Karen P. Meyers, DDS

Birmingham, MI

1875 Southfield Rd, Birmingham, MI  48009
Phone: 248-646-2450
Experience Excellence in Dental care

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Morning Headache? You May be a Tooth Grinder

July 24, 2017

If you wake up regularly with a sore jaw and headaches, or you’ve noticed tiny fractures in your teeth, you may be grinding your teeth — and you’re not alone.

Many people grind their teeth at night and many may not be aware they are doing it, according to American Dental Association. In fact, the malady, in medical parlance, is called bruxism and usually takes diagnosis by a dentist to identify it.

ADA spokeswoman Maria Lopez Howell, who is also a dentist, told the Associated Press in an interview that many times people have no idea they grind their teeth at night.

“A lot of times someone else tells them,” she said. “We will have patients who come in and say ‘Oh my wife grinds her teeth,’ or a parent saying ‘my child is really grinding’ so someone who listens to them while sleeping will report that.”

And teeth grinding doesn’t just happen at night. Here’s a look at how you can manage teeth grinding and prevent further damage:

Teeth grinding can be caused by a number of things, including: anxiety, stress, exhaustion or signs of a sleeping disorder, like an apnea, according to Howell.

The ADA stresses that people who are grinding their teeth should see a dentist to get to the bottom of why they are grinding and determine if it’s a sign of something more serious like sleep apnea.

“It’s important to talk to your dentist about if you have any sleep disorders, because you don’t want to miss an opportunity to see whether you need something other than a night guard,” Howell said.

And it’s not just anxiety and stress that can cause grinding.

A recent study from Journal of the American Dental Association (JADA) found that some behaviors, including overuse of alcohol, caffeine and tobacco may increase the risk of teeth grinding.

Drinking alcohol and smoking tobacco were both found to more than double the odds of teeth grinding, while heavy caffeine drinking increased the odds by one and a half, according to the review of seven studies ranging in size from 51 to more than 10,000 people.

What are the Symptoms?

People grind their teeth during the day, at night or both. The ADA listed several symptoms that may indicate teeth grinding, including waking up with a dull headache, sore jaw, sensitive teeth, or even notice fractures in their teeth. While some may brush off teeth grinding as no big deal, going untreated can cause a problem later.

Howell said many people don’t recognize that the jaw’s temporomandibular joint is just that — a joint — and, like any other joint,  it can suffer from a systematic disease like arthritis.

“The teeth are part of the mouth, but the whole chewing complex is part of a joint and that joint can get arthritis just like the hip, knee or any other joints. I think people really discount or just don’t realize that,” she said.

How can I treat teeth grinding?shutterstock_340736138

While there are a slew of options from over-the-counter plastic molds to companies that will send you casts for your mouth, The ADA recommends that people consult their dentist to find out the cause of their grinding and get a customized treatment plan.

“Bruxism needs to be teated by a doctor, a mouthguard is something that provides protecting against blows in sports for instance, but bruxism is a condition that needs to be treated by a dentist with a night guard or splint,” she said. “This actually involves the joint; we are protecting the joint and the teeth, and it needs to be done with experience and knowledge of that whole chewing complex.”

Filed Under: dental pain management, patient care

Patience with the Kids

January 17, 2017

 Pediatric pain control involves quick thinking to put kids at ease

Meyers_Blog_11_519866719Managing a patient’s actual or perceived pain is difficult enough, but pediatric pain management takes that difficulty to a whole new level. In truth, there’s very little a hygienist does during a pediatric cleaning that causes actual pain. Sure, there may be an occasional pinched lip, accidental pressure put on a loose tooth or even a slip with a scaler. (The most commonly uncomfortable thing asked of young patients is asking them to close on a bitewing tab for x-rays.)

Like our medical brethren and their oath of “First, do no Harm,” the American Academy of Pediatric Dentistry emphasizes to dentists: “don’t hurt them!” The AAPD, in a 2012 policy statement on pain management, begins with these two recommendations:

  • Recognize and assess pain, documenting in the patient’s chart.
  • Use non-pharmacologic and pharmacologic strategies to reduce pain experience preoperatively.

Let’s use the example of nervous little Branton, an 8-year-old who has made it clear of his displeasure visiting the dentist. Whether real or perceived, his cries of “ow, ow, ow, ow,” deserve my recognition — even if there’s a reasonably good chance he was faking it.

By asking, “Oh, no, what happened?” it gives him an opportunity to explain. Maybe I really was pinching his lip without knowing it, or maybe he was just trying to delay the inevitable. Either way, I need to assess the reason for his reaction and decide how to handle it.

