If you suffer with migraine or tension headaches, relief could be as simple as a quick visit to your dentist. Go to the dentist for migraines? Absolutely. While there is much to be said for medications when it comes to treating headaches, a custom-made dental device is now working wonders. This device is called the NTI. NTI stands for nociceptive tri geminal inhibition, which simply means the device stops painful stimulation to the nerves of the face and jaw. This stimulation typically occurs when you clench or grind your teeth-so if the grinding can be prevented, so can the migraines! Use of the NTI produces no adverse effects whatsoever, and while it can be used in conjunction with medication, it is also being met with great success when used alone.
The NTI is unlike other dental splints or night guards in that it does not cover all of the teeth in one arch with a "horse shoe" shaped appliance. It is a small, clear, hard acrylic device that snaps onto either your upper or lower front teeth. The simple brilliance of this design is that it keeps your back teeth from touching while you sleep, making it impossible to clench or grind. This, in turn, prevents the painful nerve stimulus that leads to headaches.
Another fabulous benefit of the NTI is that it reduces the overall wear on your teeth. As we age, we naturally get tiny cracks in our teeth, especially the back molars. This is because the mouth operates like a hinge, with the most pressure being applied towards the back of the hinge, like a nutcracker. While it is impossible to completely eliminate this pressure (we do have to chew our food, after all), studies show that use of an NTI will significantly reduce the damage that naturally occurs. Less damage means you will be less likely to need fillings, crowns, root canals and extractions as you get older.
The NTI prevents excessive wear on the front teeth as well. If you've ever wondered why your teeth seem shorter than they did 10 years ago, it's probably because you are grinding them down. Obviously, this is a cosmetic is sue-longer teeth are youthful teeth, so any reduction in the length of your teeth makes you appear older. The loss of vertical dimension in your mouth also creates wrinkles in your skin. But aside from the cosmetic issue, if you are losing length in your front teeth, this indicates you are grinding and clenching and forming cracks in ALL of your teeth.
At this point, the question might be, "I have a horseshoe-shaped splint, isn't that good enough?" That depends. If you are only trying to prevent grinding and you don't mind the size of it, it's probably fine. But if you have any sort of headache or TMJ (Temporomandib ular Joint) pain, you should consider a switch to the NTI. Full-coverage splints still allow the teeth to bite down on the splint. This activates the muscles and, therefore, does not prevent clenching. As long as the patient is able to clench either teeth-to-teeth or teeth-to-splint, there is still painful reception that occurs in the trigeminal nerve which can lead to migraines. The NTI prevents the back teeth from touching anything, which makes it impossible to clench at all with it in place. Other benefits of the NTI include its small, less bulky size and its position in the front of the mouth, which prevents it from triggering the gag reflex. Also, the type of acrylic used to make the NTI does not absorb odors or stains... a major plus if you've had the full-coverage type!
The FDA approved the NTI for the prevention of medically diagnosed migraine pain in 2001. In a clinical trial, 82 percent of NTI users experienced a 77 percent reduction in migraine events with no medical side effects. Those numbers are hard to argue with. And we have learned how it can prevent excessive wear, cracks and loss of length on all of the teeth. If dentists can create an environment where there is less strain and stress on the teeth, that will translate into fewer costly procedures for the patient as well as a more youthful appearance. Some dental and medical insurance companies are now covering a percentage of the NTI's cost because they have been proven to be so useful in terms of prevention. And prevention is the best medicine! Go to www.theheadacheremedy.com to find out more about the NTI.
You can contact Margaret Shaw D.D.S., P.A. by calling Family Dentistry in Ovilla at 972-223-0313.
Healthy Habits for a Healthy Smile
October is National Dental Hygiene Month, so there is no better time to emphasize why your oral hygiene habits are vital to your overall health. Healthy gums and teeth have benefits that go far beyond fresh breath and a great smile. It may surprise you to learn that numerous studies link periodontal (gum) disease to heart disease, stroke, and even Alzheimer’s. Essentially, the way you treat your mouth affects the rest of your body.
In light of these studies we should ask, "What can I do to achieve good oral health?” The single most important thing to do is visit a dentist for an exam and x-rays if you have not been within the last year. This will give the dentist a chance to evaluate your entire mouth for periodontal disease, dental cavities, oral cancer and any other conditions that may be present. Once your mouth is officially "disease free,” it is really quite simple to incorporate four oral health habits into your already busy life. You’re probably already doing most of them to some extent.
