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By Edward Joseph, D.D.S.
January 16, 2022
Category: Oral Health
Tags: thumb sucking  
LateThumb-SuckingCouldCauseBiteProblems

Of the many concerns pediatric healthcare providers hear from parents, thumb-sucking is definitely on the short list. Such a worry isn't totally unwarranted—persistent thumb-sucking could influence poor bite formation.

But if you have an infant or toddler who can't seem to keep their thumb out of their mouth, there's no need to panic—yet. Thumb-sucking is a nearly universal habit among young children, but the vast majority won't suffer any long-term harm from it.

That being said, though, it can become a problem if the habit continues on into late childhood, especially as permanent teeth begin to come in. That's because of the habit's relationship with the transition that occurs in child's swallowing patterns.

Babies initially thrust their tongue forward as they swallow, which helps them maintain a seal on the breast or bottle. This causes the jaws to remain partially open and not completely shut together, what's known as an open bite. Later, when weaning off milk for solid food, the pattern will change as the child begins moving the tongue down and away as they swallow. This in turn allows the jaws to completely shut.

Thumb-sucking often coincides with the initial infant swallowing pattern, and it usually fades about the time the child is moving into the more adult pattern. Persistent thumb-sucking, however, interferes with that process, essentially extending the open bite longer than normal, which in turn creates the conditions for poor bite development. Thumb-sucking can also put undue upward pressure on the front teeth, which could disrupt their alignment.

If thumb-sucking causes these conditions to develop, a child could eventually need extensive orthodontic treatment later in childhood or adolescence to correct their bite problems. The better course, though, is to avoid this by encouraging your child to end their finger-sucking habit, preferably by the age of 3.

It was common in years past to coat a child's thumb with something spicy that although not harmful was definitely not pleasant to taste. Today, most care providers recommend a more positive approach like offering praise or rewards to a child when they avoid sucking their thumb.

It may take time, but persistence and patience can win out. And, the biggest winner in ending thumb-sucking will be the child's long-term oral health.

If you would like more information on the dental effects of thumb-sucking, 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 “How Thumb Sucking Affects the Bite.”

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By Edward Joseph, D.D.S.
January 11, 2022
Category: Oral Health
Tags: oral health   pregnancy  
MaintainYourDentalCareDuringPregnancyForYouandYourBaby

Hearing the words, "You're going to have a baby," can change your life—as surely as the next nine months can too. Although an exciting time, pregnancy can be hectic with many things concerning you and your baby's health competing for your attention.

Be sure, then, that you include dental care on your short list of health priorities. It may seem tempting to "put things off" regarding your teeth and gums. But there are good reasons to keep up your dental care—for you and your baby.

For you: a higher risk of dental disease. Hormonal changes during pregnancy can trigger outcomes that increase your dental disease risk. For one, you may encounter cravings that include carbohydrates like sugar. Bacteria feed on sugar, which can cause both tooth decay and gum disease. This change in hormones can also trigger a form of gum disease called pregnancy gingivitis.

For your baby: dental-related complications. Some studies show evidence that a mother's oral bacteria can pass through the placenta and affect the baby. This may in turn spark an inflammatory response in the mother's body, creating potential complications during pregnancy. Other research points to what could result: Women with diseased gums are more likely to deliver premature or underweight babies than those with healthy gums.

Fortunately, you can minimize dental disease during pregnancy and protect both you and your baby.

  • Keep up regular dental cleanings and checkups during pregnancy;
  • Limit consumption of sweets and other sugary foods;
  • Brush and floss every day to remove dental plaque, which feeds bacteria;
  • See your dentist at the first sign of swollen, painful or bleeding gums;  
  • And, inform your dentist that you're pregnant—it could affect your treatment plan.

Although it's wise to put off dental work of a cosmetic or elective nature, you shouldn't postpone essential procedures. Both the American Dental Association and the American Congress of Obstetricians and Gynecologists approve of pregnant women undergoing therapeutic dental work.

Dental care during pregnancy shouldn't be an option. Maintaining your oral health could help you and your baby avoid unpleasant complications.

If you would like more information on dental care during pregnancy, 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 “Dental Care During Pregnancy.”

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By Edward Joseph, D.D.S.
January 06, 2022
Category: Dental Procedures
StayonAlertforaDecayRepeatEvenAfteraRootCanal

A deeply decayed tooth is in serious trouble, and something a regular filling may not fix. You may instead need a root canal, a common tooth-saving procedure performed by general dentists or, in more difficult cases, endodontists (specialists in interior tooth treatment).

Regardless of who performs it, though, the basics are the same: The dentist accesses the tooth's decayed interior by drilling a hole and removing diseased tissue from the pulp and root canals through it. They then fill the empty spaces with a rubber-like substance before sealing the tooth and later crowning it to prevent re-infection.

For most, a root canal gives a decayed tooth a new lease on life that can last for years, if not decades. Occasionally, though, a root canaled tooth may become reinfected from tooth decay. There are a number of possible reasons for this unfortunate outcome.

For one, the decay might not have been caught until it had advanced into root canal filling, resulting in contamination. Although root canal treatment may still be effective, the chances of success are much lower than for a decayed tooth diagnosed before it had advanced this far.

