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Posts for: May, 2014

EatingDisordersCanCauseProblemsWiththeTeethandMouth

Sometimes what’s going on in the mouth may point to a deeper issue. Although unpleasant to address, a dental examination could reveal signs of an eating disorder.

There are two disorders in particular that can adversely affect oral health: bulimia nervosa, characterized by food binging followed by purging through self-induced vomiting; and anorexia nervosa, characterized by self-starvation behavior. Occasionally, patients with one disorder may display behavior associated with another disorder.

“Binge-purge” behavior patterns are especially damaging to tooth enamel. When teeth are exposed to high levels of acid, the minerals in tooth enamel soften and erode. This is common with patients who overuse sodas, sports drinks and juices with high levels of citric acid. But bulimic patients also experience it because of stomach acid residue in the mouth after purging.

Patients with eating disorders also encounter other problems in the mouth. The salivary glands may become enlarged, giving the sides of the face a puffy appearance. The throat, palate and back of the tongue may appear red and damaged caused by fingers or other objects used to induce gagging.

There are also some differences between the two disorders in their effect on dental health. Anorexics tend to neglect grooming habits, including daily oral hygiene, which can lead to tooth decay and gum disease. Bulimic patients, on the other hand, are very mindful of body image and practice excellent grooming habits — but to a fault. In fact, aggressive brushing (especially after purging when high acid has caused enamel softening) can actually cause more erosion.

In the short-term, it’s important to treat dental problems caused by eating disorder behaviors, as well as encouraging better hygiene practices like waiting a few minutes to brush after purging or by rinsing with a little baking soda and water to help neutralize the acid. Ultimately, though, the eating disorder itself needs to be addressed and treated. In addition to your personal healthcare providers, the National Eating Disorders Association (nationaleatingdisorders.org) is a good online source for information and referrals.

Although a sensitive issue, an eating disorder can’t be ignored. Because of its effect on all aspects of health, including the teeth and mouth, the sooner it’s addressed, the better the outcome for patients and their families.

If you would like more information on the effect of eating disorders on oral 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 “Bulimia, Anorexia & Oral Health.”


By John G. Fisher, DMD
May 21, 2014
Category: Dental Procedures
BracesAreNoHurdleforOlympicTrackStar

Lashinda Demus holds the U.S record in the 400 meter hurdles, with a time of 52.47 seconds, the third fastest ever recorded. While her twin 5-year-old boys cheered her on, she brought home a silver medal from the 2012 London Olympics. But when it comes to her full set of upper and lower braces, there's no silver to be seen!

Demus is a top-ranked competitor, a wife and a mom — and an adult who is currently in orthodontic treatment. With her orthodontist's approval, she chose clear ceramic braces. These are just one of the treatment options available to adult patients, many of whom prefer a less noticeable style of orthodontic appliance.

As many as three-quarters of adults are thought to have some form of orthodontic problem. Common issues include teeth that are crowded too closely together, or ones that have drifted too far apart after an extraction or other tooth loss. It is believed that straightened teeth are easier to clean and better for chewing — they can also improve an adult's social life, and even his or her career prospects!

Some grown-ups may hesitate to consider orthodontic treatment because they remember the “railroad tracks” they saw in junior high school. In fact, there have been many changes in orthodontic appliances in the past few years. Two popular choices for adults are colorless braces (the kind Demus wears) and clear orthodontic aligners.

Colorless ceramic braces are made of high-tech composite materials. They resist staining, and are less noticeable because their translucent appearance blends with the teeth. Often, a single wire is the only part that's plainly visible. Sometimes it's even possible to place them on the lingual (tongue) side of the teeth.

Clear aligners are an alternative to braces that are available to adults and teens. Instead of wires and attachments, these consist of a series of transparent, removable trays that are placed over the teeth and worn 20 hours per day. Over a period of six months to two years, the teeth are gradually straightened as you progress from one computer-designed tray to the next. Best of all, you can remove the trays completely to clean your teeth, and for important occasions.

Which one is right for you? It depends. While aligners have been successful in treating mild to moderate spacing issues, more difficult problems with the bite may require a more traditional form of braces. Also, there are a few health problems which might need to be attended to before orthodontic treatment is begun. The best way to learn about your options is to come in for a consultation. But remember: if you want a better smile, it's never too late.

If you would like more information about orthodontic choices, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Orthodontics For The Older Adult” and “Clear Orthodontic Aligners.”


WhatYouCandotoHelpYourChildDevelopaDentalCheckupHabit

Next to brushing and flossing, a regular dental checkup is the single most important thing you can do for a healthy mouth. It’s also one of the best lifetime habits you can instill in your child, a task that’s a lot easier if your child sees visiting the dentist as a normal, even enjoyable part of life. Here are some things you can do to help make that happen.

First, if you’re not in the habit of taking your child for regular dental checkups, the sooner you start the better. We recommend you schedule your child’s first checkup around their first birthday. This will help your child become better accustomed to visiting the dentist, and get both of you on the right track with proper hygiene techniques. And by identifying and treating dental problems early, you may be able to avoid more stress-prone treatments in the future.

