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Cold Sores

Cold sores are small, painful, fluid-filled blisters or sores that appear on the lips, mouth, or nose that are caused by a virus. The sores can be painful and usually last a few days. Unlike most viral infections, the cold sore virus is not completely eliminated by the body defenses. For this reason, cold sores often recur.

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Can Sinuses Affect Your Teeth?

By: Thomas P. Connelly, D.D.S.

I once had this patient who had chronic/repeated pain in his upper teeth (basically the premolars and molars on his upper right side). He had been to two different dentists, who did an exam and took X-rays, but really couldn’t find anything wrong with the teeth. But he still had pain. This went on for a year or two.

So one day, he ended up in my chair. And like the dentists before, I took some X-rays, but couldn’t find anything wrong with the teeth themselves. In fact, they were in spectacular shape. So I asked him if there were any other issues he may be experiencing — headaches, jaw pain, etc? He said no — he felt fine, except for the teeth hurting, and the pressure…

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The Different Types of Dental Floss

Entry by Thomas P. Connelly, D.D.S.

As a NYC Cosmetic Dentist, I get asked a lot about dental floss, and which type is the “best.” I have a pretty standard answer for that question, and it goes like this: “Whatever type you will actually use daily.” That’s easily the most important aspect of floss — whether or not it’s actually used.

To begin, let’s quickly go over that “what and why” of flossing: Flossing is running a piece of floss (which resembles thread or string) between your teeth. It cleans away plaque that your toothbrush will miss, and is a very essential part of good oral health. In fact, if you only brush and do not floss, you’re only really doing half the job. So flossing daily is something everyone should do.

Ok, now we know you should be flossing. So you go to the store and look to buy some, and realize that hey, there are a lot of different “types.” Which one should I buy? I’ll go over that in a second, but I do want to preface this with an expanded explanation of my previous answer — the best floss out there is floss that gets used. Floss does you no good sitting in the cabinet — it actually has to be used, and in my opinion, there is no “better” type of floss. Using two different types of floss will not give you two different results. Now, two different types of floss may or may not be as comfortable as each other to use, or may or may not taste as good, etc. So THAT could be a determining factor in you using them. But again, any floss that gets used is good floss. This opinion of mine is shared by most other dentists and the ADA as well, which states “It’s not what type of floss you use, but how and when you use it. If you have a preferred type of floss, you may be more likely to use it.”

So that said, let’s take a look at the different “types” of floss.

 

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How Do You Treat White Spots After Braces?

How Do You Treat White Spots After Braces?
by DR. JOSEPH THOMPSON

What are these white spots on my teeth?

A very common problem that can occur while a patient has braces is the formation of white spots during treatment. When the braces are removed, some patients will have unsightly white spots and they  wonder why they are there.

Some patients are surprised and they shouldn’t be. Your orthodontist watches and warns when white spots are forming. The white spots are the decalcified areas of the teeth where plaque was allowed to stay for long periods of time. You will hear your orthodontist say over and over again to keep your teeth clean, brush and floss.

How did the white spots develop?

Heavy Plaque on Patient with Braces

There are many types of bacteria that live in our mouth. They show up after you were born and stay with you your whole life. You can’t get rid of them completely. You can only reduce the amount of bacteria in your mouth. We reduce the bacteria by brushing, flossing and rinsing with mouthwash that kills bacteria.

The bacteria streptococcus mutans and lactobacillus are the main germs in dental plaque. Dental plaque is sticky and likes to attach to smooth surfaces of the tooth. These bacteria eat sugars that you eat everyday. When you eat your food, it will contain sugar that the bacteria eats. After the bacteria ingests the sugar, they produce more of themselves and they give off acid for 20 minutes. Since, the plaque is right up against your teeth, the acid dissolves the enamel causing a white decalcification spot to form and eventually it will cause a cavity

A cavity is just a hole in your tooth. These white spots are the beginnings of a cavity. Since the outside layer of the enamel is very hard due to it being enriched with fluoride from our tooth paste, food and water, the decalcification starts below this layer deeper in the enamel. When you look at the surface of the tooth, the outside layer is intact but you can see the white decalcification spot. Once the decalcification weakens the outside layer of enamel enough, it will break through resulting in a hole in the tooth, a cavity.

Once the cavity forms, it will not go away. The bacteria will lay in it and continue the decalcification making the hole larger. As the cavity grows, it can cause pain and it may cause the pulp to die. A cavity has to be repaired by a dentist before it gets too large and the tooth has to be extracted.

Primary or baby teeth have very thin enamel and cavities grow deep quickly. Whereas, with the permanent teeth, the enamel is very thick and a cavity grows slowly.

