 Since the lockdown order of March 2020 due to the COVID-19 pandemic, there has been a significant increase in grinding and clenching teeth nationwide. These behaviors are related to stress. At our office, we have been prescribing nightguards for patients who were never diagnosed as grinders/clenchers before. Our patients who already had nightguards have ground right through them and have needed replacements.
Many of our patients have started coming in with symptoms of grinding/clenching such as sore jaw in the morning, headaches, tightness in the jaw/temples, ear aches, tender teeth when biting, chipped teeth/fillings/crowns, torn up inside of the cheeks from cheek biting, sensitivity to cold/sour. It is important to protect your teeth, because it's the only set you've got! If anyone has told you they have heard you grinding your teeth at night, or if you are experiences any of the above symptoms, it is important that you get fitted for a nightguard. We do not recommend any OTC/DIY nightguards, and have seen negative results from patients who have gone that route. Some patients have noticed their teeth moving or becoming wiggly from ill-fitting nightguards, or appliances that are not equilibrated to the opposing teeth. This can lead to tooth mobility, trauma, and potentially tooth devitalization or tooth loss. At your next appointment, let your dentist know if you think you may be grinding/clenching your teeth.
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 What is an immediate denture? When a patient has many teeth that are non-restorable and require removal, this type of denture can be placed IMMEDIATELY after extraction of the teeth. This means that the patient will not have to leave the office with teeth missing. This is in contrast to removing teeth, waiting 4-6 months for bone healing and stabilization, followed by denture fabrication. Advantage: Your new teeth are ready on the day of surgery, and you may eat with it - simpler, smaller foods at first Disadvantage: The bone is healing underneath and is changing its anatomy following surgery, which may affect the fit of the denture over time. The patient above is an 81-year old with extensive history of smoking and poor hygiene. His lower teeth have been compromised by severe periodontitis (gum disease) and gross caries (cavities). He already has an upper complete denture. The prognosis of the lower teeth is deemed NON-RESTORABLE. Recommended treatment is full lower teeth extraction in conjunction with a lower immediate denture.  Impressions of his upper and lower jaw were taken, which are sent to our dental laboratory. They then create stone models of his dentition.  The lab creates a try-in denture, in which some of the teeth are set in wax and acrylic to try in the patient's mouth and confirm fit. This try-in denture fit the patient's upper teeth and his bite perfectly.  After confirming the fit of the try-in denture, the lab removes all teeth on the stone model, which simulates the planned tooth removal. They set the REMAINING teeth onto the denture and fabricate the FINAL denture to be delivered on surgery day.  Surgery day. After extracting all the non-restorable teeth, the lower immediate denture is immediately placed. This patient will leave our office with a full set of teeth!  Post-operative instructions:
1. Sleep with the denture in place to compress the surgery site and help with healing/recovery 2. NO SMOKING FOR AT LEAST 3 DAYS - to prevent dry socket formation and reduce chance of infection 3. Eat soft, simple foods that are easy to consume, like soup or mashed vegetables 4. Sore, painful spots may develop, like a new pair of shoes that are too tight. Continue to use the denture so that a sore spot becomes visible; your dentist will now know exactly where to adjust the tight spot 5. It takes practice getting comfortable with your denture. Practice speaking and eating so your mouth and tongue can adjust  As most of us know, we are born with baby (primary) teeth, which give way for our adult (permanent) teeth. This is how the tooth fairy stays in business when parents put their kids' baby teeth under the pillow! However, what most parents need to know are that baby teeth are important placeholders for the adult teeth. Baby teeth shouldn't fall out (exfoliate) at ANY time, they need to fall out at SPECIFIC times to allow the adult teeth to grow and emerge (erupt) from the gums properly.  As stated above, baby teeth maintain the space required to allow the adult teeth enough room to grow. This is why spacing between baby teeth is great, since adult teeth are bigger and need space to enter. However, sometimes baby teeth exfoliate earlier than expected. There is a genetic component, as well as hygiene and diet component.  This patient is a 6-year old who lost his 2nd primary molar unexpectedly, leaving a large gap. As the chart above shows, this tooth should not exfoliate until he is at least 10 years old! Because he is still growing, his bone and teeth are constantly changing and moving, which means the big permanent 1st molar in the back (his adult tooth) is going to tip forward and close the gap. Why is this bad? It means the permanent 2nd premolar will be blocked underneath because there won't be enough room to grow. He will have orthodontic problems as he ages if the tooth remains blocked.  What should parents do when this happens? Timing is everything. The adult tooth will immediately start to close the gap, so children need to see the dentist ASAP.
In this case, we placed a device called a space maintainer - it maintains the gap to stop the tooth from tipping and allows space for the permanent tooth to grow. We cemented this device with a blue orthodontic cement for ease of visibility. This device can be removed when the permanent tooth below erupts, or when the baby tooth itself exfoliates in the future. TIP FOR PARENTS: Please keep an eye on your child's teeth! Early intervention in their dental health means a more beautiful, healthier smile as they grow! It has only been two months since starting my Invisalign treatment with Dr. Mathew Chow, and I couldn’t be happier with the results! Being very eager to complete my orthodontic treatment, I was a very compliant patient and stuck to wearing my trays for 22 hours a day! Crazy, right? Today, we took some new molds of my teeth so that we can add finishing touches to my treatment plan. I’m excited to perfect my smile that I will be proud to show off. Check out the pictures below to see how far we’ve come in just two months!    Happy new year!
As we move along into this new year, we feel it's important for everyone to follow through on their new year's resolutions. Exercising more, eating more vegetables, more vacations - these are all great ideas. But let's not forget about our teeth! Here are some new year's resolutions for a healthier mouth and a greater smile: 1. Brushing and flossing DAILY!
