My Blog

Posts for: January, 2018

By Ellen M. Pacleb, DDS
January 30, 2018
Category: Dental Procedures
Tags: dental implants   smoking  
3ReasonsWhySmokingDoesntMixwithDentalImplants

If you smoke, you know better than anyone how a hard a habit it is to kick. If you want to quit, it helps to have a motivating reason—like lowering your risk for cancer, cardiovascular disease or similar conditions.

Here’s another reason for quitting tobacco: it could be making your teeth and gums less healthy. And, if you’re facing a restoration like dental implants, smoking can make that process harder or even increase the risk of failure.

So, to give your willpower some needed pep talk material, here are 3 reasons why smoking doesn’t mix with dental implants.

Inhaled smoke damages mouth tissues. Though you may not realize it, the smoke from your cigarette or cigar is hot enough to burn the top layer of skin cells in your mouth, which then thickens them. This could affect your salivary glands causing them to produce less saliva, which in turn could set off a chain of events that increases your risk of tooth decay or periodontal (gum) disease. The end result might be bone loss, which could make installing dental implants difficult if not impossible.

Nicotine restricts healthy blood flow. Nicotine, the chemical tobacco users crave, can restrict blood flow in the tiny vessels that course through the mouth membranes and gums. With less blood flow, these tissues may not receive enough antibodies to fight infection and fully facilitate healing, which could interfere with the integration of bone and implants that create their durable hold. Slower healing, as well as the increased chances of infection, could interrupt this integration process.

Smoking contributes to other diseases that impact oral health. Smoking’s direct effect on the mouth isn’t the only impact it could have on your oral health. As is well known, tobacco use can increase the risk of systemic conditions like cardiovascular and lung disease, and cancer. These conditions may also trigger inflammation—and a number of studies are showing this triggered inflammatory response could also affect your body’s ability to fight bacterial infections in the mouth. Less healthy teeth, gums and underlying bone work against your chances of long-term success with implants.

If you would like more information on dental implants, 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: What are the Risks?


By Ellen M. Pacleb, DDS
January 15, 2018
Category: Dental Procedures
Tags: celebrity smiles   braces  
DwightHowardABrightNBAStarWithaSmiletoMatch

Have you started orthodontic treatment recently? Are you having a little trouble getting used to your braces? If so, you are not alone: Everybody goes through an adjustment period during which they momentarily wonder if they’ll really ever get used to this. Don’t worry — you will! And we’ve never heard anyone say, on the day their braces come off and their new smile is revealed, that they aren’t glad they went the distance. Just ask Houston Rockets all-star center Dwight Howard, who discussed his own orthodontic treatment in a recent interview.

“I’m sure I was no different than anyone else who has ever had braces,” he told Mediaplanet. “At first I hated them so much… That changed once I got used to them and I actually grew to love them.” What’s Howard’s advice? “Do exactly what your orthodontist says and know that the outcome is well worth it in the end.” We couldn’t agree more! Here are some tips for wearing braces comfortably:

  • Hard & Chewy Foods: If you love fresh fruits and vegetables, that’s great; there’s no reason to give them up, just the really hard ones. You don’t want to bite into an apple or carrot or any other hard foods like bagels and pizza that have any “size” to them. Small pieces may be ok as long as they can’t bend your wires. Chewy, sticky candy should really be avoided completely. Same with soda, sports drinks and so-called energy drinks because they contain acids that promote tooth decay and can cause a lot of damage around the braces.
  • Effective Oral Hygiene: Keeping your teeth clean is more important than ever, but also more challenging than ever. It’s easy for food to get stuck under wires and around brackets, but failing to remove it can cause tooth decay, gum irritation and soreness. Therefore, the cleaner your teeth and your braces are, the healthier you will be. Use interdental cleaning brushes and/or a floss-threader to get behind your wires. A mouthrinse can also help strengthen teeth and keep bacteria in check. If you have any questions about how to clean between your teeth, please ask for a demonstration at your next visit.
  • Pain Relief: Some soreness at the beginning of orthodontic treatment is normal. To relieve it, you can use an over-the-counter pain reliever and/or a warm washcloth or heating pad placed on the outside of the jaw. If brackets or wires are rubbing against the inside of your cheeks or lips, try applying wax to these areas of your braces. If this does not offer enough relief, we may be able to trim the end of a poking wire. Call us if you need help with this.

Our goal is to make your orthodontic treatment as comfortable as possible on the way to achieving your all-star smile. If you have questions about adjusting to braces, contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine article “Caring for Teeth During Orthodontic Treatment.”


By Ellen M. Pacleb, DDS
January 07, 2018
Category: Dental Procedures
Tags: orthodontics  
CoaxingImpactedTeethtotheRightPositioncanImproveYourSmile

What makes an attractive smile? Of course, shiny, straight and defect-free teeth are a big factor. But there’s another equally important element: all your teeth have come in.

Sometimes, though, they don’t: one or more teeth may remain up in the gums, a condition known as impaction.¬†And if they’re in the front like the upper canines (the pointed teeth on either side of the front four incisors) your smile’s natural balance and symmetry can suffer.

Impaction usually happens due to lack of space on a small jaw. Previously erupted teeth crowd into the space of teeth yet to come in, preventing them from doing so. As a result the latter remain hidden within the gums.

While impaction can interfere with the smile appearance, it can cause health problems too. Impacted teeth are at higher risk for abscesses (localized areas of infection) and can damage the roots of other teeth they may be pressing against. That’s why it’s desirable for both form and function to treat them.

We begin first with an orthodontic examination to fully assess the situation. At some point we’ll want to pinpoint the impacted teeth’s precise location and position. While x-rays are useful for locating impacted teeth, many specialists use cone beam CT (CBCT) technology that produces highly detailed three-dimensional images viewable from different vantage points.

If the tooth is in too extreme a position, it might be best to remove it and later replace it with a dental impact or similar restoration once we’ve completed other necessary orthodontic treatment. But if the tooth is in a reasonable position, we might be able to “move” the tooth into its proper place in the jaw in coordination with these other tooth-movement efforts to make room for it.

To begin this process, an oral surgeon or periodontist surgically exposes the tooth crown (the normally visible portion) through the gums. They then bond a small bracket to the crown and attach a small gold chain. An orthodontist will attach the other end to orthodontic hardware that will exert downward pressure on the tooth to gradually bring it into normal position.

Dealing with impacted teeth of this nature is often part of a comprehensive effort to correct the bite. If we’re successful, it could permanently transform both the smile and overall dental health.

If you would like more information on treating impacted 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 “Exposing Impacted Canines.”