Everything Dental by Joel Mickelwait Mt. Vernon, WA

Gum Disease

2010-05-22T21:16:00.000-07:00

If you have been told you have periodontal (gum) disease, you're not alone. An estimated 80 percent of American adults currently have some form of the disease.

Periodontal diseases range from simple gum inflammation to serious disease that results in major damage to the soft tissue and bone that support the teeth. In the worst cases, teeth are lost.

Gum disease is a threat to your oral health. Research is also pointing to possible health effects of periodontal diseases that go well beyond your mouth (more about this later). Whether it is stopped, slowed, or gets worse depends a great deal on how well you care for your teeth and gums every day, from this point forward.

Our mouths are full of bacteria. These bacteria, along with mucus and other particles, constantly form a sticky, colorless "plaque" on teeth. Brushing and flossing help get rid of plaque. Plaque that is not removed can harden and form bacteria-harboring "tartar" that brushing doesn't clean. Only a professional cleaning by a dentist or dental hygienist can remove tartar.

The longer plaque and tartar are on teeth, the more harmful they become. The bacteria cause inflammation of the gums that is called "gingivitis." In gingivitis, the gums become red, swollen and can bleed easily. Gingivitis is a mild form of gum disease that can usually be reversed with daily brushing and flossing, and regular cleaning by a dentist or dental hygienist.

TMJ Botox Therapy.

2010-03-27T20:15:00.000-07:00

The most promising and exciting new addition to the dental arsenal against TMJ is having Botox injected into the painful muscles. One single session of injections is curative for 2/3 of patients.

Now there is no need to waste money on TMJ splints or night guards that most patients quickly stop wearing. Instead, you may get relief from TMJ clenching, grinding, and headache pain within a week with therapeutic Botox injections from Dr. Joel Mickelwait at Mickelwait Family Dentistry and Spa. Dr. Swift has been trained in the therapeutic use of Botox for headache pain and other TMJ symptoms by Dr. Louis Malmacher DDS. Dr. Malmacher is a member of the American Academy of Facial Esthetics and founder of Common Sense Dentistry. Dr. Malcmacher was recently a featured smile makeover dentist on the nationally televised The Tony Danza Show and has also been extensively featured in the general media. His interviews have been seen on CNN, Fox, ABC, CBS, NBC, 20/20, Wall Street Journal, New York Times, Jane, Marie Claire, Shape, Washington Post, Cleveland Plain Dealer, Detroit Free Press, GQ, Edge, Newsweek, Prevention, Reader’s Digest, and Men’s Health. Dr. Malmacher is an internationally recognized authority on the utilization of Botulinum Toxin Type A for dental uses and is a speaker and national injector trainer.

Click here to schedule a complimentary Botox®/ TMJ Consultation!

Benefits of Botox® for Dental Patients
The most common benefit of Botox® is the reduction in the number of clenching events and their intensity. This will reduce the destruction of your teeth, gums and jaw joint, and reduce the discomfort and pain in your face and chewing muscles. A beneficial side-effect is the smoothing of lines between the brows and in the forehead. Since the muscles are unable to contract, Botox® may actually prevent new wrinkles from forming. Other benefits are that only the injected areas are affected and results are often seen within 24 - 48 hours. Another possible benefit is that the botulinum toxin does not stay in the body indefinitely, so if there is an adverse effect it is only temporary. There is also the likely possibility that with frequent treatments, the injected muscles will atrophy allowing the patient to go longer and longer between treatments.

Who is an ideal candidate?
Botox® may or may not be the best treatment for the results you desire. An ideal candidate meets the following conditions:

Between the ages of 18-65
Has a dento-facial problem caused by parafunctional muscle activity
Does not object to the disappearance of his/her wrinkles
Is looking for a non-surgical solution
Is looking for a temporary solution
Is knowledgeable about the procedure
Is realistic in expectations
Is in good physical and psychological health
Is not pregnant or nursing

Click here to schedule a free Botox®/TMJ Consultatation with Dr. Mickelwait. The above criteria are not comprehensive. Be sure to discuss with your doctor if you are an ideal candidate for Botox® and if it is the best treatment plan for your desired results.

What can I expect at the initial consultation?
At the initial consultation Dr. Mickelwait will first determine if you are an appropriate candidate (see ideal candidate) for Botox® and if indeed it is the best treatment for the results you desire. You should also discuss your medical history with the doctor. He will assess if you are allergic or hypersensitive to any ingredient in Botox®. Furthermore, it is imperative that you disclose all medications, vitamins, herbs, and supplements you currently take. These substances could hinder or intensify the potency of the Botox® or cause bleeding and bruising at the injection sites.

