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By Wendy Willoughby, D.D.S.
April 09, 2014
Category: Dental Procedures
HowWeDeterminetheBestWaytoFixYourSmile

We all know that dentistry can do amazing things these days to give you the smile you've always dreamed of. With the latest cosmetic and restorative dental techniques, it is possible to achieve amazingly natural-looking results. But how do we map out the best route to a better smile? And how do we know that the results will hold up over time?

Every individual has a unique set of conditions in his or her mouth and it is our job to figure out how you have come to your present state, dentally speaking. We need to correct or at least manage any factors that could risk the success of your treatment. These risk factors fall into four basic categories:

Periodontal Risk — This involves the condition of the structures that support your teeth, including your gum and bone tissue. It's important to establish good periodontal health before we perform any restorative or cosmetic procedures.

Biomechanical Risk — This has to do with the structural integrity of your teeth. We will look at whether any tooth structure has been lost due to decay, and take steps to reduce your susceptibility to decay if necessary.

Functional Risk — This relates to your bite: how your teeth, muscles and jaw joints are functioning. For example, do you have excessive tooth wear or joint pain? If so, you are at a higher risk in this category and we need to figure out why.

Aesthetic Risk — This is the most subjective of the categories as beauty is in the eye of the beholder. Still, if you display a lot of your teeth and gums when you smile, any issues you have (gum recession, for example) will be that much more visible and affect your smile more. We will have to take this into account when we plan your treatment.

Only when we have determined how best to minimize your risk in all four of these categories can we restore or enhance your smile in a way that will not only look great but also last as long as possible.

If you have any questions about cosmetic or restorative dental treatment, please contact us to schedule an appointment for a consultation.

By Wendy Willoughby, D.D.S.
March 25, 2014
Category: Oral Health
AfraidToVisitADentistLetUsHelpYouOvercomeYourFear

Have you been avoiding seeing a dentist because you are afraid that the visit might be unpleasant or painful? Are you unhappy with the appearance of your teeth and the health of your mouth, even envious of others who are able to visit their dentist without hesitation?

If you've answered yes to these questions, you are not alone. Many people experience some anxiety about visiting their dentist. Some fears are based on past negative experiences, indirectly influenced by family members or friends, or even by images seen in the movies. Regardless of the origin of your fear, we will work with you to turn negative perceptions or experiences into positive ones. The most important thing to remember is that allowing dental problems to remain untreated can have bad consequences, including toothache, infection, poor appearance and even general health complications.

We will listen to you and even encourage you to express your feelings. Tell us the details of your fear and anxiety. You won't be judged but, instead, we want to understand exactly what troubles you, so that together we help you overcome what is preventing you from getting the care you want and need.

You will be in control at all times and we will never rush you. First we'll spend the time necessary to get you comfortable, before we even do any dentistry. After all, attempting to rush through a procedure may only incite more anxiety, and that is the last thing we want to do! We want you to leave our office with the feeling that you can more comfortably see us again building on your last positive experience.

If you would like to talk to us about what's bothering you and begin working together towards a solution, please call us today to schedule a consultation. To learn more about how patients and dentists can work together to eradicate dental fear, read the Dear Doctor magazine article “Overcoming Dental Fear & Anxiety.”

By Wendy Willoughby, D.D.S.
March 10, 2014
Category: Oral Health
Tags: bad breath   tongue scraper  
RemovingBacterialCoatingWithaTongueScrapercanReduceBadBreath

Although usually not considered a serious health condition, bad breath is nonetheless one of the most embarrassing conditions related to the mouth. Although some serious systemic diseases may result in mouth odor, most cases originate in the mouth or nose. Bacteria are usually the culprit — certain types of the organism can excrete volatile sulphur compounds, which emit a rotten egg or rotten fish smell.

The largest breeding ground for bacteria is the tongue, typically in the back where saliva and hygiene efforts aren’t as efficient in removing food remnants. A bacterial coating can develop on the surface of the tongue, much like the plaque that can adhere to teeth; the coating becomes a haven for bacteria that cause bad breath.

There seems to be a propensity in some people who exhibit chronic bad breath to develop this tongue coating. To rid the tongue of this coating, people with this susceptibility could benefit from the use of a tongue brush or scraper. These hygienic devices are specifically designed for the shape and texture of the tongue to effectively remove any bacterial coating. Toothbrushes, which are designed for the hard surface of the teeth, have been shown not to be as effective in removing the coating as a tongue scraper.

