My Blog
By Alvaro Betancur, D.D.S.
November 11, 2017
Category: Oral Health
ActorDavidRamseySaysDontForgettoFloss

Can you have healthy teeth and still have gum disease? Absolutely! And if you don’t believe us, just ask actor David Ramsey. The cast member of TV hits such as Dexter and Arrow said in a recent interview that up to the present day, he has never had a single cavity. Yet at a routine dental visit during his college years, Ramsey’s dentist pointed out how easily his gums bled during the exam. This was an early sign of periodontal (gum) disease, the dentist told him.

“I learned that just because you don’t have cavities, doesn’t mean you don’t have periodontal disease,” Ramsey said.

Apparently, Ramsey had always been very conscientious about brushing his teeth but he never flossed them.

“This isn’t just some strange phenomenon that exists just in my house — a lot of people who brush don’t really floss,” he noted.

Unfortunately, that’s true — and we’d certainly like to change it. So why is flossing so important?

Oral diseases such as tooth decay and periodontal disease often start when dental plaque, a bacteria-laden film that collects on teeth, is allowed to build up. These sticky deposits can harden into a substance called tartar or calculus, which is irritating to the gums and must be removed during a professional teeth cleaning.

Brushing teeth is one way to remove soft plaque, but it is not effective at reaching bacteria or food debris between teeth. That’s where flossing comes in. Floss can fit into spaces that your toothbrush never reaches. In fact, if you don’t floss, you’re leaving about a third to half of your tooth surfaces unclean — and, as David Ramsey found out, that’s a path to periodontal disease.

Since then, however, Ramsey has become a meticulous flosser, and he proudly notes that the long-ago dental appointment “was the last we heard of any type of gum disease.”

Let that be the same for you! Just remember to brush and floss, eat a good diet low in sugar, and come in to the dental office for regular professional cleanings.

If you would like more information on flossing or periodontal disease, please contact us today to schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Understanding Gum (Periodontal) Disease.”

By Alvaro Betancur, D.D.S.
October 27, 2017
Category: Dental Procedures
TimingisEverythingWhenReplacingaTeenagersMissingTooth

There are good reasons, for both health and appearance, to replace a missing tooth with a dental implant or similar restoration as soon as is practical. The bone around a tooth socket diminishes the longer it remains empty, up to 25% the first year. And, of course, your smile is less attractive, especially with a highly visible tooth.

If it’s your teenager, though, you may need to wait on a permanent restoration because their jaws are still developing. An implant placed before completion of jaw development could eventually appear out of alignment with neighboring teeth.

Our biggest concern is protecting bone health at the site of the missing tooth. We can do this and encourage growth by placing bone grafts (processed minerals from another donor) that serve as scaffolds on which surrounding bone can grow. Grafts usually dissolve (resorb) over time, but the rate of resorption can be slowed for a younger patient in need of long-term bone growth.

Planned orthodontic treatment can usually go on as scheduled. The orthodontist may accommodate the tooth loss by adding a temporary tooth within the braces or other device that matches the color and shape of the patient’s natural teeth. The orthodontist will also take care to maintain the empty space for a future implant or other restoration.

A dental implant is considered the best option for a missing tooth, not only for its life-like appearance and durability, but also its ability to encourage bone maintenance. Timing, though, is essential for teenagers. As it grows, the upper jaw will tend to move forward and down. Natural teeth move with this growth; implants, though, are attached differently and won’t move with the jawbone. While the other teeth around them move, the implants can appear to shrink back resulting in an unattractive smile appearance. So waiting until the jaw has finished growing is important.

For most people, jaw growth finishes by age twenty-one for men, women usually faster, but each person is different. The dentist’s expertise and experience, coupled with comparisons of adult family members’ facial appearances, will help determine the right time to undertake a permanent restoration for the best outcome both for health and a permanent, attractive smile.

If you would like more information on treating teenagers with missing teeth, please contact us to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Implants for Teenagers.”

By Alvaro Betancur, D.D.S.
October 12, 2017
Category: Oral Health
Tags: gum recession  
4CausesforGumRecessionandWhatWeCanDoAboutIt

If you’ve noticed some of your teeth seem to be “longer” than you remembered, it’s not because they’ve grown. Rather, your gums have shrunk back or receded to expose more of the underlying tooth.

It’s not just unattractive — gum recession could lead to severe consequences like bone or tooth loss. But before we begin treatment we need to find out why it happened. Knowing the true cause will help us put together the right treatment plan for your situation.

Here are 4 of the most common causes for gum recession and what we can do about them.

The kind of gum tissues you have. There are two kinds of risk factors: those you can control and those you can’t. Because you inherited the trait from your parents, your gum tissue thickness falls into the latter category. Although there are degrees within each, gum tissues are generally classified as either thick or thin. If you have thin tissues, you’re more susceptible to gum recession — which means we’ll need to be extra vigilant about caring for your gum health.

Tooth position. Normally a tooth erupts during childhood in the center of its bony housing. But it can erupt outside of it, often resulting in little to no gum tissue growth around it. The best solution is to move the tooth to a better position within the bony housing through orthodontics. This in turn could stimulate gum growth.

