My Blog

By George R. Shepley, DDS
December 31, 2018
Category: Uncategorized
Tags: oral hygiene  
WhatYouNeedtoKnowtoBuytheRightToothbrush

If there’s one essential tool for protecting your dental health, it’s the humble toothbrush. The basic manual brush with a long, slender handle and short-bristled head is still effective when used skillfully. The market, though, is full of choices, all of them touting their brand as the best.

So how do you choose? You can cut through any marketing hype with a few simple guidelines.

First, understand what you’re trying to accomplish with brushing: removing dental plaque, that thin film of bacteria and food particles on tooth surfaces that’s the main cause of dental disease. Brushing also stimulates gum tissue and helps reduce inflammation.

With that in mind, you’ll first want to consider the texture of a toothbrush’s bristles, whether they’re stiff (hard) or more pliable (soft). You might think the firmer the better for removing plaque, but actually a soft-bristled brush is just as effective in this regard. Stiffer bristles could also damage the gums over the long term.

Speaking of bristles, look for those that have rounded tips. In a 2016 study, less rounded tips increased gum recession in the study’s participants by 30%. You should also look for toothbrushes with different bristle heights: longer bristles at the end can be more effective cleaning back teeth.

As far as size and shape, choose a brush that seems right and comfortable for you when you hold it. For children or people with dexterity problems, a handle with a large grip area can make the toothbrush easier to hold and use.

And look for the American Dental Association (ADA) Seal of Acceptance, something you may have seen on some toothpaste brands. It means the toothbrush in question has undergone independent testing and meets the ADA’s standards for effectiveness. That doesn’t mean a particular brush without the seal is sub-standard—when in doubt ask your dentist on their recommendation.

Even a quality toothbrush is only as effective as your skill in using it. Your dental provider can help, giving you tips and training for getting the most out of your brush. With practice, you and your toothbrush can effectively remove disease-causing plaque and help keep your smile beautiful and healthy.

If you would like more information on what to look for in a toothbrush, 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 “Sizing up Toothbrushes.”

By George R. Shepley, DDS
December 21, 2018
Category: Dental Procedures
BobbyBonesDancesHisWaytoDentalDamage

The long-running hit show Dancing with the Stars has had its share of memorable moments, including a wedding proposal, a wardrobe malfunction, and lots of sharp dance moves. But just recently, one DWTS contestant had the bad luck of taking an elbow to the mouth on two separate occasions—one of which resulted in some serious dental damage.

Nationally syndicated radio personality Bobby Bones received the accidental blows while practicing with his partner, professional dancer Sharna Burgess. “I got hit really hard,” he said. “There was blood and a tooth. [My partner] was doing what she was supposed to do, and my face was not doing what it was supposed to do.”

Accidents like this can happen at any time—especially when people take part in activities where there’s a risk of dental trauma. Fortunately, dentists have many ways to treat oral injuries and restore damaged teeth. How do we do it?

It all depends on how much of the tooth is missing, whether the damage extends to the soft tissue in the tooth’s pulp, and whether the tooth’s roots are intact. If the roots are broken or seriously damaged, the tooth may need to be extracted (removed). It can then generally be replaced with a dental bridge or a state-of-the-art dental implant.

If the roots are healthy but the pulp is exposed, the tooth may become infected—a painful and potentially serious condition. A root canal is needed. In this procedure, the infected pulp tissue is removed and the “canals” (hollow spaces deep inside the tooth) are disinfected and sealed up. The tooth is then restored: A crown (cap) is generally used to replace the visible part above the gum line. A timely root canal procedure can often save a tooth that would otherwise be lost.

For moderate cracks and chips, dental veneers may be an option. Veneers are wafer-thin shells made of translucent material that go over the front surfaces of teeth. Custom-made from a model of your smile, veneers are securely cemented on to give you a restoration that looks natural and lasts for a long time.

It’s often possible to fix minor chips with dental bonding—and this type of restoration can frequently be done in just one office visit. In this procedure, layers of tooth-colored resin are applied to fill in the parts of the tooth that are missing, and then hardened by a special light. While it may not be as long-lasting as some other restoration methods, bonding is a relatively simple and inexpensive technique that can produce good results.

If you would like more information about emergency dental treatment, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor articles “The Field-Side Guide to Dental Injuries” and “Knocked Out Tooth.”

By George R. Shepley, DDS
December 11, 2018
Category: Oral Health
Tags: oral health  
KeepingYourSmileHealthyThroughtheHolidays

’Tis the season for holiday joy with sweet treats at every turn. Don’t let it be the season for dental woes as well. You've heard that sugar causes cavities. That’s because bacteria in your mouth feed on sugar and release acid as a by-product. The acid eats away at tooth enamel, resulting in tooth decay if not checked. To protect your smile during the December onslaught of cookies, candies and other goodies, follow these tips:

Seek balance. Foods that stick to your teeth like candy canes, chewy candies or potato chips provide more opportunity for cavities to develop. To help keep your smile sparkling for the New Year, mix it up with healthy options. Chances are you will come across tooth-healthy offerings like raw vegetables, a cheese plate or mixed nuts. Vegetables scrub your teeth while you chew and stimulate the production of saliva, which helps neutralize acid and rebuild tooth enamel. Cheese also neutralizes acid in the mouth and has minerals that strengthen teeth, while nuts stimulate saliva production and provide vitamins and minerals that keep teeth strong and healthy.

