My Blog
By Riviera Dental
July 13, 2018
Category: Dental Procedures
ChrissyTeigensTeeth-GrindingTroubles

It might seem that supermodels have a fairly easy life — except for the fact that they are expected to look perfect whenever they’re in front of a camera. Sometimes that’s easy — but other times, it can be pretty difficult. Just ask Chrissy Teigen: Recently, she was in Bangkok, Thailand, filming a restaurant scene for the TV travel series The Getaway, when some temporary restorations (bonding) on her teeth ended up in her food.

As she recounted in an interview, “I was… like, ‘Oh my god, is my tooth going to fall out on camera?’ This is going to be horrible.” Yet despite the mishap, Teigen managed to finish the scene — and to keep looking flawless. What caused her dental dilemma? “I had chipped my front tooth so I had temporaries in,” she explained. “I’m a grinder. I grind like crazy at night time. I had temporary teeth in that I actually ground off on the flight to Thailand.”

Like stress, teeth grinding is a problem that can affect anyone, supermodel or not. In fact, the two conditions are often related. Sometimes, the habit of bruxism (teeth clenching and grinding) occurs during the day, when you’re trying to cope with a stressful situation. Other times, it can occur at night — even while you’re asleep, so you retain no memory of it in the morning. Either way, it’s a behavior that can seriously damage your teeth.

When teeth are constantly subjected to the extreme forces produced by clenching and grinding, their hard outer covering (enamel) can quickly start to wear away. In time, teeth can become chipped, worn down — even loose! Any dental work on those teeth, such as fillings, bonded areas and crowns, may also be damaged, start to crumble or fall out. Your teeth may become extremely sensitive to hot and cold because of the lack of sufficient enamel. Bruxism can also result in headaches and jaw pain, due in part to the stress placed on muscles of the jaw and face.

You may not be aware of your own teeth-grinding behavior — but if you notice these symptoms, you might have a grinding problem. Likewise, after your routine dental exam, we may alert you to the possibility that you’re a “bruxer.” So what can you do about teeth clenching and grinding?

We can suggest a number of treatments, ranging from lifestyle changes to dental appliances or procedures. Becoming aware of the behavior is a good first step; in some cases, that may be all that’s needed to start controlling the habit. Finding healthy ways to relieve stress — meditation, relaxation, a warm bath and a soothing environment — may also help. If nighttime grinding keeps occurring, an “occlusal guard” (nightguard) may be recommended. This comfortable device is worn in the mouth at night, to protect teeth from damage. If a minor bite problem exists, it can sometimes be remedied with a simple procedure; in more complex situations, orthodontic work might be recommended.

Teeth grinding at night can damage your smile — but you don’t have to take it lying down! If you have questions about bruxism, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Stress & Tooth Habits” and “When Children Grind Their Teeth.”

TeenagerswithMissingTeethUsuallyNeedaTemporaryRestoration

Anyone at any age, including older children and teenagers, can lose or be born missing a permanent tooth. And while those missing teeth can be restored, replacing them in patients who haven’t yet reached adulthood can be tricky.

That’s because their dental and facial development isn’t finished. This is especially problematic for dental implants because as the jaws continue to grow, a “non-growing” implant could eventually appear out of alignment with the surrounding natural teeth. That’s why it’s often better to install a temporary restoration until the jaws fully mature in early adulthood. Two great choices are a removable partial denture (RPD) or a bonded (“Maryland”) bridge.

While “dentures” and “teens” don’t seem to go together, an RPD in fact can effectively restore a teen’s lost dental function and appearance. Of the various types of RPDs the one usually recommended for teens has a hard acrylic base colored to resemble the gums, to which we attach prosthetic (“false”) teeth at their appropriate positions on the jaw.

Besides effectiveness, RPDs are easy to clean and maintain. On the downside, though, an RPD can break and—as a removable appliance—become lost. They can also lose their fit due to changes in jaw structure.

The bonded bridge is similar to a traditional fixed bridge. But there’s one big difference: traditional bridges crown the natural teeth on either side of the missing teeth to secure them in place. The supporting teeth must be significantly (and permanently) altered to accommodate the life-like crowns on either end of the bridge.

Instead, a bonded bridge affixes “wings” of dental material extending from the back of the bridge to the back of the natural teeth on either side. While not quite as strong as a regular bridge, the bonded bridge avoids altering any natural teeth.

While a fixed bridge conveniently stays in place, they’re more difficult than an RPD to keep clean. And while less prone to breakage, they aren’t entirely immune to certain stresses from biting and chewing especially in the presence of some poor bites (how the upper and lower teeth come together).

Choosing between the two restorations will depend on these and other factors. But either choice can serve your teen well until they’re able to permanently replace their missing teeth.

If you would like more information on dental restorations for teens, please contact us or schedule an appointment for a consultation.

FastFoodChainsTakeOneSmallStepforKidsTeeth

Eaten in a fast food restaurant lately? If so, maybe you’ve noticed some changes in the big, colorful signs behind the counters. Many have begun promoting a few “healthier” selections (like salads and grilled items) and giving a more extensive listing of nutritional information. But there’s one thing you might not have noticed on those displays: a listing for soda among the beverage choices in the kiddie meal packages. That’s because they are no longer there.

Recently, Burger King quietly removed sugary fountain drinks from the in-store and online menu boards that show what you get with kids’ meals. They were following the lead of McDonalds and Wendy’s, both of which made similar moves in prior months. You can still get a soda with your kiddie burger if you specifically ask for one, but we’re hoping you won’t; here’s why.

