Dr. Michael McGrath McGrath Dental Caring 5108 Velasko Road Syracuse, NY 13215 (315) 478-5719
Non-Surgical Gum Therapy
"The mouth is the barometer of the whole body." Sir William Osler, 19th Century Physician and Researcher
PERIODONTITIS
SEVERE PERIODONTITIS
"SEVERE PERIODONTAL DISEASE IS EQUVALENT TO A WOUND
OF ABOUT 8 SQUARE INCHES ON YOUR SKIN!!!!!"
Denise Grady, American Academy of Periodontology
Chicago, New York Times News February 1998
Recently, newspapers and periodicals have been reporting on research which shows a correlation between periodontal disease and stroke, heart attack, diabetes, pre-term, low birth weight infants and stomach ulcers. About 65 percent of the adult population in this country suffer from some form of periodontal disease. The major cause of this disease is the accumulation of bacteria-ridden plaque under the gum line.
Periodontal disease is an infection between your teeth and gums.
By-products of bacterial infections cause bone loss; therefore, loosening of the teeth and tooth loss.
Periodontal disease is a long-term degenerative disease that must be controlled.
The treatment of choice is no longer surgery. Anti-infective therapy is usually successful without gum surgery.
Microbiological tests and anti-infective therapies are used in the treatment of gum infection in the same way your physician would culture and treat an infected wound.
Treatment takes into account both local factors and systemic risk factors treating causes, not just effects.
A.
B.
C.
D.
E.
There are steps you can take at home to combat bacterial growth under your gums, such as using irrigating devices with anti-infective solutions.
Toothbrushes, dental floss and mouthwash are designed to clean your teeth, NOT to effectively treat destructive bacterial infections under your gums.
Using hand and ultrasonic instruments, our hygienists meticulously clean the teeth, gums and root surfaces in combination with anti-infective irrigants.
Perio Protect - What is Perio Protect?
The method is a combination of treatments, including a non-invasive chemical debriding therapy used in conjunction with traditional mechanical debriding procedures. The chemical therapy involves a tray delivery of doctor-prescribed solutions to chemically debride biofilm from the periodontal pocket and alter the pocket's microbiological environment to disrupt biofilm growth.
The standard cleaning procedures in dental offices (e.g. scaling and root planing) help remove plaque and tartar and help reduce bacteria, but unfortunately bacteria reproduce quickly and biofilms regenerate very easily, so it is difficult to control them between office visits.
With the Perio Protect Method, you can place prescribed solutions into periodontal pockets with an appropriately formed, customized dental tray between office visits to help manage biofilm. Although a dentist must choose the most appropriate solution for individual patients, the most commonly prescribed solution with the Method has oxidizing and oxygenating agents. Oxidizing agents debride (chemically remove) the slimy protective coating of a biofilm and its underlying layers and also cleanse the oral wounds.
Dentists may choose to treat the oral wounds with the chemical debriding and cleansing agents before mechanical debriding procedures to help reduce bacterial populations and thus reduce the risk of introducing bacteria into the bloodstream during mechanical debridement.
For most people following the Perio Protect Method, the placement of prescribed solutions into a periodontal pocket via a customized prescription tray requires only minutes each day. Patients describe the tray delivery as comfortable and appreciate its non-invasive technology.
The actual combination of mechanical treatment, chemical therapies, and prescribed treatment plan is determined by a dentist evaluating your specific conditions.
Our goal at McGrath Dental Caring is to deliver the most biocompatible dentistry possible. We recognize the impact of toxic materials and relate it to dental and physiological health. We seek to avoid materials that are toxic to the body, including metals whenever possible; the purpose being to prevent a potential galvanic response (“battery effect”) in the mouth.
What makes a good dental material?
“Ideally, then, a dental material that is to be used in the oral cavity should be harmless to the pulp and soft tissues, Also, it should contain no toxic diffusing substances that can be absorbed into the circulatory system to cause a systemic toxic response. The material should be free of potential sensitizing agents that could lead to an allergic response. Finally, the material should have no carcinogenic potential.”
Ralph Williams (1982): Skinner’s Science of Dental Materials. 8th ed. Philadelphia: W.B. Saunders Co, 311. Pp. 59 and 60.
