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Posts for: March, 2019

DealingwiththeRealityofIncreasedDiseaseRiskwithBraces

Wearing braces is all about the future: you undergo many months of treatment to gain a lifetime of better mouth function and a more attractive smile.

In the meantime, though, you'll have to deal with a few new realities during treatment: restrictions on foods, limitations with mouth function, and (perhaps) embarrassment over your new “metallic” smile.

There's one reality, though, that trumps all others in importance: your risk for developing dental disease increases significantly during orthodontic treatment. The brackets and wires of your braces make it more difficult to remove bacterial plaque, the main cause of dental disease, which allows places for disease-causing bacteria to thrive. To combat this, you'll need to step up your hygiene efforts to remove daily plaque.

One sign your efforts might not be getting the job done is red, swollen or bleeding gums. Although gums can swell in reaction to the braces themselves, it's often because plaque-induced periodontal (gum) disease has infected the gum tissues.

Gum disease is an aggressive infection. If it isn't stopped it can damage the gums and underlying bone that support your teeth — damage that could eventually lead to tooth loss. To stop it, we must remove plaque from all tooth and gum surfaces, even below the gum line. In some advanced cases it may even be necessary to remove the braces to better treat the disease.

That's why preventing gum disease through effective hygiene is so important. Besides continuing routine visits with your family dentist, you should also brush and floss every day to remove plaque. Be sure you're brushing above and below the braces. It may be helpful to use an interproximal brush specifically designed to maneuver around these tight spaces. You can also use a floss threader or a water irrigator to make the job of flossing easier.

If you do notice gum redness, swelling or bleeding, don't delay — call your dentist at once. An examination will determine if you have gum disease and to what degree, which will guide treatment. The sooner this happens, the less the impact on your dental health and your orthodontic treatment.

If you would like more information on dental care 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 “Gum Swelling During Orthodontics.”


By David A. Rosh, DMD, PC
March 19, 2019
Category: Oral Health
ADentalExamCouldUncoveranEatingDisorder

After your son or daughter's dental exam, you expect to hear about cavities, poor bites or other dental problems. But your dentist might suggest a different kind of problem you didn't expect—an eating disorder.

It's not a fluke occurrence—a dental exam is a common way bulimia nervosa or anorexia nervosa come to light. That's because the teeth are often damaged by the behaviors of a patient with an eating disorder.

Most of this damage occurs because of purging, the practice of induced vomiting after eating. During vomiting stomach acid can enter the mouth and "wash" against the back of the teeth. After repeated episodes, the acid dissolves the mineral content of tooth enamel and causes it to erode. There's also a tell-tale pattern with eating disorders: because the tongue partially shields the back of the lower teeth while purging, the lower teeth may show less enamel erosion than the upper.

Hygiene practices, both negligent and too aggressive, can accelerate erosion. Anorexics often neglect basic grooming and hygiene like brushing and flossing, which increases the likelihood of dental disease. Bulimia patients, on the other hand, can be fastidious about their hygiene. They're more likely to brush immediately after purging, which can cause tiny bits of the enamel immediately softened by the acid wash to slough off.

In dealing with a family member's eating disorder, you should consider both a short and long-term approach to protect their dental health. In the sort-term the goal is to treat the current damage and minimize the extent of any future harm. In that regard, encourage them to rinse with water (mixed optionally with baking soda to help neutralize acid) after purging, and wait an hour before brushing. This will give saliva in the mouth a chance to fully neutralize any remaining acid. Your dentist may also recommend a sodium fluoride mouth rinse to help strengthen their tooth enamel.

For the long-term, your goal should be to help your loved one overcome this potentially life-threatening condition through counseling and therapy. To find out more about treatment resources near you, visit the National Eating Disorders Association website at nationaleatingdisorders.org. Taking steps to treat an eating disorder could save not only your loved one's dental health, but also their life.

If you would like more information on eating disorders and dental health, 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 “Bulimia, Anorexia & Oral Health.”


By David A. Rosh, DMD, PC
March 09, 2019
Category: Oral Health
NancyODellonMakingOralHygieneFunforKids

When Entertainment Tonight host Nancy O’Dell set out to teach her young daughter Ashby how to brush her teeth, she knew the surest path to success would be to make it fun for the toddler.

“The best thing with kids is you have to make everything a game,” Nancy recently said in an interview with Dear Doctor TV. She bought Ashby a timer in the shape of a tooth that ticks for two minutes — the recommended amount of time that should be spent on brushing — and the little girl loved it. “She thought that was super fun, that she would turn the timer on and she would brush her teeth for that long,” Nancy said.

Ashby was also treated to a shopping trip for oral-hygiene supplies with Mom. “She got to go with me and choose the toothpaste that she wanted,” Nancy recalled. “They had some SpongeBob toothpaste that she really liked, so we made it into a fun activity.”

Seems like this savvy mom is on to something! Just because good oral hygiene is a must for your child’s health and dental development, that doesn’t mean it has to feel like a chore. Equally important to making oral-hygiene instruction fun is that it start as early as possible. It’s best to begin cleaning your child’s teeth as soon as they start to appear in infancy. Use a small, soft-bristled, child-sized brush or a clean, damp washcloth and just a thin smear of fluoride toothpaste, about the size of a grain of rice.

Once your child is old enough to hold the toothbrush and understand what the goal is, you can let him or her have a turn at brushing; but make sure you also take your turn, so that every tooth gets brushed — front, back and all chewing surfaces. After your child turns 3 and is capable of spitting out the toothpaste, you can increase the toothpaste amount to the size of a pea. Kids can usually take over the task of brushing by themselves around age 6, but may still need help with flossing.

Another great way to teach your children the best oral-hygiene practices is to model them yourself. If you brush and floss every day, and have regular cleanings and exams at the dental office, your child will come to understand what a normal, healthy and important routine this is. Ashby will certainly get this message from her mom.

“I’m very adamant about seeing the dentist regularly,” Nancy O’Dell said in her Dear Doctor interview. “I make sure that I go when I’m supposed to go.”

It’s no wonder that Nancy has such a beautiful, healthy-looking smile. And from the looks of things, her daughter is on track to have one, too. We would like to see every child get off to an equally good start!

If you have questions about your child’s oral health, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Taking the Stress Out of Dentistry for Kids” and “Top 10 Oral Health Tips for Children.”