Monthly Archives: June 2013

Sensitive Teeth – A Common Complaint

dentist talking to patientSensitive teeth is one of the most common complaints by dental patients.

Why are my teeth sensitive?

Exposed dentin is the likely reason.  Dentin is the tissueTooth anatomy that makes up the core of each tooth.  Dentin is covered by a protective coating of enamel.  When this enamel wears away or decays, the dentin becomes exposed and receptive to sensations, including pain.  Dentin exposure and sensitivity also occur when roots are exposed due to gum recession.

When does tooth sensitivity usually occur?

You may experience tooth sensitivity, or dentin hypersensitivity, after eating cold or hot foods, drinking cold or hot liquids, or breathing cold air.

What causes dentin hypersensitivity?

Eating lemonCauses of dentin hypersensitivity include brushing too hard, which wears away enamel, and gum disease.  Other causes include cracked or chipped teeth and grinding or clenching your teeth.  Medical conditions like bulimia also may lead to exposed dentin.  Your diet may play a role as well. Consumption of acidic foods and drinks, such as citrus fruits and carbonated beverages, can chemically dissolve enamel over time, resulting in exposed dentin.

What can increase dentin hypersensitivity?Whitening toothpaste

Some toothpaste brands contain abrasive ingredients that may wear away enamel.  Ingredients found in some whitening toothpastes and bleaching treatments may increase tooth sensitivity as well.

How do I know when it’s time to see a Dr. Marinic?

If your teeth are highly sensitive for more than three or four days and they react to hot and cold temperatures, it’s best to get an evaluation from Dr. Marinic

How does Dr. Marinic determine dentin hypersensitivity?

Dr. Marinic can gauge the severity of your sensitive teeth by using an air test. He sprays air across each area of your teeth to pinpoint the exact location of sensitivity.

What can Dr. Marinic do to treat dentin hypersensitivity?

Dr. Marinic will examine your teeth, look for causes of sensitivity, and make treatment recommendations. If sensitivity is associated with clenching and/or grinding, he may recommend a mouth guard.  Dr. Marinic has a variety of treatments for dentin hypersensitivity.  Products for home use include desensitizing toothpastes and mouth rinses.  In-office procedures include application of desensitizing agents or protective sealants.

What can I do to improve tooth sensitivity?

Practice good oral hygiene to maintain healthy teeth and gums.  Use a soft bristled toothbrush and avoid brushing your teeth too hard.  And watch what you eat: Avoid acidic foods and drinks.

Sleep Apnea – Do You Suffer?

What is sleep apnea?

Man sleepingSleep apnea is a serious, potentially life threatening sleep disorder that affects approximately 18 million Americans.  It owes its name to the Greek word apnea (meaning “want of breath”) and refers to episodes in which a person stops breathing for 10 seconds or more during sleep.  With each episode, the sleeper’s brain briefly wakes up in order to resume breathing, resulting in extremely fragmented and poor-quality sleep.  If you suspect you suffer from sleep apnea or if you have been diagnosed with sleep apnea, Dr. Marinic can work closely with your physician to implement and manage a prescribed therapy.

What are the different types of sleep apnea?

There are two major types of sleep apnea, both of which can severely disrupt the regular sleep cycle.

  • Obstructive apnea:  As you sleep, the muscles in the walls of your throat relax to the point where the airway collapses and prevents air from flowing into your nose and mouth, but efforts to breathe continue.  This is the most common type of apnea.
  • Central apnea:  Breathing interruptions during sleep are caused by problems with the brain mechanisms that control breathing.

What are the symptoms of sleep apnea?

People with sleep apnea usually do not remember waking up during the night.  Indications of the problem may include:Woman with headache

  • Morning headaches
  • Excessive daytime sleepiness
  • Irritability and impaired mental or emotional functioning
  • Excessive snoring, choking, or gasping during sleep
  • Insomnia
  • Awakening with a dry mouth or sore throat

What’s the difference between snoring and sleep apnea?

Couple one snoringUnlike mild snoring, individuals with sleep apnea stop breathing completely for 10 seconds or more, typically between 10 and 60 times in a single night.  If your partner hears loud snoring punctuated by silences and then a snort or choking sound as you resume breathing, this pattern could signal sleep apnea.

Why is sleep apnea a concern?

Studies have shown that people with this potentially life-threatening disorderWoman sleeping on computer are so fatigued during the day that, when driving, their performance is similar to that of a drunk driver. If left untreated, sleep apnea can lead to impaired daytime functioning, high blood pressure, heart attack, and even stroke.

How can my dentist help?

