My Blog
By Thomas W. Mitchell DDS
December 09, 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 Thomas W. Mitchell DDS
November 29, 2018
Category: Dental Procedures
Tags: gum surgery  
GumSurgeryCanImproveYourSmileandSaveYourTeeth

While the term “plastic surgery” might bring to mind face lifts or tummy tucks, not all procedures in this particular surgical field are strictly cosmetic. Some can make a big difference in a person’s health.

One example is periodontal plastic surgery, which corrects gum tissue loss around the teeth. Although these procedures can indeed improve appearance, they more importantly help save teeth.

Gum loss is most often a consequence of periodontal (gum) disease, a bacterial infection arising from a thin film of food particles on the teeth called dental plaque. As the disease weakens the gums’ attachment to teeth, they shrink back or recede, exposing the area around the roots. Without the protective cover the gums provide the roots, they become more susceptible to decay.

In milder cases of gum recession, treating the infection often results in the gums regaining their normal attachment to teeth. But with more advanced recession, natural gum healing may not be enough to reverse it. For such situations grafting donor tissue to the recessed area can help stimulate new tissue growth.

While gum tissue grafts can come from an animal or other human, the most likely source is from the person themselves. In one type of procedure, free gingival grafting, the surgeon locates and completely removes (or “frees”) a thin layer of skin resembling gum tissue, typically from the roof of the mouth, shapes it and then transplants it by suturing it to the recession site. Both donor and recipient sites heal at about the same rate in two to three weeks.

Another technique is known as connective tissue grafting. In this procedure the surgeon partially removes the donor tissue from its site while leaving a portion containing blood vessels intact. The palatal tissue is still used and transported to fit beneath the tissue that’s still attached to the blood supply. This connective tissue graft is then positioned and sutured to the recipient site while still maintaining its blood supply connection at the donor site. Maintaining this connection facilitates healing and increases the chances the graft will “take” and become firmly attached to the new site.

Grafting procedures require advanced techniques and skills. But with them we may be able to restore gum attachment to teeth with an impact on appearance and dental health that’s well worth the effort.

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 “Periodontal Plastic Surgery.”

RegardlessofWhatYouveSeenOnlineDontFearaRootCanalTreatment

With smart phone in hand, you can instantaneously find out just about anything. Unfortunately, online search results aren’t always accurate. Case in point: there’s an idea floating on the World Wide Web that root canal treatments cause cancer.

Sounds ludicrous? Yes, but like other strange ideas this one has historical roots (pardon the pun). In the early 20th Century, a dentist named Weston Price propagated the idea that leaving a “dead” organ in the body caused health problems. By his view, a root canal-treated tooth fell into this category and could potentially cause, among other things, cancer.

But concern over root canal treatment safety is on shaky ground: dentistry examined Dr. Price’s ideas over sixty years ago and found them wanting. But first, let’s look at what a root canal treatment can actually do for your health.

Tooth decay is an infection that first attacks the outer tooth enamel and then continues to advance until it infects the inner pulp. It can then travel through the root canals to the roots and bone. Without intervention, the infection will result in tooth loss.

We use a root canal treatment to save the tooth from this fate. During the procedure we remove and disinfect all of the diseased or dead tissue within the pulp and root canals. We then fill the empty chamber and canals with a special filling and seal the tooth to prevent any further infection. And while technically the procedure renders a tooth unable to respond to thermal sensitivity or tooth decay, the tooth is still alive as it is attached to the periodontal ligament and its blood supply and nerve tissue. The tooth can still “feel” if you bite on something too hard and it doesn’t affect the tooth’s function or health, or a patient’s overall health for that matter.

As to Dr. Price’s theory, extensive studies beginning in the 1950s have examined the potential health risk of root canal treatments. The latest, a 2013 patient survey study published in a journal of the American Medical Association, not only found no evidence linking root canal treatment to cancer, but a lower risk of oral cancer in 45% of patients who had undergone multiple root canal treatments.

While root canal treatments do have potential side effects, none are remotely as serious as this online “factoid” about cancer. It’s far more likely to benefit your health by saving your tooth.

If you would like more information on root canal treatment, 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 “Root Canal Safety.”

