6TA y E DENTAL

Orthopedics is part of dentistry where the treatments can be done with removable or fixed apparatus. The ideal age to start is between 8 and 10 years old, but it can be done since age 3 eliminating habits, like sucking your finger, sucking your lip or tongue, mouth breather.

With the use of retainers, dental and skeletal movements can be attained, which means problems that are related to the size and form of upper and lower teeth can be corrected this way altering the patience profile in a positive way. Usually brackets are used when finishing orthopedics.

Periodontics refers to the illnesses that take place “around” the tooth that is, the gum, the bone and the ligament. These illnesses are known as gingivitis, periodontitis or periodontal disease and in most cases do not produce pain.

Periodontal disease is so aggressive that compromises the immune system 24 hours a day. Even though it is very frequent a lot of dentists are unaware that it must be treated before starting other treatments, like crowns or implants. In cases, where it is known that the patient is diagnosed with diabetes, hypertension, circulatory or heart problems, it must be considered as a priority.

The key for controlling this illness is when the patient is more proactive with his dental hygiene at home. This is achieved with education on our behalf with the appropriate care of your mouth promoting the health area with natural remedies and products, and choosing the right vitamins and nutritional supplements as well as their quality.

We are trained to do routine or not complicated dental extractions, but we also know how to recognize our limits in our capacities and judge when it is preferable that the maxillofacial surgeon performs the surgical procedure.

We offer intravenous sedation done by an anesthesiologist medical specialist. Unlike general anesthesia, with sedation the patient enters a semi-sleep state or unconscious with the ability to respond when he is spoken to.

The teeth are organs, the same as your heart and your liver, and every time we do a treatment on them, we are aware of the impression it can make on other areas of your body or of your health. That is why we work with biocompatible materials and with a holistic approach relying on natural remedies, vitamins and herbal therapy, oxygen—ozone therapy and, when necessary, on alternative and homeopathic doctors.

These are important questions that some of you may have asked. Others may have been told by their dentist that they are doing it, usually followed up by recommending the use of a mouth guard or night guard. In some circumstances, when a dentist detects signs of clenching and grinding he may recommend crowns, tmj treatment (temporal mandibular joint, located right next to your ear canal), selective  tooth grinding, among other things. I agree on all these treatments as relief for someone who suffers from this malady and I also like to get to the root of the problem, to know why my patient clenches and grinds.

So, let’s start by the title of the problem and take it from there. If you bring your teeth together and all upper and lower teeth are in contact and remain in this position, that’s clenching. If, while holding this position without bringing your teeth apart, you begin to move your mandible back and forth, left and right, even if it’s just a minor movement, then that’s grinding. And a bruxist is the patient who does the combination of both. Simple, right? In my opinion, you can’t be a grinder without being a clencher.

Ok, so let’s go back to the definition of clenching. Take into consideration that your upper teeth should only  make contact with their antagonist lower teeth while 1) chewing, 2) swallowing food, liquids or saliva 3) if you are using a protective guard, like during sports and 4) when your jaw searches for its ‘rest position’, lateral and prognathic movements… technical stuff not worth explaining. So this means that in any other situation other than these four, if you find yourself making upper and lower teeth contact, you are probably a clencher. Think about it, if while reading a book, driving, watching TV., even walking and you catch yourself making teeth contact, you are perhaps a clencher. Then, if after this you move your mandible around, then you are maybe a grinder as well; this normally occurs during the night.

• You wake up feeling like you were chewing gum all night, like if you were lifting weights with your cheek muscles (weird, I know), you feel your whole body relaxed and ready to start your day but you feel your mouth tired.

Personally, reasons #1 through #6 are all the same to me. They all come down to being stressed. Number 7 and 8 need to be attended accordingly. In my point of view, the main reason why the majority of people clenches and grinds their teeth is due to stress. Any type of stress, you name it: going through traffic, work, neighborhood, family issues, money, love, losing a love one or your job, expecting a child, winning the lottery, bills, among other. The first question to ask you is: “What could be stressing me out?” If you don’t have an answer, try guessing one. And this is step number 1: Identifying what is stressing you out. It is often the toughest step of all since it involves some deep inner awareness. Step number 2 is to deal with that issue appropriately to bring your level of stress down. It can be something as simple and routine as reading a book all the way to going to Yoga classes. It’s all about identifying what is the cause of stress and then dealing with it ; if it’s done naturally, all the better, although in some cases pharmaceuticals or non pharmaceuticals remedies are necessary. This might include one or many of the following:

Easier said than done, right? Choose one or two that resonates to your lifestyle, something that would be simple for you to do and ease your way into them. So what can I, as a dentist, do for you in the mean time? Offer you a night guard, also called mouth guard or splint.

The guard is not the treatment for bruxism; it’s only a palliative solution while you work on what is stressing you out. The guard does two things for you: 1) keeps from grinding your tooth structure away (you’ll be grinding the acrylic away and you will need to replace it once you puncture through it) and 2) it will reprogram your jaw muscles and tmj to bring your grinding level / force down.

