Yes, I got braces.

"You did what?"  "Good for you!"  "Huh?"

These are but some of the responses from patients this week when they saw that I now have braces.  Yes, you read that right.  I have brackets and wires in my mouth.

Yes, I really do have braces.

So, why did I do it?  Well, it was time for me to take care of myself.  My teeth are relatively straight.  They are slightly crooked due to them moving over time, and if I was interested in just having them look straight I could have done invisible braces; or even veneers.

However, I have been getting food trapped in between my teeth along my gums for awhile, and the contacts between my teeth (the thing that causes the "snap" of the floss when you put it between your teeth) was very light or not there at all between many of my teeth.  When you floss you want to hear a definitive "snap" of the floss.  It means your teeth are touching each other well, and you are much less likely to have problems with food getting trapped in between your teeth.  Besides being a constant irritation, if you continually get food trapped in between your teeth, it can cause cavities, problems with your gums, and ultimately bone loss around your teeth.

So, I went to the orthodontist for a consultation.  The best way to treat my concerns was traditional braces; not invisible braces. He expects my problems to be corrected in 4-6 months.  The braces are going to straighten the teeth, and also tighten the contacts (that "snap") between the teeth.  If necessary, he will "slenderize" or "slim-down" some teeth on the sides to make my teeth have a longer, or more broad, contact.  This is a routine procedure in which a disc or strip is taken to the outside edge of a tooth to "shave" it down a little bit.  I like to describe this procedure as if you have a broken finger nail & you take an emery board to smooth it down.  It does not cause sensitivity, and it does not hurt.  It simply removes a tiny amount of enamel to allow the teeth to touch better.

I am, obviously, happy with my decision to go ahead and get braces.  Long-term it will improve my health, and short-term I hope to lose some weight since eating is a little more cumbersome.

So, if you have had similar problems (crooked teeth, food getting caught) with your teeth, come to the office and we can have a discussion about what options are best for you. It may be traditional braces, it may be invisible braces, it may be something else.

Just because it's on the internet doesn't mean it's (completely) true

I just read an article on cnn.com that states if you grind your teeth at night (also known as bruxism) that is a "major indication" of obstuctive sleep apnea.  The article also goes on to state the following:

"Sufferers of sleep apnea never get the benefits of the deepest stages of sleep, which is what reverses the aging process and repairs tissue damage. After just one night of the lack of deep sleep that the body craves, you awake in a damaged state. Cumulative damage could lead to expression of the Alzheimer's gene, high blood pressure, depression, mood disorders, suppression of the immune system, diabetes, cancer and weight gain."

That's some pretty scary words that are intended to evoke an emotional response from the reader, and the hope is that you will call your dentist immediately asking to be checked for bruxism so that you can avoid any of the POTENTIAL long term affects of sleep apnea.

So what are the points that I am trying to make?  The first point is people grind their teeth for different reasons.  In some, it is a response to stress, in others the muscles that help you move your jaw are trying to position it a certain way, and in others it MAY be related to sleep apnea.  

The second point is that there are also other possible reasons besides grinding your teeth for a person to have sleep apnea. Some of those reasons include the following: the person may be overweight; the person may have a small airway in the throat, large tonsils, or even narrow or small airways in the nose; the person's jaw may slide back into the throat when they are sleeping causing the airway to become smaller.

Diagnosing problems in dentistry, and medicine, cannot always be solved by using the equation A=B; where "A" causes "B".  Sometimes it can, but most times there is more than one cause of a problem; and just because you have one cause does not mean it's causing the problem you are having.  In other words, just because you grind your teeth does not mean you have sleep apnea.  You may have one, or both, but just because you grind ("A"), does not mean you have sleep apnea ("B").

If you are concerned that you may have sleep apnea, what should you do? Come see me or your physician.  We can then prescribe for you to have a sleep study.  This is the only way to diagnose if you have sleep apnea.  If you are concerned that you grind your teeth, what should you do?  Come see me, and we will figure out what's causing it together.

Here is the link to the article on ccn.com: http://www.cnn.com/2013/04/16/health/dental-screening/index.html?hpt=hp_c4

So you like gum & candy...

OK.  Admit it.  At least at one point in our lives all of us probably liked candies like tic-tacs and other types of mints, and ate them all the time.  Plenty of us also chew gum on a regular basis.  While there are some benefits to using mints or gum (freshening breath, increasing saliva flow), there are also some major negatives too; they can cause cavities if they are high in sugar.

When it comes to eating, everyone has certain tendencies.  For example, when you chew your food you most likely chew it on the same side the majority of the time.  Me? I usually chew my food on the left side of my mouth.  Now, when someone eats a mint, they generally let it sit in one place in their mouth every time; usually in the back somewhere resting between the cheek and a tooth.

If someone is eating mints all day, and placing the mints in the same place every time, you are creating a very sugary environment that allows the bacteria in your mouth to grow and accumulate; eventually, causing a cavity to form on the side of your tooth.

Now, I will admit that the candy and gum companies have become better over the last few years concerning what types of sugars they use.  There is one ingredient that most companies have started using more and more that actually HELPS the mouth FIGHT cavities and the bacteria in your mouth.  It's called XYLITOL.

