Can Bruxism be affected by medications.

While most dentists treat bruxism using night guards,and stress management techniques, a number of studies have shown that medications can affect bruxism. One study of bruxers has indicated that clonidine may be an effective medicine to lesson bruxism. It may work by prolonging stage 2 sleep and suppressing REM sleep.

Other studies have shown that SSRI's(antidepressents) can cause an increase in bruxism and suggested that either lessoning the dose of the SSRI or prescribing Buspirone may help.

Most dentists do not prescribe the above mentioned medicines and if you are taking an antidepressant or would like to find out about clonidine, it would be a good idea to ask your physician. If they are unaware of the use of these medicines and their effects on bruxism you can refer them to this post and the links it provides to peer review articles.

Do Whitening Toothpastes Work?

Yes and no. They do work by removing external stains on teeth, but they do not seem to actually 'bleach' the teeth the way peroxide based treatments work. Even the tooth paste formulas that include peroxide may not work well, since peroxide when mixed with toothpaste is not stable and degrades rapidly over time.

The best way to whiten your teeth still involves applying a gel with either hydrogen peroxide or carbamide peroxide on the teeth. There are a number of commercial preparations available over the counter or you can use a technique offered by your dentist. Most dentists offer either chairside whitening(in an hour or so) or can make custom trays that when worn with carbamide peroxide inside will gently whiten teeth over time.

What are the advantages of Digital Radiography?

Well, our office has been using the digital radiography since September of 2009 and I thought this topic might be good one for a blog post.

For sure, not having to develop film saves a lot of time every day and my patients almost universally approve of my upgrade to digital radiography. They like being able to easily view images of their teeth and are happy when they hear that the images are achieved with much lower radiation settings. This is the most obvious advantage of digital radiography; Patients receive a much lower dose of radiation than they would from the use of traditional X ray films. I find I can produce usable images with a third of the radiation that I used to produce film images.

Another feature of digital radiography is their ability to easily produce enlarged images of the teeth. In the last year I have found that found that showing enlarged images of their teeth to patients makes it much easier for them to understand my treatment recommendations and the digital enhancement features of my software program(Dexis) I use can help with the visualization of problems.

I also appreciate of the ease of emailing these images to specialists. I am able to get almost "instant second opinions" for my patients. Almost every day I send a radiograph to either my endodontist, periodontist or oral surgeon, in order to get their input for one of my patients. This is a great service since not only do my patients not have to pay an additional fee for the consultation, but prior to this I would have mailed their film to the specialist and I would have waited several days for the feedback.

Although I must confess that I sometimes miss the "richness" old fashioned film produced images, there is no going back for me. The advantages of digitally produced dental images far out way any disadvantages and I am fully commit ed to this new digital age!

Have you taken any good continuing education courses lately?

I've just come back from the Scottsdale Center for Dentistry. I attended a three day course by Frank Spear named "Treating the Worn Dentition". The information was well organized and helpful not only in better understanding some of the different causes of tooth wear , but also Dr. Spear presented different strategies he uses to treat successfully repair and restore different kinds of wear. I give his course a "Thumbs up". His presentation was interesting and well organized. Scottsdale is beautiful and I enjoyed visiting there as well!

What is a "UCLA" temporary crown?

"UCLA" crowns are a term for implant crowns that screwed directly into an implant without any intermediate abutment. They can fabricated as temporary or permanent implant crowns. In my practice, when I am restoring an implant in the "esthetic zone"(Premolar- Pemolar) I utilize these as interim restorations in order to help develop a gingival contour around the crown. When the gingiva is mature, I will then take a fixture level impression and have a custom abutment and a permenent crown fabricated.

Can crowns be as cosmetic as porcelain veneers are?

What makes porcelain veneers appear natural is that they can be made to appear transluscent and look like real teeth. Bonded porcelain crowns can also be made to look this way. In the photo above the left central is covered with a natural looking bonded porcelain crown. It is hard to tell its not real!