On a personal note, every one of us needs to deal with stress in some way / level or another. Very few people live a stress-free life; I only know of one friend who lives like this, Johnny Blackburn. It is hard to get around stress, especially if it’s waiting for your right around the corner, on the next traffic light or once your reach your office. You cannot control any of these factors; it’s impossible to get rid of them; since you didn’t create them you cannot destroy them. The only thing you CAN control is how YOU are going to react to it. How your body is going to respond to stress…. and here is the magic of it all, you have absolute power over this. You can look stress right in the face and then be cool about it since you now have the information and tools to work on how your body will reply to it.

Periodontal disease or periodontitis is the second stage of a first one, gingivitis. If you have it and do not take care of it, it can escalate to periodontitis, thus being more destructive and even more difficult to control. It can be with or without pain, reason why is considered very aggressive. If detected by your traditional dentist, they will probably offer deep pocket cleanings and antibiotic remedies as a treatment.

The approach that I like to take is, first of all, educating the patient of what this disease consist of. I believe that this is the first and most crucial step of all, having the patient actually understanding what his disease is, how it started and how to treat it at home by changing some routine oral hygiene habits. Think about it. This is an illness that the patient is living with 24/7 and is important that he acknowledges and address this malady with its importance. I consider that treating it is 80% patient compliance along with home care treatments and remedies and 20% dental chairside attention. It is very easy for the traditional dentist to just say “You need several appointment of deep pocket cleanings; after that, I will need to see you 4 times a year to continue with them”. Two things happen when saying this statement: 1) First, the dentist is taking away all sense of wellbeing responsibility from the patient; he is practically saying “I will do all the treatments; there is nothing you can do on your own”. And, 2) the dentist is almost giving a lifelong sentence of ‘deep pocket cleanings’ to him.

The dentist will clean his patient’s teeth, let’s say in about 60 min at the dental chair. But what will happen once the patient steps out of the dental office and has a taco and is not properly instructed on how to keep his deep pockets clean? Exactly, he will turn into a lifetime patient for deep pocket cleanings. A pretty awesome scenario for the dentist, not for the patient.

After educating the patient and providing him with sufficient knowledge to comprehend the whole scenario, he understands how his disease is directly linked with heart conditions and blood circulatory problems, such as diabetes and high blood pressure. You cannot completely take care of one without addressing the other; they go hand in hand.

Part of the education is to offer alternatives to traditional gum disease treatments. Many patients previously diagnosed with this ailment have had treatments and have continued struggling with his problem even after many years have passed since first detected. Gum disease can be controlled and, often, reversed but not if you continue doing your routing oral care habits at home and on the road. My approach is with support from holistic and alternative dentistry, remedies that can help you recover bone loss and receding gum line, often being able to improve deep pockets depths, teeth mobility and reduce tartar formation. Adding Schussler’s cell salts and xylitol into your diet can have a great impact on your oral and systemic health. Working with ozone gas and ozonated water greatly improves the outcome of your treatment. Reviewing the basics also helps a lot, that is to say re-learning how to brush, floss and the type of mouthwash to use.

Feel free to schedule an appointment to have a dental consultation in Tijuana along with gum probing and full dental x ray series to determine if you have gingivitis or periodontitis an to know and learn how to address it with a natural approach and you’ll be on your way to a better, healthier lifestyle.

The wisdom teeth are the last ones to form, they erupt outside the gum approximately around the age of 17 and 22, but if there isn’t enough space in the mouth to fit them or if these molars come in a bad position (inclined) it could cause a lot of discomfort and pain. The most common problems caused by wisdom teeth in a bad position are cavities, either on them or on the tooth next to it, infection, bad breath, gum and crowded teeth problems. Also for being in the back of the mouth brushing becomes more complicating which favours bacteria to accumulate.

In my experience I recommend to extract these molars between the age of 16 and 24, because at this age the roots are less developed and the complications are minimal when removing them. Besides being young the tissue heals up better than when you are an adult.   

We have to keep in mind the reasons why teeth start to turn darker. The first reason is age, because you start to lose the enamel layer and the dentin makes the tooth look more yellow; the second reason is the metal and/or composite restorations. With time, metal starts to pigment the rest of the tooth a greyish color and the composite when turning porous starts to pigment because of the drinks and food we eat. The third reason would be that the tooth has a root canal which devitalizes it and turns it grayish; and lastly the external agents like tobacco, coffee, wine and other tinted foods.

There are two types of teeth whitening, the interior and the exterior; the interior whitening is only done when a tooth has lost its pulp (root canal) turning grayish. The exterior whitening is a procedure that is done the most because of its aesthetic purpose, here we use a 40% hydrogen peroxide based gel which is applied to the surface of the teeth in 2 intervals of 20 minutes each.