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Posts for category: Oral Health

By Paul David Epstein, D.M.D. & Associates, P.C.
March 19, 2019
Category: Oral Health
LifeIsSometimesaGrindforBrookeShields

Ever since childhood, when her career as a model and actress took off, Brooke Shields has enjoyed worldwide recognition — through advertisements for designer jeans, appearances on The Muppet Show, and starring roles in big-screen films. But not long ago, that familiar face was spotted in an unusual place: wearing a nasal anesthesia mask at the dentist's office. In fact, Shields posted the photo to her own Instagram account, with the caption “More dental surgery! I grind my teeth!” And judging by the number of comments the post received, she's far from alone.

In fact, researchers estimate that around one in ten adults have dental issues that stem from teeth grinding, which is also called bruxism. (Many children also grind their teeth, but it rarely causes serious problems, and is often outgrown.) About half of the people who are teeth grinders report problems like persistent headaches, jaw tenderness and sore teeth. Bruxism may also result in excessive tooth wear, and may damage dental work like crowns and bridges; in severe cases, loosened or fractured teeth have been reported.

Researchers have been studying teeth grinding for many years; their findings seem to indicate that it has no single cause. However, there are a number of factors that play a significant role in this condition. One is the anatomy of the jaw itself, and the effect of worn or misaligned teeth on the bite. Another factor relates to changes in brain activity that occur during the sleep cycle. In fact, nocturnal (nighttime) bruxism is now classified as a sleep-related movement disorder. Still other factors, such as the use of tobacco, alcohol and drugs, and a high level of stress or anxiety, can make an individual more likely to experience bruxism.

What can be done for people whose teeth grinding is causing problems? Since this condition may have many causes, a number of different treatments are available. Successful management of bruxism often begins by striving to eliminate the factors that may cause problems — for example, making lifestyle changes to improve your health, creating a soothing nighttime environment, and trying stress-reduction techniques; these may include anything from warm baths and soft music at bedtime, to meditation and mindfulness exercises.

Several dental treatments are also available, including a custom-made occlusal guard (night guard) that can keep your teeth from being damaged by grinding. In some cases, a bite adjustment may also be recommended: In this procedure, a small amount of enamel is removed from a tooth to change the way it contacts the opposite tooth, thereby lessening the biting force on it. More invasive techniques (such as surgery) are rarely needed.

A little tooth grinding once in a while can be a normal response to stress; in fact, becoming aware of the condition is often the first step to controlling it. But if you begin to notice issues that could stem from bruxism — or if the loud grinding sounds cause problems for your sleeping partner — it may be time to contact us or schedule an appointment. You can read more about bruxism in the Dear Doctor magazine article “Stress and Tooth Habits.”

By Paul David Epstein, D.M.D. & Associates, P.C.
January 18, 2019
Category: Oral Health

Woman SmilingPrevention and restoration are just two aspects of care at Paul David Epstein DMD & Associates. The third pertains to the aesthetic features of your smile. Are your teeth well-shaped and aligned? Are stains or flaws detracting from your appearance and self-confidence? Dr. Epstein and his dedicated team create healthy teeth and gums that are truly beautiful and reveal the real you inside. Read below to learn more about the cosmetic dentistry options available at our Burlington, MA, office!

 

Your valuable smile

It helps you eat, speak, stay healthy and express how you feel and who you are. Frankly, if you hide it because of obvious flaws, you do yourself and your family, friends, and colleagues a disservice. Over the past three decades, cosmetic dentistry has developed into a popular and effective specialty which improves smile aesthetics and patient self-image. Dentists such as Dr. Paul David Epstein recognize the desires their patients have to look and feel their best, and so they offer innovative services which maximize the potential in each and every smile.

Dr. Epstein has developed a wealth of skills which remake damaged, chipped, discolored, uneven, and misshapen teeth. He has used his extensive expertise to benefit victims of domestic violence through the Give Back a Smile Program, and he understands how a beautiful smile can boost self-confidence and the ability to function well in the modern world.

 

A treatment plan

When you come to Dr. Epstein's office in Burlington, MA, for a cosmetic dentistry consultation, you will discuss potential changes in your smile aesthetics. You'll undergo a complete oral examination and digital X-rays to make sure your renewed image is based on good oral health.

