My Blog

By Phillip S. Tully III DMD
November 25, 2021
Category: Oral Health
Tags: teeth grinding  
GetAheadofTeethGrindingtoAvoidHarmtoYourTeeth

We like to think we're more prone to stress in our modern, fast-paced world than those who lived in "simpler" times, but a finding from the recent discovery of Richard the III's remains in England suggests differently. Investigators noted the king had well-worn teeth, perhaps from grinding them out of stress.

We can't be sure this was the cause for the king's dental problems, or if teeth grinding was common in the 15th Century. But we are sure the problem exists today among adults.

Tooth grinding is the grinding, gnashing or clenching of teeth involuntarily when not engaged in regular dental functions like eating or speaking. It can occur while a person is awake, but most often while they're asleep.

The habit regularly occurs in children, but is not considered a major problem as most outgrow it by adolescence, usually with no lingering damage. Not so with adults: Because the habit generates abnormally high biting forces, teeth grinding can lead to accelerated tooth wear. It can also weaken teeth, making them more susceptible to fracture or disease.

People who grind their teeth will typically awaken with sore jaws or the complaints of family members about the loud chattering noise emitted during an episode. If you suspect a problem, you should see your dentist for a definitive diagnosis, and to learn how to reduce its occurrence and effects.

Treatments for the habit vary depending on underlying causes. They may involve lifestyle changes like quitting tobacco, limiting alcohol or altering your use of certain drugs or medications.  Because stress is often a major factor, learning better relaxation techniques through meditation, group therapy or biofeedback may also help reduce teeth grinding.

These treatments, though, can take time, so you may also need ways to minimize the effects of the habit in the meantime. One of those ways is for your dentist to create an occlusal guard that you wear while you sleep. The guard prevents the teeth from making solid contact, thus reducing the potential biting forces.

It's important, then, to see your dentist as soon as possible if you suspect you're grinding your teeth. Finding out as early as possible and then taking positive steps to stop or reduce its effect can save your teeth from a good deal of harm.

If you would like more information on teeth grinding, 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 “Teeth Grinding.”

By Phillip S. Tully III DMD
November 15, 2021
Category: Oral Health
Tags: sleep apnea  
YourDentistMayBeAbleToProvideYouWithaSleepApneaSolution

Morning tiredness, brain fog and snoring are just some of the indicators of a medical condition known as sleep apnea. And, it's worse than waking up on the wrong side of the bed—over time, sleep apnea could increase your risk for heart disease or other life-threatening conditions.

Sleep apnea occurs when air flow becomes restricted during sleep, usually by the tongue blocking the airway. As oxygen levels begin to fall, the brain signals the body to wake up to "fix" the air flow problem.

As this arousal may only last a second or two, you may not remember it when you awaken in the morning. But it can happen numerous times a night, depriving you of the deep sleep your body needs for rest and repair.

Fortunately, there are ways to treat sleep apnea. In extreme instances, you may need surgery to correct anatomical defects causing the condition. For most cases, though, the most common treatment is continuous positive airway pressure (CPAP) therapy, which consists of a portable pump delivering pressurized air through a face mask that keeps the throat open while you sleep.

Used by millions of patients, CPAP can be quite effective. Some patients, though, feel uncomfortable using a CPAP machine for various reasons. If you're one of those unhappy CPAP campers or you would like to consider a possible alternative, your dentist might have the answer: oral appliance therapy (OAT).

An OAT device is worn in the mouth during sleep to prevent the tongue from falling back against the back of the throat and blocking the airway. There are various forms of OAT appliances, but they're all custom-made by a dentist to fit an individual patient's mouth. They work best for mild to moderate sleep apnea in which the tongue is the primary culprit in airway blockage.

If you suspect you may have sleep apnea, you should undergo a complete examination by a doctor or dentist to confirm it. If you've been diagnosed with mild to moderate sleep apnea, talk to your dentist about an OAT device. You may find OAT can provide you the relief you need for a better night's sleep.

If you would like more information on oral treatments for sleep apnea, 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 “If You Snore, You Must Read More!

By Phillip S. Tully III DMD
November 05, 2021
Category: Dental Procedures
Tags: celebrity smiles   crown  
WhatChrissyTeigensInaugurationNightCapMishapCouldMeanForYou

Inauguration night is usually a lavish, Washington, D.C., affair with hundreds attending inaugural balls throughout the city. And when you're an A-List celebrity whose husband is a headliner at one of the events, it's sure to be a memorable night. As it was for super model Chrissy Teigen—but for a slightly different reason. During the festivities in January, Teigen lost a tooth.

Actually, it was a crown, but once she told a Twitter follower that she loved it “like he was a real tooth.” The incident happened while she was snacking on a Fruit Roll-Up (those sticky devils!), and for a while there, husband and performer John Legend had to yield center stage to the forlorn cap.

But here's something to consider: If not for the roll-up (and Teigen's tweets on the accident) all of us except Teigen, her dentist and her inner circle, would never have known she had a capped tooth. That's because today's porcelain crowns are altogether life-like. You don't have to sacrifice appearance to protect a tooth, especially one that's visible when you smile (in the “Smile Zone”).

It wasn't always like that. Although there have been tooth-colored materials for decades, they weren't as durable as the crown of choice for most of the 20th Century, one made of metal. But while gold or silver crowns held up well against the daily grind of biting forces, their metallic appearance was anything but tooth-like.

