My Blog

By J. Michael Plyler, DDS, PA
January 15, 2019
Category: Dental Procedures
3ThingsYouMightNoticewithYourChildsTeethThatNeedaDentist

Dental disease doesn’t discriminate by age. Although certain types of disease are more common in adults, children are just as susceptible, particularly to tooth decay.

Unfortunately, the early signs of disease in a child’s teeth can be quite subtle—that’s why you as a parent should keep alert for any signs of a problem. Here are 3 things you might notice that definitely need your dentist’s attention.

Cavities. Tooth decay occurs when mouth acid erodes tooth enamel and forms holes or cavities. The infection can continue to grow and affect deeper parts of the tooth like the pulp and root canals, eventually endangering the tooth’s survival. If you notice tiny brown spots on their teeth, this may indicate the presence of cavities—you should see your dentist as soon as possible. To account for what you don’t see, have your child visit your dentist at least twice a year for cleanings and checkups.

Toothache. Tooth pain can range from a sensitive twinge of pain when eating or drinking hot or cold foods to a throbbing sharp pain. Whatever its form, a child’s toothache might indicate advancing decay in which the infection has entered the tooth pulp and is attacking the nerves. If your child experiences any form of toothache, see your dentist the next day if possible. Even if the pain goes away, don’t cancel the appointment—it’s probable the infection is still there and growing.

Bleeding gums. Gums don’t normally bleed during teeth brushing—the gums are much more resilient unless they’ve been weakened by periodontal (gum) disease (although over-aggressive brushing could also be a cause).  If you notice your child’s gums bleeding after brushing, see your dentist as soon as possible—the sooner they receive treatment for any gum problems the less damage they’ll experience, and the better chance of preserving any affected teeth.

If you would like more information on dental care for your child, please contact us or schedule an appointment for a consultation.

By J. Michael Plyler, DDS, PA
January 05, 2019
Category: Oral Health
Tags: oral hygiene  
4WaystoCheckonYourBrushingandFlossingEffectiveness

For most of us, brushing and flossing is a routine part of daily life. But has it become such a routine that you may not be getting the most out of your daily regimen?

First, let's be clear about what you're trying to accomplish with these two important hygiene tasks, which is to remove as much accumulated dental plaque as possible. This thin film of bacteria and food particles is the primary cause for both tooth decay and periodontal (gum) disease.

So how can you tell if you're effectively cleaning dental plaque from your teeth? Here are 4 ways to check your brushing and flossing skills.

The tongue test. Move your tongue across the surface of your teeth, especially at the gum line, immediately after brushing and flossing. "Plaque-free" teeth will feel smooth and slick. If you feel any grittiness, though, you may be missing some plaque.

Floss check. For a similar effect after your daily hygiene take a fresh piece of floss and run it up and down your teeth. If the teeth are clean and you are using un-waxed floss, the floss should "squeak" as you move it up and down.

Disclosing agents. You can also occasionally use a plaque disclosing agent. This product contains a solution you apply to your teeth after brushing and flossing that will dye any leftover plaque a specific color. Disclosing agents are handy for uncovering specific areas that require more of your future hygiene attention.  And don't worry—the dye is temporary and will fade quickly.

Dental visits. For the ultimate test, visit your dentist at least twice a year. Not only can dental cleanings remove hard to reach plaque and calculus (hardened tartar), but your dentist or hygienist can evaluate how well you've been doing. Consider it your "final exam" for oral hygiene!

Be sure to also ask your dental provider for tips and training in better brushing and flossing. Becoming more effective at these critical tasks helps ensure you're keeping your teeth and gums free of disease.

If you would like more information on best oral hygiene practices, 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 “Daily Oral Hygiene: Easy Habits for Maintaining Oral Health.”

By J. Michael Plyler, DDS, PA
December 26, 2018
Category: Dental Procedures
CharlizeTheronBackinActionAfterDentalSurgery

When they’re introducing a new movie, actors often take a moment to pay tribute to the people who helped make it happen — like, you know, their dentists. At least that’s what Charlize Theron did at the premiere of her new spy thriller, Atomic Blonde.

"I just want to take a quick moment to thank my dentists," she told a Los Angeles audience as they waited for the film to roll. "I don’t even know if they’re here, but I just want to say thank you."

Why did the starring actress/producer give a shout-out to her dental team? It seems she trained and fought so hard in the action sequences that she actually cracked two teeth!

“I had severe tooth pain, which I never had in my entire life,” Theron told an interviewer from Variety. At first, she thought it was a cavity — but later, she found out it was more serious: One tooth needed a root canal, and the other had to be extracted and replaced with a dental implant — but first, a bone grafting procedure was needed. “I had to put a donor bone in [the jaw] to heal,” she noted, “and then I had another surgery to put a metal screw in there.”

Although it might sound like the kind of treatment only an action hero would need, bone grafting is now a routine part of many dental implant procedures. The reason is that without a sufficient volume of good-quality bone, implant placement is difficult or impossible. That’s because the screw-like implant must be firmly joined with the jawbone, so it can support the replacement tooth.

