By Randall J. Bartoe, DDS, PLC
May 12, 2018
Category: Oral Health
Tags: jaw pain  
PersistentJawPainAfteranInjuryNeedsImmediateAttention

Accidents happen. And if an accident causes an injury to your jaws or surrounding facial area, it could result in serious damage. Without prompt treatment, that damage could be permanent.

You’ll usually know, of course, if something is wrong from the extreme pain near or around a jaw joint that won’t subside. If you have such symptoms, we need to see you as soon as possible to specifically diagnose the injury, which will in turn determine how we’ll treat it.

This is important because there are a number of injury possibilities behind the pain. It could mean you’ve loosened or displaced one or more teeth. The joint and its connective muscle may also have been bruised resulting in swelling within the joint space or a dislocation of the condyle (the bone ball at the end of the jaw), either of which can be extremely painful.

These injuries also cause muscle spasms, the body’s response for keeping the jaw from moving and incurring more damage (a natural splint, if you will). After examining to see that everything is functioning normally, we can usually treat it with mild to moderate anti-inflammatory drugs to reduce swelling and pain and muscle relaxers to ease the spasms. We may also need to gently manipulate and ease a dislocated jaw into its proper position.

In the worst case, though, you may actually have fractured the jaw bone. The most common break is known as a sub-condylar fracture that occurs just below the head of the joint with pain and discomfort usually more severe than what’s experienced from tissue bruising or dislocation. As with other fractures, we’ll need to reposition the broken bone and immobilize it until it’s healed. This can be done by temporarily joining the upper and lower teeth together for several weeks to keep the jaw from moving, or with a surgical procedure for more severe breaks that stabilizes the jawbone independently.

It’s important with any persistent jaw or mouth pain after an accident that you see us as soon as possible — you may have an injury that needs immediate attention for proper healing. At the very least, we can help alleviate the pain and discomfort until you’re back to normal.

If you would like more information on treating jaw injuries, 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 “Jaw Pain — What’s the Cause?

By Randall J. Bartoe, DDS, PLC
May 02, 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 Randall J. Bartoe, DDS, PLC
April 22, 2018
Category: Oral Health
Tags: oral health   pregnancy  
AnswerstoExpectantMothersFrequentQuestions

Pregnancy is an exciting time in a woman’s life — but it can also generate a lot of questions about both the mother’s and the baby’s health. The realm of dental care is no exception.

Here are a few of the questions we frequently hear from expectant mothers, along with our answers.

Does the baby’s tooth calcium come from my teeth?
This question is frequently asked by mothers who may have had dental issues and are worried they’ll pass on these problems to their baby. Simply put, no — a baby developing in the womb derives minerals like calcium for their teeth and bones from the mother’s diet, not her teeth. What an expectant mother can do is be sure to eat a healthy, balanced diet rich in nutrients and minerals like calcium.

Am I at heightened risk for dental disease during pregnancy?
Pregnancy does cause significant increases in your body’s hormones, particularly estrogen. This can cause changes in the gum tissue’s blood vessels that may make you more susceptible to periodontal (gum) disease (commonly called “pregnancy gingivitis”). It’s also possible later in pregnancy to develop non-cancerous overgrowths of gum tissues called “pregnancy tumors.” The heightened risk for gum disease during pregnancy calls for increased vigilance in monitoring gum health.

What should I do to take care of my teeth?
It’s important to brush your teeth thoroughly twice a day with ADA-approved fluoridated toothpaste to remove plaque, a thin layer of bacteria and food remnants that adhere to teeth. You should also floss daily and consider using an anti-plaque/anti-gingivitis mouthrinse. And, of course, you should see us for regular office cleanings and checkups, or if you notice swollen, tender or bleeding gums, or other abnormalities.

Should I take prenatal fluoride supplements?
This sounds appealing as a way to give your baby a head start on strong tooth development. Studies on its effectiveness, however, remain slim and somewhat inconclusive — we simply don’t have enough data to make a recommendation. What does have a solid research record is the application of fluoride to teeth in young children just after they appear in the mouth — studies involving over a thousand teeth have shown 99% cavity-free results using topical fluoride applications with sealants.

