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

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MouthguardsFoundtobeEffectiveinPreventingTeethandMouthInjuries

Athletes in contact sports are at significant risk for traumatic injury to their teeth and mouth. It’s estimated 600,000 emergency room visits each year involve a sports-related dental injury.

Athletic mouthguards have become the premier safeguard against sports-related oral injuries. First worn by professional boxers in the 1920s, mouthguards are now required for use by various sports associations and leagues — from amateur youth to professional — for a number of sports. The National Collegiate Athletic Association (NCAA), for example, requires their use during play for hockey, lacrosse, field hockey and football. The American Dental Association recommends mouthguards for 29 sports or exercise activities.

But do mouthguards actually prevent injury? To answer that question in a scientific manner, the Journal of Sports Medicine published an evidence-based report in 2007 on mouthguard effectiveness for preventing or reducing the severity of oral-facial injuries and concussions. While the report objectively analyzed many of the problems and issues associated with mouthguards (like materials, design and durability), it concluded the risk of an oral-facial injury was nearly two times greater without the wearing of a mouthguard.

That being said, most dentists and other professionals in sports safety would advise not all mouthguards are alike. The stock, “off the shelf” mouthguard found in many retail stores with limited size offerings is the least expensive, but also least protective, of mouthguard types. Mouth-formed or “boil-and-bite” protectors, which are softened in boiling water and then bit down on by the player to form the fit, are better than the stock version — however, they often don’t cover all of the player’s back teeth.

The best option is a custom-designed guard made by a dentist for the individual patient. Although relatively expensive (costs range in the hundreds, compared with $25 or less for a stock guard), they provide the highest recognized level of mouth protection.

The bottom line: a mouthguard is a must-wear part of any uniform for any sport that involves contact or high velocity objects of play. If you or a family member is a contact sport athlete, it’s essential you protect your teeth and mouth with a custom-fit, high quality mouthguard.

If you would like more information on mouthguards, 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 “Athletic Mouthguards.”

By Dr. Karst
November 11, 2014
Category: Oral Health
WhattoExpectfromTeething

Throughout your child's lifetime, you will experience many important milestones together, some more pleasant than others. Teething is one of those notable milestones, and unfortunately, this “rite of passage” may cause your baby to feel uncomfortable at times.

Teething describes the tooth eruption process by which baby teeth emerge through the gums and into the mouth. It usually begins when your baby is between six and nine months, but may start as early as three months or as late as twelve months. Most children will have all 20 baby teeth by agree three, with the lower front teeth erupting first, followed by the two upper front teeth and then the molars.

Every baby will experience teething differently, but the following symptoms are very common:

  • Irritability
  • Biting and gnawing
  • Gum swelling
  • Chin rash
  • Disrupted sleeping patterns
  • Ear rubbing
  • Drooling
  • Decreased appetite

Many babies make it through the teething phase without much discomfort, but sometimes the pain can be substantial. If your baby is lucky enough to experience no discomfort, he or she will likely demonstrate some of the classic symptoms of teething, such as swollen gums and drooling. You may also notice that he or she will bite or chew anything and will wake up frequently during the night. These symptoms occur most often the week the teeth actually break through the gums, beginning four days before the eruption and lasting about three days after.

Here are a few suggestions to help reduce your baby's discomfort during teething:

  • Teething rings: The American Academy of Pediatric Dentistry (AAPD) recommends that parents use a clean, chilled, rubber teething ring or cold wet washcloth.
  • Chilled pacifiers: Be careful not to freeze teething rings or pacifiers, as ice can burn if left in place too long.
  • Gum massage: Massaging inflamed gums with your clean finger may be helpful to reduce the pressure.
  • Over-the-counter medicine: If pain continues, you can give your baby acetaminophen or ibuprofen, but check with a pediatrician or pharmacist for the correct dosage. The medicine should be swallowed and not massaged into the sore areas, as this, too, can burn.

Other unpleasant side-effects of teething include diarrhea, rashes and fever. Though many have reported these symptoms to be normal, if your infant has fever or diarrhea during teething or continues to experience pain, you should schedule an appointment with our office. We'll examine your baby to ensure that the discomfort is related to teething and not something more serious.

If you would like more information about teething, please contact us for a consultation. You can also learn more by reading the Dear Doctor magazine article “Teething Troubles.”

BoneLossCouldbetheReasonforYourLooseDentures

When you first received your removable dentures the fit was firm and comfortable. Lately, though, they’ve become loose, making it difficult to eat or speak without slippage.

The problem may not be with your denture, but with bone loss. Human bone goes through a natural cycle of dissolving (known as resorption) and new growth to take the lost bone’s place. The jawbone receives further stimulation to grow from the forces generated by natural teeth when we bite or chew.

When natural teeth are missing, however, the jawbone lacks this stimulation, which over time results in bone loss and gum tissue shrinkage. Traditional dentures can’t transmit this stimulating force to the jawbone either, so the bone and gum structure under a denture will also shrink. This results in a looser fit for the denture.