Then, you and your dentist will agree upon a step by step plan to craft a smile that really works for you. Services may include:

  • Professional teeth whitening, today's most popular cosmetic service
  • Composite resin bonding, a one-visit service which adds a tooth-colored material to tooth structure to improve its shape and size
  • Invisalign clear aligners, the discreet method of straightening crooked smiles
  • Tooth-colored fillings to restore decay in a natural-looking way
  • Porcelain veneers to cover the front of chipped, gapped, or cracked teeth

 

Find out more
That great smile is within your grasp at Paul David Epstein DMD & Associates. Let the cosmetic dentistry experts help you be the best you can be. Call today for your personalized consultation with Dr. Epstein: (781) 273-1152.

By Paul David Epstein, D.M.D. & Associates, P.C.
December 29, 2018
Category: Oral Health
DentalInjuryIsJustaTemporarySetbackforBasketballStarKevinLove

The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.

In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?

The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.

Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.

So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”

Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.

If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”

By Paul David Epstein, D.M.D. & Associates, P.C.
November 29, 2018
Category: Oral Health
Tags: dental injuries  
ReplacingaKnocked-OutToothQuicklyIncreasesitsSurvivalChances

Mouth injuries in children and teens are more common than you might think: about one out of three boys and one out of four girls will have experienced an injury before they graduate from high school. Besides contact sports, other types of accidents like car crashes or falls are high on the cause list.

Although most dental injuries aren’t considered true emergencies, there are a few where prompt action may mean the difference between ultimately saving or losing a tooth. One such situation is a knocked out tooth.

In the event of a knocked out (or avulsed) tooth, your primary goal is to place the tooth back into the empty socket as quickly as possible. Teeth that have been out of the mouth for less than five minutes have the best chance of reattachment and survival. The first step is to quickly locate the missing tooth.

Once you’ve found it, use only cold, clean water run or poured over the tooth to carefully clean off dirt or debris (no soaps or cleansers). You should also avoid touching the tooth root or scrubbing any part of it. After cleaning it of debris, gently place the tooth back in its socket, then immediately contact us or visit an emergency room. While you’re en route to our office the patient should carefully hold the tooth in place. If the tooth can’t be immediately placed into the socket (the patient is unconscious, for example), then you should place the tooth in a clean container and keep it moist with cold milk, a sterile saline solution or even the patient’s saliva.

Taking these steps increases the chances of a successful re-implantation, although the injury may ultimately affect the tooth’s lifespan. Replanted teeth can suffer from root resorption (where the root tissue dissolves) or a process known as ankylosis in which the tooth fuses directly to the jawbone with no healthy periodontal ligament in between. Either of these conditions can lead to tooth loss.

Still, it’s worthwhile to try to save the tooth, even if for a few more years. Those extra years can help you prepare for a future restoration.

If you would like more information on responding to dental injuries, 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 “Accidental Tooth Loss.”

By Paul David Epstein, D.M.D. & Associates, P.C.
October 30, 2018
Category: Oral Health
Tags: snoring   sleep apnea  
YourDentistmayhavetheSolutionforYourSleepApnea

Your nightly snoring has become a major sleep disturbance for you and other family members. But it may be more than an irritation — it could also be a sign of sleep apnea, a condition that increases your risk for life-threatening illnesses like high blood pressure or heart disease.

Sleep apnea most often occurs when the tongue or other soft tissues block the airway during sleep. The resulting lack of oxygen triggers the brain to wake the body to readjust the airway. This waking may only last a few seconds, but it can occur several times a night. Besides its long-term health effects, this constant waking through the night can result in irritability, drowsiness and brain fog during the day.

One of the best ways to treat sleep apnea is continuous positive airway pressure (CPAP) therapy. This requires an electric pump that supplies constant pressurized air to a face mask worn during sleep to keep the airway open. But although effective, many patients find a CPAP machine clumsy and uncomfortable to wear. That's why you may want to consider an option from your family dentist called oral appliance therapy (OAT).

An OAT device is a custom-made appliance that fits in the mouth like a sports mouthguard or orthodontic retainer. The majority of OAT appliances use tiny metal hinges to move the lower jaw and tongue forward to make the airway larger, thus improving air flow. Another version works by holding the tongue away from the back of the throat, either by holding the tongue forward like a tongue depressor or with a small compartment fitted around the tongue that holds it back with suction.

Before considering an OAT appliance, your dentist may refer you to a sleep specialist to confirm you have sleep apnea through laboratory or home testing. If you do and you meet other criteria, you could benefit from an OAT appliance. There may be other factors to consider, though, so be sure to discuss your options with your dentist or physician to find the right solution for a better night's sleep.

If you would like more information on sleep apnea treatments, 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 “Oral Appliances for Sleep Apnea.”