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7150 Nob Hill Road
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Posts for: June, 2021

By Dr. Marvin Ernst General and Cosmetic Dentistry
June 29, 2021
Category: Oral Health
Tags: oral hygiene   braces  
GumSwellingCanHappenWithBraces-HeresHowtoAvoidIt

A few months into wearing braces you may notice your gums are swollen. It's likely you've developed periodontal (gum) disease.

Gum disease is a bacterial infection that usually begins with dental plaque. This thin, accumulated biofilm on teeth is filled with bacteria that cause dental disease. The more of it that remains on your teeth, the higher your risk for a gum infection.

In addition to regular dental cleanings, the best way for a person to reduce their gum disease risk is to remove plaque on a daily basis through brushing and flossing. Unfortunately, wearing braces complicates this: The brackets and wires affixed to your teeth can get in the way of your toothbrush and regular dental floss. As a result, you can easily miss plaque hidden around these bits of hardware.

Aside from gum disease, the braces themselves can irritate your gums. This irritation inflames the gums and may even cause more tissue to grow. Compound this overgrowth with a possible gum infection and it's no wonder your gums are severely swollen.

To lessen the chances of swollen gums with braces, you'll need to beef up your daily hygiene efforts. Simply put, it will typically take more time than normal to thoroughly clean around your braces. A few specialized tools, though, might make it easier.

An interproximal brush with a narrower head than a regular toothbrush is useful for accessing tight places around brackets. And a floss threader or a water flosser (which uses pressurized water to loosen and remove plaque) may help you better maneuver around wires to remove plaque between teeth.

Keeping your teeth clean as possible will certainly help you avoid gum swelling due to disease. But swelling from tissue overgrowth may not be resolved until your braces come off. In severe cases, it may even be necessary to remove the braces to treat the gums before resuming orthodontic treatment.

In any case, be as thorough as possible with your oral hygiene efforts during orthodontics and see your regular dentist for cleanings every six months. When you have completed orthodontic treatment, cleanings every six months are usually recommended. It's the best way to keep your gums healthy while you're wearing braces.

If you would like more information on dental care while wearing braces, 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 “Gum Swelling During Orthodontics.”


By Dr. Marvin Ernst General and Cosmetic Dentistry
June 19, 2021
Category: Dental Procedures
Tags: sedation dentistry  
SedationCanHelpanAnxiousChildRelaxDuringDentalTreatment

There are different ways to ease a child's potential nervousness with dental visits, like starting those visits around their first birthday or seeing a pediatric dentist who specializes in children. But even doing those things won't guarantee your child won't develop some form of dental anxiety, which could complicate their dental care.

To help make appointments easier for anxious children, many dentists use conscious sedation as a means of helping them relax. With this technique, the dentist administers a mild sedative to the child to take the edge off their nervousness, while allowing them to remain awake during treatment.

Sedation isn't anesthesia, the means we use to stop pain during treatment (although sedation may be used with anesthesia). Rather, sedation reduces emotional fear and anxiety. And unlike general anesthesia, a sedated child can still breathe without assistance and, depending on the depth of the sedation, respond to physical and verbal stimuli.

In most cases, children are administered sedation medications by mouth, usually as a syrup, although on occasion it might be delivered intravenously with an IV. The dose is usually given some time before their treatment session after the dentist has evaluated them. Dentists mostly use mild sedatives like Midazolam or Hydroxyzine with very little risk of side effects for children.

During the procedure, a designated staff member continually monitors the child's vital signs. Besides heart rate, pulse and respirations, they may also check the child's exhaled carbon dioxide levels to ensure they're breathing normally.

After the treatment session is over, staff will continue to monitor the child until their vital signs return to pre-sedation levels. If the child is of driving age, they'll need someone to drive them home. Children who've been sedated should remain home for the rest of the day, but they can usually return to school the next day depending on what kind of dental work they've undergone.

Dentists follow strict protocols for pediatric sedation adopted by the American Academy of Pediatrics, the American Dental Society, and the American Academy of Pediatric Dentistry. In addition, many states have also established processes for administering sedation therapy. It's a safe and effective method to ease a child's anxiety over their dental visit.

If you would like more information on making dental visits easier for kids, 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 “Sedation Dentistry For Kids.”


By Dr. Marvin Ernst General and Cosmetic Dentistry
June 09, 2021
Category: Dental Procedures
Tags: retainer  
ABondedRetainer-AnotherOptionforKeepingYourNewStraightSmile

For some, the excitement over their braces coming off gets dampened a bit with the prospect of now having to wear a retainer. But it has to be—newly realigned teeth have a tendency to revert to their previous positions out of a kind of “muscle memory.” A retainer prevents that from happening.

But as essential as it is, the standard retainer is almost as noticeable as braces, a major reason why many patients are less than enthusiastic about wearing them. And, because it's common for them to become lost when out of the mouth, replacing one becomes an added expense.

But there's another option—the bonded retainer. This retainer consists of a metal wire bonded to the back of the teeth to prevent them from moving. Because it's fixed in place, only a dentist can remove it.

The bonded retainer addresses the previous two issues associated with a removable retainer. Because it's behind the teeth rather than in front, it's out of sight to others. And, because it's fixed in place, there's no danger of losing it.

But unlike its removable cousin, which can be taken out for oral hygiene, the bonded retainer can make flossing more difficult. And, by nature, a bonded retainer must be worn all the time; a removable retainer allows for a more flexible schedule later in the treatment of a few hours a day.

So, which retainer option is best for you or another family member? A bonded retainer may be more attractive for appearance's sake, if it must be worn indefinitely, or if there's a high probability of the teeth moving out of alignment. And, it might be the right choice where there's a concern about a patient's ability to keep up with a removable retainer.

If you do decide to go with a bonded retainer, ask your dental hygienist for training on using floss with the fixed appliance—this can help improve oral hygiene. Whatever you choose, bonded or removable, your retainer will help you keep that new, beautiful, straightened smile.

If you would like more information on orthodontic retainers, 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 “Bonded Retainers.”




I. Marvin Ernst DDS, PA

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