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CleftDefectsCanBeOvercomeThankstoAdvancedSurgicalProcedures

One in 700 babies are born each year with a cleft lip, a cleft palate or both. Besides its devastating emotional and social impact, this common birth defect can also jeopardize a child's long-term health. Fortunately, incredible progress has occurred in the last half century repairing cleft defects. Today's children with these birth defects often enter adulthood with a normal appearance and better overall health.

A cleft is a gap in the mouth or face that typically forms during early pregnancy. It often affects the upper lip, the soft and hard palates, the nose or (rarely) the cheek and eye areas. Clefts can form in one or more structures, on one side of the face or on both. Why they form isn't fully understood, but they seem connected to a mother's vitamin deficiencies or to mother-fetus exposure to toxic substances or infections.

Before the 1950s there was little that could be done to repair clefts. That changed with a monumental discovery by Dr. Ralph Millard, a U.S. Navy surgeon stationed in Korea: Reviewing cleft photos, Dr. Millard realized the “missing” tissue wasn't missing—only misplaced. He developed the first technique to utilize this misplaced tissue to repair the cleft.

Today, skilled surgical teams have improved on Dr. Millard's efforts to not only repair the clefts but also restore balance and symmetry to the face. These teams are composed of various oral and dental specialties, including general dentists who care for the patient's teeth and prevent disease during the long repair process.

Cleft repairs are usually done in stages, beginning with initial lip repair around 3-6 months of age and, if necessary, palate repair around 6-12 months. Depending on the nature and degree of the cleft, subsequent surgeries might be needed throughout childhood to “polish” the original repairs, as well as cosmetic dental work like implants, crowns or bridgework.

In addition to the surgical team's skill and artistry, cleft repair also requires courage, strength and perseverance from patients and their parents, and support from extended family and friends. The end result, though, can be truly amazing and well worth the challenging road to get there.

If you would like more information on repairing cleft birth defects, 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 “Cleft Lip & Cleft Palate.”

By Dentistry by Design
December 30, 2019
Category: Oral Health
Tags: oral hygiene   toothbrush  
HeresHowtoCutThroughAlltheChoicestoFindYourRightToothbrush

Henry Ford famously said a customer could have any color they wanted on their Model T “as long as it was black.” Those days are over—today’s cars and trucks come with a slew of options, and not just their paint color.

There’s something else with a wide array of possible options: your choice of toothbrush. Your local store’s dental care aisle has dozens of toothbrushes in a myriad of sizes, shapes and features. And many promise better hygiene outcomes because of their unique design.

It’s enough to make your head spin. But you can narrow your search for the right toothbrush— just look for these basic qualities.

Bristle texture. At this all-important juncture between brush and teeth, softer-textured bristles are better. That might sound counter-intuitive, but soft bristles are just as capable at removing bacterial plaque, that sticky tooth film most responsible for dental disease, as stiffer bristles. Stiffer bristles, on the other hand, can damage gums and cause recession. Also, look too for rounded bristles (gentler on the gums), and multi-leveled or angled ones for better access around teeth.

Size and shape. Toothbrushes come in different sizes because, well, so do mouths. Look, then, for a brush and bristle head that can comfortably reach all the teeth in your mouth. If you have problems with manual dexterity, choose a brush with larger grip handles. A brush that’s comfortable to use and easy to handle can make your brushing more effective.

ADA Seal of Acceptance. The American Dental Association tests hygiene products like toothbrushes. If they pass the association’s standards, the manufacturer includes the ADA Seal of Approval on their packaging. Not all submit their brushes for this evaluation, so the seal’s absence doesn’t necessarily mean a brush is of low quality. The seal, though, does tell you the product passes muster with dental professionals.

It often takes a little trial and error to find the right brush, but since you should change yours out every six months, it’s a small price to experiment. And, no matter how great the brush, it’s only as good at removing plaque as the hand that holds it. So, be sure you learn proper brushing techniques—that and the right brush will keep your teeth and gums healthy.

