Mouth Protection Beyond Organized Contact Sports

Mouthguards are nothing new, but there are still far too many sports related injuries. Although most youth sport organizations have cracked down on making kids wear mouth protection, there are still injuries occurring. Taking the appropriate protective measures while on the court, field, rink, or ring can save mouths from serious injury and costly dental repairs. Any sport that presents the chance of contact or collision with another person, object, or surface can potentially cause injury to teeth, jaws, and oral soft tissue. These sports include, but are not limited to, football, basketball, soccer, hockey, boxing, and lacrosse. Individuals who participate in sports, such as biking, inline skating, or skateboarding are also at risk for injury. Teeth get in the way. Other than your nose, front teeth are “out there” and your lips only provide minimal protection. For example, a student I saw this past spring was injured playing squash at a local private school. Squash is a non-contact sport, but the game is played in close proximity to another player with a swinging racquet. The student I treated had been hit in the mouth with the other player’s racquet. He required a root canal on one front tooth with a crown. The other front tooth needed to be extracted and replaced with a dental implant. All of this could have been prevented or at least damage lessened with the use of a mouthguard. For some reason, baseball is one of those sports where kids do not wear protective mouthguards. No matter what age level, a player can misjudge a ball or a ball can take an unexpected bounce, causing serious injury. In lacrosse, both boys and girls should always be wearing mouth protection. That ball is extremely hard and heavy. Boys are better protected than girls because they at least wear helmets; both should be wearing helmets, in my opinion. A custom mouthguard made by your dentist covers the upper teeth with a soft, flexible material that prevents serious injuries such as broken teeth, jaw fractures, cerebral hemorrhage, and neck injuries. It decreases the chance of the lower jaw jamming into the upper jaw or being pushed back into the temporomandibular joint (TMJ). Mouthguards may reduce the severity and incidence of concussions as well. Custom mouthguards, made by a dentist, fit 100 times better than anything you can buy in a store. This not only improves performance (making it easier to breathe), but also makes it more likely the athlete will keep the mouthguard in. They may cost more than the boil/bite generic ones, but they are better, and that is enough reason to consider them. If you seek treatment immediately after the injury occurs, your dentist often can save knocked-out teeth and repair minor chips and cracks with appropriate dental materials. See your dentist for evaluation if your tooth changes color, if you experience any pain, or if you notice any swelling in or around your mouth following trauma. Even if it isn’t “cool” to wear a mouthguard in the sport you are playing, I strongly recommend it. You only get one set of your own teeth. Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com. You can view all previously written columns at www.jpeterstclairdentistry.com/blog.

Most people will admit that nice looking teeth make a person more attractive than not so nice looking teeth. Apparently, there are other benefits as well. In a study conducted by the American Academy of Cosmetic Dentistry (AACD) they found:

• Virtually all Americans (99.7%) believe a smile is an important social asset.
• 96% of adults believe an attractive smile makes a person more appealing to members of the opposite sex.
• 74% of adults feel an unattractive smile can hurt a person’s chances for career success.

How a Smile Changes Other People’s Impressions

The survey then went a little deeper. Photographs of individuals with different levels of attractiveness in their smiles were shown to 528 adults who represented a statistically valid cross section of the U.S. population. The respondents were asked to quickly judge the eight people as to how attractive, intelligent, happy, successful in their career, friendly, interesting, kind and wealthy they appeared. Individuals with more attractive teeth overwhelmingly beat out others in all areas.

Who knew that a new smile also makes you appear more intelligent, happy, wealthy, successful, interesting, sensitive and kind? While the change was most dramatic for the attractive, popular with the opposite sex, wealthy and successful in their career categories, the change was statistically significant in all areas.

So, what can you do to make your smile more attractive? It depends on your individual situation. Some people have very nice teeth that just need to be brightened up. This alone can make a huge difference. Over-the-counter white strips work very well on teeth of younger people or people whose teeth are more yellow than the grey aging look that teeth sometimes take on. Professional whitening with a custom tray is by far the best, most controlled and cost effective way to whiten teeth. It may cost more initially, but with all the touch-ups done over the course of years, this way is a proven winner.

