My Blog

By Philip Girgis DDS
October 19, 2018
Category: Oral Health
Tags: tooth decay  
HowtoKeeptheCavityMonsterAwaythisHalloween

Watching your kids dress up in cute, spooky costumes and go out trick-or-treating can be a real thrill. But thinking about the dental damage caused by eating all those sweets might just give you the chills. So is it best to act like a witch and take away all the candy from those adorable little ghosts and goblins?

Relax! According to experts like the American Dental Association, it’s OK to let kids enjoy some sweet treats on special occasions like Halloween—especially if they have been taking good care of their oral hygiene all year long, by brushing twice each day and flossing once every day. But to help keep cavities away from those young smiles, there are some things parents (and everyone else) should understand.

Cavities—small holes in the tooth’s outer surface that result from the decay process—get started when bacteria in the mouth feed on sugar and produce acids. The acids eat away at the hard enamel coating of teeth. If left untreated, decay will eventually reach the soft inner core of the tooth, causing even more serious damage.

There are several ways to stop the process of tooth decay. One is to take away the sugar that decay bacteria feed on. Because this ingredient is common in so many foods, it’s hard to completely eliminate sugar from the diet. Instead, it may be more practical to limit the consumption of sweets. For example, if kids are only allowed to eat sugary treats around mealtimes, it gives the mouth plenty of “downtime,” in which healthful saliva can neutralize the bacterial acids. It also helps to avoid sweets that stick to teeth (like taffy or gummy bears) and those that stay in the mouth for a long time (like hard candy).

Another way to help stop tooth decay is by maintaining top-notch oral hygiene. Decay bacteria thrive in the sticky film called plaque that clings stubbornly to the surfaces of teeth. Plaque can be removed by—you guessed it—effective brushing and flossing techniques. While it’s a good start, brushing alone won’t remove plaque from the spaces between teeth and under the gums: That’s why flossing is an essential part of the daily oral hygiene routine. Helping your kids develop good oral hygiene habits is among the best things you can do to fight cavities.

And speaking of habits, there are a few others that can help—or hurt—your oral health.  For example, drinking plenty of water keeps the body hydrated and benefits oral health; but regularly drinking soda and other sweetened or acidic beverages greatly increases the risk of tooth decay. And seeing your dentist on a regular basis for professional cleanings and routine checkups is one of the most beneficial habits of all. Working together, we can help keep tooth decay from turning into a scary situation for kids—and adults too.

If you have questions about cavity prevention or oral hygiene, please contact our office or schedule a consultation. You can learn more in the Dear Doctor magazine articles “How to Help Your Child Develop the Best Habits for Oral Health” and “Tooth Decay—How to Assess Your Risk.”

By Philip Girgis DDS
October 09, 2018
Category: Oral Health
NoahGallowaysDentallyDangerousDancing

For anyone else, having a tooth accidentally knocked out while practicing a dance routine would be a very big deal. But not for Dancing With The Stars contestant Noah Galloway. Galloway, an Iraq War veteran and a double amputee, took a kick to the face from his partner during a recent practice session, which knocked out a front tooth. As his horrified partner looked on, Galloway picked the missing tooth up from the floor, rinsed out his mouth, and quickly assessed his injury. “No big deal,” he told a cameraman capturing the scene.

Of course, not everyone would have the training — or the presence of mind — to do what Galloway did in that situation. But if you’re facing a serious dental trauma, such as a knocked out tooth, minutes count. Would you know what to do under those circumstances? Here’s a basic guide.

If a permanent tooth is completely knocked out of its socket, you need to act quickly. Once the injured person is stable, recover the tooth and gently clean it with water — but avoid grasping it by its roots! Next, if possible, place the tooth back in its socket in the jaw, making sure it is facing the correct way. Hold it in place with a damp cloth or gauze, and rush to the dental office, or to the emergency room if it’s after hours or if there appear to be other injuries.

If it isn’t possible to put the tooth back, you can place it between the cheek and gum, or in a plastic bag with the patient’s saliva, or in the special tooth-preserving liquid found in some first-aid kits. Either way, the sooner medical attention is received, the better the chances that the tooth can be saved.

When a tooth is loosened or displaced but not knocked out, you should receive dental attention within six hours of the accident. In the meantime, you can rinse the mouth with water and take over-the-counter anti-inflammatory medication (such as ibuprofen) to ease pain. A cold pack temporarily applied to the outside of the face can also help relieve discomfort.

When teeth are broken or chipped, you have up to 12 hours to get dental treatment. Follow the guidelines above for pain relief, but don’t forget to come in to the office even if the pain isn’t severe. Of course, if you experience bleeding that can’t be controlled after five minutes, dizziness, loss of consciousness or intense pain, seek emergency medical help right away.

And as for Noah Galloway:  In an interview a few days later, he showed off his new smile, with the temporary bridge his dentist provided… and he even continued to dance with the same partner!

If you would like more information about dental trauma, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Trauma & Nerve Damage to Teeth” and “The Field-Side Guide to Dental Injuries.”

By Philip Girgis DDS
September 29, 2018
Category: Oral Health
Tags: mouthguards  
MouthguardsReduceRiskofConcussionaswellasDentalInjuries

Since boxers first began using them a century ago, athletic mouthguards are now standard safety equipment for most contact sports. Without them, dental injuries would skyrocket.

But a recent study in the peer-reviewed journal, General Dentistry, indicates there’s another important reason to wear a mouthguard for contact sports or exercise: you may be able to significantly reduce your risk for a mild traumatic brain injury (MTBI), better known as a concussion. It’s believed the mouthguard absorbs some of the force generated during contact, resulting in less pressure to the brain. That reduction is even more significant if your mouth-guard has been custom-made by a dentist.

