My Blog

By Ellen M. Pacleb, DDS
September 22, 2018
Category: Oral Health
Tags: oral hygiene   oral health  
KeepUpGoodDentalHabitsinCollegetoProtectYourTeethandGums

Starting college is one of life’s biggest transition moments, the first time many young people can truly say they’re on their own. Their freshman year can be both exhilarating and frightening.

The reason for this seeming dichotomy is that both exciting opportunities and harmful pitfalls abound in college life. One such pitfall that’s often overlooked involves dental health: it’s all too easy to neglect good habits and adopt bad ones. But while it may not seem as harmful as other dangers, inattention to your dental health could create consequences that plague you long after graduation.

But being diligent about dental care can help you avoid serious problems now and in the future. At the top of the list: brush and floss your teeth daily and continue seeing a dentist at least twice a year. Hopefully, your parents or guardians have trained you in these vital habits—and they’re definitely habits you should continue for the rest of your life.

Close in importance to good oral hygiene is a healthy diet. Besides eating primarily “natural” food—fresh fruits and vegetables and less-processed foods—you should also set limits on your sugar consumption. This carbohydrate is a primary food for disease-causing bacteria, so limiting as much as possible the sugar you eat to just meal times will lower your risk for tooth decay.

Another area in which you should tread wisely is alcohol consumption. Besides the obvious consequences of alcohol abuse, immoderate drinking can also cause dental problems. Alcohol (and smoking) tends to dry out the mouth, which can increase the levels of oral bacteria and in turn increase your risk of both tooth decay and periodontal (gum) disease.

Finally, avoid getting piercings involving the lips, mouth or tongue even if it’s the thing to do. Piercing hardware can chip teeth and contribute to the shrinking back of the gums (recession). And be sure you practice safe sex: unprotected sexual activity could expose you to viral infections that cause oral problems including cancer.

Your college years should be an exciting and memorable experience. By practicing these and other common sense dental habits, you’ll be sure to remember these years fondly.

If you would like more information on dental care during college, 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 “10 Health Tips for College Students.”

By Ellen M. Pacleb, DDS
September 12, 2018
Category: Oral Health
Tags: pediatric dentistry   sugar  
3SurprisingSugarSourcesYourBabyMightbeConsuming

Tooth decay is an ever present danger for your baby’s developing teeth. It begins with disease-causing bacteria feasting on leftover sugar, producing high levels of oral acid that slowly dissolves the teeth’s protective enamel. The softened enamel then becomes an open door for decay to infect the tooth.

Meanwhile, those bacteria continue to eat and produce acid….

So how can you stop this devastating cycle? Besides daily oral hygiene and regular dental visits, the most important thing you can do is deprive bacteria in your baby’s mouth of sugar through limiting their consumption of it. This means you’ll first need to identify the different sources of sugar available to your baby—and some of them might surprise you.

Here, then, are 3 not-so-obvious sugar sources your baby might be consuming.

During feeding. If you’re breast-feeding, you may not think this is causing a sugar problem for your baby. True, breast milk by itself doesn’t promote decay: it’s the combination of it with other sugar-rich foods and liquids the baby might be consuming as they get older. Together this could significantly increase their risk of pediatric tooth decay (also known as early childhood caries or ECC). So, be careful to limit sugar in other things they’re eating or drinking in addition to nursing.

24/7 Baby bottles and pacifiers. To calm infants at nap or sleep time, parents or caregivers often use bottles filled with sweet liquids or pacifiers dipped in jam, syrup or sugar. This practice increases decay risk from both the added sugar and its constant availability to bacteria in the mouth around the clock. Instead, avoid this practice and limit any sugary foods or liquids to mealtimes.

Medications. Some medications an infant may be taking for a chronic illness may contain small amounts of sugar. Additionally, medications like antihistamines can reduce the production of saliva that’s needed to neutralize acid after meals. If your child is on medication, ask your healthcare provider about its dental effects and if there are any sugar-free alternatives. Be sure to keep up daily brushing and flossing and regular dental visits too.

Limiting your baby’s sugar intake is critical in preventing tooth decay. It’s one of the most important things you can do to protect their dental health.

If you would like more information on helping your child avoid tooth decay, 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 “Age One Dental Visit: Why It’s Important for Your Baby.”

JulianneHoughSharesaVideo-andaSong-AfterWisdomTeethComeOut

Once upon a time, celebrities tried hard to maintain the appearance of red-carpet glamour at all times. That meant keeping the more mundane aspects of their lives out of the spotlight: things like shopping, walking the dog and having oral surgery, for example.

That was then. Today, you can find plenty of celebs posting pictures from the dentist on social media. Take Julianne Hough, for example: In 2011 and 2013, she tweeted from the dental office. Then, not long ago, she shared a video taken after her wisdom teeth were removed in December 2016. In it, the 28-year-old actress and dancer cracked jokes and sang a loopy rendition of a Christmas carol, her mouth filled with gauze. Clearly, she was feeling relaxed and comfortable!

Lots of us enjoy seeing the human side of celebrities. But as dentists, we’re also glad when posts such as these help demystify a procedure that could be scary for some people.

Like having a root canal, the thought of extracting wisdom teeth (also called third molars) makes some folks shudder. Yet this routine procedure is performed more often than any other type of oral surgery. Why? Because wisdom teeth, which usually begin to erupt (emerge from beneath the gums) around age 17-25, have the potential to cause serious problems in the mouth. When these molars lack enough space to fully erupt in their normal positions, they are said to be “impacted.”