Brushing your teeth for two minutes at least twice a day is a critical component to preventing cavities and gum disease. The most important time to brush is before bed. When you brush before bedtime, you are starting six to eight hours of sleep with a clean mouth. Saliva production slows down tremendously when we sleep, so whatever we leave on the teeth before we go to bed will not be rinsed off with saliva throughout the night, meaning bacteria will multiply exponentially. Sugar (from soda, dessert, even wine) is especially destructive if left on the teeth overnight. And if you have children, do not expect them to be able to do an adequate job of brushing until they are in the double digits! Even then, many of them will need direction and supervision, especially if they have braces.
Floss daily - again, preferably before you go to bed. When asked if flossing is really necessary, the running joke among dentists is, "You only have to floss the ones you want to keep!” and there is truth to that! Flossing removes the plaque and bacteria between teeth and at the gumline, something that brushing by itself won’t accomplish. These hard to reach areas of the mouth are where cavities and gum disease often begin. There are many different kinds of floss and flossing tools available, so find what works best for you and you will be much more likely to incorporate flossing into your daily regimen.
Rinse with an anti-microbial mouthwash every day in order to kill any bacteria left after brushing and flossing. Brushing and flossing generally disrupt the plaque and bacteria growing in the mouth - rinsing expels it. Water is good, but an anti-microbial rinse is even better because it will help kill the bacteria on the tissues of your mouth and tongue. By the way, don’t forget to brush and/or scrape it too!
Lastly, and here’s the fun part, chew sugar free gum after meals. This stimulates the most important natural defense against tooth decay – saliva – which, in turn helps fight cavities, neutralizes plaque acids, remineralizes enamel to strengthen teeth, and washes away food particles. It comes in all kinds of yummy flavors, so pick your favorite and chew away for a few minutes!
Of course, a discussion regarding good oral hygiene would not be complete unless we mentioned diet. Cut back on sugars, especially those in sticky candies and sodas, and drink plenty of tap water. Yes, good old-fashioned (and free) tap water can actually be a health- ier choice than bottled water. That’s because it usually contains the optimal level of fluoride - the essential ingredient necessary to strengthen tooth enamel and prevent cavities - as recommended by the Centers for Disease control. Amounts of fluoride in bottled water vary greatly, so it is necessary to contact the manufacturer to find out whether their "pure” water contains fluoride or not.
Good habits are learned over time, so start practicing now and take that healthy smile to a whole new level!
Margaret Shaw, D.D.S., P.A., is a family dentist in Glenn Heights and a Clinical Assistant Professor at Baylor College of Dentistry. Contact her office at 972.223.0313.
Wisdom is Overrated At Least When It Comes to Teeth
Here’s a word to the wise: get your wisdom teeth out early. The third molars, or wisdom teeth, develop much more slowly than our other teeth, and despite their fashionably late appearance serve little purpose. The fact is we simply don’t need them. Many of us don’t have room for them, and leaving them in place often leads to a variety of complications, including gum infection, decay, pain, swelling and possibly even crowding.
The perfect time for removal of wisdom teeth is between the ages of 15 and 17, before the roots have formed. If this time frame is missed and the roots have begun to take hold, extractions become much more complicated and there is an increased risk of nerve and sinus damage. In fact, studies show that starting around age 18, for every period of five years a person waits, the possible complications as well as post-operative pain and recovery time grow exponentially. Simply put, the younger you are when you have this procedure done, the easier it will be on you.
"But, they don’t hurt!” That is the common objection from patients who don’t want to deal with their wisdom teeth. To which a dentist should reply, "Precisely! That’s why now is the perfect time to take them out!” Dentists don’t wait until a tooth is causing pain to perform a filling. If we did, many of those fillings would become root canals, and no one would like that! The same principle applies to wisdom teeth—it is much easier to prevent dental pain than to suffer through it once it has begun.
Then there is the age-old question: "If I don’t get them out, will my front teeth become crowded?” Local orthodontist and Associate Clinical Professor at the University of Texas Dental Branch Houston, Dr. Claude Stephens, shared this: "The question of the relationship between wisdom teeth and orthodontic crowding following the removal of braces is one that is still debated even within the profession. What is known is that wisdom teeth often begin to erupt in the late teens or early 20s, which is typically the time youngsters have lost their retainers and the teeth are free to move with or without the influence of wisdom teeth. Since crowding or relapse of the front teeth coincides with the eruption of wisdom teeth, it is natural to assume a cause and effect relationship. A review of the literature would seem to suggest that there are almost an equal number of published studies claiming that wisdom teeth do result in crowding of the anterior teeth as there are studies to say that is not the case." Dr. Stephens went on to state that unless there is clearly adequate room for the wisdom teeth to erupt fully, he routinely recommends their removal following orthodontic treatment.
