By Randall J. Bartoe, DDS, PLC
July 26, 2019
Category: Oral Health
Tags: tooth pain   tooth decay  
DontIgnoreSuddenToothPain-YourTeethmaybeTellingyouSomething

Nothing grabs your attention like a sharp tooth pain, seemingly hitting you out of nowhere while you’re eating or drinking. But there is a reason for your sudden agony and the sooner you find it out, the better the outcome for your oral health.

To understand tooth sensitivity, we need to first look at the three layers of tooth anatomy. In the center is the pulp filled with blood vessels and nerve bundles: it’s completely covered by the next layer dentin, a soft tissue filled with microscopic tubules that transmit sensations like pressure or temperature to the pulp nerves.

The third layer is enamel, which completely covers the crown, the visible part of a tooth. Enamel protects the two innermost tooth layers from disease and also helps muffle sensations so the tooth’s nerves aren’t overwhelmed. The enamel stops at about the gum line; below it the gums provide similar protection and sensation shielding to the dentin of the tooth roots.

Problems occur, though, when the dentin below the gums becomes exposed, most commonly because of periodontal (gum) disease. This bacterial infection caused by dental plaque triggers inflammation, which over time can weaken gum tissues and cause them to detach and shrink back (or recede) from the teeth. This can leave the root area vulnerable to disease and the full brunt of environmental sensations that then travel to the nerves in the pulp.

Tooth decay can also create conditions that cause sensitivity. Decay begins when certain oral bacteria multiply and produce higher than normal levels of acid. The acid in turn dissolves the enamel’s mineral content to create holes (cavities) that expose the dentin. Not treated, the infection can eventually invade the pulp, putting the tooth in danger of being lost unless a root canal treatment is performed to remove the infection and seal the tooth from further infection.

So, if you begin experiencing a jolt of pain while eating or drinking hot or cold foods or beverages, see your dentist as soon as possible to diagnose and treat the underlying cause. And protect your teeth from dental disease by practicing daily brushing and flossing, as well as seeing your dentist for regular dental cleanings and checkups. Don’t ignore those sharp pains—your teeth may be trying to tell you something.

If you would like more information on tooth sensitivity, 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 of Tooth Sensitivity.”

By Randall J. Bartoe, DDS, PLC
July 16, 2019
Category: Dental Procedures
LadyGagaWasntBornThisWay

Sometimes, looking at old pictures can really bring memories back to life. Just ask Stefani Germanotta—the pop diva better known as Lady Gaga. In one scene from the recent documentary Five Foot Two, as family members sort through headshots from her teen years, her father proclaims: "Here, this proves she had braces!"

"If I had kept that gap, then I would have even more problems with Madonna," Lady Gaga replies, referencing an ongoing feud between the two musical celebrities.

The photos of Gaga's teenage smile reveal that the singer of hits like "Born This Way" once had a noticeable gap (which dentists call a diastema) between her front teeth. This condition is common in children, but often becomes less conspicuous with age. It isn't necessarily a problem: Lots of well-known people have extra space in their smiles, including ex-football player and TV host Michael Strahan, actress Anna Paquin…and fellow pop superstar Madonna. It hasn't hurt any of their careers.

Yet others would prefer a smile without the gap. Fortunately, diastema in children is generally not difficult to fix. One of the easiest ways to do so is with traditional braces or clear aligners. These orthodontic appliances, usually worn for a period of months, can actually move the teeth into positions that look more pleasing in the smile and function better in the bite. For many people, orthodontic treatment is a part of their emergence from adolescence into adulthood.

Braces and aligners, along with other specialized orthodontic appliances, can also remedy many bite problems besides diastema. They can correct misaligned teeth and spacing irregularities, fix overbites and underbites, and take care of numerous other types of malocclusions (bite problems).

The American Association of Orthodontists recommends that kids get screened for orthodontic problems at age 7. Even if an issue is found, most won't get treatment at this age—but in some instances, it's possible that early intervention can save a great deal of time, money and effort later. For example, while the jaw is still developing, its growth can be guided with special appliances that can make future orthodontic treatment go quicker and easier.

Yet orthodontics isn't just for children—adults can wear braces too! As long as teeth and gums are healthy, there's no upper age limit on orthodontic treatment. Instead of traditional silver braces, many adults choose tooth-colored braces or clear aligners to complement their more professional appearance.

So if your child is at the age where screening is recommended—or if you're unhappy with your own smile—ask us whether orthodontics could help. But if you get into a rivalry with Madonna…you're on your own.

If you have questions about orthodontic treatment, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Magic of Orthodontics” and “Orthodontics For The Older Adult.”

By Randall J. Bartoe, DDS, PLC
July 06, 2019
Category: Oral Health
FourTipsforPreventingPrematureLossofBabyTeethFromToothDecay

Most often, all of your child’s primary teeth will eventually be replaced by permanent teeth, but you shouldn’t consider them less important — there are serious consequences for losing a primary tooth prematurely. Besides providing a means for a child to chew food and speak clearly, primary teeth also save space for the permanent teeth to erupt; a premature loss could lead to malocclusions (bad bites) that may result in costly orthodontic treatment later.

That’s why it’s important to fight tooth decay in primary teeth. By keeping them healthy and in place until it’s time for their departure, their permanent replacements have a better chance of erupting into their proper positions.