Who you see is just as important as making the visit. It’s important to find a practice that strives to create a comfortable, home-like atmosphere for their patients, especially children. Pediatric dentists (and many general dentists) are trained in child behavior and understand the importance of relating to a child first (pleasant chatting and upbeat explanations of what they’re going to do) to put them at ease before beginning examination or treatment.

Perhaps the most important factor in getting your child accustomed to dental care is you — your attitude toward not only visiting the dentist, but caring for your own teeth. Children tend to follow the lead of their parents: if you have developed healthy habits regarding oral hygiene and a nutritious, “tooth-friendly” diet, your children are more likely to follow suit. As for dental visits, if you’re calm and pleasant in the dentist’s office, your child will then see there’s nothing for them to be nervous about.

Going to the dentist at any age shouldn’t be an ordeal. Following these steps will go a long way in making dental visits something your child looks forward to.

If you would like more information on dental treatment 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 “Taking the Stress Out of Dentistry for Kids.”


By John G. Fisher, DMD
May 05, 2014
Category: Dental Procedures
Tags: cosmetic dentistry   veneers  
FrequentlyAskedQuestionsAboutPorcelainVeneers

Q: What exactly are porcelain veneers?
A: The term “veneer” usually means a very thin covering that’s designed to improve the way a surface looks. The porcelain veneers we use in cosmetic dentistry are just like that: They cover up flaws in the natural teeth, while preserving their strength and vitality. Porcelain veneers are wafer-thin layers of super-strong material, which are bonded to the front surfaces of the teeth. Once placed on your teeth, they offer a permanent way to improve a smile that’s less than perfect.

Q: What kinds of smile defects can porcelain veneers fix?
A: Veneers can help with a whole range of issues, including:

  • Color: Teeth that are deeply stained or yellowed — even those which can’t be lightened with professional bleaching — can be restored to a brilliant white (or a natural luster) with porcelain veneers.
  • Shape and size: If your teeth have become worn down with age, or have chips or roughened edges, veneers can restore them to a more pleasing shape. They can also lengthen teeth that appear too short, for a dramatic enhancement of your smile.
  • Alignment and spacing: For closing a small gap between teeth or making other minor adjustments in tooth spacing or position, veneers may be just what you need; more serious issues can be handled with orthodontics.

Q: What's involved in getting porcelain veneers?
A: First, we will talk with you about what aspects of your smile you’d like to improve, and develop a plan to accomplish that. When we’re all agreed, the next step will probably be to remove a small amount of tooth material in preparation for placing the veneers. (Some types of veneers, however, don’t require this step.) Next, we will make a mold of your teeth and send it to the dental lab; you’ll leave our office with a set of temporary veneers. In a few weeks, you’ll return to our office to have the final veneers permanently bonded to your teeth.

Q: Is it possible to preview the results?
A: Yes! The options for a preview range from computer-generated images of your new smile to an accurate, life-sized model of your teeth with veneers applied. It may even be possible to make acrylic “trial veneers” that we can actually place on your teeth to try on! So if your smile could use a little help, ask us about porcelain veneers.


TopFiveReasonstoConsiderConsciousSedationforChildrenNeedingDentalWork

When it comes to dental procedures, not everybody has the same comfort level; what’s easily tolerated by some can be a major source of anxiety and stress for others. In fact, by some estimates perhaps 10 to 15 percent of Americans avoid visiting the dentist entirely because of the fear factor — and this applies to kids as well as adults. So what should you do if your child needs dental work but is seriously scared of the chair? Here are the top five reasons for considering conscious sedation to relieve your child's dental anxiety.

  1. It allows dentists to treat children and teens who would otherwise be too fearful to come in. This can be especially useful when invasive treatments like root canals or extractions are needed. When problems are treated at an early stage, it’s often possible to prevent more extensive work from being required later; this can reduce the overall cost of treatment — and also help to preserve the natural teeth!
  2. Dentists who use pediatric conscious sedation are specially qualified to do so. Advanced training and continuing education are part of the qualification process. In addition, emergency life support equipment is kept on hand, and practitioners are familiar with its use.
  3. The medications used are safe and effective. New, fast-acting drugs get the job done and then leave the body quickly. They are commonly administered by mouth (orally), so there is no need to fear the needle. While any type of sedation comes with a slight risk, minimal conscious sedation is a lower-risk alternative to deeper levels of sedation, or general anesthesia.
  4. A designated staff member monitors your child at all times. Vital signs such as heart rate, blood oxygen level, respiration rate, blood pressure and temperature are constantly under observation. This helps ensure that the level of sedation remains effective, yet safe.
  5. It can form a foundation for stress-free dental treatment in the years to come. No one wants to put their child through a terrifying experience — especially when the fearful memories could prevent them from getting necessary treatment in the future. With conscious sedation, that’s not an issue. In fact, with many of the medications currently in use, your child may not even remember the procedure when it’s over.

Dental anxiety can be a serious problem — but it’s good to know there are ways to control it. If you would like more information, call our office to arrange a consultation. You can learn more in the Dear Doctor magazine article “Sedation Dentistry for Kids.”