My Blog

By George R. Shepley, DDS
January 15, 2018
Category: Dental Procedures
EarlyActionNeededtoSaveYourToothfromRootResorption

Along with the gums, your teeth’s roots help stabilize them. Without them your teeth couldn’t handle the normal biting forces you encounter every day. That’s why a rare condition called root resorption must be treated promptly: this gradual breakdown and dissolving of root structure could eventually cause you to lose your tooth.

Resorption is normal in primary (“baby”) teeth giving way for permanent teeth or sometimes during orthodontic treatment. But the form of resorption we’re referring to in permanent teeth isn’t normal, and is highly destructive.

The condition begins in most cases outside the tooth and works its way in, usually at the gum line around the cervical or “neck-like” region of the tooth (hence the term external cervical resorption or ECR). ECR produces pink spots on the teeth in its early stages: these are spots of weakened enamel filled with pink-colored cells that cause the actual damage. The cells create cavity-like areas that can continue to enlarge.

We don’t fully understand what causes ECR, but there seems to be links with excessive force during orthodontics, tooth trauma (especially to the gum ligaments), tooth grinding habits or internal bleaching procedures. However, most people with these problems don’t develop ECR, so the exact mechanism remains a bit of a mystery.

The good news, though, is that we can treat ECR effectively, provided we discover it before it inflicts too much damage. That’s why regular dental visits are important, coupled with your own observation of anything out of the ordinary and immediate dental follow-up.

If the affected area is relatively small, we may be able to remove the cells causing the damage and repair the area with a tooth-colored filling. If it appears the pulp (the tooth’s innermost layer) is involved, we may need to perform a root canal treatment to remove infected tissue and fill the empty space with a special filling. You may also need other procedures to reduce the chances of gum recession around the affected tooth.

Proactive dental care is your best insurance against losing a tooth to root resorption. So keep an eye on your teeth and see your dentist regularly to keep your teeth and gums healthy.

If you would like more information on the signs and treatments for root resorption, 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 “Root Resorption: An Unusual Phenomenon.”

By George R. Shepley, DDS
January 07, 2018
Category: Oral Health
DrTravisStorkDontIgnoreBleedingGums

Are bleeding gums something you should be concerned about? Dear Doctor magazine recently posed that question to Dr. Travis Stork, an emergency room physician and host of the syndicated TV show The Doctors. He answered with two questions of his own: “If you started bleeding from your eyeball, would you seek medical attention?” Needless to say, most everyone would. “So,” he asked, “why is it that when we bleed all the time when we floss that we think it’s no big deal?” As it turns out, that’s an excellent question — and one that’s often misunderstood.

First of all, let’s clarify what we mean by “bleeding all the time.” As many as 90 percent of people occasionally experience bleeding gums when they clean their teeth — particularly if they don’t do it often, or are just starting a flossing routine. But if your gums bleed regularly when you brush or floss, it almost certainly means there’s a problem. Many think bleeding gums is a sign they are brushing too hard; this is possible, but unlikely. It’s much more probable that irritated and bleeding gums are a sign of periodontal (gum) disease.

How common is this malady? According to the U.S. Centers for Disease Control, nearly half of all  Americans over age 30 have mild, moderate or severe gum disease — and that number increases to 70.1 percent for those over 65! Periodontal disease can occur when a bacteria-rich biofilm in the mouth (also called plaque) is allowed to build up on tooth and gum surfaces. Plaque causes the gums to become inflamed, as the immune system responds to the bacteria. Eventually, this can cause gum tissue to pull away from the teeth, forming bacteria-filled “pockets” under the gum surface. If left untreated, it can lead to more serious infection, and even tooth loss.

What should you do if your gums bleed regularly when brushing or flossing? The first step is to come in for a thorough examination. In combination with a regular oral exam (and possibly x-rays or other diagnostic tests), a simple (and painless) instrument called a periodontal probe can be used to determine how far any periodontal disease may have progressed. Armed with this information, we can determine the most effective way to fight the battle against gum disease.

Above all, don’t wait too long to come in for an exam! As Dr. Stork notes, bleeding gums are “a sign that things aren’t quite right.”  If you would like more information about bleeding gums, please contact us or schedule an appointment. You can read more in the Dear Doctor magazine article “Bleeding Gums.” You can read the entire interview with Dr. Travis Stork in Dear Doctor magazine.

By George R. Shepley, DDS
December 30, 2017
Category: Oral Health
Tags: tmd   tmj   jaw pain  
JawPainDisordersCouldbeRelatedtoOtherBodyConditions

As many as 36 million adults in the U.S. suffer from some form of chronic jaw pain. What’s more, many of these may also experience other painful conditions like arthritis or chronic fatigue in other parts of their body.

Chronic jaw pain is actually a group of difficult to define disorders collectively referred to as temporomandibular joint disorders (TMJD or also TMD). TMD not only refers to pain symptoms of the temporomandibular (jaw) joints but also of the jaw muscles and surrounding connective tissue. Most physicians and dentists agree TMD arises from a complex range of conditions involving inheritable factors, gender (many sufferers are women of childbearing age), environment and behavior.