As an accredited member of the International Academy of Oral Medicine and Toxicology (IAOMT), Dr. McGrath subscribes to standards of care defined by evidence-based research and clinical studies, including the Patient Protection During Mercury Amalgam Removal Standards setforth by the IAOMT. These standards can be examined by visiting www.iaomt.com.
Do you wake yourself or someone else with your snoring?
Studies show that about 40 percent of middle-aged men and nearly 30 percent of middle-aged women snore.
What causes snoring?
Snoring occurs when the soft palate and the uvula vibrate against the back of the throat or base of the tongue when a snorer inhales. As you sleep the muscles in your mouth relax, including your tongue, causing your airway to narrow. This narrowing leads to increased pressure in the airway and harder breathing, which causes loud snoring.
How serious is snoring? Connections have been made between snoring and potentially fatal obstructive sleep apnea (OSA). OSA is an illness in which the soft tissues at the back of the throat completely close off the airway so that air cannot flow into the lungs. As the brain becomes aware of this blockage, a loud gasp is often heard and breathing often accompanied by snoring resumes. OSA and snoring have been linked to diseases, such as hypertension, high blood pressure, stroke and cardiovascular disease.
Sleep apnea is very common, as common as adult diabetes, and affects more than twelve million Americans, according to the National Institutes of Health. Risk factors include being male, overweight, and over the age of forty, but sleep apnea can strike anyone at any age, even children. Yet still because of the lack of awareness by the public and healthcare professionals, the vast majority remain undiagnosed and therefore untreated, despite the fact that this serious disorder can have significant consequences.
What are the symptoms of OSA?
Excessive daytime sleepiness
Difficulty staying awake during meetings, conversations, etc…
Impaired ability to concentrate
Headaches
Impotency
Weight gain
Memory problems
Fortunately, sleep apnea can be diagnosed and treated. Several treatment options exist, and research into additional options continues.
What is Oral Appliance Therapy?
Oral appliances are worn in the mouth to treat snoring and OSA, very similar to an orthodontic retainer or sports mouth guard. One of the causes of OSA and snoring is your tongue. When you sleep, your tongue can reposition itself blocking your airway. The appliance repositions your jaw so that the airway remains unobstructed throughout the night. Each oral appliance is customized for your own individual needs based on the severity of your condition. Oral appliances can be used alone or in combination with other means of treating OSA such as a C-PAP. Dr. McGrath can design an appliance to help adjust the position of your tongue and restore peace to your bedroom.
OSA Screening
Answer YES or NO
I choke or gasp during sleep.
Yes
No
I awake with a sore, dry throat.
Yes
No
I awake with a headache.
Yes
No
I awake tired and have excessive daytime sleepiness.
Yes
No
My snoring affects my relationship with my partner.
Yes
No
My snoring causes my partner to be irritable or tired.
Yes
No
My snoring requires us to sleep in separate rooms.
Yes
No
My snoring is loud.
Yes
No
If you answered yes to one or more of the previous,
continue to the Epworth Sleepiness scale below.
Epworth Sleepiness Scale
The Epworth Sleepiness Scale is used to determine the level of daytime sleepiness. A score of 9 or more is considered sleepy. A score of 18 or more is very sleepy. If you score 9 or more on this test, you should consider whether you are obtaining adequate sleep, need to improve your sleep hygiene and/or need to see a sleep specialist. These issues should be discussed with a sleep professional. Our office will provide you with a referral for further diagnosis.
How likely are you to fall asleep in the following situations?
0 = Would never doze
1 = Slight chance of dozing
2 = Moderate chance of dozing
3 = High chance of dozing
Activity Score
Sitting and reading
_____
Watching television
_____
Sitting, inactive, in a public place (theatre, meeting)
_____
As a passenger in a car for an hour with no break
_____
Lying down to rest in the afternoon, if circumstances permit
_____
Sitting and talking to someone
_____
Sitting quietly after lunch without alcohol
_____
In a car while stopped for a few minutes in traffic (you are the driver)
_____
TOTAL SCORE:
_____
A score of ten (10) or above indicates you may be having a problem with daytime sleepiness. However, below ten does not necessarily mean you do not have a problem.
Print out this test, fill in your answers and see where you stand.
What is TMJ Disorder?