If your dentist suspects you suffer from sleep apnea, he or she will refer you to a physician, often a sleep medicine specialist. Diagnosis and treatment is based on your medical history, physical examination, and the results of a polysomnography – an overnight sleep study, which measures heart rate and how many times breathing is interrupted during sleep.

If you are diagnosed with sleep apnea, your dentist can work closely with your physician to implement and manage your therapy.

What are the treatment options?

If you have mild obstructive sleep apnea, initial treatment may include avoiding sleeping on your back, losing weight, or cessation of smoking. Dental appliances, such as the Thornton Adjustable Positioner ® (TAP®), which reposition the lower jaw and the tongue, have been helpful to some patients with mild sleep apnea.

If you have severe sleep apnea, continuous positive airway pressure (CPAP) systems are a commonly prescribed therapy. CPAP delivers air through a small mask that covers the nose, and the constant pressure keeps the airway open, which prevents both snoring and episodes of apnea. For patients who have trouble tolerating CPAP, other treatments, including surgery, can eliminate sleep apnea symptoms.

 

Athletes and Their Oral Health

Sports equipmentWhether you are a professional athlete or a weekend warrior, protecting your mouth, face, head, and neck should be a priority when you participate in your favorite sport or activity.  Taking the appropriate protective measures while on the court, field, rink, or ring can save you from serious injury and costly dental repairs.

What sports pose a threat to oral health?

Any sport that presents the chance of contact or collision with anotherColliding person, object, or surface can potentially cause injury to the teeth, jaws, and oral soft tissue.  These sports include, but are not limited to, football, basketball, soccer, hockey, boxing, and lacrosse.  Individuals who participate in sports, such as biking, inline skating, or skateboarding, also are at risk for injury.

How do mouth guards protect my mouth?

Mouth guard in hockey playerA custom mouth guard made by Dr. Marinic covers the upper teeth with a soft, flexible material that prevents serious injuries, such as broken teeth, jaw fractures, cerebral hemorrhage, and neck injuries, by decreasing the chance of the lower jaw jamming into the upper jaw or being pushed back into the temporomandibular (jaw) joint.  Mouth guards also are effective in preventing laceration (cutting) and bruising of the lips and cheeks.  Mouth guards may reduce the severity and incidence of concussions as well.

What other types of protection do I need?Hockey players equipment

Helmets are very important when participating in sports that involve speed and impact.  Properly fitted helmets can prevent major head injuries, as well as facial and neck injuries.  Helmets should always fit well and be fastened correctly.   For certain sports, other protective gear, such as facemasks and body pads, also should be worn.

What do I do if I experience trauma to my mouth?

If you experience an injury to your mouth, including major lacerations to yourKobe Bryant injured lips, cheeks, or gums, seek medical attention immediately.  If you break, chip, or lose a tooth, or experience minor injury to your gums, tongue or cheeks, contact Dr. Marinic immediately.  If you seek treatment immediately after the injury occurs, Dr. Marinic often can save knocked-out teeth and repair minor chips and cracks with appropriate dental materials.  Make an appointment to visit Dr. Marinic for evaluation if your tooth changes color, if you experience any dental pain, or if you notice any swelling in or around your mouth following trauma.

What should I tell Dr. Marinic about my physical activities?

Dr. Marinic talking to patientInform Dr. Marinic if you participate in sports or recreational activities. He can give you tips on how to best protect your mouth, face, head, and neck during these activities.  Because mouth injuries can be painful and costly, Dr. Marinic recommends that all athletes take preventative measures at all times.

Teen’s Oral Health – What You Should Know

Should I limit drinking soda?

Teenager drinking soda from bottleYES!  Whether at school, home or on the weekends, teens are drinking more soda than they have in the past.  In 1977, 12 to 19-year-olds drank 16 ounces of soda a day.  In 1996, this same age group consumed an average of 28 ounces a day.  Not only is sugar harmful to teeth, acidic flavor additives can also erode and damage tooth enamel. Drinking soda through straw

There are simple ways you can limit the harmful effects of sodas. Try sipping soda through a straw.  It cuts down on the contact the beverage has with your teeth.  Rinse your mouth with water after drinking soda.  It can also reduce the risk of cavities.

Why should I avoid oral piercings?

Tongue and cheek piercingTongue piercing remains a teen trend; however it is not always a healthy choice for your mouth.  People chip teeth on tongue piercings while eating, sleeping, talking and chewing on the jewelry.  Tongue piercing commonly causes fractured teeth.  The fracture can be confined to tooth enamel and require a filling, or it may go deeper; in which case, can cause a need for a root canal or extraction. 