What's "Xylitol?"  It is a sugar alcohol sweetener used as a sugar substitute.  Basically, the bacteria in mouth can't use xylitol for energy, so they starve and can't multiply.  Xylitol has also shown to have less calories than regular sugar (sucrose), and can be beneficial for diabetics as well by lowering one's blood sugar.  **Please consult with your doctor or nutritionist before using xylitol if you are on a diabetic diet to make sure  using xylitol is safe for you.

Now, what gums and candies have it?  Like I said before, most companies now have at least one type of gum or mint that has it in it.  The next time you are in the supermarket look at the ingredients of your favorite gum or mint, and see if xylitol is listed.  IN ORDER FOR XYLITOL TO BE EFFECTIVE, IT MUST BE LISTED WITHIN THE FIRST THREE (3) INGREDIENTS.  It it's not, find another gum or mint to use.

Some gums that I have seen it in are: Hershey's Ice Cubes, UP2You, and Trident.

If you like to go to Whole Foods, they sell xylitol-based gums and candy.  I'm sure Trader Joe's does as well.

So, if you want to keep chewing gum or mints, that's fine; just make sure that it has xylitol in it!

You can learn more about xylitol and it's benefits by going here: www.xylitol.org and here: WebMD

**PLEASE NOTE**: Xylitol is also a laxative.  If taken in high doses of more than 50 grams a day for adults & 20 grams a day in children (per WebMD), it can cause stomach irritation.  You would have to chew a lot of gum and mints in order to reach that amount!
**DOG OWNERS**: While xylitol is not toxic to humans, it is toxic to dogs. So, please be safe & make sure you put your xylitol sweets in a place where they cannot be reached by your pet!

The Tooth Fairy can help clean up a room

Some of you may have seen this on the web recently.  If you haven't, the tooth fairy decided to leave this letter instead of money recently for a girl named Emily.

Hopefully, Emily cleaned up her room!

CEREC Omnicam video

Here is a video that shows how our new CEREC machine works and allows you to have a crown made in 1 visit.

“Crowns in one visit? You can do that?”

“Crowns in one visit?  You can do that?”

“Yes!”

“How?”

“Well, we have a new machine, the Cerec Omnicam, which allows us to do everything in about 2 hours.  There are 3 parts to the machine: a small video camera, a computer program, and a milling machine.  After we remove the damaged parts of your tooth we take a 3-D color video image of your teeth.”

“Wait! You don’t need to use that gooey stuff to make a mold of my teeth?”

“That’s right; no more messy goo is needed to go into your mouth to take an impression.  Once I know that we have enough information from the video, I use the computer program to help me design the crown that is needed to restore your tooth.  Then, we send that information to the milling machine that will create the crown out of a ceramic block immediately while you wait.”

“I really don’t have to come back?”

“No, you don’t.  It takes about 10-15 minutes for the machine to mill, or create, the crown out of the ceramic block.  Then, we will place it in your mouth to make sure your bite is correct, it fits to your tooth well, and everything is sealed.  Then, we will take the crown and place it in an oven to bake it for 15 minutes.  Once it is cool, we use a very strong cement to keep it in place.  The total time you are in the chair is about the same, maybe a little less, as compared the total time needed to do a crown the traditional way; but you don’t have to get numb twice, and there is no temporary crown to worry about."

“Why don’t you need metal for the crown anymore?”

“Are there situations where metal is still necessary? Yes.  However, in your case and the majority of other patients as well, ceramics will do as great a job as their metal-based counterparts.  If used properly, the ceramic crowns are as strong as crowns with metal in them.  Another advantage is that the ceramic crowns are more esthetic than traditional crowns.”

“OK.  What is the difference in cost between a ceramic crown and a crown with metal?  It costs more right?”

“What if I told you it costs less?”

“WHAT??? HOW???”

“It’s simple.  When we used metal in the past for either the strength underneath porcelain or as an all-metal crown, we made sure our lab used nothing but the best (or noble) metals available: gold, palladium, etc.  Now, with gold rising in price significantly over the years, our lab bill, and in turn the fee we charge for our metal-based crowns, also increased.  When using a ceramic restoration, the lab bill is less.  Instead of charging you the same, or more, than a metal-based crown, I have lowered the fee to match the savings.”

Pictured: The camera, the computer, and the milling machine used
to make a crown in one visit.

“Wow! So, are they really just as strong as metal crowns?”

“Yes, if used properly.  As I said before, there will be times where a metal-based crown will be more beneficial; but in this case, and a majority of other cases, ceramic is a great material to use. “

“So, what made you get this machine now?  Why didn’t you get it before?”

“The technology is now where I want it to be.  What made me decided to get it now was the new camera.  It’s amazing.  Like I said before, it’s a 3-D color video camera.  The previous camera that was used, while also giving excellent results, was like a regular camera.  It took black-and-white still photos.  When the images from the video Omnicam camera are on the screen, you see it just as it is in your mouth.  Your gums will be pink, your silver filling in the back of your mouth will be silver.  Since the images with the old camera came up as black and white there could be situations where it would be difficult for the dentist to properly identify where the tooth ended (the margin) and the gums began.   With the omnicam, since everything is in color, it is much easier to identify the margin.”

“This seems really cool.  So, when can we do this?”

“As soon as you’re ready.”