Dr. Dezham

Dr. Dezham is inspired by the desire to help you achieve optimal health and provide you with the absolute best that dentistry has to offer. 

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3009 K street
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Sacramento, CA 95816
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Posts for: October, 2015

By A Miracle Smile by Dr. Dezham Dental Group
October 30, 2015
Category: Dental Procedures
Tags: tmj disorders   tmd  
BeWaryWhenConsideringBotoxTreatmentforTMD

If you’ve suffered from problems with your jaw joints, known collectively as temporomandibular disorders (TMDs), then you know how uncomfortable and painful they can be. You may also have heard about the use of Botox injections to ease TMD discomfort.

Before you seek out Botox treatment for TMD, though, you should consider the current research on the matter. Far from a “miracle” treatment, the dental profession is still undecided on the effects of Botox to relieve TMD pain symptoms — and there are other risks to weigh as well.

Botox is an injectable drug with a poisonous substance called botulinum toxin type A derived from clostridium botulinum, a bacterium that causes muscle paralysis. The Food and Drug Administration (FDA) has approved small dose use for some medical and cosmetic procedures, like wrinkle augmentation. The idea behind its use for TMD is to relax the muscles connected to the joint by paralyzing them and thus relieve pain.

The FDA hasn’t yet approved Botox for TMD treatment, although there’s been some use for this purpose. There remain concerns about its effectiveness and possible complications. In the first place, Botox only relieves symptoms — it doesn’t address the underlying cause of the discomfort. Even in this regard, a number of research studies seem to indicate Botox has no appreciable effect on pain relief.

As to side effects or other complications, Botox injections have been known to cause pain in some cases rather than relieve it, as with some patients developing chronic headaches after treatment. A few may build up resistance to the toxin, so that increasingly higher dosages are needed to achieve the same effect from lower dosages. And, yes, Botox is a temporary measure that must be repeated to continue its effect, which could lead to permanent paralyzing effects on the facial muscles and cause muscle atrophy (wasting away) and even deformity.

It may be more prudent to stick with conventional approaches that have well-documented benefits: a diet of easier to chew foods; cold and heat applications; physical therapy and exercises; pain-relief medications and muscle relaxers; and appliances to help control grinding habits. Although these can take time to produce significant relief, the relief may be longer lasting without undesirable side effects.

If you would like more information on treatments for TMD including Botox injections, please contact us or schedule an appointment for a consultation.


By A Miracle Smile by Dr. Dezham Dental Group
October 22, 2015
Category: Dental Procedures
TimingisEverythingWhenReplacingaTeenagersMissingTooth

There are good reasons, for both health and appearance, to replace a missing tooth with a dental implant or similar restoration as soon as is practical. The bone around a tooth socket diminishes the longer it remains empty, up to 25% the first year. And, of course, your smile is less attractive, especially with a highly visible tooth.

If it’s your teenager, though, you may need to wait on a permanent restoration because their jaws are still developing. An implant placed before completion of jaw development could eventually appear out of alignment with neighboring teeth.

Our biggest concern is protecting bone health at the site of the missing tooth. We can do this and encourage growth by placing bone grafts (processed minerals from another donor) that serve as scaffolds on which surrounding bone can grow. Grafts usually dissolve (resorb) over time, but the rate of resorption can be slowed for a younger patient in need of long-term bone growth.

Planned orthodontic treatment can usually go on as scheduled. The orthodontist may accommodate the tooth loss by adding a temporary tooth within the braces or other device that matches the color and shape of the patient’s natural teeth. The orthodontist will also take care to maintain the empty space for a future implant or other restoration.

A dental implant is considered the best option for a missing tooth, not only for its life-like appearance and durability, but also its ability to encourage bone maintenance. Timing, though, is essential for teenagers. As it grows, the upper jaw will tend to move forward and down. Natural teeth move with this growth; implants, though, are attached differently and won’t move with the jawbone. While the other teeth around them move, the implants can appear to shrink back resulting in an unattractive smile appearance. So waiting until the jaw has finished growing is important.

For most people, jaw growth finishes by age twenty-one for men, women usually faster, but each person is different. The dentist’s expertise and experience, coupled with comparisons of adult family members’ facial appearances, will help determine the right time to undertake a permanent restoration for the best outcome both for health and a permanent, attractive smile.

If you would like more information on treating teenagers with missing teeth, please contact us to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dental Implants for Teenagers.”


