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By Michael W Shields DDS
April 20, 2019
Category: Oral Health
Tags: tmd   tmj disorders   tmj  
ClickingJawWhenShouldYouBeConcerned

Have you noticed a clicking, popping, or grating sound when you open or close your jaw? As many as 36 million U.S. adults experience this phenomenon in one or both of the joints that connect the lower jaw (mandible) to the skull.

While the sounds may be disconcerting, there’s generally no cause for concern in the absence of other symptoms. They’re most likely caused by a harmless shift in the position of the disk inside each temporomandibular (jaw) joint, and it can diminish or disappear entirely over time. But, if you’re also experiencing persistent discomfort, severe pain, or limited function in your jaw (which can include getting it “stuck” in an opened or closed position), then you may be suffering from a temporomandibular joint disorder — part of a complex set of conditions affecting one or both jaw joints, muscles and/or other surrounding tissues. (You may have heard the condition called TMJ, which is actually the abbreviation for the temporomandibular joint itself. Health care professionals prefer TMJD or TMD.)

Depending on the severity, TMD can interfere with your ability to speak, chew and even make facial expressions. The cause is unclear, but genes, gender, environment, stress and behavior are believed to play a role. It can also be symptomatic of a larger medical problem, such as fibromyalgia, which can produce pain all over the body.

Management Options for TMD

TMD traditionally was viewed as a bite problem (malocclusion) requiring mechanical correction — e.g., through orthodontic braces or surgery. But the current therapeutic model approaches TMD as an orthopedic problem (joint inflammation, muscle soreness, strained tendons and ligaments, and disk damage) and favors a sequence of conservative, reversible procedures — hot or cold compresses in the jaw area, soft foods, physical therapy/massage, medication, and/or a bite guard to decrease pressure on jaw joints from tooth clenching and grinding — prior to more aggressive, irreversible treatment alternatives.

If you would like more information about TMD, please contact us or schedule an appointment for a consultation. You can also learn more about the subject by reading the Dear Doctor magazine articles “Seeking Relief from TMD” and “Chronic Jaw Pain and Associated Conditions.”

ThereareGoodReasonstoCheckYourBloodPressureDuringDentalVisits

There are a lot of opportunities to have your blood pressure checked: your doctor's office, of course; your local pharmacy; health fairs; and the dentist's office. The last one might surprise you, but blood pressure monitoring before a dental examination or office visit has become quite routine.

Why all this attention to blood pressure? Because chronic high blood pressure (hypertension) is a major cause for cardiovascular disease (CVD), a family of life-threatening conditions that affects 80 million people in the United States. And, you may not even be aware you have it.

That's why avenues for blood pressure screening are on the rise, and the dental office is a prime opportunity. Since you see us regularly for cleanings and checkups (you do, don't you?), there's a good chance we might help you become aware you have a problem if we perform blood pressure readings.

One study published by the Journal of the American Dental Association, for example, followed a group of dental patients with no previous risk factors of CVD, and who had not seen a doctor in the previous twelve months. Through blood pressure screening at their dental visits, 17% discovered they had high blood pressure and at risk for a cardiovascular event.

Your blood pressure can also have an effect on your oral health, especially if you're taking medication to control it. Some medications can cause reduced saliva flow, which could drastically increase your chances of developing tooth decay or periodontal (gum) disease. We would also need to exercise care during dental procedures with certain local anesthetics: some may cause both your pulse and blood pressure to rise.

Although we're primarily focused on your dental care, we also know it's only one aspect of your overall health. By simply including blood pressure checks during your checkup, we may help you identify a problem before it causes you greater health problems in the future.

If you would like more information on blood pressure and dental health, 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 “Monitoring Blood Pressure.”

By Michael W Shields DDS
March 31, 2019
Category: Oral Health
Tags: nutrition  
NutritionfortheBestOralHealth

It's National Nutrition Month! Good nutrition is key to overall health, but poor dental health can have a big impact on your ability to get the right nutrients. Your mouth is the first step in the digestive system, so if teeth and gums are in poor shape, food choices can be severely limited. Here are some nutritional guidelines that will benefit your oral health as well as your overall health.

Get plenty of fruits and vegetables. Plant foods provide many oral health benefits:

  • Crunchy fruits and vegetables scrub debris from your teeth during chewing and stimulate the production of saliva, which neutralizes acid and helps rebuild tooth enamel.
  • Dark, leafy greens are a good source of iron, calcium and many vitamins that are good for your teeth and gums.
  • Several fruits have vitamin C, an essential for healthy gums.
  • Bananas have magnesium, which builds tooth enamel.
  • Many yellow and orange fruits supply vitamin A, which keeps the soft membranes in your mouth healthy.

Go for dairy. Dairy products—for example, cheese, milk and unsweetened yogurt—neutralize acid as well as contribute tooth- and bone-strengthening minerals such as calcium and phosphorus.

Eat whole grains. An excess of refined carbohydrates can lead to chronic inflammation, which contributes to gum disease and many other ailments. However, the complex carbohydrates found in whole grains work against inflammation.