That last finding is important, because not all mouthguards on the market are equal. There are three basic categories of mouthguards — stock, “boil and bite,” and custom. Stock mouthguards come in limited sizes; they’re relatively inexpensive, but they provide the least level of protection. “Boil and bite” can be customized after purchase to the wearer’s bite, but they don’t always provide complete coverage of back teeth. Custom mouthguards are designed and fashioned by a dentist; they’re relatively expensive (running in the hundreds of dollars), but there’s ample evidence they provide the highest level of protection from mouth injuries.

The General Dentistry study also corroborates custom mouthguards’ effectiveness in preventing concussions. The study followed approximately 400 football players from six different high school teams. While all the players wore the same type of helmet, half of them wore custom-made mouthguards and the other half wore stock guards. 8.3% of the athletes wearing stock guards experienced a concussion injury; by contrast only 3.6% of those with custom guards sustained an injury — greater than half fewer occurrences.

The study also highlights the need not to rely solely on helmets or other protective headgear for concussion prevention. It’s important to include mouthguards along with other athletic protective gear to lower injury risk as much as possible.

So when considering how you can provide the optimum injury protection for you or your child, be sure to include an athletic mouthguard, preferably one that’s custom-made. We’ll be happy to advise you further on what you need to know to prevent traumatic dental injuries, as well as concussions.

If you would like more information on custom-fit mouthguards, 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 “Mouthguards.”

By Philip Girgis DDS
September 19, 2018
Category: Dental Procedures
Tags: dental implants  
ATeenwithaMissingToothMayNeedtoWaitonaDentalImplant

There’s a lot to like about replacing a missing tooth with a dental implant. This state-of-the-art restoration is by far the most durable and life-like option available. And unlike other replacement options implants stimulate bone growth, a major concern after tooth loss.

For that reason we encourage getting an implant as soon as possible — for adults, that is. We don’t recommend implants for younger patients because even a teenager’s jaws haven’t yet reached full maturity. Because it attaches to the jaw differently, an implant can’t move with the growing jaw as real teeth do. It would eventually look as if it were sinking into the jaw below the gum line or being left behind as the rest of the jaw grows.

It’s best, then, to postpone placing an implant until the jaw fully matures, usually in a patient’s early twenties. In the meantime, there are some things we can do to prepare for a future implant while also restoring the tooth with a temporary replacement.

As previously mentioned, our biggest concern is bone health. Like other living tissue, bone has a growth cycle of older cells dissolving and newer ones forming in their place. The teeth transmit the pressure produced when we chew to the bone to stimulate this growth. With the absence of a tooth, the adjacent bone no longer receives this stimulation — the growth cycle slows and may eventually lead to bone loss.

We can help this situation by placing a bone graft in the missing tooth socket at the time of extraction. The graft serves as a scaffold that’s eventually taken over and replaced by new bone growth. We can also try to control how fast the graft is replaced by using grafting material that’s slowly removed and lasts longer — often a preferable situation if an implant is years away.

As for appearance, we can create a custom partial denture or even a type of bridge that bonds a prosthetic tooth to neighboring teeth without significantly altering them. If the patient undergoes orthodontic treatment it’s also possible to add prosthetic teeth to an orthodontic appliance.

Eventually, we’ll be able to provide the permanent solution of a dental implant. With careful planning and measures to preserve bone health, there’s a good chance the outcome will be worth the wait.

If you would like more information on treatments for lost teeth in children and teenagers, 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 “Dental Implants for Teenagers.”

By Philip Girgis DDS
September 09, 2018
Category: Oral Health
Tags: mouthguards  
ProtectYourTeethDuringFootballSeason

Autumn begins in the month of September, a season that promises cooler days and longer nights. But more significantly for sports fans, September marks the start of football season. Football remains America’s favorite spectator sport—and it’s also played by countless college and high school athletes, as well as those who enjoy an occasional pickup game in the back yard or on the beach. Yet, like many contact sports, football (even touch football) carries a risk of injury—and one of the areas of the body most vulnerable to injury is the mouth.

Some of the most common dental injuries in contact sports include lacerations (cuts), tooth fractures, displacement (teeth pushed deeper into or out of their sockets), knocked-out teeth, and temporomandibular joint problems. While it’s hard to pin down the exact statistics, researchers estimate that over 5 million teeth are avulsed (completely knocked out) every year in the U.S. alone—a significant number of which are due to sports injuries. It is also estimated that the lifetime cost to treat an avulsed tooth ranges from $5,000 to $20,000!

Given the prevalence of sports-related dental injuries, it’s no wonder that protective devices have been developed to minimize the risk. Properly fitted mouthguards have been shown time and again to be effective at preventing many types of dental injuries. Yet the use of devices isn’t always required by rule-making organizations—and many casual players don’t use them at all. That’s a shame, because so many of the injuries are preventable.

Custom-made mouthguards are available right here at the dental office. Strong and durable, these protective devices are specially fabricated from a model of the player’s own teeth. That means they offer the maximum protection, yet can be comfortably worn during practices, backyard games or championships—an important consideration, since accidents often happen when least expected. (And if you’re a parent of a child who plays sports, that’s probably something you already know.)

It isn’t just football players who can benefit from mouthguards: Those with a passion for soccer, basketball, baseball, martial arts, and dozens of other sports can also get the protection they need from this small (but important) item. So this season, when you’re watching or playing your favorite game, think about the extra safety and peace of mind you could gain from a custom-made mouthguard.

If you have questions about custom-made mouthguards, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “An Introduction to Sports Injuries & Dentistry” and “Athletic Mouthguards.”





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