Posts for: December, 2014

By James B. Howell, D.M.D.
December 29, 2014
Category: Oral Health
Tags: gum recession  

Gum recession is a common problem affecting millions of Americans to some degree. If you have it, you will notice that the pink gum tissue surrounding one or more of your teeth has shrunk or receded and left the tooth-root surfaces exposed. How does this happen? And does it require treatment? The answers to both of these questions will vary from person to person. The good news is that treatment is available for those who need it.

The way you care for your teeth can be a major factor in gum recession. If you do not effectively remove plaque (bacterial biofilm) from your teeth daily, you may develop gum inflammation, gum disease and/or recession. Conversely, if you brush or floss too hard or for too long, you can also damage your gums. Please remember that it doesn't take a lot of pressure to remove biofilm; you just need to make sure you get to each tooth, right down to the gum line.

Other causes of gum recession include: mal-positioned and/or prominent teeth that are not fully encased in supporting bone; muscle attachments (frenums) pulling at the gum line; habits such as holding foreign objects (nails, pins) between the teeth that press on the gum tissues; and badly fitting oral appliances such as dentures, braces – even tongue bolts and lip piercings.

Besides not looking too great, gum recession can lead to anything from minor tooth sensitivity to tooth loss in the most severe cases. If you are experiencing any discomfort from a loss of gum (also called “gingival”) tissue, we'd certainly like to know about it. We would be happy to examine your condition and make recommendations.

There are surgical procedures that are very effective in treating these problems. Procedures such as gingival grafting or periodontal plastic surgery (“peri” – around; “odont” – tooth), often involve taking a small piece of healthy gingival tissue from the roof of your mouth and grafting it to the area where it is needed. Ultrafine sutures hold the graft in place until it “takes.” Laboratory-processed donor tissue can also be used. In either case, the procedure has a terrific success rate.

If you have any questions about gum recession, please contact us or schedule an appointment for a consultation. To learn more about the topic of oral appliance therapy, please see the Dear Doctor magazine article “Periodontal Plastic Surgery.”

By James B. Howell, D.M.D.
December 19, 2014
Category: Oral Health

She's an international star who's recognized everywhere she goes. As Carol Brady, she was an ambassador for the “blended family” before most of us even knew what to call her bunch. And her TV Land Pop Culture Icon Award is on permanent display in the National Museum of American History. So what item that fits inside a purse can't Florence Henderson do without?

“I will never leave home without dental floss!” she recently told an interviewer with Dear Doctor magazine. “Because I have such a wide smile, I have found spinach or black pepper between my teeth after smiling very broadly and confidently.”

Henderson clearly understands the importance of good oral hygiene — and she's still got her own teeth to back it up! In fact, flossing is the best method for removing plaque from between the teeth, especially in the areas where a brush won't reach. Yet, while most people brush their teeth regularly, far fewer take the time to floss. Is there any way to make flossing easier? Here are a couple of tips:

Many people have a tendency to tighten their cheeks when they're holding the floss, which makes it more difficult to get their fingers into their mouths and working effectively. If you can relax your facial muscles while you're flossing, you'll have an easier time.

To help manipulate the floss more comfortably, try the “ring of floss” method: Securely tie the floss in a circle big enough to easily accommodate the fingers of one hand. To clean the upper teeth, place fingers inside the loop, and let the thumb and index finger guide the floss around each tooth. For the lower teeth, use two index fingers. Keep moving the floss in your hand so you always have a clean edge... and remember, the goal is to get the tooth clean, but it shouldn't hurt — so don't use too much pressure or go too fast.

So take a tip from Mrs. Brady: Don't forget the floss! If you would like more information about flossing and other oral hygiene techniques, please contact us for a consultation. You can learn more in the Dear Doctor magazine article “Flossing: A Different Approach.”

December 18, 2014
Category: Dental Procedures
Tags: Root Canal Therapy  

Your sore tooth doesn’t necessarily need to be pulled.  

If there is sufficient bone support holding the tooth in place, your tooth can be preserved and restored and made to feel normal again with a procedure called root canal therapy.

Just those 2 words can make the hair on the back of your neck stand up, but modern treatment can be accomplished usually in one appointment with no discomfort. The advantages of saving your tooth are numerous. Tooth replacement is often more costly and requires more time and more visits. Most people want to return to normal in as few visits with as little discomfort as possible. Root canal therapy is often the answer.

