My Blog

Posts for: June, 2014

NewStudyShowsCustom-MadeMouthguardsCutConcussionInjuriesinHalf

Concussion in athletes is a topic that’s getting lots of attention recently — not only in professional leagues, but also at the level of high school, collegiate and amateur sports. Helmets are being increasingly used in both contact and non-contact sports, like skiing and biking. But when you’re looking for quality gear that gives you additional protection against head and facial injuries, do you think of getting it at the dental office?

According to some new research, you should. A study published in the journal of the Academy of General Dentistry shows that a custom-made mouthguard, obtained at a dentist’s office, is more than twice as effective against mild traumatic brain injures (MTBI) and concussions than the over-the-counter (OTC) mouthguards you can get at a sporting-goods store.

The randomized study followed six different high school football teams, with a total of 412 players. Half were assigned to wear custom-made mouthguards, while the other half used OTC types; all wore the same type of helmets. When the season ended, a total of 24 MBTI/concussion injuries were reported, for an overall rate of 5.8 percent.

But the study revealed that not all mouthguards are created equal: The incidence of concussion for players wearing OTC mouthguards was 8.3 percent, while the group with dentist-provided custom mouthguards had an incidence rate of just 3.6 percent — less than half the rate of the OTC group!

That’s a big difference — and there’s one more thing to consider: While they can give you additional protection against concussion, mouthguards are primarily designed to protect your teeth from serious injury. It is well established that athletes who wear mouthguards significantly reduce the risk of dental and facial injury. That’s why they are recommended by the American Dental Association, and why so many sports leagues and associations require their use at all levels of play.

A custom fabricated mouthguard, made from a model of your own teeth, fits you better than any generic type can; it’s also a better investment. The mouthguards we provide last much longer than the “boil-and-bite” or self-molded ones available in sporting-goods stores and big-box retailers. And if it prevents a single serious injury, a custom-made mouthguard can pay for itself many times over — not only in terms of medical bills, but also in time lost from school or work… and on the field, the trail or the slopes.

If you have questions about custom-made athletic mouthguards, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Athletic Mouthguards” and “An Introduction to Sports Injuries & Dentistry.”


By John G. Fisher, DMD
June 17, 2014
Category: Dental Procedures
ChangesDavidBowiesDentalTransformation

In his decades long career, pop-music chameleon David Bowie has gone through a dizzying series of transformations. And as he morphed from alien-inspired space oddity to fashion-forward international superstar, his smile benefited from some very dramatic ch-ch-ch-changes. While Bowie hasn't talked much about his dental treatments, a comparison of pictures from the mid 1970s to the mid '90s (not to mention a much-viewed youtube video on the subject) makes it clear: his tooth staining, misalignment and gum recession have been left behind like polyester bellbottoms.

But tooth makeovers aren't just for pop stars! Cosmetic dentistry can benefit anyone who's interested in improving their appearance, at any age. Often, treatment starts with a “smile analysis” — a review of the current aesthetics of your mouth, including the shape, spacing, color and alignment of the teeth, the appearance and general health of the gums, and the way the lips and gums frame the smile.

This analysis can help pinpoint some places where the overall look of your smile may need improvement, and it can also identify some specific treatments to make it better. It's even possible to see a simulation of what you'd look like after the treatments are complete, to help ensure that your goals are realistic and attainable. What are some of the most common cosmetic procedures?

For stained teeth, you can try in-office whitening with concentrated bleaching solutions, or professionally-supervised at-home treatments using plastic trays that are custom-made to fit your teeth. The major difference between the two is the amount of time you need — with in-office treatments, you'll see results right away, while at-home gels may require weeks.

Tooth bonding and restoration with composite resin is a relatively fast and easy way to fix minor to moderate chips, flaws and discoloration. Because the composite material bonds directly to the tooth itself, this method requires only minor tooth preparation, and is often completed in just one office visit.

If your teeth, like Bowie's, need more extensive restoration, dental veneers or crowns may be required. Veneers are super strong, wafer-thin coverings that fit over the front surface of your teeth. Besides giving you that “Hollywood white” smile, they can also lengthen teeth that are too small, correct misalignment and close gaps in your smile. To correct even more extensive problems, crowns (also called caps) can replace the entire visible portion of one or more teeth — or, if teeth are missing, a permanent, long-lasting dental implant can be placed.

