Smile Enhancements for Healthy Aging

Earlier this month, we discussed common dental problems which affect us as we grow older and how to address them.  In this installment, we will describe three popular methods to improve both the appearance and the function of your teeth. At the end of this article, we will reinforce what we believe to be the best ways to improve the health and beauty of your smile.

smile enhancementsYou may be surprised to hear about the first popular procedure which has increased in frequency over the past several years.  Once considered only appropriate for adolescents and teenagers, orthodontics has become an excellent means for adults (even those well into their 60s) to improve their smile, take years off their facial appearance, and improve their self-esteem.  This, in turn, improves their overall outlook on life. Alternatives to the metal braces commonly seen in the past have grown in popularity as they have become more comfortable, effective and invisible.  In our office, Invisalign™ orthodontics has proven to be a discrete and successful method for adults to address bite issues and crooked teeth.  Even patients who had braces as a teenager find the system an excellent way to realign teeth which have relapsed over the years.

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Invisalign™orthodontic treatment, combined with either tooth bleaching and/or bonding, can help you to achieve your dream smile, improve your appearance, help you look younger, and feel a renewed sense of self confidence.  In addition, a properly aligned bite serves to preserve your overall health and well-being.  Teeth which are not aligned and bites which are not properly balanced are much more at risk for a variety of dental issues.  These issues include tooth fractures, tooth wear, loosening teeth, gum recession, ineffective chewing ability as well as a variety of jaw, neck, and shoulder pain and headaches.

The second popular dental enhancement which has steadily gained in popularity over the last twenty-five plus years is implants. Titanium implants have evolved and become a staple in the replacement of missing teeth for those who wish for comfort, convenience, and excellent appearance. Implants can be used in a number of different ways to replace missing teeth. The simplest way, of course, is for replacing a single missing tooth. But implants can also be used to replace a series of missing teeth or even an entire arch of missing teeth. Contrary to popular opinion, the placement of implants does not involve significant discomfort and their success rate is very high.

implant, smile enhancements

There are many patients who have struggled with dentures for years. Such patients have had as few as two implants placed to stabilize their existing dentures. The benefits of such procedures are astounding for those who have struggled to eat and speak with loose plates for years. We even see patients who are about to lose all their remaining teeth in one or both arches. Such patients can have their hopeless teeth removed, four implants placed, and a set of teeth mounted on those implants all in a single appointment. That procedure is called “All-On-Four” and requires collaboration between a prosthetic dentist, an implant surgeon and a laboratory technician.  The results in these cases are life changing.

The third popular smile enhancement involves bonding or porcelain to restore worn, broken, or otherwise damaged teeth. “Bonding” utilizes tooth-colored filling material which is placed on one or a group of teeth to restore natural appearance, shape, and color. Similarly, porcelain is used in more advanced cases for those patients who wish to have the most long-lasting and cosmetic solution to their dental problems. Porcelain can be used to cover the entire tooth or limited areas of the tooth as needed in any given situation. The porcelain is bonded to the teeth which results in a very strong, cosmetic, and natural result.

Bonding and porcelain can be used to enhance smiles in a number of different ways. Teeth which have mild misalignment can be made to look perfectly aligned instantly using these materials. Similarly, problems with symmetry, proportion, color and shape can all be addressed using these materials. The next time that you are in our office, make sure to look at some of the photographs on our walls which exhibit the results gained by using these materials.

Finally, let us reiterate the best ways to ensure healthy aging at least as far as oral health is concerned.  As we grow older, we are all more prone to have decay which can sometimes develop very quickly.  It is not uncommon for adult patients to have some gum recession which results in the exposure of root surfaces.  Such surfaces are very prone to decay and must be carefully monitored both at home and in the dental office.  In addition, as our gums recede, food is more likely to lodge between the teeth creating another cause for decay developing.  Increased use of medications and other medical issues may lead to a condition of dry mouth.  Without the buffering effects of saliva, the likelihood for increased dental decay as well as gum disease is highly likely.