5 Reasons to See Your Dentist Regularly

2009-11-28T22:39:00.000-08:00

1. Dental Check Ups Include Oral Cancer Screenings

When you go for your regular dental check up, your dentist and hygienist are also screening you for any signs of oral cancer. Every hour of every day, someone dies of oral cancer in the United States. This serious dental disease which pertains to the mouth, lips or throat is often highly curable if diagnosed and treated in the early stages. Visiting your dentist for regular check ups and avoiding tobacco are the key factors in preventing oral cancer.

2. Dental Cleanings and Check Ups are Extremely Important

Going to the dentist for regular check ups & cleanings is one of the most important factors in maintaining good oral health.

Regular check ups can prevent cavities, root canals, gum disease, oral cancer, and other dental conditions. It is important not to wait until you have a problem before you see your dentist, help prevent problems before they happen.

3. To Prevent Gum Disease

Gum disease is one of the leading causes of adult tooth loss. If diagnosed in its early stages (gingivitis}, it can be treated and reversed. If treatment is not received, a more serious and advanced stage of gum disease called periodontitis may follow. Regular visits to the dentist for check ups and dental cleanings, flossing daily and brushing twice a day are key factors in preventing gum disease.

4. To Help Maintain Good Overall Health

Gum disease has been linked to heart disease, strokes, pancreatic cancer and more. Visiting your dentist for regular check ups can help you to avoid gum disease, thus promoting better overall health.

3. To Avoid Losing Your Teeth

Since gum disease is one of the leading causes of tooth loss in adults, visiting your dentist on a regular basis and maintaining good oral hygiene is crucial for avoiding false teeth and keeping your natural teeth.

New Reality International Dental Relief Trip 2009

2009-11-24T14:42:00.000-08:00

Several years ago my wife Laila and I founded a non-profit organization called New Reality International The purpose of the organization is to provide free dental care, medical care, and vocational training to those who are suffering from extreme poverty, disease and injustice.

This November we had the opportunity to lead an international team of dentists and hygienests to Haiti where we were able to serve over 500 patients compleating 856 procedures in only 6 1/2 days!

Haiti is the poorest country in the Western Hemisphere with the highest instance of AIDS and Tuberculosis. Unfortunately 80% of Haitians are unemployed and most Haitians are forced to live on less than $1 per day.

We were so pleased that we had the opportunity to serve these amazing people. Haiti is a needy country and it has so much potential.

TMJ Massage

2009-09-01T12:39:00.000-07:00

The jaw or temporomandibular joint (TMJ) is a major target for an array of joint disorders. Disorders of the jaw are typically referred to by the same name, TMJ. The temporomandibular joint connects the mandible to the skull’s temporal bone and contributes to the acts of biting, chewing, swallowing, speaking and making facial expressions. The National Institutes of Health (NIH) states over 10 million people in the United States suffer from TMJ problems.

Symptoms

Pain is the most common TMJ symptom. The pain is often described as a transient, dull ache in the jaw joint and nearby areas, including the ear. Instead of pain, some sufferers only have problems in the use of their jaws. Additional symptoms of TMJ can include:
· Inability to open the mouth comfortably
· Clicking, popping or grating sounds in the jaw joint
· Locking of the jaw when attempting to open the mouth
· Headaches
· A bite that feels uncomfortable or “off”
· Neck, shoulder and back pain
· Swelling on the side of the face
· Tinnitus or ear pain
· Dizziness

Cause

TMJ can be caused by a number of factors, including:
· Local injury
· Dental work/oral surgery
· Whiplash
· Arthritis
· Widespread joint pain from another condition
· Sinus or ear infections
· Headaches
· Bruxism (teeth grinding and clenching)
· Stress

Although teeth grinding and stress are not the leading causes of TMJ, difficulty relaxing may be a common cause many sufferers are unaware of. Holding the body tout, including the jaw, is a common response to stress. Whether metaphorical for “keeping one’s mouth shut”, a result of the incredible strength and control we have over the mandible, or due to another reason, emotional tension can easily be reflected in the temporomandibular joint.

Use relaxation techniques such as massage helps to reduce overall stress and muscle tension.
Massage is an ideal way to relieve the pain of TMJ. According to medical massage proponent Boris Prilutsky, “Massage therapy should be focused toward the reduction of tension in the masticatory muscles, releasing tension in fascia, and elimination of trigger points. Post-isometric relaxation is an extremely important tool for the restoration of the range of motion.”

