My Blog
By William L. Metz, D.D.S.
July 19, 2018
Category: Dental Procedures
NeilPatrickHarrisWhattheOscarsHostTreasuresMost

A few days before the Oscars, Vanity Fair magazine asked Academy Awards host Neil Patrick Harris to name his most treasured possession. Was it his Tony award statuette for best leading actor in a musical? His star on the Hollywood Walk of Fame? The stethoscope he wore while playing teenaged doctor Doogie Howser on TV? No, as it turns out, the 41-year-old actor’s most treasured possession is… his wisdom teeth. Yes, you read that correctly. “Oddly, I still have my four wisdom teeth,” Harris said. “I refuse to let them go or I’ll lose my wise parts.”

How odd is it for a 41-year-old to have wisdom teeth? Actually, not that odd at all. While it is true that wisdom teeth are often removed, there’s no one-size-fits-all approach to this. It all depends on whether they are causing problems now, or are likely to cause problems in the future.

The trouble wisdom teeth cause is related to the fact that they are the last molars to come in, and that molars are large in size. By the time wisdom teeth appear between the ages of 17 and 21, there often is not enough room for them in the jaw. Sometimes it’s because you may have inherited a jaw size that’s too small for your tooth size; and generally speaking, the size of the human jaw has evolved to become smaller over time.

If room is lacking, the adjacent molar (that came in earlier) can interfere with the path of eruption — causing the wisdom tooth to come in at an odd angle. The wisdom tooth can hit up against that other tooth, possibly causing pain or damaging the adjacent tooth. This is known as “impaction.” Sometimes the wisdom tooth breaks only partway through the gum tissue, leaving a space beneath the gum line that’s almost impossible to clean, causing infection. A serious oral infection can jeopardize the survival of teeth, and even spread to other parts of the body.

If a wisdom tooth is impacted, will you know it? Not necessarily. A tooth can be impacted without causing pain. But we can see the position of your wisdom teeth on a dental x-ray and help you make an informed decision as to whether they should stay or go. If removal is the best course of action, rest assured that this procedure is completely routine and that your comfort and safety is our highest priority. If there is no great risk to keeping them, as Neil Patrick Harris has done, we can simply continue to monitor their condition at your regular dental checkups. It will be particularly important to make sure you are reaching those teeth with your brush and floss, and that you keep to your schedule of regular professional cleanings at the dental office. All healthy teeth are indeed worth treasuring.

If you would like more information about wisdom teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”

ReduceFutureBiteProblemswithTheseInnovativeTechniques

When you think orthodontics, you may instantly picture braces or clear aligners worn by teenagers or adults. But there’s more to orthodontics than correcting fully developed malocclusions (poor bites). It’s also possible to intervene and potentially reduce a malocclusion’s future severity and cost well beforehand.

Known as interceptive orthodontics, these treatments help guide jaw growth in children while mouth structures are still developing and more pliable. But timing is critical: waiting until late childhood or puberty could be too late.

For example, we can influence an upper jaw developing too narrowly (which can cause erupting teeth to crowd each other) with an expander appliance placed in the roof of the mouth. The expander exerts slight, outward pressure on the upper jaw bones. Because the bones haven’t yet fused as they will later, the pressure maintains a gap between them that fills with additional bone that eventually widens the jaw.

Functional appliances like the Herbst appliance influence muscle and bone development in the jaws to eventually reshape and reposition them. The Herbst appliance utilizes a set of metal hinges connected to the top and bottom jaws; when the patient opens and closes their jaws the hinges encourage the lower jaw to move (and eventually grow) forward. If successful, it could help a patient avoid more invasive treatments like tooth extraction or jaw surgery.

Some interceptive objectives are quite simple in comparison like preserving the space created by a prematurely lost primary tooth. If a child loses a primary tooth before the incoming permanent tooth is ready to erupt, the nearby teeth can drift into the empty space. Without enough room, the permanent tooth could erupt out of position. We can hold the space with a simple loop device known as a space maintainer: usually made of acrylic or metal, the device fits between adjacent teeth and prevents them from drifting into the space until the permanent tooth is ready to come in.

Interceptive orthodontics can have a positive impact on your child’s jaw development, now and in the future. For these techniques to be effective, though, they must begin early, so be sure your child has a complete orthodontic evaluation beginning around age 7. You may be able to head off future bite problems before they happen.

If you would like more information on orthodontic treatments, please contact us or schedule an appointment for a consultation.

SavingaDiseasedPrimaryToothCouldMeanBetterOralHealthLaterinLife

It’s often best health-wise to preserve even the most troubled tooth—including a child’s primary (“baby”) tooth. If that sounds like too much effort for a tooth that lasts only a few years, there’s a big reason why—if it’s lost prematurely, the incoming permanent tooth above it could erupt out of position.

Preserving a decayed primary tooth could include procedures similar to a root canal treatment, commonly used in adult permanent teeth with inner decay. However, we may need to modify this approach to protect the primary tooth’s pulp. This innermost layer plays a critical role in early dental development.

Because an adult tooth has reached maturity, removing diseased pulp tissue has little effect on its permanent health. But the pulp contributes to dentin growth (the layer between it and the outer enamel) in primary and young permanent teeth, so removing it could ultimately compromise the tooth’s long-term health.