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So what is one to do to prevent an increase in gum disease and dental decay? Here are our favorite as well as most effective recommendations:

  1. Use an electric toothbrush and brush where the teeth and gums meet.
  2. Clean between your teeth with an appropriate sized tool. Large spaces require a proxy brush and smaller spaces require fluffy floss.
  3. Brush before bed!
  4. Rinse with a fluoride mouthwash especially before bed.  During this month we have been handing out Listerine Zero which is a good product found in the grocery store but any similar product which includes no alcohol can be used.
  5. Have regular checkups! This is the best way to make sure that small problems do not become big ones! In the past few years, we have seen more and more patients who have returned after extended periods with more severe problems. Regular checkups will save you money and give you more peace of mind.

In closing, cosmetic dentistry may be key to a person’s health in later life.  Here is a quote from a cosmetic dentist in Texas:

“We often hear older patients just wanting things patched up as opposed to getting something aesthetic. They may have the idea that they are not worth it, or their families have the idea that they are too old for cosmetic dentistry. This may lead to an attitude that things are ending.

“Improving an older person’s mouth can bring them more happiness and joy, not only by improving chewing efficiency, but also bringing joy back. They will want to smile more.”

If you have any questions concerning this article or any other dental questions, please call our office at 908.359.6655 or contact us via our website at www.designsfordentalhealth.com.

 

 

A Healthy Mouth and Healthy Aging

For over 20 years, September has been designated healthy aging month. This is an annual celebration of the positive side to growing older. During this month, a variety of sources provide Inspiration and ideas for baby boomers and adults aged 45 and above to help them to improve their physical, mental, social, as well as financial well-being.  It is our hope that we at Designs For Dental Health can provide some pertinent information to contribute to our fellow baby boomers.

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It is interesting to note that there are over 76 million baby boomers today over the age of fifty and the first of the 82 million Generation X-ers are about to reach that milestone in 2015.  Why not use September as a time to look back on where you’ve been and consider what you might truly like to do with the rest of your life.  If you’re happy and fulfilled with what you’re currently doing, keep on keeping on!  If not, this is definitely the time to make a change.  From my point of view, I’m happy to keep on doing what we, as your dental care providers, love to do most.  Help to keep you healthy! dreamstime_l_21764121

So, with that in mind, here’s our question for you today: How’s your smile? 

  

First of all, research supports the idea that those who smile more are just plain happier.  Secondly, those with a healthy mouth are much less likely to develop a myriad of diseases commonly suffered by those of us in the 60+ population. So ask yourself- when is the last time that you had a comprehensive dental examination to determine your overall oral health and the best methods used to maintain it?  I promise to provide such a comprehensive examination free of charge for anyone over age 55 who has been a patient in our practice for more than 5 years and who requests it.  That’s right!  All you have to do is ask! I’ll sit down with you for as long as it takes to discuss your concerns and desires.  Then, we’ll do a comprehensive examination including an oral cancer screening, evaluation of your teeth, gums, and bite. Together, we’ll discuss any options that might be available to you to improve your dental health and from that discussion we will arrive at the best treatment plan for you.

 

Consider this – a mere 60 years ago, it was assumed that we would lose all of our natural teeth as we aged.  Now we know that a healthy mouth and teeth will help you to not only look good, but to eat delicious and nutritious foods, to speak clearly and to be confident.  An excellent quality of life demands a vibrantly healthy mouth.  Just consider the fact that those whose oral health is subpar are at risk for various serious medical conditions including: heart disease, stroke, diabetes, pneumonia, cancer, and various other diseases which are common in older adults.

 

What are some common oral health problems?

 

  1. Dry mouth.   Reduced salivary flow is most commonly the result of cancer treatments, the use of certain medications, and certain diseases. Dry mouth is a significant cause of decay and gum disease in older patients because saliva serves to buffer acids that are produced as we eat.  Without the protection of these buffers, rapidly advancing problems occur. 

