By Dr. Edwin J. Szczepanik, D.M.D.
December 07, 2018
Category: Dental Procedures
Tags: orthodontics   braces  
3QuestionsYouShouldAskBeforeUndergoingAdultOrthodontics

Think you're too old to have your teeth straightened? While we automatically pair “teenager” with “braces,” at least one in five orthodontic patients are adults. And there's many more that could benefit, as many as three-quarters of adults with a correctable bite problem.

But although orthodontics can be performed at any age, it's not a minor undertaking. It will require time, patience and expense. So, before you decide to undergo orthodontics, here are 3 simple questions to ask first.

Why? Like children and teenagers, adults can benefit cosmetically from correcting a poor bite. But there's another great reason besides a more attractive smile: misaligned teeth are more difficult to care for than normal teeth. Orthodontic treatment is an investment and potential cost-saver in your future dental health.

Why not? Even senior adults can successfully undergo treatment. But braces might be ill-advised if you have either poor oral or general health. Periodontal (gum) disease, for example, can cause bone loss, which makes it difficult to safely and successfully move teeth (and the effort could worsen current disease activity in the gums). Medical conditions like bleeding disorders, leukemia or uncontrollable diabetes could interfere as well. You'll need both a dental and medical examination beforehand.

How? We can use braces — or we might be able to use a newer, more popular option with adults called clear aligners. These are a series of computer-designed clear, plastic trays you wear in sequence until you finish the series. Each tray is slightly smaller than the previous tray, moving the teeth in much the same manner as braces. But unlike braces, you can remove aligners for cleaning or a rare special occasion — and they're much less noticeable than metal braces. Although in some cases braces may still be the best option, it's also possible clear aligners could be the option you've been looking for.

So, are you ready for a new smile and a more maintainable mouth? Visit us for the answers to your questions and see if braces (or clear aligners) can transform your life and health.

If you would like more information on orthodontic treatment for adults, 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 “Orthodontics for the Older Adult.”

By Dr. Edwin J. Szczepanik, D.M.D.
November 27, 2018
Category: Dental Procedures
OrthodontistsAnticipateFutureFacialGrowthWhenTreatingPoorBites

Moving teeth to better positions through orthodontics not only improves dental function and health, it can vastly improve your appearance. But to achieve a result that continues to be attractive as you age requires thorough planning and forethought.

That’s because your body continues to change all during life. While the most accelerated growth happens in childhood and adolescence, even older adults continue to change, especially in their facial features. A good deal of research has helped identify and catalog these changes, which orthodontists now incorporate into their corrective treatments for poor bites (malocclusions).

For example, the lips grow until they reach their maximum thickness in girls usually around age 14 and boys age 16. But researchers have also found lip thickness gradually diminishes for most people beginning in their late teens until about age 80. In other words, the appearance of your lips in your elderly years will be vastly different than in your teens. The same holds true for other facial features: our facial profile flattens as the nose becomes longer and more pronounced while the lower part of the face shortens.

Using this knowledge of the effects of aging on the face, orthodontists now attempt to anticipate “where” the facial features will be decades down the road. This projection can help them design a treatment plan that takes advantage of these projected changes.

For example, orthodontists may begin treatment before a patient’s teenage years with techniques that serve to guide jaw growth. Keeping that development on track will help if or when braces may be needed a few years later. Guiding jaw growth will help shorten the distance of where a patient is in their orofacial development and where they should be later in life with normal development.

Orthodontists aren’t predictors of the future. But armed with an understanding of the aging process, they can help patients head in the right direction to produce a smile and facial appearance that will endure well into later life.

If you would like more information on moving teeth to achieve a more attractive appearance, 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 “Understanding Aging Makes Beauty Timeless.”

By Dr. Edwin J. Szczepanik, D.M.D.
November 17, 2018
Category: Oral Health
Tags: oral health   gum disease  
InflammationtheLinkBetweenGumDiseaseandCardiovascularDisease

Cardiovascular disease and periodontal (gum) disease are two different conditions with their own set of symptoms and outcomes. But they do share one common element: inflammation. In fact, this otherwise normal defensive response of the body might actually create a link between them.

When tissues become damaged from disease or injury, the body triggers inflammation to isolate them from the rest of the body. This allows these tissues to heal without affecting other tissues. If inflammation becomes chronic, however, it can damage rather than protect the body.

This happens with both cardiovascular disease and gum disease. In the former, low-density lipoproteins (LDL or “bad cholesterol”) in animal fat leave behind remnants that can build up within arteries. This stimulates inflammation of the vessel’s inner linings, which accelerates hardening and increases the risk of heart attack or stroke.

With gum disease, bacteria living in a thin, built-up film of food particles on the teeth called plaque infect the gum tissues, which in turn trigger inflammation. A struggle ensures between the infection and inflammation, causing the gum tissues to weaken and detach from the teeth. Coupled with erosion of the supporting bone, the risk of tooth loss dramatically increases.

Recent research now seems to indicate the inflammatory responses from these two diseases may not occur in isolation. There is evidence that gum inflammation could aggravate inflammation in the cardiovascular system, and vice-versa. The research, though, points to some possible good news: treating inflammation in either disease could have a positive effect on the other.

