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Posts for: September, 2013

By Edward Joseph, D.D.S.
September 25, 2013
Category: Dental Procedures
Tags: root planing  
RootPlaningRemovesDangerousPlaqueandTartarYourToothBrushCant

While periodontal disease can take on a variety of forms, most are caused by a thin layer of bacterial plaque called biofilm. This layer of plaque will form every 8-12 hours and sticks like glue to your teeth near the gum line. With time, tartar formation occurs at and below the gum line.

If left unchecked, biofilm can give rise to a very unhealthy progression. It first triggers an infection that leads to painful inflammation, progressive bone loss and the gum tissue losing attachment with a tooth. Void spaces (or pockets) form where the gum and bone tissue once adhered; infectious plaque and tartar moves into these pockets and advances deeper to the root. Overcome by disease, the tooth is in danger of being lost.

It's imperative then to remove as much of this entrenched plaque and tartar as possible. Renewed oral hygiene is not enough — removing plaque and tartar from the root surfaces requires a treatment known as root planing.

Root planing is a meticulous, labor-intensive process. We first clear away larger portions of plaque around the teeth and gums with hand instruments or an ultrasonic device and then flush out the pockets with water. After administering a local anesthetic for pain, we would then turn to a number of small hand instruments known as curettes to probe and scrape away as much remaining plaque below the gum line as we can get to.

Root planing requires experience and a good sense of touch to work in areas that can't be clearly seen. Observing the gum line, though, can give us a good indication of progress as these tissues will actually change color once the biofilm and tartar deposits have been removed.

Being so deeply entrenched, not all the deposits might be removed during one session. However, as plaque and tartar are removed, the gum tissues will begin to heal and become less inflamed. This will make it easier to remove plaque in subsequent sessions.

Root planing takes time, but the effort is well worth it. In the short term you'll notice less inflammation and pain around your teeth and gums. In the long-term, it just may save your teeth.

If you would like more information on root planing and periodontal disease, 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 Planing.”


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By Edward Joseph, D.D.S.
September 17, 2013
Category: Oral Health
Tags: toothache  
IdentifyingtheSourceofMouthPainLeadstoMoreEfficientTreatment

You have a toothache… or do you? That's not a facetious question — sometimes it's difficult to determine if it's your tooth that hurts, your gums or both. It's even difficult at times to pinpoint which tooth may be hurting.

This is because the pain can originate from a variety of causes. Determining the cause is the first step to not only alleviating the pain, but also treating the underlying condition. Those causes generally follow one of two paths: either the problem originates within a tooth and spreads to the gums and other tissue, or it begins with infected gum tissues and can spread to the teeth.

We refer to the first path as endodontic, meaning it originates from within a tooth. Most likely the tooth has decayed (also referred to as a cavity), which if untreated can progress, allowing bacteria to infect the tooth pulp (living tissue inside the tooth that contains nerve fibers). Pain results as the nerves become inflamed and sensitive, though often varying in quality (sharp or dull) or frequency (constant or intermittent); outside stimuli, like temperature or pressure, may also trigger pain.

Although likely originating with one tooth, it may be difficult to pinpoint which one is actually causing it; you might even feel pain in your sinus cavity radiating upward from the tooth. An untreated infection will continue to spread to surrounding soft tissue, or result in a painful abscess, an infected pocket of bacteria between the tooth and gums.

The other path is periodontal, meaning the infection originates in the gum tissues. A thin layer of dental plaque known as biofilm develops and sticks to teeth at the gum line, which can lead to infection of the gum tissue, which then becomes inflamed and painfully sensitive. The untreated infection can then progress along the tooth and invade the pulp through the accessory root canals.

Knowing the source of an ache will determine the best course of treatment, whether a root canal, root planing, or a combination of these or other procedures. It's also the best, most efficient way to relieve you of that unpleasant mouth pain.

If you would like more information on the various causes of tooth 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 “Confusing Tooth Pain.”


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By Edward Joseph, D.D.S.
September 09, 2013
Category: Dental Procedures
Tags: dental implants  
Mini-ImplantsFiveThingsYouShouldKnow

Dental implants are now the gold standard for tooth replacement. Why? Because not only do they offer the longest-lasting method of restoring missing teeth, but they also help mitigate one of the greatest problems associated with tooth loss — the loss of underlying bone structure. While standard dental implants have been around since the 1970s, mini-implants are a smaller version of the same technology that have recently come into their own. Here are a few things you should know about them.