  2. Darkened teeth.   Our teeth tend to darken with time as the pulp in our teeth recedes and the outer layer of enamel becomes thinner, thus allowing the darker dentin to show through. There are various methods available to whiten the teeth for a more youthful appearance.  These techniques do not harm teeth and most patients are extremely happy with their whiter, more beautiful smiles. 

  3. Root decay. As the gums recede, exposure of the tooth roots result. Exposed root surfaces are less resistant to decay than enamel and decay here is quite common. Good brushing and plaque removing habits go a long way to protect these surfaces. In addition, the judicious use of fluoride rinses can be most helpful to protect these exposed surfaces. 

  4. Gum disease. Inflammation of the gums and resulting bone loss in more advanced cases is quite common in adults over the age of 50.  Gum disease is worsened by poorly fitting tooth restorations, less than ideal dietary choices, and certain diseases like anemia, cancer, and diabetes.  The best way to fight gum disease is to practice excellent oral hygiene and have regular dental exams and cleanings as recommended in your particular case. 

  5. Tooth loss. Gum disease is the number one cause of tooth loss; however, teeth which have broken due to old, large silver fillings or simple attrition require prompt attention to avoid unnecessary loss of teeth!  Restoring a broken tooth is always better and less expensive than losing a tooth and later trying to replace it. 

  6. Uneven jawbone. This common problem is a result of premature tooth loss.  Once a tooth is lost, the bone previously around that root vanishes and teeth adjacent to and opposing the missing tooth will shift.  This causes an uneven bite and places for food and bacteria to become trapped. 

  7. Oral cancer. Routine examinations are essential to identify possible cancerous conditions in the mouth. Always report unusual lumps or bumps or discolorations to your dentist or hygienists promptly! 

So what is the best way to maintain your good oral health?  It’s the same regardless of your age!    

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  1. Brush at least twice a day with good quality toothpaste as recommended by your dentist or hygienist. The most important time to brush is just before bed!! 

  1. Floss or otherwise thoroughly clean between your teeth at least one time each day. 

  1. Visit your dentist or hygienist on a regular basis as recommended by them for regular cleanings and oral examinations.  

  1. Use appropriate rinses or fluorides or other such adjuncts as recommended by your dental professionals. 

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If you have any questions about healthy aging month or would like a complementary comprehensive examination please call us at 908.359.6655 or contact us via our website at www.DesignsForDentalHealth.com

All-on-4®, A Dental Miracle

All–on–4® is the name for a technique used in the total rehabilitation of patients who have lost or will soon lose all of their teeth in one or both arches. This system was developed in the 1990s through studies which were funded by Nobel Biocare which has been a corporate leader in the implant industry since the early 1980s.

The All-on-4® treatment concept is a miracle because patients arrive at their dentist’s office in the morning with either no teeth or teeth which cannot be saved in one or both arches.  At that appointment, the implant surgeon (usually a periodontist or oral surgeon), the prosthetic dentist (in this case, me) and a lab technician work collaboratively.  A few hours later the patient leaves the office with a complete set of teeth which are not removable, which function well and which look amazing.

In addition, no grafting is required before placing the implants with this system. Therefore, most patients who have been told that they are not good candidates for implants because of a lack of bone, or large sinuses, or other anatomical circumstances are perfect candidates for the All–on–4® procedure.

There is no grafting, and no lengthy healing time required. Four implants are placed in each treated jaw. This procedure takes advantage of the dense bone which is available in the front of both the top and bottom jaws and places two implants there. Two more implants are placed in the back of the jaws and at an angle to both avoid sensitive anatomic areas as well as to take advantage of available dense bone there. Permanently fixed bridges can then be secured to these four implants immediately because of the solid primary stability which is gained by these strategically placed implants.

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The full dental bridge which is attached to these implants is not removable, has no coverage of the palate, and can be used immediately to eat a complete diet without restriction. After four to six months, a final fixed prosthesis is placed over the implants once total healing is assured.

