CleftDefectsCanBeOvercomeThankstoAdvancedSurgicalProcedures

One in 700 babies are born each year with a cleft lip, a cleft palate or both. Besides its devastating emotional and social impact, this common birth defect can also jeopardize a child's long-term health. Fortunately, incredible progress has occurred in the last half century repairing cleft defects. Today's children with these birth defects often enter adulthood with a normal appearance and better overall health.

A cleft is a gap in the mouth or face that typically forms during early pregnancy. It often affects the upper lip, the soft and hard palates, the nose or (rarely) the cheek and eye areas. Clefts can form in one or more structures, on one side of the face or on both. Why they form isn't fully understood, but they seem connected to a mother's vitamin deficiencies or to mother-fetus exposure to toxic substances or infections.

Before the 1950s there was little that could be done to repair clefts. That changed with a monumental discovery by Dr. Ralph Millard, a U.S. Navy surgeon stationed in Korea: Reviewing cleft photos, Dr. Millard realized the “missing” tissue wasn't missing—only misplaced. He developed the first technique to utilize this misplaced tissue to repair the cleft.

Today, skilled surgical teams have improved on Dr. Millard's efforts to not only repair the clefts but also restore balance and symmetry to the face. These teams are composed of various oral and dental specialties, including general dentists who care for the patient's teeth and prevent disease during the long repair process.

Cleft repairs are usually done in stages, beginning with initial lip repair around 3-6 months of age and, if necessary, palate repair around 6-12 months. Depending on the nature and degree of the cleft, subsequent surgeries might be needed throughout childhood to “polish” the original repairs, as well as cosmetic dental work like implants, crowns or bridgework.

In addition to the surgical team's skill and artistry, cleft repair also requires courage, strength and perseverance from patients and their parents, and support from extended family and friends. The end result, though, can be truly amazing and well worth the challenging road to get there.

If you would like more information on repairing cleft birth defects, 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 “Cleft Lip & Cleft Palate.”

By Bencivengo & Ko
November 26, 2019
Category: Dental Procedures
TheDangersofDIYBraces

Let’s say you’ve always wanted to have straighter teeth, and you’re wondering if it’s time to seek help from a dentist or orthodontist. So you search online and find a YouTube video called “Cheap easy braces!! Without going to the dentist!!!!!” Your instincts are screaming “NO,” but you can’t help wondering… could it really be worth trying?

First of all, in case all of the exclamation points didn’t clue you in, the teenager who made this video doesn’t have any medical or dental training whatsoever. And just to make it clear right now, there’s no such thing as do-it-yourself braces — at least, none that are safe or effective. But the real problem with this video — along with many others in the same vein — is that if you try out what they suggest, you can seriously harm your teeth.

Recently, the American Association of Orthodontists (AAO) issued a consumer alert about the use of so-called “gap bands” and other home remedies for straightening teeth. It was accompanied by a graphic picture of teeth that had been seriously damaged by placing a rubber band around them (one of the methods suggested in the video). The New York Times followed up with an item about a young man who lost both front teeth as a result of DIY orthodontics. And Seventeen magazine ran a story called “Why the DIY Braces Trend is Seriously SO Dangerous: DO NOT TRY THIS AT HOME.”

So we’ll add our voices to the chorus: Braces aren’t something you can do yourself. Seriously. Trust us on this.

Why not? Because it really does take quite a bit of training and experience to gain the necessary skill, knowledge and competence to move teeth safely. That’s why all practicing dentists successfully complete a four-year dental school program; orthodontists and other specialists have an additional three years of training on top of that. (And do you really think it would take seven years of training if it was easy?) We are familiar with the science behind moving teeth, and up to date on the best clinical practices. As medical professionals, that’s our job.

There is one tiny grain of truth in those videos: we do sometimes use elastics to move teeth. The difference is, we’re using them in safe and effective ways. We know, for example, that if an elastic band is placed around teeth the wrong way, it can work its way into the gums and destroy the ligaments and bone that hold the teeth in place. This can cause teeth to loosen and fall out.

So don’t be misled. If a promised treatment seems too good to be true, it probably is… even if it’s being touted on YouTube.

If you have questions about orthodontic treatment, please call our office to schedule a consultation. You can read more in the Dear Doctor magazine article “The Magic of Orthodontics” and “Moving Teeth With Orthodontics.”

By Bencivengo & Ko
November 16, 2019
Category: Oral Health
Tags: oral health  
MoreThanIndigestionHowAcidRefluxCouldHarmYourTeeth

Your stomach is just one big processing plant: Incoming food is broken down into individual nutrients that are then absorbed into the body. The main food "de-constructor" for this process is stomach acid, a powerful fluid comparable in strength to battery acid. All's well as long as it remains in the stomach—but should it escape, it can wreak havoc on other parts of the body, including teeth.

That's the reality for 1 in 5 Americans with gastroesophageal reflux disease (GERD). Also known as acid reflux, GERD occurs when the ring of muscle at the base of the esophagus—which ordinarily keeps stomach acid contained—weakens to allow it into the esophagus. It can then irritate the esophageal lining, giving rise to the burning sensation of indigestion.

The scenario changes, however, if acid continues up into the mouth. This puts tooth enamel at risk for erosion. The resulting high acidity is enough to dissolve the mineral content of enamel, which could jeopardize the survival of affected teeth.

If you've been diagnosed with GERD, your teeth could be in harm's way. In recognition of GERD Awareness Week (November 17-23), here's what you can do to protect them from this potentially damaging disease.

Manage your GERD symptoms. There are effective ways to control GERD and reduce the likelihood of acid in the mouth with antacids or medication. You can also lessen reflux symptoms by quitting smoking and avoiding alcohol, caffeine or acidic foods and beverages. Finishing meals at least three hours before bed or avoiding lying down right after eating can also lessen reflux episodes.

