Happy 2011 from the Winterville Dental Family!

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Rebuilding Your Smile

Rebuilding Your Smile
by Phillip H. Durden, D.M.D., M.A.G.D, F.A.A.C.P.

Seems like yesterday we were 20 years old and our teeth were the last thing on our mind, doesn't it? Like the rest of our body, our teeth age, and before you know it, time has caught up with us... old fillings wear out and break down, our gums start to recede and we grind our teeth as we deal with the pressures of daily life. In our practice, we are noticing a trend of new patients with this same story.

"Okay, Doc, so what do I do?"

When it comes to your health, knowledge really is power. It is important to fully understand where you are today.
  • To provide patients with complete information, we begin with a thorough dental examination, including necessary xrays, photos, gum measurements and an oral cancer screening.
  • Your family medical/dental history plays a significant role in considering your dental future. In dentistry, understanding your ability to fight infection and your family dental patterns (i.e., rate of decay, gum disease, tooth loss) are a key determinant of "where we go from here".
Watch this video to hear Rhonda's Story about her Smile Reconstruction

Start with a Game Plan

Our goal in dentistry is to help our patients keep vital teeth for a lifetime. Countless studies support this rationale as part of a healthy body strategy to see us all into a comfortable old age. With the facts in hand, your dentist can help you prioritize your care. Primary concerns include:

# 1 Signs of active infection, such as with gum disease or decay. These are destructive processes that can cause problems with your overall health if not dealt with quickly and assertively. Common symptoms include pain, swelling or bleeding when brushing - if you have any of these, you should see a dentist as soon as possible.

# 2 Protecting your teeth. If you have fillings that are breaking down, broken or chipped teeth, these should be restored. There are a number of options available, including tooth-colored fillings, crowns, inlays and onlays.

In protecting your teeth, we must also make sure your bite is stabilized. If you have lost teeth over the years due to trauma or extensive decay, your bite most likely has been compromised.

  •  In most cases, we recommend replacing missing teeth to distribute the biting forces evenly and prevent other teeth from shifting (which can ultimately result in further damage or the loss of additional teeth).
  • One of the most remarkable options to replace missing teeth are dental implants. These tiny surgical cylinders function as a replacement for a lost tooth root. Once in place, they serve as a foundation for a crown, bridge, or as anchors for loose dentures.
# 3 Prevention. We want to make sure the surfaces of your teeth are smooth and accessible so that you can easily brush and floss to keep them clean. This includes regular visits for checkups, xrays and cleanings to avoid problems and detect any issues early.

#4 Esthetics. Studies show that how you feel about your smile affects your self-confidence in your personal and business relationships. Often we will enhance the appearance of a smile in the course of repairing and rebuilding it to healthy function. Restorations such as porcelain crowns and dental bonding have the look and feel of natural tooth structure.

  • Many patients achieve dramatic results with teeth whitening. This easy and affordable smile treatment is a safe and simple approach to help you have a brighter smile.
Whatever your situation, keeping your smile healthy is important. While it is true that as we age, our teeth age with us; however, today's dental techniques and materials give us numerous opportunities to keep our teeth in good condition and have a healthy smile for a lifetime.

Migraine Headaches -It's not "All in Your Head"

TMJ (Jaw Joint) Disorders - The Migraine Connection
by Dr. Phillip Durden

Over years of study and clinical practice, I have worked with a number of patients that suffer from chronic headaches. Often many of these patients' symptoms could be traced back to jaw joint (TMJ) and obstructive sleep disorders which trigger jaw clenching, resulting in the classic "migraine".

Watch this Video to hear about Casey's Story:

TMJ Dysfunction: What is it?

TMJ itself stands for temporomandibular joint, a complex system of bone, muscle, nerves and soft tissue located just in front of each ear. These joints are flexible, allowing the jaw to move smoothly, up-and-down and side-to-side; enabling us to talk, chew and yawn.

The TMJs are the most frequently used joints in the body, and are prone to misalignment, which can lead to chronic recurrent headaches as well as ear, facial and neck pain. It is not certain how many people have TMJ disorders, but some estimates suggest that over 10 million Americans are affected, and this condition appears to be more common in women than men.

“It's all in Your Head”

Until recently, symptoms of head and facial pain appeared unrelated, and were frequently undiagnosed or misdiagnosed as migraine, tension headache, neuritis, neuralgia, or stress. When standard treatment remedies for these types of disorders proved unsuccessful, patients were frequently labeled as “hypochondriacs” or mentally unstable.

Today we know that many of these unexplained, undiagnosed and therefore untreated symptoms are actually related to a group of problems called TMJ Dysfunction. TMJ Dysfunction is considered “The Great Imposter” because problems within this disorder can produce a myriad of symptoms which, at first glance, might seem unrelated to the jaw complex.

Common symptoms may include any of the following:

•Headache or facial pain
•Neck or shoulder pain
•Tingling in the arms or fingers
•Pain when chewing or yawning
•Clicking, popping, or grating sounds in the TMJ
•Ringing or stuffiness in the ears
•Back pain
•Limited jaw opening or locking

The Diagnostic Process

Our TMJ assessment includes a detailed medical and dental history, along with thorough documentation of symptoms and pinpointing painful areas in the facial, neck, head and jaw. We work closely with physicians to rule out possible causes related to other health conditions.