Before considering using a tongue scraper you should consult with your dentist first. If you suspect you have chronic bad breath, it’s important to determine the exact cause. Using a tongue scraper is unnecessary unless there’s an identifiable coating that is contributing to the bad odor. It’s also a good idea to obtain instruction from your dentist on the best techniques for using a tongue scraper to be as effective as possible and to avoid damaging soft tissues from over-aggressive use.

In addition, don’t neglect other hygiene habits like brushing, flossing and regular cleanings. Removing as much bacterial plaque as you can contributes not only to a healthier mouth but also pleasanter breath.

If you would like more information on the tongue and halitosis, 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 “Tongue Scraping.”

ProtectYourChildAthleteFromInjuryWithaCustom-FittedMouthguard

Youth sports can be a positive life experience for your child or teenager. But there's also a risk of injury in many sporting activities, including to the teeth and mouth. An injury to the mouth, especially for a child or young adolescent whose teeth are still developing, can have a significant negative impact on their oral health.

When it comes to teeth or mouth injuries, the best preventive measure is for your child to wear an athletic mouthguard, especially for contact sports like football, hockey or soccer. But be warned: not all mouthguards are alike — and neither is their level of protection.

Mouthguards can be classified into three types. The first is known as “stock,” which is the least expensive and offers the least level of protection. They usually are available only in limited sizes (small, medium, large, etc.) and cannot be custom-fitted for the individual. This significantly lowers their protective ability, and thus we do not recommend these to our patients.

The next type is referred to as “boil and bite.” These mouthguards are made of a material called thermoplastic, which becomes pliable when heated. When first purchased, the guard is placed in boiling water until soft; the individual can then place them in the mouth and bite down or press the guard into the teeth until it hardens and forms to their palates. Although this type offers a better fit and more protection than stock mouthguards, it isn't the highest level of protection available.

That distinction goes to the last type — a custom mouthguard made by a dentist. Although the most expensive of the three, it offers the best fit and the highest level of protection. A well-made custom mouthguard is tear-resistant, fits comfortably, is easy to clean and doesn't restrict speaking and breathing. We recommend this guard as your best alternative for protecting your child athlete from tooth and mouth damage.

If you would like more information on the use of athletic mouthguards for young athletes, contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Mouthguards.”

By Wendy Willoughby, D.D.S.
February 13, 2014
Category: Oral Health
Tags: gum disease  
TakeActionQuicklyAgainsttheAcuteFormofGingivitis

Periodontal (gum) diseases like gingivitis (inflammation of the gum tissues) can exist in a chronic form for some time, while gradually worsening. But given the right conditions, gingivitis could elevate quickly into an acute, painful condition known as Acute Necrotizing Ulcerative Gingivitis (ANUG). While it can be effectively treated, it’s important to diagnose ANUG early and begin treatment as soon as possible.

ANUG is also known as “trench mouth” as it was commonly recognized among soldiers in the trenches during World War I. Its name describes it as “necrotizing” and “ulcerative,” because when left untreated it kills (“necrotizes”) soft gum tissue, particularly the triangular tissue between teeth known as papillae, and causes severe and painful sores. A person with ANUG may also exhibit very bad breath and taste, with an odor peculiar to the disease. It’s believed that acute stress, poor nutrition and a lack of sleep can trigger the condition in individuals with pre-existing gingivitis.

As with other forms of gum disease, the first priority of treatment is to alleviate the symptoms. Besides initial cleaning (also known as scaling), we would also prescribe antibiotics (particularly Metronidazole, which is effective against the specific bacteria responsible for ANUG), an antibacterial mouthrinse like chlorhexidine, and a mild saline rinse. We would also control pain and inflammation with non-steroidal anti-inflammatory drugs like aspirin or ibuprofen.

As the symptoms come under control, it’s then necessary to treat the underlying gingivitis by continuing the thorough cleaning of the affected surfaces, including the roots, of as much plaque and tartar as possible. Good oral hygiene with semi-annual professional cleanings must become regular habits to inhibit future reoccurrences of the disease. Quitting smoking, eating a healthy diet and managing stress are also advisable.

Without treatment, ANUG symptoms will persist; you could eventually lose the affected papillae, and experience other detrimental effects to other periodontal tissue and bone structures. If you suspect you may have gingivitis or this acute form, you should visit us as soon as possible for a full evaluation and treatment. The earlier we diagnose and treat gum disease, the better your long-term outlook.

If you would like more information on painful gums, 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 “Painful Gums in Teens and Adults.”





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