My Blog
By Gregory S. Herzler, DDS
July 21, 2018
Category: Dental Procedures
Tags: braces   retainers  
KeepYourNewSmileAfterOrthodonticswithaRetainer

After months of wearing braces, the big day has arrived — they’re finally off! Your teeth have been realigned and your smile is dazzling. You’re finished with orthodontic treatment, right?

Not quite — because if you want to keep your new smile you have one more treatment phase to go — wearing a retainer. Without this phase there’s a distinct possibility you could lose all the time, effort and expense of braces because your teeth could revert to their previous position.

To understand why, we have to consider how teeth can move in the first place. Although it may seem like your teeth are rigidly fastened to the jawbone, they’re actually held in place by the periodontal ligament, a strong, elastic gum tissue that lies between the teeth and the bone. Tiny fibers from the ligament attach to the teeth on one side and to the bone in a similar manner on the other side.

When pressure is applied to the tooth as happens with braces, the bone around the side of the tooth in the direction of the force will begin to dissolve (resorb), allowing the tooth to move in that direction. New bone will then build up on the other side to stabilize the tooth. Once the pressure is removed (when we take the braces off), there’s a tendency for the teeth, bone and gums to “remember” the old position and try to revert back.

The answer is a removable mouth appliance known as a retainer. Custom-designed to fit the teeth’s new position, the retainer helps hold the teeth in place until the bone completely sets around them. In the beginning, you may need to wear the retainer around the clock and then later only at night while you sleep. While you may only need to wear it for a few months (especially if you’re an adolescent or young adult) some patients may need to wear some form of retainer indefinitely. Your orthodontist will advise you how long depending on your individual situation.

While retainers may seem like an inconvenience, they’re extremely important for keeping or “retaining” the teeth in their new and better position. Following through on this important phase of treatment will help ensure you’ll keep your new smile for a long time to come.

If you would like more information on retainers, 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 “Why Orthodontic Retainers?

TakeCareofYourDentalApplianceandItWillTakeCareofYou

What do a teenager with a poor bite, a senior citizen with multiple missing teeth or a middle-aged person with a teeth grinding habit all have in common? They may all depend on a dental appliance for better function or appearance.

There’s a wide variety of removable dental appliances like clear aligners or retainers for orthodontic treatment, dentures for tooth loss or night guards to minimize teeth grinding, just to name a few. But while different, they all share a common need: regular cleaning and maintenance to prevent them from triggering dental disease and to keep them functioning properly.

The first thing to remember about appliance cleaning is that it’s not the same as regular oral hygiene, especially if you have dentures. While they look like real teeth, they’re not. Toothpaste is a no-no because the abrasives in toothpaste designed for tooth enamel can scratch appliance surfaces. These microscopic scratches can develop havens for disease-causing bacteria.

Instead, use liquid dish detergent, hand soap or a specific cleaner for your appliance with a different brush from your regular toothbrush or a specialized tool for your particular appliance. Use warm but not very hot or boiling water: while heat indeed kills bacteria, the hot temperatures can warp the plastic in the appliance and distort its fit. You should also avoid bleach—while also a bacteria killer, it can fade out the gum color of appliance bases.

Be sure you exercise caution while cleaning your appliance. For example, place a towel in the sink basin so if the appliance slips from your hands it’s less likely to break hitting the soft towel rather than the hard sink. And while out of your mouth, be sure you store your appliance out of reach of small children and pets to avoid the chance of damage.

Cleaning and caring for your appliance reduces the risk of disease that might affect your gums or other natural teeth. It will also help keep your appliance working as it was designed for some time to come.

If you would like more information on care and maintenance for oral appliances, please contact us or schedule an appointment for a consultation.

By Gregory S. Herzler, DDS
July 11, 2018
Category: Oral Health
Tags: oral hygiene  
ReadyforSummerCampBeSuretoPackaToothbrush

Summer is the time for many children to experience the fun and freedom of sleepaway camp. Along with greater independence, camp brings increased responsibility for kids to take care of themselves, including taking care of their oral health.

Two keys to dental health are a balanced diet and good oral hygiene, but camp life may tempt kids to overdo the kinds of food they don’t often indulge in at home. For most campers, enjoying s’mores around the fire is a given, but these marshmallowy treats pack a punch in the sugar department. In fact, a single s’more has half the daily limit of sugar recommended by the World Health Organization—and if the sweet treat’s name is any indication, no one stops at just one! Because sticky marshmallows are a central ingredient, they are worse for the teeth than many other sweets; the goo adheres to the surface of the teeth and gets stuck between teeth and braces, increasing the potential for tooth decay. Add in plenty of opportunities to consume sugary drinks and other treats throughout the week, and sleepaway camp can be a less-than-ideal environment to maintain good oral health, especially since brushing and flossing may not be a high priority with so much else going on.