Infections are also common with oral piercings, and they cause more than pain.  A tongue can swell after being punctured, however in some cases the tongue becomes infected and swells so much that it may cut off breathing. Unclean piercing equipment can cause other infections, such as bloodborne hepatitis.

Why should I make time for healthy habits?

Quick meals in the form of “nutrition” bars and fast food help keep you alert Xylitol gumand on schedule between school, extracurricular activities and part-time jobs. However, today’s fast-paced lifestyle threatens to leave the teen generation with permanent damage to oral and overall health.  You can keep travel-size brushes in lockers or back packs.  Chewing sugarless gum with xylitol after meals or snacks can also help cleanse your mouth.  Drinking water throughout the day can help clean your teeth of excess bacteria and food debris.

Teens should be sure to see Dr. Marinic at least twice a year.  Regular dental visits can help catch minor problems before they become major ones!

Xylitol – A Popular Sugar Free Substitute

XylitolXylitol is a sugar alcohol sweetener that is found in birch tree bark, beets, corncobs, raspberries, mushrooms, and other natural sources.  Its sweetness is equal to that of sugar, but it has about 40 percent fewer calories, making it a popular sugar-free substitute.  Xylitol not only cuts calories, it also cuts cavities!

How does xylitol prevent cavities?

Xylitol helps prevent Streptococcus mutans, the primary bacterium associated with dental caries, from attaching to teeth and tissues in the mouth.  Xylitol cannot be metabolized by bacteria; as a result, the process that creates harmful, enamel-eating acids is drastically slowed.  Regular use of xylitol has been shown to help reduce dental plaque – the first stage of cavity development, tartar formation, and tooth staining – and promote better oral health.

How often must I use xylitol for it to be effective?Xylitol gum

Xylitol is a natural and convenient way to supplement daily dental care.  Xylitol gum or mints used three to five times daily (for a total intake of 5 grams) is considered optimal.  Because frequency and duration of exposure is important, gum should be chewed for approximately five minutes and mints should be allowed to dissolve.  Dentists who recommend using xylitol immediately after meals and snacks to help reduce plaque, do so to inhibit adhesion of bacteria to the teeth, and reduce contact time of sugar on teeth.

Has xylitol been evaluated for safety?

Yes. Human consumption of xylitol has been confirmed for safety by a number of agencies, including the U.S. Food and Drug Administration, the World Health Organization’s Joint Expert DogCommittee on Food Additives, and the European Union’s Scientific Committee on Food.  Pet owners should note, however, that xylitol is harmful to dogs.  To prevent xylitol poisoning, dog owners should be aware of products that contain xylitol as a sweetener, and keep those products out of the reach of their dogs.

What products contain xylitol and how do I find them?

Products containing xylitol have been available in the United States for a Xylitol sweetnernumber of years, but only recently have its use become main stream.  Today, xylitol can be readily found in chewing gums, toothpastes, mouthwashes and other oral care products, candies, and some pharmaceuticals.  On food labels, xylitol is classified broadly as a carbohydrate and more narrowly as a polyol.  To learn more about xylitol products, talk to Dr. Marinic.

Dentures – Full and Partial

DenturesWhat is a denture?

A denture is a removable replacement for missing teeth and adjoining tissues.  Complete dentures replace all of the teeth, while a partial denture fills in the spaces created by missing teeth and prevents other teeth from shifting position.  Complete dentures are either “conventional” or “immediate.” A conventional denture is placed in the mouth after all of the teeth have been removed and the extraction sites have healed.   An immediate denture is placed as soon as the teeth are removed.

Who needs a denture?Partial denture

Candidates for complete dentures have lost most or all of their teeth.  A partial denture is suitable for those who have some natural teeth remaining.   A denture improves chewing ability and speech, and provides support for facial muscles.   A denture can greatly enhance a patient’s facial appearance and smile.

How do you get a denture?

ImpressionsThe denture process takes about one month. There are usually five or more appointments needed to complete the process.  The process includes the initial diagnosis; the making of an impression and wax bite to determine the dimensions and proper jaw position; a “try-in” to assure proper color, shape, and fit; placement of the final denture; and any minor adjustments. 

New denture wearers need time to get accustomed to their new “teeth,” Woman wearing denturesbecause even the best-fitting dentures will feel awkward at first.  Your normal speaking ability usually resumes shortly after final denture placement.  In addition, in order to become accustomed to chewing with the new denture, it is often recommended that you start with soft, easy-to-chew foods.  To ensure proper fit, see Dr. Marinic on a regular basis.

