My Blog
By Marianna M. Detwiler, DDS
June 18, 2018
Category: Oral Health
Tags: oral hygiene  
WhatYouCanDotoSupportYourChildsDentalDevelopment

Your child’s teeth and gum development is truly a wonder. In just a little more than two decades they’ll gain and lose one set of teeth, while the subsequent permanent set will grow in coordination with other facial and oral structures. All of these structures will finally reach maturity sometime in early adulthood.

Sometimes, though, obstacles can arise: disease, trauma or even genetics can derail normal development and endanger future health. So although nature does most of the heavy lifting, there are things you should do to keep your child’s dental development on track.

For instance, begin oral hygiene practices before their first teeth come in. By wiping their gums after feeding with a clean damp cloth, you can help reduce the numbers of disease-causing bacteria in the mouth. Once teeth appear switch to brushing.

There are also habits to avoid. Don’t kiss your baby directly on the lips—you may transfer to them your own mouth bacteria, which their young immune system can’t yet adequately handle. Also, avoid putting them to bed with a sleep-time bottle filled with sugary fluids (including milk or formula) because the constant contact between the sugar and their teeth could increase their risk for tooth decay, the number one dental disease in young children.

Of course, not all prevention efforts depend on you alone—we’re your partner in helping to keep your child’s dental development progressing normally. We can provide preventive treatments like sealants or topical fluoride to reduce the risk of tooth decay, while continually monitoring for signs of the disease that may require treatment. We also look for signs of emerging bite problems that may require intervention before their effects worsen.

This is all part of regular dental visits, usually at six-month intervals, which are best begun around your child’s first birthday. Not only does this enable us to stay ahead of dental problems, it also helps your child become more comfortable with dental visits and increase the likelihood they’ll continue the habit in adulthood.

As we said, nature is responsible for most of this amazing development without any help from us. But we can assist development and hopefully prevent issues that could diminish their dental health in years to come.

If you would like more information on supporting your child’s dental development, please contact us or schedule an appointment for a consultation.

By Marianna M. Detwiler, DDS
June 08, 2018
Category: Oral Health
Tags: braces   oral hygiene  
BeVigilantwithDentalCareWhileWearingBraces

If you or a family member wears braces, you're used to visiting your orthodontist for adjustments and progress monitoring. But it's just as important that you continue regular visits with your family dentist, especially if you begin noticing abnormalities with your teeth and gums.

We need to be on alert for dental health because risks for disease increase during orthodontic treatment. Most oral infections arise from plaque, a thin film of bacteria and food particles on tooth surfaces. You avoid plaque buildup by brushing and flossing at least once a day and undergoing semi-annual office cleanings for any remaining plaque and calculus (hardened plaque deposits).

Braces, however, can complicate hygiene. It's harder to get into areas blocked by the brackets and wires with your brush or floss. This can quickly give rise to gingivitis, a form of periodontal (gum) disease characterized by gum swelling. If not treated, gum disease could eventually cause the gums to detach from the teeth and lead to bone and tooth loss.

The brackets and wires can also irritate the gums and cause them to swell or overgrow, a condition called hyperplasia. This further complicates proper hygiene, which then increases the risk for infection even more.

It takes more time and effort to brush and floss effectively while wearing braces. But it's necessary to prevent these problems. Interproximal brushes (which fit in the spaces between teeth) can help, as well as special floss threaders. You might also consider a water flosser, which use a high-pressured water spray to remove plaque between teeth.

And, don't neglect seeing us on a regular basis. If you notice gum swelling, redness or bleeding, contact us as soon as possible.

If the swelling is due to hyperplasia, treatment could wait until after the braces come off, as long as there doesn't appear to be any gum detachment from the teeth. If there is, though, you may need to see a periodontist (a gum specialist) for further evaluation. It may be necessary in advanced cases to remove the braces to treat the underlying gum condition.

It pays to keep a close eye on your teeth and gums while wearing braces. Catching problems before they become too serious will help ensure your new smile is just as healthy as it is attractive.

If you would like more information on dental care while undergoing orthodontic treatment, 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.”

JulianneHoughSharesaVideo-andaSong-AfterWisdomTeethComeOut

Once upon a time, celebrities tried hard to maintain the appearance of red-carpet glamour at all times. That meant keeping the more mundane aspects of their lives out of the spotlight: things like shopping, walking the dog and having oral surgery, for example.

That was then. Today, you can find plenty of celebs posting pictures from the dentist on social media. Take Julianne Hough, for example: In 2011 and 2013, she tweeted from the dental office. Then, not long ago, she shared a video taken after her wisdom teeth were removed in December 2016. In it, the 28-year-old actress and dancer cracked jokes and sang a loopy rendition of a Christmas carol, her mouth filled with gauze. Clearly, she was feeling relaxed and comfortable!

Lots of us enjoy seeing the human side of celebrities. But as dentists, we’re also glad when posts such as these help demystify a procedure that could be scary for some people.

Like having a root canal, the thought of extracting wisdom teeth (also called third molars) makes some folks shudder. Yet this routine procedure is performed more often than any other type of oral surgery. Why? Because wisdom teeth, which usually begin to erupt (emerge from beneath the gums) around age 17-25, have the potential to cause serious problems in the mouth. When these molars lack enough space to fully erupt in their normal positions, they are said to be “impacted.”

