Diaries of a Dentist

How To Stop Grinding Your Teeth At Night

  On   the morning of the big presentation my jaw ached as if I’d just chewed through my pillow top mattress and maybe my nightstand too.  I’d been clenching my teeth all night long, like I always do when I’m stressed.” 

  Sound familiar?  Most dentists agree, nighttime clenching, grinding and bruxing is one of the most common conditions we see. The symptoms are wide ranged, from sore muscles in the face, neck, shoulders and back, to headaches, cold sensitive teeth, cracked teeth, ear pain and joint damage.  

In most cases a custom made prescription night time appliance called a night guard or occlusal guard is the answer.  The function of the night guard is multi faceted.  It protects the teeth and enamel from wear and fractures caused by the trauma of grinding.  It also breaks the “muscle memory” of the facial muscles that control the movement of the lower jaw.  

Because of the custom fit, it also serves as a type of retainer so your teeth don’t move with age.  These guards are made of a hard high quality acrylic that will last for years.

Wake Up To A Brand New Smile - Sedation Dentistry

Who is a candidate for conscious sedation dentistry? 

•      Patients who have a fear of visiting the dentist
•      Patients who have difficulty getting numb
•      Patients who have a bad gag reflex
•      Patients who have very sensitive teeth
•      Patients who have complex dental problems
•      Patients who have limited time to complete their dental care
•      Patients who are uncomfortable with needles and shots
•     Patients who dislike the noises, smells and tastes
•      Patients who are afraid and embarrassed about their teeth 

Facts on Conscious Sedation Dentistry 

•      It is SAFE!  You take several pills prior to treatment
•      You have little or no memory of the experience
•      You snooze 5-6 hours after you take the medication
•      Work requiring a lot of appts. can be done in one
•      People who have difficulty getting numb can relax
•      It reduces the fatigue of long dental appointments
•      It Works! 

You are given oral medication one hour prior to your dental appointment.  You will relax into a comfortable chair, covered with a thick, warm cozy blanket.  Your vital signs will be monitored.  After you are comfortable, our experienced clinical team will take care of your dental needs.  When your treatment is completed, your companion will take you home to finish your relaxing sleep.

IT’S YOUR TIME! IT’S YOUR TURN!

 You worked your way through school, married, bought your first home, had children, paid for first cars, paid for summer camp, paid for college, and paid for weddings. 

Now the kids are grown, your business world is finally gearing down and you are ready for the next phase of your life! 

We are living in an era where the average life span has grown and quality of life has dramatically improved. We are blessed to live in a society focused on health and fitness.  People want to stay healthy and attractive. 

Through the years, perhaps as you passed by a mirror, did you ever notice your smile?  A little gap between your front teeth, a little tooth movement, a little darkness creeping in, a little something you wanted to do for yourself, for your smile?  Perhaps now it is your turn!  

Our office offers the latest technology, the latest materials and the best labs.  Dr. Bridger has over 25 years experience and hundreds of hours of advanced training in the art of cosmetic dentistry.  Your dreams are only a phone call away! 713-266-2244

Missing Teeth Replacement Options

No one likes to smile and show the “space” of a missing 

tooth.  Missing teeth are an embarrassment as well as can affect a person’s health and quality of life.  Some of the problems associated with missing teeth include difficulty eating, speech problems, and can cause the adjacent teeth to move and ultimately be lost!  Let’s look at the pros and cons of the 3 most common solutions. 

The three most common ways to replace missing teeth: 

1. With a dental implant
2. With a fixed, non-removable bridge
3. With a removable partial denture or complete denture. 

Implants are by far the strongest option with the most longevity.  They are the “standard of care” for replacing teeth today.  Implants are titanium “false roots” that are surgically placed into the bone.  After approximately 3 to 4 months of healing, an attachment called an abutment is screwed into the top of the implant and a crown is placed over the attachment.  Dental Implants usually will last you your lifetime, which cannot be said about any other treatment option, so although they are the most expensive on the “top” side, you will only be paying for them once!  

Fixed Bridges are the second most popular option.  This procedure involves the trimming down the adjacent teeth, sending a mold of the teeth to a dental laboratory to make the bridge, and the cementation of the bridge about 3 weeks later.  A bridge is a less expensive option to a dental implant and used to be the “standard of care”. They are still commonly used, especially when the cost of a dental implant restricts its use. The downsides of this option are the trimming down of the healthy teeth on each side of the missing tooth, the possible future complications that could arise, such as the need for root canals, and the fact that the average lifespan of a bridge is 7 to 15 years (not your lifetime).  