If his lip was being pinched, it could be because his mouth is small, in which case I needed to adjust my approach. Maybe I was distracted and not paying attention, in which case I would apologize, admit it was an accident and promise not to do it again. Mindfulness can be an asset with pediatric patients.

The second recommendation of the AAPD — to use non-pharmacologic and pharmacologic strategies to reduce pain preoperatively — can also address both actual and perceived pain.

An example of a non-pharmacologic strategy would be if a loose tooth were tender, I would concentrate on mindfulness and find another fulcrum. Pediatric dentists also manage the pain of operative treatment in various ways: local anesthetic, preceded by a good topical anesthetic, can take care of simple dental procedures. (Most children who have asked me about shots seem to take the idea in stride.)

Sedation is another option used in pediatric dentistry. Conscious sedation, for instance, is where the patient is conscious but rendered free of fear and anxiety. One of the specific goals of conscious sedation is to reduce the perception of pain and discomfort while enabling the child to be alert enough to respond to a directive such as, “stay open.”

Unlike adults, children rarely have “general sensitivity,” but if that’s the case, pre-polishing (with a product like Colgate Sensitive Pro Relief) can take care of the problem.

Patience is the key. By staying mindful, using all the tools at our disposal, employing lots of “tell-show-do,” and knowing that we will repeat ourselves fairly often, any actual or perceived pain can be kept to a minimum.

Filed Under: dental pain management, dentistry, patient care Tagged With: dental pain, patient care

My Crown Fell Out – What Should I Do?

November 23, 2016

crown-art-gold-and-black-shutterstock_519659668While unlikely, it is possible for a crown to come unstuck (“debond”), especially if it’s knocked or if you happen to bite into something hard or very sticky. Not surprisingly, it can be both unsettling and worrisome. Worse yet, what do you do if you’re unable to see your dentist for a day or two, or possibly longer, depending on the circumstance?

First Rule of Thumb: Don’t panic. If it’s not lost or swallowed, carefully take the crown out of your mouth to avoid the risk of swallowing it or, much graver, breathing it into the windpipe.

On the off chance a cap is swallowed, it will eventually work its way through the digestive system without causing harm, but… it’s a gonner. Don’t think about retrieving it.

Ideally, you’d make an appointment with your dentist as soon as possible to get the crown properly fixed back into place. Of course, that’s in a perfect world. If you still have the crown, but aren’t able to get to the dentist, clean and sterilize the cap with some Milton sterilizing fluid (sold in most drug stores), dry it and put it safely into a small container.

It’s important to keep the underlying tooth from which the crown came clean by carefully brushing with a soft toothbrush. Note: the tooth may still be alive (vital) and will likely be sensitive to hot or cold drinks and food — best to avoid them.

If the underlying tooth is non-vital it won’t hurt, but it’s important to try and prevent any food debris from lodging into any gaps that may be present if it’s a crown with a post attached.

If the tooth is right at the front of your mouth, you’ll understandably be anxious to temporarily fix it until you can see the dentist. There are temporary cements you can buy at the drugstore, but these materials aren’t strong bonding agents and may not hold the crown securely.

There could be a risk of it coming loose while you sleep and it being swallowed or inhaled, so it’s best to manage without it if you possibly can. You can always try chewing gum … people have been known to use it in a pinch.

If you decide to re-fix a crown with temporary cement, take care not to put pressure on it while eating or brushing your teeth since it is easily dislodged. However, whatever you do to temporarily fix the problem, don’t EVER use something like “SUPER-GLUE,” it’s not only dangerous, it will likely ruin the crown and tooth.

Your best bet is to get to the dentist as soon as you can; in the interim keep the area clean and be mindful of what you eat.

Filed Under: dentistry, oral health, patient care Tagged With: broken crown

Sonic Toothbrushes: Are They Worth the Cost?

July 26, 2016

Meyers_Blog_4_No 395140948Strolling down the dental aisle, you’ve no doubt seen the myriad choices available when it comes to choosing a toothbrush. From the classic manual flathead to the $100-plus electric, the choices have become a big business. Are you choosing the right one?

If you’re reading this, you’ve likely been brushing your teeth for many years and maybe you’ve tried several kinds, or maybe you stick with what you’ve always used. One question that we’ve been asked more than once is whether the cost of a “sonic” toothbrush is worth the investment.

Surprisingly, the answer isn’t a simple “yes” or “no.” Rather, it depends on a couple of important factors, including your preference for technology and, more important, your oral hygiene habits.

What Makes a “Sonic” Toothbrush Special?

