“I Have Canker Sores!”

Posted by drgracesun on March 12, 2009 under Healthy Smile, Information | 3 Comments to Read

When you stay up way too late you might find pimples on your face and canker sores in your mouth – never fun to get! This painfully annoying little mouth sore – also known as an aphthous ulcer, can be quite bothersome to your eating and speaking actions for days. Thankfully, you can still kiss your loved ones with a canker sore, which are not contagious, different from viral cold sores (also known as a fever blister) caused by the herpes virus. Both are ulcerative sores in the mouth, but canker sores occur on the soft tissue inside the mouth. Cold sores tend to be on the outside of the mouth, around the lips.

Canker sores can arise for many reasons; the most common are stress factors, like a lack of sleep. Stress can wear down your body’s immune system, making your oral environment more susceptible to ulceration. Food allergies or sensitivities (to acidic fruits or toothpaste containing sodium lauryl sulfate for example) can trigger canker sore formation. The environment you are in can also stress your body and cause canker sores, like being in extreme heat or cold. Deficiencies in iron, folic acid, zinc or vitamin B12 will lead to a nutritional imbalance in your body, making you more susceptible to canker sores. Bacterial infection, hormonal imbalances and hereditary issues can all be causative factors. Finally, dental appliances or procedures which place pressure in specific parts of your mouth (like braces) can cause canker sores. Some physicians have theorized that canker sores are actually hereditary, but extensive research on this topic has not yet taken place.

So what do you do if you have a canker sore?  Improve your lifestyle! If you are able to extend your sleep cycle to between 7 and 8.5 hours of sleep nightly, maintain a balanced diet and master “stress management” at work, school and at home, your canker sore frequency will decrease. Canker sores are your body’s way of telling you to slow down and re-evaluate! Luckily, most canker sores will heal within 14 days (albeit painfully), unless your immune system was compromised. If you have a canker sore, avoid contact with it. Any unnecessary stimulation to the site can cause you to say ouch! Avoid spicy or acidic foods as this will further irritate the site. Make sure you are eating a well balanced diet, take supplements like vitamin B and C, and reduce your acidic fruit intake.

There are topical agents which can relieve canker sore symptoms, such as Milk of Magnesia, kenalog in orabase, tetracycline, suspension or low-level-laser-therapy (LLLT). Non-alcoholic mouthwash can also reduce the frequency of canker sores. If you do suffer from severe, frequent or lingering canker sores, speak with your dental professional or your primary health care physician.  Remember, the best path to a healthy, ulcer-free mouth is proper oral hygiene, a healthy lifestyle (including quality sleep) and a healthy, balanced diet – if you take care of your body, you can enjoy your quality of life even more.

“How Do I Get Kissable Breath?”

Posted by drgracesun on March 1, 2009 under Healthy Smile, Information | Be the First to Comment

Halitosis, or bad breath can affect a person’s self-confidence, self-esteem and can be downright embarrassing.

Because most people are accustomed to their own smell, it could be difficult to tell if you have bad breath without someone else’s help. Volatile sulfur compounds (VSCs) are usually the cause of bad breath, which are created when you eat and chew food, when proteins are broken down into amino acids, an important step in digestion. When these compounds are not removed from the oral cavity through proper oral hygiene (brushing and flossing after every meal), bad breath results. Most offending particulates that cause bad breath live on the back of your tongue. Your dentist can use a tool called a halimeter to measure the sulfur levels in your mouth. Bad habits such as drinking or smoking can also cause bad breath, and the offending odor usually lingers long after the cigarette or drink has been consumed. Dry mouth loosening the self-cleansing saliva can also contribute to an odorous mouth.

Most factors contributing to halitosis are self-curable, with proper diet, good oral hygiene and habitually drinking plenty of water. There are, however, a few cases in which bad breath is not self-treatable. Gum disease, cavities or problematic dental restorations trapping bacteria in the crevices around your teeth and gums can cause severe halitosis. Certain medical disorders and sinus or respiratory infections can also lead to bad breath – if you suspect you suffer from any of these maladies, see your dental professional. Although some people believe bad breath can come from the stomach, most medical professionals agree that your tummy is a very unlikely source of bad breath – unless, of course, you are belching.

