By Edward Joseph, D.D.S.
November 13, 2018
Category: Dental Procedures
Tags: dentures  
DenturesareStillaViableChoiceforToothReplacement

Edentulism, the loss of all of a person’s teeth, is more than an appearance problem. As one in four Americans over 65 can attest, total tooth loss can lead to emotional suffering, social embarrassment and a lack of nutrition caused by limited food choices.

But there are solutions like the removable denture, an effective dental restoration for more than a century. In its current advanced form, the removable denture is truly a functional, affordable and attractive way to restore lost teeth.

Creating an effective denture begins first by taking detailed impressions of a patient’s gum ridges. We use the measurements obtained from this process to create a plastic resin base colored to resemble the natural gums.  Using old photos and other resources documenting how the patient looked with teeth, we choose the best size and shape of porcelain teeth and then position them onto the base.

Finally, we fine-tune the dentures the first time they’re in the patient’s mouth to make sure they have a secure fit and a balanced bite when the jaws come together. We also want to be sure the dentures are attractive and blend well with other facial features. The result:  a new set of teeth that can do the job of the old ones and look nearly as real and attractive.

Dentures, though, do have one major drawback: they can’t stop bone loss, a common consequence of missing teeth. In fact, they may even accelerate bone loss due to the pressure they bring to bear on the gum ridges. Continuing bone loss could eventually cause their once secure fit to slacken, making them less functional and much more uncomfortable to wear.

But a recent innovation could put the brakes on bone loss for a denture wearer. By incorporating small implants imbedded at various places along the gums, a denture with compatible fittings connects securely with the implants to support the denture rather than the gum ridges. This not only relieves pressure on the gums, but the titanium within the implants attracts bone cells and stimulates their growth.

Thanks to this and other modern advances, dentures continue to be a solid choice for tooth replacement. Not only can they restore a lost smile, they can improve overall health and well-being too.

If you would like more information on dental restorations for missing teeth, 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 “Removable Full Dentures.”

By Edward Joseph, D.D.S.
November 08, 2018
Category: Dental Procedures
CosmeticGumSurgeryCanHelpRestoreLostTissuesAroundTeeth

Your gums can take a lot — they’re resilient and they endure a variety of abrasive foods over a lifetime. But resilience isn’t the same as invulnerability: your gums can be weakened by periodontal (gum) disease or by over-aggressive brushing that causes them to shrink away (recede) from the teeth they protect.

Unfortunately, it’s not a rare problem — millions suffer from some degree of gum recession, caused mainly by gum disease. This aggressive infection arises from bacteria in dental plaque, a thin film that builds up on tooth surfaces due to inadequate oral hygiene. Fortunately, gum disease can be effectively treated in its early stages by removing plaque above and below the gum line. Diseased gums will quickly rebound to their normal health.

Unfortunately, though, heavily recessed gums from advanced stages of gum disease (as well as those who’ve inherited thinner gum tissues and are more susceptible to recession) may not come back fully without help. This can affect the health and survival of affected teeth, as well as your appearance.

Plastic periodontal surgery can help restore these lost tissues. There are a number of procedures that can be used depending on the exact nature of the recession, and most involve some form of tissue grafting. A specimen of donated gum tissue (either from another portion of the patient’s gums or a thoroughly cleansed and properly processed donation from another person) is surgically attached to the gums at the recession site.

The graft can be completely freed from the harvest area or in some cases a part of it remains attached to receive blood supply while the rest is grafted to the site. These procedures, especially the latter, require meticulous skill and sophisticated microsurgical techniques to make an effective attachment. If the tooth root is involved, it must be thoroughly prepared beforehand through polishing and decontamination to ensure the new graft will take. The graft is sutured in place and sometimes covered with a moldable dressing for protection.

As the area heals, the tissues begin to grow around the graft, restoring better coverage for the tooth. Coupled with comprehensive gum disease treatment, this form of plastic surgery can restore new health to teeth and a transformed smile.

If you would like more information on treating gum recession with plastic surgery, 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 “Periodontal Plastic Surgery.”

By Edward Joseph, D.D.S.
November 03, 2018
Category: Dental Procedures
Tags: gum surgery  
GumSurgeryCanImproveYourSmileandSaveYourTeeth

While the term “plastic surgery” might bring to mind face lifts or tummy tucks, not all procedures in this particular surgical field are strictly cosmetic. Some can make a big difference in a person’s health.

One example is periodontal plastic surgery, which corrects gum tissue loss around the teeth. Although these procedures can indeed improve appearance, they more importantly help save teeth.

Gum loss is most often a consequence of periodontal (gum) disease, a bacterial infection arising from a thin film of food particles on the teeth called dental plaque. As the disease weakens the gums’ attachment to teeth, they shrink back or recede, exposing the area around the roots. Without the protective cover the gums provide the roots, they become more susceptible to decay.

In milder cases of gum recession, treating the infection often results in the gums regaining their normal attachment to teeth. But with more advanced recession, natural gum healing may not be enough to reverse it. For such situations grafting donor tissue to the recessed area can help stimulate new tissue growth.

