Wednesday, January 22, 2014

Mouthguard and Sports in Dentistry

Sports Mouthguard Bellevue Family Dentist

With the start of the new year in 2014 and Superbowl XLVIII coming up in February 2, 2014 I thought it would be a good idea to talk about the relationship between dentistry and sports.

Contact sports like football, basketball, soccer, rugby, boxing, lacrosse, and hockey often subject the human body to physical trauma, and one area is the teeth and gums.  To help prevent and reduce injury to said teeth, lips, and gums, a sports mouthguard is recommended.  Incidentally a mouthguard may also be used as adjunctive treatment for bruxism and tooth bleaching.


In the mid 1940s Dr. Rodney Lilyquist, a dentist in Los Angeles, is credited with the introduction of the modern mouthguard for athletes.  A UCLA basketball player and a San Francisco 49er quarterback were among the first athletes to utilize the mouthguard.  1940s/1950s studies show that dental injuries accounted for as much as 50% of all injuries in football in the US.  By 1960, the American Dental Association (ADA) began recommending the use of mouthguards in contact sports.  In 1962, all US high school football players were required to wear mouthguards.  In 1973 the NCAA required mouthguards for all college football players.  The result has been a reduction in dental trauma, injuries, and contact related dental emergencies.


The role of mouthguards is prominent where accidental or incidental impacts to the face, mouth, and oral cavity can cause physical harm and oral and maxillofacial trauma.  Schools and various sports associations have begun mandating mouthguard use.  Unfortunately some studies have shown such individuals in high contact sports have low compliance of regular mouthguard usage.  However, studies have also shown that even with regular usage, complete effectiveness against dental trauma is not always achieved due to poor fit and size.


There are a few types of mouthguards available today:
  • READY MADE: These mouthguards are already premade.  The only adjustment possible is via a scissor or trimming knife to approximate shape.  Protection and fit is considered poor.
  • MOUTH ADAPTED/STORE BOUGHT:  These are readily available in many over the counter pharmacies and sports stores.  They come in a prefabricated thermoplastic material that one takes home and boil to allow the material to adapt to the teeth.  Protection and fit are considered average and better than the "ready mades" but overall protection is compromised due to the soft vinyl material.
  • CUSTOM MADE: Your dentist takes a custom mode of your teeth via an impression material, usually via a hyrdo-colloid alginate or vinyl-polysiloxane material.  The mouthguard is hence made from the impression taken.  Protection and fit is considered more optimal with this type due to the indirect custom impression, and the material is a hard, rigid, durable, and protective.
If you have any questions regarding sports and mouthguards be sure to consult your family dentist to discuss which mouthguard is right for you.

Warm Regards from your gentle family dentist in Bellevue,
Dr. Peter Chien
(425) 614-1600

Tuesday, January 14, 2014

Toothbrushes, which one should I use?

Bellevue Family Dentistry Toothbrush Oral Hygiene

With so many toothbrushes out there to choose, how do I select a proper toothbrush?  All toothbrushes are the same, right?

While any toothbrush combined with a fluoridated toothpaste will be effective in helping one achieve optimal oral health and dental hygiene, there are a few factors and variables in a toothbrush one should be aware of:

  • Manual toothbrush - This is your traditional toothbrush as shown in the photo above.  Through trial and error, the fundamental design of the manual toothbrush is a thin handle along with a head containing bristles.  Often times a thinner head can help reach and clean difficult areas of the mouth.
  • Electric toothbrushes - Essentially a handle with a motorized head that either vibrates or rotates the bristles of the toothbrush, it actually vibrates the bristles faster than one can achieve by hand.  Studies have shown that while it can be more effective in removing plaque surrounding the teeth's enamel and around the gingiva, if one has optimal brushing habits via a manual brush, there is no need to switch.  The bristles on electric toothbrushes are typically replaceable.
  • Soft bristle head - Your dentist or dental hygienist usually recommends a soft bristle head as hard bristles can actually damage the tooth's enamel and dentinal layer. Harder bristle tooth brushes eliminates plaque more efficiently but can cause more physical stressful to the teeth and gum.  Studies have shown that using a soft to medium tooth brush achieves the best compromise between cleaning effectiveness, tooth wear, and gingival health.
  • Bristle lifespan - One should be aware the condition of the bristle.  If one notices the bristles to be flared and worn out, the toothbrush head needs to be replaced to allow for optimal cleaning effectiveness.  The typical lifespan of a toothbrush should be approximately 2-3 months.  Excessive wear of the bristles may suggest over aggressive brushing with possible re-evaluation of brushing techniques.
If you have any questions on how to select a toothbrush, be sure to ask your family dentist or dental hygienist at your next dental cleaning and oral checkup appointment.