You do want kissable breath, don’t you? If your bad breath is self-perpetuated, the most important thing to do is keep your oral cavity healthy. In addition to brushing and flossing after meals, be sure to clean your tongue. A tongue scraper will effectively remove all food particles from the surface of your tongue (a toothbrush can be used as well). Avoid foods that are particularly strong in smell (garlic, onions, etc…). Keep yourself hydrated with water (a moist mouth will actually smell better than a dry mouth – sweet baby breath is partly due to constant drooling!), and if you are unable to drink water, chew sugarless gum (which will promote saliva generation). Finally, always have your teeth professionally cleaned and examined twice a year. Essential oil-containing mouthwashes like Tooth and Gum Tonic can also inhibit bad breath for hours and will not dry out your mouth like alcoholic mouthwash, which you should stay away from. Stopping bad habits like drinking and smoking will also benefit your mouth greatly.

“Wisdom Teeth – Save or Extract?”

Posted by drgracesun on February 28, 2009 under Healthy Smile, Information, Smart Smile | Read the First Comment

Only one out of every 25 people get to keep all 32 teeth to chew our food; most of us end up with only 28, and a story to tell about our wisdom teeth!

Anthropologists and evolutionary biologists think the wisdom teeth have become non-functional due to evolution: we do not have the same diet of coarse, rough food that our ancestors did, who had larger active jaw muscles. Evolutionary history lead us to our smaller jaws which can no longer accommodate wisdom teeth.

Wisdom teeth are the third set of molars, which usually start forming around age 10, and emerge in a young adult’s mouth between the age of 17-25, but often they are impacted or blocked by the second molars. Also, if the tooth is partially erupted, food can get trapped in the gum without access to clean. This leads to infection and decay. Wisdom teeth which come in tilted or remain tucked away can also lead to crowding or other problems. Completely impacted wisdom teeth can potentially develop into a cyst, forming a sac of tissue around the tooth leading to bone destruction.

Impacted Wisdom Teeth

Impacted Wisdom Tooth

There are lucky big-jawed or small-toothed people who develop wisdom teeth that function properly, they do not need to see an oral surgeon for extraction, but most of us face the unavoidable trip to the oral surgeon to prevent or treat wisdom teeth complications.

Unfortunately, there are risk factors for removing your wisdom teeth as well. Besides common surgical complications (like swelling, pain and infection), paresthesia (numbness) of the lower jaw, lip, chin or tongue could be quite annoying. If the wisdom teeth are positioned very close to or are intertwined with nerves, the process of extraction can bruise or damage these nerves. Paresthesia is rare and usually temporary, but in some cases can be permanent. Dry socket, when blood of the socket of the extracted tooth fails to coagulate (or a blood clot becomes dislodged due to trauma like sneezing, or playing a musical instrument) can cause irritation, pain and inflammation, but generally heal within a few weeks on their own. To lower the risk factors of extraction, have your wisdom teeth removed at the appropriate time, when the root has formed two-thirds of the way (approximately age 18-24) for easier handling and fewer complications. Because bone density is less developed in teenage years than in later adulthood, it is less resistant, carrying fewer risks of extraction. With age, the jaw becomes dense and extraction becomes increasingly complicated.

So it is very important to have an examination and consultation with your dental professional regarding your specific situation. Clarify the elective removal of wisdom teeth, whether the potential risks associated with the procedure exceed the benefits, or whether it’s time to get them out – for a better environment for the rest of your teeth.

“What is Tongue Thrusting?”

Posted by drgracesun on February 7, 2009 under Healthy Smile, Smart Smile | Be the First to Comment

“Dr. Sun, I’ve had braces twice and I still have all of these spaces in my teeth!” Disparaged new patient Lisa was at her wits end for the answer to her dental dilemma.

Lisa did wear her retainer for a year after the braces, bur once stop wearing the retainer, but her condition had relapsed. Two thoughts went through my mind – either bruxism (night grinding) or tongue thrusting. Checking the wear pattern of Lisa’s teeth as well as performing muscle palpitations for clues of bruxism and observing whether Lisa’s tongue could be seen between teeth during swallowing to evaluate her tongue thrust .

