On the big screen, Australian-born actress Margot Robbie may be best known for playing devil-may-care anti-heroes—like Suicide Squad member Harley Quinn and notorious figure skater Tonya Harding. But recently, a discussion of her role in Peter Rabbit proved that in real life, she’s making healthier choices. When asked whether it was hard to voice a character with a speech impediment, she revealed that she wears retainers in her mouth at night, which gives her a noticeable lisp.

“I actually have two retainers,” she explained, “one for my bottom teeth which is for grinding my teeth, and one for my top teeth which is just so my teeth don't move.”

Clearly Robbie is serious about protecting her dazzling smile. And she has good reasons for wearing both of those retainers. So first, let’s talk about retainers for teeth grinding.

Also called bruxism, teeth grinding affects around 10 percent of adults at one time or another, and is often associated with stress. If you wake up with headaches, sore teeth or irritated gums, or your sleeping partner complains of grinding noises at night, you may be suffering from nighttime teeth grinding without even being aware of it.

A type of retainer called an occlusal guard is frequently recommended to alleviate the symptoms of bruxism. Typically made of plastic, this appliance fits comfortably over your teeth and prevents them from being damaged when they rub against each other. In combination with stress reduction techniques and other conservative treatments, it’s often the best way to manage teeth grinding.

Orthodontic retainers are also well-established treatment devices. While appliances like braces or aligners cause teeth to move into better positions, retainers are designed to keep teeth from moving—helping them to stay in those positions. After active orthodontic treatment, a period of retention is needed to allow the bite to stabilize. Otherwise, the teeth can drift right back to their old locations, undoing the time and effort of orthodontic treatment.

So Robbie has the right idea there too. However, for those who don’t relish the idea of wearing a plastic appliance, it’s often possible to bond a wire retainer to the back surfaces of the teeth, where it’s invisible. No matter which kind you choose, wearing a retainer can help keep your smile looking great for many years to come.

If you have questions about teeth grinding or orthodontic retainers, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Teeth Grinding” and “The Importance of Orthodontic Retainers.”

Famed educator Maria Montessori once said, “Play is the work of the child”—and most kids take their “work” very seriously. But their avid enthusiasm might also raise the risk of blunt force injuries, particularly to the mouth.

While you should certainly take steps to protect their mouth (like a custom-made guard for contact sports), you can’t completely erase the risk. You should know, therefore, what to do in case of a mouth injury.

The lips, tongue, and other soft oral tissues often get the brunt of any contact injury, ranging from minor bruising and swelling to severe cuts that require medical attention. First, clean the area as thoroughly as possible to remove trapped dirt or debris in the wound. If bleeding occurs, apply continuous gentle pressure with a clean cloth or gauze for 10-15 minutes until it stops, and cold compresses for any swelling. If the wound looks deep or severe, take them to an emergency room.

Blunt force can also impact teeth in a variety of ways. If part of a tooth chips, attempt to find the pieces and see a dentist as soon as possible—they may be able to bond the pieces back to the tooth. If a tooth gets moved out of place, call your dentist immediately or go to an emergency room after hours.

If a permanent tooth gets completely knocked out, find it and rinse off any debris with clean water. Then, place it gently back into its socket, or alternatively between the child’s cheek and gum or in a glass of cold milk. You’ll need to see a dentist as soon as possible to have the tooth replanted. With this kind of injury, time is of the essence.

A hard impact can also fracture the jawbone, which may be suspected if the face appears distorted or the teeth can’t make contact with each other when the jaws are shut. Control any bleeding, apply cold compresses or mild pain relievers to ease any pain or swelling, and go to an emergency room immediately.

A traumatic injury can heighten everyone’s emotions, including yours. You can avoid your emotions turning into panic, though, by following these common sense guidelines to help your child get through this unfortunate event.

If you would like more information on handling children’s dental problems, please contact us or schedule an appointment for a consultation.

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.”