Fortunately, dentists have a way to help your body build new bone: A relatively small amount of bone material can be placed in the missing tooth’s socket in a procedure called bone grafting. This may come from your own body or, more likely, it may be processed bone material from a laboratory. The donor material can be from a human, animal or synthetic source, but because of stringent processing techniques, the material is safe for human use. Once it is put in place your body takes over, using the grafted material as a scaffold on which to build new bone cells. If jawbone volume is insufficient for implants, it can often be restored to a viable point in a few months.

Better yet, when grafting material is placed in the tooth socket immediately after extraction, it can keep most of the bone loss from occurring in the first place, enabling an implant to be placed as soon as possible — even before the end of a movie’s shooting schedule.

Will Atomic Blonde prove to be an action-movie classic? Only time will tell. But one thing’s for sure: When Charlize Theron walks down the red carpet, she won’t have to worry about a gap in her smile.

If you have questions about bone grafting or dental implants, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Dental Implant Surgery” and “Immediate Dental Implant.”

By J. Michael Plyler, DDS, PA
December 16, 2018
Category: Oral Health
Tags: osteoporosis  
ManageYourOsteoporosisMedicationtoAvoidJawboneProblems

Around 20 million people—mostly women after menopause—take medication to slow the progress of osteoporosis, a debilitating disease that weakens bones. But although effective, some osteoporosis drugs could pose dental issues related to the jawbones.

Osteoporosis causes the natural spaces that lie between the mineral content of bone to grow larger over time. This makes the bone weaker and unable to withstand forces it once could, which significantly increases the risk of fracture. A number of drugs have been developed over time that stop or slow this disease process.

Two of the most prominent osteoporosis drugs are alendronate, known also by its trade name Fosamax™, and denosumab or Prolia™. While originating from different drug families, alendronate and denosumab work in a similar way by destroying specialized bone cells called osteoclasts that break down worn out bone and help dissolve it. By reducing the number of these cells, more of the older bone that would have been phased out lasts longer.

In actuality this only offers a short-term benefit in controlling osteoporosis. The older bone isn’t renewed but only preserved, and will eventually become fragile and more prone to fracture. After several years the tide turns negatively for the bone’s overall health. It’s also possible, although rare, that the bone simply dies in a condition called osteonecrosis.

The jawbones are especially susceptible to osteonecrosis. Forces generated by chewing normally help stimulate jawbone growth, but the medications in question can inhibit that stimulus. As a result the jawbone can diminish and weaken, making eventual tooth loss a real possibility.

Osteonecrosis is most often triggered by trauma or invasive dental procedures like tooth extractions or oral surgery. For this reason if you’re taking either alendronate and denosumab and are about to undergo a dental procedure other than routine cleaning, filling or crown-work, you should speak to your physician about suspending your medication temporarily. Dentists often recommend a suspension of three to nine months before the procedure and three months afterward.

Some research indicates this won’t worsen your osteoporosis symptoms, especially if you substitute another treatment or fortify your skeletal system with calcium and vitamin D supplements. But taking this temporary measure could help protect your teeth in the long run.

If you would like more information on the effect of osteoporosis treatment on dental health, 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 “Osteoporosis Drugs & Dental Treatment.”

RegardlessofWhatYouveSeenOnlineDontFearaRootCanalTreatment

With smart phone in hand, you can instantaneously find out just about anything. Unfortunately, online search results aren’t always accurate. Case in point: there’s an idea floating on the World Wide Web that root canal treatments cause cancer.

Sounds ludicrous? Yes, but like other strange ideas this one has historical roots (pardon the pun). In the early 20th Century, a dentist named Weston Price propagated the idea that leaving a “dead” organ in the body caused health problems. By his view, a root canal-treated tooth fell into this category and could potentially cause, among other things, cancer.

But concern over root canal treatment safety is on shaky ground: dentistry examined Dr. Price’s ideas over sixty years ago and found them wanting. But first, let’s look at what a root canal treatment can actually do for your health.

Tooth decay is an infection that first attacks the outer tooth enamel and then continues to advance until it infects the inner pulp. It can then travel through the root canals to the roots and bone. Without intervention, the infection will result in tooth loss.

We use a root canal treatment to save the tooth from this fate. During the procedure we remove and disinfect all of the diseased or dead tissue within the pulp and root canals. We then fill the empty chamber and canals with a special filling and seal the tooth to prevent any further infection. And while technically the procedure renders a tooth unable to respond to thermal sensitivity or tooth decay, the tooth is still alive as it is attached to the periodontal ligament and its blood supply and nerve tissue. The tooth can still “feel” if you bite on something too hard and it doesn’t affect the tooth’s function or health, or a patient’s overall health for that matter.

As to Dr. Price’s theory, extensive studies beginning in the 1950s have examined the potential health risk of root canal treatments. The latest, a 2013 patient survey study published in a journal of the American Medical Association, not only found no evidence linking root canal treatment to cancer, but a lower risk of oral cancer in 45% of patients who had undergone multiple root canal treatments.

While root canal treatments do have potential side effects, none are remotely as serious as this online “factoid” about cancer. It’s far more likely to benefit your health by saving 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 “Root Canal Safety.”





This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.