In addition to reducing anxiety and TMJ relief, massage is beneficial in many other ways:

Physical Benefits of Massage

Strengthens the immune system

Relaxes the nervous system

Increases circulation of blood and lymph fluids

Promotes deeper and easier breathing

Increases joint flexibility and range of motion

Reduces blood pressure

Reduces muscle spasm and tension

Reduces pain

Psychological Benefits of Massage

Improves sense of well-being

Reduces stress and anxiety

Reduces sense of isolation

Nurtures the spirit

Increases body awareness

At Mickelwait Family Dentistry in Mt. Vernon, WA we have a licensed massage therapist trained in TMJ massage. Please call us at (360) 424-3450 or visit us at http://www.delightfuldental.com/ to learn more.

References:
Lewit, K, DG Simons DG., Myofascial pain: relief by post-isometric relaxation, Arch Phys Med Rehabil., 1984 Aug;65(8):452-6.
Prilutsky, Boris, Medical Massage for Jaw-Joint (TMJ) Disorders, Massage Today, 12/04.
www.nlm.nih.gov/medlineplus, TMJ Disorders, A.S.A.M., Inc, 2005.
www.tmj.org, Basics, TMJ Association, Ltd., 10/31/05.
Nicole Cutler, L.Ac. www.integrativehealthcare.org/mt/archives/2006/05/relieving_tmj_p.html

Dental 101: Caries aka "Cavities"

2009-08-14T20:07:00.000-07:00

What Is It?

Dental caries is the medical term for tooth decay or cavities. It is caused by acid erosion of tooth enamel. Many different types of bacteria normally live in the human mouth. They accumulate (along with saliva, food particles and other natural substances) on the surface of the teeth in a sticky film called plaque. Plaque forms especially easily in cracks, pits or fissures in the back teeth; between teeth; around dental fillings or bridgework; and near the gum line. Some of the plaque bacteria convert sugar and carbohydrates (starches) in the foods we eat into acids. These acids dissolve minerals in the surface of the tooth, forming microscopic pits or erosions that get larger over time.

The damage can occur anywhere the tooth is exposed to plaque and acid, including the hard outer enamel on the tooth crown or the unprotected root of the tooth that has been exposed by gum recession. Caries can penetrate the protective enamel down to the softer, vulnerable dentin (main body of the tooth) and continue through to the soft tooth pulp and the sensitive nerve fibers within it. No one really knows what causes the pain associated with cavities, but theories include inflammation caused by bacteria, exposure of the root surface and an imbalance of fluid levels in the tubules inside the dentin.

Symptoms
Early caries may not have any symptoms. Later, when the decay has eaten through the enamel, the teeth may be sensitive to sweet foods or to hot and cold temperatures.
DiagnosisA dentist will look for caries at each office visit, regardless of whether it is a routine visit or an appointment made by the patient because of pain. The dentist will examine the teeth visually and will probe the teeth with an instrument called an explorer to determine if there are pits or areas of damage. Periodically, or if the dentist suspects hidden caries, X-rays will be taken by looking at the teeth.
Expected DurationHow long caries lasts is determined by the stage at which it is found. White spots, indicating early caries that has not yet eroded through the enamel, may be reversed if acid damage is stopped and the tooth is given a chance to repair the damage naturally. Caries that has destroyed enamel cannot be reversed. Most caries will continue to worsen and deepen and with time, the tooth may decay down to the root. The amount of time the erosion takes will vary from person to person. Caries can erode to a painful level within months or it can take years to reach that stage.

Prevention
Cavities can be prevented by reducing the amount of plaque and bacteria in the mouth. The best way to do this is by daily brushing and flossing and professional dental cleanings twice a year. You also can reduce the amount of acid in your mouth by eating sugary or starchy foods less frequently during the day. Your mouth will remain acidic for several hours after eating, so snacking throughout the day is more likely to lead to caries than avoiding between-meal snacks. Chewing gum that contains xylitol helps to counteract the acidity that occurs after eating.
Teeth can be strengthened by fluoride. A dentist can evaluate your risk of caries and then suggest appropriate fluoride treatments. In children, new molars can be protected by having the dentist apply a sealant as soon as the teeth come fully into the mouth.

Treatment
The standard treatment for caries is to fill the tooth. After the dentist removes the decayed material in the cavity (usually following the use of anesthesia to block the pain), the cavity is filled. Fillings usually are made of a dental amalgam, which is a silver-gray material made from silver alloyed with copper or other metals in order to improve durability, or of a composite resin, which is tooth-colored for a better appearance. Amalgams are used primarily in molars and premolars. Resins are used primarily in the front teeth, although it is possible to use them in all teeth. Gold inlay may be used if greater strength is needed, but this is more expensive.
If a cavity is large with extensive erosion, the remaining tooth may not be able to support the amount of filling material that would be needed to repair it. In this case, the dentist will remove the decay, fill the cavity, and cover the tooth with an artificial crown.