The temporomandibular joint, or TMJ, is the jaw joint, located on either side of the face, just in front of the ear. TMJ Disorder is a condition that occurs when the TMJs are subjected to excess pressure through misalignment of the teeth or malfunction of the muscles/ jaw. According to the American Dental Association, approximately 75 million people in the United States suffer from some form of TMJ Disorder.
Causes of TMJ Disorder:
TEETH
Misaligned teeth, missing teeth and poor dental work including orthodontics
MUSCLES
Incorrect swallowing habit from childhood which push the jaw back.
Mouth breathing
Clenching teeth
Grinding teeth (bruxism)
JAW
Incorrect jaw growth causing mismatch of the upper and lower jaws.
Trauma such as a fall or car accident (very common in whiplash injuries).
Degenerative diseases such as osteoarthritis.
Occlusion (or “bite”) that causes the jaw to be incorrectly positioned when the teeth are closed together.
Diagnosis and Treatment:
Diagnosis requires a complete medical history, through examination of the TM joints, teeth and muscles, X-Rays, study models and bite analysis. Treatment varies depending on your individual condition with the focus on being able to restore normal function and eliminate discomfort. These may include splint therapy, physical therapy, TENS and orthodontic treatment. Surgical treatment is very rare and can be avoided with early treatment.
Dental implants are an option for patients who are missing permanent teeth. Rather than resting on the gum line like removable dentures, or using adjacent teeth as anchors like fixed bridges, dental implants are long-term replacements that are surgically placed in the jawbone. Composed of titanium metal that "fuses" with the jawbone through a process called "osseointegration," dental implants never slip or make embarrassing noises that advertise the fact that you have "false teeth," and never decay like teeth anchoring fixed bridges. Because dental implants fuse with the jawbone, bone loss is generally not a problem.
After more than 20 years of service, the vast majority of dental implants first placed in the United States continue to still function at peak performance. If properly cared for, dental implants can
last a lifetime.
Your bite (occlusion) is the foundation of dentistry. Occlusion is affected by a triad of factors — the teeth, the muscles and the temporomandibular joints. Traditional dentistry has focused on the teeth — what might be called "one-dimensional" dentistry. Neuromuscular Dentistry (NMD) is a term that has been applied to the additional consideration of the "second & third dimensions" — muscles and TM joints. Neuromuscular dentistry works with the hard tissues (teeth, bones) and the soft tissues (muscles and nerves) to place the jaw into its optimal position, relieving symptoms associated with the TMJ.
When your jaw is misaligned, both the hard and soft tissues are affected resulting in many physical problems such as:
Headaches
Tooth pain
Jaw pain
Ringing in the ears
Clicking and popping sounds in the jaw joint
Neck and shoulder pain
These symptoms are often associated with temporomandibular joint dysfunction (TMD). People who suffer from TMJ pain often have an imbalance between the muscles, joints and teeth, which is caused by a bad bite (malocclusion).
In Neuromuscular dentistry, the dentist understands that the relationship between the hard and soft tissues is complicated and works to restore balance to the system. Dr. McGrath begins with a comprehensive evaluation and develops an individualized plan to correct and realign the jaw. The section on neuromuscular equipment will familiarize you with many of the diagnostic tests Dr. McGrath uses.
Why is my bite “off”? How did this happen?
Bad oral habits are usually the culprit when it comes to having a “bad bite”. Bad oral habits include but are not limited to:
Mouth breathing
Incorrect tongue positioning
Incorrect swallow patterns
Tongue thrust
Thumb sucking
Failure to replace missing teeth
Many oral habits are correctable and since these habits affect the growth of the jaw and the eruption pattern of the teeth it is important to correct the habits and retrain the muscles at the earliest possible age.
Your interest in dentistry could not have come at a better time. Recent advances in modern dentistry have solved some previously hopeless problems. For over 20 years, Dr. McGrath has studied techniques with the best denture experts in the country. He will take the time to understand your unique problems and concerns. Your custom made dentures will look and feel the way you like. We will go that extra mile to make sure that you have the most secure, comfortable fit possible. Trust in his experience, Dr. McGrath is confident he can give you something to smile about!
Conventional Dentures
“Throughout my years of experience, I have come to understand the problems denture wearers face. I take extra time to customize your dentures to enhance the cosmetic appearance and overall fit. Your dentures are individually made for the best functioning and chewing of your food. They will be tailor-made to fit your mouth exquisitely.”
