Posts for: March, 2016

By Carlos Abreu, D.M.D. and Mahvassh Abreu, D.M.D.
March 29, 2016
Category: Dental Procedures
NeilPatrickHarrisWhattheOscarsHostTreasuresMost

A few days before the Oscars, Vanity Fair magazine asked Academy Awards host Neil Patrick Harris to name his most treasured possession. Was it his Tony award statuette for best leading actor in a musical? His star on the Hollywood Walk of Fame? The stethoscope he wore while playing teenaged doctor Doogie Howser on TV? No, as it turns out, the 41-year-old actor’s most treasured possession is… his wisdom teeth. Yes, you read that correctly. “Oddly, I still have my four wisdom teeth,” Harris said. “I refuse to let them go or I’ll lose my wise parts.”

How odd is it for a 41-year-old to have wisdom teeth? Actually, not that odd at all. While it is true that wisdom teeth are often removed, there’s no one-size-fits-all approach to this. It all depends on whether they are causing problems now, or are likely to cause problems in the future.

The trouble wisdom teeth cause is related to the fact that they are the last molars to come in, and that molars are large in size. By the time wisdom teeth appear between the ages of 17 and 21, there often is not enough room for them in the jaw. Sometimes it’s because you may have inherited a jaw size that’s too small for your tooth size; and generally speaking, the size of the human jaw has evolved to become smaller over time.

If room is lacking, the adjacent molar (that came in earlier) can interfere with the path of eruption — causing the wisdom tooth to come in at an odd angle. The wisdom tooth can hit up against that other tooth, possibly causing pain or damaging the adjacent tooth. This is known as “impaction.” Sometimes the wisdom tooth breaks only partway through the gum tissue, leaving a space beneath the gum line that’s almost impossible to clean, causing infection. A serious oral infection can jeopardize the survival of teeth, and even spread to other parts of the body.

If a wisdom tooth is impacted, will you know it? Not necessarily. A tooth can be impacted without causing pain. But we can see the position of your wisdom teeth on a dental x-ray and help you make an informed decision as to whether they should stay or go. If removal is the best course of action, rest assured that this procedure is completely routine and that your comfort and safety is our highest priority. If there is no great risk to keeping them, as Neil Patrick Harris has done, we can simply continue to monitor their condition at your regular dental checkups. It will be particularly important to make sure you are reaching those teeth with your brush and floss, and that you keep to your schedule of regular professional cleanings at the dental office. All healthy teeth are indeed worth treasuring.

If you would like more information about wisdom teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”


By Carlos Abreu, D.M.D. and Mahvassh Abreu, D.M.D.
March 14, 2016
Category: Oral Health
Tags: oral hygiene   gum disease  
AdvancingGumDiseaseRequiresThoroughTreatmenttoControlit

If you ever get out of the habit of daily brushing and flossing, you’re setting yourself up for dental disease. Neglecting oral hygiene allows bacterial plaque to build up on tooth surfaces, which can give rise to aggressive gum infections known collectively as periodontal (gum) disease.

Gum disease may first manifest itself as gingivitis, an inflammation of the outer gum tissues around teeth. Resuming hygiene habits could help reduce the infection if it’s detected early enough. If the infection has spread deeper below the gum line, though, brushing and flossing won’t be able to reach and remove the offending plaque — you’ll need our help with that.

The objective of any such treatment is the same as your daily brushing and flossing — remove plaque as well as hardened deposits (calculus) that cause disease. The most basic technique is called scaling in which we use specialized hand instruments (scalers) or ultrasonic equipment to loosen and remove the plaque and calculus from all tooth and gum surfaces.

For deeper plaque, we may need to use a technique called root planing. As its name implies, we use equipment similar to scalers to shave or “plane” plaque, calculus, bacteria or other toxins from the roots that have become ingrained in their surfaces.

These procedures are often carried out with local anesthesia to ensure patient comfort and allow us to be as meticulous as possible with plaque and calculus removal. It’s imperative that we remove as much plaque and calculus as possible, and which often involves more than one session. This is because as the gum tissues become less inflamed it allows us to access more plaque-infested areas during subsequent sessions.

Hopefully, these techniques will arrest the infection and restore good health to gum tissues. It’s then important for you to recommit and follow through on a renewed daily hygiene regimen to reduce the chances of re-infection that could lead to more serious problems and potential tooth loss.

If you would like more information on treating periodontal (gum) disease, 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 “Root Planing.”


By Carlos Abreu, D.M.D. and Mahvassh Abreu, D.M.D.
March 06, 2016
Category: Oral Health
GameSetMatchMilosRaonicSaysAMouthguardHelpsHimWin

When you’re among the top players in your field, you need every advantage to help you stay competitive: Not just the best equipment, but anything else that relieves pain and stress, and allows you to play better. For top-seeded Canadian tennis player Milos Raonic, that extra help came in a somewhat unexpected form: a custom made mouthguard that he wears on the court and off. “[It helps] to not grind my teeth while I play,” said the 25-year-old up-and-coming ace. “It just causes stress and headaches sometimes.”

Mouthguards are often worn by athletes engaged in sports that carry the risk of dental injury — such as basketball, football, hockey, and some two dozen others; wearing one is a great way to keep your teeth from being seriously injured. But Raonic’s mouthguard isn’t primarily for safety; it’s actually designed to help him solve the problem of teeth grinding, or bruxism. This habitual behavior causes him to unconsciously tense up his jaw, potentially leading to problems with muscles and teeth.

Bruxism is a common issue that’s often caused or aggravated by stress. You don’t have to be a world-class athlete to suffer from this condition: Everyday anxieties can have the same effect. The behavior is often worsened when you consume stimulating substances, such as alcohol, tobacco, caffeine, and other drugs.

While bruxism affects thousands of people, some don’t even suspect they have it. That’s because it may occur at any time — even while you’re asleep! The powerful jaw muscles that clench and grind teeth together can wear down tooth enamel, and damage both natural teeth and dental work. They can even cause loose teeth! What’s more, a clenching and grinding habit can result in pain, headaches and muscle soreness… which can really put you off your game.

There are several ways to relieve the problem of bruxism. Stress reduction is one approach that works in some cases. When it’s not enough, a custom made occlusal guard (also called a night guard or mouthguard) provided by our office can make a big difference. “When I don’t sleep with it for a night,” Raonic said “I can feel my jaw muscles just tense up the next day. I don’t sense myself grinding but I can sort of feel that difference the next day.”

 An occlusal guard is made from an exact model of your own mouth. It helps to keep your teeth in better alignment and prevent them from coming into contact, so they can’t damage each other. It also protects your jaw joints from being stressed by excessive force. Plus, it’s secure and comfortable to wear. “I wear it all the time other than when I’m eating, so I got used to it pretty quickly,” said Raonic.

Teeth grinding can be a big problem — whether you put on your game face on the court… or at home. If you would like more information about bruxism, contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Stress & Tooth Habits” and “When Children Grind Their Teeth.”




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Carlos Abreu, D.M.D. and Mahvassh Abreu, D.M.D.

1712 I St. NW , Suite 906 Washington, DC 20006