My Blog

By C. Roger Macias Jr., DDS
July 04, 2019
Category: Oral Health
3WaystoProtectYourTeethintheGreatOutdoors

It’s July—and that means it’s National Park and Recreation Month! If you’re like a lot of families, you might already be planning a trip to one of the nation’s 58 national parks, or one of the thousands of state outdoor recreational areas across the country.

Temporarily escaping the stresses of daily life in the great outdoors is a wonderful way to refresh both the soul and the body. But that’s not an excuse to neglect all your responsibilities. That includes making provisions to care for your teeth while you’re away from home—you are bringing them with you, aren’t you?

Here are three ways you can take care of your teeth during your outdoor getaway.

Keep up your daily hygiene. While you’re packing extra socks, granola and moleskin, be sure to include your toothbrush, toothpaste and floss. Just a few days of neglecting your regular oral hygiene can give bacterial plaque a chance to build up. You could even come back from your trip with the beginnings of gingivitis, an early form of gum disease. If you’re trying to pack light, take along travel-size toothpaste tubes or pre-threaded floss picks to make it easier.

Eat dental-friendly snacks and food. Escaping your usual dietary choices doesn’t mean you should take a vacation from good nutrition. Whether you’re in camp or on the trail, eat whole fruits, grains or cheeses, and avoid snacks and foods with added sugar that feeds disease-causing bacteria in the mouth. The same goes for beverages—keep your intake of sodas and sports or energy drinks (all loaded with added sugar and acid) to a bare minimum. Instead, hydrate with water.

Be prepared for emergencies. Exploration through hiking, canoeing and other physical activities is a great part of the outdoor park experience. But it also increases your risk of injury, especially in rough terrain. Before you head out, take some time to research medical and dental resources near your vacation destination in case you or a family member will need immediate care. Having that information handy can save time in the event of an emergency.

An outdoor park trip can be the experience of a lifetime. Just be sure to follow these simple tips to care for and protect your teeth. Doing so will help ensure that your memories of this summer’s outing will be pleasant ones.

If you would like more information about caring for your dental health at home or away, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Daily Oral Hygiene.”

By C. Roger Macias Jr., DDS
June 24, 2019
Category: Oral Health
Tags: snoring   sleep apnea  
SleepApneaandBehavioralProblemsinChildrenHowYourDentistCanHelp

We all know how much better we feel after a good night’s sleep: refreshed, energized and ready to handle — even excel at — our day-to-day responsibilities. Yet millions of people, young and old, are robbed of a good night’s rest by sleep-related breathing disorders such as sleep apnea, in which the soft tissues in the back of the throat block the airway during sleep. This temporarily disrupts airflow, causing numerous “micro-arousals” (sleep interruptions) that we may not even be aware of. A lack of sleep can make us drowsy, irritable and unfocused. In children, these typical symptoms of sleep apnea can lead to mistaken diagnoses of Attention Deficit Hyperactivity Disorder (ADHD).

The relationship between sleep apnea and behavioral problems has been highlighted in several recent scientific journal articles, including a major study published several years ago in Pediatrics, the official journal of the American Academy of Pediatrics. The lead author, Dr. Karen Bonuck, said at the time: “We found that children with sleep-disordered breathing were from 40 to 100 percent more likely to develop neurobehavioral problems by age 7, compared with children without breathing problems. The biggest increase was in hyperactivity, but we saw significant increases across [other] behavioral measures.” Therefore, an accurate diagnosis of a child’s behavioral problems — leading to the right treatment — is crucial. While sleep apnea must be diagnosed by a physician, treatment for the condition is often provided by a dentist.

What can be done for children suffering from sleep apnea? The most common treatment is surgical removal of the tonsils or adenoids. This treatment can sometimes be performed by an oral and maxillofacial surgeon, a dentist who has received several years of post-graduate surgical training. There are several other procedures oral surgeons can perform to open the airway, depending on what anatomical structures are blocking it.

Sometimes a child with sleep apnea can benefit from a procedure to expand the palate (roof of the mouth) to enlarge the airway. This is not a surgical treatment but rather an orthodontic one. An orthodontist (a dentist who specializes in moving teeth) will fit the child with a palatal expander, a butterfly-shaped device that gradually separates the two bones that form the upper jaw and roof of the mouth. This is often done to prevent crowding of teeth and other bite problems, but has been shown in some cases to improve airflow.

There is another dental approach used to treat adults and older children, whose jaw growth is complete. It’s called oral appliance therapy, and it involves wearing a custom-made device during sleep that resembles a sports mouthguard or orthodontic retainer. An oral appliance can maintain an opened, unobstructed, upper airway during sleep in various ways, including: repositioning the lower jaw, tongue, soft palate and uvula; stabilizing the lower jaw and tongue; increasing the muscle tone of the tongue.

If your child has been diagnosed with sleep apnea, we can help you find the best treatment approach. For more information, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Sleep Disorders & Dentistry” and “Snoring & Sleep Apnea.”

By C. Roger Macias Jr., DDS
June 14, 2019
Category: Dental Procedures
BeontheLookoutforTheseCommonBiteProblemsinChildren

Somewhere around age 6, your child’s primary (baby) teeth will begin to give way to their permanent set. If all goes well, you’ll notice all the front teeth erupting in the right position: the top teeth slightly overlapping the bottom and all coming in without crowding.

Sometimes, though, the process doesn’t occur as it should and a bad bite (malocclusion) may develop. You can get a head start on treatment if you know what to look for. Here are a few problems for which you should see a dentist — or more likely an orthodontist — for a thorough evaluation.

