My Blog

By E. Thomas Elstner Jr., DMD
May 28, 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 E. Thomas Elstner Jr., DMD
May 18, 2019
Category: Oral Health
Tags: fluroide  
KeepanEyeonYourFamilysFluorideIntake

Fluoride is a critical weapon in the war against tooth decay. But this natural chemical proven to strengthen tooth enamel has also aroused suspicion over the years that it might cause health problems.

These suspicions have led to rigorous testing of fluoride's safety. And the verdict from decades of research? We've found only one verifiable side effect, a condition called enamel fluorosis. Caused by too much fluoride present in the body, enamel fluorosis produces white streaks and patches on teeth, and can develop into darker staining and pitting in extreme cases. But other than having an unattractive appearance, the teeth remain sound and healthy.

Fortunately, you can reduce the risk of fluorosis by limiting fluoride exposure to within recommended limits. Fluoride can show up in processed foods and other substances, but the two sources you should focus on most are oral hygiene products and fluoridated drinking water.

Dentists highly recommend using toothpaste with fluoride to fight tooth decay. But be careful how much your family uses, especially younger members. An infant only needs a slight smear of toothpaste on their brush for effective hygiene. At around age 2, you can increase the amount to about the size of a vegetable pea.

As to drinking water, most utilities add fluoride to their supply. If yours does, you can find out how much they add by calling them or visiting cdc.gov ("My Water's Fluoride"), where you can also learn more about recommended levels of fluoridation. If you think it's excessive, you can switch to water labeled "de-ionized," "purified," "demineralized," or "distilled," which contain little to no added fluoride.

Even if your fluoridated water is within recommended levels, you may wish to take extra precautions for infants nursing with formula. If possible, use "ready-to-feed" formula, which usually contains very low amounts of fluoride if any. If you're using the powdered form, use only water with the aforementioned labeling for mixing.

Before making any drastic changes that might affect your family's fluoride intake, consult with your dentist first. And be sure you're keeping up regular dental visits—your dentist may be able to detect any early signs of fluorosis before it becomes a bigger problem.

If you would like more information on maintaining the proper fluoride balance with your family, 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 “Tooth Development and Infant Formula.”

By E. Thomas Elstner Jr., DMD
May 08, 2019
Category: Dental Procedures
EarlyOrthodonticTechniquesCouldStopGrowingBiteProblems

The longer many health problems go on, the worse they become. Treating them as early as possible could stop or slow their development.

That holds true for poor bites: while we can certainly correct them later in life, it's often better to "intercept" the problem during childhood. Interceptive orthodontics attempts to do this with treatments that influence how the jaws and other mouth structures develop during childhood. Many of these techniques are usually best implemented before puberty.

For example, some very complex problems called cross bites can occur if the upper jaw grows too narrowly. We might be able to stop this from happening by using an orthodontic appliance called a palatal expander during the childhood years. It works because the bone at the center of the palate (roof of the mouth) has a gap running back to front until the early teens when the gap closes.

We fit the palatal expander up under and against the palate, then extend out metal arms from a center mechanism to the back of the upper teeth that exert outward pressure on them. This widens the center gap, which the body continually fills with bone as the device gradually exerts more pressure. Over time this causes the jaw to widen and lessens the cross bite. Timing, though, is everything: it's most effective before the gap closes.

Another way to aid jaw growth is a Herbst appliance, a hinged device that alters the movement of the jaws. As a child wears it, a Herbst appliance draws the lower jaw forward to develop more in that direction. Like the palatal expander, it's best used before significant jaw growth occurs.

These are just two examples of techniques and tools that can guide structural growth and prevent bite problems. Because they're most effective in the early years of oral development, your child should undergo an orthodontic evaluation as early as age 6 to see if they need and can benefit from an interceptive treatment.

Interceptive orthodontics can stop or at least slow a growing bite problem. The effort and expense now could save you much more of both later on.

If you would like more information on interceptive orthodontics, 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 “Interceptive Orthodontics: Timely Intervention can make Treatment Easier.”

By E. Thomas Elstner Jr., DMD
April 28, 2019
Category: Oral Health
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 E. Thomas Elstner Jr., DMD
April 18, 2019
Category: Dental Procedures
NBCStarDeliversaMessageaboutthePerfectSmile

Sometimes it seems that appearances count for everything—especially in Hollywood. But just recently, Lonnie Chaviz, the 10-year-old actor who plays young Randall on the hit TV show This Is Us, delivered a powerful message about accepting differences in body image. And the whole issue was triggered by negative social media comments about his smile.

Lonnie has a noticeable diastema—that is, a gap between his two front teeth; this condition is commonly seen in children, but is less common in adults. There are plenty of celebrities who aren’t bothered by the excess space between their front teeth, such as Michael Strahan, Lauren Hutton and Vanessa Paradis. However, there are also many people who choose to close the gap for cosmetic or functional reasons.

Unfortunately, Lonnie had been on the receiving end of unkind comments about the appearance of his smile. But instead of getting angry, the young actor posted a thoughtful reply via Instagram video, in which he said: “I could get my gap fixed. Braces can fix this, but like, can you fix your heart, though?”

Lonnie is raising an important point: Making fun of how someone looks shows a terrible lack of compassion. Besides, each person’s smile is uniquely their own, and getting it “fixed” is a matter of personal choice. It’s true that in most circumstances, if the gap between the front teeth doesn’t shrink as you age and you decide you want to close it, orthodontic appliances like braces can do the job. Sometimes, a too-big gap can make it more difficult to eat and to pronounce some words. In other situations, it’s simply a question of aesthetics—some like it; others would prefer to live without it.

There’s a flip side to this issue as well. When teeth need to be replaced, many people opt to have their smile restored just the way it was, rather than in some “ideal” manner. That could mean that their dentures are specially fabricated with a space between the front teeth, or the crowns of their dental implants are spaced farther apart than they normally would be. For these folks, the “imperfection” is so much a part of their unique identity that changing it just seems wrong.

So if you’re satisfied with the way your smile looks, all you need to do is keep up with daily brushing and flossing, and come in for regular checkups and cleanings to keep it healthy and bright. If you’re unsatisfied, ask us how we could help make it better. And if you need tooth replacement, be sure to talk to us about all of your options—teeth that are regular and “Hollywood white;” teeth that are natural-looking, with minor variations in color and spacing; and teeth that look just like the smile you’ve always had.

Because when it comes to your smile, we couldn’t agree more with what Lonnie Chaviz said at the end of his video: “Be who you want to be. Do what you want to do. Do you. Be you. Believe in yourself.”

If you have questions about cosmetic dentistry, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Beautiful Smiles by Design” and “The Magic of Orthodontics.”





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