My Blog
By David E. James, DDS
September 19, 2020
Category: Oral Health
Tags: dry socket  
HowtoAvoidThisPainfulConditionAfterToothExtraction

Dentists and oral surgeons remove millions of teeth every year, most without any adverse aftereffects. But about 2% of patients experience a dry socket, a condition that, although not dangerous to health, can be quite painful.

Also known as alveolar osteitis, a dry socket occurs when the blood clot that normally forms right after extraction doesn't form or becomes lost later. The clot serves as a barrier for the underlying bone and nerves during the healing process; without it these tissues can become irritated from contact with air, food or fluids.

Dry sockets (which usually occur in the back, lower molars) are fortunately rare, mainly in patients over 25, smokers or women using oral contraceptives. Patients also have a higher risk of developing a dry socket if they attempt certain activities too soon after tooth extraction like vigorous chewing or brushing that may dislodge the protective clot.

You can reduce your chances of a dry socket after a tooth extraction with a few simple guidelines. Unless advised otherwise by your dentist, avoid brushing the day after extraction and gently rinse the mouth instead. It also helps to avoid hot liquids and eat softer foods for a few days. If you smoke, you should avoid smoking during this time and use a nicotine patch if necessary.

Over the next few days, you should remain alert for any signs of a dry socket, often a dull, throbbing pain that radiates outward toward the ears, and a bad taste or mouth odor. A prompt visit to the dentist will help alleviate these symptoms, often in just a few minutes.

To treat it, a dentist will typically irrigate the socket and apply a medicated dressing, which you would need to change every other day for up to a week. After that, you'll leave the dressing in place for a while as you heal.

A dry socket doesn't interfere with the healing process: Your extraction site will heal whether or not you have one. But prevention and treatment for a dry socket will help ensure your healing after an extracted tooth is much less uncomfortable.

If you would like more information on dry socket after tooth extraction, 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 “Dry Socket.”

By David E. James, DDS
September 09, 2020
Category: Oral Health
PopStarDemiLovatoPopsOutJayGlazersTooth

Singer and actor Demi Lovato has a new claim to fame: formidable martial artist. When she is not in the recording studio, on stage or in front of the camera, Lovato can often be found keeping in shape at Jay Glazer's Hollywood (California) gym. Glazer, who is best known as a sports journalist, also runs conditioning programs for professional athletes and celebrities based on mixed martial arts. On March 6, Glazer got more than he bargained for when 5'3" Lovato stepped into the ring and knocked out his front tooth.

Glazer reportedly used super glue to put his tooth back together. Not a good idea! While it may not be convenient to drop everything and get to the dental office, it takes an expert to safely treat a damaged tooth. If you glue a broken tooth, you risk having to undergo major work to correct your temporary fix—it's no easy task to "unglue" a tooth, and the chemicals in the glue may damage living tooth tissue as well as the surrounding gum and bone.

Would you know what to do in a dental emergency? Here are some guidelines:

  • If you chip a tooth, save the missing piece if possible. We may be able to reattach it.
  • If your tooth is cracked, rinse your mouth with warm water, but don't wiggle the tooth around or bite down on it. If it's bleeding, hold clean gauze to the area and call our office.
  • If your tooth is knocked loose or is pushed deeper into the socket, don't force the tooth back into position on your own. Immediate attention is very important.
  • If your tooth is knocked out, there's a chance it can be reattached. Pick up the tooth while being careful not to touch the root. Then rinse it off and have either someone place into its socket, or place it against the inside of your cheek or in a glass of milk. Please call the office immediately or go to a hospital.

What's the best thing to do in an emergency? Call us right away, and DON'T super glue your tooth! You can prevent worse problems by letting a professional handle any dental issues.¬†And if you've been living with a chipped, broken or missing tooth, call us to schedule an appointment for a consultation—there are several perfectly safe ways to restore your smile. Meanwhile, if you practice martial arts to keep in shape, think twice before getting into the ring with Demi Lovato!

To learn more, read the Dear Doctor articles “Trauma & Nerve Damage to Teeth” and “Saving New Permanent Teeth After Injury.”

By David E. James, DDS
August 30, 2020
Category: Oral Health
Tags: gum disease  
3ThingsThatCouldHelpYouAvoidAnotherRoundWithGumDisease

While periodontal (gum) disease could ruin your dental health, it doesn’t have to. Dentists and periodontists (specialists in gums and other supporting tooth structures) have effective methods for stopping it, especially if the infection is diagnosed and treated in its earliest stages. With effective treatment, those swollen, reddened and bleeding gums can return to a healthy shade of pink.

But even if we stop the infection, you’re not out of danger. If you’ve had at least one bout with gum disease, you’re at higher risk for another infection. We will need to maintain ongoing vigilance to prevent another infection.

If you’ve recently undergone treatment for gum disease, here are 3 things you should do to keep your now healthy gums continually healthy.

Practice daily oral hygiene. Gum disease arises most often from dental plaque, a thin biofilm of disease-causing bacteria that builds up on tooth surfaces. It’s important for everyone to remove this buildup with daily brushing and flossing, but it’s even more so if you’ve already experienced gum disease. Practicing effective oral hygiene every day will reduce the presence of bacteria that could ignite a new infection.

