If you think “vaping” electronic cigarettes (e-cigarettes for short) is healthier for your teeth and gums than smoking cigarettes, you might be disappointed with the latest research. A number of studies seem to indicate e-cigarettes could be just as damaging to your mouth as traditional cigarettes.

An e-cigarette is a device containing a chamber for liquids and a means to heat the liquid into a vapor. The user then inhales or “vapes” the vapor, which contains nicotine and flavorings. The heat also pressurizes the vapor causing it to expel as an aerosol into the mouth.

Researchers have found the ingredients and aerosol effect could lead to potential health problems. An Ohio State University researcher found that vaping disrupted the normal balance of microorganisms in the mouth known as the oral microbiome. This imbalance could make it easier for disease-causing bacteria to proliferate, particularly those most responsible for periodontal (gum) disease.

Another study coming out of the University of Rochester and Stony Brook University in New York detected cell damage in gum tissue caused by e-cigarette vapor similar to that caused by regular cigarette smoke. Some of this damage seemed to result from the flavoring agents used in the e-cigarette liquid, as well as nicotine.

Another study from Quebec, Canada appears to concur with the New York study. These researchers found the damage caused by e-cigarette vapor might substantially increase the rate of cell death in oral tissues by as much as 50% over a short period of time. This kind of damage can lead to higher risks of dental diseases like gum disease or tooth decay.

While we don’t know the long-term effect of using e-cigarettes on both oral and general health, these studies are alarming: They seem to show vaping may cause some of the same problems as smoking. With the jury still out, the prudent thing to do is limit or avoid vaping altogether to protect your mouth from these unhealthy outcomes.

If you would like more information on the possible oral health effects of e-cigarettes, please contact us or schedule an appointment for a consultation.

Bite problems aren't limited to teeth simply out of position. The problem could be some teeth aren't there—visibly, that is. They still exist below the gums and bone, but they've been crowded out and blocked from erupting. We call this condition impaction.

Any tooth can become impacted and affect the bite, but a person's smile suffers more if it involves visible front teeth. This is especially so if the teeth in question are upper canines or "eye teeth"—the smile doesn't look normal without these pointed teeth on either side of the central and lateral incisors.

Impacted teeth can also contribute to more than a cosmetic problem: they're more susceptible to abscesses (pockets of infection) or root damage both to themselves or neighboring teeth. To minimize these potential health issues, we'll often remove impacted teeth surgically (as is often done with wisdom teeth).

But because of their important role in not only appearance but also bite function, we may first try to assist impacted canines to fully erupt before considering extraction. It takes a bit of orthodontic "magic," but it can be done.

Before we can make that decision, though, we want to precisely locate the impacted teeth's positions and how it may affect other teeth. This initial evaluation, often with advanced diagnostics like CT scanning or digital x-rays, helps us determine if the impacted teeth are in a workable position to save. If they're not, we may then need to consider removing them and ultimately replacing them with a dental implant or similar restoration.

But if their position is workable and there are no other impediments, we can proceed with helping them erupt. To do this we'll have to first expose them by creating a small opening in the gums through minor surgery. We then bond a small bracket to the tooth, to which we'll attach a small chain that we then attach to orthodontic braces. This enables us to exert continuous pressure on the tooth.

Over time, the pressure coaxes the tooth to erupt. We may still need to apply other forms of orthodontics and cosmetic procedures, but using this procedure to rescue impacted canines can produce a healthier and more attractive smile.

If you would like more information on treating complex bite problems, 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 “Exposing Impacted Canines.”

Chicken pox is a common viral infection that usually occurs during childhood. Although the disease symptoms only last a short time, the virus that caused it may remain, lying dormant for years within the body's nervous system. Decades later it may reappear with a vengeance in a form known as herpes zoster, what most people know as shingles.

A shingles outbreak can be quite painful and uncomfortable—and it's also not a condition to take lightly. Occurring mainly in people over fifty, it often begins with an itching or burning sensation in the skin. This is often followed by a red rash breaking out in a belt-like pattern over various parts of the body, which may later develop into crusty sores. Symptoms may vary from person to person, but people commonly experience severe pain, fever and fatigue.

Besides the general discomfort it creates, shingles can also pose major health problems for certain people. Individuals with other health issues like pregnancy, cancer or a compromised immune system may experience serious complications related to a shingles outbreak.

In its early stages, shingles is contagious, spreading through direct contact with shingles sores or lesions or through breathing in the secretions from an infected person. This characteristic of shingles could affect your dental care: because the virus could potentially pass to staff and other patients, dentists usually postpone cleanings or other dental treatments for patients with shingles, particularly if they have a facial rash.

