Posts for: April, 2020
You probably wouldn't be surprised to hear that someone playing hockey, racing motocross or duking it out in an ultimate fighter match had a tooth knocked out. But acting in a movie? That's exactly what happened to Howie Mandel, well-known comedian and host of TV's America's Got Talent and Deal or No Deal. And not just any tooth, but one of his upper front teeth—with the other one heavily damaged in the process.
The accident occurred during the 1987 filming of Walk Like a Man in which Mandel played a young man raised by wolves. In one scene, a co-star was supposed to yank a bone from Howie's mouth. The actor, however, pulled the bone a second too early while Howie still had it clamped between his teeth. Mandel says you can see the tooth fly out of his mouth in the movie.
But trooper that he is, Mandel immediately had two crowns placed to restore the damaged teeth and went back to filming. The restoration was a good one, and all was well with his smile for the next few decades.
Until, that is, he began to notice a peculiar discoloration pattern. Years of coffee drinking had stained his other natural teeth, but not the two prosthetic (“false”) crowns in the middle of his smile. The two crowns, bright as ever, stuck out prominently from the rest of his teeth, giving him a distinctive look: “I looked like Bugs Bunny,” Mandel told Dear Doctor—Dentistry & Oral Health magazine.
His dentist, though, had a solution: dental veneers. These thin wafers of porcelain are bonded to the front of teeth to mask slight imperfections like chipping, gaps or discoloration. Veneers are popular way to get an updated and more attractive smile. Each veneer is custom-shaped and color-matched to the individual tooth so that it blends seamlessly with the rest of the teeth.
One caveat, though: most veneers can look bulky if placed directly on the teeth. To accommodate this, traditional veneers require that some of the enamel be removed from your tooth so that the veneer does not add bulk when it is placed over the front-facing side of your tooth. This permanently alters the tooth and requires it have a restoration from then on.
In many instances, however, a “minimal prep” or “no-prep” veneer may be possible, where, as the names suggest, very little or even none of the tooth's surface needs to be reduced before the veneer is placed. The type of veneer that is recommended for you will depend on the condition of your enamel and the particular flaw you wish to correct.
Many dental patients opt for veneers because they can be used in a variety of cosmetic situations, including upgrades to previous dental work as Howie Mandel experienced. So if slight imperfections are putting a damper on your smile, veneers could be the answer.
If you would like more information about veneers and other cosmetic dental enhancements, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Porcelain Veneers” and “Porcelain Dental Crowns.”
As a regular part of your daily hygiene you may be using a mouthrinse — or “mouthwash” — mainly to keep your mouth feeling fresh and clean. Some mouthrinses, though, do more than give you fresher breath.
While there are countless mouthrinses available, we can place all of them into two broad categories: cosmetic and therapeutic. The first refresh your mouth and breath, usually with a mentholated or minty taste and smell that masks unpleasant odors. How well they work is mainly subjective: if you feel better after using them, they’ve done their job.
Therapeutic rinses have a different role, intended to improve oral health in some way. We can divide these into anti-cariogenic (decay prevention) or anti-bacterial rinses. You can find fluoride-based anti-cariogenic rinses over-the-counter in retail or drug stores, usually containing about .05% sodium fluoride per volume. Numerous studies have shown these rinses highly effective in preventing tooth decay when used with daily brushing and flossing.
Likewise, over-the-counter antibacterial rinses have proven somewhat effective in reducing bacteria that leads to dental disease. Formulated usually with triclosan, sanguinaria extract, zinc or essential oils, they can also help reduce the incidence of gingivitis (inflammation of the gums), but only if used in conjunction with brushing and flossing.
Perhaps, though, the most widely studied and substantiated therapeutic mouthrinse is chlorhexidine, a prescription-only rinse. Chlorhexidine inhibits the formation of bacterial plaque on tooth surfaces, the main trigger for both tooth decay and periodontal (gum) disease. It’s often used as a post-surgery rinse when brushing and flossing may not be possible, but dentists will often prescribe it for patients who have a high propensity for dental disease.
Using a mouthrinse depends on your current oral health and personal preferences. Therapeutically, most people gain some added tooth strength protection from using a fluoride rinse in their daily hygiene. If fresh breath and the way your mouth feels are important to you, you should consider such a rinse that also has a pleasant taste and effect for you. We can further discuss with you whether a different type of rinse, or a prescription-strength formula, might be best for your particular needs.
If you would like more information on mouthrinses, 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 “Mouthrinses.”
If you know anything about dental disease, then you know bacteria ranks high on the Usual Suspects list. Tooth decay gets its start from acid produced by bacteria; periodontal (gum) disease is often triggered by bacteria that infect the gums.
But the particular strains of bacteria that can cause dental disease are a small percentage of the 10,000-plus species inhabiting your mouth. The rest, numbering in the millions, are fairly benign—and some, as recent research is now showing, play a sizeable role in protecting your teeth and gums against other malicious bacteria, fungi and viruses.
Dr. Aaron Weinberg, a dental researcher at Case Western Reserve University, has been investigating these protective bacteria for many years. His research began with a scientific conundrum: although the mouth has one of the highest densities of bacterial populations, wounds in the mouth tend to heal quickly.
The answer, he believes, originates with human beta defensins (hBDs), substances produced by cells in the lining of the mouth that are natural antibiotics against disease. He has found that certain bacteria actually help stimulate their production.
This isn't just an interesting fact about the body's defenses and immune system. During his research, Dr. Weinberg was able to identify the agent within the bacteria that triggered hBD production. This has opened up a new line of research: The possibility that harnessing this agent might help assist in our treatment of infection by boosting the body's defensive capabilities.
For example, researchers have proposed including a form of the agent in toothpaste. Over time, this might stimulate hBD production and guard the mouth against the development of dental diseases like gum disease.
These possibilities all come from our increasing knowledge and understanding of the microscopic world around us, especially in our mouths. Bacteria are much more complex than we may have realized—not all are our enemies, and some are definitely our friends. Learning more may open up new ways to keep our teeth and gums healthy.