My Blog
By Dr. JoAnne Bernard, DDS., PA
December 09, 2018
Category: Uncategorized
Tags: oral hygiene  
WhatYouNeedtoKnowtoBuytheRightToothbrush

If there’s one essential tool for protecting your dental health, it’s the humble toothbrush. The basic manual brush with a long, slender handle and short-bristled head is still effective when used skillfully. The market, though, is full of choices, all of them touting their brand as the best.

So how do you choose? You can cut through any marketing hype with a few simple guidelines.

First, understand what you’re trying to accomplish with brushing: removing dental plaque, that thin film of bacteria and food particles on tooth surfaces that’s the main cause of dental disease. Brushing also stimulates gum tissue and helps reduce inflammation.

With that in mind, you’ll first want to consider the texture of a toothbrush’s bristles, whether they’re stiff (hard) or more pliable (soft). You might think the firmer the better for removing plaque, but actually a soft-bristled brush is just as effective in this regard. Stiffer bristles could also damage the gums over the long term.

Speaking of bristles, look for those that have rounded tips. In a 2016 study, less rounded tips increased gum recession in the study’s participants by 30%. You should also look for toothbrushes with different bristle heights: longer bristles at the end can be more effective cleaning back teeth.

As far as size and shape, choose a brush that seems right and comfortable for you when you hold it. For children or people with dexterity problems, a handle with a large grip area can make the toothbrush easier to hold and use.

And look for the American Dental Association (ADA) Seal of Acceptance, something you may have seen on some toothpaste brands. It means the toothbrush in question has undergone independent testing and meets the ADA’s standards for effectiveness. That doesn’t mean a particular brush without the seal is sub-standard—when in doubt ask your dentist on their recommendation.

Even a quality toothbrush is only as effective as your skill in using it. Your dental provider can help, giving you tips and training for getting the most out of your brush. With practice, you and your toothbrush can effectively remove disease-causing plaque and help keep your smile beautiful and healthy.

If you would like more information on what to look for in a toothbrush, 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 “Sizing up Toothbrushes.”

By Dr. JoAnne Bernard, DDS., PA
November 29, 2018
Category: Oral Health
Tags: tmj disorders  
TMDandFibromyalgiaCouldShareLinksinChronicPain

Chronic pain can turn your life upside down. While there are a number of disorders that fit in this category, two of them—fibromyalgia and temporomandibular disorders (TMD)—can disrupt your quality of life to the extreme. And it may be the two conditions have more in common than similar symptoms—according to one study, three-fourths of patients diagnosed with fibromyalgia show symptoms of TMD.

To understand why this is, let’s take a closer look at these two conditions.

Fibromyalgia presents as widespread pain, aching or stiffness in the muscles and joints. Patients may also have general fatigue, sleep problems, mood swings or memory failures. TMD is a group of conditions that often result in pain and impairment of the temporomandibular joints that join the jaw with the skull. TMD can make normal activities like chewing, speaking or even yawning painful and difficult to do.

Researchers are now focusing on what may, if anything, connect these two conditions. Fibromyalgia is now believed to be an impairment of the central nervous system within the brain rather than a problem with individual nerves. One theory holds that the body has imbalances in its neurotransmitters, which interfere with the brain’s pain processing.

Researchers have also found fibromyalgia patients with TMD have an increased sensitivity overall than those without the conditions. In the end, it may be influenced by genetics as more women than men are prone to have either of the conditions.

Treating these conditions is a matter of management. Although invasive techniques like jaw surgery for TMD are possible, the results (which are permanent) have been inconclusive in their effectiveness for relieving pain. We usually recommend patients try more conservative means first to lessen pain and difficulties, including soft foods, physical therapy, stretching exercises and muscle relaxant medication. Since stress is a major factor in both conditions, learning and practicing relaxation techniques may also be beneficial.

In similar ways, these techniques plus medication or cognitive-behavioral therapy that may influence neurotransmission can also help relieve symptoms of fibromyalgia. Be sure then that you consult with both your physician and dentist caring for both these diseases for the right approach for you to help relieve the effects of these two debilitating conditions.

If you would like more information on managing TMD or fibromyalgia, 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 “Fibromyalgia and Temporomandibular Disorders.”

By Dr. JoAnne Bernard, DDS., PA
November 19, 2018
Category: Oral Health
Tags: celebrity smiles   retainer  
FanofSuperheroFilmBlackPantherBreaksSteelWirewithHerMouth

Some moviegoers have been known to crunch popcorn, bite their fingers or grab their neighbor’s hands during the intense scenes of a thriller. But for one fan, the on-screen action in the new superhero film Black Panther led to a different reaction.

Sophia Robb, an 18-year-old Californian, had to make an emergency visit to the orthodontic office because she snapped the steel wire on her retainer while watching a battle scene featuring her Hollywood crush, Michael B. Jordan. Her jaw-clenching mishap went viral and even prompted an unexpected reply from the actor himself!

