By Ali Soulati, DDS
December 31, 2018
Category: Dental Procedures
BobbyBonesDancesHisWaytoDentalDamage

The long-running hit show Dancing with the Stars has had its share of memorable moments, including a wedding proposal, a wardrobe malfunction, and lots of sharp dance moves. But just recently, one DWTS contestant had the bad luck of taking an elbow to the mouth on two separate occasions—one of which resulted in some serious dental damage.

Nationally syndicated radio personality Bobby Bones received the accidental blows while practicing with his partner, professional dancer Sharna Burgess. “I got hit really hard,” he said. “There was blood and a tooth. [My partner] was doing what she was supposed to do, and my face was not doing what it was supposed to do.”

Accidents like this can happen at any time—especially when people take part in activities where there’s a risk of dental trauma. Fortunately, dentists have many ways to treat oral injuries and restore damaged teeth. How do we do it?

It all depends on how much of the tooth is missing, whether the damage extends to the soft tissue in the tooth’s pulp, and whether the tooth’s roots are intact. If the roots are broken or seriously damaged, the tooth may need to be extracted (removed). It can then generally be replaced with a dental bridge or a state-of-the-art dental implant.

If the roots are healthy but the pulp is exposed, the tooth may become infected—a painful and potentially serious condition. A root canal is needed. In this procedure, the infected pulp tissue is removed and the “canals” (hollow spaces deep inside the tooth) are disinfected and sealed up. The tooth is then restored: A crown (cap) is generally used to replace the visible part above the gum line. A timely root canal procedure can often save a tooth that would otherwise be lost.

For moderate cracks and chips, dental veneers may be an option. Veneers are wafer-thin shells made of translucent material that go over the front surfaces of teeth. Custom-made from a model of your smile, veneers are securely cemented on to give you a restoration that looks natural and lasts for a long time.

It’s often possible to fix minor chips with dental bonding—and this type of restoration can frequently be done in just one office visit. In this procedure, layers of tooth-colored resin are applied to fill in the parts of the tooth that are missing, and then hardened by a special light. While it may not be as long-lasting as some other restoration methods, bonding is a relatively simple and inexpensive technique that can produce good results.

If you would like more information about emergency dental treatment, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor articles “The Field-Side Guide to Dental Injuries” and “Knocked Out Tooth.”

By Ali Soulati, DDS
December 21, 2018
Category: Oral Health
Tags: tmj disorders  
TMDandFibromyalgiaCouldShareLinksinChronicPain

Chronic pain can turn your life upside down. While there are a number of disorders that fit in this category, two of them—fibromyalgia and temporomandibular disorders (TMD)—can disrupt your quality of life to the extreme. And it may be the two conditions have more in common than similar symptoms—according to one study, three-fourths of patients diagnosed with fibromyalgia show symptoms of TMD.

To understand why this is, let’s take a closer look at these two conditions.

Fibromyalgia presents as widespread pain, aching or stiffness in the muscles and joints. Patients may also have general fatigue, sleep problems, mood swings or memory failures. TMD is a group of conditions that often result in pain and impairment of the temporomandibular joints that join the jaw with the skull. TMD can make normal activities like chewing, speaking or even yawning painful and difficult to do.

Researchers are now focusing on what may, if anything, connect these two conditions. Fibromyalgia is now believed to be an impairment of the central nervous system within the brain rather than a problem with individual nerves. One theory holds that the body has imbalances in its neurotransmitters, which interfere with the brain’s pain processing.

Researchers have also found fibromyalgia patients with TMD have an increased sensitivity overall than those without the conditions. In the end, it may be influenced by genetics as more women than men are prone to have either of the conditions.

Treating these conditions is a matter of management. Although invasive techniques like jaw surgery for TMD are possible, the results (which are permanent) have been inconclusive in their effectiveness for relieving pain. We usually recommend patients try more conservative means first to lessen pain and difficulties, including soft foods, physical therapy, stretching exercises and muscle relaxant medication. Since stress is a major factor in both conditions, learning and practicing relaxation techniques may also be beneficial.

In similar ways, these techniques plus medication or cognitive-behavioral therapy that may influence neurotransmission can also help relieve symptoms of fibromyalgia. Be sure then that you consult with both your physician and dentist caring for both these diseases for the right approach for you to help relieve the effects of these two debilitating conditions.