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The advantages of All–on–4® are many:

1. Get implants in one day with minimal surgery.

2. Entire procedure completed in one location and one day.

3. Avoid the expense and healing time of bone grafting.

4. Have fixed, not removable teeth.

5. Have a complete new set of teeth which look and feel natural – Smile Again!

6. Have the ability to again eat all the foods that you desire.

If you have any questions about the All–on–4® procedure or if you know someone who would benefit from it, please contact us at 908.359.6655 or via our website at www.designsfordentalhealth.com

Your Shimbashi Number And Your Bite

I am writing this article in honor of Dr. Henry “Hank” Shimbashi, a practicing dentist and researcher from Edmonton, Alberta who passed away this week. Dr. Shimbashi was a very influential friend of comprehensive restorative dentists and his research is used every day in offices like mine where problems with the bite and TMJ’s are treated.

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As a result of his research, the Shimbashi number was established to indicate an ideal relationship between the upper and lower jaws. When there is an optimal position of the lower jaw relative to the upper jaw, the muscles which are connected to them will also be at their optimal length and can function ideally.

If the relationship between the upper and lower jaws is altered, one or more of the many muscles of the head, neck and face may be overworked causing them to go into spasm — i.e., be painful. This can happen if the lower jaw is too close to or far from the upper jaw, too far forward or back, or shifted in any direction relative to the upper jaw.

Dr. Shimbashi’s research measured muscle activity in over 500 patients. He found that there was an ideal vertical dimension at which the jaw muscles functioned at their maximum potential. In addition, at this ideal position, patients had no symptoms of muscle pain. This vertical dimension was found to be universally applicable in all age groups and all races.

This simple number which we use is the measurement from the gum line of the upper front tooth to the gum line of the lower front tooth. Dr. Shimbashi found this ideal distance to be approximately 19 mm plus or minus one mm (about three quarters of an inch) when a patient bites.  In our office, we often see patients with bite problems whose Shimbashi number is significantly less than ideal  measuring as little as 10 mm or even less. In such patients, the lower front teeth are often nearly completely covered by the upper teeth. Such patients are much more likely to develop tooth and pain problems resulting from their bad bites.

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So what is your Shimbashi number?  If you have any questions about your bite as a result of this article, please feel free to call our office at 908.359.6655 or via our website at www.DesignsForDentalHealth.com

Is It Really A Migraine??

Last week in the course of a routine examination, I asked a standard question of our young woman patient: “Do you have any problem with headaches?” She replied that she does have “migraines”. So I asked a few relevant questions about the headaches, and as is often the case, this patient’s answers led me to believe that her headaches are, in fact, not migraines.

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In our office, we often treat patients with head and neck pain who have been diagnosed by their doctors as having temporomandibular joint dysfunction. Oftentimes, such patients visit their doctors because they assume that the headaches from which they suffer must be migraines.

What are the typical signs and symptoms of a migraine headache? A typical migraine may last several hours to as many as three days. The pain is moderate to severe, pulsating, and usually on one side of the head. Typical associated signs of migraines include nausea and/or vomiting, as well as sensitivity to light and noise. Many migraine patients describe an “aura” just before the migraine begins. Auras are exhibited as a change in vision or hearing. Episodic migraines occur fewer than fifteen times per month with only some of these headaches being actual migraines. Such headaches occurring more than fifteen days per month with pain lasting four hours or more over a three-month period are considered to be “chronic migraines”.

Migraines may be triggered by various factors, and three out of four migraine sufferers describe specific triggers. Common examples of these triggers are physical exertion, stress, hormonal changes, weather changes, and others.

Tension headaches are the most common primary headaches. Such headaches may be misdiagnosed as migraines and vice versa.

Cluster headaches are severe attacks of pain on one side of the head lasting between fifteen minutes and three hours. These headaches may occur every other day or as often as eight times each day. Cluster headaches may be associated with facial sweating, restlessness, agitation or nasal congestion.

