Posts for: October, 2016

By Edward Joseph, D.D.S.
October 28, 2016
Category: Oral Health
Tags: bad breath  
ProperCleaningTechniquescanHelpyouControlChronicBadBreath

We all experience the occasional bout of bad breath from dry mouth or after eating certain foods. Chronic halitosis, on the other hand, could have an underlying health cause like periodontal (gum) disease, sinus infections or even systemic illnesses like diabetes. Anyone with persistent halitosis should undergo a thorough examination to determine the root cause.

If such an examination rules out a more serious cause, it’s then possible the particular population of bacteria that inhabit your mouth (out of a possible 600 or more strains) and your body’s response makes you more susceptible to halitosis. After feeding on food remnants, dead skin cells or post-nasal drip, certain types of bacteria excrete volatile sulfur compounds (VSCs) that give off an odor similar to “rotten eggs.”

In this case, we want to reduce the bacterial population through plaque removal, which in turn reduces the levels of VSCs. Our approach then is effective oral hygiene and perhaps a few cleanings — the basics every person should practice for good oral health — along with a few extra measures specific to chronic halitosis.

This calls for brushing and flossing your teeth daily. This will remove much of the plaque, the main breeding and feeding ground for bacteria, that has accumulated over the preceding twenty-four hours. In some cases, we may also recommend the use of an interproximal brush that is more adept in removing plaque clinging to areas between the teeth.

You may also need to pay special attention in cleaning another oral structure contributing to your bad breath — your tongue. The back of the tongue in particular is a “hideout” for bacteria: relatively dry and poorly cleansed because of its convoluted microscopic structure, bacteria often thrive undisturbed under a continually-forming tongue coating. Simply brushing the tongue may not be enough — you may also need to use a tongue scraper, a dental device that removes this coating. (For more information, see the Dear Doctor article, “Tongue Scraping.”)

Last but not least, visit our office for cleanings and checkups at least twice a year. Professional cleanings remove bacterial plaque and calculus (hardened plaque deposits) you’re unable to reach and remove with daily hygiene measures. Following this and the other steps described above will go a long way toward eliminating your bad breath, as well as enhancing your total oral health.

If you would like more information on treating chronic bad breath, 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 “Bad Breath: More Than Just Embarrassing.”


By Edward Joseph, D.D.S.
October 20, 2016
Category: Dental Procedures
Tags: dental implants  
DentalImplantsCouldbeYourBestOptiontoReplaceLostTeeth

An estimated 35 million people in the United States are missing all of their teeth on at least one jaw. Your situation may not be as serious — perhaps you've only lost one tooth. But even one missing tooth could eventually impact the health of underlying bone or other teeth — and it can certainly mar an otherwise attractive smile.

Depending on other health factors, you could be an ideal candidate for a dental implant to replace that missing tooth. Since their introduction in the 1980s, implants have rapidly become the popular choice for tooth replacement. They've gained this popularity for several reasons: they're a life-like replacement that also functions like a tooth; they're adaptable to a variety of situations; and they enjoy a 95%-plus success rate.

The key to their success lies in their unique construction: they replace the tooth root, not just the crown. They accomplish this through a metal titanium post imbedded directly into the bone. The titanium attracts bone cells, which eventually grow and adhere to the post to anchor the implant securely in the jaw. This growth also deters bone loss that occurs after tooth loss and continues after acquiring other forms of removable restorations like full or partial dentures.

If implants have one drawback, though, it's their cost, especially if you have multiple lost teeth. The good news if you're missing several teeth is that each tooth does not need an implant due to their inherent strength. As few as two implants could replace three to four missing teeth or play a role as supports for other restorations like removable dentures. Some of the implants' other benefits will also carry over, including enhanced bone health.

To determine if dental implants are a good choice for your missing teeth, you'll need to undergo an evaluation of your individual dental condition (including bone health). From there we can advise you on whether implants could change your dental health and your smile.

