By Bloom & Bloom, DMDs
May 20, 2019
Category: Oral Health
Tags: oral health   nutrition   tmj disorders  
AdjustYourDiettoAccommodateTMDtoMaximizeNutrition

Eating is one of the pleasures — and necessities — of life, but people who suffer from temporomandibular joint disorders (TMD) may find eating no pleasure at all — and they may not be eating the right nutritional balance of foods.

TMD is a collection of conditions that affect the jaw joints, connecting muscles and other related facial structures. If you've been diagnosed with TMD, you're probably not only acquainted with severe pain, but also difficulty opening your jaw as widely as normal. This can make it difficult to chew certain foods.

There are a number of effective treatments for TMD, including thermal therapy (hot or cold packs), joint exercise, medication or surgery (as a last resort). But these treatments often take time to make a noticeable difference. In the meantime, you may still need to change what and how you eat to ensure you're getting the nutrients your body needs.

The overall strategy should be to soften and reduce the chewing size of your food. With fruits and vegetables, you'll want to peel and discard any hard or chewy skins, and then chop the fruit flesh into smaller pieces. Steam or cook vegetables like greens, broccoli or cauliflower until they're soft and then chop them into smaller portions. You might also consider pureeing your fruit (and some vegetables) to make smoothies with ice, milk or yogurt, or vegetable-based soups.

Treat meat, poultry or seafood in much the same way, especially biting sizes. Besides cooking meats to tenderness, include moisteners like broths, gravies or brazing liquids to further make them easier to chew.

Dairy foods are an important source of nutrition: eat milk-based products like yogurt or cheese as much as you can handle. If you have problems with these or also nut butters, then consider meal replacement beverages like instant breakfast or whey protein beverages.

And don't forget whole grains. Although some can be hard to chew, you can prepare them in hot cereal form (like oatmeal) to tenderize them. You can also prepare thin bread toast and cut into smaller pieces.

Hopefully, your treatment will bring your TMD symptoms under manageable control. Until then (and after, if need be) adjust your diet to eat the foods that keep you healthy.

If you would like more information on maintaining a healthy diet with TMD, please contact us or schedule an appointment for a consultation.

TheresaLotofEffortBehindtheScenestoMakingDenturesWorkforYou

For centuries, people who've lost all their teeth have worn dentures. Although materials in today's dentures are more durable and attractive than those in past generations, the basic design remains the same — prosthetic (false) teeth set in a plastic or resin base made to resemble gum tissue.

If you're thinking of obtaining dentures, don't let their simplicity deceive you: a successful outcome depends on a high degree of planning and attention to detail customized to your mouth.

Our first step is to determine the best positioning for the prosthetic teeth. It's not an “eyeball” guess — we make a number of calculations based on the shape and size of your jaws and facial features to determine the best settings within the resin base. These calculations help us answer a few important questions for determining design: how large should the teeth be? How far forward or back from the lip? How much space between the upper and lower teeth when the jaws are at rest?

We also can't forget about the artificial gums created by the base. How much your gums show when you smile depends a lot on how much your upper lip rises. We must adjust the base size to accommodate your upper lip rise so that the most attractive amount of gum shows when you smile. We also want to match as close as possible the color and texture of your natural gum tissues.

There's one other important aspect to manage: how your upper and lower dentures function together when you eat or speak. This means we must also factor your bite into the overall denture design. This may even continue after your dentures arrive: we may still need to adjust them while in your mouth to improve function and comfort.

Ill-fitting, dysfunctional and unattractive dentures can be distressing and embarrassing. But with careful planning and customization, we can help ensure your new dentures are attractive and comfortable to wear now and for years to come.

If you would like more information on removable dentures for teeth replacement, 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 “Removable Full Dentures.”

DentalInjuryIsJustaTemporarySetbackforBasketballStarKevinLove

The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.

In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?

The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.

Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.

So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”

Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.

If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”

WhyYouShouldFlossAroundtheImplantsSupportingYourBridge

We've been using bridges to replace missing teeth for decades. Now, recently-developed implant-supported bridges are even more dependable, promising greater durability and less interference with remaining natural teeth.

But just like other restorations, you'll need to keep implant bridges clean to ensure their longevity. Although both the bridge and implants are impervious to disease, the supporting gums and bone aren't. If they become infected, they can break down and your restoration will fail.

Cleaning an implant-supported bridge includes flossing around each of the implants to remove dental plaque, a thin film of food particles and bacteria most responsible for dental disease. To perform this task, you'll have to pass the floss between the bridge and gums to access the sides of each implant.

To help make it easier, you can use a tool like a floss threader, a thin, shaft-like device with a loop on one end and a needle-like point on the other. You'll first thread about 18" of floss through the end and then pass the threader between the bridge and gums with the sharp end toward the tongue.

With the threader completely through, you'll then wrap the floss around your fingers as with regular flossing and move the floss up and down each side of the implants you can access. You'll then pull the floss out, reload the threader and move to the next section, repeating this process until you've flossed each side of each implant.

You can also use pre-cut floss with a stiffened end to thread between the bridge and gums or an interproximal brush with a thin bristled head that can reach underneath the bridge. And you might consider using an oral irrigator, a pump device that sprays a stream of pressurized water to remove and flush away plaque around implants.

To round out your hygiene efforts, be sure you visit your dentist at least twice a year for dental cleanings. Your dentist can also advise you and give you training on keeping your implants clear of disease-causing plaque. Cleaning around your implants will help ensure your restoration will last.

If you would like more information on caring for your dental restoration, 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 “Oral Hygiene for Fixed Bridgework.”

By Bloom & Bloom, DMDs
April 10, 2019
Category: Dental Procedures
Tags: wisdom teeth  
ExtractingWisdomTeethNowMayPreventDentalProblemsLater

The reason for extracting a tooth may be all too obvious — the tooth is too decayed or damaged to attempt saving. The reason for extracting a wisdom tooth, on the other hand, may not be so apparent: from the perspective of pain or reduced function, you may not notice a thing. Our recommendation to remove a wisdom tooth is based primarily on what may be occurring out of view below the gum line and its potential threat to adjacent teeth.

Teeth grow and develop below the gum line in the jaw, and then push their way through the gums as they appear in the mouth (eruption). After a normal eruption, the enamel-covered crown is visible above the gum line; the remaining tooth root (about two-thirds of the tooth’s length) resides below the gum line. Because wisdom teeth, or third molars, erupt rather late between ages 17 and 25, they may lack the room to erupt properly due to crowding from other teeth that have already erupted. This can cause the wisdom tooth not to erupt fully through the gums, leaving the crown trapped below the gum line, a condition known as impaction. For the tooth, impaction increases the chances of infection, cyst formation and gum disease around it.

An impacted wisdom tooth can also cause problems for the adjacent teeth as well. The impacted tooth may begin to press against the roots of other teeth; the resulting pressure can damage the other roots, increasing the risk for disease or future tooth loss. A person may not even know they have this problem since there’s often little to no noticeable pain or symptoms.

It may seem counterintuitive, but the best time to remove a wisdom tooth is when it’s not causing immediate problems. There will be, however, signs found during examination (particularly x-rays or CT scan) that future problems are in the making. By extracting an impacted wisdom tooth at the appropriate time, we can avoid more serious problems in the future and improve oral health.

If you would like more information on wisdom teeth and your oral 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 “Removing Wisdom Teeth.”





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