Goshen Village
1544 Paoli Pike
West Chester, PA 19380
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Posts for category: Oral Health

By Premier Dentistry
October 30, 2011
Category: Oral Health
Tags: oral health   tmj   tmd  

Temporomandibular Disorder (TMD), which was formerly known as Temporomandibular Joint Disorder (TMJ), is an interesting condition because it can be hard to diagnose and often mimics many other conditions. It arises when there are problems inside the temporomandibular joint, and the muscles attached to it, causing pain. When treating TMD, we typically start by relieving the symptoms of pain and discomfort with heat, mild pain medications, a diet of soft foods, and some simple jaw exercises. We feel that it is critical to address your pain issues as soon as possible before preceding any further with treatment.

Once we have provided some pain relief and after having completed a thorough history and examination, we can move to the next phase of treatment. This may include the introduction of a bite guard or some form of oral appliance therapy. A bite guard is an unobtrusive yet rigid plastic horseshoe-shaped appliance that fits snuggly over the biting surfaces of the upper teeth. When in place and properly adjusted, this custom-made appliance allows your muscles and therefore jaw joints to relax. And it will prevent you from grinding your teeth, another contributing factor to TMD. We will probably ask you to wear it when sleeping or in times when you are feeling stressed when clenching or grinding habits may be active. We may also suggest that you obtain some relaxation therapy and/or biofeedback from a licensed therapist, as this can prove helpful in treating TMD.

If you have suffered from frequent jaw pain in the past and suspect that you may have TMD, please let us know so that we can address it at your next appointment. Or if you are currently in constant or severe pain, contact us immediately to schedule an appointment. You can learn more about the signs, symptoms, and treatment options for TMD by reading “TMD — Understanding The Great Imposter.”

By Premier Dentistry
October 23, 2011
Category: Oral Health

Grinding, clenching, and gritting your teeth are common reactions to stress — but their results can be quite complex. Here are some questions and answers that will fill you in on what you may not know about this widespread problem.

My dentist said I was bruxing. What does that mean?
Bruxing means that your teeth are grinding upon each other. Many people carry out this habit subconsciously and are not even aware that they are doing it.

Is bruxing or gritting harmful?
Such habits are called “parafunctional” (from para, meaning outside, and function, meaning purpose). This is because these stress habits exert much larger biting forces — as much as ten times more — than in normal biting and chewing activities. This excess pressure can cause damage to jaw joints and muscles, resulting in muscle spasm and pain; and to the teeth, resulting in wear, fractures or looseness. They can also cause headaches, earaches, and even neck and backaches because of the pressures on various structures in the face and mouth.

What is the usual treatment for problems arising from these stress habits?
The first thing we want to do is relieve your pain and discomfort. Second, we want to stop future damage. Application of heat or cold is helpful, and mild anti-inflammatory and muscle relaxant drugs are prescribed for pain and muscle spasm. To prevent future occurrences, we may treat you with biofeedback or refer you to someone who can offer psychotherapy.

What is a night guard and how can it help?
A night guard is an unobtrusive thin plastic appliance that is made to fit over the biting surfaces of your upper teeth. These guards are so unobtrusive that they can even be worn during the day if your stress level is so high that you grind your teeth during the day. The guard is adjusted to leave the lower teeth free to move against the surface of the guard, but they cannot bite into the upper teeth. This prevents wear on the teeth and lets the jaw muscles relax, preventing the pain of muscle spasm.

Contact us today to schedule an appointment to discuss your questions about stress and tooth grinding. You can also learn more by reading the Dear Doctor magazine article “Stress & Tooth Habits.”

By Premier Dentistry
October 09, 2011
Category: Oral Health
Tags: CAT scans  

CAT scans or Computer Assisted Tomograph scans have been around for years. However, it is quickly becoming the new standard in dentistry. The reasons are clear both literally and figuratively, as they provide our office with millions of pictures so that we can combine them together to create 3-dimensional (3-D) images. Prior to this technology, we could only image the body in 2-dimensions with x-rays (radiographs) — a technology first developed by Roentgen.

One of the best features of CAT scans and CBCT (Cone Beam Computed Tomography) scanning is that they enable us to see and experience the body from the inside. Having this ability changes (and many times) improves upon the way we diagnose. Here's how they work in very simplistic terms. Picture your favorite multi-layered cake with each layer representing an image. A three-layer cake requires just three images. For us to build a 3-D image similar to the cake, we require millions of very thin layers (images) that we put together, one on top of another, until our results, one 3-D image. And by having so many thin layers, we are best able to diagnose. For example, in our cake analogy, it is easier to determine if the cake contains finely chopped nuts, berries or other ingredients when you cut numerous very thin slices of cake to examine versus having one large chunk of cake.

It is important to note that in our office we may not recommend using this technology in all cases, as it may not be necessary for your particular diagnosis and/or treatment. While the technology can prove invaluable, it is quite expensive and a simple 2-D x-ray may provide everything we need. However, some dental specialty areas where CAT scans are currently used include:

  • Orthodontists and pediatric dentists
  • Cosmetic dentists and tooth replacement specialists (prosthodontists)
  • Oral surgeons
  • Root canal specialists (endodontists)
  • Gum specialist (periodontists)

To learn more about CAT scans and how they are used in the various specialty areas, read the Dear Doctor magazine article “CAT Scans in Dentistry.” Or you can contact us today to schedule an appointment to discuss your specific questions.