For one thing, youth obesity has nearly tripled in the past three decades. As the U.S. Centers for Disease Control and Prevention (CDC) has noted, it’s now an epidemic affecting more than one in six children and adolescents. Many of the extra calories kids get are blamed on sugary drinks: According to a study by the Harvard School of Public Health, children’s daily calorie intake from these beverages rose by 60 percent in recent years. Obesity makes kids more likely to get many diseases, and can lead to problems in psychological and social adjustment.

But that’s not all. As dentists, we’re concerned about the potential for soda to cause tooth decay, which is still the number one chronic disease in children around the world. The association between sugary drinks and cavities is clear. So is the fact that tooth decay causes pain, countless hours of missed school and work, and expense that’s largely unnecessary, because it’s a disease that is almost 100 percent preventable.

While the new signage at fast food restaurants won’t make soda disappear, it does tend to make it less of an automatic choice. Anything that discourages children from routinely consuming soda is bound to help — and let’s point out that the same thing goes for other sweet and acidic beverages including so-called “sports” and “energy” drinks. It’s best to try and eliminate these from your child’s diet; but if you do allow them, at least limit them to mealtimes, and give your mouth a break from sweets between meals. That gives the saliva enough time to do its work as a natural buffer and acid-neutralizer.

What else can you do to help keep your child’s oral hygiene in tip-top shape? Be sure they brush their teeth twice and floss once every day, and bring them in for regular checkups and cleanings. But if you do suspect tooth decay, don’t delay treatment: Left alone, decay bacteria can infect the inner pulp of the tooth, resulting in severe pain, inflammation, and possibly the need for root canal treatment.

If you would like more information about children’s oral health, please contact us or schedule an appointment. You can learn more by reading the Dear Doctor magazine articles “How to Help Your Child Develop the Best Habits for Oral Health” and “Top 10 Oral Health Tips For Children.”

SedationTherapycanreduceAnxietyinChildrenduringDentalVisits

Making sure children are comfortable when visiting the dentist is an essential part of creating a lifetime habit of dental care. We recommend children start dental visits around their first birthday.

But for some children this may not be enough — despite parents’ and dentists’ best efforts they may still develop an inordinate fear of dental visits and even routine procedures. This kind of anxiety could inhibit them now and later in life from receiving needed dental care.

To relieve this anxiety, dentists have developed sedation therapy for children. Not to be confused with anesthesia, which numbs pain, sedation uses drugs to place a patient in a relaxed state. Depending on the drugs and dosage used, we’re able to achieve anywhere from a light state of relaxation to a deep suppression of consciousness. The approach is similar to one used with adults, although drug dosages and applications will differ with children.

 If we’re planning to use sedation with your child we recommend you feed them a low-fat dinner the night before and then refrain from any other foods or liquids until after treatment the next day. Just before the procedure (and after we’ve evaluated them physically to be sure they’re healthy enough for the sedation medication), we’ll administer the sedative, usually Midazolam and Hydroxyzine. Taken by mouth in a syrup form, this places them in a mildly relaxed state.

During the procedure a designated staff member will continually monitor their pulse, breathing, blood pressure and other vital signs. We may also take other protective measures like special chair positioning or immobilization to keep movement to a minimum.

After the procedure, your child will remain in the office until their vital signs return to pre-sedation levels. Once at home, you should keep an eye on them for the rest of the day. They should not return to school or regular activities until the next day.

As sedation medication and techniques continue to advance, they’re becoming a routine part of dental care. If your child experiences anxiety, this can help make dental visits more pleasant and more likely to become part of their life from now on.

If you would like more information on taking the anxiety out of children’s 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 “Sedation Dentistry for Kids.”

By Riviera Dental
June 03, 2018
Category: Oral Health
Tags: celebrity smiles   retainer  
MargotRobbieKnowsAGreatSmileIsWorthProtecting

On the big screen, Australian-born actress Margot Robbie may be best known for playing devil-may-care anti-heroes—like Suicide Squad member Harley Quinn and notorious figure skater Tonya Harding. But recently, a discussion of her role in Peter Rabbit proved that in real life, she’s making healthier choices. When asked whether it was hard to voice a character with a speech impediment, she revealed that she wears retainers in her mouth at night, which gives her a noticeable lisp.

“I actually have two retainers,” she explained, “one for my bottom teeth which is for grinding my teeth, and one for my top teeth which is just so my teeth don't move.”

Clearly Robbie is serious about protecting her dazzling smile. And she has good reasons for wearing both of those retainers. So first, let’s talk about retainers for teeth grinding.

Also called bruxism, teeth grinding affects around 10 percent of adults at one time or another, and is often associated with stress. If you wake up with headaches, sore teeth or irritated gums, or your sleeping partner complains of grinding noises at night, you may be suffering from nighttime teeth grinding without even being aware of it.

A type of retainer called an occlusal guard is frequently recommended to alleviate the symptoms of bruxism. Typically made of plastic, this appliance fits comfortably over your teeth and prevents them from being damaged when they rub against each other. In combination with stress reduction techniques and other conservative treatments, it’s often the best way to manage teeth grinding.

Orthodontic retainers are also well-established treatment devices. While appliances like braces or aligners cause teeth to move into better positions, retainers are designed to keep teeth from moving—helping them to stay in those positions. After active orthodontic treatment, a period of retention is needed to allow the bite to stabilize. Otherwise, the teeth can drift right back to their old locations, undoing the time and effort of orthodontic treatment.

So Robbie has the right idea there too. However, for those who don’t relish the idea of wearing a plastic appliance, it’s often possible to bond a wire retainer to the back surfaces of the teeth, where it’s invisible. No matter which kind you choose, wearing a retainer can help keep your smile looking great for many years to come.

If you have questions about teeth grinding or orthodontic retainers, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Teeth Grinding” and “The Importance of Orthodontic Retainers.”





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