From your gentle family dentist in Bellevue,
Dr. Peter Chien
(425) 614-1600

Monday, January 6, 2014

It's a New Year! Dental Insurance Benefits Overview...

Dental Insurance Bellevue Dentist

Happy New Year everyone!  As the year 2014 gets off to a new starts, I thought it would be a good idea to go over some common questions on dental insurance and dental benefits.

Question: "I have new dental insurance.  Does it cover everything?"
Answer:  It really depends on the type of services being done.  Each insurance plan is different, and can vary by each individual and company.  The best way to find out much is covered by the insurance and how much the patient portion is to contact the dental insurance and to get a benefit breakdown.

Question: "What does PPO mean?"
Answer PPO stands for Preffered Provider Organization.  An office that is signed up to be a PPO for a dental insurance means the dentist and its providers at the office has agreed to accept the insurance's fees and benefit coverage by being in the insurance's network.  If an office is not a PPO with your dental insurance, it does not prevent you from going to that office; it just means your benefit MAY differ.  The best way to find out again is to check with your dental insurance company and inquire about benefit details.

Question: "My insurance doesn't cover it.  That means I don't need it right?"
Answer: Unfortunately no.  For example some insurance plans will not cover full coverage porcelain crowns when a tooth has suffered a large cuspal fracture, or if the decay has caused need for a root canal and/or crown.  Without a full coverage crown, the tooth has a chance to further break off at the gum line, causing possible need for extraction.  Your dentist will be able to discuss the best treatment options with you and why such services are needed or not needed.

Question: "Why do I need a deep cleaning?  There is an out of pocket expense.  Can I just get a regular dental cleaning instead?"
Answer: A deep cleaning is highly recommended in cases of periodontal disease.  A deep cleaning is the very best way to control periodontal disease and to remove bacteria and tartar/calculus buildup that is underneath the gumline.  While a regular dental cleaning/adult prophy is helpful, it does not allow your dentist or dental hygienist to remove the bacteria/buildup trapped underneath the gumline.

Question: "What do these terms mean: Preventative Services, Basic Services, Major Services?"
Answer: Preventative Services typically refers to regular adult and children cleanings/prophy, exams/checkup, fluoride, and x-rays (ie. bitewings, periapicals, and full mouth series).

Basic Services often include dental fillings (resins and amaglam), tooth extractions, and root canals.

Major Services usually refers to buildups, crowns, implants, dentures, nightguards, and orthodontics (braces).

Because the benefit level is specific to each dental insurance plan, be aware what one insurance may cover, another insurance may not.

Question: "What is a deductible?  Why do I have to pay it?"
Answer: A deductible is a contracted fee the dental insurance company sets, and will differ by each plan and service type.  The deductible is usually a one time payment per year your dental office will collect the amount when services are performed.  Your plan has specific guidelines on when and which services the deductible applies.

Question: "What are names of a few dental insurance companies? Can you recommend one?" 
Answer:  Each dental insurance company and its plans have its pros and cons.  The best way to find out which plan is suitable for you and your family is to discuss with your dentist to find out your long term needs.  Some names of common insurances include Aetna Dental, Metlife Dental, Premera, Blue Cross/Blue Shield, Delta Dental, Guardian, Standard, and Cigna.

If you have any specific questions regarding insurance and its benefits, be sure to contact your family dentist. 

Wishing everyone's 2014 off to a great start, from your gentle family dentist in Bellevue,
Dr. Peter Chien
(425) 614-1600