Author: Dr. Chea Rainford

The Headache Question

Chronic symptoms of the head and neck can often be attributed to:

 Headache — the temporalis muscle (it closes and clenches the jaw)

 Sinus pressure and pain — the lateral pterygoid muscles (it moves the jaw side to side and/or forward)

 Neck stiffness and pain — trapezius muscle (it stabilizes the skull during jaw clenching and grinding)

Dental offices have treated and helped more and more people with their headache problems. For years, we assigned all of these names to headaches, like muscle tension headaches, neuralgia, migraine and so on, and it seems that many headache patients share one very common trait- They clench or grind their teeth at night!

Most medical research has shown that headaches, even people with classical migraine headaches, have no physical reason, no vascular problems and no neurological problems; in fact their physician’s exam will give no physical reason for the pain. Many patients have had CAT scans and MRI’s that were negative, and find that drugs really don’t help their problem; instead the medication makes them groggy and “drugged out.”

What we have discovered is that people who can control their nighttime clenching and grinding will get tremendous relief for their headaches and neck aches. Many people do so much unconscious clenching of their jaw muscles that when they wake up, their teeth are sore, their muscles are already tired, and they are set up for the beginning of a headache from the start of the day, if they don’t wake up with one.

One effective treatment utilizes an NTI appliance (short for nocioceptive trigeminal inhibition), a dental device that fits between the upper and lower front teeth. (Detailed information can be gotten from the website at http://www.headacheprevention.com/ ) The simple fact is that this device reduces the intensity of nighttime parafunction by 70 percent immediately, which can explain why so many patients wake up feeling better very quickly.

A traditional dental mouthpiece, or splint, reduces the resistance to side-to-side movement, thereby, reducing the effort and resultant strain to the jaw joint and sinuses (so long as clenching intensity isn’t too intense). However, the same splint also provides an ideal clenching surface, where maximum clenching intensity may increase and/or allow jaw joint problems to perpetuate.

Many patients run the gamut of the medical world’s attempts to control their headaches- with multiple drugs, injections and so on, without ever thinking that the pain might be muscular in origin. But just like back pain is often muscle spasm, the pain we call TMJ, as well as headaches of many sorts are very much caused by overuse of the muscles of closing the jaws.

We would recommend that if you or a loved one has chronic headache problems, that you go to the web site, or give us a call and let us take a look. It can do no harm, and it might very well make a huge difference in your lives!

Invisible Braces Bring Visible Results

Invisalign® utilizes 3-D computer technology with clear, plastic removable “aligners” to move teeth at a rate similar to traditional braces, but without any metal or wires. The “aligners” can be removed to eat and clean your teeth and are generally undetectable when worn. The computer imaging technology can predetermine and develop a treatment plan from the initial position of the patient’s teeth to their final desired position. From this a series of custom-made “aligners” are fabricated. Each “aligner” moves teeth incrementally and is worn for about two weeks, then replaced by the next in the series until the final position is achieved.

For years, orthodontists and dentists have used removable appliances for limited treatment. Now Invisalign treats a broader range of cases with greater precision. The principal difference is that Invisalign not only controls forces, but also controls the timing of the force application. At each stage, only certain teeth are allowed to move, and these movements are determined by the orthodontic treatment plan for that particular stage. This results in an efficient force delivery system.

Most people experience temporary, minor discomfort for a few days at the beginning of each new stage of treatment. This is normal and is typically described as a feeling of pressure. It is a sign that Invisalign is working – sequentially moving your teeth to their final destination. This discomfort typically goes away a couple of days after you insert the new “aligner” in the series.

This procedure is especially popular for adults who previously had orthodontic treatment when they were younger and have experienced regression as they’ve aged. Rather than repeat the inconveniences and discomfort of braces all over again, Invisalign provides an appealing alternative.

A common concern is whether or not this treatment is covered by dental insurance. Because dental benefits differ significantly from policy to policy, each patient should review their coverage. However, if a patient has orthodontic coverage, Invisalign should be covered to the same extent as conventional braces. When treatment is complete, some patients might need a positioner, or conventional retainer. Other patients might need a clear plastic retainer similar to the ones Invisalign makes. Please discuss these possibilities with our office. Every patient is different and outcomes vary.

Tired Of Having Worn Teeth?