How do you care for a denture?

  • Remove and brush the denture daily with a denture cleanser or toothpaste and a brush designed specifically for cleaning dentures.
  • Avoid using boiling water to sterilize the denture, because hot water can cause the denture to lose its shape.
  • If you wear a partial denture, remove it before brushing your natural teeth.
  • When you’re not wearing the denture, soak it in denture cleanser or water.
  • To avoid misplacing your denture, store it in the same place after removal.

Should a denture be worn at night?

While you may be advised to wear your denture almost continually during the first two weeks – even while you sleep – under normal people sleepingcircumstances, it is considered best to remove it at night.  Research has shown that removing the denture for at least eight hours during either the day or night allows the gum tissue to rest, and permits for normal stimulation and cleansing of the mouth by the tongue and saliva.  This promotes better long-term health of the gums.

Are there any alternatives to dentures?

Dentures are no longer the only way to restore a mouth that has little or no teeth.  Dental implants are artificial tooth roots that are surgically anchored into your jaw to hold a replacement tooth or bridge in place.  Implants and bridges may more closely resemble the “feel” of real teeth, but they tend to be more expensive than dentures.  Not everyone is a candidate for implants and bridges, however.  Talk to Dr. Marinic to learn more.

I’m Not Being Sensitive – My Teeth Are!!

What is dentin hypersensitivity?

Tooth anatomyDentin hypersensitivity, more commonly referred to as sensitive teeth, can be defined as short, sharp pains that come from exposed dentin (the layer of tissue found beneath the hard enamel that contains the inner pulp).  Individuals with sensitive teeth may find that the pain can be triggered by hot, cold, sour, or sweet beverages or foods, forceful brushing or flossing, or even by cold air.

What causes the sensitivity?Eating ice cream

Tooth sensitivity is caused by the movement of fluid within tiny tubes (pores) located in the dentin, which results in nerve irritation.  When the hard enamel of a tooth is worn down or gums have receded, the surfaces of these tiny tubes can become exposed, resulting in pain while eating or drinking certain foods, such as ice cream or hot coffee.

How common is this condition?

Dentin hypersensitivity is one of the most common complaints among dental patients.  One in five people in the United States experience dentin hypersensitivity at some point in his or her life.

How can I avoid dentin hypersensitivity?

Excessive consumption of acidic beverages, such as orange juice or cola, can wear down hard enamel and put you at risk for dentin hypersensitivity. Limiting your consumption of acidic foods and beverages can prevent the Acidic foodserosion of hard enamel.  Conditions such as bulimia nervosa and acid reflux also can have similar erosive effects on tooth enamel.  Abrasion of the enamel from aggressive use of a toothbrush also can lead to dentin hypersensitivity.  Notify Dr. Marinic if you experience tooth sensitivity.  He can monitor the condition and can help remedy the sensitivity.

I have dentin hypersensitivity.  What can I do to prevent pain?Sensodyne

Using a soft-bristled toothbrush and brushing in a circular motion will minimize enamel abrasion and thus reduce sensitivity.  Using toothpaste containing a desensitizing agent that protects exposed dentin by blocking the tubes connected to nerves can alleviate pain.  In-office treatments, such as topical agents or sealants, can be applied by Dr. Marinic to help reduce sensitivity. Of course, limiting your intake of acidic foods and beverages is always recommended.

What other issue might be associated with dentin hypersensitivity?

Research suggests that sensitivity in the mouth may be associated with sensitivity in other areas.  A study published in the 2002 November/December issue of General Dentistry examined 47 individuals with dentin hypersensitivity and found that all participants showed sensitivities in another area such as sight, hearing, taste, smell, or touch.  Sight sensitivity, specifically to sunlight, was the most common association.

Dental Emergencies

ToothacheDental emergencies can be avoided by taking some simple precautions, such as wearing a mouth guard during sports and recreation and staying away from hard food such as candy that may crack a tooth.  Accidents do happen however, and it is important to know what actions to take immediately.

Injuries to the mouth may include teeth that are knocked out (avulsed), forced out of position and loosened (extruded) or fractured.  In addition, lips, gums or cheeks can be cut.  Oral injuries are often painful and should be treated by Dr. Marinic as soon as possible.

What do I when a tooth is knocked out?knocked out tooth

Immediately call your dentist for an emergency appointment.  Handle the tooth by the crown, not the root.  Touching the root (the part of the tooth below the gum) can damage cells necessary for bone re-attachment.  Gently rinse the tooth in water to remove dirt.  Do not scrub.  Place the clean tooth in your mouth between the cheek and gum to keep it moist.  It is important not to let the tooth dry out.  If it is not possible to store the tooth in the mouth of the injured person, wrap the tooth in a clean cloth or gauze and immerse in milk or saline solution.