If the tooth cannot be saved, then the options become a bit more complicated. The most acceptable treatment for a lost tooth in modern dental practices involves placement of an implant and crown. This treatment restores the tooth in a manner which most resembles the natural dentition. Bridges and partial dentures are still an alternative, but are now less acceptable.

Modern dental practices have patient financing available which helps patients pay for the most ideal forms of treatment.

December 11, 2014
Category: Cosmetic Dentistry

Dentures, or false teeth, have taken many forms over the years since they were first created. Their function to replace missing teeth hasn't changed, but how comfortable and natural looking they are has moved by leaps and bounds. Dentures are worn by millions of Americans, and can give you the function and look of real teeth. In the past, it was sometimes easy to tell if a person had dentures. Now, advancements in technology have resulted in dentures that are not only more comfortable, but come with the look and feel of natural teeth.

So What are Specialty Dentures?

They are actually dental implants that are made in a form that mimics the shape of the teeth in your mouth. They are used to replace teeth that have been removed whether that be a few teeth or the whole set. Depending on the type of teeth that have been removed, the dentures are available in different forms. They are mostly made out of acrylic resins and metal to hold it all together. Specialty dentures are very comfortable when worn, and give a natural look that you can be confident about. If you decide that dentures may be right for you, visit a dentist who will take a look the teeth that need to be replaced and, with the help of computer technology, come up with the best design of the dentures.

Partial Dentures

No matter your age or condition of your mouth, specialty dentures may be able to help you. Many people think that to have dentures they have to have an entire set of false teeth. Although this is a common type of denture used, it can also be made to fill even a gap of a single tooth. If you are missing one tooth or more, but still have natural teeth, dentures may still be a solution for you.

They can help you avoid cases where other remaining teeth will move to the empty space and cause discomfort and lack of self confidence. Teeth can become weak or dislodged from a variety of different reasons, but you can still have a great smile. After you remove some of your teeth, the others will begin to shift and turn. The right dentures will help them stay in position which will maintain your jaw line in its right shape even if you have removed all of your teeth.

Restore Confidence and Enjoy Comfort

When you are missing teeth from your mouth you will experience difficulty when you are eating. Some even experience pain while biting, but with dentures in place you will easily bite without the pain or discomfort allowing you to live a normal life.

Dentures present a natural and attractive appearance, and are designed to mimic the shape of your teeth. This makes them appear natural in your mouth. Most people who prefer wearing the dentures are able to enjoy a great smile, maybe even for the first time. This can restore the confidence that is sometimes lost when missing teeth.

By James B. Howell, D.M.D.
December 04, 2014
Category: Oral Health
Tags: stress   dental care  

Chronic stress can cause any number of physical problems like back pain, insomnia or stomach ulcers. In the mouth, it can also be the cause of teeth grinding or clenching habits that may lead to pain and tooth damage.

Besides toothaches and jaw pain, stress-related teeth grinding may also be causing your teeth to wear at a faster than normal rate. While the teeth can withstand normal forces generated from biting and chewing, a grinding habit could be subjecting the teeth to forces beyond their normal range. Over time, this could produce excessive tooth wear and contribute to future tooth loss.

Here, then, are some of the treatment options we may use to stop the effects of stress-related dental habits and provide you with relief from pain and dysfunction.

Drug Therapy. Chronic teeth grinding can cause pain and muscle spasms. We can reduce pain with a mild anti-inflammatory pain reliever (like ibuprofen), and spasms with a prescribed muscle relaxant drug. If you have sleep issues, you might also benefit from occasional sleep aid medication.

A Night or Occlusal Guard. Also known as a bite guard, this appliance made of wear-resistant acrylic plastic is custom-fitted to the contours of your bite. The guard is worn over your upper teeth while you sleep or when the habit manifests; the lower teeth then glide over the hard, smooth surface of the guard without biting down. This helps rest the jaw muscles and reduce pain.

Orthodontic Treatment. Your clenching habit may be triggered or intensified because of a problem with your bite, known as a malocclusion. We can correct or limit this problem by either moving the teeth into a more proper position or, if the malocclusion is mild, even out the bite by reshaping the teeth in a procedure known as occlusal (bite) equilibration.

Psychological Treatment. While the preceding treatments can help alleviate or correct dental or oral structural problems, they may not address the underlying cause for a grinding habit — your psychological response to stress. If you’re not coping with stress in a healthy way, you may benefit from treatments in behavioral medicine, which include biofeedback or psychological counseling.

If you would like more information on dental issues related to stress, 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 “Stress & Tooth Habits.”

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



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