If you think you have a cavity forming, see your dentist quickly for restoration. Seeing your dentist in a timely manner may prevent tooth loss and cost less.

 

 

What can be done to prevent white spots from developing?

Very simple, brush your teeth. Keep the plaque to a minimum. Dig with the bristles of your brush underneath the wire. The plaque will accumulate mainly between the wire and the gums and underneath the wires. Be aggressive.

Do a good inspection after you brush. Look at your teeth. If you see anything on your teeth, it is either plaque or food. Take your toothbrush that you just used and remove it.

Besides using a regular toothbrush, you can also use an electrical tooth brush like an Oral B or Sonicare toothbrush. Electric toothbrushes work very well in reducing plaque and are better than a waterpik. Waterpiks are not good at removing plaque as well as an electric toothbrush. Also waterpiks can push bacteria into the gum tissue if you have gum disease. Don’t use waterpiks to clean your teeth and braces.

What can be done about the white spots?

Ask your orthodontist for a prescription for GC MI Paste. GC MI Paste is a specially formulated paste that remineralizes the enamel. It replenishes the calcium and phosphate lost during acid production by the plaque. Another product that does not require a prescription is Tooth Mousse GC.

Another item that can be prescribed from your orthodontist or family dentist is Colgate’s PreviDent 5000 Plus (Rx only) or Colgate PreviDent 5000 Sensitive (Rx only) tooth paste. Both deliver 5000 ppm of fluoride in a professional strength 1.1% Sodium Fluoride paste. Directions state they you should brush once a day, preferable before bed, for two minutes. In three to six months, caries remineralized by 57% in most patients. These products are not recommended for children under 6 years old.

DMG ICON Infiltrating Resin for White Spot Decalcifications

After the CG MI paste is used for a period of time, and there are still some white spots, an infiltrating resin like DMG ICON can be applied by your family dentist or orthodontist to reduce the appearance of the white spots. This procedure takes just one office visit. After the teeth are cleaned, they are prepared for the resin. The resin infiltrates the enamel and changes the color of the white spot to a more tooth colored enamel. ICON may not completely get rid of all the white spots but it does accomplish a better appearance.

So it’s up to you. If you keep your teeth free from plaque, the chances of a white spot developing will be very minimal.

SLEEP APNEA AND ORTHODONTICS

An Interdisciplinary Approach to Treating a Chronic Sleep Condition Author- Jim Duffy

Interdisciplinary treatment planning is a concept that’s gaining relevance among oral health professionals. It’s one of the chief tenets of the popular Seattle Study Club, and many finding it extremely rewarding to work with a group of like-minded professionals when treating their patients. This evolving holistic approach to oral health is exemplified in the evolving role that the orthodontist can play in addressing sleep apnea.

The notion that people should see an orthodontist about the sleeping problems they or their children endure might come as a surprise to the general public, but more and more medical and orthodontic experts are pointing toward a future that heads in that direction.

Consider, for example, the most common type of sleep-disordered breathing, obsessive sleep apnea syndrome (OSAS). It’s quite common among both children and adults, though precisely how common can be difficult to say because the condition is significantly under-diagnosed.

A 2012 paper in the journal Pediatrics placed sleep apnea numbers among children within the broad range of 1 to 5 percent of the population. The nonprofit Sleep Foundation estimates that at least 18 million adults have OSAS.

The syndrome can affect patients in a range from mild to severe, with the more serious cases being quite dangerous to long-term health. Among children, OSAS has been linked with poor school performance, learning disabilities, behavior problems, and even some cardiac abnormalities. In adults, it can boost the risk of hypertension, cardiovascular disease, coronary artery disease, and insulin-dependent diabetes.

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Pediatric Sleep Disordered Breathing/Obstructive Sleep Apnea

Pediatric Sleep Disordered Breathing/Obstructive Sleep Apnea

Sleep-disordered breathing (SDB) is a general term for breathing difficulties occurring during sleep. SDB can range from frequent loud snoring to Obstructive Sleep Apnea (OSA) a condition involving repeated episodes of partial or complete blockage of the airway during sleep. When a child’s breathing is disrupted during sleep, the body perceives this as a choking phenomenon. The heart rate slows, blood pressure rises, the brain is aroused, and sleep is disrupted. Oxygen levels in the blood can also drop.

Approximately 10 percent of children snore regularly and about 2-4 % of the pediatric population has OSA.   Recent studies indicate that mild SDB or snoring may cause many of the same problems as OSA in children.

COULD MY CHILD HAVE OBSTRUCTIVE SLEEP APNEA?