Removing the wisdom teeth is relatively simple. An oral surgeon or a general dentist providing oral surgery services performs the procedure, usually with IV sedation. IV sedation is generally recommended because the drugs used produce an amnesia effect, which renders the patient unable to recall the noises and unpleasantries of the operation. In addition, IV sedation is actually the safest option since an intravenous line is already in place, making it possible to administer additional drugs or medication quickly in the unlikely event there is an adverse reaction to the procedure. Other forms of sedation—nitrous oxide, oral sedation and local anesthetic—do not allow that, but because medical needs vary with each individual, a thorough discussion with the surgeon is critical to determine the best course of action.
After the patient has been sedated and the mouth has been numbed, incisions are made behind the back molars to release the gum tissue and a drill is used to remove some of the bone from around the impacted tooth. At this point, if the patient is young and the roots have not formed, the doctor is able to simply roll the small marble-like tooth out of the socket. Stitches may or may not be required.
Antibiotics, analgesics, and a rinse are usually prescribed to help prevent infection. One week later, the patient returns for a post-operative appointment and further instructions on how to care for the sockets until they are completely healed. The downtime for this procedure is usually two days—the day of surgery and the following day. Of course, that number increases as the age of the patient increases!
So what is the wisest choice when it comes to wisdom teeth? Get them out at an early age because prevention really is the best medicine!
Margaret Shaw, DDS, PA is a family dentist in Ovilla. Contact her office at 972.223.0313.
Welcome to the new world of dentistry! As you probably know, over the
past decade digital x-rays have taken the place of old-fashioned film
x-rays. This means less discomfort and harmful radiation for the
patient, and a much better result for the dentist.
In a more
recent development, technology has also caught up with another of the
dental procedures that most patients dread - impressions. Gone are the
days of clamping down on trays full of thick goo. State-of-the-art
equipment now enables a dentist to capture much more precise digital
impressions without ever subjecting the patient to an unpleasant mouth
full of putty.
There are several machines capable of capturing
digital impressions. The iTero scanner, produced by Align Technology, is
considered cutting edge, and the scanning technology integrates
seamlessly with the company's other popular product, an innovative
system for braces known as lnvisalign (more on that in a moment). The
iTero can be used for crown and bridge procedures as well as lnvisalign
With the iTero machine, impressions - or "scans"- are
comfortable, safe, accurate and fast. Comfortable because there is no
gooey mess or unpleasant taste - the dentist uses a "wand" to capture
images of the tooth surface and gum tissue. Safe because a laser is used
to generate the images, not radiation. Accurate because there is no
material outside of the digital image that can potentially shift. And
you can view the 3D scans on-screen with your dentist immediately -
how's that for fast? The entire procedure typically takes no more than
3-5 minutes. The computer-generated 3D model is sent directly to your
dentist's lab to construct a crown; or, if you are being treated with
braces, the aligners are manufactured by lnvisalign and sent directly to
lnvisalign treats the misalignment of teeth by
using a series of clear, nearly invisible, removable appliances that
gently move teeth to a desired final position. Because it does not rely
on the use of metal or ceramic brackets and wires, Invisalign
significantly reduces the aesthetic and other limitations associated
with braces. The iTero machine comes equipped with the lnvisalign
Outcome Simulator as well, which provides a unique dual view layout
showing the prospective patient an image of his/her own current
dentition next to his/her simulated final position of how the teeth may
look after lnvisalign treatment.
While all of this cutting edge
technology might seem "fun," more than anything, dentists need to focus
on the benefit to the patient. The primary goal should be to provide
patients with the highest quality of care possible with the least
invasive methods available. Regular X-rays were good, but now there is
something better. Regular impressions were okay, but now there is
When you have a crown done the iTero way,
you can be assured that the accuracy of fit will be above and beyond
that of a conventional impression. That means you will have less
likelihood of getting decay around the margin of your crown and having
to have it redone. Not to mention the fact that you didn't have to go
through the goop and the gag to get there!
Dr. Shaw is a graduate of, as well as a Clinical Assistant Professor
at the Baylor College of Dentistry in Dallas. She has been practicing
dentistry in Ellis and Dallas Counties for 24 years. She is also the
President of Elite Mobile Dental, which serves nursing homes throughout