My Blog

Posts for: March, 2019

By John P. Ducar, DDS, Inc
March 22, 2019
Category: Oral Health
Tags: oral hygiene   orthodontics   braces  
MakeEffortstoProtectYourTeethfromDiseaseWhileWearingBraces

Orthodontic treatment is a big investment. But given the benefits for future good health and a more attractive smile, it's well worth it.

In the here and now, though, braces wearers face a different threat to their dental well-being — dental disease. Wearing braces can actually increase the risk of disease and make it more difficult to fight.

Tooth decay and periodontal (gum) disease, the two most common forms of dental disease, usually arise from plaque, a thin film of bacteria and food particles on tooth surfaces. The bacteria produce acid, which erodes enamel and makes the teeth susceptible to decay. Certain bacteria can also infect the gums and eventually weaken their attachment to teeth. Thorough brushing and flossing everyday removes this disease-triggering plaque buildup.

But braces' hardware can make brushing and flossing more difficult. The brackets attached to the teeth and wires laced through them make it more difficult for floss and brush bristles to access all the areas around the teeth. Plaque can build up in certain spots; it's estimated braces wearers have two to three times the plaque of a person not wearing braces. Acid can also remain in contact with some of the enamel surface for too long.

It's important, therefore, if you wear braces to make a concerted effort to brush and floss thoroughly. Besides improving technique and taking more time, you might also consider additional aids. You can obtain toothbrushes specially designed for use with braces, as well as floss holders or threaders that make it easier to access between teeth. Another flossing alternative is an oral irrigator that sprays water under pressure between teeth is an alternative to flossing.

As a precaution against acid damage, we can boost enamel protection with additional fluoride applied to your teeth. We may also prescribe antibacterial rinses to keep the bacteria population low.

Above all, be sure to look out for signs of disease like swollen or bleeding gums or pain. As soon as you sense something out of the ordinary, be sure and contact us.

If you would like more information on keeping your teeth disease-free while wearing braces, 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 “Caring for Teeth During Orthodontic Treatment.”


By John P. Ducar, DDS, Inc
March 12, 2019
Category: Dental Procedures
Tags: apicoectomy  
IfaRootCanalCantbeDonethisProcedureMightSaveYourTooth

Untreated tooth decay can destroy your teeth; prompt action as soon as its diagnosed will help prevent that undesirable outcome. And even if decay has advanced into the tooth's pulp and root canals, there's still a good chance we can stop it with a root canal treatment. Using this procedure, we can clean out the infection and refill the tooth's interior space with a special filling to protect it from further infection.

Although root canal treatments have gained an unwarranted reputation for pain, they rarely cause even the mildest discomfort. More importantly, they work, which is why they're the go-to treatment dentists use for advanced decay.

But sometimes a unique dental situation might make performing a root canal extremely difficult—possibly even doing more harm than good. For example, trying to access the interior of a tooth with a crown restoration might require removing the crown, which could further weaken or damage the tooth. In other cases, the root canals might have become calcified due to trauma or aging and become too narrow to access.

Even so, we may still be able to save a tooth through a minor surgical procedure called an apicoectomy. Rather than access the diseased area through the tooth crown as with a root canal treatment, an apicoectomy makes access to the infected tissue at the root end.

An apicoectomy also differs from a root canal treatment in that we'll need to surgically go through the gum tissue. After numbing the area with a local anesthetic, we'll make a small incision through the gums at the level of the infection. After removing any infected tissue, we would then fill the space with a small filling to prevent re-infection. We then close the incised gum tissues with sutures and allow them to heal.

With the help of fiber optic lighting and surgical microscopes, endodontists (specialists in interior tooth problems) can perform an apicoectomy quickly and with very little trauma at the surgical sight. If you undergo an apicoectomy, you should be back to normal activity in a day or two at the most. And like its sister procedure the root canal, an apicoectomy could help preserve your teeth for many years to come.

If you would like more information on this and other treatments for tooth decay, 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 “Apicoectomy: A Surgical Option When Root Canal Treatment Fails.”


By John P. Ducar, DDS, Inc
March 02, 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.”