My Blog

By Design a Smile
November 19, 2018
Category: Oral Health
LifeIsSometimesaGrindforBrookeShields

Ever since childhood, when her career as a model and actress took off, Brooke Shields has enjoyed worldwide recognition — through advertisements for designer jeans, appearances on The Muppet Show, and starring roles in big-screen films. But not long ago, that familiar face was spotted in an unusual place: wearing a nasal anesthesia mask at the dentist's office. In fact, Shields posted the photo to her own Instagram account, with the caption “More dental surgery! I grind my teeth!” And judging by the number of comments the post received, she's far from alone.

In fact, researchers estimate that around one in ten adults have dental issues that stem from teeth grinding, which is also called bruxism. (Many children also grind their teeth, but it rarely causes serious problems, and is often outgrown.) About half of the people who are teeth grinders report problems like persistent headaches, jaw tenderness and sore teeth. Bruxism may also result in excessive tooth wear, and may damage dental work like crowns and bridges; in severe cases, loosened or fractured teeth have been reported.

Researchers have been studying teeth grinding for many years; their findings seem to indicate that it has no single cause. However, there are a number of factors that play a significant role in this condition. One is the anatomy of the jaw itself, and the effect of worn or misaligned teeth on the bite. Another factor relates to changes in brain activity that occur during the sleep cycle. In fact, nocturnal (nighttime) bruxism is now classified as a sleep-related movement disorder. Still other factors, such as the use of tobacco, alcohol and drugs, and a high level of stress or anxiety, can make an individual more likely to experience bruxism.

What can be done for people whose teeth grinding is causing problems? Since this condition may have many causes, a number of different treatments are available. Successful management of bruxism often begins by striving to eliminate the factors that may cause problems — for example, making lifestyle changes to improve your health, creating a soothing nighttime environment, and trying stress-reduction techniques; these may include anything from warm baths and soft music at bedtime, to meditation and mindfulness exercises.

Several dental treatments are also available, including a custom-made occlusal guard (night guard) that can keep your teeth from being damaged by grinding. In some cases, a bite adjustment may also be recommended: In this procedure, a small amount of enamel is removed from a tooth to change the way it contacts the opposite tooth, thereby lessening the biting force on it. More invasive techniques (such as surgery) are rarely needed.

A little tooth grinding once in a while can be a normal response to stress; in fact, becoming aware of the condition is often the first step to controlling it. But if you begin to notice issues that could stem from bruxism — or if the loud grinding sounds cause problems for your sleeping partner — it may be time to contact us or schedule an appointment. You can read more about bruxism in the Dear Doctor magazine article “Stress and Tooth Habits.”

By Design a Smile
November 13, 2018
Category: Dental Procedures
Tags: Root Canal  

ToothacheRoot Canals are essential to oral health care. Your Miami, FL, dentist, Dr. Richard Romay, uses root canal procedures to relieve pain and help your teeth regain their health once more.

More About Root Canals

One of the main reasons people end up needing a root canal is because of poor oral hygiene. If you don't brush your teeth twice a day and floss at least once, then you will suffer from plaque and tartar building up.

A tooth is composed of several layers. In order, they are,

  1. Enamel: The outermost layer; the white part of the tooth and also the strongest part.
  2. Dentin: Right under the enamel, this layer is yellowish and a bit softer.
  3. Pulp: Located in the center of the tooth, and consists of blood vessels and nerves.
  4. Cementum: The surface layer of the tooth root; anchors the whole tooth to the jawbone.

When a cavity is deep enough to infiltrate the enamel and through the dentin, it reaches the nerve-rich layer of pulp, causing acute pain. Your Miami dentist will then need to remove the pulp, clean and disinfect the canal from any bacteria remaining, and then finally seal the canal to prevent bacteria from entering.

In order to properly care for your teeth and avoid procedures like a root canal or dental implants, you should do the following:

  • Avoid Sugar: Eating sugary foods and drinks, such as candy and soda, contribute to tooth decay, while healthy foods like apples and carrots actually help scrape plaque off teeth.
  • Visit Your Dentist: Visiting your doctor twice a year for professional cleanings will allow professionals to evaluate your teeth's health. Accordingly, the dentists will then be able to notify you if there's a problem before it becomes severe or complicated.
  • Use Fluoride-Containing Products: Fluoride prevents tooth decay, so make sure that you regularly use toothpaste and mouthwash that contain fluoride.

If you have any questions or concerns about root canals, don't hesitate to call your Miami, FL, dentist, Dr. Richard Romay. You can schedule an appointment at either our 40th Street office ((305) 667-8887) or our 88th Street location ((305) 408-3388).

By Design a Smile
November 09, 2018
Category: Oral Health
Tags: oral health   diabetes  
DiabetesandOralHealthTrueorFalse

November is National Diabetes Month—a time to focus on a disease that affects more than 400 million people around the world. What does diabetes have to do with oral health? Plenty! Here's a true-or-false quiz to test your knowledge on this important topic.

TRUE OR FALSE:

1. Diabetes and gum disease are connected.
TRUE. Studies have found a clear association between diabetes and gum (periodontal) disease, especially when diabetes is not well controlled. People with poorly controlled diabetes have a more severe inflammatory response to the bacteria that cause gum disease. While inflammation is normally a protective reaction of the body's immune system, too much inflammation can actually make the condition worse. In the case of gum disease, the reverse is also true: Untreated gum disease can worsen blood sugar levels in people with diabetes. The good news is that treatment of periodontal disease has been shown to improve blood sugar control.