Boost saliva to neutralize acid. Saliva neutralizes acid and helps restore minerals to enamel. You can boost its production by drinking more water, using a saliva-boosting product or chewing xylitol-sweetened gum. You can also decrease mouth acidity by chewing an antacid tablet or rinsing your mouth after eating or after a reflux episode with water mixed with a little baking soda.

Use fluoride oral hygiene products. You can further protect your teeth from acid by using oral hygiene products with fluoride, a chemical compound proven to strengthen enamel. If needed, we can also apply stronger fluoride solutions directly to the teeth or prescribe special mouthrinses with extra fluoride.

If you've been dealing with GERD symptoms, visit us for an exam to check for any adverse dental effects. The sooner we treat GERD-related enamel erosion, the better the outcome for your teeth.

If you would like more information on protecting your dental health from acid reflux, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “GERD and Oral Health.”

By Bencivengo & Ko
November 06, 2019
Category: Oral Health
Tags: mouthguards  
BruinsZdenoCharaBreaksHisJawDuring2019StanleyCup

Boston Bruins defenseman Zdeno Chara had a rough Stanley Cup final against the St. Louis Blues this past June. Not only did the Bruins ultimately lose the championship, but Chara took a deflected puck shot to the face in Game Four that broke his jaw.

With the NHL season now over, the 42-year-old Bruins captain continues to mend from his injury that required extensive treatment. His experience highlights how jaw fractures and related dental damage are an unfortunate hazard in hockey—not only for pros like Chara, but also for an estimated half million U.S. amateurs, many in youth leagues.

Ice hockey isn't the only sport with this injury potential: Basketball, football (now gearing up with summer training) and even baseball players are also at risk. That's why appropriate protective gear like helmets and face shields are key to preventing injury.

For any contact sport, that protection should also include a mouthguard to absorb hard contact forces that could damage the mouth, teeth and gums. The best guards (and the most comfortable fit) are custom-made by a dentist based on impressions made of the individual's mouth.

But even with adequate protection, an injury can still happen. Here's what you should do if your child has an injury to their jaw, mouth or teeth.

Recognize signs of a broken jaw. A broken jaw can result in severe pain, swelling, difficulty speaking, numbness in the chin or lower lip or the teeth not seeming to fit together properly. You may also notice bleeding in the mouth, as well as bruising under the tongue or a cut in the ear canal resulting from jawbone movement during the fracture. Get immediate medical attention if you notice any of these signs.

Take quick action for a knocked-out tooth. A tooth knocked completely out of its socket is a severe dental injury. But you may be able to ultimately save the tooth by promptly taking the following steps: (1) find the tooth and pick it up without touching the root end, (2) rinse it off, (3) place it back in its socket with firm pressure, and (4) see a dentist as soon as possible.

Seek dental care. Besides the injuries already mentioned, you should also see a dentist for any moderate to severe trauma to the mouth, teeth and gums. Leading the list: any injury that results in tooth chipping, looseness or movement out of alignment.

Even a top athlete like Zdeno Chara isn't immune to injury. Take steps then to protect your amateur athlete from a dental or facial injury.

If you would like more information about dealing with sports-related dental injuries, please contact us or schedule an appointment for a consultation. To learn more, read the Dear Doctor magazine articles “Athletic Mouthguards” and “The Field-Side Guide to Dental Injuries.”

By Bencivengo & Ko
October 27, 2019
Category: Oral Health
Tags: facial pain  
YoucanGetRelieffromFacialPain

Each year doctors treat about 150,000 new cases of severe facial pain. If you're one of those people, you don't have to suffer—there are ways to gain relief from these painful episodes.

Those recurring episodes are known as trigeminal neuralgia (TN). As the name implies, the source of the pain are the trigeminal nerves, which originate in the brain stem and extend on either side of the face. Each is divided into three branches (hence the "tri" in trigeminal) that serve the upper, middle and lower parts of the face and jaw.

TN can involve one or more of these branches, resulting in mild to severe pain that can last for several seconds. Jaw movements like chewing or speaking can trigger an episode, as well as a light touch to the face.

There are various proposed causes for TN, including links with inflammatory disorders like multiple sclerosis, which damages the insulating sheathing around nerve cells. The most common cause, though, appears to be a blood vessel pressing against the nerve. The compression causes hypersensitivity in that area of the nerve so that it transmits pain at the slightest sensation.

Other conditions like jaw joint pain disorders (TMD) or a dental abscess can cause similar pain symptoms, so it's important to get an accurate diagnosis. If your doctor does identify your condition as TN, you may then need a comprehensive approach to treatment involving a team of care providers, including your dentist.

For the most part, TN can be managed, beginning with the most conservative approach to gain relief, often with medications to block the nerve's pain signals to the brain or decrease abnormal nerve firings. If that proves insufficient, though, more intensive treatments are available.

One possible treatment for an impinging blood vessel is a microsurgical procedure to expose the affected nerve and relocate the vessel. While this can be effective, the surgery does carry some risk of facial numbness or decreased hearing. If the risks are too high for conventional surgery, an alternative procedure uses a precise beam of high-dose radiation to relieve the pressure from the vessel.

The most important thing to know about TN, though, is that it is possible to control it and relieve future pain episodes. If you're experiencing these symptoms, see your dentist or doctor for an exam and accurate diagnosis.

If you would like more information on trigeminal neuralgia, 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 “Trigeminal Neuralgia: A Nerve Disorder that Causes Facial Pain.”





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Dentist - Bristol
21 Pleasant Street
Bristol, CT 06010
(860) 582-8095

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