By Edward Joseph, D.D.S.
July 05, 2020
Category: Oral Health
Tags: oral health  
AShinglesOutbreakCouldInterruptYourDentalCare

A shingles outbreak can be painful and embarrassing. It could also interfere with many areas of your life—including your dental care.

Known medically as herpes zoster, shingles is a viral form of chicken pox. The virus can lie dormant for many years or decades in people that had chicken pox as a child, breaking out later in life (sometimes repeatedly). It's estimated about a quarter of people who had chicken pox as a child, about 90% of adults, will experience a shingles outbreak.

In the beginning, a person with shingles may notice an itching or burning skin irritation, as well as numbness or sensitivity to touch. In time, a red, crusty rash can develop, usually forming a belted or striped pattern on the torso, head or facial areas. The patterning is caused by the virus's disruption of nerves that serve those parts of the body.

Shingles could impact your dental care because it can be contagious early in an outbreak. As such, it can be transmitted to other people via contact with the rash or through airborne respiratory particles. Dental staff members or other patients who are pregnant, undergoing cancer treatment or with other conditions that compromise their immune systems can develop serious health problems if they contract the virus.

If you have an upcoming appointment, it's best then to let your dentist know you've been diagnosed with shingles. If your treatment involves physical contact that could spread the virus, they may wish to reschedule you until the outbreak clears up.

There are ways to hasten the healing process with antiviral treatments like acyclovir or famciclovir. For best results, these treatments should begin within 3 days of a shingles outbreak. There is also a shingles vaccine that can help you avoid an outbreak altogether. The U.S. Centers for Disease Control (CDC) recommend it for adults over 60.

Having shingles can be painful and stressful, and pose a major interruption of your daily life and routine. With proper management, though, it can be contained so you can get on with your life—and your dental care.

If you would like more information on managing shingles and dental care, 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 “Shingles, Herpes Zoster.”

ConsideringaSmileMakeoverBeSureYouIncludeYourBite

A lot of cosmetic dental procedures focus on how teeth look: whether they're stained, chipped or otherwise disfigured. But a true smile makeover requires looking beyond individual teeth appearance and asking if they're properly aligned. Your teeth may be beautiful in and of themselves, but they could detract from your smile if they're not straight.

Orthodontics—the dental specialty dedicated to correcting poor bites—can be just as important to your smile appearance as veneers, crowns or other restorations. Cosmetic enhancement, though, isn't an orthodontist's only priority: a poor bite can interfere with dental function and oral hygiene, so repairing it and making sure the teeth "bite" together correctly is just as important to your health.

Your first step is to undergo a comprehensive orthodontic exam. Its purpose is two-fold: to diagnose the nature of your particular bite problem; and to determine if your mouth is healthy enough to undergo the necessary treatment to correct it. From here, your orthodontist will propose a treatment plan to correct your particular bite problem.

Although a number of orthodontic appliances may be used, the most likely tools employed will be either fixed braces or removable clear aligners. Both of these use the mouth's natural ability to move teeth by applying subtle pressure on the teeth and supporting periodontal structures for a period of time.

While braces are effective, if you're an adult or teenager and nothing in your bite situation would preclude their use, you may choose clear aligners. Aligners are a sequence of plastic mouth trays that are computer-generated based on the patient's mouth impression. Patients wear the trays in succession, each slightly smaller than the previous one, until they complete the series.

People often prefer aligners over braces for a couple of reasons. Unlike fixed braces, you can take them out of your mouth for eating, cleaning or special occasions. And because they're clear, they're nearly invisible to others and so less embarrassing than metal braces.

Whichever method, you'll be under the supervision of a trained dentist or orthodontist who will monitor your progress and make treatment adjustments as necessary to keep you on course. It takes a lot of skill to make sure the bite fits together correctly. Remember, the plastic aligner is always between your teeth. Making sure your teeth come together is something a dentist must supervise or else it may not allow your teeth to fit together properly. In the end, you could have an entirely new smile that's healthier and more attractive—let's just make sure the bite is correct as well.

If you would like more information on gaining a straighter, more attractive smile, 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 “The Magic of Orthodontics: The Original Smile Makeover.”

By Edward Joseph, D.D.S.
June 25, 2020
Category: Oral Health
FAQsAboutChildrensDentalDevelopment

Watching your newborn develop into a toddler, then an elementary schooler, a teenager, and finally an adult is one of the most exciting and rewarding experiences there is. Throughout the years, you’ll note the passing of many physical milestones — including changes that involve the coming and going of primary and permanent teeth. Here are some answers to frequently asked questions about children’s dental development.

When will I see my baby’s first tooth come in?
The two lower front teeth usually erupt (emerge from the gums) together, between the ages of 6 and 10 months. But your baby’s teeth may come earlier or later. Some babies are even born with teeth! You will know the first tooth is about to come in if you see signs of teething, such as irritability and a lot of drooling. The last of the 20 baby teeth to come in are the 2-year molars, so named for the age at which they erupt.

When do kids start to lose their baby teeth?
Baby teeth are generally lost in the same order in which they appeared, starting with the lower front teeth around age 6. Children will continue to lose their primary teeth until around age 12.

What makes baby teeth fall out?
Pressure from the emerging permanent tooth below the gum will cause the roots of the baby tooth to break down or “resorb” little by little. As more of the root structure disappears, the primary tooth loses its anchorage in the jawbone and falls out.

