Family Dentistry of Ocean City
Robert W. Yaskin, D.M.D. LLC
421 15th Street
Ocean City, NJ 08226
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Among the “to-do” items on your pre-dive checklist like “Pack wetsuit” or “Fill scuba tanks,” be sure to add one other: “Check my dental health status.”
While that may seem like an odd concern, the changes in atmospheric pressure you encounter while diving (or flying, for that matter) could amplify oral sensitivity and intensify pain if you have pre-existing teeth or jaw problems.
The reason for this is the effect of basic physics on the body. All anatomical structures, including organs, bones and muscles, equalize external pressures the body encounters. We don’t notice this at normal atmospheric pressure, but when we encounter an extreme — either lower pressure during air flight or higher pressure during a scuba dive — we may feel the effects of the pressure on any structure with a rigid-walled surface filled with either air or fluid. These structures can’t equalize the pressure as fast as other areas, resulting in pain or discomfort. This is known medically as “barotrauma,” or more commonly as a “squeeze.”
One structure in particular could have an effect on your upper teeth and jaws: the sinus cavities of the skull, particularly the maxillary sinuses just below the eyes. Their lower walls are right next to the back teeth of the upper jaw and, more importantly, share the same nerve pathways. It’s quite possible, then, for pain from one area to be felt in the other, commonly known as “referred pain.” A toothache could then be felt in the sinus region, and vice-versa.
During a squeeze, then, pain levels from existing problems in the teeth and jaws that were previously tolerable (or even unnoticed) may well become amplified as the pressure from the sinus cavity impinges upon the jaw. That dull toothache you’ve been having may suddenly become excruciating at 30,000 feet — or 30 meters under the surface.
That’s why it’s important to see us if you’ve experienced any signs of tooth decay, gum disease or TMD, including pain, before your next dive or air flight. And, if you encounter any significant pain while flying or diving, be sure you consult with us as soon as possible when you return. Taking action now could help you avoid a miserable, and potentially dangerous, flying or diving experience in the future.
If you would like more information on pressure changes and dental health, 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 “Pressure Changes can Cause Tooth and Sinus Pain.”
There are many reasons why teeth may need a whitening treatment to achieve an appealing brightness: what we eat and drink, natural aging, genetics, and the lack of dedication to oral hygiene can all play a role in how we look.
For vital (living) teeth, there are basically three different options for teeth whitening, and we’d be happy to help you decide which is right for you:
While there are normally no serious side effects after professional whitening treatments, there is a potential risk of tooth sensitivity and gum irritation. If either one or both of these occur, it should disappear within a few days.
It should come as no surprise that bleaching is not permanent. The whiteness will fade eventually depending on your diet, habits, hygiene, etc., but it usually will last at least six months — more often up to two years. Obviously, if you avoid drinking coffee, tea, or red wine, don’t smoke, and have a diligent oral hygiene routine your results may last longer.
Advertisements for teeth-whitening products are everywhere. If you have any questions about what you see, or simply want to do a reality check on their claims, please contact us or schedule an appointment for a consultation. You can learn more about this topic by reading the Dear Doctor magazine articles “Teeth Whitening: Brighter, Lighter, Whiter...,” and “Important Teeth Whitening Questions Answered.”
Teeth damaged by decay, periodontal (gum) disease or trauma are often removed (extracted) if they’re deemed beyond repair. But there’s another reason we may recommend an extraction: a tooth is causing or has the potential to cause problems for other teeth and your overall oral health.
Some of the most frequent cases of “preventive extraction” involve the third molars, or wisdom teeth, located in the very back of the mouth. They’re usually the last permanent teeth to come in, which is related to some of the problems they can cause. Because they’re trying to come in among teeth that have already erupted they don’t always erupt properly, often at abnormal angles or not fully erupting through the gums, a condition called impaction.
Impacted or misaligned wisdom teeth can put pressure on adjacent teeth and their roots, which can cause root resorption that damages the second molar. They can also increase the risk of periodontal (gum) disease in the gum tissues of the second molars, which if untreated can ultimately cause teeth and bone loss.
Because of current or possible future problems with wisdom teeth, we often consider removing them at some early point in the person’s dental development. Such a consideration shouldn’t be undertaken lightly, since wisdom teeth extraction is often complex and fraught with complications, and it usually requires a surgical procedure.
