Robert A. Klement, DDS

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1310 River Run Dr.
Wisconsin Rapids, WI 54494
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Posts for: July, 2019

By Robert A. Klement, DDS
July 29, 2019
Category: Oral Health
Tags: oral health   bulimia  
ErosionandOtherProblemsmaybeSignsofBulimia

The mouth isn’t an island unto itself — problems there may be indicative of deeper physical or emotional issues.  The condition of a family member’s teeth and gums, for example, could be signs of bulimia, an eating disorder.

Characterized by food binging and purging through self-induced vomiting, bulimia can also have a severe effect on the teeth. Regular inducement of vomiting introduces stomach acid into the mouth that can attack and soften the mineral content of tooth enamel. As a result, 90% of bulimics develop enamel erosion.

The erosion pattern often differs from that produced by other high acid causes like the over-consumption of sodas. Because the tongue instinctively covers the back of the bottom teeth during vomiting, they’re often shielded from much of the acid wash. Bulimics are much more apt to exhibit heavier erosion on the upper front teeth, particularly on the tongue side and biting edges.

Bulimia and similar disorders produce other signs as well, like soft tissue ulceration or swollen salivary glands that exhibit puffiness of the face. The roof of the mouth, throat and back of the tongue may appear roughened from the use of fingers or objects to induce gagging.

Unlike sufferers of anorexia nervosa who tend to be negligent about their hygiene (which itself increases their risk of dental disease), bulimics have a heightened sensitivity to their appearance. This concern may prompt them to aggressively brush right after purging, which can cause more of the softened enamel to be removed.

Treating the dental consequences of bulimia requires a two-pronged approach. In the short term, we want to lessen the impact of stomach acid by discouraging the person from brushing immediately after purging — better to rinse with water and a little baking soda to buffer the acid and wait about an hour before brushing. We may also suggest a sodium fluoride mouth rinse to help strengthen and re-mineralize the enamel.

In the long-term, though, the disorder itself must be addressed through professional help. One good source is the National Eating Disorders website (nationaleatingdisorders.org). Besides information, the association also provides a toll-free helpline for referrals to professionals.

As with any eating disorder, bulimia can be trying for patients and their families. Addressing the issue gently but forthrightly will begin their journey toward the renewal of health, including their teeth and gums.

If you would like more information on the effect of eating disorders on dental health, 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 “Bulimia, Anorexia & Oral Health.”


By Robert A. Klement, DDS
July 19, 2019
Category: Dental Procedures
Tags: crowns  
CustomizedTemporaryCrownsHelpEnsureaSatisfyingPermanentSmile

Restoring missing or unattractive teeth can often be a lengthy process. Months may elapse between initial teeth preparation and final placement to allow time for tissue healing and permanent crown manufacturing. During that period you will likely wear temporary (provisional) crowns to protect the teeth while improving function and appearance.

In the past, provisional crowns were fairly uniform. Today, though, there are provisional crowns available that conform exactly to a patient’s individual mouth. These crowns not only enhance function and appearance, they’re an excellent way to “try out” your new smile before the permanent restoration.

Customized provisional crowns are part of a concept known as “smile analysis.” A new smile involves more than restoring affected teeth: we also consider the overall health of your mouth, the shape of your face, and your own desires and expectations. Your final smile design is a joint collaboration between you, our office and the dental laboratory that will fashion the final restoration.

There are a number of techniques for creating customized provisional crowns. Some techniques involve bonding tooth-colored materials like composite resin directly to the teeth. Others use impression models of your teeth to create an outline or shell that’s filled with an acrylic material and then affixed to your teeth. The aim with any of these techniques is to produce a provisional crown that accurately reflects the final crown’s appearance.

With these types of provisional crowns, we can see how the new teeth will look (their color, shading, shapes and proportions) against the gums, and if they appear to be in balance and harmony with the entire face, including your lips, jaws and facial contour. We can also evaluate how well the new teeth function as you chew, speak or smile.

It takes some extra effort to prepare customized provisional crowns rather than the more uniform version. But this effort is well worth it: by helping us anticipate more accurately how your new restorations will appear and function, customized crowns help ensure your new smile is an attractive and satisfying one.

If you would like more information on temporary restorations, 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 “Concepts of Temporary Restorations.”


By Robert A. Klement, DDS
July 09, 2019
Category: Oral Health
NBAPlayersInjuryPointsOutNeedforMouthguards

Basketball isn't a contact sport—right? Maybe once upon a time that was true… but today, not so much. Just ask New York Knicks point guard Dennis Smith Jr. While scrambling for a loose ball in a recent game, Smith's mouth took a hit from an opposing player's elbow—and he came up missing a big part of his front tooth. It's a type of injury that has become common in this fast-paced game.

Research shows that when it comes to dental damage, basketball is a leader in the field. In fact, one study published in the Journal of the American Dental Association (JADA) found that intercollegiate athletes who play basketball suffered a rate of dental injuries several times higher than those who played baseball, volleyball or track—even football!

Part of the problem is the nature of the game: With ten fast-moving players competing for space on a small court, collisions are bound to occur. Yet football requires even closer and more aggressive contact. Why don't football players suffer as many orofacial (mouth and face) injuries?

The answer is protective gear. While football players are generally required to wear helmets and mouth guards, hoopsters are not. And, with a few notable exceptions (like Golden State Warriors player Stephen Curry), most don't—which is an unfortunate choice.

Yes, modern dentistry offers many different options for a great-looking, long lasting tooth restoration or replacement. Based on each individual's situation, it's certainly possible to restore a damaged tooth via cosmetic bonding, veneers, bridgework, crowns, or dental implants. But depending on what's needed, these treatments may involve considerable time and expense. It's better to prevent dental injuries before they happen—and the best way to do that is with a custom-made mouthguard.

Here at the dental office we can provide a high-quality mouthguard that's fabricated from an exact model of your mouth, so it fits perfectly. Custom-made mouthguards offer effective protection against injury and are the most comfortable to wear; that's vital, because if you don't wear a mouthguard, it's not helping. Those "off-the-rack" or "boil-and-bite" mouthguards just can't offer the same level of comfort and protection as one that's designed and made just for you.

Do mouthguards really work? The same JADA study mentioned above found that when basketball players were required to wear mouthguards, the injury rate was cut by more than half! So if you (or your children) love to play basketball—or baseball—or any sport where there's a danger of orofacial injury—a custom-made mouthguard is a good investment in your smile's future.

If you would like more information about custom-made athletic mouthguards, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Athletic Mouthguards” and “An Introduction to Sports Injuries & Dentistry.”




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