My Blog
By Robert B. Malek, DDS & Associates
May 09, 2017
Category: Dental Procedures
BracesTakeAdvantageofTeethsNaturalAbilitytoMove

There are many new and exciting ways now to transform an unattractive smile into one you'll be confident to display. But not all “smile makeover” techniques are new — one in particular has been around for generations: using braces to correct crooked teeth.

Braces have improved the smiles (and also dental health) for millions of people. But as commonplace this orthodontic treatment is, it wouldn't work at all if a natural mechanism for moving teeth didn't already exist. Braces “partner” with this mechanism to move teeth to better positions.

The jawbone doesn't actually hold teeth in place — that's the job of an elastic gum tissue between the teeth and bone called the periodontal ligament. Tiny fibers extending from the ligament attach to the teeth on one side and to the bone on the other. In addition to securing them, the dynamic, moldable nature of the ligament allows teeth to move incrementally in response to forces applied against them.

To us, the teeth feel quite stationary (if they don't, that's a problem!). That's because there's sufficient length of the tooth roots that are surrounded by bone, periodontal ligament and gum tissue. But when pressure is applied against the teeth, the periodontal ligament forms both osteoblasts (bone-forming cells) and osteoclasts (bone-resorbing cells) causing the bone to remodel. This allows the teeth to move to a new position.

Braces take advantage of this in a controlled manner. The orthodontist bonds brackets to the outside face of the teeth through which they pass a thin metal wire. They attach the ends of the wire to the brackets (braces), usually on the back teeth. By using the tension placed in the wire, the orthodontist can control the gradual movement of teeth to achieve proper function and aesthetics. The orthodontist continues to monitor the treatment progress, while making periodic adjustments to the tension.

It takes time, but through this marvelous interplay between nature and dental science you'll gain a more healthy and beautiful smile.

If you would like more information on improving your smile with orthodontics, 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 “Moving Teeth with Orthodontics.”

By Robert B. Malek, DDS & Associates
April 24, 2017
Category: Oral Health
ExpertAdviceVivicaAFoxonKissingandOralhealth

Is having good oral hygiene important to kissing? Who's better to answer that question than Vivica A. Fox? Among her other achievements, the versatile actress won the “Best Kiss” honor at the MTV Movie Awards, for a memorable scene with Will Smith in the 1996 blockbuster Independence Day. When Dear Doctor magazine asked her, Ms. Fox said that proper oral hygiene was indeed essential. Actually, she said:

"Ooooh, yes, yes, yes, Honey, 'cause Baby, if you kiss somebody with a dragon mouth, my God, it's the worst experience ever as an actor to try to act like you enjoy it!"

And even if you're not on stage, it's no fun to kiss someone whose oral hygiene isn't what it should be. So what's the best way to step up your game? Here's how Vivica does it:

“I visit my dentist every three months and get my teeth cleaned, I floss, I brush, I just spent two hundred bucks on an electronic toothbrush — I'm into dental hygiene for sure.”

Well, we might add that you don't need to spend tons of money on a toothbrush — after all, it's not the brush that keeps your mouth healthy, but the hand that holds it. And not everyone needs to come in as often every three months. But her tips are generally right on.

For proper at-home oral care, nothing beats brushing twice a day for two minutes each time, and flossing once a day. Brushing removes the sticky, bacteria-laden plaque that clings to your teeth and causes tooth decay and gum disease — not to mention malodorous breath. Don't forget to brush your tongue as well — it can also harbor those bad-breath bacteria.

While brushing is effective, it can't reach the tiny spaces in between teeth and under gums where plaque bacteria can hide. But floss can: That's what makes it so important to getting your mouth really clean.

Finally, regular professional checkups and cleanings are an essential part of good oral hygiene. Why? Because even the most dutiful brushing and flossing can't remove the hardened coating called tartar that eventually forms on tooth surfaces. Only a trained health care provider with the right dental tools can! And when you come in for a routine office visit, you'll also get a thorough checkup that can detect tooth decay, gum disease, and other threats to your oral health.

Bad breath isn't just a turn-off for kissing — It can indicate a possible problem in your mouth. So listen to what award-winning kisser Vivica Fox says: Paying attention to your oral hygiene can really pay off! For more information, contact us or schedule an appointment for a consultation. You can read the entire interview with Vivica A. Fox in Dear Doctor's latest issue.

