Monday, May 1, 2017

Sensitive Teeth? We Can Help!

Many people deal with sensitive teeth. Sensitivity affects so many daily activities, from brushing and flossing, to drinking your morning coffee, to indulging in frosty dessert. There are several reasons why you may be sensitive and a few options to solve the problem.
According to the American Dental Association, sensitive teeth can be caused by the following:
  • a cavity
  • an older filling
  • a cracked tooth
  • an exposed root
The cavity or older filling are usually taken care of by a quick visit. A cavity is formed when acidic plaque dissolves part of the top layer of your tooth. The dentist will have to clean out the area of all the decay and place a filling material or porcelain restoration to prevent any more damage. Having a cavity and having sensitive teeth are not mutually exclusive. You might have decay on a tooth and not realize it until it grows deeper into the tooth. The hygienist evaluates your teeth at each cleaning, checking for cavities or weak areas. If we can fill the cavity while it’s smaller it won’t get to the point where it becomes sensitive.
If an older filling pulls away from tooth bacteria can sneak in and cause sensitivity. The dentist needs to clean out the old filling and replace it with new material. The new filling, onlay, or inlay will be snug against the natural tooth and protect it against decay. A cracked tooth also needs to be addressed by the dentist. We will take an x-ray to see the severity of the fracture and create a treatment plan to best fix the tooth.
If your gums have receded and exposed part of the tooth's root, you may experience sensitivity. You might get some relief from using sensitivity toothpaste, but it's only temporary. The dentist will be able to explain your treatment options. If your teeth have been sensitive for a while, definitely request a consultation with the doctor.
Whitening is another cause. If you used a whitening application recently and noticed your teeth were sensitive after, whitening is probably the culprit. People’s tolerance for whitening products vary. If you are interested in whitening, speak with your hygienist or doctor to choose the best option for you. If you’re already whitening your teeth and you’re experiencing sensitivity, let us know. There is usually a way to ease the sensitivity without abstaining from whitening.

Monday, January 9, 2017

Invisalign FAQ

Happy New Year! It's that time again...We resolve to make improvements and challenge ourselves to finally act on those things we've been thinking about doing for so long. If you've thought about straightening your teeth but are nervous or have some questions about the procedure, we have the answers! Below is a list of our most frequently asked Invisalign questions, answered by our very own Dr. Rick Bankhead. If you have any other questions please leave a comment or call the office and we'll be happy to help you!

