Ever since childhood, when her career as a model and actress took off, Brooke Shields has enjoyed worldwide recognition — through advertisements for designer jeans, appearances on The Muppet Show, and starring roles in big-screen films. But not long ago, that familiar face was spotted in an unusual place: wearing a nasal anesthesia mask at the dentist's office. In fact, Shields posted the photo to her own Instagram account, with the caption “More dental surgery! I grind my teeth!” And judging by the number of comments the post received, she's far from alone.
In fact, researchers estimate that around one in ten adults have dental issues that stem from teeth grinding, which is also called bruxism. (Many children also grind their teeth, but it rarely causes serious problems, and is often outgrown.) About half of the people who are teeth grinders report problems like persistent headaches, jaw tenderness and sore teeth. Bruxism may also result in excessive tooth wear, and may damage dental work like crowns and bridges; in severe cases, loosened or fractured teeth have been reported.
Researchers have been studying teeth grinding for many years; their findings seem to indicate that it has no single cause. However, there are a number of factors that play a significant role in this condition. One is the anatomy of the jaw itself, and the effect of worn or misaligned teeth on the bite. Another factor relates to changes in brain activity that occur during the sleep cycle. In fact, nocturnal (nighttime) bruxism is now classified as a sleep-related movement disorder. Still other factors, such as the use of tobacco, alcohol and drugs, and a high level of stress or anxiety, can make an individual more likely to experience bruxism.
What can be done for people whose teeth grinding is causing problems? Since this condition may have many causes, a number of different treatments are available. Successful management of bruxism often begins by striving to eliminate the factors that may cause problems — for example, making lifestyle changes to improve your health, creating a soothing nighttime environment, and trying stress-reduction techniques; these may include anything from warm baths and soft music at bedtime, to meditation and mindfulness exercises.
Several dental treatments are also available, including a custom-made occlusal guard (night guard) that can keep your teeth from being damaged by grinding. In some cases, a bite adjustment may also be recommended: In this procedure, a small amount of enamel is removed from a tooth to change the way it contacts the opposite tooth, thereby lessening the biting force on it. More invasive techniques (such as surgery) are rarely needed.
A little tooth grinding once in a while can be a normal response to stress; in fact, becoming aware of the condition is often the first step to controlling it. But if you begin to notice issues that could stem from bruxism — or if the loud grinding sounds cause problems for your sleeping partner — it may be time to contact us or schedule an appointment. You can read more about bruxism in the Dear Doctor magazine article “Stress and Tooth Habits.”
Confused about which toothpaste to buy? You’re not alone — we’re all regularly confronted with multiple choices when we shop.
But you can simplify your decision-making process by first remembering that toothpaste has one main objective: helping to break down and remove dental plaque when you brush. Plaque is a thin film of bacteria and food particles that if you don’t remove through brushing and flossing could trigger tooth decay or periodontal (gum) disease.
Toothpastes contain abrasives and detergents to help make this possible. Abrasives like hydrated silica are gritty substances that work with the mechanical brushing action to loosen plaque. Detergents (usually sodium lauryl sulfate) help loosen and break down particles on your teeth that won’t otherwise dissolve with water alone. The combination of these ingredients and daily brushing action enables you to remove a substantial portion of plaque from your teeth every day.
These ingredients (along with others to retain moisture and bind everything together) are the foundation of any toothpaste. There are other additives, however, that you may also want to consider. The most important is fluoride, a naturally-occurring chemical proven to strengthen enamel against tooth decay. If you’re interested in a brighter smile, you can also look for bleaching agents that may help whiten some enamel staining. And, of course, there are various flavors to suit your taste.
You’ll also want to pay attention to ingredients if you have special concerns. If you have sensitive teeth, your dentist may recommend particular brands that help reduce discomfort. You’ll also want to be on the lookout for ingredients that you may be allergic to like the aforementioned sodium lauryl sulfate or flavors like cinnamon. Be sure to read the ingredients label if you have known issues with certain substances.
And while you’re reading the packaging look for one more thing — the American Dental Association Seal of Approval. This seal means any manufacturer claims for lower occurrences of cavities or other effects by that toothpaste have been independently verified.
It can be overwhelming amid all the product messaging to decide which toothpaste is right for you. But by knowing these basic facts about toothpaste, you can feel more confident choosing the right one to help keep your teeth and gums clean and healthy.
If you would like more information on oral hygiene products, 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 “Toothpaste: What’s in it?”
Let’s say you’re traveling to Italy to surprise your girlfriend, who is competing in an alpine ski race… and when you lower the scarf that’s covering your face, you reveal to the assembled paparazzi that one of your front teeth is missing. What will you do about this dental dilemma?
Sound far-fetched? It recently happened to one of the most recognized figures in sports — Tiger Woods. There’s still some uncertainty about exactly how this tooth was taken out: Was it a collision with a cameraman, as Woods’ agent reported… or did Woods already have some problems with the tooth, as others have speculated? We still don’t know for sure, but the big question is: What happens next?
Fortunately, contemporary dentistry offers several good solutions for the problem of missing teeth. Which one is best? It depends on each individual’s particular situation.
Let’s say that the visible part of the tooth (the crown) has been damaged by a dental trauma (such as a collision or a blow to the face), but the tooth still has healthy roots. In this case, it’s often possible to keep the roots and replace the tooth above the gum line with a crown restoration (also called a cap). Crowns are generally made to order in a dental lab, and are placed on a prepared tooth in a procedure that requires two office visits: one to prepare the tooth for restoration and to make a model of the mouth and the second to place the custom-manufactured crown and complete the restoration. However, in some cases, crowns can be made on special machinery right in the dental office, and placed during the same visit.
