Ever since childhood, when her career as a model and actress took off, Brooke Shields has enjoyed worldwide recognition — through advertisements for designer jeans, appearances on The Muppet Show, and starring roles in big-screen films. But not long ago, that familiar face was spotted in an unusual place: wearing a nasal anesthesia mask at the dentist's office. In fact, Shields posted the photo to her own Instagram account, with the caption “More dental surgery! I grind my teeth!” And judging by the number of comments the post received, she's far from alone.
In fact, researchers estimate that around one in ten adults have dental issues that stem from teeth grinding, which is also called bruxism. (Many children also grind their teeth, but it rarely causes serious problems, and is often outgrown.) About half of the people who are teeth grinders report problems like persistent headaches, jaw tenderness and sore teeth. Bruxism may also result in excessive tooth wear, and may damage dental work like crowns and bridges; in severe cases, loosened or fractured teeth have been reported.
Researchers have been studying teeth grinding for many years; their findings seem to indicate that it has no single cause. However, there are a number of factors that play a significant role in this condition. One is the anatomy of the jaw itself, and the effect of worn or misaligned teeth on the bite. Another factor relates to changes in brain activity that occur during the sleep cycle. In fact, nocturnal (nighttime) bruxism is now classified as a sleep-related movement disorder. Still other factors, such as the use of tobacco, alcohol and drugs, and a high level of stress or anxiety, can make an individual more likely to experience bruxism.
What can be done for people whose teeth grinding is causing problems? Since this condition may have many causes, a number of different treatments are available. Successful management of bruxism often begins by striving to eliminate the factors that may cause problems — for example, making lifestyle changes to improve your health, creating a soothing nighttime environment, and trying stress-reduction techniques; these may include anything from warm baths and soft music at bedtime, to meditation and mindfulness exercises.
Several dental treatments are also available, including a custom-made occlusal guard (night guard) that can keep your teeth from being damaged by grinding. In some cases, a bite adjustment may also be recommended: In this procedure, a small amount of enamel is removed from a tooth to change the way it contacts the opposite tooth, thereby lessening the biting force on it. More invasive techniques (such as surgery) are rarely needed.
A little tooth grinding once in a while can be a normal response to stress; in fact, becoming aware of the condition is often the first step to controlling it. But if you begin to notice issues that could stem from bruxism — or if the loud grinding sounds cause problems for your sleeping partner — it may be time to contact us or schedule an appointment. You can read more about bruxism in the Dear Doctor magazine article “Stress and Tooth Habits.”
In the quest for the ideal diet, people often stress over one particular food group: carbohydrates. And for good reason—some carbohydrates have been linked to chronic inflammation, a contributing factor in many diseases. One such condition in particular, periodontal (gum) disease, could permanently damage your dental health.
But before you throw all the carbs out of your diet, let’s take a closer look at them. Not all carbs are the same or contribute to inflammation to the same degree.
Carbohydrates are organic compounds existing in living tissues. In foods, the most prevalent of these are sugars and starches that break down during digestion into the simple sugar glucose, which the cells in an organism use for energy.
But not all carb-based foods digest at the same rate, measured along a scale called the glycemic index. High glycemic foods like sugar, baked goods or potatoes digest quickly and can rapidly increase the glucose levels in the blood (blood sugar). This sudden glucose spike then triggers an insulin surge from the pancreas to restore the level to normal. This process in turn can cause inflammation.
On the other end of the glycemic index are complex or unrefined carbohydrates that digest much more slowly, and don’t quickly elevate blood sugar like simple carbs. In fact, nutritional studies consistently show carbohydrates in most vegetables, greens, beans or whole grains may actually decrease inflammation.
Inflammation is also a primary factor in gum disease, caused by a bacterial infection in the gums. Chronic inflammation damages the gums’ attachment with the teeth and can contribute to eventual tooth loss. And if your body already has an overactive inflammatory response due to your diet, you could be even more susceptible to gum disease.