2. People with diabetes can't have dental implants.
FALSE. Research has shown that dental implants can be a very successful tooth-replacement treatment for people with diabetes. But again, blood sugar control can be a factor. Dental implants are titanium posts that serve as artificial tooth roots. Minor surgery is required to insert an implant into the bone beneath the gums; a realistic-looking dental crown is later attached to it so it can look and function like a natural tooth. Studies have shown that it takes longer for the bone to heal around implants in people with poorly controlled diabetes. That doesn't make implant treatment impossible, but it does mean that it may be managed differently. For example, an implant may be allowed to heal for a longer period of time before a crown is attached to it.

3. People with diabetes can't do anything to improve their oral health.
FALSE. People with diabetes can have a very positive impact on their oral heath, by doing their best to control blood sugar levels with a healthy diet and exercise, and by sticking to an effective daily oral hygiene routine. This includes brushing twice a day for two minutes each time, and flossing at least once each day to remove bacterial plaque between teeth. Regular dental checkups and cleanings are also essential—not just for people with diabetes, but for everyone!

If you have additional questions about diabetes and oral health, please contact us or schedule an appointment for a consultation. You can learn more about diabetes and oral health by reading the Dear Doctor magazine article “Good Oral Health Leads to Better Health Overall.”

By Design a Smile
October 30, 2018
Category: Oral Health
Tags: tooth pain  
FindandTreattheActualSourceofToothPaintoRelieveit

Determining which of your teeth is causing your toothache isn’t always easy — or even if it’s a tooth at all. The pain could be coming from a tooth, the gums, or both. Only a thorough dental examination can pinpoint the exact cause and best course of treatment.

If a decayed tooth is the problem, the pain may be coming from nerves and other tissue deep within the tooth’s pulp. The symptoms could be dull or sharp, constant or intermittent, specific to one area or spread out. It’s even possible for the pain to suddenly subside after a few days. This doesn’t mean the infection has subsided, but rather that the infected nerves have died and no longer transmit pain. Pain can also radiate from the actual source and be felt somewhere else — the pain in your sinuses, for example, could actually originate from an infected back tooth.

If the source is periodontal (gum) disease, the infection has begun in the gum tissues. As they become more inflamed they lose their connectivity with the teeth, bone loss occurs and the gums may “recess” or draw back. This exposes the tooth root, which without the protective cover of the gum tissues becomes highly sensitive to changes in temperature or pressure. As a result you may encounter sharp pain when you eat or drink something hot or cold, or bite down.

Treating these issues will depend on the actual infection source. An infected tooth often requires a root canal treatment to clean out the pulp and root canals of dead or infected tissue, fill them with a special filling, and seal and crown the tooth to prevent future infection. If the source is gum disease, we must manually remove the bacterial plaque causing the disease from all tooth and gum surfaces to stop the infection and allow the gums to heal. In advanced cases, surgical procedures may be necessary to repair damage and encourage new gum and bone growth.

Where dental disease has spread from tooth to gums or vice-versa, you may need treatments for both areas to address your overall condition. Whatever the treatment course, we can put an end to your tooth pain and restore health to your teeth and gums.

If you would like more information on the sources of mouth pain, please contact us today to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Confusing Tooth Pain.”

By Design a Smile
October 20, 2018
Category: Dental Procedures
Tags: tooth decay   gum disease  
StopRootCavitieswithPreventionandPromptTreatment

Tooth decay is a highly destructive dental disease, responsible along with periodontal (gum) disease for most adult tooth loss. And we become even more susceptible to it as we get older.

One form of decay that’s especially prominent among senior adults is a root cavity. Similar to a cavity in the crown (visible tooth), this form instead occurs at or below the gum line in the roots. They happen mainly because the roots have become exposed due to gum recession, a common consequence of periodontal (gum) disease and/or brushing too hard.

Exposed roots are extremely vulnerable to disease because they don’t have the benefit of protective enamel like the tooth crown, covered instead with a thin and less protective mineral-like material called cementum. Normally, that’s not a problem because the gums that would normally cover them offer the bulk of the protection. But with the gums receded, the roots must depend on the less-effective cementum for protection against disease.

Although we treat root cavities in a similar way to those in the crown by removing decayed structure and then filling them, there’s often an added difficulty in accessing them below the gum line. Because of its location we may need to surgically enter through the gums to reach the cavity. This can increase the effort and expense to treat them.

It’s best then to prevent them if at all possible. This means practicing daily brushing and flossing to remove bacterial plaque, the thin, built-up biofilm on teeth most responsible for both tooth decay and gum disease. You should also visit your dentist at least twice a year for professional cleanings and advanced prevention methods like topical fluoride to strengthen any at-risk teeth.

You should also seek immediate treatment at the first sign of gum disease to help prevent gum recession. Even if it has occurred, treating the overall disease could help renew gum attachment. We may also need to support tissue regeneration with grafting surgery.

Root cavities are a serious matter that could lead to tooth loss. But by practicing prevention and getting prompt treatment for any dental disease, you can stop them from destroying your smile.

If you would like more information on diagnosing and treating root cavities, 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 Cavities: Tooth Decay near the Gum Line Affects Many Older Adults.”





This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.