Here are 4 tips for preventing tooth decay in primary teeth:

Begin daily oral hygiene when teeth first appear. Begin brushing with fluoride toothpaste as soon as the first primary teeth come in. Brushing removes bacterial plaque, the primary cause of tooth decay, and fluoride strengthens enamel. Because they tend to swallow toothpaste rather than spit it out, use just a smear of toothpaste for infants and toddlers, and a pea-sized amount for ages two and older.

Start regular dental visits by the child’s first birthday. By beginning regular checkups around age 1, we’ll have a better chance of discovering developing tooth decay or other problems early. You’re also setting a good foundation for what should be a lifelong habit for optimum dental health.

Limit sugar consumption. The oral bacteria that cause tooth decay feed on leftover carbohydrates like sugar, so you should limit intake especially between meals. One culprit to watch out for: a bedtime bottle filled with formula, milk or fruit juices, all of which contain carbohydrates (sugar). Water or no bottle at all is a better alternative.

Consider topical fluoride or sealants for extra protection. In some circumstances, we may advise protecting the enamel of newly erupted teeth with an applied sealant. These protective coatings fill in porous pits and fissures in young teeth to deny access to disease. Supplemental fluoride will further strengthen young tooth enamel.

Taking these measures and remaining vigilant to the first signs of decay can go a long way toward preserving your child’s teeth. Their future oral health depends on it.

If you would like more information on dental care for children, 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 “Dentistry & Oral Health for Children.”

By Randall J. Bartoe, DDS, PLC
June 26, 2019
Category: Dental Procedures
Tags: crowns  
CustomizedTemporaryCrownsHelpEnsureaSatisfyingPermanentSmile

Restoring missing or unattractive teeth can often be a lengthy process. Months may elapse between initial teeth preparation and final placement to allow time for tissue healing and permanent crown manufacturing. During that period you will likely wear temporary (provisional) crowns to protect the teeth while improving function and appearance.

In the past, provisional crowns were fairly uniform. Today, though, there are provisional crowns available that conform exactly to a patient’s individual mouth. These crowns not only enhance function and appearance, they’re an excellent way to “try out” your new smile before the permanent restoration.

Customized provisional crowns are part of a concept known as “smile analysis.” A new smile involves more than restoring affected teeth: we also consider the overall health of your mouth, the shape of your face, and your own desires and expectations. Your final smile design is a joint collaboration between you, our office and the dental laboratory that will fashion the final restoration.

There are a number of techniques for creating customized provisional crowns. Some techniques involve bonding tooth-colored materials like composite resin directly to the teeth. Others use impression models of your teeth to create an outline or shell that’s filled with an acrylic material and then affixed to your teeth. The aim with any of these techniques is to produce a provisional crown that accurately reflects the final crown’s appearance.

With these types of provisional crowns, we can see how the new teeth will look (their color, shading, shapes and proportions) against the gums, and if they appear to be in balance and harmony with the entire face, including your lips, jaws and facial contour. We can also evaluate how well the new teeth function as you chew, speak or smile.

It takes some extra effort to prepare customized provisional crowns rather than the more uniform version. But this effort is well worth it: by helping us anticipate more accurately how your new restorations will appear and function, customized crowns help ensure your new smile is an attractive and satisfying one.

If you would like more information on temporary 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 “Concepts of Temporary Restorations.”

By Randall J. Bartoe, DDS, PLC
June 16, 2019
Category: Oral Health
Tags: oral health   snoring   sleep apnea  
YourDentistcanHelpGuideyouintheBestTreatmentOptionforSleepApnea

Do you still feel tired or unfocused even after a full night’s sleep? Do others complain about your snoring? It’s possible these are signs that you may have sleep apnea.

Sleep apnea is a condition in which you stop breathing while you sleep. Your brain will awaken you to breathe, although you may not consciously realize it since the waking period can be less than a second. But it does disrupt your sleep rhythm, especially during the all-important deep sleep period called Rapid Eye Movement (REM). These disruptions don’t allow your body to receive the full benefit of sleep, hence your lack of energy and focus during the day.

One of the most common causes for sleep apnea is the collapse of soft tissues near the throat as they relax during sleep that restrict the airway. Snoring is an indication this may be occurring: air vibrates rapidly (and loudly) as it passes through this restriction when you breathe in.

As your dentist, we’re well-trained in the anatomy and function of the entire oral structure, and qualified to offer solutions for sleep apnea. If you’ve been diagnosed with sleep apnea (after a complete examination, including an observation session at a sleep laboratory), we can then help you decide on a treatment approach. The following are three such options, depending on the severity of your sleep apnea.

Oral Appliance Therapy. An oral appliance you wear while you sleep is a first line treatment for mild or moderate sleep apnea. The appliance, which we custom design for you, helps hold the lower jaw in a forward position: this moves the tongue and other soft structures away from the back of the throat, thereby opening the airway.

Continuous Positive Airway Pressure (CPAP). Intended for more moderate to severe forms of sleep apnea, a CPAP machine produces continuous air pressure to the throat through a mask you wear during sleep. This forces the tongue forward and the airway open.

Surgical Intervention. These procedures remove excess tissue that may be obstructing the airway. Due to its invasiveness and permanent alteration of the throat area, surgery is reserved for patients who haven’t responded to other therapies in a satisfactory manner.

Whether mild or severe, it’s possible to effectively treat sleep apnea. If successful, not only will you benefit from better sleep and greater alertness, you’ll also improve your long-term health.

If you would like more information on treating sleep apnea, 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 “Sleep Disorders & Dentistry.”





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