Our goal then with a child’s tooth is to remove as much diseased tissue as possible while involving the pulp as little as possible. What techniques we use will depend on how much of the pulp has become infected.

For example, if decay has advanced to but hasn’t yet penetrated the pulp, we may remove all but a small amount of the decayed structure just next to the pulp to avoid its exposure. We may then apply an antibacterial agent to this remaining portion and seal the tooth to curb further infection.

If on the other hand the pulp has become infected, we may try to remove only the infected portion and leave the remaining pulp intact. We’ll only be able to do this, however, if we deem the remaining pulp healthy enough to remain infection-free after the procedure. If not, we may need to remove the entire pulp as with a traditional root canal. This option, though, is a last resort due to the possible effect on dentin growth and the tooth’s long-term health.

As you can see attempts to preserve a primary tooth can be quite involved. But if we can help it reach its full life span, it could mean better dental health for a lifetime.

If you would like more information on caring for primary teeth, 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 Treatment for Children’s Teeth.”

By William L. Metz, D.D.S.
June 19, 2018
Category: Dental Procedures
Tags: cosmetic dentistry  
TipsforPicture-PerfectSummerSmiles

June is the month when lots of important events happen—like weddings, graduations, and family get-togethers. When the weather turns balmy and the days get longer, it’s the perfect time for a celebration…and today it’s easier than ever to capture those special moments in pictures that will be treasured for years to come. Are you ready for your close-up?

Both professional photographers and dentists want to help you look your best when you’re smiling for the camera. Here are a few suggestions from both kinds of pros for capturing a great-looking smile.

Tilt your head just a bit

Instead of looking straight at the camera, try turning or tilting your head slightly. This often presents a more flattering angle, and can hide small facial asymmetries. If your face has a “good side” (you can check by looking in a mirror), be sure to make it visible. But even if your head is tilted or turned, your eyes should be looking at the camera.

Moisten teeth before the shutter clicks

A sparkly smile is the most appealing one. Just before the picture is snapped, run your tongue over your teeth to give them a little extra shine. Highlights in the teeth, lips and eyes add liveliness to your portrait.

Relax—Don’t clench your teeth!

It’s better to smile naturally—perhaps with teeth slightly parted, or lips in a more relaxed position—than to force yourself to make an artificial-looking grin. Try recalling things that make you joyful, or think of people you care about, and chances are your natural smile will shine out.

Have your teeth professionally cleaned at the dental office

Before the big event, you can ensure that your smile looks its best with a professional cleaning at our office. This treatment removes layers of plaque and tartar on visible tooth surfaces, as well as between teeth and under the gumline. It not only makes teeth look their best, but it’s also an effective way to fight tooth decay and gum disease. And while you’re here, it’s the perfect time to talk about any cosmetic issues that may be troubling you about your smile. With treatments like teeth whitening, cosmetic bonding or dental veneers, we can help you get the smile you’ve always wanted.

If you would like more information about professional teeth cleaning or cosmetic dentistry, please call our office to schedule a consultation.

By William L. Metz, D.D.S.
June 09, 2018
Category: Oral Health
DrTravisStorkDontIgnoreBleedingGums

Are bleeding gums something you should be concerned about? Dear Doctor magazine recently posed that question to Dr. Travis Stork, an emergency room physician and host of the syndicated TV show The Doctors. He answered with two questions of his own: “If you started bleeding from your eyeball, would you seek medical attention?” Needless to say, most everyone would. “So,” he asked, “why is it that when we bleed all the time when we floss that we think it’s no big deal?” As it turns out, that’s an excellent question — and one that’s often misunderstood.

First of all, let’s clarify what we mean by “bleeding all the time.” As many as 90 percent of people occasionally experience bleeding gums when they clean their teeth — particularly if they don’t do it often, or are just starting a flossing routine. But if your gums bleed regularly when you brush or floss, it almost certainly means there’s a problem. Many think bleeding gums is a sign they are brushing too hard; this is possible, but unlikely. It’s much more probable that irritated and bleeding gums are a sign of periodontal (gum) disease.

How common is this malady? According to the U.S. Centers for Disease Control, nearly half of all  Americans over age 30 have mild, moderate or severe gum disease — and that number increases to 70.1 percent for those over 65! Periodontal disease can occur when a bacteria-rich biofilm in the mouth (also called plaque) is allowed to build up on tooth and gum surfaces. Plaque causes the gums to become inflamed, as the immune system responds to the bacteria. Eventually, this can cause gum tissue to pull away from the teeth, forming bacteria-filled “pockets” under the gum surface. If left untreated, it can lead to more serious infection, and even tooth loss.

What should you do if your gums bleed regularly when brushing or flossing? The first step is to come in for a thorough examination. In combination with a regular oral exam (and possibly x-rays or other diagnostic tests), a simple (and painless) instrument called a periodontal probe can be used to determine how far any periodontal disease may have progressed. Armed with this information, we can determine the most effective way to fight the battle against gum disease.

Above all, don’t wait too long to come in for an exam! As Dr. Stork notes, bleeding gums are “a sign that things aren’t quite right.”  If you would like more information about bleeding gums, please contact us or schedule an appointment. You can read more in the Dear Doctor magazine article “Bleeding Gums.” You can read the entire interview with Dr. Travis Stork in Dear Doctor magazine.





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