Posts for category: Oral Health

By T. Dale Twilley, DMD & Thomas D. Twilley, DMD
January 30, 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 T. Dale Twilley, DMD & Thomas D. Twilley, DMD
January 20, 2019
Category: Oral Health
Tags: tooth decay  
ToothDecaycanbeLessofaProblemwithMinimallyInvasiveDentistry

“Less is more” is a truism for much of life. It’s also an important feature of an emerging approach to treating tooth decay known as minimally invasive dentistry (MID).

MID updates another revolution in dental care that occurred in the early 1900s. Treating decay took a quantum leap thanks to techniques developed by Dr. G. V. Black, considered the father of modern dentistry. Dr. Black’s approach (known as “extension for prevention”) involved not only removing decayed tooth structure, but also adjacent areas deemed vulnerable to decay, which made them easier to clean. On the downside, though, it also created larger than normal fillings.

As the practice prevailed through much of the Twentieth Century another weakness became apparent—the approach could not guarantee a treated tooth would not experience decay again. This became the real impetus toward MID—to find more comprehensive ways to treat decay with as little impact on the tooth structure as possible.

These efforts received a real boost from emerging technology. This was especially true in diagnostics with the rise of new devices like intraoral cameras and techniques like laser fluorescence that can enable dentists to detect decay much earlier. It’s now possible to catch the disease at an earlier stage before substantial damage to the tooth occurs.

MID has also led to new treatments that preserve more of the tooth structure. Traditional drilling is increasingly giving way to air abrasion, the use of a fine particle stream of aluminum oxide, glass beads or baking soda directed precisely at decayed structure and minimizing damage to healthy structure. We’re also using new filling materials like composite resin for restorations after treatment that are strong yet still life-like and attractive.

We also can’t forget the role of the twin daily hygiene practices brushing and flossing to remove bacterial plaque, the main source of dental disease. And regular dental cleanings and checkups round out the MID approach, helping to ensure that decay doesn’t get too far. The end result of this revolutionary approach: your teeth can experience less impact from treatment and remain healthier and more attractive in the long-run.

If you would like more information on minimally invasive dental care, 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 “Minimally Invasive Dentistry: When Less Care is more.”

By T. Dale Twilley, DMD & Thomas D. Twilley, DMD
December 31, 2018
Category: Oral Health
Tags: sensitive teeth  
ThereareVariousWaystoTreatSensitivity-DependingonitsCause

You may be among the one in three Americans who suffer from the pain of tooth sensitivity. Before attempting treatment, though, we must first identify the cause.

Your teeth are made of layers of different organic tissue. The pulp at the center of the tooth contains nerves that transmit pain or pressure sensation to the brain. The pulp is encased by dentin, a layer of tissue composed of tiny tubules that conduct temperature and pressure changes from outside the tooth to the pulp nerves. The hard outer enamel shell shields the dentin from over-stimulation from these sensations.

There are, however, some instances where the dentin may become exposed and cause sensitivity in the tooth. This can occur when the gum tissue recedes and the root of the tooth is exposed to the oral environment. If the root loses its surface coating (referred to as cementum, a cement-like outer layer around the root surfaces) because of over-aggressive brushing (too hard for too long) or advanced periodontal (gum) disease, sensitivity is often the result.

Another instance is enamel erosion. Although made of the hardest substance in the human body, enamel has one major enemy — acid. A high oral acid level brought on by over-consuming acidic foods and beverages or as a symptom of gastric reflux disease dissolves (de-mineralizes) the enamel’s mineral content. Brushing just after eating actually contributes to de-mineralization because the enamel is in a softer state. It requires forty-five minutes to an hour for your saliva to neutralize acid and restore minerals to the enamel — you may actually be brushing away enamel with this practice.

Once we know the underlying cause, we can use an appropriate method to reduce sensitivity. One way is to reduce nerve sensitivity in the dentin’s tubules or block them altogether. There are several chemical products for both home and dental office application that can reduce sensitivity and encourage enamel re-mineralization (as can the fluoride added to toothpaste). We can also strengthen enamel and provide a mechanical barrier to acid through concentrated fluoride in a varnish applied to tooth and root surfaces. And, life-like restorations like crowns or veneers not only improve the appearance of your teeth, they can also provide coverage for exposed dentin.

If you are experiencing painful sensitivity, make an appointment to visit us. Once we know the source, we can treat the problem and reduce your discomfort.

