When is the best time to floss your teeth: Morning? Bedtime? How about: whenever and wherever the moment feels right?
For Cam Newton, award-winning NFL quarterback for the Carolina Panthers, the answer is clearly the latter. During the third quarter of the 2016 season-opener between his team and the Denver Broncos, TV cameras focused on Newton as he sat on the bench. The 2015 MVP was clearly seen stretching a string of dental floss between his index fingers and taking care of some dental hygiene business… and thereby creating a minor storm on the internet.
Inappropriate? We don't think so. As dentists, we're always happy when someone comes along to remind people how important it is to floss. And when that person has a million-dollar smile like Cam Newton's — so much the better.
Of course, there has been a lot of discussion lately about flossing. News outlets have gleefully reported that there's a lack of hard evidence at present to show that flossing is effective. But we would like to point out that, as the saying goes, “Absence of evidence is not evidence of absence.” There are a number of reasons why health care organizations like the American Dental Association (ADA) still firmly recommend daily flossing. Here are a few:
- It's well established that when plaque is allowed to build up on teeth, tooth decay and gum disease are bound to follow.
- A tooth brush does a good job of cleaning most tooth surfaces, but it can't reach into spaces between teeth.
- Cleaning between teeth (interdental cleaning) has been shown to remove plaque and food debris from these hard-to-reach spaces.
- Dental floss isn't the only method for interdental cleaning… but it is recognized by dentists as the best way, and is an excellent method for doing this at home — or anywhere else!
Whether you use dental floss or another type of interdental cleaner is up to you. But the ADA stands by its recommendations for maintaining good oral health: Brush twice a day for two minutes with fluoride toothpaste; visit your dentist regularly for professional cleanings and checkups; and clean between teeth once a day with an interdental cleaner like floss. It doesn't matter if you do it in your own home, or on the sidelines of an NFL game… as long as you do it!
Even after losing a tooth in an on-court collision with an opposing player, Isaiah Thomas didn’t slow down. The Boston Celtics point guard completed the play…and the rest of the game. Unfortunately, that wasn’t the end of his dental problems — it was just the beginning.
Over the next few days, Thomas had a total of ten hours of oral surgery to treat problems with multiple teeth. He got a temporary bridge, and will receive a permanent one at a later date. He also got fitted for a custom-made mouthguard to prevent re-injury.
We’re pleased to see that Thomas is getting appropriate dental treatment. But it’s unfortunate that he didn’t get the mouthguard sooner; this one piece of inexpensive safety gear could have saved him a lot of pain and trouble. If you think mouthguards are strictly for full-contact sports, Thomas’ troubles should make you think again. In fact, according to a 2015 study in the journal Sports Health, the five sports with the highest overall risk of tooth loss are basketball, football, hockey, martial arts, and boxing. Plenty of other also involve the risk of dental injury.
The study also notes that some 5 million teeth are avulsed (knocked out) each year in the U.S. alone. Countless others are loosened, fractured or chipped. What’s more, it is estimated that the lifetime cost of treating an avulsed tooth is between $5,000 and $20,000. The cost of a custom-made mouthguard is just a small fraction of that.
Where can you or your child get a custom-made mouthguard? Right here at the dental office! These high-quality items are professionally fabricated from a model of your actual teeth, so they fit much better than an off-the-shelf one ever could. They offer superior protection, durability and comfort — because, after all, no mouthguard can protect you if it’s too uncomfortable to wear.
Thomas’ season is now over due to a hip injury, but at least he will now have time to rest and get his dental problems taken care of. Let’s hope his story will inspire more athletes — both professional and amateur — to prevent similar problems by wearing custom-made mouthguards. Whether you compete on a school team, enjoy a pick-up game after work, or play in the big leagues, a dental injury is one problem that you don’t need.
It can be alarming to be awakened in the middle of the night by a screeching, gritting sound coming from your child’s bedroom. No, it’s not a scene from a horror movie: it’s your child grinding their teeth as they sleep — a behavior so prevalent in children under eleven it’s considered normal.
That doesn’t mean, however, you should completely ignore it. While it isn’t harmful for most children, a few can encounter tooth wear, pain or trouble sleeping that calls for some form of intervention.
The causes for tooth grinding and similar habits known collectively as bruxism aren’t thoroughly understood, but in children it’s believed linked to the immaturity of the neuromuscular system that controls chewing. Some point to shifts from one stage of sleep to another — more than 80% of grinding episodes occur in lighter stages of sleep and only 5% to 10% during the deeper Rapid-Eye-Movement (REM) stage. It also seems prevalent in children who snore or have other symptoms of sleep apnea.
One primary concern is how the behavior can affect teeth, particularly through abnormal wear. The teeth, of course, make hundreds of contacts with each other every day during eating, speaking or jaw movement. If, however, the forces generated during these contacts chronically exceed normal parameters, as with bruxism, it can cause accelerated tooth wear. This can result in a higher susceptibility to tooth decay and appearance changes later in life.