A change in your diet in relation to carbs could help reduce this risk. Eat less sugar, white flour, rice and potatoes and more complex carbs like fresh vegetables and fruits. For even more protection include foods rich in Omega-3 fatty acids (like certain fish and nuts) and less Omega 6 foods (fried food or pastries, or chips, for example). And don’t forget your antioxidants, vitamins and minerals.
Eating fewer simple carbs and more complex carbs will help reduce inflammation in the body. And that’s a good thing for your gums.
If you would like more information on how diet affects dental health, 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 “Carbohydrates Linked to Gum Disease.”
Preventing tooth decay is mostly about the basics: daily brushing and flossing followed by regular dental cleanings and checkups. But there’s also a bigger picture: your own personal risk profile for decay based on factors you can modify directly — and those you can’t.
The first type of factor usually involves habits and behavior that either work with your mouth’s natural defenses to fight decay or against it. Besides regular hygiene, your diet is probably the most important of these you can modify for better dental health.
A diet rich in fresh vegetables, protein and dairy products boosts strong, healthy teeth resistant to decay. Conversely, bacteria thrive on the sugar in many snack foods, while sodas, sports or energy drinks elevate acid levels that soften and erode the minerals in your teeth’s enamel.
Lifestyle habits like tobacco use or excessive alcohol consumption also increase your decay risk. Not only do they promote plaque buildup (the thin film of bacteria and food particles that feeds the decay process), but tobacco especially can impede the body’s natural prevention and healing properties.
Conscientious hygiene practices, a dental-friendly diet and modified lifestyle habits all can help you prevent decay. But diligence may not be enough — there are other possible factors you can’t control or may find difficult to change. For example, you may have a genetic propensity toward certain bacteria that cause decay. You may have a condition like gastric reflux that increases the mouth’s acid level. You may also be taking medications that reduce saliva flow, the mouth’s natural acid neutralizer.
But if we know which of these indirect risk factors affect you, we can compensate with extra measures. If enamel strength is a problem we can topically apply fluoride; we can also reduce chronic bacterial levels with prescription rinses. If you have restricted saliva flow, we can attempt to modify your prescriptions through your doctor or prescribe aids that increase saliva.
The key is to investigate your complete risk factor profile through a thorough dental examination. Once we know everything about your mouth, life and health that increases your decay risk, we can put in place a balanced strategy of prevention and treatment just for you. Doing so will greatly increase your chances for keeping your teeth decay-free and healthy.
If you would like more information on preventing and treating dental 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 “Tooth Decay: How to Assess Your Risk.”
Although toothaches are common, not all tooth pain originates from the same source. But regardless of its cause, you need to take prompt action to find out and begin treatment.
Sensitive teeth, for example, usually cause a quick stab of pain when you eat or drink something hot or cold or when you bite down. If the pain lasts only a second or two, you may have a small area of decay in a tooth, a loose filling or an exposed root. The latter often occurs either because of over-aggressive brushing or periodontal (gum) disease. In both cases, the gums may have shrunk back or receded to expose the root surface.
A sharp pain when biting down may be a sign of decay or a loose filling; it could also mean you have a fractured or cracked tooth. For any of those causes, you'll need treatment to repair the problem and relieve the pain.
You may also experience a lingering tooth pain ranging from dull to sharp, or localized to one tooth or seeming to radiate from a general area, such as above the upper jaw. There are a number of possible causes, but two prominent ones are an abscess (a localized area of infection that's become inflamed) or deep decay within the pulp, the heart of a tooth.
This usually calls for a root canal treatment for the affected tooth. In this procedure we drill an access hole into the pulp and clear it of infected and dead tissue. We then fill the empty pulp chamber and root canals with a special filling and seal the access hole. Later, we bond a permanent artificial crown to the tooth to further protect it from re-infection.
Whether your pain is momentary or lingering, dull or sharp, you should see us as soon as possible to determine its cause. You should still see us even if sharp, lingering pain goes away — this could simply mean the infected nerves in the pulp have died but not the infection. The sooner you have the cause of your pain treated, the better your chances of a happy and less costly outcome.
If you would like more information on tooth pain and what to do about it, 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 “Tooth Pain? Don't Wait!”
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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