Incorporate all food groups. Strive to eat a balanced diet that includes healthy foods from all food groups. For example:

  • Lean proteins are essential for keeping your teeth and gums healthy.
  • Good fats such as those found in salmon and nuts work against inflammation. In addition, nuts stimulate the production of saliva and contain vitamins and minerals to keep teeth strong.
  • Legumes are a great source of many tooth-healthy vitamins and minerals.

Limit sugary or acidic foods and beverages. Acid from certain foods and beverages can weaken tooth enamel, leading to cavities. The bacteria in your mouth feed on sugar and release acid that eats away at tooth enamel, causing cavities. How you eat and drink also affects dental health. For example, if you indulge in sugary treats, do so with a meal if possible so that other foods can help neutralize the acid. And if you drink lemonade or soda, don't brush your teeth immediately afterwards. Instead, wait at least 30 minutes before brushing to give your saliva a chance to neutralize the acid.

Getting the right nutrition for a healthy body requires good dental health, so it pays to take good care of your teeth. For a lifetime of good oral health, choose foods that keep your teeth and gums healthy, and don't forget to schedule regular dental checkups to make sure your teeth and gums are in great shape. If you have questions about diet and oral health, please contact us or schedule an appointment for a consultation.

By Michael W Shields DDS
March 21, 2019
Category: Dental Procedures
ArianaGrandeBreaksFree-ofHerWisdomTeeth

Via a recent Instagram post, pop diva Ariana Grande became the latest young celebrity to publicly acknowledge a dental milestone: having her wisdom teeth removed. The singer of hits such as “Break Free” and “Problem” posted an after-surgery picture of herself (wearing her signature cat-eye eyeliner), with a caption addressed to her teeth: “Peace out, final three wisdom teeth. It’s been real.”

With the post, Grande joined several other celebs (including Lily Allen, Paris Hilton and Emile Hirsch) who have shared their dental surgery experience with fans. Will "wisdom teeth removal" become a new trending topic on social media? We aren’t sure — but we can explain a bit about the procedure, and why many younger adults may need it.

Technically called the “third molars,” wisdom teeth usually begin to emerge from the gums between the ages of 17 and 25 — presumably, around the same time that a certain amount of wisdom emerges. Most people have four of these big molars, which are located all the way in the back of the mouth, on the left and right sides of the upper and lower jaws.

But when wisdom teeth begin to appear, there’s often a problem: Many people don’t have enough space in their jaws to accommodate them. When these molars lack sufficient space to fully erupt (emerge), they are said to be “impacted.” Impacted teeth can cause a number of serious problems: These may include pain, an increased potential for bacterial infections, periodontal disease, and even the formation of cysts (pockets of infection below the gum line), which can eventually lead to tooth and bone loss.

In most cases, the best treatment for impacted wisdom teeth is extraction (removal) of the problem teeth. Wisdom tooth extraction is a routine, in-office procedure that is usually performed under local anesthesia or “conscious sedation,” a type of anesthesia where the patient remains conscious (able to breathe normally and respond to stimuli), but is free from any pain or distress. Anti-anxiety medications may also be given, especially for those who are apprehensive about dental procedures.

So if you find you need your wisdom teeth extracted, don’t be afraid to “Break Free” like Ariana Grande did; whether you post the results on social media is entirely up to you. If you would like more information about wisdom tooth extraction, please call our office to schedule a consultation. You can learn more in the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”

ASmileMakeoverDependsonBalancingTechniquewithBeauty

“Redesigning” a smile is a lot like remodeling a house: the technicalities of construction must blend seamlessly with what is perceived as elegant and beautiful. The first aspect — the proper materials and techniques to achieve a sound restoration — is absolutely crucial. But the aesthetic is just as important for assuring the final restoration evokes beauty and style.

Balancing these two aspects of a smile makeover requires thoughtful intent and planning. What may be pleasing aesthetically may not be technically feasible; but what may be technically sound may not have that sought-after “curb appeal.”

You and your dentist must work together to achieve the successful blending of these two aspects. That’s why it’s important for you to have full confidence in your dentist: that he or she is both technically skilled and experienced in cosmetic procedures and artistically aware of what will look best aesthetically.

The first step in your makeover is a thorough dental examination to determine the overall state of your oral health. With this “bigger picture,” your dentist will have a better understanding of what’s possible and practical for you and your situation. The exam may also reveal problems that should be treated first before any cosmetic work.

From there, you must communicate clearly to your dentist what you perceive as wrong with your smile and what you would like to have changed. While there are general principles of beauty best followed, your dental work could hypothetically take different paths depending on your desires and expectations. You might prefer a more “sexy” look or one that’s “sophisticated.” Or perhaps you only want subtle changes that still retain features expressing your individuality.

Ultimately, though, your expectations must line up with reality. Much like your house contractor, your dentist will advise you on what’s both practical and possible. And with their experience in smile enhancement, they can also help you determine what will look most attractive given your facial structure and features.

With this preliminary planning, you can be confident as the work proceeds that the end of the project will be both exciting and satisfying. And just as with your newly renovated home, you’ll be more than happy to share your smile with others.

If you would like more information on enhancing your smile through cosmetic dentistry, 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 “Beautiful Smiles by Design.”





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