—Dr. McGrath
“ I was embarrassed. I never smiled anymore. I knew that everyone could tell that I had dentures; they looked like dentures. They were constantly shifting. I couldn’t guarantee that they would stay in place. Even my speech changed. I was no longer confident speaking in social situations. My new dentures really came to the rescue! They look so real! It’s no longer obvious that I have dentures. Since they are custom made for my mouth, I know I do not have to worry that they will stay in place. I sound like myself again and as for smiling ... I just can’t stop!”
Implant Retained Dentures
“In some cases, so much of the bone structure needed to support dentures has been lost, that you can no longer get tight fitting dentures using conventional methods. In these situations, implants are used to stabilize and retain dentures. Dentures coupled with implants, offer the most natural-looking and fitting dentures possible.”
—Dr. McGrath
“I’d had it with the bad taste of denture adhesive. My dentures were constantly loose. I couldn’t enjoy the taste of my food because of the plastic from my dentures. I wanted to taste things again. My dentures had even caused bone loss in my mouth! I wanted to have something to smile about again. Then everything changed for me. My new implants gave me the strongest most secure bite I’ve ever had. I can smile all the time and not worry about loose dentures. Since there’s no plastic covering my taste buds, it’s like I’m eating my favorite foods for the first time!”
Orthodontics is about more than the cosmetic repositioning of teeth. It also includes correcting “bad” habits that have caused the orthodontic condition. Research has shown that genetics are not the only culprit when it comes to crooked, crowded teeth. Poor myofunctional habits such as a tongue thrust, thumb or finger sucking, mouth breathing, and reverse swallowing all influence growth and dental alignment. Fixed orthodontic braces are designed to straighten teeth but they do not correct myofunctional habits.
To be effective, orthodontic treatment must address the underlying myofunctional problems causing the orthodontic disorder. Orthopedic effects of a functional appliance with a tooth guidance system plus a myofunctional training feature have been scientifically proven to reverse a deteriorating orthodontic condition, improve facial shape, realign the teeth and develop proper arch form.
Functional Orthodontics–
ALF Appliances
ALF stands for Advanced Lightwire Functionals.
It is a method to straighten teeth (orthodontic treatment).
It addresses posture (how the patient stands; orthopedic treatment) using principles of cranial osteopathy.
It brings about changes in muscle function to achieve stable results.
ALF is a whole-body-and-mind approach to straightening teeth and improving the bite (occlusion).
ADVANTAGES are:
cosmetics - barely visible from the outside
gentle - far less discomfort than with braces
treatment visits only every 6 to 8 weeks
stable
In general treatment time ranges anywhere from 2 to 4 years and achieves:
correction of existing cranial strains
developing of the upper and lower dental arches by expanding
them where needed
repositioning of the lower jaw relative to the upper
establishing the correct height of occlusion/bite (an over-closed
bite creates muscle spasms and forces the jaw joints out of position)
retention of the new position to allow the bone and teeth to solidify
and fully adapt to the new position
Treatment duration and technique vary between patients according to individual needs. Most of the treatment can be done with ALF appliances.
The ALF appliances need to be worn all the time. They are hardly visible from the outside and therefore interfere very little with your looks.
The initial period of adjustment to the appliance is short – usually about 2 to 3 days. Your tongue has to reposition and this will affect your speech a little bit in the beginning. Reading out loud to yourself is a fast way to adapt.
Special attention needs to be given to oral hygiene since food will get caught between the wire and your teeth. It is mandatory that you brush after each meal and minimize snacks, particularly sweet ones. You will still be able to floss between most teeth. Use of an oral irrigator makes home care much easier and is highly recommended.
ClearCorrect invisible braces are the
clear and simple way to straighten your teeth
so you can show off your smile!
Looking for an alternative to metal braces? ClearCorrect is the clear and simple choice. No wires. No brackets. Just clear, convenient comfort—every reason to smile.
With ClearCorrect, your dentist or orthodontist can straighten your teeth using a series of clear, custom, removable aligners. Each aligner moves your teeth just a little bit at a time until you eventually get straight teeth.
