Kathy Bates has been a familiar face to filmgoers since her Oscar-winning performance as Annie Wilkes in Misery. She's best known for playing true-to-life characters like Wilkes or Barbara Jewell in last year's Richard Jewell (for which she earned her fourth Oscar nomination). To keep it real, she typically eschews cosmetic enhancements—with one possible exception: her smile.
Although happy with her teeth in general, Bates noticed they seemed to be “moving around” as she got older. This kind of misalignment is a common consequence of the aging process, a result of the stresses placed on teeth from a lifetime of chewing and biting.
Fortunately, there was an orthodontic solution for Bates, and one compatible with her film career. Instead of traditional braces, Bates chose clear aligners, a newer method for moving teeth first introduced in the late 1990s.
Clear aligners are clear, plastic trays patients wear over their teeth. A custom sequence of these trays is developed for each patient based on their individual bite dimensions and treatment goals. Each tray in the sequence, worn in succession for about two weeks, places pressure on the teeth to move in the prescribed direction.
While clear aligners work according to the same teeth-moving principle as braces, there are differences that make them more appealing to many people. Unlike traditional braces, which are highly noticeable, clear aligners are nearly invisible to others apart from close scrutiny. Patients can also take them out, which is helpful with eating, brushing and flossing (a challenge for wearers of braces) and rare social occasions.
That latter advantage, though, could pose a problem for immature patients. Clear aligner patients must have a suitable level of self-responsibility to avoid the temptation of taking the trays out too often. Families of those who haven't reached this level of maturity may find braces a better option.
Clear aligners also don't address quite the range of bite problems that braces can correct. Some complex bite issues are thus better served by the traditional approach. But that gap is narrowing: Recent advances in clear aligner technology have considerably increased their treatability range.
With that said, clear aligners can be an ideal choice for adults who have a treatable bite problem and who want to avoid the appearance created by braces. And though they tend to be a little more expensive than braces, many busy adults find the benefits of clear aligners to be worth it.
The best way to find out if clear aligners could be a viable option for you is to visit us for an exam and consultation. Like film star Kathy Bates, you may find that this way of straightening your smile is right for you.
If you would like more information about tooth straightening, please contact us or schedule a consultation.
We Americans love our sports, whether as participants or spectators. But there's also a downside to contact sports like soccer, football or basketball: a higher risk of injury, particularly to the mouth and face. One of the most severe of these is a knocked out tooth.
Fortunately, that doesn't necessarily mean it's lost: The tooth can be reinserted into the empty socket and eventually return to normal functionality. But it must be done as soon as possible after injury. The more time elapses, the lower the chances of long-term survival.
That's because of how teeth are held in place in the jaw, secured by an elastic, fibrous tissue known as the periodontal ligament. When a tooth is knocked out some of the ligament's periodontal cells remain on the tooth's root. If these cells are alive when the tooth is reinserted, they can regenerate and reestablish attachment between the ligament and the tooth.
Eventually, though, the cells can dry out and die. If that has already happened before reinsertion, the tooth's root will fuse instead with the underlying bone. The tooth may survive for a short time, but its roots can eventually dissolve and the tooth will be lost.
Your window of opportunity for taking advantage of these live periodontal cells is only 5-20 minutes with the best chances in those earlier minutes. You should, therefore, take these steps immediately after an injury:
- Find the tooth, hold it by the crown (not the root end), and rinse off any debris with clean water;
- Reinsert the root end into the empty socket with firm pressure;
- Place clean gauze or cloth in the person's mouth between the tooth and the other jaw, and ask them to bite down gently and hold their bite;
- Seek dental or emergency medical care immediately;
- If you're unable to reinsert the tooth, place it quickly in a container with milk and see a dentist immediately.
You can also obtain an Android or IOS smartphone app developed by the International Association of Dental Traumatology called ToothSOS, which will guide you through this process, as well as for other dental emergencies. The quicker you act, the better the chances that the injured person's knocked out tooth can be rescued.
If you would like more information on what to do in a dental emergency, 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 “When a Tooth is Knocked Out.”
There's ample evidence tobacco smoking increases your risk for tooth decay and periodontal (gum) disease. But the same may be true for electronic cigarettes (E-cigs): Although millions have turned to “vaping” believing it's a safer alternative to smoking, there are growing signs it might also be harmful to oral health.
An E-cig is a device with a chamber that holds a liquid solution. An attached heater turns the liquid into a vapor the user inhales, containing nicotine, flavorings and other substances. Because it doesn't contain tar and other toxic substances found in tobacco, many see vaping as a safer way to get a nicotine hit.
But a number of recent research studies seem to show vaping isn't without harmful oral effects. A study from Ohio State University produced evidence that E-cig vapor interferes with the mouth's bacterial environment, or oral microbiome, by disrupting the balance between harmful and beneficial bacteria in favor of the former. Such a disruption can increase the risk for gum disease.
