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The Headache Question

Posted on by Dr. Chea Rainford

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 

A Crowning Achievement

Posted on by Dr. Chea Rainford

When too much tooth structure has been lost due to decay or fracture, the best treatment choice to restore the tooth to normal function and cosmetic appearance is often the fabrication of a crown [cap]. Crowns are usually made of porcelain fused to metal or all-ceramic depending on the situation and judgment of the dentist. The restoration of the damaged tooth becomes more of an esthetic concern if it is located near the front of one’s mouth. How we perceive our smile and appearance affects our self-esteem, our moods and how we function in social and business relationships. So, when this situation occurs, there is a sense of urgency.

The tooth is prepared to allow enough room for the crown to fit over the tooth without extending too far and interfering with the person’s occlusion [bite]. This procedure usually takes 2 visits, depending on the situation. A provisional acrylic crown is made and temporarily cemented over the tooth. In the second visit, the crown is “tried in” to see how accurately it fits and to check that the ceramic color chosen matches the surrounding teeth. If both the patient and dentist are satisfied, the crown is permanently cemented or bonded to the tooth. Call our office if you think you’re a candidate for this type of procedure.

Cranberries Have Unique Benefit For Women

Posted on by Vibrant Smiles

A recent study at Rutgers University, and published in Phytochemistry, confirmed a long-held theory that ingestion of cranberries is helpful in protecting against harmful bacterial in the urinary tract. This is due to one of its natural compounds called proanthocyanidin [PAC’s], and its anti-adhesion effect.

The anti-adhesion property of cranberries prevents bacteria from sticking to the urinary tract, which is one of the most common regions for a woman to develop a bacterial infection. Half off all women will experience at least one urinary tract infection in their lifetime. E. coli, bacteria that cause urinary tract infections, are becoming increasingly resistant to common antibiotics. The study concluded that 80% of the antibiotic-resistant bacteria were prevented from sticking by the anti-adhesion property of cranberries. There is some conjecture that PAC’s found in cranberry may minimize stomach ulcers and gum disease by the same mechanism.

This study compared the action of PAC’s in cranberries to those in other foods such as grape and apple juice, dark chocolate and green tea. Apparently, not all PAC-rich foods have the same success or offer the same protection. By means of comparison, one eight-ounce glass of cranberry juice has the equivalent PAC’s as a cup of frozen or fresh cranberries, 1/3 cup of sweetened dried cranberries or 1/3 cup of cranberry sauce. Both this study and earlier research show that the benefits of one glass of cranberry juice kicks in about two hours after consumption and lasts for about 10 hours. So, it is recommended that you drink one glass of cranberry juice in the morning and one in the evening for the maximum protection. Remember, cranberry is a food and not a treatment. Keep in mind that anyone who suspects an infection should consult the appropriate health care practitioner.

Here, Use My Toothbrush…

Posted on by Dr. Chea Rainford

Ever use someone else’s toothbrush? You may think twice about doing it again after reading this:

• Toothbrushes can be a source of repeated dental infections.

• Toothbrushes can cause a bacteremia (bacteria entering the bloodstream) that may result in an endocarditis (a heart infection).

• Toothbrushes can harbor and transmit viruses and bacteria.

• Toothbrushes can retain 50% of the herpes simplex virus for one week.

• Gingival [gum] inflammation can be reduced by changing toothbrushes biweekly.

Still think it’s sexy to share a toothbrush? How about sharing food? Kissing? Certain bacteria can be transmitted from site-to-site in the mouth via dental instruments or from person-to-person sharing someone else’s eating utensil. In juvenile periodontitis, virulent bacteria can move from an infected site to an uninfected site in the same mouth. Certain bacteria can be transmitted between spouses. Certain bacteria can be transmitted between parents and children. Certain bacteria can be transmitted from dogs to children.

So you see, bacteria once thought to be localized to specific sites in the mouth, can be migratory. We’re not advocating that you stop tasting a scrumptious morsel or two at a four-star restaurant; we are advocating that everyone maintain good dental health not only for themselves but for the sake of those they love.

As far as ridding toothbrushes of bacteria, soaking them in a mouthrinse containing essential oils for 20 minutes kills 100% of the bacteria on the bristles. Ultraviolet light also sanitizes toothbrushes. But when researchers* tested the efficacy of using a toothpaste containing a common disinfectant compound – triclosan – they found little benefit when it came to eliminating the offending bacteria attached to the toothbrush bristles.