Bruxism has gained awareness in recent years, but tongue thrusting is still a mostly unfamiliar word. Let’s have a discussion about this interesting phenomenon!

Although nearly all children experience tongue thrusting, it is usually self-corrected at age six, and some continue tongue thrusting into adulthood. Because we swallow up to 2,000 times a day, pressure exerted on the teeth from a protruding tongue at each swallow can create force on the teeth, leading to mis-aligned dentition or a lisp-orientated speech impediment or reversed orthodontic work.

Generally, there are several contributing factors which can lead to tongue thrusting. Certain types of pacifiers in childhood can set bad oral habits in young children. Allergies or nasal congestion causing the tongue to lie low in the mouth due to breathing obstruction (as opposed to the normal position behind the upper front teeth against the palate), genetics or ankyloglossia (a tongue tie requiring a frenectomy to remedy) can also cause tongue thrusting. A laser frenectomy is the most advanced treatment for alleviating a tongue tie.

Possible treatment includes a training appliance from your dentist. Myofunctional therapy, a proactive strategy which trains  the tongue to swallow properly. With proper myofuntional training and exercise , we can swallow without tongue thrust. To improve airway, check with your ENT doctor, retraining of proper body postures are all important for oralfacial health.

Wow, isn’t this interesting? The tongue is an essential part of our body. It is influenced by and can influence our physiology in many ways! Look at the mirror and swallow – are you tongue thrusting?

“How Long Will It Last? Bonding vs. Veneers”

Posted by drgracesun on January 30, 2009 under Beautiful Smile | Read the First Comment

“Does it hurt? How long will it last? How long will it take? How much does it cost?”

These are common questions from patients looking for cosmetic dentistry.

If you’re interested in cosmetic dentistry to get yourself a winning smile, whether the problem is mis-alignment, cracked or chipping teeth, unsightly spacing, uneven or dark colored dentition, uneven or too much (or not enough) smile showing, or even gum erosion, the eternal question always arises: What would be the best solution?

In the past, crowns were the primary choice for masking tooth problems, but since the late 1980s, cosmetic dentistry has offered both bonding and veneers to improve your smile. This leads to the eternal question: “Bonding or veneers?”

Dental bonding involves the application of a durable composite material directly to the surface of the tooth, by your dentist, which is then sculpted and artistically shaped to the exact look the patient desires, to blend naturally and seamlessly with the patient’s existing teeth. A laser (or high intensity light) is then used to cure the composite material, hardening and reinforcing it to the surface of the tooth. This bonding technique has many applications, not only for aesthetic uses but also for prosthodontics and pediatric dentistry. The advantages to dental bonding are a quick treatment time (can be completed in one office visit after a consultation), and a relatively low cost per tooth when compared with porcelain veneers. Durability of bonding will be affected by the oral environment. Since composite bonding is a mixture of quartz particle (70% – 80% filled) and resin, discoloration and breakage is inevitable if your mouth has a high acidic pH value (if you are a soda drinker, lemon lover or candy sucker), if the bonding was not supported by a solid tooth structure, or if you are a night grinder.

Porcelain veneers are fabricated in the laboratory. They are 100% filled with hard mineral particles, and are fired at a high temperature with a vacuum (to procure the best physical properties to sustain the veneer’s strength in the harsh oral environment). Compared to bonding, there is more procedural work involved with porcelain veneers. There are different techniques to fabricate the veneer pieces (which call for different methods of preparation for the tooth); the pressing technique produces a stronger veneer, but requires 0.8mm thickness of the veneer. The porcelain powder build-up technique can produce super thin veneers (0.3mm), which produces a very conservative look on your tooth structure, while at the same time keeping a natural silhouette. The veneer piece lays on top of the tooth structure and is similar to a press-on nail. They chemically adhere to the tooth with bonding composite cement; since porcelain is acid resistant and stronger in physical properties than composite material, this restoration provides long-term service. When getting the veneers, the first visit consists of preparation and imprints f the teeth (which might involve anesthetic ). After this, you will leave the office with temporary veneers which look like natural teeth. A wafer-thin veneer is then crafted out of porcelain which is seamlessly cemented to the front side of the tooth on the second visit. In addition to straightening teeth, porcelain veneers can close gaps between teeth, whiten teeth that do not respond well to bleaching , and can also be used to protect damaged tooth surfaces. The advantages to porcelain veneers over bonding is that veneers are much longer lasting (and stronger) than composite bonding material.