The MYOBRACE® effectively treats the causes of malocclusion, simultaneously providing myofunctional training, arch expansion and individual tooth alignment. The MYOBRACE™ is a new concept in orthodontic treatment, incorporating design characteristics to align the front teeth and the mandible into a Class I occlusal relationship (ideal). Individually sized tooth slots and arch size are pre-molded into a flexible appliance with an active inner DynamiCore™ for arch development. Suitable for many people requiring orthodontic treatment. For more information about these appliances including instructional videos, visit http://www.myoresearch.com/cms/index.php?trainer_system_gpe.
Today's dental materials are complex
and numerous. Patients are increasingly concerned about what materials
are being placed in their mouths. McGrath Dental Caring uses Clifford
Materials Reactivity Testing to determine your individual suitability
to hundreds of dental materials. Testing screens your blood for
antibodies. Antibodies that have been specifically formed against
harmful agents are detected and analyzed. This risk assessment helps
to select dental materials that could be used with the least degree
of risk in meeting your dental needs.
Oral cancer is one of the most curable diseases when it's caught early. That's why the ViziLite Plus exam has been developed. ViziLite Plus uses technology that has proven successful in identifying soft tissue abnormalities in other areas of the body. A ViziLite Plus exam is particularly important if you are at increased risk for developing oral cancer. An annual ViziLite Plus exam, in combination with a regular visual examination, provides a comprehensive oral screening procedure for patients at increased risk for oral cancer. The ViziLite Plus exam is painless and fast, and could help save your life.
Periodontal disease and several other oral infections are caused by specific bacteria. Because of the bacteriological specificity associated with these diseases, it is now possible for dentists to make a diagnosis and plan a course of treatment that is both practical and rigorously scientific. The concept developed “microbial fingerprints” in periodontal disease, i.e., there are microbial floras associated with health and there are different microbial floras associated with different diseases.
Effective management of periodontal disease requires early diagnosis and intervention. Periodontitis, even in remission, can be difficult to diagnose through examination only. USC Centers for Oral Health offers Oral Microbiology testing to aid in the treatment of periodontitis. This bacterial testing is useful in determining the progress of periodontal disease, in assessing treatment success and in selecting the proper anti-microbial therapy.
Do you clench or grind your teeth while sleeping?
What is Bruxism?
Bruxism is an oral parafunction consisting of clenching and grinding of teeth during the night leading to teeth damage. Symptoms include severe tooth wear, temporomandibular joint disorder (TMD), morning headaches, disturbed sleep and daytime sleepiness. You may be unaware of the condition, however others around you may complain of loud grinding sounds produced by the friction of the teeth.
The BiteStrip®: can identify the existence and frequency of bruxism. This accurate, single use home screening device can be used to confidently and precisely prepare for and evaluate bruxing therapy, treatment of a malocclusion, occlusal restoration, and TMJ therapies.
How will I know if I am a bruxist? Ask yourself:
Do you clench teeth strongly while sleeping?
Did your bed partner complain that you grind teeth while sleeping?
Do you feel pain/stiffness/weariness in your jaws when waking up?
Do you have difficulty to open your jaws when waking up?
Do you hear “click” sound when open your jaws first time in the morning?
Are your teeth sensitive to cold/hot liquid or air?
If the answer to one or more of these questions is positive, you must check yourself before it is too late. Simple to use, the self-adhesive device is placed directly over the masseter muscle before sleeping and you perform 3-4 voluntary clenches to establish an individual baseline. A central processing unit records the number of clenching events based on a percentage of the baseline. Study results are ready in the morning.
A.
B.
C.
D.
E.
Sleep apnea is very common, as common as adult diabetes, and affects more than twelve million Americans, according to the National Institutes of Health. Risk factors include being male, overweight, and over the age of forty, but sleep apnea can strike anyone at any age, even children. Yet still because of the lack of awareness by the public and healthcare professionals, the vast majority remain undiagnosed and therefore untreated, despite the fact that this serious disorder can have significant consequences.
Oral cancer is one of the most curable diseases when it's caught early. That's why the ViziLite Plus exam has been developed. ViziLite Plus uses technology that has proven successful in identifying soft tissue abnormalities in other areas of the body. A ViziLite Plus exam is particularly important if you are at increased risk for developing oral cancer. An annual ViziLite Plus exam, in combination with a regular visual examination, provides a comprehensive oral screening procedure for patients at increased risk for oral cancer. The ViziLite Plus exam is painless and fast, and could help save your life.