1) Besides the cosmetic improvement, is there any other benefit to Invisalign?
    Invisalign is often thought of as a cosmetic procedure, but it can definitely improve your dental health. When you fix overlapping or “crooked” teeth, you can floss easier and do a better job of flossing. Your gums and bones will be healthier for it, and you’ll keep your smile beautiful and healthy for a long time.
2) Is Invisalign treatment right for me?
    Invisalign is an orthdontic treatment that can be used to correct your bite, or purely for cosmetic reasons. Although we have helped many patients through Invisalign, we do occasionally refer patients to local orthodontists. Sometimes a patient will benefit more from traditional braces. Dr. Rick Bankhead or Dr. Stuart MacDonald would be happy to see you for a consultation to assess whether you are a candidate for Invisalign.
3) Does insurance cover Invisalign?
    It really depends on the insurance plan. A dental plan can have a rider for orthodontic coverage. Sometimes it only covers minor dependents, sometimes it covers everybody who is listed on the plan. If your insurance coverage does cover orthodontics, it will cover a portion of your Invisalign treatment.
If you do not have orthodontic coverage, there are several financial options available. If your employer offers a “flexible spending account” or a “cafeteria plan” you can use those benefits toward Invisalign treatment. We also work with CareCredit and Chase Health Advance. Those are financing companies that offer interest-free payment plans for up to 24 months. Once you verify you are a candidate, the front desk will discuss insurance benefits and payment options with you.
4) What makes Invisalign better than traditional braces?
    Invisalign can often achieve the same effect as traditional braces. The major benefit of Invisalign is that a patient’s home care routine isn’t affected. With traditional braces, the wires and brackets make brushing and flossing more difficult. Patients are not able to do a good a job keeping their teeth clean. With Invisalign, there is nothing between your teeth and your toothbrush and floss. Your daily home care routine can continue uninterrupted because the aligners come right out. Our patients have even noted an improvement in their brushing and flossing habits because they had to do it after every meal (see # 6). Many of them have kept the (healthy!) habit long after treatment had ended.
5) How long does the treatment take?
    The length of treatment varies by the individual case. On average treatment can take as little as 16 weeks, or roughly between 4 and 18 months. Invisalign will designate a certain number of aligner trays for your case. Typically, you wear each aligner for two weeks, then you go on to the next in series. You wear the trays constantly; the only time you remove the trays is when you eat, brush, and floss. Compliance is the key here. If you keep the trays in and stay on schedule, the treatment will successfully fly by.
6) Is it painful?
    Invisalign is a bit similar to traditional braces in this respect. For the first couple days after putting in a new aligner, your teeth will probably feel tight and might feel an ache. The tenderness is comparable to tightening traditional braces, but not as bad. The movements are done more often, every two weeks, making it less painful than traditional braces.
7) Are there any eating restrictions?
    You can eat whatever you like, but you do have to be meticulous about caring for your teeth after. Before you eat, you’ll need to remove your aligners.You can only drink non-caloric beverages (ie water, flavored water, black coffee) without removing your aligners. If you eat or drink anything else, you must take the aligners out. Once you’re finished eating, brush and floss your teeth before putting your aligners back in. This needs to be your new routine every time you eat because it ensures your aligners stay clean. A fair number of our patients reported that they were less inclined to snack during the day. They ended their treatment with straighter teeth and a few pounds lighter - a healthier smile in more ways than one!
8) Will wearing the aligners affect my speech?
    Not at all. The trays are a very thin material and don’t get in the way of speaking. You might need a day or so to become accustomed to the feeling. None of our patients reported speech issues while wearing the trays.
9) How do I keep the aligner trays clean?
    Clean the trays with warm water and a little bit of soap. Do not use hot water! Hot water can warp the trays and they won’t fit right. You can also purchase a cleaning kit from Invisalign’s website.
10) What happens if I lose an aligner?
    If you lose or damage an aligner and are unable to wear it, call us immediately. We will have to order a new aligner tray from Invisalign. In the meantime, wear the most recent aligner you have. For example, if you lose aligner # 5, wear aligner # 4 until the new aligner comes in or the dentist gives you further instructions. This will probably set back your treatment by a week or two. It’s best if you’re careful about putting the trays away when eating, keeping them out of reach of pets and children, etc.

Friday, December 9, 2016

Preparing for a Child's First Dental Visit

Preparing for your child’s first dental visit can be tricky. We encourage you to talk about us before you visit. Your child has been to the physician’s office many times, usually for shots, so it’s understandable if they are a little unsure of us. Here are some tips to help you prepare:

Please don't talk about bad experiences that you have had, or the time your child's sibling freaked out and bit the dentist. (That last one's a joke, hopefully that didn't happen!) Don’t talk about needles or pain or discomfort. Take a calm and matter-of-fact approach. If they have any questions about what we do, reassure them that we are only here to help them keep their smiles healthy.

If they are very nervous, you are always welcome to bring them with you to your own appointment. This helps them become acclimated to our office and staff, and to see how easy a dental visit can be. Seeing someone they are familiar with and look up to successfully go through an experience that is new to the child makes a big impact. If they see how calm you are they will soon realize how easy it is to visit the dentist.
There are also a good selection of books about visiting the dentist that you can read with your child.  Here is a short list of children's books that will help put your young one in a good mindset.
Arthur's Tooth by Mark Brown - The famous aardvark is nervous about a loose tooth.
The Berenstain Bears Visit the Dentist by Stan and Jan Berenstain - The title says it all. Who doesn't love the Berenstain Bears?
Elmo Visits the Dentist by PJ Shaw - That Elmo is everywhere these days...
Just Going to the Dentist by Mercer Mayer - This is one about Little Critter. We hear he's pretty famous with the kiddie demographic.
Show Me Your Smile: A Visit to the Dentist by Christine Ricci - Dora “explores” the dentist office.
A Visit to the Dentist by Eleanor Fremont - This one's about Little Bill's dental visit.
There are many more books about dentistry that are geared toward children. These particular ones have been mentioned to us by our patients as good reads that helps their children.
There's another book that's geared toward a slightly older set of kids called What-the-Dickens: The Story of a Rogue Tooth Fairy. It's written by Gregory Maguire, the author of Wicked. It probably won't ease any dental anxiety, but it's definitely good for a laugh.
We're not associated/affiliated with any of these authors/publishing companies in any way. And of course, it's completely up to you to deem what's appropriate material to read to your children. If you're looking for a tool to make your child more comfortable about visiting us, one (or more) of these books might do the trick. If you ever have any questions or other recommendations feel free to comment.

