ensure your overall treatment is successful.

If you would like more information on treating loose 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 “Treatment for Loose Teeth.”

By Barbara Preussner, DMD
June 05, 2019
Category: Dental Procedures
Tags: smoking   dental implant  
SmokingCouldShortenYourImplantsLongevity

Although costly in the beginning, dental implants often turn out to be the least expensive tooth replacement option. That's because their enviable record for longevity often outpaces dentures or bridges. Over the long-term you might spend less for implants than these other restorations.

But even with the high success rate of dental implants (greater than 95% survive the ten-year mark), we can't guarantee they won't fail. And if you're a tobacco smoker, the risk of failure might be even higher. One study, for example, found early implant failures were twice the rate for smokers over non-smokers. Although implant failures overall are low, smoking seems to be a factor in those that do.

There are a number of reasons to account for this. For one thing, inhaled smoke can damage salivary glands, reducing the flow of this important fluid. Saliva helps control bacterial growth and neutralize mouth acid, so without it you're more susceptible to tooth decay or periodontal (gum) disease. Either infection could ultimately weaken implant-supporting bone.

The nicotine in tobacco can also restrict oral blood vessels and lower their ability to supply antibodies and nutrients to the teeth and gums. This slows healing, which could have one particular effect on implant durability.

During the intervening weeks between implant placement and crown attachment, the implant's titanium post attracts bone cells that grow and adhere to its surface. The effects of nicotine on healing, especially right after implant surgery, can interfere with this integration process so that the implant doesn't anchor in the bone as well as it should.

If you're a smoker, you can increase your chances of implant success—and have a healthier mouth overall—by quitting smoking beforehand with the help of a cessation program. Or at the least, consider stopping smoking for one week before implant surgery and for two weeks afterward.

And be sure to brush and floss your teeth daily and visit your dentist regularly to keep your teeth and gums as healthy as possible. Stopping smoking and practicing effective oral hygiene could make a big difference in the success or failure of your implant.

If you would like more information on smoking and your dental health, 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 & Smoking.”





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.