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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By Oxford Dental Associates
December 02, 2019
Category: Dental Procedures
ConsideringaSmileMakeoverBeSureYouIncludeYourBite

A lot of cosmetic dental procedures focus on how teeth look: whether they're stained, chipped or otherwise disfigured. But a true smile makeover requires looking beyond individual teeth appearance and asking if they're properly aligned. Your teeth may be beautiful in and of themselves, but they could detract from your smile if they're not straight.

Orthodontics—the dental specialty dedicated to correcting poor bites—can be just as important to your smile appearance as veneers, crowns or other restorations. Cosmetic enhancement, though, isn't an orthodontist's only priority: a poor bite can interfere with dental function and oral hygiene, so repairing it and making sure the teeth "bite" together correctly is just as important to your health.

Your first step is to undergo a comprehensive orthodontic exam. Its purpose is two-fold: to diagnose the nature of your particular bite problem; and to determine if your mouth is healthy enough to undergo the necessary treatment to correct it. From here, your orthodontist will propose a treatment plan to correct your particular bite problem.

Although a number of orthodontic appliances may be used, the most likely tools employed will be either fixed braces or removable clear aligners. Both of these use the mouth's natural ability to move teeth by applying subtle pressure on the teeth and supporting periodontal structures for a period of time.

While braces are effective, if you're an adult or teenager and nothing in your bite situation would preclude their use, you may choose clear aligners. Aligners are a sequence of plastic mouth trays that are computer-generated based on the patient's mouth impression. Patients wear the trays in succession, each slightly smaller than the previous one, until they complete the series.

People often prefer aligners over braces for a couple of reasons. Unlike fixed braces, you can take them out of your mouth for eating, cleaning or special occasions. And because they're clear, they're nearly invisible to others and so less embarrassing than metal braces.

Whichever method, you'll be under the supervision of a trained dentist or orthodontist who will monitor your progress and make treatment adjustments as necessary to keep you on course. It takes a lot of skill to make sure the bite fits together correctly. Remember, the plastic aligner is always between your teeth. Making sure your teeth come together is something a dentist must supervise or else it may not allow your teeth to fit together properly. In the end, you could have an entirely new smile that's healthier and more attractive—let's just make sure the bite is correct as well.

If you would like more information on gaining a straighter, more attractive smile, 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 “The Magic of Orthodontics: The Original Smile Makeover.”

By Oxford Dental Associates
November 22, 2019
Category: Dental Procedures
Tags: dental implant  
GettingaNewToothinOneDayWillDependonYourBoneHealth

If you've thought the ads for a “new tooth in one day” seemed too good to be true, we have…sort of good news. You can get a new “tooth” in one visit, but only if your dental situation allows it.

The restoration in question is a dental implant, a metal post (usually titanium) surgically imbedded into the jawbone. They're especially durable because bone cells naturally grow and adhere to an implant's titanium surface, a process called osseointegration. Over time this process creates a strong bond between implant and bone.

Usually, we allow a few weeks for the implant to fully integrate with the bone before attaching the visible crown. With “tooth in one day,” though, we attach a crown at the same time as we install the implant, albeit a temporary crown. It's more aesthetic than functional, designed to avoid biting forces that could damage the implant while it integrates with the bone. When that process finishes, we'll install a permanent porcelain crown.

The health of your supporting bone and other structures will largely determine whether or not you're a candidate for this “tooth in one day” procedure. Your bone must be sufficiently healthy, as well as the gums surrounding the implant and the tooth's bony socket.

If, on the other hand, you have significant bone loss, gum recession or socket damage, we may first need to deal with these, usually by grafting tissue to the affected areas to stimulate new growth. Your implant, much less a temporary crown, will likely have to wait until the affected tissues have healed.

The bone can also be healthy enough for implant placement, but might still need time to integrate with the implant before attaching any crown. Instead, we would suture the gums over the implant to protect it, then expose and attach a permanent crown to the implant a few weeks later.

Obtaining even a temporary crown the same day as your implant can do wonders for your appearance. A more important goal, though, is a new tooth that you can enjoy for many, many years. To achieve that may mean waiting a little longer for your new beautiful smile.

If you would like more information on restoring missing teeth with dental implants, 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 “Implant Timelines for Replacing Missing Teeth.”

By Oxford Dental Associates
November 12, 2019
Category: Oral Health
Tags: oral health  
KeepOralCareinFocusforaFamilyMemberWithSpecialNeeds

Thanksgiving is an appropriate time to spotlight an often unsung group: individuals providing primary care for another family member. During November, National Family Caregivers Month recognizes those caring for children with special needs or senior adults with life challenges—and part of that ongoing care includes watching out for their loved one's oral health.

Keeping teeth and gums healthy requires a concerted personal effort to prevent dental disease. While most of us can handle this on our own, some need assistance. If you're caring for someone like this, be sure you focus on two main areas: daily hygiene and regular dental visits. These are the two foundation stones for preventing tooth decay and gum disease.

The relatively simple tasks of brushing and flossing are crucial for disease prevention—but they can pose a challenge for someone with diminished physical, mental or behavioral capacity. In some cases, you as a caregiver may have to perform the task for them.

But even someone with severe limitations may be able to do these tasks for themselves with some adaptations. For one, choose a place for brushing and flossing that's most comfortable for the person (not necessarily the bathroom) and keep to a routine schedule. Above all, approach the task in a positive and playful way, especially for children.

