My Blog
By W. Robert Howarth, DDS, FASD, Family and Sports Dentistry
May 01, 2021
Category: Oral Health
Tags: braces   oral hygiene  
PracticalTipsforKeepingYourTeethCleanWhileWearingBraces

Wearing braces can pose challenges for your daily life and habits. One in particular is trying to keep your teeth and gums clean.

Braces or not, your oral hygiene needs to be thorough. Every day, your teeth accumulate a thin film of bacteria and food particles called dental plaque that can cause tooth decay or gum disease. It's essential to remove as much as possible each day by brushing and flossing.

That's a more difficult task with braces. The brackets and wires interfere with accessing many of your teeth's surfaces with a toothbrush or floss. As a result, braces wearers on average have a higher incidence of dental disease than non-wearers.

But while it's difficult to keep your mouth clean wearing braces, it's not impossible. Here are some tips and tools for making oral hygiene easier during orthodontic treatment.

A low-sugar diet. Besides items like chips that could damage your braces, you should also limit your consumption of foods and snacks with added sugar.  This carbohydrate is a primary food source for disease-causing bacteria. Limiting sugar in your diet can help reduce plaque buildup.

The right toothbrush. Brushing with braces is easier if you use a soft multi-tufted brush with microfine bristles. The smaller bristles maneuver better around the braces than larger bristled brushes. You'll still need to make multiple passes above and below the wires to be sure you're brushing all tooth surfaces.

Flossing tools. Traditional flossing using just your fingers can be next to impossible to perform with braces. But a tool like a floss holder or threader can make it easier to get between teeth. You might also try a water flosser that removes plaque from between teeth with a pressurized spray of water.

Dental treatments. Your dentist can give your teeth extra protection while you're wearing braces with topically applied fluoride to strengthen enamel. Using mouthrinses with an antibacterial ingredient like chlorhexidine may also reduce harmful bacteria.

Be sure you also keep up regular visits with your family dentist while wearing braces, and especially if you begin to notice puffy and reddened gums or unusual spots on your teeth. The sooner any case of dental disease is detected, the less impact it will have on your dental health.

If you would like more information on dental care while undergoing 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 “Caring for Teeth During Orthodontic Treatment.”

By W. Robert Howarth, DDS, FASD, Family and Sports Dentistry
April 21, 2021
Category: Oral Health
Tags: gum recession  
GumRecessionCanRobYouofYourSmileandYourDentalHealthToo

If it seems like your teeth are getting longer as you get older, it's unlikely they're magically growing. More likely, your gums are shrinking or receding from your teeth. Besides the negative effect on your appearance, gum recession exposes you and vulnerable tooth areas to harmful bacteria and painful sensitivity.

Although common among older adults, gum recession isn't necessarily a part of aging: It's primarily caused by periodontal (gum) disease, in which infected gum tissues can weaken and detach from the teeth. This, along with bone loss, leads to recession.

But gum disease isn't the only cause—ironically, brushing your teeth to prevent dental disease can also contribute to recession. By brushing too aggressively or too often (more than twice a day), you could eventually damage the gums and cause them to recede. Tobacco use and oral piercings can also lead to weakened or damaged gums susceptible to recession.

You can lower your risk of gum recession by abstaining from unhealthy habits and proper oral hygiene to prevent gum disease. For the latter, your primary defense is gentle but thorough brushing and flossing every day to remove harmful dental plaque. You should also see your dentist at least twice a year for professional dental cleanings and checkups.

If, however, you do experience gum recession, there are a number of ways to restore your gums or at least minimize the recession. To start with, we must treat any gum disease present by thoroughly removing all plaque and tartar (calcified plaque), which fuels the infection. This reduces inflammation and allows the gums to heal.

With mild recession, the gums may rejuvenate enough tissue to recover the teeth during healing. If not, we may be able to treat exposed areas with a tooth-colored material that protects the surface, relieves discomfort and improves appearance.

If the recession is more advanced, we may still be able to stimulate gum regeneration by attaching a tissue graft with a micro-surgical procedure. These types of periodontal surgeries, however, can require a high degree of technical and artistic skill for best results.

In any event, the sooner we detect gum disease or recession, the quicker we can act to minimize the damage. Doing so will ensure your gums are healthy enough to protect your teeth and preserve your smile.

If you would like more information on gum recession, 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 “Gum Recession.”

By W. Robert Howarth, DDS, FASD, Family and Sports Dentistry
April 11, 2021
Category: Dental Procedures
PorcelainVeneersTransformRealHousewivesStarsSmileSpoiledbyTeethGrinding

Dorit Kemsley isn't shy. Best known to fans as an outspoken and sometimes outrageous cast member of the reality show Real Housewives of Beverly Hills, Kemsley is never reticent about “mixing it up” with fellow castmates or their significant others. Recently, though, she confessed to something that left her less than confident: her smile.

Kemsley has been self-conscious about her smile because her teeth looked noticeably short, worn down from an unconscious habit of grinding her teeth. Although teeth grinding is more common among children (who normally grow out of it by adolescence), it can persist into adulthood, usually from difficulties managing high stress (a likely component in the fashion designer/reality show star's busy life).

Stress-induced teeth grinding can occur during waking hours or, more likely, during deep sleep. The accumulating, long-term effects from the habit can lead not only to worn teeth but to weakened gum support, a high risk of tooth fracture or jaw pain and dysfunction.

