My Blog
By Michael H. Collins, DDS, PA
May 25, 2020
Category: Dental Procedures
J-LosUnluckyBreakChippingaToothonStage

Whether she’s singing, dancing or acting, Jennifer Lopez is a performer who is known for giving it all she’s got. But during one show, Lopez recently admitted, she gave a bit more then she had planned.

“I chipped my tooth on stage,” she told interviewers from Entertainment Tonight, “and had to finish the show….I went back thinking ‘Can I finish the show like this?’”

With that unlucky break, J-Lo joins a growing list of superstar singers—including Taylor Swift and Michael Buble—who have something in common: All have chipped their teeth on microphones while giving a performance.

But it’s not just celebs who have accidental dental trouble. Chips are among the most common dental injuries—and the front teeth, due to their position, are particularly susceptible. Unfortunately, they are also the most visible. But there are also a number of good ways to repair chipped, cracked or broken teeth short of replacing them.

For minor to moderate chips, cosmetic bonding might be recommended. In this method, special high-tech resins, in shades that match your natural teeth, are applied to the tooth’s surface. Layers of resin, cured with a special light, will often restore the tooth to good appearance. Best of all, the whole process can often be done in just one visit to the dental office, and the results can last for several years.

For a more permanent repair—or if the damage is more extensive—dental veneers may be another option. Veneers are wafer-thin shells that cover the entire front surface of one or more teeth. Strong, durable and natural-looking, they can be used to repair moderate chips, cracks or irregularities. They can also help you get a “red-carpet” smile: brilliant white teeth with perfectly even spacing. That’s why veneers are so popular among Hollywood celebs—even those who haven’t chipped their teeth!

Fortunately, even if the tooth is extensively damaged, it’s usually possible to restore it with a crown (cap), a bridge—or a dental implant, today’s gold standard for whole-tooth replacement. But in many cases, a less complex type of restoration will do the trick.

Which tooth restoration method did J-Lo choose? She didn’t say—but luckily for her adoring fans, after the microphone mishap she went right back up on stage and finished the show.

If you have a chipped tooth but you need to make the show go on, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”

By Michael H. Collins, DDS, PA
May 15, 2020
Category: Oral Health
Tags: oral health  
ChronicBitingHabitsCanLeadtoLooseTeeth

Periodontal (gum) disease is the most likely cause of a loose, permanent tooth. This progressive infection causes damage to the gums and bone tissues that hold teeth in place, leading to looseness and ultimately tooth loss.

Gum disease, however, isn’t the only cause: although not as common, excessive biting forces over time may also lead to loose teeth. The excessive force stretches the periodontal ligaments that hold teeth in place, causing the teeth to become loose.

This condition is called occlusal trauma. In its primary form, the patient habitually grinds or clenches their teeth, or bites or chews on hard objects like pencils or nails. Generating 20-30 times the normal biting force, these habits can cause considerable damage. It can also be a factor when gum disease is present — supporting bone becomes so weakened by the disease, even normal biting forces can cause mobility.

If you recognize the early signs of grinding or clenching, particularly jaw soreness in the morning (since many instances of teeth grinding occur while we sleep), it’s important to seek treatment before teeth become loose. The symptoms are usually treated directly with muscle relaxants, an occlusal guard worn to soften the force when teeth bite down, or stress management, a major trigger for teeth grinding. The sooner you address the habit, the more likely you’ll avoid its consequences.

If, however, you’re already noticing a loose tooth, treatment must then focus on preserving the tooth. Initially, the tooth may need to be splinted, physically joined to adjacent teeth to hold it in place while damaged tissues heal. In some cases, minute amounts of enamel may need to be removed from the tooth’s biting surfaces to help the tooth better absorb biting forces. Other treatments, including orthodontics and gum disease treatment, may also be included in your treatment plan.

If you notice a loose tooth, it’s critical you contact us as soon as possible for an evaluation — if you delay you increase the chances of eventually losing it. The earlier you address it, the better your chances of preserving your tooth.

If you would like more information on loose teeth, 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 “Loose Teeth.”

By Michael H. Collins, DDS, PA
May 05, 2020
Category: Oral Health
Tags: nerve pain  
FacialNervePainCanbeControlled

Every year 150,000 people, mostly women over age 50, find out they have a painful condition called trigeminal neuralgia. For many it begins as an occasional twinge along the face that steadily worsens until the simple act of chewing or speaking, or even a light touch, sets off excruciating pain.

The source of the pain is the pair of trigeminal nerves that course along each side of the face. Each nerve has three separate branches that provide sensation to the upper, middle and lower areas of the face and jaw.

The problem arises when areas of the myelin sheath, a fatty, insulating covering on nerves, becomes damaged, often because of an artery or vein pressing against it. As a result, the nerve can become hypersensitive to stimuli and transmit pain at even the slightest trigger. It may also fail to stop transmitting even after the stimulation that caused it is over.

Although the condition may not always be curable, there are various ways to effectively manage it. The most conservative way is with medications that block the nerve from transmitting pain signals to the brain, coupled with drugs that help stabilize the nerve and decrease abnormal firing.