Mini-implants rely on the same structure and principles as their larger relatives.
Like standard implants, mini-implants are screw-shaped devices made of titanium which are set into the bone of the jaw. Put in place permanently, they become fixed to the bone itself, which grows around and fuses to the implant. Or, they can be used as temporary anchors for the attachment of other dental work.

Mini-implants are a great option for attaching lower overdentures.
Overdentures (implant-retained dentures) are now considered the standard of care for people who have lost all of their teeth in one or both jaws. But the undesired movement of lower dentures has been a perennial problem for many denture wearers. One key use of mini-implants is to anchor overdentures to the lower jaw. Just two mini-implants provide the stability needed to attach a set of lower dentures sturdily, giving the denture wearer increased dental function — and a restored sense of confidence.

Mini-implants offer some real benefits in orthodontics.
TADS (Temporary Anchorage Devices), another type of mini-implants, are finding increasing use alongside of orthodontic appliances (braces). Braces move teeth by placing small forces on them, which are transmitted by a wire. The wire must be anchored at a “fixed” point: usually, other teeth; but it may cause these teeth to move as well! TADS offer an anchorage point that's truly immovable. They help to speed up orthodontic treatment, and give more accurate control as well.

Placing mini-implants is a relatively simple process.
It's an office procedure done by an experienced clinician, normally under local anesthesia. Most patients tolerate the procedure very well, experiencing only minor discomfort. In some cases, a single two-hour visit is all that's needed for implant placement, and the patient can go home and eat a steak afterward!

Mini-implants may be more economical than you think.
These smaller cousins of standard implants are often easier to place. They save treatment time, and, if you're a denture wearer, they may be compatible with your existing dentures. If your dental situation could benefit from using mini-implants, you should give them serious consideration.

If you would like more information about mini-implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Implant Overdentures for the Lower Jaw,” “The Great Mini-Implant,” and “What are TADS?”


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By Edward Joseph, D.D.S.
September 06, 2013
Category: Oral Health
Tags: oral health   tmd   tmj  
TMDHowCanSuchSmallJointsCauseSuchBigProblems

If you have pain in your jaws or related headaches, you may have Temporo-mandibular Joint Disorder, TMD. You are probably wondering what this is — and how it can be treated. If this sounds like something you may have, read on for some answers.

What is TMD? TMD describes a group of disorders or diseases that have the same symptoms, but may have different causes, hence it is known as “The Great Imposter.” Pain in and around the temporo-mandibular joint (TMJ), the jaw joint involved in opening and closing your mouth — is characterized by pain and soreness in the region of one or both joints, ears, jaw muscles and even the sinuses.

How does the temporo-mandibular joint work? You can feel your jaw joints working if you place your fingers in front of your ears and move your lower jaw up and down. On each side the joint is composed of an almond shaped structure at the end of the lower jaw, called the condyle, which fits neatly into a depression in the temporal bone (the bone on the side of your skull near your ear). A small disc between the two bones allows the lower jaw to move forward and sideways. The joints are stabilized by ligaments and moved by muscles, like all your joints.

What is the most common cause of TMD? Many people clench or grind their teeth as a reaction to stress. This is generally a subconscious habit, and can even occur during sleep. Continual tooth grinding habits can cause the muscles to go into spasm, which is the most common cause of TMD pain. Structures associated with the jaws — teeth, air sinuses, and even neck and back muscles — share nerves with the muscles in the joints, so the pain may be felt in those structures too, making the exact source of the pain difficult to diagnose. Symptoms of TMD may limit your ability to open your jaw and talk or eat normally.

What is the treatment for TMD? Treatment will depend on the cause, but generally the first step is to relieve pain and discomfort with heat, mild painkillers, muscle relaxants, a soft diet, and simple jaw exercises. A bite guard may be recommended, which should be custom made in our office; a rigid yet unobtrusive plastic appliance that fits over the biting surfaces of your upper teeth. Properly fitted and adjusted, it aids and causes jaw muscle relaxation by preventing clenching and grinding. It is worn during times of stress when oral habits tend to recur, and can also be worn at night.

If you are suffering from TMD — whether the pain is moderate or severe — schedule an appointment with us to have it evaluated and treated. You can learn more about TMD by reading the Dear Doctor magazine article “TMD: Understanding the Great Imposter.”


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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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