Tuesday, November 1, 2016

Children's Dental Issues

Today we’re going to discuss some common habits that can be damaging to children’s teeth, as well as some solutions to help alleviate them.
Baby Bottle Syndrome
Baby Bottle Syndrome is a condition in which the child’s teeth have been exposed to sugary liquids for extended periods of time. The result of this is extreme decay in almost every tooth, especially the front teeth where the child holds the bottle. Often, parents don’t realize the damage until it’s too late. The first baby teeth fall out around 6 or 7 years old usually, the last teeth to come out are usually when the child is 12. So it’s definitely important to keep the baby teeth healthy. It’s often expensive and time-consuming to fix the damage done by Baby Bottle Syndrome, and also negatively impacts the child’s view on oral health.
The best way to fix this is to prevent it. Help your child brush daily, visit the dentist twice a year, and don’t let them fall asleep with or sip from a bottle that has anything other than water in it. The longer your child’s teeth are exposed to sugar, the more damage is done.
Eating too many sugary snacks or chewy, sticky snacks that stay on the teeth can have a similar effect as falling asleep with a sugary bottle. The solution is the same as above: prevention is the key. Offer your kids a variety of foods and teach them from an early age how to make nutritious choices. Sugar is fine for a treat, but be sure to brush after. Establish good habits now that will last a lifetime. Their smile will benefit, and so will their overall health.
Thumb-sucking is a common habit in children. They have a natural inclination to put everything in their mouths and sucking is how they eat. It’s also a calming habit. Most kids stop thumb-sucking on their own by 3 or 4 years old or so. If they continue thumb-sucking until they’re school-age, the permanent teeth might be crooked as they come in. There might be other issues depending on how long the child has been thumb-sucking, how frequently it occurs, etc.
It is easier to discourage putting fingers near the mouth from an early age than trying to break the habit after allowing thumb-sucking for so long. If you notice your baby thumb-sucking, offer a pacifier instead (see below). If you need to break your child of the habit, be calm about the situation, offer positive reinforcement to discourage the habit. Your child will probably forget occasionally, so be prepared to give a gentle reminder. If it’s an ongoing issue, please mention it to the dentist at your child’s next appointment.
Pacifier use is better than thumb-sucking because it’s a lot easier to break the habit. You can start weaning them off the pacifier by simply limiting the amount of time that you let them use it. This isn’t as damaging as thumb-sucking, but there is still the potential of harm to the child’s teeth or jaw.
When buying a pacifier, make sure the size and shape of it fit your child’s mouth (an ill-fitting pacifier can cause pain or malformation). Choose one that is made of rubber so as not to damage your child’s gums. Pacifiers wear and tear just like anything else. If you notice the pacifier starting to break down you should purchase a new one to avoid a potential choking hazard. Only offer the pacifier when the baby needs it; using the pacifier all the time can be habit-forming.
Teething is not a habit, but every child experiences it. Typically, babies start to get their first teeth when they’re 6 to 8 months old. You can usually tell when babies teethe as they become fussy, lose their appetites, drool more than usual, and have flushed cheeks. Chewing on a hard, chilled object will help their gums feel better and help the teeth break through the gums. Try putting a teething ring in the fridge, or massage your child’s gums with your finger. The pharmacy has over-the-counter ointments, but check with your pediatrician or pharmacist before purchasing.
If you have a topic or question that wasn’t covered here, please leave a comment. If you are concerned that your child may suffer from an issue we discussed, please call the office and schedule an evaluation with the dentist. 617-364-5500