The most obvious symptom of sleep disordered breathing is loud snoring that is present on most nights. The snoring can be interrupted by complete blockage of breathing with gasping and snorting noises and associated with awakenings from sleep. Due to a lack of good quality sleep, a child with sleep disordered breathing may be irritable, sleepy during the day, or have difficulty concentrating in school. Busy or hyperactive behavior may also be observed. Bed-wetting is also frequently seen in children with sleep apnea.

A common physical cause of airway narrowing contributing to SDB is enlarged tonsils and adenoids.  Overweight children are at increased risk for SDB because fat deposits around the neck and throat can also narrow the airway. Children with abnormalities involving the lower jaw or tongue or neuromuscular deficits such or cerebral palsy have a higher risk of developing sleep disordered breathing.

Potential consequences of untreated pediatric sleep disordered breathing

  • •Social: Loud snoring can become a significant social problem if a child shares a room with siblings or at sleepovers and summer camp.
  • •Behavior and learning:  Children with SDB may become moody, inattentive, and disruptive both at home and at school.   Sleep disordered breathing can also be a contributing factor to attention deficit disorders in some children.
  • •Enuresis: SDB can cause increased nighttime urine production, which may lead to bedwetting.
  • •Growth:  Children with SDB may not produce enough growth hormone, resulting in abnormally slow growth and development.
  • •Obesity: SBD may cause the body to have increased resistance to insulin or daytime fatigue with decreases in physical activity.  These factors can contribute to obesity.
  • •Cardiovascular:   OSA can be associated with an increased risk of high blood pressure or other heart and lung problems.
 
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Dental Phobia-Treatment and Coping Methods

Communicating With Your Dentist

Talking with your dentist is the key to beating dental distress. Modern dentistry can be almost painless. Therefore, it’s worth taking the time to discuss your fears — and the potential treatment options — with your dentist.

You can feel more in control if you take part in decisions about your treatment. And that can help you to feel less anxious. Your dentist should discuss with you all the procedures you may need. You may be able to have several procedures done at one time or have a series of shorter appointments. Ask your dentist to describe the types of pain control available. Then decide which you feel will work best for you.

During the appointment, ask your dentist to explain what’s happening at every stage of the procedure. This may help to lower your anxiety. When you know what the dentist is about to do next, you can prepare yourself. You won’t be taken by surprise.

On the other hand, some people may feel less anxious if they don’t know what’s happening. If this is true for you, explain this to your dentist. He or she should be willing to adapt to your wishes whenever possible.

Another helpful technique is to agree on a hand signal you can use if you want everything to stop right away. This will give you a sense of control. It can help to lessen your anxiety. You don’t have to wait until you’re having pain to give the signal. You may ask the dentist to stop because you’d like to rinse your mouth or simply catch your breath, or just take a break for a few seconds.

You may feel embarrassed to discuss your fears. Remember that you are not alone. Fears are not uncommon. Once your dentist knows what the issues are, he or she will be better able to find workable solutions.

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Drowsy Driving ~ Raising awareness among health care communities and the public about the costs and dangers of obstructive sleep apnea when left untreated

Drowsy driving can be as dangerous as drunk driving. Drivers are 15 times more likely to be involved in a deadly motor vehicle accident when they have excessive daytime sleepiness, a common symptom of sleep apnea. Motor vehicle accidents due to drowsy driving account for $48 billion in medical costs each year. Current legislation recommends that commercial drivers get screened and treated for sleep apnea. However, many drivers do not know that they have sleep apnea. The American Academy of Sleep Medicine estimates that 18 million Americans have sleep apnea. 80 to 90 percent of cases remain undiagnosed and untreated. The Institute of Medicine reports 50 to 70 million Americans suffer from chronic sleep disorders, including sleep apnea. Help protect yourself, your loved ones and your fellow travelers.

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Mouthguards

Mouthguards

Imagine what it would be like if you suddenly lost one or two of your front teeth. Smiling, talking, eating—everything would suddenly be affected.

Mouthguards, also called mouth protectors, help cushion a blow to the face, minimizing the risk of broken teeth and injuries to your lips, tongue, face or jaw. They typically cover the upper teeth and are a great way to protect the soft tissues of your tongue, lips and cheek lining. Knowing how to prevent injuries like these is especially important if you participate in organized sports or other recreational activities.

When it comes to protecting your mouth, a mouthguard is an essential piece of athletic gear that should be part of your standard equipment from an early age. In fact, studies show that athletes are 60 times more likely to suffer harm to the teeth if they’re not wearing a mouthguard. While collision and contact sports, such as boxing, are higher-risk sports for the mouth, you can experience a dental injury in non-contact activities too, such as gymnastics and skating.

 

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