How we perceive our smile and appearance affects our self-esteem, our moods and how we function in social and business relationships. Common conditions that impact negatively on your smile include broken, cracked or worn teeth, discolored teeth, missing teeth, crooked teeth, decayed teeth, gaps between your teeth and/or “gummy smiles.” Each patient and each specific circumstance must be evaluated on its own merits. Factors such as occlusion [bite], oral habits, available space, health of the gum tissue, severity of the problem and patient expectation must be taken into consideration while planning your cosmetic makeover. Worn teeth are not only cosmetically displeasing, but they can result in functional problems also. This situation may lead to headaches, oral pain or periodontal [gum] conditions.

When teeth are worn down severely, there is loss of vertical height of the overall bite. This can be detrimental to one’s face, portraying a “collapsed” appearance. The muscles that open and close one’s mouth get use to certain patterns and degree of mouth opening. When trying to restore the normal bite and vertical height of one’s teeth, patients are often kept longer in temporary restorations to be sure that their muscles can tolerate the size of their new teeth. With a proper, carefully thought out treatment plan, the cosmetic and functional results can be dramatic. Call our office if you think you’re a candidate for this type of procedure.

The Instant Makeover

More and more these days, instant sorts of makeovers are shown on television shows and in the news. It seems that once a person makes the commitment to proceed, they want to get moving quickly. Our practice has noticed that too, and we are doing many more “makeovers” where we finish the entire treatment in a short period of time.

It seems like many people just hit a point where they have “had it” with their smile or their appearance, and decide it’s time to look better. The next steps are important, because how happy a person is with the results, depends on how the treatment is approached and accomplished.

Here is what we do when someone presents with some true esthetic concerns and is ready to do something about them:

 First of all, we interview the patient to determine their true desires, needs and wants. Everything starts with getting a good understanding of what the patient wants and expects.

 We have to do a complete exam to understand the underlying health of the teeth, gum and bone, and how the bite, or occlusion, is working.

 We take photographs, and impressions of the teeth for what we call study models. Sometimes we ask the dental lab to create the desired appearance in an ideal wax smile. It is a fun process.

Once we know where we want to be at the finish, the process of getting there is usually just a couple of long and relaxed appointments.

In the First Visit the teeth are prepared and impressions are taken; the patient leaves with plastic temporary restorations that are an actual preview of the desired end point. These provisional restorations allow us to personalize shape, size and color so that before the final porcelain restorations, we know that the patient is going to love their smile. This works really well, relieving much of the anxiety of someone not knowing how they will look.

The patient generally receives the final restorations in the Second visit, where we take off the temporary crowns/veneers and try in the permanent ones. If they are fitting and looking like we want, these restorations are permanently bonded to the teeth. Subsequent visits are made as necessary for any follow up or adjustments.

Do Natural Teeth Whiteners work?

Would you believe that you can find natural teeth whiteners in your refrigerator? Many people are hesitant to use chemicals or commercial products and therefore prefer natural teeth whiteners. One such example of a simple natural tooth whitener is rubbing the inside of an orange peel on your teeth. While fruits and vegetables can be subtle natural teeth whiteners, their effectiveness doesn’t quite match the hype.

