Posts for: June, 2013

By James B. Howell, D.M.D.
June 27, 2013
Category: Dental Procedures
BaseballandBracesJoeGirardisBargain

Sometimes, we all need a bit of prompting to do what's good for us. When Serena Girardi, the 10-year-old daughter of New York Yankees manager Joe Girardi, needed to have orthodontic treatment, she was a little nervous. To help lessen her anxiety, Girardi, then 45 years old, made a deal: if she got braces, then he would too.

“What I didn't realize,” said Girardi in an interview with ESPN, “is that she only had to get four on her front teeth and I got the full mouthful.”

But that didn't stop the baseball great from keeping up his end of the bargain. In a separate deal with his son Dante, who also needed braces, Girardi agreed to wear blue rubber bands. “It's a good look,” he said. What will he do if his third child needs braces? Stay tuned...

Whether it starts as a bargain with your kids or as a promise to yourself, orthodontic treatment can offer real benefits at any age. In fact, about one out of five orthodontic patients today is an adult. Studies have shown that up to three-quarters of all adults have some form of orthodontic problem, like drifting or crowding of teeth. And having a great-looking smile not only improves self-confidence, but can also boost an adult's social life, and even enhance his or her career opportunities.

If you or your child may need braces, but you're put off by the dreary metal hardware you remember from back in the day, take heart! Plenty has changed in the field of orthodontics since you were a teenager — and it's not just the color of the rubber bands.

In many cases, clear or colorless ceramic braces can be used instead of metal ones. These stain-resistant orthodontic appliances blend in well with your own teeth, making them much less evident. It may be possible for them to be placed on the lingual (tongue) side of the teeth, where they're even less visible.

Clear aligners offer an alternative to braces that's appropriate for some people. Aligners are a series of precision-made “trays” composed of polyurethane plastic. Worn 20-22 hours per day for a period of months, these appliances gradually move teeth into an improved position. Besides being virtually invisible, another advantage of these trays is that they may be removed for eating and for important occasions. Once recommended only for adults, they have recently become available to teenagers as well.

What's the best way to find out whether you or someone in your family could benefit from orthodontics, and which treatment option best suits your individual needs? Come in to our office for a consultation! After a thorough examination, we would be happy to recommend the most appropriate treatment methods for your particular situation.

If you have questions about orthodontic treatment, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Orthodontics For The Older Adult” and “Clear Aligners for Teenagers.”


By James B. Howell, D.M.D.
June 14, 2013
Category: Oral Health
Tags: tooth pain   toothache  
Thattoothachemaystillbeaproblemevenifthepainisgone

You experience a painful toothache that lasts for a few days, but eventually the pain subsides. Since there's no longer any pain, there's no longer anything wrong with the tooth, right?

Maybe not — the toothache may be the result of a decay-induced infection that has developed deep in the pulp of the tooth. The infection inflames both the pulp tissue and the nerves bundled in it (a condition known as pulpitis). Because it occurs in an enclosed space, the pain is even more severe.

Now it's possible for the inflammation to subside and the nerves to heal, which would explain the pain subsiding. But there is another, more likely scenario: the infected pulp tissue can no longer fight the infection and dies. The affected nerves die also, which is why you no longer feel any pain — the dead nerves are no longer transmitting a signal to the brain. The infection, however, is very much alive and continues to advance deeper into the surrounding tissues where it may eventually develop into a painful abscess.

So, how can we determine which of these two scenarios you are actually experiencing? A visit to our office for testing is the surest way to find out. The most common test involves temperature sensation, usually with the application of ice to the affected tooth. If there's no sensation, then that's evidence the nerves in the tooth have died.

If that's the case, it's important then to take steps to stop the infection's advance before it does even more damage. The most likely treatment is a root canal, a procedure that accesses the pulp from the top of the tooth, removes the dead tissue, and then cleans and prepares the root canals for filling. This procedure can usually be performed in our office, but more involved cases may require an endodontist, a specialist in root canals.

In any case, if you experience a severe toothache, please have it examined. And remember — the absence of pain after a toothache doesn't necessarily mean the problem is gone.

If you would like more information on the diagnosis and treatment of an acute toothache, 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 “A Severe Toothache.”




Louisville, KY Cosmetic Dentistry
James B. Howell, D.M.D.
3936 Dutchmans Lane
Louisville, KY 40207
(502) 899-7766

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