The sonic toothbrush, such as Phillip’s “Sonicare,” is touted as the toothbrush that cleans areas in your mouth your normal toothbrush can’t; or it can whiten your teeth in just one week. Beyond the marketing, sonic toothbrushes are, in fact, a very specialized type of electric toothbrush that — unlike other brushes — can clean deep between teeth. The vibrations from the sonic technology and the speed at which the toothbrush head vibrates are significantly faster and more powerful than your average electric toothbrush — and certainly more than a manual toothbrush. The sonic technology helps create a flow of saliva, when mixed with toothpaste, that does penetrate deeper between your teeth and below the gum line.

People who use the sonic toothbrush have said they love the way their teeth feel after they brush … “almost like they’ve had their teeth professionally cleaned.” There is no doubt that the technology of this toothbrush is great.

With that said, there is little scientific data to support the true medical benefits of sonic versus manual toothbrushes. A 2012 study published in the Journal of the Indian Society of Periodontology concluded that, “in general there was no evidence of a statistically significant difference between powered and manual brushes.” It did, however, go on to say that, “…[sonic] brushes significantly reduce plaque and gingivitis in both the short-term evaluations.”

What Are the Cons?

The most obvious drawback to the sonic toothbrush is the hefty price tag. You can expect to pay at least $50 for one and that’s if you can find an older model that’s on sale. You’ll also have to buy replacement heads just like you have to replace toothbrushes. Most of these toothbrushes are at least $100. Prices and models vary, but a big price tag is consistent — expensive.

Who Will Benefit From It?

If you’re someone who listens to your dentist’s recommendations by brushing and flossing as recommended, you’re likely cleaning everywhere a sonic toothbrush does, in which case it probably isn’t worth the financial investment to upgrade to a sonic toothbrush.

However, if you skip flossing (like so many people do), a sonic toothbrush would probably be a wise investment. Mind you, a sonic toothbrush shouldn’t supplant the place of flossing, but for those that don’t do it, it can at least partially combat the effects of… laziness. When it comes down to it, though, brushing with a standard toothbrush for two minutes and then flossing does a better job at keeping your teeth clean than brushing with a sonic toothbrush and not flossing.

Ultimately, your oral health is important and if you know your brushing and flossing habits, you will be better able to choose the best type of brush for you. The biggest thing is to be conscious of your oral health.

Filed Under: patient care

Pregnancy Awareness Month: FAQ’s about Dental Care for Expectant Women

May 25, 2016

Photo by David Roseborough

Photo by David Roseborough

May is Pregnancy Awareness Month, a time for pregnant women to focus on their overall health,  for their own sake and the sake of their children.

We are seeing an improvement in the United States in terms of pregnant women’s attention to their oral health. According to Delta Dental, more expectant women have visited the dentist during their pregnancies than in the past, an increase of 7%, this past year.

Some frequently asked questions about dental care during pregnancy:

Q: When should pregnant women visit the dentist?

A: Whenever there is an issue, certainly. Regularly scheduled cleanings (every six months) should still occur during pregnancy as there is no reason to put those appointments off. More complicated procedures need to be discussed. Any pain should be weighed against the small but present risk to the baby. For the most part, procedures that require local anesthesia are permitted and even encouraged if they will improve the well being of the mother. Extra precautions to shield the abdomen will need to be taken if x-rays are absolutely necessary.

Most dentists and women find the 2nd trimester to be the ideal time for appointments and procedures. Women who are nauseated during the 1st trimester often cannot tolerate any work done on their mouths. The third trimester can also make lying back for long periods uncomfortable.

Q: Does your mouth change when you are pregnant?

A: Yes, it can. There is such a thing as “pregnancy gingivitis”, a condition of more sensitive inflamed gums during pregnancy. This appears to be related to an increase in hormone levels. Your gums may need extra care during these 40 weeks and you may require a more intense dental cleaning during pregnancy.

In addition, there is a rarer condition that causes little tumors to appear on the gum between the teeth, related to a buildup of plaque. These typically go away as soon as the baby is born.

Q: What should pregnant women do to take care of their teeth?

A: Continue to be vigilant about brushing and flossing. Flossing becomes paramount in order to deal with the possibilities of plaque buildup and any irritation to the gumline. Make sure you see the dentist for a cleaning at least once during your pregnancy, changing the time of your appointment to the 2nd trimester if possible.

Pregnant women should contact their dental insurance provider if they are going to see their dentist earlier than planned in order to avoid the third trimester. Many plans only allow two visits per calendar year and the visits must have a certain interval between them. Calling the plan to explain that you are pregnant and you must be seen prior to the third trimester may save you save money by getting pre-approval.