If medication isn't enough to relieve symptoms, there may be some benefit from more invasive treatments. One technique is to insert a thin needle into the nerve to selectively damage nerve fibers to prevent them from firing. Another microsurgical procedure attempts to relocate the nerve away from a blood vessel that may be compressing it.

The latter procedure has some higher risks such as facial numbness or decreased hearing, and is often better suited for younger patients. Older patients may benefit more from the needle insertion procedure previously mentioned or a directed beam of high-dose radiation to alter the nerve.

To learn the best options for you, you should first undergo a neurological exam to verify you have trigeminal neuralgia and to rule out other causes. From there, you and your doctor can decide the best course of treatment for your age and individual condition.

Trigeminal neuralgia can be an unpleasant experience. But there are tried and true ways to minimize its effect on your life.

If you would like more information on trigeminal neuralgia, 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 “Trigeminal Neuralgia.”

By Michael H. Collins, DDS, PA
April 25, 2020
Category: Oral Health
Tags: dental care  
AdvancesinDentalHealththatmaybeWaitingforusJustaroundtheCorner

Today’s dental care has advanced leaps and bound over the last century. But these advances are tiny steps compared to what many believe may be coming in the next few decades. This optimism arises from our growing understanding of deoxyribonucleic acid (DNA), the chain-like molecule that houses the genetic instructions for the growth, function and reproduction of every cell in the body.

As researchers unlock the secrets of this vast genetic blueprint unique to each individual the possible applications from this knowledge are astounding. Here are just a few possibilities that could one day impact everyone’s oral health.

Preventing tooth decay. This rampant disease, triggered by bacteria (particularly Streptococcus mutans), can cause extensive damage in otherwise healthy teeth. There’s already some indications from the study of genomics that we may be able to stop or at least hinder this disease in its tracks. Already we’re seeing advances in gene therapy that might be able to inhibit the growth of Strep mutans and reduce its colonies in the mouth.

Growing new teeth. Composed of various layers, a natural tooth is part of a dynamic system of bone and gum ligaments that allow movement, protection and nourishment. Although dental implants are the closest and most advanced artificial approximation we now have to them, implants still can’t fully measure up to the function and capabilities of a natural tooth. But further insight into the genetic code may one day allow us to reproduce a living replacement tooth for a lost one.

Harnessing saliva for detecting disease. The impact of genomics related to the mouth could impact more than just the mouth itself. Researchers have discovered that saliva contains genetic information similar to blood, urine and other bodily fluids with markers for various disease conditions. Unlike other fluids, though, saliva is relatively easy to collect. The key is new equipment and testing protocols to take advantage of the information already available in a single drop of saliva.

These examples illustrate the range of possibilities for better health in the future: a reduction in dental disease early in life; new and better ways to restore missing teeth; and quicker ways to diagnose dangerous health conditions.

If you would like more information on new developments in dental care, 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 Future of Dentistry: A Sneak Preview of Your Dental Future.”

By Michael H. Collins, DDS, PA
April 15, 2020
Category: Oral Health
NBAPlayersInjuryPointsOutNeedforMouthguards

Basketball isn't a contact sport—right? Maybe once upon a time that was true… but today, not so much. Just ask New York Knicks point guard Dennis Smith Jr. While scrambling for a loose ball in a recent game, Smith's mouth took a hit from an opposing player's elbow—and he came up missing a big part of his front tooth. It's a type of injury that has become common in this fast-paced game.

Research shows that when it comes to dental damage, basketball is a leader in the field. In fact, one study published in the Journal of the American Dental Association (JADA) found that intercollegiate athletes who play basketball suffered a rate of dental injuries several times higher than those who played baseball, volleyball or track—even football!

Part of the problem is the nature of the game: With ten fast-moving players competing for space on a small court, collisions are bound to occur. Yet football requires even closer and more aggressive contact. Why don't football players suffer as many orofacial (mouth and face) injuries?

The answer is protective gear. While football players are generally required to wear helmets and mouth guards, hoopsters are not. And, with a few notable exceptions (like Golden State Warriors player Stephen Curry), most don't—which is an unfortunate choice.

Yes, modern dentistry offers many different options for a great-looking, long lasting tooth restoration or replacement. Based on each individual's situation, it's certainly possible to restore a damaged tooth via cosmetic bonding, veneers, bridgework, crowns, or dental implants. But depending on what's needed, these treatments may involve considerable time and expense. It's better to prevent dental injuries before they happen—and the best way to do that is with a custom-made mouthguard.

Here at the dental office we can provide a high-quality mouthguard that's fabricated from an exact model of your mouth, so it fits perfectly. Custom-made mouthguards offer effective protection against injury and are the most comfortable to wear; that's vital, because if you don't wear a mouthguard, it's not helping. Those "off-the-rack" or "boil-and-bite" mouthguards just can't offer the same level of comfort and protection as one that's designed and made just for you.

Do mouthguards really work? The same JADA study mentioned above found that when basketball players were required to wear mouthguards, the injury rate was cut by more than half! So if you (or your children) love to play basketball—or baseball—or any sport where there's a danger of orofacial injury—a custom-made mouthguard is a good investment in your smile's future.

If you would like more information about custom-made athletic mouthguards, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Athletic Mouthguards” and “An Introduction to Sports Injuries & Dentistry.”





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Michael H. Collins, DDS, PA