Posts for: October, 2013

By Edward Joseph, D.D.S.
October 29, 2013
Category: Oral Health
Tags: oral health   mouthguards  
AreYouanAthleteHereAreFiveReasonsYouShouldWearaMouthguard

Are you ready to suit up for sports? Mouthguards have been called the most important part of an athlete's uniform. Designed to absorb and distribute the forces of impact received while you participate in athletic activities, your mouthguard is a protective appliance that covers and cushions your teeth and gums to prevent and reduce injury to your teeth, jaws, lips and gums. A properly fitted protective mouthguard is comfortable, resilient, tear resistant, odorless, tasteless, not bulky, fits well, and has sufficient thickness where needed. If you wear it when engaging in contact sports it can prevent injury, pain, suffering and years of expensive dental treatment.

Here's why athletes need mouthguards:

  1. Sports related dental injuries account for more than 600,000 emergency room visits each year. Mouthguards are recommended particularly for contact sports such as boxing, football, hockey and lacrosse.
  2. An athlete is 60 times more likely to suffer harm to the teeth when not wearing a mouthguard. It is estimated that mouthguards prevent more than 200,000 injuries each year.
  3. Properly fitted mouthguards protect the soft tissues of the lips, cheeks, gums and tongue by covering the sharp surfaces of the teeth that can cause lacerations on impact. They also reduce the potential for tooth injury, jaw damage or jaw joint fracture and displacement by cushioning against impact — absorbing and distributing the forces that can cause injury.
  4. Custom-fitted mouthguards are made from exact and precise models of your teeth. They are effective, comfortable, easy to clean, and do not restrict breathing. The best mouthguard is custom designed to fit your mouth and made in our office after your athletic needs have been assessed. For a growing child or adolescent, a custom made mouthguard can provide space for growing teeth and jaws.
  5. A mouthguard properly fitted in our office costs little in comparison to the cost of treatment after injury. If your teeth are knocked out and are not properly preserved or replanted you may face lifetime dental costs of as much as $10,000 to $20,000 per tooth.

The American Dental Association recommends the use of custom mouthguards in 27 sports/exercise activities. Make an appointment to consult with us to find out more about mouthguards. You can also read the Dear Doctor magazine article “Athletic Mouthguards: One of the most important parts of any uniform!


By Edward Joseph, D.D.S.
October 21, 2013
Category: Dental Procedures
Tags: dental implants  
DentalImplantMaintenance5FactsYouShouldKnow

If you've recently had a dental implant placed, congratulations! You have made a good investment in your smile that should last for a lifetime — if you take proper care of it. This is easy to do with a good oral hygiene routine and regular professional cleanings. Here are some important things to keep in mind about implant care:

  1. Implants can last as long as teeth. A dental implant made of titanium will fuse to the bone surrounding it and function just like a natural tooth. It is a highly successful method of tooth replacement that succeeds more than 95% of the time.
  2. Implants and natural teeth attach to surrounding bone and gums very differently. A natural tooth does not actually fuse to the bone that surrounds it. Instead, it is held in place by a periodontal ligament (“peri” – around; “odont” – tooth) made up of tiny fibers that insert into the bone on one side and into the tooth on the other. Farther up, these collagen fibers attach the tooth to the gum tissue. Implants and the crowns that go on top of them are not anchored to the gum in this way. An understanding of this biology is important for maintaining good periodontal health when implants are present. We will go over this with you so can care for your implants correctly.
  3. Infection is the enemy. Bacterial infection is a concern with both natural teeth and implant-supported teeth. A bacterial biofilm (plaque) builds up daily on implant teeth, just as it does on natural teeth. If it is not regularly cleared away, various oral infections can develop. In the case of natural teeth, this might result in tooth decay, gum disease, and the loss of tooth-supporting bone. Implants can't decay, but they can be threatened by a rapidly progressing infection known as peri-implantits (“peri” – around; implant “itis” – inflammation), which can lead to a well-like or dish-shaped loss of bone around the implant. The implant can become loose as greater amounts of bone is lost.
  4. Good oral hygiene is as important as ever. Daily removal of bacterial biofilm is key to preventing peri-implantitis. You'll want to make sure you brush your teeth twice daily with a soft brush and fluoride toothpaste, and floss gently at least once per day.
  5. Your dental hygienist has an important role to play. Professional cleanings here at our dental office are also still as necessary as ever, if not more so. Dental hygienists have special instruments they use to clean areas around your implant that can't be reached by your brush or floss — without scratching the surfaces of your implant components.

If you would like more information about dental implants, please call us or schedule an appointment. You can also read more by reading the Dear Doctor magazine article “Dental Implant Maintenance.”


AdvancesinClearAlignersMakeThemaViableChoiceforMoreTeens

Metal braces for correcting teeth alignment have long been a fixture of adolescence. But although they're effective, they tend to put a crimp on a teenager's life with changes in diet and irritation and discomfort from the devices and regular adjustments. For many teens, though, these are minor compared to the change in their appearance that comes with traditional braces, and the embarrassment they may feel.

In recent years, there's been a growing use of another orthodontic device that reduces many of these inconveniences, especially regarding appearance. Known as the clear aligner, this transparent, “almost invisible” device can be taken out for eating, cleaning or important social events.