Filed Under: dentistry, patient care Tagged With: pregnant, pregnant gingivitis

Your Money and Your Mouth

February 15, 2016

photo courtesy of www.seniorplanning.org

photo courtesy of www.seniorplanning.org

Perhaps one of the least comfortable topics of discussion between patients and dentists is money. But patients should not shrink from having that discussion.

Dentists know that:

  • Money is an issue for most people.
  • Patients want to be able to plan to pay for the dentist’s services to the best of their ability.

Your dentist does not automatically know your financial situation. So it’s better to discuss billing and how much procedures will cost prior to a visit.

Some cost-saving measures to consider:

  • Dental insurance is usually a good deal when it is part of group coverage. If your employer offers group dental insurance, it usually covers all of your cleanings and X-rays and will discount several procedures.
  • Most dental insurance has a spending cap and many have a deductible for services other than exams and cleanings.
  • Make sure you know the specifics of your policy. For many families, the spending cap is per person, and includes orthodontia, meaning that orthodontia can be discounted but not entirely.
  • In Michigan, Medicare does not include dental coverage. If you will be aging out of group coverage and into Medicare, schedule a dental exam and any procedures before your coverage lapses.
  • Dental insurance bought on the marketplace may still save you money, depending on your ability to save and what you expect your dental expenses to be. Be sure to check out AARP and professional organizations that you belonged to when you or your partner worked.
  • Be sure that you check with your dentist as to which dental insurance plans she participates in.
  • And check with the dentist’s bookkeeper and insurance coordinator regarding which insurance plans seem to be the most cooperative regarding timely payment and transparency regarding coverage.
  • If you must go without dental insurance, spend money wisely and come in for exams when they are scheduled. Doing without may cost you much more down the road.

Filed Under: dentistry, oral health, patient care Tagged With: dental insurance, Medicare, paying for the dentist

How to Get Your Kids to Brush and Floss

January 3, 2016

child brushing teethIt’s important for kids and adults to get regular dental care through twice yearly cleanings. While at the dentist’s office, your kids will get a gentle and thorough teeth cleaning. But your kids can’t live at the dentist’s office. So, make sure you and your dentist work together to make the lessons from the cleaning cross the threshold into your own home. Some suggestions:

  • Turn your child’s brushing and losing into a game or a competition. There are products out there to help kids brush for long enough. That is the crucial issue, as children underestimate two minutes, which is the minimum amount of time to get teeth properly cleaned. Play a favorite song or video that lasts at least two minutes.
  • Switch to an electric toothbrush. Kids like a “machine” as opposed to an inanimate toothbrush.
  • Attach something large to the ends of dental floss. This give the kids something easier to grip.
  • Make sure your kids really understand the dangers of poor oral hygiene. They should understand that teeth can “get sick” and even “hurt” if we don’t clean them well. Have these discussions without frightening the children, however.
  • Let children choose the elements of their oral health hygiene, including their favorite toothpaste, the color and type of toothbrush they want and even their cups.
  • Brush and floss your teeth when they brush and floss theirs. Be their best role model so they can “do as you do”.

Make the teeth cleaning process regular and fun and ensure that it lasts for long enough, too. Together, you’ll be able to keep the cavities at bay and enjoy years of good dental health.

Filed Under: oral health, patient care

The FAQ’s on X-Rays

December 20, 2015

x ray viewerQUESTION: Why does my dentist suggest x-rays?

ANSWER: X-rays take an image of the bones, the teeth, above the gum line and more importantly, below the gumline. Dental x-rays also reveal the areas between and behind teeth. X-rays can be enlarged to show great detail. With these images, dentists can detect cracks or holes in the enamel, which if left untreated, will allow bacteria to invade the tooth and gum. X-rays also show (in comparison to previous images) any bone loss which is occurring.

QUESTION: How often do I need to be x-rayed?

ANSWER: It depends. We know you hate that answer, but it really is true. Timing of x-rays depends on your personal situation, what your previous oral health history has been, if you are prone to caries (cavities) and/or gum disease, if you have had recent dental work, and if you have other health conditions that could exacerbate dental disease processes, such as diabetes, heart disease or active chemotherapy treatments. Lifestyle choices like smoking also increase the need for more frequent x-rays. Even your age is a consideration.

Most dentists will rightfully insist on new images every 1-3 years with more frequent images if your situation indicates a need.

QUESTION: How safe are dental x-rays?

ANSWER: Pretty safe, but here are some statistics:

Patients are mostly concerned about the amount of radiation that dental x-rays emit.