Lots of people don’t know that April is National Stress Awareness Month; don’t fret if you’re one of them. For many, stress is already a common feature of everyday life. According to the American Psychological Association, 62% of Americans are stressed at their jobs, and stress has been estimated to cause the loss of some 275 million working days every year.

In addition to its other negative physical and mental consequences, stress can also spell trouble for your oral health. It may lead to the problems of teeth clenching and grinding, which dentists call bruxism. A habitual behavior that can occur in the daytime or at night, bruxism is thought to affect perhaps one in ten adults. While the evidence that stress causes bruxism is not conclusive, there’s a strong case for the linkage.

Bruxism sometimes causes symptoms like headaches, soreness or pain in the jaw muscles or joints, and problems with fully opening the mouth. It can be detected in the dental office by excessive tooth wear, and/or damage to tooth surfaces or dental work. Grinding or tapping noises heard at night may indicate that someone is grinding their teeth while sleeping. In children, nighttime bruxism is common and not necessarily a reason for concern; in adults, it may be more troubling.

So what can you do if you’re experiencing this problem? If you find yourself clenching and grinding during the daytime, simply becoming more aware of the behavior and trying to limit it can help. A bit of clenching during times of stress isn’t abnormal, but excessive grinding may be reason for concern. Many of the same techniques used to relieve stress in other situations—such as taking a step back, talking out your issues, and creating a calmer and more soothing environment—may prove helpful here as well.

Occasionally, prescription drugs may cause bruxism as an unwanted side effect; in this case, a medical professional may recommend changing your medication. The use of stimulants like coffee and mood altering substances like alcohol and illicit drugs have also been associated with teeth grinding—so if you’re having this issue, consider foregoing these substances and making healthier lifestyle choices.

There are also a number of dental treatments that can help protect your teeth from excessive grinding. The most common is an occlusal guard or “night guard.” This is a custom-fabricated appliance made of plastic that fits comfortably over your teeth. Usually worn at night, it keeps your teeth from actually coming into contact with each other and being damaged. Occasionally, additional treatments such as bite adjustment or orthodontics may be recommended to help solve the problem.

If you would like more information about teeth clenching and grinding, please call our office to schedule a consultation. You can learn more in the Dear Doctor magazine articles “Teeth Grinding” and “When Children Grind Their Teeth.”

It's easy to go overboard with sweets during the holiday season. But overconsumption of sugar, month after month, can jeopardize your oral and general health. A sugary diet nourishes the bacteria that cause tooth decay. Eating too much sugar over time also promotes general health problems such as diabetes and excessive weight gain.

The beginning of a new year is a great time to bring your diet back into balance. But if you really want to cut down on sugar, you'll need to be aware that there is a lot of sugar hiding in foods you where wouldn't normally suspect it. Here are some examples:

Ketchup. Do you like ketchup on your burger and fries? For every tablespoon of ketchup you use, you'll be adding about 4 grams of sugar (one teaspoon). That can add up pretty quickly into a significant amount of sugar!

Canned tomato soup. Read the label of your favorite brand and you might see as much as 12 grams of sugar per half-cup serving. That equals three teaspoons of sugar in every half cup of soup—even more in a full bowl!

Granola. You may think of granola as a healthy choice for breakfast. Yet you're likely to see sugar listed as the second ingredient on many favorite brands—right after oats. This typically adds up to 15 grams of sugar per serving. That's almost 4 teaspoons, in a food promoted as healthful!

Yogurt. Here, the amount of sugar varies widely among brands and flavors. One container of vanilla yogurt might contain 3 or more teaspoons of added sugar. Put that on a breakfast serving of granola, and your first meal of the day has already topped the 6-teaspoon daily limit recommended by the World Health Organization.

So, to prevent sugar from sneaking up on you, it's important to read those labels! And if you have any questions about sugar and oral health, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “The Bitter Truth About Sugar” and “Nutrition and Oral Health.”