Tuesday, October 25, 2016

Wisdom Teeth FAQ

Having your wisdom teeth removed is a rite of passage for many young adults. Dr. Kirk Bankhead is our go-to guy for extractions. Today he’ll answer some of the most common wisdom teeth questions.
  • Why do wisdom teeth need to come out?
    • In the majority of cases, people’s mouths are just too small to accommodate the wisdom teeth. We have cases where the patient’s teeth started shifting because the wisdom teeth were coming through. If the wisdom teeth are impacted, that they can’t break through the gums, it can lead to pain, headaches, and even gum disease down the road. Removing the wisdom teeth also makes home care easier. It becomes much easier for the patient to reach the back teeth with the toothbrush and floss without the wisdom teeth in the way.
  • When is the best time to schedule an appointment like this?
    • Try to schedule it during a time when you know you’ll be able to recuperate after. A Friday when you don’t have plans that weekend, for example. You’ll be sore after the procedure. You probably won’t be talking much, so you don’t want to schedule it for a weekend when you have a lot going on.
  • How long is the recovery period?
    • It really depends on the patient. You’ll be sore after the procedure, and limited to a soft diet for at least a couple days. You will most likely swell up a bit, and some people experience bruising. Different people have different tolerance levels for pain, and different rates of recovery. There are so many variables, but I’d say you should expect to take it easy for at least three days or so.
  • Am I allowed to eat before the procedure?
    • We don’t use general anesthesia so there is no need to fast. We use conscious sedation (the laughing gas) and a local anesthetic (Novocaine) during the procedure. We do recommend that you eat before you come in. Eat lightly at least one to two hours before your appointment. You probably won’t feel like eating after and you will be limited to a soft diet.
  • Does the insurance cover wisdom teeth extractions?
    • Most dental insurance plans cover the removal of wisdom teeth at a percentage. The way most insurances work is by implementing a yearly maximum of benefits allowed. They pay a percentage on every procedure, provided the maximum hasn’t been reached. Your medical insurance may also cover a portion of the procedure. The front desk will take care of billing your treatment to the insurance and following up with them. If you’d like to know exactly what your responsibility will amount to, we recommend sending a pre-treatment estimate to the insurance company. That will tell us exactly what your insurance will pay, and exactly what your co-payment will be.
  • Will I need medication after?
    • I’ll most likely prescribe you an antibiotic regimen to take following the procedure. The exact medication prescribed will depend on the severity of the case and whether you have any allergies. We will discuss appropriate pain management with you before the procedure.

Friday, September 30, 2016

Solutions for Teeth Grinding

Grinding, also known as bruxism, is when you clench your teeth tightly together, sometimes while grinding them back and forth over each other. For some people, this is a reaction to stress. It can happen when you are awake or asleep. Many people don’t even realize they’re doing it until they start experiencing symptoms.
Symptoms include:
  • pain in the jaw or teeth
  • chipped or broken teeth or fillings
  • flattened or worn down teeth
  • sensitive teeth
  • earaches
  • headaches
  • facial pain
  • damaged cheek tissue
  • noises when opening or closing your mouth (clicking or popping)
There are a few options to treat the symptoms of grinding. Over-the-counter pain relievers can be a temporary solution. Try warm wash cloths or massaging the muscles around your jaw (particularly where the upper and lower jaws connect - the temporomandibular joint). Your dentist can fabricate a custom-made splint or mouth guard for you to wear at night.
Stress isn’t the only cause of bruxism, but it’s perhaps the most common. A person’s teeth could be misaligned in such a way that grinding occurs naturally. Children, too, can experience grinding as their jaws grow and they begin to get adult teeth.
If you have a tendency to grind, try mindfulness; pay attention to your habits and make a conscious effort to relax your jaw when you catch yourself grinding or clenching. As Dr. Groipen always says, “Lips together, teeth apart!” Your teeth should only be touching each other when they are chewing (or smiling!). It can be a hard habit to break, especially if it’s in response to stress, but serious damage can occur to your teeth if it goes unchecked.