Later, dentists developed a hybrid of sorts—a metal crown fused within a tooth-colored porcelain shell. These PFM (porcelain-fused-to-metal) crowns offered both strength and a life-like appearance. They were so effective on both counts that PFMs were the most widely used crowns by dentists until the early 2000s.

But PFMs today make up only 40% of currently placed crowns, down from a high of 83% in 2005. What dethroned them? The all-ceramic porcelain crown—but composed of different materials from years past. Today's all-ceramic crowns are made of more durable materials like lithium disilicate or zirconium oxide (the strongest known porcelain) that make them nearly as strong as metal or PFM crowns.

What's more, coupled with advanced techniques to produce them, all-ceramic crowns are incredibly life-like. You may still need a traditional crown on a back tooth where biting forces are much higher and visibility isn't an issue. But for a tooth in the “Smile Zone”, an all-ceramic crown is more than suitable.

If you need a new crown (hopefully not by way of a sticky snack) or you want to upgrade your existing dental work, see us for a complete exam. A modern all-ceramic crown can protect your tooth and enhance your smile.

If you would like more information about crowns or other kinds of dental work, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Porcelain Crowns & Veneers.”

By Phillip S. Tully III DMD
October 26, 2021
Category: Dental Procedures
WhatYouCanDoToReduceGumProblemsWhileWearingBraces

Wearing braces can ultimately give you a healthier and more attractive smile. In the short-term, though, your gums in particular may be in for a rough ride.

While we're all susceptible to gum disease, braces wearers are more likely to encounter it. This stems from two related factors: the difficulty braces pose to oral hygiene; and the potential irritation of soft tissues by the braces themselves.

The main cause for any form of gum disease is dental plaque, a thin bacterial film that accumulates on teeth. Removing plaque through brushing and flossing greatly reduces the risk of any dental disease. But braces wires and brackets make it difficult to brush and floss—as a result, some plaque deposits may escape cleaning, which makes a gum infection more likely.

To exacerbate this, braces hardware can irritate the gums and cause swelling and tissue overgrowth, also known as hyperplasia. The one-two punch of ineffective hygiene with hyperplasia are why braces wearers have a higher incidence of gum problems compared to the general population.

To guard against this, patients with braces need to be extra vigilant about keeping their teeth and gums clean of plaque. It may be helpful in this regard to use specialized tools like interproximal brushes with narrower bristle heads that are easier to maneuver around braces.

And rather than using traditional flossing thread, orthodontic patients may find it easier and more effective to use pre-loaded flossing picks or an entirely different method called oral irrigation. The latter involves a handheld wand that directs a stream of pulsating water between teeth to loosen and flush away plaque.

It's also important for patients to see their dentist as soon as possible for any gum swelling, bleeding or pain. The dentist can determine if it relates to gum disease, hyperplasia or a combination of both, and recommend treatment. In extreme cases, it may be necessary to remove the braces until the gums heal, so catching and treating any gum problem early is a priority.

Regardless of the risk for gum disease, orthodontic treatment is still well worth the investment in your health and appearance. Practicing effective oral hygiene and keeping a watchful eye on your gums will help further lower that risk.

If you would like more information on oral care during orthodontic treatment, 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 Swelling During Orthodontics.”

By Phillip S. Tully III DMD
October 15, 2021
Category: Dental Procedures
StraighteningYourTeethCouldRejuvenateYourSmile

Advanced cosmetic dental techniques are helping people around the world achieve their dream smiles. But long before many of these procedures existed, straightening teeth with braces could make a big difference in a person's appearance.

Improving a smile isn't the primary reason a person should undergo teeth straightening—a poor bite can lead to an unhealthy mouth. Misaligned teeth set up conditions in which you're more prone to diseases like tooth decay or gum disease. Correcting a bite should be first and foremost about protecting your dental health.

Even so, realigning your teeth can lead to a more attractive smile—and it's often necessary first before undergoing other cosmetic restorations. Think of it like renovating a house. You usually need to fix a faulty foundation before you start building an addition.

That's why it's always a good idea to get a complete dental exam before undertaking cosmetic work. There may be underlying problems that should be treated first. If that includes a poor bite, your next visit will most likely be with an orthodontist. Using advanced diagnostics, they'll determine what kind of bite problem you have and what it will take to correct it.

In years past, that meant braces. But now patients have another option: clear aligners, a series of clear plastic trays based on the individual patient's teeth. Each tray in the series is worn for about two weeks in succession, each new tray taking up where the other tray left off moving the teeth. Not only are they nearly invisible to observers, they can be removed for eating, cleaning or special occasions.

On the cosmetic front, straightening your teeth may be all you need to realize a more attractive smile. But orthodontics can also be part of an overall "smile makeover" that may include other cosmetic procedures, usually performed after realigning the teeth. In this case, it's often necessary to coordinate orthodontic treatment with these other procedures, especially if it's necessary to remove some teeth.

Whether it stands alone or is part of an overall makeover plan, straightening teeth can be a game changer when it comes to your appearance. Not only will it help you have healthier teeth and gums, it could give you the new smile you desire.

If you would like more information on orthodontic treatment, 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 “The Magic of Orthodontics.”





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