My Blog
By Eugene B. Nichols, DMD
November 10, 2017
Category: Dental Procedures
26MillionFansLikeJustinBiebersChippedTooth

Is a chipped tooth big news? It is if you’re Justin Bieber. When the pop singer recently posted a picture from the dental office to his instagram account, it got over 2.6 million “likes.” The snapshot shows him reclining in the chair, making peace signs with his hands as he opens wide; meanwhile, his dentist is busy working on his smile. The caption reads: “I chipped my tooth.”

Bieber may have a few more social media followers than the average person, but his dental problem is not unique. Sports injuries, mishaps at home, playground accidents and auto collisions are among the more common causes of dental trauma.

Some dental problems need to be treated as soon as possible, while others can wait a few days. Do you know which is which? Here are some basic guidelines:

A tooth that’s knocked out needs attention right away. First, try and locate the missing tooth and gently clean it with water — but avoid holding the tooth’s roots. Next, grasp the crown of the tooth and place it back in the socket facing the correct way. If that isn’t possible, place it between the cheek and gum, in a plastic bag with the patient’s saliva or a special tooth preservative, or in a glass of cold milk. Then rush to the dental office or emergency room right away. For the best chance of saving the tooth, it should be treated within five minutes.

If a tooth is loosened or displaced (pushed sideways, deeper into or out of its socket), it’s best to seek dental treatment within 6 hours. A complete examination will be needed to find out exactly what’s wrong and how best to treat it. Loosened or displaced teeth may be splinted to give them stability while they heal. In some situations, a root canal may be necessary to save the tooth.

Broken or fractured (cracked) teeth should receive treatment within 12 hours. If the injury extends into the tooth’s inner pulp tissue, root canal treatment will be needed. Depending on the severity of the injury, the tooth may need a crown (cap) to restore its function and appearance. If pieces of the tooth have been recovered, bring them with you to the office.

Chipped teeth are among the most common dental injuries, and can generally be restored successfully. Minor chips or rough edges can be polished off with a dental instrument. Teeth with slightly larger chips can often be restored via cosmetic bonding with tooth-colored resins. When more of the tooth structure is missing, the best solution may be porcelain veneers or crowns. These procedures can generally be accomplished at a scheduled office visit. However, if the tooth is painful, sensitive to heat or cold or producing other symptoms, don’t wait for an appointment — seek help right away.

Justin Bieber earned lots of “likes” by sharing a picture from the dental office. But maybe the take-home from his post is this: If you have a dental injury, be sure to get treatment when it’s needed. The ability to restore a damaged smile is one of the best things about modern dentistry.

If you have questions about dental injury, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Repairing Chipped Teeth” and “Porcelain Crowns & Veneers.”

By Eugene B. Nichols, DMD
October 26, 2017
Category: Oral Health
Tags: tmj disorders  
WhytheTreatmentModelforYourJawJointDisorderMatters

Your temporomandibular joints (TMJ), located where your lower jaw meets the skull, play an essential role in nearly every mouth function. It’s nearly impossible to eat or speak without them.

Likewise, jaw joint disorders (temporomandibular joint disorders or TMD) can make your life miserable. Not only can you experience extreme discomfort or pain, your ability to eat certain foods or speak clearly could be impaired.

But don’t assume you have TMD if you have these and other symptoms — there are other conditions with similar symptoms. You’ll need a definitive diagnosis of TMD from a qualified physician or dentist, particularly one who’s completed post-graduate programs in Oral Medicine or Orofacial Pain, before considering treatment.

If you are diagnosed with TMD, you may then face treatment choices that emanate from one of two models: one is an older dental model based on theories that the joint and muscle dysfunction is mainly caused by poor bites or other dental problems. This model encourages treatments like orthodontically moving teeth, crowning problem teeth or adjusting bites by grinding down tooth surfaces.

A newer treatment model, though, has supplanted this older one and is now practiced by the majority of dentists. This is a medical model that views TMJs like any other joint in the body, and thus subject to the same sort of orthopedic problems found elsewhere: sore muscles, inflamed joints, strained tendons and ligaments, and disk problems. Treatments tend to be less invasive or irreversible than those from the dental model.

The newer model encourages treatments like physical therapy, medication, occlusive guards or stress management. The American Association of Dental Research (AADR) in fact recommends that TMD patients begin their treatment from the medical model rather than the dental one, unless there are indications to the contrary. Many studies have concluded that a majority of patients gain significant relief with these types of therapies.

If a physician or dentist recommends more invasive treatment, particularly surgery, consider seeking a second opinion. Unlike the therapies mentioned above, surgical treatments have a spotty record when it comes to effectiveness — some patients even report their conditions worsening afterward. Try the less-invasive approach first — you may find improvement in your symptoms and quality of life.

If you would like more information on treating TMD, 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 “Seeking Relief from TMD.”

By Eugene B. Nichols, DMD
October 11, 2017
Category: Oral Health
Tags: oral health  
OralHealthConcernsforPreteens

As if the preteen years didn’t give kids and their parents enough to think about, new oral health concerns loom on the horizon. Along with major changes to the body, brain and emotions, additional risk factors for tooth decay and gum disease appear during adolescence — the period of development starting around age 10 and extending through the teen years that marks the transition from childhood to adulthood.

Even with declining rates of tooth decay across the nation, the cavity rate remains high during adolescence. According to the American Academy of Pediatrics, 1 in every 5 adolescents has untreated tooth decay. What’s more, the onset of puberty — usually beginning around age 10-11 in girls and 11-12 in boys — brings changes in hormone levels that can affect gum health.