By A Miracle Smile by Dr. Dezham Dental Group
October 14, 2015
Category: Dental Procedures
ChrissyTeigensTeeth-GrindingTroubles

It might seem that supermodels have a fairly easy life — except for the fact that they are expected to look perfect whenever they’re in front of a camera. Sometimes that’s easy — but other times, it can be pretty difficult. Just ask Chrissy Teigen: Recently, she was in Bangkok, Thailand, filming a restaurant scene for the TV travel series The Getaway, when some temporary restorations (bonding) on her teeth ended up in her food.

As she recounted in an interview, “I was… like, ‘Oh my god, is my tooth going to fall out on camera?’ This is going to be horrible.” Yet despite the mishap, Teigen managed to finish the scene — and to keep looking flawless. What caused her dental dilemma? “I had chipped my front tooth so I had temporaries in,” she explained. “I’m a grinder. I grind like crazy at night time. I had temporary teeth in that I actually ground off on the flight to Thailand.”

Like stress, teeth grinding is a problem that can affect anyone, supermodel or not. In fact, the two conditions are often related. Sometimes, the habit of bruxism (teeth clenching and grinding) occurs during the day, when you’re trying to cope with a stressful situation. Other times, it can occur at night — even while you’re asleep, so you retain no memory of it in the morning. Either way, it’s a behavior that can seriously damage your teeth.

When teeth are constantly subjected to the extreme forces produced by clenching and grinding, their hard outer covering (enamel) can quickly start to wear away. In time, teeth can become chipped, worn down — even loose! Any dental work on those teeth, such as fillings, bonded areas and crowns, may also be damaged, start to crumble or fall out. Your teeth may become extremely sensitive to hot and cold because of the lack of sufficient enamel. Bruxism can also result in headaches and jaw pain, due in part to the stress placed on muscles of the jaw and face.

You may not be aware of your own teeth-grinding behavior — but if you notice these symptoms, you might have a grinding problem. Likewise, after your routine dental exam, we may alert you to the possibility that you’re a “bruxer.” So what can you do about teeth clenching and grinding?

We can suggest a number of treatments, ranging from lifestyle changes to dental appliances or procedures. Becoming aware of the behavior is a good first step; in some cases, that may be all that’s needed to start controlling the habit. Finding healthy ways to relieve stress — meditation, relaxation, a warm bath and a soothing environment — may also help. If nighttime grinding keeps occurring, an “occlusal guard” (nightguard) may be recommended. This comfortable device is worn in the mouth at night, to protect teeth from damage. If a minor bite problem exists, it can sometimes be remedied with a simple procedure; in more complex situations, orthodontic work might be recommended.

Teeth grinding at night can damage your smile — but you don’t have to take it lying down! If you have questions about bruxism, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Stress & Tooth Habits” and “When Children Grind Their Teeth.”


By A Miracle Smile by Dr. Dezham Dental Group
October 06, 2015
Category: Dental Procedures
Tags: fillings  
Tooth-ColoredFillingsProvideaViableAlternativetoDentalAmalgam

For over a hundred years dental amalgam — a combination of silver, mercury, tin and other metals — has been an effective filling material for teeth damaged by decay. But it has one major drawback — its metallic appearance stands out in stark contrast to the natural color of teeth.

As an alternative, composite resin fillings can match the color, shape and texture of natural teeth. These materials and the techniques used to bond them are proving just as effective as and more aesthetically pleasing than dental amalgam.

Fillings help protect and preserve a decayed tooth. By first removing decayed tooth structure through drilling, the resulting void is filled with durable material that strengthens the tooth and provides it protection from further decay.

The ultimate goal for restoration is to return the tooth to as near normal form and function as possible. Dental amalgam serves well in terms of function, providing the tooth strength in the face of the daily biting forces it encounters. In contrast, composite resins excel in appearance, but haven’t always matched the durability of amalgam. They’re material construction has improved over time, though, as well as the techniques used to bond them to teeth.

Most of these bonding techniques incorporate layering. The first step is to seal the dentin (the porous, living tissue just below the enamel); we then build up the composite material layer by layer within the tooth using special bonding adhesive and curing lights. In some cases where a large volume of tooth structure must be replaced, the restoration is first formed on the tooth and then removed for curing before being cemented into the tooth or a separate restoration is formed by a dental lab.

The end result is a tooth which both looks and functions like a fully intact tooth. Though care must be taken not to subject composite resin restorations to undue forces (no cracking open nutshells, for example), your new filling should continue to serve you and look great for a long time to come.

If you would like more information on metal-free 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 “The Natural Beauty of Tooth Colored Fillings.”




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