WhyemBigBangTheoryemActressMayimBialikCouldntHaveBraces

Mayim Bialik has spent a good part of her life in front of TV cameras: first as the child star of the hit comedy series Blossom, and more recently as Sheldon Cooper’s love interest — a nerdy neuroscientist — on The Big Bang Theory. (In between, she actually earned a PhD in neuroscience from UCLA…but that’s another story.) As a child, Bialik had a serious overbite — but with all her time on camera, braces were just not an option.

“I never had braces,” she recently told Dear Doctor – Dentistry & Oral Health magazine. “I was on TV at the time, and there weren’t a lot of creative solutions for kids who were on TV.” Instead, her orthodontist managed to straighten her teeth using retainers and headgear worn only at night.

Today, there are several virtually invisible options available to fix orthodontic issues — and you don’t have to be a child star to take advantage of them. In fact, both children and adults can benefit from these unobtrusive appliances.

Tooth colored braces are just like traditional metal braces, with one big difference: The brackets attached to teeth are made from a ceramic material that blends in with the natural color of teeth. All that’s visible is the thin archwire that runs horizontally across the teeth — and from a distance it’s hard to notice. Celebs like Tom Cruise and Faith Hill opted for this type of appliance.

Clear aligners are custom-made plastic trays that fit over the teeth. Each one, worn for about two weeks, moves the teeth just a bit; after several months, you’ll see a big change for the better in your smile. Best of all, clear aligners are virtually impossible to notice while you’re wearing them — which you’ll need to do for 22 hours each day. But you can remove them to eat, or for special occasions. Zac Efron and Katherine Heigl, among others, chose to wear clear aligners.

Lingual braces really are invisible. That’s because they go behind your teeth (on the tongue side), where they can’t be seen; otherwise they are similar to traditional metal braces. Lingual braces are placed on teeth differently, and wearing them often takes some getting used to at first. But those trade-offs are worth it for plenty of people. Which celebs wore lingual braces? Rumor has it that the list includes some top models, a well-known pop singer, and at least one British royal.

So what’s the best way to straighten your teeth and keep the orthodontic appliances unnoticeable? Just ask us! We’d be happy to help you choose the option that’s just right for you. You’ll get an individualized evaluation, a solution that fits your lifestyle — and a great-looking smile!

For more information about hard-to-see (or truly invisible) orthodontics, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Orthodontics for the Older Adult” and “Clear Aligners for Teenagers.”

By Thomas W. Mitchell DDS
October 30, 2018
Category: Dental Procedures
HowLongWillRootCanalTreatmentLast

Root canal treatment can be an effective life preserver for a heavily decayed tooth. The question a lot of people ask, though, is how long might the tooth survive after treatment.

That’s an important concern since the treated tooth was in dire straits beforehand as decay had infected its inner most layer, the pulp. The infection, which had caused the living bundles of nerves, blood vessels and connective tissue within to become inflamed and diseased, was poised to invade even deeper through the root canals. During the root canal treatment, the infected pulp tissue is removed and the empty chamber and root canals are filled with a special filling to seal the tooth from further infection.

The protection, though, isn’t an absolute certainty: how long a treated tooth survives depends on a number of factors. For one, the earlier a diseased tooth can be initially diagnosed — especially if the infection hasn’t spread into the jawbone — the better the procedural outcome. Likewise, the chances of longevity are also better if the initial root canal treatment was thorough in identifying and filling all the root canals as well as capping the tooth with a life-like crown in a timely manner after treatment.

The type and location of the tooth can also affect its long-term health. Front teeth, with their single roots and canals are easier to access and treat. Back teeth, by contrast, can have two or more roots and a more intricate canal network. These kinds of complications could require the use of special microscopic equipment and the expertise of an endodontist, a specialist in root canals.

Even if a re-infection occurs, the tooth isn’t necessarily lost. A repeat root canal treatment that addresses these and other issues, could give the tooth a “third” chance. In any case, if a tooth is worth saving attempting a root canal treatment is generally preferable to losing the tooth and replacing it with a prosthetic tooth — it’s well worth the try.

If you would like more information on root canal 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 “Root Canal Treatment: How Long Will it Last.”





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