Meanwhile, Sophia got her retainer fixed pronto—which was exactly the right thing to do. The retention phase is a very important part of orthodontic treatment: If you don’t wear a retainer, the beautiful new smile you’re enjoying could become crooked again. That’s because if the teeth are not held in their new positions, they will naturally begin to drift back into their former locations—and you may have to start treatment all over again…

While it’s much more common to lose a removable retainer than to damage one, it is possible for even sturdy retainers to wear out or break. This includes traditional plastic-and-wire types (also called Hawley retainers), clear plastic retainers that are molded to fit your teeth (sometimes called Essix retainers), and bonded retainers: the kind that consists of a wire that’s permanently attached to the back side of your teeth. So whichever kind you use, do what Sophia did if you feel that anything is amiss—have it looked at right away!

When Black Panther co-star Michael B. Jordan heard about the retainer mishap, he sent a message to the teen: “Since I feel partly responsible for breaking your retainers let me know if I can replace them.” His young fan was grateful for the offer—but even more thrilled to have a celebrity twitter follower.

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

By Dr. JoAnne Bernard, DDS., PA
November 09, 2018
Category: Dental Procedures
Tags: dental implants  
AvoidImplantFailurebyWatchingOutforTheseMouthProblems

There are several reasons why dental implants are so popular. Perhaps the most important, though, is their longevity: if maintained properly implants can last for decades. However, they’re not indestructible—certain mouth conditions could put them at risk for early failure. But if you address emerging problems early, you may be able to prevent that unfortunate outcome.

Your implants may be in danger, for example, if you have a teeth grinding or clenching habit. This occurs when a person involuntarily and repeatedly bites down on their teeth when not chewing or speaking. Usually triggered in adults by high stress, teeth grinding can subject both natural teeth and implants to damaging levels of force. Over time this can cause bone loss around an implant and weaken their support. It could also cause a direct break in an implant.

But there are ways to stop or at least reduce the effects of teeth grinding. One effective way is a custom-made bite guard you wear while you sleep. Made of hard plastic, the guard prevents the teeth from making solid contact with each other, reducing the amount of force generated.

A more prominent problem is periodontal (gum) disease, a bacterial infection caused by built-up dental plaque on tooth surfaces. This can trigger inflammation, a normal defensive response that when it persists for an extended period of time can damage tissues and supporting bone. It can also cause a specific form of gum disease related to implants called peri-implantitis, in which the tissues that support an implant become infected and weaken, leading eventually to possible implant failure.

If you have implants, then, you should brush and floss daily to prevent gum disease, as well as see your dentist at least every six months for cleanings and checkups. And if you notice anything like reddened, swollen or bleeding gums, see your dentist immediately. The sooner you undergo treatment, the better the outcome for your implants as well as your overall health.

Dental implants can give you years of great service and can prove to be well worth the cost. But you’ll have to stay on your guard against gum disease and other mouth conditions that could endanger them down the road.

If you would like more information on dental implants, 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 “Dental Implants: A Tooth-Replacement Method that Rarely Fails.”

By Dr. JoAnne Bernard, DDS., PA
October 30, 2018
Category: Oral Health
Tags: jaw pain   tmj disorders  
TrytheConservativePathtoJawPainReliefFirst

If you have chronic jaw pain, you know how difficult eating, speaking or even smiling can be. Many sufferers will do anything to gain relief, even surgery. But before you go down that road, consider the traditional conservative approach to temporomandibular disorders (TMD) management first—it could provide the most relief with the least risk of side effects.

The temporomandibular joints connect the lower jaw to the skull on either side of the head. These ball and socket joints also contain a cushioning disk to facilitate movement. This disk is believed to be the primary focus for jaw pain problems known collectively as TMD.

Doctors now believe injury, stress, metabolic issues, jaw anatomy defects or similar factors trigger the chain reaction of muscle spasms, pain and soreness that can erupt during a TMD episode. A TMD patient may experience pain within the jaw muscles or joints themselves, clicking sensations, or an inability to open the jaw to its full range.

TMD therapy has traditionally followed an orthopedic path—treating jaw joints like any other joint. In recent years, though, a more aggressive treatment model has emerged that promotes more invasive techniques like orthodontics, dental work or jaw surgery to relieve discomfort. But the track record for this model, especially concerning jaw surgery, remains hazy at best and offers no guarantee of relief. These techniques are also irreversible and have even made symptoms worse in some patients.

It’s usually prudent, then, to try conservative treatments first. This can include pain and muscle relaxant medication, jaw exercises, stretching and massage, and dietary changes to reduce chewing force. Patients with teeth grinding habits may also benefit from a bite guard worn at night to reduce the biting force during sleep and help the joints relax.

By finding the right mix of treatments, you may be able to find significant relief from TMD symptoms with the conservative approach. If not, you might then discuss more invasive options with your dentist. But even if your dentist recommends such a procedure, you would be wise to seek a second opinion.

TMD can definitely interfere with your quality of life and peace of mind. But there are ways to reduce its effects and make for a happier life.

If you would like more information on managing chronic jaw pain, 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 “Seeking Relief from TMD.”





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