A recent survey of approximately 1,500 TMD patients found that nearly two-thirds of them also suffered from three or more related health problems like fibromyalgia, chronic fatigue syndrome, rheumatoid arthritis, headaches, depression and problems sleeping. The understanding of TMD’s connection with these other conditions is in its early stages of research, but there’s avid interest among healthcare providers to learn more and possibly devise new treatments for TMD in coordination with these other related conditions.

In the meantime, TMD patients continue to respond best with the traditional approach to treatment, including physical therapy, thermal (hot or cold) compresses to the area of pain, medication and modifying the diet with more easier to chew foods. In extreme cases, jaw surgery may be recommended; however, success with this approach has been mixed, so it’s advisable to get a second opinion before choosing to undergo a surgical procedure.

Hopefully, further study about TMD and its connection with other conditions may yield newer treatments to ease the pain and discomfort of all these conditions, including TMD. You can stay up to date on these and other developments for coping with the discomfort of TMD at www.tmj.org and through your healthcare provider team.

If you would like more information on TMD, 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 “Chronic Jaw Pain and Associated Conditions.”

By George R. Shepley, DDS
December 15, 2017
Category: Oral Health
WhatYoucandotoEasethatBurningSensationinYourMouth

Have you ever felt a hot, burning sensation in your mouth—like it had been scalded—but you didn't eat or drink anything that could have caused it?

While you may think you’re hallucinating, there’s another possibility: Burning Mouth Syndrome (BMS). This condition, which can last for years, produces sensations in the mouth of not only scalding or burning, but also tingling, numbness and a decline in your ability to taste. Patients may feel it throughout their mouth or only in localized areas like the lips, tongue or inside the cheeks.

The exact cause of BMS is also something of a mystery. It’s been theoretically linked to diabetes, vitamin or mineral deficiencies and psychological problems. Because it’s most common among women of menopausal age hormonal changes have been proposed as a factor, although hormone replacement therapy often doesn’t produce any symptomatic relief for BMS.

To complicate matters, other conditions often share the condition’s effects, which need to be ruled out first to arrive at a BMS diagnosis. A feeling of scalding could be the result of mouth dryness, caused by medications or systemic conditions that inhibit saliva flow. Some denture wearers may display some of the symptoms of BMS due to an allergic reaction to denture materials; others may have a similar reaction to the foaming agent sodium lauryl sulfate found in some toothpaste that can irritate the skin inside the mouth.

If these other possibilities can be ruled out, then you may have BMS. While unfortunately there’s no cure for the condition, there are ways to lessen its impact. There’s even the possibility that it will resolve itself over time.

Until then, keep your mouth moist by drinking lots of water or using saliva-stimulating products, limiting alcohol, caffeinated drinks or spicy foods and refraining from smoking. If you’re taking medications that could cause dry mouth, speak with your physician about changing to an alternative. And try to reduce stress in your life through exercise, mindfulness practices or support groups.

While BMS isn’t considered harmful to your physical health it can make life less enjoyable. Careful symptom management may help improve your quality of life.

If you would like more information on Burning Mouth Syndrome, 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 “Burning Mouth Syndrome: A Painful Puzzle.”

By George R. Shepley, DDS
November 30, 2017
Category: Oral Health
Tags: dental injuries  
KeepAheadofPotentialSidetrackstoYourChildsOralHealth

From birth to young adulthood, your child's teeth gums and other mouth structures steadily grow and mature. Sometimes, though, problems arise and get in the way of their oral health. It's important we detect when that happens and take action.

We can sort these potential problems into three broad categories: developmental, disease and injury. The first category includes such problems during their childhood years as teeth erupting out of position or the jaws growing improperly and becoming abnormally long, short, wide or narrow.

The possibility of developmental problems is a primary reason for regular dental visits, beginning around your child's first birthday. If we can detect a growing problem early, we may be able to minimize or even reverse its impact to your child's oral health.

Regular dental care also helps control disease, particularly tooth decay and cavity formation. Our primary aim is to treat decay, even in primary (baby) teeth: losing a primary tooth to decay could adversely affect the incoming permanent tooth's jaw position. Besides treatment, we can also help prevent decay with topical fluoride treatments (to strengthen enamel) and sealants.

Although not as common as disease, dental problems due to injury still occur all too frequently. Blows to the mouth can chip teeth, loosen them or even knock them out. For any type of visible tooth injury you should visit us or an emergency room immediately — time is of the essence especially to save a knocked out tooth. Be sure you recover and bring any knocked out teeth or chip fragments.

We can also help you on the injury prevention front as well. For example, if your child participates in contact sports or similar activities, we can fashion a custom-fitted mouth guard to protect their teeth and soft tissues.

Keeping a vigilant eye for these potential problems will help ensure your child's future oral health is the best it can be. The sooner these problems are detected, the better and less costly their outcome.

If you would like more information on caring for your child's teeth and gums, please contact us or schedule an appointment for a consultation.





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