Saturday, September 10, 2016

Never Forget

Five years ago, Meghan collected some of the September 11th memories from our staff and published them as a Facebook Note. Tomorrow marks the 15th anniversary of the attacks, and we'd like to republish that post here. If you have a memory you wish to share, please feel free to leave a comment and join us as we reflect on and remember the sacrifices that were made that day.

“I remember walking into work that morning and literally thinking “It’s the perfect day!” The weather was beautiful. I was working at the front desk that day and I was on the phone with my sister. She had the news on while we were talking and I remember she yelled when the second plane it.”

“I was nine years old and the fifth grade. Didn't know much back then. The teachers were out in the hall most of the day acting real weird. Being kids the whole class was enjoying the free time by throwing stuff around and talking real loud.”

“I was sitting in a class and I got a text on my phone. One of my friends was telling me about the World Trade Center. Then I got another text....and another. I got five texts in a couple minutes.”

“I remember exactly where I was. I was in West Roxbury, right in the hygiene room, working on patients.”

“I was in the seventh grade. The school I went to didn't tell any of us what was going on so I didn't know until my mother picked me up from school. It wasn't until I got home and saw all the footage that I really understood what had happened.”

“I dropped my daughter off at school. As I was pulling up to the school to drop her off I heard it on the radio. School was going on as a normal day and I thought she’d be safe there, so I still dropped her off and came to work.”

“I had just started my junior year at the University of Rhode Island. My professor briefly touched upon the attacks but did not go into detail.  So I had to sit through my 90 minute lecture wondering what was going on.”

“At the time of the attacks on the World Trade Center I was performing a root canal on a patient. I was in the West Roxbury office, which had a small TV in the lobby back then.  Once we heard what happened we immediately turned on the TV.”

“I walked the kids to school I then walked to the Joyce Kilmer to vote. When I got home, my phone was ringing and it was my friend asking if I heard about the airplane and told me to turn the TV on.”

“We were walking down the hall I saw a group of teachers crowded around a TV. They watched in silence. I didn't think my teacher had a life outside the classroom, that she even watched TV, it was weird. One teacher was actually crying, I didn’t know what was wrong with her.”

“I remember being on the train wondering why people were crying and whispering about towers and planes.”

“Where was I that day? Canada. In the airport. Headed home on a 9am flight. Standing in line with a group of Americans as we saw the tragedy. A few days later I walked across the border to drive home. I was so happy to join my loved ones.”

“My teacher came in with a radio, TV, and laptop that he connected to the overhead projector. No one said a word and we spent 42 minutes listening and watching the coverage. While he wrote explanations of people and things I had never heard of before on the black board. OSAMA BIN LADEN, Al-Qaeda, Afghanistan (where the hell is that?). We watched live as the first tower came down, we heard when the president boarded air force one. We saw over and over again the planes going into the towers. It was surreal, how could this be happening in New York city, it seemed like it was war footage in some foreign country, this doesn't happen in America.”

“I was at a doctor's appointment and the receptionist had the TV on, I saw the plane crashing into the tower then left and called my husband who was watching at work. I called my brother because he worked in Boston, and they said the plane was from Boston. He said he was getting out of the city. I wanted to make sure my family was safe, it was very scary.”

“I phoned my parents in Florida to make sure they were alright. That they were home safe. I drove home for lunch that day, to turn on CNN coverage and to witness the horror of the attacks. Once it was time to head back to the office I was stopped at a red light on Centre Street in West Roxbury.  My windows were down, as were the woman's in the blue Pontiac next to mine.  I looked over at  her and saw her sobbing. That brought it all home to me.”

“I was so overwhelmed by emotion. It was horrible. To see some of the images they were showing, to see the measures people were willing to take to try to survive...just awful.”

“I remember getting to the nearest television and watching the devastating act thinking ‘This is surreal. Is this a movie?’”

“I was outside with my kids and our neighbors and no one at first knew what to think.  We stayed together all day and tried to keep updated.  I remember how silent it was with no planes flying afterward, and also seeing the first fighter jets fly over West Roxbury.”

“When I got home I was glued to the TV watching it all. It seemed so unbelievable. The following week I was down the Cape on vacation and it was so quiet down there. It was almost eerie.”