That’s why we first conduct a comprehensive examination (including x-ray or other imaging to determine exact location and possible complications) before we recommend an extraction. If after careful analysis an extraction appears to be the best course, we must then consider other factors like planned orthodontics to determine the best time for the procedure.
Once performed, a wisdom tooth extraction can resolve existing problems now and reduce the risks of gum disease or malocclusions in the future. When it comes to wisdom teeth, removing them may be in your or your family member’s best interest for optimal dental health.
If you would like more information on wisdom 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 “Wisdom Teeth.”
Semi-annual office cleanings are important for keeping teeth healthy and disease-free. If you’ve replaced some of your teeth with dental implants, though, you may be thinking they don’t need as much attention from your hygienist.
It’s quite the opposite — cleaning around implants is important, and actually requires additional attention. The reason for this relates to both how dental implants attach to the jaw and their constructive materials.
Natural teeth are held in place by the periodontal ligament with tiny fibers that attach to the teeth on one side of it and to the jawbone on the other. The ligaments and the gingival (gum) fibers (which are also attached to the tooth) provide some disease resistance to the teeth through its rich blood vessel and collagen network. Dental implants, on the other hand, anchor directly into the jawbone. The titanium integrates with the bone, which naturally attracts to the metal and grows around it, which provides the implant’s eventual attachment strength. The implant doesn’t attach to the gum tissue and won’t develop the same relationship with the periodontal ligament as natural teeth.
Bacterial plaque, the primary cause for tooth decay and periodontal (gum) disease, can collect on an implant crown just as readily as on a natural tooth. Although the materials that make up an implant can’t be affected by a plaque-induced infection, the gum tissues and supporting bone around it can. In fact, because implants lack the disease resistance of the gingival fibers and the ligament attachment, an infection can turn rapidly into a condition known as peri-implantitis that could cause bone and tissue loss and lead to the loss of the implant.
Your hygienist understands the importance of removing plaque and calculus (hardened plaque deposits) from around your dental implant. This often calls for different instruments made of plastics or resins that won’t scratch the implant’s highly polished surface. Scratches provide a haven for bacteria to collect and make it more difficult to dislodge them. Likewise, if the hygienist uses ultrasonic equipment that loosens plaque through vibration, the hygienist will often use nylon or plastic tips to minimize damage to the implant.
And don’t forget your own personal hygiene habits — they’re just as important with dental implants as with natural teeth. Keeping plaque under control, both at home and with your dentist, is crucial to longevity for your dental implants.
If you would like more information on maintaining and cleaning dental implants, 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 Implant Maintenance.”
Tooth enamel erosion is a serious issue for many children that can result in permanent impairment of oral health. The problem isn’t just bacterial acid that causes tooth decay — it’s also the high acid content of sodas, energy and sports drinks widely popular among children and teenagers today.
Enamel is made of the strongest substance in the human body, which enables it to shield the inner layers of the teeth from disease and other environmental factors. Its chief nemesis, though, is acid: when enamel interacts with high concentrations of acid for a prolonged time, its mineral content will begin to soften and dissolve, a process known as de-mineralization. Saliva is the enamel’s main protection against acid with the ability to neutralize (or buffer) acid and restore some of the enamel’s mineral content, usually within thirty minutes to an hour after we eat.
The high acid content of many popular beverages, however, can overwhelm saliva’s buffering ability, especially if a person is sipping for an extended time on an acidic drink. This kind of exposure is different from acid produced by bacteria that causes tooth decay: bacterial acid tends to concentrate in specific areas of the teeth, while the constant wash from acidic beverages will have a more generalized eroding effect on teeth.
This level of enamel loss is irreversible, which can leave a tooth in peril of decay and ultimate loss — and increase long-term dental care and costs. The best strategy is to have your child stop or significantly curtail drinking highly acidic beverages. Rather than drink sports beverages for hydration, substitute water, nature’s hydrator. Milk can also be a viable beverage substitute.
If you do allow some acidic beverages, try to limit them to mealtimes and discourage extended sipping. Look for drinks with added calcium as this can reduce the beverage’s erosive potential. The goal is to reduce the amount and duration beverage acid is in contact with tooth enamel.
Making these changes will help greatly to protect your child’s tooth enamel, and give saliva a chance to do its job protecting it. Your efforts will also increase your child’s chances of better dental health in the future.
If you would like more information on dental erosion, 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 “Dental Erosion.”