My Blog
By H. Paul Walls, DMD
May 04, 2019
Category: Dental Procedures
Tags: dental implant   bone loss  
AnImplantRestorationCouldPreventBoneLoss

Losing teeth continues to be an all too common experience for people, especially those in their senior years. Fortunately, there are several ways to replace them, ranging from partial or full dentures to implants.

Some, though, postpone or simply choose not to replace a lost tooth, often because of the cost. But putting off a dental restoration could have a long-term impact on your health, and not in a good way. Continuing bone deterioration is one of the top consequences of delayed restoration.

Like other bones in the body, the jawbone is living tissue with cells that form, grow and eventually wear out. At the end of their life, these older cells give way to new cells. Eating and chewing play an important role in maintaining this growth cycle: the forces we generate as we chew travel up through the tooth roots to stimulate bone growth in the jaw.

When a tooth goes missing, though, the stimulus ends. Over time the bone cell replacement rate can fall off and the bone slowly loses volume. To make matters worse, bone loss can continue beyond the immediate bone underlying the tooth and affect the rest of the jawbone. The jaw can shrink in height and width, and in time become weaker overall and more susceptible to fracture.

But dental implant restorations in particular could help stop or even reverse bone deterioration at the site of the missing teeth. The titanium post implanted in the jaw attracts bone cells, which grow and adhere to its surface. Over time the bone fills in and becomes stronger.

You don't want to wait too long, though, because implants depend on a minimum amount of bone present for secure placement. You should therefore undergo an implant restoration as soon as it's practical after tooth loss. Otherwise, although we may be able to restore some of the lost bone with bone grafting, you may need to consider another restorative option.

When it comes to replacing missing teeth, time isn't on your side. But the right kind of dental restoration undertaken promptly can make for a brighter, healthier future.

If you would like more information on restoring lost 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 “The Hidden Consequences of Losing Teeth.”

By H. Paul Walls, DMD
April 24, 2019
Category: Oral Health
Tags: oral health  
WhatYouShoulddoAboutThisBizarreDrugSideEffect

Drugs play an indispensable role in treating disease. For example, life without antibiotics would be much more precarious—common infections we think nothing of now would suddenly become life-threatening.

But even the most beneficial drug can have disruptive side effects. Antibiotics in particular can cause a rare but still disturbing one: a growth on the tongue that at first glance looks like dark hair. In fact, it's often called "black hairy tongue."

It isn't hair—it's an overgrowth of naturally occurring structures on the tongue called filiform papillae. These tiny bumps on the tongue's upper surface help grip food while you're chewing. They're normally about a millimeter in length and tend to be scraped down in the normal course of eating. As they're constantly growing, they replenish quickly.

We're not sure how it occurs, but it seems with a small portion of the population the normal growth patterns of the papillae become unbalanced after taking antibiotics, particularly those in the tetracycline family. Smoking and poor oral hygiene also seem to contribute to this growth imbalance. As a result, the papillae can grow as long as 18 millimeters with thin shafts resembling hair. It's also common for food debris and bacteria to adhere to this mass and discolor it in shades of yellow, green, brown or black.

While it's appearance can be bizarre or even frightening, it's not health-threatening. It's mostly remedied by removing the original cause, such as changing to a different antibiotic or quitting smoking, and gently cleaning the tongue everyday by brushing it or using a tongue scraper you can obtain from a pharmacy.

One word of caution: don't stop any medication you suspect of a side effect without first discussing it with your prescribing doctor. While effects like black hairy tongue are unpleasant, they're not harmful—and you don't want to interfere with treatments for problems that truly are.

If you would like more information on reactions to medication that might affect your oral health, please contact us or schedule an appointment for a consultation.

ADifferentKindofChipShotforProGolferDanielleKang

While the sport of golf may not look too dangerous from the sidelines, players know it can sometimes lead to mishaps. There are accidents involving golf carts and clubs, painful muscle and back injuries, and even the threat of lightning strikes on the greens. Yet it wasn’t any of these things that caused professional golfer Danielle Kang’s broken tooth on the opening day of the LPGA Singapore tournament.

“I was eating and it broke,” explained Kang. “My dentist told me, I've chipped another one before, and he said, you don't break it at that moment. It's been broken and it just chips off.” Fortunately, the winner of the 2017 Women’s PGA championship got immediate dental treatment, and went right back on the course to play a solid round, shooting 68.

Kang’s unlucky “chip shot” is far from a rare occurrence. In fact, chipped, fractured and broken teeth are among the most common dental injuries. The cause can be crunching too hard on a piece of ice or hard candy, a sudden accident or a blow to the face, or a tooth that’s weakened by decay or repetitive stress from a habit like nail biting. Feeling a broken tooth in your mouth can cause surprise and worry—but luckily, dentists have many ways of restoring the tooth’s appearance and function.

Exactly how a broken tooth is treated depends on how much of its structure is missing, and whether the soft tissue deep inside of it has been compromised. When a fracture exposes the tooth’s soft pulp it can easily become infected, which may lead to serious problems. In this situation, a root canal or extraction will likely be needed. This involves carefully removing the infected pulp tissue and disinfecting and sealing the “canals” (hollow spaces inside the tooth) to prevent further infection. The tooth can then be restored, often with a crown (cap) to replace the entire visible part. A timely root canal procedure can often save a tooth that would otherwise need to be extracted (removed).