Making heart-friendly lifestyle changes like losing extra weight (especially around the waist), improving nutrition, and exercising regularly can help reduce LDL and lower the risk of arterial inflammation. Likewise for your gums, daily oral hygiene and visiting the dentist at least twice a year reduces the risk for gum disease. And at the first sign of a gum infection—swollen, reddened or bleeding gums—seeking immediate treatment will stop it and reduce any occurring inflammation.

Taking steps to prevent or reduce inflammation brought on by both of these diseases could improve your health and save your life.

If you would like more information on how your oral health affects your whole body, 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 Link between Heart & Gum Disease.”

By Dr. Edwin J. Szczepanik, D.M.D.
November 07, 2018
Category: Oral Health
FifthHarmonysCamilaCabelloChipsaToothbutConcertStillWorthIt

Everyone loves a concert where there's plenty of audience participation… until it starts to get out of hand.├é┬áRecently, the platinum-selling band Fifth Harmony was playing to a packed house in Atlanta when things went awry for vocalist Camila Cabello. Fans were batting around a big plastic ball, and one unfortunate swing sent the ball hurtling toward the stage — and directly into Cabello's face. Pushing the microphone into her mouth, it left the “Worth It” singer with a chipped front tooth.

Ouch! Cabello finished the show nevertheless, and didn't seem too upset. “Atlanta… u wild… love u,” she tweeted later that night. “Gotta get it fixed now tho lol.” Fortunately, dentistry offers a number of ways to make that chipped tooth look as good as new.

A small chip at the edge of the tooth can sometimes be polished with dental instruments to remove the sharp edges. If it's a little bigger, a procedure called dental bonding may be recommended. Here, the missing part is filled in with a mixture of plastic resin and glass fillers, which are then cured (hardened) with a special light. The tooth-colored bonding material provides a tough, lifelike restoration that's hard to tell apart from your natural teeth. While bonding can be performed in just one office visit, the material can stain over time and may eventually need to be replaced.

Porcelain veneers are a more long-lasting solution. These wafer-thin coverings go over the entire front surface of the tooth, and can resolve a number of defects — including chips, discoloration, and even minor size or spacing irregularities. You can get a single veneer or have your whole smile redone, in shades ranging from a pearly luster to an ultra-bright white; that's why veneers are a favorite of Hollywood stars. Getting veneers is a procedure that takes several office visits, but the beautiful results can last for many years.

If a chip or crack extends into the inner part of a tooth, you'll probably need a crown (or cap) to restore the tooth's function and appearance. As long as the roots are healthy, the entire part of the tooth above the gum line can be replaced with a natural-looking restoration. You may also need a root canal to remove the damaged pulp material and prevent infection if the fracture went too far. While small chips or cracks aren't usually an emergency (unless accompanied by pain), damage to the tooth's pulp requires prompt attention.

If you have questions about smile restoration, please contact us and schedule an appointment. You can read more in the Dear Doctor magazine articles “Porcelain Veneers: Strength & Beauty As Never Before” and “Porcelain Crowns & Veneers.”

By Dr. Edwin J. Szczepanik, D.M.D.
October 28, 2018
Category: Dental Procedures
Tags: tooth decay   gum disease  
StopRootCavitieswithPreventionandPromptTreatment

Tooth decay is a highly destructive dental disease, responsible along with periodontal (gum) disease for most adult tooth loss. And we become even more susceptible to it as we get older.

One form of decay that’s especially prominent among senior adults is a root cavity. Similar to a cavity in the crown (visible tooth), this form instead occurs at or below the gum line in the roots. They happen mainly because the roots have become exposed due to gum recession, a common consequence of periodontal (gum) disease and/or brushing too hard.

Exposed roots are extremely vulnerable to disease because they don’t have the benefit of protective enamel like the tooth crown, covered instead with a thin and less protective mineral-like material called cementum. Normally, that’s not a problem because the gums that would normally cover them offer the bulk of the protection. But with the gums receded, the roots must depend on the less-effective cementum for protection against disease.

Although we treat root cavities in a similar way to those in the crown by removing decayed structure and then filling them, there’s often an added difficulty in accessing them below the gum line. Because of its location we may need to surgically enter through the gums to reach the cavity. This can increase the effort and expense to treat them.

It’s best then to prevent them if at all possible. This means practicing daily brushing and flossing to remove bacterial plaque, the thin, built-up biofilm on teeth most responsible for both tooth decay and gum disease. You should also visit your dentist at least twice a year for professional cleanings and advanced prevention methods like topical fluoride to strengthen any at-risk teeth.

You should also seek immediate treatment at the first sign of gum disease to help prevent gum recession. Even if it has occurred, treating the overall disease could help renew gum attachment. We may also need to support tissue regeneration with grafting surgery.

Root cavities are a serious matter that could lead to tooth loss. But by practicing prevention and getting prompt treatment for any dental disease, you can stop them from destroying your smile.

If you would like more information on diagnosing and treating root cavities, 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 Cavities: Tooth Decay near the Gum Line Affects Many Older Adults.”





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