By Robert B. Malek, DDS & Associates
April 16, 2017
Category: Oral Health
PreventWhiteSpotsonTeethWhileWearingBraceswithDiligentOralHygiene

After months of wearing braces it's time for the big reveal: your new and improved smile! Your once crooked teeth are now straight and uniform.

But a look in the mirror at your straighter teeth might still reveal something out of place: small chalky-white spots dotting the enamel. These are most likely white spot lesions (WSLs), points on the enamel that have incurred mineral loss. It happens because mouth acid shielded by your braces contacted the teeth at those points for too long.

Most mouth acid is the waste product of bacteria that thrive in dental plaque, a thin film of food particles that can build up on tooth surfaces. High levels of acid are a definite sign that plaque hasn't been removed effectively through brushing and flossing.

But normal hygiene can be difficult while wearing braces: it's not easy to maneuver around brackets and wires to reach every area of tooth surface. Specialized tooth brushes can help, as well as floss threaders that help maneuver floss more easily through the wires. A water irrigator that uses pulsating water to remove plaque between teeth is another option.

However, if in spite of stepped-up hygiene efforts WSLs still develop, we can treat them when we've removed your braces. One way is to help re-mineralize the affected tooth surfaces through over-the-counter or prescription fluoride pastes or gels. It's also possible re-mineralization will occur naturally without external help.

While your teeth are sound, their appearance might be diminished by WSLs. We can improve this by injecting a liquid tooth-colored resin below the enamel surface. After hardening with a curing light, the spot will appear less opaque and more like a normal translucent tooth surface. In extreme cases we may need to consider porcelain veneers to cosmetically improve the tooth appearance.

In the meantime while wearing braces, practice thorough dental hygiene and keep up your regular cleaning visits with your general dentist. If you do notice any unusual white spots around your braces, be sure to see your dentist or orthodontist as soon as possible.

If you would like more information on dental care during orthodontic treatment, 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 “White Spots on Teeth during Orthodontic Treatment.”

By Robert B. Malek, DDS & Associates
April 01, 2017
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 Robert B. Malek, DDS & Associates
March 17, 2017
Category: Oral Health
Tags: loose teeth  
DontLetYourLooseToothBecomeaLostTooth

Discovering a loose tooth can be exciting — if you're six, that is, and anticipating a windfall from the tooth fairy. If you're an adult, a loose tooth is a different story. You're in real danger of it becoming a lost tooth, and there won't be another one coming in to replace it.

Fortunately, that result isn't inevitable, but we have to take quick action if we're going to save your tooth. The first step is to find out why it's loose.

Tooth looseness occurs primarily because the gum and bone structures that hold teeth in place have been damaged in some way. Otherwise healthy teeth and gums can be injured in an accident or with dental habits like teeth grinding or clenching that increase the biting forces against teeth. The latter could require some intervention like a night guard to prevent teeth from grinding to reduce the abnormal biting force.

But disease is often the root cause for tooth looseness. Periodontal (gum) disease, a bacterial infection triggered by bacterial plaque, can inflame and weaken gum tissues, eventually causing bone loss followed by the gum tissue detaching from the teeth. In this weakened condition even normal biting forces could loosen a tooth.

If gum disease is the primary culprit, our treatment starts there. By aggressively removing plaque and calculus (tartar) from the tooth surfaces, including deep below the gum line around the root, the gum tissues become less inflamed and begin to heal. This in turn can strengthen their attachment to a loose tooth. In more advanced cases, we may need to surgically graft lost bone and gum tissue to rebuild the attachment.

We may also need to stabilize a loose tooth while we're performing these other treatments. The most common way is to join or splint a loose tooth to nearby stable teeth. There are varieties of splints: one type involves rigid dental material bonded across the enamel of the loose tooth and its neighbors. In another, we cut a small channel in the involved teeth, and then insert a metal splint, bonding it within the channel.

Whatever needs to be done, we need to do it promptly — if you notice a loose tooth, contact us as soon as possible. The earlier we begin treatment the more likely we'll save your loose tooth.

If you would like more information on treating loose 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 “Treatment for Loose Teeth.”





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