Teeth with multiple roots or complex root canal networks are also difficult to treat. The challenge is to ensure all the root canals within the tooth have been thoroughly treated. These types of situations are usually best undertaken by an endodontist with microscopic equipment and advanced techniques that can better infiltrate intricate root canal networks.

These and other situations could make it more likely a root-canaled tooth is reinfected. Depending on the extent of damage, it may be best to extract the tooth and replace it with a dental implant or other restoration. But it's also possible to repeat the root canal—and the second time may be the charm.

As with many other dental conditions, the best outcome regarding a reinfected tooth after root canal is early detection and treatment. You can increase your chances of this with regular dental visits that include monitoring of any root-canaled teeth. You should also see your dentist as soon as possible if you notice pain or gum swelling associated with the tooth.

Root canals are highly effective at saving decayed teeth. But the rare reinfection is possible—so be on the alert.

If you would like more information on root canal 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 “Root Canal Treatment: How Long Will It Last?”

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By Edward Joseph, D.D.S.
January 01, 2022
Category: Dental Procedures
Tags: veneers  
VeneersMayNotBeaGoodOptionforaTeenager

People love dental veneers—those thin, porcelain shells bonded to teeth to mask stains and blemishes. For a relatively modest price, they can vastly improve a smile.

But what if it's your teenager who needs a smile upgrade? Teens also experience dental flaws like adults—which, at their age especially, disrupt their self-image and social confidence.

So, can veneers work for teens? Technically, yes, but there's a possible snag, depending on the maturity level of their teeth.

The potential problem relates to the tooth preparation that precedes the bonding of the veneers. One option is no-prep veneers and they are a nice solution depending on the size and shape of the existing teeth. If the teeth are slight in size, no preparation is necessary. If the teeth are large, even though veneers are thin, they can still look unnaturally bulky when bonded to unprepared teeth. A dentist may need to remove some of the tooth's surface enamel before applying the veneers.

Although this alteration has little effect on an adult tooth (other than requiring a veneer or restoration from that time on), it could damage a less mature tooth and stunt its development. A younger tooth can have a larger pulp—the central tooth chamber containing blood vessels and nerves—that's closer to the enamel surface than an adult tooth.

Because of the pulp's proximity to the surface of an immature tooth, there's a risk of damaging it during the tooth preparation phase for veneers. If that happens, the tooth may need additional treatment to save it.

We don't depend on a teen's calendar age to determine whether or not it's safe to install veneers. Instead, we examine the teeth and measure how close the pulp may be to the surface, as well as the thickness of the middle layer of dentin. Veneers could be acceptable if it appears the teeth have reached a healthy level of maturity.

If not, though, we may need to consider less invasive ways to improve a teen's smile. For stains or other outer discolorations, whitening with a bleaching solution significantly brightens teeth. We can repair chips by bonding and sculpting color-matching dental material to the teeth. And, these or similar cosmetic measures won't endanger an immature tooth like a veneer application.

Once a young patient's teeth have matured, we can revisit the subject of veneers. That may take time, but the more attractive smile that results will be worth the wait.

If you would like more information on dental care for adolescents, 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 “Veneers for Teenagers.”

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By Edward Joseph, D.D.S.
December 27, 2021
Category: Oral Health
Tags: gum disease   nutrition  
CurbYourCarbConsumptiontoBoostYourDefensesAgainstGumDisease

You're doing the right things to avoid the return of gum disease: brushing and flossing every day, dental visits on a regular basis and watching for symptoms of another infection. But while you're at it, don't forget this other important part of gum disease prevention—your diet.

In relation to oral health, not all foods are alike. Some can increase inflammation, a major factor with gum disease; others strengthen teeth and gums. Carbohydrates in particular are a key part of this dynamic.

The body transforms these biomolecules of carbon, hydrogen and oxygen into the sugar glucose as a ready source of energy. But glucose levels in the bloodstream must be strictly controlled to avoid a harmful imbalance.

When elevated the body injects the hormone insulin into the bloodstream to bring glucose levels into normal range. Eventually, though, regular injections of insulin in high amounts in response to eating carbs—known as "spikes"—can increase inflammation. And, inflammation in turn increases the risk and severity of gum infections.

So, why not cut out carbohydrates altogether? That might be akin to throwing out the proverbial baby with the bath water. A wide range of carbohydrates, particularly fruits and vegetables, are a rich source of health-enhancing nutrients.

It's better to manage your carbohydrate consumption by taking advantage of one particular characteristic: Not all carbohydrates affect the body in the same way. Some cause a higher insulin response than others according to a scale known as the glycemic index. It's better, then, to eat more of the lower glycemic carbohydrates than those at the higher end.

One of the latter you'll definitely want to restrict is refined sugar—which also happens to be a primary food source for bacteria. You'll also want to cut back on any refined or processed foods like chips, refined grains or pastries.

Conversely, you can eat more of a number of low glycemic foods, most characterized as "whole", or unprocessed, like fresh fruits and vegetables, or whole grains like oatmeal. You should still, however, eat these in moderation.

Better control over your carbohydrate consumption is good for your health overall. But it's especially helpful to your efforts to keep gum disease at bay.

If you would like more information on nutrition and your oral 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 “Carbohydrates Linked to Gum Disease.”

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Burbank, CA Dentist
Edward C. Joseph, D.D.S.
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