While gum tissue grafts can come from an animal or other human, the most likely source is from the person themselves. In one type of procedure, free gingival grafting, the surgeon locates and completely removes (or “frees”) a thin layer of skin resembling gum tissue, typically from the roof of the mouth, shapes it and then transplants it by suturing it to the recession site. Both donor and recipient sites heal at about the same rate in two to three weeks.

Another technique is known as connective tissue grafting. In this procedure the surgeon partially removes the donor tissue from its site while leaving a portion containing blood vessels intact. The palatal tissue is still used and transported to fit beneath the tissue that’s still attached to the blood supply. This connective tissue graft is then positioned and sutured to the recipient site while still maintaining its blood supply connection at the donor site. Maintaining this connection facilitates healing and increases the chances the graft will “take” and become firmly attached to the new site.

Grafting procedures require advanced techniques and skills. But with them we may be able to restore gum attachment to teeth with an impact on appearance and dental health that’s well worth the effort.

If you would like more information on treating 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 “Periodontal Plastic Surgery.”

By Edward Joseph, D.D.S.
October 29, 2018
Category: Oral Health
Tags: jaw pain   tmj disorders  
TrytheConservativePathtoJawPainReliefFirst

If you have chronic jaw pain, you know how difficult eating, speaking or even smiling can be. Many sufferers will do anything to gain relief, even surgery. But before you go down that road, consider the traditional conservative approach to temporomandibular disorders (TMD) management first—it could provide the most relief with the least risk of side effects.

The temporomandibular joints connect the lower jaw to the skull on either side of the head. These ball and socket joints also contain a cushioning disk to facilitate movement. This disk is believed to be the primary focus for jaw pain problems known collectively as TMD.

Doctors now believe injury, stress, metabolic issues, jaw anatomy defects or similar factors trigger the chain reaction of muscle spasms, pain and soreness that can erupt during a TMD episode. A TMD patient may experience pain within the jaw muscles or joints themselves, clicking sensations, or an inability to open the jaw to its full range.

TMD therapy has traditionally followed an orthopedic path—treating jaw joints like any other joint. In recent years, though, a more aggressive treatment model has emerged that promotes more invasive techniques like orthodontics, dental work or jaw surgery to relieve discomfort. But the track record for this model, especially concerning jaw surgery, remains hazy at best and offers no guarantee of relief. These techniques are also irreversible and have even made symptoms worse in some patients.

It’s usually prudent, then, to try conservative treatments first. This can include pain and muscle relaxant medication, jaw exercises, stretching and massage, and dietary changes to reduce chewing force. Patients with teeth grinding habits may also benefit from a bite guard worn at night to reduce the biting force during sleep and help the joints relax.

By finding the right mix of treatments, you may be able to find significant relief from TMD symptoms with the conservative approach. If not, you might then discuss more invasive options with your dentist. But even if your dentist recommends such a procedure, you would be wise to seek a second opinion.

TMD can definitely interfere with your quality of life and peace of mind. But there are ways to reduce its effects and make for a happier life.

If you would like more information on managing chronic jaw 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 “Seeking Relief from TMD.”

By Edward Joseph, D.D.S.
October 24, 2018
Category: Oral Health
EncourageYourChildtoStopThumbSuckingbyAge4

There's something universal about thumb sucking: nearly all babies do it, and nearly all parents worry about it. While most such worries are unfounded, you should be concerned if your child sucks their thumb past age of 4 — late thumb sucking could skew bite development.

Young children suck their thumb because of the way they swallow. Babies move their tongues forward into the space between the two jaws, allowing them to form a seal around a nipple as they breast or bottle feed. Around age 4, this “infantile swallowing pattern” changes to an adult pattern where the tip of the tongue contacts the front roof of the mouth just behind the front teeth. At the same time their future bite is beginning to take shape.

In a normal bite the front teeth slightly overlap the bottom and leave no gap between the jaws when closed.  But if thumb sucking continues well into school age, the constant pushing of the tongue through the opening in the jaws could alter the front teeth's position as they erupt. As a result they may not fully erupt or erupt too far forward. This could create an open bite, with a gap between the upper and lower teeth when the jaws are closed.

Of course, the best way to avoid this outcome is to encourage your child to stop thumb sucking before they turn four. If, however, they're already developing a poor bite (malocclusion), all is not lost — it can be treated.

It's important, though, not to wait: if you suspect a problem you should see an orthodontist for a full evaluation and accurate diagnosis. There are even some measures that could discourage thumb sucking and lessen the need for braces later. These include a tongue crib, a metal appliance placed behind the upper and lower incisors, or exercises to train the tongue and facial muscles to adopt an adult swallowing pattern. Often, a reward system for not sucking their thumbs helps achieve success as well.

Thumb-sucking shouldn't be a concern if you help your child stop before age 4 and keep an eye on their bite development. Doing those things will help ensure they'll have both healthy and straight teeth.

If you would like more information on 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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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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