Choose a toothbrush and flosser that your loved one can easily handle. Flossers are also available with toothbrush-sized grips for those with less manual dexterity. An older person with arthritis may need an extra-large grip or a toothbrush modified with a bicycle handle. As an alternative, both children and older adults may benefit from using an electric toothbrush. Some special needs children can have a gag response to toothpaste, so you may wish to use less or substitute it with a diluted fluoride mouthwash on the brush.

Dry mouth is a concern among many older adults, often due to the medications they take. In fact, hundreds of medications can have dry mouth as a side effect. Saliva serves the important oral health function of washing away food debris and neutralizing acid in the mouth, but when saliva production is low, it is not only uncomfortable—it greatly increases the risk of tooth decay. To help with dry mouth, encourage your loved one to drink more water during the day and ask us to recommend a product that will boost their saliva production. You can also ask their physicians about drug alternatives without dry mouth side effects.

To make dental visits easier, be sure we know about any needs or conditions that might affect their care. If possible, accompany your older family member during their visit: Because health problems often increase with age, even routine visits may be more involved.

We understand that caring for family members who need assistance can be demanding, with needs often being prioritized. We urge you to keep dental care on the high-priority list—it could make a difference with the rest of their health and overall quality of life.

If you would like more information about oral care for a family member with special needs, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Aging and Dental Health.”

By Oxford Dental Associates
November 02, 2019
Category: Dental Procedures
HowShawnMendesandMileyCyrusGotTheirStellarSmiles

The 2019 Grammy Awards was a star-studded night packed with memorable performances. One standout came from the young Canadian singer Shawn Mendes, who sang a powerful duet of his hit song "In My Blood" with pop diva Miley Cyrus. But that duo's stellar smiles weren't always quite as camera-ready as they looked that night.

"I had braces for four and a half years," Mendes told an interviewer not long ago. "There's lots and lots and lots of photo evidence, I'm sure you can pull up a few." (In fact, finding one is as easy as searching "Sean Mendes braces.")

Wearing braces puts Mendes in good company: It's estimated that over 4 million people in the U.S. alone wear braces in a typical year—and about a quarter of them are adults! (And by the way: When she was a teenager, Miley Cyrus had braces, too!)

Today, there are a number of alternatives to traditional metal braces, such as tooth-colored braces, clear plastic aligners, and invisible lingual braces (the kind Cyrus wore). However, regular metal braces remain the most common choice for orthodontic treatment. They are often the most economical option, and can be used to treat a wide variety of bite problems (which dentists call malocclusions).

Having straighter teeth can boost your self-confidence—along with helping you bite, breathe, chew, and even speak more effectively. Plus, teeth that are in good alignment and have adequate space in between are easier to clean; this can help you keep your mouth free of gum disease and tooth decay for years to come.

Many people think getting braces is something that happens in adolescence—but as long as your mouth is otherwise healthy, there's no upper age limit for orthodontic treatment. In fact, many celebrities—like Lauren Hutton, Tom Cruise and Faith Hill—got braces as adults. But if traditional braces aren't a good fit with your self-image, it's possible that one of the less noticeable options, such as lingual braces or clear aligners, could work for you.

What's the first step to getting straighter teeth? Come in to the office for an evaluation! We will give you a complete oral examination to find out if there are any problems (like gum disease or tooth decay) that could interfere with orthodontic treatment. Then we will determine exactly how your teeth should be re-positioned to achieve a better smile, and recommend one or more options to get you there.

If you have questions about orthodontic treatment, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Magic of Orthodontics” and “Lingual Braces: A Truly Invisible Way to Straighten Teeth.”

By Oxford Dental Associates
October 23, 2019
Category: Oral Health
Tags: teeth grinding  
DontPanicOverYourChildsTeethGrindingbutDoKeepanEyeonIt

First the bad news: Those nightly hair-raising sounds are indeed coming from your child’s bedroom—from your child. It’s the result of them grinding their teeth while they sleep.

But here’s the good news: the only likely harm is a lack of sleep members of your household might experience because of it. Teeth grinding is so prevalent among pre-teen children that many healthcare professionals consider it normal. But that doesn’t mean it can’t become a problem, so it’s worth monitoring.

Teeth grinding is part of a family of dental habits known as bruxism. It involves any involuntary movement of the teeth and jaws outside of their intended functions not associated with chewing, speaking or swallowing. Our main concern with any bruxism is the possibility for generating stronger biting forces than normal that could damage teeth and gums and contribute to jaw joint problems.

Teeth grinding can occur in adulthood, with stress seeming to be the major trigger for it. With children, though, it’s believed to be mainly caused by an immaturity of the child’s neuromuscular process that controls chewing. As this matures, most children will tend to outgrow the habit none the worse for wear.

But there are pediatric cases in which the generated biting forces are strong enough to cause damage. Teeth grinding is also prevalent in children who snore or breathe through their mouths, which could be a sign of a serious health condition called obstructive sleep apnea. And certain medications used to treat depression and attention deficit disorder (ADHD) may also contribute to teeth grinding.

Most of the time we can simply let the habit run its course. If, however, the child begins to experience abnormal tooth wear, headaches, jaw pain or other issues believed caused by teeth grinding, we may need to intervene. This could include a plastic night guard the child wears during sleep that prevents the teeth from making solid contact during grinding episodes. And children with signs of airway obstruction should be evaluated by an ear, nose and throat specialist.

It can be irritating or even distressing. But your child’s teeth grinding doesn’t mean you should be alarmed—only that you should keep your eye on it.

If you would like more information on teeth grinding and similar habits, 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 “When Children Grind Their Teeth.”





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