So what can you do about bacterial contamination from toothbrushes? Soak them in a suitable mouthwash, expose them to ultraviolet light, or from a practical stance, change them frequently. As for kissing someone, the benefits may still outweigh the risks …as long as you have an inkling as to their periodontal status!

*Warren DP, Goldshmidt MC, Thompson MB, Adler-Storhz K, and Keene HJ: The effects of toothpastes on residual microbial contamination of toothbrushes. JADA 132:1241-1245, 2001.

Help! I Broke My Tooth!

Posted on by Dr. Chea Rainford

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!

What Can I Eat If I Am Wearing Braces?

Posted on by Dr. Chea Rainford

The following substances will cause damage to the braces and should absolutely not be eaten: candy apples, caramels, hard and sticky candy, candy bars, aquarium gravel, gum balls, jaw breakers, chicklets, or other gum, popcorn, bones, nuts, ice, chips, chewable vitamins, or any other crunchy or sticky items.

Foods such as apples, carrots, celery, pretzels, French bread, bagels, waffles, and meats should be cut into small pieces and chewed with your back teeth. Keep pencils, fingernails, straws, etc. out of your mouth. Please realize that the use of sugar-containing candy, soda, gum, etc. also promotes tooth decay.

If a bracket falls off, the wire bends or anything else breaks or becomes loose, the patient needs to call right away so that an appointment may be made for the appropriate length of time (generally 30-45 minutes) that we need in order to make the repair. This is especially important even if the patient already has an appointment scheduled.

We know that loose bands, poking wires and other problems can occur with even the most careful and cooperative patients and we will work with you to accommodate your needs in every way we can.

The Right Age To Consider Orthodontics

Posted on by Dr. Chea Rainford

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

Your Child’s first Dental visit: What to Expect!

Posted on by Dr. Chea Rainford

The arrival of baby teeth is momentous because they allow children to graduate to a variety of new foods. In addition to celebrating this new stage in your baby’s development, you should also begin to think about a first visit to the dentist. Although parents of infants may not yet be concerned with dental care, the American Academy of Pediatric Dentistry recommends that the first dentist visit for children take place before a baby’s first birthday. Initially, dental visits are mostly informative in nature, but even at this early age, dental professionals help to establish a proper oral care routine that can last a lifetime.

Finding a Dentist

To find a dentist, check with your pediatrician or insurance company about providers in your area. Additionally, you may want to ask friends and family members for referrals. Narrow your search based on locations and office hours that fit best into your schedule. Try to interview several dental practices before selecting the one where you and your child feel most comfortable. In addition to calling for information, many dental practices also have websites with FAQs to help answer your questions.

Prepare in Advance

Ensure that your child is well rested and not hungry around the time of the appointment. It may be helpful to write down a list of questions ahead of time to ask the dentist. Very importantly, check with your dental insurance provider about copays and coverage before the day of your child’s first dentist visit. Most dental providers ask for proof of dental and medical insurance at time of service. Last, bring a list of your child’s current medications, and be prepared to fill out a health history form.

Although it is not necessary to prepare extremely young children in advance of a dental appointment, you may want to discuss the first visit with an older child. If your child experiences some anxiety over a dental appointment, try to ease his worries by reading books about dentists or by watching television shows to help to visualize what the visit will be like.

What to Expect during Your Child’s First Dentist Visit

During the first visit, the dentist will typically educate parents on proper gum and tooth care for babies. You may also discuss pacifier use and how proper nutrition helps to maintain healthy teeth. The dental professional should also demonstrate brushing techniques for parents so that they are able to knowledgeably assist young children with oral care. At the end of the appointment, the dentist should also provide you with the opportunity to ask questions.

By establishing a good working relationship with a childdentist, parents will ensure that their child receives proper dental care beginning at an early age. Setting a precedent for dental appointments at an early age helps children to become accustomed to a proper oral care routine.

The Science And Art Of Smile Design

Posted on by Dr. Chea Rainford

Patients have asked why this office puts an emphasis on cosmetic dentistry. The answer is easy. Cosmetic dentistry involves some of the more creative aspects of dentistry, rather than the simple, straightforward and routine mechanical side. There are so many things to evaluate when trying to remake someone’s smile. The challenge of figuring out the puzzle so that the patient will look their best is really intriguing and fun, and the results are highly satisfying.

The finished product of a smile design is the result of a lot of work with excellent communication and cooperation between our dental office, the lab and the patient. Please call our office, if you would like to evaluate or discuss your smile.

The Instant Makeover

Posted on by Dr. Chea Rainford

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.