Whether you decide to invest in dental bonding or porcelain veneers, make sure you have all work done at a reputable dentist, preferably at a practice which has its own in-house ceramic lab. When ceramic work is done by an in-house lab with an in-house ceramist, any changes that need to be made to the length or color of the veneers can be done without requiring an additional office visit. Remember, the result of the cosmetic procedures are truly varied depending on the ability of the dentist, ceramist, your clinical situation and the communication between all parties involved. Do your research!

Both bonding and veneers are additive procedures, depending on the position, alignment and shape of your teeth, which is the foundation for any new restorations. This foundation will need to be in the right fundamental situation to receive restorations to result in a fabulous smile. In other words, sometimes, you do not need to do much to your own teeth before applying cosmetic restorations. It might be necessary to reduce or modify the tooth structure before anything can be added onto it to make it look perfect.

There is some risk involved with cosmetic bonding or veneers, so be cautious with any cosmetic procedure. A comprehensive evaluation of your present dental condition is absolutely necessary as a first step; blue prints of your teeth and of your prospective dental project are needed to establish clear verbal communication between all parties involved (including you), including possible mock-up or wax-up models to preview possible changes, which could avoid costly mistakes.

Do your homework: finding the right dental professional, discussing every aspect of your dental needs, understanding the pros and cons of each procedure, and making an educated decision will ensure you get the smile you’ve always wanted.

“Am I Too Old for Braces? “

Posted by drgracesun on January 29, 2009 under Beautiful Smile | 2 Comments to Read

If you’re older than 95, then maybe!

The mechanism of the movement is the result of remodeling of the bone that houses the teeth, the pressure on the side bone will disappear (the tension side), and new bone will deposit so the teeth can be guided to the ideal position. As long as you are healthy, there is no age limit! The most common age to receive braces is 9-12. Braces can be very effective to guide the jaws to reach one’s full potential development during the growth spurt period. If a child is diagnosed with teeth and jaw alignment problems at a younger age, an orthodontic appliance can be worn to correct and aid the development of the jaw. If you missed out on braces as a teenager – or you used to wear braces previously – and you now want to do something to improve your smile or dental health (because you teeth are crooked or gaped), discuss all available options to you with your dentist or orthodontist.

Orthodontic treatment can proceed with fixed braces which can be clear (less noticeable); you can also wear a removable appliance to straighten your teeth – friendly for an adult lifestyle! There are several options depending on your own unique situation and the training background of your dentist. The popular wireless Invisalign system often works well to correct crooked teeth, and most people never notice you are wearing an appliance!

Of all the orthodontic treatment recipients in my office, 95% are adults (average age is 35). The oldest patient I have orthodontically treated was 83! Treatment periods vary from three months to two years, with an average duration of 9 months. 60% of patients choose to receive clear braces for specific bite correction, 30% choose Invisalign for correction of crooked teeth and the convenience of not having to come in and see me very often! The remaining 10% choose alternative treatment methods.

Of course, cosmetic procedures like porcelain veneers or bonding can be the answer to your desire of that million dollar smile, as long as the teeth which are the foundation for your cosmetic restoration are reasonably positioned and in reasonably healthy condition. This type of procedure provides instant gratification. One big caution however to this treatment method worth taking is before the alteration treatment starts, imagine you are an architect. Can you build the design of your tooth without blue prints? Proper diagnosis , treatment planning, and / or wax-up and mock-up modeling are all extremely important things to be taken care of right by a trusted dental physician. If you’d like to know more about these terms, visit my YouTube channel for procedural videos, educational material and more.

Dental braces, a common orthodontic appliance used to straighten and properly align a person’s teeth to a person’s bite,  have been used for nearly a century.Whether your teeth are only slightly off-center or are quite crooked, whether you are age 6 or 106, dramatic transformations in your outward appearance can be achieved at any age through teeth straightening! Dont’ be afraid!