  • Orange Peels: Could an orange peel as a natural teeth whitener be too good to be true? Most likely. While this natural tooth whitener may offer a minimal amount of whitening, it’s not worth the potential damage it can cause your teeth. Because oranges are naturally acidic, using orange peels as a natural teeth whitener can actually cause damage to the enamel of your teeth, weaken your teeth, and have lasting negative effects on your smile.
  • Vegetables: Some claim that a simple way to whiten your teeth is to eat natural teeth whiteners like celery, cucumber, broccoli, and carrots. These crunchy fruits and vegetables work to gently scrub away stains on your teeth and increase production of saliva, which helps reduce plaque-causing bacteria. Unfortunately, while fruits and vegetables may be effective in washing away food particles and reducing plaque, you will have to wait an extremely long time—maybe even your lifetime—in order to see any whitening results. These natural teeth whiteners perform a very subtle role in teeth whitening, therefore the visible effects are minimal. Plus, if you drink coffee, tea, or cola often, you’re easily canceling out any whitening effects of these natural teeth whiteners.
  • Baking Soda: You’ve probably heard about the power of baking soda as a natural teeth whitener. While it’s found in many toothpastes as a natural teeth whitener, it doesn’t have the same effect when applied to your toothbrush and used directly on your teeth. Those who espouse the whitening action of baking soda as a natural teeth whitener claim that all you need to do is wet your toothbrush, sprinkle it with baking soda, and brush carefully. If you don’t brush carefully, you could grind the baking soda into your gums and cause irritation. As a natural teeth whitener, baking soda will provide a tiny amount of whitening, but it is also true that you can get much more dramatic and life-changing effects by using a whitening toothpaste containing baking soda combined with at-home teeth-whitening technology.
  • Strawberries & Baking Soda: A wide variety of household products can be used in combination to make a homemade teeth whitener. A popular homemade teeth whitener you may have heard about is a combination of crushed strawberries and baking soda. Those who swear by this method claim that you just need to crush a cup or so of strawberries and mix with baking soda. Supposedly, this homemade teeth whitener can be used just like regular toothpaste. You are advised to brush gently to avoid irritation to your gums and finish by brushing again with your favorite fluoride toothpaste. Unfortunately, not only is this not very effective as a homemade teeth whitener, this homemade teeth whitener can actually be harmful. Strawberry seeds easily become trapped in the spaces between your teeth. It is best to stay away from this homemade teeth whitener and instead make a small investment of $25-50 in scientifically-backed teeth-whitening technology. Teeth whitening strips from reputable brands provide dramatic teeth-whitening results and have been proven safe on teeth and gums.
  • Brushing, Rinsing & Flossing: Whitening teeth naturally can be challenging in a busy world full of delicious, tooth-discoloring temptations like coffee, tea, red wine, chocolate, and cola. Oral hygiene is an important tool for counterbalancing the effects of these temptations on your teeth and whitening teeth naturally. This includes brushing and rinsing, and last but not least, flossing. However, not even the combination of brushing, rinsing, and flossing is a fool-proof solution for whitening teeth naturally and solving a stained smile. Flossing is an important part of your overall oral hygiene regimen. It helps dislodge food particles that may be stuck in your teeth, which can help reduce bacteria and plaque that lead to tartar build-up and tooth discoloration. But while flossing is an important component of overall whitening teeth naturally and will help prevent future discoloration, it can’t brighten a smile that is already stained and yellow.

New Computer Technology Makes Invisible Braces Possible

Now you can have straight teeth without braces? We are a certified CLEARCORRECT provider and can provide a new alternative for adults who wish to straighten their teeth, but do not want traditional braces.

This method uses a series of clear tooth aligners to move teeth progressively into alignment. The aligners are virtually invisible because they are made of a thin, clear plastic which snap-fits comfortably over the teeth. Patients wear each set of aligners for two to three weeks, removing them only for eating and brushing. A patient may need as many as twelve to forty sets of aligners to fully straighten their teeth over a six month to two year period.

Orthodontists have been providing minor realignments with this type of appliance for years. Recently however, using 3-D computer imaging technology with the CLEARCORRECT system, these new invisible aligners have been able to straighten even moderately crowded or spaced teeth. Adults who have more severe crowding will still require braces and will be happy to know that we offer ceramic braces.

The CLEARCORRECT treatment is currently available to adults and teenagers. It is a welcome choice to those who feel that braces would not be an option for them, but who do want to have straight teeth. Consultations in our office are always free of charge so ask us, and we will be happy to schedule one for you. We will provide you with an evaluation and advise you if CLEARCORRECT is right for you!

The Right Age To Consider Orthodontics

The American Association of Orthodontics recommends that a child first be seen by an orthodontist as early as age 7 or earlier should a parent or the family dentist discover a problem. The timing of orthodontic treatment is extremely important and greatly affects the treatment result. Since no two patients are alike, there is no absolute, specific age that is best to begin treatment.

Many progressive treatments are now available for patients six to eleven years old that provide significant benefits, especially in jaw irregularities. These treatments may also prevent certain conditions from worsening. Treating children during their growth stages enables us to achieve results that may not be possible when the face and jaw bones have fully developed. This early treatment can simplify or eliminate additional treatment.

Early diagnosis and treatment by an orthodontic specialist can help guide facial growth and tooth eruption, thus preventing more serious problems from developing. Our goal is to reduce treatment time in full braces and to provide the best and most stable results possible.