If you would like more information on dental 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 article “Dental Implants 101.”


TreatingGumDiseaseImportanttoSavingtheUnderlyingBone

If you've had periodontal (gum) disease, you've no doubt experienced gum inflammation, bleeding or pain. But your gums may not be the only mouth structures under assault — the disease may be damaging the underlying support bone.

Although easing soft tissue symptoms is important, our primary focus is to protect all your teeth's supporting structures — the gums, the attaching ligaments and, of course, the bone. To do so we must stop the infection and reduce the risk of reoccurrence.

Stopping gum disease depends on removing its source — plaque, a thin biofilm of bacteria and food particles accumulating on tooth surfaces, due to poor oral hygiene. We must remove it mechanically — with hand instruments known as scalers or ultrasonic equipment that vibrates the plaque and calculus (hardened plaque deposits) loose.

It's not always a straightforward matter, though, especially if the diseased gum tissues have pulled away from the teeth. The slight natural gap between teeth can widen into voids known as periodontal pockets; they fill with infection and can extend several millimeters below the gum line. We must thoroughly cleanse these pockets, sometimes with invasive techniques like root planing (removing plaque from the roots) or surgical access. You may also need tissue grafting to regenerate gum attachment to the teeth.

One of the more difficult scenarios involves pockets where roots divide, known as furcations. This can cause cave-like voids of bone loss. Unless we treat it, the continuing bone loss will eventually lead to tooth loss. Besides plaque removal, it may also be prudent in these cases to use antimicrobial products (such as a mouthrinse with chlorhexidine) or antibiotics like tetracycline to reduce bacterial growth.

Perhaps the most important factor is what happens after treatment. To maintain gum health and reduce the chances of re-infection, you'll need to practice diligent daily hygiene, including brushing, flossing and any prescribed rinses. You should also keep up a regular schedule of office cleanings and checkups, sometimes more than twice a year depending on your degree of disease.

If you would like more information on treatments for gum 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 “Treating Difficult Areas of Periodontal Disease.”


By Edward Joseph, D.D.S.
October 04, 2016
Category: Dental Procedures
Tags: crowns  
NotAllCrownsareAlikeKnowtheDifferencestoGettheLookyouWant

If you're in need of a crown to cover a damaged tooth, you have a lot of options. But before you choose, you need to know what you want. Would you be happy with an affordable, well-fitting crown that holds up well and allows you to chew comfortably? Or are you interested in a more expensive one that also provides the most attractive result?

Crowns have been a mainstay in dentistry for generations. The first were made of metals like gold or silver — durable and effective but not very attractive.

In time, a ceramic material known as dental porcelain began to make its appearance in crowns. Dental porcelain could be fashioned to resemble the color and texture of natural teeth, but it had a significant drawback: it could be brittle and subject to shattering under chewing pressure.

This problem was somewhat addressed with the innovation of a crown with a metal substructure fused with an outer layer of porcelain. These porcelain-fused-to-metal (PFM) crowns combined the best advantages of both materials: strength and life-likeness. Up until around the mid-2000s, PFM made up over 80% of crowns.

But later porcelains continued to improve in strength, beginning in 1993 with the introduction of a Lucite-reinforced material. Newer formulations like lithium disilicate or zirconium oxide (now considered the strongest porcelain) have made all-porcelain crowns a viable option. Today, an estimated 60% of new crowns are all-porcelain.

From an appearance standpoint, all-porcelain crowns achieve the best results. The most realistic crown can be costly — not because of the material but the level of artistry required. A skilled dental technician will spend several hours, including brushing on as many as fifteen coats of liquid porcelain to the crown, to achieve the most life-like outcome. Your insurance plan, if you have one, will most likely not pay as high a percentage for that type of crown.

In the end, it's your decision as to what type of crown you wish to have. We'll help you weigh your options and decide what's best for you and your budget.

If you would like more information on crown options, please contact us or schedule an appointment for a consultation.




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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