Gregory E. Oxford, DDS, MS, PhD  &  Isabell G. Oxford, DMD
100 Whetstone Place, Suite 308, St. Augustine, FL 32086  (904) 810-2345

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Posts for: December, 2013

By Oxford Dental Associates
December 30, 2013
Category: Dental Procedures
Tags: root planing  
RootPlaningRemovesDangerousPlaqueandTartarYourToothBrushCant

While periodontal disease can take on a variety of forms, most are caused by a thin layer of bacterial plaque called biofilm. This layer of plaque will form every 8-12 hours and sticks like glue to your teeth near the gum line. With time, tartar formation occurs at and below the gum line.

If left unchecked, biofilm can give rise to a very unhealthy progression. It first triggers an infection that leads to painful inflammation, progressive bone loss and the gum tissue losing attachment with a tooth. Void spaces (or pockets) form where the gum and bone tissue once adhered; infectious plaque and tartar moves into these pockets and advances deeper to the root. Overcome by disease, the tooth is in danger of being lost.

It's imperative then to remove as much of this entrenched plaque and tartar as possible. Renewed oral hygiene is not enough — removing plaque and tartar from the root surfaces requires a treatment known as root planing.

Root planing is a meticulous, labor-intensive process. We first clear away larger portions of plaque around the teeth and gums with hand instruments or an ultrasonic device and then flush out the pockets with water. After administering a local anesthetic for pain, we would then turn to a number of small hand instruments known as curettes to probe and scrape away as much remaining plaque below the gum line as we can get to.

Root planing requires experience and a good sense of touch to work in areas that can't be clearly seen. Observing the gum line, though, can give us a good indication of progress as these tissues will actually change color once the biofilm and tartar deposits have been removed.

Being so deeply entrenched, not all the deposits might be removed during one session. However, as plaque and tartar are removed, the gum tissues will begin to heal and become less inflamed. This will make it easier to remove plaque in subsequent sessions.

Root planing takes time, but the effort is well worth it. In the short term you'll notice less inflammation and pain around your teeth and gums. In the long-term, it just may save your teeth.

If you would like more information on root planing and periodontal disease, 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 “Root Planing.”


By Oxford Dental Associates
December 27, 2013
Category: Oral Health
Tags: celebrity smiles  
HowiTheBiggestLoseriStarJillianMichaelsKeepsHerWinningSmile

Anyone who has seen fitness and life coach Jillian Michaels on The Biggest Loser and Losing It with Jillian knows she has the expertise and determination to help overweight people reach new levels of fitness and health. Using her own difficult life experiences, Jillian is able to help others look below the surface to the roots of their own unhealthy lifestyles. As a child, she suffered from night terrors, then her parents divorced when she was 12. She reacted to her anger and unhappiness by comforting herself with food. By age 17 she weighed 175 pounds — too much weight for her small 5'2" frame. To get Jillian involved in physical activity, her mother signed her up for a martial arts class. It was the right choice. Jillian loved the physical and spiritual aspects of martial arts practice, and this training pointed the way to what ultimately became her career.

It's no wonder Jillian is concerned about America's obesity problem — especially in children. To counter it, she and a business partner put together a Wii game, “Jillian Michaels' Fitness Ultimatum.” “If you turn exercise into a game, it's much easier to get kids to join in,” she says.

For adults, Jillian is concerned with unhealthy body images put forward by the fashion industry and media. She says, “Educating women on the importance of a healthy diet and exercise program is essential, but getting them to realize that women are supposed to have curves is equally important.” She is working on a new book, which is designed to help people live a healthy lifestyle, realize their true potential, and find happiness in just being themselves.

Since good health also includes good oral health, here's a sampling of what Jillian discussed about healthy habits in her interview with Dear Doctor magazine.

How can parents encourage their children to have healthy habits? Jillian says it starts with parents setting a good example. Parents can persuade children to get exercise by going outside to play with them. Gardening together and serving kids home-grown vegetables is a good way to encourage healthy eating.

What is her dental care routine? Jillian brushes her teeth two or three times a day with an electric toothbrush and she flosses daily. She never leaves home without toothpaste, an electric travel toothbrush, and floss as well as some sort of lip gloss. She sees her dentist, whom she calls “amazing,” at least twice a year for cleanings.

How does she guard against damage from martial arts? Jillian broke her two front teeth as a child and had them repaired with crowns. Now she wears a mouthguard when doing vigorous exercise.

What other cosmetic dental procedures has she had? She also had braces and has had her teeth whitened.

Jillian knows that it takes hard work and commitment to health and exercise, along with good oral health habits, to look and feel your best. You can learn more about Jillian by reading the entire interview in the article “Jillian Michaels: The Biggest Loser's health and wellness expert talks about her oral health, keeping fit and plans for the future.” Contact us today to discuss your questions about tooth whitening, crowns, or mouthguards or to schedule an appointment.


TreatingAccessoryRootCanalsImprovestheChancesforaSuccessfulToothRecovery

Without a doubt, an effective root canal treatment can extend the life of a tooth for many years. But sometimes even a well-maintained tooth can fall prey to disease months or even years after a root canal treatment. While there are a number of reasons to account for this failure, a common one is so tiny it could have easily been missed during the first treatment.

A root canal is an open space within the tooth that contains the pulp. The pulp is a connective tissue with a network of nerve fibers connected to the root that alert the brain to environmental changes involving the tooth. It is most important during the tooth’s early development, but becomes less important as we age. The pulp is susceptible to infection from tooth decay or periodontal (gum) disease, which if left untreated can threaten the tooth’s survival. During a root canal treatment, we enter these spaces, clear out the diseased pulp and fill the canal with a bio-compatible filling; we then seal it off to deter further decay.

The treatment could ultimately fail, though, because of accessory or lateral canals missed during the procedure. Like a tree with smaller branches growing out of its larger limbs, accessory canals are smaller access ways that branch off of the main root canals. These accessory canals, which can occur anywhere along a main canal, can be quite small and not easily detected during an initial root canal treatment. They are especially susceptible to infection due to gum disease if they open into the periodontal membrane, the main attachment point between teeth and bone.

If we suspect the presence of accessory canals (either initially or after ensuing problems following a root canal treatment), this could require the skills of an endodontist, a dentist who specializes in the treatment of a tooth’s interior. Accessory canals are treated in much the same way as larger canals, but may require an endodontist’s specialized microscopic equipment and filling techniques. Effective treatment of these smaller accessory canals will certainly improve the chances of a successful, long-term outcome for the tooth.

If you would like more information on root canal treatments, 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 “Accessory Canals.”