Clear aligners are a sequential set of clear trays made of polyurethane plastic that are generated for an individual patient using information derived from x-rays, photographs or models. Each tray in the sequence is slightly different from the previous one to account for the tooth movement achieved wearing the previous tray. The patient will wear a tray for about two weeks and then, if all looks well, move to the next tray. This process continues until the teeth arrive at the proper alignment, a period of about six to twenty-four months depending on the patient's initial condition and their progress.

Up until recently, aligners were a viable option for a limited category of patients, mainly adults. Recent advances have changed that. Aligners now include tiny “power ridges” that enable them to move teeth in more than one plane, something previous versions were unable to do. “Eruption tabs” can also be incorporated into aligner sets to hold the space for permanent teeth that haven't erupted yet — a must for many younger patients. We can also temporarily bond attachments to the teeth known as buttons (made with a composite that blends in with the natural tooth color) that give more leverage and stability to the aligner.

With these changes, clear aligners are now an effective choice for a wider group of patients, including many teens. Aligners are comfortable to wear, easy to care for, and for teens acutely conscious of their appearance, less obtrusive than traditional metal braces.

If you would like more information on clear aligners, 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 “Clear Aligners for Teens.”


By Edward Joseph, D.D.S.
October 11, 2013
Category: Dental Procedures
Tags: root canal   endodontics  
FrequentlyAskedQuestionsAboutRootCanals

If you think you'd rather wrestle a pack of porcupines than go to the dentist for a root canal treatment — then maybe it's time to think again! This common procedure has been the butt of jokes for a long time. Let's set the record straight by answering some common questions about the much-maligned procedure.

Q: What is a root canal?

A: Coursing through the central part of each root is a hollow space or canal, which contains the pulp tissue. The pulp tissue contains the nerves which respond to temperature changes transmitted through the tooth. When the temperatures are extreme the nerves signal sensitivity and pain. It's also shorthand for the dental procedure that is performed when the pulp tissue that fills these canals develops a disease.

Q: Why do I need to get a root canal?

A: Because an infection or inflammation has developed deep inside one or more of your teeth. When the living pulp tissue — which contains nerves and blood vessels — becomes inflamed or infected, it can cause intense pain. It also releases bacterial toxins, which can lead to further problems.

Q: What happens if I don't get a root canal?

A: Your acute pain may temporarily go away, but the infection won't. It will eventually travel through the tooth's roots into the surrounding tissues. If left untreated, it may result in an abscess or even a systemic infection. That's why you need to take care of it now.

Q: Will it be painful?

A: Generally, a root canal procedure is no more painful than getting a filling. In fact, it starts the same way: An anesthetic is given to numb the tooth and the surrounding area. Then a small hole is made through the tooth's chewing surface and down into the canal. Diseased pulp tissue is removed through the hole via a set of tiny instruments. Finally, the root canal is cleaned, disinfected, filled with inert biocompatible material and sealed up.

Q: What happens after that?

A: Your tooth may be sensitive for a few days after the treatment, but the acute pain will be gone. Over-the-counter pain relievers generally work well for pain relief at this point. To restore your tooth to its fully-functioning state, a crown or other restoration is usually needed after root canal treatment. Properly done, the restored tooth can last as long as any of your natural teeth.

Q: Is there an alternative?

A: Yes. You can relieve the pain by having the tooth removed. But you don't want to go there. Tooth loss can lead to unwanted side effects, like migration of teeth, bone loss and eventually the inability to chew properly. It's far better to save your natural teeth when you can.

If you would like more information about root canals, please contact us to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Common Concerns About Root Canal Treatment” and “Signs and Symptoms of a Future Root Canal.”


ImplantOverdenturesaMarriageofOptionsforLowerJawToothReplacement

For well over a century, removable dentures have been the main treatment option for patients suffering from severe or total edentulism (loss of teeth). In recent years, however, the dental implant has been recognized as the best option because it can provide patients with permanent tooth replacement, and even more so as implant technology continues to advance.

But while permanent tooth replacement using implants offer more comfort and a better fit than dentures, they are more expensive, sometimes out of the financial reach of many patients. There is, however, one alternative for the lower jaw that blends the two options for tooth replacement into one. This alternative is known as an implant overdenture.

The implant overdenture begins just as a fixed dental implant would: we surgically implant two titanium posts into the lower jaw and allow them to fuse with the bone over time (thanks to the unique way that bone interacts with titanium). But rather than next affixing a porcelain crown to the post as we would with a dental implant, we would instead fashion a denture that fits over the two posts (hence the term overdenture). The overdenture has receiver sites that connect securely with the titanium posts to hold the overdenture in place. This ensures a snug fit with no slippage — resulting in better ability for the wearer to chew food and speak — and without the continuous need for dental adhesive. And just as with traditional dentures, you can remove the overdenture for cleaning.

It might also be an optimal solution for patients with severe issues involving bone loss or compromised teeth that make it difficult for them to support either a fixed prosthesis or a traditional removable denture.

This option does have some drawbacks: since it's still a removable denture, it can still move during meals and food can sometimes get underneath it, which can be annoying. Also, overdentures for the upper jaw require more than two implants because the upper bone is less dense; thus because of a greater number of implants, an upper overdenture is more costly than a lower one.

In the end, an implant overdenture to the lower jaw might be an optimal solution for you — financially and practically — to restore function from severe or total edentulism.

If you would like more information on implant overdentures, 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 “Implant Overdentures for the Lower Jaw.”




Burbank, CA Dentist
Edward C. Joseph, D.D.S.
2701 West Alameda Ave, Suite #503
Burbank, CA 91505
(818) 842-7628

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