Finally the Partial or Full Denture option, which is the least expensive and also the least desired.  Partials and Dentures are removable appliances used to replace missing teeth.  They usually do not fit tight and tend to move when eating and can impair your speech.  Partials and Dentures have an unnatural feel so it takes time to adjust to them if ever. Also, a partial has wire clasps that clip around the remaining teeth that can damage those teeth and looks unsightly. However, if you think you may want implants in the future, you could temporarily wear a partial until the time is right for you to do something more permanent and more comfortable. 

Whether you choose an implant, a bridge or a partial denture will depend on many factors.  You and your dentist can discuss the benefits and limitations of each of these options before deciding what is best for you.

Dental Insurance-What is it really worth?

Unfortunately most people do not have a good understanding of their dental insurance plan.  Dental insurance is not at all similar to your medical insurance.  Unfortunately, your dental insurance in not going to be your “savior”, should you have a lot of dental needs.  Most of people have dental plans today but unfortunately they are not aware of the limitations.  

Dental Insurance is not really “insurance” at all.  Insurance is defined as a third party taking the risk of a catastrophic loss.  Most dental plans have an annual maximum of $1500.00, and I think we can all agree that there is nothing “catastrophic” about $1500.00.  

Let’s call it what is really is, a “maintenance” plan.  Dental plans help us keep our mouths in good health, from a preventative stand point, but if something serious should happen, your dental plan has significant financial limitations.  

So what can you do?  Today dentistry offers many third party financing options.  Care Credit is one of the more popular and well known.  Plans like Care Credit allow you to spread your payments out over an extended period of time.  In some cases, patients can make payments up to 12 months at no interest!  It is a wonderful plan that takes away a lot of the stress of having dental work done.  

Careful planning of your dental treatment “order” is another way to maximize the dental coverage that you do have.  Often times you can prioritize your treatment, doing the most critical teeth first, and putting off the less damaged teeth to the next year which allows you to use two years worth of dental benefits.  

One point that should be made is that patient’s reliance on their dental “insurance” has compromised appropriate care for many people.  Often times, dental “insurance” clouds the treatment planning process, and makes it more difficult for the dentists to do the best for their patients.  

Dental Insurance - what is the value?

How much do you really know about your dental insurance?  Let’s take a look at the realities.  There are two ways to get dental insurance coverage, from your employer or by purchasing an individual policy.  The majority of dental policies are provided by employers. Large companies get tax deductions and can attract a well trained work force with such packages.  However, did you know that most of the plan’s “coverage” table is actually negotiated between the employer and the insurance company?  This is one reason a lot of procedures that you might assume covered procedures, are not.  The “usual and customary”, or UCR amounts are negotiated  as well. 

Many plans tell their insured’s that they will be covered 100%, 80%, and 50% but do not clearly specify the plan’s “fee schedule” allowances, limitations and exclusions. 

Another situation is the purchase of the “individual” dental insurance, directly from the insurance companies.  Unfortunately, most of those plans are in the form of “referral” plans that totally dictates which dentist you must see.  Most of these plans are not actually insurance, but a “reduced fee” program that very few experienced dentists are willing to participate in. 

Regardless of the source of your insurance, keep in mind these insurance companies are in business to make a profit. They could lose money if they fully paid for all of the yearly cleanings and check ups as well dental work that may be needed. That is one reason most policies have a yearly maximum that will only pay a range from $1000.00 to $2000.00 per year!  Hence, most dental insurance plans are criticized for being insufficient should you need more that a few fillings. Dental Insurance is very different from Medical insurance. 

Then there is the “In Network” and “Out of Network” question.  The reality is if you go to an “In Network” dentist you are restricted to who can care for you as you have to choose a dentist on their “list”.  The true approximate savings is only around 10%.  Also the “In Network” plan still has the same yearly maximum limitation.  

The good news is, almost all dental plans cover basic dental costs that are meant to prevent dental problems.  This is important as it helps encourage patients to seek regular dental care, which can prevent later problems.  Dental insurance is also helpful for those patients with small to medium dental needs, or people who can spread their treatment out over several years.  Dental insurance is not meant to be a pay-all, but only a 

Gum Disease Linked to Baby’s Death

Gum Disease Linked to Baby’s Death

We all know research by medical doctors has linked the bacteria found in infected gums to many serious diseases, such as cardio-vascular disease, pancreatic cancer, and Alzheimer’s disease. Pregnant women with gum disease have long been warned that periodontal disease can cause a baby to be born prematurely or too small. But for the first time scientists have linked bacteria from a mother’s gums to an infection in a baby that was full-term but stillborn, according to a study which was published in Obstetrics and Gynecology. Scientists now say a pregnant woman’s gum disease caused her baby to be stillborn.