Over-aggressive brushing. Ironically, gum recession could be the result of brushing, one of the essential hygiene tasks for dental health. Consistently brushing too hard can inflame and tear the tissues to the point they begin to recede. Brushing doesn’t require a lot of force to remove plaque: use gentle, circular motions and let the detergents and mild abrasives in your toothpaste do the rest.

Periodontal (gum) disease. This, by far, is the greatest cause for gum recession: an infection caused by built-up bacterial plaque. The weakened tissues begin to detach from the teeth and recede. Gum disease can be treated with aggressive plaque removal and supporting techniques; but it’s also highly preventable. Practicing daily brushing and flossing and regularly visiting your dentist for thorough cleanings and checkups are the best practices for keeping your gums as healthy as possible.

If you would like more information on gum recession, 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.”

By Alvaro Betancur, D.D.S.
September 27, 2017
Category: Oral Health
Tags: ibuprofen   pain management  
NSAIDsforPainManagementisSafe-ifUsedProperly

Millions of Americans regularly use ibuprofen to manage minor pain and swelling. As with other fields in healthcare, the drug is a mainstay in dentistry especially for post-procedural discomfort. But ibuprofen and similar drugs also have side effects that can lead to serious health problems. So, should you be concerned about its safety?

For most people, ibuprofen is safe and effective — but only if used properly. Like aspirin, ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) that reduces pain and inflammation by blocking the effect of substances called prostaglandins, released by injured or damaged tissues. NSAIDs differ in mechanism from pain relievers like steroids or narcotics and don’t have the same side effects, especially the addictive qualities and impaired consciousness potential of narcotics like morphine or codeine. While these more potent drugs are usually reserved for serious injuries or illnesses, NSAIDs like ibuprofen are ideal for mild to moderate pain following routine dental work.

The biggest concern for the use of an NSAID is its tendency to thin the blood, especially if used continuously over several weeks; this can make bleeding control more difficult after an injury. Prolonged overuse has also been linked to erosion of the stomach lining leading to ulcers or bleeding, kidney failure, early miscarriage and repeat heart attacks for patients with cardiovascular disease.

With this in mind, we recommend that adults take no more than 2,400 milligrams of ibuprofen during one twenty-four hour period for short-term pain relief unless otherwise recommended by a doctor. Research has shown that a single 400-milligram dose of ibuprofen is safe and effective for relieving even severe post-operative pain for about five hours in most people. On the other hand, we don’t recommend a NSAID during pregnancy or for people with a history of intestinal bleeding or heart attacks.

Taking into account your medical history and the procedure you’ll be undergoing, we will recommend the best pain management medication for your situation. In most cases, ibuprofen will be an effective means to reduce your discomfort level and, taken properly, will not pose a danger to your overall health.

If you would like more information on dental pain management, 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 “Treating Pain with Ibuprofen.”

By Alvaro Betancur, D.D.S.
September 12, 2017
Category: Oral Health
GameSetMatchMilosRaonicSaysAMouthguardHelpsHimWin

When you’re among the top players in your field, you need every advantage to help you stay competitive: Not just the best equipment, but anything else that relieves pain and stress, and allows you to play better. For top-seeded Canadian tennis player Milos Raonic, that extra help came in a somewhat unexpected form: a custom made mouthguard that he wears on the court and off. “[It helps] to not grind my teeth while I play,” said the 25-year-old up-and-coming ace. “It just causes stress and headaches sometimes.”

Mouthguards are often worn by athletes engaged in sports that carry the risk of dental injury — such as basketball, football, hockey, and some two dozen others; wearing one is a great way to keep your teeth from being seriously injured. But Raonic’s mouthguard isn’t primarily for safety; it’s actually designed to help him solve the problem of teeth grinding, or bruxism. This habitual behavior causes him to unconsciously tense up his jaw, potentially leading to problems with muscles and teeth.

Bruxism is a common issue that’s often caused or aggravated by stress. You don’t have to be a world-class athlete to suffer from this condition: Everyday anxieties can have the same effect. The behavior is often worsened when you consume stimulating substances, such as alcohol, tobacco, caffeine, and other drugs.

While bruxism affects thousands of people, some don’t even suspect they have it. That’s because it may occur at any time — even while you’re asleep! The powerful jaw muscles that clench and grind teeth together can wear down tooth enamel, and damage both natural teeth and dental work. They can even cause loose teeth! What’s more, a clenching and grinding habit can result in pain, headaches and muscle soreness… which can really put you off your game.

There are several ways to relieve the problem of bruxism. Stress reduction is one approach that works in some cases. When it’s not enough, a custom made occlusal guard (also called a night guard or mouthguard) provided by our office can make a big difference. “When I don’t sleep with it for a night,” Raonic said “I can feel my jaw muscles just tense up the next day. I don’t sense myself grinding but I can sort of feel that difference the next day.”

 An occlusal guard is made from an exact model of your own mouth. It helps to keep your teeth in better alignment and prevent them from coming into contact, so they can’t damage each other. It also protects your jaw joints from being stressed by excessive force. Plus, it’s secure and comfortable to wear. “I wear it all the time other than when I’m eating, so I got used to it pretty quickly,” said Raonic.

Teeth grinding can be a big problem — whether you put on your game face on the court… or at home. If you would like more information about bruxism, contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Stress & Tooth Habits” and “When Children Grind Their Teeth.”





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