One potential problem with impacted wisdom teeth is crowding. Many people don’t have enough space in the jaw to accommodate another set of molars; when their wisdom teeth come in, other teeth can be damaged. Impacted wisdom teeth may also have an increased potential to cause periodontal disease, bacterial infection, and other issues.

Not all wisdom teeth need to be removed; after a complete examination, including x-rays and/or other diagnostic imaging, a recommendation will be made based on each individual’s situation. It may involve continued monitoring of the situation, orthodontics or extraction.

Wisdom tooth extraction is usually done right in the office, often with a type of anesthesia called “conscious sedation.”  Here, the patient is able to breathe normally and respond to stimuli (such as verbal directions), but remains free from pain. For people who are especially apprehensive about dental procedures, anti-anxiety mediation may also be given. After the procedure, prescription or over-the-counter pain medication may be used for a few days. If you feel like singing a few bars, as Julianne did, it’s up to you.

If you would like more information about wisdom tooth extraction, please call our office to arrange a consultation. You can learn more in the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”

By Marianna M. Detwiler, DDS
May 19, 2018
Category: Dental Procedures
Tags: porcelain veneers  
NewMaterialsAddStrengthtoVeneersBeautifulLife-Likeness

With exciting innovations in cosmetic dentistry over the last few decades, we can now transform nearly any unattractive smile. One of the best and most cost-effective of these is the porcelain veneer. These thin layers of dental porcelain are bonded over the front of chipped, slightly misaligned or stained teeth to create an entirely new look.

Veneers have evolved over time, especially with the materials they contain that give them their beauty and life-likeness. The first veneers were made mainly of feldspathic porcelain, a mineral composition known for its similarity in color and translucence to natural teeth.

But because this early porcelain had a high amount of silica (in essence, glass), and because they were created through overlaying several thin layers that weren’t as strong as a single piece, they were prone to shattering. This made them problematic for teeth subject to heavy biting forces or patients with clenching or grinding habits.

The situation changed dramatically in the 1990s, when dental labs began adding Leucite, a sturdier glass-like mineral that didn’t diminish the porcelain’s translucence. Not only did Leucite make veneers more shatter-resistant, it also enabled dental technicians to fashion most of the veneer in one piece to further strengthen it.

More recent veneers may now incorporate an even stronger material called lithium disilicate. Because lithium disilicate has twice the strength of Leucite, veneers made with it can be as thin as 0.3 millimeters. Not only does this blend together the most desirable qualities expected of a veneer—strength, aesthetic appeal and easy fabrication—it allows for a broader range of situations and uses.

Both of these materials can be pressed or milled to assume the exact shape necessary to fit a particular tooth. The manufacturing process also allows for creating smaller veneers that can then be overlaid with porcelain for the most life-like appearance possible.

Thanks to these stronger materials enhancing the natural beauty of porcelain, we now have a wider creative palate for transforming your smile.  

If you would like more information on porcelain veneers, 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 “Porcelain Veneers: Your Smile—Better Than Ever.”

By Marianna M. Detwiler, DDS
May 09, 2018
Category: Oral Health
Tags: dental injury  
WhattoDoForMouthInjuriesYourChildMightEncounter

Famed educator Maria Montessori once said, “Play is the work of the child”—and most kids take their “work” very seriously. But their avid enthusiasm might also raise the risk of blunt force injuries, particularly to the mouth.

While you should certainly take steps to protect their mouth (like a custom-made guard for contact sports), you can’t completely erase the risk. You should know, therefore, what to do in case of a mouth injury.

The lips, tongue, and other soft oral tissues often get the brunt of any contact injury, ranging from minor bruising and swelling to severe cuts that require medical attention. First, clean the area as thoroughly as possible to remove trapped dirt or debris in the wound. If bleeding occurs, apply continuous gentle pressure with a clean cloth or gauze for 10-15 minutes until it stops, and cold compresses for any swelling. If the wound looks deep or severe, take them to an emergency room.

Blunt force can also impact teeth in a variety of ways. If part of a tooth chips, attempt to find the pieces and see a dentist as soon as possible—they may be able to bond the pieces back to the tooth. If a tooth gets moved out of place, call your dentist immediately or go to an emergency room after hours.

If a permanent tooth gets completely knocked out, find it and rinse off any debris with clean water. Then, place it gently back into its socket, or alternatively between the child’s cheek and gum or in a glass of cold milk. You’ll need to see a dentist as soon as possible to have the tooth replanted. With this kind of injury, time is of the essence.

A hard impact can also fracture the jawbone, which may be suspected if the face appears distorted or the teeth can’t make contact with each other when the jaws are shut. Control any bleeding, apply cold compresses or mild pain relievers to ease any pain or swelling, and go to an emergency room immediately.

A traumatic injury can heighten everyone’s emotions, including yours. You can avoid your emotions turning into panic, though, by following these common sense guidelines to help your child get through this unfortunate event.

If you would like more information on handling children’s dental problems, please contact us or schedule an appointment for a consultation.





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