Potential Benefits of Timely Treatment

 Influence growth of the jaws in a positive manner

 Improve the width of the dental arches

 Reduce the need to extract permanent teeth

 Reduce or eliminate the need for jaw surgery

 Lower the risk of trauma to protruded front teeth

 Correct harmful oral habits

 Simplify and shorten treatment time

 Increase the stability of final treatment results

 Reduce the likelihood of impacted permanent teeth

 Improve speech development

 Improve the position of the first permanent molars

 Guide permanent teeth into more favorable positions

 Improve lip closure

 Preserve or gain space for erupting teeth

 Reduce the potential for damage to the Temporal Mandibular Joint

 Better cooperation before the teenage years

Help! I Broke My Tooth!

Almost every day we get a call from a patient who has broken a tooth, and generally it means that to save the tooth, we have to place a crown or permanent restoration over it to keep it from breaking further. Sometimes the tooth can’t be saved and that is a real bummer!

What causes teeth to break? Well, there are several factors, one of which we see in almost all tooth fractures. The most common contributing factor is Silver amalgam fillings- these fillings have the unique property of enlarging as they age. So, there seems to be some outward pressure on the tooth and if someone bites just the right (or wrong) way, you hear that crack!

Now this tooth broke in several planes at once, and had to be removed; there wasn’t enough sound tooth structure to save it! So an implant or bridge needed to be done.

This is a more common sort of fracture. The inside aspect of the tooth just shears away. Luckily, this tooth can be saved with a crown, after first making sure there is no decay present.

The second common factor is bruxism- the habit of grinding or clenching the teeth. Many bruxers break teeth that don’t even have fillings in them, but they always have a higher percentage of broken teeth than people who don’t brux or clench.

If you or someone you know does grind their teeth and are worried about a tooth or some teeth, don’t hesitate to give us a call and we will be glad to check it out for you! Don’t wait until it hurts!

Child’s First Visit To The Dentist

We would like to see your child as soon as the first tooth erupts (around six months of age). The most important goals of this first visit are to introduce your child to the office surroundings and to develop a trust in the dentist and our staff. We view this visit as an icebreaker. If your child is too frightened, uncomfortable or uncooperative, we may have to re-schedule several short visits. You will be charged a reasonable fee for the time. Please do not try to explain the first visit yourself. Do not use phrases like “Be brave!” or “Don’t be afraid”. Don’t offer them a bribe with special treats to get them to the office. Rather be positive and reassuring that the visit will be fun and one in which to look forward.

The appointment should be 15-30 minutes and may include necessary x-rays, a gentle, comprehensive examination of the teeth, gums, jaws, bite and oral tissues. This is both to observe any problems and to establish a baseline so we can monitor your child’s growth and development. Depending on your child’s age and cooperation, we may also clean and polish their teeth and apply a topical fluoride. Please bring to this first appointment any of your child’s medical records. We will try to discuss and answer any questions you may have at that time. Our objective is to be gentle and patient so your child develops a positive attitude towards the dental office and their own oral he

Gums Don’t Discriminate

 Gum disease might seem like something only adults suffer from but it affects people of all ages. So, while teens may feel – and often appear to be – indestructible, their gums tell a different tale.

TeenHealth.com reports that 60 percent of 15-year-olds already have gingivitis, the early stage of gum disease. Even more sobering, other studies show that teenage girls may be at higher risk of gum disease due to their hormonal changes.

This is bad news for teenagers, who may have bad breath or sore gums as the result of gingivitis. But there’s also good news: gum disease can easily be treated and prevented.

Treatment of gingivitis usually involves a scaling and root planing treatment (SRP) – also known as “deep cleaning” – to remove plaque and tartar buildup below the gum line. Just one SRP treatment can reverse the signs of gingivitis and prevent gum disease from progressing.

After SRP treatment, prevent gingivitis from returning by: brushing at least twice daily, flossing at least once daily, getting dental cleanings twice a year AND eating healthy foods. The last one might be the biggest challenge since eating tooth-and-gum-friendly foods trip most teens up; sweets, sodas, energy drinks and sports drinks are all heavily marketed to and largely consumed by teenagers.

You can make it easier for your teen to choose healthy options for their teeth and body by ensuring the refrigerator is always stocked with things like fresh fruit, vegetables, cheese and water.

If your teen suffers from gingivitis, or you’re concerned about his or her oral healthcare habits, give us a call for an appointment. We’re definitely here for you and serve as an essential barrier against gum disease.