My Blog

By Kyle Bouhana, D.D.S.
April 03, 2020
Category: Dental Procedures
StoppingToothDecayCouldRequireRootCanalTreatment

It’s absolutely critical to stop tooth decay and repair any damage to tooth structure. Hopefully, we’ve caught it early in the enamel and dentin where we’re able to repair any holes or “cavities” that might have developed by filling them.

But what if the decay has crept deeper into the interior of the tooth? In this case, you’re at a much higher risk of eventually losing the tooth. If the decay has spread into the bone, a root canal treatment is usually your best option.

The first sign that decay has invaded the pulp, the innermost layer of the tooth, and the root canals may be a severe toothache. It’s different from the wince of pain or discomfort caused by sensitivity to temperature or pressure. Inner decay pain is constant and often excruciating. This is because the infection is attacking the nerves bundled within the pulp chamber.

The pain can last for several days, and then suddenly stop altogether. No pain is good news, right? Wrong — the pain has stopped because the infected nerves have finally died and can no longer signal the brain. The infection, though, is very much alive and will continue to advance toward the root where the damage may eventually cause you to lose the tooth.

A root canal treatment removes decay in the pulp chamber and canals. We first drill an access hole to enter the pulp chamber. Once inside, we use special instruments to completely remove all tissue and disinfect the empty chamber. We then fill the chamber and root canals with a special filling and seal the access hole to prevent further decay. A few weeks later we install a custom crown to protect the tooth further.

If you have a toothache, or you’ve had one that suddenly went away, you should schedule an appointment for a dental examination as soon as possible: this is the only way to accurately determine the cause of the pain. If a root canal is deemed necessary, the sooner we perform it, the less chance the infection will cause you to lose 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 “Signs and Symptoms of a Future Root Canal.”

DontAllowYourAgetoStopYoufromaNewSmilewithOrthodontics

Think you’re too old to have your teeth straightened? In reality, healthy teeth can be moved at any age to better positions. For the many adults who have some form of malocclusion (bad bite), orthodontics is still a viable option even in later years.

As important as it is to self-image and confidence, treating misaligned teeth can benefit you more than just improving your smile. Misaligned teeth may be harder to keep clean, setting up a mouth environment advantageous to the development of tooth decay or periodontal (gum) disease, the risks of both rising with age. And normally aligned teeth are easier to chew with than those misaligned.

Age isn’t the determining factor for whether you’re a good candidate for orthodontics — but your dental health is. Gum disease in particular can cause supporting bone loss, which can complicate orthodontic treatment. It’s important then that we first perform a complete oral examination and attempt to treat problems such as decay or gum disease first before attempting tooth movement.

What type of orthodontic treatment you’ll need will depend on the type of malocclusion you have and its relationship to the way your jaws fit together. Because your adult jaws have fully developed you may need orthognathic (“jaw straightening”) surgery to address certain advanced forms of malocclusion. If your bite problems aren’t that severe (the majority of situations) they can be treated with braces or, an increasingly popular alternative, clear aligners. These customized clear plastic trays are nearly invisible compared to metal braces and are effective for most patients.

Following the completion of tooth movement and other bite procedures, you will most likely need to wear a retainer to help prevent the teeth from reverting to their older positions. You may need to wear the retainer for a longer period than a younger patient, or perhaps indefinitely. Even with this mild inconvenience, though, you’ll still experience the positive effects of healthier and better functioning teeth and a great new smile.

If you would like more information on orthodontic 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 “Orthodontics for the Older Adult.”

By Kyle Bouhana, D.D.S.
March 14, 2020
Category: Oral Health
CustomMouthguardsArentJustforNFLSuperstars

If while watching a Seattle Seahawks game you thought you saw wide receiver D. K. Metcalf sucking on a “binky,” your eyes weren’t deceiving you. Well, sort of not—he’s actually been known to wear a mouth and lip guard shaped like a child’s pacifier.

Metcalf isn’t the only pro football player customizing this essential piece of safety equipment. Broncos running back Ronnie Hillman has been seen sporting “vampire fangs.” And Odell Beckham Jr., wide receiver with the Cleveland Browns, has a series of interchangeable guards with various designs and colors.

You may say, “That’s the NFL, so of course players have the money and fame to dress up their mouthguards with a little flair.” But custom mouthguards aren’t out of reach for the average athlete—in fact, it’s actually a sound idea. Not so much for expressing personality, but for the comfort and protective advantages that a custom mouthguard may have over retail varieties.

Usually made of high-resistant plastic, an athletic mouthguard absorbs blows to the face and mouth during hard contacts in sports like football, basketball and hockey. Mandated by many organized sports associations, mouthguards can prevent dental and facial injuries like chipped or knocked out teeth, gum abrasions or jaw fractures. There’s even some evidence they reduce the risk of concussion.