The simplest option to correct a loose-fitting denture (especially if it’s the first occurrence) is to reline the dentures with additional material to re-form the fit to the new conditions in the mouth. A permanent relining will require sending your dentures to a dental laboratory to apply the new material based on a mold of your current anatomy beneath the denture.

If, however, your dentures have already undergone a few relinings, or after examining your gums we determine a relining won’t provide the fit and stability needed, then it may be time for a new denture. Although this is more costly than a relining, a new appliance could provide a more accurate fit to the current contours in your mouth.

The latter option may also give you a chance to benefit from advancements in denture technology or materials since you received your current denture. One such advancement is a removable denture that’s supported by implants. It’s possible to achieve this new supporting foundation for the denture with as few as two strategically-placed implants in the lower jaw.

If you’ve begun to notice denture looseness, be sure to make an appointment for an examination. From there, we can advise you on what will work best in your particular case.

If you would like more information on your options regarding removable dentures, 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 “Loose Dentures.”

By Dr. Karst
October 31, 2014
Category: Oral Health
Tags: tooth loss   dental implants  
ItCouldbeMoreThanaToothYoureLosing

There’s more to tooth loss than you might think. Because teeth are part of a larger system that facilitates speaking, eating and digestion, a lost tooth could eventually affect your overall health.

Tooth loss is actually about bone loss. As living tissue, bone continually reforms in response to stimuli it receives from the body. The alveolar bone (which surrounds and supports the teeth) receives such stimuli as the teeth chew and bite, as well as when they contact each other. All these stresses — hundreds a day — transmit through the periodontal ligament to the bone, stimulating it to grow and remodel.

A lost tooth reduces this stimulation and causes the alveolar bone to resorb (dissolve) — as much as 25% of its width the first year alone. Unless the process is stopped, the underlying basal bone and the periodontal (gum) tissue will begin to resorb too. Without this structural support the facial height shrinks and the front teeth begin to push forward, making chewing and speaking more difficult. These teeth begin performing functions outside their normal range, leading to damage and possible loss.

The primary goal of oral hygiene and dental care is to prevent tooth loss. When tooth loss does occur, however, it’s then important to restore the lost tooth with an artificial replacement if at all possible — not only to regain form and function, but to also stop further bone loss.

While the fixed partial denture (FPD), also known as a fixed bridge, has been the restoration of choice for many decades, dental implants may be the better long-term option. Although more expensive initially, implants can achieve a life-like restoration without involving or altering adjacent teeth as with FPDs. Plaque retention and tartar accumulations are much less likely with an implant, and the bone-loving quality of titanium, the metal used for implants, actually encourages bone growth. As a result, implants have a much higher longevity rate than FPDs.

Taking care of your teeth through effective hygiene practices and regular checkups may help you avoid tooth loss altogether. But if it can’t be avoided, restoring lost teeth is the single most important thing you can do to prevent even greater problems down the road.

If you would like more information on dental implants, 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 Hidden Consequences of Losing Teeth.”

ProperCleaningTechniquescanHelpyouControlChronicBadBreath

We all experience the occasional bout of bad breath from dry mouth or after eating certain foods. Chronic halitosis, on the other hand, could have an underlying health cause like periodontal (gum) disease, sinus infections or even systemic illnesses like diabetes. Anyone with persistent halitosis should undergo a thorough examination to determine the root cause.

If such an examination rules out a more serious cause, it’s then possible the particular population of bacteria that inhabit your mouth (out of a possible 600 or more strains) and your body’s response makes you more susceptible to halitosis. After feeding on food remnants, dead skin cells or post-nasal drip, certain types of bacteria excrete volatile sulfur compounds (VSCs) that give off an odor similar to “rotten eggs.”

In this case, we want to reduce the bacterial population through plaque removal, which in turn reduces the levels of VSCs. Our approach then is effective oral hygiene and perhaps a few cleanings — the basics every person should practice for good oral health — along with a few extra measures specific to chronic halitosis.

This calls for brushing and flossing your teeth daily. This will remove much of the plaque, the main breeding and feeding ground for bacteria, that has accumulated over the preceding twenty-four hours. In some cases, we may also recommend the use of an interproximal brush that is more adept in removing plaque clinging to areas between the teeth.

You may also need to pay special attention in cleaning another oral structure contributing to your bad breath — your tongue. The back of the tongue in particular is a “hideout” for bacteria: relatively dry and poorly cleansed because of its convoluted microscopic structure, bacteria often thrive undisturbed under a continually-forming tongue coating. Simply brushing the tongue may not be enough — you may also need to use a tongue scraper, a dental device that removes this coating. (For more information, see the Dear Doctor article, “Tongue Scraping.”)

Last but not least, visit our office for cleanings and checkups at least twice a year. Professional cleanings remove bacterial plaque and calculus (hardened plaque deposits) you’re unable to reach and remove with daily hygiene measures. Following this and the other steps described above will go a long way toward eliminating your bad breath, as well as enhancing your total oral health.

If you would like more information on treating chronic bad breath, 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 “Bad Breath: More Than Just Embarrassing.”





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