Other people may need orthodontics to straighten things out to make their smile more attractive. And then there is the group that need a little more help. These individuals may benefit from bonding, porcelain veneers or crowns. Even replacing old front fillings or re-shaping teeth can make a significant difference.

Let’s not forget those without teeth. Denture teeth are typically made of plastic. They stain and wear faster than natural teeth. Newer advances in denture teeth construction can produce smiles that are hard to tell from real. There is no reason a person with dentures should look like a person with dentures. There are many different qualities to teeth – get the good ones! A $300 denture at a chain dental office will look like a $300 denture. Better yet, consider dental implants.

Many dentists offer smile simulations. They take a picture of you smiling do a digital smile makeover. In all the times I have done this, I have never had one person say they liked their original picture better. It is truly amazing the effect that teeth can have on your overall appearance.

Being confident and happy about the way your smile looks is important. If there is something you do not like about the way your teeth look, talk to your dentist or dental hygienist about your options.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com. You can view all previously written columns at www.jpeterstclairdentistry.com/blog.

If you have read these columns in the past you have heard me talk about periodontal (gum) health and its relationship to systemic health. There is a slew of scientific evidence that poor periodontal health is not good for you systemically. It has been linked to heart disease, stroke, low birth weight babies, diabetes and more. Gum tissue health is an easy thing for patients to be lax about or even ignore. Why? The main reason is that gum problems do not hurt unless they are so severe that tooth loss is inevitable. It is the chronic inflammation in the gum tissue, regardless of whether it hurts or not, that has the potential to affect your teeth and your general health over time.

Why Bleeding Gums Deserve More Than a Brushing Reminder

How many times have you been to the dentist and heard, “Mr. Smith, you have a lot more bleeding than you should around your gums”? You then respond by saying, “My gums don’t bleed when I brush.” And you hear, “You need to brush better.” Then it happens all over again the next time you are at the dentist. If the goal is to keep your teeth and strive for good health, the scenario above is totally insufficient. We, dentists and patients, need to change our frame of mind about tissue health and really focus on the fact that chronic inflammation, anywhere in the body, is bad.  Tissue health is achievable in every single person. It is a matter of changing our views on what is acceptable and what is not acceptable that can make a difference. Patients love dentists who say that everything looks fine. Sometimes that is the case. However, most of the time there is room for improvement. If there were things in your mouth that could be healthier, would you rather have a dentist say that everything looked okay, or one who made suggestions for better health? Keep an open mind and be willing to put the effort in to make a healthier you. The oral cavity and the gum tissue around each and every tooth is a haven for bacteria. Everyone has bacteria. It is how well the bacteria are controlled that determines tissue health. Patients typically do not want to hear that they need treatment. If you went to the physician and you had signs of heart disease would you rather hear, “Mr. Smith, you have signs of heart disease. Let’s wait until you have a heart attack and then treat it.” vs. “Mr. Smith, you have signs of heart disease. These are the things that you should do to help prevent the progression of the disease. Let’s work together on lowering your risk of problems in the future.” I have said it before and I’ll say it again – the best thing you can do for yourself when it comes to your dental health is regular maintenance. Depending on a person’s needs, regular maintenance might be once a year for some, but every 2-3 months for someone else. Even if you have no dental benefits and are worried about needing a bunch of dental work, the best thing you can do for yourself is regular maintenance. Many dental offices have plans that are very reasonable to help you achieve better dental health. The mouth is the gateway to the rest of the body – don’t ignore it.

I attended a continuing education seminar this past week entitled, “Making it Easy for Patients to Say Yes”. The name of the seminar is a bit deceiving. You would think that it was about how to “sell” people into dental treatment. It was quite the opposite.