Spacing problems. Teeth should normally come in right next to each other without a noticeable gap. But if you notice excessive space between the permanent front teeth especially, this may be an indication there’s a discrepancy in size between the teeth and the jaws. At the other end of the spectrum, if teeth on the same arch appear to overlap each other, this indicates crowding in which there’s not enough space for the teeth to erupt properly.

Bad bites. Malocclusions can take different forms. In an underbite, the front bottom teeth bite in front of the upper teeth. If there’s a noticeable gap between the upper and lower teeth when the jaws are closed, this is known as an open bite. Front teeth biting too far down over the lower teeth is a deep bite and could even include biting into the soft tissue of the hard palate. Cross bites can occur in either the front or back teeth: if in the front, some of the lower teeth will bite in front of the upper; if in the back, some of the lower teeth bite outside the upper rather than normally on the inside.

Abnormal eruptions. You should also be alert for protusions, in which the upper teeth or the jaw appears to be too far forward, or retrusions, in which the lower teeth or jaw appears to be too far back. You should also be concerned if permanent teeth erupt far from their normal position — this is especially likely if the primary tooth was also out of position, or was lost prematurely or not in the right order.

If you would like more information on monitoring your child’s dental health, please contact us or schedule an appointment for a consultation.

By C. Roger Macias Jr., DDS
June 04, 2019
Category: Oral Health
LifeIsSometimesaGrindforBrookeShields

Ever since childhood, when her career as a model and actress took off, Brooke Shields has enjoyed worldwide recognition — through advertisements for designer jeans, appearances on The Muppet Show, and starring roles in big-screen films. But not long ago, that familiar face was spotted in an unusual place: wearing a nasal anesthesia mask at the dentist's office. In fact, Shields posted the photo to her own Instagram account, with the caption “More dental surgery! I grind my teeth!” And judging by the number of comments the post received, she's far from alone.

In fact, researchers estimate that around one in ten adults have dental issues that stem from teeth grinding, which is also called bruxism. (Many children also grind their teeth, but it rarely causes serious problems, and is often outgrown.) About half of the people who are teeth grinders report problems like persistent headaches, jaw tenderness and sore teeth. Bruxism may also result in excessive tooth wear, and may damage dental work like crowns and bridges; in severe cases, loosened or fractured teeth have been reported.

Researchers have been studying teeth grinding for many years; their findings seem to indicate that it has no single cause. However, there are a number of factors that play a significant role in this condition. One is the anatomy of the jaw itself, and the effect of worn or misaligned teeth on the bite. Another factor relates to changes in brain activity that occur during the sleep cycle. In fact, nocturnal (nighttime) bruxism is now classified as a sleep-related movement disorder. Still other factors, such as the use of tobacco, alcohol and drugs, and a high level of stress or anxiety, can make an individual more likely to experience bruxism.

What can be done for people whose teeth grinding is causing problems? Since this condition may have many causes, a number of different treatments are available. Successful management of bruxism often begins by striving to eliminate the factors that may cause problems — for example, making lifestyle changes to improve your health, creating a soothing nighttime environment, and trying stress-reduction techniques; these may include anything from warm baths and soft music at bedtime, to meditation and mindfulness exercises.

Several dental treatments are also available, including a custom-made occlusal guard (night guard) that can keep your teeth from being damaged by grinding. In some cases, a bite adjustment may also be recommended: In this procedure, a small amount of enamel is removed from a tooth to change the way it contacts the opposite tooth, thereby lessening the biting force on it. More invasive techniques (such as surgery) are rarely needed.

A little tooth grinding once in a while can be a normal response to stress; in fact, becoming aware of the condition is often the first step to controlling it. But if you begin to notice issues that could stem from bruxism — or if the loud grinding sounds cause problems for your sleeping partner — it may be time to contact us or schedule an appointment. You can read more about bruxism in the Dear Doctor magazine article “Stress and Tooth Habits.”

By C. Roger Macias Jr., DDS
May 25, 2019
Category: Oral Health
Tags: fluoride  
TopicalFluorideCouldFurtherLowerToothDecayRiskinChildren

Since the discovery a century ago of its beneficial effect on tooth enamel, fluoride has become an important part of tooth decay prevention. It's routinely added to toothpaste and other hygiene products, and many water utilities add minute amounts of it to their drinking water supplies. Although there have been questions about its safety, multiple studies over the last few decades have eased those concerns.

Children especially benefit from fluoride during their teeth's developing years. Some children are at high risk for decay, especially an aggressive form known as Early Childhood Caries (ECC). ECC can destroy primary (baby) teeth and cause children to lose them prematurely. This can have an adverse effect on incoming permanent teeth, causing them to erupt in the wrong positions creating a bad bite (malocclusion).

For children at high risk for decay, dentists often recommend applying topical fluoride directly to the teeth as added protection against disease. These concentrations of fluoride are much higher than in toothpaste and remain on the teeth for much longer. Topical applications have been shown not only to reduce the risk of new cavities, but to also stop and reverse early decay.

Children usually receive these applications during an office visit after their regular dental cleaning. There are three different ways to apply it: gel, foam or varnish. To prevent swallowing some of the solution (which could induce vomiting, headache or stomach pain) the dentist will often insert a tray similar to a mouth guard to catch any excess solution. Varnishes and a few gels are actually painted on the teeth.

The American Dental Association has intensely studied the use of topical fluoride and found its application can result in substantial decreases in cavities and lost teeth. They've concluded this benefit far outweighs the side effects from ingesting the solution in children six years and older. With proper precautions and waiting to eat for thirty minutes after an application, the possibility of ingestion can be reduced even further.

While topical fluoride can be effective, it's only one part of a good dental care strategy for your child. Consistent daily brushing and flossing, a nutritious diet low in added sugar, and regular dental visits still remain the backbone of preventive care.

If you would like more information on fluoride applications for your child, please contact us or schedule an appointment for a consultation.





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