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By Vincent M. Immordino, D.M.D., P.A. & Thomas J. Burns, Jr., D.D.S., P.A.
July 13, 2018
Category: Dental Procedures
ChrissyTeigensTeeth-GrindingTroubles

It might seem that supermodels have a fairly easy life — except for the fact that they are expected to look perfect whenever they’re in front of a camera. Sometimes that’s easy — but other times, it can be pretty difficult. Just ask Chrissy Teigen: Recently, she was in Bangkok, Thailand, filming a restaurant scene for the TV travel series The Getaway, when some temporary restorations (bonding) on her teeth ended up in her food.

As she recounted in an interview, “I was… like, ‘Oh my god, is my tooth going to fall out on camera?’ This is going to be horrible.” Yet despite the mishap, Teigen managed to finish the scene — and to keep looking flawless. What caused her dental dilemma? “I had chipped my front tooth so I had temporaries in,” she explained. “I’m a grinder. I grind like crazy at night time. I had temporary teeth in that I actually ground off on the flight to Thailand.”

Like stress, teeth grinding is a problem that can affect anyone, supermodel or not. In fact, the two conditions are often related. Sometimes, the habit of bruxism (teeth clenching and grinding) occurs during the day, when you’re trying to cope with a stressful situation. Other times, it can occur at night — even while you’re asleep, so you retain no memory of it in the morning. Either way, it’s a behavior that can seriously damage your teeth.

When teeth are constantly subjected to the extreme forces produced by clenching and grinding, their hard outer covering (enamel) can quickly start to wear away. In time, teeth can become chipped, worn down — even loose! Any dental work on those teeth, such as fillings, bonded areas and crowns, may also be damaged, start to crumble or fall out. Your teeth may become extremely sensitive to hot and cold because of the lack of sufficient enamel. Bruxism can also result in headaches and jaw pain, due in part to the stress placed on muscles of the jaw and face.

You may not be aware of your own teeth-grinding behavior — but if you notice these symptoms, you might have a grinding problem. Likewise, after your routine dental exam, we may alert you to the possibility that you’re a “bruxer.” So what can you do about teeth clenching and grinding?

We can suggest a number of treatments, ranging from lifestyle changes to dental appliances or procedures. Becoming aware of the behavior is a good first step; in some cases, that may be all that’s needed to start controlling the habit. Finding healthy ways to relieve stress — meditation, relaxation, a warm bath and a soothing environment — may also help. If nighttime grinding keeps occurring, an “occlusal guard” (nightguard) may be recommended. This comfortable device is worn in the mouth at night, to protect teeth from damage. If a minor bite problem exists, it can sometimes be remedied with a simple procedure; in more complex situations, orthodontic work might be recommended.

Teeth grinding at night can damage your smile — but you don’t have to take it lying down! If you have questions about bruxism, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Stress & Tooth Habits” and “When Children Grind Their Teeth.”

By Vincent M. Immordino, D.M.D., P.A. & Thomas J. Burns, Jr., D.D.S., P.A.
July 03, 2018
Category: Oral Health
Tags: oral health   gum disease  
WellHelpYouMaintainYourOralHealthAfterGumDisease

It’s been a long road back to oral health for you after periodontal (gum) disease. But after several plaque removal sessions and perhaps even surgical procedures to address deep infection, your gums have regained their healthy pink appearance.

But now you must face a hard reality: because you’ve had gum disease you’ll need to be extra vigilant with your oral hygiene to avoid another round with this destructive disease. But don’t worry—you won’t have to fight your prevention battle alone. We’ll continue to provide you care that reduces your risk of re-infection. We call that care periodontal maintenance (PM).

The heart of PM care involves regular dental visits for monitoring, cleanings and treatment when necessary. While most patients may visit their dentist at least twice a year, as a previous gum disease patient we may advise more frequent visits, especially if you’ve just finished periodontal treatment. Depending on the extent of your disease, we may begin with a visit every other week or once every two to three months. If your mouth continues to be disease-free we may suggest increasing the time between visits.

During your visit we’ll carefully examine your mouth, as well as screen you for any signs of potential oral cancer. We’re looking for both signs of re-infection or new issues with your teeth and gums. We’ll also assess the effectiveness of your oral hygiene efforts and advise you on ways you can improve.

If we find any signs of disease, we’ll then formulate a treatment plan to effectively deal with it. With frequent visits we have a better chance of discovering re-infection early—and the earlier the better to minimize any further damage. We may also need to take steps to make future PM care easier. This could include gum surgery to alter the tissues around certain teeth for easier access for examination and cleaning.

Our main focus with PM care is to look ahead: what can we do now to prevent a future bout of gum disease or at least lessen its effect? With continued monitoring and care we can drastically reduce your risk for further damage from this destructive disease.

If you would like more information on post-gum disease maintenance, 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 “Periodontal Cleanings.”

By Vincent M. Immordino, D.M.D., P.A. & Thomas J. Burns, Jr., D.D.S., P.A.
June 23, 2018
Category: Oral Health
Tags: gummy smile  
FindingtheRightSolutionforYourGummySmile

Even with picture perfect teeth, you may still be unhappy with your appearance. The problem: too much of your upper gums show when you smile.

There’s no precise standard for a “gummy smile”—it’s often a matter of perception. As a rule of thumb, though, we consider a smile “gummy” if four or more millimeters of upper gum tissue show while smiling. In any event if you perceive you have a gummy smile, it can greatly affect your self-confidence and overall well-being.

