Salem, Oregon Center of Cosmetic Dentistry
2510 12th Street SE
Salem, OR 97302
503-378-1212

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AClearDiagnosisofJawPainisNeededtoDeterminetheRightTreatment

A blow to the face can result in a variety of injuries to your jaws and the temporomandibular joints (TMJs) that join the lower jaw to the skull. Only a thorough examination can determine the type and extent of the injury, and how to treat it.

The pain you feel in your jaw may indicate a direct injury, usually near the joint. This could mean the joint head (condyle) has dislocated, or moved out of the joint space. It could also mean you’ve fractured your lower jaw, most commonly just below the head of the joint.

Jaw pain can also indicate structures near the jaw and joint have been damaged and the jaw is indirectly affected. In some cases a damaged tooth may be radiating pain signals through the jaw (along similar nerve paths). More likely, trauma to soft tissue near the jaw joint has swelled with inflammation, putting pressure on the joint and temporarily stopping the condyle from seating fully in the joint space.

Any of these injuries can also cause painful muscle spasms, a defensive reaction from the body that causes muscles on either side of the jaw to limit movement preventing further damage (a natural splint, if you will). Thus, the pain may be compounded by a diminished range of motion when you try to chew or speak.

It’s important, therefore, to determine the exact cause of pain and limited movement before commencing treatment. Spasms and inflammation are usually treated with muscle relaxant drugs and anti-inflammatory pain relievers. In the case of a dislocation, gentle manipulation can ease the condyle back into the joint space. A fracture would require more extensive treatment, including repositioning broken bone and immobilizing the jaw from movement to allow healing. In the most severe cases, surgical treatment may be necessary to internally immobilize the joint.

If you sustain an injury that results in jaw swelling and pain, you should see us without delay. The sooner we can diagnose and begin the proper treatment for your injury, the less likely you’ll encounter long-term problems and the sooner you’ll be pain and swelling free.

If you would like more information on the causes and treatment of jaw pain, 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 “Jaw Pain.”

RegularCleaningsBenefitBothYourDentalHealthandYourSmile

Dental cleanings are an important part of regular dental office visits. Performed by a dental hygienist or dentist, cleanings serve two purposes: to remove bacterial plaque and calculus (hardened deposits of plaque) from tooth surfaces missed during daily brushing and flossing; and to remove stains that can dull your smile.

There are different degrees of cleaning, including root planing that removes plaque and calculus deep below the gum line, usually for patients affected by periodontal (gum) disease. For patients in good oral health, the basic cleaning approach is known as prophylaxis, a term derived from the Greek for guarding or preventing beforehand. The techniques used in a prophylaxis remove both “coronal” (tooth surfaces visible above the gum line) plaque and staining, providing both therapeutic and cosmetic benefits.

A typical prophylaxis includes a procedure known as scaling. Hygienists use special instruments known as scalers to remove plaque and calculus by hand, or an ultrasonic device that vibrates plaque loose and is flushed away with water. The procedure removes that rough coating you often feel as you rub your tongue against your teeth, leaving the tooth surfaces feeling smooth.

Tooth polishing is a subsequent procedure to scaling that also removes plaque and surface stains. Polishing is carried out with a motorized instrument with a rubber cup in which a polishing (or “prophy”) paste is contained. The hygienist moves the rapidly rotating cup filled with the paste over the tooth surface to remove plaque and stains. The end result is a highly smooth surface and a much shinier appearance.

People with dental insurance plans are often concerned tooth polishing may be viewed strictly as a cosmetic procedure, and thus not fully qualify for benefits. This should not be the case if coded properly: tooth polishing is part of the overall prophylaxis to remove plaque and staining. The primary purpose is therapeutic and preventive; the cosmetic effect is a by-product. Most dental plans will cover one or two prophylaxes (scaling and tooth polishing) a year, but there are variations so individuals should check their plans.

If you would like more information on dental cleaning, 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 “Tooth Polishing.”

By Dr. Karst
April 30, 2015
Category: Oral Health
Tags: oral health   pregnancy  
MaintainingOralHealthWhenYoureExpecting

Every pregnant woman knows that her body will go through a series of profound changes as it's making a new life. Along with the alterations in overall size and changes in eating and sleeping patterns, pregnancy also affects the teeth and gums. Here are some answers to common questions women may have about oral health during pregnancy.

1) What's the most important thing I can do for my baby's oral health?

Maintain your own dental and general health! Eat a healthy and balanced diet — it provides the nutrients, vitamins and minerals needed for proper development of your baby's teeth and bones. While food cravings and aversions are common, try to at least limit your intake of sugary snacks to mealtimes. Don't neglect the good habits of brushing, flossing, and seeing your dentist regularly. This will help minimize the possibility of tooth decay or gum disease.

2) Does pregnancy make me more susceptible to gum disease?

Yes. “Pregnancy gingivitis” (“gingival” – gum tissue; “it is” – inflammation of) may develop from the second to the eighth month. This is mostly due to elevated hormone levels. In the presence of gum disease, pregnancy hormones may stimulate the production of prostaglandins, which cause inflammation of gum tissues. Occasionally, benign growths called “pregnancy tumors” may also appear on the gums during the second trimester. If they don't resolve themselves, these may be surgically removed after the baby is born.