But what happens if the root isn’t viable — for example, if the tooth is deeply fractured, or completely knocked out and unable to be successfully re-implanted?
In that case, a dental implant is probably the best option for tooth replacement. An implant consists of a screw-like post of titanium metal that is inserted into the jawbone during a minor surgical procedure. Titanium has a unique property: It can fuse with living bone tissue, allowing it to act as a secure anchor for the replacement tooth system. The crown of the implant is similar to the one mentioned above, except that it’s made to attach to the titanium implant instead of the natural tooth.
Dental implants look, function and “feel” just like natural teeth — and with proper care, they can last a lifetime. Although they may be initially expensive, their quality and longevity makes them a good value over the long term. A less-costly alternative is traditional bridgework — but this method requires some dental work on the adjacent, healthy teeth; plus, it isn’t expected to last as long as an implant, and it may make the teeth more prone to problems down the road.
What will the acclaimed golfer do? No doubt Tiger’s dentist will help him make the right tooth-replacement decision.
If you have a gap in your grin — whatever the cause — contact us or schedule an appointment for a consultation, and find out which tooth-replacement system is right for you. You can learn more in the Dear Doctor magazine articles “Dental Implant Surgery” and “Crowns & Bridgework.”
Your nightly snoring has become a major sleep disturbance for you and other family members. But it may be more than an irritation — it could also be a sign of sleep apnea, a condition that increases your risk for life-threatening illnesses like high blood pressure or heart disease.
Sleep apnea most often occurs when the tongue or other soft tissues block the airway during sleep. The resulting lack of oxygen triggers the brain to wake the body to readjust the airway. This waking may only last a few seconds, but it can occur several times a night. Besides its long-term health effects, this constant waking through the night can result in irritability, drowsiness and brain fog during the day.
One of the best ways to treat sleep apnea is continuous positive airway pressure (CPAP) therapy. This requires an electric pump that supplies constant pressurized air to a face mask worn during sleep to keep the airway open. But although effective, many patients find a CPAP machine clumsy and uncomfortable to wear. That's why you may want to consider an option from your family dentist called oral appliance therapy (OAT).
An OAT device is a custom-made appliance that fits in the mouth like a sports mouthguard or orthodontic retainer. The majority of OAT appliances use tiny metal hinges to move the lower jaw and tongue forward to make the airway larger, thus improving air flow. Another version works by holding the tongue away from the back of the throat, either by holding the tongue forward like a tongue depressor or with a small compartment fitted around the tongue that holds it back with suction.
Before considering an OAT appliance, your dentist may refer you to a sleep specialist to confirm you have sleep apnea through laboratory or home testing. If you do and you meet other criteria, you could benefit from an OAT appliance. There may be other factors to consider, though, so be sure to discuss your options with your dentist or physician to find the right solution for a better night's sleep.
If you would like more information on sleep apnea treatments, 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 “Oral Appliances for Sleep Apnea.”
When you’re among the top players in your field, you need every advantage to help you stay competitive: Not just the best equipment, but anything else that relieves pain and stress, and allows you to play better. For top-seeded Canadian tennis player Milos Raonic, that extra help came in a somewhat unexpected form: a custom made mouthguard that he wears on the court and off. “[It helps] to not grind my teeth while I play,” said the 25-year-old up-and-coming ace. “It just causes stress and headaches sometimes.”
Mouthguards are often worn by athletes engaged in sports that carry the risk of dental injury — such as basketball, football, hockey, and some two dozen others; wearing one is a great way to keep your teeth from being seriously injured. But Raonic’s mouthguard isn’t primarily for safety; it’s actually designed to help him solve the problem of teeth grinding, or bruxism. This habitual behavior causes him to unconsciously tense up his jaw, potentially leading to problems with muscles and teeth.
Bruxism is a common issue that’s often caused or aggravated by stress. You don’t have to be a world-class athlete to suffer from this condition: Everyday anxieties can have the same effect. The behavior is often worsened when you consume stimulating substances, such as alcohol, tobacco, caffeine, and other drugs.
While bruxism affects thousands of people, some don’t even suspect they have it. That’s because it may occur at any time — even while you’re asleep! The powerful jaw muscles that clench and grind teeth together can wear down tooth enamel, and damage both natural teeth and dental work. They can even cause loose teeth! What’s more, a clenching and grinding habit can result in pain, headaches and muscle soreness… which can really put you off your game.
There are several ways to relieve the problem of bruxism. Stress reduction is one approach that works in some cases. When it’s not enough, a custom made occlusal guard (also called a night guard or mouthguard) provided by our office can make a big difference. “When I don’t sleep with it for a night,” Raonic said “I can feel my jaw muscles just tense up the next day. I don’t sense myself grinding but I can sort of feel that difference the next day.”
Â An occlusal guard is made from an exact model of your own mouth. It helps to keep your teeth in better alignment and prevent them from coming into contact, so they can’t damage each other. It also protects your jaw joints from being stressed by excessive force. Plus, it’s secure and comfortable to wear. “I wear it all the time other than when I’m eating, so I got used to it pretty quickly,” said Raonic.
Teeth grinding can be a big problem — whether you put on your game face on the court… or at home. If you would like more information about bruxism, contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Stress & Tooth Habits” and “When Children Grind Their Teeth.”
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