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Posts for category: Oral Health

By W. Robert Howarth, DDS, FASD, Family and Sports Dentistry
November 24, 2019
Category: Oral Health
WearingaRetainerWillProtectYourNewSmileAfterBraces

After living with braces for a couple of years, the “big reveal” finally happens and you see your new smile for the first time. But then you’re told you have to wear another mouth appliance—around the clock to start and then just at night. After all the new smile excitement, wearing a retainer can be a little anticlimactic.

But this part of your orthodontic treatment is as important as the earlier tooth movement phase. That’s because your new “forever smile” doesn’t necessarily come with a “forever” guaranty. In fact, your teeth could quickly begin moving back to where they were before braces if you don’t wear a retainer.

The reason why is because of a tough but elastic gum tissue called the periodontal ligament. This ligament lies between the teeth and the jawbone, attaching to both through tiny extending fibers. The periodontal ligament actually does most of the anchoring work to hold your teeth in place.

The ligament is also why we’re able to move your teeth to different positions: As braces apply pressure to the teeth and jaw in the direction of desired movement, the ligament remodels itself to allow the teeth to take up these new positions.

The tissues involved, though, still retain a kind of “memory” of where the teeth used to be. This creates an immediate tendency for the teeth to revert to these old positions. To prevent this, we use a retainer that when worn keeps or “retains” the teeth in their new positions until they’ve stabilized and the old tissue “memory” fades.

There are different types of retainers, some removable and some fixed in place. Choosing the best one for a particular patient will depend on the complexity of the bite treatment, the patient’s age and level of self-responsibility and the preferences of the orthodontist. Whichever type of retainer you eventually use, it’s important you wear it to preserve all of the time and effort that went into transforming your smile.

Wearing a retainer might not be high on your “exciting things to do” list. But it’s the best way to guarantee you’ll enjoy your new smile for years to come.

If you would like more information on keeping your new smile after braces, 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 “The Importance of Orthodontic Retainers.”

By W. Robert Howarth, DDS, FASD, Family and Sports Dentistry
November 14, 2019
Category: Oral Health
HowEarlyDentalVisitsCanImproveYourChildsOralHealth

Pediatricians and dentists alike recommend beginning your child's regular dental visits at an earlier age rather than later. Most say children's first visits should happen around their first birthday.

Some may question whether that's necessary given the state of a child's dental development at that age. At that stage they normally have only a few primary teeth, which will eventually give way to their permanent set soon enough.

But regular dental visits can make a positive difference even at that early age. Here are 3 oral health areas that could benefit from seeing the dentist by Age One.

Protecting primary teeth from decay. It's true that primary teeth don't last long when compared to a normal lifespan. But during their short tenure, they do play a critical role in a child's health and development. Not only do they provide a child dental function for eating, speaking and smiling, they also preserve the space for the permanent teeth that will succeed them. Without them, permanent teeth can erupt out of position to form a poor bite (or malocclusion). That's why early dental care to prevent and treat decay in primary teeth helps them remain for as long as they should.

Detecting developing malocclusions. A malocclusion doesn't form overnight—there can be subtle signs of its development during early childhood. A dentist, especially a pediatric dentist or orthodontist, can often detect those signs before the malocclusion fully develops (one reason why every child should have an orthodontic evaluation around age 6). With early detection, an orthodontist can use interventional techniques that will lessen or even stop a malocclusion from forming. As a result, later orthodontic treatment may not be as extensive—or expensive—as it could have been.

Developing a healthy dentist-patient relationship. Dental anxiety is a real problem for many adults—in some cases it can be so severe they avoid professional dental care altogether. The roots of that dental fear often go back to unpleasant experiences during childhood. Starting dental visits when a child is very young appears to minimize the development of dental anxiety. A young child, especially visiting a "kid-friendly" dental clinic, will more likely view dental care as a routine part of life and will less likely be afraid.

If you would like more information on dental care 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 “Age One Dental Visit: Why It's Important for Your Baby.”

By W. Robert Howarth, DDS, FASD, Family and Sports Dentistry
October 15, 2019
Category: Oral Health
Tags: tooth decay  
HowtoLowerYourChildsToothDecayRiskFromHalloweenCandy

$9.1 billion: That's how much we Americans spent in 2018 on Halloween festivities, according to the National Retail Federation. And a sizeable chunk of that was for candy—a whopping 600 million pounds worth. That, my friends, is a lot of sugary goodness. For kids, it's what Halloween is all about—scoring a sack full of sticky, gooey, crunchy candy. For parents, though, all that sugar raises concerns for their kids' dental health.

