My Blog

Posts for: June, 2021

By George R. Shepley, DDS
June 21, 2021
Category: Oral Health
Tags: oral hygiene   braces  
GumSwellingCanHappenWithBraces-HeresHowtoAvoidIt

A few months into wearing braces you may notice your gums are swollen. It's likely you've developed periodontal (gum) disease.

Gum disease is a bacterial infection that usually begins with dental plaque. This thin, accumulated biofilm on teeth is filled with bacteria that cause dental disease. The more of it that remains on your teeth, the higher your risk for a gum infection.

In addition to regular dental cleanings, the best way for a person to reduce their gum disease risk is to remove plaque on a daily basis through brushing and flossing. Unfortunately, wearing braces complicates this: The brackets and wires affixed to your teeth can get in the way of your toothbrush and regular dental floss. As a result, you can easily miss plaque hidden around these bits of hardware.

Aside from gum disease, the braces themselves can irritate your gums. This irritation inflames the gums and may even cause more tissue to grow. Compound this overgrowth with a possible gum infection and it's no wonder your gums are severely swollen.

To lessen the chances of swollen gums with braces, you'll need to beef up your daily hygiene efforts. Simply put, it will typically take more time than normal to thoroughly clean around your braces. A few specialized tools, though, might make it easier.

An interproximal brush with a narrower head than a regular toothbrush is useful for accessing tight places around brackets. And a floss threader or a water flosser (which uses pressurized water to loosen and remove plaque) may help you better maneuver around wires to remove plaque between teeth.

Keeping your teeth clean as possible will certainly help you avoid gum swelling due to disease. But swelling from tissue overgrowth may not be resolved until your braces come off. In severe cases, it may even be necessary to remove the braces to treat the gums before resuming orthodontic treatment.

In any case, be as thorough as possible with your oral hygiene efforts during orthodontics and see your regular dentist for cleanings every six months. When you have completed orthodontic treatment, cleanings every six months are usually recommended. It's the best way to keep your gums healthy while you're wearing braces.

If you would like more information on dental care while wearing braces, 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 Swelling During Orthodontics.”


By George R. Shepley, DDS
June 11, 2021
Category: Dental Procedures
Tags: veneers  
ThisOneCosmeticMethodCouldImproveaMultipleofToothFlaws

You could have an unattractive smile because of a chipped tooth or one slightly out of alignment. Or, it could be both of the above, plus some heavy staining to boot. Correcting each flaw individually might require a combination of different methods like orthodontics or porcelain crowns, which can take an extended period of time to complete.

But you may be able to correct numerous smile flaws with just one method—and in no more than a couple of treatment visits. It's called direct veneers.

Unlike regular veneers, direct veneers don't require a dental technician to craft a thin porcelain shell to bond over teeth. Rather, a dentist applies a tooth-colored material called composite resin to the problem teeth and "sculpts" an entirely new look that can correct multiple dental flaws at one time.

The dentist usually begins the process by creating a model ("wax-up") of proposed changes based on physical impressions of the jaw and teeth. Both dentist and patient can study the model and modify it if necessary, when finalizing the treatment plan.

At a subsequent appointment, the dentist prepares the tooth surface for bonding by removing a thin layer of tooth enamel, then shapes the teeth to better accommodate the composite resin. This tooth prep is similar to that done with traditional veneers, so it's permanent—the teeth will require some form of restoration from then on.

After applying an etchant and a bonding agent, the dentist applies the composite resin in small amounts, hardening each layer with a special light before applying the next one. With each subsequent layer, the dentist sculps the composite material to eventually resemble the wax-up model.

After completing the composite application, the dentist then uses hand tools and a dental drill to complete shaping, as well as an abrasive strip between teeth to aid future flossing. After just a few hours, the transformation is complete.

Direct veneers are durable, but not to the same extent as regular veneers or other cosmetic enhancements. They can also pick up stains over time, and may require re-treatment at some point. Still, direct veneers are a cost-effective way to improve the appearance of teeth with multiple flaws that could radically change your smile for the better.

If you would like more information on the direct veneer method, please contact us or schedule an appointment for a consultation.


SedationCanHelpanAnxiousChildRelaxDuringDentalTreatment

There are different ways to ease a child's potential nervousness with dental visits, like starting those visits around their first birthday or seeing a pediatric dentist who specializes in children. But even doing those things won't guarantee your child won't develop some form of dental anxiety, which could complicate their dental care.

To help make appointments easier for anxious children, many dentists use conscious sedation as a means of helping them relax. With this technique, the dentist administers a mild sedative to the child to take the edge off their nervousness, while allowing them to remain awake during treatment.

Sedation isn't anesthesia, the means we use to stop pain during treatment (although sedation may be used with anesthesia). Rather, sedation reduces emotional fear and anxiety. And unlike general anesthesia, a sedated child can still breathe without assistance and, depending on the depth of the sedation, respond to physical and verbal stimuli.

In most cases, children are administered sedation medications by mouth, usually as a syrup, although on occasion it might be delivered intravenously with an IV. The dose is usually given some time before their treatment session after the dentist has evaluated them. Dentists mostly use mild sedatives like Midazolam or Hydroxyzine with very little risk of side effects for children.

During the procedure, a designated staff member continually monitors the child's vital signs. Besides heart rate, pulse and respirations, they may also check the child's exhaled carbon dioxide levels to ensure they're breathing normally.

After the treatment session is over, staff will continue to monitor the child until their vital signs return to pre-sedation levels. If the child is of driving age, they'll need someone to drive them home. Children who've been sedated should remain home for the rest of the day, but they can usually return to school the next day depending on what kind of dental work they've undergone.

Dentists follow strict protocols for pediatric sedation adopted by the American Academy of Pediatrics, the American Dental Society, and the American Academy of Pediatric Dentistry. In addition, many states have also established processes for administering sedation therapy. It's a safe and effective method to ease a child's anxiety over their dental visit.

If you would like more information on making dental visits easier for kids, 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 “Sedation Dentistry For Kids.”