For less serious chips, dental veneers may be an option. Made of durable and lifelike porcelain, veneers are translucent shells that go over the front surfaces of teeth. They can cover minor to moderate chips and cracks, and even correct size and spacing irregularities and discoloration. Veneers can be custom-made in a dental laboratory from a model of your teeth, and are cemented to teeth for a long-lasting and natural-looking restoration.

Minor chips can often be remedied via dental bonding. Here, layers of tooth-colored resin are applied to the surfaces being restored. The resin is shaped to fill in the missing structure and hardened by a special light. While not as long-lasting as other restoration methods, bonding is a relatively simple and inexpensive technique that can often be completed in just one office visit.

If you have questions about restoring chipped teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Porcelain Veneers” and “Artistic Repair of Chipped Teeth With Composite Resin.”

By H. Paul Walls, DMD
April 04, 2019
Category: Dental Procedures
Tags: teeth grinding  
StressandNighttimeTeethGrinding

April is National Stress Awareness Month. But what does stress have to do with dentistry? According to the American Academy of Sleep Medicine, if you have a Type A personality or are under a lot of stress, you are more likely to suffer from a condition called bruxism, which means you habitually grind or gnash your teeth. One in ten adults grind their teeth, and the rate is much higher in stressful professions. In fact, the bruxism rate is seven times higher among police officers!

Many people grind their teeth in their sleep without realizing it, so how would you know if you are a "sleep bruxer"? If your spouse frequently elbows you in the ribs because of the grinding sounds you make, that could be your first clue. Unfortunately, dental damage is another common sign. Some people find out they are nighttime teeth grinders only when they are examined by a dentist since bruxing often leads to wear patterns on the teeth that only happen because of this behavior. Other complications can also develop: The condition can interfere with sleep, result in headaches and cause soreness in the face, neck or jaw. Chronic or severe nighttime teeth grinding can damage dental work, such as veneers, bridgework, crowns and fillings, and can result in teeth that are worn down, chipped, fractured or loose.

The most common treatment is a custom-made night guard made of high-impact plastic that allows you to sleep while preventing your upper and lower teeth from coming into contact. Although a night guard will protect your teeth and dental work, it won't stop the grinding behavior. Therefore, finding and treating the cause should be a priority.

The Bruxism Association estimates that 70 percent of teeth grinding behavior is related to stress. If you are a bruxer, you can try muscle relaxation exercises, stretching and breathing exercises, stress reduction techniques and, where feasible, any lifestyle changes that can allow you to reduce the number of stressors in your life. Prescription muscle relaxants may also help. In addition, teeth grinding may be related to sleep apnea. This possibility should be investigated since sleep apnea can have some serious health consequences—we offer effective treatments for this condition as well.

We can spot signs of bruxism, so it's important to come in for regular dental checkups. We look for early indications of dental damage and can help you protect your smile. If you have questions about teeth grinding or would like to discuss possible symptoms, please contact our office or schedule an appointment for a consultation. You can read more in the Dear Doctor magazine articles “Teeth Grinding” and “Stress & Tooth Habits.”

By H. Paul Walls, DMD
March 25, 2019
Category: Uncategorized
Tags: teeth grinding  
3ThingsYouShouldKnowAboutTeethGrinding

Do you grind your teeth? If you're not sure, ask your family—sometimes the sound of teeth grinding against teeth might make enough noise to be keeping them up at night. You might also be waking with sore jaw muscles and joints.

If you suspect you have this habit of involuntarily grinding, gnashing or clenching your teeth, it's a good idea to get it checked. Here are 3 things you should know about this odd habit.

Teeth-grinding more prevalent among children. Children are more likely than adults to grind their teeth in their sleep, thought to be a consequence of their developing swallowing mechanism, but usually grow out of it without any long-term effects. Adults with the habit seem to grind their teeth for different reasons, one of the most significant being a response to high stress. Tobacco could be another factor: users are twice as likely as non-users to grind their teeth. Adult teeth-grinding may also be associated with high caffeine consumption, illicit drug use or Parkinson's Disease, which impairs brain nerve function.

Sleep apnea can be an underlying cause. There's one other major underlying cause to add to that list: obstructive sleep apnea. One international study of thousands of patients from different countries found both high anxiety or stress and sleep-related breathing disorders were two of the most significant risk factors for adult teeth-grinding. It's believed the physical stress generated by these temporary episodes of breathing obstruction occurring several times a night could trigger teeth-grinding.

Teeth-grinding can cause dental problems. While having a teeth-grinding habit doesn't automatically mean you'll have dental issues, your risk can increase dramatically. Due to its chronic nature, teeth-grinding can lead to excessive tooth wear, dental work damage or jaw joint dysfunction. In some extreme cases, it could cause tooth fracture.

If you grind your teeth, your dentist may be able to help by creating a custom-made occlusal guard that can reduce biting forces while you're wearing it. You might also minimize teeth-grinding by quitting tobacco and other lifestyle changes, or getting a better handle on stress management. And if you're also diagnosed with obstructive sleep apnea, getting treatment for that condition will not only improve your overall health, it could help put an end to your teeth-grinding habit.

If you would like more information on bruxism, 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 “Teeth Grinding: Causes and Therapies for a Potentially Troubling Behavior.”





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