When will I know if my child needs braces?
Bite problems (malocclusions) usually become apparent when a child has a mixture of primary and permanent teeth, around age 6-8. Certain malocclusions are easier to treat while a child’s jaw is still growing, before puberty is reached. Using appliances designed for this purpose, orthodontists can actually influence the growth and development of a child’s jaw — to make more room for crowded teeth, for example. We can discuss interceptive orthodontics more fully with you at your child’s next appointment.

When do wisdom teeth come in and why do they cause problems?
Wisdom teeth (also called third molars) usually come in between the ages of 17 and 25. By that time, there may not be enough room in the jaw to accommodate them — or they may be positioned to come in at an angle instead of vertically. Either of these situations can cause them to push against the roots of a neighboring tooth and become trapped beneath the gum, which is known as impaction. An impacted wisdom tooth may lead to an infection or damage to adjacent healthy teeth. That it is why it is important for developing wisdom teeth to be monitored regularly at the dental office.

If you have additional questions about your child’s dental development, please contact us or schedule a consultation. You can also learn more by reading the Dear Doctor magazine articles “Losing a Baby Tooth” and “The Importance of Baby Teeth.”

By Edward Joseph, D.D.S.
June 20, 2020
Category: Oral Health
Tags: gummy smile  
WhyIsYourSmileGummyHereAre4Possibilities

What makes a beautiful smile? Beautiful teeth, for sure. But there's also another component that can make or break your smile, regardless of your teeth's condition: your gums. Although their primary function is to protect and stabilize the teeth, your gums also enhance them aesthetically by providing an attractive frame.

But just as a painting displayed in an oversized frame can lose some of its appeal, so can your smile if the size of your gums appears out of proportion with your teeth. Normally, a smile that displays more than four millimeters of gum tissue is considered “gummy.”

There are some things we can do to improve your gum to teeth ratios. What we do will depend on which of the following is the actual cause for your gummy smile.

Excess gum tissue. We'll start with the obvious: you have excess gum tissue that obscures some of the visible tooth crown. We can often correct this with a surgical procedure called “crown lengthening,” which removes some of the excess tissue and then reshapes the gums and bone to expose more teeth length.

Teeth that appear too short. The problem may not be your gums — it could be your teeth appear too short. This can happen if the teeth didn't erupt fully, or if they've worn down due to aging or a grinding habit. One option here is to “lengthen” the tooth cosmetically with veneers, crowns or other bonding techniques.

Higher lip movement. Rather than your teeth and gums being out of size proportion, your upper lip may be rising too high when you smile, a condition known as hypermobility. One temporary fix is through Botox injections that paralyze the lip muscles and prevent their movement from overextending. We could also use periodontal surgery to perform a lip stabilization procedure that permanently corrects the upper lip movement.

Overextended jaw. Your gums may seem more prominent if your upper jaw extends too far down and forward. In this case, orthognathic (jaw straightening) surgery might be used to reposition the jaw relative to its connection with the skull. Setting the jaw up and back in this way would reduce the prominence of the gums when you smile.

As you can see, treatments range from cosmetic techniques to moderate surgical procedures. A full dental exam will help determine which if any of these measures could reduce gumminess and improve your smile.

If you would like more information on correcting gummy smiles, 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 “Gummy Smiles.”

By Edward Joseph, D.D.S.
June 15, 2020
Category: Dental Procedures
WhatReallyHappensDuringaRootCanalTreatment

Bad news at your last dental visit: You have a decayed tooth. And not just in the enamel—the decay has invaded the tooth's inner pulp and the resulting infection is threatening the supporting bone structure.

You're thinking that tooth is toast. Then comes the good news: your dentist believes the tooth can be rescued with a root canal treatment.

But then you begin thinking about how often Uncle Sid says he'd rather undergo a colonoscopy than have a root canal. Is the procedure really as painful and uncomfortable as popular culture says it is? What is a root canal really like?

First step: Things go numb. Uncle Sid is wrong: A root canal treatment is painless because your dentist will first make sure the entire area involving the tooth is anesthetized. This does involve injecting the local anesthetic deep within the tissues, but you won't even feel the needle prick thanks to topical anesthesia applied to the surface gums.

Second step: Drilling deep. After applying a protective dam to isolate the infected tooth from its neighbors, your dentist will drill a small access hole through the enamel and dentin to reach the pulp and root canals. If it's one of the larger back teeth, the access hole is usually drilled in the tooth's biting surface; in a front tooth, the hole is usually located on the tongue side.

Third Step: Removing diseased tissue. Using special instruments, your dentist will remove the diseased tissue in the pulp and root canals, essentially stopping the infection and any tooth pain you've been experiencing. The empty pulp chamber and canals are often then disinfected with a special antibacterial solution.

Fourth Step: Protecting the tooth. After some shaping, the pulp chamber and root canals are filled with a special filling to prevent further infection. The access hole is then filled and sealed to complete the procedure. At some point in the future, the tooth typically will need a crown to add support and further protection.

You may have some minor discomfort afterward, but this can usually be managed with a mild pain reliever like ibuprofen or acetaminophen. After a week or so, you'll be good as new—and so will your tooth.

If you would like more information on root canal therapy, 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 “A Step-By-Step Guide to Root Canal Treatment.”





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Burbank, CA Dentist
Edward C. Joseph, D.D.S.
2701 West Alameda Ave, Suite #403
Burbank, CA 91505
(818) 842-7628

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