So, how do you know if you grind your teeth, especially if it's only happening at night? Typical signs include sore jaws after awaking from sleep, increased tooth pain or sensitivity or, like Kemsley, a noticeable difference in your tooth length. Your family or sleeping partner may also complain about the “skin-crawling” noise you make during the night.

There are ways to lessen the effects of teeth grinding. The first step is to have us verify the underlying cause for the habit. If it's tension from stress, then you might reduce the habit's occurrences by learning better stress management or relaxation techniques through individual counseling, group support or biofeedback therapy. We can also fit you with a mouth guard to wear at night or through the day that reduces the force generated during teeth grinding.

And if you've already experienced accelerated tooth wear like Kemsley with a resultant “small teeth” smile, you might pursue the same solution as the RHOBH star: dental veneers. These thin, life-like wafers of porcelain are custom-made to mask imperfections like chips, staining, slight tooth gaps and, yes, worn teeth.

Veneers are often less expensive and invasive than other cosmetic techniques, yet they can have a transformative effect, as Kemsley's Instagram followers have seen. In conjunction with other dental treatments needed to repair any underlying damage caused by a grinding habit, veneers are an effective fix for the smile you present to the world.

If you suspect you may have a grinding habit, see us for a complete examination. From there, we'll help you protect your teeth and your smile.

If you would like more information on teeth grinding habits and their effects, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Teeth Grinding.”

By W. Robert Howarth, DDS, FASD, Family and Sports Dentistry
April 01, 2021
Category: Dental Procedures
Tags: root resorption  
AlthoughRareThisConditionCouldDestroyaTooth

Most dental problems are caused by tooth decay or periodontal (gum) disease, easily preventable with dedicated daily hygiene and regular dental care.  But there are a few other rare conditions to be on alert for that could pose just as serious a threat to your dental health.

One of these is a phenomenon called root resorption. Put simply, certain cells arise within a tooth root that eat away and dissolve (resorb) tooth structure. Left unchecked, it could eventually lead to the tooth's demise.

Although its exact cause remains elusive, we suspect root resorption is associated with trauma to the gum ligaments earlier in life, perhaps from an injury or too much force applied during orthodontics. Other possible contributing factors include teeth-grinding habits or internal tooth bleaching procedures.

Root resorption in adults isn't that common, so your chances of experiencing it are low. But it is still possible, so you should be on the lookout for potential signs: Early on, it may appear as faint pink spots on teeth where the enamel has filled with the destructive cells eating away at the tooth. In time, these spots can increase to form cavities.

More than likely, though, your dentist may detect the problem during a dental exam. That's why regular dental cleanings and checkups are essential—a routine exam is a prime opportunity to uncover conditions like root resorption that silently undermine your teeth.

If found early, we can often treat root resorption effectively. We can often expose a small affected area with minor gum surgery, remove the harmful cells and fill any cavities with a tooth-colored filling. In some cases, we may recommend orthodontics beforehand to encourage a buildup of bone around the root by moving the affected tooth outward from the jawbone. If the resorption has affected the tooth pulp, you may also need a root canal treatment.

There is also the possibility with advanced resorption that the best course of action is to remove the tooth and replace it with a dental implant. So, keep up your regular dental visits—early detection and intervention can stop this destructive dental condition from destroying your tooth.

If you would like more information on root resorption, 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 “Root Resorption: An Unusual Phenomenon.”

By W. Robert Howarth, DDS, FASD, Family and Sports Dentistry
March 22, 2021
Category: Oral Health
Tags: oral health  
ANewDentalPainManagementApproachReducestheNeedforNarcotics

Narcotics have long played an important role in easing severe pain caused by disease, trauma or treatment. Healthcare professionals, including dentists, continue to prescribe them as a matter of course.

But narcotics are also addictive and can be dangerous if abused. Although addictions often arise from using illegal drugs like heroin, they can begin with prescriptive narcotics like morphine or oxycodone that were initially used by patients for legitimate reasons.

As a result, many healthcare providers are looking for alternatives to narcotics and new protocols for pain management. This has led to an emerging approach among dentists to use non-addictive non-steroidal anti-inflammatory drugs (NSAIDs) as their first choice for pain management, reserving narcotics for more acute situations.

Routinely used by the public to reduce mild to moderate pain, NSAIDs like acetaminophen, ibuprofen or aspirin have also been found to be effective for managing pain after many dental procedures or minor surgeries. NSAIDs also have fewer side effects than narcotics, and most can be obtained without a prescription.

Dentists have also found that alternating ibuprofen and acetaminophen can greatly increase the pain relief effect. As such, they can be used for many more after-care situations for which narcotics would have been previously prescribed. Using combined usage, dentists can further limit the use of narcotics to only the most severe pain situations.

Research from the early 2010s backs up this new approach. A study published in the Journal of the American Dental Association (JADA) concluded that patients receiving this combined ibuprofen/acetaminophen usage fared better than those only receiving either one individually. The method could also match the relief power of narcotics in after care for a wide range of procedures.

The NSAID approach is growing in popularity, but it hasn't yet displaced the first-line use of narcotics by dental professionals. The hesitancy to adopt the newer approach is fueled as much by patients, who worry it won't be as adequate as narcotics to manage their pain after dental work, as with dentists.

But as more patients experience effective results after dental work with NSAIDs alone, the new approach should gain even more momentum. And in the end, it promises to be a safer way to manage pain.

If you would like more information on dental pain management, 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 “Are Opioids (Narcotics) the Best Way to Manage Dental Pain?





This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.