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Posts for: September, 2016

By Dr. Marvin Ernst General and Cosmetic Dentistry
September 27, 2016
Category: Dental Procedures
HowKathyBatesRetainsHerMovie-StarSmile

In her decades-long career, renowned actress Kathy Bates has won Golden Globes, Emmys, and many other honors. Bates began acting in her twenties, but didn't achieve national recognition until she won the best actress Oscar for Misery — when she was 42 years old! “I was told early on that because of my physique and my look, I'd probably blossom more in my middle age,” she recently told Dear Doctor magazine. “[That] has certainly been true.” So if there's one lesson we can take from her success, it might be that persistence pays off.

When it comes to her smile, Kathy also recognizes the value of persistence. Now 67, the veteran actress had orthodontic treatment in her 50's to straighten her teeth. Yet she is still conscientious about wearing her retainer. “I wear a retainer every night,” she said. “I got lazy about it once, and then it was very difficult to put the retainer back in. So I was aware that the teeth really do move.”

Indeed they do. In fact, the ability to move teeth is what makes orthodontic treatment work. By applying consistent and gentle forces, the teeth can be shifted into better positions in the smile. That's called the active stage of orthodontic treatment. Once that stage is over, another begins: the retention stage. The purpose of retention is to keep that straightened smile looking as good as it did when the braces came off. And that's where the retainer comes in.

There are several different kinds of retainers, but all have the same purpose: To hold the teeth in their new positions and keep them from shifting back to where they were. We sometimes say teeth have a “memory” — not literally, but in the sense that if left alone, teeth tend to migrate back to their former locations. And if you've worn orthodontic appliances, like braces or aligners, that means right back where you started before treatment.

By holding the teeth in place, retainers help stabilize them in their new positions. They allow new bone and ligaments to re-form and mature around them, and give the gums time to remodel themselves. This process can take months to years to be complete. But you may not need to wear a retainer all the time: Often, removable retainers are worn 24 hours a day at first; later they are worn only at night. We will let you know what's best in your individual situation.

So take a tip from Kathy Bates, star of the hit TV series American Horror Story, and wear your retainer as instructed. That's the best way to keep your straight new smile from changing back to the way it was — and to keep a bad dream from coming true.

If you would like more information about orthodontic retainers, please contact us or schedule an appointment for a consultation. You can learn more about this topic in the Dear Doctor magazine articles “Why Orthodontic Retainers?” and “The Importance of Orthodontic Retainers.” The interview with Kathy Bates appears in the latest issue of Dear Doctor.


By Dr. Marvin Ernst General and Cosmetic Dentistry
September 12, 2016
Category: Oral Health
TreatingBurningMouthDependsonWhatsTriggeringit

There's a burning sensation in your mouth even though you haven't had anything hot to eat or drink. It's an experience you've had for years, often accompanied by mouth dryness, tingling or numbness that leaves you irritable, anxious or depressed.

The root causes for Burning Mouth Syndrome (BMS) remain elusive, although there appear to be links to diabetes, acid reflux, menopausal hormonal changes or even psychological issues. Although we may not be able to pinpoint the root cause we can identify contributing factors to BMS through a detailed oral examination and medical history (including drugs you're taking).

Mouth dryness is one of the most common factors for BMS. The lack of lubrication from adequate saliva flow can contribute substantially to the irritating burning sensation. There are a number of causes for mouth dryness, including as a side effect from many medications or other treatments.

We must also consider whether an allergic reaction — the body's over-reaction to a foreign substance — may have a role in your symptoms. Some people react to sodium lauryl sulfate, a foaming agent found in many types of toothpaste, along with whitening substances or flavorings like cinnamon; denture wearers can become allergic to the plastic materials used to construct the denture. These, as well as spicy foods, smoking or alcohol, can irritate or cause the tissues lining the inside of the mouth to peel.

Determining what factors contribute to your symptoms allows us to develop a treatment approach tailored to your situation. If, for example, we've determined your BMS stems from dry mouth as a side effect to medication, we can ask your doctor to prescribe an alternative, increase your water intake when taking pills or stimulate saliva flow. If we identify an allergen as a factor, you can eliminate the substance to reduce symptoms.

You may also need to make changes to your eating and lifestyle habits: stop smoking, reduce your alcohol or coffee consumption and avoid very hot or spicy foods. And look for ways to reduce stress, another contributing factor, through relaxation techniques, exercise or support groups.

It's possible that BMS will resolve itself over time. In the meantime, though, we can help you find ways to alleviate the irritation.

If you would like more information on diagnosing and treating BMS, 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 “Burning Mouth Syndrome.”


By Dr. Marvin Ernst General and Cosmetic Dentistry
September 04, 2016
Category: Dental Procedures
NewFrontTeethforaTeenagedDavidDuchovny

In real life he was a hard-charging basketball player through high school and college. In TV and the movies, he has gone head-to-head with serial killers, assorted bad guys… even mysterious paranormal forces. So would you believe that David Duchovny, who played Agent Fox Mulder in The X-Files and starred in countless other large and small-screen productions, lost his front teeth… in an elevator accident?

“I was running for the elevator at my high school when the door shut on my arm,” he explained. “The next thing I knew, I was waking up in the hospital. I had fainted, fallen on my face, and knocked out my two front teeth.” Looking at Duchovny now, you’d never know his front teeth weren’t natural. But that’s not “movie magic” — it’s the art and science of modern dentistry.

How do dentists go about replacing lost teeth with natural-looking prosthetics? Today, there are two widely used tooth replacement procedures: dental implants and bridgework. When a natural tooth can’t be saved — due to advanced decay, periodontal disease, or an accident like Duchovny’s — these methods offer good looking, fully functional replacements. So what’s the difference between the two? Essentially, it’s a matter of how the replacement teeth are supported.

With state-of-the-art dental implants, support for the replacement tooth (or teeth) comes from small titanium inserts, which are implanted directly into the bone of the jaw. In time these become fused with the bone itself, providing a solid anchorage. What’s more, they actually help prevent the bone loss that naturally occurs after tooth loss. The crowns — lifelike replacements for the visible part of the tooth — are securely attached to the implants via special connectors called abutments.

In traditional bridgework, the existing natural teeth on either side of a gap are used to support the replacement crowns that “bridge” the gap. Here’s how it works: A one-piece unit is custom-fabricated, consisting of prosthetic crowns to replace missing teeth, plus caps to cover the adjacent (abutment) teeth on each side. Those abutment teeth must be shaped so the caps can fit over them; this is done by carefully removing some of the outer tooth material. Then the whole bridge unit is securely cemented in place.

While both systems have been used successfully for decades, bridgework is now being gradually supplanted by implants. That’s because dental implants don’t have any negative impact on nearby healthy teeth, while bridgework requires that abutment teeth be shaped for crowns, and puts additional stresses on them. Dental implants also generally last far longer than bridges — the rest of your life, if given proper care. However, they are initially more expensive (though they may prove more economical in the long run), and not everyone is a candidate for the minor surgery they require.

Which method is best for you? Don’t try using paranormal powers to find out: Come in and talk to us. If you would like more information about tooth replacement, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Crowns & Bridgework,” and “Dental Implants.”




I. Marvin Ernst DDS, PA

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