That's because of something that loves sugar as much as little humans: oral bacteria. The more these microscopic creatures consume, the more they reproduce, which consequently leads to more mouth acid, a by-product of their digestion. Elevated acid levels can dissolve the mineral content in enamel and create the conditions for tooth decay.

To cut to the chase, excessive candy consumption increases the risk of tooth decay. Short of banning candy and ruining your kids' holiday fun, what then can you do to lower that risk this Halloween?

Here are a few tips:

Limit candy to mealtimes. The mouth's acid levels tend to rise while we're eating. The body counters with saliva, which has the capacity to neutralize acid and restore lost minerals to enamel. But if your kids are snacking on sweets over a long period, saliva can't get ahead of the recurring waves of acid. So, try to limit your kids' candy consumption to a few pieces at mealtimes only.

Don't brush right after eating candy. The short period during and after eating of high acid levels can still soften tooth enamel. If your child brushes soon after eating candy, they could also remove tiny bits of softened enamel. Instead, wait at least 30 minutes to an hour before brushing to allow saliva time to remineralize the enamel.

Encourage alternatives to candy as Halloween treats. While candy is a huge part of Halloween, it needn't have a monopoly on all the celebratory fun. So, encourage your little tricksters to accept—and their treaters to provide—other kinds of treats like small toys, glow sticks, or other items that count as treasure to children (be sure they're age-appropriate, though).

Halloween is a great time of family fun, and candy may always play a prominent role in the merriment. Just be sure to practice moderation with sweet Halloween treats to avoid dental problems down the road.

If you would like more information about how to manage your family's sugar consumption for optimum dental health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “The Bitter Truth About Sugar” and “Nutrition & Oral Health.”

By W. Robert Howarth, DDS, FASD, Family and Sports Dentistry
October 05, 2019
Category: Oral Health
Tags: teeth grinding  
DontPanicOverYourChildsTeethGrindingbutDoKeepanEyeonIt

First the bad news: Those nightly hair-raising sounds are indeed coming from your child’s bedroom—from your child. It’s the result of them grinding their teeth while they sleep.

But here’s the good news: the only likely harm is a lack of sleep members of your household might experience because of it. Teeth grinding is so prevalent among pre-teen children that many healthcare professionals consider it normal. But that doesn’t mean it can’t become a problem, so it’s worth monitoring.

Teeth grinding is part of a family of dental habits known as bruxism. It involves any involuntary movement of the teeth and jaws outside of their intended functions not associated with chewing, speaking or swallowing. Our main concern with any bruxism is the possibility for generating stronger biting forces than normal that could damage teeth and gums and contribute to jaw joint problems.

Teeth grinding can occur in adulthood, with stress seeming to be the major trigger for it. With children, though, it’s believed to be mainly caused by an immaturity of the child’s neuromuscular process that controls chewing. As this matures, most children will tend to outgrow the habit none the worse for wear.

But there are pediatric cases in which the generated biting forces are strong enough to cause damage. Teeth grinding is also prevalent in children who snore or breathe through their mouths, which could be a sign of a serious health condition called obstructive sleep apnea. And certain medications used to treat depression and attention deficit disorder (ADHD) may also contribute to teeth grinding.

Most of the time we can simply let the habit run its course. If, however, the child begins to experience abnormal tooth wear, headaches, jaw pain or other issues believed caused by teeth grinding, we may need to intervene. This could include a plastic night guard the child wears during sleep that prevents the teeth from making solid contact during grinding episodes. And children with signs of airway obstruction should be evaluated by an ear, nose and throat specialist.

It can be irritating or even distressing. But your child’s teeth grinding doesn’t mean you should be alarmed—only that you should keep your eye on it.

If you would like more information on teeth grinding and similar habits, 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 Children Grind Their Teeth.”

By W. Robert Howarth, DDS, FASD, Family and Sports Dentistry
September 25, 2019
Category: Oral Health
DentalInjuryIsJustaTemporarySetbackforBasketballStarKevinLove

The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.

In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?

The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.

Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.

So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”

Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.

If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”