If you would like more information on dental care during pregnancy, 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 “Expectant Mothers.”

By Randall J. Bartoe, DDS, PLC
April 12, 2018
Category: Dental Procedures
Implant-SupportedDenturesProvideBetterFitandmayStopBoneLoss

Your dentures have served you well over the years. Lately, though, you’ve noticed the fit loosening in the lower denture. It’s not a new problem: you’ve had them refitted a few times already. But now it seems to be growing worse and you’re having more trouble chewing food or speaking clearly.

The problem isn’t all wear and tear with your dentures — the bone in your jaw is shrinking. A denture applies forces that are compressive. Natural teeth produce forces when we chew that travel through the tooth root and stimulate the bone to grow. Without teeth, there’s no such force to stimulate the bone. As a result, new bone cells don’t replace older cells at a healthy rate and bone volume diminishes over time. Because traditional dentures are supported by the gum ridges, the constant compressive forces on the gums can also contribute to bone loss.

As mentioned, we can refit dentures by lining them with new acrylic material. Eventually, though, it may be necessary to consider a new set of dentures that match the altered contours of your jaw. But continuing bone loss might lead to the same fate for your new dentures as your previous pair.

There’s a relatively new alternative, though, that could provide greater denture stability and help deter bone loss: implant overdentures. They’re actually a union between a traditional denture and a dental implant, a tooth replacement approach introduced over thirty years ago.

With this option, two strategically-placed implants are surgically inserted into the jaw bone. We then manufacture a denture (or retrofit your current dentures, if possible) with fittings that connect to the implants. Once in the mouth, the dentures gain their main support from the implants rather than the gum ridge, which relieves pressure on the bone. And because the titanium implant has a natural affinity with bone, new bone will grow and attach itself to it, increasing its stability and stopping bone loss.

Although more expensive than traditional dentures, implant overdentures are more affordable than individual teeth replaced by implants and are very cost-effective over time. What’s more, they can restore the comfort and confidence to eat, speak and smile that you once enjoyed when you had your own teeth.

If you would like more information on implant-supported dentures, 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 “Implant Overdentures.”

By Randall J. Bartoe, DDS, PLC
March 28, 2018
Category: Oral Health
Tags: nutrition  
FoodforThought-WhattoEatforOptimumOralHealth

March is national nutrition month—a good time to look at the connection between diet and oral health. You probably know that sugar is a major culprit in dental problems. This is because bacteria feed on sugars and create acid that can lead to tooth decay and gum disease. Avoiding sugary foods and drinks as much as possible is a good rule of thumb, but there are some food choices that actually benefit your oral health. Here are nutrition tips that will help keep your smile healthy for life:

Say cheese. Dairy products such as milk, cheese and yogurt contain calcium and phosphorus to build teeth and strengthen the supporting bone. And cheese neutralizes acid in the mouth to help fight cavities and gum disease.

Choose lean proteins. Lean meats, poultry, fish, milk and eggs help strengthen teeth. They are rich in protein and phosphorous, which is essential for building strong bones and teeth.

Eat a rainbow. Fruits and vegetables provide many key nutrients, including vitamins necessary for healing, bone strength, and healthy gums. Besides being nutritious, fruits and veggies scrub your teeth while you chew and stimulate the production of saliva, which is necessary for neutralizing acid and rebuilding enamel.

Nibble on nuts. Nuts contain protein, fiber and healthy fats. They also contain essential vitamins and minerals to keep teeth strong and gums healthy. Further, chewing nuts stimulates saliva production, lowering the risk of tooth decay.

Go for the grains. Studies have shown that eating too many refined carbohydrates such as white bread and sweet bakery items can lead to chronic inflammation, which is a factor in gum disease, heart disease, stroke and other conditions. In contrast, eating complex carbohydrates such as whole grains may reduce inflammation in the body.

What you put in your body can play a big role in preventing tooth decay and gum disease, so choose foods that provide the right building blocks for optimal dental and overall health.

If you have questions about how nutrition affects oral health, please contact our office or schedule a consultation. You can learn more in the Dear Doctor magazine article “Nutrition & Oral Health.”





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