My Blog
By Margret Quimby, DDS
June 03, 2021
Category: Dental Procedures
Tags: braces  
LingualBracesAThirdChoiceforMovingTeeth

First, there were braces; then came removable clear aligners—both great ways to straighten teeth. But braces with their metal brackets and wires aren't the most attractive look. And, although nearly invisible aligners improve appearance, they don't work in every bite situation (although their range has improved of late).

But now a third choice has emerged: lingual braces. Like their traditional counterparts, lingual braces are fixed in place—but on the back side of the teeth rather than the front. Instead of "pushing" teeth toward new positions, they "pull" them, arriving at the same "destination" by another path.

This new method came about simultaneously by two different orthodontists a world apart and for different reasons. A Beverly Hills dentist was looking for an invisible form of treatment similar to clear aligners for his appearance-conscious patients. A Japanese dentist wanted an alternative that would reduce the risk of damage or injury posed by traditional braces to his martial arts patients.

Lingual braces (referring to their proximity to the tongue) address both of these concerns. All of the brackets and wiring are positioned out of sight. And because they're shielded by the teeth, they're not as likely to be damaged or cause injury following hard contact to the face—a great benefit for athletes, law enforcement officers and, yes, martial artists.

Even so, lingual braces won't replace the other two methods any time soon. You'll need to consider other factors, such as that lingual braces can cost up to a third more than traditional braces. And although their availability is steadily growing, not all orthodontists have been trained to offer lingual braces, so you may have to widen your search radius for a provider near you.

You may also find it takes a bit of time to get used to the feel of lingual braces. Upper braces can affect speech ability, at least initially, and the lower ones can interfere with tongue comfort. Most people, though, do adjust to them within a week or so.

But by and large, lingual braces do offer a fixed option that's out of sight, out of mind. With this newer orthodontic choice, you now have three good options for achieving a healthier mouth and a more attractive smile.

If you would like more information on methods for straightening teeth, 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 “Lingual Braces.”

By Margret Quimby, DDS
May 24, 2021
Category: Oral Health
Tags: gum recession  
GumRecessionCanHarmYourOralHealthandYourSmile

Your gums don't just attractively frame your teeth—they protect them as well. If they shrink back (recede) from their normal covering, portions of the teeth could become exposed to bacteria and other hazards.

Unlike the visible crown, which is protected by enamel, the tooth root depends largely on the gums as a shield against bacteria and other hazards. When the gums recede, it exposes the roots and makes them more susceptible to disease or trauma. It may also cause sensitivity to hot and cold foods as the now exposed dentin gets the full brunt of temperature and pressure sensations once muffled by the gums.

There are actually a number of causes for gum recession. In rare cases, a tooth may not have erupted normally within its bony housing, which inhibits the gums from covering it fully. Thinner gum tissues, passed down genetically, are also more susceptible to recession. And a person can even damage their gums and cause them to recede if they brush too aggressively.

The most common cause, though, is advanced periodontal (gum) disease. This bacterial infection arises from dental plaque, a thin biofilm that accumulates on tooth surfaces, usually because of poor hygiene practices. As the infection and resulting inflammation in the gums worsens, they lose their attachment to teeth resulting in a number of harmful outcomes that include recession.

The first step then in treating gum recession is to treat the underlying problem as much as possible. In the case of gum disease, effective treatment could stop mild to moderate recession and sometimes reverse it. For more extensive recession, a patient may need gum grafting surgery to help regenerate lost gum tissue.

You can help prevent gum disease, and thus lower your risk for recession, with daily brushing and flossing to remove bacterial plaque. Likewise, see your dentist at least twice a year for dental cleanings to remove any residual plaque and tartar (hardened plaque).

You should also visit your dentist promptly if you notice swollen or bleeding gums, or more of your teeth surfaces showing. The earlier your dentist diagnoses and begins treatment for gum recession, the better your chances for a healthy and more attractive outcome.

If you would like more information on maintaining good gum health, 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.”

AreYourTeethSensitivetoWhiteninglikeDrewBarrymoresHeresWhatYouCanDo

Best known for her roles in E.T. and Ever After, and more recently as a suburban mom/zombie on Netflix's Santa Clarita Diet, Drew Barrymore is now bringing her trademark quirky optimism to a new talk show, The Drew Barrymore Show on CBS. Her characteristic self-deprecating humor was also on display recently on Instagram, as she showed viewers how she keeps her teeth clean and looking great.

In typical Drew fashion, she invited viewers into her bathroom to witness her morning brushing ritual (complete with slurps and sloshes). She also let everyone in on a little insider Drew 411: She has extremely sensitive teeth, so although she would love to sport a Hollywood smile, this condition makes teeth whitening difficult.

Barrymore's sensitivity problem isn't unique. For some, bleaching agents can irritate the gums and tooth roots. It's usually a mild reaction that subsides in a day or two. But take heart if you count yourself among the tooth-sensitive: Professional whitening in the dental office may provide the solution you are looking for.

In the dental office, we take your specific needs into account when we treat you. We have more control over our bleaching solutions than those you may find in the store, allowing us to adjust the strength to match your dental needs and your smile expectations and we can monitor you during treatment to keep your teeth safe. Furthermore, professional whitening lasts longer, so you won't have to repeat it as often.