Other types of headaches include those brought on by exertion or coughing.  They may be described as feeling like stabbing pain or other equally unpleasant feelings.

If you or someone that you know suffers from headaches, we can generally help determine whether or not migraine headache is a proper diagnosis. The determination is made based upon the patient’s history and description of the pain as well as a screening examination to rule out the possibility of TMJ-type pain. We even have a computerized evaluation system to diagnose which muscle or muscles may be causing the problem. Patients often find it hard to believe that their headaches may be related to their jaw joints or their bite. The truth is, the connection between head and neck pain and the muscles involved in moving the jaw as well as those holding the head erect are commonly the source of such pain.

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If you have a question about headaches or would like additional information please feel free to contact us via our website www.DesignsForDentalHealth.com or by calling our office at 908.359.6655.

I Learned First Hand What Being a TMD Patient Feels Like! AND, It’s All About the Bite!

First, I believe that this is one of the most important articles that I’ll write.  For the past twenty plus years, the study of occlusion (how the teeth meet plus A LOT more) has been my passion.  It is very difficult to explain to patients how the bite can be responsible for so many dental issues.  And, it is even more difficult for patients to understand that fixing the bite does not generally mean just getting braces (orthodontics).

richardtensTENS To Relax Muscles

Having just returned from a three-day advanced TMD (Temporomandibular Disorder or TMJ disorder) program, I learned updated techniques to assist in the establishing of proper bites for patients –  especially those who suffer form head, neck and facial pain.  We were able to see objectively with the help of computer analysis how getting the jaw position right results in muscles which RELAX, and, therefore, STOP HURTING!

 And that is the big paradigm shift that is difficult for patients to understand.  Occlusion involves a system which includes the teeth, the upper and lower jaws, muscles, ligaments, nerves, etc.  And, when this system is out of balance, there may be a variety of signs (what the dentist sees) and symptoms (what the patient experiences) which develop.

If a person’s occlusion is out of balance, he or she may develop loose teeth, sensitive or painful teeth, worn and broken teeth, headaches, neck and shoulder pain, facial pain, dizziness, clicking or popping jaw, ringing in the ears, tingling fingers, and much more.  Most people, if told that they have problems due to their bite, assume that the only way to fix it is by having orthodontics or braces on their teeth. 

Orthodontics is a dental specialty which addresses how to straighten teeth and how to make the upper and lower teeth fit together.  It does not address the position of the jaw nor the muscles and other “soft” tissues which support the jaw.  And it is the jaw position and the muscles which need treatment to solve most bite-related problems.   Picture the jaw just hanging from the skull by muscles and ligaments.  As we close our mouths, we bite to bring our teeth together as best we can.  If our ideal “physiologic” jaw position and the tooth biting position do not match, the jaw is forced into a ”bad” position requiring muscles to work overtime.  Muscles which are over-worked build up lactic acid and begin to hurt.  Most people experience such pain when they begin a new exercise program.   So, just straightening the teeth without regard for jaw position nor muscle relaxation will not solve most problems of occlusion.

 Please do not misunderstand the value of orthodontics.  Due to various hereditary and environmental conditions, children develop crooked teeth which require straightening.  Such “malocclusions” are best treated early and after a thorough analysis of how the problem developed.  Orthodontists provide an excellent service and help both children and adults to look great and function well.  Having dabbled in orthodontics, I have a real appreciation for the amazing work that they perform.

richardk7Establishing a Correct Bite

But this article is intended for those who have true “occlusal” issues which tooth straightening alone will not resolve.  A thorough examination including a complete history, comprehensive examination, necessary xray evaluations, and diagnosis by a doctor or dentist who is well-versed with occlusal issues is the first step to successful  treatment.

 I am very excited about the wonderful advances that are being made in this field, and I welcome your comments and questions.  I plan to continue addressing this subject in upcoming blog articles.  Please let me know if you have specific questions which you will find interesting and pertinent.  You may contact me by calling the office at 908.359.6655 or through our website at www.DesignsForDentalHealth.com .