Other studies from the University of Rochester, New York and Universit? Laval in Quebec, Canada also found evidence for vaping's negative effects on oral cells. The Rochester study found astringent flavorings and other substances in vaping solutions can damage cells. The Quebec study found a staggering increase in the normal oral cell death rate from 2% to 53% in three days after exposure to E-cig vapor.
Nicotine, E-cig's common link with tobacco, is itself problematic for oral health. This addictive chemical constricts blood vessels and reduces blood flow to the mouth's tissues. This not only impedes the delivery of nutrients to individual cells, but also reduces available antibodies necessary to fight bacterial infections. Regardless of how nicotine enters the body—whether through smoking or vaping—it can increase the risk of gum disease.
These are the first studies of their kind, with many more needed to fully understand the effects of vaping on the mouth. But the preliminary evidence they do show should cause anyone using or considering E-cigs as an alternative to smoking to think twice. Your oral health may be hanging in the balance.
If you're one of the more than 26 million people in the U.S. with diabetes, you know first hand how the disease impacts your life. That includes your dental health — and whether or not implants are a good tooth replacement option for you.
Diabetes is actually the name for a group of diseases affecting how your body processes glucose, a simple sugar that provides energy for the body's cells. The level of glucose in the blood is regulated by insulin, a hormone produced in the pancreas. Diabetes causes the pancreas to either stop producing insulin (Type 1) or not produce enough (Type 2). Also in Type 2, the body can become unresponsive to the insulin produced.
The implications for either type are serious and can be life-threatening. If glucose levels are chronically too low or high the patient could eventually go blind, suffer nerve damage, or develop kidney disease. Diabetes also interferes with wound healing and creates a greater susceptibility for gangrene: diabetics thus have a higher risk for losing fingers, toes and limbs, and can even succumb to coma or death.
Type 2 is the most common form of diabetes. Fortunately, most people with this type can effectively manage it through diet, exercise and regular glucose monitoring; if need be, prescription medication can help regulate their levels. Even so, diabetics with their disease under control must still be alert to slower wound healing and a higher risk of infection.
Because implant placement is a minor surgical procedure, the aspects of diabetes related to healing, infection and inflammation could have an adverse impact on the ultimate success of the placement. Implant surgery creates a wound in the surrounding gum tissues and bone that will need to heal; the body's immune response in a diabetic can interfere with that process. And if infection sets in, the risks of implant failure increase.
But research has shown that diabetics with good glucose management have as high a success rate (over 95% after ten years) as non-diabetic patients. That means the implant option is a viable one for you as a diabetic — but only if you have your disease under control.
Boston Bruins defenseman Zdeno Chara had a rough Stanley Cup final against the St. Louis Blues this past June. Not only did the Bruins ultimately lose the championship, but Chara took a deflected puck shot to the face in Game Four that broke his jaw.
With the NHL season now over, the 42-year-old Bruins captain continues to mend from his injury that required extensive treatment. His experience highlights how jaw fractures and related dental damage are an unfortunate hazard in hockey—not only for pros like Chara, but also for an estimated half million U.S. amateurs, many in youth leagues.
Ice hockey isn't the only sport with this injury potential: Basketball, football (now gearing up with summer training) and even baseball players are also at risk. That's why appropriate protective gear like helmets and face shields are key to preventing injury.
For any contact sport, that protection should also include a mouthguard to absorb hard contact forces that could damage the mouth, teeth and gums. The best guards (and the most comfortable fit) are custom-made by a dentist based on impressions made of the individual's mouth.
But even with adequate protection, an injury can still happen. Here's what you should do if your child has an injury to their jaw, mouth or teeth.
Recognize signs of a broken jaw. A broken jaw can result in severe pain, swelling, difficulty speaking, numbness in the chin or lower lip or the teeth not seeming to fit together properly. You may also notice bleeding in the mouth, as well as bruising under the tongue or a cut in the ear canal resulting from jawbone movement during the fracture. Get immediate medical attention if you notice any of these signs.
Take quick action for a knocked-out tooth. A tooth knocked completely out of its socket is a severe dental injury. But you may be able to ultimately save the tooth by promptly taking the following steps: (1) find the tooth and pick it up without touching the root end, (2) rinse it off, (3) place it back in its socket with firm pressure, and (4) see a dentist as soon as possible.
Seek dental care. Besides the injuries already mentioned, you should also see a dentist for any moderate to severe trauma to the mouth, teeth and gums. Leading the list: any injury that results in tooth chipping, looseness or movement out of alignment.
Even a top athlete like Zdeno Chara isn't immune to injury. Take steps then to protect your amateur athlete from a dental or facial injury.
If you would like more information about dealing with sports-related dental injuries, please contact us or schedule an appointment for a consultation. To learn more, read the Dear Doctor magazine articles “Athletic Mouthguards” and “The Field-Side Guide to Dental Injuries.”
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