One potential problem with impacted wisdom teeth is crowding. Many people don’t have enough space in the jaw to accommodate another set of molars; when their wisdom teeth come in, other teeth can be damaged. Impacted wisdom teeth may also have an increased potential to cause periodontal disease, bacterial infection, and other issues.

Not all wisdom teeth need to be removed; after a complete examination, including x-rays and/or other diagnostic imaging, a recommendation will be made based on each individual’s situation. It may involve continued monitoring of the situation, orthodontics or extraction.

Wisdom tooth extraction is usually done right in the office, often with a type of anesthesia called “conscious sedation.”  Here, the patient is able to breathe normally and respond to stimuli (such as verbal directions), but remains free from pain. For people who are especially apprehensive about dental procedures, anti-anxiety mediation may also be given. After the procedure, prescription or over-the-counter pain medication may be used for a few days. If you feel like singing a few bars, as Julianne did, it’s up to you.

If you would like more information about wisdom tooth extraction, please call our office to arrange a consultation. You can learn more in the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”

By Ellen M. Pacleb, DDS
August 23, 2018
Category: Dental Procedures
Tags: partial denture  
CantAffordDentalImplantsConsiderPartialDentures

We’ve come a long way in our ability to restore missing teeth. Today’s top choice is dental implants, prized not only for their close resemblance to real teeth but also their durability.

The rise of implants, though, hasn’t put older restorative methods out to pasture—many continue to offer patients a viable and affordable choice for tooth replacement. One example is the removable partial denture (RPD).

Once quite common, RPDs’ popularity has only slightly diminished with the advent of implants. They’re a fair option in terms of dental function and appearance, and much less expensive than implants or fixed bridges.

Similar to a full denture—a removable appliance that replaces all the teeth on a dental arch—a RPD can replace multiple missing teeth in a variety of configurations. A traditional RPD is usually constructed of vitallium, a lightweight but strong metal alloy, which allows for a very thin and comfortable frame. It’s covered in a gum-colored resin or plastic with prosthetic (false) teeth precisely set at the missing teeth’s locations. The appliance stays in place through a series of clasps that attach to the remaining teeth.

 Each RPD is custom-made to fit a patient’s mouth contours and the locations and patterns of the missing teeth. The top design goal for each individual RPD is to minimize any rocking movement during chewing; achieving that goal will depend not only on how many teeth are missing and where, but also what type of teeth are being replaced. For example, teeth missing from the back would require a different support design than teeth missing from the side or front.

RPDs’ biggest benefits are comfortable fit, effective dental function and good appearance. However, their means of attachment can create difficulties keeping remaining teeth clean of disease-causing bacterial plaque. Furthermore, an ill-fitting or unstable RPD could damage or even loosen natural teeth. It’s therefore essential for wearers to diligently practice daily hygiene (including cleaning the RPD) and undergo regular fit monitoring with their dentist.

Even with these constraints, a RPD can do an acceptable job providing dental function. What’s more, it can definitely improve your smile.

If you would like more information on options for dental restoration, 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 “Removable Partial Dentures: Still a Viable Tooth-Replacement Alternative.”

AnchorsMakealltheDifferenceinSuccessfulOrthodonticTreatment

Orthodontics shares a principle with the classic tug of war game: if you want things to move in the right direction you need a good anchor. Anchors help braces and other appliances apply constant pressure to misaligned teeth in the direction they need to go to correct a malocclusion (poor bite).

Orthodontic treatments work in cooperation with an existing oral mechanism that already moves teeth naturally in response to biting forces or other environmental factors. The key to this mechanism is an elastic tissue known as the periodontal ligament that lies between the tooth and the bone. Besides holding teeth in place through tiny attached fibers, the ligament also allows the teeth to move in tiny increments.

Braces’ wires laced through brackets affixed to the teeth exert pressure on them in the desired direction of movement –the periodontal ligament and other structures do the rest. To maintain that pressure we need to attach them to an “anchor”—in basic malocclusions that’s usually the back molar teeth.

But not all malocclusions are that simple. Some may require moving only certain teeth while not moving their neighbors. Younger patients’ jaws and facial structures still under development may also need to be considered during orthodontic treatment. That’s why orthodontists have other anchorage methods to address these possible complications.

One example of an alternate anchorage is a headgear appliance that actually uses the patient’s skull as the anchor. The headgear consists of a strap running around the back of the head and attached in front to orthodontic brackets (usually on molar teeth). The pressure it exerts can trigger tooth movement, but it can also help influence jaw development if an upper or lower jaw is growing too far forward or back.

Another useful anchorage method is a tiny metal screw called a temporary anchorage device (TAD) that is implanted into the jawbone above the teeth through the gums. Orthodontists then attach elastic bands between implanted TADs and specific braces’ brackets or wires to exert pressure on certain teeth but not others with pinpoint accuracy. After treatment the TADs can be easily removed.

Using these and other appliances allows orthodontists to customize treatment to an individual patient’s particular malocclusion. With the right anchor, even the most complex bite problem can be transformed into a beautiful and healthy smile.

If you would like more information on orthodontic treatment, 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 “Orthodontic Headgear & Other Anchorage Appliances.”





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