Many amateur players use what is known as a “boil and bite” mouthguard, available in retail sporting goods stores. They’re softened first, usually in hot water, and then placed in the mouth and clenched between the jaws to obtain a somewhat individualized fit.

Although they do provide some level of protection, a boil and bite mouthguard can’t match the accuracy of a custom mouthguard produced by a dentist based on impressions and measurements of an individual player’s mouth. As a result, custom mouthguards can be made thinner than many boil and bite guards, increasing their comfort while being worn. More importantly, their accurate fit enhances their protective capabilities.

As you might imagine, custom mouthguards are more expensive than their retail counterparts, and with younger athletes whose mouth structures are still growing, it may be necessary to upgrade a custom guard after a few seasons. Still, the cost of a custom mouthguard may be well worth the superior protection it provides for your own little star athlete. And although it may not necessarily look like a binky or vampire fangs, a custom mouthguard could make their playing experience safer and more comfortable.

If you would like more information about custom athletic mouthguards, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Athletic Mouthguards.”

By Kyle Bouhana, D.D.S.
March 04, 2020
Category: Oral Health
Tags: oral health  
YouDontHavetoLiveWithUncomfortableCrackedMouthCorners

While a relatively minor health issue, cracked mouth corners (medically known as angular cheilitis) can certainly be irritating. Fortunately, you don't have to live with it—we can help reduce the discomfort and even make it less likely to happen in the future.

 Angular cheilitis is most characterized by redness and fissures (or cracks) in the skin at the corners of the lips. It commonly happens in younger ages (children to younger adults) because of drooling or complications from wearing braces. Older adults can also develop cracked mouth corners due to wrinkling around the mouth. The immediate causes are usually localized to the mouth and lip region, but it can sometimes arise from systemic conditions.

A case of angular cheilitis can also become infected, usually with a strain of yeast known as “candida albicans,” which then intensifies inflammation and discomfort. This is usually due to interaction between saliva and the open fissures, helped along by people's tendency to habitually lick these cracks (hence the other name for cracked mouth corners, perleche, from the French “to lick”).

The best way to treat angular cheilitis is with a series of applications of oral or topical antifungal medication. These may also be combined with steroid ointments that help retard redness and inflammation. If the infection involves the inside of the mouth, you may also need to use an antibacterial rinse until it clears up.

There are also things you can do to minimize future occurrences. Be sure to have missing teeth replaced or loose dentures refitted, and stay vigilant with daily brushing and flossing. You might also consult with a dermatologist about ways to treat wrinkling around the mouth. And easing those wrinkles could not only minimize your chances of developing angular cheilitis, but also give you a more youthful appearance.

Cracked mouth corners can be unnerving. But with a few simple steps we can help relieve any current discomfort and help you reduce the chances of another occurrence.

If you would like more information on cracked mouth corners and other oral irritations, 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 “Cracked Corners of the Mouth.”

By Kyle Bouhana, D.D.S.
February 23, 2020
Category: Oral Health
Tags: tooth decay  
ManageTheseRiskFactorstoReduceYourRiskofToothDecay

Tooth decay doesn't occur out of thin air, but is the end result of bacteria feeding on sugar, multiplying and producing acid. High acidity erodes tooth enamel and creates an environment for cavity development.

Modern dentistry can effectively treat cavities and often save the tooth from further damage. But you don't have to wait: You can reduce your chances of cavities by managing risk factors that contribute to decay.

Here are 4 top risk factors for tooth decay and what you can do about them.

Poor saliva flow. Saliva neutralizes acid and helps restore minerals to enamel after acid contact. But your enamel may not have full protection against acid if you have diminished saliva flow, often due to certain medications. You can help increase your saliva by consulting with your doctor about drug alternatives, drinking more water or using a saliva boosting product. Smoking can also inhibit saliva, so consider quitting if you smoke.

Eating habits. High sugar content in your diet can increase bacterial growth and acid production. Reducing your overall sugar consumption, therefore, can reduce your risk of decay. Continuous snacking can also increase your decay risk, preventing saliva from bringing your mouth back to its normal neutral pH. Instead, limit your snack periods to just a few times a day, or reserve all your eating for mealtimes.

Dental plaque. Daily eating creates a filmy buildup on the teeth called dental plaque. If not removed, plaque can then harden into a calcified form called calculus, an ideal haven for bacteria. You can help curtail this accumulation by thoroughly brushing and flossing daily, followed by dental cleanings at least every six months. These combined hygiene practices can drastically reduce your cavity risk.

Your genetics. Researchers have identified up to 50 specific genes that can influence the risk for cavities. As a result, individuals with similar dietary and hygiene practices can have vastly different experiences with tooth decay. Besides continuing good lifestyle habits, the best way to manage a genetic disposition for dental disease is not to neglect ongoing professional dental care.

If you would like more information on managing your tooth decay risk factors, 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 “What Everyone Should Know About Tooth Decay.”





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