My Blog

Posts for: May, 2019

By W. Robert Howarth, DDS, FASD, Family and Sports Dentistry
May 28, 2019
Category: Oral Health
Tags: celebrity smiles   retainer  
FanofSuperheroFilmBlackPantherBreaksSteelWirewithHerMouth

Some moviegoers have been known to crunch popcorn, bite their fingers or grab their neighbor’s hands during the intense scenes of a thriller. But for one fan, the on-screen action in the new superhero film Black Panther led to a different reaction.

Sophia Robb, an 18-year-old Californian, had to make an emergency visit to the orthodontic office because she snapped the steel wire on her retainer while watching a battle scene featuring her Hollywood crush, Michael B. Jordan. Her jaw-clenching mishap went viral and even prompted an unexpected reply from the actor himself!

Meanwhile, Sophia got her retainer fixed pronto—which was exactly the right thing to do. The retention phase is a very important part of orthodontic treatment: If you don’t wear a retainer, the beautiful new smile you’re enjoying could become crooked again. That’s because if the teeth are not held in their new positions, they will naturally begin to drift back into their former locations—and you may have to start treatment all over again…

While it’s much more common to lose a removable retainer than to damage one, it is possible for even sturdy retainers to wear out or break. This includes traditional plastic-and-wire types (also called Hawley retainers), clear plastic retainers that are molded to fit your teeth (sometimes called Essix retainers), and bonded retainers: the kind that consists of a wire that’s permanently attached to the back side of your teeth. So whichever kind you use, do what Sophia did if you feel that anything is amiss—have it looked at right away!

When Black Panther co-star Michael B. Jordan heard about the retainer mishap, he sent a message to the teen: “Since I feel partly responsible for breaking your retainers let me know if I can replace them.” His young fan was grateful for the offer—but even more thrilled to have a celebrity twitter follower.

If you have questions about orthodontic retainers, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Importance of Orthodontic Retainers” and “Bonded Retainers.”


By W. Robert Howarth, DDS, FASD, Family and Sports Dentistry
May 18, 2019
Category: Oral Health
Tags: oral health  
PreservingthePulpisPriorityOnewithaNewlyEruptedPermanentTooth

The change from primary teeth to permanent is an announcement to the world that a boy or girl is "growing up." "Growing up," though, is still not "grown"—the new teeth are still in a period of development that can affect how we treat them if they're injured or diseased.

While a new tooth erupts with all its anatomical layers, the middle dentin is somewhat thinner than it will be after it matures. The pulp, the tooth's innermost layer, produces new dentin and gradually increases the dentin layer during this early development period. While the pulp continues to produce dentin over a tooth's lifetime, most of it occurs in these early years.

To prevent or stop any infection, we would normally perform a root canal treatment in which we remove the pulp tissue and fill the empty pulp chamber and root canals. This poses no real issue in an older tooth with mature dentin. Removing the pulp from an immature tooth, though, could interrupt dentin development and interfere with the tooth's root growth. Besides a higher risk of discoloration, the tooth could become more brittle and prone to fracture.

That's why we place a high priority on preserving a younger tooth's pulp. Rather than a root canal treatment, we may treat it instead with one of a number of modified techniques that interact less with the pulp. Which of these we use will depend on the extent of the pulp's involvement with the injury or disease.

If it's unexposed, we may use a procedure called indirect pulp therapy, where we remove most of the tooth's damaged dentin but leave some of the harder portion intact next to the pulp to avoid exposure. If, though, some but not all of the pulp is damaged, we may perform a pulpotomy: here we remove the damaged pulp tissue while leaving the healthier portion intact. We may then apply a stimulant substance to encourage more dentin production to seal the exposure.

These and other techniques can help repair an injured young tooth while preserving most or all of its vital pulp. Although we can't always use them, when we can they could give the tooth its best chance for a full life.

If you would like more information on caring for your child's 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 “Saving New Permanent Teeth after Injury.”


By W. Robert Howarth, DDS, FASD, Family and Sports Dentistry
May 08, 2019
Category: Oral Health
Tags: fluroide  
KeepanEyeonYourFamilysFluorideIntake

Fluoride is a critical weapon in the war against tooth decay. But this natural chemical proven to strengthen tooth enamel has also aroused suspicion over the years that it might cause health problems.

These suspicions have led to rigorous testing of fluoride's safety. And the verdict from decades of research? We've found only one verifiable side effect, a condition called enamel fluorosis. Caused by too much fluoride present in the body, enamel fluorosis produces white streaks and patches on teeth, and can develop into darker staining and pitting in extreme cases. But other than having an unattractive appearance, the teeth remain sound and healthy.

Fortunately, you can reduce the risk of fluorosis by limiting fluoride exposure to within recommended limits. Fluoride can show up in processed foods and other substances, but the two sources you should focus on most are oral hygiene products and fluoridated drinking water.

Dentists highly recommend using toothpaste with fluoride to fight tooth decay. But be careful how much your family uses, especially younger members. An infant only needs a slight smear of toothpaste on their brush for effective hygiene. At around age 2, you can increase the amount to about the size of a vegetable pea.

As to drinking water, most utilities add fluoride to their supply. If yours does, you can find out how much they add by calling them or visiting cdc.gov ("My Water's Fluoride"), where you can also learn more about recommended levels of fluoridation. If you think it's excessive, you can switch to water labeled "de-ionized," "purified," "demineralized," or "distilled," which contain little to no added fluoride.

Even if your fluoridated water is within recommended levels, you may wish to take extra precautions for infants nursing with formula. If possible, use "ready-to-feed" formula, which usually contains very low amounts of fluoride if any. If you're using the powdered form, use only water with the aforementioned labeling for mixing.

Before making any drastic changes that might affect your family's fluoride intake, consult with your dentist first. And be sure you're keeping up regular dental visits—your dentist may be able to detect any early signs of fluorosis before it becomes a bigger problem.

If you would like more information on maintaining the proper fluoride balance with your family, 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 “Tooth Development and Infant Formula.”