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Posts for: December, 2014

By Paul David Epstein, D.M.D. & Associates, P.C.
December 30, 2014
Category: Oral Health
Tags: celebrity smiles   pregnancy  
NancyODellSpeaksOutOnHerExperiencesWithPregnancyGingivitis

When it comes to sensitive gums during pregnancy, Nancy O'Dell, the former co-anchor of Access Hollywood and new co-anchor of Entertainment Tonight, can speak from her own experience. In an interview with Dear Doctor magazine, she described the gum sensitivity she developed when pregnant with her daughter, Ashby. She said her dentist diagnosed her with pregnancy gingivitis, a condition that occurs during pregnancy and is the result of hormonal changes that increases blood flow to the gums. And based on her own experiences, Nancy shares this advice with mothers-to-be: use a softer bristled toothbrush, a gentle flossing and brushing technique and mild salt water rinses.

Before we continue we must share one important fact: our goal here is not to scare mothers-to-be, but rather to educate them on some of the common, real-world conditions that can occur during pregnancy. This is why we urge all mothers-to-be to contact us to schedule an appointment for a thorough examination as soon as they know they are pregnant to determine if any special dental care is necessary.

Periodontal (gum) disease can impact anyone; however, during pregnancy the tiny blood vessels of the gum tissues can become dilated (widened) in response to the elevated hormone levels of which progesterone is one example. This, in turn, causes the gum tissues to become more susceptible to the effects of plaque bacteria and their toxins. The warning signs of periodontal disease and pregnancy gingivitis include: swelling, redness, bleeding and sensitivity of the gum tissues. It is quite common during the second to eighth months of pregnancy.

Early gum disease, if left untreated, can progress to destructive periodontitis, which causes inflammation and infection of the supporting structures of the teeth. This can result in the eventual loss of teeth — again, if left untreated. Furthermore, there have been a variety of studies that show a positive link between preterm delivery and the presence of gum disease. There has also been a link between an increased rate of pre-eclampsia (high blood pressure during pregnancy) and periodontal disease. Researchers feel this suggests that periodontal disease may cause stress to the blood vessels of the mother, placenta and fetus.

To learn more about this topic, continue reading the Dear Doctor magazine article “Pregnancy and Oral Health.” And if you want to read the entire feature article on Nancy O'Dell, continue reading “Nancy O'Dell.”


By Paul David Epstein, D.M.D. & Associates, P.C.
December 26, 2014
Category: Oral Health
Tags: dental injury   mouthguards  
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 Paul David Epstein, D.M.D. & Associates, P.C.
December 11, 2014
Category: Dental Procedures
Tags: celebrity smiles   bonding  
ARoyalFix

So you’re tearing up the dance floor at a friend’s wedding, when all of a sudden one of your pals lands an accidental blow to your face — chipping out part of your front tooth, which lands right on the floorboards! Meanwhile, your wife (who is nine months pregnant) is expecting you home in one piece, and you may have to pose for a picture with the baby at any moment. What will you do now?

Take a tip from Prince William of England. According to the British tabloid The Daily Mail, the future king found himself in just this situation in 2013. His solution: Pay a late-night visit to a discreet dentist and get it fixed up — then stay calm and carry on!

Actually, dental emergencies of this type are fairly common. While nobody at the palace is saying exactly what was done for the damaged tooth, there are several ways to remedy this dental dilemma.

If the broken part is relatively small, chances are the tooth can be repaired by bonding with composite resin. In this process, tooth-colored material is used to replace the damaged, chipped or discolored region. Composite resin is a super-strong mixture of plastic and glass components that not only looks quite natural, but bonds tightly to the natural tooth structure. Best of all, the bonding procedure can usually be accomplished in just one visit to the dental office — there’s no lab work involved. And while it won’t last forever, a bonded tooth should hold up well for at least several years with only routine dental care.

If a larger piece of the tooth is broken off and recovered, it is sometimes possible to reattach it via bonding. However, for more serious damage — like a severely fractured or broken tooth — a crown (cap) may be required. In this restoration process, the entire visible portion of the tooth may be capped with a sturdy covering made of porcelain, gold, or porcelain fused to a gold metal alloy.

A crown restoration is more involved than bonding. It begins with making a 3-D model of the damaged tooth and its neighbors. From this model, a tooth replica will be fabricated by a skilled technician; it will match the existing teeth closely and fit into the bite perfectly. Next, the damaged tooth will be prepared, and the crown will be securely attached to it. Crown restorations are strong, lifelike and permanent.

Was the future king “crowned” — or was his tooth bonded? We may never know for sure. But it’s good to know that even if we’ll never be royals, we still have several options for fixing a damaged tooth. If you would like more information, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Repairing Chipped Teeth” and “Crowns and Bridgework.”