What do I do if the tooth is pushed out of position?

Attempt to reposition the tooth to its normal alignment using very light finger pressure, but do not force the tooth.  Bite down to keep the tooth from moving.  Dr. Marinic may splint the tooth in place to the two healthy teeth next to the loose tooth.

broken toothWhat about when the tooth is fractured?

Rinse mouth with warm water and use an ice pack or cold compress to reduce swelling. Take ibuprofen, not aspirin, for pain. Minor fractures can be smoothed by your dentist with a sandpaper disc or simply left alone. 

Restorative procedures can also be done to fix the tooth.  In either case, treatTooth anatomy the tooth with care for several days.  Moderate fractures include damage to the enamel, tissue and/or pulp.  If the pulp is not permanently damaged, the tooth may be restored with a full permanent crown.  If pulp damage does occur, further dental treatment will be required.  Severe fractures often mean a traumatized tooth with slim chance of recovery.

What should I do when the tissue of my mouth is injured?

Injuries to the inside of the mouth include tears, puncture wounds and lacerations to the cheek, lips or tongue.  The wound should be cleaned right away with warm water, and the injured person taken to a hospital emergency room for the necessary care. Bleeding from a tongue laceration can be reduced by pulling the tongue forward and using gauze to place pressure on the wound.

Can I somehow prepare for dental emergencies?  Yes, by packing an emergency dental care kit including:

  • Dentist’s phone numbers Emergency kit
  • Saline solution
  • Handkerchief
  • Gauze
  • Small container with lid
  • Ibuprofen (Not aspirin – Aspirin is an anti-coagulant, which may cause excessive bleeding in a dental emergency.)

Your Child’s First Dental Visit

Child in dental chair holding toyIt’s important for children to visit the dentist early to ensure they are off to a good start with their oral health.  The first dental visit is an extremely important step in a child’s life long oral health.

When should my child first see a dentist, and why?

The ideal time for a child to visit the dentist is six months after the child’s firstSMall baby (primary) teeth erupt – and no later than his or her first birthday.  This time frame is a perfect opportunity for Dr. Marinic to examine carefully the development of the child’s mouth.  Because dental problems often start early, the sooner the child visits our office, the better.  Dr. Marinic also can provide or recommend special preventive care to protect against problems, such as early childhood tooth decay, teething irritations, gum disease, and prolonged thumb or pacifier sucking.

How do I prepare my child and myself for this first visit?

Before the visit, ask Dr. Marinic about the procedures that will take place during theMom talking to child first appointment so there are no surprises.  Plan a course of action for any possible reactions your child may have.  Very young children may be fussy and not want to sit still.  Others may become very frightened and cry.  Some children may not react negatively at all.  Some may enjoy the appointment very much! 

Make the upcoming appointment something for your child to look forward to.  Help your child understand what will happen during the visit.  There are a number of children’s books about going to the dentist.  Read these books with your child before his or her first visit to familiarize your child with what will happen at the dental office and help lessen any potential anxiety.

Also, be sure to bring records of your child’s complete medical history for his or her dental file.

What happens during the first visit?Child in dental chair

Often a first visit is simply a time to acquaint your child with Dr. Marinic and the practice.  As a parent, you should reassure your child that the visit is not scary or something about which to be afraid.  Short, successive visits can build the child’s comfort with Dr. Marinic and the dental office.

Your child’s appointment should be scheduled earlier in the day, when your child is alert and refreshed.  You may need to sit in the dental chair and hold your child during the first examination.  The first visit usually lasts between 15 and 30 minutes and may include any of the following, depending on the child’s age:

  • A gentle but thorough examination of the teeth, jaw, bite, gums, and oral tissues to monitor growth and development and observe any problem areas
  • A gentle cleaning, which includes polishing teeth and removing any plaque, tartar build-up, and stains
  • X-rays
  • A demonstration on how to properly care for your child’s mouth and teeth at home
  • Nutritional counseling
  • An assessment of the need for fluoride

Dr. Marinic will be able to answer any questions you have and will make you and your child feel comfortable throughout the visit.

When should we schedule the next appointment?

Children, like adults, should see Dr. Marinic every six months.  When your child is very young, some dentists may schedule interim visits every three months in order to build the child’s comfort and confidence levels or for treatment needs.

If you have questions about your child’s dental needs, please talk with our team.