The good news is we can often correct or at least minimize a gummy smile. The first step, though, is to find out why the gums are so prominent.

There are a few possible causes: the most obvious, of course, is that there’s more than normal gum tissue present. But the cause could be the front teeth didn’t fully erupt in childhood and so the gums appear more prominent. Other causes include the upper lip moving too far upward when smiling (hypermobile) or an elongated upper jaw that’s out of proportion with the face.

Finding the exact cause or combination of causes will determine what approach we take to minimize your gummy smile. If too much gum tissue or not enough of  the teeth show, we can use a surgical procedure called crown lengthening to expose more of the crown (the visible part of a tooth), as well as remove excess gum tissues and reshape them and the underlying bone for a more proportional appearance.

A hypermobile upper lip can be treated with Botox, a cosmetic injection that temporarily paralyzes the lip muscles and restricts their movement. But for a permanent solution, we could consider a surgical procedure to limit upper lip movement.

Surgery may also be necessary for an abnormal jaw structure to reposition it in relation to the skull. If, on the other hand it’s the teeth’s position and not the jaw causing gum prominence, we may be able to correct it with orthodontics.

As you can see, there are several ways varying in complexity to correct a gummy smile. To know what will work best for you, you’ll need to undergo an orofacial examination to determine the underlying cause. It’s quite possible there’s a way to improve your smile and regain your self-confidence.

If you would like more information on improving a gummy smile, 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 “Gummy Smiles.”

By Vincent M. Immordino, D.M.D., P.A. & Thomas J. Burns, Jr., D.D.S., P.A.
June 13, 2018
Category: Dental Procedures
Tags: braces   orthodontics  
TheresaGoodReasonforAdultstoConsiderOrthodontics-BetterOralHealth

You’ve had crooked teeth since you could remember. Perhaps you and your parents talked about braces when you were a teenager, but it never happened. Now you’re well into your adult years and you’re comfortable with how you look — so why go through the expense and time now to have them straightened?

There’s a good reason to consider orthodontics at any age — improved health. While we mainly associate teeth straightness with an improved smile, the more serious impact of misaligned teeth is on function — how we bite, chew and speak. As with many other areas of life, good form usually makes for good function. When we have crooked teeth, we may not be able to chew our food properly or speak as well as we could if our teeth were aligned properly.

Misaligned bites (malocclusions) can also have an impact on individual tooth health. Because they don’t interact efficiently with their opposing counterparts during chewing or biting, teeth can become loose or migrate further out of alignment.

While improvement in oral health is the primary reason for considering treatment for a malocclusion, don’t discount the benefit of orthodontics to your appearance. Your smile impacts many aspects of your life, including career and social relationships. A straighter, more attractive smile could also boost your self-confidence: even if you think you’ve grown accustomed to your smile, straightening your teeth could vastly change how you view yourself and how you believe others view you.

And if you’re dreading the look and feel of metal braces, orthodontic treatments have made giant strides in the last few decades. Clear aligners, for example, are much less noticeable than traditional fixed braces (and can be removed for special occasions), but still effective for moving teeth. There’s never been a better time to consider straightening your teeth — and change the course of your health and your life.

If you would like more information on orthodontics for adults, 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 “Why Straighten Teeth.”

By Vincent M. Immordino, D.M.D., P.A. & Thomas J. Burns, Jr., D.D.S., P.A.
June 03, 2018
Category: Dental Procedures
ArianaGrandeBreaksFree-ofHerWisdomTeeth

Via a recent Instagram post, pop diva Ariana Grande became the latest young celebrity to publicly acknowledge a dental milestone: having her wisdom teeth removed. The singer of hits such as “Break Free” and “Problem” posted an after-surgery picture of herself (wearing her signature cat-eye eyeliner), with a caption addressed to her teeth: “Peace out, final three wisdom teeth. It’s been real.”

With the post, Grande joined several other celebs (including Lily Allen, Paris Hilton and Emile Hirsch) who have shared their dental surgery experience with fans. Will "wisdom teeth removal" become a new trending topic on social media? We aren’t sure — but we can explain a bit about the procedure, and why many younger adults may need it.

Technically called the “third molars,” wisdom teeth usually begin to emerge from the gums between the ages of 17 and 25 — presumably, around the same time that a certain amount of wisdom emerges. Most people have four of these big molars, which are located all the way in the back of the mouth, on the left and right sides of the upper and lower jaws.

But when wisdom teeth begin to appear, there’s often a problem: Many people don’t have enough space in their jaws to accommodate them. When these molars lack sufficient space to fully erupt (emerge), they are said to be “impacted.” Impacted teeth can cause a number of serious problems: These may include pain, an increased potential for bacterial infections, periodontal disease, and even the formation of cysts (pockets of infection below the gum line), which can eventually lead to tooth and bone loss.

In most cases, the best treatment for impacted wisdom teeth is extraction (removal) of the problem teeth. Wisdom tooth extraction is a routine, in-office procedure that is usually performed under local anesthesia or “conscious sedation,” a type of anesthesia where the patient remains conscious (able to breathe normally and respond to stimuli), but is free from any pain or distress. Anti-anxiety medications may also be given, especially for those who are apprehensive about dental procedures.

So if you find you need your wisdom teeth extracted, don’t be afraid to “Break Free” like Ariana Grande did; whether you post the results on social media is entirely up to you. If you would like more information about wisdom tooth extraction, please call our office to schedule a consultation. You can learn more in the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”





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