You can help your camper feel more invested in their oral hygiene routine by involving them in as many preparations as possible, such as making a list of items to pack and shopping together for dental supplies. These can include a travel toothbrush with a case and a travel-sized tube of fluoride toothpaste—or a package of pre-pasted disposable toothbrushes. And don’t forget dental floss! You may also wish to include gum sweetened with xylitol, a natural sweetener that helps fight cavities. This could come in handy for those times your child gets too busy to brush.

Consider scheduling a teeth cleaning for the downtime after your child gets home from camp and before the start of the new school year, just in case your child wasn’t the most diligent about oral hygiene while away—and to ensure that they begin the new school year in the best oral health.

If you would like more information about how your child can maintain good oral health, please call our office to schedule a consultation. You can learn more in the Dear Doctor magazine articles “How to Help Your Child Develop the Best Habits for Oral Health” and “The Bitter Truth About Sugar.”

By Gregory S. Herzler, DDS
July 06, 2018
Category: Oral Health
Tags: gum recession  
4ImportantFactsAboutGumRecessionandWhatYoucandoAboutIt

While gum recession is a common occurrence related to aging, it’s not just an “old person’s disease.” It can happen to anyone, even someone with a relatively healthy mouth. And this detachment and shrinking back of the gums from the teeth may not be a minor problem—your dental health is definitely at risk.

Here then are 4 things you should know about gum recession, and what you can do about it.

The most common cause: periodontal (gum) disease. A bacterial infection triggered by built-up dental plaque, gum disease weakens the gums’ attachment to teeth that leads to recession. To help prevent it, clean away plaque with daily brushing and flossing and visit a dentist regularly for more thorough plaque removal. If you already have gum disease, prompt treatment could stop the infection and reduce any resulting damage including recession.

…But not the only one. There are other factors that contribute to recession besides disease. In fact, it could be the result of “too much of a good thing”—brushing too hard and too frequently can damage the gums and lead to recession. You might also be more susceptible to recession if you’ve inherited thin gum tissues from your parents. Thin gums are at increased risk of recession from both disease and over-aggressive hygiene.

Best outcomes result from treating gum disease and/or recession early. The earlier we detect and treat a gum problem, the better the outcome. See your dentist as soon as possible if you see abnormalities like swollen or bleeding gums or teeth that appear larger than before. Depending on your condition there are a number of treatment options like plaque removal or techniques to protect exposed teeth and improve appearance.

Grafting surgery could regenerate lost gum tissue. While with mild cases of gum recession the gums may respond well to treatment and actually rejuvenate on their own, that might not be possible with advanced recession. We may, however, still be able to restore lost tissue through grafting. Using one of a number of techniques, a graft of donor tissue can foster new replacement growth. It’s a meticulous micro-surgical approach, but it could be a viable answer to extreme gum recession.

If you would like more information on gum recession, 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 “Gum Recession.”

DentalCareisDifficultbutnotImpossibleforaSpecialNeedsChild

A child with a chronic illness or condition often requires a lot of focus on care for their special needs. Other aspects of their health can often take a back seat — too often including dental care.

Proper dental care can be a challenge for special needs children if they have diminished physical, intellectual or behavioral capacities. Children with autism or attention deficit disorders may not be able or willing to perform tasks like brushing and flossing. Other conditions could make them intolerant to toothpaste in the mouth, or create an inability to keep their mouths open or to spit.

Some chronic conditions also seem predisposed to dental defects. For example, enamel hypoplasia, a lack of sufficient tooth enamel, is common with Down, Treacher-Collins or Turner Syndromes, and can greatly increase the risk of tooth decay.

But even though difficult, effective dental care isn't impossible. It begins with your dental provider.

Pediatric dentists are often excellent in this regard: they often have the training and experience to treat children with chronic conditions. Whoever you choose must be able to partner with you in caring for your child's dental needs.

Daily hygiene is also a critical factor. Your goal should be the same as with any child — to teach them to brush and floss for themselves. Depending on their condition, however, you may need to assist them for a longer term, perhaps permanently. But it is imperative — daily hygiene is their best defense against oral diseases.

You should also consider their medication and how it may impact their dental health. Antidepressants, antihistamines or drugs that assist with breathing function can cause mouth dryness. This, as well as drugs with sugar or acid compounds, can increase risk for dental disease. If they must take these types of medications, try to give them at mealtime to reduce their effect in the mouth.

Above all, pursue the same professional dental care as you would for any other child. Keep up regular dental visits beginning around their first birthday for cleanings and preventive measures like topical fluoride or sealants. By taking these measures you'll help ensure their dental health won't suffer.

If you would like more information on dental care for special needs children, 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 “Managing Tooth Decay in Children with Chronic Diseases.”





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