After treatment, you can minimize discomfort from sensitive teeth by avoiding hot or cold foods and beverages. You may also find it helpful to use a toothpaste or other hygiene product designed to reduce tooth sensitivity.

The best thing you can do is to schedule an appointment with us to fully explore your problems with sensitivity and how we may help. First and foremost, you should undergo an exam to ensure any sensitivity you're experiencing isn't related to a more serious issue like tooth decay or gum recession.

Having a bright smile isn't just advantageous to celebrities like Drew Barrymore—it can make a difference in your personal and professional relationships, as well as your own self-confidence. We can help you achieve that brighter smile while helping you avoid sensitivity afterward.

If you would like more information about teeth whitening, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Important Teeth Whitening Questions Answered.”

By Margret Quimby, DDS
May 04, 2021
Category: Oral Health
Tags: oral health  
GumDiseaseCouldImpactMoreThanYourOralHealth

Preventing periodontal (gum) disease not only preserves your teeth and gums, it might also benefit the rest of your health. There's growing evidence that gum disease has links to other systemic diseases.

Gum disease usually starts with dental plaque, a thin film of bacteria and food particles, which triggers a bacterial gum infection. Left untreated, the infection advances and steadily breaks down the gums' attachment to teeth.

This can create large ulcerated areas that are too weak to prevent the passing of bacteria and toxins into the bloodstream and other parts of the body. There's growing evidence from epidemiology (the study of the spread and control of disease) that this bloodstream transfer, as well as the inflammation that accompanies gum disease, could affect other body-wide conditions or diseases.

Diabetes. This chronic condition occurs when the body can't adequately produce insulin, a hormone that regulates sugar (glucose) in the blood, or can't respond to it. Diabetes can inhibit healing, cause blindness or lead to death. Both diabetes and gum disease are inflammatory in nature, and there's some evidence inflammation arising from either condition may worsen the other.

Heart disease. Heart attack, congestive heart failure, stroke and other cardiovascular diseases are a leading cause of death. Like diabetes and gum disease, these heart-related conditions are also characterized by inflammation. There are also specific types of bacteria that arise from gum disease that can travel through the body and increase the risk of heart disease.

Arthritis. An autoimmune disease, rheumatoid arthritis causes debilitating pain, particularly involving the joints, and leads to decreased mobility. Interestingly, many newly diagnosed arthritis patients are also found to have some form of periodontal disease—the two diseases, in fact, follow a similar development track. Although this may hint of a connection, we need more research to determine if there are indeed links between the two diseases.

Regardless of any direct relationships between gum disease and other conditions, preventing and treating it can improve both your oral and general health. You can lower your risk of gum disease by practicing daily brushing and flossing and undergoing regular dental cleanings to remove plaque. And at the first sign of gum problems, see your dentist as soon as possible for early intervention—the earlier the better.

If you would like more information on oral health care, 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 “Good Oral Health Leads to Better Health Overall.”

By Margret Quimby, DDS
April 24, 2021
Category: Oral Health
Tags: sensitive teeth  
TreatingToothSensitivityDependsonItsCause

A scoop of ice cream is one of life's little pleasures.┬áBut for one in three Americans, it could be something altogether different—an excruciating pain when cold ice cream meets teeth. This short but painful experience that can happen when dental nerves encounter hot or cold temperatures is called tooth sensitivity.

A look at tooth anatomy will help explain why. Teeth are mainly composed of outer enamel, a layer of nerves and blood vessels within the tooth called the pulp, and dentin, a porous layer in between. The pulp nerves pick up temperature and pressure sensations from outside the teeth through a network of tiny passageways (tubules) in the dentin. Enamel muffles these sensations before traveling the tubules, which prevents overstimulation of the nerves.

This careful balance can be disrupted, however, if the enamel becomes eroded by acid from foods or beverages, or as a byproduct of bacteria. This exposes the underlying dentin to the full brunt of outward sensations, which can then impact the nerves and cause them to overreact.

This hyper-sensitivity can also occur around the tooth roots, but for a different reason. Because the gums primarily protect this area rather than enamel, the roots can become hyper-sensitive if they lose gum coverage, a condition known as gum recession caused mainly by gum disease or over-aggressive hygiene.

Besides using dental products that block nerve sensation, reducing sensitivity largely depends on addressing the underlying cause. If gum disease, the focus is on removing plaque, a bacterial film on dental surfaces that causes and sustains the disease. Stopping an infection allows the gums to heal and hopefully regain their original teeth coverage. More advanced cases, though, may require grafting surgery to foster gum regeneration.

If the cause is enamel erosion or other results of decay or trauma, we can utilize a number of treatments depending on the extent of tooth damage including cavity filling, root canal therapy or crowning. As a last resort, we may need to remove a tooth that's beyond reasonable repair.

If you've begun to experience sensitive teeth, it's important that you see us as soon as possible. The earlier we can diagnose the cause, the less invasive we can be with treatments to ease or even stop this most unpleasant experience.

If you would like more information on tooth sensitivity, 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 “Treatment of Tooth Sensitivity.”





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