Consider your timing. There’s a higher risk of developing tooth decay when sweets are consumed as standalone snacks, so when you do eat sugary treats, try to have them at mealtime. Repeated snacking between meals exposes teeth to food particles throughout the day, and the acids produced can continue to act on your teeth for 20 minutes after a treat is consumed. During meals, however, other foods present help balance out the sugar and stimulate saliva production, which helps neutralize acid and wash away food particles, sugar and acid from your teeth.

Watch what you drink. Sipping sweet drinks over time can have ill effects on your teeth because of prolonged contact with sugar. If you consume sugary beverages, try to do so in moderation and preferably along with a meal. Sipping your drink through a straw can help keep the beverage away from direct contact with your teeth. Consider opting for water—there are plenty of other opportunities for extra sugar and calories! Besides, water washes away food bits and dilutes acidity. After eating the sweet stuff, it’s a good idea to drink water or at the very least swish a little water around in your mouth.

Keep up good oral hygiene. With all the holiday busyness—shopping, gatherings with friends and family, school functions—you may find yourself exhausted at the end of the day. Still, this is an especially important time to keep up your oral hygiene routine. Brushing your teeth with fluoride toothpaste morning and night and flossing every day are key to keeping your teeth for the long haul.

Finally, if you are due for a dental checkup or cleaning, give us a call to make sure you start the New Year with a healthy smile. If you have a flexible spending account that will expire with the calendar year, make it a priority to fit in an end-of-year dental appointment. Please contact us or schedule an appointment for a consultation if you would like more information about keeping in the best oral health. To learn more, read the Dear Doctor magazine articles “Nutrition & Oral Health” and “The Bitter Truth About Sugar.”

By George R. Shepley, DDS
December 01, 2018
Category: Dental Procedures
Tags: orthodontics  
AnAssortmentofOrthodonticToolshelpsusSolveComplexBiteProblems

There are an assortment of techniques and treatments in an orthodontist's toolkit, braces being the most common and best known. Of course, there wouldn't be any tools at all if teeth couldn't move naturally.

Teeth aren't directly connected to the jawbone. An elastic tissue called the periodontal ligament lies between each one, with tiny fibers attaching to the tooth on one side and to the bone on the other. The ligament's elasticity and other qualities allow micro-movements of the teeth as we bite.

The ligament can also adapt to changes in the mouth and teeth by allowing the teeth to move to different positions. That's the basic concept behind braces: we thread a thin wire through brackets attached to the teeth, which we then attach to anchor points (usually back teeth not intended to move) and apply tension to it. Gradually over time, the target teeth move.

But what if your malocclusion (poor bite) is more complicated or the back teeth can't supply enough anchorage for moving the intended teeth? That's where we take advantage of other sources of anchorage.

One such source is the patient's skull, which we can make use of through special headgear worn a few hours a day. The device consists of a strap under tension that runs around the back of the head or neck to a wire housing attached to brackets on the target teeth. If you want to “pull” the teeth forward, the strap would come over the chin, forehead or a combination of both.

We may sometimes want to isolate some teeth to move without moving nearby teeth, such as moving front teeth backward to close a space without affecting teeth further to the rear. We can create a separate anchor point in the jaw with a TAD or temporary anchorage device.

TADs are tiny screws made of stainless steel inserted temporarily into the bone. We loop an elastic band over the TAD on one end and to a bracket or tension wire attached to the target teeth on the other. When we've achieved the teeth's new position we can easily remove the TAD from the bone.

These various tools make it possible to correct difficult or complex malocclusions. They may not always look attractive, but they'll help ensure the final result is.

If you would like more information on available orthodontic treatments, 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 “Orthodontic Headgear & Other Anchorage Appliances.”

By George R. Shepley, DDS
November 21, 2018
Category: Dental Procedures
LasersCouldbetheFutureforGumDiseaseTreatment

We’ve developed a number of effective treatments for periodontal (gum) disease. Depending on how far and deep a patient’s infection has advanced, treatment can be quite invasive and even require surgery. The more invasive, the longer and more uncomfortable the healing process can be.

But using a medical laser could make that less so. Although its use for gum disease treatment is still in its infancy, the latest observations from the field seem to show patients undergoing laser treatment may have less tissue trauma and bleeding, less discomfort after the procedure and quicker healing times.

Gum disease is a bacterial infection mostly caused by dental plaque, a thin film of food particles that build up on teeth in the absence of effective oral hygiene. The infection can advance deep below the gum line, weakening gum attachment to teeth and destroying supporting bone. Ultimately the affected teeth can be lost.

Traditionally, the only way to stop the disease is to manually remove plaque buildup on teeth and gum surfaces, which is continuing to sustain the infection, with special hand instruments called scalers or ultrasonic equipment. Because it’s important to remove as much plaque and diseased tissue as possible, we may need to perform a surgical procedure called flap surgery to move some of the gum tissues out of the way to get to these deeper areas. As with any surgery, this can create tissue trauma that may cause discomfort during the healing process.

Our new alternative is to use an Nd:YAG medical laser in a procedure known as Laser Assisted New Attachment Procedure or LANAP. With light energy delivered through a small fiber no more than the width of three human hairs, the laser can pinpoint diseased tissue and destroy bacteria through intense heat. Because of the laser beam’s tiny width and pulsing action, healthy tissue is at less risk for trauma than with the traditional treatment.

Coupled with other techniques, LANAP procedures could remove as much infected tissue and plaque as traditional methods, but with less healthy tissue trauma. In the future, then, patients with advanced gum disease undergoing laser treatment could have less bleeding and discomfort and faster healing times.

If you would like more information on treating gum disease, 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 “Treating Gum Disease with Lasers.”





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