If a TMJ disorder is suspected, we will then use digital xray images and analytical technologies, such as JVA (Joint Vibration Analysis), Jaw Tracking, EMG and imaging to show the alignment and relationship between the jaw and skull to help us arrive at an appropriate course of treatment.


Because the cause of TMJ Disorders is multi-faceted and often unclear, current research supports the use of conservative, reversible treatments. Surgery is rarely indicated and is always the last resort.

•Many patients respond to therapy which is based on achieving proper position of the joint(s) and allowing the body an opportunity to heal itself. We often use an orthotic appliance to stabilize and correct jaw alignment, along with physical therapy to help maintain fluid joint movement and keep the muscles relaxed during healing. Medications may also be necessary to reduce inflammation.

•Other options to address TMJ disorders include making changes to the bite through restorative dentistry to rebuild broken-down teeth or minor tooth reduction (occlusal adjustment) to adjust the bite and better support proper jaw position.

If you think you have a TMJ Disorder

I always recommend that my patients keep a daily journal to document the details of their symptoms, including the time(s) pain occurred and what they were doing, along with the level of pain and specific location. We use forms that allow the patient to chart this information, which gives us invaluable details in developing their treatment plan.

Chronic pain is one of the most prevalent causes of depression and stress, with the resulting effect of diminishing quality of life. If you or a loved one is suffering with these types of symptoms, I encourage you to contact our office and let us help you take back control of your health.

Reference: National Institute of Dental and Craniofacial Research,
Prevention of Mouth Injuries in Sports

According to the U.S. Centers for Disease Control, sports-related dental injuries account for more than 600,000 emergency room visits each year (

As we approach the school sports season, I wanted to focus this month's article on protecting the smiles of young athletes. As important as a helmet, shielding your child's teeth from impact trauma could spare them a great deal of pain and costly procedures.

Teeth are tough - but not THAT tough...

Teeth are designed to bite together in alignment and grind side-to-side as they work together to create powerful chewing forces. They are, however, vulnerable to blows that strike the facial aspect, or front of the tooth.

  • When you receive a blow to the mouth, be it due to human contact, a fall or encountering a hard object such as a fast-moving baseball, the teeth receive a jolt they are not prepared for.
  • Depending on the angle of the blow, teeth may break. But, even if they don't break, the nerves and blood vessels that keep the tooth vital and firmly in place may become severely “bruised”. Often this results in permanent damage, requiring root canal and crown procedures to repair and save the tooth.
Speaking of hard objects...

In facial trauma, teeth can become an unyielding hard surface. Tooth enamel is the hardest substance in the human body - when the soft tissue of the lips and face hit the teeth, you get a “split lip”. For patients with orthodontic wires and brackets, this can be a double-whammy.

Other Injuries

Not to use scare tactics, but even more serious injuries are possible: In addition to broken teeth, a hard blow to the mouth and teeth can cause jaw fractures, with potential complications that include cerebral hemorrhage, concussion or neck injuries if the lower jaw gets jammed into the upper jaw.

Sports Mouthguards

Dentists recommend the use of a sports mouthguard, a flexible appliance that is worn in athletic and recreational activities to help protect teeth from trauma. Mouthguards typically are worn on the upper arch and nudge soft tissue in the oral cavity away from the teeth; this helps prevent laceration and bruising of the lips and cheeks, especially for those who wear orthodontic appliances. They may also reduce the severity and incidence of related concussions in head trauma.

In what sports should my child wear a mouthguard?

Anytime there is a chance for contact with other players or hard surfaces, it is a good idea to wear a mouthguard. Athletes who participate in basketball, softball, football, hockey, wrestling, soccer, lacrosse, in-line skating and martial arts, as well as recreational sports such as skateboarding and bicycling, should wear mouthguards while engaged in these activities.

Fit Matters...

With any mouth appliance, if it is not well-fitted, it can impair breathing and speech. And, if a blow to the face occurs, an ill-fitted mouthguard may become dislodged and thus become ineffective.

Types of Mouthguards:

1. Over-the-Counter Mouthguards. These come in a few varieties, the standard stock, non-fitted version being the least effective (and not recommended). “Boil and bite” mouthguards are designed to be warmed in hot water and fitted in the mouth by pressing the softened acrylic to mold it to the teeth; the acrylic is then set by running cool water over the guard.

2. Custom-fitted Mouthguards. Custom-fitted mouth protectors are designed by a dentist to snugly fit your child's mouth. They are more expensive, but because they are customized, it is possible to achieve a better fit than over-the-counter types.

Mouthguard Care

One of the common problems with any dental appliance is the risk of oral exposure to harmful surface bacteria that can accumulate if good hygiene practices are not followed. Here are some great mouthguard care tips from

  • Clean the mouthguard by washing it with soap and cool (not hot) water. Before storing, soak it in mouthwash.
  • When not in use, the mouthguard should be stored in a plastic storage box that has several holes in it and allowed to dry.
  • Heat is bad for a mouthguard; don't leave it in direct sunlight or in a closed automobile.
  • Don't bend the mouthguard when storing.
  • Never let your child handle or wear someone else's mouthguard.
Clearly, we recommend that all of our patients that participate in sports activities wear a well-fitted mouthguard as a protective measure against teeth and mouth injuries.. If you have questions about sports mouthguards or other dental topics, please feel free to give us a call at 706.742.7000. We will be happy to help!