My Blog

By George R. Shepley, DDS
September 27, 2019
Category: Oral Health
PopStarDemiLovatoPopsOutJayGlazersTooth

Singer and actor Demi Lovato has a new claim to fame: formidable martial artist. When she is not in the recording studio, on stage or in front of the camera, Lovato can often be found keeping in shape at Jay Glazer's Hollywood (California) gym. Glazer, who is best known as a sports journalist, also runs conditioning programs for professional athletes and celebrities based on mixed martial arts. On March 6, Glazer got more than he bargained for when 5'3" Lovato stepped into the ring and knocked out his front tooth.

Glazer reportedly used super glue to put his tooth back together. Not a good idea! While it may not be convenient to drop everything and get to the dental office, it takes an expert to safely treat a damaged tooth. If you glue a broken tooth, you risk having to undergo major work to correct your temporary fix—it's no easy task to "unglue" a tooth, and the chemicals in the glue may damage living tooth tissue as well as the surrounding gum and bone.

Would you know what to do in a dental emergency? Here are some guidelines:

  • If you chip a tooth, save the missing piece if possible. We may be able to reattach it.
  • If your tooth is cracked, rinse your mouth with warm water, but don't wiggle the tooth around or bite down on it. If it's bleeding, hold clean gauze to the area and call our office.
  • If your tooth is knocked loose or is pushed deeper into the socket, don't force the tooth back into position on your own. Immediate attention is very important.
  • If your tooth is knocked out, there's a chance it can be reattached. Pick up the tooth while being careful not to touch the root. Then rinse it off and have either someone place into its socket, or place it against the inside of your cheek or in a glass of milk. Please call the office immediately or go to a hospital.

What's the best thing to do in an emergency? Call us right away, and DON'T super glue your tooth! You can prevent worse problems by letting a professional handle any dental issues.¬†And if you've been living with a chipped, broken or missing tooth, call us to schedule an appointment for a consultation—there are several perfectly safe ways to restore your smile. Meanwhile, if you practice martial arts to keep in shape, think twice before getting into the ring with Demi Lovato!

To learn more, read the Dear Doctor articles “Trauma & Nerve Damage to Teeth” and “Saving New Permanent Teeth After Injury.”

By George R. Shepley, DDS
September 17, 2019
Category: Oral Health
Tags: gum recession  
DontDelaySeeingtheDentistIfYouSuspectGumRecession

Calling someone "long in the tooth" is an unflattering way of saying they're getting old. The phrase refers to the effects of gum recession, in which the gums pull away from the teeth and cause them to appear longer. The problem, which makes the teeth vulnerable to disease as well as look unattractive, is a common problem for older people.

The most common cause for gum recession is periodontal (gum) disease. Bacteria and food particles, which make up dental plaque, trigger an infection. The deposits of plaque and calculus (hardened plaque) continue to fuel the infection as it continues to weaken gum tissue attachments.

As a result, the gums begin to lose their attachment to the teeth and pull away, exposing the root areas normally covered by the gums. Unlike the enamel-protected crowns (the parts of teeth you can see), the root is covered by a thin layer of material called cementum.

Although cementum offers less protection than enamel, this normally isn't a problem because the gums also act as a barrier against bacteria and other harsh aspects of the mouth environment. But without gum coverage, the root area becomes vulnerable to disease and is more prone to painful sensitivity.

Because gum disease is the main culprit, you can reduce your chances of gum recession by keeping your teeth clean of plaque through brushing and flossing, and regularly undergoing professional cleanings. If gum disease does occur, it's important to seek treatment as soon as possible: The earlier it's treated the more likely that any recessed gum tissues can regenerate.

If the recession is extensive, however, you may need clinical intervention to assist with its regrowth. This can be done by grafting tissue at the site that then serves as scaffold for new tissue to grow upon. Though effective, these microsurgical techniques are quite complex and involved.

So, if you suspect you have gum disease or recession, see your dentist as soon as possible for a full examination. It may be possible to restore your gums and enhance your smile.

If you would like more information on protecting your gum 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 “Gum Recession.”

By George R. Shepley, DDS
September 07, 2019
Category: Oral Health
Tags: tmj disorders  
DoaLittleExtraFoodPreptoEaseTMDDiscomfort

Because it requires jaw movement, eating can be difficult and painful if you have a temporomandibular joint disorder (TMD). During flareups you may switch to foods that are easier to eat but may be less nutritious than those you're giving up.

But there are ways to keep healthier foods in your diet while minimizing TMD discomfort. In many cases, it's a matter of preparing your food differently. Here are a variety of food groups known for their nutritional value and what you can do to prepare them for easier eating with TMD.

Fruits and Vegetables. You should peel any fruits or vegetables with hard or chewy skin like apples, peaches or cucumbers. Try chopping or pureeing fruits and vegetables you can eat raw to reduce their size and make them easier to chew. Vegetables like carrots, potatoes, broccoli or cauliflower can be cooked, then chopped or mashed.

Legumes and nuts. Pod-based vegetables like beans or peas provide a number of nutritional elements, as do nuts with their healthy fats. Your motto with these foods should be "Not too large and not too hard." Be sure then to cook, mash or puree legumes that are larger than a pea. With nuts, try nut butters for a softer serving than eating them out of the shell.