3) With all my other concerns right now, why is the health of my teeth and gums so important?

Several studies have shown a link between periodontal (gum) disease, pre-term delivery and low birth weight — conditions which put some newborns at greater risk for health complications. There's also a correlation between more severe periodontal disease and an increased rate of pre-eclampsia, a potentially serious condition. But treating periodontal disease decreases the level of inflammation-causing prostaglandins. That's one reason why you should come into our office for an evaluation as soon as you know you're expecting.

4) Is it safe to get dental treatments while I'm pregnant?

Dental examinations and routine treatment during pregnancy is generally safe for both mom and baby. If you need non-urgent dental care, it may be most comfortable in the first five months of pregnancy. Situations requiring urgent care are managed as they arise, to treat pain and infection and to reduce stress to the developing fetus. Under the watchful eye of your dentist, it's possible to have anesthesia, X-rays and dental medications (if needed) without undue risk. So don't let worries about dental treatments keep you from coming in for a check-up!

If you would like more information about pregnancy and oral health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Pregnancy and Oral Health,” and “Expectant Mothers.”

FixedorRemovableDecidingWhichImplant-SupportedBridgeisBestforYou

Although dental implants are best known as single tooth replacements, they can actually play a role in multiple or complete tooth loss (edentulism) restorations. While replacing multiple teeth with individual implants is quite expensive, there’s another way to incorporate them in a restoration at much less cost — as supports for bridges.

In this case, only a few strategically placed implants are needed to support restorations of multiple crowns fused together into a single unit. Implant-based bridges consist of two main types: the first type is a fixed bridge, which is permanently attached to the implants and can’t be removed by the patient. It’s often the preferred treatment for patients who’ve lost most or all of their teeth but have not yet experienced significant bone loss in the jaw.

This choice, however, may not be the best option for patients with significant bone loss. In these cases, there’s a second type of fixed bridge: an implant-supported fixed denture. This type of fixed denture provides support for the lost bone support of the lips and cheeks. If a fixed bridge is not possible due to finances or inadequate bone support to place 4 to 6 implants, a removable denture (also known as an overdenture) that’s supported and held in place by implants is the next best alternative. Unlike a fixed bridge, an overdenture can be removed by the patient for cleaning purposes, and will require less investment than a fixed bridge.

For people with bone loss, the overdenture does more than restore chewing and speech function. Because bone loss can diminish support of the facial structures — actually shorten the distance between the chin and the tip of the nose — an overdenture provides additional bulk to support these structures to improve appearance. Depending on what the patient needs for facial support, overdentures for the upper jaw can be designed as “full palates,” meaning the denture plastic completely covers the upper jaw palate, or open in which the plastic doesn’t completely cover the palate.

Besides the condition of your teeth, gums and bone, your own personal preferences and financial ability will also play a role in which option is best for you. After considering all these factors, we can recommend which of these types of implant-based restorations will fit your needs. With either bridge, fixed or removable, you’ll certainly benefit from the improvement to both your mouth function and your smile.

If you would like more information on implant-supported bridges, 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 “Fixed vs. Removable.”

GumDiseaseCanIncreaseYourRiskofHeartDisease

You've probably heard that old song about the leg bone being connected to the knee bone; it's easy to see how the human skeleton links together. But the concept of anatomical parts being interconnected actually goes further than you might think. Problems in almost any part of the body can have profound effects in other areas. Your gums offer a perfect example.

Believe it or not, medical research has established a connection between gum disease and cardiovascular disease (CVD). They appear to be linked by inflammation, a protective response to infection. Inflammation can be characterized by a redness and swelling of the body's tissues that you can see. Or its effects can be less obvious.

Gum disease is an infection caused by bacteria, which build up in the mouth in the absence of regular or effective brushing and flossing. When left undisturbed, the bacterial biofilms (dental plaque) change over time so that a small set of highly pathogenic (“patho” – disease; “genic” – causing) organisms emerge that cause periodontitis (“peri” – around; “odont” – tooth; “itis” – inflammation).

Periodontitis can cause not just a localized inflammation of the gum tissue, but also a systemic (whole-body) inflammation. And this chronic, low-grade inflammation throughout the body appears to increase the risk of heart disease considerably. The good news is that there is a lot we can do about gum disease. And when we reduce the inflammation it causes, we can also reduce the risks for CVD and the heart attacks and strokes that can result.

The first step is a thorough, professional periodontal cleaning to remove the bacterial biofilm attached to the roots of the teeth. Sometimes a short course of antibiotics is prescribed to further fight the infection. Advanced periodontitis may require surgery so that we can reach all of the contaminated root surfaces for removal of the bacterial biofilm.

We will also review with you how you can prevent the growth of harmful bacteria through an effective daily oral hygiene routine. This is crucial to maintaining your oral health, which in turn affects your general health and overall well-being.

Contact us today to schedule an appointment to discuss your questions about the relationship between gum disease and heart disease. You can also learn more by reading the Dear Doctor magazine article, “The Link Between Heart & Gum Diseases.”





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