“I remember that all cell phones were down and my mom was so nervous for myself and my brother where we were away at college.”

“When I got home I remember my mom called all my family in New York to make sure they were all right.”

“My daughter was in the sixth grade, and the school hadn’t told them anything. It was business as usual for them. I was so stressed debating what to tell her, when to tell her, how to tell her. I didn’t want to tell her right away. It was a tough question, how much could an eleven-year-old handle?”

“It was a time of shock and disbelief that this could have happened in a split second and it was out of our control. As the hours went by the day became a blur. It was such a terrible disaster which would change every American's life forever.”

“I remember watching it on television and thought this can't be real. I really thought it was a movie, thinking no one is really this cruel, til my kids’ school called to pick them up. On my way there I remember feeling depressed with tears running down my face scared that something will happen here in Boston.”

“This other girl got a text on her phone, too, and she raises her hand and tells the professor. At first the professor didn’t believe her, she thought she was mistaken or trying to get out early. So I spoke up and said I got five texts saying the same thing. The professor was shocked, you could tell, but she tried to keep things all business. We had twenty minutes left in class and she made us sit through it. I guess maybe she didn’t want us to panic.”

“It was just a normal workday and then people started talking about what happened. We tried our best to keep things normal, but I think we were all in shock.”

“I had to stay focused and finish my patient’s treatment.  She was under the effects of nitrous oxide, but in her laughing gas "fog" was confused about all that appeared to be happening.  At one point she removed the mask and asked if what she was hearing was really taking place.”

“I know people who were home that day sat watching the news and crying. We couldn’t do that. We had to work, we had to hold it together for the patients, to make the day as normal as possible even though it wasn’t.”

“We were all dealing with the same emotions. But we did the best we could to keep things normal because that’s all you can do. Patients still came in to get their teeth cleaned and I still cleaned their teeth.”

“In the following two or three months, there was no sound of honking automobile horns. People were all numb. It was a silent grieving, we were all family bonded in a deep loss.”

“My husband is a firefighter and his firehouse was beginning to organize a group of firefighters to go from the area to be stand-ins for the New York Fire Department. He had volunteered but he didn't end up going.”

“The next few days were hectic, every time the news came on you worried something else, or something worse happened.  Eventually the fear subsided but the government kept saying we had to be vigilant, it just made me more aware of my surroundings and I tried to be vigilant, whatever that meant.”

“Over the next few days, I thought it was really touching to see people band together and try to help each other through the grief and shock. It almost slowed life down a bit as people made time to be kind to each other.”

“I worked downtown on the weekends at the Swan Boats. The mayor instructed us to open for business that Saturday, the city was dead, it was like a ghost town, again surreal. The Hancock observation deck and top of the Pru were closed to tourists. We were open for 2 weeks after till the end of the season and everyday I worked it was weird. Something had changed in everyone.”

“It was so sad to see people holding up pictures of lost loved ones and hearing about Gerard Dewan.”

“The thing that affected me most about that day was the story of Flight 93. Just the fact that they had to take down that plane and the highjackers. The passengers on Flight 93 saw that they could change things, that they could take control. That’s always the thing that bothered me the most.”

“My kids were young, so I always watched them closely anyway. I was afraid to fly though, for a long time. I still don't like to fly!”

“I was a senior in high school at the time. That spring Senator Ted Kennedy and Supreme Court Justice Anthony Kennedy visited my school. All the seniors in the AP US history class were involved in a round table discussion. We talked about the concepts of freedom and terrorism, civil rights, foreign policy, diversity and tolerance. It was an interesting experience to have two people with that much authority sit and listen to an 18-year-old’s thoughts.”

“9/11 was one of those disasters that had me wondering what if I was there...or worse a family member? It really put things into perspective.”

“Going from a hateful man like Osama to electing a man named Obama shows the diversity and strength of a country united in the goal of equality and freedom. We have lots of problems as a society but my experience having such a literally "in your face" job proves to me how wonderful and beautiful human beings can be. I believe the 9/11 heroes left their love to each of us. We owe it to them to succeed, take an active interest in life, and make it our personal responsibility to add value to our world.”