By Nathan C. Steele, DMD
April 16, 2019
Category: Oral Health
JamieFoxxChipsaTooth-ThisTimebyAccident

Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.

“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…

For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.

When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.

A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.

But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.

Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!

If you have questions about repairing chipped teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”

By Nathan C. Steele, DMD
April 06, 2019
Category: Dental Procedures
Tags: teeth grinding  
StressandNighttimeTeethGrinding

April is National Stress Awareness Month. But what does stress have to do with dentistry? According to the American Academy of Sleep Medicine, if you have a Type A personality or are under a lot of stress, you are more likely to suffer from a condition called bruxism, which means you habitually grind or gnash your teeth. One in ten adults grind their teeth, and the rate is much higher in stressful professions. In fact, the bruxism rate is seven times higher among police officers!

Many people grind their teeth in their sleep without realizing it, so how would you know if you are a "sleep bruxer"? If your spouse frequently elbows you in the ribs because of the grinding sounds you make, that could be your first clue. Unfortunately, dental damage is another common sign. Some people find out they are nighttime teeth grinders only when they are examined by a dentist since bruxing often leads to wear patterns on the teeth that only happen because of this behavior. Other complications can also develop: The condition can interfere with sleep, result in headaches and cause soreness in the face, neck or jaw. Chronic or severe nighttime teeth grinding can damage dental work, such as veneers, bridgework, crowns and fillings, and can result in teeth that are worn down, chipped, fractured or loose.

The most common treatment is a custom-made night guard made of high-impact plastic that allows you to sleep while preventing your upper and lower teeth from coming into contact. Although a night guard will protect your teeth and dental work, it won't stop the grinding behavior. Therefore, finding and treating the cause should be a priority.

The Bruxism Association estimates that 70 percent of teeth grinding behavior is related to stress. If you are a bruxer, you can try muscle relaxation exercises, stretching and breathing exercises, stress reduction techniques and, where feasible, any lifestyle changes that can allow you to reduce the number of stressors in your life. Prescription muscle relaxants may also help. In addition, teeth grinding may be related to sleep apnea. This possibility should be investigated since sleep apnea can have some serious health consequences—we offer effective treatments for this condition as well.

We can spot signs of bruxism, so it's important to come in for regular dental checkups. We look for early indications of dental damage and can help you protect your smile. If you have questions about teeth grinding or would like to discuss possible symptoms, please contact our office or schedule an appointment for a consultation. You can read more in the Dear Doctor magazine articles “Teeth Grinding” and “Stress & Tooth Habits.”

4Common-SenseTacticstoLowerToothDecayRiskBetweenDentalVisits

If your dentist found tooth decay on your last visit, you might have been surprised. But tooth decay doesn't occur suddenly—it's a process that takes time to unfold.

It begins with bacteria—too many, that is. Bacteria naturally live in the mouth, but when their populations grow (often because of an abundance of leftover sugar to feed on) they produce high amounts of acid, a byproduct of their digestion. Too much acid contact over time softens and eventually erodes tooth enamel, making decay easier to advance into the tooth.

So, one important strategy for preventing tooth decay is to keep your mouth's bacterial population under control. To do that, here are 4 common-sense tactics you should perform between dental visits.

Practice daily hygiene. Bacteria thrive in dental plaque, a thin film of food particles that builds up on teeth. By both brushing and flossing you can reduce plaque buildup and in turn reduce disease-causing bacteria. In addition, brushing with a fluoride toothpaste can also help strengthen tooth enamel against acid attacks.

Cut back on sugar. Reducing how much sugar you eat—and how often –deprives bacteria of a prime food source. Constant snacking throughout the day on sweets worsens the problem because it prevents saliva, the body's natural acid neutralizer, from reducing high acid levels produced while eating. Constant snacking doesn't allow saliva to complete this process, which normally takes about thirty minutes to an hour. To avoid this scenario, limit any sweets you eat to mealtimes only.

Wait to brush after eating. Although this sounds counterintuitive, your tooth enamel is in a softened state until saliva completes the acid neutralizing process previously described. If you brush immediately after eating you could brush away tiny particles of softened enamel. Instead, rinse your mouth out with water and wait an hour for saliva to do its work before brushing.

Boost your saliva. Inadequate saliva flow could inhibit the fluid's ability to adequately neutralize acid or provide other restorative benefits to tooth enamel. You can improve flow with supplements or medications, or by drinking more water during the day. Products with xylitol, a natural sugar alternative, could give you a double benefit: chewing gums and mints containing it could stimulate more saliva flow and the xylitol itself can inhibit bacterial growth.

If you would like more information on staying ahead of tooth decay, please contact us or schedule an appointment for a consultation.

By Nathan C. Steele, DMD
March 17, 2019
Category: Oral Health
Tags: oral health   gum disease  
GumDiseaseCouldbeAffectingMoreThanJustYourMouth

Periodontal (gum) disease can weaken gum attachment and cause bone deterioration that eventually leads to tooth loss. But its detrimental effects can also extend beyond the mouth and worsen other health problems like heart disease or diabetes.

While the relationship between gum disease and other health conditions isn't fully understood, there does seem to be a common denominator: chronic inflammation. Inflammation is a natural defense mechanism the body uses to isolate damaged or diseased tissues from healthier ones. But if the infection and inflammation become locked in constant battle, often the case with gum disease, then the now chronic inflammation can actually damage tissue.

Inflammation is also a key factor in conditions like heart disease and diabetes, as well as rheumatoid arthritis or osteoporosis. Inflammation contributes to plaque buildup in blood vessels that impedes circulation and endangers the heart. Diabetes-related inflammation can contribute to slower wound healing and blindness.

Advanced gum disease can stimulate the body's overall inflammatory response. Furthermore, the breakdown of gum tissues makes it easier for bacteria and other toxins from the mouth to enter the bloodstream and spread throughout the body to trigger further inflammation. These reactions could make it more difficult to control any inflammatory condition like diabetes or heart disease, or increase your risk for developing one.

To minimize this outcome, you should see a dentist as soon as possible if you notice reddened, swollen or bleeding gums. The sooner you begin treatment, the less impact it may have on your overall health. And because gum disease can be hard to notice in its early stages, be sure you visit the dentist regularly for cleanings and checkups.

The most important thing you can do, though, is to try to prevent gum disease from occurring in the first place. You can do this by brushing twice and flossing once every day to keep dental plaque, the main trigger for gum disease, from accumulating on tooth surfaces.

Guarding against gum disease will certainly help you maintain healthy teeth and gums. But it could also help protect you from—or lessen the severity of—other serious health conditions.

If you would like more information on preventing and 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 “Good Oral Health Leads to Better Health Overall.”

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.”





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Nathan C. Steele, DMD

(908) 526-2113
17 Monroe Street Bridgewater, NJ 08807