Many adults are choosing orthodontics to correct problems of tooth position, alignment or spacing — in fact, some 20% of all orthodontic patients today are grown-ups! It's never too late to start treatment, and with less-noticeable appliances like clear aligners and tooth-colored braces, it's easier than ever to make those ch-ch-ch-changes.

If you would like more information about the options available in cosmetic dentistry, 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 “Cosmetic Dentistry.”


By John G. Fisher, DMD
June 09, 2014
Category: Oral Health
TheImportanceofSavingImpactedCanineTeeth

Your upper canine teeth are pretty easy to identify — they’re usually longer and more pointed than other front teeth, and are normally positioned just under the eyes (hence their other name, eyeteeth). Besides helping us chew and bite our food, upper canines are part of a normal smile — when they don’t appear in the mouth (erupt) properly, the person’s smile may appear unnatural or “off.”

Unfortunately, upper canines can become impacted, meaning the teeth have grown and developed in positions that prevent them from erupting. Because impacted teeth can develop abscesses and cysts, or damage the roots of neighboring teeth, it’s necessary to treat them.

The first step is a thorough orthodontic evaluation to assess not only the teeth in question, but also how they could affect the position of other teeth in the future. Next, we must locate the exact position of the impacted canines through some form of radiographic examination, either x-rays or 3-D imaging using a cone beam CT scanner (CBCT). This evaluation will determine our treatment options for these teeth.

If the teeth are in a reasonable position, the best option is to expose the impacted tooth and prepare it for movement into proper position. To expose the tooth, a surgeon creates a small, surgical opening or flap in the gum tissue closest to the crown of the tooth. Once gaining access, the surgeon then bonds a small bracket to the crown and attaches a small gold chain to it. The chain can then be looped over orthodontic hardware attached to adjacent teeth, which will pull the impacted tooth over time into the proper position. Although this may sound complicated, coaxing the impacted canine in this manner into a proper eruption is actually quite routine and predictable.

If at all possible, saving impacted upper canine teeth should be the primary treatment goal — extracting them could have an adverse effect on biting and chewing, as well as disrupting your appearance. If they must be removed, however, tooth replacement such as dental implants can help restore any lost form or function.

If you would like more information on 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.”


By John G. Fisher, DMD
June 06, 2014
Category: Dental Procedures
Tags: orthodontics   braces  
AnEarlyOrthodonticEvaluationcanReduceTreatmentLater

While most orthodontic treatment doesn’t commence until a child is older or entering adolescence, it’s still a good idea for children as young as 6 to undergo an orthodontic evaluation. An early orthodontic evaluation may reveal emerging problems with the child’s bite and jaw development, and help inform the best course of treatment when the time is right.

A specialty within dentistry, orthodontics focuses on the study and treatment of malocclusions or poor bites. Orthodontists are most concerned with the interaction of the face, jaw and teeth, and whether these structures are developing normally and in the right position.

It’s possible to detect the beginning stages of a malocclusion as a child’s permanent teeth begin to erupt, sometime between ages 6 and 12. Children at this stage may begin to experience crowding of the teeth (or the opposite, too much space between teeth), protruding teeth, extra or missing teeth or problems with jawbone development. While these tend to be congenital (inherited conditions), some problems can be caused by excessive thumb-sucking, mouth breathing, or dental disease stemming from tooth decay. In some cases, “interceptive” orthodontic treatment might be necessary during this early period to improve the chances that future treatment for a malocclusion or poor jaw development will be successful.

An early orthodontic evaluation should be undertaken no later than age 7 to be most effective. It’s also advisable to have regular checkups beginning around the child’s first birthday to spot developing teeth and jaw problems even when only primary teeth are present. The orthodontic evaluation itself takes advantage of an orthodontist’s trained eye to locate more subtle problems with teeth and jaw growth. Knowing this well in advance can make it easier in the long run when orthodontic treatment takes place when they’re older. Waiting until after the full emergence of permanent teeth and further jaw and facial development to evaluate for treatment could make it more difficult or even impossible to correct malocclusion issues found later.

The most effective dental care starts early in life. Not only treating immediate problems but also anticipating those that will require treatment later will help ensure your child will have healthy teeth for life.

If you would like more information on childhood orthodontic evaluations, 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 “Early Orthodontic Evaluation.”