A sensitive gag reflex is a source great concern and embarrassment for many people. It's often beyond an individual's ability to control. Children are especially effected be- cause adults may not fully understand how physic- ally difficult it is for them. Kids may be easily embarrassed, particularly if they vomit. Children frequently need a long series of visits, often over a period of years if they require orthodontics (braces). A sensitive gag reflex can be a childhood battle when kids are sick and need to take medications or swallow pills. These events can add up to a series of traumatic episodes that leave the patient with dental phobia as an adult. Patients may also have a gag reflex or intolerance of foreign objects in their mouth relating to a traumatic, abusive past. Intolerance to foreign objects in the mouth, sensitivity to tastes, textures and even foods can also be caused by a condition termed, sensory integration dysfunction.

Fortunately, there are many things we can do to make patients comfortable at the dentist and make dental care available without the fear or embarrassment. Dental visits most often begin with dental x-rays. We can use mouth rinses that dull sensation to help the x-ray process. Panoramic x-rays are also available, where no dental film is placed inside the mouth at all. If need be, all x-rays can be taken while the patient sleeps under sedation. There are techniques with local anesthesia (commonly called novocaine) that can numb the tongue and palate to reduce gagging. Various forms of sedation are available that generally can make patients entirely free from the gag reflex. The purpose of the initial consultation is to learn the needs of the patient and begin to develop a plan of care so that the patient can have their dental care in comfort, their way. I hope that our patients will always be able to tell us how they feel, and what we can do to make them the most comfortable.

When too much tooth structure has been lost due to decay or fracture, the best treatment choice to restore the tooth to normal function and cosmetic appearance is often the fabrication of a crown [cap]. Crowns are usually made of porcelain fused to metal or all-ceramic depending on the situation and judgment of the dentist. The restoration of the damaged tooth becomes more of an esthetic concern if it is located near the front of one's mouth. How we perceive our smile and appearance affects our self-esteem, our moods and how we function in social and business relationships. So, when this situation occurs, there is a sense of urgency.

The tooth is prepared to allow enough room for the crown to fit over the tooth without extending too far and interfering with the person's occlusion [bite]. This procedure usually takes 2 visits, depending on the situation. A provisional acrylic crown is made and temporarily cemented over the tooth. In the second visit, the crown is "tried in" to see how accurately it fits and to check that the ceramic color chosen matches the surrounding teeth. If both the patient and dentist are satisfied, the crown is permanently cemented or bonded to the tooth. Call our office if you think you're a candidate for this type of procedure. 

Dental implants offer people an alternative to the traditional ways of replacing missing teeth. The actual implant is an artificial root [anchor] made from synthetic material, usually titanium metal. There are three phases to the implant process.

First, the dental implant is surgically placed into the jawbone. It takes 3-6 months to fuse with the bone [called osseointegration]. An abutment [post] is attached to the implant and protrudes above the gum tissue. A replacement restoration is cemented or screwed to the implant abutment. Depending on the situation, dental implants can support a fixed crown or bridge or act as a stabilizing base for a full denture. The procedure can take up to 9-12 months for completion and has a high degree of success.

Some individuals have had so much bone resorption [loss] that the remaining bony ridge is too thin to hold an implant. In many cases, synthetic or natural bone can be grafted [added] or grown to allow for dental implants as an alternative treatment.

Implants have a great advantage for people already wearing full dentures since they can support and stabilize the denture while minimizing further bone loss of the denture ridge.

Not everyone is a good candidate for dental implants. There are certain risk factors that may limit success including smoking, excessive alcohol consumption, chronic bruxism [grinding teeth], systemic problems such as diabetes and individuals with poor oral hygiene.

Dental implants offer a "second chance" to those who have lost all of their teeth. For people missing only one or several teeth, dental implants provide benefits as an alternative way to restore your mouth. To determine if implants are for you, a clinical examination, x-rays, study casts and other appropriate records and measurements will be necessary. Call our office if you have questions or would like to schedule an implant exam.

The primary cause of tooth decay [cavities], periodontal [gum] disease and halitosis [bad breath] is failure to remove plaque [sticky mixture of bacteria, food and debris] for the tooth surface. The surest way is mechanical removal of plaque with proper toothbrushing and flossing. While a toothbrush is effective in cleaning the biting, front and back surfaces of a tooth, the bristles cannot adequately clean between the teeth [interproximally or interdentally]. Dental floss is the best choice to remove plaque from these difficult areas. Floss, which is like a fine string, is available in a variety of forms – unwaxed or waxed, flavored or unflavored and regular or wide [dental tape]. These specifications give the floss different characteristics. For example, waxed floss may be easier to slide through tight teeth or restoration contacts, while unwaxed floss will spread out it fibers during use for greater tooth contact. Dental floss should be used at least once a day for 2-3 minutes. It’s important to be consistent, starting in the same place and working your way around the dental arch so as not to miss any spots. For individuals who have fixed restorations in their mouth, floss threaders may be utilized to get the floss under the contacts of the bridge. Pre-threaded floss holders are available for people who lack dexterity or for those caregivers who are flossing someone else’s teeth. While there are many types of interdental cleaners, dental floss remains the best choice for relatively healthy mouths. If you need some help with your flossing technique, ask our hygienist at your next visit. Depending on the condition of your mouth, we may suggest some other home care ideas.

Clicking or popping could mean trouble, that is if it comes from your jaw. Joint sound is one of the most recognized signs of temporomandibular disorders, commonly referred to as TMD. While not all jaw sounds necessarily point to TMD, it could be an early sign and always should be checked out by your dentist, urges the Academy of General Dentistry (AGD), an organization for general dentists dedicated to continuing education.

The temporomandibular joints are the points at which the lower jaw (the mandible) attaches to the skull. They are among the most complex joints in the human anatomy. If you place your fingers on the sides of your face, just in front of your ears, and open and close your mouth, you can feel the movement of the mandible in the temporomandibular joints.

Researchers have discovered that sound can be a good tool when diagnosing TMD. Sounds from subjects with TMD had a larger amplitude than sounds fromsubjects without the disorder.

"Joint sound for some people is normal, but it could still mean trouble," says AGD spokesperson Julie Ann Barna, DMD. "The difference between healthy jaw movement and TMD is said to be only one millimeter."

Dr. Barna says that if TMD is diagnosed, a team approach to therapy by a dentist and physical therapist leads to effective treatment. She advises that patients should contact their dentist as soon as they notice any new joint sound or discomfort in the mouth. "It may be nothing," she says. "But it's better to be safe than sorry."