By Premier Dentistry
August 21, 2011
Category: Oral Health
Tags: oral health   oral cancer  

Let's talk about oral cancer. Yes, it's a scary subject — but the truth is, the more you know about it, the better able you are to protect yourself.

  1. Who is more likely to get oral cancer? Because of your genetic disposition — heredity — men are twice as likely to develop oral cancer as women. African-Americans have a higher incidence than Caucasians. The disease is also related to aging, although in recent years many young people have been diagnosed with this disease.
  2. Are some habits related to development of oral cancer? Risk factors include use of tobacco in any form, both smoking and chewing, chronic exposure to sun, and consumption of alcohol. Moderate to heavy drinkers have a three to nine times greater risk than non-drinkers. Tobacco smokers are at five to nine times greater risk than non-users, and users of snuff or chewing tobacco are at four times greater risk than non-users.
  3. Where do most oral cancers occur? The most common areas are in the mouth itself, the lips, the tongue, and the pharynx (back of the mouth and throat).
  4. What are the statistics for survival after treatment for oral cancer? Conquering cancer depends most on early detection. Since most cases of oral cancer are discovered at a late stage, survival is poor, with less than 60% surviving five years after treatment. When oral cancers are detected early, the survival rate is more than 80%.
  5. What are some of the symptoms of oral cancer? Most oral cancers are “squamous” (small scale-shaped) cell carcinomas in the lining of the mouth. Signs of these cancers can be seen as white or red patches in the early pre-cancerous stage. These develop into an ulcer that does not heal.
  6. When should you seek medical help? If you notice color changes (white or red patches) or sores or ulcers anywhere in your mouth that do not heal within two or three weeks, go to your dentist for a checkup right away. Sometimes the sores resemble cold sores. A definitive diagnosis requires a tissue biopsy, in which a small piece of tissue is removed under anesthesia and taken to a lab for microscopic examination.
  7. What about regular routine examinations? An oral cancer examination should be part of your visit to our office. We will inspect your face, neck, lips and mouth for signs of cancer, feel the floor of the mouth and sides of the neck for any lumps, examine your tongue and the back of your throat. The American Cancer Society recommends a cancer related check-up annually for all individuals aged 40 and older and every three years for those between 20 and 29.

Contact us today to schedule an appointment to discuss your questions about oral cancer. You can also learn more by reading the Dear Doctor magazine article “Oral Cancer.”

By Premier Dentistry
August 14, 2011
Category: Oral Health
Tags: oral health   tooth decay   chewing gum  

Can chewing gum prevent cavities? Yes! It can if the gum is sweetened with xylitol.

What is xylitol?
Xylitol is a type of “sugar alcohol,” similar to sorbitol and mannitol, sugar replacements that are used in many low calorie foods. Xylitol occurs naturally in many fruits and vegetables and is obtained from the bark of birch trees, coconut shells and cottonseed hulls. It looks and tastes like sugar and is a diabetic-safe, low-calorie carbohydrate.

How does xylitol stop cavity formation?
Decay starts when certain bacteria break down sucrose (regular table sugar) and produce acids that dissolve the minerals in the enamel, the outer protective layer of your teeth. When the decay-causing bacteria try to consume xylitol, they are unable to break it down, and instead they begin to starve.

A normal mouth contains a large population of bacteria, and it is better for your teeth to have more “good” bacteria of the kind that do not cause cavities. Xylitol also stops your saliva from becoming acidic, so your mouth becomes a better environment for the “good” bacteria.

Chewing xylitol gum also increases your flow of saliva. Saliva contains calcium and fluoride and helps give these minerals back to your teeth (re-mineralization), undoing some of the effects of the cavity-causing bacteria. This makes chewing xylitol gum a particularly good solution for people who suffer from dry mouth.

How much xylitol do you need to prevent cavities?
We recommend that you chew or suck on two pieces of xylitol gum or two pieces of xylitol candy for five minutes following meals or snacks, four times daily — if you are at moderate to extreme risk for cavities. The target dose of xylitol is 6 to 10 grams (one or two teaspoons) spread throughout the day. Prolonged gum chewing is not advised, so most xylitol-sweetened products contain flavor that only lasts a short time to discourage excessive chewing. The only side effect of too much xylitol ingestion is that it may have a mild laxative effect.

I don't like chewing gum. Is there another way to get xylitol?
People who don't like to chew gum have the option of using xylitol in mints, candies, mouthwash, toothpaste, or mouth sprays. For these individuals, a minimum dose is 5 to 6 grams (one teaspoon) three times per day.

So now you can add xylitol to the list of ways to fight cavities: daily brushing and flossing, and regular professional cleanings — and chewing xylitol gum.

Contact us today to schedule an appointment to discuss your questions about xylitol and other methods of preventing tooth decay. You can also learn more by reading the Dear Doctor magazine article “Xylitol in Chewing Gum.”



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  • Member of Pennsylvania Dental Association
  • Member ot Delaware Valley Osseointegration Society
  • Governor of Dental Society for Chester and Delaware Counties

 

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