If you're diagnosed with shingles, most physicians recommend you begin antiviral treatment as soon as possible. You should also let your dentist know if you have shingles, which may put off any scheduled treatments until your doctor determines you're no longer contagious.

There's one other thing you can do, especially if you're over 60: obtain a shingles vaccine, available from most physicians or clinics. The vaccine has proven effective in preventing the disease, and could help you avoid this most unpleasant health experience.

If you would like more information on shingles and its effect on dental care, please contact us or schedule an appointment for a consultation.

Basketball isn't a contact sport—right? Maybe once upon a time that was true… but today, not so much. Just ask New York Knicks point guard Dennis Smith Jr. While scrambling for a loose ball in a recent game, Smith's mouth took a hit from an opposing player's elbow—and he came up missing a big part of his front tooth. It's a type of injury that has become common in this fast-paced game.

Research shows that when it comes to dental damage, basketball is a leader in the field. In fact, one study published in the Journal of the American Dental Association (JADA) found that intercollegiate athletes who play basketball suffered a rate of dental injuries several times higher than those who played baseball, volleyball or track—even football!

Part of the problem is the nature of the game: With ten fast-moving players competing for space on a small court, collisions are bound to occur. Yet football requires even closer and more aggressive contact. Why don't football players suffer as many orofacial (mouth and face) injuries?

The answer is protective gear. While football players are generally required to wear helmets and mouth guards, hoopsters are not. And, with a few notable exceptions (like Golden State Warriors player Stephen Curry), most don't—which is an unfortunate choice.

Yes, modern dentistry offers many different options for a great-looking, long lasting tooth restoration or replacement. Based on each individual's situation, it's certainly possible to restore a damaged tooth via cosmetic bonding, veneers, bridgework, crowns, or dental implants. But depending on what's needed, these treatments may involve considerable time and expense. It's better to prevent dental injuries before they happen—and the best way to do that is with a custom-made mouthguard.

Here at the dental office we can provide a high-quality mouthguard that's fabricated from an exact model of your mouth, so it fits perfectly. Custom-made mouthguards offer effective protection against injury and are the most comfortable to wear; that's vital, because if you don't wear a mouthguard, it's not helping. Those "off-the-rack" or "boil-and-bite" mouthguards just can't offer the same level of comfort and protection as one that's designed and made just for you.

Do mouthguards really work? The same JADA study mentioned above found that when basketball players were required to wear mouthguards, the injury rate was cut by more than half! So if you (or your children) love to play basketball—or baseball—or any sport where there's a danger of orofacial injury—a custom-made mouthguard is a good investment in your smile's future.

If you would like more information about custom-made athletic mouthguards, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Athletic Mouthguards” and “An Introduction to Sports Injuries & Dentistry.”

If you have chronic jaw pain, you may be one of an estimated 10 million Americans suffering from temporomandibular joint disorders (TMD). If so, it's quite possible you're also coping with other health conditions.

TMD is an umbrella term for disorders affecting the temporomandibular (jaw) joints, muscles and adjoining tissues. The most common symptoms are limited jaw function and severe pain. Determining the causes for these disorders can be difficult, but trauma, bite or dental problems, stress and teeth clenching habits seem to be the top factors. Women of childbearing age are most susceptible to these disorders.

In recent years we've also learned that many people with TMD also experience other conditions. In a recent survey of TMD patients, two-thirds reported having three or more other health conditions, the most frequent being fibromyalgia, chronic fatigue syndrome, rheumatoid arthritis or chronic headaches. Researchers are actively exploring if any systemic connections exist between TMD and these other conditions, and how these connections might affect treatment changes and advances for all of them including TMD.

In the meantime, there remain two basic approaches for treating TMD symptoms. The most aggressive and invasive approach is to surgically correct perceived defects in the jaw structure. Unfortunately, the results from this approach have been mixed in their effectiveness, with some patients even reporting worse symptoms afterward.

The more conservative approach is to treat TMD orthopedically, like other joint problems. These less invasive techniques include the use of moist heat or ice to reduce swelling, physical therapy and medication to relieve pain or reduce muscle spasming. Patients are also encouraged to adopt softer diets with foods that are easier to chew. And dentists can also provide custom-fitted bite guards to help ease the stress on the joints and muscles as well as reduce any teeth grinding habits.

As we learn more about TMD and its relationship to other health conditions, we hope to improve diagnosis and treatment. Until then, most dentists and physicians recommend TMD patients try the more conservative treatments first, and only consider surgery if this proves unsatisfactory. It may take some trial and error, but there are ways now to ease the discomfort of TMD.

If you would like more information on the causes and treatments of TMD, 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 “Chronic Jaw Pain and Associated Conditions.”