We all have millions of microorganisms in our mouth, representing hundreds of different species of mostly helpful, but some harmful, bacteria. Research has shown that total oral bacteria increases between ages 11 and 14, and new types of bacteria are introduced, including some that are not friendly to teeth and gums. Some unfamiliar microbes trigger an exaggerated inflammatory response to dental plaque, so gum bleeding and sensitivity are experienced by many children in this age group. In fact, “puberty gingivitis,” which peaks around age 11-13, is the most common type of gum disease found during childhood.

A combination of hormones, lifestyle changes and poor oral hygiene habits raises the risk of oral health problems among adolescents. A more independent social life may be accompanied by a change in eating habits and easier access to snacks and beverages that are sugary, acidic (like sports drinks and soda) or full of refined carbohydrates — none of which are tooth-healthy choices. And as children move toward greater independence, parents are less likely to micromanage their children’s personal care, including their oral hygiene routines. Good oral hygiene can keep dental plaque at bay, lowering the chance of having gingivitis and cavities. But let’s face it: Adolescents have a lot to think about, and keeping up with their oral health may not be top of mind.

To help your preteen stay on top of their oral health, keep healthy snacks at home for your children and their friends and make sure you are well stocked with supplies such as new toothbrushes, floss and toothpaste. In addition, most preteens (and teens) can benefit from gentle reminders about oral hygiene routines.

For optimal oral health through all stages of life, make sure your preteen keeps up with professional teeth cleanings and exams, and talk with us about whether fluoride treatments or sealants may be appropriate for your child.

For more on your child’s oral health, read “How to Help Your Child Develop the Best Habits for Oral Health” and “Dentistry & Oral Health For Children” in Dear Doctor magazine.

By Eugene B. Nichols, DMD
September 26, 2017
Category: Dental Procedures
ThinkYoureTooOldforOrthodonticsReadThis

You’ve lived most of your life with crooked teeth and an imperfect smile. You feel you should have done something about it years ago, but now you’re approaching your golden years — what would be the point?

Here’s the point: there’s a growing trend of older adults undergoing orthodontic treatment. People are discovering the life-changing benefits of straightening their teeth — even if they’re no longer teenagers.

So, what’s really holding you back?

I’m too old to have my teeth straightened. Not true — teeth can be straightened at any age, not just during childhood or adolescence. If anything would prevent orthodontic treatment it would be the state of your oral and general health, not your age. Your teeth’s supporting bone must be reasonably sound and healthy; likewise, systemic problems like bleeding disorders, leukemia and uncontrolled diabetes can make orthodontics difficult. But if you and your mouth are reasonably healthy, you can have your teeth straightened.

It’s too much to spend just to look better. Yes, orthodontic treatment can transform your smile — but it can also improve your oral health. Misaligned teeth are harder to keep clean, increasing the risks for tooth decay and periodontal (gum) disease; they also don’t work well together so chewing is more difficult. By correcting your bite, you can reduce your chances of dental disease and improve overall mouth function.

I’d look silly at my age in braces. Self-consciousness about wearing these traditional appliances is common at any age. It’s understandable — the glint of metal is the first thing people see when you smile. But there’s a good chance you may be able to wear an alternative appliance that’s barely noticeable: clear aligners. These are a series of removable, clear plastic trays that you wear in sequence to gradually move your teeth. Not only are they less noticeable than braces, you can take them out for special occasions.

Don’t let these or other excuses keep you from a more attractive smile and healthy mouth. Visit your dentist for an examination to see if orthodontics can work for you.

If you would like more information on transforming your smile through 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 “Orthodontics for the Older Adult.”

By Eugene B. Nichols, DMD
September 11, 2017
Category: Uncategorized
BaseballsFranciscoLindorShinesasMrSmile

At the first-ever Players Weekend in August 2017, Major League Baseball players wore jerseys with their nicknames on the back. One player — Cleveland Indians shortstop, Francisco Lindor — picked the perfect moniker to express his cheerful, fun-loving nature: “Mr. Smile.” And Lindor gave fans plenty to smile about when he belted a 2-run homer into the stands while wearing his new jersey!

Lindor has explained that he believes smiling is an important part of connecting with fans and teammates alike: “I’ve never been a fan of the guy that makes a great play and then acts like he’s done it 10,000 times — smile, man! We’ve got to enjoy the game.”

We think Lindor is right: Smiling is a great way to generate good will. And it feels great too… as long as you have a smile that’s healthy, and that looks as good as you want it to. But what if you don’t? Here are some things we can do at the dental office to help you enjoy smiling again:

Routine Professional Cleanings & Exams. This is a great place to start on the road toward a healthy, beautiful smile. Even if you are conscientious about brushing and flossing at home, you won’t be able to remove all of the disease-causing dental plaque that can hide beneath the gum line, especially if it has hardened into tartar, but we can do it easily in the office. Then, after a thorough dental exam, we can identify any problems that may be affecting your ability to smile freely, such as tooth decay, gum disease, or cosmetic dental issues.

Cosmetic Dental Treatments. If your oral health is good but your smile is not as bright as you’d like it to be, we can discuss a number of cosmetic dental treatments that can help. These range from conservative procedures such as professional teeth whitening and bonding to more dramatic procedures like porcelain veneers or crowns.

Tooth Replacement. Many people hide their smiles because they are embarrassed by a gap from a missing tooth. That’s a shame, because there are several excellent tooth-replacement options in a variety of price ranges. These include partial and full dentures, bridgework, and dental implants. So don’t let a missing tooth stop you from being Mr. (or Ms.) Smile!

If you’d like more information about oral health or cosmetic dentistry, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Beautiful Smiles by Design” and “The Impact of a Smile Makeover.”





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