If you would like more information on choosing the right 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 Dentistry by Design
December 20, 2019
Category: Oral Health
Tags: dental exam  
YouMayNeedSomethingOtherThanOintmenttoClearupThisFacialRash

During your latest dental cleaning and checkup, your dentist notices a skin rash around your mouth. You sigh—it’s been going on for some time. And every ointment you’ve tried doesn’t help.

You may have peri-oral dermatitis, a type of skin rash dentists sometime notice during dental treatment. It doesn’t occur often—usually in only 1% of the population—but when it does, it can be resistant to common over-the-counter ointments.

That’s because peri-oral dermatitis is somewhat different from other facial rashes. Often mistaken as acne, the rash can appear as small red bumps, blisters or pus-filled pimples most often around the mouth (but not on the lips), nostrils or even the eyes. Sometimes the rash can sting, itch or burn.

People with peri-oral dermatitis often try medicated ointments to treat it. Many of these contain steroids that work well on other skin conditions; however, they can have an opposite effect on peri-oral dermatitis.

Because the steroids cause a constriction in the tiny blood vessels of the skin, the rash may first appear to be fading. This is short-lived, though, as the rash soon returns with a vengeance. Prolonged steroid applications can also thin the affected skin, making it more susceptible to infection and resistant to healing.

Peri-oral dermatitis requires a different treatment approach. The first step is to stop using any kind of steroidal cream, as well as moisturizers, ointments and both prescription and non-prescription medications. Instead, you should only use a mild soap to wash your face.

You may find the rash looking worse for a few days but be patient and continue to avoid ointments or creams. Your healthcare provider may also prescribe oral antibiotics, usually of the tetracycline family. It may take several weeks of antibiotic treatment until the skin noticeably clears up.

For most people, this approach puts their rash into permanent remission. Some, though, may see a reoccurrence, in which case it’s usually best to repeat treatment. With a little patience and care, though, you’ll finally see this persistent rash fade away.

If you would like more information on peri-oral dermatitis, please contact us or schedule an appointment for a consultation.

By Dentistry by Design
December 10, 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.”

By Dentistry by Design
November 30, 2019
Category: Oral Health
Tags: oral health   nutrition  
4FoodsThatAreGoodforBothYourMouthandYourBody

You can't separate your oral health from your overall health. What's beneficial for your body in general is usually beneficial for your teeth and gums.

Take the foods you eat: good nutrition is essential to general health and well-being. But the same foods that keep the rest of your body healthy often do the same for your mouth—and those that are not so good for the rest of you are usually not good for your teeth and gums either.

Here are 4 different types of foods that positively impact both mouth and body.

Cheese and dairy. Dairy products are rich in calcium, essential for strengthening both your bones and your teeth. Cheese helps stimulate saliva and protects against calcium loss. Cow's milk contains minerals and proteins both your body and mouth needs. It also contains lactose, a less acidic sugar that doesn't contribute to tooth decay.

Plant foods. Vegetables and fruit are loaded with vitamins and nutrients that keep the body functioning normally. They also contain fiber: Not only is this good for your digestive system, it requires chewing to break it down in the mouth, which stimulates saliva. A good flow of saliva helps prevent your mouth from becoming too acidic and thus more prone to dental disease.

Black and green teas. A nice cup of hot tea isn't just soothing—it's rich in antioxidants that help fight disease in the body (and the mouth). Black tea also contains fluoride, which has been proven to strengthen enamel against acid attack.

Chocolate. There's both good and bad news about this perennial favorite. The good news is the polyphenolic compounds (a kind of antioxidant) in unrefined cocoa can protect against disease including tooth decay. The bad news is most processed chocolate is loaded with added sugar—not the healthiest substance for your body, and definitely not for your teeth. Try then to incorporate small amounts of chocolate in your diet, the lower the sugar content the better.

Eating nutritiously helps your body stay healthy and disease-free. And coupled with daily hygiene and regular dental visits, it's one of the best things you can do for your teeth and gums.

If you would like more information on nutrition and dental 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 “Nutrition and Oral Health: How Diet Impacts Dental and General Health.”





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