If you would like more information on tooth sensitivity and how to treat it, 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 “Treatment of Tooth Sensitivity.”

By T. Dale Twilley, DMD & Thomas D. Twilley, DMD
November 01, 2018
Category: Oral Health
Tags: oral health   saliva  
SalivaPerformsManyFunctionsforBothOralandGeneralHealth

While oral hygiene, a nutritious diet and regular dental visits are all crucial to long-term oral health, these efforts complement what your body already does to keep your mouth healthy. One of the major players in this function is saliva.

Produced by hundreds of glands located throughout the mouth, saliva does much more than help you swallow and wash away food. As you chew, an enzyme in saliva known as amylase breaks down starches in your food to make it easier to digest in the stomach. Saliva also contains antibodies, similar to what’s in tears, which can fight bacteria and other disease-causing organisms.

Perhaps its most important function, though, is its ability to protect and maintain healthy tooth enamel. The strongest substance in the body, enamel nevertheless has one primary enemy — the acid found in certain foods or as a byproduct of bacteria feeding on sugar and other carbohydrates.

When the ideally neutral pH level of the mouth becomes too acidic (nearly every time you eat), minerals in the enamel begin to soften and dissolve. The increased saliva flow when we eat floods the mouth with buffering agents that neutralize the acid and restore the mouth’s normal pH level. Not only does saliva stop demineralization, but it also restores a good bit of the enamel’s mineral content.

In recent years, a new role for saliva has begun to emerge as a means to diagnose disease. Like blood, urine and other bodily fluids, saliva contains molecules that serve as biological markers for disease. Given the right equipment, saliva has the potential to indicate early signs of cancer (including oral), diabetes and other systemic conditions. As the means to examine saliva for these markers increases it promises to be easier and less expensive to collect and sample than blood, while reducing the chances of transmitting bloodborne diseases to healthcare workers.

It’s a lot to consider with this fluid that you hardly notice, except when it isn’t there. Saliva is proof that our efforts at keeping our mouths healthy cooperate and depend on our bodies’ amazing systems.

If you would like more information on saliva and other ways your body maintains a healthy mouth, 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 “Saliva.”

By T. Dale Twilley, DMD & Thomas D. Twilley, DMD
October 22, 2018
Category: Oral Health
Tags: tooth decay  
LimitingRefinedSugarinYourDietcanReduceRiskofToothDecay

“Cut down on sweets, especially between meals” is perhaps one of the least popular words of advice we dentists regularly give. We’re not trying to be killjoys, but the facts are undeniable: both the amount and frequency of sugar consumption contributes to tooth decay. Our concern isn’t the naturally occurring sugars in fruits, vegetables, grains or dairy products, but rather refined or “free” sugars added to foods to sweeten them.

The World Health Organization and the U.S. Food and Drug Administration both advise consuming no more than 50 grams (about ten teaspoons) of sugar a day. Unfortunately, our nation’s average per person is much higher: we annually consume around 140 pounds per capita of refined sugars like table sugar or high fructose corn syrup, more than three times the recommended amount. Soft drinks are the single largest source of these in our diets — Americans drink an average of 52 gallons every year.

The connection between sugar and tooth decay begins with bacteria that ferments sugar present in the mouth after eating. This creates high levels of acid, which causes the mineral content of tooth enamel to soften and erode (a process called demineralization) and makes the teeth more susceptible to decay. Saliva naturally neutralizes acid, but it takes about thirty minutes to bring the mouth’s pH to a normal level. Saliva can’t keep up if sugars are continually present from constant snacking or sipping on soft drinks for long periods.

You can reduce the sugar-decay connection with a few dietary changes: limit your intake of sugar-added foods and beverages to no more than recommended levels; consume sweets and soft drinks only at meal times; replace sugar-added foods with fresh fruits and vegetables and foods that inhibit the fermentation process (like cheese or black and green teas); and consider using mint or chewing gum products sweetened with xylitol, a natural alcohol-based sugar that inhibits bacterial growth.

Last but not least, practice good oral hygiene with daily brushing and flossing, along with regular office cleanings and checkups. These practices, along with limits on refined sugar in your diet, will go a long way toward keeping your teeth and mouth healthy and cavity-free.

If you would like more information on the relationship of sugar and dental disease, 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 “Nutrition & Oral Health.”