Protein and Dairy. Any meats like poultry or beef should be cut into bite-sized pieces; you can also moisten them with broths, gravies or sauces for easier chewing, or braise or stew them in liquid to tenderize them. You can also consume most milk, yogurt or cheese products you can tolerate. If you can't, try alternatives like meal replacement or whey protein beverages.

Grains. Prepare grains by cooking them until they're softened. Hot cereals like oatmeal offer a lot of nutrition and they're relatively easy to eat. Toast your bread and cut the slice into smaller pieces to minimize jaw movement.

One last tip: take your time while eating. A slower rate not only helps you enjoy your food more, it reduces the amount of work your jaws perform while eating. Less jaw work can help further ease the discomfort of TMD.

If you would like more information on how to relieve TMD pain and dysfunction, 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 “What to Eat When TMJ Pain Flares Up.”

ToExtractornotExtractTheBigDecisionAboutYourChildsWisdomTeeth

Your child's permanent teeth come in gradually, starting just as they begin losing their primary ("baby") teeth and not ending until late adolescence or early adulthood. That's when the third molars or "wisdom teeth" close out the process.

Because of their late arrival, wisdom teeth have a high potential for dental problems. With a greater chance of crowding or obstruction by other teeth, wisdom teeth often get stuck fully or partially below the gums and bone (impaction) or erupt out of position. In one study, 7 in 10 people between the ages of 20 and 30 will have at least one impacted wisdom tooth at some time in their lives.

It's not surprising then that wisdom teeth are among the most extracted teeth, to the tune of about 10 million per year. Besides those already diseased or causing bite problems, many are removed preemptively in an attempt to avoid future problems.

But wisdom teeth usually require surgical extraction by an oral surgeon, which is much more involved than a simple extraction by a general dentist. Given the potential consequences of surgical extraction, is it really necessary to remove a wisdom tooth not creating immediate problems?

That's not an easy question to answer because it's often difficult to predict a wisdom tooth's developmental track. Early on it can be disease-free and not causing any problems to other teeth. But as some researchers have found, one in three wisdom teeth at this stage will later develop disease or create other issues.

For many dentists, the best approach is to consider extraction on a case by case basis. Those displaying definite signs of problems are prime for removal. But where there are no signs of disease or other issues, the more prudent action may be to keep a watchful eye on their development and decide on extraction at some later date.

More than likely, your dentist will continue to have an ongoing discussion with you about the state of your child's wisdom teeth. While extraction is always an option, wisdom teeth that aren't yet a problem to dental health may be best left alone.

If you would like more information on treating wisdom teeth issues, please contact us or schedule an appointment for a consultation.

By George R. Shepley, DDS
August 18, 2019
Category: Dental Procedures
DontBreakItLikeBeckham

During his former career as a professional footballer (that's a soccer star to U.S. sports fans) David Beckham was known for his skill at “bending” a soccer ball. His ability to make the ball curve in mid-flight — to avoid a defender or score a goal — led scores of kids to try to “bend it like Beckham.” But just recently, while enjoying a vacation in Canada with his family, “Becks” tried snowboarding for the first time — and in the process, broke one of his front teeth.

Some fans worried that the missing tooth could be a “red card” for Beckham's current modeling career… but fortunately, he headed straight to the dental office as soon as he arrived back in England. Exactly what kind of treatment is needed for a broken tooth? It all depends where the break is and how badly the tooth is damaged.

For a minor crack or chip, cosmetic bonding may offer a quick and effective solution. In this procedure, a composite resin, in a color custom-made to match the tooth, is applied in liquid form and cured (hardened) with a special light. Several layers of bonding material can be applied to re-construct a larger area of missing tooth, and chips that have been saved can sometimes be reattached as well.

When more tooth structure is missing, dental veneers may be the preferred restorative option. Veneers are wafer-thin shells that are bonded to the front surface of the teeth. They can not only correct small chips or cracks, but can also improve the color, spacing, and shape of your teeth.

But if the damage exposes the soft inner pulp of the tooth, root canal treatment will be needed to save the tooth. In this procedure, the inflamed or infected pulp tissue is removed and the tooth sealed against re-infection; if a root canal is not done when needed, the tooth will have an increased risk for extraction in the future. Following a root canal, a tooth is often restored with a crown (cap), which can look good and function well for many years.

Sometimes, a tooth may be knocked completely out of its socket; or, a severely damaged tooth may need to be extracted (removed). In either situation, the best option for restoration is a dental implant. Here, a tiny screw-like device made of titanium metal is inserted into the jaw bone in a minor surgical procedure. Over time, it fuses with the living bone to form a solid anchorage. A lifelike crown is attached, which provides aesthetic appeal and full function for the replacement tooth.

So how's Beckham holding up? According to sources, “David is a trooper and didn't make a fuss. He took it all in his stride." Maybe next time he hits the slopes, he'll heed the advice of dental experts and wear a custom-made mouthguard…

If you have questions about restoring damaged teeth, please contact our office to schedule a consultation. You can read more in the Dear Doctor magazine articles “Trauma and Nerve Damage to Teeth” and “Children's Dental Concerns and Injuries.”





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