Radiation of this type is measured in micro-Sieverts. Each x-ray of your teeth on digital or fast-speed film emits about 8 or 9 micro-Sieverts. A panoramic x-ray, which is used to obtain a large image of both the upper and lower jay with a wide lens emits about 24 micro-Sieverts.

So, what can we compare this radiation to?

We are all constantly subject to radiation that comes down to us from outer space, as well as elements in our own earth’s atmosphere that emit radiation. For Michigan residents (since this is a fairly low-lying area), our yearly exposure to this naturally occurring radiation is 3,000- 4,000 micro-Sieverts a year. (Residents of higher altitude regions are subject to higher levels of naturally occurring radiation.)

So, while it is prudent to be concerned with radiation levels of x-rays, your exposure to radiation in the dentist’s chair is a pretty minimal in comparison to the radiation you are regularly exposed to.

If you are concerned with any aspect of dental x-rays, we urge you to talk to your oral health care team.

Filed Under: dentistry, patient care Tagged With: radiation exposure, x-ray frequency, x-ray radiation, x-rays

Before You Retire, See Your Dentist!

August 3, 2015

retirement cakeIf you are about to retire, your to-do list is not short. You have to make a visit to human resources, make arrangements with your pension plan, make a determination about how and when to collect Social Security.

And you have to take care of your teeth.

Many people who are working have the benefit of some sort of dental insurance coverage. But as you move into retirement, that number goes down. You may be able to arrange for dental coverage.

Sources of continuing dental coverage could include:

  • Continuing coverage through your previous employer
  • Certain Medicare Advantage plans (Part C), if you choose one
  • Medicaid coverage for low-income seniors
  • Other association plans that you might be a part of, like AARP or associations or consortiums that were part of your industry

If you have not or cannot obtain continuing dental coverage, then you need to have as many dental health needs dealt with prior to retirement, so make an appointment to see your dentist right away, prior to the end of your insurance coverage. Have a thorough cleaning and make arrangements to deal with any chronic issues prior to your retirement.

If you plan to permanently forego dental insurance coverage, be sure you can afford to pay for dental care out of pocket. If you have had a history of optimal oral health, this might be a reasonable risk. But, for many, this is a poor financial decision. If you are going to be without dental insurance, set aside money for cleanings and treatments, take care of your teeth fastidiously and see a dentist at the earliest sign of tooth or gum problems, while the problem remains small.

Many legislators are trying to include dental care into Medicare coverage, but this is not yet the standard. Until then, the newly retired need to either privately pay for coverage or pay up. A poor choice is to go without dental visits. Please don’t make that choice.

 

Filed Under: patient care Tagged With: dental insurance, Medicare dental coverage

Getting Ready for a First Visit to the Dentist

April 27, 2015

child visit to dentist

If you will be taking your child or grandchild to their first dental appointment soon, good for you! Early dental care is crucial for continued good oral health among the youngest of dental patients. Dental visits may have changed since you were a kid. What can you expect to happen at that first visit?

You might have more anxiety than your child. You may have your own preconceived notions about childhood dentist visits. It is really important that you do not somehow transmit these fears to your child.

For a child, a first visit to the dentist is a happy milestone. It can be a little exciting, and if all goes well, a very positive experience. Many children list their dentists among some of their most trusted adults in their lives. Dentists see them regularly, ask the kids to smile, put the kids in a cool comfy chair, and dentists are trained to be gentle and positive.

What will happen at the first dental visit? In general, the answer is “Nothing scary”. The dentist will look at the teeth very gently and count them. Some dentists will engage the children in helping to count the teeth, too. Dentists will discuss with the caregivers any oral health concerns, including eating and drinking habits, current oral hygiene practices and any worrisome areas, like thumb-sucking. If the children are old enough, the child’s teeth will be gently cleaned and polished.  Dentists can also give parents a timeline as to when teeth should erupt and even when to expect visits from the Tooth Fairy.

Dentists are teachers. Dentists and their staff will help work with older children to make sure they understand how to brush their teeth and why it is important. For parents, having another adult authority who values teeth brushing is very helpful. Whenever there is pushback at home about brushing or flossing, parents can invoke the authority of the dentist, saying, “But Dr. ___said….”

So, make your appointment for that little one and help usher them into a lifetime of great habits and pearly whites.

Filed Under: patient care Tagged With: baby teeth, first dental visit, thumb sucking

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Karen P Meyers, DDS 
1875 Southfield Road, Birmingham, MI  48009

Phone: 248-646-2450

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