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.”
About one-quarter of people have teeth that never developed. While most of these congenitally missing teeth are wisdom teeth, they can also include premolars or lateral incisors (the teeth right next to the two front teeth, the central incisors).
Missing teeth can have an adverse effect on smile appearance. But that’s not all: because each type of tooth performs a specific function, one or more missing teeth can lead to bite problems and disruption of dental function. In the case of missing lateral incisors, the canines (eye teeth) normally positioned beside and toward the back of the mouth from them may begin to drift into the empty space and grow next to the central incisors. This can result in greater difficulty chewing and a smile that “doesn’t look right.”
To correct this situation, we must often first attempt to orthodontically move any out of place teeth to their normal positions. This re-establishes the space needed for the missing teeth to be replaced, which we can then restore with prosthetic (artificial) teeth. If the permanent restoration of choice involves dental implants, we’ll usually need to wait until the completion of jaw development around early adulthood. In the mean time, we can use a retainer appliance to hold the teeth in their new positions with prosthetic teeth attached to fill the empty space for a better smile appearance in the interim.
The real issue is timing—beginning orthodontic treatment when appropriate to a person’s oral development, as well as completing the implant restoration when the mouth has matured sufficiently. There are other considerations such as bone volume, which may have diminished due to the missing teeth. At some point we may need to consider grafting to build up the bone sufficiently to support dental implants.
This all may entail a team approach by various specialties like orthodontics, periodontics and implantology. Working together and coordinating within a timely schedule, a mouth and smile marred by undeveloped teeth can be transformed.
If you would like more information on treating smiles with underdeveloped permanent teeth, 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 “When Permanent Teeth Don’t Grow.”
Probably a day doesn’t go by that you don’t encounter advertising for dental implants. And for good reason: implants have taken the world of dentistry by storm.
Since their inception over thirty years ago, implants have rocketed ahead of more conventional tooth replacements to become the premier choice among both dentists and patients. But what is an implant—and why are these state-of-the-art dental devices so popular?
Resemblance to natural teeth. More than any other type of dental restoration, dental implants mimic both the appearance and function of natural teeth. Just as teeth have two main parts—the roots beneath the gum surface and the visible crown—so implants have a similar construction. At their heart, implants are root replacements by way of a titanium metal post imbedded in the jawbone. To this we can permanently attach a life-like porcelain crown or even another form of restoration (more about that in a moment).
Durability. Implant materials and unique design foster a long-term success rate after ten years in the 95-plus percentile. They achieve this longevity primarily due to the use of titanium as the primary metal in the implant post. Because bone has an affinity for titanium, it will grow and adhere to the post over time to create a well-anchored hold. With proper maintenance and care implants can last for decades, making them a wise, cost-effective investment.
Added stability for other restorations. While most people associate implants with single tooth replacements, the technology has a much broader reach. For example, just a few strategically-placed implants can support a removable denture, giving this traditional restoration much more security and stability. What’s more, it can help stop bone loss, one of the main drawbacks of conventional dentures. In like fashion, implants can support a fixed bridge, eliminating the need to permanently alter adjacent teeth often used to support a conventional bridge.
With continuing advances, implant technology is becoming increasingly useful for a variety of restorative situations. Depending on your individual tooth-loss situation, dental implants could put the form and function back in your smile for many years to come.
If you would like more information on dental implant restorations, 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 “Dental Implants: Your Best Option for Replacing Teeth.”
White, translucent teeth are the hallmark of a beautiful smile. But with age or the foods we eat our teeth’s natural brightness can dim to a dingy yellow.
If this is your case, you may be able to benefit from teeth whitening techniques that brighten up your less than “pearly whites.” A teeth whitening treatment from time to time could put the dazzle back in both your smile and your self-confidence.
Here, then, are 3 reasons for considering tooth whitening to improve your smile.
You might be able to do it yourself. There are a number of home whitening options (including whitening strips) that are safe and effective to use at home. But there are a couple caveats: because your dentist can use stronger bleaching solutions they may be able to perform the procedure in less time and with longer lasting results than a home kit. Also, some forms of staining originate inside a tooth—a home kit won’t help with that kind of discoloration.
It’s safe and relatively inexpensive. Home bleaching solutions aren’t strong enough to be harmful (unless you disregard the product directions) and are usually not very costly. Your dentist uses stronger solutions but with the training and curing equipment to minimize any risk to your teeth. And compared to other cosmetic treatments, dental office teeth whitening is still a relatively inexpensive option.
Dental office whitening can be more comprehensive and precise. Another reason to opt for your dentist to whiten your teeth is the wide range of discoloration they can alleviate. They have clinical techniques for alleviating internal tooth staining, and could even combine these with treatments for external staining. Your dentist can also help you achieve the exact degree of whiteness you desire—from a more subtle, natural shade to “Hollywood Bright.”
Whitening isn’t permanent—but with a thorough application and avoiding foods and habits that contribute to staining, professional whitening effects can last up to two years. If you’re interested, see your dentist for a full dental examination for any issues that might interfere with the whitening process. From there, you’re not far from a brighter and more attractive smile.
If you would like more information on teeth whitening and other dental cosmetic enhancements, 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 “Teeth Whitening: Brighter, Lighter, Whiter….”
On the big screen, Australian-born actress Margot Robbie may be best known for playing devil-may-care anti-heroes—like Suicide Squad member Harley Quinn and notorious figure skater Tonya Harding. But recently, a discussion of her role in Peter Rabbit proved that in real life, she’s making healthier choices. When asked whether it was hard to voice a character with a speech impediment, she revealed that she wears retainers in her mouth at night, which gives her a noticeable lisp.
“I actually have two retainers,” she explained, “one for my bottom teeth which is for grinding my teeth, and one for my top teeth which is just so my teeth don't move.”
Clearly Robbie is serious about protecting her dazzling smile. And she has good reasons for wearing both of those retainers. So first, let’s talk about retainers for teeth grinding.
Also called bruxism, teeth grinding affects around 10 percent of adults at one time or another, and is often associated with stress. If you wake up with headaches, sore teeth or irritated gums, or your sleeping partner complains of grinding noises at night, you may be suffering from nighttime teeth grinding without even being aware of it.
A type of retainer called an occlusal guard is frequently recommended to alleviate the symptoms of bruxism. Typically made of plastic, this appliance fits comfortably over your teeth and prevents them from being damaged when they rub against each other. In combination with stress reduction techniques and other conservative treatments, it’s often the best way to manage teeth grinding.
Orthodontic retainers are also well-established treatment devices. While appliances like braces or aligners cause teeth to move into better positions, retainers are designed to keep teeth from moving—helping them to stay in those positions. After active orthodontic treatment, a period of retention is needed to allow the bite to stabilize. Otherwise, the teeth can drift right back to their old locations, undoing the time and effort of orthodontic treatment.
So Robbie has the right idea there too. However, for those who don’t relish the idea of wearing a plastic appliance, it’s often possible to bond a wire retainer to the back surfaces of the teeth, where it’s invisible. No matter which kind you choose, wearing a retainer can help keep your smile looking great for many years to come.
If you have questions about teeth grinding or orthodontic retainers, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Teeth Grinding” and “The Importance of Orthodontic Retainers.”
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