See the dentist more frequently. The general rule for routine dental cleanings and checkups is twice a year. But you may need more frequent visits, post-gum disease. Depending on the severity of your disease, we may recommend you make return visits at two- to three-month intervals of time. These visits may also include heightened screenings to ensure another infection hasn’t taken hold, as well as procedures to make it easier to clean certain tooth areas prone to plaque buildup.

Manage other health conditions. Gum disease’s severity is often caused by the inflammatory response your body initiates to fight the infection, which then becomes chronic. This is similar to other conditions like diabetes, heart disease or rheumatoid arthritis: There’s evidence inflammation elsewhere in the body could worsen a gum infection, and vice-versa. Managing other health conditions through medical care, medication and lifestyle changes could minimize the occurrence and severity of a future gum infection.

If you would like more information on remaining infection-free after gum 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 “Periodontal Cleanings.”

InterceptiveOrthodonticsStoppingPoorBitesBeforeTheyDevelop

Approximately 4 million tweens and teens are currently undergoing orthodontic treatment for a poor bite (malocclusion) that can cost their families thousands of dollars in braces or clear aligners. But treatment doesn't always have to follow this track: Found early, many malocclusions can be corrected or minimized before they fully develop.

Known as interceptive orthodontics, this particular approach to bite correction often begins as early as 6-10 years of age. Rather than move existing teeth, interceptive orthodontics focuses instead on redirecting jaw growth and intervening in other situations that can cause malocclusions.

For example, a child's upper jaw may not be growing wide enough to accommodate all incoming permanent teeth, crowding later arrivals out of their proper positions. But taking advantage of a gap during early childhood that runs through the center of the palate (roof of the mouth), orthodontists can increase jaw width with a device called a palatal expander.

The expander fits up against the palate with “legs” that extend and make contact with the inside of the teeth. With gradually applied pressure, the expander widens the central gap and the body naturally fills it with new bone cells. The bone accumulation causes the jaws to widen and create more room for incoming teeth.

Another way a malocclusion can develop involves the primary or “baby” teeth. As one of their purposes, primary teeth serve as placeholders for the future permanent teeth forming in the gums. But if they're lost prematurely, adjacent teeth can drift into the vacant space and crowd out incoming teeth.

Dentists prevent this with a space maintainer, a thin metal loop attached to the adjoining teeth that puts pressure on them to prevent them from entering the space. This spacer is removed when the permanent tooth is ready to erupt.

These and other interceptive methods are often effective in minimizing the formation of malocclusions. But it's often best to use them early: Palatal expansion, for example, is best undertaken before the central gap fuses in early puberty, and space maintainers before the permanent tooth erupts.

That's why we recommend that children undergo an orthodontic evaluation around age 6 to assess their early bite development. If a malocclusion looks likely, early intervention could prevent it and reduce future treatment costs.

If you would like more information on interceptive orthodontics, 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 “Interceptive Orthodontics.”

MouthBreathingCanLeadtoSeriousOralProblemsEspeciallyforChildren

It's normal for people to breathe through their nose. And for good reason: Nasal breathing filters contaminants, warms and humidifies incoming air, and helps generate beneficial nitric oxide. Chronic mouth breathing, on the other hand, can trigger a number of harmful effects, especially for the teeth and gums.

Because our survival depends on continuous respiration, our bodies automatically seek out the air flow path of least resistance, normally through the nose. But if our nasal passages become obstructed, as with enlarged adenoids or sinus congestion, we may involuntarily breathe through the mouth.

This can lead to oral problems like chronic dry mouth, which not only creates an unpleasant mouth feel, it also produces the ideal environment for dental disease. And, it could cause an even more serious problem for children during jaw and teeth development.

This is because the tongue rests along the roof of the mouth (palate) while breathing through the nose. In this position, the tongue serves as a mold for the upper jaw and teeth while they're growing during childhood. During mouth breathing, however, the tongue moves away from the palate, depriving the jaw and teeth of this molding effect, and possibly resulting in a poor bite.

You can prevent these and other oral problems by seeing a healthcare professional as soon as you notice your child regularly breathing through their mouth. The best professional for this is an ENT, a medical specialist for conditions involving the ears, nose and throat. ENTs provide treatment for diagnosed obstructions involving the tonsils, adenoids and sinuses.

Even so, persistent mouth breathing may already have affected your child's bite. It may be prudent, then, to also have their bite evaluated by an orthodontist. There are interventional measures that can help get jaw development back on track and minimize future orthodontic treatment.

Finally, a child who has undergone treatment to remove nasal breathing obstructions usually reverts to nasal breathing automatically. But sometimes not: To “relearn” normal breathing, a child may need to undergo orofacial myofunctional therapy (OMT) with a certified therapist to retrain their facial muscles and tendons to breathe through the nose.

Your child's tendency to mouth breathing may not seem like a major problem. But prompt attention and treatment could prevent it from interrupting their dental development.

If you would like more information on correcting mouth breathing, 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 Trouble With Mouth Breathing.”





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