If your child is exhibiting problems associated with teeth grinding, there are ways to address it. We may recommend a thin, plastic mouthguard they wear while sleeping that prevents the teeth from making solid contact with each other. We may also refer you to an ear, nose and throat specialist if we suspect signs of sleep apnea. And, children under severe psychological stress, which can also trigger teeth grinding, could benefit from behavioral therapy.
The good news is most grinding habits fade as children enter their teens. In the meantime, keep a watchful eye and see us if you notice any indications this common habit is affecting their health and well-being.
If you would like more information on teeth grinding habits, 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 “When Children Grind Their Teeth.”
A blow to the face can result in a variety of injuries to your jaws and the temporomandibular joints (TMJs) that join the lower jaw to the skull. Only a thorough examination can determine the type and extent of the injury, and how to treat it.
The pain you feel in your jaw may indicate a direct injury, usually near the joint. This could mean the joint head (condyle) has dislocated, or moved out of the joint space. It could also mean you’ve fractured your lower jaw, most commonly just below the head of the joint.
Jaw pain can also indicate structures near the jaw and joint have been damaged and the jaw is indirectly affected. In some cases a damaged tooth may be radiating pain signals through the jaw (along similar nerve paths). More likely, trauma to soft tissue near the jaw joint has swelled with inflammation, putting pressure on the joint and temporarily stopping the condyle from seating fully in the joint space.
Any of these injuries can also cause painful muscle spasms, a defensive reaction from the body that causes muscles on either side of the jaw to limit movement preventing further damage (a natural splint, if you will). Thus, the pain may be compounded by a diminished range of motion when you try to chew or speak.
It’s important, therefore, to determine the exact cause of pain and limited movement before commencing treatment. Spasms and inflammation are usually treated with muscle relaxant drugs and anti-inflammatory pain relievers. In the case of a dislocation, gentle manipulation can ease the condyle back into the joint space. A fracture would require more extensive treatment, including repositioning broken bone and immobilizing the jaw from movement to allow healing. In the most severe cases, surgical treatment may be necessary to internally immobilize the joint.
If you sustain an injury that results in jaw swelling and pain, you should see us without delay. The sooner we can diagnose and begin the proper treatment for your injury, the less likely you’ll encounter long-term problems and the sooner you’ll be pain and swelling free.
If you would like more information on the causes and treatment of 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 “Jaw Pain.”
In her decades-long career, renowned actress Kathy Bates has won Golden Globes, Emmys, and many other honors. Bates began acting in her twenties, but didn't achieve national recognition until she won the best actress Oscar for Misery — when she was 42 years old! “I was told early on that because of my physique and my look, I'd probably blossom more in my middle age,” she recently told Dear Doctor magazine. “[That] has certainly been true.” So if there's one lesson we can take from her success, it might be that persistence pays off.
When it comes to her smile, Kathy also recognizes the value of persistence. Now 67, the veteran actress had orthodontic treatment in her 50's to straighten her teeth. Yet she is still conscientious about wearing her retainer. “I wear a retainer every night,” she said. “I got lazy about it once, and then it was very difficult to put the retainer back in. So I was aware that the teeth really do move.”
Indeed they do. In fact, the ability to move teeth is what makes orthodontic treatment work. By applying consistent and gentle forces, the teeth can be shifted into better positions in the smile. That's called the active stage of orthodontic treatment. Once that stage is over, another begins: the retention stage. The purpose of retention is to keep that straightened smile looking as good as it did when the braces came off. And that's where the retainer comes in.
There are several different kinds of retainers, but all have the same purpose: To hold the teeth in their new positions and keep them from shifting back to where they were. We sometimes say teeth have a “memory” — not literally, but in the sense that if left alone, teeth tend to migrate back to their former locations. And if you've worn orthodontic appliances, like braces or aligners, that means right back where you started before treatment.
By holding the teeth in place, retainers help stabilize them in their new positions. They allow new bone and ligaments to re-form and mature around them, and give the gums time to remodel themselves. This process can take months to years to be complete. But you may not need to wear a retainer all the time: Often, removable retainers are worn 24 hours a day at first; later they are worn only at night. We will let you know what's best in your individual situation.
So take a tip from Kathy Bates, star of the hit TV series American Horror Story, and wear your retainer as instructed. That's the best way to keep your straight new smile from changing back to the way it was — and to keep a bad dream from coming true.
If you would like more information about orthodontic retainers, please contact us or schedule an appointment for a consultation. You can learn more about this topic in the Dear Doctor magazine articles “Why Orthodontic Retainers?” and “The Importance of Orthodontic Retainers.” The interview with Kathy Bates appears in the latest issue of Dear Doctor.
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