2. Less sugary food and drinks
3. Cut down on smoking
4. Improving your smile
Good luck on all of your resolutions! We hope this is the best year ever for you!  Photo from ABC News
We have grown up in the Bay Area our entire lives. San Francisco is one of the most beautiful cities in the world, and we feel lucky to work here. We are extremely fortunate that the fire is beginning to be contained and we are safe; however, we see that the aftermath of damaged homes, damaged lives, and smoke clouds still lingers. As a reminder of this terrible disaster, the smoke clouds remain in the air above our San Francisco and San Carlos dental offices. We hope that the Bay Area recovers quickly, as we know Californians are capable of doing so! We donated to help the victims of the California fire, and we encourage you to do so as well. Here's a link of approved organizations to help donate to the cause: http://www.californiavolunteers.org/index.php/Disaster_Volunteering/current_disasters/ Do you ever wake up with a HEADACHE or a TOOTHACHE? Do you ever wake up with SORENESS in your jaw? Do your teeth look DENTED or CHIPPED? If you answered YES to any of these questions, you MIGHT be GRINDING your teeth at night. A treatment option for the effects of tooth grinding (or bruxing) is a NIGHT GUARD. A night guard works as a protective layer between your top and bottom teeth to prevent them from grinding (which may lead to CHIPPED or CRACKED teeth), and DECREASE STRAIN on your jaw muscles. While there are OTC appliances you can find at your local pharmacy, night guards prescribed by your dentist are made of HIGH QUALITY materials by a professional lab, and will fit your teeth LIKE A GLOVE! At your appointment, we would take molds of your top and bottom teeth, and a record of your bite. And VOILÀ, in 2 weeks you will be on your way to protecting those pearly whites! Check out the video below of Dr. Mat getting impressions taken for his new night guard!  In 2014, the American Dental Association reported that 22% of people skip dental appointments because they are afraid of the dentist.
(Source: www.ada.org/en/science-research/health-policy-institute/dental-statistics/patients) Dental fear is common, so we wanted to shed light on what our appointments are like. Every office is different of course, but here is what our new patients generally experience at the first appointment: 1. A warm welcome from our friendly doctors and staff! Our staff is very warm and friendly by nature, so we always spread the love to our patients. Our philosophy is that if you're happy, we're happy. If we're happy, you're happy! 2. "How can I help you?" You came to the office for a reason. Whether it's for a routine checkup or a sensitive tooth, we make sure that your chief concern is the first thing on the doctor's agenda. 3. X-rays We need x-rays to perform a proper diagnosis and construction of your treatment plan. They allow us to see the extent of both dental health AND dental disease; thus, they are CRUCIAL to the diagnoses of your dental health. 4. Soft tissue exam We check for "lumps and bumps", salivary flow, and routinely perform oral cancer screenings. We also check for the presence of gum disease (gum bleeding with bone and attachment loss). The Center for Disease Control estimates that in the US, 47.2% of adults over 30 have untreated gum disease. This number jumps to 70% infection in adults over 65. Don't become a statistic! (Source: https://www.cdc.gov/oralhealth/periodontal_disease/index.htm) 5. Hard tissue exam This is the examination of the teeth, themselves.
6. Photos It's hard to explain your oral health verbally. We need visuals as well so patients know EXACTLY what we're talking about. 7. Your personalized treatment plan At this point, we display your photos and x-rays onto the computer to explain all of our findings. This is a dialogue, so we encourage our patients to ask a ton of questions and interrupt us as needed. It's your mouth after all, so we want our findings and planned treatment to be crystal clear! 8. Teeth cleaning Time to give your teeth a much needed bath! We'll remove plaque, tartar above the gums, and any coffee stains you might have. We also routinely give our patients a complimentary hygiene kit to take home (brush, floss, toothpaste, and mouthrinse). 9. Any questions? We make sure we answer all of your questions, and ensure that we have addressed your chief concerns. 10. Dismissal and setting up your next appointment! We hope this post is useful to explain exactly what your first dental appointment is like in our office. We also want to show you exactly how much detail and care we put into our appointments. No two mouths are the same, and each has their own unique story to tell!  If I had a dime for every time a patient told me they used super glue to re-cement their crown and didn't have problems after, I'd have ZERO dimes.
Seeing these "crown cements" at Walgreen's made me very concerned. It says "Dentist Recommended" but I don't know a single dentist who would recommend these unless they were out of their minds. Yes, it seems like a quick, cheap, and easy solution, but here's why it's discouraged: 1. Risk of incorrect placement - can create crown open margins leading to tooth decay 2. Risk of crown fracture - incorrect placement can lead to a heavy bite on the crown 3. Risk of tooth fracture - incorrect placement can compromise the already weakened tooth structure 4. Inability to clean up the "cement" - cement that flows uncontrollably can end up deep in the gums, contributing to gum disease, gum abscess, further decay, and bone loss If you have a crown (or filling) that comes off, please see a dentist - we are trained to fix these things!   At a quick glance, my teeth might appear straight…but once you take a closer look you can see crowding on my upper teeth. I’ve started to become more self-conscious of my teeth over the years as the crowding has become very noticeable. Occasionally food would get stuck between my crooked teeth (we all know how embarrassing that is!), and we know that can lead to cavities and gum disease. I decided I want everything straightened out! Dentists need dental work too sometimes.
I finally decided to get Invisalign (clear braces), thanks to my bro Dr. Mat. Here are my reasons for starting Invisalign:
I can’t wait to share the final results! Invisalign is a great alternative to traditional wires and brackets, and may be a treatment option if you want to achieve that perfect smile. |
Photo used under Creative Commons from Michael Dunn~!