 Scientists from Case Western University made the discovery after a 35 year old California woman contacted them to help investigate the death of her baby. Bacteria from the mouth can easily get into the bloodstream once a woman’s gums are bleeding, explains the study’s lead author Dr. Yiping Han, a professor of periodontics and pathology at Case Western University.  “Once the bacteria are in the blood, they can go almost anywhere,” Hans explains. The placenta is an immuno-suppressed organ, which makes it easy for the bacteria to colonize the placenta. Plaque samples from the woman’s teeth were found to be positive for the exact same strain of the oral bacteria found in the dead baby’s stomach and lung.

 Now we all realize this is an extreme case, which probably does not occur that often. But it makes one consider getting one’s gum disease treated before any of these situations arise. Gum disease is simple to diagnose and easy to treat by our dental professionals.

periodontal (gum) disease

Do your “gums” hang low, do they wobbel to and fro?

Are you one of the millions with periodontal (gum) disease?  The World Health Organization published a report on oral health with research showing that up to 85% of adults in the US have some form of gum and bone disease.  Unfortunately most of these people do not know it.  Some of the most obvious symptons of gum disease include: bleeding gums, cold sensitive teeth, obvious plaque or tartar, bad breath, swollen red or tender gums, spaces developing between the teeth, receding gums that can make the teeth look “longer”, and loose or mobile teeth, to name the most common.

These symptoms are inflammatory factors and the bodies response to a bacterial infection.  The bacteria and infection get into the blood stream and there is a systemic effect.  Most people ignore these symptoms because they cannot FEEL any discomfort and they cannot see any infection.  You can easily swallow the blood and bacteria when brushing and flossing, but keep in mind a “little” bleeding is not normal.  If you were bleeding from an infected wound on your hand you would probably treat it!

Current research has linked this type of bacteria to many conditions including: cardiovascular disease, type II diabetes, blood clots and strokes, preterm and low birth weight babies, respiratory disease, pancreatic cancer and Alzheimer’s disease, to name a few.

These studies suggest that infected gums act as a portal for bacteria to enter the body.  The new PERIO TRAY method offers a new, non-invasive treatment for periodontal disease using a newly approved system to deliver antimicrobial agents to the source of the infection.  This system breaks up the ‘biofilm’  which is a sticky film that adheres to the teeth protectiong the bacteria and other pathogens. 

The perio trays are comfortable to wear, easy to use and custom made for YOUR mouth.  The perio trays offer long term homecare maintenance to help manage this disease.  Your doctor will advise you how often and how long to wear your trays.
Yours for better health,
John N. Bridger D.D.S., F.A.G.D.

New Year's Resolution: #1 Save Marriage,Stop Snoring

Snoring can create severe strain on a relationship.  Imagine sleeping next to a buzz-saw every night.  In the morning you are both tired and upset from the night’s disturbance.  In one extreme case, a wife applied crazy glue to her husband’s lips! 

The majority of noisy snoring is caused by a restricted airflow at the back of the throat.  This happens when the soft tissues at the back of the throat close up so air has to be forced through. This closing up happens when asleep because the muscles at the back of the throat go slack, and the lower jaw relaxes, constricting the airway.  Snoring is also linked to a condition called obstructive sleep apnea or OSA. 

 Snoring and OSA are so common that their true impact on our daily lives is difficult to appreciate.  OSA  studies found that quality-of-life was significantly impaired in these patients, and can also contribute to hypertension, coronary artery disease, stroke, irregular heart beat, etc.   Most physicians treat this condition with a medical device called a CPAP, a continuous positive airway pressure machine.  Few people tolerate this appliance very well.

Now there is a new, more comfortable and less expensive option!  The Dental Snore Guard or the Mandibular Advancement Appliance.  

The Snore Guard is custom made to fit every patient precisely. It advances the lower jaw to prevent the tissue collapse in the back of the throat.  Simply put the appliance in the mouth before going to sleep to keep the airway unblocked eliminating  the snoring.

Sleep Apnea and Teeth Grinding

As we have seen in our practice and as recently noted in PerioEducation.com there is a high prevalence of nocturnal teeth grinding, or bruxism, in patients with obstructive sleep apnea (OSA), particularly in Caucasians. New research presented at CHEST 2009, the 75th annual international scientific assembly of the American College of Chest Physicians (ACCP), found that nearly 1 in 4 patients with OSA suffers from nighttime teeth grinding; this seems to be especially more prevalent in men and in Caucasians compared with other ethnic groups.

Find out more: Teeth Grinding Linked to Sleep Apnea