Sometimes the crown of the tooth remains relatively intact, and there is more damage in the interior of the tooth. In these cases, the dentist may refer you to a dental specialist called an an endodontist for root canal treatment. In this procedure, the endodontist removes the tooth's pulp and replaces it with an inert material. In most cases, the tooth's natural crown will need to be replaced with an artificial crown.

When To Call A Professional
The early stages of decay are usually painless. Only regular professional examinations and X-rays can detect early trouble. If you develop sensitivity to chewing or to hot, cold or sweet foods or beverages, contact your dentist. If you are experiencing any of these symptoms visit our office online or call (360) 424-3450 to schedule an exam.

If a cavity goes undiagnosed, it likely will cause the tooth to erode significantly. Eventually, the tooth may be destroyed by uncontrolled decay.

Having caries increases your risk of more caries for several reasons:

The same oral care and dietary habits that contributed to the plaque and acids that caused the initial cavity may cause more decay
Bacteria tend to adhere to fillings and other restorations more than to smooth teeth, so those areas will be more susceptible to new caries
Cracks or gaps in the fillings may allow bacteria and food to enter the tooth, leading to decay from beneath the filling

For More Information Send an Email to Dr. Joel Mickelwait DDS at delightfuldental@gmail.com

If you are in Skagit Valley, WA and would like to consult Dr. Joel Mickelwait visit us online at http://www.delightfuldental.com/ or call (360) 424-3450

Teeth Whitening Frequently Asked Questions

2009-08-14T19:53:00.000-07:00

There is undoubtedly a buzz these days about teeth whitening and many people are asking questions about this procedure. Listed below are some frequently asked questions about teeth whitening answered by the American Dental Association

"What should you ask your dentist?
You may want to start by speaking with your dentist. He or she can tell you whether whitening procedures would be effective for you. Whiteners may not correct all types of discoloration. For example, yellow-ish hued teeth will probably bleach well, brownish-colored teeth may bleach less well, and grayish-hued teeth may not bleach well at all. Likewise, bleaching may not enhance your smile if you have had bonding or tooth-colored fillings placed in your front teeth. The whitener will not affect the color of these materials, and they will stand out in your newly whitened smile. In these cases, you may want to investigate other options, like porcelain veneers or dental bonding.

What is in-office bleaching?
If you are a candidate for bleaching, your dentist may suggest a procedure that can be done in his or her office. This procedure is called chairside bleaching and may require more than one office visit. Each visit may take from 30 minutes to one hour.
During chairside bleaching, the dentist will apply either a protective gel to your gums or a rubber shield to protect the oral soft tissues. A bleaching agent is then applied to the teeth, and a special light may be used to enhance the action of the agent. Lasers have been used during tooth whitening procedures to enhance the action of the whitening agent.

What are at-home procedures and products?
There are several types of products available for use at home, which can either be dispensed by your dentist or purchased over-the-counter.

Bleaching solutions. These products contain peroxide(s), which actually bleach the tooth enamel. These products typically rely on percent carbamide peroxide as the bleaching agent, carbamide peroxide comes in several different concentrations (10%, 16%, 22%).
Peroxide-containing whiteners typically come in a gel and are placed in a mouthguard. Usage regimens vary. Some products are used for about twice a day for 2 weeks, and others are intended for overnight use for 1-2 weeks. If you obtain the bleaching solution from your dentist, he or she can make a custom-fitted mouthguard for you that will fit your teeth precisely. Currently, only dentist-dispensed home-use 10% carbamide peroxide tray-applied gels carry the ADA Seal.

You also may want to speak with your dentist should any side effects become bothersome. For example, teeth can become sensitive during the period when you are using the bleaching solution. In many cases, this sensitivity is temporary and should lessen once the treatment is finished. Some people also experience soft tissue irritation—either from a tray that doesn't fit properly or from solution that may come in contact with the tissues. If you have concerns about such side effects, you should discuss them with your dentist.

Toothpastes. All toothpastes help remove surface stain through the action of mild abrasives. "Whitening" toothpastes in the ADA Seal of Acceptance program have special chemical or polishing agents that provide additional stain removal effectiveness. Unlike bleaches, these ADA Accepted products do not alter the intrinsic color of teeth.

How should I choose a whitening product?
When selecting a whitener or any dental product, consult your dentist and he or she can tell you whether the product meets ADA standards of safety and effectiveness."

If you live in or around Mt. Vernon/Burlington WA and are interested in the possibilities of teeth whitening, please visit our office online or call (360) 424-3450 to schedule a consultation appointment.