Patient Education Before Accepting a Treatment Plan

I am a firm believer in educating patients about their own dental health with the help of things like photography, which I discussed last week.  I also think it is important to spend as much time as necessary to bring the patient’s dental I.Q. to a level that allows them to make more educated decisions about the degree of dental health they wish to achieve. Some people require more time than others and some are not interested in the dialogue. Although this seminar did confirm that educated patients make better decisions, it highlighted the fact that it is more important for the dentist to understand the patient and where they are in their life. In order for this to happen it takes time to build relationships with people. This sounds pretty basic. However, the presenter of this seminar, who is a well-known figure in the dental world, felt that this relationship-based aspect of dental care is missing in most dental offices. Why? The cost to run a dental business, and many times the influence from insurance companies, creates the need to speed things up. Shortening the time the dentist/physician spends with the patient is a common goal in health care these days. Most patients who require extensive dental treatment know that they have issues. They may not understand the extent of their issues, but they know things are not right. It is easy to move patients toward treatment if they have pain or something is broken. However, patients who may not have pain or broken teeth, but still have dental needs, require a different approach. Before any educating is done or before any treatment is discussed, it is vital for the dentist to understand more about the person behind the teeth. Sure, there are patients who come into an office and just want a tooth extracted, or know they need a root canal, but most people who go to the dentist have the desire to keep their teeth and be healthy. The fact of the matter is, even if the patient knows they need extensive work, they may not be in the right place in their lives to accomplish this goal. There is no disputing that dentistry can be expensive, especially if you are in need of significant work. There are many options out there for people who require more extensive care. You can choose lower cost options such as franchised dental offices where you may not see the same dentist every time, or you can choose one of the many great private dentists we have in our area.  However, the key is – what is suitable for you? The dental insurance industry is a broken system and it is unfortunately getting worse. If possible, choose your provider based on who you want to go to. Use whatever dental benefits you have but develop a relationship with a provider who takes the time to understand your specific situation. Does a real estate agent show everyone the same house? Do they show everyone the most expensive house? They show them what fits into their life at that particular time. Dentistry should be approached the same way. It may not be the right time in your life to have the four bedroom house and the three car garage. But, having a good solid roof over your head that is comfortable is important to everyone. You can always upgrade.

I remember one time seeing a commercial for a cholesterol medication in which the person playing the doctor says, “I wish my patients could see what I see.” I think there are two ways to look at that statement. The commercial showed an image of animated artery walls clogging with particles of plaque clinging to one another making the opening of the artery smaller and smaller. This is a visual that is easy to understand. The second, and more subtle way to take this statement, is the doctor wishing that patients could see what happens to people over time with and without compliance to taking medication or changing their diet. If patients could only understand and use the vast experiences of the doctor to make better decisions for themselves, wouldn’t everyone choose to do all the “right” things for a better and healthier life? Conventional wisdom would say “yes” but reality says something different.

Using Photos to Show Patients What the Dentist Sees

I have been photographing teeth since dental school. When I tell a patient that I am going to take a series of pictures of their teeth the response I often hear is, “I just had x-rays taken.” When I explain that they are pictures and not x-rays it is not uncommon for the patient to ask, “Why?” or say, “No one has ever done this before.” I explain that the photographs are used for documentation and communication. Showing a patient visual images of their own teeth is by far the most powerful tool I use in practice. Patients often get frustrated when a dentist explains and recommends treatment they can’t see. Pictures help in telling the story and help patients make better informed decisions. When displaying the images and giving the patient a tour of their own mouth, the patient will often say, “Wow, that doesn’t look good. I can’t believe that is in my mouth.” Photographs help in explaining why things look the way they do. From there it is easier to explain to patients what to expect in the future. Photographs are invaluable for this exercise and most patients appreciate being able to see what I see. If a patient has not been to a dentist in a while or is seeing a new dentist who is doing a complete exam, photographs help patients with decision making. It is important to try to get the patient to look beyond the pictures and envision where they want to be 5, 10, 20+ years down the road. The goal is for the dentist to tie their experience together with where the patient is currently, where they are headed, and give them the opportunity to potentially change the course of their future. This approach may be different for some patients. It is easy to get overwhelmed by any new approach, but it is important to keep an open mind. Photographs of your own mouth in the dental office are an important part of the doctor/patient relationship, because communication is the key to any relationship. You, as a patient, should look beyond today and make choices for ANY aspect of your health based on where you want to be in the future. Take advantage of the knowledge you gain from all your experiences and make decisions that you feel are right for you.

You’ve decided to take your oral hygiene a little more serious, so you want to start by evaluating the type of toothbrush you usually buy. Is it the right one? And if not, what kind is better? Your dentist says there are some simple criteria that you can use to make the right decision. Continue reading to find out what he has to say.

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