If you would like more information on managing TMD or fibromyalgia, 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 “Fibromyalgia and Temporomandibular Disorders.”

By Ali Soulati, DDS
December 11, 2018
Category: Oral Health
Tags: jaw pain  
TheresNewHopeforaBetterUnderstandingofChronicJawPain

Chronic jaw pain and limited jaw mobility are two common symptoms of a group of conditions known as temporomandibular joint disorders (TMJD or TMD). Several effective treatments have developed over the years, despite the fact that the underlying causes for TMD remain an elusive quarry for medical researchers.

But we may now have a promising new lead in understanding TMD: a possible link between it and other systemic inflammatory diseases. In recent study researchers interviewed over 1,500 people with TMD about various aspects of their lives. Nearly two-thirds reported at least three or more other inflammatory health conditions like fibromyalgia, chronic headaches or rheumatoid arthritis.

These statistics suggest a relationship between TMD and these other conditions. Further exploration of these possible links could result not only in a greater understanding of TMD but better treatment strategies for it and the other related conditions.

In the meantime, though, what can you do if you're currently dealing with TMD?

As of now the approaches with the best results continue to be conservative, non-invasive techniques we've used for several years. Thermal therapies like hot or cold compresses to the jaw area, for example, are quite effective in providing pain relief, and muscle relaxant drugs have proven beneficial for improving jaw mobility.

More radical approaches like jaw surgery have also come into prominence. But there's a caveat here: a significant number of people find their conditions don't improve or may even worsen. In the study previously mentioned, only 38% of respondents who had undergone jaw surgery saw any range of improvement (from slight to significant); by contrast, 28% indicated no change in symptoms and 46% said they were worse off.

It's important, then, that you thoroughly discuss your condition with your dentist, verifying first that you have TMD.  Together you can develop a treatment plan to relieve pain and restore jaw function. If your dentist or surgeon suggests surgery, consider seeking a second opinion before choosing this more radical approach.

Hopefully, further research into the causes and relationships of TMD with other health conditions will yield still better treatments. In the meantime, you may still find relief and improve your quality of life with the proven techniques available now.

If you would like more information on treatments for chronic jaw pain, 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 “Chronic Jaw Pain and Associated Conditions.”

InfectionControlStandardsKeepDentalPatientsSafefromDisease

The chances of contracting an infectious disease from a dental visit are extremely low, thanks to the stringent safety standards practiced by over 170,000 dental care providers across the U.S. Without these standards, you and your family would be at risk for diseases like hepatitis from even a routine office visit.

The main prevention focus centers on blood-borne diseases in which blood from an infected person is introduced into the body of another through a cut, incision or injection site. While HIV/AIDS (autoimmune deficiency syndrome) is perhaps the most well known of blood-borne diseases, a more common and thus a more threatening disease is hepatitis. Caused by a pair of viruses known as HBV and HCV, hepatitis damages the liver, which disrupts normal bodily function and can even cause death.

The spread of hepatitis and similar diseases is a major concern for blood transfusion and surgical centers that commonly use invasive procedures and intravenous (IV) equipment. It’s also a concern in dental offices where even a hygienic cleaning may result in some bleeding. To reduce the risk of disease, the dental profession has several layers of both mandatory and recommended standards for protection against viral or microbial transmission.

The Center for Disease Control, for example, publishes and regularly updates recommended procedures for equipment sterilization and disinfection. State level dental licensing boards also mandate safety procedures and require continuing education for infection control as a requirement for re-licensing, as often as two years. Professional organizations such as the American Dental Association (ADA) also encourage safety protocols among its members.

The vast majority of dentists place infection control among their highest priorities. These care providers institute and practice daily protocols and procedures for hand washing, use of masks, gloves and other biohazard protection, and disinfection. Through effective infection control you and your family can receive the dental care you need without endangering your general health.

If you would like more information on health safety in the dental office, 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 “Infection Control in the Dental Office.”

DentalInjuryIsJustaTemporarySetbackforBasketballStarKevinLove

The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.

In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?

The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.

Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.

So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”

Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.

If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”





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